Vibrant Spring 2017

Your Connection to Healthy Living

Volume 5, Issue 2 | Spring 2017

AT FULL STRENGTH

Lung screening program helps find cancer at its earliest stages, when it is most treatable. Page 6 Former smoker Su Dierbeck found peace of mind with a clear low-dose CT lung cancer screening at Porter Cancer Center.

3  Do you need an ER? 4  New treatments for irritable bowel disease 7  Simple steps to better living

porterhospital.org :: Spring 2013

1 PHOTO BY ELLEN JASKOL

What’s new in health

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Health needs, home upkeep, or simply a desire to join a community where social activities and meals are provided can all be reasons to consider senior living.

“Services vary widely from place to place,” says Charlene Mason, sales representative for Porter Place, a senior community offering independent, assisted living, and secure memory care. “For example, at Porter Place, residents can go up a care level to receive more assistance — right in their same apartment — if their wellness or lifestyle needs change,” Mason says. “That definitely sets us apart.”

Here’s a primer on senior care options.

INDEPENDENT LIVING Services Offered: Daily meals, housekeeping, activities programs, and transportation.

Ideal Resident: Independent with no need for assistance.

ASSISTED LIVING Services Offered: The same as independent living plus assistance with dressing, grooming and, if needed, meal or medication reminders; 24/7 staffing is available. Some facilities offer secured Alzheimer’s/memory care wings.

Ideal Resident: Requires some assistance with personal care or mobility. “A good rule of thumb is that the resident needs to be OK being alone for two hours,” Mason says.

LOSE THE WEIGHT Liver cancer was once thought to mainly affect alcoholics. But a recent study suggests that bigger waistlines also lead to bigger liver cancer risk.

“We have seen obesity associated with an increased incidence in other cancers.

Now we’re seeing a spike in liver cancer from ‘nonalcoholic fatty liver disease,’ the buildup of extra fat in liver cells not caused by alcohol use,” says Mary Ann Huang, MD, MS, transplant hepatologist at Porter Adventist Hospital.

Dr. Mary Ann Huang

Huang says the study, published in the journal Cancer Research, offers three key takeaways:

 Liver cancer does not only strike alcoholics

SKILLED NURSING (NURSING HOME)

 Controlling diabetes and losing

Services Offered: 24/7 nursing supervision and services such as IVs; catheters; wound care; and physical, occupational, and speech therapy.

Residents receive the highest level of care available outside of a hospital.

 Patients with a “fatty liver,”

Ideal Resident: Requires a high level of short-term or long-term medical management following an illness, injury, or serious health decline.

Want to learn more and see the options in action? Schedule a tour of Porter Place by calling 303-765-6800.

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Another reason to

VIBRANT :: Porter Adventist Hospital

weight may lower your risk

which may develop in people who are overweight or have diabetes, should see a gastroenterologist or hepatologist

For more information or to make an appointment, call the Transplant Center at Porter Adventist Hospital at 303-778-5797.

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Senior Living

How to know where to go in an

EMERGENCY With freestanding emergency rooms, urgent care centers, and boutique micro-hospitals popping up on every corner, medical care in the Denver area is not hard to find. That’s the good news.

911

That’s also the bad news.

Dr. Ahmed Stowers

So many choices can be overwhelming. “Add the pain and fear that can cloud the decision-making process following an injury or illness, and it’s hard to know where to go,” says Ahmed Stowers, MD, emergency physician at Porter Adventist Hospital. These guidelines can help.

Should you go to the ER?

Calling 911

Hospital-based ERs have the medical staff, equipment, and technology to handle immediate, severe medical emergencies.

During the stress of a medical emergency, it may be tempting to “take charge” and drive yourself or your loved one to the hospital. But if you suspect heart attack or stroke, sustain head or spine trauma, or experience a sudden or severe life-threatening situation, call 911.

WHEN TO GO: “If you have something life-threatening, you absolutely need to go to a hospital-based ER,” Stowers says, adding that suspected heart attack or stroke, a broken bone protruding through skin, an extreme allergic reaction, bleeding that will not stop, or sudden/severe vomiting warrant a trip to a hospital-based ER.

“Paramedics do a great job of sorting out where to take patients. They can treat on the way. And they can alert the hospital so that a team is ready to help save your life when you arrive,” Stowers says.

Is It Serious?

Urgent care or ER? Here’s a list of tricky symptoms and what they can mean. > Headache (migraine or stroke) > Chest pain (heartburn or heart attack) > Sudden, sharp pain (kidney stone or appendicitis) > Fever (flu or meningitis) Stowers says context and common sense are key. What is the patient’s age and health history? What happened leading up to the pain or injury? Are other symptoms present? His rule of thumb: If you think your life is at risk, call 911.

Porter Adventist Hospital is part of the Centura Health Trauma System, the region’s largest and most comprehensive network of trauma care and emergency services.

U.S. News & World Report ranked Porter Adventist Hospital #2 Best Hospital in Denver. To learn more and get the ER wait time, go to porterhospital.org.

Porter Adventist Hospital is part of the Centura Health Trauma System, the region’s largest and most comprehensive network of trauma care and emergency services.

porterhospital.org :: Spring 2017

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GIWoe Inflammatory bowel disease is on the rise, but treatment options are better than ever

A report released last fall is sounding the alarm bell over a rapid increase in the number of Americans with inflammatory bowel disease (IBD). The report found that three times as many U.S. adults have IBD than previously reported. In all, more than 3 million adults were diagnosed with this painful — and sometimes life-threatening — disease in 2015.

While that may not be an alarming number compared with other, more prevalent health issues, those living with IBD know just how life-altering the symptoms are. They can include abdominal pain and cramps, persistent diarrhea, bleeding, and constipation. IBD may also trigger loss of appetite, weight loss, fever, and low energy or fatigue.

The good news is, research is leading to better understanding of IBD and better treatment options for it.

What Causes It? IBD is a serious condition in which the immune system attacks the intestinal bacteria that aids with digestion. The theory is that, while normally protected from such attacks, these bacteria may be mistaken for foreign invaders in people with IBD. The constant attacks trigger chronic inflammation.

IBD is a broad term to describe this chronic or recurring immune response. The two most common IBD diagnoses are ulcerative colitis, which affects only the large intestine, and Crohn’s disease, which can strike any part of the GI tract.

The perplexing thing for specialists is that the cause is not known. While diet or stress may

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VIBRANT :: Porter Adventist Hospital

IBS and IBD:

What’s the difference? irritate IBD, they are not thought to cause the condition.

“There are many theories about what causes IBD. We think there is a genetic predisposition with an environmental trigger,” says Aliya Hasan, MD, a gastroenterologist at Porter Adventist Hospital. The “hygiene theory” is also gaining traction. “We see IBD more in first-world countries, where there is a higher level of hygiene. The idea is that in thirdworld countries, residents are exposed to many more pathogens early on and so their immune systems work much harder. With Dr. Aliya Hasan our use of antibacterial soaps and sanitizers, our immune systems don’t have the same workload.”

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Hasan says it’s hard to pinpoint why IBD seems to be on the rise. There is the possibility that increased awareness has led to an uptick in the number of diagnoses. “Maybe there was a time when people with minor symptoms didn’t seek medical attention,” she says.

Treatment for IBD Treatments for Crohn’s and colitis are similar. In both cases, medication to suppress inflammation and allow the GI tract to recover and heal is the first response. “It depends on where the inflammation is. Is it just in the colon? The upper GI tract?

Where the inflammation is dictates what type of drug we’re going to go to first,” Hasan says. Some drugs — like corticosteroids — target CROHN’S inflammation, while others DISEASE is target the immune system’s more prevalent response. Some patients among also benefit from antibiotics or biologic medications, adolescents which disrupt the process of and young inflammation. adults between

the ages of 15 and 35.

While there are a growing number of medications that attack IBD from different angles, Hasan acknowledges IBD triggers emotional as well as physical symptoms. “It can be scary to be diagnosed with a chronic condition,” she says.

“But, for the vast majority

What a difference a letter can make.

Inflammatory bowel disease (IBD) is often confused with irritable bowel syndrome (IBS). While they sound like close cousins, they actually differ sharply in prevalence and severity.

“IBS is more of a quality-of-life issue. While symptoms are disruptive, IBS does not shorten your life span,” says Aliya Hasan, MD. IBD, however, can be a serious medical condition leading to intestinal obstruction, infection, and even a higher risk for colon cancer. “If you have IBD and you’re not treating it, you can end up with serious complications,” Hasan says.

Similarities

Differences

• The exact causes of IBS and IBD are not known.

• IBS is more prevalent. Up to 7 percent of U.S. adults have an IBS diagnosis (although up to 15 percent may actually be affected), compared with 1.3 percent with an IBD diagnosis.

• Both IBS and IBD cause cramping and/or pain in the abdomen.

• Both conditions disrupt normal quality of life.

• IBS does not cause inflammation or damage to digestive organs. IBD involves chronic inflammation of the colon or GI tract.

of patients with IBD, it is a condition that can be brought under control with very good treatment options.” And new medications are always on the horizon with ongoing research yielding promising treatments that push surgery even further out as a last resort.

For patients who do not respond to first-line medications and whose symptoms are debilitating, surgery may be the next step. Because Crohn’s disease can affect any part of the GI tract, taking out just part of the GI tract means Crohn’s can recur somewhere else, Hasan says. For those with colitis, surgery to remove the colon can be a cure, but does require lifestyle changes.

If you’re suffering with stomach, digestive, or GI issues, it’s time to find relief! Call 303-260-2740 to schedule an appointment at the Digestive Health Center at Porter Adventist Hospital.

porterhospital.org :: Spring 2017

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SMOKE SCREEN Low-dose CT scans find lung cancer in earlier stages

AT ALMOST AGE 70, Su Dierbeck still remembers the first carton of cigarettes she At her peak, Dierbeck smoked three packs a day. Her parents were heavy smokers, and both would ultimately die before age 70 of smoking-related diseases.

She recently decided to get a low-dose CT lung cancer screening at Porter Adventist Hospital. She was terrified of what the test might find.

Peak number for 30-pack-year smokers Dierbeck’s experience is fairly typical. “Smoking in women peaked in the 1960s and ’70s.

Lung cancer rates parallel this and follow by about 20 years,” says Mary Elmasri, MD, an interventional pulmonologist at Porter Adventist Hospital. Accordingly, new lung cancer cases peaked for women in 1998 and have declined since.

Still, lung cancer remains notoriously difficult to detect and treat. Low-dose CT scans can help those at high risk. This includes those who, like Dierbeck, have a 30-packyear history (a pack a day for 30 years or two packs a day for 15 years).

“It is so important for high-risk candidates to get screened. A 2011 study showed that low-dose CT scans drove the mortality rate down by 20 percent,” Elmasri says.

rettes Su Dierbeck has put down the ciga her and picked up the weights, going to core fitness classes six days a week.

Reprieve from risk As for Dierbeck and that nerve-racking matter of her screening results? Statistics say that quitting before the age of 40 — which she did — reduced her risk of dying from smoking-related disease by about 90 percent. “Still, I was terrified between the time I had the screening and the time I got my results,” she says.

When they arrived? She exhaled like she had never exhaled.

There was no cancer. “It gave me total peace of mind. I plan now to have the screening done every year as recommended,” she says.

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VIBRANT :: Porter Adventist Hospital

Time to Quit The best way to lower your risk for lung cancer? Quit smoking.

“Smoking damages the normal lining of cells,” says Mary Elmasri, MD. “In smokers, you have all these damaged cells — precursors to cancer — proliferating and growing.”

The good news? There are more tools to help smokers quit than ever. Elmasri recommends talking to a pulmonologist or calling 1-800-QUIT-NOW for counseling and access to free or discounted samples of FDA-approved cessation medications.

Breathe Easier

Low-dose CT lung cancer screenings are available at Porter Adventist Hospital, Littleton Adventist Hospital, Parker Adventist Hospital, and Castle Rock Adventist Hospital. Call 303-778-2415 or visit porterhospital.org/ healthylung to see if you are a candidate. Medicare and most insurance plans cover the cost if you meet the criteria, but be sure to check with your plan.

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

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purchased as a college freshman in 1965. The price was about $5.60 — for the entire 10-pack carton. The cost? That turned out to be much greater.

Living well

SIMPLE STEPS to fight fatigue and depression

with a chronic disease About half of American adults live with chronic, lifelong health conditions such as arthritis, heart disease, or diabetes, according to the Centers for Disease Control and Prevention. The result can be fatigue, frustration, and sometimes depression.

But simple steps can help. “Eating healthy, exercising, and getting enough sleep will make you feel better and can even improve some chronic diseases,” says Sarah Boyce, MD, a family medicine physician at Centura Health Physician Group Primary Care Cherry Creek. Here’s how:

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Dr. Sarah Boyce

FEEL-BETTER FUEL: “Stock up on healthy foods if you can’t get to the store often. Make meals in advance and freeze meal-sized portions so you don’t have to cook as often.”

GET MOVING: “Start by walking around your block or doing the first few minutes of an exercise DVD,” she recommends. Increase your goal slowly and try to get up to 150 minutes a week. If you can’t, that’s OK; even a small amount of exercise helps.

ZZZ TIPS: “Going to bed and getting up at the same time each day will help you sleep better,” Boyce says. Exercise can help you sleep, but do it at least four hours before bedtime. Keep electronics out of the bedroom. Limit caffeine after noon.

Personal, Purposeful Care Relational care that helps you meet your health and wellness goals.

Sounds good, right? Then, meet Sarah Boyce, MD. “Getting to know my patients as people — that is the real joy for me in this work.

Knowing my patients better allows me to take better care of them and deliver more personal care,” she says.

In fact, the long-term potential for doctor/patient relationships and the variety of health needs in patients from infants to seniors are the reasons Boyce chose family practice. Newly married and new to the Denver area, Boyce practices at Centura Health Physician Group Primary Care Cherry Creek.

When not at work, Boyce loves skiing, hiking, and Colorado’s laid-back vibe, which the East Coaster admits does sometimes pose a minor problem. “Figuring out the ‘dress code’ here is still sort of a weird adjustment for me,” she says.

Dr. Boyce’s medical training included a one-month elective in rural Ecuador.

“I’m interested in medical missions,” she says, noting that the experience offered her the chance to practice her fluent Spanishspeaking skills.

To make an appointment with Dr. Boyce, call 303-316-0416.

porterhospital.org :: Spring 2017

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PRIMARY CARE PRACTICES

Portercare Adventist Health System

Non-Profit Organization U.S. Postage

PAID

AURORA CHPG Cornerstar Primary Care (Parker and Arapahoe) 303-269-2626 • cornerstarprimarycare.org

Denver, CO Permit No. 4773

2525 South Downing Street Denver, CO 80210

CHPG Southlands Primary Care 303-928-7555 • southlandsprimarycare.org

CASTLE ROCK Ridgeline Family Medicine at the Meadows 720-455-3750 • ridgelinefamilymedicine.org Ridgeline Family Medicine — Castle Pines 303-649-3350 • ridgelinefamilymedicine.org

CENTENNIAL CHPG Grace Family Practice (near Arapahoe and Holly) 720-528-3559 • gracefamilypractice.org CHPG Holly Creek 303-649-3820

DENVER CHPG Clermont Park 303-649-3155 • clermontparkseniorcare.org

FREE CLASSES & EVENTS Around the Community RSVP required. Locations and times vary. Visit porterhospital.org/events or call 303-765-3825 for more information.

CHPG Primary Care Cherry Creek 303-316-0416 primarycarecherrycreek.org CHPG Primary Care Highlands (near I-25 and Speer) 303-925-4580 • chpghighlands.org CHPG Primary Care Porter 303-649-3200 • porterprimarycare.org

GREENWOOD VILLAGE

R por egiste terh r osp online ital. org/ at eve nts

HEALTHY AGING – CONTINUUM OF CARE Come for a variety of FREE and low-cost health screenings, and health advice from the experts at Porter Adventist Hospital.  Date: Wed, Apr 26  Time: 7 a.m.-Noon  Info: 9healthfair.org

CHPG at DTC (Ulster and Belleview) 303-770-6500 • dtcfamilymedicine.org

HIGHLANDS RANCH

It isn’t always fun to think about, but as we age or care for an aging loved one, we need guidance and support. Join our panel to learn more about at home care, palliative care, and hospice care. We will also have information on the various forms and programs you may need assistance with.  Date: Wed, May 3  Time: 6-7 p.m.  L ocation: Porter Place, 1001 East Yale Avenue

Highlands Ranch Medical Associates 303-649-3140 highlandsranchmedicalassociates.org

RUMBLES, GURGLES, AND GROWLS

GI health impacts us all. Join Dr. Samita Garg to better understand your overall GI health.  Date: Wed, May 10  Time: 6-7 p.m.  L ocation: Porter Adventist Hospital Conference Center

MOVIE NIGHTS

Don’t miss our fun summer family movie nights at the University of Denver coming in June. Check back for details.

LITTLETON Chatfield Family Medicine 303-738-2714 • chatfieldfamilymedicine.org Clement Park Family Medicine 303-932-2121 clementparkfamilymedicine.org South Suburban Internal Medicine (at Littleton Hospital) 303-347-9897 southsuburbaninternalmedicine.org

PARKER CHPG Internal Medicine Parker (on hospital campus) 303-770-0500 • internalmedicineparker.org

THE MOUTH AND BODY CONNECTION

Did you know your oral health effects almost all of your body? Join us to learn how to keep your mouth healthy to keep your body healthy.  Date: Mon, May 1  Time: 6-7 p.m.  L ocation: Porter Adventist Hospital Conference Center

CHPG Primary Care Meridian 303-649-3100 • parkerprimarycare.org Timberview Clinic at Parker (on hospital campus) 303-269-4410 • timberviewclinic.org

WHEN YOU GOTTA GO!

porterhospital.org

Leaky bladder can happen for a number of reasons, and you don’t have to live with it. Join us to learn more about possible causes and treatments.  Date: Tue, May 9  Time: 2-3 p.m.  L ocation: Porter Place, 1001 East Yale Avenue

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, 2017.

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Porter Adventist Hospital is a regional medical center that provides care for complex health issues. We specialize in complex surgery, cardiovascular care, spine care, joint replacement, liver and kidney transplants, and cancer care. We are part of Centura Health, the region’s leading health care network. Vibrant is published quarterly by Porter Adventist Hospital – Portercare Adventist Health System. The purpose of this publication is to support our mission to improve the health of the residents in our community. No information in this publication is meant as a recommendation or to substitute for your physician’s advice. If you would like to comment or unsubscribe to this magazine, please email us at vibrant@centura.org. Vibrant is produced by Clementine Healthcare Marketing.