ASPIRE Connecting to a healthier you
SPRING 2018 • VOLUME 2, ISSUE 2
Robotic surgery
is down to a
SCIENCE
Technology leads to fewer complications AN? p. 7 E and a faster recovery p. 3 M N I A P G E HAT DOES L
plus
P p. 2
RM-U A W T I U S BATHING
IES p. 6 | R E V O C S I D S | DIABETE
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SPINE SURGERY NEW PROGRAM PREPARES PATIENTS FROM PREHAB TO RECOVERY p. 4
Linda Stever’s experience with roboticassisted surgery at Longmont United Hospital was positive and pain-free.
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Get set for summer Prep your body for a season of activity
Spying the first tulip of the season may have you rushing to trade your fuzzy slippers for hiking boots. But while you’re no doubt mentally ready for summertime activities, jumping back into a fitness routine after months of being sedentary can lead to injury. Are you physically prepared? “The ideal way to protect yourself from such problems is to stay active year-round,” says Marek Odehnal, MD, an internal medicine physician with CHPG Primary Care Longmont. Dr. Marek Odehnal “But if winter weather slowed you down, you’ll need to restart your activities at a much lower pace and gradually increase the intensity.” Here are some ways to prepare: ACTIVITY
RISK
PREPARE YOURSELF
Hiking
Ankle sprains
Stabilize your ankles with single-leg dips: Stand on one foot, look at your toes, and do a squat until your knee covers your toes.
Mountain biking Pulled leg muscles
Strengthen your hamstrings, quads, and glutes before getting on a bike. Start with squats and lunges and then try jump squats and split squats (where one leg is in front of your body and the other behind).
Golfing
Back pain
Strengthen your back and core with physioball twists: Lie on your back on a physioball and hold a dumbbell straight up with both hands. Engage your core and twist to one side, and then the other.
Kayaking
Shoulder strain
Protect your rotator cuffs with external rotations: Hold a dumbbell and bend arm 90 degrees so forearm is parallel to ground. Rotate weight out 90 degrees from your body.
To make an appointment with Dr. Odehnal, call 720-652-8400.
WHAT’S NEW IN WEIGHT LOSS? Aiming to fit into that swimsuit by summer? Here’s what’s new in weight loss science:
Try rye.
Whole grains — particularly rye — make you feel fuller longer, confirmed a study from the Technical University of Denmark. Instead of processed white grains, opt for whole wheat, rye, barley, oats, and brown and red rice.
Embrace resistance.
Dieting isn’t the only path to weight loss. Seniors who incorporated resistance training lost 17 pounds after 18 months, compared with seniors who dieted only and lost an average of 10 pounds, according to a study published in the journal Obesity.
Beware “healthy” foods. Watch
out for clever marketing. You’re more likely to overeat when foods are labeled “healthy,” according to a study published in the journal Appetite. You’re better off sticking to a single serving of “indulgent” eats.
ASPIRE is published four times annually by Longmont United Hospital. Executive editor is Kirsten Pfotenhauer. As part of Centura Health, our mission is to nurture the health of the people in our community. The information herein is meant to complement and not replace advice provided by a licensed health care professional. For comments or to unsubscribe to this publication, please email us at aspire@centura.org. ASPIRE is produced by Clementine Healthcare Marketing. 1950 Mountain View Avenue | Longmont, CO 80501-9865
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LONGMONT UNITED HOSPITAL
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The robot will see you now W
hen people hear the word “robot,” they can worry about losing the human touch. But, you can relax. With robot-assisted surgery, the surgeon is always in control — plus, he’s better able to perform complex procedures with increased flexibility and precision. “The instruments are controlled by the surgeon,” says Longmont United Hospital surgeon Chris Webster, MD. After making small incisions, Webster uses a three-dimensional camera, which magnifies the surgery area, providing better visualization. Often, robot-assisted technology makes minimally invasive surgery possible. The benefits of that method include: ➠ Fewer complications ➠ Less pain ➠ Less bleeding ➠ Quicker recovery ➠ Smaller scars
Dr. Chris Webster
Robotic surgery brings less pain, but substantial gain When her surgeon told Linda Stever he would be performing robot-assisted surgery, she says, “My daughter and I just looked at each other like ‘What?’ But he assured me he was going to run the robot.” Stever hadn’t heard of robot-assisted surgery. But her doctor, Longmont United Hospital surgeon Chris Webster, MD, has been using robot-assisted technology for more than a decade. Stever had an obstruction in one of the tubes, called ureters, that carry urine from the kidneys to the bladder. Looking back, the 71-year-old suspects she had it for years. “I felt like I had to go to the bathroom all the time, but couldn’t. I was getting urinary tract infections a lot,” she says. Stever just thought it was a natural part of aging. That is, until the morning in March 2017, when she “woke up in so much pain I could barely move.” Physicians at Longmont United Hospital’s emergency room diagnosed the problem, and referred her to Webster. The surgery repaired the blockage, restored her urinary function, and, “I went home the day after, and never had any pain from the surgery,” Stever says. “It’s fantastic. That’s all I can say about the robotic surgery.”
The Center of Excellence in Robotic Surgery (COERS) program ensures that the safest, highest quality of care is delivered to robotic surgery patients worldwide. Longmont United Hospital is one of only two hospitals in Colorado designated as a Center of Excellence in Robotic Surgery for its unparalleled commitment and ability to consistently deliver safe, effective, evidence-based care.
What can robots do for you? Since robot-assisted surgery using the da Vinci® surgical system was approved in 2000, the technology has been used for a growing number of procedures. In his practice, Longmont United Hospital surgeon Chris Webster, MD, uses the system to perform a number of urologic and gynecologic procedures, including: ➠ Remove or repair kidneys ➠ Repair vaginal prolapse ➠ Remove cancerous tissue in the kidney, prostate, or bladder ➠ Repair enlarged prostate
<< Linda Stever revisits the OR where her successful robot-assisted surgery was performed.
303-651-5111 | LUHCARES.ORG
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SURGERY BY THE BOOK From prehab to rehab, new spine program helps patients prepare for surgery
A
ny surgery can be scary, but for some patients, spine surgery is especially intimidating. Now, a new program at Longmont United Hospital — where some 200 spine surgeries are performed each year— is taking much of the fear and uncertainty out of the process. The spine surgery preparation program, which began in January, includes a twice-monthly class that informs patients about what to expect, and helps get them physically and emotionally ready for surgery and recovery. “We cover from start to finish what a patient should expect — pre-operation, during surgery, and during their hospital stay — and then the most important aspects of what they will experience for several weeks after Dr. Matthew Gerlach they return home,” says Longmont United Hospital spine surgeon Matthew Gerlach, MD. “When a patient is better informed, and has a better sense of what they are going to experience, that tends to result in better outcomes for the patient.” The program, modeled after the hospital’s successful preparation classes for joint replacement surgery, includes a take-home book filled with information and answers to potential questions. Patients in the program also participate in “prehab,” says Allan “Tripp” Nanney, III, MD, spine surgeon at Longmont United Hospital. Many spine surgery patients have been in pain or debilitated for a while, Nanney says. “Because of the pain, they may have become less active and experienced loss of muscle mass or decreased mobility and weight gain. We want to give them an opportunity to get into better shape before surgery, which helps with recovery after surgery.” Prehab involves strengthening exercises for the core, arms, and legs, because patients will rely on those muscles to move around after surgery.
Pump It Up
Ankle pump exercises are part of the spine surgery preparation playbook, but they’re good for anyone on a long flight, or who sits all day. They get blood pumping, helping it flow back up to the heart, which can prevent swelling, says Sally Barbe, RN, director of acute care services at Longmont United Hospital. And they’re simple to do: Extend legs, and then flex and straighten your ankles quickly. Repeat 20 times.
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LONGMONT UNITED HOSPITAL
GET BACK INTO LIFE The right surgery, at the right time, for the right patient can relieve pain
S
ooner or later, almost everyone will experience some back pain.
Because most of that pain will go away on its own, few people will need spine surgery, according to Longmont United Hospital spine surgeons Matthew Gerlach, MD, and Allan “Tripp” Nanney, III, MD. Gerlach may be a spine surgery specialist, but surgery is rarely the first recommended treatment option. Most patients get better with conservative forms of treatment. “I see a fair number of patients who don’t know I’m a spine surgeon.” No matter the diagnosis, spine surgery has become much more refined and precise in recent years, he says. “Longmont United Hospital has an intraoperative CT scan system that is one of the most advanced imaging techniques available, allowing for extremely precise placement of implants.” Gerlach and Nanney go over the most important criteria for spine surgery:
Dr. Tripp Nanney
The right problem Surgery to relieve pain from spondylolisthesis, a condition in which one vertebra slides forward over the bone below it, has high success rates, Nanney says. Certain other spine conditions respond well to surgery, while some don’t so it’s important to ask your physician about outcomes for your particular diagnosis.
The right time “If a patient is three weeks into a flare-up of back pain, surgery is rarely recommended at that stage,” Gerlach says. “You should always exhaust physical therapy, steroid injections, and chiropractic treatment first — and give it time. A lot of these problems will resolve on their own.”
Two patients with the same condition can have very different outcomes, Nanney says. The patient’s overall health and fitness before the surgery can have a significant impact on the success of surgery.
! Don’t be swayed by practices that market “laser” spine surgery, advises Longmont United Hospital spine surgeon Tripp Nanney, MD. “Laser surgery does not have any well-accepted role in spine surgery. If it did, we’d all be doing it.”
303-651-5111 | LUHCARES.ORG
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The right patient
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Blood Sugar Solutions INSULIN RESISTANCE Despite its reputation, the hormone is nothing to fear
Dr. Iratxe Eskurza Garcia
In the past decade, several new medications are giving patients and physicians more alternatives to insulin injections, says endocrinologist Iratxe Eskurza Garcia, MD, of Centura Health Physician Group Endocrinology Longmont.
Two types: • Sodium-glucose co-transporter 2 (SGLT2) inhibitors lower blood glucose by increasing glucose excreted by the kidneys, and helping the body release glucose. • Glucagon-like peptide-1 (GLP-1) receptor agonists, which can be injected daily or weekly, not only control blood sugar, but have been shown to aid weight loss. One GLP-1 receptor agonist also reduces cardiovascular death in patients with heart disease and type 2 diabetes. “This is a new piece in diabetes treatment. Up to this point we were reducing A1C, but not mortality and heart disease,” Eskurza Garcia says. Medications offer great benefit, Eskurza Garcia says. But she cautions against relying solely on them. “The biggest effect I ever see in controlling type 2 diabetes is lifestyle changes. We don’t have any medicine that can make as big an impact as that.” To schedule an appointment with Dr. Garcia, call 720-652-8680.
A big part of Dorothy Price’s job involves replacing diabetes myths with facts. Price, RN, MSN, a certified diabetes educator and Longmont United Hospital’s diabetes education program coordinator, says some common myths about insulin include that it causes health complications and that injections are painful. “Insulin got a bad rap years ago,” Price says, because physicians hesitated to prescribe what used to be painful injections, waiting until the disease progressed. So, insulin became associated with diabetes complications. Many type 2 diabetes patients will need insulin. But Price says that’s nothing to fear. New pens make injection easy and nearly painless. “We need to make friends with insulin. It’s not a drug; it’s a natural hormone the body needs.”
Longer Life Brewing? If you’re a woman with type 2 diabetes, have a cup of coffee — it could help you live longer. Portuguese researchers found women with type 2 diabetes who drank coffee were 51 percent less likely to die than women who were caffeine-free. Curiously, the benefit did not extend to men.
Learn to better manage your diabetes with our Diabetes SelfManagement program. To learn more, call 303-485-4195.
SURPRISING SUGAR SPIKERS It’s not just cupcakes that make blood sugars soar. Some surprising triggers include:
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Caffeine
Sunburn
Dehydration
Losing Sleep
Blood sugars may be sensitive to the stimulant.
The pain causes stress, which spikes blood sugars.
When water levels in the body drop too low, blood sugar gets too high.
Just one night of inadequate sleep can make your body use insulin inefficiently.
ASPIRE
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LONGMONT UNITED HOSPITAL
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If the soaring rates of type 2 diabetes have brought any benefit, it may be greater understanding of the disease, and a growing variety of ways to treat it.
Listen to your legs Leg pain can be a sign of a dangerous condition that also can lead to heart attack and stroke Most of us know chest pain can be a sign of heart disease — and a reason to see a doctor, fast.
WHEN IT HURTS, WALK IT OFF For many patients with peripheral artery disease, starting and sticking to a simple exercise regimen can help relieve the pain, says Longmont United Hospital cardiologist Jim Beckmann, MD. The regimen: Walk five minutes, rest two minutes, and repeat six times, for a total of 30 minutes. Unfortunately, exercise is often the thing that hurts most, so many patients give it up. “When they exercise less, they don’t have symptoms,” Beckmann says. “But the absence of exercise actually speeds progression of the disease.” Rehabilitation programs, which allow patients to exercise with assistance, help increase odds of success, he says.
For information on Longmont United Hospital’s cardiac rehab program, call 303-678-4000.
Peripheral artery disease (PAD) risk factors Your chances of developing PAD increase with age, and the risk is greater at any age if you smoke or have:
♦ Diabetes
♦ High blood pressure
♦ High cholesterol
ERECTILE DYSFUNCTION, ESPECIALLY IN MEN WITH DIABETES, CAN BE A SIGN OF PERIPHERAL ARTERY DISEASE.
Fewer people know that leg pain when walking also could signal significant cardiovascular trouble in the form of peripheral artery disease (PAD). Dr. Jim Beckmann Untreated PAD can be dangerous because it can lead to loss of a leg, and patients with PAD have an increased risk of coronary artery disease, stroke, and heart attack. Longmont United Hospital cardiologist Jim Beckmann, MD, who leads the hospital’s new vascular program, wants to make more people aware of PAD, and to know that it is treatable. “It’s an emerging field. People are becoming more aware of it, and our ability to treat it has improved as well,” Beckmann says. PAD is usually caused by atherosclerosis, or plaque buildup, in the peripheral arteries, usually of the legs. That plaque restricts blood flow, and pain can result. Diagnosing peripheral artery disease involves a simple, noninvasive test. “Everyone’s had their blood pressure taken. We can do the same thing at the ankle,” Beckmann says. “Then we compare the two blood pressures – the arm with the leg pressure – they should be the same. But if the pressure at the ankle is lower, that probably indicates PAD.” Treatment usually begins with a prescription for exercise. But if the condition worsens, tests can pinpoint exactly where the blood flow slows, and a minimally invasive procedure, done in the hospital’s cath lab, can remove the plaque buildup and deposit a drug that opens up the clogged artery. Most patients go home the next day, Beckmann says, and their leg pain is improved.
“Everyone’s had their blood pressure taken. We can do the same thing at the ankle.”
! Longmont United Hospital is part of the Centura Health Heart & Vascular Network. With more than 120 cardiovascular experts, the network is one of the region’s leading providers of comprehensive heart care. 303-651-5111 | LUHCARES.ORG
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NON-PROFIT ORG US POSTAGE
TIPS FOR
crisis HELPING A
TEEN IN
PAID
DENVER, CO PERMIT NO. 3280
1950 Mountain View Avenue Longmont, CO 80501-9865
f a teenager close to you was experiencing a mental health crisis, would you recognize the signs? Would you know what to do? Youth Mental Health First Aid, a free, eight-hour course offered at Longmont United Hospital in partnership with the Supporting Action for Mental Health coalition, can help participants understand the risk factors and warning signs of youth mental health issues. Designed for parents and family members, teachers and school staff, peers, and anyone who works with or cares for teens, the course provides the tools necessary to help an adolescent in need. The course offers a five-step action plan for helping young people who are experiencing anxiety, depression, substance use, eating disorders, and other challenges.
To register or to learn more about Youth Mental Health First Aid, call 303-651-8469.
2018 CALENDAR
SENIOR SHOWCASE
Join us on Friday, May 4, for information on health and safety services being offered by Longmont United Hospital and their partners. Longmont Meals on Wheels will showcase “Project Homecoming” for all patients coming home from the hospital. Longmont Senior Services and AgeWell representatives will showcase exercise activities, educational programs, and resources to assist older adults in remaining in their homes. When | Fri, May 4, 10 a.m.-2 p.m. Where | Longmont United Hospital Cost | FREE
LUH FOUNDATION LEARNING CENTER PRESENTATIONS
We are excited to introduce the Innovative Learning Center at Longmont United Hospital and invite you to a presentation in partnership with the LUH Foundation. The presentation will include demonstrations on the Simulators (Sim Man, Sim Mom, and Preemie Annie) and the center. Come to learn how the Innovative Learning Center elevates the training capabilities of our hospital and makes us stand out on a national level. When | Call for specific dates Where | Longmont United Hospital Cost | FREE Registration | 303-485-4190
VOLUNTEER OPPORTUNITIES
Our Volunteer Services team is seeking individuals interested in volunteering in a hospital setting. Individuals may choose to volunteer in a variety of capacities such as informational and visitor areas, patient contact areas, office support, and specialty programs. We have opportunities for both adults and teens to serve as volunteers at LUH. Our Junior Volunteer program is a great opportunity for students interested in pursuing a career in the medical field to receive firsthand experience in a hospital environment. For more information or to apply, please contact our Volunteer Office at 303-651-5205 or visit luhcares.org/ volunteer.
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SPRING
Longmont United Hospital is part of Centura Health, the region’s leading health care network. Centura Health does not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, and marital status in admission, treatment, or participation in its programs, services and activities, or in employment. For further information about this policy, contact Centura Health’s Office of the General Counsel at 303-673-8166 (TTY: 711). Copyright © Centura Health, 2018. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 303-485-3439 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 303-485-3439 (TTY: 711).