Elevate Winter 2014

Living at the height of wellness WINTER 2014 | Volume 2, Issue 1

Roll Into a Healthy New Year Small choices reap huge rewards in your physical, mental, and emotional health

It Takes A Village

A young Castle Rock man’s life is saved through the efforts of strangers

Stronger Backs Page 3

CHOOSING a Doctor Page 6

Solving Stomach Pain Page 7

FREE Health Classes Page 8

Slow and Steady Wins The accepted belief that it takes about 21 days to change or form a habit may not be true after all.

A 2009 study found that it can take anywhere from 18 to 254 days, and can vary widely from one person to the next.

Choosing to

Change

Whether you call them resolutions or just healthy changes, turning a decision into a habit requires making choices — and not just one, but all day, every day, from what you eat (or don’t) to how often you move, and so on. That’s why it’s so important to zero in on one change Amanda Wheatley at a time, says Amanda Wheatley, MD, a physician at Ridgeline Family Medicine in Castle Rock. “I tell my patients to make one change in their diet and maybe one change in their activity. That helps them be realistic about it,” she says. Choice is also one of the key principles guiding the CREATION Health Lifestyle, a scientifically proven approach that Castle Rock Adventist Hospital’s wellness programs are based on.

To learn more, visit castlerockhospital.org/choice.

The Hardest Step The bad news: Of the 40 percent of Americans who make New Year’s resolutions, just 8 percent keep them for more than a few weeks.

The good news: The stalwarts who make it past this hurdle are more apt to stick with their resolutions all year.

New Year — new you Choose to make one positive change in your life to improve your overall health, and stick to it for 30 days. Join us in the challenge at Cafewell.com/challenge/chooseto-improve-and-stick-to-it.

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

choice Healthy Instincts For humans, the ability to make choices isn’t really a choice; it’s just part of being human. The frontal lobe of our brains, which controls reasoning and planning, accounts for 33 percent of our brains, compared with just 3 percent in cats and 7 percent in dogs.

Rehab Services Help Patients Grow

Occupational therapy helps regain skills needed for daily living; includes specialized hand therapy program for patients recovering from hand or wrist injuries or conditions such as arthritis.

Physical therapy teaches exercises to help reduce pain and increase mobility, strength, and functioning.

Speech therapy helps children and adults with challenges, including speaking, understanding, reading, and writing.

Using modified barium swallow studies, our skilled team of speech pathologists also can assess and treat individuals with swallowing disorders.

Jaime Butler

Q&A

with Jaime Butler, MSPT, rehabilitation coordinator Q. Which is better for an injury — heat or ice?

A. The short answer is, it depends on the type of injury. Here’s a quick rule of thumb: • Ice an acute injury such as a pulled muscle and follow the R.I.C.E. principle: Rest, Ice, Compression, and Elevation • Choose heat for chronic injuries before an activity and ice after an activity • Avoid applying heat or ice for more than 20 minutes at a time.

FAST FACT

10%

Young female athletes are 10 percent more likely to suffer knee injuries, but programs that teach girls how to jump and land properly can reduce the risk.

To learn more or schedule an appointment at Castle Rock Adventist Center for Rehabilitation, call 720-455-3700 or visit online at castlerockhospital.org/rehab.

castlerockhospital.org

Squat Your Way to a Stronger Back Treating back pain early on with physical therapy may not only be healing but also cost-effective, according to a recent study. Physical therapy may help reduce pain, and increase mobility, strength, and functioning. Castle Rock Adventist Hospital’s rehab therapy program can get you started on the path back to health.

If you want to prevent back pain, engage in daily activity to strengthen your core muscles. One good exercise is wall squats: • Stand with your feet hip-width apart and your back against a wall • Draw your abdominals in, bend your knees, and slowly lower into a squat

• Slide down the wall to 45 degrees, keeping your knees in line with your toes • Hold for five seconds and slowly return to standing position • Repeat 10 times

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Photos clockwise: ©Istock.com/4774344sean, ©Istock.com/monkeybusinessimages, ©Istock.com/b-d-s, ©Istock.com/OSTILL

Whether you are recovering from an illness or injury or just trying to prevent them, rehabilitation can support your health plan. Castle Rock Adventist Hospital is the only local facility that offers outpatient physical, occupational, and speech therapy all under one roof. Rehabilitation services are used to help patients recover from joint replacement surgery, strokes, sports injuries, heart attacks, and many other conditions. The three specialties offered at the Castle Rock Adventist Center for Rehabilitation include:

Though he’s used to being the savior, when one of America’s bravest found himself in need of help, his community and his hospital were there for him

Saving a Soldier CPR Saves Lives CPR was instrumental in saving Greg Archer’s life, yet 70 percent of Americans are hesitant to administer CPR during a cardiac emergency.

• While 88 percent of cardiac arrests happen at home, less than 10 percent of those victims survive.

• But if CPR and automated external defibrillators are administered before EMS providers arrive, the survival rate jumps to 40 percent.

On Aug. 6, 2013, Greg Archer experienced a condition known as sudden cardiac death on the front lawn of his Castle Rock home, yet he lived to tell about it. Sudden cardiac arrest occurs when the heart’s electrical system becomes extremely irregular, causing its ventricles to quiver very rapidly and irregularly (ventricular fibrillation). When this happens, little or no blood gets pumped to the body. Death can occur if treatment isn’t received immediately.

Before the incident, Archer had suffered with migraines following traumatic brain injuries received during two tours as a senior medic in Iraq. “I’d also begun having a slight electrical problem with my heart that wasn’t considered a big deal at the time,” he says. So when the 32-year-old felt a migraine coming on that afternoon, he took his medication, unaware that a potential side effect could be electrical disturbances in the heart.

Greg Archer, cardiac arrest patient (right), and Dr. Jeffrey Sippel, pulmonary and critical care specialist at Castle Rock Adventist Hospital

Castle Rock Adventist Hospital is part of the Centura Heart Network, the region’s leading provider of cardiovascular care.

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A rapid response at every turn

Giving thanks for a second chance

Since the day it all happened — a day Archer doesn’t remember — he’s been piecing the story together and experiencing a sense of renewed hope he says he finds difficult to express adequately. But the one thing he hasn’t had trouble expressing is his gratitude for those who saved his life. Archer and his neighbors now hug when they see one another. He’s thanked the EMS crew repeatedly, and he’s visited Castle Rock Adventist Hospital more than once, where he says he now feels like a rock star.

“I was so impressed by everyone’s attitude toward me. It wasn’t like I was a patient; I was everyone’s friend. That’s why I’m such a huge fan of the Centura hospitals now, because of the way they treat people,” Archer says.

As for what comes next — the father of three is starting a second career as a photographer, and is even donating some of his work to Castle Rock Adventist Hospital. (You can check out his website at spectrumarcher.com.) And while he has some residual heart and lung damage from the incident — along with the injuries suffered in combat — he says he’s grateful for another chance at life.

“It’s not a big deal when I think about the alternative. I’m doing fine because I’m alive.”

Castle Rock Adventist Hospital offers a full continuum of heart care, from wellness programs and heart-healthy cuisine to emergency care and interventional treatment. And because Castle Rock Adventist Hospital is part of Centura Health, its sister hospitals are just a few minutes away by Centura Health’s Flight For Life if cardiac surgery is needed.

castlerockhospital.org

Advanced technology comes to Castle Rock Castle Rock Adventist Hospital boasts a new type of catheterization lab rarely found in community hospitals. Called a hybrid cath lab, this feature allows physicians to perform heart procedures as well as other treatments for conditions such as stroke and gastrointestinal bleeding, says Russ Royer, manager of the lab.

“Its dual capabilities allow us a lot more flexibility in the types of procedures we can offer to the community.”

The new hybrid lab provides the opportunity for interventional radiologists to provide treatments, such as stopping internal bleeding, without the need for invasive surgery. It also can construct 3-D images from X-rays while reducing radiation exposure, Royer says.

Royer has plans for the lab on an education front as well.

“Traditionally, the cath lab has had this veil of mystery around it regarding what we do here. But one of my goals is to lift that veil,” he says. He and his staff will be working with EMS to provide continuing education as well as offering community classes on heart health.

Seeing the signs:

Recognizing a heart attack

As February is American Heart Month, it’s a good time for a refresher on the signs and symptoms of a heart attack. And while we often think of heart attack pain being limited to the chest, it can actually occur anywhere between the belly button and the jaw, says Steven Friedrich, MD, a cardiologist at South Denver Cardiology.

“It’s typically a vague pain that lasts for several minutes, and is often worse with exertion,” he says. “Anything that lasts only a second or two that you can pinpoint is probably not your heart.”

The pain may be accompanied by shortness of breath, sweatiness, or nausea. Though research shows that women do have more atypical symptoms than men, the vast majority of symptoms are similar. Heart disease remains the leading killer of women in the U.S.: 1 in 3 women die of heart disease, compared to 1 in 30 women who die of breast cancer.

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Photos opposite page: ©Istock.com/NickS, PORTRAIT© Michael Richmond

Shortly after taking the medication, Archer collapsed on his front lawn. Fortunately, Archer’s neighbor found him and administered CPR until EMS arrived and began advanced cardiac life support protocols, including CPR, intubation, chest compressions, and defibrillation.

“Three critical things happened within 27 minutes that gave this gentleman the opportunity to survive,” says Jeffrey Sippel, MD, pulmonary and critical care specialist who treated Archer at Castle Rock Adventist Hospital. “His neighbor returned home 15 minutes later than normal and saw Greg in his front yard; paramedics arrived incredibly fast; and the hospital had all critically needed therapies started and the patient heading up to the ICU by the 27-minute mark.”

Once Archer arrived at Castle Rock Adventist Hospital’s emergency department, a temperature management system called the Arctic Sun® was used to cool his body and stabilize his condition.

When the heart starts beating and blood begins to flow back to the brain and the heart following cardiac arrest, those organs can be damaged, says Stefen Ammon, MD, medical director for emergency services at Castle Rock Adventist Hospital.

“We know that cooling a patient effectively slows the metabolic rate in vital organs, such as the heart and brain, limiting the damage suffered by these organs in a patient who has suffered cardiac arrest. This allows patients to not only survive, but to do so with good neurologic outcomes.”

After waking up the next day, Archer’s condition worsened. He was flown via Centura Health’s Flight For Life® to Castle Rock’s sister hospital, Porter Adventist Hospital, where he was placed on a rotating bed to help drain fluid from his lungs.

It would be 11 days before Archer would awaken again — this time for good.

“The nurses and doctors just started coming in, one after another, to see me.

You really felt a sense of faith there,” says Archer, who had a cardiac defibrillator implanted on Aug. 21.

3 questions to consider when choosing your family physician

A primary care physician, PCP, commonly falls under one of three specialties: a family physician (treating patients of all ages), a pediatrician (specializing in children from birth to adolescence), or a general internist (for patients 18 and over). Sometimes women also use gynecologists as their PCP. “Your primary care doctor should be your home for medical care,” says Jane Ruger, MD, a physician at Ridgeline Family Medicine in Castle Rock. “This should be the first person patients consult with when they have a concern, need a referral, or want advice; and also to give them preventive health recommendations.”

With the evolution of technology and the advent of the Affordable Care Act, choosing your family doctor shouldn’t be just a matter of who is in the neighborhood or who is on your health plan (although those are important).

Ruger recommends adding these three questions to your selection process:

Does the doctor use an electronic medical record (EMR)?

Is your doctor part of a medical home?

How long is the initial visit for a new patient?

An EMR is a digital file of a patient’s medical history. Not only does this improve quality and convenience of patient care but because all doctors involved in the patient’s care can access the patient’s medical record, it allows for better diagnosis, treatment, and coordination of care.

A patient-centered medical home, PCMH, is a new model of health care, promoted through the Affordable Care Act. In this model, your PCP becomes the quarterback, taking the lead in providing preventive and primary care that keeps you healthy while also coordinating specialty care when needed. The goals are to improve health status, improve quality of health care services provided, and reduce costs.

You’re not looking to save time when it comes to you and your family’s health. Check with the doctor’s office to make sure that the doctor plans to spend at least 30 minutes with you on your initial visit to obtain a complete health history.

According to a 2011 Consumer Reports study, 76 percent of doctors surveyed reported that forming a long-term relationship with a PCP is the most important thing a patient can do to obtain better medical care.

The Centura Health Physician Group has doctors in your neighborhood whose offices can serve as medical homes, helping to ensure patients get the most appropriate and cost-effective health care.

Ridgeline Family Medicine at Plum Creek Brian Hill, MD Marlow Perez, MD Jane Ruger, MD 831 S. Perry St., Suite 200 (Located near Safeway, just south of Plum Creek Parkway and Perry St.) Castle Rock, CO 80104 303-649-3120 Ridgeline Family Medicine at The Meadows B. Douglas Hallmark, MD Raewyn Shell, DO Dwayne Thomason, DO Drew Werner, MD Amanda Wheatley, MD P. Kim Engler, PA 2352 Meadows Blvd., Suite 300 (Located on the campus of Castle Rock Adventist Hospital, Alexander Building) Castle Rock, CO 80109 720-455-3750 Ridgeline Family Medicine at Castle Pines Opening in early spring 2014 Centura Health Neighborhood Practices Castle Pines Family Medicine 7280 Lagae Rd., Unit J Castle Rock, CO 80108 720-236-1292 Founders Family Medicine 4386 Trail Boss Dr. Castle Rock, CO 80104 303-688-8666

Learn more about these physicians, services they offer, locations, and hours by visiting online at

ridgelinefamilymedicine.org.

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Photo: FAMILY ©iStockphoto.com/mediaphotos

The ABCs of finding a PCP

Find a Doctor

More than

laparoscopic cholecystectomies — minimally invasive gallbladder removals — are performed each year in the U.S.

Dr. David Lundy

Help for a little-known gallbladder disorder that’s becoming more widespread

Gallstones are a common problem — especially among women over 40. But in the last couple of decades, medical professionals have begun to understand that not all gallbladder disease originates from stones. In fact, many people may actually have suffered for years from biliary dyskinesia, a lesser-known gallbladder disorder that is coming to light as more people are being diagnosed with it.

What it is: Biliary dyskinesia is a condition in which the gallbladder can’t release bile into the small intestine. “Simply stated, biliary dyskinesia is nothing more than your gallbladder not working right,” says David Lundy, MD, a minimally invasive general surgeon at Castle Rock Adventist Hospital.

What it feels like: People with this condition typically have pain in their right upper abdominal area; they often feel nauseated or bloated, especially after eating fatty or fried food.

How it’s diagnosed: A test known as a HIDA scan can determine the functionality of the gallbladder by measuring the rate that bile is released from it — known as your ejection fraction.

“If your ejection fraction is lower than about 35 percent, you’re going to have symptoms of gallbladder issues,” Lundy says. “This is biliary dyskinesia and when we take their gallbladders out, most people will feel a lot better.”

Could it be biliary dyskinesia?

If you are experiencing any of the following symptoms, talk with your doctor about being tested for this gallbladder disorder: • Dull persistent pain or recurring pain that feels like a cramp below right ribs (pain may also spread to upper back and shoulders) • Feeling nauseous or bloated after eating fatty or fried foods • Burping, vomiting, or loose stools, and indigestion

A related syndrome: The same symptoms also can occur when HIDA results are abnormally high, Lundy says. In just a few short months at Castle Rock Adventist Hospital, he’s already seen three young women who fall into this category, known as hyperactive gallbladder.

“Instead of having an acute gallbladder attack, they have chronic pain, and no one’s been able to figure it out after multiple tests,” Lundy says. “But when they finally have a HIDA scan, they end up having a very high ejection fraction, and we removed their gallbladders and they’ve all felt better.”

Lundy believes sharing this knowledge could help many people and their care providers. “For primary care physicians who are frustrated with not being able to identify these patients who have this chronic abdominal pain, a certain percentage of them probably have biliary dyskinesia, whether it’s too high or too low,” he says. castlerockhospital.org

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Photos: Portrait: © Michael Richmond, ©Istock.com/kaarsten

Relief At Last

Why women may be more prone to gallbladder problems Gallbladder problems are on the rise — even among younger women — and excess estrogen may be a factor. It can increase cholesterol levels in bile and decrease gallbladder contractions, which may cause gallstones to form.

“There’s a lot more estrogen in our environment.

And as body mass index continues to go up among women, there’s even more, as fat produces estrogen in the body,” Lundy says. However, he notes that obesity isn’t necessarily a precursor for problems.

“I take gallbladders out of young, healthy, thin women regularly as well, so it’s something we’re still learning about.”

Portercare Adventist Health System

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Ban cold meds for kids 2350 Meadows Boulevard Castle Rock, CO 80109

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

Copyright © Centura Health, 2014.

WINTER 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.

Curing A-Fib Learn when it’s time to consider surgical ablation for your atrial fibrillation from cardiologist Dr. Sri Sundaram.

Date: Tue, Feb 4 Time: 6:30-7:30 p.m.

Time for Knee Replacement?

If knee pain is stopping you from being active, your overall health is taking a toll. Find out if it’s time to replace your joint with orthopedic surgeon Dr. John Xenos.

Date: Wed, Feb 12 Time: 6:30-7:30 p.m.

Treating Hernias Learn about hernias, the different types, and treatment options with surgeon Dr. David Lundy.

Date: Tue, Feb 18 Time: 6:30-7:30 p.m.

Overcoming Back Pain Discover the myths and facts of treatment options for the more common causes of back pain with neurosurgeon Dr. Brad Duhon.

Date: Thu, Feb 20 Time: 2-3 p.m.

Dine Your Way to Low Cholesterol Are you unable to take a statin due to an adverse reaction or side effect? Join us to taste some foods that can help with The Cooking Cardiologist Dr. Richard Collins.

Date: Wed, Feb 26 Time: 6:30-7:30 p.m.

When a Runny Nose Is More Find out when you need to see your pediatrician about your child’s ongoing runny nose with pediatric ENT Dr. James Jaskunas.

Date: Tue, Mar 25 Time: 6:30-7:30 p.m.

Breast Cancer Surgery Options Learn how to assess your risk of breast cancer and the different surgical options for breast cancer with breast surgeon Dr. Toni GreenCheatwood.

Date: Thu, Mar 13 Time: 6:30-7:30 p.m.

Upcoming classes in May Do You Need a Yearly Mammogram?

Is It Your Thyroid?

Common GYN Issues

Sidelined by a Sports Injury?

Learn how to prevent injuries, how to treat at home, and when surgery is needed with sports medicine orthopedist Dr. Todd Wente.

Date: Wed, Mar 19 Time: 6:30-7:30 p.m.

Shoulder Pain Options From arthritis to rotator cuff damage, find out why your shoulders hurt and what you can do about it with sports medicine orthopedist Dr. Anthony Sanchez.

Date: Thu, Apr 3 Time: 6:30-7:30 p.m.

New Spine Pain Treatments Learn about emerging pain treatments, such as the use of stem cells, for spinal pain with spine specialist Dr. Scott Bainbridge.

Date: Wed, Apr 9 Time: 6:30-7:30 p.m.

Photo: ©iStockphoto.com/Sabrina Pintus

elevate your winter

If your child is fighting a stuffy nose or cold, don’t be tempted to reach for an over-the-counter cough or cold medicine, says Donald Traver, MD, a Castle Rock pediatrician. “There’s been no indication that for kids under the age of 6 these medicines are beneficial and may even be harmful,” he says. Side effects can include breathing problems and seizures.