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A Division of OCC Orthopedic Centers of Colorado


INTRODUCING OUR

CANCER CARE SPECIALISTS The in-depth knowledge you need; the care you trust. Providing the most advanced treatment options for cancer, including personalized therapies and national clinical trials.

MICHELE BASCHE, MD Breast Cancer, Gastrointestinal Cancers and Gynecologic Cancers Denver – Rose, Lone Tree

ALLEN COHN, MD Gastrointestinal Cancer, Carcinoid/Neuroendocrine Tumors (NET), Genitourinary Cancer and Drug Development

DANIEL DONATO, JR, MD, FACOG, FACS Gynecologic Oncology Surgeon Denver - Rose

ALAN FEINER, MD, FACP Medical Oncology/ Hematology Denver – Rose

Denver – Midtown, Denver – Rose, Steamboat Springs

MICHELLE LEVY, MD Medical Oncology/ Hematology Denver – Midtown, Lone Tree

ERIC LIU, MD, FACS General Surgeon, Neuroendocrine Specialist Denver - Midtown

IOANA HINSHAW, MD Medical Oncology/ Hematology Denver – Midtown, Lone Tree

ROBERT JOTTE, MD, PhD General Medical Oncology, General Hematology, Co-Medical Director of US Oncology Thoracic Committee, Drug Development Denver – Midtown, Lone Tree, Castle Rock

MABEL MARDONES, MD Breast Cancer and Women at High Risk for the Disease Denver – Rose, Lone Tree

CHARLES MATESKON, MD Radiation Oncology Lone Tree

DEV PAUL, DO, PhD, FACP Breast Cancer Denver – Rose

ROBERT RIFKIN, MD, FACP Medical Oncology/Hematology, Blood Cancers, Myeloma, Coagulation and Biosimilars Denver – Midtown, Lone Tree, Steamboat Springs

Locations DENVER – MIDTOWN 1800 Williams Street Suite 200 Denver, CO 80218 303-388-4876

DENVER – ROSE

Rose Medical Center Campus 4700 East Hale Parkway Suite 400 Denver, CO 80220 303-321-0302

LONE TREE

Sky Ridge Medical Center Campus 10107 RidgeGate Parkway Suite 200 Lone Tree, CO 80124 303-925-0700

CASTLE ROCK

1189 S. Perry Street Suite 230 Castle Rock, CO 80104 303-925-0700

STEAMBOAT SPRINGS

UCHealth Jan Bishop Cancer Center – Steamboat Springs 1100 Central Park Drive Steamboat Springs, CO 80487 970-870-1047

RockyMountainCancerCenters.com Rocky Mountain Cancer Centers complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Call 303-930-7880 (TTY:711) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 303-930-7880 (TTY: 711). ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 303-930-7880 (телетайп: 711). @2018 Rocky Mountain Cancer Centers. All rights reserved. Updated 9/24/18


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We treat you like family The compassion, care, and cutting-edge success rates you expect and deserve.

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Our Physicians: • Mark R. Bush, MD, FACOG, FACS • Robert A. Greene, MD, FACOG • Natalia M. Grindler, MD, FACOG • Althea M. O’Shaughnessy, MD, FACOG • Grace Y. Cheng, MD, FACOG Become an Egg Donor! 303.738.5319

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DO DO YOU YOU HAVE HAVE A A HEARING LOSS?

HEARING LOSS? Captioned Telephone (CapTel®) service allows you to LISTEN and Captioned Telephone (CapTel®) READ captions of everything during phone conversations! serviceyour allows you to LISTEN and

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n Bluetooth® capability*

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Website: relaycolorado.com/captel

Order a CapTel phone, contact the Colorado Communications Technology Program (CTP):

CapTel 840 For use with analog telephone lines.

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CapTel 840 For use with analog telephone lines.

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Phone: (303) 866-2097 (855) 767-6128 toll-free

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Website: relaycolorado.com/captel

* Available for Internet-based CapTel only. FEDERAL LAW PROHIBITS ANYONE BUT REGISTERED USERS WITH HEARING LOSS FROM USING INTERNET PROTOCOL (IP) CAPTIONED TELEPHONES WITH THE CAPTIONS TURNED ON. IP Captioned Telephone Service may use a live operator. The operator generates captions of what the other party to the call says. These captions are then sent to your phone. There is a cost for each minute of captions generated, paid from a federally administered fund. No cost is passed on to the CapTel user for using the service. See sprintcaptel.com for details. ©2019 Sprint. All rights reserved. CapTel® is a registered trademark of Ultratec, Inc. Bluetooth® is a registered trademark of Bluetooth SIG, Inc. Other marks are the property of their respective owners.


CONTENTS FEATURES

18 Keto Diet and Intermittent Fasting More Than Trendy

30 Sofia Montoya: From Heart Defect at Birth to AHA Spokeswoman

36 You’re Never Too Old to Learn a Musical Instrument

Living In Colorado Can Present Some Specific Risks For Skin Cancer

26

Adventurer and Adaptive Sports Icon Erik Weihenmayer Pioneers a ‘No Barriers’ Philosophy

32

Boom in Smoking Alternatives Catches Many Parents Off Guard

40


PUBLISHER

22 The Experts’ Guide to Sleeping Supplements Denver Caregiver for the Dying Brings Reverence to Patients’ 38 Final Days

42

Peter Solveson peter@solvepublications.com

CREATIVE DIRECTOR

Patrick Creyts

EDITOR

Andrea Juarez

COVER STORY

Morgan Tilton

FEATURE WRITERS

An Unhealthy Obsession with Healthy Food Ensnares Many Active, Fit Coloradans

44 Preventing and Treating Erectile Dysfunction

HEALTH PROFILES

Agape Provides Care to Families Dealing with Serious Illness

Struggling Adolescents Finding Help and Hope at Denver Springs

8

HEALTH PROFILE WRITER

Sarah Protzman Howlett Joelle Klein Mary Lemma Meghan Rabbitt Kris Scott Jeannette Moninger

PHOTOGRAPHERS

Megan Aurich Jeff Burak Clayton Jenkins Farrah Jobling James Q Martin Dan Sidor Mark Woolcott

HEALTHWELLNESSCOLORADO.COM

9

10

Meet Dr. Bruce Albrecht of Denver Fertility Albrecht Women’s Care

Meet Dr. Tyler Chan, Endocrine Surgeon with The Medical Center of Aurora

Advanced Radiosurgery Treatment at Swedish Helps People with Brain Tumors

11

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COMMITTED TO SUSTAINABLE PRINTING METHODS Publication Printers of Denver prints Health & Wellness magazine. The paper fibers, soy, agri-based inks, and methods used meet or exceed all federal Resource Conservation Recovery Act (RCRA) standards of the U.S. Environmental Protection Agency (EPA).

Copyright 2019 Solve Health Media. All Rights Reserved. Reproduction or use of editorial, data or graphic content is prohibited without written consent from Solve Health Media. Health & Wellness is a biannual publication of Solve Health Media. It is not intended to provide medical advice on individual health matters. Please consult your physician for any health concerns. Subject matter and content of editorial and advertisements do not necessarily reflect the viewpoints of Solve Health Media. Every effort has been made to ensure the accuracy of this publication. Solve Health Media assumes no responsibility for errors or omissions. Please notify Solve Health Media with any changes, additions or complimentary copies.

HEALTH M E D I A

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Advanced Stroke Treatment at Sky Ridge Proves Lifesaving for Aurora Resident

D E S I G N

Boulder, Colorado

303.484.9001 HealthWellnessColorado.com

AUTUMN/WINTER 2019

HEALTH & WELLNESS

16

Innovative Hip Surgery Stops Pain, Reducing Need for Hip Replacement

COMMUNITY EDITION — CALL TODAY FOR DETAILS —


AGAPE Photo: Dan Sidor


Photo: Dan Sidor

Denver Springs Behavioral Health Hospital Offers Help & by Jeannette Moninger Hope to Struggling Teens and Families

Dr. Adam Richmond, Denver Springs medical director, licensed professional counselor candidate Martha Johnson

Anxiety and depression, as well as substance abuse issues and suicide, are on the rise among youths nationally and here in Colorado. An estimated one in three Colorado teens have experienced a major depressive episode in the past 12 months, according to the U.S. Department of Health and Human Services.

Struggling adolescents and their families are finding help and hope at Denver Springs. The Englewood-based behavioral health hospital opened in July 2017 and provides services for anyone ages 12 and older. A separate outpatient clinic for adolescents is slated to open this year in Parker. Here’s a look at how Denver Springs can help your family.

MENTAL HEALTH ASSESSMENTS: A mental health counselor is available 24/7 to assess your child’s situation and determine the appropriate level of care. There’s no need to schedule an appointment and no charge for an evaluation. “We might recommend one of our programs or refer you to a community mental health provider,” says Dr. Adam Richmond, Denver Springs medical director. He urges families to seek help immediately if there are concerns about a child’s mental wellbeing. “Don’t try to be your child’s therapist. Get professional help.” INPATIENT TREATMENT: The center provides around-the-clock care for teenagers experiencing a mental health crisis, such as suicidal thoughts. “We offer a full day of group therapies, including activity, art, music and pet therapy,” says professional counselor Martha Johnson. “We also spend time each day outside or in our gym to provide the most comprehensive wellness program.” Teens will see a licensed psychiatric medication provider, such as Dr. Richmond, who is a board-certified child and adolescent psychiatrist, for medications to manage depression, anxiety, bipolar disorder or other problems.

PARTIAL HOSPITALIZATION PROGRAM (PHP): This program is geared towards adolescents who are struggling with mental health issues but who don’t require strict safety measures. Participants attend the program Monday through Friday for six hours each day, returning home to their families each evening. PHP offers teens a safe place to participate in group therapy with individual and family check-ins for safety planning and care coordination. Teens meet with a psychiatric nurse practitioner for a medication evaluation, but may not be prescribed medications. Most adolescents participate in PHP for approximately 2 weeks. INTENSIVE OUTPATIENT PROGRAM (IOP): This group-

based therapy helps teenagers learn healthier ways to cope and manage emotions around a variety of mental health issues, including substance use. Three-hour IOP sessions take place three nights a week. “There’s a lot of character-building exercises and camaraderie,” says Johnson. IOP typically lasts four to six weeks.

DENVERSPRINGS.COM | CALL 24/7: 720-744-3813


MEET THE DOCTOR

BRUCE ALBRECHT, MD Approximately one in eight couples has problems getting or staying pregnant. Infertility problems can be heartbreaking. As one of Denver’s pioneers in fertility care, Dr. Bruce Albrecht of Denver Fertility Albrecht Women’s Care helps to create families. What attracted you to the field of reproductive medicine?

Photo: Dan Sidor

Growing up on a ranch in Rye, Colorado, I learned about the importance of reproduction at a young age. My family’s livelihood depended on our livestock having offspring. Later, I watched a member of my family go through the painful experience trying to conceive and carry babies to term. I was already planning to become a doctor, but this personal experience prompted me to explore obstetrics. After completing medical school at the University of Colorado in Denver, I went to Harvard Medical School to train in obstetrics and gynecology, and then specialize in reproductive endocrinology and infertility. What’s unique about your in vitro fertilization (IVF) program?

At Denver Fertility Albrecht Women’s Care, we offer IVF to couples at a fraction of the usual cost thanks to our new state-of-the-art IVF lab. IVF typically costs between $12,000 and $20,000 excluding medications; our IVF pricing starts at less than $8,000 excluding medications. We built our new lab with the intention of offering patients the best technology at a more affordable price. Our phenomenal embryologists, Ellen Marello and Jennifer DiStefano, are renowned for their expertise in designing sophisticated IVF labs that get results. We’ve had a 62.3 percent success rate since the lab opened last October. This is almost double the national average for women in their mid- to upper-thirties. What other services do you offer?

My colleague Dr. Dana Ambler and I are dedicated to pinpointing the cause of infertility in both women and men. We only offer IVF to couples after less invasive (and less costly) methods have failed to work. We offer ovulation hyperstimulation, intrauterine insemination (IUI), fibroid removal, donor egg and donor sperm programs, frozen

Dr. Bruce Albrecht is board certified in reproductive endocrinology as well as obstetrics and gynecology.

embryo transfer and more. I am also a reproductive surgeon who performs procedures, such as opening blocked fallopian tubes and treating severe endometriosis, to improve the odds of conception. What is the Life Program for Polycystic Ovarian Syndrome (PCOS)?

One out of every 10 women of childbearing age has PCOS. This metabolic condition comes on at puberty and causes a range of problems including facial hair and acne, high blood pressure, diabetes and weight gain. It also causes irregular menstruation and is a leading cause of infertility. The Life Program for PCOS was the first in the state to help teenage girls and women manage this lifelong condition. We offer nutrition and lifestyle counseling, hormonal therapies and other treatments for each stage of a woman’s life.

www.albrechtwomenscare.com 720-420-1570 | Lone Tree 10


MEET THE DOCTOR

by Jeannette Moninger

TYLER CHAN, MD

Endocrine Surgeon with The Medical Center of Aurora What attracted you to the field of endocrine surgery? Chan: I started focusing on endocrine surgery after

completing my surgical residency. I was attracted by how meticulous and refined the procedures are. The techniques have really advanced over the last several decades. I can perform minimally invasive surgeries that allow patients to go home the same day or the next morning with very little pain. In the past, patients would have a large surgical incision and spend several days recovering in the hospital.

of endocrine organs, such as the thyroid, parathyroid glands and adrenal glands. The majority of the procedures I perform are thyroidectomies, or surgical removal of the thyroid gland. This butterfly-shaped organ in the neck secretes hormones to help regulate metabolism. Thyroid removal may be needed if a patient has thyroid cancer, an enlarged thyroid (commonly known as a goiter) or hyperthyroidism. Once the thyroid is removed, patients will require thyroid hormone replacement therapy. I also perform surgery to remove one or more of the parathyroid glands that regulate calcium production. Sometimes these glands develop into benign tumors that secrete excess hormones, which leads to elevated calcium levels. This can lead to severe osteoporosis, kidney stones or extreme fatigue. What surgery do you perform to treat adrenal gland problems? Chan: The adrenal glands secrete hormones like

adrenaline and cortisol. These two small organs sit above each kidney. The glands may develop cancerous or noncancerous tumors. Even noncancerous tumors can be problematic because they can secrete excess hormones. When this happens, you may develop uncontrollable high blood pressure, a racing heart, headaches and unexplained weight gain.

1421 S. Potomac St., Suite 230, Aurora

Photo: Dan Sidor

What is endocrine surgery? Chan: Endocrine surgery concentrates on the removal

Dr. Tyler Chan treats parathyroid, thyroid and adrenal gland conditions at The Medical Center of Aurora.

Adrenal gland surgery used to require a large abdominal incision. I perform the surgery laparoscopically. This minimally invasive approach requires four small incisions. Because the incisions are tiny, patients experience less blood loss, pain and scarring. They often stay overnight in the hospital and go home the next day. What advice do you have for someone needing endocrine surgery? Chan: If you need surgery, go to a surgeon who performs a high volume of

endocrine surgery annually. The more experience a surgeon has, the greater your chances of a good outcome and recovery. My practice is focused on endocrine surgery and the latest techniques. Our operating rooms at The Medical Center of Aurora are equipped with the tools that enable the surgical team to successfully perform minimally invasive endocrine surgeries.

|

303-794-6747

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auroraendocrinesurgery.com

Health Profile •

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by Jeannette Moninger

Photo: Megan Aurich

In a strange twist of fate, Wyoming rancher Randy Stevenson may owe his life to a car accident that nearly killed him. On a crisp fall day in October 2004, Stevenson crossed the center line and sideswiped a truck hauling gravel while driving back to his homestead in Wheatland, about 70 miles north of Cheyenne. 12

• Health Profile


Photo: Dan Sidor

Fortunately, neither driver was seriously hurt, and Stevenson was able to make it to his scheduled eye examination the next day. It was there that the then-50-year-old rancher learned he had complete left-side peripheral vision loss. “Apparently, my brain had been compensating for this blindness without me realizing anything was wrong,” he says. “When I hit that car, I could have sworn I was completely on my side of the road.” A magnetic resonance imaging (MRI) scan revealed a hemangiopericytoma, a slow-growing, rare type of tumor that develops in cells around blood vessels in the brain. Stevenson soon underwent surgery in Cheyenne to remove the tumor, which was benign (not cancerous). But because hemangiopericytomas grow back, his doctors recommended he head south to the Center for Stereotactic Radiosurgery at Swedish Medical Center for state-of-the-art radiation treatment. Swedish Medical Center is one of only two facilities in Colorado, and one of seven locations in the western United States, to offer stereotactic radiosurgery. Also called Gamma Knife® radiosurgery (the trademark name for the technology), this treatment concentrates hundreds of highly focused radiation beams to target tumors inside the brain. The radiation damages cancer cells, preventing them from multiplying and growing. Radiosurgery is a knifeless treatment, meaning there’s no cutting of the skull. Prior to the introduction of radiosurgery in the early 1980s, people with brain tumors underwent traditional radiation therapy. Although effective, the treatment hit a larger section of the brain, injuring healthy cells along with diseased ones. As a result, the number of times a patient could receive radiation was limited to prevent extensive permanent damage to the brain. “Stereotactic radiosurgery is a very precise procedure that allows us to target only the diseased portion of the brain without affecting surrounding healthy brain tissue and cells,” says Dr. Marshall Davis, a radiation oncologist at Swedish Medical

Dr. D. Marshall Davis is a radiation oncology specialist at Swedish Medical Center.

Learn more: swedishhospital.com

“Stereotactic radiosurgery is a very precise procedure that allows us to target only the diseased portion of the brain without affecting surrounding healthy brain tissue and cells.” Center. “As a result, patients can undergo radiosurgery multiple times without experiencing problems.” When Stevenson had his first stereotactic radiosurgery in early 2005, the treatment required the use of a head frame. The frame was pinned to a patient’s skull to prevent movement and ensure the radiation beams hit the intended target. Although radiosurgery is essentially painless, the head frame was uncomfortable. Patients typically received a sedative to calm nerves and a mild topical anesthetic at the pin sites. “I often got a compression headache from the pins pushing into my skull, and then another headache after the pins were removed and the pressure released,” recalls Stevenson. In 2018, Swedish Medical Center switched to a frameless device for radiosurgery. The day prior to treatment, a medical team custom makes a thermoplastic mask that fits a patient’s unique facial features (the mask has an opening for the nose so the patient can easily breathe). On the day of the procedure, a nurse places the mask on a patient’s face and then secures it to the table. The secured mask keeps the patient from moving his or her head. A small reflective marker placed on the patient’s nose helps the team check for potential movements that would affect the treatment’s accuracy. “The mask is so much more comfortable,” says Stevenson, “It’s really no different than getting an MRI. You experience a warm sensation like being outside on a sunny summer day.” The actual radiosurgery takes place as an outpatient procedure and lasts less than 30 minutes. “Our patients generally go home after about four hours and resume normal activities within a few days,” says Dr. Davis. Stevenson can attest to the amazing powers of this treatment having undergone eight stereotactic radiosurgery procedures, and one more brain surgery, since his initial diagnosis. “My advice to anyone who has a significant health issue is to seek out the best doctors and medical center you can find,” he says, “because their outcomes are going to be so much better and more consistent, which only means good things for you.” A team of nine neurosurgeons and Dr. Davis (a radiation oncologist) have performed more than 1,000 stereotactic radiosurgery procedures at Swedish Medical Center since 2004. The treatment is most often used to treat brain tumors and lesions, including arteriovenous malformation (AVM), meningiomas, pituitary tumors and acoustic neuromas. It also can treat metastatic cancer that develops in the brain as the result of other cancers, such as breast, lung or prostate cancer. As a Neuroscience Center of Excellence, Swedish Medical Center offers advanced, comprehensive care for all types of neurological disorders and diseases.

Health Profile •

13


Photo: Dan Sidor

Advanced Stroke Treatment at Sky Ridge Is a Winning Hand for Aurora Resident by Jeannette Moninger

Julia Neumeier is proactive about taking care of her health. The 78-year-old Aurora resident tries to keep her high blood pressure in check by exercising, eating healthy and taking prescribed medications. Despite these efforts, she’s had three strokes in the last five years. The most recent one, which occurred on October 31, 2018, was the most dangerous. “The doctors at Sky Ridge Medical Center told me there was only an 11 percent chance that she would make it,” recalls Julia’s husband, Orvin.

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Julia was getting her annual mammogram at an imaging center in the Denver Tech Center area when the stroke happened. Staff immediately called 911. While en route to the hospital in an ambulance, emergency medical technicians performed a brain imaging scan. After determining the size and location of the blood clot, they knew that Julia had the best chance of surviving if she received stroke care at Sky Ridge Medical Center. Last year, Sky Ridge Medical Center became the first hospital in southeast Denver to offer a stroke treatment called endovascular thrombectomy. During this minimally invasive procedure (also known as intra-arterial or mechanical thrombectomy), a surgeon threads a catheter through a patient’s femoral artery to reach the blocked artery in the brain. Devices inserted into the catheter then pull or suction the clot out of the artery. The removal of Julia’s blood clot was particularly challenging. “It was a substantially large clot in the posterior cerebral artery. This artery is located at the base of the skull, making it a difficult area to access,” says Dr. Don Frei, a neurointerventional radiologist who sees patients at Sky Ridge Medical Center and Swedish Medical Center. To make matters worse, the clot broke into two pieces with each piece going in different directions. Surgeons now had to retrieve clots lodged in two different arterial sections. When a person is having a stroke, every second counts. Clots restrict blood flow to the brain. Oxygen deprivation can destroy neurons critical for movement, speech and thinking. “You can lose up to two million neurons every 60 seconds,” says Dr. Frei. Fast treatment is key to saving a life and preserving brain function. “About 45 minutes after Julia was brought into the emergency department at Sky Ridge and the brain imaging scans were completed, our stroke team began the procedure to access the femoral artery,” says Dr. Frei. “We had Julia’s blocked arteries cleared in less than 20 minutes.” The average time for an endovascular thrombectomy at Sky Ridge—from the start of diagnostic testing to confirm the location of a blood clot to its actual removal—typically takes less than one hour.

ACE UP OUR SLEEVE

Not all hospitals have the trained staff and technology to perform this lifesaving procedure. Many hospitals treat stroke patients with an intravenous medication called tissue plasminogen activator (tPA). The treatment is effective when given within 4.5 hours of symptoms, but the medication doesn’t always break up larger clots like what Julia had. Plus, it increases the risk of hemorrhage or bleeding in people who take blood-thinning medications. Julia had been taking blood thinners since having her first stroke in 2014. An endovascular thrombectomy was her best chance at survival.

Photo: Mark Woolcott

MEDICAL TALENT IN SPADES

Dr. Don Frei, neurointerventional radiologist

“The odds certainly weren’t in her favor,” but not only did Julia survive, she suffered minimal damage from the stroke thanks to the fast actions of Sky Ridge’s doctors... FOLLOWING SUIT

Fortunately, Dr. Frei and his associates at Radiology Imaging Associates (RIA) Neurovascular are experts at performing this procedure. RIA Neurovascular is a national leader in neurointerventional surgery practices and has the most experienced group of physicians treating stroke in Colorado. “We perform a large volume of endovascular stroke treatments, which gives us great depth of experience,” says Dr. Frei. When Julia awoke from the procedure, she was the same bubbly, enthusiastic person she had always been. “I didn’t have any paralysis or loss of movement or speech. I was mostly concerned with whether I had finished the mammogram or if I needed to go back,” she says. Her recovery was so remarkable that Orvin says the hospital staff refers to his wife as “the miracle woman of Sky Ridge.” “The odds certainly weren’t in her favor,” says Orvin. But not only did Julia survive, she suffered minimal damage from the stroke thanks to the fast actions of Sky Ridge’s doctors and their expertise performing an advanced stroke treatment. After four days at Sky Ridge, Julia spent two weeks at Spalding Rehabilitation Hospital. There, she worked with therapists to regain her strength, improve her balance and sharpen her cognitive functions. Once at home, she continued with physical and occupational therapy for two more months. Today, Julia is back to walking in her neighborhood, playing card games with friends and participating in numerous social activities. She uses a fitness tracker to see how many steps she walks each day. She and Orvin recognize how fortunate she is to be able to do these things and to have more time to spend with their children and grandchildren. “It’s definitely a miracle,” she says.

SKYRIDGEMEDCENTER.COM

Health and Wellness Magazine •

15


Innovative Hip Surgery Stops Pain, Reducing Need for Hip Replacement by Jeannette Moninger

Photo: Clayton Jenkins

“I immediately felt at ease with Dr. Swann. I knew if anyone could get me back to a pain-free active life, it was him.”

16

• Health Profile


Sydney Potkanowicz started experiencing hip pain at the young age of 12. “It felt like my hip joints were slipping in their sockets. It was a constant painful, uncomfortable feeling,” she says. Sydney’s mom blamed growing pains, puberty and an active lifestyle for her daughter’s aches. By the time Potkanowicz started Fossil Ridge High School in Fort Collins, the pain made playing sports unbearable. She gave up both basketball and softball. “I told people that I didn’t like those sports anymore, but the truth was that it hurt too much to run,” she says.

Photo: Clayton Jenkins

Learn more: skyridgemedcenter.com

“After surgery, there’s an 80 percent chance that a patient won’t need hip replacement for at least 20 years, if ever.” from their teens to their fifties. His expertise has led to impressive results for patients. He performs the surgery in an extremely efficient manner, keeping patients in the operating room for about 90 minutes (most PAO procedures take up to four hours). “Because patients are in surgery for less time, they don’t lose much blood so there’s no need for a blood transfusion,” Dr. Swann says. He works with Dr. Presley Swann an anesthesiologist who is highly skilled at performing continuous lumbar plexus blocks. Patients go home within three days (compared to five to seven days at other hospitals) with a nonaddictive painblocking medication pump that they control. On August 6, 2018, Potkanowicz, then 17, had labral repair and PAO surgeries on her left hip at Sky Ridge. She went home after two days and participated in physical therapy for a couple of months. At six weeks, she could walk without crutches. During a trip to New York City, she walked 10 miles every day. “My left hip felt great. There was no pain,” she says. A few months later in December, she had the same surgeries on her right hip. Now, three months post-surgery, Potkanowicz is pain-free and looking forward to being cleared to start running again. “It was so discouraging to have people dismiss my pain because they thought I was too young to have hip problems,” says Potkanowicz. “One doctor suggested that I live with the pain for another 20 years and then get a hip replacement.” Dr. Swann hears these types of comments all too often from young, on-thego patients. “There’s a mechanical reason that a person needs a hip replacement. Something is out of alignment,” says Dr. Swann. “If you can fix the problem before the joint deteriorates and preserve natural bone, it’s like reversing time. A patient might not even need replacement surgery down the road.” Photo: Dan Sidor

It was during a family trip to San Francisco in 2017 that Potkanowicz decided something had to be done. “I took so many breaks while we walked,” Potkanowicz recalls. “There came a point where I told my mom I couldn’t go any farther. We agreed that I would see a doctor when we returned to Colorado.” The doctor recommended surgery on both hips to repair torn labrums, cartilage rings that aid joint movement. Trauma, repetitive motions or improper hip alignments can cause a labral tear. Hip surgery on someone so young seemed drastic to Potkanowicz and her parents, so they sought a second opinion from Dr. Presley Swann, an orthopedic surgeon with Advanced Orthopedic & Sports Medicine Specialists, who performs surgeries at Sky Ridge Medical Center. Dr. Swann agreed that she needed labral repair surgery, but cautioned that the procedure alone wouldn’t solve her problem. Instead, Potkanowicz needed an additional surgery to fix hip dysplasia, a condition in which the hip socket doesn’t fully cover the femoral ball of the upper leg causing the hip joint to partially or completely dislocate. “People are born with this condition, but they might not experience problems until they become more active in their teen years or young adulthood,” says Dr. Swann. “It tends to affect girls more than boys. The joint starts to wear down from the misalignment, which is why hip dysplasia is the second leading cause of arthritis in the hip.” Dr. Swann recommended a surgical procedure called periacetabular osteotomy (PAO). “The procedure repositions the hip socket to cover more of the femoral head,” says Dr. Swann. “This correction improves the stability of the hip joint and stops damage that can lead to arthritis. After surgery, there’s an 80 percent chance that a patient won’t need hip replacement for at least 20 years, if ever.” Only three surgeons in Colorado are trained to perform this highly complex procedure. Dr. Swann is the only one in the state who has advanced fellowship training in hip preservation techniques. “I immediately felt at ease with Dr. Swann,” says Potkanowicz. “I knew if anyone could get me back to a painfree active life, it was him.” Potkanowicz had good reason to feel confident. Dr. Swann performs approximately 100 PAO procedures every year on patients ranging Sydney with her puppy, Winston

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KETO DIET & INTERMITTENT FASTING by Meghan Rabbitt What You Need To Know To Figure Out If One (Or Both) Is Right For You

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Ryan Dawson struggled with his weight for years when he decided to try the ketogenic diet. He’d read a lot about the low-carb, high-fat regimen — often called the keto diet — and how it was helping people lose weight and keep it off. “I’d been dieting or trying to curb my unhealthy eating patterns for a long time without any lasting success,” says Dawson, a 43-year-old therapist and owner of Elevated State Counseling in Boulder. “During the week, I’d eat pretty healthy. By the time Friday rolled around, I’d get carbheavy at night in the form of alcohol and desserts, and spent weekends ‘cheating’ with more alcohol and sugar. I wanted to try a diet that had firmer

boundaries. I also like to eat, so I didn’t want to have to count calories.” Within a week of strictly following the keto plan, he was down five pounds. After three months, Dawson was down nearly 20 pounds. Even better, he had more energy than he’d had in years. “The keto diet has put me on my A-game more than ever before,” he says.

THE KETO DIET

Some of the increased, sustained energy Dawson and so many others on the keto diet experience is because this eating plan actually changes the way your body uses food for energy, says Dr. Rebecca Andrick, an obesity medicine specialist and owner of Weigh to Wellness Denver. How it works: When you eat carbohydrates, your body stores those carbs for energy (a process that prompts your body to retain fluid too). When you minimize carbohydrate intake and increase your healthy fats, you go into a metabolic state called ketosis, which is when your body doesn’t have enough carbs for your cells to use for energy and starts burning fat instead. To get into ketosis, you need to eat about 60-75 percent of your calories from fat, 15-30 percent from protein, and just 5-10 percent from carbs. It’s important to keep in mind that you need to follow the keto diet strictly to see the benefits — and to avoid potential downsides, says Andrick. “A lot of people think they need to avoid things like bread, but they don’t understand that they need to strictly monitor all carbohydrate intake, which has to be under 50 grams a day to get into ketosis,” Andrick says. “I’ve had a few patients say, ‘Well, I’m trying these

15-30% PROTEIN 5-10% CARBS 60-75% FAT

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keto recipes,’ but that is just a high-fat meal. If you’re not in ketosis, this diet is not going to work the way it’s intended.” Side effects: If you follow this diet incorrectly, you could experience some

serious negative consequences. For example, if you eat lots of saturated fats — rather than the healthy, unsaturated fats recommended on the keto diet — you’re at risk for raising your cholesterol levels. And even if you follow the diet to a tee, you can experience the “keto flu” — fatigue and achiness from the decrease in sodium, as well as deficiencies in sodium and potassium, and constipation. However, these side effects are often manageable — and worth dealing with if you have a lot of weight to lose, says Laura Fry, a Denver-based registered dietitian. “Keto works really well for a lot of people,” she says. “It can be a safe, effective way to burn fat more efficiently and lose weight.”

INTERMITTENT FASTING

Some Coloradans are finding weight-loss success by combining the ketogenic diet with another popular diet called intermittent fasting, says Fry. On this plan, you alternate between cycles of fasting and eating — usually 12 to 16 hours of fasting and 12- to 8-hour eating windows. New research shows intermittent fasting can promote weight loss, protect against disease, and even help you live longer. How it works: For the first 6-8 hours of your fasting period, your body uses its glucose stores for energy. After about 8 hours of fasting, that glucose is used up, so your body has to tap into its fat stores. What’s more, fasting for 8 hours or longer gives your hormonal and digestive systems a much-needed break, says Fry. 20

“When you’re fasting, your insulin levels plummet, which leads to a decrease in disease-promoting inflammation, helping you better control your portions...”


“When you’re fasting, your insulin levels plummet, which leads to a decrease in disease-promoting inflammation, helping you better control your portions, and even lets your body use energy more efficiently,” she says. Another advantage Fry points to: There’s research reporting that intermittent fasting can increase the number of mitochondria in the body. Mitochondria promote healthy cell turnover and DNA replication, but they usually decrease with age. Fry likens the boost to an anti-aging boon. Side effects: Intermittent fasting is OK for most people to try — and it’s pretty easy to follow, says Andrick. “You can start out just fasting 12 hours a day by eating breakfast at 7 and making sure you don’t eat after 7 each night,” she says. For quicker results, Andrick recommends building up to 16 hours of fasting and an 8-hour eating window. She also advises drinking enough water during your fasting window to feel full and to cut out refined carbohydrates, because sugarfilled foods will make you hungrier.

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WHAT WORKS FOR YOU

No matter what your approach, says Andrick, remember that following any diet has a good chance of helping you lose weight. She cites a recent study published in the Journal of the American Medical Association that found that after a year, both low-carb and low-fat diets were almost indistinguishable when it came to the study participants’ weight loss. The most important thing is to find a diet that you can stick to. That’s what happened for Dawson. “The keto diet just works for me,” he says. “I’m not thinking about food all the time because I’m not on an insulin roller coaster.”

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The Experts’ Guide to

SLEEPING SUPPLEMENTS Nutritional Deficiencies Could Be a Factor In Your Sleepless Nights, But Experts Say See a Specialist Before You Start Popping Pills. by Kris Scott

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About one-third of U.S. adults get less than the recommended seven hours of sleep each night. This might not seem like a big deal to some, but evidence suggests otherwise. Sleep deprivation is linked to type 2 diabetes, heart disease, obesity, depression and even vehicular safety. “If we all could just eat well, do yoga and meditate, use essential oils and not work, we’d all sleep like babies,” says Dr. Dawn Stanley-Cohen, a board-certified sleep medicine physician at Sky Ridge Medical Center in Lone Tree.

Stanley-Cohen knows sleep disorders aren’t a joking matter. There are a number of reasons a person doesn’t sleep well, and narrowing down the cause can be a puzzle. The issue is complex, she notes, even for highly trained professionals.

HOLISTIC APPROACH

There is, however, one area of sleep science that’s seeing more interest and an increasing amount of research, and that’s the connection between sleep and certain hormones, minerals, vitamins and amino-acids that we get from or are affected by our diets. “I think sleep doctors and naturopaths are tapping into knowledge that we didn’t have before or that we didn’t think was important,” Stanley-Cohen says. “No one talked about vitamin levels when I went to med school but, more and more, there are doctors taking a natural approach to things.” Denver naturopath Kelsey Asplin at Whole Health Center in Highlands Ranch notes that hormone levels are one of the first things she investigates in her insomniac patients. “That entire system dances together, so if any part is off, a lot of things can be affected by it,” Asplin says. Insulin, melatonin and cortisol, in particular, are all affected by diet, stress and other lifestyle factors and can affect sleep if out of whack.

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SUPPLEMENTS

There are other naturally occurring elements — minerals, vitamins and amino acids — that can affect sleep. But, StanleyCohen tells patients to proceed cautiously when considering supplements and to consult a sleep specialist doctor or naturopath and do some research. “More research needs to be done and that research needs to involve more randomized controlled trials,” Stanley-Cohen says. However, below are four supplements that sleep and medical experts say are supported by scientific and medical research. MAGNESIUM

This essential mineral plays a critical role in overall health, including sleep, but most people “don’t have diets that replenish magnesium very well, so a lot of people are at risk for low levels,” says Asplin. Similarly, StanleyCohen notes that limited research has shown that increased magnesium levels can help regulate melatonin, a hormone naturally secreted by humans that helps control daily sleepwake cycles, and GABA, a neurotransmitter that slows brain activity, helping people to relax and therefore get to sleep easier. Asplin uses magnesium with many of her sleep disorder patients, and particularly magnesium threonate, which research has shown can be an effective sleep aid for people with anxiety and PTSD. GLYCINE

While glycine is found in a lot of foods — eggs, fish, bone broth, kale and others — Stanley-Cohen says probably none of us consume enough of them and are deficient in some way. Research shows this tiny amino acid elevates serotonin and lowers core body temperature, both of which can promote better sleep. In one study, patients who were given 3 grams of glycine got to sleep faster, had more stable sleep states and longer stretches of REM sleep. Asplin notes glycine is in many sleep formula supplements.

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IRON

The connection between iron deficiency and sleeplessness is more well documented. Low iron levels can cause periodic limb movement disorder (PLMD), and restless leg syndrome. With these conditions, Stanley-Cohen advises checking iron levels before you start with anything else. If you experience either condition, talk to your doctor about supplementation, as new research introduced in the 2018 issue of Sleep Medicine provides clearer guidelines regarding treatment. VITAMIN D

A 2015 SLEEP journal study of more than 3,000 men aged 68 or older used objective reporting methods to show that vitamin D deficiency was associated with poorer sleep, shorter sleep duration and lower sleep efficiency (the ratio of time spent asleep to time spent in bed). However, Stanley-Cohen says the connection is not yet well understood and needs more and better research. BEYOND DIET

If your sleep is less than optimum, yes, your diet could be the problem. But, both Stanley-Cohen and Asplin advise their patients to evaluate the whole picture, including sleep habits. “Throwing supplements or herbs at people is only going to be so effective,” Asplin says. “We need to talk more about sleep hygiene — what are you doing for that hour or two before you go to bed? The foundation pieces mean nothing if you don’t take care of that.” “I think it goes back to enforcing good sleep hygiene and good habits before you start taking medications or supplements,” Stanley-Cohen says. “You can’t fix bad sleep habits with any pill.”

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SKIN CANCER

by Meghan Rabbitt

WHAT COLORADANS NEED TO KNOW Living in Colorado can present some specific risks for skin cancer. Here’s what you need to know to stay safe and still have fun in the sun.

It was three months before her wedding when Julie Dugdale, a Denver-based writer, noticed an irritation near her nose that wouldn’t seem to go away. She thought it might be a pimple and ignored it. When a little voice inside nagged her to see a dermatologist, she brushed it off. “I didn’t want to hear news I didn’t want to hear before the wedding,” she says. “I figured I’d deal with it later.” Dugdale saw a dermatologist soon after her nuptials, and a biopsy showed that the little, inconspicuouslooking spot was skin cancer. “Even though it was a basal cell carcinoma, which is ‘the good kind’ to get, it was terrifying,” Dugdale says. “Nobody wants to hear the ‘C word’ in a medical diagnosis.” 26

Luckily, Dugdale had outpatient surgery to remove the skin cancer and is left with just a small scar. She’s proof that while skin cancer is scary, it is often treatable if caught early, and most skin cancers are preventable. Here’s what you need to know to learn about your risk, plus the best ways to arm yourself with information and sun protection strategies that’ll help keep you safe.


Photo: Jefferson Panis

Julie Dugdale with her husband.

GEOGRAPHIC RISK FACTORS FOR COLORADANS

Here in Colorado, we love spending time outside — and the longer you’re in the sun, the more damage it can do, says Dr. Chandler Rundle, a research fellow at the University of Colorado School of Medicine. “Just minutes of sun exposure can do a significant amount of damage to skin,” Rundle says. Living at elevation presents another risk factor, adds Rundle. “The higher your elevation, the more ultraviolet (UV) light you’re exposed to,” he says. “And while both UVA and UVB cause damage to the skin, UVB is more important in the development of skin cancer, as that wave length does more damage to DNA.” Another consideration is snow, which reflects UV light. So, while you might not think to slather on the SPF when you’re bundled up in cold weather, it’s crucial. The same is true for cloudy or overcast days, says Rundle.

A

B

C

THREE MAIN TYPES OF SKIN CANCER

It’s helpful to have a basic knowledge of the different types of skin cancer, so you can stay on top of signs that a mole or skin growth might be something to talk to your doctor about. The Skin Cancer Foundation (www.skincancer.org) provides guidance on what you need to know about the different kinds of cancers, how to spot them, and what your dermatologist will do if you’re diagnosed:

A. BASAL CELL CARCINOMA (BCC)

B. SQUAMOUS CELL CARCINOMA (SCC)

C. MELANOMA

BCC are the most frequently occurring form of all cancers, with more than 4 million cases diagnosed each year. BCC occur when lesions or uncontrolled growths arise in the skin’s basal cells, which line the deepest layer of the outermost layer of skin.

This is the second most common type of skin cancer that results when sun damage leads to an uncontrolled growth of abnormal cells in the skin’s outermost layer.

This is the most dangerous type of skin cancer, and one that should be on Coloradans’ radars, considering we’re diagnosed at a slightly higher rate than the rest of the country. Melanoma develops when damage to skin cells caused by sun exposure or tanning beds triggers mutations that lead skin cells to multiply rapidly and form malignant tumors. These tumors originate in the skin’s melanocytes, which produce the skin’s pigment.

What to look for: They often look like open

sores, pink growths, red patches, shiny bumps, or even scars. While BCC almost never spreads beyond the original site, it should be treated immediately. Treatment: For small lesions, your dermatologist might use a technique called curettage and electrodesiccation, where the growth is scraped off with a curette (sharp instrument) and desiccated (burned) with a needle. Another common treatment option is Mohs surgery, where a qualified dermatologist examines the skin cells during the surgery to get rid of all of the cancer while sparing as much healthy skin as possible.

What to look for: These typically appear as persistent, thick, rough, scaly patches that may bleed when irritated. They’re sometimes mistaken for warts; other times, they look like open sores with a raised border and crusted surface. The skin around SCCs typically shows signs of sun damage (think wrinkles, pigment changes, and loss of elasticity). Treatment: In most cases, SCCs are

treated the same way BCCs are, with either Mohs Surgery or curettage and electrodesiccation. If your SCC is just on the surface of your skin, your dermatologist might do a procedure called cryosurgery, where your lesion is frozen with liquid nitrogen.

What to look for: Melanomas often look

like moles, but they can also be skincolored, pink, red, purple, blue or white. They tend to have an asymmetrical shape, uneven border, dark or uneven color, and are greater than 4 mm in diameter (the size of a pencil eraser). Treatment: First, your doctor will do a biopsy, where the mole is removed and sent to a lab for analysis. If it’s melanoma, your doc will remove the primary melanoma tumor and will test its borders to be sure all of the cancer is gone. Your dermatologist may also test the nearest lymph nodes, to be sure the cancer hasn’t spread.

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Are You Doing Monthly Skin Exams?

4 Skin-Cancer Prevention Steps You Can Take

If you’re skimping on self-skin checks, here’s a statistic that might inspire you to make it a priority: Up to 57 percent of melanomas are detected by patients themselves, according to one recent study. And all it takes is just five minutes to do a thorough job, says Rundle.

Staying out of the sun this summer is, well, not going to happen. That’s OK, say dermatologists — as long as you follow this advice:

DON’T USE TANNING BEDS Using an indoor tanning bed before age 35 can increase your risk of melanoma by 59 percent, and the risk increases with each use.

When you look at your moles, think of the ABCDEs: ASYMMETRY Perfect circles are OK; lopsided shapes are not

SEEK SHADE Choose the shade over sun when you can. Rundle says it’s a small step you can take to prevent excessive sun exposure.

BORDERS Even is good, uneven is bad COLOR You want it to be uniform, not varied DIAMETER Bigger than 4 mm isn’t great EVOLUTION Look for moles that have grown, are inflamed, itch, or bleed If you find a spot that looks suspicious, see your doctor or dermatologist immediately. This is especially true if you have more than 50 moles, large or unusual moles, a history or family history of skin cancer, fair skin, or have had excessive sun exposure or a history of tanning bed use —all of which put you at a greater risk of melanoma. “There is a lot of anxiety associated with skin cancer, but it’s important to make the appointment,” says Rundle. “Skin cancer is highly treatable, but the sooner you catch it, the better the outcome.”

DID YOU KNOW? 28

WEAR PROTECTIVE CLOTHING Hats, lightweight long sleeve shirts, and clothing with UV protection built in can help keep you protected from the strong, Colorado sun.

USE SUNSCREEN Look for SPF of 30 or higher, which blocks 97 percent of UV rays. You’ll also want to choose one that says “broad spectrum” on the label, which means it will protect against both UVA and UVB rays. Finally, opt for a water-resistant formula if you’re active, and remember to reapply after lots of sweating.

More than 13 million cases of skin cancer will be diagnosed this year. More people will be diagnosed with skin cancer this year than all other cancers combined. Source: www.skincancer.org.


The Real Truth About Sunscreen Here are the biggest myths — and the facts you need to know about the correct use of sunscreen and what it really takes to stay protected from the UV rays that cause skin cancer.

MYTH NO. 1 It’s fine to forgo

sunscreen at first, because getting a “base tan” will prevent burns all summer. Truth: A tan is essentially one big scab all over your body. The melanin in your skin only turns brown as a protective response, says Rundle. Once that protective melanin has appeared, it means damage has been done — and you’ll continue to do damage if you don’t protect your skin by using sunscreen.

MYTH NO. 2

Sunscreen isn’t necessary if your skin doesn’t burn. Truth: Just because you don’t burn doesn’t mean you’re immune to skin cancer or that the sun won’t damage your skin. The Skin Cancer Foundation reports more than 90 percent of the visible changes attributed to skin aging (think wrinkles, sun spots, and dry patches) are caused by the sun. Studies show daily sunscreen use can reduce skin aging in all of us — despite the color of our skin.

MYTH NO. 3 Sunscreen isn’t necessary on cloudy days.

Truth: Even if the sun isn’t shining, its harmful UV rays still reach you. That’s why Rundle says wearing sunscreen all year is crucial — not just during the sunny, summer months.

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BORN TO BE

A NATIONAL SPOKESWOMAN

Colorado’s Sofia Montoya Talks Surgery, Overcoming Obstacles And Adulthood

by Joelle Klein

Sofia Montoya, 20, is a sophomore at the University of Colorado Boulder studying business with an emphasis on marketing. Like most college students, Montoya who is from Englewood, Colorado, spends her time studying, working and socializing. In 2019, she’s also serving as a national spokeswoman for the American Heart Association (AHA). 30


“I’ve been able to continue & overcome no matter what life throws at me.” Montoya was born with Holt-Oram Syndrome, a rare heart disease that affects one in every 100,000 babies. As a result of this condition, Montoya’s heart was on the wrong side of her body and had a large hole in it. She had four fingers on her right hand and malformed intestines. Since 2013, Montoya has been involved in the Denver chapter of the AHA sharing her story and volunteering at events. Last year she was selected with seven other women from across the country as AHA’s 2019 national spokeswomen. “As a college student, I didn’t think that I would still be getting the opportunity to share my story on this kind of scale and get the support and love from so many friends,” Montoya says. Most of her friends were surprised to learn that this hard-working, vivacious college student had hand surgery, stomach surgery, and open-heart surgery by the time she was 2 years old. She also required a feeding tube until age 4. And, had pacemaker surgery at age 7. Montoya is happy people think of her as a young woman working toward a career in business and not a girl with health issues.

LIVING WITH CONGENITAL HEART DISEASE

Photo: Jeff Burak

Even with a heart condition, Montoya had a relatively normal, active childhood. She played soccer, went boating with her family and did most things young kids did. “I really didn’t have any big complications. I went to see my cardiologist every year, but I didn’t need any medication or pills,” she says. Eventually, at 7, she would need a pacemaker and then have it replaced at 14. But, still, she kept active, joining the marching band and Future Business Leaders of America at Englewood High School. More and more children are living normal healthy lives after a congenital heart disease diagnosis, says Dr. Abhay Divekar, a pediatric cardiologist and adult congenital heart specialist with Rocky Mountain Hospital for Children at Presbyterian/St. Luke’s.

Decades ago the chances of survival were far slimmer for patients with complex heart disease. “Not only are they surviving because of surgical and intensive care, and overall cardiology care, they are becoming adults in large numbers and not only a lucky few,” Divekar says.

CARE INTO ADULTHOOD

As a result of the growing number of adults with complex congenital heart conditions, a new cardiology subspecialty called adult congenital heart disease was developed with the first exam administered in 2015. Divekar feels strongly about the importance of assisting pediatric heart patients transition to adult care armed with information and education to help them take care of and advocate for themselves. The transitioning process from pediatric cardiology to adult congenital heart disease specialist, or just to an adult practice as they get older and go off to college, should begin at about age 14, with transition occurring sometime between 18 and 21. Divekar says this process should start with just a conversation about their disease so that the teenager starts getting familiar with the terms and more knowledgeable about the disease. “Because patients usually come with their parents their entire adolescence, they don’t always know about their condition,” he explains. As adults, they’re going to need to know about their medications and how to identify a qualified physician for ongoing follow-up care. “It’s important to have their last cardiology letter from their doctor, their last ultrasound report, their last surgery report and their last heart cauterization report with them,” Divekar recommends. “They should always carry these things with them in case, for example, they end up in an emergency room in another state. Even though everything is electronic these days, information between institutions is not easy. Even in the ER. Not everyone knows about certain complex heart diseases.”

MONTOYA’S MISSION

8 OF EVERY 1,000 BABIES At least eight of every 1,000 babies born in the United States have a congenital (present at birth) heart defect, according to the American Heart Association.

Montoya hopes to inspire other young people born with congenital heart issues and other health challenges to live life to the fullest, as she’s done, through her work with AHA. The message Montoya wants to get out as a spokeswoman is that people should keep going and never give up: “I’ve been able to continue and overcome no matter what life throws at me. You make adaptions, but you just keep going, no matter what.”

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CLEAR ROUTE FOR

BLIND ADVENTURER by Morgan Tilton

C O L O R A D O ’S E R I K W E I H E N M A Y E R P I O N E E R S ‘ N O BARRIERS’ FROM WHITEWATER TO ICE AND ROCK

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Short, swaying waves lapped against the kayak’s belly. The flowing water slightly hummed against the boat’s walls and reached the legs of professional adventurer Erik Weihenmayer, who alternated his paddle side-to-side. He felt the sunshine disappear behind the Grand Canyon’s rim. His crew chattered, as they pulled up to banks of Redwall Cavern, a ginormous alcove and beach the size of a football field. Weihenmayer dragged his boat onto shore. He dug his toes into the sand, clicked his tongue, snapped his fingers, and sprinted full-force ahead. Weihenmayer was sure he couldn’t collide with any obstacles here — despite being blind. At age four, Weihenmayer was diagnosed with retinoschisis, a rare condition in which an area of the retina separates into two layers. Less than a decade later, he completely lost his sight. As an athletic, active kid, he eventually found rock climbing. His passion for scaling mountains would shape his entire life.

Photo: Dan Sidor

WORLD-CLASS ADVENTURER Weihenmayer’s iconic stature as a world-class explorer burgeoned at age 32, when he became the first blind person to summit Mount Everest in 2001 — and he didn’t stop there. He completed the Seven Summits, reaching the top of the highest peak on each of the seven continents; rock climbed the 3,000-foot Nose technical route on El Capitan; and ice climbed Losar, an equally-long ice-waterfall in the Himalayas. He learned to skydive, paraglide and kayak, all while steering his own vessels. He skis backcountry and navigates expert runs in-bounds. And that’s the abbreviated list of his accomplishments. The trailblazer’s most herculean feat to date, however, might be the trophy whitewater mission that surrounded Redwall Cavern. In September 2014, Weihenmayer, then 45, paddled the entire length of the Grand Canyon: a 277-mile run along the Colorado River, one of the most prized, challenging waterways in the country. The epic passage entails a notorious boxing-ring of swells, drops, whirlpools and several hundred rapids — which swing into class IV — that can swallow an entire raft let alone a kayaker. “In climbing, you can stop and collect yourself. You can’t do that with kayaking,” says Weihenmayer. “Kayaking pushes the uncontrollable to a higher level than in climbing. The experience becomes more about letting go of what you can’t control while not letting fear consume you.” Fortunately, Weihenmayer is committed to the due diligence that’s needed to reach his audacious pursuits. Captured in the documentary, “Weight of Water,” which kicked-off a tour in Colorado in March 2019, Weihenmayer trained for six years — including an 11-day trip to paddle half of the Grand Canyon’s biggest rapids — before he put-in at Lee’s Ferry. “I wanted to know if this was a realistic goal,” Weihenmayer says. “I don’t take crazy, massive risks.” For the voyage, he was joined by friends: a crew of expert kayakers including Lonnie Bedwell — the Grand Canyon’s first-ever blind kayaker — and river guide Harlan Taney, who paddled behind Weihenmayer and provided commands via a waterproof radio headset. “Harlan has this beautiful sense of trusting the journey, even though the waves can slam you. I’ve learned great lessons from him,” Weihenmayer says.

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LETTING GO AND LETTING TRUST WIN

MIND AND BODY

In a strange paradox, losing his ability to see vastly enriched his life, due to the deep bonds that he shares with people. “When you go blind, you have to let your ego go. It’s a hard lesson, but you’re not going to accomplish anything through stubborn independence,” Weihenmayer says. “It’s been a backwards gift in my life. Because I’ve had to do activities with other people, I’ve been so lucky to find amazing biking, skiing, and climbing partners and to connect with them in ways most people don’t. They trust me and I them.” Teamwork is a fundamental component in Weihenmayer’s formula of success, which is coined as, the “No Barriers” approach to life. “We all want to live a big life and barriers stagnate you. It’s not motivation that’s the problem. People need the tools, mindset and team: that’s the formula. Then, the ultimate goal is stepping outside of yourself to elevate the world around you,” Weihenmayer says. To teach this mental framework, Weihenmayer co-founded No Barriers USA in 2005. The nonprofit organization uses transformative outdoor experiences to coach people with challenges — be it physical, emotional, psychological, socio-economic, or otherwise — so that they can achieve their individual and collective potential. Each year, the curriculum helps 10,000 students of all ages to dissolve mental barriers, accomplish their goals and adopt a give-back ethos. “At the No Barriers Summit, we’ve shown people how to manage pain beyond prescription drugs,” says Weihenmayer. “We’ve helped immobile people drive Action Trackchairs, so that they could charge up extreme, steep terrain and summit mountains. Those triumphs are 99 percent of what keeps me excited about life and the ‘No Barriers’ spirit.”

A

Beyond his philanthropic work and mental training, Weihenmayer follows a physical training routine, hones his skillsets, cultivates strong teams, and creates logistical systems for his outdoor travel. In an ebb and flow, he also recovers well at home in Golden, Colorado, between expeditions. He prioritizes a plant-based diet, lets his weight fluctuate, relaxes, cross-trains, and rides bikes with his wife and kids. When it’s go time, he’s ready to focus. “I’m 50 years old now. My knee gives out sometimes. Life isn’t perfect, but I train a ton,” says Weihenmayer, who shifts his gym regime to support each season and objective. Throughout the year, he regularly rides a tandem mountain bike, climbs, and skins uphill. “I even lift weights and do hideously boring things like two hours on the StairMaster. I train hard.”

“We all want to live a big life and barriers stagnate you. It’s not motivation that’s the problem... the ultimate goal is stepping outside of yourself to elevate the world around you. ”

B

Photos A & B: James Q Martin (A & B) Weihenmayer crashing into “V” wave in the Grand Canyon’s most infamous rapid, Lava Falls.

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C


NEXT CRESTS This year is fueled by redemption. For the spring season, his mind’s eye is set on ice climbing La Pomme d’Or, a 1,200-foot ice-waterfall that fills-in on the periphery of Quebec City in Quebec, Canada. “It’s the ‘Big Apple,’ and a stunning, steep climb,” describes Weihenmayer. To prep, he ice climbs, does pull-ups, and practices hanging exercises with ice tools. The project will be round two. “I tried La Pomme d’Or once. The conditions were bad. Ice the size of bowling balls was coming down on our faces and exploding everywhere,” he recalls. Later this year, in November, he plans to return to Ama Dablam, a 22,349-foot high Himalayan peak, also known as “The Mother’s Jewel Box.” Weihenmayer first attempted the ascent 18 years ago with climbing partner Eric Alexander. The duo was ice climbing mid-plot when they were caught in a seven-day storm. “[Alexander] had to get down, because he was starting to gurgle, a sign of hypoxia. On the descent, he fell 150 feet — it was amazing he lived,” Weihenmayer says. At basecamp, the team hand-pumped air into a hyperbaric chamber for three days to support Alexander, which kept him alive until a sliver in the sky was wide enough for the helicopter evacuation. His survival was miraculous: Pulse oximeter values beneath 90 percent are considered low. Alexander’s reading was at 47 percent. The ensuing year and Alexander’s recovery was extremely taxing. But, as comrades, Weihenmayer and Alexander didn’t allow adversity to become a permanent barrier for their ambitions. A year later, the two crested Everest, and their cohort set a world record for the most team members — 19 out of 21 — to reach the summit in a single day. “Everyone had a mission to get me to the summit, and that gave everyone the energy to rise above themselves,” Weihenmayer says. He attributes his and Alexander’s cooperative progress to their lessons learned on Ama Dablam.

“It was healthy for us to learn how we handle crisis together. It was a secret ingredient for the next year,” Weihenmayer says. “You don’t start as a team. When the mountain erects a barricade in front of you and you cross through it as a team, you grow as a team.” In November, Alexander plans to join Weihenmayer for their second effort up Ama Dablam. Together, they’ll face and stand on top of the crux — the prize but never the full picture. “Wilderness and mountains are beautiful,” Weihenmayer says, “but they throw hardship at you. It’s so much nicer to be there with the people you love.”

Erik Weihenmayer is the subject of the new, award-winning documentary “The Weight of Water,” which chronicles the adaptive adventurer’s physical, mental and emotional journey kayaking the harrowing whitewaters of the Colorado River through the Grand Canyon.

D

E

(C) Weihenmayer summits Himalayas’ Mount Everest; earth’s highest mountain above sea level. (D) Erik is the first blind rock climber to summit the tallest peak in every continent. (E) Weihenmayer ice climbs Colorado’s epic 365-foot Bridal Veil Falls.

Health and Wellness Magazine •

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Music

A TOTAL BRAIN WORKOUT by Mary Lemma Photo: Farrah Jobling

“Music hath charms to soothe a savage breast, to soften rocks, or bend a knotted oak.” The late-17th- century poet and playwright William Congreve had it right. But music — especially playing music — is good for the brain, too. In a sense, it’s a total brain workout. Music engages the whole brain because it is “structural, mathematical, and architectural,” according to a Johns Hopkins otolaryngologist. Barbara Calhoon, 73, learned to play a musical instrument for the first time at age 70. She and her husband spent a year and a half in Hawaii as volunteers in veterinary services when she discovered what the ukulele could do. Although she didn’t care for Hawaiian music, she heard professional ukulele musician Jake Shimabukuro demonstrate the complex capacity of the seemingly simple instrument in his masterful rendition of “Bohemian Rhapsody.” She got hooked. 36

“Learning to play a musical instrument is like solving a puzzle,” Calhoon says, “putting pieces together to make a whole.” As a former medical technologist, Calhoon knows puzzles. “I have osteoarthritis in my fingers, so playing the ukulele also provides exercise that’s fun,” she says. “And my brain, of course, sends messages to my hands.” Learning to play a musical instrument requires cognitive activity. “When you’re starting from zero,” Calhoon says, “it’s like learning a foreign language.” Older students have a bit more of a challenge. Younger players move much faster. We have to push ourselves harder.” Casey Cormier, a teacher at Swallow Hill Music in Denver, has taught students ages 6 to 96, including Calhoon. He enjoys working with older students, because of their attitude and approach.


Photo: Farrah Jobling

Barbara Calhoon

“They’re the students who aren’t feeling obligated,” Cormier says. “Many are retired, so they can finally make the time to do what they’ve wanted to do.”

HOW DOES IT WORK?

Just ask Emily Grant, a music therapist at The Medical Center of Aurora’s Behavioral Health Services center. Grant works with patients combatting depression, dementia and other mental health issues. “It’s about brain plasticity,” Grant says. “Playing an instrument activates the entire brain. Visual input, tactile input, fine motor coordination, memory, visual processing and sequencing skills are necessary to play even a simple piece on a piano.” The brain’s corpus callosum, Grant explains, “connects the brain’s two hemispheres to coordinate motor skills, convey the emotional message of the music, remember the notes, and process all the sensory information coming back, such as playing in tune, at the right volume, and at the right tempo. Music exercises our brain in an appealing and enjoyable way.”

IT’S GOOD FOR OLDER ADULTS

“As we age, we tend to rely on habits and information we already have, without challenging our brains,” Grant says. “And it’s effective for degenerating brains because we have more avenues to access stored information.” Although there is no way to prevent or stop the progression of dementia, Grant says, “Engaging in music by listening, singing, or playing an instrument can help strengthen auditory and motor neural networks, which facilitates performing other tasks that use those same networks. That helps maintain function despite the disease progression.” All of this is why, Calhoon says, “You’re never too old to learn something new.”

FAMILY LILTON MED PED CENTER Health and Wellness Magazine •

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D E M Y S T I F Y I N G

Death by Sarah Protzman Howlett

Denver caregiver for the dying brings reverence to patients’ final days

For Heather McGuire, death is a verb. When you’re “deathing,” she says, the process often feels like work — beautiful, sacred work. And yet, it’s not something most of us are all that comfortable witnessing. McGuire, a certified death doula in Denver, stands lovingly in that gap. “When everyone else in the room is crumbling and falling apart,” McGuire says, “I can be a lighthouse for that person dying.”

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Nurturing the Dying Death doulas — McGuire also calls them “soul midwives” — offer varying kinds of support for a dying person. While not medical professionals, they work alongside them and act as advocates for the dying person and oftenoverwhelmed family. Sometimes, the dying reflect on their lives. Others are quiet. Some want McGuire to hold their hand or give gentle massage. She’ll bring candles, incense, music. Whatever makes them feel good. Before her career change, McGuire didn’t really know death; she was 40 before she lost her first grandparent. She was briefly a birth doula in the 1990s, but the unpredictability of the job didn’t suit her responsibilities as a single mom. McGuire then found Denver-based Elder Concierge Services, which provides one-on-one life enhancement for seniors. Through this work, McGuire provides companionship to elderly people in their homes or in nursing facilities. Early on in her time there, she became close with several and ended up witnessing their deaths. “I quickly found it was a beautiful experience,” McGuire says, “to help them release fear, embrace the last sweet days and — dare I say — welcome death.” Nursing facilities soon began regularly requesting her presence specifically for people who would be dying soon. McGuire would soon become one of the first graduates of the Conscious Dying Institute in Boulder, which since its 2013 inception has trained about 500 death doulas. Her education there solidified her drive to create a nurturing, loving space for someone’s final days. “I tidy. I open the window. I bring in good smells,” she says. “I want to love them on the journey home, in the way that is most comforting for them. You are a human and you are dying, and your life deserves to be witnessed and supported.”

Specialties Some death doulas find a niche. McGuire’s friend is a doula for people dying of Lou Gehrig’s disease. Others gravitate toward cancer patients, the LGBTQIA community or terminally ill children. Certified death doula Annie Seidman of Boulder heard McGuire speak on a panel at the Conscious Dying Institute while Seidman was a student there. “I like Heather’s energy,” Seidman says, “and she has had really interesting experiences.” Seidman, who graduated from the Conscious Dying Institute in 2016, works at Windhorse Elder Care in Boulder and volunteers with TRU Community Hospice. “I hold the clients in my heart very closely,” Seidman says. “They give me strength when I’m feeling anxious or like I can’t do something.”

Practical and Emotional Support Death doulas often act as surrogates for family members who are tethered to jobs, kids and other restraints that make extended absence difficult or impossible. Candace Klein-Loetterle of Brooklyn, New York, enlisted McGuire to help care for her mother, Phyllis Klein, who died in 2016 in the Boulder home where she raised two daughters. She says McGuire brought a measure of peace to the draining, all-consuming process that was losing her mother. “Heather helped us all deal with letting go — including my mother,” Klein-Loetterle says. In addition to emotional support, McGuire also brings up practical matters: wills, medical power of attorney, what kind of burial and funeral they want — things loved ones can feel too sad to ask about, she says. But mainly, she encourages those longoverdue phone calls. “What they talk about at the end is forgiveness: ‘I wish I would have told my brother I love him despite what he did,’” McGuire says.

Readying for the Experience Sometimes, however, there’s more time. When McGuire is contacted early enough, she may spend weeks in conversation with the dying person. While many want “their entire family” with them at the moment of death, McGuire remembers one man who wanted to die alone. “He told me, ‘I want to ascend without distraction,’” she recalls. “I didn’t understand until a couple of years ago how innately private the experience must be.” And even though loved ones can find the “deathing” process exhausting, respecting a readiness to die can likewise be difficult. Sometimes family will hold the dying person’s hands or feet, which can feel “like you’re anchoring them to earth,” she says. It’s a resistance she understands though: In her 20s when she still had living grandparents, “I just wanted them to hold on,” McGuire says. “I didn’t understand the grace and beauty of death.”

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VAPING QUESTIONS, ANSWERED by Sarah Protzman Howlett

Boom In Smoking Alternatives Catches Many Parents Off Guard The good news: Smoking is losing ground. Only 7 percent of Colorado teens now smoke, down from a high of 25 percent in the 2000s, according to the 2017 Healthy Kids Colorado Survey tobacco data. But vaping? It’s huge — and high schoolers’ (mis)perception is that it’s safer than smoking. Vaping is the act of inhaling and exhaling aerosol (also called vapor) from an e-cigarette or similar device. And like any nicotine product, it can become addictive and affect brain development, which is still forming until about age 25.

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In this article, Colorado Health & Wellness breaks down parents’ most pressing questions on this growing concern. Only half of high school kids surveyed say they think vaping is risky, and more than one in four Colorado teens surveyed say they use an electronic vapor product. This can include e-cigarettes, vape pens or advanced personal vaporizers, known as mods. So what’s in vaping products?

E-cigarette products are filled with a liquid called e-liquid or e-juice, which often — but not always — contains nicotine. A small heating element inside the device turns the liquid to vapor, which is then inhaled through the mouthpiece. The vapor usually consists of a propylene-glycol or vegetable glycerin–based liquid that contains nicotine, flavoring, and other chemicals and metals. But it almost never contains tobacco leaves and it’s not water vapor — two common misperceptions.

“Parents say they would find these items in kids’ backpacks and never know.” What do vaping devices look like, and how do they work?

A vaping device consists mainly of a mouthpiece, cartridge for the e-liquid/e-juice and battery. When the device is in use, a battery activates the heating component, which converts the e-liquid into aerosol. The aerosol is inhaled into the lungs and then exhaled. The battery can be plugged in and recharged like a phone, taking about an hour to go from empty to full. E-cigarettes (also called “cig-a-likes”) resemble traditional cigarettes, while vape pens look more like a large fountain pen. “They’re all sleek and easy to put in your pocket,” says Alison Reidmohr, tobacco communication specialist with the Colorado Department of Public Health and Environment. “Parents say they would find these items in kids’ backpacks and never know.” Pod mods and box mods, which are slightly larger with a bulky battery, are yet another type of vaping device. What vaping products are most popular?

There are literally thousands of independently made products on the market, Reidmohr says, but it’s also common to call vaping “JUULing,” after the company that makes three out of every four vaping products sold today. On the market since 2015, JUUL is popular in large part due to its use of nicotine salts, which don’t dry out the throat as much and often provide a higher nicotine spike.

(left) Box Mod, named for its large, battery box (middle) JUUL, with charger and pods beneath and left (far-right) Suorin, a newer pod-based product resembling a credit card. Which Colorado teens vape?

Reidmohr says several factors predict not just whether a kid will vape, but also if they’ll use a variety of other substances, such as: • Youth who have clear family rules and a curfew are 39 and 38 percent less likely to vape, respectively. • Parents who know where their kids are and who they are with are 49 percent less likely to vape. • Youth who did not skip school in the past month are 52 percent less likely. “We’re here to say there are more healthy coping mechanisms to get through the difficult parts of life,” Reidmohr says. Can you always tell when someone is vaping?

No. While presence of humectant — a moisturizing substance — makes a visible cloud, JUUL products do not make as visible a cloud, and kids say they can “stealth vape” that way. “Sometimes, they’ll act like they’re coughing, take a draw, hold the vapor in their lungs for a long time,” Reidmohr explains, “and then by the time they exhale there’s very little vapor or cloud.” The smell can be similar to food, lip balm or gum, so it can confuse teachers, parents and other adults. When should I talk to my kids about it?

The 2012 Surgeon General’s report showed kids start smoking and chewing tobacco at age 12, on average. The CDC recommends seizing on a natural moment, such as seeing an ad for vaping or walking by a store where the products are sold, to start a conversation: Rather than the old, “We need to talk,” ask what they think about it. Parents should also model good behavior by abstaining from smoking yourself and be observant. In addition to studying what the products look like, be on the lookout for difficult-to-explain behavior: Stepping away for frequent breaks; several kids gathered in one bathroom stall; spending lots of money on unexplained items; and paying attention to otherwise unexplained fruity or minty smells. These could all be signs your teen is vaping.

Health and Wellness Magazine •

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ORTHORE X IA AN UNHEALTHY OBSESSION WITH HEALTHY FOOD ENSNARES MANY ACTIVE, FIT COLORADANS by Sarah Protzman Howlett

Many Coloradans have a deep passion for healthy eating: Our wellness-focused lifestyle has led to media attention, population growth and the lowest obesity rates in the nation. In Denver-area experts caution that what begins as health consciousness is increasingly descending into a still largely untalked-about eating disorder called orthorexia.

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GROWING CONCERN

The term, coined in 1997 by Colorado Dr. Steven Bratman, literally means “righteous eating.” It’s a quest for dietary perfection that consumes one’s daily routine — while exacting a physical and social toll. More than 20 years after its recognition, orthorexia is still not an official diagnosis of the National Eating Disorders Association, and without a set of diagnostic criteria, studies on its prevalence are nonexistent. Erin Carpenter, a licensed clinical social worker and founder of Thrive Counseling in Denver, says that already fit and athletic women 20 to 40 years old are increasingly symptomatic of orthorexia. Carpenter says one in four of her patients exhibit orthorexic tendencies. She calls it the “nothing is healthy enough” point of view. Sufferers might fixate on the food situations they’ll encounter each day and worry whether the options will be pure or perfect enough, which is ultimately isolating. “If you can’t go with your friends to the movies or a restaurant because of the food options,” Carpenter says, “that can lead to depression and loneliness.”

FIXATED ON FOOD

Orthorexic people may also find themselves judging what others eat, she says, while cutting out more and more foods from their diet and over-exercising to compensate for perceived slips. With so many Coloradans vocal about and proud of their eating habits, experts are careful to note that a balanced pursuit of quality, healthful food is not orthorexia. And while Carpenter says many popular regimens aren’t necessarily to blame, she sees many vegetarian, vegan, paleo, raw-food and “clean” eating devotees start to restrict even further and slip into orthorexia. “The culture is conflating food with morality, and the clean/dirty food thing is very toxic,” she says. “If we talk about ‘clean eating,’ whatever is not ‘clean’ is dirty and bad. This all-or-nothing way doesn’t reflect how our bodies actually work. No food is bad.” Janelle Hunt, a registered dietician at Sollus Nutrition Therapy in Denver, says the search for identity is often a trigger for orthorexic behavior, which she sees in many of her mid-20s female patients. “It gives them a sense of being good at something,” Hunt says. “It’s a visual thing others can see and you get status for it. If you’re not sure what you’re good at, you can cling to those food rules and become really good at that. They’ll go no sugar, no gluten, then from vegetarian to vegan — until soon they’re only eating vegetables.”

REEXAMINING THE ‘FOOD RULES’

These days, many social media influencers with no nutritional certification are pushing the elimination of perfectly fine foods, Carpenter says, which can encourage orthorexia and other forms of disordered eating. She prefers the advice of registered dieticians like Hunt, who steers her clients toward studies in medical journals. “I want them to see whether studies have actually backed something up,” Hunt says. For example, the need to stop eating carbs or sugar — or if these are just fads. For most of us, enjoying a wide range of foods bodes well for mental and physical health. “We all have preferences of food we like to eat, but if food is set before us and this causes anxiety, this is not normal,” Hunt says. “We need to start working through the rules around that food, and why food is holding so much power over us.”

The Orthorexia Overlap with Anorexia While symptoms like dry skin and hair, lack of menstruation and being underweight can coincide with orthorexia, it differs from anorexia, the widely known eating disorder that centers on restricting food quantity. “People are ashamed of their anorexia, but they actively evangelize their orthorexia,” wrote Dr. Steven Bratman, who coined the term in the late 90s and updated his observations in a 2016 blog post, reflecting on the rise of orthorexia and the distinctions between the two eating disorders. “People with anorexia skip meals; people with orthorexia do not (unless they are fasting). Those with anorexia focus only on avoiding foods, while those with orthorexia both avoid foods they think are bad and embrace foods they think are super-healthy (such as the ubiquitous kale). And when an anorexic person is in treatment, they have no particular objection to being fed with Ensure or Boost except regarding the calories, whereas an orthorexic person would object to the chemicals.”

Are you or someone you know orthorexic? Take a quick self-test online at

www.orthorexia.com

Health and Wellness Magazine •

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Preventing & Treating ERECTILE DYSFUNCTION A Denver Urologist Answers Men’s Pressing Questions by Meghan Rabbitt For years, many men thought of erectile dysfunction (ED) — the inability to get and keep an erection firm enough for sex — as an embarrassing condition that needed to be kept a secret. And while that’s changed, largely thanks to drugs that improve erectile function and the widely-played commercials that tout them, it’s still something that causes a lot of anxiety for men of all ages, says Dr. Richard Heppe, a urologist with The Urology Center of Colorado (TUCC).

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“Yet one thing people don’t realize is that ED is extremely common,” Heppe says. “A lot of guys think they’re alone, but that’s not the case.” Here, Heppe answers questions about this top concern for men of all ages, including what you can do to prevent and treat ED. What exactly is ED, & why does it happen?

This common condition is typically the result of a lack of blood flow due to the narrowing or hardening of blood vessels in the penis. As men age, the smooth muscle cells that line blood vessels become stiffer and less able to stretch. Just as this has the potential to cause problems with blood flow to the heart, it can also prevent the blood flow required for the penis to become erect. But it’s more than blood vessels at play, says Heppe. It’s also a combination of hormones, emotions, nerves, and muscles — and there’s a number of health conditions that can also cause men to experience ED symptoms. “Diabetes, high blood pressure, and certain medications can all affect erectile function,” he says. What’s more, performance anxiety can impact a man’s ability to get and keep an erection, as the release of adrenaline causes blood to flow to vital organs (like the heart, lungs and brain) and away from less vital organs (like fingers, toes and the penis). “Psycho-social issues can play a bigger role than people think,” he says. For example, men who’ve been divorced and are back on the dating scene for the first time in decades can experience stress that may impact their ability to have an erection. Other factors that can contribute to ED include tobacco use, which restricts blood flow to veins and arteries over time; being overweight; low testosterone; prostate surgery or radiation treatment for cancer; and medications, including those commonly prescribed for depression, allergies, high blood pressure and pain.

DID YOU KNOW? More than 18 million men in the U.S. over age 20 are affected by ED, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health.

What are the best treatment options? Medications: The three most popular ED

Is it essential to see a specialist or can I go to a treatment center?

treatments on the market are sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). These drugs increase nitric oxide in the blood vessels of the penis, causing them to stretch, which ultimately leads to increased blood flow. “These medications are extremely effective for most patients,” says Heppe. If they don’t work, a drug called alprostadil (Caverject or Edex) can be injected directly into the side of the penis to dilate the arteries and allow blood to flow to the penis, producing an erection. Heppe says these drugs are now available in generic form, which can save quite a lot of money.

If you’re experiencing ED, Heppe says, it’s important to see your primary care physician or a urologist who can provide you with a full range of treatment options. For the low intensity shockwave treatment, Heppe’s advice is to go to a urologist. “If you go to a place advertised on the radio as specializing in ED, they’ll typically have a product or two they’re trying to push, and they make a lot of money off those products,” Heppe says. Also, keep in mind that even if you’re embarrassed to talk about your symptoms, talking to a professional can be a game-changer. “Oftentimes treating an underlying condition can reverse erectile dysfunction,” Heppe says. “And, there are effective treatments with minimal side effects that can really help.”

New low intensity shockwaves: This new treatment option may have a more curative effect than current treatments. Essentially, it treats the blood vessels in the penis with low intensity shockwaves, which stimulates endothelial growth factor and supports blood vessel health. This ultimately has beneficial effects on the vascular system in the penis. “It’s not a home run, but it’s a solid double in terms of improving functionality,” Heppe says. Heppe explains that there are two offerings: Gainswave, which is acoustic shockwave therapy, and Corewave, which is ultrasound therapy. He says the data on the ultrasound technique is much better. The downside to this new treatment? It’s expensive and not covered by insurance. It’s also not yet FDA-approved.

Health and Wellness Magazine •

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Colorado Health & Wellness magazine  

COVER Adventurer and Adaptive Sports Pioneer Erik Weihenmayer Spreads No Barrier Philosophy Keto Diet vs Intermittent Fasting Advanced Radio...

Colorado Health & Wellness magazine  

COVER Adventurer and Adaptive Sports Pioneer Erik Weihenmayer Spreads No Barrier Philosophy Keto Diet vs Intermittent Fasting Advanced Radio...

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