Elevate Spring 2014

Living at the height of wellness spring 2014 | Volume 2, Issue 2

Shouldering Through Pain Exercises and early treatment can keep your shoulders in winning shape Page 7

Put Allergies To Rest Page 3

the Goods on Gluten Page 4

Weight-Loss Surgery Page 6

FREE Health Classes Page 8

Hug It Out A recent study in the journal Comprehensive Psychology found that a 10-second hug once or twice daily may lower blood pressure and increase levels of the feel-good hormones oxytocin and cortisol.

Elevate Your

environment

When you think about protecting your environment, your thoughts likely turn to the earth and the great outdoors. But your personal environment — your home, office, and other places where you spend the most time — can significantly impact how you feel from day to day.

Shauna Rusovick, wellness coordinator at Castle Rock Adventist Hospital, recommends taking a moment to analyze your spaces. “Are your spaces cheerful and healthy places that nurture your soul and recharge your spirit?

Or are you surrounded by clutter that causes stress and anxiety? If the latter is true, work to eliminate the mess and move toward simplicity,” Rusovick says. Environment is one of the key principles guiding the CREATION Health Lifestyle, a scientifically proven approach to improved health that Castle Rock Adventist Hospital’s wellness programs are based on. To learn more, visit castlerockhospital.org/environment.

ELEVATE is published four times annually by Castle Rock Adventist Hospital. 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 elevate@centura.org. ELEVATE is produced by Clementine Words LLC. Executive editor is Christine Alexander.

2350 Meadows Boulevard | Castle Rock, CO 80109

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Sound Advice More reason to carve out some quiet time: Studies show noisy environments can elevate blood pressure, reduce perceived quality of life and productivity, as well as decrease concentration and contribute to long-term memory loss.

A Whiff of Wellness Did you know that certain scents can improve your well-being? Choose: • Eucalyptus to clear your head and invigorate your mind • Chamomile to promote relaxation • Pine to stimulate creativity • Orange to refresh the mind • Tea tree to ground your thoughts • Thyme to refresh and strengthen your immune system • Cucumber to calm the nerves

Cover photo: ©Istock.com/Dejan Ristovski, This Page clockwise: ©Istock.com/Talaj, 101cats, marekuliasz, StephanieFrey,Alexander Bedrin

environment Spring Clean Your Life Getting your environment in order can feel overwhelming, but it doesn’t have to be. Join the CaféWell challenge to “Spring Clean Your Life,” and take it one week at a time. Each week, you’ll select a different room in your environment to organize, clear out the clutter, and create calm, positive spaces. For more details on the challenge and how to join, visit castlerockhospital.org/outlookchoice.

Exercise

dancing

gardening

brisk walking

Diabetes and hypertension are two conditions that often go hand in hand. In the U.S., 50 to 80 percent of people with type 2 diabetes also have high blood pressure, and the two are also leading risk factors for heart attacks and strokes. And while a healthy lifestyle overall is always a good idea, research is showing that physical activity in particular may play a significant role in prevention and management of both conditions, even when genetics come into play.

For example, the FTO gene (also known as the obesity gene), which contributes to obesity and overeating, is more pronounced in people who are sedentary. Yet individuals who meet the daily recommendations for physical activity can overcome FTO’s effects on conditions like diabetes and high blood pressure.

You can meet the daily physical activity recommendations with 30 minutes a day (or 150 minutes a week) of moderateintensity exercise, which includes activities such as:

FAST FACT

10,000 steps in a day is a rough equivalent to the Surgeon General’s recommendation to accumulate 30 minutes of activity most days of the week.

Join us on Wednesday, June 25, for a community open house to celebrate the opening of Ridgeline Family Medicine’s new location in Castle Pines.

Free Refreshments ~ Door Prizes ~ Meet the Doctors 250 Max Drive, Suite 102 Castle Pines, CO 80108 303-649-3350 Office Hours: Mon-Fri: 7 a.m.-6 p.m.

Sat: 8 a.m.-noon Opening early June 2014 Go to ridgelinefamilymedicine.org for more information We accept most insurance, including Medicare and Medicaid. We are accepting new patients of all ages.

castlerockhospital.org

Put Allergies to Rest If springtime allergies leave you tossing and turning, you’re not alone. Research has shown that sleep can be significantly disrupted by allergies. Brian Hill, MD, a primary care physician at the new Ridgeline Family Medicine at Castle Pines, offers these tips to help you safeguard your sleep against allergy season: • Launder your sheets in hot water weekly and your blankets regularly • Wash your pillow if possible, or dry it at a high temperature to kill mites • Mite-proof your mattress, box spring, and pillows with sealed covers made from a breathable micro-weave fabric • Keep dogs and other furry pets out of your sleeping space • Close your windows if outside irritants like pollen trigger allergies • Vacuum your home frequently • Consider an air purifier to help fight allergens If these remedies don’t help, talk to your doctor about other options. If you need a physician, call the new Castle Pines Clinic at 303-649-3350.

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Photos clockwise: ©Istock.com/4774344sean, monkeybusinessimages

Fighting Diabetes and Hypertension with

7 facts about celiac and beyond Gluten-free. It’s a term that’s become pervasive in our everyday lives in recent years. Your local grocery store, corner baker, and favorite restaurants are all brimming with gluten-free options, from breads and pastas to cereals and even soy sauce (yep, it’s often fermented using wheat). But what’s behind it all? Have gluten issues like celiac disease and gluten sensitivity or intolerance truly become more prevalent in recent years, or are they simply being better understood and thus more widely diagnosed? We’ll explore these questions and more to give you the facts about gluten sensitivity and whether reducing or eliminating gluten from your diet is worth considering.

Gluten sensitivity shouldn’t be viewed separately from celiac disease. Celiac disease is an autoimmune disease in which people can’t tolerate gluten, a protein found in wheat, barley, and rye, because it causes damage to the small intestine. It is typically diagnosed through a blood test or endoscopic biopsy.

But non-celiac gluten-sensitivity issues may have the same symptoms — such as abdominal pain, bloating and gas, nausea, vomiting, and malabsorption of nutrients — but can’t be proven with a blood test or biopsy.

“The concept of non-celiac gluten sensitivity is relatively new, but celiac and non-celiac gluten sensitivity are part of the same disease spectrum — one we can prove directly and the other only indirectly,” says Prashant Krishnan, MD, a gastroenterologist at Castle Rock Adventist Hospital.

The only way to know if you’re sensitive to gluten is to go off gluten for two months, he says. If symptoms resolve and then return when reintroducing gluten into your diet, then you may be sensitive to gluten.

ELEVATE 4 Spring 2014

grain The great

glitch Gluten issues are becoming more prevalent — and more widely understood. The rise in both gluten-related awareness and diagnoses in recent years can be attributed to a number of factors, including environmental awareness and higher gluten exposure, says Scot Lewey, DO, also a gastroenterologist at Castle Rock Adventist Hospital.

“It’s gained traction as people have tried gluten-free diets, and as it’s received more media attention, with Olympic athletes and Hollywood stars as proponents,” he says.

Another issue driving gluten problems is that the flour we eat is not the same as it was just a few decades ago.

“It wasn’t genetically modified and cultivated back then to yield a higher gluten content. But the grain and food industry realized a higher gluten content made things bake, store, and taste better, and they could get better yields because high-gluten wheat is easier to process to make the kinds of products that people want,” Lewey says.

Celiac can cause more than just GI problems. Even though celiac and gluten sensitivity are commonly associated with intestinal issues, they also can be present with or without the intestinal symptoms. Skin problems are common with celiac, and often involve a blistering, painful rash typically found on knees, elbows, chins, buttocks, and around the scalp.

Lewey also estimates that 10 to 20 percent of his patients present with purely neurological symptoms, which can be similar to symptoms of multiple sclerosis, including vision issues, aching joints, and coordination problems.

“They may go through a neurologic workup looking for multiple sclerosis, including an MRI of the brain,” he says.

Unexplained iron deficiency, recurrent miscarriages or infertility, premature osteoporosis, and other autoimmune conditions such as type 1 diabetes — can also be celiac-related.

Screenings are recommended for individuals with autoimmune diseases, as well as people who have first-degree relatives with celiac. “The prevalence of celiac in a person with a first-degree relative can be as high as 30 percent,” Lewey says.

Celiac disease, an autoimmune disorder in which people are unable to digest gluten, is 100 times more common now than it was 10 years ago.

Unchecked celiac ups your risk for other autoimmune diseases. The case for controlling celiac goes beyond the disease itself.

For people with undiagnosed or untreated celiac disease, the longer they continue to consume gluten, the higher their risk is of developing a second, third, or fourth autoimmune disease, Lewey says. “Your risk for type 1 diabetes, lupus, or a thyroid condition goes up dramatically. But once you’ve been gluten-free for about five years, your risk for these and other autoimmune diseases goes back to what it is for the normal population.”

Some people do require more treatment than eliminating gluten.

For most people, a strict gluten-free diet — no exposure at all — is sufficient to relieve celiac symptoms. “If that doesn’t work because you’re extremely sensitive to gluten, we may need to suppress your immune system by putting you on steroids like prednisone,” Krishnan says. “It can help decrease the inflammation in order to alleviate symptoms and improve absorption of nutrients.”

Eliminating or reducing gluten can be good for your health — period. Even if you haven’t been diagnosed with celiac or non-celiac gluten sensitivity, reducing or eliminating gluten from your diet can be healthy. Some people who’ve done so have experienced benefits from decreased joint pain to clearer skin and weight loss. But if you’re considering it, Lewey offers a cautionary note.

“If you’re going to completely eliminate gluten or restrict it significantly, you really should get screened for celiac first. Because once you go gluten-free or restrict gluten, many people feel much better, but then you’re left with the question: Did you or did you not have celiac, and do you need to be gluten-free?”

FREE COMMUNITY SEMINAR Date: Thu, Apr 24 • Time: 6-7 p.m.

Want to learn more about gluten sensitivity? Join Dr. Krishnan for a discussion on gluten, celiac, irritable bowel syndrome and other digestive health issues. Bring your questions for the Q&A session.

Location: Castle Rock Adventist Hospital Conference Center RSVP to CRAHRSVP@centura.org Dr. Prashant Krishnan

castlerockhospital.org

GASTROINTESTINAL AND ENDOSCOPY SERVICES Endoscopy Services at Castle Rock Adventist Hospital offers outstanding care by highly experienced nursing staff and physicians — close to home.

Some of our services include: • Latest technology in diagnosis and treatment of digestive system problems and diseases • Ability to examine the esophagus, stomach, small and large intestine • Colorectal cancer screening • Upper GI screenings (heartburn symptoms) The Castle Rock Endoscopy Services features the newest generation of technology, which affords greater patient comfort and safety.

Physicians use the highest definition imaging, which allows them to view the gastrointestinal path with a level of detail not previously possible.

This advanced technology combined with the experience of the physicians and staff helps diagnose problems earlier, often leading to easier treatment. It also improves the accuracy of the diagnosis and treats even the most advanced disorders.

For more information about the services available, visit castlerockhospital.org/gi.

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Photos: ©Istock.com/NickS, SeaHorseTwo, Douglas_Freer , Vankina

Being overweight does not exclude you from celiac.

Traditionally, people with “classic” celiac have trouble absorbing nutrients and historically would have been underweight. But about 30 percent of newly diagnosed people with celiac are overweight, and about 30 percent are constipated, Lewey says. “In the U.S., we have easy access to simple calories that don’t require any real work by the body to digest and can be absorbed easily throughout the intestine. For example, soda, fruit juice, and high fructose corn syrup,” he says. “So you can be overweight and have celiac.”

How one woman used bariatric surgery as a stepping-stone to begin a more active lifestyle Less than two years ago, Carol Timm was morbidly obese, had little energy to accomplish more than the minimum tasks of daily life, and was facing a future defined by serious health problems.

“I have a family history of heart disease and my cardiologist told me that if I didn’t do something about my weight, he thought that within three to five years I’d probably have a cardiac arrest,” Timm says.

It was this risk coupled with the regret that she wasn’t able to be active with her four young grandchildren that led Timm to decide on bariatric surgery, and in November 2012 she underwent laparoscopic gastric bypass at Parker Adventist Hospital, a bariatric surgery center of excellence.

Since then, the 64-year-old has shed 159 pounds and counting, changed her eating habits for the better—including giving up the sweets that she used to love—and is a regular exerciser. In December, she competed in her first 5K run with her family.

“I would never have been able to do that before the surgery. I would never have even considered it … but I made it!” she says. “A whole new life has opened up for me.”

“A whole new life has opened up for me.”

Fighting a losing battle While many people like Timm struggle for years losing and regaining weight, there’s solid scientific evidence showing that the hormonal production of fat cells pulls strongly in the wrong direction for them, says Joshua Long, MD, medical director of bariatrics at Parker Dr. Joshua Long Adventist Hospital.

Parker Adventist Hospital and Castle Rock Adventist Hospital are part of Centura Health, the region’s leading health care network.

“They often come in buried in guilt and blaming themselves, but what they need is something powerful to help level the playing field.”

According to Long, the best candidates for surgery are individuals with a body mass index (BMI) of 35 or higher with a health condition related to their obesity, or a BMI of 40 without a related After bariatric surgery and condition. losing 159 pounds, Carol Timm “The most successful candidates are also committed is now running 5k races and to the overall process and to using all the tools that we give them,” playing with her grandchildren.

Long says. “Patients who are highly motivated and really interested in partnering with us to maximize their benefits will get the most out of it.”

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Beating diabetes with bariatric surgery The evidence that weight-loss surgery can resolve diabetes is mounting. A study published last September in the Annals of Surgery found that the biggest predictors of sustained diabetes remission after bariatric surgery were:

 Long-term weight loss  Having diabetes for less than

five years before surgery

 Having gastric bypass surgery

versus gastric banding

Matthew Metz, MD, a bariatric surgeon at Parker Adventist Hospital, helped collect data from his patients for the study. Another procedure not studied in this research offers even greater odds for long-term resolution of diabetes, he says. The duodenal switch calls for removing a large Dr. Matthew Metz part of the stomach and rerouting food away from much of the small intestine to limit how the body absorbs it.

“We’re seeing as high as a 98.9 percent resolution of diabetes with the duodenal switch,” he says.

Learn More If you are interested in learning more about the types of weight-loss surgery and whether you are a candidate, join Dr. Josh Long, bariatric surgeon, for a FREE community seminar at Castle Rock Adventist Hospital on Wednesday, May 7, at 6 p.m. To register, call 303-777-6877 or go online to castlerockhospital.org/ wellnessprograms.

Photos: © ellen Jaskol

Starting Anew

spring

into

acti n

Ace advice for treating shoulder injuries to keep you off the sidelines

Pinpointing the pain Shoulder injuries are common in adults, and sometimes their causes can be difficult to determine, says Todd Wente, MD, an orthopedic surgeon at Colorado Orthopaedics who is fellowship-trained in sports medicine.

“It often is related to several factors, such as diminishing blood supply, progressing arthritic disease, and repetitive stress to the shoulder region,” he says.

Shoulder impingement and rotator cuff injuries are some of the problems Wente encounters most frequently. They are particularly common with activities where the person is working over their head or out and away from the body.

“These are vulnerable positions, particularly for the rotator cuff. We see a lot of shoulder issues with weight lifters lifting above shoulder height and in tennis players, especially those with a more aggressive overhead game,” he says.

Preventing long-term problems While a shoulder injury — even a mild one — isn’t something you should simply play through, the good news is most pain responds well to early treatment.

“Shoulder pain may be an indicator of a muscle imbalance or a shoulder at risk for potential injury. Oftentimes a simple exercise program may help restore their activity level and avoid more significant injury in the future,” Wente says.

Some conditions may respond better to surgical intervention. For example, impingement may ultimately require resection of bone spurs or of a chronically inflamed bursitis, and some types of rotator cuff tears may respond better to surgical repair. Many of these procedures are now performed arthroscopically through small incisions using wands that hold tiny instruments. This minimally invasive surgery minimizes trauma to the area and promotes fast recovery, Wente says. And that means you’ll be back at your game even sooner.

FREE COMMUNITY SEMINAR Date: Wed, Apr 30 • Time: 6-7 p.m.

From shoulder replacement to physical therapy options, learn how to take care of your shoulder and what shoulder replacement surgery entails. Presented by Dr. Todd Wente and physical therapists at the Castle Rock Adventist Center for Rehabilitation.

Location: Castle Rock Adventist Hospital Conference Center RSVP to CRAHRSVP@centura.org

castlerockhospital.org

Dr. Todd Wente

Give it a rest Shoulder injuries aren’t just a problem for adults: Adolescents are vulnerable, too.

“In young people, the vast majority of shoulder pain results from overuse,” says Todd Wente, MD, an orthopedic surgeon at Castle Rock Adventist Hospital. “In the developing skeleton, the repetitive high forces seen in sports that involve throwing, swimming, and volleyball can cause significant injury to the shoulder.”

He recommends a two-pronged approach to keeping your teen healthy: 1. A defined period of rest. “Some kids spend their summer playing baseball, pitching several games a week, and practicing when they’re not playing,” Wente says. “They need to have a period of rest as well as follow the established pitch count recommendations for their age group.” For more information, visit stopsportsinjuries.org.

2. Targeted training. Shoulder problems very rarely require surgery in this age group, but it’s important to understand the mechanics of their sport. “Proper technique as well as customized exercise programs may be needed to strengthen the muscles that get fatigued playing these sports all season or all year long,” Wente says.

Get your shoulder back in shape If you are looking for physical therapy options to treat shoulder pain — ­ we can help! Castle Rock Adventist Center for Rehabilitation provides expert care for shoulder pain, including sports injuries and postoperative care. Go to castlerockhospital.org/rehab for more information or call us at 720-455-3700.

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Photo: ©Istock.com/kaarsten

As the weather warms up, many of us are eager to resume our outdoor activities on the field, course, and court. But getting back into action after winter hibernation can sometimes spell shoulder pain. Here we take a look at some common shoulder problems and what medical therapies are available should you need them.

Portercare Adventist Health System Non-Profit Org US POSTAGE

Castle Rock Adventist Hospital is GROWING! 2350 Meadows Boulevard Castle Rock, CO 80109

Castle Rock Adventist Hospital is 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.

Spring HEALTH CLASSES AND EVENTS

Join the health experts at Castle Rock Adventist Hospital to learn ways to stay healthy as well as new treatments for health problems. All programs are FREE and will be held at Castle Rock Adventist Hospital unless otherwise noted. Check-in and light refreshments will begin 30 minutes prior to each class. For further information or to register, go to castlerockhospital.org/wellnessprograms or call 303-777-6877.

Menopause Review what to expect during the menopause transition, outline management options, and raise awareness of the predatory practices that take advantage of women going through menopause. Presented by Dr. John Stallworth, OB/GYN. Date: Tue, Apr 29 Time: 6:30-7:30 p.m.

Breast Screening: THE HOW’S AND WHY’S OF AN ANNUAL EXAM There is a lot of confusion about when and how often to get a mammogram. Learn how the screening works and how it may play an important part in your breast health.

Presented by Dr. Jinnah Phillips, breast radiologist.

Date: Tue, May 6 Time: 6:30-7:30 p.m.

An Overview of Thyroid Disorders Thyroid diseases include hyperthyroidism, hypothyroidism, Hashimoto’s disease, and thyroid cancer. Learn about the causes, symptoms, and treatments for these thyroid disorders. Presented by Dr. Julia Rifkin, endocrinologist.

Date: Thu, May 15 Time: 6-7 p.m.

Photo: ©IStockphoto.com/mediaphotos

elevate your spring

Please join us for some gardening fun at the Garden of Eatin’, our community garden which boasts 94 raised garden beds which are available to the community.

The garden also features a children’s play area, a large plot for the hospital’s restaurant, and an outdoor area where we host healthy cooking classes.

Visit castlerockhospital. org/community-garden for your application today.

Hurry – space is limited!

PAID

Denver, CO Permit NO. 4773