Bloom Winter 2014 by Clementine Words

Exercise Your Brain

Easier Lung Cancer Surgery

Beat Brittle Bones

Cherish Your Heart Learn what you can do to stop the No. 1 killer of women

Think

your way toPage thin 2 Winter 2014 Volume 4, Issue 1

Think your way to thin If you’ve made a New Year’s resolution to lose weight, you’re not alone. That is the No. 1 resolution in America. Just making a resolution has gotten you off to a good start. People who make resolutions are 10 times more likely to attain their goals than people who don’t make resolutions, according to the Journal of Clinical Psychology. But if you’ve found it hard to stick to your plan in the past, it may be because you’re an all-or-nothing thinker — a common trait of women, particularly smart women! These women often throw in the towel if they eat one thing not on their plan, says Michelle Somers, certified wellness coach for Penrose-St. Francis Health Services. “You think, ‘I’ll start clean tomorrow.’ That’s black-and-white thinking,” she says. A typical example? It’s a co-worker’s birthday, so you eat a piece of cake. You immediately tell yourself the day is shot, so you reach for another piece of cake, a hamburger with fries for dinner, and maybe a bowl of ice cream before bed — why not, you’re starting over in the morning, right? “What you need to understand is that the 500-calorie piece of cake doesn’t make you or break you, but the 2,000 calories that you eat after you give up will make a difference,” Somers says. Her advice? Get right back on your plan and eat normally for the rest of the day. By the end of the week, you’ll probably still hit your goal. Talk about having your cake and eating it, too!

Want to learn more tips for weight-loss success? Penrose-St. Francis Health Services is offering a new seven-week program called Think Like a Thin Person. In a weekly 30-minute class, you’ll learn how to change the way you think to help you shed pounds. The $25 class includes a book and pre- and post-program measurements. Call 719-776-7983 for more information and registration.

bloom is published four times annually by Penrose-St. Francis Health Services. As part of Centura Health, our mission is to nurture the health of the people in our community. The information herein is meant to complement and not replace advice provided by a licensed health care professional. For comments or to unsubscribe to this publication, please email us at bloom@centura.org. bloom is produced by Clementine Words LLC. Executive editor is Jill Woodford.

Get your head in the game Most of us exercise for our physical health, but getting your heart pounding is also good for your head. As you exercise and put stress on your heart, your brain responds by releasing a protein called brain-derived neurotrophic factor. BDNF helps generate new brain cells and repair memory neurons. The brain also releases norepinephrine and endorphins, which work together to calm the brain and produce feelings of happiness. These effects are even stronger if you’re participating in an activity that brings you joy or you’re exercising with others, says Margaret Sabin, CEO of Penrose-St. Francis Health Services and a certified fitness instructor who teaches fitness classes at the hospital. “There’s something about the collective consciousness of working out with a group that is inspiring. You share energy, joy, laughing, and fun,” she says.

POWER UP with Margaret Sabin, Penrose-St. Francis Health Services’ CEO and certified fitness instructor, on Saturday mornings in her fitness boot camp. Get full details on this and many other fitness classes at penrosestfrancis.org/ wellness or call 719-776-7983.

2222 North Nevada Avenue, Colorado Springs, CO 80907

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Penrose-St. Francis Health Services

Cover photo: ©IStockphoto.com/Bastian Weltjen; This Page: ©IStockphoto.com/flyfloor; Opposite Page: Portrait ©Steve Bigley, ©IStockphoto.com/Kali Nine LLC

healthystart

Q&A

With Chitra C. Peddada, MD

Medical Director, Penrose-St. Francis Cardiovascular and Pulmonary Rehabilitation Program

Q: How can

people with COPD stay out of the hospital?

A: About 24 million people in

the U.S., including 4.6 percent of people in Colorado, have chronic obstructive pulmonary disease (COPD), a group of lung diseases usually caused by smoking. Some have two or more hospitalizations each year, and many have frequent ER visits, when their disease flares up (called a COPD exacerbation). Preventing COPD exacerbations is important. Recognizing the early warning signs of an exacerbation and then calling your doctor is the best way to do this. The early warning signs are changes in the mucus, such as amount, color, or

Health

care at your

fingertips Have a headache and don’t know what’s causing it? Wondering if you should take your child to the ER? Not sure if it’s indigestion or something more than that? A smartphone app can help answer those questions and more. The FREE iTriage app gives you access to medical information for more than 300 symptoms, 1,000 diseases, and 350 medical procedures. And now, you can use the iTriage app to alert the ER at Penrose Hospital, St. Francis Medical Center, or Penrose’s three urgent care centers that you’re on your way so they can be prepared for any special needs. iTriage also tells you ER wait times up to the minute. Go to penrosestfrancis.org/itriage to learn more, see a video, and download the FREE app. penrosestfrancis.org

texture (thicker or more foamy), and feeling fatigued or being more short of breath than usual.

Breathe Easier Exercise can help COPD patients stay healthier and feel better. The Penrose-St. Francis Pulmonary Rehabilitation Program can help you get started with a plan customized to your needs and supervised exercise sessions. For more information, call 719-776-4880.

Dr. Peddada helps people learn how to live with COPD, with a focus on prevention and early treatment of exacerbations.

For the man in your life:

Motivate him to build muscle As we get older, it’s not just women who lose muscle. Men also need to focus on keeping and building muscle to help stave off weight gain, support an active lifestyle, and prevent injuries, says Gil Porat, MD, chief medical officer at Penrose-St. Francis Health Services and a certified personal trainer. Porat gives these tips for getting the most out of your muscle-building workouts: • Build up. When lifting weights, start slow and gradually add intensity. This allows time for connective tissues and the nervous system to adapt to new stresses. • Time limit. Move between sets quickly to burn more calories, fatigue muscles sooner, and leave more time for family and work. • Mix it up. Aim to use three different exercises for each muscle. Recruit as many muscle fibers by utilizing different angles to maximize your skeletal muscle (hypertrophy). • Pack the protein. Add one to two protein drinks per day to boost gains. Protein consumption is anabolic and supports muscle growth. “The more muscle mass you have, the more calories you burn even when not exercising,” Porat says. “Muscle is earned slowly, and progress takes patience.” More Info For regular health advice from Dr. Porat, download his FREE Hospital Medicine podcasts on iTunes: https://itunes.apple.com/us/podcast/hospital-medicine-podcast/id541752791

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e h T

dh Co l

e a rt e d T ru th

More women die of heart disease every year than men, but we still think it’s not our problem

For the last 30 years, more women have died of heart disease every year than men. Yet, women are less likely to seek care when having a heart attack. It simply doesn’t occur to them to do so. Here, we look at the facts about women and heart disease, why women don’t seek help, and how to know if you or a loved one is having a heart attack.

Startling Statistics • Heart disease is the No. 1 killer of women, yet women overwhelmingly think it is breast cancer • One in three women dies of heart disease, while one in 31 dies from breast cancer • Approximately one woman dies every minute from heart disease in the U.S. Source: American Heart Association

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Dangerous Delay Women — along with seniors, smokers, and diabetics — are the most likely to delay seeking help when experiencing the signs of a heart attack, according to a 2010 Mayo Clinic study. One of the most common reasons is because women perceive heart disease as a male problem. “When a middle-aged woman experiences symptoms, heart attack is not the first thing that crosses her mind,” says Peter Kriekard, MD, a cardiologist at Colorado Springs Cardiology, a Centura Health Clinic. “This is an important topic that we have not publicized very well for women.”

Since women tend to experience heart attacks after the age of 50 — and about 10 years after men — a common thought is that estrogen is a protective factor. However, synthetic hormones do not offer the same protection, leading researchers to believe that there are other reasons, such as the way women process insulin, that might help women ward off heart disease early in life. Nonetheless, Kriekard says, women of all ages can experience heart disease and heart attacks — particularly women who have diabetes or prediabetes. Penrose-St. Francis Health Services

Penrose-St. Francis Health Services has been named one of America’s Top 100 hospitals for cardiac care by Healthgrades, an independent hospital rating organization.

Mixed Messages Many women ignore symptoms of a heart attack, thinking it’s something else or that it will pass. Sometimes that’s the case. The problem, however, is that there’s no way to know up front. “There is a lot of overlap. Sometimes it’s very difficult, if not impossible, for patients to figure out,” Sharon says. Some common health problems that have similar symptoms to a heart attack include: • Gallbladder attack • Anxiety attack • Indigestion • Pneumonia • Chest wall pain • Blood clot in the lung “Even as physicians, we can’t tell you what’s wrong from listening to your story,” Kriekard says. “The majority of the time when we get calls, we tell patients to go to the ER. The risk of waiting is too great. People who wait may be risking permanent heart damage. Heart damage can lead to developing congestive heart failure later, which is a very life-limiting disease.” penrosestfrancis.org

Nine out of 10 women have at least one risk factor for developing heart disease: • High cholesterol or blood pressure • Obesity/waist size larger than 35 inches • Personal or family history of cardiac event before age 55 • Diabetes or prediabetes • Smoking • Unhealthy diet • Lack of physical activity • Stress Get Help Fast It’s not just a woman thing — everyone is reluctant to call 911. But calling 911 is your best bet for survival if you are experiencing the signs of a heart attack. That’s because paramedics can begin lifesaving treatments immediately and call the hospital so that the cardiac team is at the door when you arrive. “Calling 911 jump-starts the emergency process,” Sharon says. “Paramedics can do an EKG and call us with the results so that we can activate the cardiac cath lab team. Our data shows that 80 percent of the time 911 is activated, it is less than 90 minutes from the paramedic contact time until the clogged artery is opened. The thing to remember is that time is muscle. The longer your heart muscle is deprived of blood, the more heart muscle dies.”

Pamper Your Heart Learn more about your risk for heart disease and what you can do to lower that risk at a FREE seminar on Saturday, Feb. 8. You’ll also be treated to a heart-healthy breakfast, get your body mass measured, and learn some fun exercises to pump up your heart! See Page 7 for details.

Size of cholesterol particles impacts heart disease risk Even people with normal levels of lowdensity lipoprotein, also known as LDL or the bad kind of cholesterol, can be at risk of heart disease if their LDL particles are small, says Thomas Bartlett, MD, a cholesterol specialist at Penrose-St. Francis Primary Care in Colorado Springs. When LDL attaches to the internal layer of the artery, it can cause the arteries to narrow or clog, leading to heart disease. Small LDL particles appear to do more damage because they stay longer in the bloodstream, Bartlett says. Although there are now tests to measure particle size, not everyone needs these. “The people who benefit the most are people with prediabetes, diabetes, insulin resistance, or metabolic syndrome,” Bartlett says. The good news is that small LDL particles are treated best by changes in diet, Bartlett says. “I can throw drug after drug at this, and it won’t make a difference unless the patient complies with diet,” says Bartlett, who recommends the South Beach Diet® approach of low carbohydrates and low fat in prediabetic or diabetic patients.

To learn if you are a good candidate for a cholesterol particle test, talk to your primary care physician. If you do not have a primary care physician, you can schedule an appointment with Dr. Bartlett at 719-571-8100.

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photos: Opposite Page: ©IStockphoto.com/Double_Vision; This Page: ©IStockphoto.com/lunanaranja

Unusual Symptoms Few people — men or women — experience the stereotypical chestclenching, sweating heart attack. “There are a hundred different ways a heart attack can present, and probably twice that many in women,” says Jack Sharon, MD, medical director of emergency services at Penrose-St. Francis Health Services. Women may get chest pain or pressure, discomfort in arms or the jaw, or shortness of breath. But in many cases, it’s not the most obvious symptom. Instead, they’re more likely than men to have these symptoms: • Unusual fatigue • Nausea or indigestion • Dizziness or light-headedness • Abdominal pain • Discomfort described as an “uncomfortable feeling” in the neck, shoulder, or upper back • Unusual sense of impending doom or anxiety

Theolyn Price, MD Thoracic Surgeon Penrose-St. Francis Health Services

A better way to remove lung tumors

improves Quality of life Lung cancer is the leading cancer killer in the United States, resulting in more deaths than colon, breast, and prostate cancers combined. About one in 16 women, mostly smokers, will develop lung cancer. When discovered early, surgery offers the best chance for cure. But traditional surgery involves a large incision that requires cutting a rib. Recovery can be quite painful and takes up to eight weeks. An easier, more precise procedure Minimally invasive, robotic-assisted surgery is as effective as traditional surgery — and much easier on patients. “Robotic-assisted lung procedures provide the same traditional surgery through the most minimally invasive approach. They are performed with less blood loss, less pain, shorter hospital stays, quicker recovery, and earlier return to work,” says Theolyn Price, MD, a general thoracic surgeon at Penrose-St. Francis Health

Services who specializes in lung cancer and other chest diseases. Price is one of only four surgeons in Colorado who perform robotic-assisted lung surgery. Using the da Vinci® Surgical System, Price can remove a section (lobe) of lung along with the lymph nodes through four incisions of less than half an inch each, enlarging one of these to 1-1.5 inches to remove the lobe. The robot’s magnified, high-definition, 3-D view of the lung and specialized instruments that simulate the human wrist help Price operate more precisely. The patient is usually in the hospital for two days, compared to up to five days for traditional surgery. Full recovery ranges from two to six weeks, but “most patients are fairly well recovered within a month. Some will even be back to desk jobs within two weeks,” Price says. Robotic-assisted lung surgery is often performed for early stage lung cancer, but can also be used for more advanced cancers.

Lung screening helps high-risk people live longer The Penrose-St. Francis Lung Cancer Screening Program helps find lung cancer in high-risk people early, when it’s more successfully treated. The program offers annual low-dose CT scans to current smokers or smokers who quit within the last 15 years.

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You should consider being screened for lung cancer if you fit these criteria: Current smoker or quit less than 15 years ago

55 to 74 years of age

To schedule a $199 lung cancer screening or to learn more about your risk, call 719-776-LUNG (5864).

By the age of 8, Theolyn Price knew she wanted to be a doctor. The Alabama native earned her medical degree from the University of Alabama at Birmingham School of Medicine. She then moved on to the Mayo Clinic, where she completed residencies in general surgery and thoracic and cardiovascular surgery, as well as a fellowship in general thoracic surgery and specialized training in robotic-assisted surgery. Price also performed surgery at University Hospital Zurich in Switzerland through a fellowship travel award, as well as robotic-assisted procedures at MD Anderson Cancer Center Orlando, where she worked before joining Penrose-St. Francis Health Services. Price also volunteers with Children’s HeartLink to help build programs in developing countries to treat children born with heart defects.

Smoked a pack of cigarettes a day for 30 years or more You also may qualify if you have a personal history of lung disease, a family history of lung cancer, or you have been exposed to certain chemicals.

Penrose-St. Francis Health Services

Pamper Your Heart — Are You at Risk for Heart Disease?

Photos opposite page: ©IStockphoto.com/AleksandarNakic, Portrait ©Steve Bigley; this page: ©IStockphoto.com/andresrimaging, ©IStockphoto.com/MollyAnne

Join Dr. Thomas Bartlett, registered dietitian Sharon Jacob, and a Strive fitness instructor to learn basic heart disease risk factors, prevention tips, and what tests you really need from your doctor. This event is open to both men and women. Wear comfortable clothing for a short, low-impact exercise session. Includes heart-healthy breakfast treats, blood pressure checks, body mass index screening, and more!

Bloom winter Calendar

Penrose-St. Francis Health Services offers dozens of health classes each quarter. Here is just a sampling of our classes. For a complete list, go to penrosestfrancis.org/wellness. Think Like a Thin Person Date | Tues, Jan 21-Feb 25 Time | 5-5:30 p.m. Location | Penrose Hospital, 2222 North Nevada Avenue, PCC Conference Room A - OR Date | Weds, Apr 16-May 21 Time | 5-5:30 p.m. Location | St. Francis Medical Center, 6001 East Woodmen Road, Conference Room 1 Cost | $25/person Registration | 719-776-7983

Have you been stuck in a weight-loss/regain cycle? It’s not your fault! You haven’t been given the right tools — until now. This interactive seven-week program based on the successful book The Beck Diet Solution* will change the way you think about food and end the crazy cycle for good. You will be given the tools and confidence to: • Avoid unplanned eating • Stop overeating • Resist tempting foods • Overcome cravings • Refrain from emotional eating * Each participant will receive a FREE copy of The Beck Diet Solution. penrosestfrancis.org

What If? What Else? What Now? Date | Sat, Jan 25 Time | 8 a.m.-5 p.m. Location | Penrose Pavilion, 2312 North Nevada Avenue, 2nd Floor Conference Room Cost | $125/person Registration | penrose stfrancis.org/whatif1 Are you exploring a career change; have you recently become an empty nester; or are you just in need of clarity around the next chapter of your life? Experience a one-day interactive, life planning session facilitated by bestselling author Sara Boatz. You’ll identify your dreams, articulate your goals, and leave with a clear purpose, direction, and a written plan to live the life of your dreams. Seminar includes continental breakfast, boxed lunch, work binder, and book. Registration is required by Jan. 22. Payment due at time of registration.

WomenHeart Support Groups Dates | 2nd Wed of each month Time | 11:30 a.m.- 1 p.m. Dates | 3rd Wed of month (men and women) Time | 6:30-8 p.m. Location | Penrose Hospital, 2222 North Nevada Avenue Cost | FREE Info | 719-200-2645 Join a group of women beating heart disease. Share encouragement while learning the latest in heart science, and strategies for coping. The support group that meets on the third Wednesday of each month is open to both men and women; call for information on topics and speakers for upcoming meetings.

$199 Heart Scan A coronary artery calcium screening is a noninvasive CT scan that measures the level of calcification in your arteries to help you learn if you are at risk of heart disease. This test does not require a physician referral, but you should talk to your doctor about whether it is right for you. For more information or to schedule an appointment, call 719-776-8768. Paint It Forward Date | Thu, Feb 6 Time | 6-8 p.m. Location | Color Me Mine, Chapel Hills Mall, Lower Level Cost | $12/per mug Registration | penrose stfrancis.org/mug Join us for a fun evening of mug painting for a cause. Your painted mug will be donated to patients undergoing treatment at Penrose Cancer Center as a token of support and encouragement. All supplies are included, along with helpful instruction to design a beautiful handpainted mug. Space is limited to 60 people.

Becoming a Woman Class for Teens Date | Sat, Mar 1 Time | 1-3 p.m. Location | St. Francis Medical Center, 6001 East Woodmen Road Cost | $20 per mother/ daughter pair (additional daughters $5 each) Registration | 719-571-3101 Not sure how to sit down with your daughter and have “the talk?” Mothers and daughters are invited to attend this class together in an atmosphere of love and learning to discuss the important topic of growing up and becoming a woman. This class covers information girls need to understand their growing bodies and establish a foundation for continued communication between mothers and daughters. Topics include: • Your changing body • The female and male reproductive systems • The onset of ovulation and menstrual cycles • The wonder of human life and the case for abstinence A Q&A time is included. Winter 2014

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Catholic Health Initiatives Colorado

Best for bones

Non-Profit Org. U.S. Postage

PAID

Colorado Springs, CO Permit No. 14

2222 North Nevada Avenue Colorado Springs, CO 80907

Penrose-St. Francis Health Services has received the 2014 Orthopedic Surgery Excellence Award™ from Healthgrades, an independent hospital rating organization, for the second year in a row (2013, 2014).

Penrose-St. Francis Health Services is part of Centura Health, the region’s leading health care network. Centura Health complies with the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973, and no person shall be excluded from participation in, be denied benefits of, or otherwise be subjected to discrimination in the provision of any care or service on the grounds of race, religion, color, sex, national origin, sexual preference, ancestry, age, familial status, disability or handicap. Copyright © Centura Health, 2014.

Keeping Bones Strong With Sharon Ortiz, Adult Nurse Practitioner at Penrose-St. Francis Primary Care

About 9 million Americans, mostly women, have osteoporosis. Another 48 million have low bone density, which can lead to osteoporosis. Caused mainly by aging, osteoporosis makes the bones so weak that a minor fall, or sometimes even coughing or bending, results in a broken bone, usually in the hip, wrist, or spine. That broken bone is usually the first sign of osteoporosis. But the disease can be diagnosed before that and treated, or prevented, through an imaging test called dual-energy X-ray absorptiometry (DEXA). What do bones need? Preventing osteoporosis or strengthening weak bones is fairly simple. “You can make a difference,” says Sharon Ortiz, ANP, an adult nurse practitioner at Penrose-St. Francis Primary Care. “Getting adequate vitamin D and calcium and exercise are your best bets to prevent osteoporosis and maintain bone health.” Vitamin D helps the body absorb calcium, along with protecting bones. While exposure to sunlight and a few foods, like milk and the skin of fatty fish (wild-caught mackerel, salmon, and tuna), provide vitamin D, most people need a supplement to get enough (1,000-2,000 IU daily). It’s easy to get enough calcium (1,000-1,200 mg daily) through foods like low-fat and nonfat milk, yogurt, and cheese, and certain green vegetables. Supplements are also available. Building strong bones also takes weight-bearing exercises like walking and muscle-strengthening exercises that use weights.

women over age 50 will break a bone because of osteoporosis

People most likely to get osteoporosis include: Women over age 65 and men over age 70 • People age 50 and older: - After menopause - With a personal or family history of fractures - Who take corticosteroids or had cancer related hormone treatments - Who smoke or drink heavily (more than three drinks daily) •

Know Your Risk A DEXA scan is an X-ray that measures the density of your bones. This painless test usually takes 10-20 minutes and X-rays the hip and/or spine. It is generally covered by most insurance plans and Medicare, but most women will need a referral. To schedule a DEXA scan at The Center for Women’s Imaging, call 719-776-8010. Or if you do not have a primary care provider, make an appointment* with Sharon Ortiz to learn more about osteoporosis, call 719-776-4646. *Office visit fee will apply.