Cheers Spring 2014 by Clementine Words

s r e e h C

CE LE B R AT ING YO U R H EA LTH

Spring 2014 | Vol. 4, No. 2

Change of Plans No one plans on breast cancer, but earlier diagnosis is saving more lives.

Diagnosed with breast cancer at 35, Jaime Sandoval has bright plans for the future with her daughter, Lola.

Living better with heart failure.

Managing menopause symptoms.

Centura Health Pueblo West welcomes walk-ins.

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PHOTO BY STEVE BIGLEY

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STEPS

Dear Friends and Neighbors,

ave you ever noticed that getting sick is a bit like getting a flat tire? It happens at the worst possible time! For many years, people who have gotten sick in our community after normal business hours have had few options to the local emergency room. But in many cases, that level of care—and associated expense—is unneeded. With a commitment to inspire healthier communities, St. Mary-Corwin and its affiliated physicians decided to fix this problem, so we are working on expanding access to health services in our community. Touchstone Health Pueblo West recently moved into our beautiful new Centura Health Pueblo West facility that offers walk-in or same-day doctor appointments for urgent needs as well as on-site X-rays and lab tests. Touchstone Health Pueblo West is open from 7 a.m.-7 p.m. on weekdays, and weekend hours are planned for fall 2014. You can read more about this medical practice on Page 4. Centura Health Pueblo West is part of Centura’s Colorado Health Neighborhoods. This model incorporates the key components of optimal health, and encourages coordination among providers, building a consumer-centric health care delivery model that reduces costs and makes care more understandable and accessible. Health Neighborhoods deliver better care by focusing on wellness, prevention, and keeping people healthy, utilizing evidence-based medicine and best practices. We will do this while increasing convenience through multiple access points, within a service-friendly environment at an affordable cost. While we can’t fix that flat tire, we hope that our extended hours will make your life a bit easier and much healthier!

Brian Moore President and CEO St. Mary-Corwin Medical Center

Cheers | St. Mary-Corwin Medical Center

INTO ACTION 5 simple health habits help prevent cancer

ith the days growing longer and warmer, it’s a perfect time to kick your health habits into high gear. This spring, why not focus on some simple habits that can improve your ability to fight off cancer. Add one of these each month to your life (without giving up the ones you start) and by fall, you’ll be living a lifestyle that not only reduces your risk of cancer but also heart disease, diabetes, and even the common cold.

Bring on the berries. On your cereal, in a smoothie, or as a snack, berries deliver a high dose of cancer-crushing antioxidants that help heal cell damage. They are also very high in compounds such as ellagic acid, quercetin, vitamin C, and anthocyanins — all good things for your body. Play in real life. Don’t let screen time be your only source of recreation. Throw a Frisbee, walk your dog, or join a softball league. Exercise can lower estrogen and insulin levels, both of which raise cancer risk. Your goal should be 30 minutes of moderate exercising, like walking, each day.

Keep your doctor on speed dial. Get regular checkups and screenings, and speak up if you notice any suspicious symptoms. If you are 50 or older, you should be getting regular screenings for breast, colon, skin, and head and neck cancers. Current or former smokers should talk with their physicians about lung cancer screenings, and men over 50 should discuss prostate screening. Skip a smoke. Put down the pack of cigarettes, and chew on gum or an apple. Tobacco smoke contains more than 60 known carcinogens, including the cancer-causing toxin arsenic, according to the American Cancer Society. Ask your doctor to help you quit for good.

Get a little sun. Some evidence suggests that vitamin D, which your body produces when exposed to sunlight, can help prevent or decrease cancer cell growth. Just be sure not to overdo it or you will increase your risk of skin cancer. Fifteen minutes daily is about right.

 FIND support for your fitness goals with a FREE

online program offered by Centura Health. CaféWell is a FREE website that allows you to set goals, track your progress, and win prizes for improving your health. As a member, you can join thousands of others from across the country on health challenges. Sign up at centura.org/cafewell. 

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

1008 Minnequa Avenue Pueblo, CO 81004 719-557-4000

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H E A LT H Y

St. Mary-Corwin Medical Center brings specialized care in the complex areas of cancer care, robotic surgery, joint replacement surgery, sports medicine, pediatrics, women’s services, cardiology, and more. We are part of Centura Health, the state’s largest health care network. 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 as a substitution for your physician’s advice. If you would like to comment on this magazine, please email cheers@centura.org. Cheers is produced by Clementine Words LLC of Denver, Colo. Executive editor is Rochelle Kelly Wristen.

W O M E N ’ S H E A LT H

Best Laid Plans

No one plans to get breast cancer — especially not at 35

aime Sandoval wasn’t planning on having a mammogram. She wasn’t planning on missing out on her daughter’s kindergarten year. She wasn’t planning on fighting breast cancer at 35. “I just happened to notice the lump one day,” she recalls. Sandoval’s doctor felt the lump, too, and sent her for a mammogram. And after a biopsy in June 2012, Sandoval was diagnosed with Stage II breast cancer.

Jaime’s Journey

Jaime Sandoval, with daughter Lola, started a support group at St. Mary-Corwin for younger women with breast cancer.

PHOTO BY STEVE BIGLEY

Sandoval didn’t know any women her age facing breast cancer. And that’s not surprising. Fewer than 5 percent of cases are in women younger than 40, according to the American Cancer Society (ACS). Sandoval didn’t have a family history of breast cancer to warrant earlier screenings or genetic testing. But she tested positive for the breast cancer gene, BRCA2, after her diagnosis.

Because of the BRCA marker, she decided to have both breasts removed (a double mastectomy) at St. Mary-Corwin Medical Center. Then Sandoval went through four chemotherapy treatments before having breast reconstruction. With the BRCA gene comes an increased risk of ovarian cancer, so Sandoval also chose to have a preventive hysterectomy. But Sandoval, now 37, looks on the bright side. “I was really lucky all around,” she says. “If I was going to get a cancer, that’s the one to get. It’s so treatable, especially if you catch it early.”

Mammograms Matter

The key to catching breast cancer early is regular screening. “Mammograms catch breast cancer earlier when it’s smaller,” says Conor Heaney, MD, a radiologist at St. Mary-Corwin. So, in addition to having a better chance at saving your life, catching the cancer sooner can mean easier treatment, he explains. A study published in the American Journal of Roentgenology found that women ages 40-49 who have regular screening mammograms are diagnosed at earlier stages than women who don’t. Their tumors were also smaller, and they were less likely to require chemotherapy. Women of average risk should

begin screening mammograms at age 40, following the ACS guidelines. Younger women should talk to their doctors about their family history to determine if earlier screenings are necessary. Sandoval adds that it’s important to be aware of your body. “Know what’s normal for you,” she says. “Don’t be afraid to examine yourself.” Sandoval didn’t plan on breast cancer. But she won. And now, she has plans for the future: “I’ll be around for a long time now.”

St. Mary-Corwin’s Breast Center of Excellence is detecting more cancers earlier — when they are more treatable — with its state-of-the-art digital mammography technology.

St. Mary-Corwin Breast Center is ‘women’s choice’ The Breast Center of Excellence at St. Mary-Corwin Medical Center has received a Women’s Choice Award as one of America’s Best Breast Centers. “Our patients have a choice when it comes to their health care,” says Brian Moore, president and chief executive officer of St. Mary-Corwin. “And we are proud that this award represents the superior care and outstanding patient experience they can expect from our hospital.” St. Mary-Corwin’s Breast Center of Excellence earned the award by meeting the National Accreditation Program for Breast Centers’ standards from the American College of Surgeons. The center also carries the seal of the American College of Radiologists as a Breast Imaging Center of Excellence, and scored above average on the Centers for Medicare & Medicaid Services’ patient satisfaction measures.

 SUPPORT FOR YOUNGER WOMEN

Stage 0

Stage I

2011 (before digital) 2012 (with digital)

Stage II

Pink Ladies Embracing Today is a support group designed specially for premenopausal women who are fighting or surviving breast cancer. The group meets the first Tuesday of each month at 6 p.m. in the Dorcy Cancer Center. For more information, call Barbara Young at 719-557-4301.  stmarycorwin.org | Cheers

YOUR

H E A LT H FEVER

CONCUSSION

ACHES & PAINS

FEELING DOWN

Signs YOU SHOULDN’T IGNORE Some things may not be emergencies, but that doesn’t mean they don’t need medical care

our neighbor runs to urgent care every time his kid runs a slight fever. And you know a few folks who thought a sprained ankle required a trip to the emergency department. Not you, though. You’re cool as a cucumber. You have home remedies galore and the patience of Job. You can wait to see a doctor. Or can you? “It’s true that the body is a miraculous machine and has an amazing ability to take care of itself over time,” says Tanya Hrabal, MD, a family practice physician at Centura Health Pueblo West, a completely new clinic that is part of the statewide Centura Health Physician Group. But, she adds, be careful, because some health concerns shouldn’t wait forever. That’s because some injuries and illnesses can get worse if they aren’t treated soon enough, and you can risk serious or long-term damage.

ER, urgent care, or walk-in clinic?

So, how do you know if your health concern warrants a trip to the emergency department or urgent care — or if your primary care doctor or a walk-in clinic like the new Centura Health Pueblo West will do? “The emergency department is for a life- or limb-threatening condition,” says Hrabal, who has more than 20 years of experience in family, sports, and emergency medicine. “That means things like major car accidents, strokes, heart attacks, gunshot wounds. Medical care must be provided then and there.” Debra McCormack, MD, also a family practice physician at Pueblo West, adds that the value of a walk-in clinic is that you can be seen for health concerns that aren’t life-threatening emergencies even if you don’t have a primary care doctor — health issues like a sprained arm or urinary tract infection, for example. For every stage of life, here are a few symptoms to watch for that warrant a trip to the doctor.

Babies

Just like the rest of us, babies get sick. (Some babies get sick a lot.) Most colds require rest, time, and maybe an over-the-counter medication from your local drug store. But contact a doctor if you notice these or other unusual symptoms: Feeding changes. If your baby isn’t eating normally or skips several consecutive feedings, see a doctor. Fever. For babies younger than 3 months, a fever that lasts more than three days or runs higher than 100.4 should be checked out by a doctor. For older babies, stick with the three-day rule for mild fevers, and call a doctor or visit a walk-in clinic for a fever of 102 or higher.

Cheers | St. Mary-Corwin Medical Center

Persistent cold. If cold symptoms don’t improve after a week, see a doctor to rule out other problems. Severe cough. A cough that persists longer than three days or is accompanied by vomiting warrants a doctor’s visit. Dehydration. If your baby has fewer wet diapers than usual or cries without tears, see a doctor.

Children and adolescents

You can treat simple colds and flus at home and yes, sometimes your child is just trying to get out of that big math test. But some symptoms should be checked out by a doctor. Here are just a few to be aware of. Frequent or severe headaches. If your child gets headaches often or if a child’s headache lasts for many hours and doesn’t respond to over-the-counter medications, see a doctor to rule out any neurological problems. Concussion. If your child sustained a sportsrelated concussion, it might not have necessitated a trip to the emergency department at the time. But before letting your child return to play — and certainly if headaches are persisting — talk to a physician. Severe diarrhea or vomiting. Whether caused by a flu bug or food poisoning, severe stomach symptoms can lead to dehydration, which should be treated by a physician.

Adults

By this point in your life, you know what’s normal for you and what isn’t. Still, some of us put off seeing a doctor for too long. Keep an eye out for: Burning sensation in the feet. People with diabetes need to monitor their feet for ulcers and other problems. But there are also millions of Americans who have undiagnosed diabetes and for those individuals, a burning sensation in the feet can be a first sign. McCormack, who has diabetes, works with

CENTURA HEALTH PUEBLO WEST OPENS

PHOTOS BY STEVE BIGLEY

patients with diabetes at the Pueblo West clinic. “I enjoy taking care of them and helping them manage their condition,” she says. Persistent aches and pains. “If something hasn’t gotten better within six weeks, then it needs to be seen,” Hrabal says. “Don’t drag it out any longer than that.” A strained muscle that hasn’t healed, for example, might be a symptom of something bigger. Or what you thought was just a low-back strain could really be a herniated disk in the spine. Painful urination. If you experience pain when you urinate or notice a pinkish hue in your urine, a urinary tract infection might be to blame. A doctor can diagnose the issue and prescribe the right course of treatment — as well as make sure there isn’t a bigger problem.

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Seniors

Aches and pains are normal as we age, right? To an extent, yes, but it doesn’t mean you should put off seeing a doctor. Call a doctor or visit a walk-in clinic if you are experiencing: Worsening joint pain. Arthritis is common in older adults, and pain can progressively worsen. A doctor can help you find therapies to help reduce the pain so that you can enjoy a more active lifestyle. Falls or lack of balance. For older adults, falls are a leading cause of disability and even death. If you feel like you’re losing some of your coordination, talk to a doctor. Physical therapy or some home-safety measures might help. Feeling down. Depression may become more common with age, but that doesn’t mean it’s not a medical concern. If you’re experiencing regular bouts of depression, a doctor can help determine whether treatment is needed.

No matter your age, you shouldn’t feel like you’re on your own for medical care. A family care physician is a good place to start your journey toward better health.

Tanya Hrabal, MD, earned her Bachelor of Science from Texas A&M University, graduating cum laude. She received her medical degree from the Texas A&M University College of Medicine before completing her residency at the St. Paul Medical Center and a primary care sports medicine fellowship at the Hughston Orthopaedic Clinic in Columbus, Ga. She is board-certified in family medicine and is a member of the American Academy of Family Physicians and the American Board of Family Medicine. She’s also a highaltitude mountain climber and has climbed all the 14,000foot peaks in Colorado.

Debra McCormack, MD, has a Bachelor of Science from East Carolina University, and earned her Doctor of Medicine from the University of North Carolina School of Medicine in Chapel Hill, N.C. She completed her residency at the University of Florida in Fort Lauderdale and her fellowship at Nagoya School of Medicine in Nagoya, Japan. She has been in private practice since 1998 and is board certified in family practice. She also speaks conversational Spanish and Japanese.

For residents in Pueblo West, Touchstone Health Pueblo West has moved into a beautiful new and convenient location so patients receive high-quality, comprehensive primary care. At the Centura Health Pueblo West facility, Debra McCormack, MD, and Tanya Hrabal, MD, see patients of all ages, and the office offers a walk-in clinic for patients who need prompt medical care but don’t have an appointment. In addition, Centura Health Pueblo West now features on-site X-ray and lab services. As part of Centura Health, Pueblo West patients are assured the highest quality care and access to specialists from the region’s largest health care network. The office, currently accepting new patients, is located at: 729 Spaulding Drive, Pueblo West. Walk-ins welcome. Office hours are 7 a.m. to 7 p.m., Monday through Friday. Weekend hours are planned for fall 2014. Most major insurance plans, as well as Medicaid and Medicare, are accepted.

For appointments or additional information about Centura Health Pueblo West, call 719-547-9119.

stmarycorwin.org | Cheers

HEART

H E A LT H

Living heart failure with

How St. Mary-Corwin Medical Center is helping heart patients avoid repeat visits to the hospital

Heart failure and hospitalization

Heart failure is a chronic condition caused by a weakened heart. It can occur after a heart attack, as a result of a congenital heart defect, or in connection with heart disease, diabetes, high blood pressure, or another condition. As the heart weakens, it can’t work hard enough to meet the body’s demands for blood and oxygen. It’s a condition that worsens over time and can lead to hospitalization. In fact, more than 1 million people are admitted to U.S. hospitals every year for heart failure. About 24 percent of those patients are readmitted to the hospital within just 30 days, and more than half are readmitted within six months. But at St. Mary-Corwin, fewer than 6 percent of patients are readmitted to the hospital within 30 days — just one-quarter of the national average. When a patient returns to the hospital, there are often multiple reasons, says Jenny Lee, MD, a cardiologist at St. Mary-Corwin. Common reasons are excessive salt or water intake or not properly taking medications. Other explanations lie with the hospital and include inadequate patient education and waiting too long to follow up with a patient after he or she is sent home. So, in addition to treating a patient’s heart failure, treatment should include comprehensive patient and family education, dietary education, clear discharge instructions, and an emphasis on close follow-up, Lee says.

Cheers | St. Mary-Corwin Medical Center

The St. Mary-Corwin secret

To help heart failure patients, St. Mary-Corwin We are part of launched the Multidisciplinary Heart Failure the Centura Heart Team (MDHFT) last spring. The team includes representatives from pharmacy, cardiac rehab, primary Network, the care, cardiology, quality, and case management, who region’s leading visit patients daily. They make sure patients are getting what they need, and the team provides the patient provider of and family with important education. cardiovascular care. “Our goal was to decrease heart failure readmission rates by increasing the patient and family’s knowledge of the disease,” says Pam Cornella, NP, who helped start the MDHFT and leads the heart failure discharge program. In addition, Cornella calls every patient within 72 hours of going home from the hospital. She and her team also call patients at least once a week during the following month, ensuring they understand how to take their medications and that they have all the medications they need. And if a patient is struggling, she’ll call the patient’s primary doctor. When hospital staff, patients, and families work together, Lee and Cornella agree, patients can be healthier — and spend less time in the hospital.

Preventing Readmissions St. Mary-Corwin Medical Center is one of many hospitals throughout Colorado participating in Colorado’s Reducing Hospital Readmissions and Safe Transitions Collaborative. The goal of this initiative is to improve inpatient and outpatient safety and reduce avoidable readmissions for many health conditions. This project, which launched in early 2012, sought a 20 percent reduction in hospital readmission rates for the same condition and a 10 percent drop in readmission rates for any reason. The first phase of the initiative, which was based on Boston University School of Medicine’s Project RED (Re-Engineered Discharge), focused on the discharge process, while the second phase concentrated on care transitions. Through this program, St. Mary-Corwin decreased its heart failure readmissions by more than 20 percent.

t’s no secret that people don’t want to spend time in the hospital. You’d rather be home if possible. We’re here to help. St. MaryCorwin is working hard to help patients living with heart failure avoid a second (or third or fourth) visit to the hospital.

H E A LT H A N S W E R S

Navigating the Change What you need to know about hot flashes, mood swings, and osteoporosis

What can be done about those pesky hot flashes associated with premenopause? It’s one of the most common questions, Richmond says. Some women notice that spicy foods, caffeine, alcohol, or hot beverages can bring on hot flashes. If avoiding these triggers isn’t enough, talk to your doctor about the benefits and risks of medications like estrogen hormone therapy and low-dose antidepressants. You may read about some herbal treatments as well, but beware, Richmond says. “These have not been scientifically

problems and osteoporosis, she says, because estrogen has a protective benefit for women. After menopause, talk to your doctor about your osteoporosis and heart disease risk and whether screenings are appropriate for you.

Can I have a healthy sex life after menopause? proven to work, and they can interact with other medications,” she adds. “So I don’t encourage them.”

What symptoms should a woman be sure to have checked out? Call your doctor right away about any postmenopausal vaginal bleeding — that is, bleeding after not having a period for 12 months. “It could be a sign of endometrial (uterine) cancer or another condition,” Richmond says. In addition, she says, be cautious of extreme mood disturbances. “While there can be mood swings when you have hormone fluctuations such as those during menopause, depression is something that is to be taken seriously and should be evaluated,” Richmond says.

Wendy Richmond, MD, is board-certified in family medicine and a member of the American Society of Breast Surgeons. She earned her medical degree from American University of the Caribbean in St. Maarten, Netherlands Antilles. She completed her residency at St. Mary-Corwin and practices at Centura Family Care Center, 916 Indiana Avenue, Suite 120, in Pueblo, part of the statewide Centura Health Physician Group. In her free time, she enjoys cooking, gardening, and playing with her dogs.

And you don’t have to live with incontinence (not being able to control bladder function), which is common during this phase of life. There are treatments available.

What other health changes come along with menopause? Is menopause the cause? During this time, a woman’s risk for cancer and osteoporosis increases, and it’s common for cholesterol and blood pressure to go up as well. These things are multifactorial, Richmond says — meaning they aren’t necessarily caused by menopause alone. The menopause-related dip in estrogen, though, may be partially to blame for heart-related health

Yes! “Many women are embarrassed to discuss it,” Richmond says. “But vaginal dryness is fairly common in postmenopausal women and results in painful intercourse.” There are treatment options available to help you continue to have a normal, healthy sex life.

What else should postmenopausal women be aware of? “Because these women are typically in their 50s, it’s important to discuss colon cancer screenings and mammograms as well,” Richmond says. And it remains important to continue conversations with your doctor about nutrition and exercise. This is not a time to stop routine preventive care.

 MAKE AN APPOINTMENT with Wendy Richmond, MD, a primary care physician at Centura Family Care Center by calling 719-562-1122. 

stmarycorwin.org | Cheers

or women, menopause is kind of like taxes — annoying and inevitable. But unlike taxes, there’s no deadline. While the average age of menopause, which occurs 12 months after your last menstrual period, is about 51 in the U.S., the symptoms of premenopause can last for several years leading up to it. Wendy Richmond, MD, a primary care physician at St. Mary-Corwin Medical Center, weighed in on a few questions surrounding menopause.

Mother’s Month B ecause we think mothers deserve more than a day and daughters, sisters, and friends

In recognition of the vital roles women play in our families and in our community, St. Mary-Corwin Medical Center is honoring you during the month of May with these special events. Birth Place Tours: Pregnant or thinking about starting a family? Take a tour of our Birth Place during May and you’ll be entered in a drawing to win a $100 Target gift card. Call 719-557-5544 to schedule your private tour.

Screening Mammograms: Get your annual digital mammogram this month at our Breast Center of Excellence and you’ll receive 10 percent off treats from our coffee bar, 20 percent off all purchases in our gift shop, and be entered to win a FREE manicure and pedicure. Call 719-557-5054 to schedule your appointment.

DEXA Scan: If you’re 60 and older, or younger with risk factors for osteoporosis, you need a bone density screening. Schedule your screening during May by calling 719-557-4444 and you’ll be entered to win a FREE antiaging facial. A physician’s order is required, but our schedulers can obtain that for you.

Walk With A Doc: Special Women’s Edition: Join physicians from Southern Colorado Family Medicine for a special walk to discuss women’s issues. The walk is FREE and goes around Lake Minnequa. FREE pedometers and T-shirts to all walkers!

 Date: Saturday, May 17  Time: 8 a.m.  Location: Lake Minnequa

St. Mary-Corwin is good for women. St. Mary-Corwin Medical Center is the recipient of three prestigious awards recognizing outstanding care to women:

 Women’s Choice Award as one of America’s Best Breast Centers. St. Mary-Corwin’s Breast Center of Excellence earned this award by meeting the National Accreditation Program for Breast Centers’ standards from the American College of Surgeons. The center also carries the seal of the American College of Radiologists as a Breast Imaging Center of Excellence, and scored above average on the Centers for Medicare & Medicaid Services’ patient satisfaction measures.

 Women’s Choice Award as one of America’s Best Orthopedics Hospitals. This award recognizes hospitals that provide a full array of orthopedic services for top scores in patient recommendations, low rates of complications and infections, and high quality outcomes.

 CIGNA Center of Excellence for obstetrical care. This designation recognizes the nation’s best hospitals for overall quality, lower readmission rates, and fewer complications.

(by the fire station)

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, 2014.