Grow Spring 2015

Spring 2015 | Volume 7, Issue 2

Back with a

SPLASH Back pain can hold you back from all that life has to offer. See how Parker Adventist Hospital can help relieve your pain to put you back in the swim of things.

Page 4

Nancy Rosenberg is free of pain and back in the lane one year after spinal fusion surgery at Parker Adventist Hospital.

PLUS...

GYN Cancer Signs

Relieving Incontinence

New Weight Loss Surgery

PAGE 3

PAGE 6

PAGE 7 PHOTO BY ELLEN JASKOL

Gaining on Pain Can snails make your pain go away?

MORE THAN ONE IN THREE AMERICANS SUFFERS FROM CHRONIC PAIN. We sat down with Stephen Campbell, DO, a pain management specialist at Centura Health Physician Group Parker Pain Specialists, to talk about two new advancements that could make pain management more convenient.

Snails for pain — Prialt, a unique non-narcotic medication derived from snails, blocks pain signals between the brain and the nerve. “While it’s relatively new, we’ve seen positive results in patients with chronic pain who have not benefited from other pain Treating Pain management medications or treatments,” Campbell says.

MRI-compatible stimulators — Previously, patients who had implanted Dr. Stephen Campbell believes spinal cord stimulators — which use electrical signals to interrupt pain in combining a variety of transmission in the spine — were ineligible for MRIs. A new type of stimulator modalities to treat pain. removes that problem.

Dr. Stephen Campbell He is trained in anesthesiology “This advancement is great for those who are younger and could really Pain Specialist and pain management. benefit from stimulation but shied away from it in the past because of the To schedule an appointment, MRI restrictions,” Campbell says. Spinal cord stimulation is often recommended for call 303-269-2626. people with failed back surgery syndrome, herniated disc pain that is unresponsive to other treatments, and complex regional pain syndrome.

WARD OFF WOUNDS

Schedule your screening mammogram The Trio Breast Center at Parker Adventist Hospital encourages women to start the spring right by getting their annual screening mammogram. To help make it more convenient, the center is providing extended hours, from 7 a.m.-7 p.m., on May 12 and June 23. To schedule an appointment during this time or regular hours, call 303-269-4150 — or simply text your name to 303-816-8648, and our schedulers will call you.

Trio Breast Center — 2 convenient locations Parker Adventist Hospital

Alpine Medical Building • 9397 Crown Crest Blvd., Suite 100 • Parker, CO 80138

IF YOU’VE GOT A CHRONIC CONDITION like diabetes or cancer, you are at high risk of developing a wound that won’t heal.

Thankfully, good preventive measures can minimize your risk. Michael Bertocchi, MD, medical director of the Wound Care Center at Parker Adventist Hospital, offers these tips:  FOCUS ON FOOT CARE: Wear slippers Dr. Michael Bertocchi, Wound Care Expert around the house and well-fitting shoes outside. “Don’t go barefoot, particularly if you have a chronic condition that affects blood flow and sensation in your feet,” he says.  VISIT A PHYSICIAN REGULARLY: Physicians can identify and treat wounds and adjust medications to avoid potential wounds.  MOVE MORE: For paraplegics and obese people, focus on shifting your weight and regularly move positions. “Mobility is key to preventing wounds like skin ulcers and bedsores,” he says.  STOP SMOKING: Studies show that smoking can make people up to six times more susceptible to wounds and prevent proper healing.

“Bottom line — people with chronic conditions need to be aware of their risk of wounds and take extra precautions,” Bertocchi says.

Centura Health at Southlands

6069 S. Southlands Parkway • Aurora, CO 80016 (within Southlands Mall, next to Olive Garden) 303-269-4150 2 ■ Spring 2015 ■

grow

The Wound Care Center at Parker Adventist Hospital specializes in treating chronic wounds, offering a variety of modalities, including two hyperbaric oxygen chambers. For more information, go to parkerhospital.org/woundcare or call 303-269-2310.

PHOTOS CLOCKWISE FROM TOP ©DOLLARPHOTOCLUB.COM/PRZESZLO; DOCTOR PHOTO BY ELLEN JASKOL; ©DOLLARPHOTOCLUB.COM/VILOR

Wearing good shoes and quitting smoking help prevent wounds

Know the signs of GYN cancers

Parker Adventist Hospital is part of the Centura Health Cancer Network, delivering integrated, advanced cancer care across Colorado and western Kansas.

NEARLY 100,000 WOMEN WERE DIAGNOSED with gynecologic cancers last year. Of those, one-third will survive fewer than five years.

Many of these lives could be saved if women were aware of the signs and symptoms and reported them promptly to their doctors, says Glenn Bigsby, DO, the gynecologic oncology medical director at Parker Adventist Hospital.

“Stage and type of cancer at the time of diagnosis determine prognosis,” Bigsby says. “It’s important to note that if detected early, as in Stage I, the five-year survival rate is very high for most types of gynecologic cancers.”

1

in a thousand

Dr. Glenn Bigsby is one of just 1,100 gynecologic oncologists in the United States. Bigsby recently moved to the metro area from Florida and now practices at Parker Adventist Hospital and Littleton Adventist Hospital.

Take endometrial cancer, for instance. This is the most common form of gynecologic cancer, with more than 40,000 women expected to be diagnosed this year. When found at the earliest stage, 90 percent of patients will survive five years or longer, according to the American Cancer Society.

“I encourage women to see their doctors on a regular basis and tell them about anything out of the ordinary,” Bigsby says. “Sharing all symptoms with both your gynecologist and primary care physician helps them hone in on problems more quickly.”

GYNECOLOGIC CANCER SYMPTOMS Symptoms

Cervical Cancer

Ovarian Cancer

Uterine Cancer

Vaginal Cancer

Vulvar Cancer

Abnormal vaginal bleeding or discharge Pelvic pain or pressure Abdominal or back pain Bloating Changes in bathroom habits Itching or burning of the vulva Changes in vulva color or skin, such as a rash, sores, or warts

DON'T DELAY! Call your doctor right away if you have any abnormal vaginal bleeding between periods, after sex, or after menopause or if you have any of the other signs shown above for two weeks or longer.

Join Dr. Glenn Bigsby for a FREE seminar on Thursday, April 16, at 6:30 p.m. to learn the signs and symptoms of gynecologic cancers, the risk factors, and what you can do to lower your risk. To register, go to parkerhospital.org/seminars.

TEST

YOUR

HEALTH

More than 15 health screenings, from body mass index to blood pressure checks, will be offered at the FREE 9Health Fair at Parker Adventist Hospital. The health fair will be held on Sunday, April 26, from 7 a.m.-noon. Screenings are provided on a first-come, firstserved basis. For more information, go online to 9healthfair.org.

APRIL

FREE

health seminars Join Parker Adventist Hospital for a series of FREE health seminars. All seminars are held in the Parker Adventist Hospital Conference Center, located on the Garden Level at the west entrance. A light lunch is served during daytime programs, and light snacks are served during evening programs. Registration is required for all seminars. New online registration at parkerhospital.org/seminars.

Signs and Symptoms of GYN Cancer

Thu, Apr 16 | 6:30-8 p.m.

Dr. Glenn Bigsby, gynecologic oncologist, will discuss signs and symptoms of cancers of the female reproductive system, as well as risk factors and prevention tips.

Hyperbaric Oxygen and Chronic Wound Care

Tue, Apr 21 | Noon-1:30 p.m.

Join Dr. Michael Bertocchi, wound care medical director, for a discussion on hyperbaric medicine and the treatment of difficult wounds. Learn what causes nonhealing wounds and how wound care centers help with healing.

Weight Loss Surgery Seminar

Thu, Apr 23 | 6:30-8 p.m.

Join Dr. Thomas Brown, bariatric surgeon, as he discusses the latest advancements in weight loss surgery and if you are a candidate.

Spine Fusions

Thu, Apr 30 | 6:30-8 p.m.

Join spine surgeon Dr. Zak Ibrahim, as he discusses lower back fusions. Learn how and why spinal fusion is performed and who is a good candidate.

9395 Crown Crest Blvd., Parker, CO 80138 grow is published quarterly by Parker Adventist Hospital— Portercare Adventist Health System—as part of our mission to nurture the health of the people in our community. To comment or unsubscribe, please email grow2@centura.org. grow is produced by Clementine LLC of Littleton, Colo.

Executive Editor: Rachel Robinson

grow

■ parkerhospital.org ■ 3

Forget the bad rap you’ve heard about fusion surgery. This spine surgery is helping thousands get back to their lives, pain-free.

Nearly 500,000 spinal fusions are performed in the U.S. every year — six times as many as were performed two decades ago. While the increase in spinal fusion rates has caused debate, the reality is that spinal fusions, particularly lower back (lumbar) fusions, which join together one or more vertebrae in the lower back, can greatly benefit carefully selected patients, says Scott Stanley, MD, an orthopedic spine surgeon at Parker Adventist Hospital.

“Lumbar fusions get a bad reputation, as people have a misconception that you are stiff and can’t move afterward,” Stanley says.

Patients like 75-year-old Nancy Rosenberg, who suffered from lumbar degenerative disc disease for years, prove otherwise.

“I can now move painfree,” says Rosenberg, a region, longtime runner and yoga The lumbar spine is the lower back enthusiast who underwent the which starts roughly 6 inches below a lumbar fusion and a ves shoulder blade, where the spine cur laminectomy, which spine is inward to the stomach. The lumbar removed a portion of her 5. composed of five vertebrae, called L1-L vertebrae, a year ago. “If you played ’50s music, I could do the twist.”

“The prominent reason why we do lumbar fusions is to stabilize the back and, in cases of severe arthritic changes, to eliminate pressure on nerve fibers,” Stanley says. “Fusion is not a surgery you seek out to solve back pain. It is used as an adjunct for nerve and instability problems.”

4 ■ Spring 2015 ■

grow

Common conditions that could warrant lumbar fusion include: gS pondylolisthesis: when one vertebra slips forward over another and causes pressure on the nerves gD egenerative scoliosis: caused by slow degeneration of the stabilizing joints between vertebrae gS pinal stenosis: narrowing of the spinal canal, causing irritation to the spinal cord or nerves and resulting in pain, weakness, or numbness “If you are 20 with back pain, a fusion is not for you. But if you are older and suffer from one of the conditions above, fusion could positively change your life,” Stanley says.

Road to recovery Rosenberg had tried nearly everything to relieve her pain — injections, rest, medications, and physical therapy — to no avail. After a road trip to New Orleans in March last year, she was at her wit’s end.

Dr. Scott Stanley “I could not walk from Spine Specialist the car to the motel without extreme pain,” Rosenberg says. “I came back home and had another injection, but it didn’t help.”

That’s when Rosenberg went to see Stanley, whom she was referred to by two primary care physicians and a physical therapist. Stanley quickly discovered she had three worn discs in her lower back and

SWIM PHOTO BY ELLEN JASKOL; WATER ©DOLLARPHOTOCLUB.COM/MOMO-C; SPINE ©DOLLARPHOTOCLUB.COM/CLIPAREA

Back on Track

Nancy Rosenberg, 75, went from not walking without pain to running and swimming pain-free after spinal fusion surgery at Parker Adventist Hospital.

Patients with spinal stenosis are mo re likely to find relief and greater improvement in functio n with surgery than those treated nonoperatively, accord ing to the Spine Patient Outcomes Research Trial (SPORT). The study also supports the effectiveness of spinal fusion at the two lowest spinal vertebrae (L4 and L5) for degenerati ve spondylolisthesis.

spondylolisthesis. Rosenberg had surgery soon after and has never looked back.

“It’s not great to have surgery, period, but the whole process went so well,” Rosenberg says. After her hospital stay, Rosenberg spent three weeks in a rehabilitation facility, which helped her recover and took strain off her husband.

“I can do everything now and can’t wait to head out on the road,” she says.

Lumbar fusion pros and cons “Not all spine fusion is bad,” Stanley stresses. “Things have changed drastically over the years, and it’s a great surgery for the right candidates.”

Like every surgery, lumbar fusion offers pros and cons to patients.

PROS

CONS

g Patients can often function

g No bending, lifting, or twisting

and move better than before surgery

g Can provide pain relief for

certain conditions when conservative treatments fail

g Once healed, you can go back

to normal activities

for up to three months

g May initially require some

pain medications

g Recovery requires help

from family, physical therapists, and occupational therapists

PHOTO: ©DOLLARPHOTOCLUB.COM/SAMOTT

“Like with any surgery, you have to be patient,” Stanley says.

The fusion is similar to an internal cast; once the body repairs and recovers, the benefits become exponential, he adds.

“Dr. Stanley did wonders for my body, inside and out, repairing my vertebrae and sparing me from a nasty scar,” Rosenberg says. “I couldn’t be happier.”

Parker Adventist Hospital offers a FREE patient education class prior to spine surgery. For more information and to watch a video, visit parkerhospital.org/spinevideo.

Rehab Your Back Eight out of 10 people with back pain will find relief without surgery. Physical therapy available at Parker Adventist Hospital includes a range of treatments for back pain, including: Neuromuscular re-education activities for retraining the core muscles Modalities such as electrical stimulation for pain and inflammation Manual therapy, which utilizes a broad array of highly skilled, hands-on techniques to restore proper joint mechanics and soft tissue properties “Because back pain can be multifaceted, we combine an array of services tailored to the patient’s needs,” says Teresa Legerski, MS, a physical therapist at Parker Adventist Hospital.

For alleviating back pain at home, Legerski recommends the following tips: Actively participate in a home exercise program that augments therapy.

Change your posture and positioning. Your hips and shoulders should be aligned, as should your ears and the tops of your shoulders.

Improve flexibility.

Simple stretching can lengthen muscles and minimize pain.

Build core strength.

Core stability can support the spine and prevent or reduce back pain.

Lift properly. Use your legs, rather than your back, to lift, and avoid twisting and lifting.

Make healthy lifestyle choices. Engage in regular moderate exercise and cease smoking, as it has been linked to chronic back pain, according to a recent study published in the journal Human Brain Mapping.

grow

■ parkerhospital.org ■ 5

Women, If you experience incontinence, chances are good that Kegels — if you learn to do them right — can help repair the problem

IF YOU’VE GIVEN UP JUMPING ON THE TRAMPOLINE with your kids or have to clench your core when you sneeze, you’re not alone. It’s estimated that one in four women over the age of 18 experiences some level of incontinence.

And if you’re one of these women, you’ve probably tried thousands of Kegels without results. Chances are you’ve been doing them incorrectly — and may even be making the problem worse.

“Studies show only 50 percent of women are able to do pelvic floor contractions successfully with verbal instruction alone,” says Allison Ariail, a physical therapist who specializes in women’s pelvic health at the Centura Health Center for Therapy at Parker Adventist Hospital. “Unfortunately, 25 percent perform these contractions in a way that makes urinary incontinence worse.”

Stress incontinence occurs when the muscles that control the bladder are weakened, resulting in a loss of urine during activities such as coughing, sneezing, laughing, or exercising. Childbirth, constipation, strenuous exercise, and menopause all can increase a woman’s risk of stress incontinence.

“Women have many muscles that form a hammock between the front of the pelvis and the tailbone,” Ariail explains. “For optimum pelvic floor health, these muscles must be strengthened through specialized daily exercises.”

The Centura Health Centers for Therapy at Parker Adventist Hospital, Littleton Adventist Hospital, Porter Adventist Hospital, and Castle Rock Adventist Hospital offer a program that teaches women how to strengthen their pelvic floor muscles correctly to reduce incontinence. Using ultrasound and EMG, therapists can actually show women when they are correctly contracting the right muscles.

In addition, physical therapists use manual therapy techniques and functional activity training. The majority of patients see a marked decrease in their incontinence after completing the 12- to 16-week program, Ariail says.

Dr. Johnny Yi and Dr. Mandi Beman at Aracea Women's Care also offer urogynecology treatments, including surgery.

For more information, call 303-316-6677 or go online to araceawomenscare.org.

6 ■ Spring 2015 ■

grow

INCONTINENCE THERAPY is available at Centura Health Centers for Therapy at these hospitals: Parker Adventist Hospital 303-269-4590

•

Castle Rock Adventist Hospital 720-455-3700

•

Littleton Adventist Hospital 303-730-5883

•

Porter Adventist Hospital 303-778-5842

One in seven women suffers from a condition known as chronic pelvic pain, or CPP, which ranges from tightness or heaviness in the pelvic floor (the area between the naval and hips) to excruciating pain.

“Chronic pelvic pain presents in different ways,” says Allison Ariail, a physical therapist who specializes in women’s pelvic health at Parker Adventist Hospital. “For some, it’s pain with intercourse. Other women hurt all the time and can’t get out of bed; they can’t sit; they can’t exercise.”

A physical therapy program similar to the one used to treat incontinence can help reduce CPP. The program, offered at Parker Adventist Hospital, helps reduce any scar tissue, if present, and also helps train women how to relax their pelvic floor muscles.

“ EVERYONE HAS A PLACE WHERE THEY STORE THEIR STRESS AND FOR SOME WOMEN, THAT’S IN THEIR PELVIC FLOOR.” “A lot of women are actually contracting their muscles when they think they are relaxing them,” Ariail says.

In many cases, the cause of CPP is unknown or could be the result of many factors, including endometriosis, sexual trauma, and even stress. “Everyone has a place where they store their stress and for some women, that’s in their pelvic floor,” Ariail says. In one study, for example, when women were shown scary movies, researchers found that their pelvic floor contractions were higher than during childbirth.

To learn more about CPP rehabilitation, call 303-269-4590.

PHOTO: ©ISTOCKPHOTO.COM/KANGAH

TAKE CONTROL

PELVIC PAIN RELIEF

Switch Success

PHOTOS: APPLE ©ISTOCKPHOTO.COM/T_KIMURA; WOMAN BY ELLEN JASKOL

New surgery helping patients lose more weight A WEIGHT LOSS SURGERY PROCEDURE that combines two techniques of limiting food intake while also restricting calorie absorption is helping patients more successfully lose excess weight and keep it off.

The procedure, called a loop duodenal switch, entails creating a smaller stomach pouch and bypassing part of the small intestine. Patients generally lose 70-95 percent of their excess weight within 12 months following surgery, with the most dramatic weight loss during the first six months, says Joshua Long, MD, a fellowship-trained bariatric surgeon at Parker Adventist Hospital.

“I have seen so many patients benefit from this surgery, many of Dr. Joshua Long whom have lost as much as 100 Bariatric Surgeon percent of their excess weight less than a year after surgery,” Long says.

Loop duodenal switch is quickly gaining recognition as the most effective operation for weight loss. And recent studies have found that it Loop duodenal may be the most effective switch surgery helps method for curing many patients lose up to obesity-related health 95 percent of excess problems such as type 2 weight and reverses diabetes, Long says. diabetes in 99 Unlike earlier duodenal percent of patients. switch surgeries, the new “loop” technique retains a much longer portion of the small intestine, which improves the absorption of nutrients and reduces diarrhea. Ideal candidates for the surgery have a body mass index (BMI) of 50 or more, or are obese To learn more about with type 2 diabetes. loop duodenal “It is by far the most and other types of effective weight loss bariatric surgery, surgery we have today,” visit the Bariatric & Long says.

Metabolic Center of The surgery lasts Colorado online at roughly two hours and bariatriccenterco.com or call 303-269-4370. is covered by many insurance carriers.

Patients often leave the hospital in two to three days and can consume solid foods within six weeks.

Annamarie Edwards successfully lost weight after having loop duodenal switch surgery at Parker Adventist Hospital.

An ounce of prevention Bariatric surgery is known to reverse type 2 diabetes in morbidly obese patients, but new research shows that weight loss surgery can actually prevent the condition.

“The research is very compelling and is evidence to consider Dr. Thomas Brown bariatric surgery,” says Thomas Brown, MD, a bariatric surgeon at Weight Loss Surgeon Parker Adventist Hospital.

Bariatric surgery, such as the loop duodenal switch, limits food intake and calorie absorption to help patients lose weight. The study, published in The Lancet Diabetes & Endocrinology, found that prediabetic patients who had the surgery were 80 percent less likely to develop type 2 diabetes.

“Only one in three people who are morbidly obese reaches the age of 65 because of obesity-related conditions like high blood pressure, sleep apnea, and diabetes,” Brown says. “As this study shows, the sooner patients can undergo surgery, the greater the longterm effects.”

Morbidly obese is defined as having a body mass index (BMI) of 40 or more, or a BMI of 35 with obesity-related conditions.

Weight Loss Seminar Join Dr. Josh Long or Dr. Thomas Brown for a FREE class to learn more about this procedure and other types of weight loss surgery. See Pages 3 and 8 for details.

grow

■ parkerhospital.org ■ 7

MAY

FREE health seminars

Portercare Adventist Health System

Non-Profit Organization U.S. Postage

PAID

Denver, CO Permit No. 4773

9395 Crown Crest Blvd.

Parker, CO 80138

Become more body-wise with the experts at Parker Adventist Hospital. All seminars are FREE but require registration by going online to parkerhospital.org/seminars.

Seminars are held in the Parker Adventist Hospital Conference Center at the west entrance. A light lunch is served during noon seminars, and light snacks are served during evening programs.

Pain Management Tue, May 5 | Noon-1:30 p.m.

Join Dr. Stephen Campbell, a pain management specialist, and learn about your options for identifying the cause of your pain and how to get an individualized plan to get back to doing the things you enjoy most.

Part of Centura Health, the region’s leading healthcare 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 303-804-8166. Copyright © Centura Health, 2015.

Easing Joint Pain

Head Games

Thu, May 7 | 6:30-8 p.m.

Join Dr. Derek Johnson, orthopedic medical director, to learn about computer-navigated knee replacement, patient-specific knee replacement, and minimally invasive anterior hip replacement surgery.

Recognizing concussions in children under 4 PARENTS HAVE LONG BEEN WARNED about the risks of concussion for their athletic teenagers. But did you know that more than twice as many children ages 0-4 suffer from a concussion than youth ages 15-24, according to the Centers for Disease Control and Prevention (CDC)?

A concussion is a traumatic brain injury (TBI) followed by physical and cognitive symptoms. Falls account for more than half of concussions among children ages 0-4, the CDC reports.

“In children, particularly those who are preverbal and cannot express what’s bothering them, we have to look at physical symptoms that could signal a concussion,” says Paul Davidson, MD, the medical director of Southlands ER. Preverbal children may appear dazed, cry uncontrollably, change eating or sleeping patterns, lack interest in toys, or become irritable.

Special Extended Mammo Hours Tues, May 12 and Jun 23 | 7 a.m.-7 p.m.

Join us as we celebrate spring and moms with a special mammo event at The Trio Breast Center. Enjoy light refreshments and convenient hours. Call 303-269-4150 to make your mammogram appointment today.

Pelvic Health Seminar Thu, May 14 | 6:30-8 p.m.

Join women’s health physical therapist Allison Ariail and learn the signs, symptoms, and treatment options of pelvic floor disorders. Learn how to strengthen your pelvic floor with easy exercises and tips.

Signs of a concussion can include:

Vomiting

Weight Loss Surgery Seminars

Headaches

PHOTO: ©DOLLARPHOTOCLUB.COM/VIPERAGP

Presented by Dr. Joshua Long: Wed, May 13 | 6:30-8 p.m.

Wed, Jun 10 | 6:30-8 p.m.

Presented by Dr. Thomas Brown: Thu, May 28 | Noon-1:30 p.m. or 6:30-8 p.m.

Thu, Jun 25 | Noon-1:30 p.m. or 6:30-8 p.m.

Join our bariatric surgeons as they discuss the latest advancements in weight loss surgery and learn if you may be a candidate.

Nausea

Dizziness

Delayed Respon se

Slurred Speech Fatigue

Amnesia

“If the child is asking the same question over and over again, it could indicate a concussion,” Davidson says. “If you suspect your child has a concussion, take the child to an ER or primary care physician as soon as possible.”

Parker Adventist Hospital and Southlands ER are part of the Centura Health Trauma System, the region’s largest and most comprehensive network of trauma care and emergency services.

Southlands ER, at E-470 and Smoky Hill Road in Aurora, is a full-service ER with an on-site CT scanner and MRI, capable of handling all types of illness and injury. For information, go to parkerhospital.org/southlands.