Bloom Fall 2017

STROKES STRIKE YOUNGER | HEALTHY AGING STRATEGIES | TAMING HYPERVIGILANCE

Penrose-St. Francis Health Services

Nurturing women’s health in Colorado Springs

SHAPE UP

YOUR HEART Ornish program reverses disease with a little love, support, good food, and movement

STOP

BACK PAIN with spinal cord stimulation

FALL 2017 Volume 7, Issue 4

Page 8

HealthyStart

STROKE OF MISFORTUNE

YOUTH ISN’T A CERTAIN PROTECTOR AGAINST A DEBILITATING BLOCKAGE About 8 out of 10 people have high blood pressure at the time of their first stroke.

The proportion of people with at least three of the five major risk factors for stroke — high blood pressure, diabetes, high cholesterol, obesity, and smoking — rose in all age groups between 2003 and 2012, but soared most in adults aged 35 to 44.

Between 1987 and 2011, deaths from stroke decreased by 40%, possibly due in part to better treatment and fewer people smoking.

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ust because you’re not ready for retirement doesn’t mean you’re immune from having a stroke.

In fact, a recent study found that the greatest increase in the number of people hospitalized with a common type of stroke was among those aged 35 to 44. And researchers speculate that Dr. Riz Khan some of the major risk factors for stroke — smoking, diabetes, heart disease, high cholesterol, and obesity — may be partly to blame.

Ischemic stroke, the most common type, occurs when a clot blocks an artery carrying blood to the brain, says Riz Khan, MD, a neuroendovascular surgeon with Centura Health Physician Group Penrose Neurosciences. Those clots typically result when blood flow is restricted, he says. High cholesterol, diabetes, high blood pressure — all linked to obesity — along with smoking, can cause damage that restricts blood flow.

His best advice for reducing your stroke risk: Get blood pressure and diabetes under control. And if you smoke, stop.

Strokes most often occur without warning, so it’s important to remember F.A.S.T., Khan says: Face drooping Arm weakness Speech difficulty Time to call 911

Not good, says Albina Gadeliya, MD, with Centura Health Dr. Albina Gadeliya Physician Group Primary Care Tri-Lakes.

In addition to the empty calories, dark soft drinks can increase osteoporosis risk. How that happens is disputed but one theory is that in order to neutralize soda’s acid, the body actually pulls calcium out of bones, Gadeliya says.

Light-colored sodas aren’t in the clear, either. Sodas of all colors are brimming with high fructose corn syrup, which slows metabolism and becomes toxic to the liver. A soda or two daily increases risk of fatty liver disease, a precursor to cirrhosis.

But don’t drown your sorrows in diet soda either. The artificial sweeteners in those can be carcinogens, Gadeliya says.

Need a final reason to put down that soda? Citrus-flavored soft drinks may contain brominated vegetable oil, which is used as a flame retardant.

FAST FACT Soda is the No. 1 source of added sugar in the American diet.

“It’s true that time is brain. Each half hour blood to the brain is blocked, you lose 10 percent of the neurons in the brain,” Khan says.

bloom is published four times annually by Penrose-St. Francis Health Services. Executive editor is Jill Woodford. As part of Centura Health, our mission is to nurture the health of the people in our community. The information herein is meant to complement and not replace advice provided by a licensed health care professional. For comments or to unsubscribe to this publication, please email us at bloom@centura.org. bloom is produced by Clementine Healthcare Marketing.

2222 North Nevada Avenue, Colorado Springs, CO 80907

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Penrose-St. Francis Health Services

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HOW BAD IS IT ...

TO DRINK SOFT DRINKS?

FOR THE MAN IN YOUR LIFE

GET A GRIP ON TESTICULAR HEALTH

PREVENTING OSTEOPOROSIS AFTER A HYSTERECTOMY

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he risk of osteoporosis — weak and brittle bones that fracture easily — suddenly increases after a hysterectomy that involves the removal of ovaries along with the uterus — even for younger women. “Women undergoing hysterectomy (with ovary removal) before they would normally go through menopause are more likely to develop osteoporosis than other women,” says Carlos A. Dube, MBA, director of imaging services at Penrose-St. Francis Health Services.

Regular bone density tests, or dual-energy X-ray absorptiometry (DEXA) scans, help women who’ve had a hysterectomy prevent osteoporosis.

This test uses X-rays to measure the amount of calcium and other minerals in the bone, and shows the risk for developing fractures. Get a baseline DEXA scan the year after a hysterectomy, with follow-up scans every two years. “Having the necessary DEXA scans can help you maintain a healthy lifestyle,” Dube says.

Call 719-776-8010 to schedule your DEXA scan and mammogram during one visit at the Center for Women’s Imaging.

T

he power to detect testicular cancer is in your man’s hands. A monthly self-exam is the best way to find testicular cancer early — which is especially important for high-risk 20- to 35-year-olds. Yet, many men don’t do it, or wait to see a doctor after finding something.

So what are they feeling for? Testicles normally feel smooth and soft — somewhat like hard-boiled eggs. Testicular cancer feels firmer and can be in the form of a mass, lump, or nodule.

“He should check himself once a month in a warm shower, when the skin is relaxed and it’s easier to feel anything abnormal,” says Scott RISK Jennings, MD, a urologist at Penrose-St. Francis Health Services.

FACTORS “The minute he identifies something abnormal, he should be on An undescended testicle the phone to his doctor saying he needs to be checked out. Days don’t make a difference, but weeks can.” More than 99 percent Family or personal history of testicular cancer of testicular cancers are curable when found early.

HIV infection Carcinoma in situ of the testicle Caucasian

While younger men need to worry about testicular cancer, older men should focus on prostate cancer risk.

To request a FREE guide about prostate screenings, send an email to bloom@centura.org with a “PSA Guide” in the subject line.

SAME-DAY SERVICE WHEN YOU’RE FEELING SICK Have a sore throat or fever that needs checking right away?

Centura’s new online service, sameday.centura.org can save the day. You can now use that website to find a Centura Health Physician Group (CHPG) primary care provider near you who has an opening, and schedule your same-day appointment online. You can choose a provider by name, appointment time, or geographic preference.

Not only will you be seen the same day, but the provider you choose can access your health record through our Centura network.

This alternative to urgent care lets you save money, see a Centura network provider, and start feeling better right away.

penrosestfrancis.org

If you’re an existing patient of a CHPG prirmary care provider, bookmark sameday.centura.org for the next time you need to schedule a same-day appointment!

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PUT A LITTLE IN YOUR HEART HEART DISEASE CAN BE REVERSED WITH DIET, EXERCISE, STRESS MANAGEMENT — AND LOVE

40%

Participants in the Ornish program lowered LDL cholesterol (the bad type) by an average of 40 percent.

Kristen Reisinger combats heartdamaging stress with meditation and support from her Ornish community.

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Imagine not being able to walk to your mailbox without

gasping for air and feeling your chest seize up. That’s what congestive heart failure feels like, and it contributes to one out of every nine deaths in the United States.

But the good news is that with a little love, the condition can be reversed.

Dr. Robert A. Cadigan Well, a little love plus some nutrition changes, exercise, and stress management.

It’s not easy, but it’s worth it. Just ask Kristen Reisinger.

Reisinger, of Highlands Ranch, Colo., was just 47 when heart failure struck. Years of putting work first and herself last landed her in the emergency room. “I think it was a combination of genetics and not taking care of myself,” says Reisinger, who has type 2 diabetes and has always struggled with her weight.

Eager to heal her heart and feel better, Reisinger joined the Ornish Lifestyle Medicine™ program.

The program, now offered by Penrose-St. Francis Health Services in Colorado Springs, doesn’t just stop heart problems from getting worse — it actually reverses the disease that kills half of its victims within five years.

GET WITH THE PROGRAM

Medicare and other insurers cover the Ornish Lifestyle Medicine™ program for patients who’ve had:

A heart attack within the last 12 months

Bypass surgery Developed by Dean Ornish, MD, the lifestyle program has proven through medical tests to unclog arteries and allow the heart to function better. Studies over more than 35 years have shown that the program helps participants:  Lower cholesterol and blood pressure  Lose weight  Reduce the risk of future heart attacks and other events  Reduce the need for surgery “Participants are surprised by how much better they feel three or four weeks into the program,” says Robert A. Cadigan, MD, the program’s interim medical director at PenroseSt. Francis. “Those fast results give participants the energy and stamina to sustain the changes they’re making,” he adds.

The program has proven so successful that Medicare and most insurance companies will pay for it. Each participant joins a small group of peers that is led and supported by a team of clinical professionals that includes a cardiologist, dietitian, chef, stress management specialist, group support facilitator, and an exercise physiologist. The peers and their team stay together over the full course of the program and even beyond.

“We give participants all of the tools that they need to retake control of their health,” says Melanie Faulkender, RN, program care coordinator.

penrosestfrancis.org

Over nine weeks, the group meets for four hours twice a week for a total of just 72 hours.

Each session includes an hour of the program’s four tenets:  Stress management  Love and support  Nutrition  Exercise

Heart valve repair or replacement

Angioplasty or stenting

NOURISHING BODY, AND SOUL Nutritious food and regular exercise are the foundations of most any reputable heart health plan. Ornish Lifestyle Medicine is a comprehensive approach that goes beyond measuring calories and encouraging movement to address what’s going on inside participants’ heads and hearts, and teaching them how that impacts their health.

The program includes two components designed to reframe the reason for adopting healthy habits “from fear of dying to joy of living.”

Stress management: Chronic stress contributes to a host of ills, from making you look older to damaging your heart.

Stretching, yoga, deep breathing, meditation, and simply learning how to relax can tame harmful stress and anxiety, and those techniques are all part of the program. And they all can help hearts beat stronger, and lead to better health.

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Heart or heart-lung transplant

Stable angina (chest pain) Other patients interested in making lifestyle changes can also participate in the program.

To get in-depth details about the Ornish Lifestyle Medicine program, visit ornish.com, and then call 719-776-4880 to get information and to register for the Penrose-St. Francis program.

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PHOTO: ©ELLEN JASKOL

MEASURABLE RESULTS

Continued from Page 5

The Penrose Ornish team with Dr. Dean Ornish (in suit).

Reisinger says the techniques have helped her learn to control stress, and focus on what’s important in life. “Before, my frustration was easily triggered. Now, when I feel frustrated, I do 15 minutes of meditation,” she says.

Love and support: In the Ornish program, there is no such thing as healing on your own. A core principle is that connection to community, to love and support, is powerful — and essential — medicine.

Each participant begins the program by becoming connected to a community of eight to 10 other participants.

“The same group of people starts at the same time and stays together,” Cadigan says. Those groups often form bonds that last well beyond the program’s nine weeks. In Reisinger’s case, her  group still gets together each week, through a “The Ornish conference call, to support each other.

EATING BETTER, MOVING MORE

program has been lifechanging for me. It’s taking care of every aspect of my health.”

The Ornish program doesn’t ignore the importance of a healthy diet and regular exercise, however. Far from it.

Nutrition: The program stresses a diet that helps participants gain health as well as lose weight. It emphasizes the importance, and pleasure, of food as nature intended, not as a factory packaged it. “We use a low-fat, wholefood, plant-based approach,” Faulkender says. It includes whole grains, fruits, vegetables, legumes, and soy foods, and a limited amount of nonfat dairy and egg whites. Participants eat small, frequent meals throughout ~ Kristen Reisinger, the day to prevent hunger and keep energy constant. At each session, the participant dietitian teaches participants about nutrition — and the chef prepares a healthy meal.

Reisinger says the diet was an adjustment at first. “Once I got through the first couple of weeks and focused on the things I could have and not the things I shouldn’t have, I found there are some wonderful things you can have and make great,” says Reisinger, who trained as a chef.

Exercise: The program encourages participants to get moving. It helps them do that, slowly at first, with a personalized and safe exercise program that eventually helps participants work up to a minimum of three hours a week of aerobic exercise, and strength-training activities at least twice a week. During sessions, participants exercise at the center, under the watchful eyes of health care professionals.

“Heart patients have the potential to accomplish more for themselves than the doctor can with medications or other interventions. The scientifically proven Ornish Lifestyle Medicine program helps participants build habits to reduce their risk of future heart events,” Cadigan says.

Since she “graduated,” from the program in May, Reisinger has been following the Ornish diet, working out, and using stress management techniques daily. Her blood sugar has dropped significantly, and she’s lost 20 pounds.

Reisinger may have completed the program, but she is by no means through with it.

“Living in Colorado, where there’s so much going on outside, made it easier for me to make healthy lifestyle changes,” she says.

“The Ornish program has been life-changing for me. It’s taking care of every aspect of my health.”

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REPLICATE THE REVERSAL AT HOME

11.

Focus on whole foods.

Eat mostly whole, plant-based foods. Limit processed foods, refined carbohydrates, and sugars.

2

Make time to exercise.

Work in 30 to 45 minutes of exercise most days, even if it has to be in 15-minute chunks.

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Join a heart support group like the Penrose-St. Francis Mended Hearts. Ask your health care provider for suggestions or call 719-776-4864 for information.

4

Find a yoga teacher who specializes in stress management. Search for yoga and gentle or restorative yoga classes.

Attend our Matters of the Heart program. See Page 11 for details.

Penrose-St. Francis Health Services

& QA

GARY KLEIN, MD DOMINIQUE WALKER, MD EMILY VALENTA, DO Penrose-St. Francis Primary Care for Seniors 3027 North Circle Drive Colorado Springs, CO 80909 719-776-4650

HEALTHY AGING STRATEGIES

Q: WHAT’S MOST IMPORTANT IN

Q: WHAT CAN SENIORS DO TO

A: Staying active and eating right can help prevent diabetes, heart disease, and stroke. Take a 30- to 45-minute walk every day or exercise more intensely two to three times a week. Eat right and try to keep your weight down. No food is off-limits, but be careful with bad carbs and starches.

Get intellectual activity, too. Instead of sitting at home all the time, volunteer in the community or at a school. Go online and learn more about your health. WebMD and mayoclinic.org are reliable websites for health information.

A: Many older people fall because they lose coordination, balance, muscle strength, and reflexes. Staying active will help you stay strong.

Consider joining a program like SilverSneakers, where you can go to YMCAs for free. Make your home safer by: • Removing loose rugs • Installing grab rails in the bathroom • Using nonslip mats in your bathtub or shower • Keeping pathways clear and well-lit

HEALTHY AGING?

PENROSE-ST. FRANCIS PRIMARY CARE FOR SENIORS FOR UNITEDHEALTHCARE™ MEDICARE ADVANTAGE PATIENTS More proactive and preventive care is now available for seniors on a Medicare Advantage Plan through UnitedHealthcare. “Penrose-St. Francis Primary Care for Seniors is using a different approach to care management to get things done better so they don’t fall through the cracks,” says Gary Klein, MD, a physician at the practice.

A team of health care professionals, including a care coordinator, will help each patient stay healthier and prevent problems.

The care coordinator will make sure that patients have transportation to appointments, fill their prescriptions, get the referrals they need, and more.

Along with traditional primary care services, the clinic offers: • Medication review with pharmacists • Behavioral health visits • Assistance with senior living options • Referrals to physical therapy, nutritional support, and other services, and for products such as oxygen • On-site urgent care, physical therapy, laboratory, and radiology • Reserved parking

PREVENT FALLS?

Q: WITH ALL OF THE MEDICATIONS THAT MANY SENIORS TAKE, HOW CAN THEY STAY SAFE?

A: Have a strong primary care provider who monitors all of your medications from all of your doctors, and take your medications properly.

If you can’t afford a medication or have other questions or concerns, talk to your primary care provider. We’re not here to judge you. We want to help you find a way to be compliant.

Learn about your medications and know why you’re taking them. Carry a list of your medications and the dosages with you for emergencies. Don’t be afraid to ask questions about your medications and go online to learn more about them. But don’t let stories about drug interactions or side effects alarm you; just talk to your doctor about your concerns.

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Drs. Klein, Valenta, and Walker head the team who helps seniors meet all of their health needs.

To learn more about our practice, come to one of our FREE open houses (see Page 11 for details) or call 719-776-4650.

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technology

A PACEMAKERLIKE DEVICE IMPLANTED IN THE SPINE BRINGS RELIEF

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hen back pain gets bad, it seems like you can think of nothing other than the pain. But a new treatment option from the Centura Spine Care program is helping loosen pain’s grip. Spinal cord stimulation can block pain signals from reaching the brain by sending mild electrical pulses to the spinal cord.

“This modality is strong enough to handle intense pain and reduce the need for opioids,” says William L. Lippert, MD, a pain medicine specialist who’s part of the Centura Spine Care program and director of pain medicine at Penrose-St. Francis Health Services.

STIMULATING PAIN RELIEF The device is like a pacemaker for the back, with a battery-powered computer that’s connected to thin wires (leads) that deliver the electricity. The newest spinal cord stimulators relieve pain better, and without the uncomfortable tingling of earlier stimulators.

Patients can “try out” the device for five to seven days before having it surgically implanted. For the trial, Lippert places the leads in the spine through a needle

(no incisions), and then an external generator delivers the electrical pulses. He monitors and adjusts the programming to provide maximum pain relief for each patient.

At the end of the trial, if the patient decides to proceed, Lippert or a spine surgeon implants the device near the spine during a minimally invasive outpatient procedure. With the implanted device, patients can do virtually any activity.

MORE TREATMENT OPTIONS From state-of-the-art treatments like spinal stimulation to ancient practices like yoga, the Centura Spine Care program is helping more people with back pain heal, often without spine surgery. When patients’ back pain “interferes with their quality of life and function, they need more advanced care,” Lippert says. “Our integrated program expedites care to ensure that these patients are well taken care of, and that they recover quicker and have better outcomes.”

STREAMLINED

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COORDINATED

CARE

A nurse navigator guides each patient in the Centura Spine Care program. “The nurse navigator is the patient’s contact person through the continuum of care, helping with appointments, education, communication with the spine care team, and more,” says Peggy Plylar, RN, MS, CNS, CRRN, program manager of Neuro-Ortho Services at Penrose-St. Francis Health Services. For most patients, the initial care plan includes: • Physical therapy and sometimes manipulative therapy (manual movement, adjustment, and/or manipulation of the spine) • Nonopioid pain medicine • Early treatment could also include yoga, massage, and/or acupuncture If the pain continues, injections to ease back pain and inflammation, guided by imaging, are a common next step. Other treatments include spinal cord stimulation and injections of stem cells or plateletrich plasma to promote healing.

Call our nurse navigator at 719-571-8550 to discuss options for treating your back pain.

Dr. William L. Lippert provides a range of treatment options to relieve back pain.

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BLOCKING BACK PAIN

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hen stress becomes overwhelming, it could make you overly alert and extremely sensitive to your surroundings — or hypervigilant. Many people who are hypervigilant may have post-traumatic stress disorder. They’re often on guard, trying to spot potential threats and prevent their traumatic experience from recurring.

But there’s another type of hypervigilance. It happens in women and is triggered by changes that are a regular part of life, like moving, getting married or divorced, changing or losing a job, having a child, or losing a loved one. Even the stress of daily life can lead to hypervigilance. “All of these things can have a cumulative effect that we don’t realize,” says Laura Tulley, MA, LPC, LAC, a behavioral health specialist at Centura Health Physician Group Behavioral Health.

COPING

WITH LIFE’S CHALLENGES THE ANXIETY OF HYPERVIGILANCE CAN LEAD TO PHYSICAL AND EMOTIONAL SYMPTOMS

A THREAT TO MIND AND BODY More women are being treated for hypervigilance, because it’s becoming more widely recognized. “It’s something that’s always been there, but we’re talking about it more,” Tulley says. Women are more likely to become hypervigilant if they have experienced trauma such as: • Domestic violence • Sexual assault • Divorce • Child abuse or neglect The way you feel changes when you’re hypervigilant, which is usually a symptom of an anxiety disorder. Physical symptoms like sweating; a faster heart rate; and shallow, rapid breathing can lead to exhaustion. Emotionally, you may feel anxious, irritable, and unable to stop worrying. And it can make it hard to cope with the people in your life, enjoy work, focus fully, or sleep peacefully.

COPING WITH LONG-LASTING STRESS “It’s time to do something when your ability to cope isn’t enough, and when stress is lasting longer and interfering with daily life,” Tulley says. Start by talking to your primary care provider, who can help you decide whether to see a therapist or psychiatrist. You can also try: • Relaxation training • Exercise • Cognitive behavior therapy • Medication “We look at each woman holistically and assess what’s going to work for her,” Tulley says. Often, a combination of treatments is used. “The sooner you get help, the sooner you can recover. Hypervigilance is always treatable,” she says.

4 WAYS TO REDUCE YOUR STRESS 1

Reach out to others. Talk to friends and family about what’s going on, and ask for support.

2

Listen to music. Slow, quiet classical music relaxes the mind and the body.

3

Move your body. Exercise can provide an immediate mood boost.

4

Meditate and be mindful. Calm yourself by spending a few minutes focusing on the present instead of reacting to what’s going on around you.

Behavioral health services are available at Centura Health Physician Group primary care offices for patients. To learn more, call 719-776-6850.

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STORIES IN MY GENES

THE VALUE OF DISCOVERING YOUR FAMILY HEALTH HISTORY

Date | Wed, Nov 8 Time | 6-8 p.m.

Location | Penrose Cancer Center, 2222 North Nevada Avenue, Rooms A-C Cost | FREE Registration | penrosestfrancis.org/ events or call 719-776-5279

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nowing your family history can change how you manage your health. This seminar will address the importance of collecting family health history and offer tips for success. You will learn what information to record (emphasis on cancer family history), tips on how to talk to relatives about health history, and resources for finding information outside your family.

REMINDER: Daylight savings time ends Sunday, Nov. 5.

BE PREPARED

ADVANCE MEDICAL PLANNING: HAVING THE CONVERSATION Date | Thu, Nov 2 Time | 11:30 a.m.-1 p.m.

Location | St. Francis Medical Center, 6001 East Woodmen Road, Conference Room 1 Cost | FREE Registration | Send email with name by Mon, Oct 30, to johnzondlo@centura.org The best time to make decisions about medical care is before you or your family has a medical crisis. Advance medical planning allows you to determine who can make medical decisions for you in the event you are not able to make them yourself. Studies show that making medical decisions in advance and having those difficult conversations with loved ones diminishes moral distress during times of crisis. Having a completed Medical Power of Attorney and Living Will guides the decision-making process and allows the providers to care for the patient per his or her own wishes. Let us guide you through the various Advance Directive forms and answer your questions. Lunch provided with RSVP.

FROM COVERAGE TO CARE: HOW TO ACCESS THE RIGHT HEALTH CARE AT THE RIGHT TIME Date | Thu, Nov 9 Time | 11:30 a.m.-1 p.m.

Location | St. Francis Medical Center, 6001 East Woodmen Road, Conference Rooms 1 and 2 Cost | FREE Registration | RSVP by Mon, Nov 6, to johnzondlo@ centura.org When you are not feeling well, there are an increasing number of options (primary care, urgent care, freestanding emergency rooms, hospital EDs) that are available to you.

They may or may NOT be your best option. This workshop will help you determine what is your best option and how you can manage your experience to get the best and safest care possible. You will be more confident in selecting the right place to go when you (or a family member) are not feeling well and be better equipped to ask the right questions as a health care consumer and patient advocate. Lunch provided with RSVP.

Penrose-St. Francis Health Services

PENROSE-ST. FRANCIS PRIMARY CARE FOR SENIORS — OPEN HOUSES Date | Wed, Oct 18, 5-6 p.m.; Sat, Oct 21, 10-11 a.m.; Tue, Oct 24, 2-3 p.m.; Thu, Oct 26, 9-10 a.m.; Wed, Nov 1, 5-6 p.m.; Thu, Nov 9, 10-11 a.m.; Sat, Nov 18, 10-11 a.m.; Tue, Nov 28, 2-3 p.m.; and Wed, Nov 29, 10-11 a.m.

Location | Penrose-St. Francis Primary Care for Seniors, 3027 North Circle Drive Cost | FREE Registration | 719-776-4650 If you’re looking for a health care home that caters to those ages 65 and older, we invite you to our open house. Meet our physicians, and learn about services and how to become a patient. Plus, you can learn about UnitedHealthcare’s™ Medicare Advantage Plan from UnitedHealthcare licensed representatives. *A salesperson will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 719-331-9126 (TTY: 711).

MATTERS OF THE HEART Date | Sat, Oct 21 Time | 8:30-11:30 a.m.

Location | CHPG Primary Care Tri-Lakes, 17230 Jackson Creek Parkway, Suite 300 Cost | $10 Registration | penrosestfrancis.org/ events or 719-571-8605 Cardiologists Dr. Paul Sherry and Dr. David Albrecht, with Colorado Springs Cardiology, A Centura Health Clinic, will discuss the main risk factors of heart disease and teach you prevention techniques to keep your heart healthy. A registered dietitian will share helpful hints for heart-healthy food choices, and an exercise physiologist will demonstrate common-sense ways to strengthen and tone your way to heart fitness.

Wear comfortable clothes. Includes refreshments and binder. Limited to 20 attendees. Meet at the YMCA Information Desk.

LEARN TO QUIT Date | Tue, Nov 7 Time | 4-5:30 p.m.

Location | Penrose Cancer Center, 2222 North Nevada Avenue, Conference Rooms B and C Cost | FREE Registration | 719-776-QUIT (7848) A FREE workshop designed for people who are ready to quit tobacco or may be thinking about quitting tobacco. At this workshop, participants will learn how to: overcome nicotine addiction, manage cravings and triggers, use medications to help reduce nicotine cravings, and develop a personalized quit plan.

TRUNK OR TREAT Date | Sat, Oct 14 Time | 10 a.m.-1 p.m.

Location | St. Francis Medical Center, 6001 East Woodmen Road Cost | FREE A free and safe Halloween event for kids and parents. Wear your favorite costume and stop by more than 30 stations to collect candy and trinkets, play games, and pick up kids’ health information. penrosestfrancis.org

WATCHING YOUR SODIUM INTAKE Date | (select one) Tue, Dec 5, 4-5 p.m., CHPG Primary Care Broadmoor, 1263 Lake Plaza Drive; Wed, Dec 6, 10:30-11:30 a.m., Tri-Lakes YMCA Community Room, 17250 Jackson Creek Parkway; or Thu, Dec 7, 4-5 p.m., Penrose-St. Francis Primary Care, 3027 North Circle Drive Cost | FREE Registration | penrosestfrancis.org/ events Which foods are high in sodium?

Should you toss the salt shaker? Are certain types of salt healthier? How much is too much? Learn the answer to these questions and more.

WOMENHEART SUPPORT NETWORK Date | 2nd Tue of the month Time | Noon-1:30 p.m.

Location | Penrose Pavilion, 2312 North Nevada Avenue, Conference Room A Cost | FREE Registration | Elizabeth at 626-688-3420 or Stephanie at 719-200-2645 Support, advocacy, and education for survivors of heart disease and stroke.

Led by peers who have experienced heart disease or stroke, our goal is to thrive for the best quality of life. Call for more information.

BRAIN INJURY SUPPORT GROUP Date | 3rd Thu of the month Time | 5:30-7 p.m.

Location | Penrose Pavilion, 2312 North Nevada Avenue, 2nd Floor Cost | FREE Registration | penrosestfrancis.org/ events Education, emotional support, and opportunities for socialization and peer support to brain injury survivors, caregivers, family, and friends.

GIVE BACK, GIVE LIFE, GIVE BLOOD Help save a person’s life by becoming a blood donor. Visit the Penrose-St. Francis Blood Bank at 2222 North Nevada Avenue, Mondays, 10 a.m.6:15 p.m.; Tuesdays-Thursdays, 7:30 a.m.-4 p.m.; Fridays, 7:30 a.m.-3 p.m. Walk-ins welcome or make an appointment by calling 719-776-5822.

CLASSES FOR CANCER PATIENTS/SURVIVORS The Penrose Cancer Center offers FREE classes and support groups for cancer patients and survivors. Visit penrosecancercenter.org/events for dates, times, and locations for the following classes.

• TaijiFit • Writing for Personal Well-Being • Mat Yoga • Beginning Again: Tools for the Journey Through Grief • Therapeutic Drumming • Also, there are support groups for younger women; Latinos; breast, GYN, and head and neck cancers HEART CALCIUM SCORING — $149 This noninvasive CT scan is a quick, painless method for detecting heart disease. You can learn at the time of your screening by a cardiac nurse, if you are at risk for heart disease before a single symptom occurs.

Calcium scoring does not require a physician referral, but you should consult with your physician to see if calcium scoring is right for you. For more information or to schedule an appointment, call 719-776-8080.

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EATING FOR ENERGY Date | (select one) Tue, Oct 17, 4-5 p.m., CHPG Primary Care Broadmoor, 1263 Lake Plaza Drive; Wed, Oct 18, 10:30-11:30 a.m., Tri-Lakes YMCA Community Room, 17250 Jackson Creek Parkway; or Thu, Oct 19, 4-5 p.m., Penrose-St. Francis Primary Care, 3027 North Circle Drive Cost | FREE Registration | penrosestfrancis.org/ events Learn how to make healthy food choices to increase your energy and maximize your performance. Learn to separate myths from facts regarding eating for energy.

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Penrose-St. Francis Health Services is part of Centura Health, the region’s leading health care network. Centura Health does not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, and marital status in admission, treatment, or participation in its programs, services and activities, or in employment. For further information about this policy, contact Centura Health’s Office of the General Counsel at 1-303-673-8166 (TTY: 711). Copyright © Centura Health, 2017.

ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-719-776-5370 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-719-776-5370 (TTY: 711).

EATING FOR ENERGY

QUENCH YOUR METABOLISM

With Melaina Bjorklund, MS, RD, clinical dietitian at Penrose-St. Francis Health Services

A

s the days get shorter, it’s easy to feel sluggish. Rev up your energy by eating the right combination of foods in four to six smaller meals or snacks throughout the day.

For optimum energy, eat this combination of foods: • Complex carbs with fiber, found in whole-wheat or whole-grain foods, beans, legumes, and starchy vegetables • Lean protein like fish, white-meat poultry, or tofu • Healthy fats, including olive oil and omega-3 fatty acids These more frequent meals and snacks sustain energy by providing a steady stream of nutrients, keeping blood sugar levels even, and helping you feel fuller, longer. On the go, pack nonperishable snacks like almonds or energy bars with double-digit protein and single-digit sugar.

FRUITY AND REFRESHING

Adding fruits or cucumbers is one way to drink more water. Just add them to water, shake, and drink — or infuse overnight for more flavor. Try: • Oranges, lemons, or limes (squeezed) • Berries • Frozen fruit mixes Avoid premade flavored waters, which can include a lot of sugar or chemical-based artificial sweeteners.

ENERGY ZAPPERS

Keep your energy up by avoiding: • Added sugar, which leads to energy crashes due to unstable blood sugar levels.

• Trans fats in processed foods (usually partially hydrogenated oils on food labels), which require extra energy to metabolize.

• Excess caffeine, which leads to energy crashes and reduces hydration. What’s excessive varies for each person, but experts say four cups of coffee or five cups of tea (8 ounces each daily) is safe for most adults.

Make the most of energizing foods by drinking enough water: eight 8-ounce glasses for most adults. Water helps you stay hydrated and maintains electrolytes, which help your metabolism function properly and give you more energy.

ENERGY COMBOS

• Oatmeal with peanut butter • Whole-wheat toast with avocado and an egg • Brown rice, chicken, and veggies sautéed in olive oil • Guacamole and turkey sandwich on whole wheat Attend one of our Eating for Energy seminars listed on Page 11.

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For the 10th year in a row, Penrose-St. Francis Health Services has been named one of America’s 50 Best Hospitals™ (2008-2017)

by Healthgrades®, an honor only achieved by six hospitals in the country.