Grow Winter 2015

Winter 2015 | Volume 7, Issue 1

JOY Multiplied When multiples are on the way, the joy is compounded, but so are the risks. Parker Adventist Hospital helps moms-to-be navigate the waters.

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PLUS...

Southlands ER now open

Radiation therapy close to home

Finding colon cancer early

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PAGE 7 PHOTO BY ELLEN JASKOL

What you really need to know

PEANUT-FREE TABLES and dairy-free desserts might have you on edge about food allergies. Yet fewer than 8 percent of children under the age of 3 and only 3 percent of children ages 10-12 have food allergies, says Shauna Gulley, MD, a pediatrician at Timberview Clinic at Parker, part of the Centura Health Physician Group.

“While food allergies need to be taken seriously, not every reaction to a food is an allergy,” Gulley says.

“Oftentimes, the actual culprit is a food sensitivity or intolerance.”

A food allergy causes an immune system response that occurs quickly after ingesting even a small amount of the food. A food sensitivity or intolerance typically causes symptoms to develop gradually, are mild, and may be accompanied by digestive problems.

Common signs of food allergies include:

Hives or a rash • Itchy nose or eyes • Wheezing or vomiting Swelling of the lips, throat, or tongue • Diarrhea People with food allergies may be at risk of anaphylaxis, a severe, life-threatening allergic reaction that requires immediate medical attention.

If you suspect a food allergy, Gulley recommends the following: > Determine if the situation is life-threatening Yes: Call 911 No: Schedule an appointment with your pediatrician to determine testing to identify whether your child has an allergy or intolerance Dairy is the most common food allergy among children, with eggs, wheat, fish, peanuts, and tree nuts following, Gulley says.

The number of children being self-diagnosed with a food allergy has dramatically increased during the past two decades, according to a study in the Annals of Allergy, Asthma and Immunology. “It’s important to consult a pediatrician before self-diagnosing,” Gulley says.

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24/7 Southlands ER now open Parker Adventist Hospital’s Southlands ER is making ER care faster.

Through “ER Express Care,” patients are taken immediately to a room where they tell their stories just once to a doctor and nurse. If a patient has a minor illness or injury, the necessary tests are obtained and the patient is taken to a comfortable lounge with refreshments to wait. Once the tests are completed, a nurse takes the patient to a private room to complete treatment.

The Southlands ER, located at E-470 and Smoky Hill Road, is open around the clock every day of the year. It is part of Centura Health, the region’s largest and most comprehensive network of trauma care and emergency services. Go to parkerhospital.org/ER for more info.

See the end of dry eyes with new procedure MORE THAN 23 MILLION AMERICANS SUFFER from dry eye, a condition that can cause eye fatigue, redness, burning, tearing, and blurred vision.

“Dry eye is especially common here in LipiFlow has Colorado with our arid climate, high altitude, been shown to and intense sun,” says Jennifer Grin, MD, a provide relief for board-certified ophthalmologist at Parker nearly 80 percent Adventist Hospital. Cellphones and computer of patients with usage also cause dry eye, as they affect blinking evaporative patterns, Grin adds. dry eye.

Nearly 90 percent of people with dry eye suffer from evaporative (lipid deficient) Dry Eye dry eye — a condition commonly Symptoms caused by issues in the meibomian glands, which secrete oil needed for healthy tear film.

Dryness While eye drops are traditionally prescribed for symptoms, Grittiness LipiFlow®, a new procedure approved by the Food and Soreness Drug Administration for evaporative dry eye, addresses the Irritation root issue by applying heat and gentle pulsation to affected Burning meibomian glands. LipiFlow is done in a physician’s office Tearing and takes roughly 12 minutes. Patients can resume normal activities immediately following the procedure.

Blurred vision “It’s like a spa treatment for your eyes,” says Grin, one of Eye fatigue the only physicians in Colorado to offer the procedure.

To find out if you’re a candidate for LipiFlow, attend a FREE seminar with Dr. Grin on Thursday, Feb. 12, at 6:30 p.m. See page 3 for details.

PHOTOS: FOOD FROM TOP ©DOLLARPHOTOCLUB.COM/AFXHOME, /TESCHA555, /TESCHA555, /MIMADEO, /SARAHDOOW. STAFF PHOTO BY ELLEN JASKOL.

Food allergies eating at your kids?

FEBRUARY

Small but

MIGHTY

FREE

Three steps

health seminars

to big health gains

WHEN IT COMES TO CHANGING YOUR HEALTH, think small for big rewards, says Chris West, DO, a family medicine physician in Parker who has a special interest in nutrition and its effects on health.

“Big goals like losing 50 pounds can feel so overwhelming that you quit before you even get started,” West says. “Small goals are not only more reachable, they also boost your commitment to continuing because you get results fast.”

If you want to make some big changes this year, try these three small steps:

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.

Dr. Chris West

Easing Joint Pain

Tue, Feb 10 | 6:30-8 p.m.

Join Dr. Derek Johnson, orthopedic medical director, to learn about computernavigated knee replacement, patientspecific knee replacement, and minimally invasive anterior hip replacement surgery.

Weight Loss Surgery

Run five minutes

Lose 5 percent

Stop smoking

Running just five minutes a day can reduce mortality and increase your life span, according to a new study published in the Journal of the American College of Cardiology. The study found that intensity and distance had no impact on outcomes. Try incorporating running into your routine — run to pick up the mail, run your dog around the block, or run loops around the playground while your kids are playing.

Losing just 5-10 percent of your body weight can greatly reduce your risk of heart disease and diabetes, according to the National Heart, Lung, and Blood Institute. To lose 1 pound a month this year, you only have to cut out about 115 calories a day, which is equal to one glass of wine, a latte, or a bag of chips.

Your heart rate improves within 20 minutes of ditching the cigarettes and your heart attack risk is cut in half within a year, according to the Centers for Disease Control and Prevention.

Unfortunately, this is one health habit that you can’t take in steps. Cutting down on the number of cigarettes you smoke generally does not result in health improvements, probably because most people who cut back actually start inhaling more deeply.

New Year, New You Come to a FREE seminar on March 15 with Dr. Chris West to learn some simple strategies that will help you make 2015 your healthiest year yet. See back cover for details.

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

Join bariatric surgeon Dr. Josh Long for a look at various surgical weight loss options, and learn whether you’re a candidate for surgery.

Dry Eyes

ILLUSTRATION: ©DOLLARPHOTOCLUB.COM/MEJN PHOTO: ©DOLLARPHOTOCLUB.COM/RIDO

PHOTOS: RUNNER ©ISTOCKPHOTO.COM/LJUPCO, APPLE ©VEER.COM/AREKMALANG, ©ISTOCKPHOTO.COM/MICHAELJUNG, SCALE ©DOLLARPHOTOCLUB.COM/ANTONIOGUILLEM, EYES ©DOLLARPHTOTOCLUB.COM/AUREMAR

Sm o Fre ke Zon e e

Thu, Feb 12 | 6:30-8 p.m.

Do you suffer from burning, scratchy eyes, have light sensitivity, redness, or blurred vision? Some people don’t produce enough tears, resulting in dry eyes. Ophthalmologist Dr. Jennifer Grin will discuss the latest advancements in treatment.

Groin Hernias

Tue, Feb 17 | Noon-1:30 p.m.

Join general surgeon Dr. Peter Phan to learn more about groin hernias — what they are, and how they’re treated.

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B a b h Managing multiples during and after pregnancy

Multiples Checklist

Finding out you’re having twins (or triplets or more) is one thing, but knowing what to do next is another.

Here are a few tips.

Look for an OB/GYN with:

Experience with multiples Close ties to a perinatology team Look for a hospital with: A neonatal intensive care unit (NICU) capable of caring for babies 28 weeks or older. Parker Adventist Hospital’s BirthPlace and Level III NICU offer around-the-clock perinatal and neonatal care by Children’s Hospital Colorado.

A perinatal center that provides

prenatal services and consultation for patients with maternal or fetal complications. The Parker Perinatal Center features state-of-the-art equipment and highly skilled specialists. For more information, visit parkerhospital.org/birthplace.

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and increases the likelihood of multiples.

Today, women aged 35 and older account for 35 percent of all births, compared to just 20 percent of all births in 1980.

For 24-year-old Dunst, neither age nor fertility treatment attributed to her multiples. “We later discovered that my grandmother has twins on her side of the family,” she says.

The chance of multiples increases for women with a family history of twins, who have had multiple pregnancies, who are African-American, or who are a twin.

The odds of having twins without fertility treatment is one in 85.

More Babies = More Risk + More Appointments Multiples may bring more excitement but can also mean more worries.

“The complication rate seen in singleton births [one baby] is double or more for twins and goes up from there with other multiples,” says Henry Galan, MD, head of the maternal and fetal medicine (perinatology) program at Parker Adventist Hospital.

To monitor potential complications, prenatal checkups are more frequent with multiples than with a single pregnancy.

“With twins, I had my normal OB/ GYN appointments and then specialist appointments and stress tests,” says Dunst, who suffered gestational diabetes and a pruritic urticarial papules and plaques of pregnancy (PUPPS) rash — an itchy rash that typically develops by the abdomen and spreads — while pregnant.

“If anything looked questionable, they did additional tests. Toward the

FAMILY PHOTO BY ELLEN JASKOL.

Whitney Dunst and daughter Ashlynn welco med Spencer and Preston to their family last May.

hen Whitney Dunst found out she was pregnant with twins, life changed quickly. She and her husband, who were living in Colorado Springs, soon relocated to Denver with their 2-year-old daughter to be closer to her family. But a move was just the beginning of their changes …

Multiples are on the rise across the country, with one in 30 babies born in the U.S. today a twin, compared to one in 53 babies in 1980 — a whopping 76 percent increase — according to the Centers for Disease Control and Prevention (CDC).

Twins account for nine out of 10 sets of multiples.

The increase is largely due to assisted reproductive technologies (ART), like fertility medications and in vitro fertilization (IVF), yet up to one-third of the rise in multiples is attributed to an increased maternal age, according to the CDC. “The reality is that women are waiting longer to have children,” says Jillian Tyler, MD, an OB/GYN at Pinnacle Women’s Healthcare, with offices at Parker Adventist Hospital and Centura Health Southlands.

Last summer alone, Tyler provided care for Dunst and seven other mothers who Dr. Jillian Tyler delivered twins.

“As women age, they are more likely to have twins spontaneously or use assisted reproductive technologies.”

Women in their mid to late 30s produce more follicle-stimulating hormone (FSH), which causes eggs to mature for ovulation

by

. . .

B y aby ! b a B . ..

end of my pregnancy, I was going in four times a week.”

PHOTO: ©DOLLARPHOTOCLUB.COM/ARMYAGOV

Twins fall into two categories: > Dizygotic (fraternal) — when two eggs are fertilized > Monozygotic (identical twins) — which occurs when one zygote splits to form two embryos; the longer the split occurs after fertilization, the more likely the babies share a sac and/or a placenta, and the increased risk of complications “With multiples, it’s important to determine the kind of pregnancy it is as early as possible so that we can plan treatment and monitor accordingly,” Galan says.

Two of the main concerns with multiples are preterm birth and low birth weight, the first of which contributes to the latter. One out of every 10 babies born in Colorado is of low birth weight and 20 percent of low-weight babies (5 lbs. 8 oz. or less) is a multiple, according to the Colorado Department of Public Health & Environment.

“There are many factors that contribute to the likelihood of survival, namely gestational age and birth weight when born,” Tyler says. “Twins, on average, will deliver at 35-36 weeks and are induced by their doctors to deliver by 37-38 weeks.

Fetal lung maturity is aided by the in utero stress of being a twin, so while twins tend to have lower birth weights than single births, their lungs mature quicker, giving them a slightly better chance of survival when born at 35 weeks or older.

The mother’s weight gain during

Nearly 60 percent of twins and 90 percent of triplets are born prematurely, according to the March of Dimes.

1/3

One in three twin births and 77 percent of triplet and higher-order births result from conception assisted by fertility treatments, according to an article published in the New England Journal of Medicine. Non-IVF approaches like clomiphene citrate (Clomid), which spurs ovulation, carry a 5-10 percent chance of producing multiples and account for significantly more multiples than in vitro fertilization (IVF).

pregnancy also can affect birth weight. Galan recommends that mothers of twins consume 300 more calories per day than with single-baby pregnancies.

Along with a prenatal vitamin, mothers of multiples should take 1 milligram of folic acid (0.4 milligrams is recommended for single pregnancies).

Recommended Weight Gain During Pregnancy

BMI 18-24.9 25-29.9 Above 30

Weight Gain (lbs.)

Singleton Pregnancy 25-35 lbs.

15-25 lbs.

11-20 lbs.

Weight Gain (lbs.)

Twin Pregnancy 37-54 lbs.

31-50 lbs.

25-42 lbs.

Thanks to Tyler’s close monitoring, Dunst delivered two healthy fraternal baby boys — Spencer and Preston — in May at 36 weeks gestation, the average gestation time for twins. Both of the boys were normal birth weight and had minimal complications.

“The reality is that a multiple pregnancy is a hard pregnancy,” Tyler says. “But people do it every day and make it look easy. I think the pregnancy prepares you for what’s to come.”

Baby on the way?

Schedule your tour of The BirthPlace at Parker Adventist Hospital by calling 303-269-4090 and check out the array of birthing classes available, including the Marvelous Multiples Class, online at: parkerhospital.org/birthplace.

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ON TARGET More precise radiation therapy means fewer side effects for people with cancer

CHANCES ARE LIKELY that you might be sitting in a driverless car in the next decade. In addition to being safe, you’re sure to be hoping that the car will get you exactly where you want to go.

Thankfully, these type of advancements have already occurred in radiation oncology. Today’s sophisticated multimillion dollar radiation therapy machines — coupled with highly trained cancer experts — can now deliver exactly the right amount of radiation directly pinpointed at cancerous cells with very little damage to surrounding tissue.

How Radiation Works Radiation targets quickly growing cancer cells and damages their DNA so they can’t grow and divide. Normal cells can repair themselves in a way that cancer cells can’t.

A PRESCRIPTION FOR PRECISION

CUSTOM CONTOURING

INTEGRATED IMAGING

360-DEGREE ACCESS

The TrueBeam accelerator has what’s called a high-definition multileaf collimator. That’s a fancy term that basically means that the radiation beam can be shaped to match the cancer tumor and avoid healthy tissue.

“By contouring the dose into the areas that we actually want to treat, that allows us to limit the side effects in a way we were not able to do before,” says Jeremy Land, manager of radiation oncology at Porter Cancer Care Center.

The linear accelerator has a built-in imaging system that can visualize the tumor during treatment.

In the past, radiation oncologists had to plan a wide safety margin around the treatment area to account for the patient’s breathing and any changes in position from day to day.

“Now, with image guidance, we can be much more confident in delivering the radiation to where we need it, so we can be more sparing,” Peddada says.

To treat a tumor from multiple angles previously required stopping and starting the treatment. TrueBeam rotates around the patient to deliver radiation from nearly any angle.

“We can treat anything in a 360-degree arc without stopping, which allows us to reduce the treatment time significantly,” Land says.

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DITCH THE TRAVEL Parker Adventist Hospital is part of the Centura Health Cancer Network, delivering integrated, advanced cancer care across Colorado and western Kansas. We provide radiation therapy in three South Denver locations to allow you to receive treatment close to home.

Radiation Oncology at Parker Adventist Hospital The Cancer Center 9395 Crown Crest Blvd.

Parker, CO 80138 303-269-4975 parkerhospital.org/ cancercare Radiation Oncology at Porter Adventist Hospital The Cancer Center 2555 S. Downing St. Denver, CO 80210 303-778-5714 Opening Fall 2015 Radiation Oncology at Littleton Adventist Hospital Cancer Care Center 7700 S. Broadway Littleton, CO 80122 303-734-8740

ILLUSTRATION: DART ©ISTOCK.COM/LEVKING, PHOTO BY ELLEN JASKOL

“The word ‘radiation’ can scare us,” says Anuj Peddada, MD, medical director of radiation oncology at Parker Adventist Hospital’s Cancer Center. “I tell my patients to think of radiation as medicine. If you don’t need it, we don’t prescribe it. If you need it, it can be lifesaving.”

Just as medications have improved to reduce side effects, so has radiation therapy. The machine itself, called a linear accelerator, is the focus of improved treatment and decreased side effects. Parker Adventist Hospital’s Cancer Center and Porter Cancer Care Center at Porter Adventist Hospital offer the most advanced type of linear accelerator called the Varian TrueBeam.

This machine offers several technological advancements that allow more precise dosing and placement of the radiation, including:

Colon cancer still robbing lives

Screening colonoscopies ma y reduce the risk of new, late-stage ca ncer by 70 percent, according to res earchers at the University of Pennsylva nia.

Simple test can reduce risk by more than half NINE OUT OF 10 CASES of colorectal cancer — also known as colon cancer, rectal cancer, or bowel cancer — are found in people age 50 and older, according to the American Cancer Society. However, colon cancer can affect anyone. Kim Harris started having problems with bloating and going to the bathroom when she was 48.

“I knew something wasn’t right,” Harris says.

Harris had a colonoscopy performed

by Lisa Perryman, MD, a board-certified and fellowship-trained colon and rectal surgeon at Parker Adventist Hospital.

A malignant tumor was found, and Harris underwent surgery and chemotherapy shortly thereafter.

Dr. Lisa Perryman “A colonoscopy can save your life,” says Harris, whose cancer was found early, thanks to a colonoscopy.

PHOTO BY MICHAEL RICHMOND

A Lifesaving Procedure

Colorectal cancer affects one out of 20 Americans and is the third most deadly cancer in the United States. It is also one of the most preventable cancers, Perryman says.

“Undergoing regular screenings can significantly reduce your risk of colon cancer,” Perryman says. “Unlike other screenings like mammograms, colonoscopy can actually prevent you from getting cancer since polyps can be removed during the procedure.”

Polyps are precancerous growths within the lining of the colon that can become cancerous if not removed.

Colonoscopy uses a thin, flexible tube with a camera to examine the entire colon and a portion of the small intestine.

Colonoscopy reduces the occurrence of colorectal cancer by nearly half, when compared to other screenings, according to research in the New England Journal of Medicine.

Kim Harris celebrates her cancer-free life with her husband, David, and dogs Bear and Darla.

A colonoscopy to screen for colorectal cancer is recommended once every 10 years starting at age 50, or earlier if you have any of these risk factors: > History of colon polyps, inflammatory bowel disease, or specific cancers > Family history of colorectal cancer or polyps > Inherited diseases like Lynch syndrome > African-American > Obese, physically inactive, a smoker, or a heavy drinker

“Your physician can recommend when and how frequently you should be screened if you are at higher risk of developing colon cancer,” Perryman says.

“In addition, to lower your risk, eat a diet high in fiber and low in fat, avoid smoking, limit alcohol use, and eat red meats in moderation.”

And listen to your body, adds Harris, who is adopted and does not know her family history. Harris went back to work six weeks after her surgery and is now enjoying life cancer-free with her husband, three children, and two grandchildren.

WARNING SIGNS of colon cancer

Changes in bowel habits  Rectal bleeding or bloody stools Persistent bloating, cramps, or gas Inability to empty bowel  completely

I f you have any of these symptoms, contact your physician immediately.

Are you at risk for developing colorectal cancer?

Learn more about how to reduce your risk at a FREE seminar on Tuesday, March 3, at noon.

See back cover for details.

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March

FREE health seminars

Portercare Adventist Health System

Non-Profit Organization U.S. Postage

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.

PAID

Denver, CO Permit No. 4773

9395 Crown Crest Blvd.

Parker, CO 80138

Avoiding Colon Cancer Tue, Mar 3 | Noon-1:30 p.m.

Join colorectal surgeon Dr. John Sun to learn if you are at risk for colorectal cancer, how to reduce that risk, and how a colonoscopy can save your life.

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.

Chronic Pain Thu, Mar 5 | 6:30-8 p.m.

Join pain specialist Dr. Stephen Campbell to learn the underlying causes and symptoms of chronic pain.

You’ll hear about the newest and innovative medical treatments on how to manage pain levels effectively.

New Year, New You Tue, Mar 10 | 6:30-8 p.m.

Weight loss in the new year not working? Join family practitioner Dr. Chris West to learn of some simple changes that can make a difference and start your year off on the right foot.

Weight Loss Surgery Wed, Mar 11 | 6:30-8 p.m.

Join bariatric surgeon Dr. Josh Long for a look at various surgical weight loss options, and learn whether you’re a candidate for surgery.

Heart Health Thu, Mar 12 | Noon-1:30 p.m.

Join cardiologist Dr. Joan Eldridge to find out how the heart changes as you age and steps to protect your heart.

Robotic Surgery Thu, Mar 19 | 6:30-8 p.m.

The second most common surgery for women can now be done with less pain and a faster recovery time.

Join gynecologist Dr. Jill Tyler to learn about minimally invasive hysterectomies using robotic surgery.

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

Better Together Adding HPV testing to Pap tests can better predict cervical cancer risk YOU MAY HAVE HEARD that an annual Pap smear is no longer automatically recommended for all women, but that doesn’t give you permission to skip your annual GYN appointment.

“It is still so important to have your yearly well-woman exam,” says Randi McVay, MD, an OB/GYN at Integrated OB/GYN in Parker, which is part of the Centura Health Physician Group.

A yearly pelvic exam screens for abnormalities of the ovaries, uterus, cervix, and vagina. Women also should have a clinical breast exam every year.

In addition to a Pap test, it’s now recommended that women Dr. Randi McVay are screened for the human papillomavirus, or HPV. A sexually transmitted disease carried by more than half of all adults, HPV causes virtually all cervical cancers.

“The HPV test helps identify women who are at higher risk for cervical cancer,” McVay says.

Here are current screening recommendations by age: Women age 21-29

o

Pap test every three years

Women age 30-65

o

Pap test and HPV test every three to five years

Women over 65 o Stop cervical cancer screening if they don’t have a history of cervical cancer or dysplasia (precancerous changes) Ultimately, a woman and her doctor should decide what screening schedule is appropriate.

“You can’t just read these guidelines and automatically apply them to yourself,” McVay says.

Are you due for an annual exam?

Call your OB/GYN today or visit parkerhospital.org/parker-doctor to find a doctor.