Grow Spring 2012 by Clementine Words

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grow

Nurturing the health of you and your family

Spring 2012 | Volume 4, Issue 2

fresh take

Weight-loss surgery produces healthy results

Neko Upson lost 77 pounds after having weight-loss surgery at Parker Adventist Hospital.

PLUS...

Could you be gluten intolerant? page 3

Look inside an ICU page 6

How stress may cause diabetes page 7

Parker Adventist Hospital is a certified Primary Stroke Center and has received the Joint Commission Seal of Approval for exceptional stroke care.

Warningsign Detecting a ministroke can save your life

It can last less than five minutes. In fact, it often happens so quickly that most people don’t recognize the symptoms, or they think they’re imagining things. Half of the people who experience this event will not report it to their doctor. But one in 20 will feel much worse within two days. “This” is a ministroke, known formally as a transient ischemic attack, or TIA. More than 240,000 Americans have a TIA every year, according to the American Stroke Association. Five percent will suffer a full stroke within two days. “Ten to 15 percent of people who have a TIA will go on to have a stroke within three months,” says Ravi Shah, MD, a neurologist and medical director of the Stroke Program at Parker Adventist Hospital. “If a patient recognizes the symptoms and seeks medical help right away, there is a very good chance that we can provide treatment to prevent a potentially lifethreatening and certainly life-altering stroke.” The symptoms of a TIA are the same as a stroke, but they typically last less than a day, most lasting less than five minutes. It’s important to acknowledge these symptoms and seek help as soon as possible, as they may be the first signs of a full stroke.

Boot camp whips fat

It may be 2012, but it’s still not always cool for men to talk about their fears – particularly when it comes to being a new dad. Now a new class at Parker Adventist Hospital is providing a safe haven for men to share their concerns, fears, and questions about being a new father. “I wish this class were mandatory for new dads,” says Shelby Hawkins, the certified instructor for the course. “Not only do we talk about what to expect when you bring the baby home, but we also prompt them to think about what kind of a father they want to be.” Daddy Boot Camp, a nationally accredited program, is a threehour class that covers topics such as crying babies, caring for new moms, and how to balance the demands of work with a new baby in the house. Dads-to-be will get to talk to new fathers and hold their babies. The next Daddy Boot Camp will be held Thursday, April 19, from 6-9 p.m. in the Parker Hospital Conference Center. The class costs $40. For more information and registration, please call 303-777-6877, option 1. For a list of all birth and parenting classes at Parker Hospital, go to parkerhospital.org/find-a-birthing-class.

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Face: Does one side of the face droop when asked to smile?

Arms: Can the person raise both arms equally and hold them up?

Speech: Can the person repeat a simple phrase without slurring?

Time: If you observe symptoms, call 911 immediately.

Learn the Top Five Ways to prevent a stroke at a FREE community seminar on May 3. See Page 8 for details.

Teens in Medicine

Summer program inspires future careers Parker Adventist Hospital’s popular “Teens in Medicine” program is back this summer – but Witness it fills up fast, so register early! This the brain lunch-and-learn program offers at work TEST teens a firsthand look into dozens your of health care careers and the lifesaving education necessary to get those jobs. skills This program is a valuable resource for students ages 13 – 19 who want to choose high school and college courses to position themselves for health care careers. This year’s program will cover career in trauma medicine (be a WATCH opportunities flight nurse!), surgery, neurodiagnostics sound waves (go inside the brain!), radiology, nursing, reveal the and rehabilitation (help someone learn to inner body walk again!). Dates: Wednesdays, June 27; July 11, 18, and 25 Time: Noon-1 p.m. Lunch is provided. Cost: FREE Location: Parker Hospital Conference Center Registration is required and the program fills up quickly. For more information and to register, go online to parkerhospital.org/volunteer.

Photo: LIGHT ©iStockphoto.com/futureimagefutureimage; BABY ©iStockphoto.com/AnaBGD

-to-be! Calling all dads hers into shape

A simple way to remember the signs of a stroke is to think FAST:

Q&A

with Susanna Choi, MD, Parker Integrated Medicine

Gluten intolerance is no fad

Is gluten intolerance a real medical condition? There is confusion around this topic because so many people today are avoiding “wheat” in an effort to reduce carbohydrates in their diets. Gluten intolerance is an actual food allergy that can cause a variety of moderate to severe symptoms. Some Dr. Susanna Choi researchers speculate that nearly three out of 10 people are gluten-sensitive. What is gluten intolerance? Gluten is a protein composite contained not just in wheat but also in barley, rye, and spelt. Gluten intolerance is an allergy to this protein that can cause symptoms including diarrhea, gas, weight loss, depression, chronic fatigue, fibromyalgia, headaches, skin problems, and osteoporosis. People with a gluten allergy may

experience just one, several, or all of these symptoms. And they can suddenly develop these symptoms at any point, from childhood through adulthood. If you are gluten-intolerant, your intestinal villi may be damaged by constant exposure to gluten. These tiny fingerlike protrusions in the intestine help absorb nutrients. If they are damaged, this interferes with the breakdown and absorption of nutrients from foods. When we get these patients off gluten, they feel so much better. Their villi recover and they start absorbing nutrients. Is there a test for gluten intolerance? Yes, there is a simple blood test and a stool test. We recommend that if a person suspects gluten intolerance that they see a doctor to rule out celiac disease, which mimics gluten intolerance but requires medical treatment.

Did You Know gluten can be present in lipstick? Learn more sources of hidden gluten and taste gluten-free foods at a FREE community seminar on gluten intolerance on May 1. See Page 8 for details.

APRIL FREE health seminars Join Parker Adventist Hospital for a series of FREE health seminars throughout the spring. All seminars are held in the Inspiration Room of the Parker Hospital Conference Center, located on the hospital’s Garden Level at the west entrance. A light lunch is served during daytime programs, and light snacks are served during evening programs. Registration is required for all seminars by calling 303-777-6877, option 1. Guests are encouraged to park on the west side of the hospital for direct access to the conference center.

Weight-Loss Surgery Wed, Apr 4 | 6:30-8 p.m. Join Matthew Metz, MD, FACS, bariatric medical director, to learn about weight-loss surgery options, from gastric bypass to lap-band®, and why to choose surgery at a Center of Excellence.

Back Pain Thu, Apr 5 | noon-1:30 p.m. Join neurosurgeon Brad Duhon, MD, for an informative discussion on the latest innovations in back and neck surgery.

Kidney Stones Wed, Apr 11 | 6:30-8 p.m. Learn how to prevent this painful problem, what a metabolic evaluation is, and why you need one if you’ve ever had a stone. Oscar Dominguez, MD, nephrologist will lead you through this discussion.

Incontinence

Safe in the saddle

Thu, Apr 26 | 6:30-8 p.m. Don’t suffer in silence. Learn the new ways to cure this problem with Vandna Jerath, MD, OB/GYN.

A few precautions head off injury

Did you Falling as little as two feet can cause brain damage? know A human skull can be shattered by impact at

Photo: HORSE ©iStockphoto.com/pixalot

4 mph?

Now apply those facts to horse ridin g where riders sit eight feet or mor e from the ground and gallop at speeds as fast as 40 mph. It’s no wonder that hea d injuries account for 60 percent of all deaths that occur due to equestrian acciden ts. To learn more about equestrianrelated head injuries, join neurosu rgeon Sean Markey, MD, on April 28 at the Colorado Horse Park for a FRE E community seminar. Go to parkerhospital.org /equestrian-safety for more deta ils. Parker Adventist Hospital and the Parker Hospital Foundation have don ated 1,000 equestrian helmets to riders in our community since 2009. The hospital and Foundation are proud sponsors of the Colorado Horse Park.

9395 Crown Crest Blvd., Parker, CO 80138 grow is published quarterly by Parker Adventist Hospital as part of our mission to nurture the health of the people in our community. To comment or unsubscribe, please email grow@centura.org. grow is produced by Clementine LLC. Executive Editor: Rachel Robinson

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A healthy commitment

Weight-loss surgery can improve your health – for life

eko Upson had lost weight before. But it always managed to come back. She had considered weight-loss surgery, also known as bariatric surgery, in the past. But this time Since was different. After having learning about LAP-BAND® The Bariatric & Metabolic Center of surgery last Colorado at Parker May, Upson Adventist Hospital, has lost 77 Upson decided the time was right. pounds. “It means everything,” the 43-year-old says. “I have a 3-yearold and a 9-year-old. They expect me to jump around and play and have a lot of

stamina. To be able to do that now means the world to me.” She also relishes her overall health – blood pressure, cholesterol, and blood sugar levels all in the normal range.

A Center of Excellence Upson had her surgery at The Bariatric & Metabolic Center of Colorado, which is a designated Bariatric Center of Excellence. “This is an internationally recognized designation that says we have excellent long-term results,” says Matthew Metz, MD, FACS, a fellowship-trained bariatric surgeon at Parker Hospital

and the bariatric center’s medical director. “It requires a long-term relationship with patients as well as the highest standards for safety and outcome measures.” To maintain this designation, the bariatric center must track its data (with no names attached) in a national registry. According to the American Society for Metabolic and Bariatric Surgery, this data is used to monitor compliance and conduct research. The bariatric center also benefits from being directly attached to Parker Hospital. “Everyone is under one roof – coordinator, nurse practitioner, dietitian,

surgeon, and more,” Metz says. “We’re all linked by a computer system, which helps us work as a comprehensive team to put the best care plan together for each patient.”

Throughout the process

Weight-loss surgery is about more than the procedure itself. “When I meet with patients, I tell them that once they have surgery with us, we’re now committed to them for the rest of their lives,” Metz says. Before surgery, patients meet with a social worker to ensure they have a support

Family fun now happens off the couch. Neko has more energy to keep up with daughters Camryn (9) and Kyndal (3).

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Photo by Michael Richmond

More than 220,000 people in the United States had bariatric surgery in 2009, according to the American Society for Metabolic and Bariatric Surgery.

Weight-loss surgery options Choosing to have weight-loss surgery is a big decision. The second decision that your physician will help you make is which type of surgery is best for you. This depends on how much weight you need to lose, your lifestyle, and your goals. These are the three most common options:

Are you a candidate?

Description Pros Cons LAP-BAND®

An inflatable silicone device is inserted around the upper part of the stomach. It is designed to help you feel full longer and limit the amount of food you can eat.

> No rearranging of the anatomy > Typically no overnight hospital stay needed

> Risks such as infection and obstruction of the stomach > Must return 6 to 8 times in the first year for adjustments

Roux-en-Y gastric bypass

One of the most common weightloss procedures performed in the U.S., gastric bypass creates a smaller stomach, or “pouch,” for food to enter, letting food bypass part of the stomach and small intestine.

> Considered the gold standard for weight-loss surgery > Most powerful at getting rid of type 2 diabetes

> Requires rearranging of anatomy > Typically requires a hospital stay of two nights

By removing part of the stomach, this procedure limits the amount of food needed to make you feel full.

> No rearranging of the anatomy > No foreign objects

> Requires a hospital stay of one to two nights

Vertical sleeve gastrectomy

Photo: FOOD ©iStockphoto.com/Dimitris66

system in place. “Some people can turn to drugs, alcohol, or gambling in place of food (after the surgery),” Metz says. “We want to make sure they’re in a good place mental healthwise.” A dietitian works with patients to ensure they are knowledgeable about healthy foods and can afford fresh ingredients. Surgeons check in with patients two weeks after surgery, then every three months for the first year, and then yearly for the rest of their lives. For Upson, the bariatric

People who are obese have an increased risk of diabetes, heart disease, stroke, arthritis, and some cancers. Losing just 5 to 10 percent of your body weight can make a healthy difference, according to the National Institutes of Health.

center’s commitment has provided the support she needed. “I like going there,” she says. “They’re like a family to me.” Weight-loss surgery helps make it easier to lose weight– reducing the amount of food

The Bariatric & Metabolic Center of Colorado at Parker Adventist Hospital is a certified Center of Excellence.

a person needs, for example. But it doesn’t lead to weight loss by itself. “A lot of people think it’s easy, that it’s a magic bullet,” Upson says. “It’s not. You have to do the work.” Upson eats a healthy diet and exercises four days a week at the gym, incorporating aerobic machines such as the treadmill and elliptical machine as well as strength training. “I feel motivated because I know I’m going to get the weight off,” she says, “and I’m going to maintain it and stay healthy for the rest of my life.”

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Surgery isn’t right for everyone. To find out if you’re a candidate for weight-loss surgery, visit The Bariatric & Metabolic Center of Colorado online at bariatriccenterco.com and click on “Are You a Candidate?”

View a video of bariatric surgeon Matthew Metz, MD, explaining each procedure at parkerhospital.org/ bariatricsurgery.

FREE seminar This is your chance to get your questions about weight-loss surgery answered. Learn if you’re a candidate and what the options are from Matthew Metz, MD, FACS, medical director of The Bariatric & Metabolic Center of Colorado at Parker Adventist Hospital. When: Wednesdays, April 4, May 9, June 13, July 11 Time: 6:30-8 p.m. Location: Parker Adventist Hospital, Inspiration Room, 9395 Crown Crest Blvd. (located on the Garden Level of the hospital, adjacent to the Peakview Café) More information: bariatriccenterco.com/ seminars Registration: 303-777-6877, option 1

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INTENSIVE care Care for the most critically ill

ICU is short for intensive care unit. It’s also called a CCU or critical care unit in many hospitals, including Parker Adventist Hospital. Florence Nightingale is largely credited with inventing the concept of the ICU on the battlefields of the Crimean War in 1853. The first ICU opened 105 years later in Baltimore City Hospitals, now John Hopkins Baltimore. Today, there are more than 5,000 ICUs across the U.S. Equipment rotates 360 degrees.

Family-inspired design A team of physicians, nurses, respiratory experts, pharmacists, social workers, and others who worked alongside the architects designed Parker Hospital’s new 16-bed critical care unit. The team looked at CCUs around the world in search of the best designs that would help make care more efficient, safer, and more comfortable. Parker Hospital’s patients and their family members played a large role in the design, contributing unique ideas such as elevated visitor chairs, sanctuaries, and showers near patient rooms.

Bedside care Two “booms” rotate 360 degrees around every bed, and emergency “carts” house all the equipment necessary to deliver lifesaving treatments right to the patients without having to move them to an operating room.

Cooling care Cardiac arrest patients at Parker Hospital are treated with an innovative device called the Arctic Sun that cools their bodies to 91.4 degrees Fahrenheit (33 degrees Celsius). Like icing a sore muscle to prevent swelling, this technique prevents dangerous swelling in the brain that could cause brain damage.

Intensivists are hospital-based physicians who care for critically ill patients in the critical care unit, collaborating with the medical staff to organize care for the patients and developing processes for the CCU to improve care. These physicians complete residency training in a specialty area such as surgery or internal medicine plus an additional two- to three-year fellowship in critical care medicine, often in conjunction with a pulmonary (respiratory medicine) fellowship. Studies have shown that patients receiving care in CCUs with intensivist coverage receive higherquality care at a lower cost than patients receiving care in critical care Dr. Matt Dickinson, Parker Hospital units without intensivists. intensivist

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Patient education is available on demand.

Critical Care Specialists

Dr. Rick Feret, Parker Hospital hospitalist

Top

reasons patients are admitted to Parker Hospital’s CCU: > Infection > Neurological problems, such as stroke or head injuries > Respiratory problems, including pneumonia

Hospitalists are typically internal medicine- or family medicine-trained physicians who specialize in caring for hospitalized patients. Their offices – and all their patients – are inside the hospital. Because they care for hospitalized patients day in and day out, they often are more familiar with treating and preventing problems that occur in these patients. They represent a patient’s primary care physician while a patient is hospitalized and coordinate care and communication with the patient’s doctors.

Photos by Toby Fike

Families have a private area within every room.

Tall chairs allow doctors and visitors to visit eye-to-eye with patients.

Diabetes developments What’s new in managing this chronic condition

Next time you’re in a crowd, look around. Pick out a dozen people. Odds are, one of them has diabetes. This year, nearly 2 million more Americans will be newly diagnosed with diabetes. Another 79 million adults have prediabetes, which puts them at high risk for the disease. If you’re one of these people, it’s time to do something about it. These three recent studies shed new light on successfully managing diabetes.

Take things into your own hands.

Education has always been key in diabetes management, but researchers at Brigham and Women’s Hospital show just how much. They spent seven years tracking more than 30,000 people with diabetes. Those who received monthly counseling with information and encouragement needed less than four weeks to reach their target blood sugar, blood pressure, or cholesterol levels vs. 13.5 months for those without counseling. A second study from the American Diabetes Association (ADA) found that patients in group care, like the diabetes education classes offered at Parker Adventist Hospital, exhibited more positive attitudes and a higher sense of empowerment. “People are surprised to learn that diabetes management is 95 percent selfcare,” says Christy Beyerly, a registered dietitian and certified diabetes educator at Parker Hospital. “When people come into our classes, they’re scared. But after we give them seven hours of education, they’re usually left wanting more. They’re amazed at what is within their control to manage.”

All fats are not created equal. There’s nothing fishy about recent ADA-funded research that shows unsaturated fatty acids, like omega-3, can actually help lower risk for diabetes. What is fishy – and fabulous – is that omega-3-rich foods like salmon, halibut, walnuts, and flaxseed, can help break down sugars and enhance insulin sensitivity. On the flip side, saturated fats like those in butter and red meat can cause insulin resistance. When these “bad” fatty acids get into cells, they trigger specific enzymes that interfere with insulin function. “Diabetes education classes start out like Nutrition 101, because what you eat is so essential to managing your blood glucose levels,” says Beyerly. “In addition to the basics, we teach people how to spend their calorie ‘budget’ on good fats, not bad ones.”

Consider the whole picture. While insulin may seem like a quick fix for treating diabetes, your overall wellness holds the critical key. In addition to healthy eating, regular exercise, weight management, and getting enough sleep are vital. “The most important thing you can do to manage diabetes is exercise because it decreases insulin resistance,” Beyerly says. Another important factor – stress – was highlighted in a study recently published in Proceedings of the National Academy of Sciences. Researchers found that stress can trigger the release of cytokines, a “signaling” molecule linked to inflammation. Chronic, low-grade inflammation can contribute to diseases that include heart disease, cancer, and diabetes. One of the best ways to fight stress – and control your weight – is with exercise. Beyerly advises a combination of cardio, strength training, and yoga.

DIABETES EDUCATION at Parker HOSPITAL Parker Adventist Hospital offers a diabetes education program recognized by the ADA, which qualifies it for coverage by Medicare and most insurance companies. This recognition means that the ADA believes the program offers high-quality education that is an essential component of effective diabetes treatment. Classes include:

✓ Comprehensive Diabetes Class for Type 1 and Type 2: This series covers diabetes, nutritional management, physical activity, medications, monitoring, and more.

✓ Insulin Injection Class: Learn the function of different insulin types and how to self-administer injections. ✓ Cholesterol and Prediabetes Education: Learn about preventing diabetes and controlling cholesterol through diet and exercise. 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, 2012

Take a FREE online diabetes assessment, plus get information about upcoming classes and register at parkerhospital.org/diabetes or by calling 303-269-4500.

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MAY Health Seminars Become more body-wise with the experts at Parker Adventist Hospital. All seminars are FREE but require registration by calling 303-777-6877, option 1. Seminars are held in the Parker Hospital Conference Center at the west entrance. A light lunch is served during noon seminars, and light snacks are served during evening programs.

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9395 Crown Crest Blvd. Parker, CO 80138

Denver, CO Permit No. 4773

Gluten Intolerance Tue, May 1 | noon-1:30 p.m. Learn how to determine if you have a gluten intolerance and how to spot hidden gluten with Susanna Choi, MD, OB/GYN. You’ll also get to taste delicious gluten-free food samples and talk to people who have gone gluten-free.

Stroke Thu, May 3 | noon-1:30 p.m. Join neurologist and Parker Hospital’s stroke director, Ravi Shah, MD, to learn about stroke prevention and warning signs.

Weight-Loss Surgery Wed, May 9 | 6:30-8 p.m. Join Matthew Metz, MD, FACS, bariatric medical director, to learn about surgical weight-loss options, from gastric bypass to lap-band®, and how these can help improve diabetes and other health conditions.

Abdominal Hernia Thu, May 31 | 6:30-8 p.m. Learn about the most advanced techniques in complex abdominal hernia repair and what treatment might be best for you with general surgeon Michael Bertocchi, MD.

Mammograms and More Join The Trio Breast Center at Parker Adventist Hospital to get your annual screening mammogram while enjoying a bit of pampering. Each event includes music, gourmet refreshments, and special goodies. Bone density screenings also are available. Thu, April 19 4-7 p.m.

Thu, May 10 4-7 p.m.

Thu, June 14 4-7 p.m.

Appointments are required by calling 303-269-4150. This program is supported by the Parker Hospital Foundation.

Skip the stones

Healthy lifestyle wards off kidney problems Genetics play a key role in the development of kidney stones, but a healthy lifestyle can help ward off this painful problem. “The good news is that the same good health habits that prevent heart disease, diabetes, and cancer also prevent kidney stones,” says Oscar Dominguez, MD, a nephrologist with Parker Adventist Hospital. Dr. Oscar Dominguez More than 2 million people see a doctor every year for kidney stones, according to the National Institutes of Health. People can reduce their risk of kidney stones by: || Avoiding dehydration at any level. || Eating a low-salt diet: Nine out of 10 Americans eat double the recommended daily amount—and that’s before adding salt at the table. || Avoiding carbonated sodas, especially colas, which contain phosphoric acid. Some studies show that drinking even three cans of soda a week may increase a person’s risk of developing stones by 15 percent. “If a person has a kidney stone but doesn’t modify his or her lifestyle, it is almost a certainty that they will have a recurrence within five years,” Dominguez says. He added that it is essential that a person who has a kidney stone receive a metabolic evaluation to discover the underlying cause of the problem.

LEARN MORE about preventing and treating kidney stones at a FREE community seminar with Dr. Oscar Dominguez on April 11. See page 3 for details.