One of America’s 100 Best Hospitals for Critical Care by Healthgrades
Winter 2014 | Volume 6, Issue 1
Hitting the right notes One-quarter of back pain sufferers might find relief with new diagnosis and treatment Page 4
Richard Foust, a Denver musician, was diagnosed and successfully treated for sacroiliac joint dysfunction after years of pain.
PLUS...
10 years strong!
New therapies for lung cancer
Healing chronic wounds with oxygen
PAGE 2
PAGE 3
PAGE 7 PHOTO BY ELLEN JASKOL
Dear Friends, Family, and Community Members,
ned s ago, Parker Adventist Hospital ope It’s hard to believe that just 10 year e cam We l. pita hos ice ity call for a full-serv its doors in response to a commun a in ed injur and ill ion — to care for the to this community with a clear miss e not only healed but held people clos who s, Jesu manner modeled for us by and loved them without judgment. ns quietly carried out this work, As the initial associates and physicia We became part of the fabric of this something remarkable happened. new lives, rs, we celebrated the beginning of community and, with our neighbo passed. lives r ove ow , and we joined in sorr we prayed together over hurt lives ose cho ld cou who y physicians — man Gradually, new associates and new e to com to se cho — here in the country to work in major medical centers anyw ity mun com our that came new services Parker Adventist Hospital. With them this e leav to ents pati would have required needed — services that previously be able to offer our community a wide to d prou community. Today, we are as ding very complex specialties such range of health care services, inclu ery, surg atric bari , care acement, stroke neurosurgery, spine surgery, joint repl . and now comprehensive cancer care y accolades for various programs, man iving rece While we are proud of ide are equally proud of the way we prov patient safety, and quality care, we — s way y man in that healing comes that care. For, like Jesus, we know of the And that is why, with the support lly. itua spir physically, emotionally, and rams prog r offe to able r donations, we are Parker Hospital Foundation and you that ps grou port sup es, counseling, and such as bedside musicians, massag care for the whole person. us. but we have strong roots that guide Like our community, we are young, you. with ther toge grow and 100 years as we We look forward to the next 10, 20, May God Bless You,
Morre Dean, FACHE President & CEO
Celebrate With Us! Parker Adventist Hospital celebrates its 10th year anniversary on Feb. 3. Go online after that date to parkerhospital.org to watch a video honoring patients, associates, and physicians in our community for all they have given over the past 10 years.
COME NEXT MONTH (weather permitting), Parker families will have a new place to exercise. In celebration of its 10th year in the community, Parker Adventist Hospital teamed up with the Town of Parker to build an outdoor fitness path along the Sulphur Gulch Trail just south of Town Hall. The hospital donated funds to purchase seven Norwell Outdoor Fitness stations that will form the basis of the fitness circuit. The Town is expected to complete installation along the trail by mid-February. “We are grateful to be part of this community, and we wanted to make a meaningful gift that would be enjoyed by the community and help families stay healthy,” says Morre Dean, president and CEO of Parker Adventist Hospital. “Our mission is not just to take care of people when they are ill but also to help them stay healthy in the first place. We think this gift is right in line with our mission.” The equipment is designed by Denmark-based Norwell, which was founded by a family to build community fitness equipment that helps develop an active and healthy lifestyle naturally. 2 ■ Winter 2014 ■
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PHOTOS: STREAMERS ©ISTOCKPHOTO.COM/PHOTKA; EXERCISE ©NORWELL
Building a healthier lifestyle
FEBRUARY
Living better
FREE
health seminars
with lung cancer TREATMENTS THAT ZERO IN ON LUNG TUMORS while sparing the rest of the body are helping patients live better and, in some cases, longer. Advanced radiation therapy and targeted gene therapies attack cancer cells without the often severe side effects of many cancer treatments.
Radiation oncology now at Parker Adventist Hospital
Taking aim at tumors with radiation therapy
Intensity-modulated radiation therapy (IMRT) uses special computers to precisely map the tumor’s location, shape, and size. This allows doctors to aim several small beams of radiation at the tumor from several directions. “IMRT enables us to spare the normal tissue, thus decreasing toxicities and improving quality of life,” says Seth D. Reiner, MD, a radiation oncologist at The Cancer Center at Parker Adventist Hospital. Less advanced types of radiation therapy can cause side effects like sore throat, trouble swallowing, cough, problems breathing, and shortness of breath. Patients who had IMRT have reported a much better quality of life than those who had standard radiation therapy. Parker Adventist Hospital, which opened its radiation therapy program last November, now also offers an advanced form of IMRT, called image-guided radiation therapy. In IGRT, a CT scan is taken during each treatment to verify the exact location of the tumor, which can move when the patient breathes and as the tumor shrinks. This imaging makes IGRT even more precise than standard IMRT.
3-D Mammography
Precisely targeting tumors with genetic therapies
Healing Chronic Wounds
Medical therapies for lung cancer are advancing rapidly as well. Research has helped identify that there are many different lung cancer types, each involving different genetic traits. By focusing on these specific genetic changes in cells that cause cancer, targeted medicines can block the growth of cancer cells. “Targeted therapies go after those genetic mutations and leave the rest of your body alone. The side effects are much less because they don’t hit normal cells like chemotherapy,” said Todd Capizzi, MD, a medical oncologist at The Cancer Center at Parker Adventist Hospital. ILLUSTRATION: STETHOSCOPE ©ISTOCKPHOTO.COM/ALASHI PHOTO: ©ISTOCKPHOTO.COM/OJO_IMAGES
Join Parker Adventist Hospital for a series of FREE health seminars. All seminars are held in the Parker Adventist 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 303-777-6877, option 1.
TEST YOUR HEART FREE Cholesterol Screening
Get a complete cholesterol profile, including HDL, LDL, and triglyceride levels. Screenings are limited to the first 500. Fasting is required. Date | Fri, Feb 21 Time | 7-10 a.m. Location | Parker Adventist Hospital, Inspiration Conference Center (enter on west side of hospital) Registration | Required; call 303-777-6877, option 1
$99 Heart Scan for 99 Days
Get a coronary artery calcium screening for $99 (normally $333) Jan. 20-April 29 at Parker Adventist Hospital. This noninvasive test measures the level of calcification in the coronary arteries, which is a marker of heart disease. The test is recommended for people with one or more risk factors for heart disease and who are over age 50. A physician’s referral is not required, but test results must be sent to a doctor. To schedule a scan, please call 303-269-4500.
Fri, Feb 14 | noon-1:30 p.m. Join breast radiologist Dr. Monique Fox to learn about 3-D mammography, the latest technology that increases the detection of invasive breast cancers.
Weight-Loss Surgery Wed, Feb 12 | 6:30-8 p.m. Join bariatric surgeon Dr. Josh Long for a look at various surgical weight-loss options, and whether you’re a candidate for surgery.
Hernia Pain & Repair Thu, Feb 13 | noon-1:30 p.m. Join general surgeon Dr. John James to learn why hernias happen, how they differ in men and women, and the latest in hernia surgery. Tue, Feb 18 | noon-1:30 p.m. Join Wound Care Medical Director Dr. Michael Bertocchi to learn how hyperbaric therapy can help heal wounds.
New Parkinson’s Surgery Wed, Feb 19 | 6:30-8 p.m. Join neurosurgeon Dr. David VanSickle to learn about the newest asleep deep brain stimulation and why you should consider it sooner rather than later. Also learn about LSVT (Big and Loud) therapy.
Easing Joint Pain Thu, Feb 20 | 6:30-8 p.m. Join Dr. Derek Johnson, orthopedic medical director, to learn about computer-navigated knee replacement, patient-specific knee replacement, and minimally invasive anterior hip replacement surgery.
Sleep Disorders Tue, Feb 25 | noon-1:30 p.m. Join sleep specialist Dr. Stephen Duntley for an informative talk on the importance of sleep, types of sleep disorders, and what you can do to help get a good night’s rest.
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Back to
MAKING Richard Foust has been making music since the age of 14, playing trombone and acoustic bass with big bands and as a recording artist in Nashville and Los Angeles. When Foust decided to partially retire,
Local musician hits the right note after finding a cure for little-known back problem
he moved to Denver so he could fly-fish, sail, hike, and ice-skate — while continuing to perform occasionally with his band, OCEANJAZZ. “I can’t quit playing,” says the 73-year-old. Scoliosis, a sideways curvature of the spine caused by years of bending while playing, didn’t stop Foust. Neither did surgery to realign his spine by connecting (fusing) seven spinal bones in 2008. But the pain in Foust’s low back, groin, and buttocks got worse after that, until he could barely move. He had to stop playing. “There were times when the pain was so excruciating and debilitating that I didn’t want to be around,” he says.
Searching for relief
None of the 10 specialists Foust saw over the next few years knew what was wrong. Physical therapy made him feel worse, and even morphine didn’t relieve the pain. Finally, a pain management doctor referred Foust to Bradley Duhon, MD, a neurosurgeon at Parker Adventist Hospital with extensive experience in diagnosing and treating a little-known condition called sacroiliac (SI) joint dysfunction. The SI joints are where the lower spine and the pelvis connect. SI joint dysfunction can cause severe pain in the upper buttock, groin, or lower back, and even down one or both legs. The pain often gets worse after standing for a long time or climbing stairs. “As many as 25 percent of patients with low back pain have SI joint dysfunction,” Duhon says. SI joint dysfunction is often misdiagnosed as another type of back pain. Imaging tests, the standard for diagnosing Parker Adventist most back problems, don’t detect it. Hospital is the only hospital Fusion of the lower back, pregnancy, injury to the SI joints, and in the Rocky Mountain region uneven leg length are common causes of SI joint dysfunction. When pregnancy is the cause, the pain usually goes away after utilizing Mazor Robotics’ the baby is born. Renaissance™ guidance Based on Foust’s spinal fusion, the location of his pain, and an system in complex spine exam, Duhon suspected SI joint dysfunction. When an injection surgeries. of anesthetic into the SI joint temporarily relieved Foust’s pain, this confirmed the diagnosis.
Finding a miracle cure
For most people with SI joint dysfunction, rest, physical therapy, medications, and injections are enough. Since none of these had helped Foust (except for a few hours of relief from the injection), Duhon recommended minimally invasive SI joint fusion. Last August, Duhon performed the procedure at Parker Adventist Hospital, using Mazor Robotics’ Renaissance guidance system. Parker Adventist
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PHOTOS: ELLEN JASKOL
Richard Foust
MUSIC
Relief for other
painful back problems
Up to 25 percent of low back pain is actually sacroiliac joint pain.
Hospital is the only hospital in the Rocky Mountain region offering this technology. Using Renaissance, Duhon created a 3-D blueprint for surgery, customized to Foust’s anatomy. During the procedure, the system’s mechanical guidance helped guide Duhon to place three triangular devices (the iFuse Implant System®) across the SI joint. Over time, the bone grows into and around the implants to stabilize the SI joint. Duhon did the procedure through two 1-inch incisions on the hip, instead of an incision that could be as long as the buttock in traditional surgery.
Many other painful back problems are being treated with Mazor Robotics’ Renaissance™ guidance system at Parker Adventist Hospital. Slipped vertebra (a bone in the spine that slips out of place onto the bone below it), degenerative disc disease (pain in the back, buttocks, or legs from aging of the rubbery cushions between the bones in the spine), and scoliosis are common examples. “We always try to Dr. Zaki Ibrahim make patients better first with nonsurgical means,” says spine surgeon Zaki Ibrahim, MD. “But if patients need surgery, most are candidates for a minimally invasive procedure.”
Back in the spotlight
“It was a miracle,” says Foust. “Right after the surgery, I was completely pain-free except for the incision pain. I went home the next day and have been pain-free since.” With traditional surgery, Foust would have been in the hospital about five days, and it would have taken up to six months to return to most daily activities, instead of about three months with the minimally invasive surgery. “Minimally invasive SI joint fusion has given a tremendous amount of relief to a lot of patients who have been suffering from SI joint pain for years,” said Duhon, who teaches the Renaissance system and the iFuse SI joint fusion procedure to other surgeons nationwide. Up to 85 percent of patients are still pain-free a year after minimally invasive SI joint fusion. Since it’s a fairly new procedure, longerterm statistics aren’t available yet, but two ongoing clinical trials should provide more information over the next few years, Duhon says. As for Foust, he has started practicing his music and expects to be performing again soon. He also plans to get back to fly-fishing, sailing, hiking, and iceskating. “Dr. Duhon has given me my life and my lifestyle back,” he says.
Correcting deformities and relieving pain The Renaissance system is especially useful in spinal fusion. By connecting two or more bones in the spine, fusion can improve stability, correct deformities, and relieve pain. Ibrahim, an orthopedic spine surgeon, uses a bone graft or a bone substitute and in many cases, metal plates, screws, and rods, to help the bones fuse together.
Learn More 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 whether this is causing your back pain and what to do next. DATE | Tue, Mar 25 TIME | noon-1:30 p.m. See details on back cover.
PHOTO BY ELLEN JASKOL
The most common symptoms of SI joint dysfunction are: > Pain in the upper buttock, which may go into the groin or thigh, usually with low back pain > Pain that gets worse with sitting, sleeping, climbing stairs, or squatting > Stiffness and difficulty getting up when seated or getting out of bed
PHOTO: BACK PAIN ©ISTOCKPHOTO.COM/ERAXION; ILLUSTRATION: MUSIC NOTES ©ISTOCKPHOTO.COM/RED_FROG
Is your back pain coming from the SI joint?
An easier, quicker recovery “We typically get patients out of the hospital within a day. By the time they come and see us a few weeks later, they’re doing quite well,” Ibrahim says. Rehabilitation, which depends on the patient’s condition, takes about half as long after a minimally invasive procedure as after a traditional procedure.
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The ABCs of finding a PCP
Find a Doctor 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.
Access Family Medicine
choosing your family physician
A PRIMARY CARE PHYSICIAN,
1
Does the doctor use an electronic medical record (EMR)?
2
Is your doctor part of a medical home?
3
How long is the initial visit for a new patient, and what is included?
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 Brett Walker, MD, a family medicine physician with Centura Health at Southlands. “He or she should be the first person patients consult with when they have a concern, need a referral, or want advice; and he or she is also the best person 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). Walker recommends adding these three questions to your selection process: 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 affiliated doctors and hospitals 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.
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Oswaldo Grenardo, MD Josh Solot, DO 19284 Cottonwood Dr. Suite 201 Parker, CO 80138 303-269-2626 accessfamilymed.com
Parker Primary Care Lisa Walker, MD Bree Willis, MD 10371 Parkglenn Way Suite 220 Parker, CO 80138 303-649-3100 parkerprimarycare.org
Centura Health at Southlands
Karen Gavigan, MD Ashu Rangole, MD Maria Archie Villavert, MD Brett Walker, MD 6240 S. Main St. Suite 255 Aurora, CO 80016 303-928-7555 centuraatsouthlands.org
Timberview Clinic at Parker
Shauna Gulley, MD Ramona Rodriguez, MD Jeff Turk, MD Paige Turk, MD 9399 Crown Crest Blvd. Suite 200 Parker, CO 80138 303-269-4410 timberviewclinic.org
Comprehensive OB/GYN
Lorie Jones, MD Erica Drennen, MD Diane Schmitz, MD 9397 Crown Crest Blvd. Suite 431 Parker, CO 80138 720-851-8230 comprehensiveobgyn.org
Integrated OB/GYN
Chia-Hui Lee, MD Sunmee Lee, MD Megan Woodman, MD 9397 Crown Crest Blvd. Suite 220 Parker, CO 80138 303-721-1670 integratedobgyn.org
Pinnacle Women’s Healthcare
Chutaporn Charnsangavej, MD Michael Gavigan, MD Mark Saunders, MD Jill Tyler, MD Tara Wiebe, MD Parker Adventist Hospital 9397 Crown Crest Blvd. Suite 331 Parker, CO 80138 Southlands Mall location 6240 S. Main St. Suite 255 Aurora, CO 80016 303-840-8780 pinnaclewomenshc.org
nsumer Reports According to a 2011 Co ctors surveyed study, 76 percent of do long-term relationship reported that forming a t important thing a with a PCP is the mos in better medical care. patient can do to obta
PHOTO: FAMILY ©ISTOCKPHOTO.COM/MEDIAPHOTOS
3 questions to consider when
wound healing Hyperbaric medicine is like a breath of (highly oxygenated) fresh air
How oxygen can cure wounds Wound Ca r Center No e w
OPEN!
O2
FOR PATIENTS SUFFERING FROM CHRONIC WOUNDS, a specialized treatment offered at the new Wound Care and Hyperbaric Medicine Center at Parker Adventist Hospital can expedite healing time and help many patients, especially those with diabetes, avoid amputation. Hyperbaric Oxygen Therapy (HBOT), long used to treat divers for decompression sickness, has proven in the last decade to be an especially effective option in healing persistent wounds by delivering 100 Patients can watch TV, listen to music, percent oxygen into the or read a book while bloodstream. Wounds that receiving hyperbaric won’t heal are often caused oxygen therapy. by bone infections, diabetic foot ulcers, complications of radiation therapy used to treat cancer, and severe skin and muscle infections. Approximately 6.5 million Americans suffer from chronic wounds. Of the 23 million people in the U.S. who have diabetes, about 35 percent of them will develop a diabetic foot ulcer, which can lead to discomfort at best and amputation at worse.
How It Works
PHOTO: CHAMBER ©ISTOCKPHOTO.COM/JACUS; ILLUSTRATION: ©ISTOCKPHOTO.COM/KCHUNGTW
Patients receiving HBOT are placed in a clear chamber where they are pressurized and exposed to pure oxygen. The pressurization helps carry the oxygen through the bloodstream much faster than normal, explains Michael Bertocchi, MD, general surgeon and medical director for the Wound Care and Hyperbaric Medicine Center at Parker Adventist Hospital. “What that does is allow oxygen to diffuse directly into the injured tissue and increase the oxygen tension at that level,” Bertocchi says. “This markedly improves the ability of compromised tissue to heal.” Bertocchi estimates that about 20 to 30 percent of patients at the new Parker Adventist Hospital Wound Care and Hyperbaric Medicine Center will need HBOT.
Painless Pressure
Patients typically receive 20 to 30 daily treatments that last two to three hours. Although some patients worry about how they will feel under pressurization, most quickly get used to it. “It’s similar to the effect of diving in the ocean anywhere from 30 to 60 feet in depth,” says Bertocchi. Before receiving treatment, patients are taught how to relieve any discomfort. HBOT is noninvasive and painless. The most common side effects include earaches, claustrophobia and, in diabetics, hypoglycemia. But the vast majority of patients, Bertocchi says, are able to tolerate the treatment very well. Many even watch TV, take naps, or listen to music.
Pure oxygen is pumped into the chamber, and the pressure is increased to higher-than-normal atmospheric levels. During the treatment, the patient breathes 100 percent oxygen. The increased pressure in the chamber quickly increases the concentration of oxygen in the patient’s bloodstream, which is carried to the patient’s wounded tissue. The increase in oxygen in the bloodstream helps reduce swelling, fight infection, and build new blood vessels, ultimately producing healthy tissue to heal the wound.
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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 Adventist Hospital Conference Center at the west entrance. A light lunch is served during noon seminars, and light snacks are served during evening programs.
Eye Health Tue, Mar 4 | 6:30-8 p.m. Dr. Jennifer Grin will discuss various diseases and conditions of the eye, how to treat them, and what to do to keep your eyes healthy as you grow older.
Weight-Loss Surgery Wed, Mar 12 | 6:30-8 p.m. Join bariatric surgeon Dr. Josh Long for a look at various surgical weight-loss options. Learn more about the LAP-BAND®, gastric bypass and sleeve surgical procedures, and whether you’re a candidate for surgery.
Q&A
With Monique Fox, MD, Breast Radiologist, Parker Adventist Hospital’s Trio Breast Center
15 What is 3-D mammography?
Minimally Invasive Hysterectomy
A: Tomosynthesis, also called 3-D mammography, is the latest advancement in breast screening technology. This technology takes 15 images of the breast from all angles and reconstructs them into an image that allows us to see through the breast rather than looking at a flat image. There is much less overlap of tissue that can obscure suspicious spots, and it picks up much smaller masses.
Thu, Mar 20 | 6:30-8 p.m. Join OB-GYN Dr. Hope Cassel and learn how robotic surgery has dramatically improved hysterectomy surgery. Typically results in less pain, scarring, and a quicker recovery.
Is It Really Back Pain? Tue, Mar 25 | noon-1:30 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.
Dr. Monique Fox
Parker Adventist Hospital’s Trio Breast Center now uses tomosynthesis for all screening mammograms in addition to traditional 2-D digital mammography. Because the cost of a tomosynthesis mammogram is not yet covered by insurance plans, Parker Adventist Hospital charges only for the traditional digital mammogram so that women do not have a copayment or deductible when getting their screening mammogram.
9395 Crown Crest Blvd., Parker, CO 80138
Parker Adventist Hospital is part of Centura Health, the region’s leading 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.
PHOTO: TEXTING ©ISTOCKPHOTO.COM/IZUSEK
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
The latest studies show that tomosynthesis increases the detection of invasive cancers by 40 percent while decreasing the number of callbacks (when a woman is called back for another test due to a suspicious finding) by 15 percent.
Text us to schedule your mammogram! Text your name to 303-816-8648, and we’ll call you within two business days to schedule your mammogram.