Elevate Spring 2018

Living at the height of wellness SPRING 2018 | VOLUME 6, ISSUE 2

IT’S SPRING,

BABY Midwives are giving women peace of mind about their pregnancy and delivery

YOU’RE

INVITED

TO THE BIRTH & BABY EXPO Page 8

ORTHO INJURIES Page 3

MIGRAINE MANAGEMENT Page 5

TUMMY TROUBLES Page 7

et’s face it, ladies, routine health screenings don’t always fit our routine. But it’s

important not to let time, finances, or fear sabotage the discovery of health problems.

Lauren Burke, nurse practitioner at Ridgeline Family & Sports Medicine at the Meadows, offers these screening guidelines for healthy women at average risk for disease.

40s

The 40s are full of questions about mammograms. When to start?

How often? Burke says 40 is not an automatic start age, but it is time to discuss pros and cons with your provider.

Also consider screening for blood pressure annually, cholesterol every five years, diabetes every three years, and vision screening every two to four years.

70s

20s 3

Make time in the jet-setting 20s to begin cholesterol and blood pressure checks every three to five years. Also, schedule a Pap test every three years beginning at 21 and chlamydia screening for sexually active women up to age 25.

50s

Age 50 brings a not-so-nifty rite of passage: colonoscopy. The good news?

If there are no signs of colorectal cancer, you can wait a whopping 10 years to repeat. It’s also the only screening test that can actually prevent cancer because nodules that can turn into cancer are removed during the procedure.

At 50, annual mammograms are a must. At 55, if you’re a current or former smoker, begin low-dose CT screening for lung cancer if you smoked the equivalent of a pack a day for 30 years (or two packs for 15 years).

s

Thirty-somethings are in the thick of careers and kids. Lucky for you, there’s just one big screening to remember: At 30, begin getting a Pap test with HPV testing. If both results are normal, you don’t need another for five years.

60s

By the 60s, your screening schedule — like your body — experiences a few starts and stops. At age 65, start bone density (DXA) screening to check for osteoporosis and stop Paps if your recent test history is normal.

Congratulations on your septuagenarian status and on arriving at another decision about mammography. Some guidelines suggest ceasing mammography at 74, but with increasing life spans, it’s a good idea to discuss the decision with your doctor.

Lauren Burke, NP

SEARCHING FOR A PRIMARY CARE OR FAMILY DOCTOR? Call Ridgeline Family & Sports Medicine at the Meadows in Castle Rock at 720-455-3750 or Ridgeline Family & Sports Medicine — Castle Pines at 303-649-3350.

Or go to ridgelinefamily medicine.org.

A new definition of high blood pressure means that nearly half of all U.S. adults have hypertension.

And nearly half of these are women.

Birth control pills raise blood pressure risk in some women, as does menopause.

ELEVATE is published four times annually by Castle Rock Adventist Hospital. 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.

2350 MEADOWS BOULEVARD | CASTLE ROCK, CO 80109 | 720-455-5000

ELEVATE

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Spring 2018

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Spring

HEALTH BRIEFS

L

SCREEN TIME A decade-by-decade guide for women’s health screenings

ORTHO

AVOID THESE THREE COMMON

Between work, school, and family responsibilities, you count on being able to go, go, go. Imagine how a joint injury would slow you down.

“Orthopedic injuries can be quite limiting,” says Anthony Sanchez, Dr. Anthony Sanchez MD, orthopedic surgeon at Centura Orthopedics & Spine — ­ Castle Rock.

“They often require rest and joint immobilization.”

Here are three common orthopedic injuries and how to avoid them:

1

WRIST FRACTURE

Accounting for 18 to 25 percent of all fractures, wrist fractures are the most common in all age groups. They often result from trying to catch yourself during a fall, but car crashes and other accidents are also culprits.

Prevent it: Focus on bone health by eating a healthy, calcium-rich diet and engaging in strengthening exercises like wrist extensions.

Wear wrist guards when skating or doing other activities with a high risk of falling.

Treat it: Wrist fractures require diagnosis and treatment by a physician. If you have pain and swelling, have difficulty moving your hand, or feel tingling in your fingertips, call your doctor.

2

ANKLE SPRAIN

Nearly 25,000 people sprain an ankle every day while walking on an uneven surface, twisting at the ankle, or falling. Sprains can range from mild to severe.

Prevent it: Always wear the right shoes for your activity. Strengthen your ankles with exercises like balancing on one leg and using a balance board.

Treat it: Mild sprains can be treated at home with rest, ice, compression, and elevation. If you can’t bear weight on the joint or there’s significant swelling, go to the doctor for an X-ray. castlerockhospital.org

ANSWERS

ORTHOPEDIC INJURIES 3 DISLOCATED SHOULDER

Your shoulder has the greatest range of motion of any joint, and it’s also the most commonly dislocated. Young men and older women are at the highest risk for dislocating their shoulders during accidents or falls.

Prevent it: Wear protective gear when playing contact sports. Avoid falls by keeping floors clear of trip hazards and talking to your doctor about any dizziness you experience.

Treat it: Joint dislocation is an emergency.

If your shoulder is visibly out of place, you experience severe pain, or you’re unable to move the joint, get to the ER. In the meantime, ice the joint, but do not move it.

WHAT’S THE DIFFERENCE? PRIMARY CARE SPORTS MEDICINE PHYSICIANS

specialize in the prevention and nonoperative treatment of sports-related conditions, such as musculoskeletal injuries, concussions, and asthma.

Ridgeline Family & Sports Medicine at the Meadows in Castle Rock and Ridgeline Family & Sports Medicine in Castle Pines offer primary care sports medicine. For an appointment, call 720-455-3750, or go to ridgelinefamilymedicine.org.

HealthFit Family Medicine in Castle Rock offers primary care and fitness services.

For an appointment, call 303-218-7774 or go to healthfitcolorado.com.

ORTHOPEDIC SURGEONS specialize in operative treatment of musculoskeletal injuries in athletes and nonathletes.

Centura Orthopedics & Spine offers expert orthopedic surgeons and pain physicians who provide care for all orthopedic injuries and conditions. To learn more, go to centuraorthopedics.org or to make an appointment, call 720-455-3775.

Spring 2018

3 ELEVATE

MIDWIVES TO MIGRAINES

BIRTH RIGHT

HOSPITAL MIDWIVES OFFER MOMS-TO-BE COMFORT AND SAFETY

LABOR AND DELIVERY Less monitoring, more roaming. During labor, many women can walk, eat, even shower. Monitoring is intermittent, not constant.

Pain control options. A common misconception is that using a midwife excludes an epidural. In fact, a range of pain control is available.

No labor timetable. Some hospitals and physicians expect labor to progress and may intervene if it doesn’t. Slocum likes that Castle Rock Adventist Hospital has no enforced timetable for labor.

Reality checks. Some women are adamant about following a birth plan, Slocum says. “I tell them, ‘This is your birth wish. The little person in your tummy is going to dictate what happens.’”

She reminds moms that emergencies can arise, but assures them that education and communication will continue. “Explaining why we need to do something is going to help alleviate anxiety. And whatever else happens, the ultimate goal is a healthy mom and healthy baby.”

AFTER BABY’S BORN Extra visits. While many obstetricians see new moms six weeks after delivery, she and the other midwives in her practice visit two weeks after baby’s birth. “We check healing of any tearing that occurred during delivery and look for signs of postpartum depression.”

Moms are encouraged to bring baby to those visits and discuss any nursing issues.

For more info on midwifery services at Castle Rock Adventist Hospital, call our birth concierge at 720-455-0355.

ELEVATE 4 Spring 2018

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In 2008, certified nurse-midwives delivered 7.5 percent of babies born in the U.S. That was more than twice the percentage 20 years earlier.

To learn about Castle Rock Adventist Hospital’s annual Birth & Baby Expo, featuring raffles, education booths, and all things baby, please see back cover.

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hen Castle Rock Adventist Hospital certified nursemidwife Barbara Slocum, MSN, entered the profession, many people assumed midwives shunned conventional medicine.

Now, many moms-to-be understand the truth about certified nurse-midwives: They are highly trained practitioners who can provide women a more natural delivery, without sacrificing the peace of mind of hospital resources standing by just in case.

“People are coming around to the idea that we are professionals,” Slocum says.

And a growing number of women experiencing a low-risk pregnancy appreciate the care nursemidwives provide at all phases of the birth process, including:

Doctors usually recommend an anti-nausea medication and Tylenol for migraines during pregnancy, since NSAIDs and “triptans” may be harmful. Migraine prevention medications may be harmful, too, and are usually stopped during pregnancy. OBs usually work closely with neurologists to treat migraines during pregnancy, because they’re different for each patient.

RELIEF FROM MIGRAINES ore than 1 in 10 Americans suffer from regular migraines, the most common form of disabling headaches. Pamela Kinder,

MD, a neurologist at Castle Rock Adventist Hospital, specializes in treatments for headaches. Here she answers a few common questions.

Q: HOW ARE MIGRAINES DIFFERENT FROM REGULAR HEADACHES? A: Migraines are recurring headaches that cause pounding, throbbing pain. They often cause sensitivity to light, sound, and/or smell, and can cause nausea and vomiting. A migraine may begin with a visual aura, or feelings of fatigue, confusion, or “slowing.”

Q: WHO GETS MIGRAINES? A: Three times as many women have migraines as men. Migraines usually start at puberty and stop after menopause. Although, some women have their first migraine with, or continue to have migraines after, menopause.

Migraines are most common the first day of a woman’s period, although some women also have migraines with ovulation. While most pregnant women do not have migraines after their first trimester, others have their first migraine following pregnancy. castlerockhospital.org

Q: CAN I PREVENT MIGRAINES? A: Some, but not all, migraines can be prevented.

Most importantly, don’t feel guilty about having migraines. Your family needs to understand that even if you do everything you can, you’ll still have them occasionally.

A regular sleep-wake cycle, especially waking up at the same time every day, may reduce the number of migraines. Waking up more than an hour earlier or later than normal may trigger a migraine.

Other common triggers are caffeine, stress, red wine, alcohol, preserved or aged meats or cheeses, fluorescent lights, and perfumes.

Reduce caffeine intake to one or two cups of coffee in the morning. And try to reduce stress through exercise and meditation.

If you have frequent migraines, you also might consider preventive medication.

Q: WHAT SHOULD I DO IF I HAVE MIGRAINES? A: See your doctor if you have more than four migraines a year, migraines that last more than six hours, or if over-the-counter migraine medications don’t help. The right medications, taken at the onset of a migraine, can shorten migraines and make them less debilitating. Combining a nonsteroidal antiinflammatory medication (NSAID) like ibuprofen, a “triptan” like Imitrex, and a medication to relieve nausea works well. Resting away from noise may help, too.

There are more than

3

million

cases of migraines in the U.S. each year.

We would like to welcome Pamela Kinder, MD, neurologist, to Castle Rock.

She is accepting new patients, and her practice is located in the Limelight Building just east of the hospital.

Neurology of the Rockies 4350 Limelight Avenue, Suite 250 Castle Rock, CO 80109 303-840-5051 Spring 2018

5 ELEVATE

MIDWIVES TO MIGRAINES

TREATING MIGRAINES IN PREGNANCY

A ROCK

AND A HARD PLACE

The surprising cause of most kidney stones — plus how to prevent them The kidneys are bean-shaped, fist-sized filtering units that send important minerals back into the bloodstream and waste and extra fluid to the bladder as urine.

The most common type of kidney stone (calcium oxalate) forms when there’s too much waste and too little liquid. Often, not drinking enough water is to blame.

The result? The body keeps too much calcium, which crystallizes. “Calcium is not the culprit.

Low urine volume is the culprit,” says Dayne Nelson, MD, urologist with Centura Health Dr. Dayne Nelson Physician Group Urology in Castle Rock.

Too much salt in the diet makes matters worse. How? “Salt pulls calcium along with it into the urine,” Nelson says.

Downstream from all this activity is the bladder, which is connected to the kidney by a thin tube called the ureter.

A stone the size of a tiny pebble can block urine flow.

Blocked urine backs up into the kidney, which swells and triggers five-alarm flank pain. Other symptoms may include blood in the urine, nausea and vomiting, and fever and chills.

TREATMENT See your primary care physician or urologist immediately.

Treatments include:  Passing the stone on your own  Ureteroscopy, which uses small instruments to retrieve or obliterate the stone  Shock wave lithotripsy, which uses sound waves to blast the stone  Percutaneous stone removal (for large or irregularly shaped stones)

WHAT NOT TO DO

COLD STATS Research out of South Carolina suggests that teenagers are at growing risk for kidney stones. In fact, from 1997 to 2012 teens had the highest rate of increase of kidney stones among all groups in a 150,000-patient study.

What gives? Dayne Nelson, MD, says Western diets heavy in soda, caffeine, and salt are likely driving the increase.

 Do not cut back on

calcium. Low dietary calcium increases risk of kidney stones.  Do not try crash diets, especially high-protein weight loss diets, which have been linked to kidney stone formation.

PREVENTION

 Drink fluids. Nelson recommends

ten 10-ounce glasses of water daily.

Clear urine signals good hydration.  Limit sodium to 1,500 milligrams daily.  Eat more fruits and vegetables, which may create urine less conducive to stone formation.  Lose weight if you are overweight.

Obesity changes the acid levels in the urine, which causes stones not to dissolve well.

ELEVATE

6 Spring 2018

If you have a history of kidney stones or suspect you’re at risk, or you need a urologist, schedule an appointment with Dr. Nelson by calling Centura Urology at 720-455-0670 or visit chpgurology.org.

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WHAT TO DO

STONE-

TAMING TUMMY TROUBLES EMERGING DIAGNOSTIC TOOLS MAKE FINDING THE CAUSE OF STOMACH AILMENTS EASIER

H

eartburn, ulcers, pain. The list of common stomach complaints is long — as are their possible causes.

Traditionally, diagnosing and treating stomach ailments has been difficult, and many people have resigned themselves to suffering.

Now, improved diagnostic techniques, like those available at Castle Rock Adventist Hospital’s outpatient GI Lab, can help pinpoint the problem and tame tummy unrest.

“We can diagnose and treat most gastrointestinal conditions, including those in the esophagus, stomach, small intestines, and colon,” says Maneesh Gupta, MD, an internal medicine physician and gastroenterologist with Centura Gastroenterology — Castle Rock.

Diagnostic tests at the GI Lab include: • Colonoscopy to detect conditions including polyps and colon cancer, which is recommended for most adults 50 and over • Upper endoscopy uses a tiny camera on the end of a long, flexible tube to visually examine the upper digestive system • Endoscopic retrograde cholangiopancreatography (ERCP) combines upper endoscopy with X-rays to diagnose and possibly treat problems in the bile and pancreatic ducts • Esophageal manometry is a procedure that uses a thin tube inserted in the nose to measure how the esophagus is working STOMACH SOLUTIONS

KNOW WHEN TO GO

Usually upset stomach symptoms go away on their own in a few days and don’t require a doctor’s care. But, Gupta says, always get checked out if: • Symptoms don’t improve after four days • Symptoms are so severe that you can’t stay hydrated • There is blood in your vomit or stool • You’ve lost weight without trying

castlerockhospital.org

To schedule an appointment with Dr. Gupta or another physician at Centura Gastroenterology, call 720-455-3879 or go to chpggi.org.

When conventional medications don’t help chronic stomach ailments, there are alternatives.

Maneesh Gupta, MD, says some of the best include the following: • Reduce stress. The connection between the gut and the emotions is welldocumented, he says. “When you’re stressed or anxious, or under duress, the resulting fluctuation in hormones causes a variety of GI issues.”

• Pour on the peppermint oil. Best consumed in capsule form, peppermint oil is a great substance to relax the gut and get rid of spasms, Gupta says.

• Ditch the dairy. “Most people lose the ability to break down lactose after age 35,” he says.

PROTON-PUMP INHIBITORS: GOOD MEDICINE OR BAD NEWS? Millions of people take protonpump inhibitors (PPIs), like Prilosec and Nexium, to relieve ulcers and heartburn.

Recent studies, though, have raised red flags about risks of their long-term use.

Those studies have not shown cause and effect, says Gupta. “It’s OK to use them occasionally for seven to 14 days. But if you need them more often, you might want to see a physician to determine what’s causing your symptoms.”

Spring 2018

7 ELEVATE

D

id you know

that postpartum depression symptoms are more common among new and expecting moms than high blood pressure or gestational diabetes? It’s true. Yet, many women — and their families — may not recognize symptoms or be willing to talk about them.

The good news: Help is available for anyone experiencing postpartum depression or anxiety.

In two free classes for new parents, maternal mental health specialist Melissa Lemire, LPC, will present facts and treatment options, and answer questions about new moms and mental health.

WHAT:

Maternal Mental Health

WHEN:

Wednesday, May 2, and Tuesday, May 8.

Both events are from 6:30-8 p.m.

WHERE:

Castle Rock Adventist Hospital, 2350 Meadows Boulevard, First Floor Conference Room

To learn more, or to reserve a spot, call 720-455-0355 or visit castlerockhospital.org/ birthclasses.

NON-PROFIT ORG US POSTAGE

PAID

DENVER, CO PERMIT NO. 3280

2350 Meadows Boulevard Castle Rock, CO 80109

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 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 1-720-455-2531 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-720-455-2531 (TTY: 711).

BABY TALK

ANNUAL EVENT OFFERS MOM AND INFANT CARE INFORMATION, PRODUCTS, AND PRIZES Whether you’re a new parent or about to become one, Castle Rock

Adventist Hospital’s second annual Birth & Baby Expo is your chance to learn about and celebrate all things baby — and maybe even win a prize.

“We’re calling it an educational celebration,” says Castle Rock Adventist Hospital Birth Concierge Jacque Northrup.

“It’s a community event with seminars and local vendors. It’s a chance for expecting moms and new parents to meet obstetricians and pediatric providers, and enter drawings to win baby items.”

The hospital’s physicians will present seminars on topics such as maternal mental health and childhood allergy and asthma, and maternal mental health specialist Melissa Lemire, LPC, will discuss postpartum depression and treatment.

Second Annu W H A T al Birth

Birth & Baby Expo offers a chance to do good while learning and having fun. Bring new and gently used pregnancy and baby items to donate, and they’ll be used to stock the Mommy & Me Market at Castle Rock Adventist Hospital. Families in need can “shop” the market and take home baby items at no cost.

For more info, call our birth concierge at 720-455-0355.

You are cordially invited WHE

& Baby Expo

Castle Rock A R E dven First Floor Con tist Hospital, ference Cente 2350 Meado r, ws Boulevard, Castle Rock WHE

Saturday, May N 12, 9 a.m.-noon ADMISSI

FREE

ON

To get up-to-the-date details, follow us on Instagram and Facebook!

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Get the facts, mom

Portercare Adventist Health System