Cheers Summer 2015 by Clementine Words

St. Mary-Corwin Medical Center

CELEBRATING YOUR HEALTH

Summer 2015 Volume 5, Number 3

Bundle of

JOY

Robotic fibroid removal at St. Mary-Corwin gives hope to women who want to start families.

A smooth recovery after robotic myomectomy allowed Pueblo veterinarian Courtney McDonald to return to work quickly.

Story on Page 3

News for better breast health PAGE 4

Pinpointing pelvic pain PAGE 6

EAR-ly signs of hearing loss PAGE 7

PHOTO BY STEVE BIGLEY

Health Briefs

Give kids a break

Tips to help your teens dodge stress fractures

veruse injuries account for half of sports injuries among teens, according to research in Until It Hurts: America’s Obsession with Youth Sports and How It Harms Our Kids. Stress fractures — tiny cracks in the bone — are one of the most common overuse injuries among teens. Use these training tips to help your teen stay healthy this season:

START SLOW: Make sure your teen gradually builds up frequency and intensity of activities and takes a day or two off each week.

SEEK OUT SOFT SURFACES: Encourage your teen to mix up surfaces and opt for grass when possible.

FOCUS ON FOOTWEAR THAT FITS: Get your child properly fitted with footwear, and replace footwear on a regular basis.

TAKE A TIME OUT: Try to encourage your child to play on only one team per season, and to take two to three months off from each sport per year.

 SPORTS PHYSICAL DAY!

VAPOR DANGER

HEALTH TIP

E-cigarette usage up in teens

Zzzs to keep off the pounds

lectronic cigarettes, also known as e-cigarettes or personal vaporizers, are picking up steam among teenagers. A 2014 study conducted by the University of Michigan found that more teens use e-cigarettes than tobacco cigarettes, and one in 10 teens will try e-cigarettes, according to the Centers for Disease Control and Prevention. E-cigarettes use batteries to vaporize nicotine from tobacco plants, releasing a fine mist into the air (aerosol) rather than smoke like traditional cigarettes. Two out of three teens believe e-cigarettes are healthier than conventional cigarettes. However, research conducted by the Food and Drug Administration (FDA) in April 2014 shows that e-cigarettes contain detectable levels of known carcinogens and toxic chemicals, including diethylene glycol (an ingredient in antifreeze).

cheers | St. Mary-Corwin Medical Center

E-cigarettes may be a gateway to other drugs, including cocaine, according to a 2014 study published in the New England Journal of Medicine.

dequate sleep in children and teens — eight to 10 or more hours a night — is one of the best ways to protect against obesity, according to a 2014 study published in Frontiers in Psychology. Good sleep habits for the whole family, including seven or more hours for parents, played an important role. Other key factors from the study were having a family mealtime routine, limiting screen time, and not having a bedroom TV.

 SLEEP ON THIS

Take an online sleep quiz at stmarycorwin.org/sleep to assess whether you and your children are getting enough sleep.

PHOTOS: CLOCKWISE FROM TOP ©ISTOCKPHOTO.COM/GEMENACOM; ©DOLLARPHOTOCLUB.COM/SADLOWSKI, /CAPUZZO

Make sure your kids are healthy before they compete. St. Mary-Corwin Medical Center and the Southern Colorado Family Medicine Clinic are hosting their annual FREE Sports Physical Day for Pueblo City Schools and District 70 student athletes (6th-12th grades) on Friday, July 31, from 1 to 7 p.m. at Southern Colorado Family Medicine, 902 Lakeview Avenue, just north of the hospital. Physicals are good for one year. Schedule an appointment by calling 719-557-3080.

Great Expectations For women with fibroids who want to become pregnant, robotic myomectomy offers help and hope

hen most women hear the term fibroids, one thought comes to mind first: pain. That’s because these typically noncancerous tumors that grow in the uterus can wreak havoc on your menstrual cycle, causing heavy bleeding, bloating, and painful periods, among other symptoms. And they’re fairly common, with more than 30 percent of women experiencing fibroids between age 40 and 60. But even fibroids that aren’t painful can still be problematic — especially for women in their childbearing years. “What we are seeing more and more is patients who are waiting longer to get pregnant, and when they have fibroids that need to be removed, they want a solution that allows them to still be able to get pregnant in the future,” says Fernando Mahmoud, MD, an Dr. Fernando Mahmoud OB-GYN at St. Mary-Corwin Medical Center. That’s where myomectomy can help. Once performed only through open surgery using a large incision, today’s robotic myomectomy is often a same-day surgery that can be performed through three small incisions in the abdomen, removing fibroids with minimal blood loss and pain.

Bouncing back with ease Courtney McDonald, 38, of Pueblo, counts herself among robotic myomectomy’s successes. When she sought help for pain associated with her menstrual cycle last fall, three fibroids were discovered. To help minimize scar tissue and improve her chances of being able to start a family, McDonald decided on robotic myomectomy. “I went in in the morning, and my recovery at the hospital was very easy, with minimal pain or discomfort; and I went home the next morning,” she says. Endometriosis lesions were also discovered during the surgery, and they were able to be addressed during the same procedure. Her recovery at home went just as smoothly. “My mom had come out to help me. But I didn’t need much assistance, so it just turned into a nice visit,” she says. “She tried to get me to take it easy because I felt well enough to continue my normal activities.” McDonald recently completed a follow-up visit to confirm that everything had healed, and she’s now taking steps toward starting a family.

Soon after minimally invasive surgery at St. Mary-Corwin, veterinarian Courtney McDonald was back at work helping furry friends stay healthy.

PHOTO BY STEVE BIGLEY

 EXPECT GREAT RESULTS

Only a small percentage of women do not qualify for robotic myomectomy, due to the size or number of fibroids. “If the tumor is over 2 inches in diameter or the woman has more than five fibroids, we typically recommend open surgery,” Mahmoud says, though he reports that most of his patients are candidates for robotic myomectomy.

St. Mary-Corwin Medical Center has the most experienced robotic surgery team in Pueblo, with more than 750 procedures since the program launched in 2011. To learn more about robotic myomectomy and other roboticassisted surgery options at St. Mary-Corwin Medical Center, visit stmarycorwin.org/robotic. 

St. Mary-Corwin Medical Center’s advanced robotic surgery program is supported by Centura Centers for Clinical Innovation, extending advanced health technologies across Colorado and western Kansas. stmarycorwin.org • Summer 2015 | cheers

Breast Cancer

UPDATE A step closer to breast cancer prevention Breast cancer may have one of the highest survival rates of any cancer, but the ultimate goal is prevention. Fortunately, one category of drugs currently being studied is showing preventive promise. Aromatase inhibitors lower estrogen levels in postmenopausal women by keeping an enzyme found in fat cells called aromatase from turning certain hormones into estrogen. The drugs are currently used to treat some types of breast cancer, but researchers think they may aid in prevention as well. In fact, two studies have found that aromatase inhibitors were effective in cutting breast cancer risk in women at high risk by nearly half. One study found a 47 percent reduction after women were on the drug for three years, and the other study saw a 47 percent reduction after five years, according to the American Cancer Society. However, these drugs don’t come without risks. Common side effects were similar to menopause — hot flashes, night sweats, and vaginal dryness. Some women reported bone and joint pain. Risk of osteoporosis is also raised with aromatase inhibitor use. However, the drugs have not been found to increase risk of blood clots and uterine cancer as some other breast cancer Dr. Wendy Richmond drugs do. “The data that’s out there is promising; there’s just not a lot of it,” says Wendy Richmond, MD, a family medicine physician at St. Mary-Corwin Medical Center. “The bottom line is more research is necessary.”

cheers | St. Mary-Corwin Medical Center

5 ways to avoid recurrence Hearing the words, “You’re scans are clear” is music to any breast cancer patient’s ears. Still, there will likely always be worries about recurrence. While patients who had early stage breast cancer have only a 7 to 11 percent risk of recurrence in the five years after their initial diagnosis, according to Susan G. Komen, every breast cancer survivor should take steps to reduce their risk of recurrence. Here are five ways to help protect yourself: 1 > GET SOME SUN. Some studies suggest vitamin D deficiency ups a woman’s risk for breast cancer recurrence. Seek sunlight for 20 minutes a day to get your vitamin D. If you’re out longer than that, use sunscreen or cover up to avoid sun damage. And ask your doctor to check your vitamin D levels. If your time in the sun isn’t sufficient, you may need to take a supplement. 2 > SCHEDULE SCREENINGS. “If you had a lumpectomy, you’ll still need regular mammograms,” says Wendy Richmond, MD, a family medicine physician at St. Mary-Corwin Medical Center. “Even if you had a mastectomy, there is a small chance of recurrence, so you still need regular clinical exams.” 3 > WATCH YOUR FAT INTAKE. The Women’s Intervention Nutrition study found that women who got less than 25 percent of their daily calories from fat had a lower risk of recurrence than women who had higher-fat diets. But remember, low-fat doesn’t necessarily mean healthy. Always check the nutrition label to get a full picture of the foods you’re eating. 4 > KEEP YOUR WEIGHT IN CHECK. Women who gain weight after breast cancer treatment are at higher risk for recurrence, according to breastcancer.org. That’s because fat produces higher levels of estrogen, which is linked to higher rates of breast cancer. 5 > TALK TO YOUR DOCTOR BEFORE TAKING SUPPLEMENTS. Cancer survivors often take multivitamins and supplements thinking they will help boost immunity. But some research suggests taking unnecessary supplements can have adverse effects on cancer survivors, according to the American Cancer Society. So check with your doctor first.

Survivors, Celebrate!

Breast cancer survivors are invited to the fifth annual Breast Cancer Survivor Retreat Aug. 1-2 at the Mountain Park Environmental Center in beautiful Beulah. Survivors share with each other the strength, courage, humor, wisdom, and kindness they experience on this common path, while learning about relaxation and exercise. RSVP by Jul. 29 to Brenda Galassini at 719-557-4548.

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

Health care professionals wish they could say the effects of breast cancer surgery end when the incisions heal, but that’s not always the case. After surgery, some women develop lymphedema, or swelling in an extremity, most often in the arm closest to the incision site. “It’s defined as a protein-rich inflammation of fluid in the body,” says Janet Dennis, a physical therapist at St. Mary-Corwin Medical Center. “It’s fairly common after breast surgery where lymph nodes have been removed.” Untreated, lymphedema can lead to mobility issues and decreased function in the affected limb. “For those who develop it, it really affects quality of life,” Dennis says. “Unfortunately, there’s really no predictor as to who will get it and who will not.” That’s why it’s important to work with a lymphedema specialist before surgery. He or she will take baseline measurements that will aid in screening for lymphedema later. “At St. Mary-Corwin, we have an L-Dex machine that helps us detect lymphedema in the earliest stage,” Dennis says. “It’s completely noninvasive. It basically just passes an electrical signal of very low strength through the body to measure fluid.” If lymphedema is detected, a physical therapist can help the patient prevent it from developing further by using a variety of techniques, including massage and compression garments.

Finding the right fit Recovering from a mastectomy or double mastectomy involves more than physical healing. Emotional healing also takes time. Many women report feeling less feminine following surgery. Fortunately, the Dorcy Cancer Center at St. Mary-Corwin Medical Center understands these feelings. It has recently partnered with Horizon Prosthetics to offer breast prostheses with bra fitting specialists from Horizon at Pueblo once a month. “Many women are so busy taking care of their families that they don’t take time to care for themselves,” says Barbara Young, RN, breast care navigator at the Dorcy Cancer Center. “We want them to know that they can be fitted here at the Cancer Center.” Patients need a physician referral, and Horizon will work with insurance carriers to discuss coverage. “Usually eight weeks post-surgery is the appropriate time for an appointment,” Young says. “Prosthetics have a very positive impact on patients. Women generally feel more comfortable with their appearance, and will regain a sense of self-esteem.”

Barbara Young, RN, breast cancer navigator (right), helps women regain self-confidence after breast surgery.

PHOTO BY STEVE BIGLEY

PHOTOS: DOVE ©DOLLARPHOTOCLUB.COM/GUNNAR3000; MEAL DOLLARPHOTOCLUB.COM/MICHELAUBRYPHOTO; WOMEN ©ISTOCKPHOTO.COM/SUSANCHIANG

Spotting early stage lymphedema

stmarycorwin.org • Summer 2015 | cheers

Pelvic pain no more Although its origin can be elusive, women need not suffer with debilitating chronic pelvic pain

veryone has aches and pains, but when discomfort lasts six months or more and begins to affect your daily life, it’s considered chronic. Many women — more than 15 percent, according the American College of Obstetrics and Gynecology — have chronic pelvic pain that has lasted a year or more. And although pelvic pain can stem from different bodily systems, and possibly more than one, there’s no need to suffer through it. If chronic pain is keeping you from enjoying all that life has to offer, it’s time to take action. CONSIDER THE CAUSE. Because it can originate from many different places, the cause of chronic pelvic pain can be difficult to identify. St. Mary-Corwin Medical Center OBGYN Stephen Wassinger, MD, says common causes are slowgrowing infections such as pelvic inflammatory disease and uterine infections, and endometriosis and fibroid tumors, but pelvic pain also can come from bladder dysfunction, digestive problems, or musculoskeletal issues in the pelvic floor.

women have chronic pelvic pain.

SEEK HELP. “Like most chronic conditions, chronic pelvic pain comes on slowly,” Wassinger says. “It begins to drag women down, causing fatigue, avoidance of certain activities, missing of work, even depression.” He advises women to seek a doctor’s care for acute pain right away, and for any low-grade discomfort that has lasted two to three months. “And that’s not necessarily constant pain,” he says. “It can be the type that relapses and remits over the course of those months.” PREP SMART. Before your appointment, take time to create a pain journal that details all aspects of your pain. In an empty calendar, note when you feel pain, what makes it worse or better, and how it relates to other activities such as eating, sex, exercise, menstruation, urination, or bowel movements. It’s also important to describe what the pain itself feels like. Is it dull, sharp, quick, or lasting? “Having a pain journal helps us zero in on the cause more quickly,” Wassinger says. EXPECT THIS. While the pain journal you prepare for your doctor can help determine the origination of pelvic pain, oftentimes, other tests may be needed. Following a pelvic exam and depending on findings, your gynecologist may order tests or procedures such as pelvic ultrasound, basic blood work, cystoscopy, colonoscopy, or even minimally invasive laparoscopy to investigate further. “It’s important that women take care of themselves and reach out to their doctors to investigate ongoing pain,” Wassinger says. “In the vast majority of cases, we’re able to ease patient concerns about more serious causes and help improve a woman’s quality of life.”

cheers | St. Mary-Corwin Medical Center

PHOTOS: ©ISTOCKPHOTO.COM/JWEBB

Dr. Stephen Wassinger

LOUD and

Hearing loss isn’t just for the elderly

earing loss affects 36 million Americans and is the third most common chronic health condition, according to the American Speech-LanguageHearing Association. And it happens earlier than you think — typically beginning between 40 and 45, says Roxann Murphy, AAS, a certified otologic technician at St. Mary-Corwin Physician Partners ENT.

Hearing loss can be caused by many factors, including: I Age (by age 65, one-third of Americans experience hearing loss) I Family history of hearing loss I Exposure to loud noises I Smoking (even nonsmokers exposed regularly to smoke are 28 percent

more likely to develop hearing loss) I Medical conditions, such as diabetes and ear infections I Medications, including some antibiotics or cancer therapies

“There are subtle signs of hearing loss that people often brush off, but that worsen over time,” Murphy says.

Early signs of hearing loss include: I Difficulty hearing when background noise is present I Inability to clearly follow a conversation I Straining to understand a conversation I Mumbling or not speaking clearly I Misunderstanding what others are saying I Turning up the radio or television louder than what others in the

PHOTOS: EXAMINATION BY STEVE BIGLEY; COUPLE ©ISTOCKPHOTO.COM/ALDOMURILLO

room can tolerate “Often, people don’t realize they have hearing loss because their spouse or a family member overcompensates for them, acting as their hearing aid,” Murphy says. “It’s important to avoid doing so and encourage your loved one to seek medical attention sooner than later.” Murphy recommends starting with a visit to an ear, nose, and throat (ENT) specialist to determine if there is a medical problem that needs to be addressed. If not, a range of assistive devices is available, including hearing aids, amplified phones, and digital gadgets. “Hearing loss is actually more visible than hearing aids,” Murphy says. Numerous studies have found that those who wear hearing aids not only improve their own quality of life, but also that of their spouse/partner. “Seeking help for hearing loss is really a win-win for the patient and his or her loved ones and friends,” she says.

Roxann Murphy

Roxann Murphy,

Certified Otologic Technician Many people rely on their family physician to screen for hearing difficulties, but according to the Better Hearing Institute, only 13 percent of doctors include a hearing assessment as part of routine physicals. Experts like Roxann Murphy, AAS, can help. For 21 years, she has worked with patients of all ages to detect and treat hearing loss and perform other types of hearing-related care. She finds the improvement in a patient’s ability to communicate the most rewarding and lifechanging aspect of her work. “If people can’t hear, they can’t communicate,” Murphy says. “I love being able to help patients communicate again.” Murphy, who is board-certified in hearing instrument sciences, provides the following hearing-related services:  Hearing loss evaluation  Amplification recommendation  Selection and fit of hearing instruments  Hearing instrument follow-up care and service  Assistive listening device recommendation  Custom ear molds  Musician molds  Hearing protection recommendation

 HEAR, HEAR!

To book an appointment with Roxann Murphy at St. Mary-Corwin Physician Partners ENT, call 719-557-8660. 

stmarycorwin.org • Summer 2015 | cheers

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 Health Marketing of Denver, Colo. Executive editor is Rochelle Kelly Wristen.

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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, 2015.

Events Calendar

Looking for some inspiration or motivation to improve your health? Join the health experts at St. Mary-Corwin Medical Center at a variety of health classes and programs around the community. Here are just a few of the programs we offer. To see more classes, go online to stmarycorwin.org/calendar. Cheers to your health!

Farm Stand

Saturdays through Sep 26 8-10:30 a.m. 719-557-5246 St. Mary-Corwin’s Farm Stand is back, providing locally grown, seasonal whole fruits and vegetables. Located just north of Fire Station No. 4 on Lake Avenue.

Joint Replacement Seminar Mon, Jul 13 | 5 p.m. FREE Dorcy Cancer Center 719-557-5622 Call to let us know you’re coming. You can also visit us online at stmarycorwin.org/ jointreplacementcenter.

Walk With a Doc

Saturdays, Jul 18, Aug 15, FREE and Sep 19 | 8 a.m. This is the perfect way to stay active! The walk is FREE and goes around Lake Minnequa with physicians from Southern Colorado Family Medicine. Meet by the Lake Avenue fire station across from St. Mary-Corwin. Participants receive a free T-shirt and pedometer.

Sportsmedipalooza Annual Coaches Clinic Fri, Jul 31 | 8 a.m.-1 p.m. Sangre de Cristo Arts Center 719-557-4639 Featured presentations include: Orthopedic Sports Injuries and Emergencies, The Importance of Sports Medicine Rehabilitation, and The 4 Hs That Can Kill: Head Injuries, Heat Stroke, Hemoglobin SC, and Heart. Plus a bonus session on CPR/AED certification. Reservation required.

Stepping On!

7-week classes begin Tuesdays, Aug 11 and Nov 3 Dorcy Cancer Center FREE 719-557-3631 FREE but reservation required Stepping On! covers falls and risk, strength and balance exercises, home hazards, safe footwear, vision and falls, safety in public places, community mobility, how to cope after a fall, and understanding how to initiate a medication review. Participants must be 65 years or over; have fallen in the past year or be fearful of falling; be living in a home or apartment; be able to walk by themselves or with a

walking stick; and not be suffering from dementia.

Healthy Bessemer Block Party

Sat, Aug 15 | 8 a.m.-Noon FREE 719-557-5246 Activities will include health screenings, a walk through the historic Bessemer neighborhood, Farm Stand shopping, health exchange sign-up opportunities, and door prizes. Watch your local newspaper for details. For more information, go to stmarycorwin. org/bessemer.

Colorado State Fair

Aug 28-Sep 7 Visit the St. Mary-Corwin First Aid Station, located in the Fine Arts building, if you need medical attention during the fair. Or stop by and pick up a FREE packet of sunscreen to prevent sunburn. For fair location, hours, and ticket info, go to coloradostatefair.com.

Blood Drive

Cowboys Kickin’ Cancer

Mon, Aug 31 Colorado State Fair 719-557-5247 Enjoy a VIP evening of gourmet Southwest cuisine, a live auction, and exciting rodeo action! Funds raised directly benefit the Patient Assistance Fund for the Dorcy Cancer Center, which gives cancer patients financial support for basic living needs while going through treatments. Tickets before July 24 are $60/person or $550/table of 8. After July 24, tickets are $75/person or $700/table of 8.

Colorado Health Day

Sat, Sep 5 | Noon-8 p.m. Colorado State Fair Visit the St. Mary-Corwin Inspiring Health Communities area during Colorado Health Day for health screenings, giveaways, and education.

Fri, Sep 25 | 10:30 a.m.-4 p.m. | St. Mary-Corwin, West tower entrance Save up to three lives with just one donation of blood. To make an appointment, call 719-776-5822. Walk-ins are also welcome!