Living at the height of wellness SUMMER 2017 | VOLUME 5, ISSUE 3
BACK TOBEING GRANDPA
Minimally invasive spine surgery offers big benefits for neck and lower back pain
CUSTOMIZE
YOUR
Page 4
MAMMOGRAPHY SCREENING SCHEDULE Page 6
FIX FOR CHRONIC SINUS INFECTIONS Page 3
HIDDEN HIP PROBLEMS Page 5
LARGER MRI EASES FEARS Page 7
BE A
good sport
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, Mark Christensen, MD, a primary care sports medicine physician at Ridgeline Family Medicine at Castle Pines, offers these suggestions:
Dr. Mark Christensen
ACTIVITY
POTENTIAL PAIN POINT
Running
“For lots of people, when they start running things just start hurting — their knees, heels, ankles,” Christensen says.
Trail running Mountain biking Baseball
PREVENTION TIP
Gradually increase mileage. “Start over each season, even if you maintained your cardio over the winter,” he says. Change your shoes regularly and run on a good surface. Trails and treadmills are softer than asphalt. Ankle sprains Build lower-body and ankle strength and stability. Christensen 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. Concussions and broken clavicles If you’re not ready for higher speeds, start slow and low (collarbones) and take your time to build up your comfort level. Overuse of the shoulder and elbow Gradually increase your activity and work with coaches — especially in kids with open on good mechanics. If your technique is good, you will growth plates. use your legs and lower body — not your shoulder — to generate power, he says
For more information, call Ridgeline Family Medicine at 720-455-3750.
HEALTHFIT
HF HealthFit
HEALTHCARE • NUTRITION • FITNESS
FAMILY MEDICINE
HealthFit is a full-service fitness and physical health facility in the Briscoe building on the campus of Castle Rock Adventist Hospital. Staffed by kinesiologists, who specialize in human biomechanics and physiology, HealthFit offers a full lineup of services designed by physicians and health specialists, including: • Membership options • Cardio equipment, including treadmills, spin
bikes, and elliptical machines • Strength equipment and free weights • Classes in conditioning, endurance, neuromuscular strength, and neuromuscular response (balance and coordination) • Individual appointments • Top-of-the-line supplements For more information, call 720-651-9015 or visit healthfitcolorado.com.
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: 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
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 | 720-455-5000
ELEVATE
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Summer 2017
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Summer
HEALTH BRIEFS
SUMMER STORM SAFETY
TIME TO SEE AN
ENT?
Ear, nose, and throat problems are more pervasive than you might think. But the good news is, with the help of otolaryngologists — better known as ENTs — these conditions are highly treatable. Allison Rasband, MD, an otolaryngology-head and neck surgeon, walks us through three common issues she treats. Dr. Allison Rasband
EAR: HEARING LOSS
Hearing loss is a problem typically associated with older adults, but it’s also extremely common at younger ages, Rasband says. She and her colleagues work to treat two primary types of hearing loss: Conductive: Problems with the eardrum or middle ear, including the bones that conduct and amplify sound. “We’re able to assess and often perform surgery to improve this type of loss,” she says. Sensorineural: An inner-ear or nerve-related hearing loss. “We have a hearing booth in our Castle Rock office where we can perform hearing tests the day patients see us,” she says. If the individual is a good candidate for hearing aids, audiologists can customize them by turning frequencies up or down.
Go online to castlerockhospital.org to watch a video with Dr. Rasband.
castlerockhospital.org
NOSE: CHRONIC SINUS INFECTIONS
Surgery often isn’t the first line of defense for sinus problems, but there are two red flags that may indicate it’s needed: recurrent sinus infections (three or more per year) or infections that are unresponsive to antibiotics. Minimally invasive techniques have revolutionized outpatient sinus surgery in the last two decades, with benefits including: • Internal incisions, made through the nose. • Minimal pain and recovery time. • Advanced image guidance. “At Castle Rock Hospital, we’re able to use the patient’s CT scan to individualize and guide the procedure,” Rasband says.
THROAT: THYROID
NODULES
Thyroid nodules are extremely common, yet most people don’t even know they have them, Rasband says. Symptoms can include fullness in the neck or difficulty swallowing, a sign that your thyroid is pressing on your esophagus, and nodules can be benign or cancerous. “If nodules cause symptoms or are concerning for malignancy, we remove the thyroid while using nerve monitoring to help safeguard the voice box,” she says. “Most thyroid cancer is slow-growing, and can frequently be cured if it’s caught early.”
LIKE FATHER, LIKE DAUGHTER
Rasband recently returned from the Chicago area to Colorado, where she grew up and where her father was also an otolaryngologist. She specializes in the full breadth of ENT care, including the evaluation and treatment of sinus/allergy, hearing, voice, and snoring/sleep apnea concerns, with particular interests in pediatric and endocrine surgery. Her Castle Rock practice is located in the Alexander Building at 2352 Meadows Boulevard, Suite 300. Call 720-897-7160 for an appointment or visit denvercoloradoearnose throatallergysinusdoctors. com.
29.4
MILLION: the number of American adults who suffer from chronic sinusitis.
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MINIMAL SURGERY, MAXIMUM LIFE
SOME NECK AND BACK PROBLEMS COULD BENEFIT FROM CONSERVATIVE SURGICAL APPROACH
7.57%
The number of minimally invasive spine surgeries is expected to increase nearly 8 percent by 2020. Source: Technavio
After minimally invasive spine surgery, Lynn Barnes is pain-free and back to being a hands-on grandpa. ELEVATE 4 Summer 2017
a major surgery,” Gallus says. But after studying Barnes’ medical images and symptoms, Gallus was able to do a much less invasive back surgery to relieve Barnes’ chief symptom of leg numbness. Today, Barnes is back to being the kind of grandpa he wants to be for his eight Denver-area grandkids. BACK TO BASICS Discs are soft, rubbery pads that act as shock absorbers between vertebrae. If the gel-like center portion of the disc herniates, or protrudes through the outer edge toward the spinal canal or into nerves, this can cause pain, numbness and tingling, and loss of strength. Most patients with herniated discs improve with nonsurgical measures, but sometimes surgery is necessary. And that’s when you want a “minimalist.” Gallus breaks down the most common surgeries he performs to repair or replace herniated or bulging discs.
LOWER BACK Lumbar microdiscectomy: Removes just the part of the disc that is protruding. Laminectomy or hemilaminectomy: Removes arthritic bone that’s pressing on a nerve. Lumbar fusion: Addresses instability, misalignment, or a mechanical problem with the spine by removing problematic discs and fusing two or more levels of vertebrae. NECK Cervical fusion with discectomy: Similar to lumbar fusion, this surgery removes the herniated disc(s) and fuses vertebrae. Artificial disc replacement: A newer technique replaces a bad disc with a new, artificial disc.
Learn more about joint and spine care at Castle Rock Adventist Hospital. Visit castlerockhospital. org/orthopedics.
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Being called a minimalist isn’t exactly the word-ofmouth advertising that most professionals seek. But Castle Rock Adventist Hospital spine surgeon Christopher Gallus, DO, doesn’t mind. “Dr. Gallus Dr. Christopher Gallus is a minimalist. He did what was required and nothing more,” says 75-year-old Castle Rock Adventist Hospital surgery patient Lynn Barnes. “I take that as a compliment,” Gallus says. “I pride myself on doing the minimal amount of surgery I can do to make a patient better.” With Barnes — who had bad discs in his neck and back, complicated by scoliosis — this took some sleuthing. First, Gallus performed cervical fusion with discectomy, removing a disc in Barnes’ neck that threatened injury to his spinal cord. “In the lower back, I really thought he would need
IS YOUR HIP ON ITS LAST LEG?
HIT THE
ROAD
TO RECOVERY Pain is no longer keeping Lauri Hutchinson from her favorite activities, like motorcycle trips and jogging.
Minimally invasive advances in hip replacement help patients return to their active lives faster — and with less pain than ever before
300,000+ Total number of hip replacements performed in the U.S. each year.
H
Dr. Ed Szuszczewicz
ip problems are common, but they aren’t always easy to identify. That’s because they often masquerade as something else entirely. In fact, there’s a fair amount of crossover between back issues and hip issues, says Ed Szuszczewicz, MD, an orthopedic surgeon and hip specialist at Centura Orthopedics Castle Rock. “Usually hip arthritis will manifest itself as groin, buttock, or deep lateral pain, and that’s when it can be confused with lower back issues. I’ve also had a few patients that I’ve done hip replacements on where their only complaints were knee pain.”
IN SEARCH OF A BETTER WAY
Lauri Hutchinson, 58, initially thought her iliotibial (IT) bands — the ligaments that run down the outside of your legs from hip to knee — were tight because she couldn’t stretch them out. But X-rays showed that she was nearly bone-on-bone in both hips and needed surgery. She recalled her sister’s difficult experience with conventional hip replacement a few years earlier, so after researching and discovering hers could be done via the direct anterior approach, with minimal incisions and a quicker recovery time, she was on board. This approach has changed hip replacement for the better, and Szuszczewicz was one of the first in the country to start doing it 13 years ago. He replaced Hutchinson’s left hip in January 2015 and her right hip last October at Castle Rock Adventist Hospital. Her recovery was typical for both surgeries: home within a day and doing physical therapy within a week. This spring, she was cleared to resume all normal activities, which means jogging and motorcycle trips she had given up due to pain. Now she can hit the road again. “I feel so blessed with this procedure and Dr. Szuszczewicz. He is excellent at what he does, and Castle Rock was wonderful,” she says.
For many patients, deciding when it’s time to have hip replacement surgery can be tricky. And often, people put off hip replacement until the pain is unbearable. That may seem like a sign of toughness, but Ed Szuszczewicz, MD, an orthopedic surgeon at Centura Orthopedics Castle Rock, cautions that waiting too long can make surgery more difficult, and slow your recovery. “If you’re getting to the point where the joint is starting to erode, that is when cases become challenging.” Age is a factor, too, Szuszczewicz says. For those under 70, it’s natural to want to wait because you don’t want to face multiple hip replacements. But for those 70 and older, sooner may be better than later. “If it’s not a question of if, but when, then what are you waiting for? You generally don’t get healthier as you get older, so it may be better to get on with it,” he says. Generally, it may be time to have that hip replacement if: You can’t complete daily tasks without help or significant pain Pain keeps you awake at night Walking and bending over are difficult, and medications don’t provide relief You are in discomfort physically, emotionally, and mentally Your pain is limiting activity, which is harming your overall health
To make an appointment with Dr. Szuszczewicz, call Centura Orthopedics Castle Rock at 303-790-7181.
castlerockhospital.org
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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. Jinnah Phillips, MD, board-certified radiologist and women’s imaging specialist at Castle Rock Adventist Hospital’s Breast Care Center, says there should be no doubt about when to have that first mammogram. “We recommend every woman have a baseline mammogram at 40,” Phillips 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, Phillips says. She 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,” she says. ELEVATE
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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. High-risk patients at Castle Rock Adventist Hospital are referred to Melissa Gilstrap, a genetic counselor at Parker Adventist Hospital. She can help you measure your risk, and discuss steps you can take to address it. Before visiting the clinic, each woman fills out a family history questionnaire, Gilstrap 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, Gilstrap says. The clinic also offers testing for genetic mutations that have been linked to breast cancer risk. For more information, call 720-455-1111.
SAME-DAY MAMMOGRAMS may be available at the following Centura Breast Cancer Center locations. To schedule your mammogram, call: • Castle Rock Adventist Hospital: 720-455-1111 • Centura Health Meridian: 303-269-4150 • Centura Health Southlands: 303-269-4150 • Littleton Adventist Hospital: 1-844-325-5579 • 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.” —Jinnah Phillips, MD
MORE THAN JUST X-RAYS
IMAGING OPTIONS AT CASTLE ROCK ADVENTIST HOSPITAL HAVE BENEFITS BEYOND DIAGNOSIS
Advanced imaging is an indispensable tool in medicine, providing the capabilities to effectively visualize,
detect, and diagnose injuries and disease, as well as monitor treatment and even save lives. With an assist from J. David Gilliland, MD, imaging medical director at Castle Rock Adventist Hospital, we explore today’s imaging technologies and their most noteworthy benefits.
Normal MRI 60 cm or smaller
Wide-Bore MRI 70 cm
BIGGER MRI BRINGS MORE COMFORT
The high-quality images provided by MRI make it an important tool for diagnosing. However, its tubelike shape can cause anxiety for those with claustrophobia — including children — and it can be a tight fit for larger individuals. At Castle Rock Adventist Hospital, our new widebore MRI unit takes those worries away. The only unit of its type in the Castle Rock area, our MRI is shorter than traditional units, so less of your body is inside the bore. Plus, it offers a foot of expanded headroom and more elbow room for patient comfort. The wide-bore MRI is designed to accommodate a wider range of body types.
15% WIDER!
COMPUTERIZED TOMOGRAPHY (CT)
3-D MAMMOGRAPHY
How it works:
The rotating, doughnut-shaped X-ray tube delivers computergenerated 3-D images, with clearer soft-tissue detail of internal organs and the anatomy of complex joints than routine X-rays.
DEXA scans painlessly measure Also known as digital breast bone density via an X-ray that tomosynthesis, this type of scans the lumbar spine and hips. mammography uses a special X-ray tube that allows for 3-D imaging of internal breast tissue architecture.
Benefits:
Improved image quality and optimized safety via new low-dose radiation protocols with Castle Rock Adventist Hospital’s 32- and 64-slice scanners.
Allows for a more confident assessment by a radiologist, and according to recent research, a whopping 40 percent increase in the detection of invasive cancers.
Aids in the diagnosis and monitoring the treatment of osteoporosis, as well as providing a reliable estimate of fracture risk.
Delivers a clearer picture of soft tissues like muscles and ligaments (as well as nerves, the spinal cord, and brain) than X-ray or CT — and without the radiation.
NO
YES
YES
MD referral YES required?
DUAL-ENERGY ABSORPTIOMETRY (DEXA)
MAGNETIC RESONANCE IMAGING (MRI) Similar to a CT, this doughnutshaped tube uses radio waves instead of X-rays to create computer-generated 3D images of organ and joint anatomy, and provide data on tissue and organ function.
Same day appointments may be available; call 720-961-2033 for scheduling details.
castlerockhospital.org
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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, Littleton, Parker, and Porter Adventist Hospitals 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 fivestep 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.
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, 2017. 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).
AT CASTLE ROCK ADVENTIST HOSPITAL
WE CARE ABOUT OUR COMMUNITY
THE MOMMY & ME MARKET ALLOWS US TO PARTNER WITH THE COMMUNITY TO PROVIDE FOR THOSE IN NEED.
We accept donations of new and gently used baby items to stock the market. Families in need can “shop” the Mommy & Me Market and bring home new and gently used baby items at no cost. WHAT IS THE MOMMY & ME MARKET? Mommy & Me Market is designed to help families in need with pregnancy and children’s items. The Mommy & Me Market is open one day a month to allow families to come in and get any of the items they need. WHAT ITEMS ARE AVAILABLE AT THE MOMMY & ME MARKET? • New diapers and wipes • New and used 0-4T children’s clothes • New and used maternity clothes (when available) • New and used baby gear (when available) WHAT TYPES OF DONATIONS DOES THE MOMMY & ME MARKET ACCEPT? • New diapers and wipes • New and used 0-4T children’s clothes • New and used maternity clothes (when available) • New and used baby gear (when available) Unfortunately, we cannot accept used cribs or car seats.
WHAT ARE THE TIMES THAT I CAN COME AND “SHOP” FOR ITEMS THAT I MAY NEED FOR MY CHILD? Last Friday of every month, 9:30 a.m.-noon. WHAT ARE THE DROP-OFF TIMES FOR DONATED ITEMS? First Friday of every month, 9:30 a.m.-noon. Contact Jacque Northrup at 720-455-0355 to arrange a time outside of the designated time frame. DO I HAVE TO PROVE THAT I AM IN NEED OF THESE ITEMS? You do not have to prove need to shop the Mommy & Me Market. However, we would ask that you not take advantage of the service and re-donate the items when done with them so others can benefit from the market.
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MENTAL HEALTH FIRST AID