Grow Spring 2016

Spring 2016 | Volume 8, Issue 2

First Steps A new BirthPlace nurse navigator helps families prepare for childbirth.

Parker Adventist HospitalĘźs Steps Ahead program made childbirth less stressful for Katya Petrova, as she and her husband welcomed baby Vasilissa.

See Page 4.

PLUS...

Banishing essential tremor with DBS

All-in-one ER and Urgent Care

Better ways to manage diabetes

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PAGE 7 PHOTO BY ELLEN JASKOL

Essential tremor meets its match

Deep brain stimulation gives patients hope & control AFFECTING UP TO 3 PERCENT OF AMERICANS, essential tremor is the most common type of involuntary shaking. Essential tremor movements in the hands and head are the most noticeable and can interfere with daily activities, including drinking, writing, and eating. Conservative treatments — medications, stress reduction, and caffeine avoidance — are the first line of treatment. But for patients who don’t respond to these, Parker Adventist Hospital offers deep brain stimulation (DBS), a surgical procedure that uses a pacemakerlike device to send electrical signals to areas of the brain that control movement.

“For the right patient, DBS can be life-changing,” says Ravi Shah, MD, a board-certified neurologist and medical director of stroke and Dr. Ravi Shah neurology at Parker Adventist Hospital. “DBS can give them back control of their movements.”

Good candidates for DBS include essential tremor patients with progressive, worsening tremors that affect daily living and do not respond to more conservative treatments, says Shah. He works alongside Mariel Szapiel, MD, a neurosurgeon at Parker Adventist Hospital, who has more than a decade of experience performing DBS surgery.

First introduced in the 1980s and approved by the Food and Drug Administration (FDA) in 1997 for essential tremor, DBS has been performed on more than 100,000 patients.

Could DBS help your tremors?

Patients who might be good candidates for deep brain stimulation (DBS) include those whose essential tremor: Is not controlled by conservative treatments Interferes with socializing and quality of life Complicates necessary tasks like writing or eating Becomes progressively worse

JOIN US for a FREE seminar with Dr. Shah to learn more about DBS to treat tremors and Parkinsonʼs disease. See details on back cover.

DBS has been shown to effectively subdue essential tremor for more than six years, according to a study published in the Movement Disorders Journal.

SNEEZING. SNIFFLING. ITCHING. RASHES. An allergy is one of the most common chronic conditions.

Aside from being uncomfortable and annoying, if left unchecked, allergies can exacerbate related problems, like sinus infections, eczema, and asthma. Over-the-counter medications like nasal steroids and oral antihistamines can help. But are they safe for long-term use?

“They are well-tolerated and low-risk drugs, but there are potential side effects. So if they’re going to be used long term, it should be discussed with your doctor,” says Mark W. Willis, MD, an otolaryngologist (ear, nose, and throat) at Parker Adventist Hospital. The primary side effects of over-the-counter medications may include: Dr. Mark Willis o Sedation, loss of productivity, and feeling lethargic that can go along with taking oral antihistamines o Nosebleeds and perforation of the nasal septum that can occur with nasal steroids Willis stresses that the benefits of these medications far outweigh the risks. But if you’re not getting adequate relief or you are having to use them for weeks at a time, you may need to see your doctor for testing and more treatment options, such as allergy shots or a new oral immunotherapy that can be used for limited allergens.

SUFFERING FROM ALLERGIES? Take our sinus symptoms quiz at coloradoentspecialists.org.

To make an appointment with Dr. Willis, call 720-274-2544.

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Effective care for persistent, low-grade allergy symptoms

FOODfor Health Four healthy habits to fuel good nutrition through cancer treatment UP TO 80 PERCENT OF CANCER PATIENTS may suffer from malnutrition, a health condition that results from improperly eating or the body’s inability to absorb necessary nutrients, according to research published in the Journal of Cachexia, Sarcopenia and Muscle.

Parker Adventist Hospital offers nutritional support to help cancer patients avoid this problem and find ways to use nutrition to aid in recovery.

EMERGENCY and URGENT CARE center aims to lower cost, improve care CENTURA HEALTH IS COMBINING an emergency room and an urgent care center into one at the Meridian Neighborhood Health Center, opening this fall at Oswego Street and Lincoln Avenue.

Dietary Support “Cancer treatments like chemotherapy, hormonal therapy, and radiation can carry with them side effects that can affect a person’s ability to get adequate nutrition, which is why nutritional support is so important,” says Margo Hahn, RD, oncology clinical dietitian at the Cancer Center at Parker Adventist Hospital.

Parker Adventist Hospital cancer patients meet with a registered dietitian to discuss their food tolerances, manage appetite changes, and create an eating plan specific to their individual needs. All recommendations are based on the latest research, Hahn says.

“Proper nutrition during cancer treatments can play a huge role in a person’s success,” she says. “Good nutrition helps the body heal.”

Appetite for Wellness

To curb common side effects like nausea, and changes in taste and appetite, and to maintain good nutrition, Hahn offers these four tips: Grab ginger: Ginger can calm the stomach, decrease nausea, and balance out certain taste changes.

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Drink between meals: Fluids with meals can impact appetite, so drink between meals rather than during. Water and protein-rich fluids (proteins help build tissues and muscles) are best.

Choose nutrients over calories: “Eat a variety of nutrient-dense foods every day instead of eating just to get enough calories,” Hahn says. For example, half an avocado and a single cream-filled snack cake have similar calorie counts, but the avocado contains more protein, unsaturated fats, fiber, potassium, vitamin A, folate, and calcium with less sugar and carbohydrates.

“Providing consumers with one solution for their emergency and urgent care needs allows more people to get the right care at the right time in their neighborhood for an affordable price,” says Deb Carpenter, RN, director of ambulatory projects at Centura Health South Denver Group.

The Neighborhood Health Center will have: + 24/7 coverage by ER physicians and nurses +2 4/7 urgent care +2 4/7 emergency room + F ull imaging services +M ammography and dual-energy X-ray absorptiometry (bone density) + Ability to accept ambulances + Primary care, women’s health, pediatrics, and urogynecology services

LEARN MORE at parkerhospital.org/comingsoon

Get moving: Exercising an hour before a meal can help stimulate the appetite.

LEARN MORE about the Cancer Center at Parker Adventist Hospital and cancer care services and programs at parkerhospital.org/cancercare or call 303-269-4975.

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

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 Health Marketing of Littleton, Colo.

Executive Editor: Lisa Gates

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Pregnancy and childbirth can be some of the happiest times in a woman’s life. But it’s not unusual for these events to also cause anxiety or depression. About one-quarter of women may experience these unexpected emotions.

For Russian native Katya Petrova, who gave birth to her first child in October, a new program at Parker Adventist Hospital’s BirthPlace, called Steps Ahead, helped calm her fears and reduce stress.

“There were so many unknowns for me and my husband, as it was our first child,” Petrova says. “To be able to get more information up front and cross off certain things before they needed to happen — like signing forms — was so useful and made the experience less stressful for us.”

Making sense of childbirth

Parker Adventist Hospital launched the Steps Ahead program in July 2015. It helps expectant families, surrogates, and adoptive parents feel informed and more prepared for childbirth with the

assistance of a BirthPlace nurse navigator who is available to give personal tours, answer questions, and help tailor the childbirth experience to each family.

“The program is such a great way to provide parents with individual guidance and personalized care through every step of pregnancy and childbirth,” says Tiffany Harr, RN, BirthPlace nurse navigator at Parker Adventist Hospital. With nearly 20 years of experience working in women’s health, reproduction, and the neonatal intensive care unit (NICU), Harr jumped at the chance to become the hospital’s first BirthPlace nurse navigator.

“It’s a perfect fit between my care coordinator skills and background in women’s and children’s health services,” she says.

Patients who plan to deliver at Parker Adventist Hospital typically meet with Harr between 28 and 35 weeks gestation.

Harr provides tours of The BirthPlace and meets one-on-one with patients to answer questions, fill out paperwork, explore special requests, discuss a feeding plan, and complete a birth plan.

Harr also assists with families planning to adopt and families who are pursuing surrogacy, as their specific needs are not always met in a typical hospital experience.

“Particularly for first-time moms, who can be overwhelmed and anxious, I can see their confidence increase and anxiety decrease after meeting with me and before their big day arrives,” Harr says.

Saving time and worry

For Petrova, the Steps Ahead program launched at the perfect time for her and her husband Shyam Bevinamara’s first child, Vasilissa, who was born in October.

The couple moved to Colorado in 2010

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Steps Ahead

BirthPlace nurse navigator helps put expectant parents at ease

Consulting with the BirthPlace nurse navigator

Tiffany Harr, RN, BirthPlace nurse navigator (right), worked with Katya Petrova to help reduce the stress of planning for the arrival of her daughter, Vasilissa.

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Tiffany Harr, RN, BirthPlace nurse navigator for the Steps Ahead program at The BirthPlace at Parker Adventist Hospital, meets individually with patients, who should bring a list of questions and insurance information.

Private sessions typically last one hour and include: ❋ Answering any pregnancy- and delivery-related questions ❋ Completing a thorough health history screen ❋ Assisting with pre-registration and selecting prenatal classes ❋ Creating a birth plan customized to the expectant mother’s wishes ❋ Discussing feeding options and resources available, such as the use of donor breast milk and details about the lactation team

Something to get pumped about Under the Affordable Care Act, all insurance plans are required to provide mothers with breastfeeding counseling, equipment, and support. Parker Adventist Hospital’s BirthPlace nurse navigator Tiffany Harr can supply you with information about counseling and support as well as help identify which breast pumps are covered by your insurance.

forms. Petrova also opted to fill out a donor milk form in case she was unable to feed her baby right away.

“While it may sound routine, filling out forms can alleviate a lot of worry the day of delivery,” Harr says. “By having the forms in place, parents can focus on the task at hand when they come to deliver.”

The role of a nurse navigator originated in cancer programs, but hospitals have started adding them in other programs after seeing the high level of patient satisfaction.

“I would recommend working with the navigator to anyone planning to

New parents Katya Petrova and Shyam Bevinamara welcomed their daughter, Vasilissa, at The BirthPlace in October.

Steps Ahead: ❋ Providing a specialized birth plan for those pursuing surrogacy or adoption ❋ Coordinating the use of needed specialists, such as neonatologists ❋ Making plans for any special requests — like placenta encapsulation, umbilical cord preservation, or cord blood banking — that may require additional paperwork and testing ❋ Reviewing insurance coverage and expected out-of-pocket costs ❋ Providing information about community resources such as support groups, car seat checks, and breastfeeding

give birth at Parker Adventist Hospital,” Petrova says. “Even with our next child, I plan to call on Tiffany so that we know what to expect and can fill out the paperwork ahead of time.”

Harr is available via email, phone, and in person throughout a patient’s pregnancy.

“I’m here to help in any way to make your experience as carefree and smooth as possible, whether it’s your first child or your fourth,” Harr says. “Patients should reach out at any time, even with general pregnancy questions, as I am your resource and here for you.”

Find childbirth classes and more at parkerhospital.org/ birthplace.

Schedule a tour of The BirthPlace and a Steps Ahead private consultation with Parker Adventist Hospital’s BirthPlace nurse navigator Tiffany Harr by calling 303-269-4760.

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and lives blocks away from the hospital, making the choice to deliver at Parker Adventist Hospital easy.

“We went for a BirthPlace tour and Tiffany mentioned that she offers oneon-one consultations, which we took her up on,” Petrova says.

During the consultation, the couple originally sought information about their out-of-pocket costs, but they reaped much more. “We spoke for more than an hour and got all of our questions answered,” Petrova says.

Harr assisted Petrova in completing her registration and health history

LOOKING FOR LUNG CANCER Low-dose CT scan catches cancer earlier when it’s more treatable

No. 1 cancer killer “Lung cancer is the leading cause of cancer death in the U.S. among both men and women. It claims more lives every year than colon, prostate, ovarian, and breast cancers combined,” says Nadine Mikhaeel, MD, medical oncologist at Parker Adventist Hospital.

Does that get your attention? It should — especially if you have a history of smoking.

“Lung cancer is by far the most deadly cancer out there,” says Mikhaeel. “Patients who develop metastatic disease — cancer that has spread beyond the lungs — have a five-year survival rate of 1 percent. However, when lung cancer is detected at its earliest, most treatable stage, survivorship soars to 50 percent,” she says.

Dr. Nadine That’s where a low-dose CT scan comes into play.

Mikhaeel

Who is eligible?

The screening is offered to those at highest risk of developing lung cancer. Based on data from the Lung Cancer Screening Trial, a study involving more than 50,000 current or former smokers, the patients mostly likely to benefit from screening are:  Between the ages of 55 and 74  Current smokers, or those who have quit within the past 15 years  Heavy smokers — a history of 30 pack years or more (a pack year is an average of one pack per day per year; for example, one pack per day for 30 years or two packs per day for 15 years) Mikhaeel says results are promising. “Trial participants who got the CT scan had a 20 percent overall less chance of dying of lung cancer than those who just got a chest X-ray,” she says.

Castle Rock Adventist Hospital, Littleton Adventist Hospital, Parker Adventist Hospital, and Porter Adventist Hospital are part of the Centura Health Cancer Network, delivering integrated, advanced cancer care across Colorado and western Kansas.

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SYMPTOMS

not to ignore

While lung cancer often has no early symptoms, if you experience any of these signs, talk with your doctor to evaluate the cause: A new cough that doesn’t go away Coughing up blood Chest pain that worsens with coughing or deep breathing Shortness of breath and wheezing Recurrent infections, such as bronchitis or pneumonia Swelling of the face Losing weight without trying

Schedule Your Screening These South Denver hospitals now offer low-dose CT scans to screen for lung cancer for $199.* Parker Adventist Hospital: 303-269-4500 Castle Rock Adventist Hospital: 1-855-456-LUNG(5864) Littleton Adventist Hospital: 303-738-7747 Porter Adventist Hospital: 303-778-2415 *Some insurance plans may cover the screening.

Check with your plan.

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OUR LUNGS WORK WITHOUT US DIRECTING THEM. You could even say our lungs work silently, behind the scenes. Here’s the scary thing: Lung cancer progresses silently too, often not showing symptoms until it’s no longer curable.

But there is promising news. A low-dose CT scan that may catch cancer early enough to treat it — and beat it. Here’s what you need to know.

SPR NG into good health

Diabetes education can help you or a loved one improve your health and prevent complications WITH WARMER TEMPERATURES, longer days, and fresh produce on the horizon, now is a great time to jump-start healthy habits, including recognizing and managing diabetes.

Multiple large studies have found that managing diabetes through a healthy lifestyle — with or without diabetes medication — helps slow the progression of the disease, reduce complications, extend life, and improve quality of life. However, by some statistics, fewer than 25 percent of people with diabetes actively manage their condition. For 39-year-old Jeremy Yantiss, who was diagnosed with type 2 diabetes in 2009, it took a scary episode before he learned how.

“Until I was taken to Parker Adventist Hospital, I had no clue that I was reading the nutrition labels incorrectly,” Yantiss says.

Yantiss was tailgating prior to a Denver Broncos game in 2014 when an extreme headache sent him to the paramedics. Yantiss’ blood glucose level was over 700 mg/dL — normal blood glucose should be below 200 mg/dL. He was taken to Parker Adventist Hospital where, during his stay, he was introduced to the Diabetes Education Program.

“Now I feel like I have a much better handle on looking at carb counts and portion sizes so that I can better manage my diabetes,” Yantiss says.

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BUILDING SELF-MANAGEMENT SKILLS The Diabetes Education Program at Parker Adventist Hospital has been recognized by the American Diabetes Association for the high quality of its diabetes self-management education program, which includes oneon-one consultations and group classes. It provides education for people with prediabetes, and type 1 and type 2 diabetes.

“The program here is excellent and empowers patients by teaching them in a practical way how to take control of their blood sugar,” says Sharmini Long, MD, a board-certified endocrinologist at Parker Endocrinology.

Patients referred to the program have a fasting blood sugar equal to or greater than 126 mg/dL or an A1C of Dr. Sharmini Long 6.5 or greater. A1C is a blood test that assesses average levels of blood glucose over the past three months.

Patients work with certified diabetes educators Christy Beyerly, RD, CDE, and Lisa Woltering, RN, to learn diabetes management skills. Patients also attend two, three-hour classes on diabetes selfmanagement, which have a 100 percent satisfaction rate.

“Diabetes is a chronic condition that is mostly managed day to day by the patient,” Beyerly says. “Our job as educators is to give them the skills so that they don’t need to rely only on medications to control their condition.”

Yantiss entered the program with an A1C of over 10. After education and lifestyle changes, his A1C dropped to 7.3.

“Every 1 percent decrease in A1C reduces the risk of complications from diabetes by 30 percent,” Beyerly says. Diabetes increases the risk of heart disease, stroke, kidney failure, vision loss, amputation, and premature death.

“The program lifted a huge weight off my shoulders and helped me realize that I could still eat things, just not as much,” Yantiss says.

Jeremy Yantiss is back to tailgating, but with a new knowledge of good food choices.

Diabetes education helps people decrease their average A1C by:

1%

Nationally

3%

Parker Adventist Hospital

1%

drop in A1C =

30%

drop in complications

Whether you’ve just been diagnosed or been living with diabetes for years, the diabetes educators at Parker Adventist Hospital can help you learn ways to stay healthy and feel better. Medicare, Medicaid, and most insurance providers cover diabetes education — but patients need a physician referral for most classes. For more information, go online to parkerhospital.org/diabetes.

IF YOU HAVE ADDITIONAL QUESTIONS or would like more information about managing diabetes, join our educators for a seminar on April 26 at 11:30 a.m. See full details on back cover.

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PRIMARY CARE PRACTICES

Portercare Adventist Health System

Non-Profit Organization U.S. Postage

AURORA

PAID

CHPG Cornerstar Primary Care

15901 East Briarwood Circle, Suite 200 Aurora, CO 80016 303-269-2626 • cornerstarprimarycare.org

Denver, CO Permit No. 4773

9395 Crown Crest Boulevard Parker, CO 80138

CHPG Southlands Primary Care

6069 South Southlands Parkway Aurora, CO 80016 303-928-7555 • southlandsprimarycare.org

CASTLE ROCK Ridgeline Family Medicine at the Meadows 2352 Meadows Boulevard, Suite 300 Castle Rock, CO 80109 720-455-3750 • ridgelinefamilymedicine.org

Ridgeline Family Medicine — Castle Pines

CENTENNIAL CHPG Grace Family Practice

6909 South Holly Circle, Centennial, CO 80112 720-528-3559 • gracefamilypractice.org

CHPG Holly Creek

5500 East Peakview Ave., Centennial, CO 80121 303-649-3820

DENVER CHPG Clermont Park

2479 South Clermont Street, Denver, CO 80222 303-649-3155 • clermontparkseniorcare.org

CHPG Primary Care Porter

950 East Harvard Avenue, Denver, CO 80210 303-649-3200 • porterprimarycare.com

CHPG Primary Care Cherry Creek

300 South Jackson Street, Denver, CO 80209 303-316-0416 • primarycarecherrycreek.org

GREENWOOD VILLAGE CHPG at DTC

8200 East Belleview Avenue Greenwood Village, CO 80111 303-770-6500 • dtcfamilymedicine.org

HIGHLANDS RANCH Highlands Ranch Medical Associates 9135 South Ridgeline Boulevard Highlands Ranch, CO 80129 303-649-3140 highlandsranchmedicalassociates.org

LITTLETON Chatfield Family Medicine

free SPRING 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. Register online at parkerhospital.org/seminars.

Weight Loss Surgery

Are You Managing Your Diabetes?

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

Wed, May 11 | 6:30-8 p.m.

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

Presented by Dr. Katie Irani Wed, Apr 27 | 6-7:30 p.m.

Wed, May 25 | 6-7:30 p.m.

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

Urinary Incontinence, Overactive Bladder, and Aging

Thu, Apr 14 | 11:30 a.m.-1 p.m.

Join our new urogynecologist, Dr. Alison Tate, to learn about common pelvic floor disorders and effective treatment options.

10789 Bradford Road, Littleton, CO 80127 303-738-2714 • chatfieldfamilymedicine.org

Clement Park Family Medicine

6901 South Pierce Street, Littleton, CO 80128 303-932-2121 • clementparkfamilymedicine.org

South Suburban Internal Medicine

7750 South Broadway, Littleton, CO 80122 303-347-9897 southsuburbaninternalmedicine.org

PARKER Parker Primary Care

10371 Parkglenn Way, Suite 220 Parker, CO 80138 303-649-3100 • parkerprimarycare.org

Timberview Clinic at Parker

9399 Crown Crest Boulevard, Suite 200 Parker, CO 80138 303-269-4410 • timberviewclinic.org

Sun, Apr 17 | 7 a.m.-Noon More than 15 free and low-cost health screenings, from body mass index to blood tests, will be offered at the FREE 9Health Fair. Screenings are provided on a first-come, firstserved basis. For more information, go to 9healthfair.org.

Tue, Apr 26 | 11:30 a.m.-1 p.m.

Join our diabetes educators Christy Beyerly, RD, CDE, and Lisa Woltering, RN, CDE, for an in-depth look at properly managing diabetes, and tips and tricks for staying healthy.

Deep Brain Stimulation for Essential Tremor and Parkinson’s Disease Mon, May 2 | 6-7:30 p.m.

Join Dr. Ravi Shah, neurologist, to learn more about who is a candidate for DBS and how it can improve tremors.

Prevention and Early Detection of Gynecological Cancer

Tue, May 3 | 5:30-7 p.m.

Join our gynecologic oncologists Dr. Glenn Bigsby and Dr. Jeffrey James to learn about the signs, symptoms, and screening options for various forms of gynecological cancer.

Special Extended Mammo Hours

Mondays, May 9, 16, 23 6:30 a.m.-6:30 p.m.

Join us as we celebrate spring with more convenient hours!

Call 303-269-4150 or visit us online at parkerhospital.org/ mammogram to make your mammogram appointment today.

Advancements in Joint Replacement

Tue, May 24 | 5:30-7 p.m.

Join Dr. Derek Johnson, orthopedic surgeon, to hear about the latest advancements in knee and hip replacement surgery and learn if you may be a candidate.

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 303-804-8166. Copyright © Centura Health, 2016.

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250 Max Drive, Suite 102 Castle Rock, CO 80108 303-649-3350 • ridgelinefamilymedicine.org