M.A.X. SPRING 2018
A man’s guide to maximum health
GO
BIG BUT GO SAFELY
Colorado Springs physician Dr. Benjamin Cole provides basics in backcountry survival p2
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Customized Cancer Care
Personalized medicine is targeting specific cancers with positive results p5
Maintaining your high-performance machine p8
PAY ATTENTION HEART ATTACK
symptoms may be more subtle than you think p4 JOINT
REPLACEMENT
ACCELERATE RECOVERYYOUR p6
PHOTO BY TOM KIMMELL
G MENTAL HEALTH
SURVIVAL
The snowy weather and warmer temperatures of early spring make the backcountry a winter wonderland for crosscountry skiing and snowshoeing. But avalanches, most likely during or right after a snowstorm, and wildly fluctuating temperatures can quickly lead to a life-threatening ordeal.
MINIMIZE RISK
“Know the terrain, check the weather, and don’t overestimate your resilience to changing temperatures,” says Benjamin Cole, MD, a family medicine doctor at CHPG Primary Care Powers and a backcountry enthusiast. Never go into the backcountry alone, and choose terrain with the least risk of avalanche or getting lost. If you do get lost, a handheld GPS can point the way out — but it won’t tell you about obstacles like cliffs. Take a backcountry map, too. Before you head out, test your avalanche beacon and other gear. And look up sunset times, so you can be out of the backcountry before then. Have an avalanche rescue plan and safety gear, including an avalanche beacon, shovel, and probe — and know how to use them. “If you or a buddy gets caught in an avalanche, know what you’re going to do,” says Cole.
DRESS RIGHT
Between midday and sunset, the temperature can drop as much as 50 degrees. Plummeting temperatures and sweat from skiing and snowshoeing make the right gear essential to prevent frostbite and frostnip. “Men get warm and tend to dress down,” says Cole. “If you’re moving at high intensity and then stop or slow down, sweat accumulation can lead to a cold-related injury.” In addition to your base, insulating, and shell layers, take an extra moisture-wicking base layer. M
Cellphones don’t always work in the backcountry. Take a handheld GPS made for the outdoors.
DEPRESSION
in men
While commercials would have you believe people with depression are quietly sad and withdrawn, the truth is men and women express symptoms of depression differently. “People equate depression only with sadness; it’s really a shame it’s been publicized that way,” says Thomas Caughlan, LCSW, supervisor of behavioral health for Penrose-St. Francis Health Services. “Men, in particular, are much more likely to repress their emotions and so depression manifests for them in other ways.” Common signs of depression in men are: 1 Anger or irritability 2 Difficulty sleeping (falling or staying asleep) 3 Substance abuse and other risky behavior M
Centura primary care offices offer on-site behavioral health specialists so you can take care of your mental and physical health at the same place. These practices are accepting new patients, including Medicare. CHPG Primary Care Broadmoor Colorado Springs 719-776-3300
If you’re looking for a motivated physician partner and health care coach, Dr. Cole is accepting new patients. Call 719-571-1088 for an appointment.
CHPG Primary Care Powers Colorado Springs 719-571-1088
Benjamin Cole, MD, featured on cover, is a family medicine doctor in Colorado Springs and outdoor enthusiast who has a special interest in wilderness safety.
CHPG Tri-Lakes Primary Care Monument 719-571-7000
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M.A.X. PENROSE-ST. FRANCIS HEALTH SERVICES
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Backcountry
3 signs of
The Undercover Caregiver Women aren’t the only ones providing support
Men don’t often identify as caregivers, but that doesn’t mean they aren’t taking on the role. A caregiver is anyone who supports a loved one, often a spouse, with a chronic or serious health condition. “Men and women get sick at the same rate, so I would suspect there are just as many men caregivers out there as women,” says Heidi Likins, RN, education coordinator for the Eleanor Capron Rehabilitation Unit at Penrose Hospital. Because men may avoid seeking support and resources, they’re more susceptible to caregiver burnout. Signs include: physical and emotional exhaustion; increased illness; irritability; depression; difficulty sleeping; changes in appetite; and excessive use of drugs, alcohol, or tobacco.
AVOID BURNOUT WITH THREE TIPS: 1 Put you first. Post a list of at least 10 things you enjoy and do one every day. 2 Think positive. Remind yourself that you’re doing the right thing. 3 Bring in a ringer. Take a real break. Ask a family member to step in or contact Pike’s Peak Area Agency on Aging for a voucher for in-home or respite care. M
Build Your Skills Join us for Stroke and the Art of Living: A Community Conference for Stroke and Brain Injury on Saturday, May 5, from 8 a.m.–noon. Men and women are invited to learn about caregiving skills and resources. Learn more and register at penrosestfrancis.org/events.
WEAK BONES Osteoporosis isn’t just for women. “At age 65, bone loss in men catches up with bone loss in women,” says Steven Myers, MD, an orthopedic surgeon at Centura Orthopedics Audubon and director of Centura Bone Health. Other factors can exacerbate the issue. For instance, a treatment used with some prostate cancers that suppresses male hormones can weaken bones. Other culprits include: Sedentary lifestyle, lack of weight-bearing exercise Too much alcohol Too little calcium and vitamin D Family history of osteoporosis Some medications, such as steroids
Like women, men should have a bone scan as they get older. Men with risk factors should get one at age 50 and all other men at age 70. For more information, call 719-776-BONE or come to a FREE seminar for men and women, Bone Health Matters, on April 11. Visit penrosestfrancis.org/events for seminar details and registration. M
PENROSESTFRANCIS.ORG
M.A.X. 3
PAY ATTENTION to the stealthy signs of HEART ATTACK
In the movies, heart attacks are obvious — a man grabs his chest, and staggers around gasping. In reality, heart attacks and heart disease can come with those classic symptoms, or they can be subtle. The danger is that when symptoms are subtle, they are easier for men to ignore. “It’s true that men are more likely to deny symptoms,” says Paul Sherry, MD, of Colorado Springs Cardiology, A Centura Health Clinic. “I’ve seen heart attacks missed initially because men attribute symptoms to muscle strain, too much yard work, or heartburn and indigestion.” Heart attack symptoms fall into two categories, Sherry says. CLASSIC symptoms: V Chest discomfort, often described as a heavy or tight feeling V Radiating pain that spreads to the neck or either arm V When the pain occurs with exertion, see your doctor, Sherry says. But when pain occurs while you’re resting and lasts for 30 minutes, call 911.
BOTTOM LINE Don’t be afraid to get checked, Sherry says. “Whether it’s a heart attack or any other disease, prevention is always better than treatment.” M
SUBTLE symptoms: V Shortness of breath climbing stairs or walking to the mailbox V Tingling or numbness in hands and fingers V Unusual fatigue
Calcium in the bones is good. But in your arteries — not so much. As people age, calcium starts to build up in the walls of the arteries and forms plaque. These plaques cause arteries to become narrow and can restrict blood flow. As tissue is deprived of oxygen, it can become damaged and lead to a heart attack or stroke. But there’s a test that can tell you before that happens if you’re headed for trouble. A noninvasive imaging test, called a calcium scoring scan or heart scan, measures calcium in your arteries before plaque forms. Calcium scoring can be beneficial for those with risk factors for coronary artery disease, Sherry says, because it can help convince a patient to quit smoking or to eat healthy. “That physical evidence of coronary artery disease sometimes will be the motivation to change behavior.” M
Know your score. Penrose-St. Francis Health Services offers a $149 heart scan. The only scan in southern Colorado read by a radiologist and cardiologist. Schedule an appointment at 719-776-8010 or visit penrosestfrancis.org/heart for more information.
MEASURE YOUR RISK FOR HEART DISEASE To calculate your 10-year risk of developing heart disease, download the free ASCVD (atherosclerotic cardiovascular disease) Risk Estimator app on your smartphone. M
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M.A.X. PENROSE-ST. FRANCIS HEALTH SERVICES
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Heads-Up
KNOW THE SCORE
Cancer treatment GETS PERSONAL Your barista knows your favorite drink before you order it. Amazon recommends things you’ll like based on your preferences. Personalization is becoming more common in many areas of your life — including cancer treatment. Instead of a one-size-fits-all fix for cancer, men (and women) are now getting treatment that works better for their very specific cancer and is less toxic. “We use a multipronged approach to determine what’s going to be the most appropriate treatment plan for each patient,” says Maurice Markus, MD, PhD, a medical oncologist/hematologist at the Penrose Cancer Center.
Personalized medicine
Personalized or precision medicine uses information from blood tests and biopsies to customize cancer treatment based on each patient’s tumor and genes. Armed with this information, doctors are using two newer types of cancer treatment to fight cancer. TARGETED THERAPY: This treatment uses drugs that target the specific genes and proteins found in cancer or cancer-related cells. The drugs can: • Destroy the cancer cells • Block the signals that tell cancer cells to grow or divide • Shorten the life of cancer cells
IMMUNOTHERAPY: This treatment uses biologic drugs, which are immune system substances, to increase the body’s own ability to fight cancer. Monoclonal antibodies, oncolytic virus therapy, T cell therapy, and cancer vaccines can be used to: • Help the immune system fight cancer cells • Stop the spread of cancer • Slow or stop cancer cell growth
“Early results from clinical studies show that combining targeted therapy and immunotherapy works better than using either alone, without excessive toxicity.” — Dr. Maurice Markus
THE TOP MALE CANCERS In 2016, about three out of every 1,000 men across the U.S. were expected to be newly diagnosed with one of the top three male cancers: prostate, lung, and colorectal. This chart shows the screenings to catch these cancers early and signs and symptoms to discuss with your physician. (Many of these signs can be caused by conditions other than cancer, so see your doctor to know for sure.)
Screenings
Signs and symptoms
Prostate cancer
Lung cancer
Colorectal cancer
PSA blood test • All men 50 and older: Talk to your doctor about whether screening is right for you • Men under 50 at high risk of prostate cancer: Talk to your doctor about when to start
Computed tomography (CT) scan • Smokers and past smokers ages 55-80
Colonoscopy • All men age 50 and older • Men under 50 and at high risk of colorectal cancer: Talk to your doctor about when to start
• Problems urinating • Blood in the urine or semen • Trouble getting an erection • Weight loss • Bone pain • Weakness or numbness in the legs or feet • Loss of bladder or bowel control
• Cough • Shortness of breath • More sputum (spit or phlegm) • Weight loss • Feeling tired or weak • Bone pain
• Blood in the stool • Anemia • Belly pain, nausea, and vomiting • Weight loss • Feeling tired or weak M
Call 719-776-5273 today to make an appointment for a lung screening. PENROSESTFRANCIS.ORG
M.A.X. 5
BOUNCE BACK faster after joint replacement
When it comes to recovering from a hip or knee replacement, more men than women go home the day of surgery. “Men might be more competitive than women. When they hear about their friends going home the same day, that spurs them on,” says Steven Myers, MD, an orthopedic surgeon at Centura Orthopedics Audubon and director of the Accelerated Total Joint Recovery Program at Penrose Hospital. Advances in surgery, anesthesia, and rehabilitation are helping patients go home and get back to their normal lives faster. Minimally invasive surgery, in particular, limits injury to the muscles and tendons from surgery, resulting in less pain and a quicker route home. Most hip replacement patients do physical therapy at home, based on instructions from the hospital’s physical therapist. Recovery from a knee replacement is more difficult, so these patients usually have outpatient physical therapy.
Benefits of accelerated recovery:
› Less pain, swelling, and blood loss › Shorter hospital stay › Fewer problems like blood clots and infections › Faster return to normal activities M
Watch our video at penrosetfrancis.org/ortho, under “Patient Education & Resources,” or call 719-776-7846 for more information about our Accelerated Recovery Program.
A M S A L P f o e is m o r p e h T s to ease joint pain
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M.A.X. PENROSE-ST. FRANCIS
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Male menopause:
FACT FAKE? OR
True causes of erectile dysfunction
What midlife hormonal changes mean for men
Male menopause has gotten increasing amounts of attention in recent years, even
getting its own moniker — manopause. But is male menopause really a concern? Is it even a thing?
Not really. Both men and women experience a decline in sex hormones as they age. But while women experience a sudden, marked drop in estrogen around midlife, it’s different for men. “The change is much more gradual in men,” says Gary Klein, MD, a family medicine physician at Penrose-St. Francis Primary Care for Seniors. “We certainly don’t have the drop like women do. We lose about 1 percent of our testosterone per year over age 30.” Furthermore, declining testosterone might not be the doomsday scenario low-T (testosterone) clinics would have you believe. Low-T clinics are practices dedicated to the diagnosis and treatment of low testosterone. They often use testosterone therapy outside FDA approval.
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Behind the smokescreen
“A lot of symptoms get blamed on low-T levels — fatigue, poor sleep, sexual problems — but usually there’s more going on,” Klein says. “These are symptoms everybody has, and they can be caused by a lot of things other than low testosterone.” Other causes of fatigue, poor sleep, and sexual problems in midlife include heart disease, prediabetes, thyroid problems, renal issues, depression, alcoholism, and obesity. Klein emphasizes the importance of treating the underlying issue. And sometimes, the solution is simpler than you might think. “When a patient in his 40s or 50s comes in and his testosterone is low, the first thing I do is assess whether it’s because of a primary problem with his testes or if there’s a secondary cause such as alcohol, narcotics, or excess body fat,” says James Simon, MD, a urologist with PenroseSt. Francis Health Services. Because being overweight can signal the body to produce less testosterone, Dr. Simon recommends that some patients try a three-month workout program, and then retest their testosterone. “Generally, after working out, their testosterone increases, they lose weight, they feel better, and their sex drive improves.”” M
Erectile dysfunction (ED) may be the last thing men want to talk about — but they should at least talk with their physician. ED likely signals more than just a disappointing evening, says James Simon, MD, a urologist with Penrose-St. Francis Health Services. And it’s rarely the result of low testosterone. Rather, ED may signal a treatable health condition, including: Heart disease Diabetes Spinal injury Depression or stress Any condition that damages nerves or affects blood flow can cause ED, Simon says. Likewise, cigarette smoking, which constricts arteries, and alcohol consumption are frequent culprits. BOTTOM LINE For persistent ED, see your doctor, Dr. Simon says. You could save more than just your sex life.
If you have ED and haven’t had it checked, make an appointment with a urologist or your primary care provider. Need a primary care provider? Find a doctor at penrosestfrancis.org.
Risky business: Testosterone therapy may contribute to sleep apnea, prostate enlargement, and blood clots. PENROSESTFRANCIS.ORG
M.A.X. 7
Don’t wait until you have a heart attack. Know your score.
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$149 Heart Scan See page 4. Penrose-St. Francis Health Services is part of Centura Health, the region’s leading health care network. Centura Health does not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, and marital status in admission, treatment, or participation in its programs, services and activities, or in employment. For further information about this policy, contact Centura Health’s Office of the General Counsel at 1-303-673-8166 (TTY: 711). Copyright © Centura Health, 2018. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-719-776-5370 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-719-776-5370 (TTY: 711).
6-Point Inspection ESSENTIAL SCREENINGS AT 65 Just as your car needs certain checks and services at the 100,000-mile mark, your body needs specific care at age 65. “It’s good timing because it coincides nicely with the Welcome to Medicare exam,” says Gary Klein, MD, a family medicine physician at Penrose-St. Francis Primary Care for Seniors. “We’re taking the opportunity not only to poke and prod the patient, but truly establish a care plan for the coming years.” It’s a good time to find a physician you trust and are comfortable with. M
Here’s what you can expect at the 65-year mark:
BMI calculation. Body mass index is a measure of your weight relative to your height. Normal is 18.5 to 24.9.
Immunizations. Expect a pneumonia vaccine, tetanus booster, and annual flu shot.
Advanced lipid testing. A more detailed cholesterol test that can better predict heart disease.
Vision test. The earlier agerelated macular degeneration and glaucoma can be treated, the better.
Hearing test. Hearing loss affects safety and quality of life. Treatment options are better than ever.
Depression screening. Risk of depression increases with age, particularly in patients who have health problems.
Penrose-St. Francis Primary Care for Seniors specializes in caring for people age 65-plus on a Medicare Advantage Plan through UnitedHealthcare®. Attend a FREE monthly presentation to learn more about the practice and becoming a patient. A UnitedHealthcare salesperson will be present with information and applications. For accommodations of persons with special needs at sales meetings, call 719-331-9126 (TTY: 771). 3027 North Circle Drive, Colorado Springs, CO 80909, 719-776-4650 M.A.X. is published 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. M.A.X. is produced by Clementine Healthcare Marketing. For comments or to unsubscribe to this publication, please email us at max@centura.org. Executive editor is Jill Woodford.