Grow Winter 2018

Winter 2018 | Volume 10, Issue 1

SET SAIL Same-day hip surgery puts Coast Guard retiree back in action.

See Page 4.

PLUS...

Laughing through Labor

Solving Spine Pain

Getting at Gallstones

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PAGE 6

PAGE 7 PHOTO BY ELLEN JASKOL

CENTURA

Winter

health briefs

s You

Centura Health Heart & Vascular Network is the region’s leading provider of comprehensive heart care, offering advanced heart diagnostics and state-of-the-art treatments to:  Open blocked arteries R epair or replace heart valves  Fix abnormal heart rhythms H elp patients recover after heart attacks R educe heart disease risk factors To find a heart program or expert in your neighborhood, go to centura.org/heart.

Heart rate apps may be missing a beat or two, according to a study last spring in the European Journal of Preventive Cardiology. “They tested four heart rate applications, and results were all over the place,” says Grant Bailey, MD, a cardiologist with South Denver Cardiology, A Centura Health Clinic. This is partly due to the lack of regulation, he says. Better to stick to apps that motivate like “nutrition apps that track actual calories, or exercise apps that record steps or distance.”

Silent

TREATMENT Yes, heart attacks can happen without symptoms. The good news, Bailey says, is that there are some signs that signal silent heart attacks. If you’ve been experiencing even mild reflux or heartburn or a general sense of fatigue, especially if they persist despite diet changes and rest, talk to your doctor.

Also, diabetes and kidney disease raise your risk for silent heart attack. So don’t shrug off signs.

CAPSULE-SIZE PACEMAKER WORKS WITHOUT LEADS

A new pacemaker the size of a vitamin that is implanted through a vein and uses no electrical wires has hit the scene.

The new Micra Transcatheter Pacing System, available through South Denver Cardiology, A Centura Health Clinic, at the Porter Heart & Vascular Institute, is especially good for active Actual or younger patients in whom leads size might wear out over time. For more information, go to porterhospital.org/heart.



HEART SCAN If you’re a man over age 40 or a woman over age 45, your risk for heart disease is on the rise. A heart calcium scoring exam, a noninvasive scan that checks for calcium buildup in the arteries, can help you assess your risk. To learn more or to schedule a heart calcium scoring exam, call: Parker Adventist Hospital: 303-269-4500 Littleton Adventist Hospital: 303-744-1065 Porter Adventist Hospital: 855-854-3278

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: Rebecca McLuskey

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PHOTOS: HANDS ©ISTOCKPHOTO.COM/NASTCO; HEART APP ©ADOBESTOCK.COM – SYDAPRODUCTIONS; TRANSCATHETER COURTESY OF MEDTRONIC

APP FAILURE

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SERIOUS UPSIDES of laughing gas

Nitrous oxide offers laboring moms a new option for pain management WHEN WOMEN SAID THEY WANTED A NATURAL ALTERNATIVE for pain relief during labor, Parker Adventist Hospital listened. It will soon become one of only a handful of hospitals in Colorado to offer nitrous oxide to laboring women.

“More of the public said they wanted another option for pain management, and our physicians told us their patients were asking for it,” says Lori Adams, RNC, clinical manager of The BirthPlace at Parker Adventist Hospital.

Best known as the “laughing gas” used for dental patients — although at a lower concentration — nitrous oxide produces temporary euphoria and eases maternal anxiety when inhaled through a mask the mom-to-be holds to her face.

About 45 seconds before a contraction begins, she More than half of inhales. “If she starts inhaling before a contraction, laboring women in it helps with that contraction,” Adams says. The the United Kingdom, nitrous is 100 percent controlled by the patient.

Australia, Canada, “Because it’s self-administered, patients feel and Finland use like they have control of the pain, and how it’s nitrous oxide. managed.”

A big part of the appeal is that the gas doesn’t linger in the woman’s body or travel through the bloodstream to the baby, nor does it affect breast milk.

There are also few side effects. Some women report mild nausea; others say they feel unsteady after using it. But unlike some other pain-management methods, women using nitrous oxide are free to walk around during labor.

“If a woman finds she’s not getting enough pain management, she can switch to an epidural anytime,” Adams says.

PHOTOS: WOMAN ©ISTOCKPHOTO.COM/RYANKING999; ICONS ©ADOBESTOCK.COM — SAM

50%

Learn the nine questions you should ask when choosing a birth center and how The BirthPlace at Parker Adventist Hospital measures up. Visit our “Questions to Ask” webpage at parkerhospital.org/birthplace.

Home away from home

Make your hospital delivery room a bit cozier by packing these items:

SPECIAL MUSIC

YOUR PILLOW

AROMATHERAPY

Create a playlist to soothe you and welcome your baby.

Nothing else is as soothing; be sure to pack extra cases.

Candles are a hospital no-no, but diffusers can create a relaxing mood.

SMALL SEAL,

BIG DEAL

Parker Adventist Hospital has been named a Magnet Hospital for nursing by the American Nurses Credentialing Center. This prestigious designation is given to only 8.8 percent of U.S. hospitals. It recognizes our hospital for superior nursing processes and quality patient care, which lead to increased levels of safety, quality, and patient satisfaction. grow

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Hip

TO

the times

Hip replacement patients are home sooner — some the same day as surgery — and back on their feet quicker

A

s strange as it sounds, 65-year-old Michael Gorin of Aurora says if he had a third hip, he wouldn’t hesitate to have Derek Johnson, MD, replace it. Of course, it’s hyperbole. But it’s also his way of saying, Johnson, an orthopedic surgeon with Centura Orthopedics & Spine – Meridian and medical director of joint replacement at Parker Adventist Hospital, is batting a perfect two for two in replacing Gorin's hurting, arthritic hips.

Gorin, formerly part of the U.S. Coast Guard Search and Rescue, always prioritized his physical health. But as eventually happens with all of us, Gorin felt his age catching up to him. At 60, his family members noticed him walking with a limp.

And then the excruciating nerve pain began shooting down his leg.

To put him back together again, Gorin had back surgery in 2015 to relieve pain from a herniated disc, followed by two hip replacements by Johnson in April and Dr. Derek Johnson August 2017.

SAME-DAY DISCHARGE

A technique called anterior hip replacement is making rapid recovery — including same-day discharge for some patients — possible. Like many of Johnson’s patients, Gorin went home the day of his hip surgeries.

Anterior hip surgery, performed through a 3- to 5-inch incision through the front of the hip, works between muscles. The traditional posterior approach requires 8- to 10-inch incisions through gluteal muscles at the back of the hip. “We’re not cutting or detaching muscles. That’s the key,” Johnson says.

This means: Less pain • Faster healing • Fewer restrictions after surgery • Quicker return to activities Anterior hip replacement surgery seems to be catching on. “Anterior went from about 2 to 3 percent of hip replacements in 2010 to now accounting for about one in five replacements,” says Johnson, who has performed nearly 1,000 of the procedures. He believes in the approach — and in the ability of his patients to get up, get moving, and get home sooner.

“Most patients with arthritis are not sick. They just have a bad joint,” he says.

Still, many are surprised to learn they may be able to go home the same day.

“They don’t have to stay in the hospital. Some can go home and sleep in their own bed the day of surgery,” Johnson says.

WHO IS A CANDIDATE?

Hip joint replacement involves removing damaged bone and cartilage and replacing it with prosthetic components.

Ideal candidates for hip replacement have: X-ray evidence of arthritis Hip pain or stiffness that limits everyday activities Inadequate pain relief from anti-inflammatory drugs, physical therapy, or walking supports Johnson says that anyone who is a candidate for hip replacement is a candidate for the anterior approach.

“The surgery is more technically demanding in an

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PHOTOS: HOURGLASS ©ISTOCKPHOTO.COM/NICKS; PATIENT BY ELLEN JASKOL; HOURGLASS ICON ©ADOBESTOCK.COM – VITALIY

Just two months after hip replacement surgery, Michael Gorin was back to walking 3 miles a day.

obese patient or very muscular males, but that is also true of the posterior approach. The most important thing is to have a surgeon who is experienced in the anterior approach.”

The FDA recently approved a custom total hip implant that Johnson predicts could more accurately maintain leg length, a common concern following hip surgery. “I expect to be one of the first surgeons to have access to it, possibly within eight to 10 months,” says Johnson, whose experience with custom knee implants is already well-known in the region.

WHEN IS IT TIME?

Johnson says patients will know when it’s time to have hip replacement surgery. “There’s not really an ideal age; it’s more about quality of life. You’ll know when you’re giving up things you enjoy,” he says.

For his part, Gorin knew it was time. “I lived with the pain.

Scratch that, I suffered with the pain. I took pain pills. I was limping and compensating,” he says, noting that his mind had to be as ready for the surgery as his hips. “I’ve always been active. It’s difficult to accept that you have to slow down. I had to realize that I can’t expect to run, swim, and skip like a 25-year-old anymore,” he says.

What he didn’t anticipate was a recovery that had him walking a brisk 3 miles and logging more than 30 minutes on his elliptical trainer daily by October, just two months after his second hip replacement So, that business about having a third hip? He means it.

“I’m fantastic. I haven’t walked this way in years. I’ve lost 10 pounds. I feel terrific. In fact, sometimes I have to keep in mind that I’m still healing.”

Life after hip replacement

Today’s hip replacements aren’t your grandma’s hip replacements. “Most people think after hip replacement you can’t do anything. They picture an 85-year-old grandma sitting in her chair. I have patients who are now running 10Ks, skiing, playing basketball, and power lifting,” says Derek Johnson, MD.

So, what’s changed? Plenty.

IMPROVED IMPLANTS: Johnson says data shows that 95 percent of today’s joint implants are lasting 20 or more years.

This means younger patients now can pursue surgery sooner.

IMPROVED TECHNIQUE: With an anterior approach to surgery, muscles and tissue are spared, the surgical incision is smaller, and recovery is quicker.

FEWER RESTRICTIONS: After about three months of recovery, today’s hip replacement patients can return to active lives.

Learn more about advancements in hip and knee replacement surgery by attending a FREE seminar with Dr. Johnson on Feb. 8. See back page for full details.

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PUSHING BACK PAIN An estimated eight in 10 people will experience back pain in their lifetime. “Back pain is one of the leading causes of not being able to work or

enjoy recreational activities,” says Scott Stanley, MD, a spine surgeon with Centura Orthopedics & Spine.

Most back pain resolves with anti-inflammatory medications (such as Motrin), rest, and physical therapy. When symptoms persist, however, surgery may relieve pain. And Dr. Scott Stanley today’s spine surgery is not like that of even five years ago. “Hardware is better now, and newer techniques performed through small incisions spare muscles,” Stanley says.

Stanley helps take a look at conditions that often require spine surgery.

To make an appointment with Dr. Stanley, call Centura Orthopedics & Spine at 303-925-4750 or visit

centuraorthopedics.org.

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WHOM IT AFFECTS:

SURGICAL TREATMENT:

Spondylolysis/ Spondylolisthesis

Spondylolysis is a fancy name for a crack or stress fracture in a lower back vertebra. Its more serious cousin, spondylolisthesis, occurs when that fractured vertebra slips out of place.

Children and adolescents active in sports such as gymnastics, football, and weight lifting are at greatest risk, as are active adults in their 20s-40s.

Rarely responds to nonsurgical treatment.

Spinal fusion “welds” vertebrae together to stabilize the spine.

Spinal Stenosis

Stenosis is a narrowing of the “tunnel” around your spinal cord. This can place pressure on nerves, leading to numbness, tingling, pain, and leg weakness.

It occurs mainly in adults over 60.

Arthritis is the most common cause.

Decompression surgery removes bone and bone spurs that are causing pressure on nerves.

Herniated Disc

A disc is a soft, rubbery pad that serves as a “shock absorber” between vertebrae.

When it herniates, or ruptures, its soft center pushes through the outer edge of the disc, sort of like the jelly seeping out of a doughnut.

Older adults are at risk, as are smokers, those who are overweight, and those who improperly lift or engage in repetitive strenuous activities.

Microdiscectomy, which removes only the protruding portion of the disc, is common for lower back pain. At all levels, disc removal and fusion of the two vertebrae also may be an option. Artificial disc implantation is an alternative to fusion in some neck pain patients.

BACK PAIN NOW RANKS AS THE THIRD MOST BURDENSOME CONDITION ON HEALTH IN 2010, UP FROM SIXTH IN 1990.

Parker Adventist Hospital — along with Littleton Adventist Hospital, Castle Rock Adventist Hospital, and Porter Adventist Hospital — are part of Centura Health, the region's leading health care provider.

The Orthopedic Spine Center at Parker Adventist Hospital offers comprehensive spine care from pain management to surgery.

To learn more, go to parkerhospital.org/spine.

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WHAT IT IS:

NO TIME for DOWNTIME

When painful gallbladder disease strikes, fast surgery brings fast relief SPORTING A 3-INCH SCAR FROM A CHILDHOOD OPERATION, Jolynne Alger didn’t want another abdominal surgery. So, when tests revealed the source of her worsening stomach pain was gallbladder disease, she hesitated to have the organ removed.

As she was weighing treatment, Alger went to a movie, ate popcorn — and paid a price. “By that evening, I was throwing up and in so much pain that I ended up in the emergency room.”

She recalls the ER doctor telling her, “You have confirmed gallstones. This isn’t rocket science. You need your gallbladder removed.”

A HOUSEHOLD TO MOVE

She was referred to Parker Adventist Hospital surgeon John James, MD. James explained that gallbladder removal now is done through a single, small incision via the belly button — which leaves a small, nearly invisible scar. The surgery, James told her, can be performed in a minimally invasive procedure using robot-assisted technology.

Those less-invasive techniques mean Dr. John James less pain, and shorter recovery, which took care of another of Alger’s concerns: She couldn’t spend days recovering in a hospital room because she and her family were about to move to California.

Alger had surgery at Parker Adventist Hospital in the morning. By that night, she was home and out of bed without any pain medications.

For two years before surgery, Alger’s stomach hurt and Jolynne Alger with her family the pain had been getting progressively worse. She also had developed nausea and fevers. It was so bad she had trouble eating, and was losing weight.

But three months after surgery, the mother of two says she has no pain and no noticeable scar. “I’m grateful I had the right people taking care of me at the right time.”

PHOTOS: STONES ©ISTOCKPHOTO.COM/FABRIKACR; DENTAL ©ISTOCKPHOTO.COM/PASHAIGNATO

GALLBLADDER

COMMON GALLSTONE SYMPTOMS 1. Aching or stabbing abdominal pain 2. Nausea or vomiting 3. Back pain 4. Heartburn or indigestion that worsens after eating

Although researchers have not identified an exact cause of gallstones, factors that may increase the risk of developing them include:

friends AND FOES

• Being female • Being age 40 or older • Being overweight or obese • Being sedentary • Being pregnant • Eating a high-fat diet • Eating a high-cholesterol diet • Eating a diet low in fiber • Family history of gallstones • Having diabetes • Very rapid weight loss • Taking medications that contain estrogen • Having liver disease

Researchers aren’t certain what causes gallstones. But what you eat can make a difference in how well you and your gallbladder get along.

friends • Fruits and vegetables, especially leafy greens, tomatoes, and citrus • Nuts • Lentils • Low-fat dairy • Fish

FOES • Fatty, fried foods • Processed foods • Pasta, breads, and other foods made with refined white flour

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THE ROUTE

Portercare Adventist Health System

Non-Profit Organization U.S. Postage

to good health

WE ALL WANT TO BE HEALTHY.

For some, that means overcoming, or preventing, chronic illnesses like diabetes, high cholesterol, or heart disease. For others, it means maintaining a healthy weight. And for still others, it means just feeling great, in body, mind, and spirit.

Whatever your health destination, Centura Health’s 18-session holistic program, Pathways to Health & Wellness, can help you get there.

This three-month program is designed to provide priceless health benefits, including helping you: • Reverse chronic disease • Lose weight • Gain energy • S pend less on food and medications • Enjoy life again

TO LEARN MORE about Pathways to Health & Wellness, attend one of these FREE information sessions at Parker Adventist Hospital: Monday, Feb. 5, 6:15-7:15 p.m.

Wednesday, Feb. 7, 6:15-7:15 p.m.

Tuesday, Feb. 13, 1-2 p.m.

Thursday, Feb. 15, 1-2 p.m.

Tuesday, Feb. 20, 1-2 p.m.

Register for an information session at coloradocreationhealth.com.

PAID

Denver, CO Permit No. 4033

9395 Crown Crest Boulevard Parker, CO 80138

free WINTER 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.

Non-Narcotic Joint Replacement

Tue, Jan 30 | 6-7 p.m.

Join Dr. Presley Swann to learn more about his method for non-narcotic joint replacement surgery.

Advances in Hip Replacement

Thu, Feb 8 | 6-7 p.m.

Join Dr. Derek Johnson to hear about the latest techniques for hip replacement surgery, including how to reduce pain and even go home in one day.

Shoulder Surgery Options

Tue, Feb 20 | 6-7 p.m.

Dr. Landon Fine will discuss the latest in shoulder surgery and how to know when surgery is right for you.

Hands-Only CPR

Tue, Feb 20 | 5:30-7:30 p.m.

Most cardiac arrests happen outside of the hospital — in a home, at work, or in a public location. Receiving immediate bystander CPR can significantly increase a person’s chance of survival. The Hands-Only CPR course is designed to give community members the confidence to deliver effective CPR and activate the emergency medical response system in the case of an emergency. Limited to eight people.

Just Say No to Colon Cancer

Tue, Mar 6 | 6-7 p.m.

March is Colon Cancer Awareness Month. Join Dr. John Sun to learn your risk factors, how to help reduce your risk, and the latest treatment options.

Stepping On

Mondays, Apr 2-May 7 Location: Conference Center Pine A and B Stepping On is an evidence-based fall prevention class for seniors. In a small group setting, older adults practice balance exercises and gain 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 Mindie Ottke at 303-269-4638.

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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).