A REFERENCE GUIDE TO HEALTH & WELLNESS IN SOUTHWEST MONTANA
wellness resource J U LY, 2016
MIND, BODY & BALANCE Get advice from health experts around the Gallatin Valley
A special advertising publication of the
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Bozeman OB/GYN Reproductive Medicine Specialty offered at Bozeman OB/GYN
By Stacy Shomento, MD Reproductive Endocrinology and Infertility Specialist Bozeman OB/GYN – Billings Clinic Reproductive Endocrinology and Infertility (REI) is a specialty that focuses on the diagnosis and management of hormonal disorders affecting women of all reproductive ages. Fertility care is one of the areas in medicine that is rapidly changing. A reproductive endocrinology and infertility specialist provides a wide array of advanced reproductive medicine treatments and procedures, not limited to, but including: • Comprehensive fertility evaluations • Surgical interventions including tubal reversal, removal of uterine fibroids, and laporoscopic surgery of the female
reproductive tract • Fertility-specific management of endometriosis and polycystic ovarian syndrome (PCOS) • Intrauterine insemination (IUI) • Alternative care – Donated sperm or eggs – Gestational carrier • In-vitro fertilization (IVF) • Preconceptual genetic testing and counseling • Preimplantation genetic screening Billings Clinic is the first health care organization in this region to develop a stateof-the-art in-vitro fertilization laboratory. In-
Leading the way in women’s health
As the longest standing OB/GYN practice in Bozeman, we are dedicated to providing comprehensive health care to women, including: • Obstetrics • Annual Physicals • Reproductive Medicine • Female Continence & Fertility Care Services • Gynecology • Menopause Management • Gynecological Surgery
• Minimally Invasive Surgery • Midwifery • Nutrition • Diabetes Counseling
Midwife Tyler Bradford, MD Reproductive Medicine Cassie Belzer, CNM, MSN Fanee Freeman, MD & Fertility Care Brooke Cadwell, CNM Shelby Haugan, MD Stacy Shomento, MD Christene McDonnell, PA Nutrition and Amy Korten, MD Samuel Sillitti, MD CVS Genetic Testing Diabetic Counseling Jennifer Yarger, MD William Peters, MD Katie Sonnek, RD,LN For more information or to make an appointment, call (406) 587-9202 or 1-866-587-9202 or visit bozemanobgyn.com 925 Highland Blvd, Suites 1210/1220 • Monday-Friday, 8 am to 4:45 pm
vitro fertilization services have previously only been available in larger metropolitan areas. My partner Colleen Milroy, MD (located in Billings) and I are the only fellowship-trained reproductive endocrinologists practicing full-time in Montana. We are fortunate to have Kathleen Miller as our IVF Laboratory Director. She has more than 25 years of embryology experience at top programs in the United States and Canada and is internationally recognized for her expertise. We will work with your OB/GYN, family physician or other fertility practitioner to ensure continuity of care. To make an appointment, call Bozeman OB/GYN at (406)587-9202 or (866)587-9202 or visit our website at www. billingsclinic.com/fertility to request an appointment on-line or for additional information.
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Alta Physical
Therapy and Fitness
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ollowing an accident, injury or surgery, patients often turn to a physical therapist for treatment. Those with chronic pain, orthopedic problems and certain diseases frequently do the same. What exactly does a physical therapist do? “Physical therapists are trained to properly diagnose and treat the patient,” with a goal to decrease pain and increase range of motion and strength, said Michele Simard, physical therapist and owner of Alta Physical Therapy and Fitness in Bozeman. “We cover a very large scope of practice – musculoskeletal, neuromuscular, cardiovascular/ pulmonary and wound care – with an age span from pediatrics to geriatrics,” Simard said. To diagnose and treat each patient, a physical therapist creates and carries out an “evidence-based treatment plan.” “Physical therapists perform evaluations by taking history, conducting a systems review and performing tests and measures to properly diagnose and treat the patient,” she said. The treatment prescription might include aquatic therapy strength development and stretching programs, gait and balance training, functional capacity testing (done to provide parameters for lifting and bending at work), hippotheraphy (horse therapy) and work hardening; as well as modalities such as ultrasound, electrical stimulation, traction (to help
decrease compression), anodyne (an infrared heat treatment used with patients who have peripheral neuropathy), and heat, ice and proprioception (spatial awareness of limbs) activities. If one approach doesn’t work, there are various others to try.
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Come join us at Alta Physical Therapy & Fitness
One-to-One Care Eliminate Pain Maximize Strength Increase Flexibility Improve Balance & Coordination SPORTS INJURIES, POOL THERAPY, GERIATRICS
“Basically, we are trying to get people back to their functional status,” Simard said. “With injuries, we want to get them back to 100 percent of where they were before the injury.” Oftentimes, patients believe that once they are injured, they will not be able to participate in certain activities following recovery. However, that’s not the case. “After physical therapy, you should be able to do everything you did functionally before the injury,” she said.
Continue to exercise in our supervised setting once physical therapy has been discharged. We Bill All Insurance Companies
When selecting a physical therapist, patients have the right to choose the therapist they prefer, even when they are directed to a particular facility, she added. “The patient can determine who they wish to see.” In Montana, patients have direct access to physical therapists or they may be referred. However, federal programs such as Medicare require a physician referral. Physical therapy is covered by federal, state and private insurance plans, she said.
2430 N. 7th Avenue, Unit 2 Bozeman • 586-2772
Visit www.altaptandfitness.com for more information.
www.altaptandfitness.com
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Bozeman Health Electronic Health Records Makes Managing Your Health More Efficient and Effective Getting access to your persona l medica l information ha s never been ea sier, now that Bozema n Hea lth ha s a f ully integrated electronic medica l record system, k nown a s My Cha rt. Ever y medica l provider within the Bozema n Hea lth system— including clinic physicia ns a nd adva nced practice clinicia ns, hospita l sta f f a nd communit y providers —now uses My Cha rt to track your clinic visits, hospita l stays, medications –in fact a ll your medica l information. This ma kes it possible for a ll your Bozema n Hea lth physicia ns to be awa re of your hea lth conditions a nd issues, a llowing for better coordination of ca re a nd eliminating potentia l problems such a s adverse medication interactions. My Cha rt a lso promotes your involvement in your own ca re, since you too ca n enjoy sa fe, secure a nd ea sy access to your hea lth information, prescriptions, test results a nd your ca re tea m a ny time of the day – or night – that work s for you. With My Cha rt, you ca n review your immunizations,
a llergies, summa ries of recent visits to the doctor a nd current hea lth concerns, from your computer, tablet or phone. Ma k ing a n appointment to see your provider is a s ea sy a s logging on to the secure My Cha rt porta l. View your provider’s ava ilabilit y a nd select the appointment that work s with your schedule. W hen something unexpected happens, My Cha rt a llows you to ca ncel appointments, too. When you have a non-emergency question or health concern, you can email your provider directly and securely with MyChart. Your care team can email you with important information as well. It’s a great way to exchange information without having to coordinate schedules. Responses are typically within two business days. With My Cha rt, your doctor will send norma l test results a s soon a s they’re ava ilable. You ca n a lso see a ny provider notes a nd comments so you ca n better understa nd those results. My Cha rt a lso lets you conveniently request prescription renewa ls for you a nd your fa mily.
Additiona lly, My Cha rt a llows you to access your children’s medica l information. You ca n review their immunizations a nd test results, schedule appointments a nd excha nge ema ils with your children’s ca re tea m. You a lso ca n a rra nge for the sa me access to hea lth information of your elderly pa rents, with their consent. Bozema n Hea lth My Cha rt is secure a nd the information stays bet ween you a nd your hea lth tea m. Since Bozema n Hea lth uses Sa nford Hea lth a s its electronic hea lth record vendor, to access My Cha rt for the f irst time, go to w w w.bozema n hea lt hmycha r t. org a nd enter a one-time ID verif ication. You ca n then access My Cha rt a ny time from the w w w. bozema n hea lt h.org website. You now have access to your hea lth information, when you wa nt, from where you wa nt it, ma k ing it ea sier to stay informed, a nd stay hea lthy! My Cha rt is yet a nother way we at Bozema n Hea lth work to improve communit y hea lth a nd qua lit y of life, achieving better hea lth for more people, in more places.
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At Bozeman Health Women’s Specialists Clinic, we can’t always find words to describe our approach to health care. So we asked our patients. They had a lot to say. And we’re happy to know the care they receive reflects the kind of care we work hard to provide. From family planning through pregnancy and childbirth to menopause and beyond, our patients expect the best. And, according to them, they get it—and so will you. Women’s Specialists Clinic
406-414-5150 | 905 Highland Blvd, Suite 4440, Bozeman | bozemanhealth.org
MyChart from Bozeman Health is a safe, secure electronic record of your health and medical history. And, it will make managing your care and treatment more accessible and convenient than ever before. You can log on to the secure MyChart system from any device and view your medical records, schedule appointments, access test results, renew prescriptions, and contact your providers by e-mail. The same information
will be accessible to parents for their children. And, MyChart will make your health records readily available to all authorized providers throughout Bozeman Health, from your primary care team to specialists, hospitalists, pharmacists, laboratories, and other healthcare professionals involved in your care. MyChart from Bozeman Health. Easy. Accessible. Safe. Secure.
The fuTure of healTh care is here. and iT has your name on iT.
BozemanHealthMyChart.org
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Bozeman Sport & Spine How Stem Cells Help Us to Heal Ourselves
For ma ny suf fering with degenerative a rthritic joints like hip a nd k nee, treatment options have been limited to steroid injections, physica l therapy or joint replacement surger y. But Stem Cell Therapy is now cha nging that pa radigm. According to Sports Medicine Specialist Bradley Aylor, MD, of Bozeman Sport & Spine, Stem Cell Therapy is a promising although relatively new area in the realm of Orthopedic Medicine. Stem Cell Therapy is being used around the world to regenerate or regrow tissue by using one’s own “ harvested ” cells that are specially processed and reinjected back into targeted areas of injury or inf lammation . This procedure can help with many dif ferent types of musculoskeletal injuries f rom muscle sprains and strains, tendon inf lammation and meniscus tears in the knee to arthritis and degenerative disc disease. Stem cells a re natura lly occurring cells that have the unique capacit y to dif ferentiate into a specif ic t y pe of cell. They produce chemica ls k nown a s grow th factors a nd c y tok ines that help to repa ir a nd regenerate da maged tissues.
Mesenchymal stem cells can produce bone, cartilage, ligament and tendon tissues. Our bone marrow and adipose (fatty) tissues have high concentrations of these cells. By using a liposuction-style technique and specialized equipment, doctors like Brad Aylor are able to retrieve and “harvest” these stem cells from your fat to then reinject back into damaged areas of the body. Specif ic conditions that ca n be treated with Stem Cell Therapy include: • Mild to moderate
osteoa rthritis/ degenerative a rthritis of the joints especia lly hip a nd k nee
• Tendon injuries,
including pa rtia l tea rs of the rotator cuf f of the shoulder
• Back pa in related to
degenerative disc a nd facet joint
For a consultation to see if you can benef it f rom Stem Cell Therapy, call Bozeman Sport & Spine at 406 -5229 067.
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Community Health Partners
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ur mission at Community Health Partners (CHP) is to enhance community health and well-being. We take this mission seriously by striving to deliver services that are easy and close to access when you need them and are of the highestquality regardless of your ability to pay. Did you know that CHP offers primary medical care to patients of all ages at four locations (Belgrade, Bozeman, Livingston and West Yellowstone), as well as dental care in Bozeman and Livingston? Each of our four medical sites has been awarded Level 3 PatientCentered Medical Home honors from the National Committee for Quality Assurance. This is the highest standard that can be met and ensures that all of our patients receive the care coordination expected when CHP is your medical home. It also means we work extra hard to make sure you receive all the recommended preventive testing based on your age, gender and medical conditions. Our clinicians and support staff will partner with you so that you can make the best decisions regarding your health. Did you know that all of our
Medical CHP-Belgrade............922-0820 CHP-Bozeman............585-1360 CHP-Livingston...........222-1111 CHP-West Yellowstone................646-9441
medical locations also provide licensed therapists combined with resource and enrollment coordinators to help our patients with life’s complexities and point them to other community resources when needed?
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his Mother’s eyes. his Father’s footsteps. his Sister’s cold. Real people. Remarkable healthcare.
Did you know that whether you have terrific health insurance or are uninsured, CHP can provide services to you at a price you can afford? CHP can also help you learn about and sign up for insurance under the Affordable Care Act. Since the 2015 Montana Legislature enacted expansion of Medicaid benefits, CHP looks forward to helping patients qualify. CHP plays a unique role in our healthcare community by offering the greatest number of services to anyone and everyone, all under one roof. Call us to make an appointment.
Dental CHP-Bozeman Dental..........................922-0820 CHP-Livingston Dental...........................585-1360
www.chphealthmt.org Find Us on Facebook: CHPhealthmt
PROUDLY SERVING THE PEOPLE OF PARK AND GALLATIN COUNTIES SINCE 1997 With clinics in Belgrade , Bozeman , Livingston & West Yellowstone .
C OM M U NITY HEALTH PARTNERS www.chphealthmt.org
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The Ridge Athletic Clubs More Physical Activity, Less Chronic Disease
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s we age, the relative risk of developing chronic diseases such as cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), obesity and certain cancers increases. In addition, one’s physical activity (PA) behaviors, or lack thereof, can profoundly impact the relative risk of developing many of these conditions. In other words, the natural progressive course of aging coupled with living a physically inactive lifestyle can create a distasteful recipe for developing chronic disease(s). Physical activity and exercise have been shown to reduce the risk of developing numerous chronic conditions and diseases such as CVD, T2DM, hypertension, osteoporosis, obesity, stroke, certain cancers, cognitive impairments, anxiety and depression. In addition, regular PA has been shown to be effective in helping manage and treat many of these conditions. The federal PA guidelines recommend adults engage in at least 150 minutes per week of moderate intensity aerobic PA or 75 minutes per week of vigorous intensity activity. Further, aerobic activity should be performed
in bouts of at least 10 consecutive minutes. Adults should also do muscle-strengthening activities of moderate or high intensity two or more days a week. Adults may obtain many of the health benefits related to PA if they satisfy these guidelines. The best part is anyone can do it! At any age, adopting an active lifestyle can have positive impacts on health outcomes, quality of life and longevity. Whether you’re 20 or 80 years old, it’s not too late to begin an active lifestyle and experience the many advantages associated with PA.
Consult with your healthcare provider before starting a PA program. You should also consult with a qualified fitness professional to make sure you receive a program that is safe and specific to your needs and desires. Happy Exercising, Eddie Davila, MS, ACSM-RCEP, EP-C, EIM 3, CEAS I Director of Fitness Ridge Athletic Clubs
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Livingston HealthCare “In March of this year, a long awaited child was born. A child who wouldn't exist if it wasn't for the care given by a skilled doctor to a hopeful couple . . .
our providers at our clinic, it's more than a visit – it’s a part of building a relationship together. That's important for your health. When you feel confident and comfortable about seeing your physician, you're more likely to discuss health concerns and schedule routine visits.
“I will never forget the moment (Dr. Helin) held my hand as I was going under anesthesia and told me it was going to be OK. It was a complicated surgery where my entire reproductive system was compromised. She successfully was able to keep my reproductive organs intact and functioning so we would have the best chance for future IVF procedures. . . .
Address: 320 Alpenglow Lane Livingston, MT 59047 Emergency Department open 24/7 Clinic 8 am – 4 pm 406-222-3541
“We traveled back to Livingston from Portland to once again have Dr. Helin perform my surgery. I knew it was going to be the most complicated surgery yet, and I also knew that there was a high likelihood that I might lose some function of my reproductive system, if not all of it. I also knew that whatever the outcome, Dr. Helin would do any and all that could be done for me. . . . In the next 2 years she still oversaw my medical needs even though I remained in Oregon. . . . “Our admiration for her care is also felt amongst a large number of our friends and family who are her patients. With the beautiful new hospital . . . with her at the OBGYN helm, Livingston will have the best care that they can ask for right in their backyard!” —Geoff and Lorraine Blatter “I had the splendid opportunity to have diagnostic ultrasounds performed yesterday by a dedicated, competent, professional technician, Jake. This facility is enhanced by such an employee. I worked in medical
administration for over 40 years, hiring and releasing various professionals in all levels of healthcare. Any of the hospital settings I managed would have welcomed and treasured such an employee. Administration usually hears about the negative occurrences, I strive to proclaim services and people who excel. I feel fortunate and comfortable in my encounters of care I have received from the staff here at Livingston HealthCare… —Martha Bonds “The staff at the ER and the paramedics were all fantastic! As a nurse practitioner for 30 years, I recognize superior care when I see it! Many thanks!”
Livingston HealthCare
Livingston HealthCare, in Livingston, Montana, is a top-rated, 25-bed critical access hospital with a Level 4 Community Trauma Facility, a multi-specialty provider clinic, as well as rehabilitation and home-based services. Livingston HealthCare is an affiliate of Billings Clinic. Livingston HealthCare has been named one of the Top 20 Critical Access Hospitals (CAHs) in the United States by the National Rural Health Association (NRHA) based on a study from a nationally reputed health care research firm, iVantage Health Analytics. This prestigious honor highlights the hospital’s continued growth as a vital regional health care provider. When you schedule an appointment with one of
Livingston HealthCare Shields Valley Clinic
Clinic Address: 309 Elliot St. North Wilsall, MT 59086 Mailing Address: PO Box 26 Wilsall, MT 59086 Open Monday-Thursday 8 am – 5 pm 406-578-2222
Livingston HealthCare UrgentCare
Clinic Address: 104 Centennial Drive, Suite 103, Livingston, MT 59047 *Open 7 days a week* Monday-Friday 9 am – 8 pm. Saturday and Sunday 9 am – 5 pm 406-222-0030
Livingston HealthCare Gardiner Rehab Outreach Clinic
Clinic Address: Gardiner Baptist Church, 802 Scott St. W., Gardiner, MT 59030 LHC staff is on site every Monday, Wednesday and Friday from 9 am – 4 pm for appointments. Please call to schedule an appointment. 406-222-7231
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The Alzheimer’s Association Navigating Life with Alzheimer’s
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I didn’t know it would be like this,” Barbara said. “I can’t remember people’s faces now or their names. They have on name tags, but I can’t read anymore.” She paused and then quietly said again, “I didn’t know it would be like this.” Barbara (names changed to protect privacy) has Alzheimer’s. Driving, reading, cooking, following along in a conversation, even choosing what to wear are activities of daily living that Barbara can no longer do, given the deteriorative effects of Alzheimer’s disease. Together, Barbara and Mike, her husband of nearly 50 years, are navigating life with Alzheimer’s. A schoolteacher her entire career, Barbara realized in 2010 that “something wasn’t right” when she had to put name tags on her students’ desks. “I always knew their names,” she said. Barbara told Mike about her forgetfulness, and he remembers thinking that maybe it was a brain tumor. The Alzheimer’s diagnosis came some months and many doctor visits later. Mike, who is Barbara’s primary caregiver, admits that their retirement years are not shaping up as they had planned. Still, he is quick to clarify; there is no place he’d rather be than by Barbara’s side. Like most family caregivers, Mike took on providing all aspects of her care by choice, but not because he was especially well-prepared for all it entails. Few people are. Caring for a loved one with Alzheimer’s has been referred to as the “36 hour day.” Feelings of guilt, frustration, confusion and fear become constant companions as caregivers struggle with the unending demands of care coordination, managing legal concerns and attending to daily matters of diet, hygiene and socialization – all the while experiencing the troubling and prolonged loss of their loved one.
The Growing Epidemic That is Alzheimer’s
Alzheimer’s Association Offers Help and Hope
Alzheimer’s is all too often a profoundly misunderstood and undiagnosed illness. Not a normal part of aging, Alzheimer’s is a degenerative disease, the 6th leading cause of death in the United States. It is a triple threat with soaring prevalence, lack of treatment and enormous costs that no one can afford. More than 5 million Americans are currently living with Alzheimer’s or related dementia. Of that number, over 19,000 live here in Montana – approximately 10 percent are under the age of 65. Another 49,000 family members provide their care.
The Alzheimer’s Association is working to bring help and hope to families like Barbara and Mike’s. Through a 24/7 Helpline (800272-3900), Montanans can access confidential care consultation or resource referral to local services at any hour of the day or night. There is never a cost for this confidential help – whether it is for decision-making support, crisis assistance or education on issues families face every day.
The human costs mount as caregivers, predominantly elderly spouses or adult children, often neglect their own health and emotional needs, increasing their risk for physical health problems. Most are managing the burden of care alone, subsisting on modest incomes with limited family or community support. The duration of the disease varies but can last from 8 to 10 years, during which time families can become emotionally, physically and financially shattered.
Currently, the staff of the Montana chapter has just two employees, but it is developing a group of impassioned volunteers who assist with service delivery, support groups, community education and organizing fundraising/awareness-raising events like the Walk to End Alzheimer’s on September 18 at Bozeman Ponds. Barbara and Mike take part in Walk to End Alzheimer’s every year, raising money for the cause while sharing a day of laughter and tears with family and friends. By working with the Alzheimer’s Association,” said Mike, “we’ve met other families facing this disease and we realize, we are not alone.”
If you are interested in getting involved . . . or getting help for yourself, a friend or family member, contact the Alzheimer’s Association at 800-272-3900 or email montana@alz.org.
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THE END OF ALZHEIMER’S STARTS WITH YOU
Sunday, September 18, 2016 1pm Bozeman Ponds, Bozeman SIGN UP TODAY
START A TEAM 800.272.3900 alz.org/walk Alzheimer’s is an epidemic devastating our families, our finances and our future. The disease is all around us — but the power to stop it is within us. Join us for the Alzheimer’s Association Walk to End Alzheimer’s® and be inspired by all the footsteps that fall into place behind yours. Together, we can end Alzheimer’s 2016 NATIONAL PRESENTING SPONSOR
2016 MONTANA PRESENTING SPONSOR
Walks also in Billings, Butte, Eureka, Great Falls, Helena, Missoula and Kalispell. Visit alz.org/walk for details or call 800.272.3900
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MONTANA’S OWN With nearly 600 of Montana’s very own employees, Blue Cross and Blue Shield of Montana is one of the most loyal employers in town. Since 1940, we’ve been here when our boys came home from the war, when you first got married, when you had your first baby and when you went through a family health crisis. We’ve always been here for you. And we pledge we’re not going anywhere. We’re Montana’s own Real Montanans helping you when you need it most. Through it all.
A division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of Blue Cross and Blue Shield Association.
Learn More or Enroll Today bcbsmt.com I 1.800.447.7828
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Blue Cross Blue Shield of MT GAME CHANGER: Health Information Exchange, or HIE, unlocks key to better patient outcomes
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ood information exists throughout Montana’s health care community, but access is hit-and-miss. And without extensive access to patients’ true medical history—electronic health records (EHR) and other clinical data—providers and insurers alike will continue to find it difficult to deliver on value-based care. Value-based care shifts reimbursement from fee-for-service to a model that rewards providers for the quality of care they deliver. The goal of value-based care is to create an efficient system where providers use proven techniques and treatments so patients receive quality, lasting and safe care at a reasonable cost. It’s impossible, however, to measure value without good data. That’s why Dr. Jon Griffin, Blue Cross and Blue Shield of Montana medical director, is spearheading a collaboration of Montana providers, facilities, insurance companies and other stakeholders to open up the flow of that information.
“The key to identifying value is information,” Dr. Griffin said. “The problem is, we don’t have access to the information we need. This is a very well-established problem, not only locally, but also at the federal level.” While EHRs are replacing paper records, many health care databases that store that information are unable to communicate because they reside in closed networks or use different software vendors. Among many other things, a lack of even basic information can result in dangerous medication or medical errors, or costly and unnecessary testing. “But there is hope,” said Dr. Griffin. That solution is known as a health information exchange (HIE). An HIE serves as a secure repository and conduit to electronically integrate information from different information systems. The ideal result for an exchange is a well-connected health care environment, where physicians have access to a patient’s true medical history the minute the patient walks through the door, and where insurers or other payers like Medicare and Medicaid can pair clinical data with claims data to develop value-based care programs. BCBSMT has taken a leading role in facilitating the process to establish a pilot HIE project in Billings. The goal, Dr. Griffin said, is to expand the HIE statewide in time. “HIE is still a concept and a vision here,” he said.
With Dr. Griffin’s leadership, the HIE pilot is nearing its launch. But it’s not just about one insurer or one provider participating. It’s about all the stakeholders in the health care system convening electronically to improve health care delivery. “This isn’t all about BCBSMT. We will certainly leverage it, but this is for everybody. This will function best if all the state’s providers and other payers are involved as well.” Other models of value-based care that BCBSMT has successfully implemented include patient-centered medical homes (PCMH) and accountable care organizations (ACO). A PCMH is a model of coordinated care led by a physician that puts patients at the center of all health care decisions. An ACO features a group of doctors or hospitals held accountable to their patients and payers for the quality, cost and effectiveness of the health care provided. Additionally, Dr. Griffin said BCBSMT is developing some specialty value-based programs in orthopedics and oncology. “Value-based care is all about partnering with providers and helping them develop a delivery system that leads to a better outcome and experience for patients, all while controlling cost,” Dr. Griffin said.
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Montana Vein Clinic Varicose Veins – Modern Treatment for a Common Problem by Andrew W. Grace, M.D., F.A.C.S.
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aricose veins are a common medical condition and occur when veins don’t efficiently carry blood back to the heart. Most frequently seen in the legs and feet, they can appear at the skin surface as small networks of blue or red veins (often called spider veins) or larger veins that bulge under the skin. Common symptoms along with leg discomfort include itching, burning, throbbing, fatigue, cramping, and heaviness of the legs. Symptoms are usually worse at the end of the day. Untreated varicose
veins slowly get worse with time and can cause problems such as superficial blood clots, leg swelling, skin changes or, in severe cases, skin ulcers. Anyone can get varicose veins but risks factors include a family history of varicose veins, being female, pregnancy, aging, and occupations that involve prolonged standing. The treatment of varicose veins has been fundamentally changed by modern medicine. Most people pursue treatment to alleviate discomfort, improve appearance, or prevent new veins from
forming. Accurate diagnosis requires an exam by a physician with expertise in varicose vein care and a high quality ultrasound test to identify abnormal veins. Modern treatments use minimally invasive techniques to close or remove poorly functioning veins. These procedures are safely done in the office, usually require only local anesthesia, and typically take less than one hour. Discomfort afterwards is minimal and most people resume normal activities the day of treatment. Larger surgeries which were
common years ago, such as vein stripping, are essentially obsolete with today’s vein treatments. Varicose vein treatment is safer and more effective than ever. A careful assessment and ultrasound evaluation is critical for success. Montana Vein Clinic is a dedicated, experienced, and local varicose vein treatment center. We see and take care of those with all types of varicose veins using the most current technology available. www.MontanaVeinClinic.com
Minimally Invasive | Outpatient | Fast Recovery
BOZEMAN’S EXPERT VARICOSE VEIN TREATMENT CENTER MOST INSURANCES ACCEPTED—INCLUDING MEDICARE
Vein problems can cause: Aching | Heaviness | Swelling | Throbbing | Itching
If this describes your legs, call us! Andrew W. Grace, MD, FACS
Diplomat of the American Board of Venous & Lymphatic Medicine Diplomat of the American Board of Surgery
MontanaVeinClinic.com (406) 414-5037
Promoting Healthy Legs...for Life
The only vein clinic associated with Bozeman Health Deaconess Hospital, we’re conveniently located on the Bozeman Health medical campus.
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ImprovIng LIfe, Sport, and Work. Serving the gallatin valley for 35 yearS!
Top 6 Reasons to See a Physical Therapist at APRS
bozemanaprs.com 10 Physical Therapists providing the highest quality and affordable care
ADVANCE PERFORMANCE & REHABILITATION SERVICES (APRS PHYSICAL THERAPY), WAS ESTABLISHED IN 1981. Our foundation is to provide the highest quality care at the most affordable price. What sets us apart? Our clinics offer physical therapists who are also Certified Strength & Conditioning Specialists, Athletic Trainers, Licensed Massage Therapists and Board Certified Specialists in the areas of orthopedics, sports, and vestibular care. APRS Physical Therapy is physical therapist owned and operated.
See a physical therapist: 1. To Reduce Pain. If you are struggling with ankle, foot, knee, shoulder, back or hip pain, a physical therapist can perform an evaluation and create a customized treatment plan. 2. For Work Related Injuries. If you get hurt on the job, our Montana Works Team is dedicated to working with you, your employer, your physician and your worker’s compensation company. Our goal is to get you back to work safely and as quickly as possible. In addition to injury
management, APRS provides pre-work screens for many employers. 3. To Avoid Surgery. Physical therapy has been shown to help prevent surgery in many cases and to minimize medical costs. 4. Following Surgery. Our physical therapists have vast experience working with both local and national surgeons to provide you with the best recovery.
ServiceS offered: Orthopedics: Pre and Post Operative Services • Injury Prevention • Performance Enhancement • Running Analysis • Orthotics • Manual Therapy Vestibular Therapy: Dizziness, Vertigo, and Concussion Management Workers Compensation Injury Prevention & Management.
5. For Concussion, Falls and Dizziness. Our Certified Vestibular Therapists have advanced training treating balance, vertigo, dizziness and concussion. 6. For Sport Injury Prevention. Our Board Certified Sports Physical Therapists can help you reach your potential with the use of video analysis, custom orthotics and individualized sport specific training programs.
2 Convenient Locations Visit us at bozemanaprs.com, or call one of our two locations (APRS East at 406-587-4501 or APRS West at 406-404-1897) for more information.
east clinic 1532 ellis St., Suite 201 587-4501 West clinic 4515 valley commons Drive Suite 101 • 404-1897
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G R I L L E D P O TAT O S A L A D 4 red potatoes, sliced into 1� pieces 4 yellow potatoes, sliced into 1� pieces 2 Roma tomatoes, seeded and chopped coarsely 1 cup baby arugula leaves, chopped 1/2 cup pitted kalamata olives, halved 1/2 cup banana pepper rings 1 Tbsp capers 3 Tbsp red wine vinegar 2 Tbsp olive oil, divided 1/2 tsp red pepper flakes 1/2 tsp dried parsley flakes 1 tsp ground mustard 1/2 tsp salt Fresh ground black pepper
Place potato slices into a medium bowl. Drizzle with 1 Tbsp olive oil and toss to coat. Place slices onto a medium-high heated grill. Grill potatoes for ~4 minutes on each side, until grill marks appear. When slices are cooked, remove from heat and allow to cool. Whisk together vinegar, remaining olive oil, parsley, red pepper flakes, ground mustard, salt and pepper. Stir in pepper rings, chopped tomatoes, olives and arugula. Set aside. When potatoes have cooled, cut each slice into quarters and gently fold chunks into vinegar mixture. Serve immediately! Nutrition Info per 1/2 cup serving: 147 calories, 5.5 g fat, 4 g protein, 26 g carbohydrates, 3.5 g fiber
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GRILLED FRUIT YOGURT DIP 1 cup low fat plain yogurt or 2% Greek yogurt 1/2 tsp ground cinnamon 1 Tbsp honey or 1 Tbsp balsamic syrup (reduced balsamic vinegar) Whisk ingredients together until smooth.
Acorn Pediatrics
provides superior healthcare from Cradle to College! Call to schedule for Well Visits, Sports Physicals, Sick Visits, Immunizations, and Urgent Care! Now Accepting New Patients! 1819 S. 22nd Avenue, Suite 100 (406) 522-5437 www.acornpediatrics.com
Celebrating 20 Years in Business! 406-453-1613 or 1-800-541-2417 Mark F. Ozog M.D. 1417 9th Street South #100 | Great Falls, MT 59405
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Call today to schedule your free initial screening! 1484562
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Advanced Medical Imaging New Tool for Early Breast Cancer Detection
Great strides have been made in the fight against breast cancer, but doctors agree the best defense against this all-too-common disease continues to be early detection. Survival rates for breast cancer patients are dramatically affected by early detection, with a five-year survival rate of almost 100 percent if the cancer is found before it has spread to lymph nodes. Fortunately, great minds have developed Genius™ 3D digital mammography, or tomosynthesis, to make it easier for physicians to detect even very small breast cancers and it’s available at Advanced Medical Imaging (AMI), located in the Bozeman Health complex. “Because our primary goal has always been to deliver the highest quality care to our patients, we were first in the state to add breast tomosynthesis to our
breast health services in 2012,” said AMI Director Courtney Funk. “We chose Genius™ 3D mammography because it’s the only mammography exam proven to detect 41% more invasive breast cancers and reduce false positive results by up to 40%.” In a standard two-dimensional mammogram image, overlapping normal breast tissue can prevent physicians from seeing cancer. This can result in a negative report even though the patient may have breast cancer. On the other hand, pockets of dense but benign tissue can be seen as suspicious, requiring additional testing. Genius 3D mammogram images lessen the impact of overlapping tissue, making them easier to read. The imaging system allows doctors to examine breast tissue one layer at a time, using high-powered computing to convert digital breast
images into a stack of very thin layers or “slices” for review. In fact, Genius™ 3D mammography is like reading a book. If you look at just the cover, you cannot see the individual pages. However, a 3D mammogram allows you to open the book and go through it page by page. Singer Sheryl Crow, who was diagnosed with breast cancer in 2006, recently told People Magazine, “Every woman should have the opportunity to have the best kind of mammography. The Genius 3D Mammography exam is proven to detect breast cancer 15 months earlier than any 2D mammography. It’s the best way, really, to prevent breast cancer from being a terrible prognosis.” A Genius exam is very similar to a traditional mammogram, but the X-ray arm sweeps in a slight arc over the breast, taking
multiple breast images in just seconds. Very low X-ray energy is used during the screening examination so radiation exposure is below federal guidelines. There is no additional compression required, and it only takes a few seconds longer for each view. “We are excited to offer this breakthrough technology to patients in the Gallatin Valley and surrounding areas,” said AMI breast care specialist Cindy Carter PA-C, CBPN-IC. “We believe 3D digital mammography will benefit all breast imaging patients. We are committed to the fight against breast cancer.” For further information or to schedule an exam, please call 406-556-5200 or visit www. amibozeman.com.
3D Digital Mammography can save your life. Tomosynthesis, or 3D Digital Mammography, is helping us to detect breast cancer at its earliest stages, while helping us to reduce unnecessary call backs. And, our latest statistics show that 73% of breast cancers detected locally in 2010— due in large part to digital screening—were at stage II or earlier. And, women diagnosed within these early stages have over a 90% five-year survival rate. We won’t be satisfied until we’ve eliminated breast cancer altogether, but we’re thankful for the advances in medical imaging we’re able to offer and the many lives being saved as a result.
Bozeman Health & Intercity Radiology
amibozeman.com | 406-414-5201 | Bozeman, MT
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QUALICARE ® FAMILY HOMECARE The name is new in Bozeman, but the people behind Qualicare® Big Sky Family HomeCare have a long history in both the health care profession and Gallatin County. Fifth-generation Gallatin Valley resident and company owner Jen Krum, RN, has been a nurse for 25 years and managed a skilled home health and private duty agency. Client Services Director Suzette Kuntz, a Certified Nurse Aide, has worked with area residents and coordinated private duty care since 2010. “Working as long as I have in health care, I’ve seen some gaps that are very fillable,” Krum said. “Our care is nursemanaged. An RN sees every client. Our 360-degree approach ensures that all needs are being met, and all of our staff are, at minimum, certified nurse aides.” The company provides home care, hospital support, care for clients transitioning from hospital to home, escorted transportation, and collaborative representation and communication for clients
and their families and other health care providers. “We serve all ages and all levels of need, from a new mom needing support in her first week home from the hospital to respite and palliative care to supplement the hospice team. We provide care for the continuum. It’s family care. We take to heart that when there’s a major impact on someone’s health it affects the whole family. We take on the stressful pieces, providing professional care and representation for the family with health care providers, so spouses, children and other family members can maintain their roles as family.” Qualicare provides flexible healthcare options up to 24/7, short- or long-term for acute and chronic conditions, with extensive experience with dementias, mental illness and a wide range of medical and surgical care. The company assists individuals in Gallatin, Park and Madison counties and surrounding areas.
MONTANA SKIN CANCER AND DERMATOLOGY CENTER Montana Skin Cancer & Dermatology Center Using Mohs Surgery While there are a number of treatment options available for skin cancer, one has proved the most effective over the years in treating various skin cancer types: Mohs surgery. According to Aaron Bruce, DO, owner of Montana Skin Cancer and Dermatology Center, Mohs surgery is used to treat the most common types of skin cancers, including basal cell carcinomas and squamous cell carcinomas. It is used when tumors are located on delicate structures such as the ear, eyelid, nose or lip. Information posted on the Montana Skin Cancer and Dermatology Center website indicates that “with the Mohs technique, physicians can
precisely identify and remove an entire tumor while leaving the surrounding healthy tissue intact and unharmed.” The surgery is done in the office, under a local anesthetic in about two to four hours. A narrow margin of skin around the tumor is removed – keeping the hole as small as possible – and checked in the lab while the patient waits. This ensures complete removal of the cancer. “Before we put in one stitch, we know the tumor is gone,” Bruce said. Mohs surgery offers the “highest cure rate of any modality for these types of skin cancers,” he added. For more information about Mohs surgery, visit www.montanaskincancer.com.
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Healthy Meal Option G R I L L E D F R U I T P L AT T E R This is hardly a recipe. Basically, I am just telling you that grilled fruit is a delightful summer dessert! Here are a few fruits that grill wonderfully: Apricots, halved Bananas, peeled Peaches, halved Pineapple, sliced into rings Pears, sliced into thick slices Melon - I used honeydew Strawberries Mangoes, sliced into thick slices
Instructions: Preheat grill to medium-high heat. Spray grill lightly with cooking spray after grate has been cleaned (with a scraper is fine). Lay pieces of fruit on grill and cook for ~3-4 minutes on each side, depending on grill temperature. Flip when grill marks appear. Remove from heat and serve with a side of grilled fruit yogurt dip.
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Preheat grill to medium heat
G R I L L E D PA S TA PA C K E T S 1 lb whole grain spaghetti, cooked slightly less than al dente per package instructions (subtract 1 minute from cooking time) 6 Roma tomatoes, seeded and chopped 1 cup fresh basil leaves, chopped coarsely 4 oz fresh goat cheese 1 lemon, cut into 6 wedges 1/2 tsp salt 1/4 tsp fresh ground black pepper 3 cloves garlic, finely minced 3 Tbsp olive oil me)
Cut one dozen 8x12-inch pieces of aluminum foil. Layer foil so that you are using 2 per packet. In a bowl, toss together pasta, chopped tomato, basil, salt, pepper, garlic and olive oil. Spoon one serving of pasta mixture (~1-1/4 cups) into the center of each packet. Squeeze lemon wedge over pasta before adding to packet. Spoon a few teaspoons of goat cheese into packet. Bring long edges of foil together, then roll to secure. Roll edges of packet to form a closed space (do not squeeze out all air). Reduce grill heat to low, then place packets on grill. Cook for 10-12 minutes, shaking packets halfway through cooking.
Remove from grill and serve immediately Nutrition Info per 1 packet as shown above: 224 calories, 11 g fat, 8 g protein, 20 g carbohydrates, 4.5 g fiber
INTEGRATIVE THERAPIES AT CANCER SUPPORT COMMUNITY
Join Us.
There is strength in Numbers. You Count. Welcome to Cancer Support Community. A place where you walk through the door as one touched by cancer and instantly become part of something much bigger, much stronger. Through education, support and encouragement, everyone speaks the same language. You are not alone on this journey. You are part of a community. You count. Ensuring that all people impacted by cancer are empowered by knowledge, strengthened by action, and sustained by community.
Partnering with Bozeman Health Cancer Center www.cancersupportmontana.org 1484505
Cancer is difficult. When a person is diagnosed with cancer, stress, depression and anxiety are increased and can affect how well the patient responds to medical treatment. Side effects of fatigue, nausea and pain can cripple quality of life as people seek to continue working, playing and living during their cancer journey. Integrative medicine is the combination of all appropriate therapeutic approaches, healthcare professionals and disciplines to emphasize wellness and health of the whole person. Using conventional Western medicine and complementary therapies, the goal is to enhance patient-centered care. Cancer Support Community provides many of these services. Examples of Integrative Therapies include nutrition education, acupuncture, yoga, QiGong,
support groups, meditation and other ways that address holistic approaches to wellness. Experts stress that complementary or integrative therapies are not the same as “alternative medicine.” Complementary therapies for cancer are designed to complement – not replace – traditional treatments for cancer, and are offered as a way to help manage the side effects of having a cancer diagnosis and the process of moving through treatments. Integrative Therapies are available for all cancer patients in the Gallatin Valley and, like all Cancer Support Community activities, are free of charge. To find out how to participate in the programs at Cancer Support Community, go to www.cancersupportmontana.org, call us at 406582-1600 or find us on Facebook.
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P E P I TA S S H R I M P SKEWERS ~50 shrimp, peeled, de-veined, tail-on 1 medium Anaheim chile, roasted, peeled and seeded (see below) 1/4 cup roasted pepitas 1 large garlic clove, pressed and minced 1/4 tsp ground black pepper 1 tsp salt 1/2 cup Canola oil 2 Tbsp cup red wine vinegar 3 tablespoons grated cotija cheese (or shredded Parmesan) 1 small bunch cilantro, stemmed 1-1/2 cups lowfat yogurt
Instructions:
Place Anaheim chile on a grill and cook until charred on all sides (rotate throughout cooking), ~ 10 minutes. Allow to cool. Peel off skin and cut off top of chile. Remove seeds with fingers and slice flesh. Place all ingredients except cilantro, yogurt and shrimp in a blender or food processor. Blend about 10 seconds, then add cilantro little by little until blended smooth (reserve some cilantro for garnish if desired). Place yogurt in a medium stainless steel bowl and mix with a wire whip until smooth. Add the blended ingredients and mix thoroughly. Add shrimp to mixture. Refrigerate at least 3 hours. 20 minutes prior to cooking, soak bamboo skewers in water (to prevent burning). Preheat grill. Skewer 5-6 shrimp on each stick. Cook over medium heat until done (~10-15 minutes). Nutrition Info per 2 Tbsp pepitas dressing/ marinade: 101 calories, 6 g fat, 3 g protein, 3 g carbohydrates Nutrition Info per 8-9 shrimp: 55 calories, 1 g fat, 11.5 g protein, 0 g carbohydrate, 107mg cholesterol Recipes and photos courtesy of Lindsay Kordick; from her blog: Eighty Twenty www.eat8020.com
Lindsay Kordick has been a registered dietician with Bozeman Deaconess Hospital for more than six years. She is also an Certified Exercise Specialist and writes a blog featuring recipes based on her 80/20 principle - eating wholesome, healthy meals 80 percent of the time and indulging a bit 20 percent of the time.
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W E L L N E S S R E S O U R C E 2016 | B I G S K Y P U B L I S H I N G | B O Z E M A N D A I LY C H R O N I C L E