Elevate Spring 2017

Living at the height of wellness spring 2017 | VOLUME 5, ISSUE 2

Better Bellies

A bevy of treatments can help improve the symptoms of irritable bowel syndrome Page 10

How

Touch

Helps Preemies at Castle Rock Adventist Hospital’s NICU Page 9

GET SMART ABOUT STROKES Page 3

Cures for common MIDLIFE health issues Page 4

Summer Shoulder Safety Page 7

When and Why to Call 911 Page 8

TRUST Take a second look Being able to trust your own instincts — as well as your care plan — is critical. And while 70 percent of Americans feel confident enough in their care provider’s advice that they don’t ask for a second opinion, there are times when one may be warranted. For example, if you’re not making progress/feeling better, you’ve been diagnosed with a lifethreatening illness, or if other treatment options may be available. If you think a second opinion is needed, don’t be afraid to ask for one.

Generation Gap Millennials are not only less trusting of institutions like government and religion than any other age group, according to a Pew Research study, they’re also less likely to trust other people. Just 19 percent say that most people can be trusted. On the more positive side, 49 percent of millennials trust that our best years are still to come as a country.

Lessons in

trust

It’s not something we might typically associate with our health, but trust is an integral part of our overall well-being — internally and externally.

“Trust is baked into the human experience and if we don’t have it, it’s hard to function,” says Eric Shadle, MD, South Denver Group Director of CREATION Health and Community Health for Centura Adventist Hospitals. “And that’s why it’s such a deep wound when someone violates it.”

First, we must trust our own instincts where our health is concerned, from finding healthy ways to stay motivated and meet our goals to paying attention when something’s “not right” and seeking care. And we must also be able to trust our care providers.

“I always think about the rule of threes for military survival: You can live three weeks without food, three days without water, three hours without shelter in extreme conditions, three minutes without air, but only three seconds without hope or trust. If we can’t trust, our health journey is compromised,” Shadle says.

Trust us with your sleep Do you or someone you love have trouble getting a good night’s rest? The Sleep Disorders Center at Castle Rock Adventist Hospital performs in-lab and at-home sleep studies. Many health-related issues are actually sleep disorders and can be treated by our specialists. Take a sleep disorder self-exam on our website at castlerockhospital. org/sleep-disorder-center and don’t waste another good night’s sleep! To make an appointment, call 720-455-3740.

To learn more about CREATION Health, go to castlerockhospital.org/ creation-health.

ELEVATE is published four times annually by Castle Rock Adventist Hospital — Portercare Adventist Health System. Executive editor is Christine Alexander. 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 elevate@centura.org. ELEVATE is produced by Clementine Healthcare Marketing.

2350 Meadows Boulevard | Castle Rock, CO 80109

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Cover photo: ©Istockphoto.com/WhitneyLewisPhotography; This Page: ©Istockphoto.com/Glayan, /Zoran Kolundzija, /amphotora; opposite Page: ©Istockphoto.com/asiseeit

CREATION Health is a wellness program designed to support whole-person health.

Stroke Smarts S

trokes, whether a blocked artery or a leaking or burst vessel that interrupts blood flow to the brain, cause one out of every 20 deaths in the U.S., the Centers for Disease Control and Prevention reports. Here’s what you need to know to build your stroke smarts.

53

%

Strokes are striking the young

Strokes among people ages 18 to 45 have jumped by as much as 53 percent since the mid-1990s. Yet three out of four Americans surveyed in that age group didn’t know the signs of a stroke and would opt to “wait out” the symptoms rather than seek medical treatment.

Castle Rock Adventist Hospital neurologist Claude Fortin, MD, says that while incidence of stroke has decreased overall, the number of younger Americans hospitalized for strokes has increased. Risk factors such as obesity, diabetes, high blood pressure, and sleep apnea may be to blame.

“One cause of strokes, arterial dissection — when arteries tear because of a sports injury or congenital defect — is more likely to affect active younger people,” he says. Pregnancy and birth control pills also can cause clotting disorders and increase stroke risk.

FAST FACT

10% of all strokes happen to those under age 45.

About

Use FAST to recognize and react to warning signs: Face droop Arm weakness Speech slurred Time to call 911 immediately 3-4 Hours The first three or four hours after the onset of stroke symptoms are called “the golden window,” when doctors have the best chance of minimizing damage by restoring blood flow to the brain. Clot-busting drugs like tPA (tissue plasminogen activator) can effectively treat stroke, but they must be administered quickly. “Once the brain tissue is damaged, there is not much that can be done,” Fortin says.

“Whatever tissue is lost is lost for good.”

9

10

out of

Castle Rock Adventist Hospital is part of the Centura Health Stroke Network, the region’s leading provider of stroke care.

castlerockhospital.org

strokes are preventable Ten controllable risk factors account for 90 percent of all strokes, according to a 2016 study.

1. High blood pressure 2. Physical inactivity 3. Unhealthy diet 4. Obesity 5. Smoking 6. Heart disease 7. Diabetes 8. Alcohol use 9. Stress 10. Lipids (high levels of blood fats)

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Ageless Care

Annual visits to an OB-GYN can be key to maintaining good health

N

o matter what stage of life a woman is in, an annual visit to an obstetrician/ gynecologist is a good idea, even if she sees a primary care doctor, says Kristen Boylan, MD, of Centura Health Physician Group RidgeGate OB-GYN. Dr. Kristen Boylan “Even if women have normal Pap smears and can space them out, we still like to see them every year.”

While a primary care doctor likely will screen for high blood pressure and cholesterol, and check blood sugars, an annual checkup and screenings with an OB-GYN might uncover a problem before it becomes serious. “We like to do breast and pelvic exams, checking for masses, tenderness, or pain, and talk about general health maintenance.” And, Boylan says, she believes it’s important for women to have an annual mammogram, starting at age 40.

ELEVATE 4 Spring 2017

For women who are experiencing symptoms, an OB-GYN can offer solutions for: • Fibroids. As many as 77 percent of women develop these noncancerous tumors of the uterus during their childbearing years. Many won’t have any symptoms, but others may experience heavy menstrual bleeding, and pelvic or back pain, or both. Treatment includes hormone therapy, such as birth control pills, hysterectomy, or embolization (a catheter-based procedure that blocks off the blood supply to the fibroids).

• Endometriosis. When uterine tissue grows on pelvic organs outside the uterus, it can cause severe pain and excessive bleeding. Those symptoms often can be abated with hormone therapy, or a Mirena IUD, which releases hormones that suppress bleeding, Boylan says. “We try to have patients exhaust medical therapies before choosing surgery,” Boylan says. “But a lot of women are just tired of the pain and want a hysterectomy.” Unlike years ago, hysterectomies today often can be done using minimally invasive techniques, and women can be back to normal activities within about six weeks.

• Incontinence. As many as one in four adult women experiences urinary incontinence, which can be caused by pregnancy and childbirth, as well as weakening of pelvic muscles with age. Physical therapy specifically designed to train pelvic floor muscles helps many women, while others may need minimally invasive surgery.

Menopause-related symptoms, including: • Painful intercourse. One-quarter to one-half of women experience painful intercourse after menopause.

Fortunately, vaginal estrogen creams offer relief. The doses of estrogen in those creams are far less than in birth control pills and hormone replacement therapy, Boylan says. “So even if you can’t do regular hormone therapies, you can benefit from vaginal estrogen creams.”

• Hot flashes. For women who don’t want to take hormone therapy, there are other options, says Boylan, including several antidepressants that are approved for relief of hot flashes. “And there are lifestyle changes we can talk about.

For instance, women who exercise regularly seem to cope with hot flashes a little better.”

Control the go: Physical therapy often can relieve urinary incontinence Castle Rock Adventist Hospital physical therapist Wendy Conley, DPT, who is certified in women’s health, has a message for women struggling with leaking, or frequent, or sudden and uncontrollable, urges to go: You don’t have to live with urinary incontinence.

“Many people think urinary incontinence is just part of aging. But it’s not,” she says.

Conley offers suggestions for managing your symptoms: Don’t: • Go when you don’t need to. Many women will go before they leave home, as a precaution. “That trains your bladder to expect to go at certain times,” Conley says.

• Give into “need-to-go” triggers, like arriving at home or getting on exercise equipment. “That sends a signal that ‘I need to go here, because I always go here.’”

Do: • Cut back on caffeine, and maintain a healthy weight.

• Stay hydrated. A lot of people think drinking a lot of water will make them have to go more, but actually, the opposite is true, Conley says. “If we are chronically dehydrated, it shrinks the bladder.”

When those strategies aren’t enough, physical therapy may help.

In addition to discussion and handouts with bladder control tips, Conley uses biofeedback to help train patients to do Kegel exercises properly, and learn to use pelvic muscles to aid bladder control. “We use an ultrasound machine, so patients can see layers of muscle. I have them contract and relax so they can see how the muscles work.”

A lot of people know Kegel exercises can help alleviate incontinence, but many don’t do them properly, Conley says.

Typically, people are told to contract muscles as though they’re trying to stop urine, she says. A better description is to imagine a string from the pubic bone to the rectum, and imagine pulling that string up from the inside. And most importantly, don’t bear down.

Typically, four or five visits are enough to equip women with the tools they need to manage symptoms long term.

Conley says she’s passionate about her work, because it can make a difference. “We can make really positive changes in people’s lives.”

Photos: ©Istockphoto.com/iconogenic, /BlackJack3D

Specialized Solutions

To schedule an appointment for outpatient therapy at the Castle Rock Center for Rehabilitation, call 720-455-3700.

To schedule an appointment with Dr. Boylan, call Centura Health Physician Group RidgeGate OB-GYN at 303-649-3380.

castlerockhospital.org

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Smoke Screen

Low-dose CT scans find lung cancer in earlier stages

At almost age 70, Su Dierbeck still remembers the first carton of

cigarettes she purchased as a college freshman in 1965. The price was about $5.60 — for the entire 10-pack carton. The cost? That turned out to be much greater.

At her peak, Dierbeck smoked three packs a day. Her parents were heavy smokers, and both would ultimately die before age 70 of smoking-related diseases.

She recently decided to get a low-dose CT lung cancer screening. She was terrified of what the test might find.

Peak number for 30-pack-year smokers Dierbeck’s experience is fairly typical. “Smoking in women peaked in the 1960s and ’70s.

Lung cancer rates parallel this and follow by about 20 years,” says Eric Stramel, DO, a pulmonologist at Castle Rock Adventist Hospital. Accordingly, new lung cancer cases peaked for women in 1998 and have declined since.

Still, lung cancer remains notoriously difficult to detect and treat. Low-dose CT scans can help those at high risk. This includes those who, like Dierbeck, have a 30-pack-year history (a pack a day for 30 years or two packs a day for 15 years).

“It is so important for high-risk candidates to get screened. A 2011 study showed that low-dose CT scans drove the mortality rate down by 20 percent,” Stramel says.

es Su Dierbeck has put down the cigarett core and picked up the weights, going to her fitness classes six days a week.

Reprieve from risk As for Dierbeck and that nerve-racking matter of her screening results? Statistics say that quitting before the age of 40 — which she did — reduced her risk of dying from smoking-related disease by about 90 percent. “Still, I was terrified between the time I had the screening and the time I got my results,” she says.

When they arrived? She exhaled like she had never exhaled.

There was no cancer. “It gave me total peace of mind. I plan now to have the screening done every year as recommended,” she says.

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The best way to lower your risk for lung cancer? Quit smoking.

“Smoking damages the normal lining of cells,” says Eric Stramel, DO. “In smokers, you have all these damaged cells — precursors to cancer — proliferating and growing.”

The good news? There are more tools to help smokers quit than ever. Stramel recommends talking to a pulmonologist or calling 1-800-QUIT-NOW for counseling and access to free or discounted samples of FDA-approved cessation medications.

Breathe Easier

Low-dose CT lung cancer screenings are available at Parker Adventist Hospital, Porter Adventist Hospital, Littleton Adventist Hospital, and Castle Rock Adventist Hospital. Call 1-855-456-5864 or visit southdenverhealth.org/ lung-screening to see if you are a candidate. Medicare and most insurance plans cover the cost if you meet the criteria, but be sure to check with your plan.

Castle Rock Adventist Hospital is part of the Centura Health Cancer Network, delivering integrated, advanced cancer care across Colorado and western Kansas.

PHOTOs: This page: ©Casther stock.adobe.com, /Kenishirotie, /BrianWeed stock, WOMAN ©Ellen Jaskol; opposite page: ©IStockphoto.com/humonia, /miflippo

Time to Quit

Arm yourself this spring

Painful

Separation

Dr. Anthony Sanchez

For a common shoulder injury, surgery may be called for — or not

You take a corner a little too fast, and suddenly

you’re launched over the top of your bike’s handlebars, and land hard on your shoulder.

When you pick yourself up, you’re in a lot of pain, and your shoulder is no longer where it’s supposed to be.

You’ve probably suffered a shoulder separation.

And now you and your physician have a decision to make: Should you have surgery or let time and physical therapy heal it?

The answer depends on the nature and severity of the separation, says Anthony Sanchez, MD, a surgeon at Centura Orthopedics in Castle Rock.

With a slight separation of the acromioclavicular (AC) joint, which is located at the top of the shoulder between the collarbone and the shoulder blade, surgery is rarely needed. For a complete separation, surgery is likely called for. But for those injuries that fall somewhere in between, treatment

becomes uncertain and somewhat controversial, Sanchez says.

“The literature shows that nonoperative treatment results in good outcomes” that are similar to surgery for those middle-ground injuries, Sanchez says. Nonoperative treatment typically includes: • Icing • Over-the-counter pain medications • Immobilizing the shoulder with a sling • A gradual increase in activity • Physical therapy Without surgery, the dislocation may remain visible. “The swelling will subside, but the clavicle may remain elevated,” Sanchez says. For that reason, some people request surgery.

Surgery involves reconstruction of ligaments, and typically means six weeks in a sling after surgery, followed by six to 12 weeks of physical therapy.

The most common shoulder pain doesn’t come from the sudden trauma of a separation, but from age, overuse, and repetitive motion — like you experience in golf, tennis, and other spring activities. To avoid the aches of shoulder tendinitis and bursitis:

1 Go slow. When starting a new season or sport, don’t overdo it. Gradually build up your intensity.

2 Stretch. Warm up before and after to prevent injury.

3 Get a caddy. Don’t carry golf clubs on achy shoulders.

4 Check your form. If golf or tennis hurts, have a pro analyze your serve or swing.

5 Bulk up. Build muscle strength and flexibility around your shoulder.

6 Give it a rest. When pain hits, take time off and try the treatments listed above.

Dr. Sanchez is an orthopedic surgeon who treats a wide range of orthopedic conditions and provides comprehensive treatment, including minimally invasive shoulder surgery and joint replacement.

To schedule an appointment with Dr. Sanchez or another provider at Centura Orthopedics in Castle Rock, please call 720-455-3775.

castlerockhospital.org

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How to know where to go 911

Why dialing is better than driving

With freestanding emergency rooms, urgent care centers, and boutique microhospitals popping up on every corner, medical Dr. Stefen Ammon care in the Denver area is not hard to find. That’s the good news.

That’s also the bad news.

“So many choices can be overwhelming.

Plus, confusion can cloud the decisionmaking process following an injury or illness, and it’s hard to know where to go,” says Stefen Ammon, MD, medical director of the ER at Castle Rock Adventist Hospital. In all cases that are not life-threatening, turn to your family physician first. But if that’s not an option, follow these.

URGENT CARE There’s definitely a need for urgent care

centers in the right circumstances. They can be a good alternative for minor illnesses or injuries — sprains, minor cuts, ear infections, and the flu — when you can’t get in for a same-day appointment with your doctor.

HOSPITAL-BASED ER “For life-threatening situations, you need to go to a hospital-based ER because they can provide the highest level of care,” Ammon says. Choose an ER for suspected heart attack or stroke (see Page 3 for stroke signs), a broken bone protruding through skin, an extreme allergic reaction, bleeding that will not stop, or sudden/severe vomiting.

An ER has specialists on call to provide immediate care and can admit you to the hospital if necessary. They also have surgeons, anesthesiologists, and surgical teams in-house 24/7 for trauma or other urgent surgery needs.

We are part of the Centura Health Trauma System, the region’s largest and most comprehensive network of trauma care and emergency services.

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Emergency care at Castle Rock Adventist Hospital • 24/7 emergency care provided by boardcertified physicians and specialty-trained emergency nurses • On-site laboratory services and imaging, including MRI, CT, ultrasound, X-ray, and digital mammography • Pediatric emergency services available 24/7 • 12 treatment rooms • Helipad for rapid transport of patients • Less than a 10-minute drive from most communities in and around Castle Rock

For real-time wait times at Castle Rock Adventist Hospital ER, visit castlerockhospital.org.

Photo: ©iStockPhoto.com/olaser; Opposite page: ©iStockPhoto.com/metinkiyak, /skhoward

Making sense of your health care options in an emergency

If you have a life-threatening condition, did you know that calling 911 is always better than driving to the emergency room? Here are three reasons why: 1. They know what to look for.

Emergency medical services (EMS) providers are highly trained in recognizing heart attack and stroke symptoms or concussions.

2. Care begins sooner. “Paramedics arrive quickly and can start treatment on the way in a controlled environment,” Ammon says.

3. Hospital care standing by. Plus, EMS providers will call ahead, so specialists will be ready to expedite treatment immediately when you arrive.

High touch in the high-tech

preemie world D

on’t let the high-tech environment of the neonatal intensive care unit (NICU) give you the wrong idea. When it comes to caring for prematurely born babies (born before 37 weeks), a parent’s love and touch are as essential as skilled medical care.

Dozens of clinical trials have found that a mom’s voice, touch, and milk are potent medicine. “I’ve seen all of these things make a difference, professionally and personally,” says Castle Rock Adventist Hospital’s neonatal nurse practitioner Joyce Madonia. “Both of my kids were preemies. The human touch is incredibly important for bonding for both babies and parents.”

It’s the little things  Mom’s singing (and even recordings of her singing) or reading soothes premature newborns, helping them breathe easier during their time in the NICU, according to analysis of more than a dozen clinical trials.  Pumped breast milk provides strong nutrition and boosts immunity. The milk of moms with preemies is even higher in certain proteins and amino acids than that of mothers of full-term babies.  Skin-to-skin contact, also called “kangaroo care,” is a therapeutic touch technique offered under the supervision of a nurse or nurse practitioner who helps baby and mom. Research shows it promotes regular breathing, helps with sleep, improves temperature control, decreases stress and pain, and bolsters breastfeeding and milk production.

Specialized care for your special delivery Castle Rock Adventist Hospital’s Level II neonatal intensive care unit strives to provide parents with a positive experience along with specialized care for infants delivered prematurely (3237 weeks) and for babies with special needs after full-term pregnancy. For a tour of our unit, contact birth concierge Jacque Northrup at 720-455-0355.

castlerockhospital.org

The BirthPlace NICU at Castle Rock Adventist Hospital • Castle Rock Adventist Hospital NICU’s expert staff includes a neonatal nurse, neonatal nurse practitioner, neonatologist, and pediatrician specializing in the care of sick infants • All neonatal nursing staff have several years of neonatal intensive care training • Our neonatal nurse practitioners are registered nurses with master’s degrees who have 10 or more years of experience caring for the sickest of newborns • A neonatal nurse and neonatal nurse practitioner are present in the hospital 24 hours a day, seven days a week

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Dealing with IBD

Inflammatory bowel disease can be incredibly painful and cause severe complications, but treatment can help improve quality of life and offer a cure in some cases Experiencing GI distress is no picnic. But the chronic, severe symptoms that accompany inflammatory bowel disease — diarrhea, pain, fatigue, and weight loss — are a whole different Dr. Prashant Krishnan matter. What do you do when faced with an illness like this? Is surgery the right way to go? We’ll explore available treatments for individuals with IBD to help them weigh their options.

At war with your gut About 3 million Americans suffer from inflammatory bowel disease, which involves chronic inflammation of all or part of your digestive tract, causing the symptoms mentioned. There are two basic types of IBD: • Crohn’s disease affects any part of the gut from the mouth to anus • Ulcerative colitis, only affects the colon

3,000,000

About ELEVATE

10

IBD can be debilitating and can lead to life-threatening complications as well as an increased risk of colon cancer.

The immune system is programmed to recognize the difference between good cells and bad, says Prashant Krishnan, MD, a gastroenterologist at Castle Rock Adventist Hospital. “But with IBD, it loses the ability to tell them apart and begins to attack your good cells in the gut, creating inflammation, which causes the symptoms.” Other parts of your body can be affected, too, like your joints, your vertebrae, or even your skin and eyes. Treatment involves suppressing your immune system to get rid of inflammation, thereby calming symptoms.

Fortunately, there are treatments available — including several classes of medications, as well as surgery — that can help. Krishnan and Doug Benson, MD, a colorectal surgeon at Castle Rock Adventist Hospital walk us through the primary options.

Spring 2017

Americans suffer from inflammatory bowel disease

Option

What it is

What it does (benefits and side effects)

Medications

Aminosalicylates (or 5-ASA drugs)

These types of medications are generally prescribed for mild disease, but they can have a welcome by-product. “Not only can they help relieve symptoms of IBD with minimal side effects, studies show they can decrease the risk of developing colon cancer in the future,” Krishnan says.

Oral steroids

While effective at getting an individual into remission (symptom-free), they’re best for short-term use due to their harsh side effects. “When someone flares, we typically put them on steroids, taper them off fairly quickly, and then modify their medication or put them on something stronger if needed,” he says.

Immunomodulators

Azathioprine (Imuran) and 6-mercaptopurine (6-MP) work to weaken or modulate your immune system, and can help achieve and maintain remission in both types of IBD.

Biologics

These lab-grown antibodies (including Remicade, Humira, and Stelara) can prevent certain proteins from causing inflammation and have revolutionized IBD treatment.

“Previously when patients had symptoms like diarrhea and bleeding, they couldn’t make it 10 feet without running for a restroom. Now, most of them can live normal lives without worrying about fecal urgency or incontinence.”

Surgery

Surgery to remove the colon can help cure ulcerative colitis, Benson says. Because Crohn’s disease affects the entire GI tract, surgery is not curative. But it’s still a treatment option.

“Up to 90 percent of Crohn’s patients will need surgery at some point. Sometimes it’s a good option early because if you’re able to remove a really bad area up front, the patient will be more responsive to biologics and other medications,” he explains. Surgery is a serious step, and it’s very important to find a surgeon who is well-versed in procedures to treat IBD.

FAST FACT Severe stress can make you five times more likely to have a flare-up of ulcerative colitis, according to a 2014 study published in the journal Gastroenterology Research. castlerockhospital.org

Imaging — including X-ray, CT, and MRI — is an essential tool in diagnosing IBD and many other health conditions. To schedule with outpatient imaging at Castle Rock Adventist Hospital, call 720-455-1111.

IBS vs. IBD

and how stress can affect both

The terms IBS (irritable bowel syndrome) and IBD are often used interchangeably, but they’re actually two very different conditions.

“When you talk about a syndrome, it’s a constellation of symptoms, and what the patient describes that they’re feeling,” Krishnan says.

“Inflammatory bowel disease is an actual disease process we can see when we’re scoping the patient.”

IBS also tends to be less severe and incapacitating than IBD, but they have one big thing in common: Both can be aggravated by stress.

“The second highest concentration of neurons, after the brain and spinal cord, is in the gut. So, when you have neurotransmitters firing under stressful situations, it’s going to affect your gut and can cause symptoms like a queasy stomach or diarrhea,” he explains.

That’s why it’s so important to have stress management techniques that work for you in place, and see your doctor for possible medications to help.

For more information about Castle Rock Gastroenterology or to make an appointment, go to castlerockGI.org or call 720-455-3879.

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Photos: ©istockphoto.com/cmannphoto, /PeopleImages

Leaving the bag behind A major concern among people who do consider surgery is having a colostomy bag, but there’s actually good news on that front.

“There are surgeries that can now be done that don’t result in a bag,” Krishnan says. He estimates surgical recovery time at about a week or less. And while patients who need surgery tend to do well, he recommends seeking out a surgeon with extensive experience managing IBD. Benson agrees. “I tell Crohn’s patients that less is more. When you’re doing surgery in the belly, you see a lot of disease. As a surgeon, you have to limit the procedure to as much as needed while taking as little as possible,” he says. “It takes a lot of discipline — and experience — to leave asymptomatic disease alone.”

His biggest takeaway where surgery is concerned is to make sure that your GI physician and colorectal surgeon are working together. “Most patients need a concert of both types of treatment,” he says. “The key is to do it tactfully. If you’re too aggressive, you can make things worse.”

Primary Care Practices

Portercare Adventist Health System Non-Profit Org US POSTAGE

PAID

Denver, CO Permit NO. 4773

Aurora CHPG Cornerstar Primary Care (Parker and Arapahoe) 303-269-2626 • cornerstarprimarycare.org CHPG Southlands Primary Care 303-928-7555 • southlandsprimarycare.org

2350 Meadows Boulevard Castle Rock, CO 80109

Castle Rock Ridgeline Family Medicine at the Meadows 720-455-3750 • ridgelinefamilymedicine.org Ridgeline Family Medicine — Castle Pines 303-649-3350 • ridgelinefamilymedicine.org

Centennial CHPG Grace Family Practice (near Arapahoe and Holly) 720-528-3559 • gracefamilypractice.org CHPG Holly Creek 303-649-3820

Denver CHPG Clermont Park 303-649-3155 • clermontparkseniorcare.org CHPG Primary Care Cherry Creek 303-316-0416 primarycarecherrycreek.org CHPG Primary Care Highlands (near I-25 and Speer) 303-925-4580 • chpghighlands.org CHPG Primary Care Porter 303-649-3200 • porterprimarycare.org

Greenwood Village CHPG at DTC (Ulster and Belleview) 303-770-6500 • dtcfamilymedicine.org

Highlands Ranch Highlands Ranch Medical Associates 303-649-3140 highlandsranchmedicalassociates.org

Littleton Chatfield Family Medicine 303-738-2714 • chatfieldfamilymedicine.org Clement Park Family Medicine 303-932-2121 clementparkfamilymedicine.org South Suburban Internal Medicine (at Littleton Hospital) 303-347-9897 southsuburbaninternalmedicine.org

Castle Rock 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 303-804-8166. Copyright © Centura Health, 2017.

Spring Is Sprouting

Three great veggies to plant in your garden now

With an altitude of 6,224 feet, Castle Rock’s growing season starts later than most, typically in early June. But the good news is, cool-weather plants can be started early. Dan Skay, executive chef at Manna Restaurant inside Castle Rock Adventist Hospital, suggests three lesser-known vegetables to consider planting as soon as the ground thaws: Leeks are bursting with vitamin A, are a good source of vitamin C and folate, and also make a tasty side dish, roasted and drizzled with olive oil.

Sugar snap peas are packed with vitamin C and are perfect for adding to a spring salad or to nosh as an afternoon snack.

Brussels sprouts are a good source of protein, iron, and potassium, and are also high in fiber and vitamin C. When selecting and preparing Brussels sprouts: • Look for them still on the stalk for superior freshness • Choose sprouts that are smaller in size (as they tend to be sweeter, with a less woody taste or fibrous texture than larger sprouts), with leaves that are tight and firm Overcooking Brussels sprouts gives them a bitter flavor and diminishes their nutritional value, while roasting helps bring out their best flavor and retains their bright green color.

As Manna Restaurant’s favorite side dish, Brussels sprouts can be a dish worthy of a second chance.

CHPG Internal Medicine Parker (on hospital campus) 303-770-0500 • internalmedicineparker.org CHPG Primary Care Meridian 303-649-3100 • parkerprimarycare.org Timberview Clinic at Parker (on hospital campus) 303-269-4410 • timberviewclinic.org

Chefs Dan Skay and Adam Freisem create menus for Manna Restaurant that reflect Colorado’s growing seasons. To see what is on the current menu, visit mannasbounty.com or call 720-455-3664.

Photos: ©Ellen Jaskol

Parker