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pROACtive with pROBiOtiCs Tips & tricks to calm IBS (and other colon issues)

hOw sLeep AFFeCts yOuR BLOOD pRessuRe A step A DeCADe tO stOp heARt pROBLems why wOmen get mORe ACL teARs

pAmpeR yOuR heARt with a FREE massage, yoga, and yummies. Page 7

Winter 2013

Volume 3, Issue 1


sLeepLess nights RAise BLOOD pRessuRe Women who don’t get enough sleep — or get poor quality If you snore or feel tired despite sleep — are twice as likely a full night’s sleep, you may to have high blood pressure be suffering from sleep apnea. that can’t be controlled by The Penrose-St. Francis Sleep medication. High blood pressure is Disorders Center now offers a major risk factor for stroke and heart home sleep tests that can disease. reveal sleep issues. “Sleep is our personal repair system,” Call 719-571-8868 says Athena Stroud, manager of the for more information. Penrose-St. Francis Sleep Disorders Center. “If you don’t get enough or the right kind, it can literally take years off your life.” Sleep apnea, a condition often associated with snoring, causes a person to momentarily stop breathing throughout the night. The body then does not get enough oxygen, so the heart has to pump faster and harder to circulate what oxygen is there, leading to high blood pressure.

hOme sLeep test

“If you don’t get enough sleep or the right kind, it can literally take years off your life.” About 40 percent of people with high blood pressure have sleep apnea. That figure doubles for people with drug-resistant hypertension. Although short sleep duration was prevalent in all patients, women were more likely to suffer from poor sleep quality, according to a study released late last year. “The problem doesn’t go away once you wake up,” Stroud explains. “Poor sleep seems to trigger a mechanism that carries over into the daytime, resulting in permanent hypertension.”

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 bloom@centura.org. bloom is produced by Clementine llC of Denver, Colo. executive editor is Jill Woodford.

2222 North Nevada Avenue Colorado Springs, CO 80907

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2 Winter 2013

Her firSt GYn viSit Your daughter’s first visit to the gynecologist shouldn’t be for a Pap smear. In fact, it should be many years before she ever needs that. The American College of Obstetricians and Gynecologists recommends that girls see a gynecologist between the ages of 13 and 15. But most won’t need a Pap smear or internal exam until they are 21. “The primary reason to come so young is to begin to build that doctorpatient relationship,” says Toby Genrich, MD, an obstetrician and gynecologist at Penrose-St. Francis Health Services. “By the time she might be exposed to risky behavior, we already have an established relationship so she will feel more comfortable confiding in me.” While many parents may think of gynecologists only in terms of sexual health, gynecologists also give guidance on other issues, such as healthy eating, smoking, alcohol, self-esteem, and depression or anxiety. “The primary reason for those first visits in the early years is to talk about prevention and education, not just for the adolescent but for the parent as well,” Genrich says.

BeCOming A wOmAn

Mothers and daughters are invited to share a very special class about the beauty and wonder of growing into a woman. In a safe and warm atmosphere, girls will learn about their changing body and be able to ask questions. To learn more about the class, go to penrosestfrancis.org/womanhood. DAtes | This one-session class is offered on these Saturdays: March 2, June 8, Sept. 7, and Dec. 7 time | 1-3 p.m. LOCAtiOn | St. Francis Medical Center, 6001 East Woodmen Road COst | $20 per mother/daughter pair (additional daughters $5 each) RegistRAtiOn | Required; call 719-571-3101

Penrose-St. Francis Health Services

PHOtOS leFt tO RIgHt: ©IStOCkPHOtO.COm/AySe NAzlI DelIORmANlI, ©IStOCkPHOtO.COm/lOUIS-PAUl St-ONge, ©Steve BIgley, ©IStOCkPHOtO.COm/ROBeRt ADRIAN HIllmAN

healthystart


Q: Is

&A Q

WiTh DiAne ThomPson, mD Psychiatric Oncologist at the Penrose Cancer Center

depression common in cancer patients? A: Yes,

the rates of depression do increase in patients with cancer due to a variety of factors.

FoR thE Man In youR LIFE

SAvinG men from SuiCide Do you feel comfortable talking to your spouse or partner about depression and suicide? You need to, say local experts. Men between the ages of 25 and 55 commit the greatest number of suicides in El Paso County, where suicide rates overall are among the highest in the nation. “It’s heartbreaking when a youth dies from suicide, but the truth of the matter is that it’s middle-age men who are most likely to take their lives,” says Janet Karnes, executive director of Suicide Prevention Partnership Pikes Peak Region. It’s unclear why suicide rates are higher here than elsewhere,

but one contributing factor is the high number of veterans. The rate of suicide among veterans is five times greater than the national average. Experts believe that access to guns and a “frontier” mentality that values independent problem-solving are other contributing risk factors. “We know that as a whole, working-age men don’t seek help as readily as others,” Karnes says. Most people contemplating suicide demonstrate recognizable signs. If friends or family members recognize these signs, more than one-third of suicides can be prevented, research shows.

stOp suiCiDes with QpR

Learn the signs of suicide and how to stop it. Question-PersuadeRefer (QPR) is a FREE program that teaches people how to help someone who is considering suicide. DAte | Thursday, Jan. 31 time | 6-7:30 p.m. LOCAtiOn | Penrose Pavilion, 2312 North Nevada Avenue, Conference Room C (plentiful FREE parking outside building) RegistRAtiOn | Call 719-776-6558

penrosestfrancis.org

Stress and anxiety created by the diagnosis can cause depression. Depression also can be a physical side effect of treatment and hormonal changes. There is even some research that suggests the cancer itself can cause depression. Depression is frequently associated with the cancer, and we now have ways to treat it just like we’ve learned how to treat nausea and other side effects. Patients respond very well to talk therapy and medication therapy. With medication, we want to make sure there aren’t any adverse interactions between drugs patients are taking. There are some medications available to

treat the depression that also can help with cancer side affects such as nausea or fatigue. Cancer-associated depression is real and can occur at different times. For some, it’s at the time of diagnosis or during treatment. For others, it may come after treatment is done. Cancer therapy helps patients and their families through all stages of treatment and recovery.

Learn More To reach Dr. Diane Thompson or learn more about cancer therapy, call 719-776-5311.

speCiAL OFFeR FOR BLOOm ReADeRs get yOuR vitAmin D testeD FOR just $25! nOw thROugh ApRiL 1 LOCAtiOns | Colorado Laboratory Services,

3245 International Circle, Suite 104 Monday-Friday, 8 a.m.-5 p.m. or Colorado Laboratory Services at Penrose Pavilion, 2312 North Nevada Avenue Saturdays, 8 a.m.-noon

No appointment is necessary; fasting is not required. You must mention you saw this offer in bloom to receive the special $25 price. For more info, call 719-667-3141.

tO D OR nOt tO D? nce associated only with rickets, inadequate vitamin D is now being associated with cancer, heart disease, diabetes, and depression. But should you be concerned? “It’s really a mixed bag,” says Lloyd Strode, DO, a family practice physician at Penrose-St. Francis Health Services. “For every 10 articles, eight are pro vitamin D, but two claim it could be harmful.” Vitamin D levels are measured through a simple blood test. Most health experts say that a level between 30 and 50 nanograms/ milliliter is adequate. “For every 10 “The studies are somewhat controversial,” he articles, eight are says. “People think vitamins are benign, but they are pro vitamin D, but just as powerful as prescription medicines, so we want two claim it could to be cautious. Not to mention they’re expensive.” be harmful.” Anyone over 40 should be tested annually, especially postmenopausal women since adequate levels of vitamin D are necessary for the body to absorb calcium and prevent osteoporosis. Other groups who should be tested regularly include darkskinned people since they do not absorb vitamin D-producing sunlight readily and people with a body mass index (BMI) over 30 since fat inhibits the absorption of vitamin D. Winter 2013

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Colon Conversations GI problems are very TreaTable If women are wIllInG To Talk

Talking about colon health won’t make you the hit of the party, but you should speak up — at least with your doctor.

FRee CLAss: gut sOLutiOns am I gluten intolerant? Do I really need probiotics, or is that a marketing ploy? If my mom had colon cancer, will I get it?

A panel of gastroenterologists and nutritionists from Penrose-St. Francis Health Services will host a FREE community forum to discuss the latest in GI health and answer audience questions. DAte | Thursday, Feb. 28 time | 6-7:30 p.m. LOCAtiOn | Northcare Building, 6071 East Woodmen Road (on the St. Francis Medical Center campus)

COst | FREE; GI-friendly refreshments will be served RegistRAtiOn | Required; call 719-776-5052

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Colon ailments range from annoying irritable bowel syndrome to deadly colon cancer. All told, one in every four women will suffer from IBS at some point; seven out of 10 will have diverticulosis by age 70; and one in every 20 will be diagnosed with colon cancer. “For many women, their problems have been minimized,” says Lukasz Kowalczyk, MD, a gastroenterologist at Penrose-St. Francis Health Services who specializes in women’s GI issues. “They’re told they’re just stressed and to relax when actually something serious could be going on.” Irritable Bowel Syndrome IBS strikes early, generally before age 30. Although it doesn’t cause any long-term health issues such as cancer, IBS can be embarrassing and sometimes painful. “We don’t really know what causes IBS, but it is associated with stress and diet,” says Bryan Kavanaugh, MD, also a gastroenterologist at Penrose-St. Francis. Women are nine times more likely to experience IBS than men, says Kavanaugh. Symptoms include bloating, gas, diarrhea, and constipation. Many treatments help relieve these symptoms, including: • Dietary restrictions. Eliminate milk, soy, gluten, fish, and nuts from the diet; add each food group back weekly until the culprit is found. • Stress-reduction techniques. IBS often occurs in highly stressed women, particularly those who were abused. Try meditation, yoga, counseling, and antidepressants for relief. • Muscle relaxants. These can reduce the spasticity in the colon. • Antibiotics and probiotics. They can restore a healthy balance of bacteria in the colon. Diverticulosis More than 70 percent of Americans will develop diverticulosis by the time they are in their 70s, Kavanaugh says. This condition occurs when the walls of the colon weaken, forming pits or little pockets. “It’s much more common in the U.S. than the rest of the world, maybe because we don’t eat as much fiber,” he says. The condition is harmless unless it becomes diverticulitis, which occurs when one of the pockets becomes infected. When this occurs, it can cause severe pain, fever, and nausea. “It’s actually rare for someone with diverticulosis to get diverticulitis, but because so many people have diverticulitis, we see diverticulitis in the ER frequently,” Kavanaugh says. Diverticulitis usually can be treated with antibiotics, but surgery may be needed if it continues to recur.

Penrose-St. Francis Health Services


neW CoLon sURGeRY TReATs inConTinenCe AFTeR ChiLDBiRTh Childbirth results in one (or maybe more) wonderful thing — a baby — but also some not-so-wonderful things. One of these is fecal incontinence caused by perineal tearing or an episiotomy during labor. A new colon surgery approved just a year ago by the FDA could provide help to these women and others who suffer fecal incontinence. The treatment involves placing a probe into the spinal column to stimulate the sacral nerve, explains Ben Delano, MD, a colon and rectal surgeon at Penrose-St. Francis Health Services. “When we stimulate the nerves, it causes them to help improve the incontinence,” Delano says. Delano, the only fellowship-trained colorectal surgeon in Colorado Springs, also performs: • Colon resections to treat colon cancer and diverticulitis • Hemorrhoid surgery, including minimally invasive transanal hemorrhoidal dearterialization • Anorectal fistula repair • Intestine resection to treat Crohn’s disease To learn more, go to penrosecancercenter.org/colon-and-rectal-cancer.

penrosestfrancis.org

eAt Your WAY to HeALtH Want to calm your tummy and decrease your chances of other colon problems? A few nutrients may help, says Sharon Jacob, a clinical dietitian with St. Francis Medical Center. “Keeping on top of your diet rather than trying to fix it once it becomes a problem is key,” she says. Jacob recommends focusing on two types of nutrients: Prebiotics and probiotics: These are the good bacteria that keep your GI tract functioning. Prebiotics (such as NutraFlora®) help your gut grow the right kind of bacteria, while probiotics (those found in yogurt) give your gut a booster shot of the good bacteria. Use both daily for optimal health, Jacob says. Soluble fiber: Soluble fiber creates a gel-like substance and slows down digestion, keeping you feeling full longer. It helps resolve constipation and diarrhea both, while also lowering LDL (bad) cholesterol and blood sugar. Sources include oatmeal, barley, lentils, and black beans or kidney beans. Jacob’s current favorite is chia seed, which can be put in cereal, muffins, oatmeal, or just eaten directly.

Winter 2013

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PHOtO: elleN JASkOl

Colon Cancer Colon cancer can be deadly, but it’s also one of the easiest cancers to prevent. All colon cancers grow out of polyps that form in the colon. If found and removed through regular colonoscopies, the polyps are prevented from growing into cancer. “Colon cancer is the second leading cause of cancer deaths in the U.S.,” Kowalczyk says. “Colon cancer prevention is paramount for women.” The four most important steps in preventing colon cancer are: • Know your health history. If you have an immediate family member who had colon cancer before age 50, you should be tested for Lynch syndrome, a gene mutation that accounts for up to 7 percent of colon cancers and also can cause uterine and cervical cancer. Women with ulcerative colitis or Crohn’s disease are at higher risk, too. • Get screened. Adults at normal risk should obtain their first colonoscopy at 50. Depending on the results, you’ll need another one every three, five, or 10 years. “If polyps are removed, find out what type because that will determine how often you need future colonoscopies,” Kowalczyk says. • Watch for blood. “Blood in the stool should always be a red flag,” Kavanaugh says. It’s most likely a hemorrhoid. But blood can be a symptom of colon cancer, so alert your physician. • Sudden, drastic change in bowel habits. Many women attribute this to IBS, but if you’re over 30 and experience a radical change, it could be cancer.


HeartS ConneCted

Penrose-St. Francis Heart and Vascular Center is part of the Centura Heart Network, Colorado’s leading provider of cardiovascular care.

seeing ReD

PHOtO: ©SHUtteRStOCk.COm/PAvel l PHOtO AND vIDeO

tHe riGHt moveS HAmper HeArt diSeASe Every time you see red, the heart experts at Penrose-St. Francis heart and Vascular Center would like you to remember this fact: heart disease is the leading killer of women in america. “Despite a long-running campaign to educate women about this, it still seems like many women don’t pay much attention to their heart health,” says Deborah Jalowiec, MD, a cardiologist at Colorado Springs Cardiologists, a Centura Health Clinic. More than 40,000 women under the age of 55 will experience a heart attack this year. And nearly 3 million women struggle with chronic heart failure, a disease that leaves many ill, depressed, and frequently in the hospital. The great news is that heart disease is largely preventable. Even if you have a family member who had a heart attack before age 55, a risk factor that increases your chances of heart disease by 30 percent, you can mitigate that higher risk through lifestyle changes.

pAmpeR yOuR heARt

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6 Winter 2013

20s

stop smoking. Even smoking two cigarettes a day doubles a woman’s chance of a heart attack at any age.

30s

manage your stress. This is the decade when life starts to get busy for many women, and it just keeps getting

tougher as women try to juggle work, children, and aging parents. Whether it’s yoga, prayer, or a regular girls’ night out, find a way to relax that you can practice regularly.

40s

Cut the salt. Blood pressure in women begins to rise in their 40s. Salt, excess weight, and stress — along with age — are the leading culprits. “One out of every three women ages 45-54 has hypertension,” Jalowiec says. If your blood pressure is 135/85 or above, you need to check it several times a year and take steps to reduce it.

50s

embrace statins. As women pass through menopause, they lose the protective factor of estrogen and their

cholesterol levels start to rise — even in the healthiest women. “Menopause can cause a woman’s cholesterol profile to change dramatically,” Jalowiec says. “And it’s about 10 to 15 years later that we start to see heart attacks.” Some women might need to start taking cholesterol-lowering medications, called statins. If a woman has high cholesterol, taking statins will cut her risk of a heart attack after age 65 by 39 percent.

60s

An aspirin a day. This is the decade that a woman’s risk of having a heart attack skyrockets. You can reduce that risk by taking one aspirin daily. Aspirin also cuts the risk of stroke.

70s

watch your rhythm. A slowing heart rate, resulting in dizziness or fainting, is common as you grow older and may require a pacemaker. Another common problem is atrial fibrillation, a condition that occurs when the upper part of the heart beats irregularly. A-fib, which occurs in 25 percent of women, can cause fatigue but just as often has no symptoms, so an annual checkup with your doctor is essential. A-fib increases your risk of stroke 5 to 10 percent. Join Penrose-St. Francis Health Services in celebration of National Heart Month for a morning of mini massages, FREE cholesterol checks, and much more! See next page for details.

Penrose-St. Francis Health Services


pAmpeR yOuR heARt

Date | feb 16 time | 8:30 a.m.-noon Location | st. francis medical Center, 6001 east woodmen road Cost | FRee space is limited, so you must register online at penrosestfrancis.org/pyH Join us for a day to make your heart happy — and healthy. Pamper Your Heart is a FREE community event open to all women, featuring massages, heart-healthy cooking, yoga, and heart lectures. Karen Linamen, author of 16 books on strategies for living well, will be the keynote speaker for the day. A frequent and much-loved speaker at churches, corporate events, and community days, Karen will share secrets about seven things you already love that are good for your heart! Cindy Draving, a registered dietitian, will dish out a heart-healthy breakfast while also telling you the best foods for your heart and your soul. In between, treat yourself to chair massages, yoga and more goodies from a variety of heartloving organizations.

Winter CLASS CALendAr

Penrose-St. Francis Health Services

offers dozens of health classes each quarter. Here is just a sampling of our classes. For a complete list, go to penrosestfrancis.org/wellness.

PHOtO: ©IStOCkPHOtO.COm/FRANCkRePORteR

gut sOLutiOns Date | feb 28 time | 6-7:30 p.m. Location | northCare building, 6071 east woodmen road (on the st. francis medical Center campus) Cost | FRee Registration | 719-776-5052 What is gluten intolerance? Do I need probiotics, or is that a marketing ploy? Get answers to these and other GI health questions from a panel of gastroenterologists and nutritionists. FREE GI-friendly foods and an open forum to get your questions answered. See Page 4 for more info. penrosestfrancis.org

CARegiveR CAFé Date | mar 5 time | 11:30 a.m.-1 p.m. Location | penrose pavilion Conference room b, 2312 north nevada avenue Cost | FRee Registration | 719-776-5311 Caring for a loved one with cancer is the best gift you can give, but sometimes you need to be cared for, too. This is your time to rejuvenate and connect with other caregivers. Enjoy coffee, conversation, and a light lunch while you gain insight and support from other caregivers.

pReventing ACL teARs in wOmen Date | mar 7 time | 6-8 p.m. Location | northcare building, 6071 east woodmen road (on the st. francis medical Center campus) Cost | FRee Learn why knee injuries are more common among women and what surprising things you need to do to avoid this injury. You’ll learn the science behind the injury and then get on your feet to learn exercises and stretches to prevent ACL tears.

Design yOuR DReAm LiFe Dates | mar 15-17 time | 6-7:30 p.m. Location | Cheyenne mountain resort, 3225 broadmoor valley road This two-day interactive seminar will help women articulate their personal dreams and build their personal legacies. Sponsored by Penrose-St. Francis Health Services. For more information and registration, go to whatifwhatelsewhat now.weebly.com.

eAsing BACk pAin Dates | apr 9, 16, 23 time | 5:30-6:30 p.m. Location | penrose Health learning Center Gym, 1644 medical Center point Cost | $20/person or $30/two people Registration | 719-776-4852 Sleeping position, posture, and core strength all affect your back. Learn tips about these and other little-known issues along with stretches and exercises to help relieve your pain and keep you moving!

wOmenheARt suppORt gROup Date | 2nd wed of month time | 11:30 a.m.-1 p.m. Location | penrose Hospital, 2222 north nevada avenue Date | 4th wed of month time | 5-6:30 p.m. Location | st. francis medical Center 6001 east woodmen road Cost | FRee info | 719-200-2645 Join a group of women beating heart disease. Share encouragement while learning the latest in heart science, and strategies for coping. Two groups meet monthly. Winter 2013

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Catholic Health Initiatives Colorado

Non-Profit Org. U.S. Postage

PAID

Colorado Springs, CO Permit No. 14

2222 North Nevada Avenue Colorado Springs, CO 80907

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.

ACL ACCidentS

tAke steps tO pROteCt yOuR knees

PHOtO: ©IStOCkPHOtO.COm/kRIStIAN SekUlIC

W

omen are up to eight times more likely to tear the anterior cruciate ligaments (ACLs) in their knees than men, and downhill skiing is a major culprit in the Rocky Mountain region. “Women tend to develop stronger quadriceps than hamstrings, so that unequal ratio pulls the bone forward and puts more stress on the ACL,” says Vicki Lieber, a physical therapist and certified athletic trainer at Penrose-St. Francis Rehabilitation Services. “Women also tend to land with their knees straight.” Recent research also shows that female estrogen levels may increase the risk of ACL injury, Lieber says. While women are at high risk of ACL injuries year-round, downhill skiing is responsible for many winter ACL injuries. But that doesn’t mean you should give up skiing, Lieber says. “Instead, train your body to protect your knees and be sure your ski gear is in top order.”

pROteCt yOuR knees

Learn the reasons behind knee injuries and the right exercises to keep you out of trouble at a FREE community seminar. Details on Page 7.

Best in COLORADO Penrose-St. Francis Health Services was ranked No. 1 in Colorado and among the top 100 hospitals nationwide for orthopedic care by HealthGrades, an independent hospital quality rating agency.

To protect against knee injuries, take these steps: • Strengthen your hamstrings and glutes • Strengthen your core to gain better control of your legs • Have your ski bindings checked annually to ensure they are not too tight for your level of skiing

FOR mORe inFORmAtiOn,

go to healthgrades.com.


Bloom Winter 2013