Bloom Summer 2018

TRAVEL SAFELY WITH DIABETES | BREAKING FREE OF ADDICTIONS | SUPER SALADS

Penrose-St. Francis Health Services

Nurturing women’s health in Colorado Springs

WHAT’S

HOT INMENOPAUSE Advances in hormone replacement therapy

HIGH-TECH STROKE PREVENTION

SUMMER 2018 Volume 8, Issue 3

for AFib patients Page 8

HOW BAD IS IT ...

TO USE YOUR GYM’S YOGA MATS?

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HIGHER-THAN-AVERAGE RISK OF SKIN CANCER Dr. Elizabeth Piantanida

15%

HIGHER

The annual rate of new melanoma diagnoses in Colorado was 15 percent higher than the national average from 2002-2006, according to the Centers for Disease Control and Prevention.

Living in Colorado Springs makes you more likely to get skin cancer than most people.

At 6,035 feet above sea level, you’re getting: • 25 percent more UV rays than at sea level • 300 sunny days each year “Wear protective clothing, use sunscreen regularly and liberally, and seek shade,” says Elizabeth Piantanida, MD, a dermatologist at Penrose-St. Francis Health Services.

“Protect your kids with sunscreen before they leave for school or outdoor activities.”

LITTLE-KNOWN RISK FACTORS Alcohol and smoking are also risk factors for skin cancer. One study found that for every daily beer or glass of wine, the risk increased: • 7 percent for basal cell carcinoma • 11 percent for squamous cell carcinoma Smokers are more likely to get squamous cell carcinoma than nonsmokers.

SHEDDING LIGHT ON TANNING PRODUCTS Everyone knows tanning beds increase your risk for melanoma. While tanning sprays and lotions are safer, they might still be harmful. “These products perpetuate the culture that looking tan PROTE makes you look healthy,” CT YOUR LIPS W says Piantanida.

ITH

A primary care provider can perform a skin cancer screening as part of your annual physical.

To find a primary care provider near you, visit penrosestfrancis.org.

hink public toilet seats are dirty? Yoga mats at a gym have just as many germs. “Warm rooms used for yoga classes, body heat, and sweat breed organisms on yoga mats,” says Joan Strauch, RN, an infection preventionist at Penrose-St. Francis Health Services.

Germs that cause colds and flu, herpes infection, plantar warts, flesh-eating disease, and more live on yoga mats. But the risk of getting sick from your yoga mat is low if you’re generally healthy, except during flu season, says Strauch.

Limit danger from germs

Bringing your own yoga mat is the best way to avoid germs. If you must use your gym’s yoga mat: • Wear long yoga pants, a long-sleeve T-shirt, and grip yoga socks • Put a towel between you and the mat • Use hand sanitizer or alcohol gel before and after class • Don’t touch your face, eyes, nose, or mouth

SUNS CR OR LIP EEN BALM WITH SPF 30 .

bloom is published four times annually by Penrose-St. Francis Health Services. Executive editor is Jill Woodford. As part of Centura Health, we’re on a mission to build whole person care and flourishing communities. 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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HealthyStart

TAKING DIABETES ON THE ROAD KEEPING BLOOD SUGAR STEADY WHILE YOU TRAVEL MEANS PREPARATION AND PLANNING

D

Diabetes medication is typically allowed to exceed the TSA limit of 3.4 ounces of liquid.

Check tsa.gov for specific guidelines.

PACK SNACKS You might miss meals sitting on the runway or in traffic.

PILE ON SUNSCREEN Sunburn can cause blood sugar spikes.

TEST BLOOD SUGAR OFTEN New foods in new places make it hard to estimate your carb intake.

on’t let type 2 diabetes keep you grounded this vacation season. Traveling healthy means planning ahead, and expecting the unexpected, says certified diabetes educator Judy Kibby, RN, BSN, of Penrose-St. Francis Health Learning Center. “If you’re going away for a week, pack two weeks’ worth of medications.”

She also recommends carrying a copy of your prescriptions, and a card indicating you’re on blood sugar-lowering medication. Kibby’s other travel tips:

TAKE THE HEAT OFF Don’t let insulin get too hot — or too cold.

BE CARBCONSISTENT Eat what you like, but plan portions — and don’t skip meals.

••••• Attend a Diabetes Expo on Saturday, Sept. 8. See Page 10 for details. •••••

3 TIPS FOR A HEALTHY

RUNNER’S HIGH

Has the summer sunshine motivated you to hit the jogging trails? Reduce injuries and enjoy your runs more by following these tips:

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Walk, run, repeat. Build your strength and endurance by alternating walking and running. Walk one minute, run one minute, and repeat for 20 minutes.

“As you become more fit, make your walking periods shorter and your running periods longer,” says Erin Heberlein, MS, wellness manager at Penrose-St. Francis Health Services.

Wear the right shoes on the right surface. Stay comfortable and injuryfree with good running shoes. Get fitted at a running store. Run mostly on soft surfaces like rubber tracks, dirt trails, or a treadmill.

Cross-train. Improve overall fitness and prevent injuries by cross-training with activities like yoga, Pilates, swimming, and strength training.

Find a yoga, Zumba, or fitness class at penrosestfrancis.org/events.

FOR THE MAN IN YOUR LIFE

M

IS BACK SURGERY IN YOUR FUTURE?

ost Americans experience lower back pain. Ice, heat, nonsteroidal anti-inflammatories, and time typically resolve the problem. But when pain persists, surgery may be the next step, says Sergiu Botolin, MD, surgeon with Centura Spine Care.

Generally, surgery is recommended when a clear cause of pain — pinched nerves, scoliosis, or instability — can be identified.

While pain usually brings patients to the doctor, other symptoms are more worrisome, Botolin says, including: • Sudden loss of bowel or bladder control • Numbness and tingling • Weakness in legs, feet, arms, or hands • Progressive worsening of balance, the ability to walk, move around, or stand for a long time Loss of bowel or bladder control and weakness in the legs can be signs of a rare but potentially dangerous condition known as cauda equina syndrome (CES), in which spinal nerves are severely compressed. “Without surgery, the damage may be irreversible,” Botolin says.

Dr. Sergiu Botolin

penrosestfrancis.org

Centura Spine Care offers a team of spine specialists to evaluate the cause of your back pain and recommend a comprehensive treatment program. To learn more, visit penrosestfrancis.org/ centuraspinecare or call 719-571-8550.

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WHAT’S THE WORD ON HRT? PROS

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WEIGHING THE PROS AND CONS OF HORMONE REPLACEMENT FOR MENOPAUSE SYMPTOMS Hot flashes, vaginal dryness, brain fog, decreased libido.

Sound familiar?

If you’re experiencing any of these symptoms and you’re of a certain age, you can probably chalk them up to menopause.

“Menopause is unique to each woman. But if your symptoms are affecting your quality of life, your doctor can help you,” says Shelly Asbee, MD, an OB/GYN at Centura Health’s Academy Women’s Healthcare Associates. Up to about a third of Asbee’s patients have symptoms severe enough to seek relief. The good news is, effective treatments are available.

If you’re one of those women, you’re probably wondering whether hormone replacement therapy (HRT) can help.

And is it safe?

Dr. Shelly Asbee

CONS

Penrose-St. Francis Health Services

THE HORMONE CONTROVERSY

NOT RIGHT FOR EVERY WOMAN But HRT is not risk-free. In fact, just last year, the U.S. Preventive Services Task Force (USPSTF) issued a recommendation that HRT not be used for preventing chronic disease. The USPSTF found that the benefits — in terms of chronic disease management — were not greater than the increased risk for breast cancer blood clots, stroke, and even dementia.

“There was some thought that hormone replacement could be beneficial to women at increased risk of developing heart disease, but that’s no longer the case,” Asbee says. Instead, it’s generally used to treat severe menopausal symptoms, such as hot flashes, sleep disturbances, low libido, and vaginal dryness. It also can be used to help prevent osteoporosis.

Each woman’s need for HRT should be assessed by her doctor, but there are some general guidelines, Asbee says:

No,

IF YOU:

• Are 60 or older and started menopause more than 10 years ago • Are at increased risk for breast, uterine, or endometrial cancer • Have had any of these: - Blood clots, TIA, or stroke - Invasive breast cancer - Unexplained vaginal bleeding - Heart attack - Heart or liver disease

penrosestfrancis.org

Yes,

IF YOU:

• Are 59 or younger and started menopause less than 10 years ago • Are healthy • Have no chronic medical conditions

ARE BIOIDENTICAL HORMONES BETTER? If you’re considering hormone replacements, you’ll quickly hear the term “bioidentical.” Proponents say bioidenticals are safer than standard hormone replacements. As opposed to standard hormones, which are synthesized in the lab from chemical sources, bioidentical hormones are made from soy and yam extracts — and they mimic the molecular structure of your body’s own hormones.

But according to the American College of Obstetricians and Gynecologists, bioidentical hormones carry the same risks as standard FDAapproved hormone therapies.

The third type of HRT women might consider are called compounded hormones. Compounded HRT is prepared by a pharmacist using a mixture of bioidentical hormones in dosages specified by a physician for a particular patient based on blood or saliva tests.

There is no evidence that compounded hormones are safer or more effective than other hormone therapies.

Plus, Asbee says, they may be slightly riskier because “dosing of compounded bioidentical hormones isn’t as precise as standard hormone therapy or bioidentical hormones.”

Continue reading on next page

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Hormone replacement therapy does what its name implies — replaces the hormones women’s bodies start losing as they go through menopause: estrogen and progesterone. Used mainly to relieve symptoms such as hot flashes and vaginal dryness, HRT was also thought to prevent heart disease, which becomes more of a risk as women age due to declining levels of estrogen.

HRT was widely used before 2002, when the Women’s Health Initiative, a large research study, suddenly pulled the legs out from under women and their doctors. The researchers abruptly stopped the study, saying that it greatly increased the risk of breast, endometrial, and ovarian cancer in women. Doctors nationwide stopped prescribing it, and women were left to suffer.

Recently, some researchers have taken a closer look and say that the study may have been misinterpreted.

The study included older postmenopausal women and excluded women experiencing menopausal symptoms.

Most doctors now believe that for healthy women in their 40s and 50s, HRT may be a good choice when used for the shortest amount of time needed to relieve severe symptoms and at the lowest doses.

“The shortest amount of time is usually one to five years,” says Asbee. “Over a couple of months, we can get to a dose where her quality of life is where she wants it to be.”

ALTERNATIVE SOLUTIONS FOR COMMON SYMPTOMS Hormone-free medications and over-thecounter products can help with menopause symptoms. But some of the commonly used products may not work or be safe.

Talk to your doctor about whether these alternative options are for you:

Continued from Page 5

HRT OPTIONS If you decide with your doctor that HRT is an option, your doctor will first determine if you need estrogen and progestin or estrogen alone. Women who still have their uterus and/or cervix must take estrogen plus progestin. Estrogen alone can increase their risk for endometrial cancer.

Then, you and your doctor will consider what form of HRT to use. HRT can be administered through: • Pills, which are the most common form, but also the riskiest because the hormones circulate through the body.

• Patches are slightly lower risk, but they don’t work as well for some women.

• Creams, tablets, or rings work well for vaginal dryness and have less risk than pills or patches.

• Pellets that contain the bioidentical hormone estradiol are a newer HRT option. The pellets are implanted under the skin in the hip area and deliver consistent levels of hormones for three to six months.

THE MALE HORMONE

Vaginal dryness and pain during sex: Osphena is an FDA-approved pill for painful sex due to menopause. Asbee also recommends over-the-counter water-based vaginal lubricants and moisturizers.

Hot flashes, night sweats, and other symptoms: Paroxetine (Brisdelle) is the only FDA-approved antidepressant specially formulated to treat hot flashes.

Gabapentin (Neurontin), an antiseizure medication, and clonidine (Catapres), a high blood pressure medication, are sometimes used for hot flashes and sleep problems.

Another hormone in women that is not often talked about is testosterone. Low testosterone in women can start in middle age and can mimic symptoms of an underperforming thyroid, including fatigue and depression. Testosterone also helps maintain muscle mass, strong bones, mental clarity, energy, and libido. If a blood test finds your levels are low, your doctor may consider prescribing testosterone injections, creams, or implantable pellets.

However, use of testosterone supplements in women is considered off-label. That means that while the drug has been approved by the FDA, it has not been approved for treating menopausal symptoms in women. “There haven’t been any long-term studies of testosterone supplements in women,” Asbee cautions. “So, we are just guessing at its effectiveness and side effects.”

Testosterone supplements may cause acne, deepening of the voice, hair growth on the face and chest, lower HDL (“good”) cholesterol levels, and male-pattern baldness. The long-term impact on cancer and heart disease risk is unknown.

To make an appointment with Dr. Asbee or another gynecologist at Academy Women’s Healthcare Associates, call 719-571-4500 or visit awha.com for more information.

THE NATURAL PATH Plants and herbs like soy, black cohosh, and Chinese herbal remedies are widely used for menopause symptoms. However, the FDA doesn’t regulate these products and few have scientific research to support their effectiveness. Some herbs have been linked to liver damage, and dong quai and evening primrose oil can lead to bleeding complications.

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BENJAMIN COLE, MD Family Medicine Physician CHPG Primary Care Powers 6080 North Carefree Circle Colorado Springs, CO 80922 719-571-1088

HEALTHY TRAVELS THIS SUMMER

Q: HOW CAN I STAY HEALTHY IN

AIRPORTS, ON AIRPLANES, AND IN OTHER PUBLIC PLACES?

A: Keeping your hands clean is the best thing you can do when traveling. Wash your hands frequently, especially when you touch anything that looks dirty. Hand sanitizer is good, but washing your hands with soap and water is better.

Stay well-hydrated. When flying, altitude and pressurization make the air in the cabin dry. Bring and drink water. Fill your own water bottle after passing through security. Even if you’re not flying, drink at least 64 ounces of water per day.

And don’t sit for too long. Get up and walk around every two hours. Prolonged sitting, especially on an airplane, could lead to blood clots.

Q: WHAT SHOULD I KNOW ABOUT MY PRESCRIPTIONS?

A: Travel with your prescriptions in their

original bottles, not in a pill organizer or a baggie, and put them in your carry-on. Each

bottle should have your name, the name of the medication, and the prescribing doctor. This can prevent problems if security or customs checks your medications.

If you’ll run out of regular medications while you’re away, ask your pharmacy for a travel refill before you go. Most insurance companies allow this. Carry a list of your medications and your medical conditions, in case you need to seek care while you’re away.

Q: SHOULD I SEE MY DOCTOR

BENJAMIN COLE, MD

BEFORE A TRIP?

A: If you’re traveling outside the country, it’s a good idea to see your doctor. He or she can review the dangers and illnesses specific to your itinerary and recommend ways to stay healthy, such as the right type of antidiarrheal medication (if necessary). Your primary care doctor can handle most travel-related questions. If you’re going somewhere exotic or need something like a yellow fever shot, see a doctor certified in travel medicine.

Optimal health is Cole’s goal for each of his patients. “I help my patients maintain their best possible health so they can maximize their enjoyment of life,” he says. When not partnering with his patients, he enjoys outdoor activities like mountain biking, hiking, and photography. This summer, Cole, his wife, Colleen, and their two children, Alexander, 9, and Victoria, 6, will be traveling to Utah.

To make an appointment with Dr. Cole, call 719-571-1088.

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HIGH-TECH STROKE PREVENTION

Walt Kruckeberg is back to taking regular walks with his dog, Annie, now that his AFib is under control.

DANGER People with AFib who take blood thinners and are active are at risk of deadly bleeding if they fall while mountain biking, rock climbing, or other outdoor activities.

WATCHMAN helps reduce this risk by eliminating the need for blood thinners.

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stop to catch his breath every 20 feet when he walked his dog, Annie. The 76-year-old Colorado Springs resident has atrial fibrillation (AFib), an irregular heartbeat that can cause stroke and Dr. Christopher Cole other serious problems. Some people barely notice their AFib. Others, like Kruckeberg, have difficulty breathing, shortness of breath, and severe fatigue.

“I was losing energy and wasn’t able to do what I like to do,” he says.

High blood pressure, heart failure, and Kruckeberg’s age put him at high risk of a stroke, says Christopher Cole, MD, an electrophysiologist at Colorado Springs Cardiology, A Centura Health Clinic. Cole put Kruckeberg on a blood thinner, the usual lifelong treatment for AFib. But that caused problems. “Many people on blood thinners, including Walt, have bleeding problems, and may be unhappy about having to be on these powerful medications,” says Cole. And most blood thinners are expensive.

A DIFFERENT TREATMENT

Then Cole told Kruckeberg about WATCHMAN™, a device

heart’s left atrial appendage, where more than 90 percent of blood clots that cause stroke form. In studies, WATCHMAN worked as well as warfarin, the blood thinning medication.

Eager to get off blood thinners and feel better, Kruckeberg got his WATCHMAN in February 2018. Cole implanted the device during a catheterization procedure that lasted less than an hour. Kruckeberg went home the next day.

For the first 45 days, Kruckeberg continued on blood thinners and then switched to Plavix, a mild blood thinner, and aspirin. After six months, the device will have permanently sealed the left atrial appendage and he will need only a low-dose aspirin daily.

A BETTER LIFE

“I’m feeling better and better, and I’m up to about 1.5 miles with Annie now,” Kruckeberg says. Cole’s noticed the difference, too. “When Walt was dealing with his AFib and his blood thinner, he wasn’t as sharp as he usually is. At this last visit, I knew he was right back to his usual brilliant self,” he says.

To make an appointment with Dr. Cole, call 719-776-8500.

Penrose-St. Francis Health Services

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DECREASING

NEW DEVICE REDUCES RISK IN PATIENTS WITH AFIB that can permanently reduce stroke risk for patients with Walt Kruckeberg used to have to AFib. About the size of a quarter, the device closes off the

A

n estimated 21.5 million in the U.S. battled a substance abuse disorder in 2014. While this eye-popping number is four times the

population of Colorado, it is also likely underreported, says Rachel Hall, LPC, LAC, therapist with the Riegel Center, Centura Behavioral Health. “Denial is part of addiction. If people are struggling with chemical dependency, most of the time they aren’t reporting it.”

LEARNING TO LIVE

DRUG-

FREE SUPPORT FOR THOSE BREAKING FREE FROM SUBSTANCE ABUSE

TIME TO MAKE A CHANGE? How do you know if you have a problem? “If you think your use isn’t really healthy anymore, if you feel out of control, or if it is affecting your life, your relationships, or your job, it is time to seek help,” Hall says.

The good news is, that’s a great place to be. “A desire to make a change is the most crucial first step in success,” Hall says, adding that it is important to medically detox from substance abuse. Ideally this happens in an inpatient residential program.

Your primary care physician, Alcoholics Anonymous, or the Riegel Center can offer referral options.

SUBSTANCE ABUSE SUPPORT The first weeks and months after detoxing are also critical, as patients learn to navigate the stressors of life substance-free.

That’s where the Riegel Center comes in. A chemical dependency outpatient program, the center helps patients transition back into life without substance use.

“We help patients deal with everyday stressors with structured support. We help them live life without the drug,” Hall says.

Program components include: • Education and group support • Addressing past issues, such as trauma or abuse • Coping skills for conflict, anger, grief, and shame • Gaining healthy life skills • Referrals to on-site Centura Health behavioral health therapists for counseling “Having support makes a huge difference in long-term recovery,” Hall says. “If you realize this isn’t the way you want to live your life, there is help.”

ARE ADDICTIONS HEREDITARY? Family history stacks the deck against many substance abusers. Addiction is inherited about 50 percent of the time. “A family history of addiction increases your susceptibility to addiction, in the same way a family history of cancer increases your likelihood of cancer,” says Rachel Hall, LPC, LAC. But if addiction is in your DNA, are you doomed?

Of course not.“You have to be smart and realize you’re at greater risk,” Hall says, adding that positive role models and healthy environments can make an enormous difference.

Learn more about the Riegel Center’s Intensive Outpatient and Cultivating Recovery groups by calling 719-776-6850.

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We know you’ve got it in you. DONATE BLOOD! Donate blood or plasma at the Penrose-St. Francis Blood Bank located at Penrose Hospital.

Visit penrosestfrancis.org for donation times, to schedule an appointment, or to view upcoming community blood drives.

DIABETES EXPO

A FREE expo with the latest updates and trends in diabetes, including nutritional information and more!

Date | Sat, Sep 8 Time | 9 a.m.-Noon Location | Penrose Cancer Center, 2222 North Nevada Avenue, Cancer Center Conference Rooms Cost | FREE Information and Registration | Call Jen De Groot at 719-776-5536

SUMMER FITNESS GROUP FITNESS CLASSES From tai chi to spinning to body toning, the PenroseSt. Francis Wellness Center hosts an average of 17 group fitness classes per week. Get your healthy dose of strength, aerobic, and flexibility training with a wide array of class offerings. We are excited to announce the new addition of Heart Zones wearable heart rate technology in our aerobics classes to provide instant feedback on your training intensity. For the latest class schedule and class descriptions, visit penrosestfrancis.org/events and click “Fitness Schedules,” or contact the Wellness Center manager at 719-776-7394. Class packages range from five classes for $30 to $180 for six months of unlimited classes.

SILVERSNEAKERS® SilverSneakers is the nation’s leading fitness program designed exclusively for older active adults. Get fit the way you want, at your convenience. With this innovative program, you can take part in our strength training or SilverSneakers Classic Fit classes. Plus, we have treadmills, NuStep® recumbent bikes, arm ergometers, resistance bands, dumbbells, and stability balls. Paperwork and orientation are required before participating.

Location | 3030 North Circle Drive, Suite 217 Cost | FREE Eligibility I People who are 65+ and have insurance through AARP, Aetna, Anthem BlueCross/BlueShield (HMO and HMO SNP), Humana, Kaiser Permanente, and UnitedHealthcare Information | Visit penrosestfrancis.org/events and click on “Fitness Schedules” or call 719-776-4880

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PENROSE-ST. FRANCIS PRIMARY CARE FOR SENIORS PRESENTATION Are you about to turn 65 and join Medicare? Learn how we are redefining senior health care. A UnitedHealthcare salesperson will be present with information and applications. For accommodations of persons with special needs at sales meetings, call 719-331-9126 (TTY: 711). Visit chpgprimarycare.org/ penrose-seniors for clinic details.

Date | Tuesdays, Jul 17, Aug 14, OR Sep 18 Time | 5-6 p.m.

Location | Penrose-St. Francis Primary Care for Seniors, 3027 North Circle Drive Cost | FREE Registration | 719-776-4650 STOP THE BLEED Everyone should be prepared to respond to help prevent deaths caused from blood loss. Stop the Bleed is a one-hour class that teaches basic actions to stop lifethreatening bleeding. Participants will learn how to use bandages and tourniquets, and to pack wounds.

Limited to 30 people.

Date | Fridays, Jul 20 OR Sep 21, 1:30-2:30 p.m. OR 3-4 p.m.

Location | St. Francis Medical Center, 6001 East Woodmen Road, Conference Rooms 4 and 5 Date | Fri, Aug 17, 1:30-2:30 p.m.

OR 3-4 p.m.

Location | Penrose Pavilion, 2312 North Nevada Avenue, Conference Rooms A and B Cost | FREE Registration | Call Angela Kedroutek at 719-776-5924 or email angelakedroutek@centura.org

MENDED HEARTS — COLORADO SPRINGS Mended Hearts is a community-based organization designed to inspire hope and improve the quality of life for heart patients and their families through ongoing support, peer-to-peer hospital visits, education, and groups that meet five times a year. Our goal is to create a strong local support group that is run by and for the cardiac population in any stage of event — pre-op to recovery, and thereafter. Open to men and women.

Date | Thu, Aug 2 Time | 5-6 p.m.

Location | Audubon Medical Campus, 3030 North Circle Drive, Suite 215 Cost | $20 membership (payable if you decide to join) Information | Call Tricia Mooney, chapter president, at 719-776-4880 or email patriciamooney@centura.org

FROM COVERAGE TO CARE: HOW TO ACCESS THE RIGHT HEALTH CARE AT THE RIGHT TIME When you are not feeling well, there are an increasing number of options (primary care, urgent care, freestanding emergency rooms, and 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. Lunch provided with reservation.

Date | Mon, Aug 6 Time | 11:30 a.m.-1 p.m.

Location | St. Francis Medical Center, 6001 East Woodman Road Cost | FREE Registration | Register by Aug 1 at penrosestfrancis.org/events or 719-776-5813

ADVANCE MEDICAL PLANNING: HAVING THE CONVERSATION 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. We’ll help you understand the requirements and nuances, guide you through the various advance directive forms, and answer questions. Lunch provided with RSVP. Date | Thu, Aug 2 Time | 11:30 a.m.-1 p.m.

Location | St. Francis Medical Center, 6001 East Woodman Road Cost | FREE Registration | Register by July 26 at penrosestfrancis.org/events or 719-776-5813 penrosestfrancis.org

STEPPING ON Stepping On empowers older adults to carry out healthy behaviors that reduce the risks of falls. In a small group setting, older adults learn balance exercises and develop specific knowledge and skills to prevent falls.

Older adults who should attend are those who are at risk for falling, have a fear of falling, or who have fallen one or more times. Limited to 15 participants.

Date | Fridays, Aug 17-Sep 28 Time | 10 a.m.-Noon Location | Penrose Pavilion, 2312 North Nevada Avenue, Conference Room B Cost | FREE Registration | Call Angela Kedroutek at 719-776-5924 or Heather Ditzler at 719-776-5098 2018 COLORADO SPRINGS MARATHON Presented by Centura Orthopedics A community running event that features a full marathon, half marathon, and 5K beginning and ending at Acacia Park in Downtown Colorado Springs. The course winds through the beautiful Old North End Neighborhood, past America the Beautiful Park and the Olympic Training Center. For cost, maps, more information, or to register, visit cospringsmarathon.com.

Date | Sat, Sep 29 Time | 7 a.m. start Location | Acacia Park, 115 East Platte Avenue DIABETES EDUCATION CLASSES If you have diabetes, education can help you optimize your health through a customized diet, exercise, and medication management plan.

Individual appointments and group classes are available.

Date | Group classes start monthly Location | Penrose-St. Francis Health Learning Center, 3207 North Academy Boulevard Cost | Covered by private insurance/ Medicare/Medicaid; physician referral required Information and Registration | Call Jean at 719-776-3611

HEART SCAN — $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. A heart scan does not require a physician referral, but you should consult with your physician to see if calcium scoring is right for you. To schedule an appointment, call 719-776-8010.

For more information, call 719-776-8080.

BRAIN INJURY SUPPORT GROUP Education, emotional support, and opportunities for socialization and peer support to brain injury survivors, caregivers, family, and friends.

Date | Third Thursday of the month Time | 5:30-7 p.m.

Location | Penrose Pavilion, 2312 North Nevada Avenue, 2nd Floor Cost | FREE Registration | penrosestfrancis.org/ events (No August meeting)

CULTIVATING RECOVERY A FREE drug and alcohol relapse prevention group facilitated by a therapist and designed to continue accountability and treatment for those who have successfully completed a primary treatment program (inpatient or intensive outpatient). Topics are based on the needs of participants and may include self-care, support systems and relationships, coping skills, boundaries, spirituality, grief, assertiveness, communication, anger and resentment, developing joy, as well as moving forward in wellness on the recovery road. For more information, call 719-776-6850.

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NON-PROFIT ORG US POSTAGE

We’re on a mission to build whole person care and flourishing communities.

PAID

DENVER, CO PERMIT NO. 3280

2222 North Nevada Avenue Colorado Springs, CO 80907

Penrose-St. Francis Health Services is part of Centura Health, the region’s leading health care network. Centura Health does not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, and marital status in admission, treatment, or participation in its programs, services and activities, or in employment. For further information about this policy, contact Centura Health’s Office of the General Counsel at 1-303-673-8166 (TTY: 711). Copyright © Centura Health, 2018.

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

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

T

ired of that same-old salad? Add summer fruits or veggies, whole grains, and crunchy toppings to take your salads from so-so to sensational.

Intensify flavor by grilling or roasting fruits and veggies. Grilling fruits like peaches, pears, or watermelon brings out their sweetness. Peppers, squash, eggplant, and onions all taste great when grilled or roasted and added to salads.

GO BEYOND THE GREENS Make your salad extra filling with cooked quinoa or another whole grain that has fiber and protein to fill you up. Quinoa goes great with fruits and veggies. Sprinkle in the grain as a topping or make it the base of the salad, instead of greens.

Crunchy salad toppings include celery, jicama, nuts and seeds, and roasted chickpeas.

MIX IT UP Use different greens or combinations of greens, like spinach, mixed baby greens, arugula, and romaine. For a refreshing and summery feel, add dill or mint. Dill tastes great in salads with salmon or other fish. Both herbs complement fruit such as oranges and pineapple. Fresh oregano, basil, tarragon, thyme, and rosemary also taste great in salads.

3 WAYS TO UP YOUR SALAD GAME

Balance the sweetness of fruit with feta, goat cheese, or roasted nuts.

HEARTY QUINOA SALAD

Ingredients 2 cups quinoa, dry 1 cup black beans, rinsed 1 cup corn 1 cup edamame 1-3 bell peppers (various colors), diced ½ red onion, finely diced ½ cup red wine vinegar or to taste Salt and pepper to taste Instructions 1. Cook quinoa following instructions on box.

2. Cool for a few hours.

3. Mix quinoa with other ingredients.

4. Serve cold.

Make your own versatile dressing.

Find a tasty dressing that works with many salads, like olive oil and vinegar. Change the flavor with different herbs and spices.

Stock up on salad staples.

Keep greens, fruits and veggies, protein options (including whole grains), crunchy toppings, and spices in your refrigerator and pantry.

Step out of your comfort zone.

Look for interesting salad recipes online. Allrecipes.com provides personalized recommendations based on your tastes.

Is medical nutrition therapy right for you?

Call 719-776-3600 for information.

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SO LONG, BORING SALADS