Create Summer 2017

SUMMER 2017 • Volume 5, Issue 3

Your health. Your life.

BEST

No longer experiencing the pain of trigeminal neuralgia, Mark Bentz and his four-legged friend, Jackson, are back exploring the great outdoors.

FACE

FORWARD

THREE DIFFERENT TREATMENTS FOR TRIGEMINAL NEURALGIA HELP PUT AN END TO EXCRUCIATING FACE PAIN Page 4

a n d ...

LITTLETON PROGRAM REVERSES HEART DISEASE Page 3

BUILDING A CUSTOMIZED BREAST SCREENING SCHEDULE Page 6

ANEURYSM TREATMENT SAVES AURORA MOM’S LIFE Page 7

HEALTH BRIEFS

Summer

SUMMER STORM SAFETY

Be a good sport Dr. Kathryn Reitz

Colorado summers offer a great mix of activities to enjoy. But they all bring a chance of injury. To make the most of your summer fun, Kathryn Reitz, DO, a primary care physician at Clement Park Family Medicine in Littleton, offers these suggestions:

ACTIVITY

POTENTIAL PAIN POINT

TIP

Running

“For lots of people, when they start running things just start hurting — their knees, heels, ankles,” Reitz says.

Gradually increase mileage. “Start over each season, even if you maintained your cardio over the winter,” she says. Change your shoes regularly and run on a good surface. Trails and treadmills are softer than asphalt.

Trail running

Ankle sprains

Build lower-body and ankle strength and stability. Reitz recommends single leg dips: Stand on one foot, look at your toes, and do a squat until your knee covers your toes. Try 3 sets of 10 on each side.

Mountain biking

Concussions and broken clavicles (collarbones)

If you’re not ready for higher speeds, start slow and low and take your time to build up your comfort level.

Baseball

Overuse of the shoulder and elbow — especially in kids with open growth plates

Gradually increase your activity and work with coaches on good mechanics. If your technique is good, you will use your legs and lower body — not your shoulder — to generate power, she says.

AROUND-THE-CLOCK CARE

Not sure if that ankle pain needs urgent or emergency care? No worries.

Centura Health Emergency & Urgent Care — Highlands Ranch offers both with emergency care 24/7 and urgent care from 7 a.m.-9 p.m. in the same location at 9205 S. Broadway, Highlands Ranch. Call 303-649-3650 for information.

Try to get below tree line or find the lowest point in an open area Avoid solitary trees and other objects that are taller than the rest of terrain Get rid of any metal objects you’re carrying (trekking poles, backpacks with a metal frame, even jewelry) Stay out of caves and buildings with exposed openings like picnic pavilions Avoid any water and stay out of low spots that might accumulate any rain

15-27%

SPIKE IN SUMMER ER VISITS The top culprits: heatrelated conditions, sunburns, foodborne illnesses, trampoline injuries, lawn mower accidents, and animal bites

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 | SUMMER 2017 • Create

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Afternoon thunderstorms are routine in the Rockies — and they can come on suddenly.

When you’re hiking, protect yourself from lightning strikes with these tips:

Undoing Heart Disease

Littleton program turns back the clock on heart trouble Although he remembers the exact day he last ate meat — a pulled pork sandwich on Jan. 2 — Ed Stump

says he doesn’t miss it. The 63-year-old Golden resident has lost 23 pounds, he exercises regularly, and his cholesterol and blood pressure have improved to Dr. Richard Collins the point that his doctor slashed the dose of one heart medication and took him completely off two others. “I have turned back the clock on heart disease,” he says.

Life-Changing Lifestyle Stump, who suffered a heart attack and had five stents placed inside plaque-clogged arteries in his 50s, learned last year that one artery had become clogged again. “My own dad died of a heart attack at age 61,” he says, knowing that at age 62 he needed to change his lifestyle.

Little did he know his new lifestyle would change him.

After having another stent placed to unclog his artery, his medical team recommended that he enroll in the Ornish Lifestyle Medicine program now offered exclusively Patients who in Colorado through Centura Health. Dean participate Ornish is a California-based cardiologist in the Ornish who invented the program and has written program multiple books about it. The program lowered LDL delivers 72 hours of cardiac rehabilitation cholesterol and training, broken up into two four-hour levels by an sessions each week for nine weeks. average of 40 percent.

The program is intense, and involves four major components: exercise, stress management, group support, and a plant-based, reduced-fat nutrition plan with cooking instruction and lectures led by a registered dietitian. Candidates must have suffered a cardiac event, such as a bypass or heart attack. “Patients must also be willing and motivated to make changes,” says cardiologist Richard Collins, MD, with South Denver Cardiology, a Centura Health clinic that provides the program in the south metro Denver area.

40%

Open Heart, Healthy Heart Statistically, those who enter the program leave healthier, less dependent on heart medication and insulin, and less depressed.

Collins reports that nationally, 82 percent of program participants reduced the narrowing in their arteries. “Heart disease can be reversed. We’re not talking stabilization — we’re talking about undoing heart disease,” Collins says, noting that 95 percent of

Ed Stump lost 23 pounds and two medications through a local program to reverse heart disease.

participants comply with the program.

While Stump was originally leery that the support group component would be too touchy-feely, he now misses that twiceweekly camaraderie the most.

“A lot of people have a misconception that diet alone does the job, but the group support helps patients deal with the frustration and depression around their diagnosis. Dean (Ornish) has always said, ‘If you want to avoid open-heart surgery, then open up your heart,’” Collins says.

Looking back, Stump says he is thrilled he entered the program and wishes he would have known about it a decade ago. “This last episode was in many ways a lifesaving episode for me,” he says. “It put me on a path that is healthy.”

Discover how the Ornish program could give your heart new life. Call 303-74HEART to set up a consultation or tour today.

We are part of the Centura Heart Network, the region’s leading provider of cardiovascular care.

create | mylittletonhospital.org | 3

Facing the Littleton neurosurgeon offers hope for those with excruciating trigeminal neuralgia facial pain

M

ark Bentz likens the pain that attacked his face to torture. “Basically, it’s as if you took a meat cleaver and put it against your face and then hooked it up to a car battery.”

It took many visits and many specialists before Bentz got a diagnosis of a degenerative condition called trigeminal neuralgia. And with that diagnosis, Bentz got a referral to Littleton neurosurgeon J. Adair Prall, MD, a leader in treating the disorder.

SHOCKING NERVE PAIN Trigeminal neuralgia (TN) is most often caused by Dr. J. Adair Prall a blood vessel bumping up against the trigeminal nerve, which runs through the face to the brain, and controls sensation in the face, and motor functions such as biting. Trigeminal neuralgia also can be caused by multiple sclerosis, and much less commonly, benign tumors.

The searing pain attacks intermittently, and unpredictably. “I was lucky,” Bentz says.

“My shocks never lasted more than about three minutes.” But almost as debilitating as the pain itself, he says, was never knowing when it would strike.

For some, medication controls the pain.

But for many, medication’s side effects become intolerable. And for others, medications eventually become inactive.

“Medicine is always the first option, but patients don’t need to feel like they have to try every last medication before they look at surgery” says Prall, a boardcertified neurosurgeon with South Denver Neurosurgery, A Centura Health Clinic. ”

TN TREATMENT OPTIONS Typically, patients with trigeminal neuralgia have one or two areas along the nerve

4 | SUMMER 2017 • Create

causing pain. Bentz had three. So medication, he says, wasn’t cutting it.

Prall offered Bentz three treatment options: • Radiosurgery is a low-risk, minimally invasive procedure that actually isn’t surgery. A neurosurgeon uses computer images to precisely target focused beams of high-dose radiation at the trigeminal nerve. “The radiation injures the nerve just enough to stop the pain,” Prall says.

But it rarely damages the nerve enough to cause lasting side effects such as numbness. And up to 95 percent of patients experience pain relief that can last for many years.

• Microvascular decompression (MVD) is a surgical procedure to relocate or remove blood vessels pushing against the trigeminal nerve, and place a cushion between the nerve and the arteries. If arteries are not pressing on the nerve, the surgeon may cut the trigeminal nerve.

MVD eliminates or reduces pain in about 90 percent of cases. “The advantage of MVD is that it is more durable overall.

People are more likely to never have pain again,” Prall says.

• Percutaneous rhizotomy is a surgical procedure in which a thin needle is inserted through the cheek into the trigeminal nerve to damage the nerve and stop it from transmitting pain signals.

About 90 percent of patients get relief with this procedure as well, and pain often does not return. However, patients who experience pain relief will suffer some facial numbness.

SURGERY TO STOP THE PAIN In 2008, Bentz opted for radiosurgery.

The outpatient procedure was fast, and he recovered almost immediately. “I was completely pain-free, right after the surgery.

And it worked for eight years, which was phenomenal.”

Bentz says he was so satisfied with the treatment that when the pain eventually returned, he chose a second radiosurgery procedure. But he had become too claustrophobic to endure the MRI that is required to precisely target the radiation.

So, Bentz went with option No. 2, MVD. Prall performed the surgery at Littleton Adventist Hospital on a Wednesday, and Bentz went home on Friday. His recovery, with his wife and corgi, Jackson, at his side, involved little discomfort other than headaches. He has mild facial numbness, which is improving. But the pain is gone, and he is grateful to Prall. “I can’t imagine what the pain might be like if it weren’t for him.”

Mark Bentz found relief from the excruciating pain of trigeminal neuralgia and is enjoying life with Jackson by his side.

Other symptoms involving the face and other parts of the head also can be one of the group of disorders known collectively as vascular compression syndromes. Vascular compression syndromes are caused by pressure applied to cranial nerves, usually by a blood vessel.

These conditions include: Hemifacial spasm, characterized by frequent, painless muscle spasms on one side of the face. The spasms usually begin around the eye and progress to the entire side of the face.

Glossopharyngeal neuralgia causes pain in the throat and the base of the tongue that may radiate to the ear and/or neck. Pain can be intermittent or chronic. The condition may also cause excessive salivation and coughing.

Vertigo is a fairly common condition characterized by dizziness. Typically caused by irregularities in the peripheral vestibular system, vertigo can, in rare cases, be caused by compression of the vestibulocochlear cranial nerve, which is responsible for balance.

When medications and other options don’t provide relief, surgery may be a treatment option, says neurosurgeon J. Adair Prall, MD. Prall and colleagues at South Denver Neurosurgery are among the area’s few neurosurgeons experienced at performing microvascular decompression surgery to provide relief for vascular compression syndromes.

To download a FREE guide to trigeminal neuralgia treatment, visit southdenverneurosurgery.org and choose the “News and Resources” tab. To schedule an appointment at South Denver Neurosurgery, A Centura Health Clinic, call 720-638-7500.

create | mylittletonhospital.org | 5

PHOTO: ©ELLEN JASKOL

Pain

Face-to-face with pain

In April, Colorado lawmakers joined 29 other states in requiring that a woman be notified when a mammogram reveals she has dense breasts.

SCREENING OUT

CONFUSION

Knowing your breast cancer risk helps guide screening decisions With prominent medical organizations disagreeing about when women should begin getting mammograms and how often they should have them, it’s no wonder women are confused.

Stanley Smazal, MD, a diagnostic radiologist and breast imaging specialist at Littleton Adventist Hospital’s Breast Cancer Center, says there should be no doubt about when to have that first mammogram.

“We recommend every woman have a baseline mammogram at 40,” Smazal says. “One of the most important risk factors is breast density. And you don’t know if you have dense breasts until you get a baseline mammogram.”

Dense breasts are not synonymous with large breasts.

Density measures the ratio of glandular and fibrous tissue to fatty tissue. The more glandular and fibrous tissue, the greater the breast density. As breast density increases, so does cancer risk, Smazal says. He recommends ultrasound with mammograms for women with dense breasts.

Knowing your breast density is important to help you and your doctor calculate your overall breast cancer risk. Other factors that can impact risk include: • Family history • Childbirth history • Age at first period • Menopause after 55 • Body mass index “If your lifetime risk is over 20 percent, we recommend screening each year, with MRI,” he says.

6 | SUMMER 2017 • Create

TAKING BREAST CANCER RISK PERSONALLY We’ve heard the numbers: One in eight women develops breast cancer in her lifetime. But all breast cancer risk is not equal. If your mother had it, your risk may be higher. If you had a child before age 30, it may be lower.

Littleton Adventist Hospital’s genetic counselor Erin Hoffman can help you measure your risk, and discuss steps you can take to address it.

Before visiting the center, each woman fills out a family history questionnaire, Hoffman says. “So, I have their risk determined when they come in. From there we can discuss what the guidelines say is right for them.”

Then, a woman can choose monitoring in the high-risk clinic, or send the information to her primary care doctor, Hoffman says.

The center also offers testing for genetic mutations that have been linked to breast cancer risk.

To learn more about genetic testing, call Hoffman at 303-734-3969.

SAME-DAY MAMMOGRAMS available at the following Centura Health Breast Care Center locations. To schedule mammograms, call: • Littleton Adventist Hospital: 1-844-325-5579 • Castle Rock Adventist Hospital: 720-961-2033 • Centura Health Meridian: • 303-269-4150 • Centura Health Southlands: 303-269-4150 • Parker Adventist Hospital: 303-269-4150 • Porter Adventist Hospital: 303-765-6500

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WE RECOMMEND EVERY WOMAN HAVE A BASELINE MAMMOGRAM AT 40.” — Stanley Smazal, MD

Back in Circulation

A pain in her neck turned out to be a lifethreatening aneurysm for Angela Kernell.

Aurora woman returns to active life after serious health scare

10

A

People who have a family history of aneurysms may be 10 times more likely to develop one. Other risk factors include smoking and high blood pressure.

n active, athletic mom, Angela Kernell of Aurora looks back on the day she

played football with her son as the day that saved her life.

“I threw the football and felt like I pulled a muscle in my neck,” she says. The pain worsened until a trip to the ER revealed that the “pulled muscle” was actually a damaged artery that tipped doctors off to an even bigger problem.

Aneurysm Awareness

Kernell had three separate arteries in her head that had aneurysms — areas in the wall of the artery that have “ballooned.” Christopher Nichols, MD, a vascular and interventional neurologist at Littleton Adventist Hospital, says aneurysms occur in the blood vessels inside the head in 1 to 2 percent of the population.

Dr. Christopher Nichols Because they often do not cause symptoms, most aneurysms in this area are discovered after they rupture. “This generally causes a sudden, severe headache that almost all patients describe as the worst headache they have ever had,” Nichols says. And here’s the scary part: “Between 30 and 50 percent of patients who suffer a ruptured aneurysm die,” he says.

Thankfully for Kernell, the aneurysms were detected before they caused serious problems.

NEUROVASCULAR SPECIALISTS

Using extremely small microcatheters and computerbased angiography with 3-D reconstruction, specially trained physicians called neurointerventionalists can open and close abnormal vessels with less risk and faster recovery times.

These specialists use minimally invasive techniques to treat brain aneurysms, open blocked arteries in the brain, and remove clots in brain arteries. Littleton Adventist Hospital interventional neurologists include: Mark Murray, MD Board-certified neurologist Fellowship-trained in endovascular surgical neuroradiology Perry Ng, MD Board-certified in diagnostic radiology Fellowship-trained in neuroradiology and interventional neuroradiology Christopher Nichols, MD Board-certified neurologist Fellowship-trained in endovascular surgical neuroradiology and stroke and vascular neurology

Treatment and Recovery

This isn’t to say her treatment wasn’t serious. In 2013, Kernell had a craniotomy — a surgery that involved opening her skull — to “clip” two of the aneurysms, one of which was located behind her eye. “In this procedure, a surgeon comes in from the outside and pinches the aneurysm shut,” Nichols says.

One year later, after testing showed the third aneurysm had grown, Nichols treated it with a much less invasive approach called coiling. The treatment, offered at Littleton Adventist Hospital, involves threading a catheter through the groin to the brain. Then the aneurysm is filled with tiny platinum coils to wall it off from the artery.

Today, Kernell has been cleared for physical activity, allowing her to keep up with her 9-year-old son and her fitness goals. At age 40, she just ran her first half marathon since 2013. “I’m not scared to go out and exercise anymore,” she says.

Littleton Adventist Hospital is a leading neuroscience center, offering advanced care for conditions including stroke, brain tumors, and aneurysms.

create | mylittletonhospital.org | 7

Portercare Adventist Health System NON-PROFIT ORG US POSTAGE

PAID

DENVER, CO PERMIT NO. 4773

We may not realize it, but most of us know someone who struggles with mental illness.

Colorado is home to nearly 500,000 people living with a diagnosed mental illness, and the state consistently has one of the nation’s highest suicide rates.

Yet few of us would know how to respond if a friend, colleague, student, or loved one experienced a mental health emergency.

That’s why Castle Rock Adventist Hospital, Littleton Adventist Hospital, Parker Adventist Hospital, and Porter Adventist Hospital are offering Mental Health First Aid classes. The FREE, eight-hour classes don’t attempt to teach participants to diagnose, or treat, mental illness.

Instead, participants learn to recognize symptoms and develop strategies to support someone experiencing mental illness or emotional crisis.

A separate youth class is offered for teachers, social workers, coaches, and others who work with children and teens. Youth and adult classes offer a five-step action plan to: • Assess risk of suicide or harm • Listen nonjudgmentally • Give reassurance and information • Encourage appropriate professional help • Encourage self-help and other support

To learn more about Centura’s FREE Mental Health First Aid classes, or to register for a class, visit mhfaco.org.

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 1-719-776-5370 (TTY: 711).

TEENS AND VACCINES Most parents meticulously track their children’s vaccination schedule when the kids are little. But it’s easy to fall behind when calendars get packed with sports, scouts, and band practice. Still, preteens and teens need certain vaccinations just as much as babies and toddlers do. Before your older kids head back to school, or off to college, make sure they’re fully covered. Here’s a quick look at what they need: Age

Vaccine

What It Does

11-12

Meningococcal (MenACWY)

Protects against serious and sometimes deadly infections of the brain and spinal cord (meningitis) and bloodstream (septicemia)

11-12 (can be given as early as age 9 or as late as age 26)

HPV

Protects against a virus that causes cervical cancer, genital warts, and some forms of throat cancer

16

Meningococcal (MenACWY)

The CDC recommends a second dose at this age

16

Meningococcal B (MenB)

Protects against a common type of meningitis that the MenACWY does not protect against

All ages

Influenza

Protects against the flu, which can be serious in young people

To keep your preteen or teen’s vaccines up to date, call one of our Centura Health Physician Group primary care providers: • Chatfield Family Medicine: 303-738-2714 • CHPG at DTC: 303-770-6500 • Clement Park Family Medicine: 303-932-2121 • Grace Family Practice: 720-528-3559 • Highlands Ranch Medical Associates: 303-649-3140 • South Suburban Internal Medicine: 303-347-9897

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MENTAL HEALTH FIRST AID