Vibrant Winter 2017

Your Connection to Healthy Living

Volume 5, Issue 1 | Winter 2017

Staged for

SUCCESS A two-day, two-part spine surgery at Porter Adventist Hospital helps end debilitating back pain.

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Centennial resident Brian Caldwell, 44, is pain-free and back to enjoying life with his family.

2  Same-day joint replacement on the horizon 3  Why 50 is the golden age for screenings 7  Hope for healing hepatitis C

porterhospital.org :: Spring 2013

1 PHOTO BY ELLEN JASKOL

What’s new in health

REVOLUTION

in joint replacement Orthopedic surgeon Douglas A. Dennis, MD, estimates he has performed more than 10,000 hip and knee replacements, spanning the past three decades. Throughout that time, he has completed research to help make the procedures more effective and has traveled abroad multiple times to perform hip and knee replacements in Asia, Europe, and Central America.

We recently sat down with Dennis to ask him about exciting developments on the horizon.

“I truly believe five years from now, 70 percent of patients will be having outpatient joint replacements,” he says. Dennis credits improved surgical techniques, plus anesthetic and pain management methods for helping get patients up, moving, and out of the hospital much quicker — which also can help reduce the chance of Dr. Douglas A. Dennis infection.

“I’ve been doing this for 30 years and in my early years, patients were in the hospital for two weeks after a total hip or knee replacement,” he says. “Today the majority of my patients are leaving the hospital the next day.”

Individualizing the position that components are implanted is another advance that will provide patients with new joints that feel more natural. “Implanting the devices in the same position for every patient may not be the best,” Dennis says. “We already align knee implants based, in part, on the anatomy of the hip joint, and we’re starting to look at how an individual’s unique lumbar spine flexibility affects pelvic alignment to determine the best position of the artificial hip components.”

Douglas A. Dennis, MD, is a board-certified orthopedic surgeon specializing in knee and hip replacement surgery at Colorado Joint Replacement at Porter Adventist Hospital and medical director of Operation Walk Denver.

To schedule an appointment with Dr. Dennis, call Colorado Joint Replacement at 720-372-0926.

Pelvic congestion syndrome may be the root of pelvic pain While uterine fibroids seem to get plenty of press, another leading cause of chronic pelvic pain in females is a condition you’ve probably never heard of. Pelvic congestion syndrome, caused by varicose veins in the pelvis, affects up Dr. Peter Stratil to one in 10 women, says Peter Stratil, MD, MBA, an interventional radiologist at Porter Adventist Hospital.

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VIBRANT :: Porter Adventist Hospital

Symptoms include:  Severe, dull, aching pelvic pain that

worsens through the day or worsens with prolonged standing  Painful intercourse  Labial or pelvic region varicose veins

Pelvic congestion syndrome is similar to varicose veins in the legs — in fact, patients who have the latter are more at risk. In both cases, valves in the veins no longer

function normally, allowing blood to pool or back up. This increases the pressure in the veins, causing them to dilate, especially after long periods of standing.

Varicose veins in the pelvic region are most often not visible, making the condition tricky to diagnose. “Many women go through multiple tests —

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When it comes to colorectal cancer, it’s just this simple — screening saves lives

Colorectal cancer is the second leading cancer killer. Yet statistics show that more than 60 percent of deaths from colorectal cancer could be avoided with screening.

Gavin Sigle, MD, colorectal surgeon at Porter Adventist Hospital, joins other experts who call colonoscopy the “gold standard” screening for colorectal cancer.

While there are other tests that can detect the presence or possible presence of cancer, colonoscopy is the only test that can actually prevent it.

“All cancers start as polyps.With colonoscopy, we can find and remove polyps,” Sigle says. And even when a polyp has advanced to cancer, if it’s caught early, the outlook for patients is very good. “We know it takes eight to 10 years for a cancer to grow or develop. It’s a relatively slow process,” Sigle says.

Statistically, about one in three adults is not getting screened, even though about two-thirds of that unscreened population has health insurance and a regular doctor.

Sigle says that group is taking a big risk. “The most important thing to understand is that colon cancer is usually asymptomatic. You’re not going to know you have it. That’s why we screen,” he says.

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NUMBERS D0N’T L1E 4

Dr. Gavin Sigle

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22 Colorado ranks 22nd out of 50 states in colon cancer screening rates, with just two-thirds of residents (ages 50 to 75) getting recommended screenings.

50

Why is

nifty?

“I get asked often, ‘Why do we start screening at age 50?’ The risks of colonoscopy — bleeding and perforation of the colon — are very low. At age 50, the risk of cancer overtakes those,” Sigle says. In other words, by age 50, risks from the test are outpaced by the risk of cancer.

sometimes invasive tests — to diagnose the cause of their pelvic pain,” Stratil says, adding that a diagnostic ultrasound can be the key. “If that shows dilated veins, then a follow-up CT scan or MRI can confirm the diagnosis.”

The good news is pelvic congestion syndrome is highly treatable with a procedure done through a catheter (tiny tube inserted into a vein) that shuts down the faulty veins. “This removes the pressure, and the pain goes away. We have about a 90 to 95 percent success rate with treatment.”

PHOTOS: DANCING ©ISTOCKPHOTO.COM/KUPICOO; HIPS ©ANEESE — STOCK.ADOBE.COM; NOTEPAD ©HAPPYART — STOCK.ADOBE.COM

Looking for a doctor? Call Centura Connect at 720-321-3939.

To learn more about these topics and more, join us for FREE seminars held throughout the community.

See back cover for details.

We are part of the Centura Health Cancer Network, delivering integrated, advanced cancer care across Colorado and western Kansas.

porterhospital.org :: Winter 2017

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Spine SOLUTION

A common spine problem gets complicated, and a “miracle worker” steps in for a Denver-area man

A

s an emergency management consultant, Brian Caldwell’s job is to write local, state, and federal government disaster preparedness plans.

But when his own disaster struck? The 44-year-old Centennial resident says he needed a miracle worker.

But after Caldwell went to another Denver-area hospital for a routine laminectomy, a surgery that removes bone to relieve pressure on pinched nerves, his health took some dangerous turns. “I nearly died from a staph infection. I was in massive pain. You name it, I couldn’t do it. I couldn’t play with the kids, couldn’t help around the house,” Caldwell says. Irony hung over his work days as he wrote disaster response plans from bed, wondering if he would ever recover.

He ultimately found Porter Adventist Hospital and its director of spinal surgery, Michael Gallizzi, MD, MS, and today he is pain-free.

Turn for the worse Brian Caldwell is once again having a ball with his family after spinal surgery at Porter Adventist Hospital put an end to his severe sciatic pain.

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VIBRANT :: Porter Adventist Hospital

Back pain didn’t settle in gently for Caldwell. He developed sudden, aroundthe-clock sciatic pain in September 2015 and found a specialist who recommended laminectomy. Still in pain following that first surgery, he had a

PHOTOS: FAMILY ©ELLEN JASKOL; BICYCLE ©GRAPHICCOMPRESSOR — STOCK.ADOBE.COM; GOLF BALLS ©123DARTIST — STOCK.ADOBE.COM

Caldwell’s story is familiar to many Americans — a bulging disc in his lower back pinched a nerve, which shot excruciating sciatic pain down his leg.

Statistics show that as many as eight in 10 people will experience back pain in their lifetimes.

I was in massive pain. You name it, I couldn’t do it. I couldn’t play with the kids”

second laminectomy in November. During Thanksgiving week 2015, he developed a postsurgical staph infection that nearly took his life, led to a 17-day hospitalization, and ultimately enveloped the facet joints in his lower spine. One of those joints was removed.

Even after he was discharged from that hospital, debilitating pain still controlled his life. By the time Caldwell found Gallizzi, his once-active life had spiraled into a cycle of painkillers, depression, and immobility.

Staged for success In his first consultation with Caldwell, Gallizzi explained that the previous removal of the facet joint — which he likens to one of the two wheels in the back of a tricycle — compromised the stability of Caldwell’s spine.

He recommended a twopart, two-day surgery. Day one would restore the spine’s height, curve, and stability.

Day two would free up the nerves.

“I stage my surgeries. I have the patient get up and walk between surgeries to tell me what’s better and what’s not better. That tells me what specific nerve needs to be decompressed,” Gallizzi says.

Dr. Michael Gallizzi

His approach differs with each patient — a quality that’s important, he says, when it comes to choosing a surgeon. Gallizzi says reputable surgeons will discuss all applicable treatment options with patients, even if they don’t offer all of them.

Surgically, this can include laminectomy, discectomy (removal of a herniated portion of a disc), spinal fusion, and, more recently, artificial disc replacement.

Positioned for recovery He advises patients to ask prospective spine surgeons the following questions:  What treatment options are appropriate for my condition?  Are there any treatments that may be appropriate that you don’t perform?  Are your surgical approaches minimally invasive and muscle-sparing?  Do you offer several approaches?

Which one is right for me?  What is your infection rate? What is the infection rate of the hospital?  Do you perform this surgery regularly?  How do you manage pain from surgery?  How do you supplement patient nutrition and bone health prior to surgery?

To the last point, Gallizzi likens spine surgery to building a house. “You wouldn’t start building without ordering the lumber and concrete. I supplement protein and vitamin D levels in the blood,” he says. This positions patients for optimal recovery.

Caldwell knows all about optimal recovery.

After a harrowing, pain-filled year when he could hardly leave his bed, he now can run around with his son at soccer practice and hit golf balls at the driving range. He calls Gallizzi a miracle worker. “He did everything he said he would. He gave me my life back.”

A Personal Perspective

Many doctors enter medicine out of a desire to help people. Dr. Michael Gallizzi’s choice was guided more specifically by his hope to help one person: his mom.

When he was a toddler growing up in Detroit, Gallizzi’s mom buckled him into his child safety seat and they embarked on a bike ride that altered their family life forever. They were struck by a car. While Gallizzi was unharmed, his mother suffered serious injuries to her legs and back that affect her still.

As a young man, Gallizzi set his sights on orthopedic surgery. He completed a spine fellowship at Duke University, where he learned minimally invasive techniques as well as complex deformity correction. “I don’t want anyone to go through what I had to — seeing their loved one in and out of hospitals,” he says. “I work as hard as I can to prevent this because I truly understand the dramatic and lifechanging effect this has on everyone.”

If back pain is limiting the way you live your life, take positive action today.

Schedule an appointment at Centura Orthopedics by calling 303-925-4540. porterhospital.org :: Winter 2017

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M E N TA L H E A LT H

FIRST

AID Could you recognize a mental health emergency?

A mental health emergency is a common occurrence in every corner of our communities. But if you witnessed one, would you recognize it? Would you know what to do?

Anytime people are a danger to themselves or others, it’s a mental health emergency that requires immediate attention. This includes someone who:

 Is expressing a desire to commit suicide  Shows signs of a psychosis (delusions, paranoia, fear) that impairs functioning  Is extremely agitated, wildly overactive, and unable to calm down An all-too-common problem Nearly 500,000 Coloradans struggle with diagnosed mental health issues, according to the Colorado Health Foundation. And Colorado has one of the nation’s highest suicide rates.

“We all face mental health issues or know those who could experience a mental health crisis,” says Doug Muir, director of Porter Adventist Hospital’s Behavioral Health Service Line. “Mental health is a huge part of our overall health. People need to know that mental illnesses are often caused by chemical imbalances, which can be alleviated by medication and/or treatment.”

Mental illness emergencies rarely arise suddenly, or in a vacuum. Most people who experience them have some history of mental health problems.

Common kinds of mental illness include anxiety, depression, substance abuse, bipolar disorder, eating disorders, and schizophrenia.

Helping each other “We want to reduce the stigma around mental health and help more people be in a position where they feel comfortable supporting people in a crisis and connecting them to the help they need,” Muir says.

People who have a friend or loved one struggling with mental health issues can and should prepare before a crisis by getting to know the mental health services available in their area, such as mobile crisis teams and walk-in crisis centers.

They also should learn some basic tools, which they can get at area classes or from mental health providers, such as: 

I f someone seems suicidal, ask if the person is thinking of hurting himself.

Offer to take the person to a mental health professional, call a suicide hotline, or call 911 — don’t leave him alone.



I f someone around you is threatening violence, call 911, or take the person to the nearest emergency room if you feel safe to do so.

nts, hospitals, local public health departme In 2015, Centura Health South Denver tal men tified iden and other leaders churches, police agencies, government, al community needs, prompting the critic as n entio prev de health care and suici Aid classes. Class participants First lth development of a series of Mental Hea offer reassurance, give information and learn how to listen nonjudgmentally, essional help, and help them find it. encouragement to those needing prof held: Mental Health First Aid classes will be 20, 8:30 a.m.-5:30 p.m., Feb , Mon l: pita Hos st  Parker Adventi Inspiration B Conference Room Feb 28, 8 a.m.-5 p.m.,  Littleton Adventist Hospital: Tue, Conference Rooms 3 & 4 Mar 3, 8:45 a.m.-5:45 p.m.,  Castle Rock Adventist Hospital: Fri, Greenland Conference Room 2 14 8 a.m.-5 p.m.,  Porter Adventist Hospital: Tue, Mar Grand Mesa Conference Room go to southdenverhealth.org/register.

Classes are FREE to attend. To register,

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VIBRANT :: Porter Adventist Hospital

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What does our community need?

NEW HOPE

for hepatitis C patients Hepatologists offer help for damaged livers The liver is the body’s ultimate comeback kid. In fact, Gerond Lake-Bakaar, MD, PhD, who joined Porter Adventist Hospital last fall as medical director of liver transplantation, likens the liver to a plane capable of remaining airborne on a single engine — even after multiple engines have failed. “And unlike mechanical engines, the undamaged portion of the liver can regenerate and grow back,” he says.

We appear to have broken the back of the hepatitis C epidemic.”

Most people equate liver damage with heavy drinking and, while alcohol abuse does take a heavy toll, it is not the No. 1 reason that livers become diseased and fail.

Since the 1980s, hepatitis C has actually been the top reason for cirrhosis, the late-stage scarring that develops in response to liver damage. Lake-Bakaar says there is very good news on this front. In the last two years, drugs that inhibit hepatitis C cells have been developed. “We appear to have broken the back of the hepatitis C epidemic,” he says, adding that the newer drugs are curing almost 90 percent of cases.

This is big news for hepatitis C patients who have not sought treatment. “Many didn’t bother because treatment made patients very sick and was not very effective,” Lake-Bakaar says, urging anyone with hepatitis C to see a hepatologist to learn more about promising new treatment options.

To make an appointment with Dr. Lake-Bakaar, call the Transplant Center at Porter Adventist Hospital 720-809-8199.

PHOTOS: DOCTOR ©MICHAEL RICHMOND; BALL ©BRUCEPARROTT — STOCK.ADOBE.COM

Dr. Gerond Lake-Bakaar Liver transplant hepatologist Gerond Lake-Bakaar, MD, PhD, is on the verge of liver research that could be game-changing.

Working with the makers of a special pump that emulates blood flow to and from the liver, he plans to study viable, diseased livers that have been removed from patients during transplantation. “This has never been done before with cirrhotic livers in humans,” he says.

The research could yield new understanding of how to control viruses and processes that damage the liver.

This latest research is a continuation of the career path that was born in medical school when he attended a lecture by Dame Sheila Sherlock, whose pioneering work helped establish hepatology as a medical specialty. Lake-Bakaar trained with Sherlock and later with Rosalyn Yalow (Nobel Laureate 1977).

He joins Porter Adventist Hospital from Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, where he was director of the Liver Tumor Center. He is triple board-certified in internal medicine, gastroenterology, and transplant hepatology, and will treat liver and GI patients from throughout the Rocky Mountain region.

Dr. Lake-Bakaar was a star rugby left wing for King’s College Hospital, London. “I say I was a rugby superstar. My wife says I’m a legend in my own mind,” he says.

porterhospital.org :: Winter 2017

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PRIMARY CARE PRACTICES

Portercare Adventist Health System

CHPG Cornerstar Primary Care

Non-Profit Organization U.S. Postage

CHPG Southlands Primary Care

Denver, CO Permit No. 4773

AURORA

15901 East Briarwood Circle, Suite 200 Aurora, CO 80016 303-269-2626 • cornerstarprimarycare.org 6069 South Southlands Parkway Aurora, CO 80016 303-928-7555 • southlandsprimarycare.org

PAID

2525 South Downing Street Denver, CO 80210

CASTLE ROCK

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

Ridgeline Family Medicine — Castle Pines

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

CENTENNIAL

CHPG Grace Family Practice

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

CHPG Holly Creek

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

DENVER

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

FREE CLASSES & EVENTS Around the Community

CHPG Clermont Park

RSVP required. Locations and times vary. Visit porterhospital.org/events or call 303-765-3825 for more information.

CHPG Primary Care Highlands

SUPPORT YOUR HEART

2479 South Clermont Street, Denver, CO 80222 303-649-3155 • clermontparkseniorcare.org 2490 West 26th Avenue, Suite A120 Denver, CO 80211 303-925-4580 • chpghighlands.org

CHPG Primary Care Porter

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

CHPG Primary Care Cherry Creek

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

GREENWOOD VILLAGE

CHPG at DTC

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

HIGHLANDS RANCH

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

LITTLETON

Chatfield Family Medicine

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

Clement Park Family Medicine

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

Understand what heart disease is and learn to combat it.  Date: Tue, Feb 7  Time: 3-4 p.m.  L ocation: Clermont Park, 2479 South Clermont Street

BACK PAIN?

Dr. Michael Gallizzi covers what you need to know about spine health and back pain.  Date: Wed, Feb 15  Time: 2-3 p.m.  L ocation: Holly Creek, 5500 West Peakview Avenue

MEDICARE 101

GROCERY STORE WALK AND TALK

Join one of the registered dietitians from Porter Adventist Hospital and learn the best way to shop heart healthy.  Date: Thu, Feb 16  Time: 1-2 p.m.  L ocation: Sprouts Farmers Market, 2880 South Colorado Boulevard

Porter Adventist Hospital has an ongoing partnership with the University of Denver. As part of that partnership, we support several “Pink Night” events to encourage screening mammograms, raise awareness for breast cancer, and support survivors. Please join us for a fun family night. Wear pink and show your support! Both events are held at Magness Arena (inside the Ritchie Center), 2240 East Buchtel Boulevard.

DU Women’s Basketball ‘PINK NIGHT’

DU Women’s Gymnastics ‘PINK NIGHT’

 Date: Sat, Jan 21  Time: 1 p.m.

 Date: Sun, Feb 26  Time: 2 p.m.

South Suburban Internal Medicine

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

Unravel the Medicare mystery. Learn what you need to know before you turn 65.  Date: Thu, Mar 2  Time: 6-7 p.m.  Location: Porter Adventist Hospital Conference Center

INS AND OUTS OF JOINT INJECTIONS — RESCHEDULED

Dr. Steve Kitchen will answer your questions on overall joint health and when injections are a reasonable option.  Date: Wed, Mar 15  Time: 1:30-2:30 p.m.  L ocation: Holly Creek, 5500 East Peakview 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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PARKER

CHPG Primary Care Meridian

9949 South Oswego Street, Suite 200 Parker, CO 80134 303-649-3100 • parkerprimarycare.org

Timberview Clinic at Parker

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

porterhospital.org

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.