Grow Spring 2011

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Nurturing the health of you and your family

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Spring 2011 | Volume 3, Issue 2

Winning Results Parker Hospital stroke program improves the odds for patients

Kevin Dickson of Parker is back in the game after suffering a stroke one year ago.

See Page 4.

INSIDE

Equestrian Safety | Parenting Classes | New Options for Incontinence

Crash Landing Equestrian head injuries can show subtle symptoms

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Parker equestrians (from left) Shannon Dahmer, Suzie Halle, Mary Allyn, Lisa Sutila, with Dr. Sean Markey and Vikki Pope, RN, received custom helmet fittings through Parker Hospital.

ith spring in the air, equestrians will be hitting the trails—literally.

About 80 percent of all equestrian injuries result from falling off a horse.

Leading the list of injuries—and the most life-threatening—are head injuries.

“The impact on your head from falling off a horse can be greater than taking a header off a mountain bike, yet many horse riders don’t wear helmets or they wear helmets that are mostly decorative,” says Sean Markey, MD, a neurosurgeon and medical director of neurosurgery at Parker Adventist Hospital.

Riders should buy—and wear—high-quality equestrian helmets that are properly fitted and replaced every five years or whenever a head strike with direct impact occurs, says Vikki Pope, RN, the trauma manager who oversees Parker Hospital’s equestrian safety program. Parker provides free certified equestrian helmets and custom fittings to riders in the community.

If you take a fall from a horse, watch carefully for signs of trouble, Markey says.

A person does not need to lose consciousness to have a head injury. If a rider who takes a fall exhibits any of the following signs, he or she should be seen by a doctor as soon as possible:

Vacant stare // Delayed answers to questions // Easily distracted // Headache Disorientation to time and place // Emotionality out of proportion to circumstances Memory deficits // Loss of consciousness // Slurred speech // Vomiting

ApFRriEEl health seminars

for Join Parker Adventist Hospital s a series of FREE health seminar inars sem All ng. spri throughout the the are held in the Inspiration Room of Parker Hospital Conference Center, l located on the hospital’s garden leve light A nce. entra t wes at the new lunch is provided during daytime programs and light snacks during evening programs. Registration is required by calling 303-777-6877, ext. 1. Guests are encouraged to park on the west side of the hospital.

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Weight Loss Surgery

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Acid Reflux: Eliminate the Burn

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Parker Adventist Hospital provides an equestrian safety program, free equestrian helmets and custom helmet fittings to the community. For more information, go online to parkerhospital.org/ equestriansafety or call 303-269-4809.

Peripheral Artery Disease

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Thursday, April 21 ■ Noon–1:30 when legs your in pain e Do you experienc heral perip from ring suffe be may You walking? e mor ts artery disease (PAD), which affec n the than eight million Americans. Lear ns with optio t men treat and s ptom signs, sym man, DO. Sass interventional radiologist Michael

Put Your Shoulder In It

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Thursday, April 28 ■ Noon–1:30 t’s g…i bikin ntain mou is, tenn , Golf prime season for shoulder injuries. ni, Join orthopaedic surgeon Todd Alija your ect prot to how learn to MD, es shoulders and the latest procedur do to fix them if they get hurt.

Laparoscopic hernia surgery offers better results Approximately 400,000 patients each year in the United States have surgery to repair ventral hernias, which are tears in the “six pack” of stomach muscles often resulting from weakened tissue due to abdominal surgery.

Dr. Jessica Evans In complicated cases, repairing these hernias can require a surgeon to make another large incision through the abdomen and then divide a layer of deep oblique muscles to relieve tension so the hernia doesn’t recur.

Now, however, this procedure can be performed in a minimally invasive surgery through three small incisions on each side of the abdomen, says Jessica Evans, MD, a minimally invasive surgeon at Parker Adventist Hospital.

“Performing this procedure laparoscopically decreases the risk of wound infection, allows the patient to heal faster and is more effective at preventing recurrent hernias,” Evans says.

Abdominal surgery that cuts vertically through the middle of the “six pack” is a common procedure used in trauma surgery, colon surgery and other types of surgeries. Ten percent to 15 percent of these patients go on to develop large hernias that separate the muscles and bulge out of the abdomen.

If left untreated, parts of the abdomen may become stuck or twisted in the hernia, causing problems with digestion or other organ functions. An untreated hernia can even become a surgical emergency, which can lead to other health problems and make closing the hernia more difficult.

April 17 | 7 a.m.–noon Parker Adventist Hospital

More than 15 health screenings— including body mass index (BMI), vision screenings and blood pressure checks—will be offered FREE at this health fair. Blood chemistry (cholesterol), PSA and colon cancer screenings will be provided at discounted prices. All screenings are provided on a first-come, first-served basis. For more information, go online to 9healthfair.org.

Annual mammograms Starting at age 40 saves lives Getting annual mammograms starting at age 40 reduces breast cancer deaths by 40 percent, according to a new study.

Last year, the U.S. Preventive Service Task Force (USPSTF) —a national task force that evaluates the effectiveness of health screenings—recommended that women should get screening mammograms every other year starting at age 50. The American Cancer Society and other organizations came out against the recommendations, creating confusion for many women.

The new study, published in the February issue of the American Journal of Roentgenology, analyzed the same data used by the USPSTF but found that 71 percent more lives are saved with yearly screenings beginning at age 40 than with everyother-year screenings beginning at age 50.

“The evidence is clear— annual mammography screenings starting at age 40 saves lives,” says Christine Rogness, MD, breast surgeon and medical director of the breast program at Parker Adventist Hospital.

If all women currently in their 30s received annual mammograms from age 40–84, nearly 100,000 more lives would be saved than if they followed the USPSTF recommendations for biennial screenings from ages 50–74, the study found.

The Trio Breast Center at Parker Adventist Hospital has received the highest level of accreditation as a Comprehensive Breast Center by the National Accreditation Program for Breast Centers, which is administered by the American College of Surgeons.

Get screened!

The Trio Breast Center at Parker Adventist Hospital is making it easier than ever to get your annual screening mammography.

Join the Trio Breast Center for a special evening of Mammograms, Music and More. Women can get their annual mammograms, relax to live music and enjoy gourmet appetizers and desserts.

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April 14 4 – 7:30 p.m.

Trio Breast Center at Parker Adventist Hospital (just off main lobby) Reservations are required by calling 303-269-4150. Please have insurance information available. If you have had previous mammograms at other facilities, we are happy to retrieve the results for you.

9395 Crown Crest Blvd., Parker, CO 80138 grow is published four times annually by Parker Adventist Hospital as part of our mission to extend the healing ministry of Christ by caring for the ill and nurturing the health of the people in our community. For comments or to unsubscribe to this publication, please email us at grow@centura.org. grow is produced by Clementine Communications, Denver, Colo.

Executive Editor: Rachel Robinson

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Stroke

Parker Hospital improves the odds for stroke patients

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Kevin Dickson uses basketbal to rehabilitate from his stroke.

Know this!

Know the warning signs of stroke > Sudden numbness or weakness of face, arm or leg—especially on one side of the body. Look in the mirror to spot a one-sided or droopy smile. > Sudden confusion, lack of understanding or slurred/delayed speech. > Sudden vision trouble. > Sudden trouble walking, balancing or coordinating movements. > Sudden, severe headache with no known cause.

Note the time you first notice symptoms. This is critical because clot-busting drugs must be administered within three hours of the onset of symptoms.

Call 9-1-1 if you suspect a stroke, instead of driving to the hospital. This allows emergency responders to call in a “stroke alert” that prepares the hospital’s stroke team to be ready to treat as soon as the patient reaches the hospital.

evin Dickson spends hours each week on the basketball court at Parker Field House, relentlessly driving to the basket with his left hand.

At 52, Dickson isn’t dreaming of a professional basketball career, but he is trying to put his career as a mechanical engineer—and his life—back on track after suffering a stroke a year ago that impaired the left side of his body.

“It was a Friday night and I was at home when my left arm suddenly went numb,” Dickson recalls. “The first thought in my mind was, ‘Did I just have a stroke?’ But then I started thinking it was a pinched nerve because I had been to see my chiropractor earlier that day.”

Dickson went to bed, hoping he’d be better in the morning. By the time he woke up, the entire left side of his body was paralyzed. He lay on his bathroom floor for two days before he could make it to his phone. Emergency responders rushed him to the stroke center at Parker Adventist Hospital, where he was treated and immediately began receiving rehabilitation to help regain the functions he had lost during the stroke.

“My decision to go to sleep was a dumb decision, obviously, but I never thought I could be having a stroke,” Dickson says. “I’m pretty optimistic about my recovery, but it’s taken a lot of work.”

Dickson’s story, unfortunately, is not unusual in many ways. More and more stroke victims are under the age of 65. Indeed, one out of every five stroke patients seen at Parker Hospital over the past year was under the age of 60.

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And few stroke patients—in fact, just 5 percent—get treated in time to prevent permanent disability or death.

“Stroke is the fourth-leading cause of death in Americans, but it’s the No. 1 cause of long-term disability,” says Pam Elser, RN, manager of the Parker Hospital stroke program. “I try to educate people that although they may survive a stroke, they may have lasting long-term deficits, such as difficulty walking, talking or even swallowing.”

Seconds count A stroke occurs when the blood flow to the brain is cut off, either because the artery has become clogged or it has burst. Without oxygen, brain cells begin to die rapidly. For every 12 minutes the cells are deprived of oxygen, a pea-size portion of the brain dies.

Depending on where the damage occurs, different symptoms begin appearing. Most commonly, stroke victims lose function on one side of their bodies, develop slurred or slow speech, have difficulty seeing and swallowing, or Dr. Ravi Shah experience cognitive difficulties, says Ravi Shah, MD, a neurologist and medical director of Parker’s stroke program.

Nearly 90 percent of all strokes are caused by a clot in the artery, called an ischemic stroke. In these cases, a clot-busting drug (called tPA) can be given to restore blood flow if the patient is treated within three hours of the onset of symptoms. A few people also may benefit from a procedure to remove the clot after receiving tPA. This

Stroke centers deliver better odds

of luck treatment also requires fast timing to be effective, Shah says.

“There is a part of the damage that will be irreversible, but the surrounding area called the penumbra might be salvageable,” Shah says. “Our goal is to save that area by getting blood flow restored, making the extent of the damage and the resulting disability smaller.”

Parker’s stroke team has several goals when providing treatment: > Restore blood flow to the brain as quickly as possible. > Prevent secondary conditions such as pneumonia, which is common in stroke victims who cannot swallow properly. > Treat the underlying cause of stroke to prevent future strokes. One quarter of stroke victims will have a second stroke within five years, according to the American Stroke Association.

Window of opportunity When a stroke occurs, not all cells within the affected area are killed.

Aggressive rehabilitation after a stroke can actually use the remaining cells to “retrain” the brain or develop new pathways that can partially or fully restore the functions lost. But that rehabilitation needs to begin as soon as possible, Shah says.

“Aggressive rehabilitation in the first three to six months results in the best outcomes, and the benefits begin to plateau after that time,” he says. “After a stroke, the patient can be fatigued or depressed and not want to engage in rehabilitation, but there really is a window of opportunity to make the biggest difference.”

As part of being a Primary Stroke Center, Parker Hospital offers a comprehensive rehabilitation program that includes physical, occupational and speech therapy through the Parker Adventist Center for Rehabilitation & Sports Medicine. It’s this program that Dickson credits with his recovery.

“There were nurses and (rehabilitation) therapists at Parker who told me I needed to work really hard to get myself out of this,” Dickson says. “I’m really grateful because that motivated me.”

Dickson went through five months of rehabilitation and continues daily exercises, including playing basketball primarily with his left hand (despite being right-handed). He is back working full time but still has to take one day off each week due to fatigue. He now takes medication to control his blood pressure, the single biggest risk factor for strokes.

“I had run three marathons in the three years before my stroke,” Dickson says. “My goal is to run again.”

Take a free online stroke assessment and learn more about stroke prevention, warning signs and treatment at parkerhospital.org/stroke. grow

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Patients who receive care at a certified “stroke center” have a 20 percent lower risk of death 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.

Parker Adventist Hospital was recently certified as a Primary Stroke Center by The Joint Commission, an agency that inspects and certifies hospitals. Certified Primary Stroke Centers provide comprehensive care, from emergency treatment through rehabilitation, and followed scientifically proven methods to achieve the best outcomes possible for patients. Parker Hospital’s Stroke Center is part of the Centura Health stroke network that offers a collaborative, comprehensive network of hospitals to provide expert stroke care throughout Colorado.

“Having a stroke center in the community means that intervention is at least 20 minutes closer,” says Pam Elser, RN, manager of Parker Hospital’s stroke program. “That 20 minutes can be critical.”

Brain

Damage

A stroke cuts off blood flow to the brain, depriving it of oxygen. For every 12 minutes that a stroke is left untreated, a pea-size portion of the brain dies, resulting in mental and physical disabilities. The location of the damage determines which functions will be affected.

Left Brain > Paralysis on the right side of the body > Speech/language problems > Slow, cautious behavioral style > Memory loss

Right Brain > Paralysis on the left side of the body > Vision problems > Quick, inquisitive behavioral style > Memory loss

Suffering in silence Incontinence can be cured if women seek help

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hree in every 10 women experience urinary incontinence, an embarrassing but often curable condition.

The most common form of incontinence is called “stress incontinence,” which is urine leakage caused by pressure such as exercise, coughing or lifting. Vaginal child birth, menopause and even athletics are common causes of stress incontinence in women of all ages. Because the problem is embarrassing, women often don’t talk about it—not even to their doctors.

But incontinence is a problem that, in most cases, can be cured—or at least significantly improved—if women seek help.

Treatment typically includes at least three options, says Oscar A. Aguirre, MD, a urogynecologist who specializes in treating urinary incontinence at Parker Adventist Hospital.

“Every treatment plan should offer conservative approaches so that a woman can decide what’s best for her,” he says.

The most common treatments include: ● Physical therapy: Therapists use ultrasound to help women identify and strengthen the proper muscles (through Kegels) to help control urine leakage. (See story below.) ● Vaginal pessary: Patients insert a removable diaphragm-like device to support the bladder. ● Surgery: A mesh “hammock” is placed around the urethra to stop the flow of urine during moments of strain or exercise.

Surgery is often the most effective and longestlasting treatment for stress incontinence, Aguirre says. This minimally invasive surgery takes about 20 minutes and the patient returns to normal activities within a week.

“Eighty-five out of 100 patients will be completely dry five years after surgery, and another 7 percent will see significant improvement,” says Aguirre, who has performed this procedure more than 3,000 times.

Physical therapy helps keep women dry Performing Kegels, or exercises to contract and relax the pelvic floor muscles, is often recommended as a treatment for stress incontinence. However, more than half of all women perform Kegels incorrectly, says Allison Ariail, a women’s health physical therapist who treats incontinence at the Parker Adventist Center for Rehabilitation & Sports Medicine.

“Most women try too

LEARN

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hard and actually make their incontinence worse,” she says.

The Women’s Health Program at the Parker Center is one of the few programs to use ultrasound to help train women properly. During the therapy session, the woman will lie fully clothed on a table while the therapist holds an ultrasound on her abdomen.

The woman is then coached on how to contract and release the appropriate muscles, which she can see on the ultrasound

screen. Women typically meet with a physical therapist weekly for 12 to 16 weeks and practice the exercises daily at home.

“When they’re doing the exercise properly, most women say that they feel like they’re not doing anything—it’s usually that subtle,” Ariail says. “We have very high success rates

with women who have pure stress incontinence.”

If a woman requires surgery for incontinence or prolapse, a condition in which the bladder and/or urethra has shifted down into the vagina, this program can help strengthen weak pelvic floor muscles after surgery and make patients more satisfied with the outcome, she adds.

The Parker Adventist Center for Rehabilitation & Sports Medicine offers a special Women’s Health program to treat urinary incontinence.

To learn more, go to parkerhospital.org/rehab or call 303-269-4590. grow

Classes help prepare parents

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Right Start

Newly pregnant? Do you know the difference between false and real labor and when to head for the hospital? What are your options for pain management? Would you like to breastfeed and need to know how to handle it when you go back to work?

These are just a few of the hundreds of questions that are answered in a series of birthing and parenting classes at The BirthPlace at Parker Adventist Hospital.

“Classes are a great way to get many of your questions answered—even questions you may not know you have,” says Lori Adams, the perinatal nurse educator at The BirthPlace. “It is helpful entering the labor suite with some knowledge of what to expect. Research shows that moms who take childbirth classes are more satisfied with their labor experience.”

The BirthPlace offers a wide variety of classes, including childbirth, breastfeeding, For information about birthing baby care and infant CPR. Childbirth classes and parenting classes at Parker now include a new segment on epidurals Adventist Hospital, go to taught by an anesthesia provider. Marvelous Multiples offers parents important information parkerhospital.org/birthplace. unique to pregnancy and delivery of multiples.

Classes are free or low cost.

Foundation seeks local families The Parker Hospital Foundation is launching a new program aimed at families who are trying to balance family time with community involvement. The foundation’s new Advisory Board will be made up of 100 local families who will help guide the foundation’s efforts to improve the health of the community.

“Nearly three-quarters of our community is working families,” says Lisa Sandoval, executive director of the foundation. “These families want to be involved, but they also want to spend time together. That opportunity just isn’t out there.”

The Advisory Board will launch in May. Each position will be held by two adult family members who will serve for five years. While the Advisory Board meets only once each year, foundation staff members are hoping the members will become involved in the organization’s events throughout the year.

A small financial commitment is required.

Get your tee time!

“It’s really an opportunity for families to become engaged in health care,” Sandoval says.

The foundation raises funds to support Parker Adventist Hospital’s mission to take care of the ill and injured while also improving the health of the community.

The foundation this year will fund a series of free health screenings, Sandoval says. The foundation also built the hospital’s healing garden and is now funding a $100,000 safety program in the operating rooms.

If you and your family are interested in becoming more involved in the health of the community and would like more information about the Advisory Board, please call Sandoval at 303-715-7614. Applications are being accepted through April 29.

Teens in Medicine > Look inside a PET scanner. >W ork in a state-of-the-art medical laboratory. >T est out your medical skills on a robotic patient.

These are just a few of the opportunities teens will have this summer during a special free program at Parker Adventist Hospital. The hospital will host a series of four lunch-and-learn programs for teens to learn about many types of health care professions.

Parker Hospital staff members will speak at the programs, helping teens learn about various health care jobs and the educational requirements for those jobs. The one-hour programs will be held at noon every Wednesday June 22– July 13 and include free pizza.

The series is open to all teens 13 and older.

“The kids in our community are curious and are eager to get information,” says Jude Keller, manager of volunteer services at Parker Hospital. “What better resource to get that information than their local hospital?”

Registration for these events is required. For more information and to register, go online to parkerhospital.org/volunteer.

Parker Golf Classic Benefiting Parker Adventist Hospital Aug. 29, 2011 :: Blackstone Country Club For more information or registration, call 303-715-7600 or email foundationevents@centura.org.

Like us at facebook.com/ parkeradventisthospital

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May Health Seminars Make an appointment with the experts at Parker Adventist Hospital to become more body-wise. All seminars are FREE but require registration by calling 303-777-6877, ext. 1.

Seminars are held in the Inspiration Room of the Parker Hospital Conference Center, located on the hospital’s garden level at the new west entrance. A light lunch is provided during noon seminars and light snacks during evening programs.

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Denver, CO Permit No. 4773

9395 Crown Crest Blvd.

Parker, CO 80138

Weight Loss Surgery Wednesday, May 11 ■ 6:30–8 p.m.

Join Matthew Metz, MD, medical director of bariatrics at Parker Hospital, for a look at the surgical and medical approaches to weight loss. Learn the options, including gastric bypass and lap band surgeries, and whether you may be a good candidate.

Joint Replacement Wednesday, May 18 ■ 6:30–8 p.m.

Come learn about the latest in joint replacement—completely customized joints made just for your body. Join orthopaedic surgeon Derek Johnson, MD, to learn about these new joints as well as the latest in pain relief techniques.

Living with Lung Disorders

Minimally Invasive Spine Surgery

Thursday, May 19 ■ Noon–1:30 p.m.

Is your asthma, COPD or other lung disorder stopping you from living life to its fullest? Join pulmonologist Kate Hodgin, MD, to learn why weak muscles affect you just as much as weak lungs— and how to build back your strength safely.

Thursday, May 26 ■ Noon–1:30 p.m.

Significant advancements in spinal surgery are allowing physicians to perform certain procedures through tiny incisions, helping patients recover faster and with less pain.

Join orthopaedic spine surgeon Zaki Ibrahim, MD, to learn about new, less-invasive surgical procedures for back surgery and whether you are a good candidate.

strength

compassion

hope

innovation

expertise

Exercising your lungs If chronic obstructive pulmonary disease, better known as COPD, is making you feel tired and breathless, exercising is probably the last thing on your to-do list. But exercise actually can make you feel better.

“COPD can be a viscous cycle,” says Kate Hodgin, MD, an internal medicine physician who specializes in pulmonary and critical care at Parker Dr. Kate Hodgin Adventist Hospital. “As the disease progresses, you feel less like exercising.

But without exercising, your muscles get weaker and you feel even worse.”

More than 400,000 Coloradans suffer from COPD, occurring mainly in smokers.

While rates have been dropping in men,

they have been going up in women.

“Exercise won’t extend a patient’s life, but it will help them live life in a way that is satisfying rather than sitting at home feeling ill,” Hodgin says.

Hodgin offers these tips: ✔ Check with your physician before you start an exercise program. A heart screening may be necessary. ✔ Try to move for at least 30 minutes three times a week. Even simple walking counts. ✔ Stop immediately if you experience chest pain, dizziness or inability to draw a breath. ✔ Wear a finger oxygen monitor (available at outdoor stores) and maintain oxygen levels above 90 percent. Levels below that can damage the heart.

To learn more about exercising with COPD, asthma or other types of lung problems, come to a free program on May 19.

See above for details.

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.