Grow Winter 2013

Winter 2013 | Volume 5, Issue 1

Surgery

Evolution Robotic surgery arrives at Parker Hospital

PLUS...

Michael Gavigan, MD, medical director of Parker Hospital’s robotics program

Express mammograms for busy women.

Weight-loss surgery improves fertility.

When is back pain not back pain?

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page 7 Photo by Ellen Jaskol

Cancel out colon cancer If you could prevent a deadly type of cancer with a halfday procedure once every five to 10 years after age 50, would you?

Apparently, only two in three Americans are willing to do so.

That’s the number of Americans ages 50-75 who are current with their colon screenings, according to a recent study by que uni is cer can n the Centers for Disease “Colo Control and in that it’s preventable, and Prevention.

“It’s really an eyewe can save lives by opener to know that despite everything we’re doing colonoscopies.” doing, we’re not doing enough to get Americans to take action,” says Jehad Barakat, MD, a gastroenterologist at Parker Adventist Hospital. “Colon cancer

Get a complete cholesterol profile, including HDL, LDL, and triglyceride levels. Screenings are limited to the first 500.

Fasting is required.

Date: Feb. 22 Time: 7-10 a.m.

Location: Parker Adventist Hospital Conference Center Registration: Required; call 303777-6877, option 1

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Under the Affordable Care Act, colonoscopies are now paid for completely by insurance with no out-of-pocket charges to the patient.

Parker Adventist Hospital offers a $1,000 colonoscopy to people who do not have any health insurance. To find out more, please call 303-269-4185, or go to parkerhospital.org/colonoscopy.

health screenings FREE Cholesterol Screening

of six years, only five people had developed colorectal cancer, all at an early stage, and none died. That compares to 50 cases in patients who did not have polyps removed.

Overall, colonoscopies and removal of polyps lower the risk of colon cancer by 76 to 90 percent, according to the study.

“It’s really a tragedy if someone dies from colon cancer because they missed the opportunity of being screened appropriately,” Barakat says.

Express Mammograms

Text us to s your mam chedule mogram!

Text yo

ur name to 303-816-8 648, and w e’ll call you w ithin two business d ays to schedule y our mammogra m.

The Trio Breast Center is offering “express” screening mammograms with early morning and lunchtime hours. Make an appointment, pull into valet parking, and head straight to your test. You’ll be out in 30 minutes, and your car will be waiting. All mammograms are performed with the latest digital technol ogy and interpreted by a board-certified breast radiologist. Trio is accredi ted by the National Accreditation Program for Breast Centers.

NEW extended hours: Monday-Friday, 7:15 a.m.-4:30 p.m., INCLUDING lunch appointments from noon-1 p.m.

Location: The Trio Breast Center, located just off the main lobby of Parker Hospital Parking: Pull into the FREE valet service at the main entrance to the hospital and tell them you are scheduled for an express mammogram, and they’ll hold your car close by Schedule your screening mammogram by calling 303-269-4150 .

Photo: Couple ©iStockphoto.com/Nastco; PHONE ©iStockphoto.com/kenex

PREVENTION

is unique in that it’s preventable, and we can save lives by doing colonoscopies.”

The majority of colon cancers develop from polyps, abnormal growth of tissue out of the colon wall. About 15 to 20 percent of people have polyps, which can be removed easily during a colonoscopy and tested for cancer. About 75 percent of people survive five years or longer if colon cancer is detected and treated at its earliest stage, compared to just 6 percent if found at its most advanced stage, according to the American Cancer Society.

The National Polyp Study tracked 1,400 people who had colonoscopies and all existing polyps removed. After an average

Huh?

Although most people associate hearing loss with old

age, one in five adults has some degree of Hearing loss hits teens hearing loss by age 35.

“A recent study found that hearing loss is occurring at earlier ages. The use of earbuds has been implicated as a possible cause,” says Mark Willis, MD, an otolaryngologist (ENT) at Parker Adventist Hospital.

Prolonged exposure to loud noises damages the hearing over time, Willis says, and it can happen as early as the teen years. To prevent hearing loss, Willis recommends using over-the-ear headphones rather than earbuds. Limit regular sound to below 85 decibels (a hand drill is about 95 decibels); use apps on devices to limit volume; and use ear protection when exposed to loud noises.

If you do have hearing loss, there are many treatment options, including hearing aids that fit entirely inside the ear canal. A variety of surgeries also are available, including reconstruction of the middle ears with prostheses.

Hearing Screening Colorado ENT Specialists is hosting two FREE hearing screenings for adults and children.

Adult screening (18 and over): Jan. 25, 1-4 p.m.

Pediatric screening (ages 2-17): Feb. 1, 1-4 p.m.

Location: Sierra Medical Office Building at Parker Adventist Hospital, Suite 401 Registration: Required; space is limited; call 720-274-2544

FEBRUARY

F REE health seminars

Join Parker Adventist Hospital for a series of FREE health seminars. All seminars are held in the Parker Hospital Conference Center, located on the 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 303777-6877, option 1. Guests are encouraged to park on the west side of the hospital.

Weight-Loss Surgery Wed, Feb 6 | 6:30-8 p.m.

Join bariatric surgeon Dr. Josh Long for a better understanding of what works and what doesn’t when it comes to weight loss and why you may want to consider surgery sooner rather than later if you have diabetes.

Is It Really Back Pain?

Burning Question Stopping heartburn before it leads to bigger problems

Photo: HEART ©iStockphoto.com/laflor; SURGICAL—COURTESY OF Mazor Robotics Ltd.

Occasional heartburn is no reason to panic. But when symptoms are frequent, it’s time to talk to your doctor.

“The chronic exposure of the lower part of the lining of the esophagus to acid or alkaline fluid can cause inflammation,” explains Christine Rogness, MD, a general surgeon at Parker Adventist Hospital.

Over the long term, that inflammation can lead to Barrett’s esophagus, a possible precursor to esophageal cancer.

“The other problem with chronic inflammation,” she explains, “is that it can cause such severe scarring that it actually narrows the esophagus, and you can’t swallow.”

Surgery for gastroesophageal reflux disease (GERD) should be considered if medication and lifestyle modifications have failed.

Fundoplication is a surgical procedure that wraps the Join Dr. Christine upper part of the stomach (the fundus) around the base of Rogness at a FREE the esophagus to strengthen the sphincter. The procedure community seminar is done laparoscopically, using small wandlike surgical instruments inserted through tiny incisions. on March 5 to learn “If your symptoms can’t be controlled, then surgery is a more. See back great option,” says Rogness, who is now performing these cover for details. surgeries using the da Vinci® robotic system that results in less pain and faster recovery for patients.

Stop the Burn

Thu, Feb 14 | 6:30-8 p.m.

Thirty percent of back pain sufferers actually have SI joint problems. Once correctly diagnosed, it’s very treatable. Join SI joint specialist Dr. Brad Duhon, neurosurgeon, to learn more.

Robotic Spine Surgery Tue, Feb 19 | noon-1:30 p.m.

Spine surgery with laserlike precision can lead to better outcomes. Join orthopedic spine surgeon Dr. Scott Stanley to learn the benefits of spine surgery with the new Mazor robotic system.

Joint Replacement Surgery Thu, Feb 21 | 6:30-8 p.m.

Are you considering joint replacement? Learn how new procedures being used at Parker Hospital result in faster recovery with less pain, with orthopedic surgeon Dr. Derek Johnson.

See back cover for March seminars!

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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evolution

SURGERY

Potential

Patient Benefits

Photo by Ellen Jaskol

� Less blood loss � Less pain � Less recovery time � Less scarring

Enhanced Visualization

Surgeon Hand Control

360-Degree Wrist Rotation

The da Vinci 3-D camera provides images that are magnified 10 times.

Surgeons view the anatomy through both eyes instead of a single lens that is used in traditional laparoscopic surgery.

As the surgeon views the anatomy, he or she uses highly sensitive hand controls to perform the surgery. The surgeon’s movements are instantly translated into precise movements by the robotic instruments inside the patient.

The robotic endowrists rotate in a complete circle.

This allows more precise incisions and sutures than possible with freehand surgery or traditional laparoscopic tools, which rotate only 180 degrees.

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Tiny Instruments Four instruments — one to hold the camera and three to perform the surgery — are inserted through half-inch incisions. Parker Hospital’s da Vinci robot also allows gallbladder removal through just one incision through the naval. The small size of the incisions along with the precise movements of these instruments result in less trauma to the patient.

Firefly Fluorescence Imaging A special dye lights up in “firefly green” when using a specialized camera, revealing the difference between cancerous and healthy tissue. This allows surgeons to remove the cancer while leaving more healthy tissue intact.

Robotic surgery helps patients heal faster with less pain

New robot helps spine surgeons deliver precise results

ONE OF The newest robotS at Parker Adventist Hospital is providing laserlike precision to very delicate back surgeries.

The Renaissance™ surgical robot provides surgeons with an instant “blueprint” of each patient’s spine. Once the spine is mapped out, the robot positions a cannula, or tube, that guides the surgeon’s hand to the precise position for the surgery.

“It’s like having a helping hand or a second surgeon beside me stabilizing my hand,” says Scott Stanley, MD, medical director of the spine program at Parker Hospital. “It takes away more potential for error. We’re talking about less than a millimeter, but even that one millimeter will result in better outcomes for our patients.”

In a study published in the European Spine Journal, robotic-assisted spine surgery achieved the following results compared with freehand surgery: � Improved accuracy � Reduced X-ray doses � Reduced complications � Reduced number of revision surgeries

W

hen Michael Gavigan, MD, enters the operating room at Parker Adventist Hospital, he has a new robot helping him perform surgeries with more precision than ever.

“The No. 1 benefit to me of having the robot is what it does for my patients,” says Gavigan, a gynecologist and medical director of the Parker Hospital robotics program. “There is less blood loss because the visualization is optimal, and it allows us to operate in small spaces with very little impact to the surrounding tissue.”

Parker Hospital opened its advanced robotics center last fall, featuring two robotic surgery systems — the da Vinci Si Surgical System and the Mazor Robotics Renaissance™ Guidance System. The hospital is the first in the region to offer the Renaissance, which is used for spinal surgery. Parker’s da Parker Hospital Vinci system features Single-Site™ surgeons are robotic technology, which allows using the da Vinci gallbladder surgery to be performed robotic system to virtually scarless through one small perform surgical incision through the navel. procedures in: ✓ Gynecology Less pain for patients ✓ Urology Geoff Ledgerwood, MD, a urologist ✓ General surgery at Parker Hospital, has performed ✓ Colorectal surgery several hundred robotic-assisted ✓ Single-incision surgeries. The robot’s “wrists” that gallbladder surgery rotate in a complete circle allow him Learn more and find to suture more easily. a robotic surgeon at “One of the goals is to spare as parkerhospital.org/ much normal tissue as possible,” he robotics. explains. “That leads to less blood loss and less pain for the patient.”

Using the robot is particularly beneficial in surgery to remove part of the kidney due to cancer.

“To do this surgery, we have to clamp off blood supply to the kidney,” Ledgerwood explains. “The robot allows me to move very quickly yet very precisely. And the faster we can restore blood flow, the faster the patient’s recovery.”

Orthopedic spine surgeons and neurosurgeons at Parker Hospital are using the Renaissance to navigate spinal surgery for patients suffering from debilitating back pain or limited range of motion caused by spinal deformities, degenerative conditions, slipped vertebrae, scoliosis, and pinched nerves.

Some of the procedures performed include spinal implants, spinal fusion, and bone cement injections.

Dr. Scott Stanley

Parker Hospital’s advanced robotic surgery program is supported by Centura Centers for Clinical Innovation, extending advanced health technologies across Colorado.

Photo courtesy of 360 media

n

Steady Hands

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A Growing Problem Extra weight puts moms and babies at risk One out of every five adults in Colorado is obese — and that includes women who are pregnant and trying to get pregnant. And along with the increase in obesity has come an increase in diabetes.

“Both pregestational and gestational diabetes are on the rise, mirroring increasing obesity rates,” says Sharmini Long, MD, an endocrinologist at Parker Adventist Hospital. “About 18 percent of women will be diagnosed with diabetes during pregnancy.”

Just being overweight puts a woman at risk for high blood pressure and preeclampsia, and the complications significantly increase with uncontrolled diabetes. The three major complications are miscarriage, birth defects, and low birth weight babies. High blood sugar during pregnancy also may lead to metabolic changes in the baby that promote obesity and diabetes later in life.

“If blood sugar is well-controlled during pregnancy, those risks come close to the typical rate for nondiabetic women,” Long says. “This emphasizes the importance of tight blood sugar control before and during pregnancy.”

Q&A

If you are overweight, prediabetic, or diabetic, Long recommends:

Before pregnancy: Get a diabetes screening if you are overweight. If you’re diagnosed with prediabetes or diabetes, make sure your blood sugar is under control before getting pregnant.

During pregnancy: Maintain an A1c level below 6 percent throughout your pregnancy.

Do this with diet and exercise and medications if necessary.

After pregnancy: Be diligent about increasing physical activity and losing weight. Women with gestational diabetes have a 50-70 percent chance of developing type 2 diabetes after pregnancy, but that risk can be reduced by maintaining a healthy weight and regular exercise.

Should obese women have weight-loss surgery before getting pregnant?

With Josh Long, MD, Bariatric Surgeon

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To learn more

about weight-lo ss surgery, attend our FREE seminar on Feb. 6 or March 13. See Page 3 and back cove r for details.

Photo: WOMAN ©iStockphoto.com/AngiePhotos

A: Women with a body mass index over 35 with diabetes or over 40 without any health problems should consider weight-loss surgery if they have tried diet and exercise to no avail. And because diet and exercise are effective in only 1 percent of the morbidly obese, chances are that most obese women will qualify for surgery.

Bariatric surgery can help you — and your future baby — in many ways.

Bariatric surgery is highly effective at curing or improving type 2 diabetes, especially when patients have been diabetic for less than eight years or are not yet on insulin.

Getting rid of your diabetes before getting pregnant significantly increases your chances of having a healthy pregnancy, delivery, and baby. Reversing the obesity trend in your family culture also may prevent your children from becoming obese and acquiring diabetes and other related health problems later in life.

Dr. Josh Long Bariatric surgery can even help you get pregnant. Many obese women have polycystic ovarian syndrome (PCOS), causing irregular menstrual cycles that prevent women from getting pregnant. Bariatric surgery is so effective at reversing infertility problems that discussion about birth control is part of our preoperative counseling.

Joint replacement patients going home quicker A new program that combines

Back Relief New surgery relieves SI joint pain

People who suffer from SACROILIAC (SI) joint dysfunction

PhotoS: BACK ©iStockphoto.com/peepo; SKI ©iStockphoto.com/ultramarinfoto

are finding relief from a new surgery at Parker Adventist Hospital.

SI joint dysfunction causes pain in the upper buttocks and upper legs.

It often occurs during pregnancy when hormones loosen the joint, causing increased stress, abnormal wear, and back pain. Fusion of the lower back, uneven leg lengths, and abnormal gaits also are common culprits.

“As many as 30 percent of patients with low back pain actually have SI joint problems,” says Brad Duhon, MD, a neurosurgeon at Parker Hospital who performs the procedure and also teaches it to other surgeons across the country. Parker Dr. Brad Duhon Hospital is one of just a few hospitals Is it your back in Colorado to offer this procedure. or your SI joint?

Once diagnosed, the majority of SI patients are Lie on your back and treated successfully with nonsurgical therapies. For cross your legs. If it’s the remaining patients, the new SI fusion surgery is highly effective. “Ninety percent of patients are SI joint dysfunction, pleased with the results,” Duhon says. you won’t be able to A two-inch incision is made on the hip while the do this without pain. patient is asleep. Using X-ray guidance, the surgeon implants three triangular devices across the SI joint.

Made of the same material as artificial joints, the implants allow bone to grow into and around them to stabilize the joint. Surgery typically requires a one-night hospital stay and a six-week recovery.

Join Dr. Brad Duhon on Feb. 14 to learn more about SI joint dysfunction, nonsurgical treatments, and the new fusion surgery. See Page 3 for details.

better pain control and earlier rehabilitation is helping joint replacement patients at Parker Adventist Hospital have a speedy recovery.

“Since putting these protocols in place, we are discharging nearly half of our patients less than 24 hours after surgery,” says Derek Johnson, MD, an orthopedic surgeon and medical director of Parker Hospital’s joint replacement program.

The reduced length of stay — twice as fast as the average time for most joint replacements—is leading to better outcomes and decreased complications.

“The longer the patient is in bed, the higher the risk of blood clots, pneumonia, and other medical complications,” Johnson says.

Patients also reported lower pain levels and greater overall satisfaction.

Parker Hospital’s program includes comprehensive pain control and an early mobilization protocol. Most patients at Parker Hospital receive one or more rehab sessions the same day as surgery, with many walking 50-100 feet within hours of surgery.

Join Dr. Derek Johnson Feb. 21 to learn tips for a faster, easier recovery from joint replacement surgery.

See Page 3 for details.

The Joint Commission recently awarded its highest level of accreditation to the joint replacement and spine programs at Parker Hospital. The level of engagement and passion of the physicians and staff were “unprecedented,” noted the inspector. Parker Hospital performed more than 300 hip and knee replacements and 800 spine surgeries in 2012.

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MARCH FREE health seminars

Portercare Adventist Health System

Non-Profit Organization U.S. Postage

Paid

Denver, CO Permit No. 4773

9395 Crown Crest Blvd.

Parker, CO 80138

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.

GERD Tue, Mar 5 | 6:30-8 p.m.

Join general surgeon Dr. Christine Rogness to learn more about gastroesophageal reflux disease, the dangers of leaving it untreated, and the new robotic surgery to treat chronic heartburn.

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, 2013.

Colon Cancer Thu, Mar 7 | noon-1:30 p.m.

Thumbs Up

Colon cancer screenings save lives, but which one is right for you? Join gastroenterologist Dr. Jehad Barakat as he discusses the different options and when screenings should begin.

Early arthritis appears in hands first

Weight-Loss Surgery

Did you know your thumb is responsible for up to 70 percent of

Wed, Mar 13 | 6:30-8 p.m.

your hand function?

Then it’s no surprise that the thumb is one of the first areas to feel the pain of arthritis. And women are three times more likely than men to be affected, says Kelly Martin, a certified hand therapist with the Parker Adventist Center for Rehabilitation & Sports Medicine. That’s because the basal joint that supports the thumb is smaller and flatter in women, which puts more wear on the joint.

“It’s not unusual to see women in their 40s already feeling pain and stiffness,” Martin says.

Most people put too much pressure on the thumb joint, which deteriorates the cartilage and leads to pain. We turn the key in the ignition with force, hold our pencils too tight, squeeze our cellphones, and just generally put too much strain on the thumb.

Join bariatric surgeon Dr. Josh Long for a better understanding of what works and what doesn’t when it comes to weight loss and why you may want to consider surgery sooner rather than later if you have diabetes.

Prostate Health Tue, Mar 19 | noon-1:30 p.m.

Join urologist Dr. Geoff Ledgerwood for a discussion on prostate health and robotic surgery as a treatment option with better results for men needing surgery.

To stave off arthritis or help relieve pain if you already have it, Martin recommends: Give your hands a break every 15 minutes when performing repetitive work, such as knitting or typing Use everyday tools with larger grips, such as cushioned pens Replace “squeeze” bottles, such as shampoo and toothpaste, with pumps

An Easier Hysterectomy



Thu, Mar 21 | 6:30-8 p.m.

 

FREE

CHOLESTEROL SCREENING See Page 2!

For more tips on relieving pain in your thumbs, Photo: HANDS ©iStockphoto.com/DKart

The second most common surgery for women can now be done with less pain and faster recovery time. Join gynecologist Dr. Michael Gavigan to learn about minimally invasive hysterectomies using robotic surgery.

go to parkerhospital.org/thumb. Or call the Parker Adventist Center for Rehabilitation & Sports Medicine at 303-269-4590.