Flourish Fall 2011 by Clementine Words

Brain remodeling

HPV Shot in men

Fit to Drive

flourish Fall 2011

Penrose-St. Francis Health Services

PLUS!

Learn the five foods that can slow down aging

SeedS OF HOPE

Breast cancer surgery made more precise

healthystart Safe Driving

Fitness to Drive is recommended for: • People who have stopped driving due to a stroke, brain injury, multiple sclerosis or other condition. • Older adults who are experiencing vision changes, arthritis, diabetic neuropathy, or dementia or are unsure of their driving skills. • Students and new drivers with learning disabilities, attention deficit disorder or physical disabilities. The program includes a driving test to assess vehicle control, judgment and problem-solving skills as well as a clinical evaluation of vision, cognitive skills (memory, judgment, speed of response) and motor function. After the assessment, drivers meet with a driving specialist to go over the results and receive recommendations.

Cover Photo: ©iStockphoto.com/ kcline

Go to penrosestfrancis.org/drive to learn more, or call 719-776-5200. Flourish is published four times annually by Penrose-St. Francis Health Services. 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 flourish@centura.org. Flourish is produced by Clementine LLC of Denver, Colo. Executive Editor is Jill Woodford.

2222 N. Nevada Ave., Colorado Springs, CO 80907

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Magic Elixirs 5 foods that can turn the tides of time Although the Fountain of Youth has yet to be found, there are many natural foods that can help keep you young, inside and out. Sharon Jacob, a registered dietitian with St. Francis Medical Center, shares five essential “youthful” foods.

5 servings/day

2 cups/day

3 servings/day

Fruits and Vegetables provide vitamins, minerals, fiber and anti-aging phytochemicals. Dark green and brightly colored fruits and vegetables are best.

Tea is high in antioxidants, which help prevent damage to cells. Green tea is particularly high in polyphenols—a free-radical fighter— and can reduce heart disease risk by 31 percent.

Whole Grains provide fiber, B vitamins, antioxidants and minerals such as iron, zinc and copper.

Dairy is often overlooked in adulthood but provides necessary nutrients, including calcium, Vitamin D and potassium, that are necessary for longevity.

No More Mouth-to-Mouth A new CPR method that doesn’t require mouth-to-mouth breathing can double a person’s chance of surviving cardiac arrest. “Hands-only” CPR only requires a bystander to make rapid, firm pushes on to how Learn andsthe chest. “When a person collapses, they have as much as 10 h perform PR at minutes’ worth of oxygen left in their blood,” says David Ross, only C rancis DO, an emergency medicine physician with Penrose-St. Francis tf s e penros /CPR. Health Services. “By pushing on the chest, the bystander is g .or actually pumping the heart and circulating that blood.” Penrose-St. Francis Health Services

Photos left to right: ©iStockphoto.com/ procurator, adlifemarketing, dwall817, sdominick, Kasiam, pjjones, amphotora, julichka, AlexRaths

Drivers impaired by injury, illness or age can now get help to stay on the road safely through a new program being offered by Penrose Hospital rehabilitation services. The program, called Fitness to Drive, assesses drivers and then makes recommendations for physical training or adaptive equipment that can help them continue to drive safely.

Hear more ways to slow down the aging process at a free program. See back cover for details.

For the Man in Your Life Vaccinate:

HPV, or human papillomavirus, is the leading cause of cervical cancer in women and is now the top cause of oropharyngeal cancer in men, beating out smoking and drinking, according to recent studies. “We’ve seen an alarming increase in tonsil and throat cancer in non-smoking men in their late 30s through their early 50s that is a result of exposure to HPV earlier in their lives,” says Joel Ernster, MD, a head and neck surgeon with the Penrose Cancer Center. The HPV vaccine, once recommended just for girls, is now recommended for boys as well. In addition to reducing the risk of oropharyngeal cancer, the vaccine prevents 90 percent of genital warts in males.

& QA Matthew Blum, MD

Thoracic Surgeon specializing in lung cancer with the Penrose Cancer Center

Should current or former smokers get CT scans to screen for lung cancer? A study released a year ago showed that screening current and former smokers with CT scans can reduce lung cancer deaths by 20 percent, compared to chest X-rays. This was the first evidence of a viable screening to help us find lung cancer earlier. However, we do not recommend CT screening for all people in the same way we recommend colonoscopies or mammograms. Currently we believe CT screening is most useful in patients who match the criteria used in the study:

2 servings/week Omega 3 Fatty Acids reduce the risk of heart disease, diabetes, Alzheimer’s and age-related brain decline. Overall reduced inflammation is the reason for such powerful benefits.

Tough Call

• 55-74 years old • Smoked the equivalent of at least 1 pack of cigarettes daily for 30 years or more • Access to follow-up with a multidisciplinary team specializing in lung nodules

To more a learn bout u sing CT s to dete creenings ct lung cancer, call th Cance e Penrose rC Nodule enter Lung C 719-776 linic at -6997.

Choosing between an ER and urgent care Sure, it’s easy to know you need an emergency room if bones are protruding or someone’s unconscious. And a 100-degree fever typically can wait until your doctor’s office opens. But what about the “in-betweens” — conditions that can’t wait, but you also don’t want to spend money or time going to an ER unnecessarily. Carey Pelto, MD, medical director of Penrose Community Urgent Care, offers this guide to knowing the difference when it comes to the three most common visits to an ER. “If you’re unsure, call ahead and ask the nurse for the most appropriate venue for your symptoms,” he recommends. Condition

Needs an ER When Accompanied By:

Needs Urgent Care When Accompanied By:

Chest Pain

Pressure or squeezing feeling; shortness of breath; numbness; sweating; nausea; high fever; or sharp pain in chest

Cough with or without mucus production, chest muscle soreness

Headache

Described as “worst” headache of your life; severe pain; stiff neck; vomiting; injury to head; numbness, tingling or weakness in arms or legs; or slurred speech

Dull pain; accompanied by cold or flu symptoms; history of migraine; or sinus infection

Abdominal Pain

Abdomen tender to touch; bloody or black, tarry stool; vomiting blood; fever; or pregnant

Watery diarrhea; fever and muscle aches; chills; burning when urinating

For a more in-depth look at signs and symptoms that require emergency care, please go online to penrosestfrancis.org/urgentcare. penrosestfrancis.org

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Pinpoint Precision

High-tech procedure puts a bullseye on breast tumors

New-School Procedure Historically, tumors have been located through a wire-localization procedure, which requires patients to arrive at the hospital hours before surgery. The radiologist conducts a mammogram and inserts a needle threaded with wire into the breast near

the area of the tumor. The wire is taped into place and covered with what Green calls a “coffee cup” so the wire doesn’t move. “Wires are bulky, old-school technology,” says Green, who was trained to perform seed localization at the Mayo Clinic in Minnesota before joining Penrose last summer. “The wire can move around a little bit or become dislodged, so it has the potential to be not as accurate. And it can be painful depending on where it’s located.”

Fewer follow-up surgeries Seed localization also requires fewer follow-up surgeries to remove cancerous cells that were missed in the first surgery, according to studies. Margins were negative in 73 percent of radioactive seed patients versus 54 percent of wire localization patients, according to a study published in the Breast Journal in 2008. Positive margins are cancer cells that extend beyond the tumor to the edge of the surrounding tissue. A 2001 study published in the Annals of Surgical Oncology was one of the first studies published about radioactive seed localization. This study demonstrated that 26 percent of radioactive seed localization patients required second operations to remove additional positive margins compared with 57 percent of wire localization patients who required additional surgery.

Patients recommend seed localization having to arrive hours earlier on the day of surgery to have a radiologist insert a needle and wire at the site. • Speed: The procedure takes about 15 minutes. • Results: Seed localization removes less healthy breast tissue and requires fewer follow-up surgeries than traditional wire localization. Jennifer Kronebusch, 51, says her decision was easy after her surgeon, Toni Green, DO, medical director of

Patients who have had radioactive seed localizations to pinpoint breast tumors before lumpectomies say they’re pleasantly surprised at the ease and convenience of the new procedure. Seed localization, available in Colorado only at Penrose Hospital, offers these benefits to patients: • Convenience: Patients can schedule the procedure up to five days before surgery rather than

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Jennifer Kronebusch

Penrose-St. Francis Health Services

Photos (except dr. pomerenke): Ellen Jaskol

Women with breast cancer in Colorado Springs are the first in the state to be offered a new high-tech tool to more easily and accurately find and remove breast tumors. The procedure, called radioactive seed localization, offers “more precise detection (of the tumor), reduces the amount of breast tissue that needs to be removed and is more convenient for the patient,” says Toni Green, DO, medical director of breast oncology at Penrose-St. Francis Health Services. Penrose is the only hospital system in the state permitted to offer the procedure and Green is the only surgeon in the state authorized to perform it. Dr. Toni Green, With seed localization, a radiologist inserts breast surgeon a small radioactive metal capsule the size of half a grain of rice into the breast at the location of the tumor, which is detected via a mammogram. The procedure takes about 15 to 20 minutes and can be performed up to five days before surgery. The seed contains very low doses of radiation, far lower than X-rays or CT scans, Green says. During surgery, the surgeon locates the seed using a handheld device similar to a Geiger counter and then removes the tumor and the seed.

Family Tree

Your risk of breast cancer goes up if you have a family history of the disease or you inherited a cancercausing gene. Kate Crow, genetic counselor at Penrose Cancer Center, helps sort out fact from fiction regarding inherited breast cancer. Equal Opportunity Although the incidence of breast cancer in men is very low, you have just as much chance of inheriting a breast cancer gene from your father as from your mother. Family Looks Genes that create external appearance are different from those that cause breast cancer. You don’t have to look like your mother to inherit a cancer-causing gene. Six Genes Although BRCA is the most commonly known, there are now six known genes that cause breast cancer.

Radioactive seeds smaller than a grain of rice help surgeons locate and remove breast tumors more precisely.

☎

“So a full quarter of surgeries were avoided,” Green says. The procedure is appropriate for any patient who needs a localization, Green says. “It’s been very well received.” to reach Dr. Toni Green, call 719-571-8840

breast oncology at Penrose-St. Francis Health Services, compared seed and wire localizations with her. “It seems to be less invasive and it was amazing how quickly it went,” she says. “It took more time for them to set up than it did to put the seed in. When it was over, I walked out and said to my husband, ‘OK, let’s go get lunch.’ ” penrosestfrancis.org

Ounce of Prevention If you are carrying a breast cancer gene, you can take preventive measures to reduce your risk of getting breast cancer, such as taking tamoxifen or removing your ovaries.

Personal Assessment To understand your personal risk for breast cancer, sign up for a Breast Cancer Risk Assessment with the experts at the Penrose Cancer Center. You will meet with a genetic counselor for 60 to 90 minutes and then receive customized recommendations on genetic testing along with the type and frequency of breast cancer screenings you should obtain. The assessment costs $25 and a report will be sent to your physician.

For more information or to make an appointment, please call 719-776-5279.

Yearly breast screenings still best By Laura Pomerenke, MD Breast Surgeon with Penrose-St. Francis Health Services Two years ago, the U.S. Preventive Services Task Force recommended that women wait to begin annual screening mammograms until age 50 and then get them only every other year, versus the previous recommendation for annual mammograms beginning at age 40. Results of this new recommendation are still being analyzed, To but one study sched ule estimates that a dig i t al if all American mamm o g ram, women now in call 719-776 their 30s follow optio -8010, n 3. the new guidelines, 65,000 more women will die than under the previous recommendation. The USPSTF recommendation was based on studies in Europe and Canada, where digital mammography is not readily available as it is in the U.S., including at Penrose-St. Francis Health Services. Digital technology is more effective at finding breast cancer early, which provides more treatment options and the best chance for a cure. The American Cancer Society and the American College of Radiology continue to recommend that women at normal risk of breast cancer get: • Monthly breast self-exams • Annual physical exams by a trained professional • Annual screening mammograms starting at age 40 Fall 2011

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Making New Connections Rehabilitation helps brains recover after stroke

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they didn’t previously do. Partially damaged neurons can wake up. Other parts of the brain can take over. There’s this incredible interconnection throughout our brains.” Studies have found that the faster rehabilitation starts, the bigger the potential gains. Penrose starts rehabilitation in acute care within 24 hours if the patient is medically stable. Patients are moved to the rehabilitation unit as soon as possible, resulting in one of the earliest intervention programs regionally and nationally. “By doing this, we’ve been able to achieve outstanding outcomes,” House says. Rehabilitation acts like exercise for the brain muscle, helping the brain cells grow and take over new functions. For instance, a stroke patient may start out not being able to stand, let alone walk. So rehabilitation therapists will hold up the patient using a suspension system and help move the patient’s body through the motion. As the motion is repeated over and over and over, small electrical impulses are flashing in the brain that help form the new connections to relearn the function, House says. “We see miracles every week ” he says. “We’re shocked by what people end up being able to do. But we’re also shocked at how well people can adapt despite their disabilities.”

Stroke Centers Improve Odds Penrose-St. Francis Health Services is the only Joint Commission-certified Primary Stroke Center in Colorado Springs. Patients who receive care at a certified stroke center have a 20 percent lower chance of dying than patients treated at other hospitals, according to a study published in the Feb. 26, 2011, issue of the Journal of the American Medical Association. Penrose-St. Francis Health Services

In just a matter of minutes, a stroke can wipe out your ability to tie your shoes, remember your name or climb stairs. But doctors are learning that thanks to your brain’s amazing ability to remold itself, those functions don’t have to be lost forever. “In the last 10 years, we’ve really begun to understand the capability of the brain to accomplish neuroplasticity, literally the ability to change or mold itself like plastic,” says Glen House, MD, medical director of rehabilitation services at Penrose-St. Francis Health Services. Eighty percent of strokes are caused by a clogged artery that stops oxygen-laden blood from getting to the brain. Within 12 minutes, a pea-sized portion of Colorado Springs the brain dies from has the highest the lack of oxygen. stroke incidence And with it goes those in the state. Find functions that were out your risk of a controlled by that stroke by taking particular region. a free online The surroundassessment at ing area, called the penrosestfrancis penumbra, also has .org/stroke, where been damaged by the you also can learn lack of oxygen but is the warning signs not quite dead. “It’s of a stroke. teetering on ‘Do I die or do I live?’ ” House says. If blood flow can be restored to bring it oxygen, that portion often can be saved and further damage averted. Once the initial crisis has been controlled, that’s not the end of the story. With rehabilitation, the neurons (or brain cells) that remain can form new connections and take over the lost functions — even if they are in completely different parts of the brain. “There are many ways for neuro recovery to occur,” House says. “Existing neurons can sprout new dendrites and take over functions

calendar Fall FITNESS CLASSES Winter Sports Conditioning Get ready to shred the slopes. Cardiovascular conditioning, plyometrics, stability, full body and core strength will be the foundation of this functional and athletic workout. By first snowfall, you will be ready to take your training and fitness to the slopes. Date: Six-week session on Mondays: Oct. 17 – Nov. 21 Time: 5:15 – 6:15 p.m. Location: Penrose Hospital Wellness Center, 2222 N. Nevada Ave. Cost: PSF employees: $35 PSF volunteers: $40 Community members: $45 Registration required: 719-776-7393

Pilates A fun and energizing mat workout designed to improve posture, create long and lean muscles, and build strength and flexibility. Focus is on breathing patterns, spinal alignment and engaging the deep core muscles. Students of all levels are encouraged to participate, as exercises are presented at multiple fitness levels. Date: Four-week session on Tuesdays: Nov. 22 – Dec. 13 Time: 6:10 – 7:00 a.m. Location: Penrose Hospital Wellness Center, 2222 N. Nevada Ave. Cost: PSF employees: $25 PSF volunteers: $30 Community members: $35 Registration required: 719-776-7393 Women’s Healthy Back Club Do you have back issues like muscle tightness, aches and spasms, or do you just want to learn how to keep your back healthy? Let our experts help you incorporate fitness into your busy lifestyle, motivate you to stick to an exercise plan, and improve your overall back health. Each session will include a halfhour discussion with a back expert followed by a half-hour of supervised stretches and exercises. Date: 4-week program runs every Tuesday, Oct. 25 – Nov. 15 Time: 5:15 – 6:30 p.m. Location: Penrose Health Learning Center Gym, 1644 Medical Center Point Cost: $20/person Registration required: 719-776-4852 (Class is limited to 20 participants) *Note: If you have sharp back or leg pain, this class may not be right for you. Please consult your physician.

Tai Chi This form of ancient Chinese martial arts works to improve body awareness, strength and coordination. Date: Four-class session on Nov. 15, 17, 22 and 29 Time: 9 – 10 a.m. Location: Penrose Health Learning Center Gym, 1644 Medical Center Point Cost: $20/person Registration required: 719-776-4780

FEATURED PROGRAM

SUPPORT GROUPS Integrative Therapies for Cancer Patients A weekly support group offering a wide range of complementary therapies for cancer patients and caregivers including Reiki, Easy Chair Yoga, Progressive Relaxation, Guided Imagery, Managing Insomnia, Cognitive Behavior Therapy, Nutrition, Humor, and Aromatherapy. Classes are open to all cancer survivors in the community regardless of where they have received cancer treatment. Date: Thursdays Time: 2 – 3 p.m. Location: Penrose Cancer Center, 2222 N. Nevada Ave. Information: 719-776-5311 WomenHeart Support Group Have you been diagnosed with heart disease or suffered a heart attack? Are you at risk for heart problems? EMPOWER your personal journey toward heart health by joining the WomenHeart Support Group. Shared experiences can help you regain a sense of control, feel less alone, develop a positive life outlook and find the strength to commit to lifestyle changes. All ages are welcome! Date: Third Friday every month – Oct. 21, Nov. 18 and Dec. 16 Time: 11:30 a.m. – 1 p.m. Location: Penrose Hospital Volunteer Conference Room, 2222 N. Nevada Ave. Cost: FREE! Information: 719-200-2645

birthing classes

Back to Your Future: Survivorship Workshop for Women with Breast or GYN Cancers If you’re a survivor of breast or GYN cancer, join us for this four-week support group to rebuild a life of energy, excitement and enthusiasm—all in the company of other women sharing your journey. Each session will feature a cancer expert along with fellowship and sharing. Learn to: • Plan your post-cancer care • Boost your self-esteem and sexuality • Heighten your health with nutrition and supplements • Fight fatigue and escalate energy through exercise.

Date: 4-week program runs every Tuesday, Oct. 18 – Nov. 8 Time: 6 – 7:30 p.m. Location: Julie Penrose Health Education and Resource Center (Northcare Building on the St. Francis Medical Center campus) 6071 E. Woodmen Road Cost: FREE! Registration required: 719-776-4541

Preventing Premature Babies Babies born before the 37th week or weighing less than 5 ½ pounds encounter serious health problems and may require intensive hospital care. Recognize the signs of premature labor and take precautions to prevent premature birth. The ideal time to attend this class is from 18 to 35 weeks pregnant. This class is a must for all expectant couples! Date: Single class offered Monday: Oct. 17, Nov. 21 or Dec. 12 Time: 6:30 – 8 p.m. Location: St. Francis Medical Center, 6001 E. Woodmen Road Cost: FREE! (Fathers are encouraged to attend) Registration required: 719-571-3101, option 1 Additional classes in parenting, childbirth, breast-feeding, infant CPR and many others are offered through The Birth Center at St. Francis Medical Center. For a full list and calendar, please go to penrosestfrancis.org/birth.

Visit penrosestfrancis.org/wellness for a list of additional health and fitness classes. penrosestfrancis.org

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Pet Therapy Chelsea and Sherwood don’t have last names and they don’t get paychecks, but they are integral members of the rehabilitation team at Penrose Hospital. The two dogs, part of the hospital’s “rehab buddy” program, help retrain patients who have suffered from strokes, spinal cord injuries or brain injuries. “It’s amazing to watch what patients can do when they are with the dogs and not thinking about what they can’t do,” says Lynette Olson, a physical therapy assistant. “You can have a stroke patient who can’t speak suddenly say ‘sit’ to the dog.” The dogs are used to help patients retrain their bodies. For example, a patient having a difficult time sitting may be placed on a mat and play tug-of-war with the dog. At other times, the dogs are used simply to lift the spirits of a patient. “If we have a patient who is depressed, we’ll bring in the dog and we can get the patient to do things they wouldn’t do before,” Olson says.

Sherwood, rehab buddy at Penrose Hospital

Pets bring a bounty of health benefits. According to the U.S. Centers for Disease Control, pets can help increase opportunities for exercise and socialization while also decreasing: ✓ Blood Pressure ✓ Cholesterol Levels ✓ Triglyceride Levels ✓ Feelings of Loneliness

Catholic Health Initiatives Colorado

Non-Profit Org. U.S. Postage

PAID

2222 North Nevada Avenue Colorado Springs, CO 80907

Colorado Springs, CO Permit No. 14

HEART CARE at Penrose-St. Francis Health Services

has received more quality awards and recognition than any other cardiac program in Colorado, including the Consumer Reports Top 50 Heart Bypass Surgery Program for 2010 and 2011. Penrose Cardiothoracic Surgery was one of only two groups of cardiothoracic surgeons in Colorado to receive the highest three-star grade by the rating agency.

We stand against aging! Health Connected

Register Today! Date: Tuesday, November 15, 2011 Time: 6-8 p.m. Refreshments will be served. Location: Julie Penrose Health Education and Research Center (Northcare Building on the St. Francis Medical Center campus) 6071 E. Woodmen Road Cost: FREE For more information and to register, call 719-776-5052. A drawing for a free facial will be held at event—must be present to win.

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.

You’re not getting older, you’re getting to better. Join us for the latest program Enter in our Conversations with Women a free series to hear why this statement win thyou is true in so many ways. Did you know, for instance, that healthy reviving l! mitochondria can keep your facia muscles as lean as when you were in your 20s? (And if you don’t know what mitochondria are, we’ll tell you that, too.) Or the 10 things that your brain can do better as you age? Or how phytochemicals in pomegranates prevent wrinkles? Learn these secrets and more to staying young as you age!