Elevate Summer 2018

Living at the height of wellness SUMMER 2018 | VOLUME 6, ISSUE 3

WINNING AT AGING How to use exercise to ward off the years — and disease.

CASTLE ROCK ADVENTIST HOSPITAL CELEBRATES

Page 4

5 YEARS! Page 5

SPOTTING HIDDEN DIABETES Page 2

HOW MEDS AFFECT PERFORMANCE Page 6

HIP IMPINGEMENT IN KIDS Page 7

Dealing With

DIABETES

NEW MEDICATION OPTIONS

In the past decade, more than 30 million Americans with type 2 diabetes have had a growing list of medication options to treat their disease. Two of the most promising classes of those drugs are: • Sodium-glucose transporter 2 (SGLT2) inhibitors work by preventing the kidneys from releasing excess glucose back into the bloodstream.

That means more sugar leaves the body through urine, which helps maintain appropriate blood sugar levels.

• Glucagon-like peptide-1 receptor agonists (GLP-1) are injectable medications that limit how much sugar the liver releases into the blood and slow the rate at which food leaves the stomach. These medications may also allow the pancreas to produce more insulin, which helps lower blood sugar levels.

SCREENING OUT HIDDEN DIABETES

Often people can develop type 2 diabetes without knowing it, because symptoms mimic other conditions, says Susan Weitkunat, RDN, certified diabetes educator at Castle Rock Adventist Hospital. Common symptoms include: g Unexplained fatigue g Frequent urination g Dry mouth g Extreme thirst g Unexplained weight loss The American Diabetes Association recommends annual screening for everyone starting at age 45. Start earlier if you have risk factors such as a family history of diabetes; you are overweight or have high blood pressure; you’ve had gestational diabetes; or you are of African-American, Asian, Native Hawaiian, Hispanic, or Latino descent.

LEARN MORE

To learn more about diabetes education classes, call Castle Rock Adventist Hospital’s program at 720-455-3662 or Parker Adventist Hospital’s program at 303-269-4859.

Over time, high blood sugar can damage the delicate nerve fibers and weaken the small vessels that carry blood to and from arms, hands, legs, and feet.

The resulting lack of sensation — called neuropathy — carries hidden dangers, says David Hardin, MD, surgeon with the Porter Wound Care & Hyperbaric Center. “Let’s say you’re walking with a rock in your shoe. You would stop and pull it out. But those with diabetes may have no sensation and not realize it’s there.”

People with diabetes are likely to get more wounds. Those wounds tend to heal more slowly and are prone to infection due to decreased blood flow and oxygen.

That’s where the hyperbaric oxygen (HBO) therapy can help.

“We can use hyperbaric pressure to supersaturate the blood with more oxygen,” to facilitate healing, Hardin says. “Oxygen is the building block for healing.”

HEALTHY HEALING If you are suffering from any type of wound, the wound care experts at Centura Health can help. Our two South Denver wound care centers are: Porter Wound Care & Hyperbaric Center 990 E. Harvard Ave., Denver 303-778-5242 Wound Care Center at Parker Adventist Hospital 9395 Crown Crest Blvd., Parker 303-269-2310

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

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HEALTH BRIEFS

Summer

HYPERBARIC WOUND HEALING

PRACTICAL ADVICE C

onfused about what a nurse practitioner does — and why you should consider seeing one? They’ve been practicing for half a century, yet their role is still often misunderstood. Alicia Jones,

FNP-C, a nurse practitioner in family medicine who recently joined Ridgeline Family and Sports Medicine — Castle Pines, helps clear things up.

Alicia Jones, FNP-C

WELL-TRAINED FOR THE JOB

Lauren Burke, NP

Ridgeline Family & Sports Medicine has two new nurse practitioners accepting patients: Alicia Jones, FNP-C, at Ridgeline Family & Sports Medicine — Castle Pines 303-649-3350 Lauren Burke, NP, at Ridgeline Family & Sports Medicine at the Meadows 720-455-3750

Nurse practitioners provide care for patients of all ages — from toddlers to seniors.

Nurse practitioners are required to hold a bachelor’s degree in nursing and a master of science degree in their specialized field. They are qualified to see patients of all ages and can: • See new and established patients • Manage chronic conditions, such as diabetes and heart disease • Write prescriptions • Order lab tests and imaging • Make referrals to send patients to specialists as needed

CUTTING THROUGH THE CONFUSION

Many people are confused about what nurse practitioners do, believing that if they see a nurse practitioner they’re going to have to also see a physician to oversee their care. But that’s not necessarily true, Jones says. “In the state of Colorado, nurse practitioners can be pretty autonomous. We have a physician we can ask questions and use as a resource, but patients don’t need to see us as a stepping stone to a physician. We can actually be their primary provider.”

BETTER CARE FOR CHRONIC CONDITIONS

Not only can nurse practitioners treat patients with chronic conditions, some research shows they may be even more effective at caring for conditions like diabetes. And it’s easy to see why this could be the case. First, most have been nurses for a while before studying to become nurse practitioners, Jones says. “And we like the patient involvement and tend to be good at teaching, so we’re able to diagnose and provide critical patient education.

“I like getting my own care from a nurse practitioner,” Jones says. "I feel like I have a little bit more time with them, and I’m able to make those longer-term relationships.”

FAST FACT

2X

As of March 2018, there are more nurse practitioners than ever before:

248,000 NPs

and counting are licensed to practice in the U.S. That’s more than double the number of NPs in 2007.

castlerockhospital.org

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Regular workouts have helped Sally Robertson and her husband, Bob (also pictured below), feel younger and healthier than they have in years.

GOLDEN YEARS, REDEFINED Sally Robertson had always been fairly active. But as she

BRAWN AND BRAINS

A recent study found moderate physical activity could enhance metabolism in the regions of the brain responsible for learning and memory in older adults.

aged, she’d slowed down and started to feel, well … old. So, the now Dr. Kiyoshi Yamazaki 80-year-old webmaster started taking daily walks near her home in the northeast corner of Black Forest, just east of Castle Rock.

“I’d begun to notice that the more I sat at my computer, the more I wanted to sit,” she says. “I was falling asleep in the afternoons, and walking wasn’t giving me the alertness I wanted.”

Last year, when her husband, Bob, was having difficulty with mobility, they both went to HealthFit Family Medicine and Gym so he could work with a physician and their kinesiologists to get moving again.

“We thought it was his peripheral neuropathy, but the doctor took one look at how Bob moved and said, ‘Oh, your IT band is locked up.’”

Bob began working with a kinesiologist, and within a week had already made significant progress. During one of his visits, Sally saw a flyer about how weight lifting could help lower blood sugar, a trouble spot for her, and decided to try working with a trainer. Little did she know, just a few months later she’d compete in the Senior Olympics and bring home gold by deadlifting 125 pounds.

A PRESCRIPTION FOR HEALTH As incredible as Sally’s story is, research shows exercise sometimes can be as effective as prescription medication in treating health conditions such as heart disease and diabetes.

In fact, according to Kiyoshi Yamazaki, MD, sports medicine physician at HealthFit Family Medicine and Gym, prescribed exercise can help: u Lower blood pressure u Decrease medication dependence u Stabilize mood u Increase alertness u Enhance coping skills The biggest key to getting started is having expert guidance. “Kinesiologists are trained in assessing strengths and weaknesses. If your assessment is not done well and customized for your individual needs, it can set you up for failure — whether that’s injury or simply quitting,” he says. “But with expert guidance, no goal is too high to attempt in a safe way.”

Sally agrees, and says she’s going for the gold again this summer — and sticking with HealthFit. “The kinesiologists know so much, and you don’t have to be an athlete there or look a certain way. And it’s just simply fun.”

To learn more about HealthFit Family Medicine and Gym, call 303-218-7774.

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AT AGE 79, SALLY ROBERTSON BEGAN WEIGHT LIFTING FOR THE FIRST TIME IN HER LIFE. A FEW MONTHS LATER, SHE WON THE SENIOR OLYMPICS.

GROWING WITH THE COMMUNITY

CASTLE ROCK ADVENTIST HOSPITAL CELEBRATES ITS FIRST FIVE YEARS OF SERVICE The first five years of life are a critical time filled with epic milestones and remarkable growth. That also sums up how life has been so far for Castle Rock Adventist Hospital.

On Aug. 1, the hospital will celebrate its fifth year of serving the Castle Rock community.

“We’re excited to have grown up with Castle Rock,” says Jeremy Pittman, the hospital’s chief operating officer. “And each year, that growth has allowed us to increase the breadth and depth of the services and community support we provide.”

THERE’S ALWAYS ROOM AT OUR TABLE ON AVERAGE, MANNA FEEDS EACH OF CASTLE ROCK’S 60,000 RESIDENTS APPROXIMATELY FIVE TIMES EACH YEAR.

castlerockhospital.org

HERE ARE A FEW HIGHLIGHTS: PROVIDING EXCELLENT CARE Stroke accreditation. Castle Rock Adventist Hospital’s stroke program recently received accreditation from the Joint Commission on Accreditation of Healthcare Organizations. It also is a Primary Stroke Center, a designation recognizing its capability to care for the most critically ill stroke patients.

Cardiac care. The hospital received the Silver Performance Achievement Award in 2016, signifying it had reached an aggressive goal in treating heart patients according to care standards outlined by the American College of Cardiology/American Heart Association clinical guidelines and recommendations.

Advanced surgical capabilities.

Castle Rock Adventist Hospital became the first hospital in Colorado to add the BrightMatter™ robotic digital microscope in 2017, making surgery safer and more efficient while expanding research capabilities.

SUPPORTING THE COMMUNITY Ambassadors of Compassion.

For the past two years, the hospital has provided resiliency training through the Ambassadors of Compassion program for all seventh-grade students in Castle Rock.

Feeding the community. Since opening, Manna Restaurant has become one of the top-rated restaurants in the area. It also has evolved into a local gathering place, and is a big part of how the hospital stays connected to the community.

Creating jobs. With its population more than tripling since the year 2000, the city of Castle Rock knew it needed a hospital to provide high-quality and convenient care. Castle Rock Adventist Hospital has met and exceeded this need, creating more than 500 new jobs and becoming the city’s largest employer along the way.

“We’re proud to have played a role in not just providing great care but in helping the community live healthier, better lives,” Pittman says.

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PERSONAL BEST

Primary care sports medicine physicians can help you reach your peak performance

care doctors also can serve as your personal trainer?

Family practice and internal medicine doctors who have additional training in sports medicine are called primary care sports medicine physicians. These physicians can treat the vast majority of activity-related injuries, using nonsurgical techniques to treat pain and get you back to your game.

Primary care sports medicine physicians also can help develop programs that prevent injuries and enhance your performance, whether you’re a serious athlete or just trying to stay active. They also help patients with chronic conditions, such as asthma, learn how to exercise safely and effectively.

Subbing In | Many patients think that since these specialists are primary care doctors then they have to leave their family doctor. But the title can be misleading — primary care sports medicine doctors Dr. Heidi Christensen are adjuncts to your normal care team.

“You can actually keep your PCP,” says Heidi Christensen, MD, CAQSM, FACEP, primary care sports medicine physician at Ridgeline Family and Sports Medicine at the Meadows. “We can help with issues like acute and chronic overuse injuries and provide counseling on improving your sports performance and injury prevention.”

While sports injuries are common, approximately 90 percent of them don’t require orthopedic surgery. But they do benefit from the kind of comprehensive, nonsurgical approach to treatment and rehabilitation that primary care sports medicine physicians provide.

And if surgery is needed for an injury, primary care sports medicine physicians team up with orthopedic surgeons to make sure the transition is smooth.

COMMON CONDITIONS TREATED From strains and sprains to chronic injuries, primary care sports medicine physicians have the specialized training and expertise to help you return to your sport or get back to enjoying your favorite recreational activities. Here are a few of the conditions they treat:

★ Ankle sprains ★ Carpal tunnel syndrome ★ Concussion ★ Femoroacetabular impingement ★ Golfer’s elbow ELEVATE

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★ Growth plate injuries ★ Osteoarthritis in children ★ Patellar tendinitis ★ Iliotibial (IT) band ★ Plantar fasciitis syndrome ★ Rotator cuff syndrome ★ MCL and LCL knee ★ Tennis elbow injuries ★ Trigger finger ★ Neck and back strains

COULD YOUR MEDS BE AFFECTING YOUR PERFORMANCE?

Managing chronic diseases can look different for athletes than other people — especially when it comes to medications.

“There are medications that are fine for the general population that would not be good to treat an athlete,” Christensen says.

She and other primary care sports medicine physicians can help with medication modifications. For example, beta-blockers are a common concern.

“People with high blood pressure or chronic headaches are often prescribed betablockers, which slow the heart rate,” Christensen says. They can be problematic because without an appropriate increase in heart rate in response to exercise — or any physical exertion for that matter — vital organs are not able to get appropriate blood flow during exercise. Because of this, people on these medications can have some serious side effects, such as shortness of breath, chest pain, and fainting, Christensen explains.

Make an appointment with Dr. Christensen by calling 720-455-3750.

No referral is needed, and same-day appointments may be available for urgent needs.

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You go to them forhits.yourButannual exams and when the flu did you know that some primary

PREVENT THE

PINCH RECOGNIZING AND TREATING HIP IMPINGEMENT IN YOUNG ATHLETES

HIP TO GENDER DIFFERENCES

Does hip impingement present differently in young boys vs. girls? Yes, recent research shows males may actually experience more severe cam abnormality than female patients.

castlerockhospital.org

Active children and teens have youth on their side, but they aren’t immune to sports-related injuries, including hip impingement. It’s a growing concern,

especially for athletes from age 11 to 15, who develop hip impingement due to genetics or overuse. Symptoms include activity-related groin pain with a clicking or “catching” feeling, and pain that is frequently felt during activity at first but becomes constant over time.

“As young athletes become increasingly competitive, particularly those who specialize in one sport year-round, we’re seeing more hip impingement,” says Lionel Gottschalk, MD, a triple board-certified orthopedic sports medicine physician with Centura Orthopedics & Spine who specializes in hip and pediatric sports injuries. “Recognizing and treating hip impingement is critical, not just to keep the athlete strong now but also later in life because it can cause osteoarthritis.”

Dr. Lionel Gottschalk

RECOGNIZING IMPINGEMENT The socket of the hip bone and the head of the femur (thighbone) form the socket and ball of the hip joint. When there’s an abnormality in one or both, it can cause friction and lead to one of three types of impingement: Cam impingement, which occurs when there’s a bony overgrowth on the femoral neck that rubs against the hip socket Pincer impingement, where the hip socket bone is bigger than normal and hangs out further than it normally would, rubbing against the femur A combination of both cam and pincer impingement Likelihood of impingement is greater with sports that involve squatting, twisting, and turning.

The injury can lead to tears in the labrum (the cartilage that lines the hip socket) and osteoarthritis later in life.

Hip impingement is easy to spot during an exam, Gottschalk says. “We do a series of moves that test range of motion to see which movements reproduce symptoms. The diagnosis is confirmed through special pelvic views via X-ray,” he says. MRI and CT scans can provide a 3-D view in greater detail.

TREATING IMPINGEMENT Gottschalk is a big proponent of physical therapy, which can be used to strengthen the muscles surrounding the hip joint.

Modifying activities and injections also can help, but surgery may eventually be needed, depending on how severe the impingement is and the person’s activity level.

“It’s like if you have something caught in the door. No matter how much you oil the hinges, the door still won’t shut all the way,” Gottschalk says. He educates patients and their parents about their options to help them make an informed treatment decision.

Minimally invasive hip arthroscopy can be performed as an outpatient procedure, with the patient using a stationary bike on the same day and returning to full activity within six to 12 months.

To schedule an appointment with Dr. Gottschalk or another physician at Centura Orthopedics & Spine, call 720-455-3775.

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Portercare Adventist Health System 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 PREP

Anticipating the birth of your new baby is a joyous time, but one that requires lots of loving preparation. Here are a few tips from The BirthPlace at Castle Rock Adventist

Hospital to help the whole family — new mom, dad, and siblings — prepare for the arrival of your newest family member. All birth classes at The BirthPlace are free!

GETTING THE WHOLE FAMILY READY FOR THE NEW ARRIVAL

FOR MOMS

Jacque Northrup, RN, BSN, CLC, ICCE

Castle Rock Adventist Hospital has your baby prep needs covered, with a multitude of classes for new moms. “We offer prenatal classes for childbirth, breastfeeding, and baby care, and encourage both mom and dad to come,” says Jacque Northrup, RN, BSN, CLC, ICCE, program coordinator and birth concierge. Families also can meet with Northrup for a private consultation and tour of Castle Rock Adventist Hospital’s BirthPlace.

FOR DADS

What if there was a place where dads could go to prepare for the new baby’s arrival, from how to soothe a crying baby and the secrets of bonding to caring for new moms and managing the work-family balance? There is! Castle Rock Adventist Hospital’s Daddy Boot Camp covers these topics and then some.

FOR SIBLINGS

Helping siblings prepare for their new role as big brother or big sister is critical. Castle Rock Adventist Hospital offers a sibling’s class that covers the bases, from what to expect during mommy’s hospital stay to how a new baby looks and behaves.

To learn more or register for classes for moms, dads, siblings — and even grandparents — go to castlerockhospital.org/events.

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ELEVATE YOUR SUMMER

LEADER IN STROKE CARE Castle Rock Adventist Hospital has earned The Joint Commission's Gold Seal of Approval for certification as a Primary Stroke Center by demonstrating compliance with The Joint Commissions national standards for health care quality and safety in disease-specific care. This advanced certification award recognizes Castle Rock Adventist Hospital’s exceptional efforts to foster better outcomes for stroke care.