Flourish Summer 2018 by Clementine Healthcare Marketing

AVISTA ADVENTIST HOSPITAL AND ST. ANTHONY NORTH HEALTH CAMPUS

SUMMER 2018 • Volume 2, Issue 3

e a H r y t h T t l i p ae Lifestyle changes you can make month to month for a happier, healthier heart

p. 4

Cultivating your health and your family’s

Backcountry safety from hydration to tick control p. 2

Integrative medicine goes mainstream p. 6

Bat, rodent, and rattlesnake bites and what you should do p. 7

GROW with us

VISIT OUR COMMUNITY

GARDEN p. 8

Get Out! Practical advice for staying outside AND staying injury-free this summer

hether it’s hiking, climbing, pedaling, or picnicking, it’s hard to resist the lure of summer activities in Colorado. We all know that in our high altitude, using sunscreen and staying hydrated are essential. Here, Mark Wisthoff, DO, of St. Anthony North Family Medicine, and nurse practitioner Lindsey Burch, of CHPG Church Ranch Primary Care, offer some additional advice for enjoying the outdoors safely.

ten

FOOD POISONING PROTOCOL

Burch’s outdoor dining rule of thumb: “Keep hot foods hot and cold foods cold.” If not stored properly, food can spoil. Symptoms like nausea, vomiting, and diarrhea can appear within hours, or up to a week after consuming tainted food. Most symptoms go away on their own, but seek medical care if you: • Experience fever or chills CHILL ABOUT THE GRILL • Become dehydrated If you are cooking your • See blood in your stool food to the proper • Pass out or become temperature, you lethargic or confused shouldn’t worry too

much about getting food poisoning from grill grates. To stay safe, throw away any marinade that had raw meat in it, and don’t use the same utensils and platters for cooked meat that you used to handle it when it was raw.

100 Health Park Drive Louisville, CO 80027

flourish | SUMMER 2018

14300 Orchard Parkway Westminster, CO 80023

° 212 F If you need to purify water for drinking in the backcountry, boiling is your best bet. Filtration and disinfection products help protect against some but not all pathogens. Boil water for one minute — three minutes if you’re at an altitude over 6,562 feet, suggests the Centers for Disease Control and Prevention.

YEARS

You need a tetanus booster every 10 years.

“The immunity wears off,” Wisthoff says, leaving you vulnerable to the bacterial toxin often found in dirt or rust. The infection, which can enter your system through a puncture or open wound, causes muscle stiffness, trouble swallowing, and even breathing difficulties.

THE GREAT D-BATE Sunscreen is a must outside. Generally, apply every 90 minutes. “But if you’re in and out of a pool or sweating a lot, use it more often,” Wisthoff says. Dermatologists, concerned about skin cancer, advocate full coverage, always. But some physicians worry we’re becoming vitamin D deficient, which can increase risk for diabetes, heart disease, and certain cancers. Some researchers now recommend five to 10 minutes of direct sunshine two or three times a week. Others say foods like fatty fish, and supplements, are safer sources. If you choose supplements, Wisthoff says, look at the recommendations of when and how much to take.

flourish is published three times annually by Avista Adventist Hospital and St. Anthony North Health Campus. Executive editors are Kirsten Gurmendi and Dan Wawrzyn. 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 flourish@centura.org. flourish is produced by Clementine Healthcare Marketing.

AVISTA ADVENTIST HOSPITAL | ST. ANTHONY NORTH HEALTH CAMPUS

Miracle Melon

Lindsey Burch, NP

Watermelon is, hands down, one of summer’s best foods, says Burch. “It requires almost no prep, it’s refreshing, and helps keep us hydrated.” It’s also low in calories, and packed with vitamins and antioxidants. A bonus: Watermelon may decrease muscle soreness after workouts and lower cancer and heart disease risk.

WATER LOGGING We all need extra fluids in summer, but seniors may need a little extra help staying hydrated. They don’t technically need more water than others, but they tend to drink less than they should because the sense of thirst dulls with age. They also may skip sips to avoid too many trips to the bathroom. If you or a senior you know needs extra help remembering to drink up, free smartphone apps like Daily Water and Hydro Coach track consumption and send reminders.

EVERY YEAR Sunscreen retains effectiveness for three years after packaging. But not all containers carry an expiration date, and exposure to heat can compromise effectiveness. It’s sunsmart to buy a new bottle at least once a year. “And don’t forget sunglasses to protect your eyes, and use lip coverage with SPF 15 or greater,” Burch says.

DON’T GET

ticked off

Every summer, ticks transmit Rocky Mountain spotted fever, a potentially serious bacterial infection, which can cause complications if not treated with antibiotics. Protect yourself by keeping skin covered and using anti-tick spray. After being outdoors, check yourself, your kids, and pets. You also can dry clothes on high heat to kill ticks. Remove any ticks quickly. The longer they feed, the greater your chances of infection. See a doctor if you have these symptoms:  Spotted rash  Fever  Headache  Light sensitivity  Muscle pain  Weakness  Nausea, vomiting, or diarrhea

Bees: A REAL BUZZKILL

If you get stung, remove the stinger without squeezing — “try scraping over it with a fingernail or side of a credit card,” Burch says. Then, wash the area with soap and water. Ice can ease pain or swelling. Get help immediately for anyone who shows signs of allergic reaction, such as swelling around the eyes, lips, tongue, or throat.

No. COVER PHOTO: ©ELLEN JASKOL; ©ISTOCKPHOTO.COM/JAG_CZ, /GASPR13, /BET_NOIRE, /BOONCHUAY1970, /ANTAGAIN, /HALFPOINT

Mark Wistoff, DO

Colorado is second from the top in the number of annual lightning-related deaths.

“Summit in the morning, because Colorado storms come in the afternoon,” Wisthoff says. To protect yourself when lightning threatens:  Get down as low as you can.  Seek cover, but not under a tree.  Stop sporting events when lightning is 7 miles away or closer. If you can count to seven between the thunder and the lightning, that’s 7 miles.

Need a family doctor? Make an appointment with: CHPG Primary Care at Church Ranch 303-925-4940 St. Anthony North Family Medicine 720-580-4657 Or visit chpgprimarycare.org for a list of all our primary care providers.

flourish | SUMMER 2018

Six months to a healthy heart Nearly 200,000 people could avoid

heart disease each year by changing their lifestyle habits, estimates the Centers for Disease Control and Prevention. But don’t worry, it doesn’t Dr. Lawrence Lazar take an extreme makeover to positively affect your heart health. And, you can forget the need to adhere to any one strict diet and exercise regimen. “Heart health is much more individualized than it used to be,” says Lawrence Lazar, MD, a peripheral and interventional cardiologist who sees patients at both Avista Adventist Hospital and St. Anthony North Health Campus. What’s important is making changes where you need to. Start by having a conversation with your doctor. Then tackle at least one change in each category every month, and you’ll be on your way to a healthier heart by the new year.

4 flourish | SUMMER 2018

STRATEGIZE WITH YOUR PHYSICIAN

It’s not enough to just know your numbers. “It’s what you do with those numbers that matters,” Lazar says. “For example, normal blood pressure is less than 120. Whether yours requires treatment depends on your other cardiovascular risk factors, and that requires a conversation with your physician.” In late 2017, the American College of Cardiology and American Heart Association lowered the stage at which high blood pressure should be treated from 140/90 to 130/80. And updated recommendations on cholesterol put an emphasis not just on your numbers, but on individual risk factors like weight or smoking. Use these guidelines to talk to your doctor about where you stand. • Blood pressure: Less than 130/80 mm Hg • BMI: 18.6 to 24.9 • Waist circumference: Less than 35 inches for women and 40 inches for men • Family history of heart disease, particularly a first-degree relative who had a heart attack or stroke before age 55 (males) or 65 (females)

MOVEMENT

High blood pressure, cholesterol, and blood sugar, all increase your chances for a heart attack. Exercise helps lower all three. But don’t stress about blocking an hour of your day to hit the gym. “It’s the cumulative exercise you do throughout the day you get credit for,” Lazar says.

TRY THESE TIPS: • Set a standing timer. Whether you’re at work or Netflix bingewatching, get up and walk around for three to five minutes every half hour. • Walk while you wait. Instead of sitting on the bleachers during baseball practice, walk around the building or field. • Step it up. Get your steps in by swearing off escalators, elevators, and moving sidewalks.

AVISTA ADVENTIST HOSPITAL | ST. ANTHONY NORTH HEALTH CAMPUS

How does it help?

DIET

When it comes to diet, more is better in some respects. “Diets that are higher in whole grains, nuts, and fruits and vegetables correlate with fewer cardiovascular events,” Lazar says. Plus, they can prevent excess weight gain, which increases the risk of heart disease.

STRESS

Stress temporarily raises blood pressure, but chronic stress can keep your levels elevated, putting your heart at risk. A study involving hundreds of women found that stressful events were linked to shorter telomeres, which causes cells to age and die. It’s this cellular aging that is associated with age-related illnesses, such as heart disease, Alzheimer’s, and cancer. The good news is that women who maintained active lifestyles, ate healthy, and slept well showed no significant shortening of their telomeres, even under increased stress.

TRY THESE TIPS: • Plan ahead. Prepare your meals fresh and then freeze them for use throughout the week rather than hitting the drive-through. • Rearrange your plate. Make meat a side and vegetables the star of the show. Better yet, replace animal proteins with beans or other non-meat proteins at least twice a week. • Snack on nuts. They pack as much crunch and infinitely more nutrients than chips. Cashews in particular have been found to raise good cholesterol levels.

SPIRITUAL AND EMOTIONAL HEALTH

Having purpose in life and connecting with others does wonders for your heart, including lowering blood pressure. Relationships built on trust also have shown to benefit your health. A study in the Journal of the American Medical Association found that a person’s trust in their doctor had a positive correlation on outcomes. Another study found that patients who believed in God saw the greatest benefits from treatment for depression and bipolar disorder. One possible reason, researchers said, was that people who had faith in God had a stronger faith that treatment would work.

TRY THESE TIPS:

TRY THESE TIPS: • Get outside. Nature is the natural stress reliever. Plan a mountain retreat or take a hike after work. • Tackle your insomnia. Stress and sleep deprivation are a toxic cycle. Talk to your doctor about sleep problems.

• Create no-phone zones. Ban mobile devices from the dinner table and the bedroom, and be present when interacting with loved ones. • Reflect on your day. Spend time each day praying or meditating. • Give back. Volunteer your time for a cause you’re passionate about.

Knowing your numbers encourages you to improve them and thus, your cardiovascular health.

Exercise causes the heart’s arteries to dilate more readily, allowing it to pump more blood with less effort.

Stress triggers adrenaline production, a hormone that elevates heart rate and blood pressure, so reducing chronic stress may have positive effects on blood pressure.

A healthy diet rich in whole grains, vegetables, and healthy fats reduces inflammation, which can cause cholesterol buildup.

Spirituality can make you more likely to have a positive outlook and take better care of yourself — and your heart.

PHOTOS: ©ISTOCKPHOTO.COM/T:RICARDOINFANTE, /SPUKKATO, /KUMEDA, /BYMURATDENIZ, /POIKE

Avista Adventist Hospital and St. Anthony North Health Campus are part of the Centura Health Heart and Vascular Network, the region’s leading provider of cardiovascular care.

If you have any risk factors for heart disease, it’s time to talk to a cardiologist about an individualized plan to prevent a cardiovascular event. Ask your primary care physician for a referral or call one of our cardiologists at St. Anthony North Health Campus at 303-426-1717, or at Avista Adventist Hospital at 303-515-4640.

flourish | SUMMER 2018

PARTS WHOLE

Sara Diaz, DO, incorporates mindfulness techniques in her own life to reduce stress.

and the

Complementary medicine, alternative medicine, integrative medicine. We hear these terms a lot, and often they

Dr. Sara Diaz

seem interchangeable. But integrative medicine isn’t just another item on that list. It’s really everything on that list. Sara Diaz, DO, a primary care physician at St. Anthony North Family Medicine — Orchard, explains.

IS INTEGRATIVE Q WHAT MEDICINE?

A: Integrate means to combine one thing with another so that they become a whole. That describes integrative medicine, which is based on the idea that body, mind, and spirit are one, and that each impacts the others. To heal the whole, integrative medicine practitioners blend proven therapies. It’s not alternative medicine. It’s a mix of traditional medicine with other modalities that are effective.

ARE SOME EXAMPLES Q WHAT OF THOSE MODALITIES? A: • Massage

• Acupuncture • Nutrition • Mindfulness, prayer, and other de-stressing techniques • Western medicine, including prescription medications and, when necessary, surgery We blend all those to give the patient the best outcome.

6 flourish | SUMMER 2018

IS AN EXAMPLE Q WHAT OF A CONDITION THAT

LENDS ITSELF TO INTEGRATIVE MEDICINE TREATMENT? A: Pain. We use what we need as far as

medications. But we also employ manual therapy, such as massage or acupuncture. Mindfulness techniques can be part of a pain relief program, too. It can’t make physical pain go away, but it can change how the mind processes and responds to pain. When people feel pain, they often link that with feelings of hopelessness and despair — and that triggers emotions that can worsen pain. Nutrition is part of it, too. It’s well-known that the Mediterranean diet is an anti-inflammatory diet. So, filling your plate with fruits and vegetables, plus protein from fish and lean meat, while avoiding processed foods and high amounts of sugar, is one more weapon in the fight against pain.

Start your day the mindful way Evidence is growing that mindfulness practices help lower anxiety and increase focus. Sara Diaz, DO, primary care physician at St. Anthony North Family Medicine — Orchard, recommends starting with this simple, two- to fiveminute exercise:

1 Breathe in through your nose and out slowly through your mouth.

2 Let go of thoughts about things you have to do or pending projects. Simply focus on your breath.

3 Watch your breath in your mind, focusing your awareness on it as it enters your body.

4 To learn more about the integrative medicine program at St. Anthony North Family Medicine, call 720-580-4657.

Be aware of your breath as it moves up and out of your mouth and dissipates.

PHOTOS: THIS PAGE: ©ELLEN JASKOL; OPPOSITE PAGE: PHOTO ©MATTHEW STAVER; ILLUSTRATIONS ©ISTOCKPHOTO.COM/BUBAONE, /HEIN NOUWENS, /KIMBERRYWOOD

Integrated medicine combines approaches to treat the entire person

AVISTA ADVENTIST HOSPITAL | ST. ANTHONY NORTH HEALTH CAMPUS

Once Bitten

What you need to know if an animal sinks its teeth into your child

ach year, pediatrician Lori Smith, MD, of CHPG Primary Care — Church Ranch sees children who’ve come out on the wounded end of an animal encounter.

That happens most often in the summer, when all creatures like to get outside and enjoy warm weather.

Dangers of Bites

In the case of wild animals, many carry diseases that can be transmitted to humans, Smith says. While attacks by bears or mountain lions can be the most dangerous, those are few. Instead, Smith says, Colorado’s most likely culprits are much smaller:

Bats are the most common source of rabies in humans, although just one or two people in the U.S. each year contract the disease. If a bat lets you get close enough to get bitten, Smith says, it’s probably sick and your child needs to be seen right away by urgent care or an ER. Rabbits and some rodents carry a disease called tularemia, which affects the skin, eyes, lymph nodes, and lungs. Humans can become infected through the bite of an infected tick or through contact with an infected animal. See your physician if you have a fever or skin ulcer at the bite site. Rattlesnake bites increase during the summer in Colorado. Centura Health treats many rattlesnake bites annually, including the state’s first rattlesnake bite fatality in decades in the fall of 2017. If your child is bitten, getting immediate medical attention is critical. Do your best to stay calm; keeping the bite below heart level will help slow the spread of the venom. Hollywood would have us believe we should use a tourniquet — this is bad advice. Call 911 and get to your closest emergency room as quickly as possible.

Dr. Lori Smith encourages patients to enjoy nature safely.

Pet Problems

Wild animals are concerning, but household pets are responsible for most bites. Dogs and cats bite when they feel scared, sick, threatened, or they are protecting something valuable, like food or offspring. That’s why it’s important, Smith says, to teach children never to pet a dog or cat without the owner’s permission, and never to rush at any animal. Here’s what you need to know:

• Dogs: If you have proof of rabies shots, irrigate and wash the wound thoroughly. See a doctor as soon as possible if stitches are needed, bleeding won’t stop, or if there are signs of infection. If your child was bitten by a strange dog and you can’t locate the owner, report the incident to your local animal control agency and try to be seen by a doctor within eight hours to discuss vaccination.

• Cats: Cat bites can be particularly dangerous, as they carry bacteria that can cause serious infections, including sepsis. Smith says, “Cat bites always, always need to be seen as soon as possible. When they break the skin, their teeth tend to be piercing; so the wound tends to be deeper; and bacteria gets deeper into the tissue.”

To schedule an appointment with Dr. Smith, call CHPG Primary Care — Church Ranch at 303-925-4940. To find a Centura Health pediatrician near you, visit chpgprimarycare.org. flourish | SUMMER 2018

Portercare Adventist Health System NON-PROFIT ORG US POSTAGE

PAID

DENVER, CO PERMIT NO. 4033

100 Health Park Drive Louisville, CO 80027

A Healthy Gathering Place

he community garden at St. Anthony North Health Campus provides a sustainable, healing environment for community members, patients, and associates to grow and harvest nutritious foods, experience nature, and gather for nutrition and health education classes. Strong evidence shows that when people have access to parks and gardens, they improve their overall physical and psychological health. The garden includes walking trails, flower and vegetable gardens, a fruit tree orchard, gardening plots, and ADAaccessible planter boxes. A community-built sculptural mural called “The Four Seasons” serves as the centerpiece of the garden. To get garden updates, “Like” St. Anthony North Health Campus on Facebook. To volunteer in the community garden, call 720-627-0129.

Avista Adventist Hospital and St. Anthony North Health Campus are 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 1-303-673-1250 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-303-673-1250 (TTY: 711).

SUMMER

2018 CALENDAR

INFANT/CHILD CPR This two-night class is encouraged for all expectant couples, new parents, grandparents, and others who may take care of the children. Professional EMS instructors through HeartSmart, Inc. teach the CPR/pediatric first-aid classes using a customized curriculum specific to child emergencies. When | Mondays, Jul 16 and 23; OR Sep 10 and 17, 6-9 p.m. Location │ Avista Adventist Hospital OR When | Thursdays, Aug 9 and 16; Aug 23 and 30 OR Sep 20 and 27, 6-9 p.m. Location │ Church Ranch Neighborhood Health Center Cost | $40 per person Registration avistahospital.org/events

SIBLING PREPARATION This class is designed to help children ages 3 to 7 feel involved in becoming a big brother or sister. When | Wednesdays, Aug 8, 4-5:30 p.m. OR Sep 12, 4-5:30 p.m. OR Oct 10, 4-5:30 p.m. Location │ Avista Adventist Hospital Cost | $25 per child Registration avistahospital.org/events

HAPPIEST BABY ON THE BLOCK Are you an expectant or new parent? Do you want to learn proven techniques for soothing your baby by Dr. Harvey Karp? Then join us to discover how you can have the Happiest Baby on the Block. When | Saturday, Aug 18, 9:30 a.m.-Noon Location │ Avista Adventist Hospital Cost | $40 per couple Registration avistahospital.org/events

DOG AND NEW BABY The Dogs & Storks™ program is perfect for expecting families with dogs as they prepare for life with baby. This class helps ease families into the transition from pet parents to baby parents with pets. This 3.5-hour presentation helps you plan and prepare for baby’s arrival — specifically with your dog(s) in mind. Dogs & Storks fills in the gaps left uncovered by obedience training. There will be time at the end of class for questions. When | Saturday, Sep 8, 9:30 a.m.-1 p.m. Location │ Avista Adventist Hospital Cost | $15 per person Registration avistahospital.org/events