s r e e h C
CE LE B R AT ING YO U R H EA LTH
Summer 2014 | Vol. 4, No. 3
WATCH ME
NOW
It’s never too late to adopt a healthy lifestyle.
PHOTO BY STEVE BIGLEY
Ron Cothran Jr., of Pueblo, is part of CNN’s 2014 Team Fit Nation. Read his story on Page 6.
Pain Relief
Farm Fresh
Stroke Care
Page 2
Page 3
Page 4
New program treats pain with wide variety of therapies.
St. Mary-Corwin helps residents improve health through healthy eating.
Recognizing symptoms is key to full recovery from stroke.
H E A LT H Y
STEPS
Treating pain from the inside out New, holistic approach to pain management available in Pueblo
U
ntil recently, hospital quality was something that was talked about over the backyard fence or in the grocery store. “Did you know Joe from down the street went to that hospital and it didn’t turn out well?” As consumers, we really didn’t have reliable information. Joe could have actually had an incredible outcome given his prognosis. Or, it could have been that Joe didn’t like the food he was served and that became a “quality” issue. The good news is that consumers no longer have to settle for over-the-fence information. Hospitals are now being evaluated by governmental and private organizations according to actual outcomes and practices. And all of this information is available to the public. One example is the “core measure composite” evaluated by The Joint Commission, the agency that inspects and evaluates hospitals on behalf of the government. The core composite is comprised of standards that have been If you would like to proven to improve patient research the quality outcomes. These standards include treatments for of hospitals in your things such as heart community, go online attacks, pneumonia, stroke, and surgery. to medicare.gov/ For the past year, which ended June 30, St. Maryhospitalcompare. Corwin scored 99.44 percent. This means that 99.44 percent of patients who were admitted to our hospital for these conditions received the highest quality of care that is proven to provide the best outcomes. This score places St. Mary-Corwin in the top 25 percent of hospitals nationally! click It’s that score and many others that we hope our community will consider when choosing a hospital, rather than relying on information that might not be valid. We will continue to work to ensure that every patient receives the highest quality and safest care available. But don’t just take our word for it—or that of your neighbor—take some time to do a little research. Cheers to your health,
O
ne out of three Americans suffers from chronic pain. To combat persistent pain, the St. Mary-Corwin Physician Partners — Pain and Rehabilitation program offers an individualized approach that provides patients with a variety of treatment options beyond medication. “There is a misperception that chronic pain can only be treated with opioid pain medications,” says Mallikarjuna Nallegowda, MD, a board-certified pain medicine physician for the program. “By treating patients with an individualized, holistic approach, we are better able to manage their pain without relying solely on medications.” Patients who are treated with a multimodal approach to pain management achieve a 40 percent greater reduction in pain than patients treated only with medication, according to a study published in 2011 in the medical journal Lancet. Multimodal approaches also help reduce the use of medications by 60 percent. “Our approach to care provides patients with more options and better pain control — an ideal combination,” says Rose Wertz, MSN, a nurse practitioner for the program. All physicians at the St. Mary-Corwin Physician Partners — Pain and Rehabilitation program are fellowship-trained in pain management and have extensive backgrounds in rehabilitation.
Individualized treatment plans combine an assortment of the following options: • Injection and interventional pain management • Adjuvant pain medications (e.g., NSAIDs and antidepressants) • Diagnostic testing: electromyography and nerve conduction studies (EMG/NCS) • Cognitive behavioral therapy* • Complementary therapies (e.g., biofeedback, massage, and meditation)* • Acupuncture* • Physical therapy* • Occupational therapy* Opioid medications are only prescribed to patients under special circumstances. *St. Mary-Corwin Physician Partners — Pain and Rehabilitation refers patients to trusted partners for treatments.
A ll patients interested in St. Mary-Corwin Physician
Partners — Pain and Rehabilitation must be referred by a physician. The pain management program at St. Mary-Corwin Medical Center is part of Centura Health Clinical Innovation, extending advanced health technologies across Colorado and western Kansas.
Brian Moore President and CEO St. Mary-Corwin Medical Center
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Cheers | St. Mary-Corwin Medical Center
1008 Minnequa Avenue Pueblo, CO 81004 719-557-4000
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Dear Neighbors,
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.
N U T R I T I O N A L H E A LT H
Farm fresh
Fresh local produce available Saturdays through Oct. 4.
at St. Mary-Corwin Farm Stand
PHOTO BY STEVE BIGLEY
Volunteers sell farm-fresh produce at the St. Mary-Corwin Farm Stand every Saturday through Oct. 4.
Vege-fact Beets contain betaine, a substance that relaxes the mind and promotes well-being.
“For Pueblo, the top four health concerns are obesity, diabetes, teen pregnancy, and access to health care,” Stetter says. Further studies, in partnership with the Pueblo City-County Health Department, revealed that the area surrounding St. Mary-Corwin was a “food desert” — meaning that the area lacks access to adequate healthy food sources. “For example, in ZIP code 81004, there are no supermarkets,” Stetter says. “For many older, low-income, and disabled persons with limited or no transportation, this means their main source of food comes from two convenience stores that primarily offer foods high in sugar, fat, and
Farm Stand: A Colorado Health Neighborhoods Program Farm Stand is part of Colorado Health Neighborhoods, a new program by St. Mary-Corwin’s parent company, Centura Health. Colorado Health Neighborhoods helps communities across Colorado prepare for a new future of health care by focusing on wellness, healthy behaviors, and illness prevention while offering care that’s cost-effective, convenient, and accessible. Consumers get the depth and breadth of expertise they need, right where they live. Learn more at coloradohealthneighborhoods.org.
carbohydrates — exacerbating both obesity and diabetes.” With helpful suggestions from Southern Colorado Family Medicine physicians, St. Mary-Corwin’s Farm Stand offers fresh, whole vegetables and fruits that come from a single-source consortium of 16 local farmers. The doctors’ recommendations included the best choices for those who want to address or prevent obesity, diabetes, heart disease, and high blood pressure. “Because we are purchasing the produce at wholesale prices, we can offer them to our customers at very low prices, which will help those on limited or fixed incomes make their dollars stretch further,” Stetter says. Stetter hopes that in the future physicians can give patients prescriptions for particular foods just as they offer prescriptions for other medications. “Prescriptive food programs have been pioneered successfully in other communities, and we believe they can be beneficial here in Pueblo as well.”
MAKE PLANS to attend the Healthy Bessemer
Block Party on Saturday, Sept. 13, beginning at 8:30 a.m. Activities will include health screenings, a healthy walk through the historic Bessemer neighborhood, Farm Stand shopping, health exchange sign-up opportunities, healthy snacks, and door prizes. Watch your local newspaper for more details. The event is FREE and open to the public. For more information, go to stmarycorwin.org/bessemer. stmarycorwin.org | Cheers
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f an apple a day keeps the doctor away, imagine what a colorful bounty of fresh fruits and vegetables can do for a person! Thanks to St. Mary-Corwin Medical Center’s new Farm Stand, those who live in the Bessemer neighborhood and surrounding community now have access to locally grown, seasonal whole fruits and vegetables. The Farm Stand, which began in July, is open Saturday mornings from 8 a.m. to 10:30 a.m., just north of Fire Station No. 4 and across from the visitors’ parking lot at the corner of Lake and Minnequa avenues. The concept resulted from the findings of the hospital’s recent Community Health Needs Assessment that pinpoints the most costly and prevalent health issues within the community, says the Rev. Linda Stetter, director of Mission Integration and Spiritual Care at St. Mary-Corwin.
3
H E A LT H
More than a
stroke of luck A
fter 53 years of marriage, Elsie Wodishek woke up one morning and found that her husband, Robert, couldn’t understand her because she was slurring her words. Alarmed, Robert called their primary care doctor, who sent her to St. Mary-Corwin Medical Center, where she was diagnosed as having suffered a stroke. Because of his fast action and the quick response of St. MaryCorwin’s Primary Stroke Center, though, Wodishek was back home and nearly back to normal two weeks later — a feat that would have been rare just 10 years ago.
Fast action
A stroke happens when blood flow to the brain stops. Brain cells begin to die within minutes. A stroke can cause permanent brain damage, leading to problems such as paralysis on one side of the body or difficulty talking, thinking, or remembering things. It can also be deadly. “During a stroke, 160,000 brain cells die per second. The faster you can get treated, the better your chances of a full recovery,” says Kevin Weber, MD, an emergency doctor at St. Mary-Corwin Medical Center. Knowing the symptoms of a stroke and getting expert care faster have helped improve outcomes for people who have strokes. Deaths from strokes have dropped 30 percent over the past 11 years, making it now the fourth — down from the third — leading cause of death,
PREVENTING FUTURE STROKES Strokes are most common in people over the age of 65. Men are more likely to have strokes than women, but women are more likely to die of stroke. Mexican Americans have more disability after a stroke, but are less likely to die of stroke than other people, according to a recent study in the American Heart Association’s Rapid Access Journal Report. Researchers don’t know why. Everyone should know and act on the symptoms of stroke. An easy way to remember the signs of stroke is to remember the acronym FAST. If anyone you know is having any of these signs of stroke, call 911 immediately: Does one side of the face droop Face when asked to smile? Arms
Can the person lift both arms and hold them up?
Speech
Is the person’s speech slurred, strange, or hesitant?
If the person has any of these Time symptoms, call 911.
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Cheers | St. Mary-Corwin Medical Center
Faster recognition of stroke symptoms and specialized care are improving — and saving — more lives than ever before
according to a recent study published in the journal Stroke. The most effective treatment, a drug called tPA, breaks up the blood clot that causes the most common type of stroke (ischemic stroke), restoring blood flow to the brain and limiting damage from the stroke. But it has to be given within four and a half hours of the start of the stroke. Other treatments also are more effective when provided early. Unfortunately, some people, like Wodishek, have a stroke while they’re asleep and tPA isn’t an option. “We have no way of knowing when the symptoms started. Other people are in denial that they’re having a stroke and wait too long to get help,” Weber says.
Speeding stroke care
When Wodishek arrived at St. Mary-Corwin, a stroke alert notified the stroke team, on call 24 hours day, to speed testing and diagnosis. Within minutes, a CT scan was performed to help doctors determine if she had bleeding in the brain, called a hemorrhagic stroke, which is usually treated with surgery. Doctors decided that Wodishek’s stroke was ischemic, the most common type of stroke. It was probably caused by her atrial fibrillation, a type of irregular heartbeat, and high blood pressure. People with atrial fibrillation are five times more likely than others to have a stroke. Doctors admitted Wodishek to the hospital and gave her aspirin to help prevent another stroke and medicine to lower her blood pressure. To lessen possible problems from the stroke, Wodishek started speech, physical, and occupational therapy right away. “The service couldn’t have been better. The doctors, nurses, and therapists were all super,” she says.
Making a full recovery
Wodishek did so well that when she went home three days later, she only needed to continue the exercises the speech therapist taught her. Within two weeks, her speech was nearly back to normal. Before leaving the hospital, nurses taught Wodishek about stroke prevention, recognizing the symptoms, and how to take care of herself at home. They also made an appointment with Wodishek’s cardiologist, who put in a pacemaker (a small device placed under the skin near the heart) to help control her irregular heartbeat. Back home, Wodishek is enjoying time with her husband, two daughters, and five grandchildren, all of whom live in Colorado. She also volunteers at St. Therese Catholic Church. The couple hopes to start traveling again soon, possibly to visit Lake Powell.
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YOUR
STROKE PROGRAM IMPROVES PATIENT OUTCOMES As a Primary Stroke Center with a Gold Seal of Approval, St. Mary-Corwin Medical Center meets Joint Commission standards for better outcomes for stroke care. St. Mary-Corwin Medical Center also received the Get With The Guidelines® Gold Plus Quality Achievement Award and the Target Stroke Honor Roll from the American Heart Association/ American Stroke Association. These awards recognize outstanding stroke care based on the use of the latest treatment guidelines. “These awards come from getting the appropriate treatment in place at the right time,” says Stroke Coordinator Ashley Trujillo, RN. “They reflect the care that patients receive at St. MaryCorwin Medical Center.”
60 minutes 35 minutes
American Heart Association goal for hospitals to give tPA
Time from arrival at St. Mary-Corwin Medical Center to treatment with tPA (on average)
PHOTO BY STEVE BIGLEY
Every stroke patient leaves St. Mary-Corwin Medical Center with a stroke recovery book and a personalized treatment plan.
Elsie Wodishek, of Pueblo, returned to volunteering at her church just two weeks after being treated for a stroke at St. Mary-Corwin Medical Center.
St. Mary-Corwin’s Stroke Center is part of the Centura Health Stroke Network, the region’s leading provider of stroke care.
ASSESS YOUR RISK of stroke and
LOWER YOUR RISK OF STROKE To help prevent a stroke or reduce the damage it can cause: Control high blood pressure Control high cholesterol Quit smoking Control diabetes Control weight Drink alcohol in moderation, if at all
explore how stroke impacts the brain at the MEGA Brain exhibit at the Colorado State Fair on Saturday, Aug. 30. Admission to the MEGA Brain, sponsored by St. Mary-Corwin Medical Center, is FREE with your fair ticket.
stmarycorwin.org | Cheers
5
H E A LT H
JOURNEY
CHANGE
Tri for
Pueblo respiratory therapist inspiring self, others to live healthier
R
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Cheers | St. Mary-Corwin Medical Center
I WANT TO PROVE
TO MYSELF AND OTHERS THAT IT’S NEVER TOO LATE
TO MAKE A
CHANGE.
Top 5 insider tips to living healthier 1
Surround yourself with positive, supportive people. Whether encouragement, compliments, or motivation, people make the difference, says Cothran, whose wife Lori and their children are his biggest supporters.
2
Value yourself. Believe in yourself and your worth. “You aren’t junk, so don’t treat yourself like it,” Cothran says.
3
PHOTO BY STEVE BIGLEY
on Cothran Jr. is determined to live the second half of his life healthier than the first. To help with his goal, Cothran, a respiratory therapist at St. Mary-Corwin Medical Center, applied for and was selected as one of six members of CNN’s 2014 Team Fit Nation. “I want to prove to myself and others that it’s never too late to make a change,” says Cothran, who turned 50 in July. “Triathlon training is the first step.” Every year, CNN selects “iReporters” as members of its Team Fit Nation to race in the Nautica Malibu Triathlon with Sanjay Gupta, MD, a neurosurgeon and CNN’s chief medical correspondent. iReporters receive training equipment and guidance from personal and nutritional trainers, while sharing their stories and progress on CNN.com and Facebook and with each other via conference calls. They meet twice before the actual race — in January for a kickoff event and in late spring for a training week. “I have always enjoyed swimming and biking, but running was a challenge,” Cothran says. “I knew a triathlon would get me out of my comfort zone. Being on the team has been a huge help.” Cothran hit rock bottom in 2008 — he was going through a divorce and was at his heaviest, weighing 350 pounds and suffering from sleep apnea, high blood pressure, and type 2 diabetes. After undergoing bariatric surgery, Cothran lost 100 pounds and discontinued diabetic and blood pressure medications. Yet, he continued to struggle. “I was as low as I could get,” says Cothran, who gained back 40 pounds of what he lost after surgery but has since shed it with the triathlon training. “I was treating patients every day but even after the surgery,
I still struggled to take care of myself.” While the triathlon on Sept. 14 will be Cothran’s first, it won’t be his last. Next year, in addition to running the 5K Spring Runoff in Pueblo and the 10K BolderBOULDER again (which he ran this year and were the first races he’s ever run), Cothran plans to participate in two or three triathlons as well. “I feel better now than when I was 40,” Cothran says. “I can’t even imagine how I’ll feel when I’m 60 or 70. This is just the beginning.”
Focus on simplicity. Break big goals (like a triathlon) into manageable, bite-sized accomplishments (like adding a mile to your bike ride every week).
4
Be consistent and disciplined. “There will be days you don’t want to get out the door, but those are the days you need to get out there more than ever,” he says.
5
Embrace interconnectivity. Appreciate that others are with you in your journey and use it as inspiration. “It’s not about me anymore, which gives me motivation to keep going,” Cothran says.
WATCH MORE about Ron Cothran Jr.
St. Mary-Corwin Respiratory Therapist Ron Cothran Jr. at cnn.com/specials/fit.nation.
SPORTS INJURY
Teens in Training O
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ne out of 10 teens participating in sports will suffer an injury this fall. For football players, shoulder injuries — while rare — could interrupt their season. A new study published in Pediatrics found that football players are more prone to shoulder injuries than other athletes and are six times more likely to suffer an injury in competition than in practice. “The study highlights the importance of being aware of less-common injuries that could be career-ending,” says Alex Romero, MD, a sports medicine specialist at St. Mary-Corwin Physician Partners — Orthopedics. Get your teen geared up for a great season by understanding these common sports injuries: > Strains and sprains account for 30 percent of all sports injuries in teens, according to USA Today. Romero frequently treats medial collateral ligament (MCL) knee sprains in football players and ankle sprains in other athletes. > Contusions (bruises) account for nearly one out of five sports injuries in teens. While less common, ligament tears, like anterior cruciate ligament (ACL) tears in the knee, affect thousands of teens a season, with girls being four to six times more likely to suffer an ACL tear than boys. “ACL tears not only sideline an athlete for up to a year, but also can affect them for years,” Romero says. Teens who suffer ACL injuries are 10 times more likely to develop osteoporosis later in life, according to The American Journal of Sports Medicine.
Treatment
Most sprains, strains, contusions, and bruises can be treated with rest, ice, compression, and elevation (RICE). Romero recommends seeking medical treatment if: Swelling persists A significant amount of swelling exists The teen is unable to bear weight on the injury or obtain normal range of motion A ligament tear is suspected
Sports-injury prevention to keep your kid in the game
Prevention
Proper equipment and warm-up regimens can help reduce injuries. Many can be found online, including FIFA 11+ (f-marc.com) and Prevent Injury and Enhance Performance (PEP) Program (smsmf.org). “FIFA 11+ was originally developed for soccer, but it can be modified for any sport,” Romero says. “Studies have shown that it significantly lowers the rate of injuries.” Romero also stresses the importance of properly fitting gear, including knee braces for football linemen, which have been shown to reduce the occurrence of MCL sprains. “If we can prevent injuries, it does a lot for the health of the athletes down the line, whether in their athletic career or when being recreationally active as an adult,” Romero says.
Concussion 101 Nearly 20 percent of athletes will suffer a concussion this year, yet only 10 percent of those will lose consciousness (the most recognizable sign of concussion). Other signs of concussion that can develop over time include: > Headaches > Problem with vision > Sensitivity to noise or bright lights > Vomiting or nausea > Mood changes > Forgetfulness “Seek immediate medical attention if a concussion is suspected,” Romero says.
DOWNLOAD FREE sport-specific and injury-specific guides for your teen at: stopsportsinjuries.org.
stmarycorwin.org | Cheers
7
SUMMER EVENTS
Colorado State Fair Aug 22-Sep 1 Visit the St. Mary-Corwin First Aid Station, located in the Fine Arts building, if you need medical attention at the fair. Or stop by and pick up a FREE packet of sunscreen to prevent sunburn. Colorado Health Day at the Colorado State Fair Sat, Aug 30 | 10 a.m.-7 p.m. Visit the St. Mary-Corwin “Inspiring Healthy Communities” area in front of the Events Center featuring MEGA Brain, health screenings, and important information. Breast Cancer Survivor Celebration Sat, Oct 4 | 10 a.m.-2 p.m. Old Towne Carriage House Breast cancer survivors are invited to a special luncheon celebrating life and each other. Nancy Saltzman is a breast cancer survivor and the featured speaker at the event. In addition to learning about her amazing journey of hope and healing, the event encourages women to come together and learn. The luncheon is FREE to survivors and $25 for caregivers. Reservation required. Call 719-557-5298.
Sugar, Sugar In pregnancy, everything you do is for two — including controlling your blood sugar
P
lenty of thoughts cross a woman’s mind when she finds out she’s pregnant. Will it be a boy or girl? Should I stop drinking coffee? What will labor be like? Another thing women should wonder about — and talk to their doctors about — is gestational diabetes. Gestational diabetes, a type of diabetes that happens in pregnancy, is on the rise. As many as 18 percent of pregnancies are affected, according to the National Diabetes Education Program. Jennifer Pascoe, of Pueblo, became part of the statistic during her fourth pregnancy. “I was pretty bummed at first,” she says. “I felt guilty, like maybe I didn’t eat right or that my weight was an issue.” But attending a diabetes management class at St. Mary-Corwin Medical Center and meeting with a dietitian eased Pascoe’s fears and taught her how to deal with her blood sugar levels.
Managing Gestational Diabetes
Left uncontrolled, gestational diabetes has consequences for baby: being too large, getting stuck in the birth canal, low blood sugar at birth, and breathing problems. As adults, these children are at risk for obesity and diabetes. “People often don’t realize all of the possible negative consequences,” says Alison Hastings, DO, an obstetrician/ gynecologist at St. Mary-Corwin Medical Center. “There’s even an increased risk of having a stillbirth if blood sugars are not controlled.” But the condition can be managed. Women should follow these steps to ensure a healthy pregnancy: Attend a class. Diabetes education teaches you how to manage your blood sugar levels. A nutritionist will help you develop a balanced meal plan. Move for 30 minutes a day. “We don’t want women doing anything excessive that the body wasn’t used to doing before pregnancy,” Hastings says. “But we do encourage 30 minutes a day of activity, even if it’s simply walking.” Document blood sugar. Testing as directed by your physician and maintaining an accurate record will enable your physician to make needed recommendations. “I tested my blood sugar four times
FIND OUT whether or not you are at risk for
gestational diabetes and learn how to prevent it at St. Mary-Corwin’s Diabetes Education Program. Call 719-557-5955 for more information.
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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.
Jennifer Pascoe managed her gestational diabetes in order to give daughter Cora a healthy start.
PHOTO BY STEVE BIGLEY
Are You a BRCA Girl? Sat, Aug 23 | 11:30 a.m.-3:45 p.m. Dorcy Cancer Center Women with a family history of breast or ovarian cancer should attend this FREE event to learn more about breast cancer screening and genetic risk. The event includes information from physicians and specialists, such as Kate Crow, St. Mary-Corwin’s genetic counselor. Reservation required. Call 719-557-4548.
a day,” Pascoe says. “I kept a journal of my blood sugar levels and shared it with my doctor weekly.” Take a supplement. A small study found that taking a calcium and vitamin D supplement helped women control their blood sugar levels during pregnancy, but more research is still needed, Hastings says. Above all, Hastings says, “Don’t panic. This is something that can be managed. It’s just a matter of taking it seriously.” Fortunately, Pascoe was able to control her gestational diabetes through lifestyle changes and, on May 14, gave birth to a healthy baby girl named Cora.
Cut the (Animal) Fat The best way to deal with gestational diabetes is to avoid it in the first place. “Of course, aiming for a healthy body mass index and getting regular exercise before pregnancy is ideal,” says Alison Hastings, DO, an obstetrician/gynecologist at St. Mary-Corwin Medical Center. Avoiding animal fat has also been found to reduce risk. A study published by the National Institutes of Health found that women whose diets were high in animal fat were more likely to develop gestational diabetes than women whose diets were equally high in fat from nonanimal sources.