Create Fall 2017

FALL 2017 • Volume 5, Issue 4

Your health. Your life.

STICK YOUR

NECK OUT

CONSERVATIVE AND SURGICAL OPTIONS TO EASE CHRONIC NECK PAIN Page 4

a n d ...

MIDWIVES GIVE MOMS-TO-BE PEACE OF MIND Page 3

6 WAYS PRIMARY CARE PROVIDERS KEEP YOU HEALTHY Page 6

EVALUATION AND TREATMENT OPTIONS FOR EPILEPSY Page 7

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Women need to know what’s normal and what’s not at this major health milestone

SIGNS YOUR THYROID IS UNDERPERFORMING

Hormonal changes in women around 50 often can be attributed to perimenopause, but the chances of developing hypothyroidism (low thyroid hormone) increase during midlife as well. Here are five signs to watch for: 1. You’re cold when others aren’t.

2. You tire more easily.

3. You’re constipated without cause.

4. Your skin is dry.

5. You’re forgetful and depressed.

NEED ANOTHER

reason TO KEEP

POUNDS OFF? Here’s one: your brain.

A recent study of more than 8,000 women ages 65-79 found that with each one-unit increase in body mass index, scores Dr. Bruce R. Dorr on a measure of cognitive abilities dropped by nearly one point. Keeping pounds off can be a struggle for older women, but maintaining healthy weight may help preserve cognitive abilities, says Bruce R. Dorr, an obstetrician-gynecologist at Littleton Adventist Hospital.

HYSTERECTOMIES

CAUSE RAPID BONE LOSS M

ost women today undergoing hysterectomies have their ovaries removed along with their uterus, a procedure called an oophorectomy. While this procedure eliminates the risk of ovarian cancer, it has an often overlooked side effect: Women who have their ovaries removed prior to menopause lose bone mass at twice the rate of women who still have their ovaries, according to a study published in the journal Fertility and Sterility.

If you’ve had your ovaries removed, you should get a bone density test every two years, regardless of your age (young or old), recommends Bruce R. Dorr, MD, a obstetrician-gynecologist at Littleton Adventist Hospital. If your results are low, talk to your doctor about medication that could slow bone loss. Plus, get adequate calcium and vitamin D, do daily weight-bearing exercises, quit smoking, reduce alcohol consumption, and talk to your doctor about medications that can accelerate bone loss — such as antacids and steroids.

Who

NEEDS PAP TESTS?

elines American Cancer Society guid results test Pap l ma nor say women with V HP plus s test Pap should continue test Pap a or rs yea five screening every The 65. age il unt rs yea e alone every thre l tota a had e hav who n exception: Wome ries and hysterectomy (removal of ova ir doctor’s the at ing test cervix) can stop . recommendation

SCHEDULE A BONE SCAN

Women at average risk for osteoporosis should begin bone density screening at age 65.

Screenings require a physician referral and can be scheduled at the following Centura Health South Denver centers: • Littleton Adventist Hospital: 1-844-325-5579 • Castle Rock Adventist Hospital: 720-263-4245 • Parker Adventist Hospital: 720-809-8956 • Porter Adventist Hospital: 1-844-325-5584 • Meridian and Southlands: 720-809-8956

Littleton Adventist Hospital brings specialized care to the people of South Denver in the complex areas of trauma, cancer, neurology, cardiology, orthopedics, women’s services, and more. We are part of Centura Health, the state’s largest health care network. The purpose of this publication is to support our mission to improve the health of the residents of our community. No information in this publication is meant as a recommendation or as a substitution for your physician’s advice. If you would like to comment or unsubscribe to this magazine, please email create@centura.org. Create is published four times annually by Littleton Adventist Hospital — Portercare Adventist Health System.

7700 S. Broadway | Littleton, CO 80122 | mylittletonhospital.org 2 | FALL 2017 • Create

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HEALTH BRIEFS

Fall

Turning the big

BIRTH RIGHT

Hospital midwives give moms-to-be comfort and safety

M

any moms-to-be face a dilemma: They want a natural birth with a midwife and the comforts of home, but they don’t want to sacrifice the peace of mind that comes with having experienced physicians and a hospital standing by just in case.

Littleton Adventist Hospital’s BirthPlace solves the problem by offering moms the best of both — midwife-attended delivery inside the hospital.

Certified nurse-midwife Karen Hashemi says many women choose a midwife because they are looking for less intervention, and a more natural pregnancy and delivery.

They can get that, she says, plus a lot of individual attention. “We talk a lot with women and educate them about what’s going on throughout the pregnancy, and after delivery. We want people to bring questions.”

A plan for pain management They also encourage women to consider and communicate their preferences for pain control, among other things. Pain medication, including nitrous oxide and epidurals, are available — or not. “Women can choose to use a few of the tools the hospital has, or all the tools,” Hashemi says.

During labor, women who forgo epidurals can eat, walk, use the spa tub or shower, and are monitored intermittently. And women always can change their mind during delivery without pressure.

Teaming up for safe deliveries If a laboring mom, or baby, shows signs of distress, nursemidwives work closely with obstetricians — and that’s when the advantages of being in a hospital become clear.

Some moms-to-be aren’t candidates for midwife delivery, Hashemi says. They include women who have: • History of blood clots • Multiple babies on board • Type 1 diabetes • Uncontrolled high blood pressure • Seizure disorder • History of preterm labor, or pregnancy lasting more than 42 weeks • Fetal abnormalities requiring surgery

Learn more through our family life education classes at mylittletonhospital.org/classes-and-events.

HOW TO PICK A PEDIATRICIAN

1. Start searching for your pediatrician well before your due date, the American Academy of Pediatrics advises.

2. Begin the search by asking friends, family, and your OB/GYN for recommendations; then check credentials online, and look for practices nearby — you don’t want a long commute with a sick child.

3. Once you’ve narrowed your search, make appointments to meet two or three pediatricians. Most will provide a free consultation. Ask questions, such as: • What is your philosophy of care (do they focus on wellness programs, or are they more available for sick children)?

• Do you have a subspecialty or area of interest?

• Are you available after hours, or do you use a service?

• Will I see you at every appointment?

• Which hospitals do you work with, and do you have an integrated electronic medical record with those hospitals?

• How long will I wait for an appointment for a well-child visit?

• Do you have same-day appointments for sick children?

• What’s your approach to immunizations?

• How do you feel about alternative medicine?

To find a Centura pediatrician or family practice physician, go online to centura.org and click on “providers.”

create | mylittletonhospital.org | 3

SAVE YOUR

NECK CERVICAL DISC REPLACEMENT CAN EASE CHRONIC PAIN

Y

our neck is an amazing apparatus.

It holds up your head; it swivels and turns. It bends so you can throw your head back and laugh; it bends forward so you can stare at your phone.

All too often, though, it can hurt.

In fact, every year an estimated 15 percent of adults in the U.S. report neck pain. Often, no specific event is identified that caused the neck pain. In other instances, the pain is caused by simply sleeping in the wrong position, or by sudden injury or trauma. Fortunately, most neck pain resolves with rest and over-the-counter pain relievers.

But, according to neurosurgeon Paul Boone, MD, of South Denver Neurosurgery, when neck pain lasts for several weeks, radiates down your arms, or causes numbness and tingling in the arms or hands, the pain may indicate that a lifetime of bending and twisting has taken a toll.

You may be suffering from degeneration of the cervical spine, the neck portion of the spine. This is a common consequence of aging, Boone says. This degeneration can lead to the development of a disc bulge or bone spur that causes compression of the nerves or spinal

4 | FALL 2017 • Create

cord in the neck.

When this happens, it may be time to see a doctor. “Surgery is never the first treatment choice,” Boone says. “We recommend noninvasive approaches first, when appropriate.”

Those noninvasive approaches include: • Ibuprofen or other anti-inflammatory medications • Muscle-relaxing medications • Physical therapy But if those approaches don’t relieve your pain, surgery may be an option. Emerging techniques, including artificial disc replacement, mean better results and faster recovery than cervical spine surgery patients experienced in the past, Boone says. A 2016 study found, for example, that artificial cervical disc replacement resulted in better function, less need for additional surgery, and fewer complications than other surgical approaches.

Not every patient is a candidate for artificial disc replacement surgery, however. Those who are candidates include patients who: • Experience arm pain • Experience numbness and tingling in the arm and hands • Have degenerative disc disease in only one or two discs • Have no allergies to stainless steel

NO MORE PAIN IN THE NECK

Skilled manipulation offers noninvasive solution to chronic pain

Dr. Paul Boone is a fellowship-trained, board-certified neurosurgeon with expertise in disorders of the spinal column and cord.

He specializes in complex reconstructive surgical techniques as well as minimally invasive approaches.

To schedule an appointment with Dr. Boone or another spine specialist at South Denver Neurosurgery, call 720-638-7500 or visit southdenverneurosurgery.org.

Artificial disc replacement surgery offers significant advantages over other methods, Boone says. The approach reduces the chance that nearby segments of the cervical spine will degenerate, and eliminates the possibility of complications that can result from other surgical approaches, such as failure of the spine to fuse, which can happen with bone-grafting techniques.

“The traditional approach to long-term neck pain relief has been fusion surgery. That addresses the pain, but results in some degree of immobility,” Boone says. “Disc replacement, however, allows me to accomplish the pain relief, and still preserve mobility. In fact, most patients can resume full activity, including jogging or hiking, within a few weeks to months of disc replacement surgery.”

Eventually, nearly everyone gets neck pain. Among the noninvasive pain-relief options to try is osteopathic manipulation.

Osteopathic manipulation differs from massage, and from chiropractic treatment, says Timothy Judd, DO, an Dr. Timothy Judd osteopathic doctor and family medicine physician with Centura Health Physician Group Denver Tech Center. Massage manipulates soft tissue; chiropractic manipulates joints. Osteopathy addresses both, he says.

Judd begins exams by making sure there is no structural problem, such as a displaced disc or nerve damage, causing the pain.

Then, he typically employs one of many available approaches to treatment, including: • Muscle energy techniques use isometric muscle contractions and controlled manipulation to address and slowly increase restricted range of motion • Articulatory techniques involve “popping” the affected joint in a careful, controlled manner, and then articulating the joint to free it and increase motion • Trigger point injections of lidocaine numb the nerve at the pain source, allowing the muscle to relax Other soft-tissue techniques, such as myofascial release, balanced ligamentous tension, and cranial osteopathy can also treat neck problems.

Treatment is crafted so patients can take the techniques home with them. “We focus on overall health, and helping patients to do things on their own, such as stretching. That way they don’t have to come back every week for life.”

To prevent neck pain from occurring in the first place, Judd advises: “Push away from your computer at least once every hour. Get up, stretch, walk around, loosen things up.”

To make an appointment with Dr. Judd, call 303-770-6500.

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“Most patients can resume full activity, including jogging or hiking, within a few weeks to months of cervical disc replacement surgery.”

If you are considering neck surgery, learn the differences between fusion and disc replacement and which would better suit you by downloading a FREE guide summarizing clinical research at southdenverneurosurgery.org/ cervical-neck-pain-surgery-guide

create | mylittletonhospital.org | 5

reasons to have a primary care provider Do you have a regular hairstylist? Dry cleaner? Mechanic? If so, you know the importance of building relationships

Dr. Neha Patel

with people who understand your preferences.

And a good primary care physician (PCP) should be on your list as well. A PCP knows your health history and can look out for your greatest asset — your health.

“Primary care physicians provide a lot more value than the general public knows,” says Neha Patel, DO, a family medicine physician at Centura Health Physician Group Denver Tech Center. Here are six ways you can benefit from having a PCP.

You won’t have to wait.

Being an established patient means getting an appointment quicker when you need one because the newRemin der patient paperwork is already on file.

Appoi nt 30 minment in utes

You’ll have access to trusted specialists. When you have an issue that requires a specialist, start with your PCP. “Having a PCP expedites the process of getting a referral,” Patel says.

“Your PCP then will act as a point person and coordinate the care between multiple specialists.”

You won’t have to explain yourself. Primary care physicians keep your personal and family health history in electronic medical records, which means you won’t have to start from scratch at every visit.

Your health will improve.

Having access to primary care improves health and reduces the risk of death from heart disease, cancer, or stroke, according to a review of multiple studies spanning 30 years by the National Institutes of Health.

What’s a DO? Everyone knows what MD stands for. But an increasing number of physicians are opting for a “DO” after their name. What does it mean?

DO stands for Doctor of Osteopathic Medicine, and it’s equal to MD in level of education. What is different is their care philosophy. While MDs focus their training on medication and procedures to heal the body, DOs receive additional musculoskeletal training and tend to rely on methods that encourage the body to heal itself.

6 | FALL 2017 • Create

You’ll have help interpreting your Google results. Massive amounts of information — and mis-information — swirls the internet. Your PCP can help you understand what’s beneficial for you.

You can get no-hassle prescription refills. Did you forget you need more asthma inhalers and now you’re leaving town? Your PCP can approve refills of routine medications without an office visit.

Online Scheduling Having a primary care physician means you’ll be seen quickly. And Centura is making it even quicker by now offering same-day appointments and online appointment scheduling at sameday.centura.org.

Find a Centura primary care doctor online at centura.org/find-a-provider.

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Primary

High-tech epilepsy treatment ADVANCES AT LITTLETON ADVENTIST HOSPITAL BRING NEW HOPE TO PATIENTS WITH THIS NEUROLOGICAL DISORDER

1 26 in

Americans are affected by epilepsy

OF THESE

1 3 in

need advanced treatments to control seizures

R

epeated, unpredictable seizures are the hallmark of epilepsy, making it difficult for patients to drive, swim, or even hold a job.

Epilepsy is estimated to affect one in every 26 Americans. Of these, one in three has little chance of ever becoming seizure-free.

Until now.

Neurosurgeon David VanSickle, MD, PhD with South Denver Neurosurgery, outlines exciting new treatments offered at Littleton Adventist Hospital for patients who have medication-resistant forms of epilepsy: Dr. David VanSickle • Responsive neurostimulation: Epilepsy seizures stem from abnormal bursts of electrical activity in the brain.

RNS, or responsive neurostimulation, is a device implanted under the skull which is then connected to leads that are placed at the seizure focus in the brain. The RNS system monitors and records brain signals.

“The device will detect if you have a seizure starting and abort it by disrupting the abnormal brain activity,” VanSickle says.

• Laser ablation: This minimally invasive approach uses heat to destroy the tiny region of the brain where seizures begin. It is an alternative to traditional surgery. “Often the area that triggers seizures is hard to get to,” VanSickle says, adding that patients understandably were hesitant to choose surgery because of the risk of damaging healthy tissue. “With ablation, we guide a laser fiber in. This tends to avoid cognitive impact,” VanSickle says. “The majority of ablation patients are seizure-free for the rest of their lives.”

• On the horizon: Deep brain stimulation (DBS). More widely known as a treatment for Parkinson’s disease or essential tremor, DBS for epilepsy is pending approval by the Federal Drug Administration. Similar to a pacemaker for the heart, DBS delivers electrical stimulation to regulate the brain’s electrical signals. “DBS can be used for people who have seizures coming from many different places in the brain,” says VanSickle, who was the first neurosurgeon in the country to perform robotic-guided DBS surgery while the patient is asleep.

EVALUATION IN THE EMU Identifying the type, origin, and quantity of epileptic seizures greatly influences treatment — and whether or not it’s successful.

The Epilepsy Monitoring Unit (EMU), located within the Intensive Care Unit at Littleton Adventist Hospital, provides a safe, expert-staffed, closely monitored environment in which seizure activity can be provoked in epilepsy patients. This leads to a definitive diagnosis in nearly 90 percent of cases and guides treatment in as many as 80 percent of cases.

“This type of epilepsy monitoring unit is almost always only available in a university setting,” says neurosurgeon David VanSickle, MD, PhD. To learn more about Littleton Adventist Hospital’s EMU, call 720-528-0823.

To make an appointment with Dr. VanSickle to discuss surgical options, call South Denver Neurosurgery at 720-638-7500.

create | mylittletonhospital.org | 7

Portercare Adventist Health System NON-PROFIT ORG US POSTAGE

PAID

DENVER, CO PERMIT NO. 4033

FALL

rmation More ingfosoon! comin

2017

CALENDAR

7700 S. Broadway Littleton, CO 80122

Littleton Adventist 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 303-738-7781 (TTY: 711). Copyright © Centura Health, 2017. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 303-738-7781 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 719-776-5370 (TTY: 711).

MAMMOS, MOCKTAILS, AND MORE

You show everyone else love; it’s time to take care of yourself, too!

Join us for Mammos, Mocktails, and More and stay on top of your breast health. Schedule your mammogram; stay for the chair massages, refreshments, and giveaways.

Dates | Oct 18 or Nov 8 Time | 3-7 p.m.

Location | The Breast Care Center at Littleton Adventist Hospital, 7700 S. Broadway, Littleton Registration required 303-738-2767

MY HEART’S A FLUTTER

Atrial fibrillation, or A-fib,is a quivering or irregular heartbeat. Join Dr. Sri Sundaram to learn more about this disease, our innovative treatment options, and what you can do to support better heart health.

Date | Thu, Oct 19 Time | 6-7 p.m.

Location | South Denver Heart Center, 1000 South Park Drive, Littleton Registration porterhospital.org/ events or 303-765-3825

THE BENEFITS OF DEEP BRAIN STIMULATION FOR PARKINSON’S DISEASE AND ESSENTIAL TREMOR

Join Dr. Mihaela Alexander, Dr. Luisa Solis-Cohen, and Dr. David VanSickle to learn more about this minimally invasive procedure that has been proven effective for disorders such as Parkinson’s disease, essential tremor, dystonia, and obsessive-compulsive disorder.

Date | Mon, Oct 23 Time | Registration opens at 8:30 a.m.; program 9-10 a.m.

Location | Douglas H. Buck Community Recreation Center, 2004 W. Powers Ave., Littleton Registration required mylittletonhospital.org/ lahclasses

ORNISH HEART DISEASE REVERSAL PROGRAM

Littleton Adventist Hospital and South Denver Cardiology Associates are proud to offer Ornish Lifestyle Medicine™ — the first and only program that is scientifically proven to slow, stop, and even reverse the progression of heart disease. Dr. Mark Sheehan, cardiologist, will discuss the science behind the program and share the life-changing results we are seeing in participants.

Learn more about this life-changing program and see if you are eligible to participate.

Date | Tue, Nov 7 Time | 6-7 p.m.

Location | South Denver Heart Center Conference Room, 1000 South Park Drive, Littleton Registration required 303-744-1065

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Littleton Adventist Hospital is now offering highly advanced robotic-arm assisted joint replacement. We’re the first hospital in Denver to offer robotic-arm assisted total knee, partial knee, and total hip replacements with one system.