Grow Spring 2018 by Clementine Healthcare Marketing

Spring 2018 | Volume 10, Issue 2

When

SECONDS

MATTER

Fast action makes a lifesaving difference when it comes to stroke care. See Page 4.

Drew Baske, a Parker first responder trainer, knew just what to do when he experienced symptoms of a stroke.

PLUS...

Clearing Up Congestion

Preventing Kidney Stones

Navigating Colon Cancer

PAGE 3

PAGE 6

PAGE 7 PHOTO BY ELLEN JASKOL

A decade-by-decade guide for women’s health screenings

et’s face it, ladies, routine health screenings don’t always fit our routine.

But it’s important not to let time, finances, or fear sabotage the discovery of health problems. Sunmee Lee, MD, an OB/GYN with Integrated OB/GYN and CHPG Women’s Health in Parker and South Aurora, offers these screening guidelines for healthy women at average risk for disease.

40s

The 40s are full of questions about mammograms. When to start? How often? Forty is not an automatic start age, but it is time to discuss pros and cons with your provider. Also consider screening for blood pressure annually, cholesterol every five years, diabetes every three years, and vision screening every two to four years.

70s

20s 3

Make time in the jet-setting 20s to begin cholesterol and blood pressure checks every three to five years. Also, schedule a Pap test every three years beginning at 21 and chlamydia screening for sexually active women up to age 25.

50s

Age 50 brings a not-so-nifty rite of passage: colonoscopy. The good news? If there are no signs of colorectal cancer, you can wait a whopping 10 years to repeat. It’s also the only screening test that can actually prevent cancer because nodules that can turn into cancer are removed during the procedure. At 50, annual mammograms are a must. At 55, if you’re a current or former smoker, begin low-dose CT screening for lung cancer if you smoked the equivalent of a pack a day for 30 years (or two packs for 15 years).

Thirty-somethings are in the thick of careers and kids. Lucky for you, there’s just one big screening to remember: At 30, begin getting a Pap test with HPV testing. If both results are normal, you don’t need another for five years.

60s

By the 60s, your screening schedule — like your body — experiences a few starts and stops. At age 65, start bone density (DXA) screening to check for osteoporosis and stop Paps if your recent test history is normal.

Congratulations on your septuagenarian status and on arriving at another decision about mammography. Some guidelines suggest ceasing mammography at 74. But with increasing life spans, it’s a good idea to discuss the decision with your doctor.

ONE-STOP SCREENINGS

Maintaining your health is easier than ever with Parker Adventist Hospital’s new Care on Cue Clinic. This women’s clinic offers backto-back medical screenings, including mammograms, fasting labs, GYN exams, and bone density screenings. Make your appointment at our Care on Cue Clinic at CHPG Southlands Women’s Health today by calling 303-649-3090.

A new definition of high blood pressure means that nearly half of all U.S. adults have hypertension. And nearly half of these are women. Birth control pills raise blood pressure risk in some women as does menopause.

9395 Crown Crest Boulevard, 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 Healthcare Marketing. Executive Editor: Abel Del Valle

2 ■ Spring 2018 ■

grow

PHOTOS: ©ISTOCKPHOTO.COM/FATCAMERA, /IVONNEW, /GRANDRIVER, /TOM MERTON, /RIDOFRANZ; / ANTONIO_DIAZ OPPOSITE PAGE: PETERSON BY ELLEN JASKOL

HEALTH BRIEFS

Spring

SCREEN TIME

ALL

STUFFED UP

Trouble breathing? It could be time for surgery.

IF YOU STRUGGLE WITH SINUS PROBLEMS due to structural issues such as a deviated septum, there’s no need to suffer longer. Sinus surgery may be the answer. “The whole point of sinus surgery is to make the natural openings of the sinuses bigger by removing bone and soft tissue,” says Ben Milam, MD, an otolaryngologist with Colorado ENT Specialists in Parker. One type of surgery is septoplasty, which is often used when one side of the wall of bone and cartilage between the nostrils is bent or crooked. With septoplasty, Dr. Ben Milam Milam works to elevate the lining of the septum on both sides and remove the bent section. Most patients are off pain medications and back to work without strenuous activities within a couple of days, he says.

Three signs you need surgery: 1 2 3

Nasal obstruction, nasal drainage, loss of sense of smell, and/or facial pain. Symptoms that last longer than three months. Symptoms that don’t respond to medications.

To schedule an appointment with Colorado ENT Specialists, a Centura Health Physician Group practice, call 720-274-2544.

At Parker Adventist Hospital, patient safety is a top priority. Our patient safety efforts aim to ensure highquality, compassionate care for all patients. Just a few of the ways we are doing this include:

To ensure our patients leave with clear information and instructions, our nursing and quality departments have created a discharge checklist that is monitored, and the results are used to continuously improve our discharge process.

A process to identify sepsis and begin treatment within three hours has helped us achieve a sepsis mortality rate well below the national rate.

Free and Clear For as long as he could remember, James Peterson had trouble breathing through his nose. But last April, his symptoms worsened and wouldn’t resolve. His primary care physician referred him to an otolaryngologist. “Dr. Milam took one look in my nose and told me I had polyps,” he says. He also had a deviated septum, so Peterson had the polyps removed as well as a septoplasty to correct his septum. He says his life has changed drastically since then, in more ways than just breathing. “I can smell and actually taste food again. I can concentrate at work now,” he says. “I sleep better, I’m more active, and I’m now getting some dental work done that would have been torturous before.”

First-Rate Quality

Our cancer nurse navigator routinely evaluates patient distress using the National Comprehensive Cancer Network (NCCN) Distress Thermometer, and connects patients in distress with appropriate resources.

Conversion to an electronic form for surgery scheduling requests has significantly reduced errors, rework, and time needed for staff to scan and email forms. James Peterson of Parker is enjoying the aroma of food once again.

grow

■ parkerhospital.org ■ 3

ON STROKE SYMPTOMS aren’t always easy to spot, but Drew Baske recognized his and was able to get lifesaving treatment. Learn what to look for — and how to help prevent a stroke from striking.

Thanks to his training, Drew Baske recognized the signs of a stroke and sought lifesaving care immediately.

On March 16, 2017, Drew Baske, 55, awoke at 5 a.m. like he normally does, but this would not be a normal day. Shortly after letting the dog out and making coffee, he developed a sudden onset of some troubling symptoms. “I noticed a low-grade headache, my vision was slightly blurry, and I had some numbness in my right hand,” Baske says. The former firefighter who trains first responders in how to treat stroke quickly realized he might be having one. As he struggled to get dressed, his wife, who works as a nurse, noticed him acting strangely. When Baske told her his concerns and symptoms, she drove him straight to Parker Adventist Hospital. He was taken immediately to the ER, where a stroke alert was called and he was given medication to lower his blood pressure enough to administer the stroke drug tPA, which can not only be lifesaving, but can also help prevent or reduce the long-term effects of stroke. But Baske still had a long road ahead of him. After six days in the hospital, Baske faced another two weeks of inpatient rehabilitation before he was able to go home and begin outpatient rehabilitation. Many of his symptoms, like memory loss, have resolved — and he was able to return to work within a few months. But he did experience a 50 percent loss in his field of vision in both eyes, and he’s still learning to navigate by scanning his path for obstacles.

4 ■ Spring 2018 ■

grow

PHOTOS: AMBULANCE ©ISTOCKPHOTO.COM/CHRISTOPHERBERNARD; BASKE BY ELLEN JASKOL

When FAST isn’t enough

People often have been taught that the signs of a stroke are facial drooping, arm weakness, and speech difficulties. These signs are often referred to as FAST (face, arm, speech, time). But not all strokes manifest this way, says Kim Roth, RN, neuroscience and stroke clinical coordinator at Parker Adventist Hospital. “FAST does a really good job of identifying strokes in the right or left hemisphere of your brain, but not in the back of your head, which are known as posterior circulation strokes.” This is the type Baske had, and it actually accounts for up to 25 percent of all strokes, Roth says. The symptoms can be vague, from sudden vision changes to minor balance

and coordination issues. To help increase recognition, when Roth teaches stroke education in the community, she’s begun using the modified acronym BE-FAST, to include “balance” and “eyes” (see “BE-FAST” below). And vigilance is still key, which means not ignoring anything that feels off — especially multiple symptoms like Baske experienced. While tPA can be highly effective, it can only be given within a limited window of time from the onset of symptoms. To ensure more patients are able to receive various forms of treatment, Parker Adventist Hospital recently extended its window from seven to 12 hours of onset, Roth says.

Heading off a stroke

Beyond recognizing symptoms, understanding the biggest risk factors — including smoking, high blood pressure, diabetes, high cholesterol, and cardiac arrhythmias — is also critical, says Kathryn Polovitz, MD, a neurologist at Parker Adventist Hospital. “Stress is also a likely risk factor, and it’s one that we see frequently with posterior circulation strokes,” Polovitz says. Baske admits stress may have been a factor for him, as he’d been working long hours leading up to his stroke. But now, he’s doing what he can Dr. Kathryn Polovitz to prevent another one by following his doctor’s recommendations and working to reduce his stress levels. And he also wants to give back. “I can’t say enough good things about all the people involved in my care. They were fantastic, and it all went like clockwork,” he says. “I’m looking forward to telling my story and helping other field providers catch the subtle signs and symptoms they may not have learned in school.”

BE-FAST

SILENT STROKES Not all strokes are obvious — even after they’ve occurred. A type known as “silent” strokes often goes unnoticed, but can cause permanent damage. Here’s what you need to know: › 1 4 times more common than a stroke with symptoms › 2 0 percent of all adults over age 80 have one or more silent strokes › C an cause short-term problems such as headaches, cognitive problems, or dizziness as well as long-term effects on memory

PHOTOS: SENIOR ©ISTOCKPHOTO.COM/GLOBALSTOCK; STOPWATCH ©ISTOCKPHOTO.COM/ZAPTIK

Watch for a sudden onset of changes in:

BALANCE. Be aware of any balance or coordination issues, as well as dizziness.

E F A S T

EYESIGHT. Look for vision loss, double vision, or changes such as blurriness. FACE. Notice any facial drooping. ARMS. Does one arm drift downward, or is it weak or numb? SPEECH. Listen for slurred or confused speech. TIME. Call 911 immediately for any of these symptoms.

Learn the risk factors of stroke starting at age 40, prevention tips, and how to spot warning signs at a FREE community class on June 12. See back cover for details. Or, call our stroke program at Parker Adventist Hospital for more information at 303-269-4990.

grow

■ parkerhospital.org ■ 5

END-TO-END STROKE CARE Parker Adventist Hospital is a Primary Stroke Center with The Joint Commission Seal of Approval for exceptional stroke care. The program uses a multidisciplinary approach that delivers stroke treatment according to nationally accepted standards and recommendations, with services that include: › 2 4/7 neurology and neurosurgery coverage › S troke education and prevention programs › R ehabilitation, including physical, occupational, aquatic, cognitive, and speech therapy, as well as low-vision therapy for vision loss

A ROCK

AND A HARD PLACE The surprising cause of most kidney stones — plus how to prevent them The kidneys are bean-shaped, fist-sized filtering units that send important minerals back into the bloodstream and waste and extra fluid to the bladder as urine. The most common type of kidney stone (calcium oxalate) forms when there’s too much waste and too little liquid. Often, not drinking enough water is to blame. The result? The body keeps too much calcium, which crystallizes. “Calcium is not the culprit. Low urine volume is the culprit,” says Geoff Ledgerwood, MD, urologist with Centura Health’s Colorado Dr. Geoff Ledgerwood Health Neighborhoods (CHN). Too much salt in the diet makes matters worse. How? “Salt pulls calcium along with it into the urine,” Ledgerwood says. Downstream from all this activity is the bladder, which is connected to the kidney by a thin tube called the ureter. A stone the size of a tiny pebble can block urine flow. Blocked urine backs up into the kidney, which swells and triggers five-alarm flank pain. Other symptoms may include blood in the urine, nausea and vomiting, and fever and chills.

WHAT TO DO TREATMENT See your primary care physician or urologist immediately. Treatments include:  Passing the stone on your own  Ureteroscopy, which uses small instruments to retrieve or obliterate the stone  Shock wave lithotripsy, which uses sound waves to blast the stone  Percutaneous stone removal (for large or irregularly shaped stones)

WHAT NOT TO DO

STONE-

COLD STATS Research out of South Carolina suggests that teenagers are at growing risk for kidney stones. In fact, from 1997 to 2012 teens had the highest rate of increase of kidney stones among all groups in a 150,000-patient study. What gives? Geoff Ledgerwood, MD, says Western diets heavy in soda, caffeine, and salt are likely driving the increase.

 DO NOT cut back on

calcium. Low dietary calcium increases risk of kidney stones.  DO NOT try crash diets, especially high-protein weight loss diets, which have been linked to kidney stone formation.

PREVENTION  Drink fluids. Ledgerwood recom-

6 ■ Spring 2018 ■

grow

IF YOU SUFFER

with recurring kidney stones, a urologist can help you find the cause and the right treatment. Visit centura.org and click the “Find a Provider” tab today.

mends ten 10-ounce glasses of water daily. Clear urine signals good hydration.  Limit sodium to 1,500 milligrams daily.  Eat more fruits and vegetables, which may create urine less conducive to stone formation.  Lose weight if you are overweight. Obesity changes the acid levels in the urine, which causes stones not to dissolve well.

GuidingLIGHT

New program guides patients through colon cancer treatment

A DIAGNOSIS OF CANCER TURNS YOUR WORLD UPSIDE DOWN. The personal and emotional toll is huge, and it can be made even worse by the seemingly complex journey through treatment. A new program at Parker Adventist Hospital hopes to relieve some of that burden. The program helps patients and their families navigate through diagnosis, surgery, treatment, and follow-up care. “We can take care of them from the beginning throughout their treatment. Every patient with colon cancer is tracked,” says John Sun, MD, colorectal surgeon with CHPG Colorectal Parker.

TEAM CARE

As more has become known about cancer, physicians have the opportunity to fight it on many fronts. But that fight takes an army. And Parker Adventist Hospital’s new program comes with a full cadre of specialists, says Nadine Mikhaeel, MD, a medical oncologist with Cypress Hematology and Oncology. Parker Adventist Hospital’s multidisciplinary colon cancer team includes:  Gastroenterologists  Medical oncologists  Colorectal surgeons  Radiation oncologists  Genetic counselor  Patient navigator “Pathology, radiology, medical oncology, surgeons, genetics, dietitian, naturopath, and support staff are all in the room, discussing what is best for the individual patient, since each case is unique,” says Mikhaeel.

Dr. John Sun

WALKING BESIDE PATIENTS

Each patient is guided through the treatment process by a nurse navigator, who can help make sure patients get fast access to treatment and timely appointments, Mikhaeel says. “When people hear the word ‘cancer,’ that may be all they hear. We want to help them through the process, and ease their burden by providing navigation and guidance until they complete their care and are on their way to recovery and survivorship,” she says. Many patients are interested in complementary medicine, she says. “It’s important to make sure they are not using supplements that could interfere with chemotherapy or with their treatment in general. We have a naturopath who specializes in oncology, who is trained in chemotherapy side effects, and in interactions between natural medicines and chemotherapies.” Sun says he recently treated a patient who underwent a Dr. Nadine Mikhaeel colonoscopy at another facility. She was told she had colon cancer and needed treatment, but that was all the information or follow-up she got. A friend who’d had colon cancer suggested she see him, Sun says. Getting a cancer diagnosis is difficult, and no patient should have to be on their own after that diagnosis, seeking treatment or waiting weeks for answers about their disease, Sun says. And with Parker Adventist Hospital’s colon cancer navigation program, he says, no patient will.

PREVENTING COLON CANCER

A colonoscopy is the only cancer screening that can prevent cancer from forming. That’s because polyps, which are the precursor to cancer, are removed during a colonoscopy. All adults without risk factors should have a colonoscopy at age 50 and every 10 years after that if the test is normal. For more information, talk to your family physician or call Centura Gastroenterology at 303-925-4720.

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

■ parkerhospital.org ■ 7

Portercare Adventist Health System

CENTURA HEALTH PHYSICIAN GROUP PRIMARY CARE PRACTICES

Non-Profit Organization U.S. Postage

PAID

Denver, CO Permit No. 3280

9395 Crown Crest Boulevard Parker, CO 80138

AURORA CHPG Cornerstar Primary Care (Parker and Arapahoe) 303-269-2626 cornerstarprimarycare.org CHPG Cornerstar Women's Health (Parker and Arapahoe) 720-851-8230 cornerstarwomens.org CHPG Southlands Primary Care 303-928-7555 southlandsprimarycare.org CHPG Southlands Women's Health 303-649-3090 southlandswomenshealth.org

PARKER CHPG Internal Medicine Parker (on hospital campus) 303-770-0500 internalmedicineparker.org CHPG Primary Care Meridian 303-649-3100 meridianprimarycare.org CHPG Women's Health and Urogynecology Meridian 303-925-4650 womensurogyn.org Integrated OB/GYN 303-721-1670 integratedobgyn.org Pinnacle Women's Healthcare 303-840-8780 pinnaclewomenshealthcare.org Timberview Clinic at Parker (on hospital campus) 303-269-4410 timberviewclinic.org

free SPRING Seminars & Events Join Parker Adventist Hospital for a series of FREE events and seminars. All seminars are held in the Inspiration A and B conference rooms in the Parker Adventist Hospital Conference Center, located on the Garden Level at the west entrance, unless otherwise noted. 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/events.

Teens Take the Wheel

Mon, Apr 16 | 6-8 p.m. This two-hour event includes distracted driving simulations, a mock teen crash trauma scenario, and presentations provided by a teen crash survivor and the medical director of trauma services called “What Do You Consider Lethal?”

Nasal Obstruction — Causes and Treatment

Wed, Apr 25 | 6-7 p.m. Join Dr. Ben Milam, ear, nose, and throat surgeon, to learn more about the causes and treatment options for nasal obstruction.

Sun, Apr 29 | 8 a.m.-Noon More than 20 FREE and low-cost health screenings will be offered, including comprehensive blood tests and colon cancer screening kits. All screenings are provided on a first-come, first-served basis. For more information, go online to 9healthfair.org.

Stroke Overview

Tue, Jun 12 | 6-7 p.m. Learn about stroke prevention, symptoms, treatment, rehabilitation, and recovery from Dr. Katie Polovitz, neurologist.

Stepping On

Mondays, Jun 18-Jul 30, or Sep 3-Oct 15 | 1-3 p.m. Location: Conference Center Pine A and B Stepping On is an evidencebased fall prevention class for seniors. In a small group setting, older adults learn balance exercises and strength training and develop specific knowledge and skills to prevent falls, including how vision affects balance, how medication can contribute to falls, how to check your home for safety hazards, and more! Designed for seniors who are at risk for falling, have a fear of falling, or have fallen one or more times. Classes meet for two hours a week for six weeks. Space is limited. To register, call 303-269-4638.

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 1-303-269-4053 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-303-269-4053 (TTY: 711).