April 2016 Prime by The Greeley Publishing Company

SRING - APR. 2016

Companies build ers in northern colorado to meet demand even as too many patients use ers for primary care.

PG. 6 It's easy to forget that alcohol is a drug associated with health implications. PG. 10 changing health guidelines label more people as diabetic. PG. 17 UCHealth Buys west greeley land for new health facility.

Do you know the

signs of a stroke? Think F.A.S.T. Know the signs.

F A S T

FACE

Ask the person to smile. Does one side of the face droop?

ARMS

Ask the person to raise both arms. Does one arm drift downward?

SPEECH

Ask the person to repeat a simple phrase. Is their speech slurred or strange?

TIME

Act fast. Every second, brain cells die.

Call 911 if you think you or a loved one is having a stroke. When it comes to stroke care, UCHealth is the team you want on your side.

MEDICAL CENTER OF THE ROCKIES | POUDRE VALLEY HOSPITAL

uchealth.org/stroke

Features

PG.12

PG.8

Care Center Crossroads

White Men & Suicide

The Health Care Paradox: Companies build ERs in northern Colorado to meet demand even as too many patients use ERs for primary care.

PG 4

PG 5

Program helps nurses get into the hospital setting.

Find out whether you need to be taking the vitamins you do.

Getting a Foot in the Acute Care Door

Let's Talk About Vitamins

PG 6

It's Easy to Forget That Alcohol Really is a Drug

Alcohol is associated with glitz and glamour but also has serious health implications.

PG. 18 Prime eats: bucantini with shrimp avocado sauce recipe

PUBLISHER Bryce Jacobson EDITOR Randy Bangert CREATIVE MANAGER Kyle Knoop BUSINESS MANAGER Doug Binder MANAGING EDITOR Nate A. Miller CREATIVE SERVICES SUPERVISOR Amy Mayer

Performing the 3 Ps: White men have an abnormally high suicide rate, mostly because of the need to procreate, provide and protect.

CONTRIBUTING WRITERS Bridgett Weaver Joe Moylan Sharon Dunn Emily Kimme Sales MANAGERs Stephanie Mighell Bruce Dennis Sales Staff Cristin Peratt Mollie Lee Becky Colvin Constance Marx Lead designer Joshua Aho

PG 10

Thinking About Health

Changing guidelines label more people as diabetic.

PG. 19 Aprilâ&#x20AC;&#x2122;s health events

PG 17

UCHealth Buys West Greeley Land for New Health Facility

With the city of Greeley hitting 100,000 in population, it means more health care.

PG. 20 Prime medical directory

PRIME MAGAZINE 501 8th Ave. P.O. Box 1690 Greeley, CO 80632 For all editorial, advertising, subscription and circulation inquiries, call (970) 352-0211. Send editorial-related comments and story ideas to: rbangert@greeleytribune.com For advertising inquiries, contact: bdennis@greeleytribune.com April 2016, Volume 2, Issue 2.

Published by: Greeley Publishing Co., publisher of The Greeley Tribune, Windsor Now, the Fence Post, Tri-State Livestock News, and Energy Pipeline

PRIME \\ APR. 2016

Getting a foot in the acute care door Program helps nurses get into the hospital setting

By Kati Blocker Photo Credit: Kati Blocker, UC Health For UCHealth

egistered nurse Erin Morris wanted to work in a hospital, but she didn't have the experience to get her foot in the door despite having a bachelor's degree in nursing. After moving to northern Colorado and spending three months applying for jobs, she was hired by a long-term care facility in Loveland.

“Unfortunately, a new grad without hospital experience struggles to get on [at a hospital],” she said. “I found a lot of my fellow graduates were experiencing the same thing and had to start in long-term care and acute rehab settings.” And after working two years in a nursing home, she still found hospitals wanted her to have hospital experience. But then she came across UCHealth’s Transition to Acute Care Practice program, and her qualifications were perfect. Morris was part of UCHealth first cohort to go through the northern Colorado program, which provides nurses outside the hospital setting with the skills necessary to work in acute care, with the end result of a hospital job, said Jody DeStigter, education nurse specialist with UCHealth’s Clinical Education and Innovation Center in Windsor. “This program is a great op4

PRIME \\ APR. 2016

Registered nurse Erin Morris was offered an opportunity to transition from working in long-term care to an acute-care position with UCHealth as part of the system’s Transitions to Acute Care Practice program.

portunity for nurses to follow their passion into acute care,” she said. The program originated at Memorial Hospital in Colorado Springs, DeStigter said. And because of its success, the first cohort of five students started in fall 2015 with the program in northern Colorado. Participants go through mandatory orientation, and spend a week in skills labs at the Clinical Education and Innovation Center learning more acute care techniques, such as using pumps and chest tubes — skills they’ll use on the floor but might not have used in a long-term health care setting. Each nurse then moves onto the floor for a two-month orientation with either Poudre Valley Hospital or Medical Center of the Rockies’ Medical Services unit. During

that time, the group also meets with DeStigter to go over issues that may have come up doing their floor orientation. “We tackle their concerns, and I talk with their unit managers to see what we may need to review,” DeStigter said. “It’s also a nice way for them to get together and share their experiences.” Morris said it’s nice knowing she has a support team as she takes on her new and different responsibilities. “It’s nice to have that extra buddy on the floor,” she said. “We are both new but with nursing experience, so it’s just that extra support system that’s nice when you are transitioning to a new job and a new setting.” Morris said the program has

helped immensely with her transition into acute care. “It's a big jump from long-term care to the hospital,” she said. “But I feel my long-term care comes in handy as far as bedside manner. That experience shines through when dealing with the patients and their families.” Morris said she hopes the program continues, for the sake of others like her. “I think it’s very beneficial,” she said. “There are nurses out there who want to be in the hospital but feel like I did — stuck — and this is a great opportunity for them.” Kati Blocker is a freelance writer. She wrote this on behalf of UCHealth.

Let’s talk about vitamins

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henever I meet with a patient for the first time, we always review medications and vitamins or supplements that my patient is taking.

reduce their baby’s risk of neural tube defects by 50 percent to 70 percent. I usually recommend EASY FINANCING AVAILABLE FOR women begin taking these suppleAPPROVED CREDIT - APPLY ONLINE ments three months prior to starting their pregnancy. Often my patients may be taking I am not a big fan of just taking a multivitamin, and especially a vitamins or supplements but they Give us a call today 24/7 aren’t sure why, or they may ask my multivitamin in addition to a bunch of other supplements that are likely opinion on whether they should be (970) 352-3500 taking certain vitamins or supplealready in the multivitamin. www.a1heat-air.com ments. What I generally recommend Like us for special deals, Let’s start with what vitamins news, tips & more! is: know what you are taking, what are. Vitamins are organic subdose and why. Also, what clinical stances (not carbohydrate, fat or indication (symptom/concern) do protein), which are present in small you have to explain why you would quantities in the food we eat and take a specific supplement. are necessary for metabolism. They Most important, respect that are classified together because they vitamins, supplements and herbs are vital factors in our diet but do absolutely still have side effects and not fit into the other categories of risks. Your primary care physician nutrients. should always be aware of supple I am in general a big fan of vitamins and supplements if ments or natural over-the-counter they’re used within a reasonable items that you are taking, because What makes Widex UNIQUE be3er than other similar What and makes UNIQUE han other swith imilar context withW a idex specific goal be3er they tcan interact prescription hearing a ids? inhearing mind. For example, prenatal aids? medications or be so similar to vitamins• contain valuable iron andpicture • medications wider ound picture -‐ so you can hear A w ider sound -‐ so you c an A hear prescription thatsyou folic acid. Iron helps to create red b oth s o> a nd loud sounds in comfort. both so> and loud sounds n comfort. may inot need both. blood cells that are essential for the What makes sWidex •  system The vitamin best wind noise reduc9on ystem UNIQUE better than other rFor example, taking the The best w ind Anoise educ9on placenta• and growing baby. Kindy counteracts the aeffect of blood aids? vailable , so even similar in windy ehearing nvironments available , so environments healthy woman giving birth toeaven in w thinners like Warfarin. you cAnother an sDll hexear speech. baby with an average birth you can sDll weight hear speech. A wider sound picture ample is red yeast rice and statins, of about 7.26 pounds will increase so you can hear both soft and loud sounds in comfort. both lower cholesterol, which her plasma volume by an averThe best wind noise reduction system available, makes taking red yeast rice and age of about 1,250 milliliters, or so even in windy environments you can still hear speech. just under a 50 percent increase statins redundant. of what she would produce if Vitamins and supplements have Dr. Leann Johnson Dr. Robert M. Traynor she were not pregnant. Folic acid Board Certified their purposes. I often recommend Board Certified Doctor of Audiology also helps your body make red Doctor of Audiology certain supplements for patients blood cells and is essential for the and believe there is definitely a production and function of DNA role for them in pursuing wellness, which is particularly important for when they are taken the right way a developing baby. Audiology Associates, where personal service and and for the right reasons. The Centers for Disease Control

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It’s easy to forget that

alcohol really is a By Lyn Tausan Drive Smart Weld County

ftentimes, people get caught up in the glitz and glamour of alcohol. Cocktails for every occasion, drinks that smell good and look pretty, and the fact that alcohol is a drug is promptly forgotten. That is why once a year it is good to remind people about the dangers and health implications associated with alcohol.

Each April since 1987, the National Council on Alcoholism and Drug Dependence, Inc., has sponsored Alcohol Awareness Month to increase public awareness and understanding, reduce stigma and encourage local communities to focus on alcoholism and alcohol-related issues. This year’s theme is “Talk Early, Talk Often: Parents Can Make a Difference in Teen Alcohol Use.” The focus, nationally, is aimed at educating people about the treatment and prevention of alcoholism, especially among the youth, and the important role that parents can play in giving kids a better understanding of the impact that alcohol can have on their lives. Alcohol use by young people is extremely dangerous, to themselves and to others, and is directly associated with traffic fatalities, violence, suicide, educational failure, alcohol overdose, 6

PRIME \\ APR. 2016

drug unsafe sex and other problem behaviors, even for those who may never develop a dependence or addiction. The teen years are a time of heightened risktaking and as alcohol and drugs enter the scene, parents are faced with a unique set of challenges. The parents can either simply sit back and hope their kids will “get through it,” or they can take an active role in learning about alcohol and drugs and helping their kids to do the same. Research has shown that parents who have conversations with their teens about the dangers of alcohol and drug use are 50 percent less likely to use these substances than those who don¹t have such conversations. Here are some ideas on how to get involved to help raise awareness about alcohol misuse and abuse in your community: • Work with your local high school or youth organization to host an event about alcohol abuse prevention. • Invite local restaurants and our local radio station to provide free food and music at your alcohol free block party. • Work with your local health clinic to offer free or low-cost screenings for alcohol abuse. • Work with your local police station to host a Family Information Night. Share free information on preventing alcohol abuse and provide

demonstration. Example: use drinking goggles to how drinking too much can affect vision or a driving simulator available through Drive Smart Weld County. • Post information on bulletin boards at local community centers, places of worship, the library, and post office. Lyn Tausan is a retired school administrator and resides in Greeley with her husband. She is the marketing/public relations specialist for DRIVE SMART Weld County.

Resources North Colorado Medical Center, 1808 16th St., Greeley. Call: (970) 810-4121 Drive Smart Weld County: www.drivesmartweldcounty.com Weld County Health Department, 1555 No. 17th Ave, Greeley. Call: (970) 304-6420 North Range Behavioral Health, 928 12th St., Greeley. Call: (970) 347-2120 University of Colorado Health, 1900 16th St., Greeley. Call: (970) 353-1551

Was the REAL “Father of Rock ‘n Roll” Hearing Impaired? This assertion might startle more than a few historians of pop music. The origins of rock and roll have been fiercely debated by commentators and music historians. Conventional literature indicates that Rock and Roll music arose in the Southern United States through the homogenation of African musical traditions with European musical instruments. Although it’s difficult, if not impossible, to pinpoint the exact birth of Rock and Roll, its bloodline is typically traced back to the likes of Bill Haley, Little Richard, Elvis Presley and, of course, Chuck Berry, even Allen Freed..... but there is an idol of Elvis Presley and some of the other founders of Rock and Roll that many feel should carry the “Father of Rock and Roll” title that has never even made it to the Hall of Fame! If Not Bill, Dick, Elvis, Chuck or Allen.....Then Who? The story begins January 10, 1927. This day Elmer and Hazel Ray, direct descendants of a native American and an Oregon Trail Pioneer from England of Dallas, Oregon, USA had their second child, a baby boy. The boy, John Alvin Ray, grew up on an Oregon farm dazzling his family and friends with musical and acting talents from an early age. In 1937 at about age 10, John Alvin lost hearing in his right ear as a result of an accident clowning around at the first Boy Scout Jamboree in Washington, DC. It seems that he and some of his Boy Scout buddies were playing “blanket toss” which is sort of a trampoline activity and he became injured as a result of a fall. John Alvin flew up into the air but missed the blanket coming down. No one really knows the specifics of what happened but a common theory is that he landed on a piece of stubble. Whatever the cause, he lost over half the hearing in his right ear. Based upon the available data, young John Alvin’s hearing loss was moderately - severe in the right ear and stories suggest that it was an inner ear impairment, so it was likely a permanent sensori-neural loss. Of course, this was the late 1930s --in the milieu of polio, tuberculosis and other serious disorders, hearing impairment was a minimal issue of the time. The loss was not known to his immediate family for several months after the accident. All Elmer and Hazel knew was that young John Alvin had suddenly become withdrawn. In 1940, with the addition of a vacuum tube hearing aid in the right ear at about age 13, John Alvin came out of his withdrawal, singing and acting out as his old self. But he would never forget the experience of silence and isolation. The family moved to Portland, Oregon, seeking better opportunities and John Alvin went to high school there. After high school, he began singing locally in a wild, flamboyant style, unlike any other white singer up to that time. Inspired by rhythm singers like

Kay Starr, LaVern Baker and Ivory Joe Hunter, he developed a unique rhythm/blues-based singing style, described as alternating between pre-rock rhythm & blues and a more conventional classic pop approach. He began singing professionally with his hearing aid obvious to the studio audience as Johnnie Ray on a Portland, Oregon, radio station in 1942 at age 15. According to IMDb (2016) by 1952 at age 25 he was an American sensation. According to the stories and various accounts Ray’s singing style became pre-rock Rhythm & Blues. Insert Photo #6 about Here) He would jump about as he sang, bend his knees and cup his hand to his right ear, where a hearing aid had been in place for many years. In 1954, he starred with Marilyn Monroe in “There’s no business like show business” where he sang and danced. By this time, he had a number of hits and was an idol to Elvis Presley as well as other later “Rock and Roll” stars. The Songs Among the first was the 1952 two sided hit “Cry”/”The Little White Cloud That Cried,” a 45 RPM record that made it very big! Later that same year (1952) he had a #4 United States hit with his version of “Walkin’ My Baby Back Home.” In 1954, he did his version of The Drifters’ R & B hit “Such A Night.” His version of “Just Walkin’ In The Rain,” rose to #2 on the American charts in December, 1956. His last major hit in the U.S. was in 1957, entitled “You Don’t Owe Me A Thing.” In 1960, Johnnie Ray’s record label dropped him. The credible stories suggest that a contributing factor to the label dropping Johnnie was that by 1958, his hearing had dropped significantly in his left ear and the overall hearing impairment became severe. To correct his hearing and continue his career he decided to go to New York and

have ear surgery which was supposed to regain his hearing in the left ear. While there are no public records as to the specific surgery conducted, recounts of the time indicate that the surgery procedure was totally botched, leaving Johnnie profoundly hearing impaired. The unsuccessful surgery necessitated the use of a second hearing aid for his left ear. From this time (1959) on, Johnnie Ray was deaf without his hearing aids and despite his successful use of hearing aids and attempting to have his hearing corrected by surgical intervention, the label dropped him anyway. He would never record another record but had very loyal fans that continued to love his songs. These fans supported him in Las Vegas shows and television appearances for the rest of his career. Johnnie Ray continued to perform until 1989 when he became ill and later died at age 63 in Los Angeles February 24, 1990. Epilog While Johnnie Ray had many personal problems in addition to his hearing impairment during his lifetime that contributed to his up and down career struggles as well as to his death. As an idol of Elvis and a forerunner to Rock and Roll, he contributed much to the new musical style. His contributions to the new music led Tony Bennet to call him the “Father of Rock and Roll”. Although the Rock and Roll hall of fame has eluded him, Johnnie Ray, the unlikely hearing impaired kid from Oregon of the 1940s, created a new kind of music that inspired a generation of rock stars. References: Adam, A. (2016). Johnnie Ray. IMDb. Retrieved March 1, 2016. Art (2016). There’s no business like show business. Classic Stills. Retrieved March 2, 2016. Folkart, B. (1990). Johnnie Ray, Balladeer of the 1950s, Dies at 63. Los Angeles Times. Retrieved March 1, 2016. User Contributed Text (2016). Johnnie Ray. Creative Commons on Last FM, MP3.com. Retrieved March 1, 2016. Images: Old picture of the day (2016). Blanket Toss. Retrieved March 2, 2016. ¿Cuáles son los artistas que influyeron más en el Rock And Roll? Pantilla Dynamic Views. Retrieved March 1, 2016. Washington University (2016). Deafness in Disguise. Bernard Becker Medical Library. Retrieved March 2, 2016. People (2016). Kay Starr, Lavern Baker, Johnnie Ray. Pin it. Retrieved March 2, 2016.

Author’s Bio:

Robert M. Traynor, Ed.D., MBA, FAAA Robert M. Traynor is the CEO and practicing audiologist at Audiology Associates, Inc., Greeley, Colorado with particular emphasis in amplification and operative monitoring. Dr. Traynor holds degrees from the University of Northern Colorado (BA, 1972, MA 1973, Ed.D., 1975), the University of Phoenix (MBA, 2006) as well as Post-Doctoral Study at Northwestern University (1984). He taught Audiology at the University of Northern Colorado (1973-1982), University of Arkansas for Medical Sciences (1976-77) and Colorado State University (1982-1993). Dr. Traynor is a retired Lt. Colonel from the US Army Reserve, Medical Service Corps and currently serves as an Adjunct Professor of Audiology at the University of Florida, the University of Colorado, and the University of Northern Colorado. For 17 years he was an Audiology Consultant to major hearing instrument and equipment manufacturers providing academic and product orientation for their domestic and international distributors. A clinician and practice manager for over 35 years, Dr. Traynor has lectured on most aspects of Audiology in over forty countries. PRIME \\ APR. 2016 7

Performing the 3 Ps: White men have an abnormally high suicide rate, mostly because of the need to procreate, provide and protect

By Joe Moylan For Prime

espite decades of progress in the areas of civil rights and gender equality — real or perceived — there’s no denying being a white man in America continues to have its advantages. Why then are working-age white men dying by suicide at an epidemically high rate compared with other races and genders? “Men are not conditioned to talk,” said Kim Pratt, educator and clinician at Suicide Education and Support Services in Greeley. “They’re taught that they’re not allowed to have or show emotion. It’s crippling. It’s literally killing the men in our lives.” Last month, Pratt hosted a community meeting about suicide during which she presented a number of sobering statistics to an audience of about 50. According to 2014 Centers for Disease Control and Prevention data, suicide is the 10th leading cause of death in the United States. That year, 42,773 people died by suicide. More than 75 percent, or 33,113, of those people who died by suicide in 2014 were men, according to the American Association of Suicidology. 8

PRIME \\ APR. 2016

Suicide symptoms »» »» »» »» »» »» »» »» »» »» »» »» »»

Serious depression. Obvious stress or worry. Change in appetite or energy. Change in sleeping habits. Loss of interest in favorite things. Isolation. Fatigue or decreased energy. Feelings of worthlessness, guilt or hopelessness. Comments about death. Difficulty concentrating and making decisions. Giving away prized possessions. Preoccupation with death and dying. Sudden drop in school or work performance.

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when we don’t meet them, the pervasive spirit becomes overrun.” Solving the problem is about as complicated as trying to understand why suicide is such a public health concern among men in the first place, Pratt said. Regional influences clearly play a role as states in the mountain west — along with Alaska — have suicide rates far above the national average of 13.4 deaths per every 100,000 residents. Montana led the way in 2014 with 24.5 deaths by suicide per 100,000 residents, followed by Alaska with 22.7, New Mexico with 21.5, Wyoming with 20.5 and Colorado and Nevada tied for fifth highest with 20.2. Although scientists in Utah are studying altitude as a possible connection to suicide, there are no concrete theories. Cultural influences, however, are more clearly defined in both causes and prevention of suicide, especially when it comes to the Second Amendment, Pratt said. Firearms were used in 50 percent of suicides in Weld County and throughout the country in 2014. “Sometimes in our society we feel it isn’t appropriate to talk to people about removing their weapons

preservesandcelebrates theirpast whilecultivatingnewandvaluedrelationships.

Suicide Education and Support Services (970) 313-1089 North Range Behavioral Health, Crisis Support Services 928 12th St. in Greeley; (970) 347-2120 Colorado Crisis Line (844) 493-TALK (8255) National Suicide Hotline (800) 273-TALK (8255)

Of those men who ended their own lives, more than 90 percent — 29,971 — were white. Those trends also hold true in Weld County. In less than a decade, the number of deaths by suicide doubled to 56 in 2014 from 27 in 2008, according to the Weld County Coroner’s

from their homes — we feel like it’s not our business,” Pratt said. “It needs to be our business, and more often than not, people aren’t going to get mad. No one wants to die by suicide, and if you take away the means, you’re reducing the risk significantly.” The last possible solution deals with what Pratt and Frantz agree men are the worst at — asking for or admitting they need help. But there is a place men can go to at least begin the process of seeking help, Pratt said, and they can do so from the privacy of their own home. It’s a web site called www. mantherapy.org. “So much of the focus of depression and depression counseling has been built around the needs of women and children,” Pratt said. “Men are taught to take care of the people around them, but who’s taking care of them? There’s a huge gap in mental health programs and it’s terrifying. “Man Therapy is the first thing to come along that recognizes that depression doesn’t discriminate and it’s beginning to bridge that gap in services in a way that men relate to.”

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whose happiness revolves around the ability to provide, protect and procreate. “That’s what makes men tick, and when I float this concept by them, they understand it,” Frantz said. “When there’s something wrong with one of the 3 Ps, that’s when

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• PhysicalTherapy • Spe chTherapy men begin to have trouble.” Anyone can find evidence of the importance of the 3 Ps by watching football on Sundays. “How many Viagra commercials can you possibly cram into the length of a football game?” Frantz said. Men also don’t tolerate physical problems because they tend to diminish their ability to protect, Frantz said. Earning money, or providing for the family, also is key to a man’s mental health. But the 3 Ps are just a basis for understanding what makes men happy. What often contributes to a man’s declining mental health are the high expectations they place on themselves to perform the Ps. “Every yardstick is exactly 36 inches, but for some reason, men think their yardstick needs to be 39 ½ inches,” Frantz said. “We create these fantasy-like expectations, and

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Office 2014 annual report. Of the 56 people who died by suicide in 2014, all but three — 95 percent — were white. Men accounted for 84 percent of the deaths. There isn’t one explanation outlining why white men are so much more prone to suicide, said Dan Frantz, clinical nurse specialist at North Range Behavioral Health. Cultural and regional influences, societal expectations and access to mental health services all are contributing factors to suicide rates across all demographics in this country. However, Frantz said he thinks the problem could be traced back to early human evolution and three relatively simple needs that are deeply rooted in a man’s DNA known as “The 3 P’s of Manhood.” Although they face some unique stresses, forced and selfimposed, men are simple creatures

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PRIME \\ APR. 2016

THINKING ABOUT HEALTH: changing guidelines label more people as diabetic By Trudy Lieberman Rural Health News Service

PRIME \\ APR. 2016

few months ago came some alarming health news. “Diabetes nation? Half of Americans have diabetes or pre-diabetes,” screamed a Los Angeles Times headline. WebMD weighed in with “Diabetes a Concern for Half of Americans.” NBC News announced, “Half of Americans Have Diabetes or High Blood Sugar.”

What was missing from these stories was the fact that the definition of who has the disease has been expanding, and a new disease called pre-diabetes has arisen from the changing definitions. That means, of course, that more people will get costly drugs when they might not need them and put themselves at risk from complications arising from blood sugar that is controlled too tightly. Evidence is coming in that shows blood sugar levels can become dangerously low especially for older people, according to a study reported in 2014 in JAMA Internal Medicine. That study noted other research that showed drugs which lower blood glucose have been implicated in 25 percent of emergency hospitalizations for older people. The lowering of the diabetes threshold is a good example of how politics and money influence guidelines not only for diabetes but also for high cholesterol, high blood pressure and many other conditions. Although diabetes medicines are necessary for people who truly have the disease, “not everyone accepts the claim that half of all Americans have either diabetes or pre-diabetes, primarily because not everyone accepts the rigid boundaries and the lower boundaries that now start labeling you as pre-diabetic if your hemoglobin A1C test comes back at 5.7 percent or higher,” my colleague Gary Schwitzer wrote in Health News Review. (Hemoglobin A1C is a test used to screen and test for diabetes.) One of those who doesn’t is Nilay Shah, a researcher at the Knowledge and Evaluation Research Unit at the Mayo Clinic, who told me the focus has been to get blood sugar numbers lower, but “getting it too low may not have potential benefits for patients.” The American Diabetes Association considers people with A1C levels of 6.5 percent and higher to be diabetic; those with levels lower than 5.7 percent are normal, and everyone else is pre-diabetic. These definitions have shifted over the years to include more patients, and as doctors label them diabetic or pre-diabetic, sales of drugs to treat these conditions have risen. The Milwaukee Journal Sentinel in a series on drug safety that should be required reading for every patient pointed out that before 1997 when the American Diabetes Association lowered the threshold for who qualifies as diabetic, 9.7 percent of American adults were considered diabetic. By 2014, 11 percent of adults were diabetic. In 2003, the threshold was lowered again, and in 2008 professional organizations like the American Association of Clinical Endocrinologists said that drugs could be used to treat pre-diabetes “with careful judgment.” The next year the sales of diabetes drugs reached $15 billion. In 2010, when the American Diabetes Association said the A1C test could be used to diagnose pre-diabetes, nearly 22 percent of the adult population was considered pre-diabetic. In 2013, the professional groups issued another statement saying that pre-diabetics can be treated with drugs if diet and exercise don’t work. That year sales of diabetes drugs hit $23 billion. Setting guidelines is hardly straightforward. In fact, the process is “absolutely” fraught with politics, Shah said. “There are a lot of different incentives people have that make it tough to figure out what the right numbers are.” Many members of the guidelines committees have strong ties to the pharmaceutical industry. Most of the time, but not always, those ties are disclosed in reports and published papers, and a patient can see that a drug company may have funded a committee members’ research. Do those connections make it more likely members will vote to expand the market for a company that’s been generous to them? Do they make it

easier to overlook evidence of harm caused by a particular drug? Those new definitions of who has diabetes raise questions for millions of Americans with A1C levels in the pre-diabetes range. Should they take these drugs, change their diet, or exercise more? “It’s increasingly acknowledged that setting the targets for lowering blood sugar should be done with doctors and patients based on what they believe is important and the benefit they are likely to derive,” Shah said. The Mayo Clinic offers decision tools for patients to help them weigh risks and benefits of particular drugs. The Shared Decision Making National Resource Center http://shareddecisions. mayoclinic.org/ offers guides and information that should be helpful as patients work their way through the confusing, often misleading, and sometimes-scary claims about diabetes medications.

O I

The Rural Health News Service is funded by a grant from The Commonwealth Fund and distributed through the Nebraska Press Association Foundation, the Colorado Press Association, the South Dakota Newspaper Association and the Hoosier (Indiana) State Press Association.

What do you think? What are your experiences with diabetes medicines? Write to Trudy at trudy.lieberman@gmail.com

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The Health care

paradox: Companies build ERs in northern Colorado to meet demand even as too many patients use ERs for primary care By Bridgett Weaver Photo Credit: Joshua Polson, Staff Photographer For Prime

hen Laura Cicuto puts on her emergency room physician badge before each shift, it’s a ritual that prepares her for anything.

She could get a broken hip, a car accident victim or someone who was shot, although those are rare. Many times, though, Cicuto, who works at the Banner Health ER in west Greeley, treats a cough, a cold or the flu. She doesn’t mind the minor illnesses, except when the ER is packed, giving her patients long wait times. Then she thinks those people would have been better served by an urgent care or a physician’s office. “People often come here because they know they will get answers in a more timely fashion than if they were to go to a regular physician,” she said. “But we get so many that maybe aren’t true emergencies that might be better served at an urgent care or primary care physician.” Cicuto worries that too many patients are using emergency rooms as their primary care physicians, and her worries are shared by many

health care providers in northern Colorado and across the U.S. Yet even with these concerns, health systems continue to build emergency centers to meet the demands brought on by such patients. In fact, a new freestanding ER will open in Greeley by the end of the year. That will make four emergency rooms, three of which are freestanding, in the city of Greeley. Banner Health and University of Colorado Health both opened freestanding ERs in 2012. No health system, it seems, wants to the be only one without an ER, even when they wish at times that their patients would make better choices in their health care options. Evolving options Five years ago, the only emergency room in Greeley was the more traditional ER at North Colorado Medical Center on 16th Street. By the end of this year, the fourth 24hour facility will occupy an empty lot at 2009 35th Ave. Bruce McVeign, chief operating

“People often come here because they know they will get answers in a more timely fashion.” 12

PRIME \\ APR. 2016

officer of Neighbors Health System, the Texas based company building on 35th Avenue, said the company targeted Greeley despite the competition. While it may seem unlikely that there is a need for another ER in Greeley, McVeign said his company believes there is one. “I can assure you, it was based on a fully studied out demographic analysis of the area,” he said, “and there was a need based on the study.” Those studies, Neighbors said, found that need based on many factors, including that the wait times in Greeley were high. They also wanted a city that included a lot of working-class adults. The Care Paradox The other major health care players don’t seem to be worried about the new ER. Both UC Health and Banner Health have freestanding ERs of their own, and they’ll likely get business from Neighbors anyway. In fact, Neighbors Health Systems contracts with the local hospitals to provide additional care needed beyond emergencies. Even so, there are some concerns that the influx of emergency centers will encourage people to use the ER as their primary care. Emergency health-care facilities are much more expensive than an urgent care facility, and the urgent care can mostly provide the same care. “But the bottom line is, in America, the ERs are kind of becoming the default of where people go for primary care,” said Rick Sutton, CEO at North Colorado Medical Center. Part of this is because primary care physicians are short in the area, and part is because ERs are easy to access. “I’ve been a physician in Greeley for over 20 years, and access to primary care has always been lacking,” said Jim Campain, medical director of

Laura Cicuto, an emergency doctor, demonstrates how she's able to pull up patient files and and information quickly at the Banner North Colorado Emergency Care facility, 2000 70th Ave., in west Greeley.

UC Health’s freestanding ERs in Greeley and Fort Collins. “It seems like we’ve never been able to catch up with the need.” Patients using the ER as a first choice is something all health systems are trying to combat by providing new inroads to doctors, with online appointments, late office hours and urgent care centers. “That’s not just a Greeley problem. That’s not a northern Colorado problem. That’s a national problem,” Sutton said. “But what we want to do is try to encourage people to get primary care at a primary care location or an outpatient location.” It’s hard though, because to different people, different levels of sickness and injury constitute an emergency. If someone’s puking throughout the night, even if it’s just from the flu, some would tough it out, and others might be worried enough to visit an ER, for example. Jason Tacha, executive director of operations for the health insurance provider Kaiser Permanente in northern Colorado, said they are trying to encourage their customers to establish and use a primary care physician. They try to set up easier means of getting in touch with regular physicians, such as email and an online portal, so that patients feel they have access to care through their primary care physician when they need it. This is all in an attempt to curb those unnecessary ER visits. “A lot of our visits that are not true emergency visits are almost a failure of our health care system,” he said. Why so many ERs? Population growth is another one of the main reasons for the growing freestanding ER trend, said Randy Kuykendall, director of the Health Facilities and Emergency Medical Services

division for the Colorado Department of Public Health and Environment. “Like any business, hospital systems will take a look at a market and — just like opening a restaurant or anything else — they’ll do all of the demographics (research) that goes with that and then make their decisions on where and what kind

Paramedics Mike Blonquist, right, and Sebastian Narajo guide a patient through the hallways of the the Banner North Colorado Emergency Care facility, 2000 70th Ave., on Wednesday in Greeley. Freestanding emergency rooms are becoming more of a trend with hospitals across the U.S. as health care providers look to meet patient demands.

of facility to open in a given area,” Kuykendall said. In fact, that’s just what Neighbors Health Systems did in the decision to build the fourth ER in Greeley. Northern Colorado is an attractive spot for most business right now, with future growth in the area expected to help the region hit a million people. The state makes things easier as well. Colorado health care systems have the option to be licensed as a freestanding ER, making it easier to build in Colorado than some states. “Obviously if there are less regulations and hoops to jump through in an environment, businesses tend to look at those areas first because it decreases their costs,” Kuykendall said. Colorado also makes it easier on businesses because the state doesn’t require companies to prove that there is a community need for the medical facility before building. “Anyone that sees an opportunity is certainly allowed to open (a facility) and make a go of it,” Sutton said. Sutton said no matter who is moving into town, the Banner team is going to continue in the same way it has been. “I try not to focus on being reactionary,” he said. Campain said a few other things might be driving the trend. Because a lot of health care is now outpatient, hospitals are being cautious to not overbuild their inpatient beds. “What we’re seeing now is these more specialtyoriented hospitals or these smaller ones, where the health systems are not saying — OK, we need another 150-bed hospital in this town,’ ” he said. PRIME \\ APR. 2016

Dawndee Schmunk, a registered nurse, works on a her computer as a few paramedics approach Wednesday at the Banner North Colorado Emergency Care facility, 2000 70th Ave., in Greeley.

“I think in some ways freestanding ERs try to bridge that (with 24-hour care), and if that patient needs to be admitted into the hospital, we have a hospital within a reasonable distance and we can

Campain said, and Sutton agreed, that the hospital systems in Colorado all maintain a good working relationship. Hope for the future The new Affordable Health Care Act insurance plans are helping drive patients from ERs, whether they were meant to or not. Cheaper, high deductible insurance plans mean that patients have to pay more out of pocket to meet an annual deductible, forcing them to make good financial decisions about where they seek health care. Because of this, Tacha said he thinks people are starting to reconsider using an ER because it’s more convenient. “I think you’ll see more people gravitating to urgent care clinics for those things that are perhaps not emergent but urgent or inconvenient,” Tacha said. But, as Dr. Cicuto said, it’s generally easier and quicker to use the ER, especially compared to seeing a primary care physician, and adding more

Dave Scott, an emergency department technician, talks with a patient on Wednesday at the Banner North Colorado Emergency Care facility, 2000 70th Ave., in Greeley. While hospitals are building more freestanding emergency rooms due to demand, they're urging patients to use them for emergencies only. Many patients use ERs as primary care.

Understanding your choices Making the right choice in a bad health situation is important, but it can sometimes be hard to step back and think it through. Kaiser Permanente provides its members with a quick reference to help understand the difference between emergency and urgent care options. If you¹re still not sure what kind of health care you need, and time permits, call a doctor or nurse help line for help triaging the situation. Primary Care Physicians: Kaiser encourages everyone to choose and maintain a primary care physician, because it builds trust between the doctor and the patient and it allows the doctor to get to know the patient¹s history. »» »»

»»

Doctors in family medicine care for people of all ages, and often members of the same family. Doctors in internal medicine include general practitioners and/or internists who may have particular areas of focus. Doctors in pediatrics care for infants, children, adolescents, and teens.

Urgent Care: An urgent care (non-emergency, nonroutine) need is an illness or injury that requires prompt medical attention and is required to prevent serious deterioration of your health, but is not an emergency condition. Emergency Care:

admit them.” He said the ERs try to build health care into the suburbs and to smaller communities. “If you remember back, there was a boom in urgent cares where they started popping up everywhere,” Campain said. “So this may be the next wave of that. I think the trend is toward short stay inpatient and robust outpatient and emergency care.” All in all, Campain said more choices aren’t a bad thing for patients, and patient satisfaction is everyone’s main concern. At the end of the day, if a patient shows up at a UC Health ER but asks to be transferred to a Banner Health hospital, the request will be honored. 14

PRIME \\ APR. 2016

ERs means they have to keep educating patients on when to use the emergency room. “We make it easily and readily available,” Cicuto said. “Our goal is a lot of patient satisfaction,” and emergency or not patients want to be helped quickly and efficiently. “I’m happy to help anybody who needs a physician, whether it’s more primary care, urgent care or emergency.” The key is helping patients make the right decision for them. Cicuto said she thinks calling the nurse line, which is a phone line where nurses help triage patients, is a great first step. Most doctor’s offices and emergency rooms have an option like this. “We have taken a stance to try to educate

A medical emergency is for a medical or psychiatric condition, including severe pain, that requires immediate medical attention to prevent serious jeopardy to your health. In the event of an emergency medical condition, call 911 or go to the nearest emergency department. Source: Kaiser Permanente Northern Colorado Medical Guide

patients but not make their decisions for them,” Campain said. “It’s really up to the patient. Giving patients a choice in where they get their medical care, I think, is still good for the market.”

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UCHealth buys west Greeley land for new health facility By Sharon Dunn For Prime

ith the city of Greeley hitting 100,000 in population, that not only means more retail and restaurants, but more health care too.

UCHealth, which operates Medical Center of the Rockies in Loveland and Poudre Valley Health Center in Fort Collins, has plans to build a medical office building and potentially a larger medical facility at the St. Michael’s subdivision off of U.S. 34 and 65th Avenue in west Greeley. The massive Colorado health chain recently closed on 21 acres just west of the Discount Tire store for $2.8 million. UCHealth officials Tuesday wouldn’t confirm specifics, however. “UCHealth is working through the planning process for a possible new location in west Greeley,” wrote spokeswoman Kelly Tracer in an email. “We’re excited to provide more information to the community as soon as those plans are finalized.” Greeley planner Mike Garrott said UCHealth has not submitted

an application for work at the site. The deal was recorded last month. UCHealth will be the second announcement at St. Michael’s in recent months. Christian Bros. Automotive has plans to move in as well; plans already are at the city of Greeley community development offices. St. Micheal’s is finally coming into its own, said Richard Werner, CEO and president of Upstate Colorado Economic Development. “It tells me that the economy is still doing well, and that population projections are creating the market demand,” Werner said. UCHealth was one of three rumors he had heard of projects coming to long-neglected retail and residential area. This one was the only one that’s come to reality. “It just speaks to that particular area,” Werner said. “People are always looking for facilities close to them, so it’s part geography, it’s part business, and the good thing about it is, it’s signaling more growth in the area.” Werner said when populations grow, the No. 1 beneficiary of such

Site of new UC Health facility 65th Ave.

71st Ave. 34

W. 29th St.

St. Michaels subdivision 16

PRIME \\ APR. 2016

growth is health care. He said with Greeley’s population at its new height, a second hospital or major health care center, could create a domino effect of economic development. “When you’re talking about attraction for companies and quality of life issues, obviously, health care and the ability to service the population are things that always come up when companies are looking. Banner does an absolutely amazing job with the facilities they have, and this will add to the area. It’s a market demand issue.” The move could mean hundreds of new jobs in Greeley. “We’re excited about having that many jobs come to St. Michael’s,” said Mark Bradley, a broker with Realtec Commercial Real Estate Services who brokered the property with agent Gage Osthoff. The deal, Bradley confirmed, had been in the works for the last year. “It’s a good piece of ground. It’s one of those things that kinda got caught up in the recession, and it had gone back to the bank,” Bradley said. Banner Health officials opted not to comment on the plans. For those keeping score, this will be the latest pull in the tug-of-war over health care market share in northern Colorado that has pitted UCHealth against the home team, Banner Health, which operates North Colorado Medical Center. For the past five years, each health care provider has increasingly located services in each other’s territories. It started in 2012, when UCHealth opened its west Greeley emergency room — not even three months after Banner opened an emergency center not 5 miles to the south at the former Summitview building.

Timeline »»

»»

Aug. 1, 2012: Banner North Colorado Emergency Care opens at 71st Avenue and 20th Street in Greeley. Nov. 17, 2012: UCHealth opens Greeley Emergency and Surgery Center at 6906 10th St. April 6, 2015: Banner Health opens its Banner Fort Collins Medical Center, a two-story, 146,000-square-foot facility, and a fullservice, acute care hospital. The site is on 28 acres at 4700 Lady Moon Drive, off of Harmony in south Fort Collins. The cost was $86 million, and the hospital opened with 22 patient beds and three operating rooms. Oct. 30, 2015: UCHealth opens UCHealth Emergency Room, a 17,000 square foot facility just west of Banner¹s new hospital at 4630 Snow Mesa Drive off of Harmony in south Fort Collins. Cost was $12.3 million, with 12 rooms a lab and a 24hour pharmacy.

Banner shot back in 2015, opening a 146,000-square-foot acute care hospital in south Fort Collins off of Harmony Road. Six months later, UCHealth opened the UCHealth Emergency Room about a mile west along Harmony.

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PRIME EATS By Emily Kimme For Prime

Bucatini with Shrimp Avocado Sauce Recipe

ucatini is a pasta that appeals to my inner child. It turns one of my favorite forms of pasta ‹ spaghetti ‹ into a straw I imagine might be capable of slurping up sauce. Hollow and long, bucatini is a magical form

of pasta because it conjures up the thought that it might work like a straw. It doesn’t, of course, but even so, this type of tubular pasta has a wonderfully, chewy mouthfeel that makes it special. What better than to pair it with a new version of another favorite, shrimp with avocado sauce. Here the sauce is lightened by

substituting coconut milk for heavy cream. The result is the same: a bowlful of creamy lusciousness loaded with plump shrimp and avocado, spiked with just the right amount of red pepper. What's even better? It’s one of my Weeknight Quickies! Fast, easy, tasty, and guaranteed delicious without wearing you out on a work night.

INGREDIENTS: • 8 T unsalted butter (yes, this is one pound, but it’s necessary for thickening the sauce, and there’s no cheese or cream to help, which the original recipe requires) • 1 large garlic clove, minced • 1 lb large shrimp, peeled and deveined • 2 T Italian parsley, minced • ½ cup dry white wine • 1 cup coconut milk

Note: So Delicious Coconut Milk is an easy choice when substituting for cream. It’s available in 32 ounce cartons at most grocery stores, and creates a beautifully rich sauce.

• 1 tsp red pepper flakes • salt and pepper to taste • 1 lb bucatini, cooked al dente according to package directions, drained and tossed with 1 T olive oil to prevent sticking • 2 firm ripe avocados, peeled and diced • handful of micro greens for garnish and crunch

I can say it a hundred times. I love pasta. I love shrimp. I love avocados. So obviously, the very best thing is to put them all together and eat them, right?

DIRECTIONS: In a large skillet, melt 2 T butter over medium heat. Add garlic and sauté for one minute. Add shrimp and wine and cook for 3 minutes, stirring, until shrimp is pink. Remove shrimp mixture to clean bowl. Add remaining butter to skillet and melt. Reduce

heat to medium low and add coconut milk and red pepper flakes, stirring to combine. Simmer until sauce thickens enough to coat the back of a spoon. Salt and pepper to taste. Return shrimp and any accumulated juices to skillet and toss to coat with sauce. Add avocado and stir gently.

Blanco. It has a cool Arts and Crafts label. Stephanie recommends enjoying this wine with friends, food, and on any day that ends in “Y.” Easy on the budget, too, priced at $12/bottle.

tephanie Davis from Winacea, a wine education and entertainment company, thinks this dish needs a refreshing glass of zingy white wine, stat!

Have I ever mentioned that Stephanie (in a former life) was a Pharmacist? That means she knows what she’s talking about when a recipe needs to be invigorated, right now! She’s found a new and unusual Spanish white wine made from the Malvar grape and immediately made it her new “house white.” I think that means she really likes it. Stephanie says Malvar tastes like a cross between Sauvignon Blanc and unoaked Chardonnay. This particular bottle is Zestos 18

PRIME \\ APR. 2016

Award-winning author Emily Kemme writes about human nature, illuminating the everyday in a way that highlights its brilliance. Follow her on her blog, Feeding the Famished, https://www.facebook.com/EmilyKemme, or on Twitter @EmFeedsYou . Life inspired. Vodka tempered.

Serve shrimp avocado sauce over bucatini in warmed, shallow bowls. Top with micro greens. Serves 2-4.

HEALTH Events Calendar CPR for Health Care Providers (Initial), 5-8:30 p.m. April 4, NCMC, Union Colony Room. This class is designed for licensed and non-licensed health care providers. The certification is valid for two years. Cost is $55. Call (970) 810-6633 by noon April 2 to register to register Bright by Three Infant Group, noon-1 p.m. April 5, Medical Center of the Rockies, 2500 Rocky Mountain Ave., Loveland. Free class provides parents and caregivers with educational tools, books and games. A free infant packet includes a handbook provided by Bright Beginnings, brochures, a toy and board book. To register and for more information, call (970) 495-7500. CT Heart Score, 1 p.m. and 2 p.m. Tuesdays and Thursdays at North Colorado Medical Center. Cost is $199, due at time of service. Call (970) 8106070 to schedule an appointment. Yoga Support Group for Cancer Survivors, 9:30-10:30 a.m. April 6 and 20, North Colorado Medical Center, 1801 16th St., Greeley. Class is free, call (970) 810-6633 to register. Childbirth Breastfeeding Basics, 6:30-8:30 p.m., April 7 at Medical Center of the Rockies, 2500 Rocky Mountain Ave., Loveland. Learn the benefits of breastfeeding, establishing and maintaining a good milk supply and solutions to common challenges. Partners are welcome. Cost: $20. To register and more information, call (970) 495-7500. Fast Track Childbirth Preparation (two-day), 6-9 p.m. April 8 and 1-5 p.m. April 9 at Medical Center of the Rockies, 2500 Rocky Mountain Ave., Loveland. An overview of labor and delivery, hospital routines, coping techniques, medications, medical interventions and cesarean birth. Bring a support person, two bed pillows and water bottle. Wear loose-fitting, comfortable clothing. Register for hospital tour and Breastfeeding Basics class separately. Cost: $55. To register and more information, call (970) 495-7500. Blood Tests, 4-8:45 a.m. or by appointment, April 13, North Colorado Medical Center, 1801 16th St., Greeley. Call (970) 810-6633 to schedule an appointment. Payment is due at time of service, costs vary. Aging Well, 9-11 a.m. Thursdays April 14-June 2 at North Colorado Medical Center in the Colonial Room. Weld County Area Agency on Aging

offers a variety of Aging Well Self-Management classes. Call (970) 346-6950 ext. 6117 to register. Cost is free, but donations are accepted. Natural Childbirth, 6-9 p.m., April 14, April 21 and April 28 at Medical Center of the Rockies, 2500 Rocky Mountain Ave., Loveland. For expectant mothers and birth partners. Will go over techniques and coping strategies for a non-medicated childbirth. Parent preview tour class is included. Cost: $65. To register and more information, call (970) 495-7500. Take Charge of Your Health: Mindful Eating, 10:30 a.m.-3:15 p.m. April 15, Medical Center of the Rockies, 2500 Rocky Mountain Ave., Loveland. Symposium will help define ways to be mindful during daily routines as it relates to managing stress and eating habits. Cost: $25. To register and more information, call (970) 4957500. Cooking Classes, 6-7:30 p.m. April 19, North Colorado Medical Center in the Cardiac Rehab Kitchen. April’s class will be “Muffin Tin Meals.” Learn to make mini meals to make meal planning easy. Cost is $10. Call (970) 810-6633 to register Spirit of Women: Gut check, 6:30 p.m., April 19, Zoe’s Café and Event Center, 711 10th St., Greeley. Doors open at 5:30. Learn digestive remedies and solutions you can stomach Enjoy fashions for the waistline, plus learn the history of belly dancing, the costumes and why it’s a great exercise. Cost is free for spirit members, $10 for non-members. Register by calling (970) 8103000 or email spirit.of.women@bannerhealth. com. Blood Tests, 4-8:45 a.m. or by appointment, April 20, Banner Health Clinic, 222 Johnstown Center Drive, Johnstown. Call (970) 810-6633 to schedule an appointment. Payment is due at time of service, costs vary. Peripheral Vascular Disease screening, 1-3 p.m. April 21 at Summit View Medical Commons 2001 70th Ave., Greeley. Cost is $100 for four screenings, due at time of service. Call (970) 8106070 to schedule an appointment. HeartSaver CPR with AED, 6-8 p.m. April 21, Windsor Recreation Center, 250 11th St., Windsor. Upon completion, participants will receive a Heart Saver course completion card valid for two years. Cost is $48. Call (970) 674-3500 to register.

Registration closes at noon April 19. Body Check... What you need to know: Head to Toe, by appointment April 21, Summit View Medical Commons, 2001 70th Ave., Greeley. This head-to-toe health assessment gives you tools to put health first. Call (970) 810-6070 to schedule an appointment. All results are sent to your personal physician and to you. Cost is $175, due at time of service. Blood Tests, 7-8:45 a.m. or by appointment, April 27, North Colorado Medical Center, 1801 16th St., Greeley. Call (970) 810-6633 to schedule an appointment. Payment is due at time of service, costs vary. Afternoon Tea and Spring Fashion Show, 1:30-3 p.m., April 27 at Chilson Senior Center, 700 E. 4th St., Loveland. This relaxing afternoon for ladies will feature tea, treats, spring fashions provided by Dress Barn and fancy hats from Masonville Mercantile. Cost: $5. To register and more information, call (970) 495-8560. Fast Track Childbirth Preparation (two-day), 6-9 p.m. April 29 and 1-5 p.m. April 30 at OB/ GYN West Greeley, 1715 61st Ave. An overview of labor and delivery, hospital routines, coping techniques, medications, medical interventions and cesarean birth. Bring a support person, two bed pillows and water bottle. Also, wear loosefitting, comfortable clothing. Register for hospital tour and Breastfeeding Basics class separately. Cost: $55. To register and more information, call (970) 495-7500. Spirit of Women: Love your Selfie, 6 p.m. April 29, North Colorado Medical Center Auditorium, 1801 16th St., Greeley. Experience an evening of laughter and education while learning from an panel of Banner Health experts. Enjoy appetizers, fashion tips, skin care information, aromatherapy, make-up tips, curling iron tutorials and more. Cost is $2 for adults, $1 for teens. Purchase tickets at the NCMC gift shop. For more information call (970) 810-3000. CPR for Health Care Providers Skills Check, this class is designed for licensed and non-licensed health care providers who need to recertify through the American Heart Association. Complete the renewal online at www.onlineaha. org. When the online module is complete and a completion certificate is printed, call Wellness Services to schedule a skills check. Cost is $50, due at registration. Call (970) 810-6633 to register. PRIME \\ APR. 2016

PRIME Medical Directory 2016 Alzheimerâ&#x20AC;&#x2122;s/Skilled Care GRACE POINTE

1919 68th Avenue Greeley, CO 80634 Phone: (970) 304-1919 www.gracepointegreeley.com

Assisted living GRACE POINTE

1919 68th Avenue Greeley, CO 80634 Phone: (970) 304-1919 www.gracepointegreeley.com The Bridge Assisted Living

4750 25th Street Greeley, CO 80634 Phone: (970)339-0022

BALANCE

CARDIOLOGY

LIFE CARE CENTER OF GREELEY- ASCENT

4800 25th Street Greeley, CO 80634 Phone: (970)810-6607 Professionals: Cozette Seaver, PT; Leslie Vail, PT

Endocrinology Endocrinology Clinic (NCMC)

1800 15th Street, Ste 200 Greeley, CO 80631 Phone: (970)810-4676 www.bannerhealth.com

burn Care western states burn center (NCMc)

1801 16th Street, Greeley, CO 80631 Phone: (970)810-6607 www.bannerhealth.com

Family practice medicine Banner Health Clinic

1300 Main Street Windsor, CO 80550 Phone: 970-686-5646 www.bannerhealth.com

CARDIAC vascular surgery

AUDIOLOGY

Banner Health Clinic

Alpine All About Hearing

1124 E. Elizabeth Street, #E-101 Fort Collins, CO 80524 Phone: (970)221-3372 Fax: (970)493-9237 3820 N. Grant Avenue Loveland, CO 80538 Phone: (970)461-0225 Fax: (970)593-0670 www.allabouthearing.com Professionals: Renita Boesiger, M. A., CCC-A Rachel White, M. A., CCC-A Cheryl Hadlock, M. S., CCC-A

Cardiovascular institutE (NCMC)

1800 15th Street, #310 Greeley, CO 80631 Phone: (970)810-0900 www.bannerhealth.com

HEART FAILURE CLINIC (NCMC)

(970)810-6953 www.bannerhealth.com

DENTISTRY Ascent Family Dental

Audiology Associates

2528 16th Street Greeley, CO Phone: (970)352-2881 Professionals: Robert M. Traynor, Ed. D. F-AAA; Karen Swope, M. A. CCC-A Miracle-Ear

2404 17th Street Greeley, CO 80634 Phone: (970)351-6620 749 S. Lemay Avenue, Suite A1 Fort Collins, CO 80524 (970)221-5225 20

PRIME \\ APR. 2016

Hubbard Family Dental

Hygiene Clinic 2918 W. 10th Street Phone: 673-8411 www.hubbarfamily dental.com

Cardiac, Thoracic & Vascular surgery (NCMC)

1800 15th Street, Suite 340 Greeley, CO 80631 Phone: (970)810-4593 www.bannerhealth.com

Scott Williams, DMD 3535 W. 12th Street, Suite B Greeley, CO 80634 Phone: (970)351-6095 www.dentalgreeley.com Ralph R. Reynolds, D.M.D., M.D.

Oral Surgery 7251 W. 20th St. Building H, Suite 2 Greeley, CO 80634 (970) 663-6878 www.reynoldsoralfacial.com

100 S. Cherry Ave., Suite 1 Eaton, CO 80615 Phone: (970)454-3838 www.bannerhealth.com Banner Health Clinic

222 Johnstown Center Drive Johnstown, CO 80534 Phone: (970)587-4974 www.bannerhealth.com Banner health clinic

5623 W. 19th Street, Greeley, CO 80634 Phone: (970) 810-9011 www.bannerhealth.com Family Physicians of Greeley, LLP-Central

2520 W. 16th Street Greeley, CO 80634 (970) 356-2520 Fax: (970) 356-6928

Family Physicians of Greeley, LLP-Cottonwood

2420 W 16th Street Greeley, CO 80634 (970) 353-7668 Fax:970-353-2801

Family Physicians of Greeley, LLP-West

6801 W. 20th St., Suite 101 Greeley, CO 80634 (970) 378-8000 Fax: (970) 378-8088 Kenneth M. Olds

6801 W. 20th Street, Suite 208 Greeley ,CO 80634 Phone: (970)330-9061

gastroenterology

Health and fitness WORK OUT WEST

Health & Recreation Campus 5701 W. 20th Street, Greeley, CO 80634 Phone: 970-330-9691 www.workoutwest.com

home health care Caring Hearts Home Healthcare

6801 W. 20th Street, Suite 207 Greeley, CO 80634 Phone: (970)378-1409 Bloom at Home

1455 Main Street Windsor, CO 80550 Phone: (970) 460-9200 www.columbinehealth.com/bloom Rehabilitation and Visiting Nurse Association

2105 Clubhouse Drive Greeley, CO 80634 Phone: (970) 330-5655 Fax: (970) 330-7146 www.rvna.info Professionals: Lori Follett, CEO

Touchstone home health

5312 W. 9th St. Dr., Suite 120 Greeley, Co. 80634 Phone: 970-356-3922 www.touchstonehomehealth.com Dowgin, Thomas A., MD. CENTERS FOR GASTROENTEROLOGY

7251 W. 20th St., Bldg J, Greeley, CO Phone: (970)207-9773

3702 Timberline, Ft. Collins, CO Phone: (970)207-9773 2555 E. 13th Street, Suite 220, Loveland, CO Phone: (970)669-5432 www.digestive-health.net North Colorado Gastroenterology (NCMC)

2010 16th Street, Ste. A Greeley, CO 80631 Phone: (970) 810-4475 www.bannerhealth.com

independent assisted Living GRACE POINTE

1919 68th Avenue Greeley, CO 80634 Phone: (970) 304-1919 www.gracepointegreeley.com

infectious disease

medical equipment & supplies Banner HOme Medical Equipment (NCMC)

Phone: (970)506-6420 www.bannerhealth.com

Mental health services North Range BEHAVIORAL HEALTH

Adult Mental Health & Addiction Services 1260 H Street Greeley, CO 80631 970.347.2120 Child, Youth, & Family Mental Health & Addiction Services 1300 N 17th Avenue Greeley, CO 80631 970.347.2120

Counseling Center at West Greeley Children, Adult, & Family Counseling 7251 W 20th Street, Building C Greeley, CO 80634 970.347.2123 Crisis Support Crisis Intervention, Care, and Detox Services 928 12th Street Greeley, CO 80631 970.347.2120 Suicide Eduction & Support Services Prevention, Education, & Grief Support 2350 3rd Street Road Greeley, CO 80631 970.347.2120 or 970.313.1089

Breen, john f., md (NCMC)

Additional Weld County Locations www.NorthRange.org

internal medicine

Dr. Patricia Al-Adsani, Child and Adolescent Psychiatry Carole Diamond, PMHNP Brett Smith, DD 5890 W. 13th Street #114 Greeley, CO 80634 Phone: 970)810-5454

1801 16th Street Greeley, CO 80631 Phone: (970)810-6071

BANNER HEALTH CLINIC

2001 70th Avenue, 3rd Floor Greeley, CO 80634 Phone: (970)810-5660 www.bannerhealth.com

Banner Health Clinic 222 Johnstown Center Dr., Johnstown, CO 80534 Phone: (970)587-7543 Stephanie Carroll, LCSW, CACIII Banner Health Clinic 1300 Main Street, Windsor, CO 80550 Phone: (970)674-3155 Susan Garvin, LCSW Banner Health Clinic -Loveland Pediatrics Loveland Pediatrics, Loveland CO Banner Health Clinic - Windsor 1300 Main Street Windsor, CO 80550 Phone: (970)674-3158 Renee Rogers, LMFT Banner Health Clinic 1300 Main Street, Windsor, CO 80550 Banner Health Clinic - Fossil Creek 303 Colland Dr Fort Collins, CO 80525 Phone: (970)821-3808

NEPHROLOGY Greeley medical clinic

1900 16th Street, Greeley, CO 80631 Phone: (970) 350-2438 Professionals: Donal Rademacher, MD

NEUROLOGY

banner BEHAVIORAL HEALTH

Shawn Crawford, LPC PRIME \\ APR. 2016

NEUROLOGY CLINIC (NCMC)

1800 15th Street, Suite 100B Greeley, CO 80631 Phone: (970) 810-5612 www.bannerhealth.com

NEURo-SURGERY BRAIN & SPINE BANNER HEALTH neurosurgery clinic

1800 15th St., Suite 130 Greeley, CO 80631 Phone: (970) 810-5996 www.bannerhealth.com

nursing home rehabilitation Centennial Health Care Center

1637 29th Ave. Place Greeley, CO 80634 Phone: (970) 356-8181 Fax: (970) 356-3278

obstetrics & gynecology BANNER HEALTH GYN CONSULTANTS

1800 15th St., Suite 130 Greeley, CO 80631 Phone: (970) 810-1335 www.bannerhealth.com Banner Health OB/GYN Clinic

2001 70th Avenue, 3rd Floor Greeley, CO 80634 Phone: (970) 810-6353 www.bannerhealth.com banner health clinic

5623 W. 19th Street Greeley, CO Phone: (970) 810-9011 www.bannerhealth.com

oncology & HemaTology cancer Institute (NCMC)

1800 15th Street, Greeley, CO 80631 Phone: (970) 810-6680 Toll Free (866) 357-9276 www.bannerhealth.com

orthodontics Orthodontic Associates of Greeley, PC

Professionals: Bradford N. Edgren, DDS, MS 3400 W. 16thSt., Bldg 4-V Greeley, CO 80634 Phone: (970) 356-5900 www.drbradsmiles.com

orthopedics Mountain Vista Orthopaedics

5890 W. 13th Street, Suite 101 Greeley, CO Phone: (970) 810-0020 www.bannerhealth.com

pediatrics Banner Health Clinic

2001 70th Avenue, 3rd Floor Greeley, CO 80634 Phone: (970) 810-5828 www.bannerhealth.com

pediatric rehabilitation

pulmonary/critical care North Colorado Pulmonary (NCMC)

1801 16th Street, Greeley, CO 80631 Phone: (970) 810-2026 www.bannerhealth.com

Prosthetics & orthotics HANGER PROSTHETICS & ORTHOTICS

7251 West 20th Street, Building M, Greeley, CO 80634 Phone: (970) 330-9449 Fax: (970) 330-4217 2500 Rocky Mountain Avenue, Suite 2100 North Medical Office Building, Loveland CO 80538 Phone: (970) 619-6585 Fax (970) 619-6591 www.hanger.com Professinal: Ben Struzenberg, CPO Michelle West, Mastectomy Fitter

Banner Rehabilitation Center

1801 16th Street, Greeley, CO Phone: (970) 810-6900 www.bannerhealth.com

personal response service Banner Life Line (NCMC)

2010 16th Street, Suite C, Greeley, CO 80631 Phone: 1-877-493-8109 (970) 378-4743 www.bannerhealth.com

physical therapy Front Range Therapy

rehabilitation ASCENT AT LIFE CARE CENTER

4800 25th Street, Greeley, CO 80634 Phone: (970) 330-6400 Website: www.lcca.com Professionals: Annie Bennett Leslie Vail

Banner Rehabilitation Center

1801 16th Street, Greeley, CO Phone: (970)810-6900 www.bannerhealth.com Front Range Therapy

1475 Main Street, Windsor, CO 80550 Phone: (970) 492-6238 www.columbinehealth.com

Northern colorado rehabilitation hospital

4401 Union Street, Johnstown, CO 80534 Phone: (970) 619-3400 NCRH@ernesthealth.com

Peakview Medical Center

5881 W. 16th St., Greeley, CO 80634 Phone: (970)313-2775 Fax: (970)313-2777 22

PRIME \\ APR. 2016

Skilled care/Rehab GRACE POINTE

1919 68th Avenue, Greeley, CO 80634 Phone: (970) 304-1919 www.gracepointegreeley.com

sports medicine Mountain Vista Orthopaedics

5890 W. 13th Street, Suite 101, Greeley, CO Phone: (970)810-0020 www.bannerhealth.com North Colorado Sports medicine

1801 16th Street, Greeley, CO Phone: (970)810-2496

speech language pathology Banner Rehabilitation Center

1801 16th Street, Greeley, CO Phone: (970)810-6900 www.bannerhealth.com Northern colorado rehabilitation hospital

4401 Union Street, Johnstown, CO 80534 Phone: (970) 619-3400 NCRH@ernesthealth.com

Surgery General & Trauma

Banner Health Surgical Associates (NCMC)

NextCare - Urgent Care

veins

2928 W. 10th St. Greeley, CO (970) 351-8282 nextcare.com

1800 15th St. Suite 200, Greeley, CO Phone: (970) 810-8216 Toll Free: 1-888-842-4141 www.bannerhealth.com

Vein Clinic (NCMC)

Urology Banner health clinic (NCMC)

urgent care SUMMITVIEW URGENT CARE (NCMC)

2001 70th Avenue, Suite 110 Greeley, CO 80634 Phone: (970) 810-4155 www.bannerhealth.com

1800 15th Street, Suite 340, Greeley, CO 80631 Phone: (970) 810-4100 www.bannerhealth.com

5890 W. 13th Street, Suite 106, Greeley, CO 80634 Phone: (970) 810-1000 www.bannerhealth.com

Your Guide to Living a Healthy, Active and FULFILLING LIFE! WINTER - FEBRUARY 2015

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2015

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America’s 50 Best Hospitals Award™ (2015-2016) Distinguished Hospital Award for Clinical Excellence™ (2009-2016) Critical Care Excellence Award™ (2009 – 2016) Pulmonary Care-America’s 100 Best Hospitals™ (2013-2016) Pulmonary Care Excellence Award™ (2009-2016) Neuroscience: Stroke Care Excellence Award™ (2014 – 2016) 1801 16th St,. Greeley • (970) 810-4121 • www.BannerHealth.com/NCMC

North Colorado Medical Center 1801 16th St, Greeley CO • 970-810-4121 www.BannerHealth.com/NCMC