Elevate Winter 2018

Living at the height of wellness WINTER 2018 | VOLUME 6, ISSUE 1

WINTER IS

BACK

When the strain on your spine causes pain, surgery could be an option.

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NEW TESTS FOR PROSTATE CANCER Page 4

PUT YOUR BEST FACE FORWARD Page 3

GET A HANDLE ON HAND AND WRIST PAIN Page 5

NEW SPINE MICROSCOPE IMPROVES SURGICAL OUTCOMES Page 7

CENTURA

Centura Health Heart & Vascular Network is the region’s leading provider of comprehensive heart care, offering advanced heart diagnostics and state-of-theart treatments to: • Open blocked arteries • Repair or replace heart valves • Fix abnormal heart rhythms • Help patients recover after heart attacks • Reduce heart disease risk factors To find a heart program or expert in your neighborhood, go to centura.org/heart.

APP FAILURE

Heart rate apps may be missing a beat or two, according to a study last spring in the European Journal of Preventive Cardiology. “They tested four heart rate applications, and results were all over the place,” says Ajay Yadlapati, MD, an interventional cardiologist with South Denver Cardiology, A Centura Health Clinic. This is partly due to the lack of regulation, he says. Better to stick to apps that motivate like “nutrition apps that track actual calories, or exercise apps that record steps or distance.”

Silent

TREATMENT

Yes, heart attacks can happen without symptoms. The good news, Yadlapati says, is that there are some signs that signal silent heart attacks. If you’ve been experiencing even mild reflux or heartburn or a general sense of fatigue, especially if they persist despite diet changes and rest, talk to your doctor. Also, diabetes and kidney disease raise your risk for silent heart attack. So don’t shrug off signs.

CAPSULE-SIZE PACEMAKER WORKS WITHOUT LEADS

A new pacemaker the size of a vitamin that is implanted through a vein and uses no electrical wires has hit the scene. The new Micra Transcatheter Pacing System, available through South Denver Cardiology, A Centura Health Clinic, is especially good for active or younger patients in whom leads might wear out over time. For more information, go to Actual size porterhospital.org/heart.

HEART SCAN

If you’re a man over age 40 or a woman over age 45, your risk for heart disease is on the rise. A heart calcium scoring exam, a noninvasive scan that checks for calcium buildup in the arteries, can help you assess your risk. To learn more or to schedule a heart calcium scoring exam for $149, call: • Littleton Adventist Hospital (South Denver Cardiology): 303-744-1065 • Parker Adventist Hospital: 303-269-4500 • Porter Adventist Hospital: 1-855-854-3278

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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Winter 2018

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Winter

HEALTH BRIEFS

s You

ABOUT FACE

PLASTIC SURGERY ISN’T ALL ABOUT VANITY. FOR MANY, IT’S A MATTER OF BOTH FORM AND FUNCTION.

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econstructive surgery after trauma or skin cancer is not often categorized as an aesthetic procedure. But to David Archibald, MD, a facial plastic surgeon at Castle Rock Adventist Hospital, “aesthetic and reconstructive surgery are inseparable, because the goal for both is that patients look and feel their very best.”

In most cases, the best approach to remove skin cancer on the face is to first see a dermatologist who specializes in Mohs micrographic Dr. David Archibald surgery. “With Mohs surgery, the cure rates are high while preserving as much normal skin as possible,” he says.

The Mohs surgeon removes the cancer and examines the tissue at the time of surgery, to make sure all the malignant tissue is removed. For more advanced cancers, or those that involve critical structures like the nose, lips, eyelid, or ear, “often a combined specialty approach with Mohs surgeons and facial plastic surgeons collaborating is best for patients.”

Archibald, who trained at the Mayo Clinic, performs approximately 30 surgeries of this type each week.

CHANGE IN FACE NEARLY 1.8 MILLION COSMETIC PROCEDURES WERE PERFORMED IN THE U.S. IN 2016. THREE OF THE TOP FIVE PROCEDURES INCREASED OVER THE PREVIOUS YEAR

UP 2%

NOSE RESHAPING

UP 2%

EYELID SURGERY

UP 4%

FACELIFT

A FRESH RESTART As people become more health conscious — eating a healthy diet and exercising regularly — today’s cosmetic procedures reflect this focus on wellness.

“With safer and more minimally invasive procedures, we’ve seen facial plastic surgery evolve into a natural extension of people’s pursuit of a healthy lifestyle,” Archibald says.

Popular cosmetic procedures include: Facial rejuvenation procedures, both surgical and nonsurgical Aesthetic nasal surgery Laser skin resurfacing Archibald’s primary goal for patients is always to make them feel better about themselves.

“Making the decision to undergo cosmetic facial surgery isn’t simply about recapturing the beauty of one’s past,” Archibald says. “It’s about facing the future unencumbered by personal insecurities about appearance. Patients walk out of our office feeling more self-confident than ever before. They resonate the meaning of true beauty.” castlerockhospital.org

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SCREENING OUT UNCERTAINTY

NEW TOOLS HELP PRECISELY DIAGNOSE AND GUIDE TREATMENT FOR PROSTATE CANCER

ELEVATE 4 Winter 2018

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rostate cancer screening has bounced in and out of favor so often that men can get dizzy trying to keep up.

TO SCREEN OR NOT TO SCREEN The most common screening, the prostate-specific antigen While influential organizations disagree (PSA) test, measures blood levels of an antigen produced by about who should be screened for normal as well as malignant cells in the prostate. If cancer is prostate cancer and when, Castle Rock present, those levels can rise. But plenty of other things can cause Adventist Hospital urologist Dayne them to rise, too, says Castle Rock Adventist Hospital urologist Nelson, MD, sticks to some Dayne Nelson, MD. So, when routine screening was the norm, he commonsense guidelines: adds, “We were overdiagnosing cancer and overtreating.”

Ages 40-54: Routine screening for men However, as recommendations against routine screening at high risk, including those who: took hold, “I’ve seen a lot more people diagnosed with advanced • Are African-American prostate cancer,” Nelson says.

• Have a family history of prostate cancer The good news: New detection methods are available, and more Ages 55-69: Screening is a shared are emerging. Some determine whether cancer is actually present; decision, based on discussion of risks and others predict the aggressiveness of already-detected cancers, benefits. including: DETECTION TESTS • PSA3 is a urine test that measures a molecular marker for prostate cancer.

NO RUSH TO TREAT • Mi-Prostate Score (MiPS) incorporates PSA levels and As more precise methods for predicting molecular ribonucleic acid (RNA) markers into one score that prostate cancer aggressiveness emerge, provides a personalized risk assessment.

Dayne Nelson, MD, predicts more men • ConfirmMDx helps identify undetected prostate cancer may embrace active surveillance, in by uncovering abnormalities in DNA. This test is useful in which doctors routinely monitor PSA men whose PSA is elevated, yet biopsies have not detected levels and other measures without taking cancerous cells, Nelson says. action unless measures rise. Active ASSESSMENT TESTS ® surveillance can spare men unnecessary • Prolaris is a genetic test that helps predict the aggressiveness treatment, and its side effects. of detected cancer.

“We’re becoming more successful • Oncotype DX prostate cancer test looks at specific gene at treating localized prostate cancers Castle Rock Adventist activity in early stage prostate cancer, to help identify the detected early, and there can be a Hospital is part of Centura cancer’s aggressiveness.

99 percent survival rate at 15 years.

Health, the only accredited ConfirmMDx and Oncotype DX can both spare men cancer care network in That’s really amazing,” Nelson says. the discomfort and risks of biopsies and repeated biopsies, Colorado.

To learn more and help inform decisions about diagnosis and treatment, about cancer prevention and Nelson says. screenings, visit centura.org/cancer.

& QA

WITH BILL PAGE, DO HAND SURGEON AT CASTLE ROCK ADVENTIST HOSPITAL

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ith a network of 27 bones and associated structures, including nerves, tendons, and ligaments, the hand and wrist are at risk for a variety of painful conditions. We sat down with Bill Page, DO, a board-certified orthopedic surgeon joining Castle Rock Adventist Hospital specializing in hand surgery, to discuss common causes of pain and available treatment options.

What are the most common causes of hand and wrist pain?

A: Common complaints include finger and thumb pain or clicking (trigger finger); hand/finger pain and numbness (carpal tunnel syndrome); and arthritis of the thumb, finger, and wrist. I also see quite a bit of tendon irritation in the wrist and elbow, related to overuse issues.

Q

What are the best ways to manage symptoms?

A: When dealing with degenerative changes (those that occur over time) or arthritis, nonoperative measures to alleviate pain include splinting or bracing, anti-inflammatory medications, ice, adjusting the work environment, and patient education.

Therapy plays a substantial role in treating hand and wrist pain; an educated hand therapist can help treat conditions using massage, stretching, and modalities such as iontophoresis (electrical stimulation) and dry needling. Alternative treatments, like acupuncture, may be helpful as well.

Q

When should patients seek medical care?

A: I often ask my patients what they do for fun. When pain interferes with a favorite activity, an evaluation is certainly a good option. For conditions such as carpal tunnel syndrome and trigger finger, an earlier evaluation is preferred, as these conditions may worsen or become irreversible if not addressed early. In addition, any time the pain is the result of an injury, patients should seek medical attention to rule out more serious issues.

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DIS-ARMING PAIN

NONINVASIVE SURGERY BRINGS CARPAL TUNNEL RELIEF

Carpal tunnel symptoms vary and can

include tingling, numbness, and severe pain, says Bill Page, DO, orthopedic surgeon. The condition causes pain when compressed arteries cut off blood to the nerves.

Page advises seeking treatment soon after symptoms start. “Some of the damage can be irreversible if it’s too far along.”

Most patients try medication and physical therapy first, but when those fail to bring relief, surgery may be an option. Endoscopic carpal tunnel surgery is performed on an outpatient basis and involves inserting a tiny camera and cutting tool through a small incision in the wrist. The transverse carpal ligament is cut, which takes pressure off the nerve.

Dr. Page is joining Centura Orthopedics & Spine beginning March 2018! To make an appointment, call 720-455-3775 or visit precisionspine.org. castlerockhospital.org

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PUSHING BACK PAIN

An estimated eight in 10 people will experience back pain in their lifetime. “Back pain is one of the leading causes of not being able to work or enjoy

recreational activities,” says Christopher Gallus, DO, a spine surgeon at Centura Orthopedics & Spine in Castle Rock.

Most back pain resolves with anti-inflammatory medications (such as Motrin), rest, and physical therapy. When symptoms persist, however, surgery may relieve pain. And Dr. Christopher Gallus today’s spine surgery is not like that of even five years ago. “Hardware is better now, and newer techniques performed through small incisions spare muscles,” Gallus says.

Here he helps take a look at conditions that often require spine surgery.

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SURGICAL TREATMENT:

Spondylolysis/ Spondylolisthesis

Spondylolysis is a fancy name for a crack or stress fracture in a lower back vertebra. Its more serious cousin, spondylolisthesis, occurs when that fractured vertebra slips out of place.

Children and adolescents active in sports such as gymnastics, football, and weight lifting are at greatest risk, as are active adults in their 20s-40s.

Rarely responds to nonsurgical treatment.

Spinal fusion “welds” vertebrae together to stabilize the spine.

Spinal Stenosis

Stenosis is a narrowing of the “tunnel” around your spinal cord. This can place pressure on nerves, leading to numbness, tingling, pain, and leg weakness.

It occurs mainly in adults over 60.

Arthritis is the most common cause.

Decompression surgery removes bone and bone spurs that are causing pressure on nerves.

Herniated Disc

A disc is a soft, rubbery pad that serves as a “shock absorber” between vertebrae. When it herniates, or ruptures, its soft center pushes through the outer edge of the disc, sort of like the jelly seeping out of a doughnut.

Older adults are at risk, as are smokers, those who are overweight, and those who improperly lift or engage in repetitive strenuous activities.

Microdiscectomy, which removes only the protruding portion of the disc, is common for lower back pain. At all levels, disc removal and fusion of the two vertebrae also may be an option. Artificial disc implantation is an alternative to fusion in some neck pain patients.

90% OF CASES OF LOW BACK PAIN IMPROVE WITHOUT SURGERY.

ELEVATE

WHOM IT AFFECTS:

To make an appointment with Dr. Gallus, call Centura Orthopedics & Spine at 720-455-3775 or visit centuraorthopedics.org.

Castle Rock Adventist Hospital — along with Littleton Adventist Hospital, Parker Adventist Hospital, and Porter Adventist Hospital — are part of Centura Health, the region’s leading health care provider.

Our spine care program offers comprehensive spine care, from pain management to surgery. To learn more, go to centura.org/spine.

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WHAT IT IS:

THE BACK STORY

A BRIGHT IDEA

NEW ROBOTIC MICROSCOPE REVEALS BETTER WAYS TO PERFORM SPINE SURGERY

Everyone knows that being a spine surgeon requires good hands. But it also requires good

eyes to see the intricacy of the spinal column and make miniscule incisions to repair herniated discs Dr. William Choi and other problems that cause pain.

And a new robotic microscope at Castle Rock Adventist Hospital is helping spine surgeons get even better.

Castle Rock Adventist Hospital is the first hospital in Colorado to add the BrightMatter™ robotic digital microscope — and William Choi, MD, FRCSC, a spine surgeon at the hospital, was the first to use it. Here he walks us through a few of its biggest benefits.

A BETTER VIEW With a regular surgical microscope, the surgeon has just one small area in focus at a time, which means it needs to repeatedly be moved and readjusted. With the robotic microscope, the surgeon can view the surgical site from multiple angles and directions on a 55-inch high-definition monitor while sitting or standing, and everything in view of the camera system is in focus.

ENHANCED ERGONOMICS (AND SURGICAL ENDURANCE) Ironically enough, many spine surgeons end up needing surgery themselves after years spent working in ergonomically challenged positions. “Not looking down into the surgical site for three to four hours and experiencing muscle fatigue is huge,” Choi says. He notes that other surgeons who have recently begun using the new system believe it could extend their career by as much as a decade or more.

IMPROVED EFFICIENCY In the beginning, the new system will offer a better view, but eventually it could assist in performing procedures, Choi says. “Over time, we want to adapt the robot to help the surgeon perform the surgery, essentially giving the surgeon an extra pair of hands.”

BETTER OUTCOMES THROUGH RESEARCH With all its benefits, it’s the research component and the possibilities it could bring that Choi says he’s most excited about. For example, with posterior cervical laminectomy used to address neck pain, a large incision must be made in the back of the neck. But Choi says early research indicates the spine microscope system may help to reduce the incision size down to an inch or smaller.

“This is another tool that can help make surgery safer and more efficient with minimal incisions,” he says. “And we will literally be on the forefront of this technology at Castle Rock, beyond even major teaching hospitals. It will definitely put us on the map.”

To make an appointment with Dr. Choi, call Precision Spine Center in Castle Rock at 303-790-2225.

SHARING THE KNOWLEDGE

As the first hospital in Colorado to acquire the robotic spine microscope, Castle Rock Adventist Hospital will serve as a center for physicians throughout the region to be trained on the new system.

castlerockhospital.org

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Portercare Adventist Health System NON-PROFIT ORG US POSTAGE

PAID

DENVER, CO PERMIT NO. 4033

2350 Meadows Boulevard Castle Rock, CO 80109

We all want to be healthy. For

some, that means overcoming, or preventing, chronic illnesses like diabetes, high cholesterol, or heart disease. For others, it means maintaining a healthy weight. And for still others, it means just feeling great, in body, mind, and spirit.

Whatever your health destination, Centura Health’s 18-session holistic program, Pathways to Health & Wellness, can help you get there.

This three-month program is designed to provide priceless health benefits, including helping you:  Reverse chronic disease  Lose weight  Gain energy  Spend less on food and medications  Enjoy life again

To learn more about Pathways to Health & Wellness, attend one of these FREE information sessions at Castle Rock Adventist Hospital: • Thursday, Feb. 1, 6:30-7:30 p.m.

• Sunday, Feb. 4, 1-2 p.m.

• Tuesday, Feb. 6, 6:30-7:30 p.m.

Register for an information session at coloradocreationhealth.com.

WHERE TO TURN WHEN WINTER AILMENTS HIT

Winter. We love it for the skiing and the cuddling by the fireplace. The blizzard of chilly weather ailments, not so much. Here are some tips for handling some of the most common winter ills: Flu. If you didn’t get a vaccine, and the virus hits, make a trip to the doctor in the first 24 hours of illness. If you catch it early enough, your physician can write a prescription for Tamiflu, which not only relieves symptoms, but can also lessen the illness’ duration.

Back strain. From purging holiday decorations to shoveling snow and slipping on ice, winter is a back-injury minefield. If ice and ibuprofen don’t bring sufficient relief, see your doctor.

Pneumonia. This lung infection causes persistent coughing, mucus, and fever. Antibiotics can be effective against bacterial pneumonia, but not when the disease is virus-caused. Symptoms that should signal a doctor visit — especially for very young children, adults over 65, and people with compromised immune systems — include shortness of breath, chest pain, confusion, or a fever combined with coughing up yellow, green, or brown sputum.

To schedule an appointment, call Ridgeline Family and Sports Medicine, Castle Pines, at 720-552-5990, or the Meadows, at 720-477-4266.

EXPANDED DOCTOR HOURS

Whether you’re sick or just scheduling a checkup, everyone wants a quick and convenient appointment.

At Centura Health Physician Group Ridgeline Family and Sports Medicine, they agree. They now offer Convenient Care to fit your schedule: WEEKDAYS: 7 a.m.-6 p.m.

SATURDAYS: 8 a.m.-Noon SUNDAYS: 10 a.m.-4 p.m. (acute and return visits)

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THE ROUTE TO GOOD HEALTH

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).