Prime October 2015

FALL - OCT. 2015

PG. 4 Even as more people get insurance, questions about coverage remain.

PG. 6 foor for thought, tips for packing fun, healthy school lunches PG. 9 Reducing road rage, Tips to cut back on aggression behind the wheel

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Features ALTERNATE LOGO \\ MASTEAD

PG.8

PG.12

Life experience

When seconds count

PG 4

PG 9

Experts wonder why Weld County has higher rate of uninsured residents than the rest of the state.

Tips to cut back on aggression behind the wheel.

Patient urges women to learn from her and get regular pelvic exams.

Insurance questions

PG 6

Expert offers tips for packing fun, healthy school lunches.

PUBLISHER Bart Smith EDITOR Randy Bangert

Reducing road rage

PG 11

Surprise, surprise

Food for thought

PG. 17 How safe is our food?

North Colorado Medical Center’s collaboration with rural hospitals saves lives.

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PG. 18 Distinct communities, different needs

CONTRIBUTING WRITERS Allison D. Bluemel James Redmond

Doctor shares what she wishes she would have known about family planning. |

PG. 19 October’s health events

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PG. 20 Prime medical directory

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3

Survey sees

state residents without health insurance decrease, but faces hurdles on insurance education

By James Redmond and Allison Dyer Bluemel For Prime

By James Redmond and Allison Dyer Bluemel For Prime

T

he number of Colorado residents without health insurance fell dramatically in the past two years — but not nearly as dramatically in Weld County, according to new information from the Colorado Health Institute.

Finding health coverage that fits residents’ needs Numerous state, regional and local resources exist to help Colorado residents understand their needs for insurance and what the details of different policies mean.

Below are some examples of organizations that can provide information to residents: Connect For Health Colorado at: www.connectforhealthco.com State of Colorado at: www.cohealthinfo.com/i-need-health-insurance Colorado Health Insurance Brokers at: www.coloradohealthinsurancebrokers.com Northern Colorado Health Alliance: www.northcoloradohealthalliance.org/news 4

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Weld County still saw a drop in its uninsured population to 8.5 percent in 2015 from 9.3 percent in 2013.

However, that less than 1 percentage point drop pales in comparison to the state’s drop, which fell to a record low of 6.7 percent of residents without health care from 14.3 percent in the same time frame.

By contrast to the state halving its uninsured population, Weld’s small decrease stands out in the 2015 Colorado Health Access Survey, which was released Aug. 31.

However, in the larger context, the local numbers look rather good, said Mark Wallace, executive director of the Weld County Department of Public Health and Environment. Colorado Health Institute numbers show only 9.3 percent of Weld residents didn’t have insurance in 2013. A year earlier, community health surveys showed Weld ’s uninsured population at about 17 percent, Wallace said.

“I think one of the big takeaways from the data is that there are still a lot of disparities in uninsurance rates,” said Joe Sammen, executive director of the Colorado Coalition for the Medically Underserved.

State officials credit Weld’s rather modest decline to a drop in the number of people getting their health insurance through work.

“One of the quirks that we saw was that there was a fairly large drop in

employer-sponsored insurance from 2013-15,” said Joe Hanel, Colorado Health Institute senior communications expert.

Although the statewide percentage of people on employer-sponsored health insurance dropped from 52.6 percent in 2013 to 50.9 percent in 2015, Weld dropped more. The 2013 survey showed Weld had about 55.1 percent of its residents on employer-sponsored health insurance. That dropped to about 49.1 percent in 2015.

“That’s a bigger drop than we saw in the state average,” Hanel said. “I’m not quite sure why. I’ve been kind of speculating that it might be the nature of the private economy up in Weld County. (It’s) really agriculture- and energy-driven and has a boom and bust cycle. I’m not sure, that’s speculation.

But we did see a lot of failure to achieve a lower uninsured rate. That looks like a lack of employer-sponsored insurance throughout the area would allow that.”

Weld may have seen a decrease in people insured through employer-sponsored programs, Wallace said.

“It is interesting to look at what has happened in the job market,” he said.

Business in the area may have grown in such a way where they started hiring new employees who do not qualify for employer-sponsored health insurance, diluting those numbers more than actually decreasing them, Wallace said.

What they hear about locally are issues with families, self-employed individuals and small business owners trying to navigate the new health care marketplace, he said.

Additionally, young Coloradans and racial minorities are more likely to be underinsured, said Sammen.

“We know for example that there is a disparity based on race,” he added. “We

also know that, for instance, certain chronic disease are more prevalent in certain racial and income groups.”

While Latinos and Hispanics make up about 21 percent of Colorado’s population the group accounted for about 38 percent of the uninsured population, he said.

The Colorado Health Institute will conduct another survey later this year that researchers hope will shed some light on the role of undocumented residents and healthcare.

They expect the rate of uninsured and undocumented residents to be between 20 and 40 percent, said Amy Downs, senior director for policy and analysis for the Colorado Health Institute.

With the new data, the state can look at how they need to allocate resources to help address issues.

“We will be relooking at our formula or how we fund our partners,” said Sue Birch, executive director of the Colorado Department of Health Care Policy and Financing. “We’ll be reconvening. We just got this information as well, so we’ll be thinking about where we need to put some extra resources.”

Although the 2015 Colorado Health Access Survey shows Weld has an uninsured population almost 2 percentage points higher than the rest of the state, Wallace feels the area is in a similar place to the rest of Colorado. He said he hopes and believes that in time Weld’s uninsured population will decrease, but he admits some people will feel they cannot afford coverage and remain uninsured.

“I think we’re consistent with the other areas,” he said. “My hope is that we’ll get more people covered (in the future) though. From a (health care) provider’s point of view, it’s easier to provide care to someone if they’re covered.”

However, having health insurance doesn’t always mean that policyholders can afford the care they need.

“Not all coverage is created equal,” Sammen said.

Fees and copays, prescription costs and other cost barriers can prevent people from visiting health care providers, even if they signed up for private insurance, government services or have it provided through their work.

About 10 percent of Coloradans skip going to doctor and getting a prescription because of the cost, Sammen said.

This idea that health care is expensive regardless of health insurance status is part of the reason some people don’t sign up, he said.

In terms of why the nearly 350,000 Coloradans on the survey tallied as uninsured, Sammen said it comes down to three reasons.

First, some feel like they can’t afford health insurance or don’t qualify for government programs such as Medicare.

In fact, cost remains the No. 1 reason why Coloradans remain uninsured, Downs said.

However, as users of Connect for Colorado’s website have to go through a qualification page in one of the first steps, the number of those in government program has gone up, she said.

Those who feel that they don’t need insurance — a category mostly made up of young adults — comprise the second category.

Finally, the group that disagrees with the Affordable Care Act and pressure to sign up for health care under it make up the third group, Sammen said.

“It’s the can’t, don’t and won’t groups,” he said.

Those groups point to a burgeoning need to increase insurance literacy, particularly in the basic details of how policy’s work and how to select them, Sammen said.

“There’s a lot of work to be done around that concept and understanding how to navigate that,” he said.

The process can be particularly daunting to those who don’t speak English well, have lower literacy and those who just don’t have the time to sit down and get through the process.

“In some cases (the barriers are) concepts as simple as copay,” Sammen said. “There’s a real learning curve there to understanding those variables.”

Thankfully, there are a lot of resources available to those running into barriers, including government agencies and insurance brokers that can answer a wide array of questions.

“Not being afraid to ask for assistance is the first step,” he said.

Persistence also plays a big role in getting coverage, Sammen added.

“Being persistent and going through the process is worth it and it leads to a real safety net for people and their families if they get hurt,” he said.

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Healthy recipes BAKED OATMEAL CUPS Ingredients -1 cup egg substitute (equivalent to 4 eggs) or just use -4 eggs -1/2 cup canola oil -1/2 cup unsweetened applesauce -2/3 cup sugar -2 cups milk –1% -1/2 tsp baking soda -1 tsp baking powder -1/2 tsp salt (optional) -1 ½ Tbsp cinnamon (try Saigon cinnamon) -1/4 cup dried cranberries -1 granny smith apple — grated -2 Gala apples- grated -6 cups quick oats

Tips to help make healthy lunches for kids

By Mary Branom Banner Health Lots of preparation goes into getting kids ready for school. In the midst of getting new school supplies, clothes and books, don’t overlook healthy eating and lunch box packing.

Healthy eating can stabilize children’s energy, sharpen their minds and even out their moods.

Children participating in sports need to have enough energy to get through extracurricular activities after school. They need a healthy combination of protein, carbohydrates and fat to help maintain energy levels.

A general guideline: Busy, active children need three meals per day along with two to three snacks. Here are a few tips to help make meals easier: 1. Use the basic concept of the Choose my Plate, where half the plate comes from produce, a quarter from a protein source, and a quarter from grains and starches. School lunch programs have made improvements to include more fresh prepared meals to assure a nutritionally balanced lunch. Check the school lunch menu, then decide with your kids the days they want to take their lunch to school and use the ChooseMyPlate.gov guidelines to assist you in packing creative options.

2. Plan ahead and make some meals that yield leftovers. To prepare for the week: Cook extra chicken so you can add it to a whole-grain tortilla wrap, a salad or sandwich.

Prep fruits and veggies ahead of time, saving precious time in the morning and filling your fridge with easy-to-grab, healthy eating choices.

Bake healthy snacks like muffins or 6

PRIME \\ OCT. 2015

homemade granola bars. This will save you money, too.

Pack lunches the night before; get the kids involved.

3. Avoid processed foods that contain hydrogenated oil, added sugar, color and additives. Many store-bought snack foods are high in processed carbohydrates, giving kids a sugar high then low energy levels later. Some healthy snack options to try could be: Trail mix containing nuts, oats and unsweetened dried fruits Apple slices dipped into a natural nut butter Hummus with bell peppers, cucumbers and carrots 4. One of the most important things kids need to start the day is a healthy breakfast with a quality protein source, a healthy fat and a carbohydrate source to help them be more alert and focused at school. Try some of these ideas as easy options for breakfast: Baked Oatmeal Cups (see recipe) Mini Omelet Breakfast muffins (see recipe) Yogurt parfait (layered yogurt, granola, fresh fruit) 5. Help kids stay hydrated by sending them to school each day with a full water bottle.

Encourage them to drink it in the morning, refill at lunch and again in the afternoon. If they are doing sports after school, make sure they have a full water bottle then, too.

Encouraging healthy eating now can make a huge impact on lifelong habits.

Mary Branom is a Banner Health registered dietitian

Directions Mix together the egg substitute, oil, applesauce and sugar. Add the milk alternately with the rest of the ingredients. Spray muffin tins with cooking spray. Pour mixture into the prepared muffin tin, filling ¾ full and bake at 375˚F for 12-15 minutes or until a toothpick inserted in the center comes out clean. Serve with fatfree Vanilla yogurt & berries if desired.

Makes 24 muffins Nutrition Facts: Serving size 1 muffin. Calories 179;Total fat 6.7g; Saturated fat 0.7; Cholesterol 0.6mg; Sodium 122mg; Total Carbohydrate 25.2g; Dietary fiber 2.8g; Protein 5.4g

OMELET MUFFIN CUPS Ingredients -4 eggs -1 cup liquid egg whites -2/3 cup skim or 1% milk -1/2 cup cheddar cheese -2 cup of diced vegetables of your choice (red peppers, asparagus, broccoli, mushrooms, onions, green chilies etc. be creative!)

-1/2 teaspoon dry mustard -1/2 teaspoon onion powder -1/2 teaspoon garlic powder -1/2 teaspoon pepper -1/2 teaspoon salt Directions Combine eggs, milk, veggies and spices. Whisk together until well blended. Spray muffin tins with cooking spray. Pour the egg mixture into the sprayed muffin tins and bake in a pre-heated 350°F oven for 20-25 minutes or until set.

Makes 12 muffin cups.

Nutrition Information: Calories 127; Protein 15g; Carbohydrate 8g; Total Fat 3.6g; Saturated fat 1g; Cholesterol 6.7mg; Sodium 271g; Fiber 0 For more fun cooking tips, join us for one of our cooking classes. Go to www.BannerHealth.com/NoCoWellness for more information

Advertisement

Eavesdropping and Football Something changes as the days grow a little shorter -- there’s a tiny hint of coolness to the morning walk and the flowers aren’t quite as happy. The sinking feeling of reality that fall will pay a visit is tempered with the joy that football season will be

our guest. Best of all, for perhaps the last time this season, our favorite team has a perfect unbeaten record. We welcome the new football season that began on Sunday, September 7, 2015. This week we have a guest author to present a unique, season-starting story of how deafness influenced the game.

Attempting to secretly listen to what another person is saying dates back to the late 1400’s in Germany and maybe even earlier. Its origin relates to a person standing under the eaves of a house where the rain drips while intercepting a private conversation, hence, the term “eavesdropping”. Evidently, there was a lot of interest in finding out what Frau Mueller was putting into her meat pie or white sausage.

Much later, during World War II, everyone was trying to eavesdrop on everyone else to get a leg up on what the battle plans were for the next week or where the next invasion was going to take place. In order to thwart these clandestine invasions of

privacy, everyone came up with their own exotic version of some mathematical or mechanical jumble of a private code.

The Germans were perhaps the most clever with their very sophisticated Enigma machine. This electro-mechanical rotor cipher generator used five different rotors, each with 29 different characters (not the 26 in the alphabet) to produce a code based on random daily changes in key characters. The Enigma code remained undecipherable until early in 1940 when a German submarine was captured before sinking and its Enigma processor was rescued. According to the wildly popular but historically inaccurate 2014 movie, The Imitation Game, the recovery of the Enigma enabled Alan Turing to break the code at Bletchley Park in England.

It is true that the allies were able to eavesdrop on the Germans and upset a lot of secret war plans. Almost all codes were broken by someone in World War II, except in the South Pacific were the Japanese were eavesdropping on the U.S. Army. In perhaps one of the simplest forms of solution ever devised by our military, the U.S. Army discovered that (surprise!) the only people on earth who could understand the Navajo language, were Navajos! And

because their language was not based on an alphabet, it was not possible to trans-

late. In the Navajo language, each of the twenty-six letters of the English alphabet would be represented by an Indian term.

For example, the South Pacific island of Tarawa would be transmitted as “turkeyant-rabbit-ant-weasel-ant.” In Navajo, the words would be pronounced “Than-zie, wol-la-chee, gah, wol-lo-chee, gloe-ih, wol-la-chee”. To avoid repetition, which would make the code penetrable, letters carried multiple terms and were changed on a random schedule. Imagine the surprise and frustration when, for the first time, the Japanese were eavesdropping on a U.S. marine speaking in Navajo. The Navajo code was never broken.

So What Does All That Have To Do With The Game?

Although you might be mildly interested in the history of eavesdropping, you might be wondering what the real connection of eavesdropping and coding is with Gridiron Football.

In 1856, Amos Kendall became concerned about the lack of care and education for the hard of hearing, deaf and blind children of Washington, DC. He generously gave up 2 acres of his own real estate and using his own funds, started a small school that would attend to the special needs of those with hearing and seeing needs.

first commencement in June 1869 when three young men received diplomas.

In 1954, congress recognizing that they may have created the most politically incorrect faux paus in the history of the country, changed the name of the school to “Gallaudet College” and later to “Gallaudet University”. In 1892, the quarterback for the Columbia Institution for the Instruction of the Deaf, the Dumb and the Blind, Paul D. Hubbard realized he had a major problem. Every time he got his teammates together to explain--in sign language-the next play, the opposing team was “evesreading” what he said. The results were disastrous.

On the ensuing plays Hubbard instructed his team to gather around him, forming a very tight circle with Paul’s back to the opposing team, and he described in private, the details of the next play. The following excerpt from a 1946 issue of Football News said “The recent death of Paul D. Hubbard, for 43 years an instructor in the Kansas State School for the Deaf, removed from the sports world the originator of the huddle system used nowadays in football. Back in the 1890s while a student at Gallaudet college, Hubbard was an outstanding athlete and

played quarterback on its first football team Since all players on the Gallaudet team were deaf, Hubbard had to devise a system for calling plays, thus giving birth to the huddle system.”

“At Gallaudet his team threw much scare among big college teams as it won great victories over the Navy, Georgetown, the University of Virginia and other big teams.

At one time Princeton challenged Gallaudet to a game, but the faculty of Gallaudet turned it down. Upon his graduation from Gallaudet in 1899, Hubbard returned to teach at the Kansas State School for the Deaf. He organized the first football team at the school, and was its coach for fifteen years. ”Today, and for the last 123 years, we’ve called it the “huddle”.

As Paul Harvey used to say on his ever popular radio program, “now here is the rest of the story!”

References: Biography (2015). Alan Turing. Retrieved September 7, 2015: http://www.biography.com/people/alan-turing-9512017 Central Intelligence Agency (2015). Navaho code talkers and the unbreakable code.

Retrieved September 7, 2015: https:// www.cia.gov/news-information/featured-story-archive/2008-featured-story-archive/navajo-code-talkers/: Dade, L. (2015). How enigma machines work. Retrieved September 7, 2015: http://enigma.louisedade.co.uk/howitworks.html Musser, A. (2015). Huddleup! How the hard of hearing changed football. Its Vanish Blog. Retrieved September 7, 2015: www.itsvanish.com Sports Library (1996). The Huddle debate continues. Retrieved September7, 2015: http://library.la84.org/SportsLibrary/CFHSN/CFHSNv11/CFHSNv11n2c.pdf

Author’s Bio:

Robert M. Traynor, Ed.D., MBA, FAAA

By 1857 the school at Kendall School was growing and the demands for care outstripped his resources, so he was able to convince the 34th Congress to fund a much grander version of his early efforts. ConMiller, a co-researcher at Michigan, thatagreed the noise-induced hearing loss prevention concoction could be gress in their inimitable wisdom to available within two and years.named the school the fund the effort “Columbia Institution for the Instruction of the Deaf, the Dumb Robert M. Traynor is the CEO and practicing audiologist at Audiology and the Blind”. KenAssociates, Inc., Greeley, Colorado with particular emphasis in dall, recognizing that amplification and operative monitoring. Dr. Traynor holds degrees from the school was now demanding more the University of Northern Colorado (BA, 1972, MA 1973, Ed.D., 1975), time and effort than the University of Phoenix (MBA, 2006) as well as Post-Doctoral Study at In another study funded by the Oklahoma Medical Research Foundation, he was willing to give, Northwestern University (1984).

He taught Audiology at the University researchers Dr. Robert Floyd and retired Army surgeon, Dr. Richard Kopke, M.D., discovered a hired the first superof Northern Colorado (1973-1982), University of Arkansas for Medical combination of two compounds stopped damage to the inner ear caused by acute acoustic trauma – intendent, Edward Minor Gallaudet.

Sciences and were Colorado State University (1982-1993). Dr. Traynor something like an IED exploding. Although they did not indicate what(1976-77) the compounds they felt that,“This very exciting finding,” Floyd, Merrick Chair the in Aging is a the retired Lt.Foundation Colonel from US Army Reserve, Medical Service Corps Edwardis aMiner Gallaudet wassaid theDr. son of who holds Research at OMRF. “The research is who still atfounda pre-clinical stage, we’re hopeful that can begin Thomas Hopkins Gallaudet, and but currently serves aswe ansoon Adjunct Professor of Audiology at the University testing in humans. ed the first school for deaf students in of Florida, the University of Colorado, and the University of Northern the United States. Congress authorized

Colorado. For 17 years he was an Audiology Consultant to major hearing 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.

therecently, institution to confer collegework degrees More Dr. Kathryn Campbell's at Southern Illinois University involves the use of an instrument and equipment manufacturers in 1864,called and D-methionine, President Abraham Lincoln antioxidant a component of fermented protein signed the bill into law. EM Gallaudet was made president of the institution, including the college, which that year had eight students enrolled. He presided over the

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Greeley patient urges all women to get regular pelvic exams

By Karla Oceanek UCHealth

L

oretta Armfield made a big health mistake and lived to tell about it.

Now she wants to share her hard-won wisdom with other women in hopes she can help keep more of them alive.

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At some point in the past 10-20 years, Armfield quit going to the gynecologist for her annual pelvic exam. It was so long ago that she can’t remember when.

“I come from healthy stock,” she explained. “My mom was 98 when she died and never took any medication her whole life. In my family, you only saw a doctor when you knew something was wrong. And I was feeling fine.”

So a while back, when the female gynecologist she’d seen for a long time and was comfortable with moved away, Armfield just stopped going. One year turned into two, which turned into five turned and into 10. Even though she had worked as a receptionist at an urgent care clinic in Greeley for 20 years and was relatively savvy about medical conditions and care, she didn’t worry about her own health.

“I was sticking my head in the sand,” she said.

Until there came a day when Armfield didn’t feel so fine anymore.

“I’d started gaining weight,” she said, “and I couldn’t breathe very well. I’d also begun to lose urine.”

At long last, Armfield scheduled an appointment with University of

Colorado Health OB/GYN Dr. Natalie Rochester, who an urgent care colleague recommended.

Armfield walked into the clinic in November 2013 assuming that Rochester would tell her she simply needed to lose a few pounds.

But her problem wasn’t so simple.

“Loretta’s exam was abnormal,” Rochester said. “I could feel masses in her pelvis and suspected this came from her ovaries. It’s never a happy day when you meet a patient for the first time and have to tell them something’s wrong.”

Next came a pelvic ultrasound followed by a CT scan. The images said it all.

“Dr. Rochester used that nasty ‘C’ word on me is what she did,” laughed Armfield, a mother of three and grandmother to many.

“It turned out that ignorance was bliss.”

Fortunately, Rochester was able to get Armfield into surgery a few days later at the University of Colorado Hospital in Aurora, where gynecologic oncology specialist Dr. Saketh Guntupalli removed her ovaries and uterus, and completed a surgical staging in a nine-hour marathon.

Pathology confirmed that Armfield had stage-3 ovarian cancer.

Under the supervision of oncologist Dr. Douglas Kemme at UCHealth’s Cancer Care and Hematology clinic in Greeley, Armfield took IV chemo every three weeks for four months. While she did lose every hair on her body, she didn’t lose her quality of life.

“I didn’t get sick,” Armfield said.

“I didn’t lose my appetite. I didn’t

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Loretta Armfield hadn’t been to a gynecologist in years. She didn’t think she needed to because she was healthy and feeling fine. Luckily, she recognized some worrisome symptoms and made the appointment that saved her life.

Photo by: UCHealth/Josh Barrett:

have any trouble with chemo. It was really, really easy because the nurses and doctors there all went above and beyond. I was 100 percent comfortable. I have never had such good care in my whole life.”

Today, a year and a half postsurgery, Armfield remains cancer free.

“I feel great,” said Armfield, who enjoys gardening as well as spending time with Lowell, her husband of 56 years, and their big family. “I’m doing fabulous.”

“Loretta is one of those patients who give doctors hope that ovarian cancer can be beat,” Rochester said.

“With her type and stage of cancer, women don’t usually do well. But Loretta is in remission. She’s a feisty lady and a miracle.”

Still, both Rochester and Armfield want to emphasize that even though Armfield has defied the ovarian-cancer odds so far, the better path would have been the one leading to earlier detection and treatment.

“Many patients incorrectly

assume that because new cervicalcancer screening guidelines don’t require every woman to have a pap smear every year, they also don’t need an internal pelvic exam,” Rochester said. “That’s not true.

Even postmenopausal women need a pelvic exam at least every year to confirm the uterus and ovaries are normal. It’s the only way I can talk to them about the often vague symptoms they might be having and feel their uterus and ovaries.”

And when they do have symptoms, Rochester said, such as vaginal bleeding, weight gain or loss, abdominal fullness, or just a feeling that something’s not quite right, they need to make an appointment right away.

“It had been too long,” said Armfield of her many years away from the gynecologist’s office. Her normally bubbly tone grew stern.

“I should have known better. Other women should not pull that foolish act.”

Karla Oceanek is a freelance writer and children’s author in northern Colorado.

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Drive Smart: Aggressive driving concerns grow on our roadways

By Lyn Tausan DRIVE SMART Weld County Are you an aggressive driver?

Does it seem like there are more angry drivers on the roadways these days? It might not be your imagination.

In a recent poll by the Washington Post, the number of drivers who confessed to feeling “uncontrollable anger toward another driver” doubled between 2005 and 2013.

Drivers are more likely to see aggression in other drivers than in themselves. It is becoming a growing problem on our roadways.

The National Highway Traffic Safety Administration defines aggressive driving as occurring when an individual commits a combination of moving traffic offenses so as to endanger other persons or property.

The driver behaviors associated with aggressive driving are lane blocking, tailgating, lack of signal use, gestures, horn use, parking the car with more than one space, keeping headlights on high beams, dimming the lights and blocking traffic.

Are you an aggressive driver? Here are four ways to tell if you are one. Do any of these behaviors sound familiar?

You hit the gas when the light turns yellow.

When someone tries to merge at the last minute, you “teach them a lesson”

by not letting them in.

You lay on your horn when someone is slow to respond to a green light.

You are frustrated by a slow driver in the left lane, so you ride their bumper or zoom past them on the right.

Is it possible to avoid becoming an aggressive driver? Aggressive driving not only puts you and others in danger, it can be expensive as well.

Most insurers won’t cover an accident resulting from deliberate or reckless behavior, and a roadrage incident on your record can substantially raise your rates. Here are some tips to avoid conflicts with other drivers: • Use the left lane for passing only • Remember to always use your turn signals • Be courteous and allow plenty of room when passing and merging • If you make a mistake, acknowledge it with a friendly wave • Use your horn only when necessary • Don’t use hand gestures to express your frustration • Adjust your attitude • Don’t drive when you are angry • Consider altering your schedule • Avoid stress and fatigue before driving In Colorado, the State Patrol aggressive driver program was implemented July 1, 1998. The Colorado State Patrol has partnered

with several cellular companies to provide a phone number, free of charge, to be used by motorists, bicyclists, and pedestrians to report “real time” aggressive driving behavior.

The phone number is *CSP (*277).

Since the program was started, the State Patrol has received more than 230,000 reports of aggressive behavior.

When observing an aggressive driver who is putting other motorists at risk, the aggressive driver should be avoided by getting out of the way and not making eye contact or giving indication of disapproval of their driving behavior.

Contact the CSP as soon as is safely possible and be prepared to provide the following information: vehicle

description, license plate number, location and direction of travel, driver description and the aggressive driving behavior being demonstrated.

With the educational programs available for the public to assess their own behavior and recognizing the signs of aggressive driving, more people can see their own behavior in new light.

This will allow them to adopt safer driving practices and manage risk more effectively.

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.

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Top things I wish someone had told me about

Family Planning Dr. Lindsey Gerdes Dr. Lindsey Gerdes is a family medicine physician practicing at Kaiser Permanente’s Greeley Medical Offices

By Lindsey Gerdes Kaiser Permanente

I

am a big proponent of family planning, particularly because it enables women and men to decide when they are ready to start a family before they get pregnant. That being said, you can only plan so much. Having children is clearly a life-changing event for the mother and father — but what I haven’t always anticipated are the various journeys people take to parenthood.

Here are the top five things I learned on the journey to having my twins earlier this year.

1. Fertility is not guaranteed This is perhaps made more frustrating by our best efforts to enable women to have access to appropriate birth control options.

Making those responsible choices does not automatically mean stopping birth control will result in a quick pregnancy. Let me be clear — using birth control (any reversible form) does not inhibit future fertility, but not being on birth control does not mean you can get pregnant immediately.

Making the decision to have a baby is big enough, if that decision is followed by any difficulty achieving that pregnancy, it can make the decision feel more and more difficult.

I recommend seeing your doctor if you have questions about future fertility, or how to best try to plan your family.

2. Multiples — the rising of twins and multiple pregnancies.

Who plans for that? I’m pretty sure no one. With the increased average maternity age and increase of fertility treatments, more and more families are having multiples. It’s definitely challenging but equally amazing; my advice is to take one step at a time and try to remember to enjoy all the moments — including the pregnancy and all the late nights with hungry babies. Which brings me to my next point.

3. Pregnancy It’s not necessarily all glowing and wonderful. Pregnancy is a different experience for each woman and with each pregnancy. Some women just seem to be made for it — they glow, eat all kinds of things and have energy like a super human. It’s important to remember not all women enjoy pregnancy. If you happen to be a

woman who does not enjoy your pregnancy, it is not an indication of what type of mother you are going to be. Whether you are glowing or not do what you can to eat right, take your vitamins and certainly get prenatal care to keep yourself and your baby healthy during this time.

4. The delivery room I have helped deliver plenty of babies for other women, but even with that experience, it was daunting to anticipate having my own delivery.

Knowing my chances of C-section were higher because of the twins actually gave me some relief that there was a safe backup plan.

I do recommend parents familiarize themselves with their delivery plan and options, but I always stress the most important aspect to any delivery plan is a healthy mom and healthy baby.

Don’t get so attached to your delivery plan you forget the ultimate goal.

5. Becoming responsible for a very tiny human This is the most overwhelming kind of responsibility. Both new mom and dad are going through a lot of emotions and then you actually bring that little, brand new baby home.

No new mother can escape the

fact that sometimes their situation will overwhelm them. It is a lot to adjust to, and there are plenty of friends, family members, and support groups around you who are more than happy to lend a hand when you are feeling like you can’t manage. The key is to not be afraid to ask for help, or feel ashamed to accept help when you need it. You would be amazed by how helpful it is when your parents or your friends fix a few meals, fold some laundry or wash the dishes. Don’t try to be superwoman; accept the help.

It’s normal to have strong emotions during this time; part of your responsibility as a new parent is to be aware of them and know when to ask for help coping with your emotions — not being able to bond with your baby, feeling too tearful or too fearful can be signs of postpartum depression and should be addressed with your health care provider.

At times while you prepare for this new life you might be left feeling like you’ve taken on way too big a task. It is true things will never be the same, but being a new mom myself I can safely say that it is all worth it. Take a deep breath. You’re going to be great.

Dr. Lindsey Gerdes is a family medicine physician at the Kaiser Permanente Greeley Medical Offices.

PRIME \\ OCT. 2015

11

THE Race against time Partnership between rural hospitals and NCMC saves lives

By Allison D. Bluemel \\ Photos By Joshua Polson For Prime

12

PRIME \\ OCT. 2015

G

lenn Lawrence woke up on a March morning at 5:30 as he always does at his home in Brush. Lawrence was a military man, a Marine who fought in World War II. He thrived on his set daily schedule.

Lawrence did his routine of strength exercises followed by breakfast and, later, brewing coffee. Since the death of his wife three years ago, Lawrence has lived alone in his two-story Brush home. Lawrence was 87, but he felt good that day: He had more energy than normal.

At 9 a.m., while the coffee was still brewing, he felt a gripping, icy sensation in his chest. The pain was so severe that he broke into a cold sweat.

Lawrence was going into what doctors at East Morgan County Hospital in Brush and North Colorado Medical Center in Colorado later diagnosed as severe cardiac arrest.

Despite the crushing pain, Lawrence remained level headed. He went downstairs to the kitchen to stop the coffee so it wouldn’t burn.

He called 9-1-1. Lawrence then unlocked the front door of his two-story home so responders wouldn’t need to knock it down.

From there, he went back upstairs, staying on the phone with dispatch the entire time while he lay down.

Lawrence was not only a Marine, he later worked as a firefighter in the age when firefighters also had to diagnose and begin treatment for medical emergencies if they were first on scene, as emergency medical technicians weren’t around. He trusted that the first responders would know what to do, even though he also knew from his time as a firefighter that with each passing minute more of his heart muscle was dying from the attack.

••• Patients in rural areas, such as Lawrence, may need critical care, just like residents of Greeley, yet don’t live close to Greeley’s North Colorado Medical Center and its life-saving equipment and specialists needed.

Partnerships between larger hospitals such as Greeley’s NCMC and rural hospitals like East Morgan County Hospital in Brush give those residents a chance to make it.

“There are some people who wouldn’t be here today if that partnership wasn’t there,” East Morgan

»TIME continued on page 6

“ There are some people who wouldn’t be here today if that partnership wasn’t there ” -Dr. Christopher Doll East Morgan County Hospital

LEFT: Med Evac Pilot Isaiah Dionne prepares for takeoff earlier this month at East Morgan County Hospital in Brush. In emergencies, pilots will make the flight from Brush to Greeley in roughly 24 minutes.

BELOW: The MedEvac helicopter hovers for a landing over Jackson Field during a drill last month in Greeley.

PRIME \\ OCT. 2015

13

»TIME continued from page 5

County Hospital Dr. Christopher Doll said. “There’s only so much that one physician can do.”

Through that partnership, NCMC gives rural hospitals and their doctors the resources and training to save lives in the case of a Code STEMI. A Code STEMI is what was happening to Lawrence.

It is when clot completely blocks blood flow in an artery in the heart.

UCHealth has a similar program with other rural hospitals in Colorado, Nebraska and Wyoming.

The program saves minutes, and therefore lives, for those living in rural areas.

••• A few minutes later, a police officer showed up and Lawrence asked him to call Barbara Naeve, a close neighbor and friend.

Naeve refers to Lawrence as the grandfather of her children.

Lawrence wanted someone there, but didn’t want to worry his son. He asked Naeve not to call him yet. EMTs went upstairs, cut off Lawrence’s shirt and gave him nitroglycerin to treat the chest pain before carrying him down the stairs.

They carried to the ambulance despite Lawrence’s offer to walk himself. Shortly after he left, Naeve let Lawrence’s son know about the heart attack.

EMTs in the ambulance asked him if they could use TNK, a clot-busting drug commonly used in heart attacks, once they arrived at the hospital.

When someone in a rural area goes into cardiac arrest with a full blockage of the artery, a clotbusting drug such as TNK is a rural hospital’s main line of defense. If the medication didn’t work, they would need to try their hardest to keep him stable and alive until the helicopter arrived so he could be rushed to NCMC’s cath lab to have the artery reopened. The helicopter would fly Lawrence regardless since doctors can’t afford the 60-90 it takes to determine whether TNK works.

“The longer that artery is blocked the more damage is continued,” said Dr. Jim Beckmann, NCMC’s Director of Catheterization Laboratories. “The quickest way for those of them on the eastern plains without a lab is a clot busting drug.”

Beckmann and a team of three technicians are part of a team that can confer with rural hospitals on a patient’s treatment.

EMTs brought Lawrence in well under the door-to-needle time – the period between when a patient is admitted and when they receive the clot buster.

The goal is 30 minutes; in Lawrence’s case the drug was administered in seven.

Thankfully, the TNK began to take, and Lawrence’s EGK and vitals climbed closer to normal.

“They were all pretty calm and organized” Lawrence said. “.I was in awe.”

No matter how well doctors and responders in Brush did up to that point, if Code STEMI and access to a cath lab wasn’t available at NCMC, Lawrence may not have made it out of the hospital, if the medication hadn’t worked.

Instead, when the helicopter arrived, technicians from NCMC

loaded him onto the medivac and took him to facilities that later helped save his life.

The helicopter ride reduced what would have been an hour drive to Greeley to about 20 minutes, saving crucial time and the muscle in Lawrence’s heart.

While it was a stressful situation, compared to his time in the Marines, Lawrence said it was a pretty uneventful flight.

When Lawrence landed in Greeley on one of NCMC’s three available medivacs – one in Akron, one in Greeley and one in Boulder - the technicians who kept him company and communicated with NCMC on the flight escorted him to a room in NCMC quickly. The process was sped along by NCMC’s automatic acceptance of patients – no additional paperwork required – coming from rural hospitals through Code STEMI. In Lawerence’s case, they were able to wait until the next day for the muscle to become less inflamed before taking him to cath lab.

While on the table, a cardiologist and a team of three technicians helped to break up the clot and expand the artery using a balloon to reestablish blood flow.

Muscle had already died, but the procedure saved what was left. It also saved his life.

••• When he left the lab, Lawrence began a three-month recovery.

He spent the first week at NCMC, where his doctor developed a rehab and exercise plan that was then shared with East County Morgan Hospital for his continued care.

Throughout the process, even at the end, NCMC communicates back to the local hospital, updating them on the patient.

Naeve and her family kept Lawrence company during his hospital stay.

At the end of the week, he was

Warning signs of a heart attack Most heart attacks cause discomfort in the center of the chest that can last for more than a few minutes of go away and come back, according to the American Heart Association.

The pain can feel like uncomfortable pressure, squeezing, fullness or pain.

If any of the following signs are present, call 9-1-1: • Pain or discomfort in one or both arms, the back, neck, jaw or stomach • Shortness of breath, with or without chest discomfort • Breakout out into a cold sweat • Nausea or lightheadedness The signs of cardiac arrest: • Person does not respond to tapping on shoulders • Person does not take normal breath when head is tilted up.

Check for at least five seconds.

Source: Information courtesy of the American Heart Association

transferred to Eben-Ezer Lutheran Care in Brush where he worked on the program between their facilities and the local hospital.

As part of the rehab program, Lawrence worked on light cardio and strength exercises three times a week for 12 weeks.

When the treatment was over, East Morgan County Hospital extended an offer to let him work out there for another 14 sessions.

“I’ve spent over three months gaining strength to take care of myself,” he said.

Even though he has recovered well, Lawrence plans to continue to continue the workouts after his prescribed time ends.

LEFT: Daniel Beckle, program manager for the North Colorado Med Evac watches as the helicopter is cleared out for another flight last month at North Colorado Medical Center in Greeley.

14

PRIME \\ OCT. 2015

Partnerships offer live-saving training, resources to rural hospitals and doctors

By Allison Dyer Bluemel For Prime

W

hen minutes matter, seconds save lives.

With that in mind, NCMC and UCHealth worked together in 2004-05 to develop a response system that would not only assist in getting patients adequate care quickly, but educating the staff of rural healthcare facilities.

During the years, the partnership has branched off as UCHealth focuses on the work between its traveling physicians and local clinics, and NCMC works on improving its response time to rural areas with medivac and consultation services.

The partnership between NCMC and the six rural counties in northeastern Colorado and Nebraska as part of Code STEMI: Morgan County, Logan County, Yuma County, Phillips County, Sedgwick County and Keith County, Neb. The program not only aims to provide transport but EMTs, nurses and doctors using “blue phone” consultation lines.

UCHealth’s traveling physicians serve hospitals in the Colorado, Nebraska and Wyoming areas, a service they have offered for 20 years since before the inception of the cardiac arrest programs.

The support system for doctors at smaller hospitals comes in two forms: the ability to transport patients via helicopter to hospitals with catheterization labs and the ability for doctors to call specialists for consultations and case questions.

“It’s more physician-to-physician,” said Dr. Jim Beckmann, NCMC’s Director of Catheterization Laboratories. “Part of that was educating the community, and they took it on extremely well.”

The education of rural doctors is vital, especially in the rare instance where helicopters can’t immediately make the flight due to weather conditions, he said.

Of the six counties, about 88 to 90 percent of the time the patients are treated within a 30-minute window, Beckmann said, the recommendation from the American Heart Association.

NCMC is also available to give advice or answer questions on the echocardiograms taken of the heart within that first 30 minutes.

“If they’re unsure they can call us,” Beckmann said. “We can look at the EKG and answer specific questions about the administration of TNK (a clot-busting drug). It’s a pretty smooth process.”

If a patient doesn’t respond to the medicine, rural doctors call up NCMC and let them know

that they’ll need assistance and immediate transport to the hospital’s cath lab.

Throughout the heart attack, multiple EKGs are performed to check up on the heart and see if blood flow has been reestablished.

“If they have reestablished blood flow by the EKG and symptoms have subsided, then we give them a little bit of time to cool away from the original event,” he said.

However, if blood flow has not been reestablished, crews on the helicopter communicate with NCMC so doctors like Beckmann know what to expect.

Doctors and their teams prepare for arrival while the patient is in the air, whether that’s by driving to the hospital in the middle of the night or finishing up another patient’s case in the lab to make room.

In the cath lab, cardiologists like Beckmann and a team of three assisting technicians look over the EKG and decide how to best expand constricted arteries.

Additionally, the helicopter acts as a flying intensive care unit, so the entire time the patient is in the air they receive treatment.

“We kind of have an idea all the way through the process of how the patient is responding,” he said. “We know that the sooner the treatment for the heart attack the great the

survival rate.”

Having a program in place that improves in the survival rate without requiring patients to move closer to major hospitals also improves quality of life. “(They) shouldn’t be penalized in (their) healthcare for living a rural area and so, by taking it to them, that penalty is gone,” Beckmann said.

Communication with the local hospital helps to include their staff on the process as well, making care easier once a patient is transitioned back to their local area.

“We treat here and then try to get them back to their communities,” Beckmann said.

By and large, the program is a success with most patients coming in well below the American Heart Association’s goal of treatment in a cath lab within 90 minutes, Beckmann said.

It’s this success with the program that has caused NCMC’s program to become an example for other network’s heart attack treatment plans.

“If you look at the American Heart Association’s Mission Life Line, they have adopted our program that we actually developed,” Beckmann said. “We were ahead of most of the state, and they used to as the cornerstone for the development of Mission Life Line.”

PRIME \\ OCT. 2015

15

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We are so pleased with all the people at Aqua Spas. They are all so pleasant and informative about their products. We highly recommend them and their products.”

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THINKING ABOUT HEALTH: Food safety law would be good for consumers — if it were funded

By Trudy Lieberman

Rural Health News Service

Just five years ago, Congress passed a big, widely hailed law that promised to make Americas’ food supply safer. But because of inadequate funding for new regulations and inspectors, the promise has yet to be kept.

Sometimes cutting government spending has serious consequences, and there’s no better example of that than what’s happened to the Food Safety Modernization Act. In 2010, Congress enacted legislation whose goal was to set tough anti-contamination standards for foods ranging from peaches to imported pesto sauces and to increase the number of inspectors for the increasingly complex food system.

Two decades ago inspectors for the Food and Drug Administration, which is in

charge of most of the food supply, checked on 200,000 imports.

Today, they are charged with overseeing 12 million imports, accounting for about 15 percent of what the nation eats. About 80 percent of the country’s seafood and about half of all fruits and vegetables are imported.

American food companies might get inspected every four or five years, but foreign food producers may never be inspected.

The U. S. Department of Agriculture inspects what FDA does not, but sometimes it’s hard to tell who does what. For example, the FDA regulates eggs unless the eggs are cracked or processed. Then the USDA takes over.

After several major outbreaks of illness caused by contaminated food, momentum built in Congress for fixing the system.

The food industry, which worried that bad publicity about

Americans dying from tainted spinach was giving them a black eye, got behind the new law.

But did the food industry really want what could be tough new rules and regulations, or was the law simply intended as a symbol to assure the public the food supply was safe? Given what’s happened to the law in the last few years, it’s easy to conclude that symbolism may have been the goal all along.

In a story that may make you think twice before licking an ice cream cone, Politico food policy reporter Helena Bottemiller Evich, has told a sorry tale of the food safety law, including reference to the recall, earlier this year, of the entire ice cream inventory of Blue Bell Creameries.

This and other deadly incidents have come five years after former Iowa Sen. Tom Harkin, declared, “This legislation means that parents who tell their kids to eat

»HEALTH continued on page 19.

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Educators, rural communities working together

Dr. Marc Ringel Dr. Marc Ringel is a member of the board of the Centennial Area Health Education Center.

can deliver great results

By Marc Ringel

Centennial Area Health Education Center

O

ne of the coolest things I’ve done in my professional life is to have shepherded into existence a couple of training programs for family doctors who want to practice close to their communities. I did this work when I was on the faculty of North Colorado Family Medicine, a three-year residency for medical school graduates on their way to becoming family physicians.

The programs are labeled alternative training tracks. One, based at Sunrise Community Health Center in Greeley, focuses on serving the medically needy. The other, sited in Wray is designed to prepare doctors for rural practice.

Both have been going since 1992.

Since there is such a huge range of practice types in family medicine — from suburban outpatient to inner city hospital to frontier rural — and enormous variability in services provided at different locations, it makes perfect sense to educate physicians in places that

are a lot like where they plan to apply their skills after they finish training. (No doctor, at least no good doctor, actually ever finishes training. In this profession there is always a vast amount of new stuff to learn.)

Back around 1990, when the residency director and I were concocting the plan for alternative training tracks, our first step was to find practices that could support the programs, in terms of teaching resources like doctors and patients and hospital services. It was also essential, we soon learned, that the community itself support the idea of doing more than the usual amount of medical training in their midst.

I recall the second of two long days visiting hospitals and medical practices in towns all over northeast Colorado and even a couple in Nebraska. Joe Ferguson, the residency director, and I had been explaining to doctors, hospital administrators, chief financial officers, and board members how we’d tailor the rural training track to their particular medical community, all the time addressing realistic concerns about

how much the program would cost and who’d pay.

Then we arrived in Wray where the visionary Dr. Jack Berry greeted my boss and me at the curb in front of the old Wray District Hospital with these words, “I’m here to see what it will take to put the Rural Training Track in Wray.”

And so it happened. Jack mustered the support of his colleagues, the hospital administration, and the community to make it happen.

Two of the four family physicians currently at Wray Clinic are graduates of the Greeley program, as well as two residents, licensed doctors who are there most of the time. Since the inception of the Rural Training Track Wray has never had trouble recruiting physicians. It’s the perfect setup for a doctor who wants the rural experience without risking a sense of professional isolation. Being affiliated with a topnotch full-time education program is about as connected as you can get. With the exception of practices located in resort towns, maintaining an adequate number of physicians is the Achilles heel of virtually every rural practice in the

country. Though Wray is beautiful, it is hardly a resort town.

Sunrise Community Health Center also has benefited hugely from being a residency training site. Six of the family physicians there, including the current medical director and the recently retired medical director, all trained at North Colorado Family Medicine.

Currently the University Of Colorado School Of Medicine is investigating putting a training track in Fort Morgan. Banner Health is eyeing Sterling for a program too. I hope they succeed.

These sorts of programs are enormously effective at training doctors to do the jobs that need doing and motivating them to stay. Everybody benefits: patients, community, and trainees.

That’s what happens when communities and educators get together, which is what; Centennial Area Health Education Center is all about.

Dr. Marc Ringel is a member of the board of the Centennial Area Health Education Center.c

If you’d like to investigate opportunities for learning and practicing almost any health career in northeast Colorado or to support others in doing so, please contact www.cahec.org or call (970) 330-3608.

18

PRIME \\ OCT. 2015

»HEALTH continued from page 17.

their spinach can be assured it won’t make them sick.”

When the law was passed, the Congressional Budget Office estimated the FDA, which regulates most of the country’s food supply, would need an increase of $116 million to its $4 billion budget each year for five years in order to do the job the law intended. In 2012, even though the Obama administration asked for $183 million, Congress approved only $46 million.

After that, the administration asked for smaller increases, although this year it has asked for $109 million, closer to the estimate. But

Evich told me appropriations bills moving through Congress would result in less than a $46 million boost for the FDA. FDA deputy commissioner Michael Taylor told Politico, “At this juncture, (the law) either succeeds … or it falls off the rails.”

Evich reported the coalition that backed the law has walked away from funding it. She told me, “Who is actually going in and asking for money is a very short list.” In other words, very few groups are using their political capital to wring out more money for more inspectors or are pushing the FDA for rules that make the law a reality.

The FDA has yet to issue regulations, implementing the anti-

contamination standards that were supposed to make it harder to get sick from bad food.

Does the country still need to beef up its food inspection program? A visit to the website of Food Safety News helps answer that question. From July 1 through July 25, it reported 11 recalls listed for foods consumed by humans and several more for pets. Some of those for consumers involved millions of pounds of chicken products that put them at risk for salmonella poisoning, spices found on supermarket shelves, cashew nuts and bags of fruit and nuts also linked to salmonella, and pickles and sauces recalled for potential botulism risk.

In the absence of more forceful regulation which is not likely anytime soon, you’ll have to be careful about your food choices checking with Food Safety News to see what foods have been recalled.

And when you hear some politician talk about cutting government spending, think about who will be hurt. As the food safety fiasco shows, real people do die from government penny-pinching.

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.

Weigh in: We’d like to hear about your experiences with paying for medications. Write to Trudy at trudy.lieberman@gmail.com.

HEALTH Events Calendar Tai Chi, Moving for Better Balance,10-11 a.m., Mondays and Tuesday, North Colorado Medical Center. Twelve-week, evidence-based fall prevention program for older adults. $60 for 12-week session. Call (970) 810-6633 to register.

Sessions began Sept. 14.

provides an informative, one hour visit for the expectant mother and one support partner.

Tours are designed for adults and you must call (970) 495-7500 if you would like to bring an older child. For more information or to register, call (970) 495-7500.

Bright by Three Infant Group, noon-1 p.m. Oct. 6 or 20 at UCHealth’s Medical Center of the Rockies, 2500 Rocky Mountain Ave., Loveland.

Free class provides parents and caregivers with educational tools, books and games to make the most of the very important developmental years. A free infant packet includes a handbook provided by Bright Beginnings, brochures, and a toy and board book. To register or for more information, call Jennifer Salvador at (970) 4957500.

Childbirth Preparation Class, (three-week course), 6-9 p.m. Oct. 8, 15 and 22 at UCHealth’s Medical Center of the Rockies, 2500 Rocky Mountain Ave., Loveland. Class includes overview of labor and delivery, hospital routines, coping techniques, medications, medical interventions and cesarean birth. Please bring a support person, two bed pillows and water bottle. Also, wear loose-fitting, comfortable clothing. Register for hospital tour and Breastfeeding Basics class separately. Cost: $55. To register or for more information, call (970) 495-7500.

CT Heart Score, 1 p.m. and 2 p.m., Tuesdays and Thursdays. North Colorado Medical Center. Call (970) 810-6070 to schedule an appointment. CT Heart Score provides a noninvasive test that accurately measures the amount of calcified plaque in the arteries. The procedure begins with a fast, painless computed tomography CT exam. Cost is $199, due at time of service. Community Wellness is not able to bill insurance.

Memory Fitness, 9-11:30 a.m., Oct. 7, 14, 21 and 28 and Nov. 4 and 11 at Greeley Senior Center, 1010 6th St., Greeley. Sponsored by UCHealth’s Aspen Club, this class is designed for people 50+ who want to improve or maintain memory abilities, learn about the keys to maintaining memory fitness and are committed to attending the 12 memory sessions. To register or for more information, call (970) 495-8560.

Parent Preview Tour, 7-8 p.m., Oct. 8, 9:3010:30 a.m. Oct. 17 or 5:30-6:30 p.m. Oct. 22 at UCHealth’s Medical Center of the Rockies, 2500 Rocky Mountain Ave., Loveland. The tour

Blood Tests, Open labs 7-8:45 a.m., Oct. 14.

North Colorado Medical Center, 1801 16th St., Call (970) 810-6633 to schedule an appointment.

Wellness Services offers low-cost blood screenings open to community members; some immunizations are also available upon request and availability. Payment due at time of service, cost varies.

Scam Alerts-Five Red Flags, 9:30-11 a.m.

Oct. 14 at Greeley Senior Center, 1010 6th St. Sponsored by UCHealth’s Aspen Club, this free class will be a discussion on how to identify a scam, provide tips on how to avoid a scam, and advice on how to protect yourself. To register or for more information, call Stephanie Reid at (970) 495-8560.

Fast Track Childbirth Preparation (two-day course), 6-9 p.m. Oct. 16 and 1-5 p.m. Oct. 17 at UCHealth’s Medical Center of the Rockies, 2500 Rocky Mountain Ave., Loveland. Class includes overview of labor and delivery, hospital

routines, coping techniques, medications, medical interventions and cesarean birth.

Please bring a support person, two bed pillows and water bottle. Also, wear loose-fitting, comfortable clothing. Register for hospital tour and Breastfeeding Basics class separately. Cost: $55. To register or for more information, call (970) 495-7500.

Free Fitness Class, 9:15 a.m.-10:15 a.m., Oct. 17, 250 11th St., Windsor.

Body Check... What you need to know: Head to toe, Oct. 20. Summit View Medical Commons, 2001 70th Ave. Call (970) 810-6070 to schedule an appointment. This head-to-toe health assessment gives you the tools to put your health first by receiving a comprehensive set of preventive health screenings. Cost: $175.

Payment due at time of service.

CPR/First Aid/AED Class, 9 a.m., Oct. 20, UNC Recreation Center, 1600 23rd Ave., Greeley.

PAD Screening (Peripheral Vascular Disease), 1-3 p.m., Oct. 20, Summit View Medical Commons 2001 70th Ave., Greeley. NCMC’s Peripheral Vascular Disease Screening program offers the education and prevention proven to be the best tools for fighting vascular disease and stroke. Call (970) 810-6070 to schedule an appointment. Cost is $100 and due at time of service. NCMC Wellness Services is not able to bill insurance.

Blood Tests, Open labs 7-8:45 a.m., Oct. 21.

Banner Health Clinic 222 Johnstown Center Drive. Call (970) 8106633 to schedule an appointment. Wellness Services offers low-cost blood screenings open to community members; some immunizations are also available upon request and availability.

Payment due at time of service, cost varies.

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PRIME Medical Directory 2015 Alzheimer’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

1801 15th Street, Ste 200 Greeley, CO 80631 Phone: (970)378-4676 Fax: (970)-378-4315 www.bannerhealth.com

4800 25th Street Greeley, CO 80634 Phone: (970)330-6400 Professionals: Cozette Seaver, PT; Leslie Vail, PT

Family practice medicine burn Care

Banner Health Clinic

1300 Main Street Windsor, CO 80550 Phone: 970-686-5646 Fax: 970-686-5118 www.bannerhealth.com

western states burn center (NCMc)

1801 16th Street, Greeley, CO 80631 Phone: (970)350-6607 www.bannerhealth.com

Banner Health Clinic

CARDIAC vascular surgery

100 S. Cherry Ave., Suite 1 Eaton, CO 80615 Phone: (970)454-3838 www.bannerhealthc.om

AUDIOLOGY Alpine All About Hearing

Cardiovascular institutE (NCMC)

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

1800 15th Street, #310 Greeley, CO 80631 Phone: (970) 392-0900 www.bannerhealth.com

HEART FAILURE CLINIC (NCMC)

(970) 350-6953 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 \\ OCT. 2015

Endocrinology Endocrinology Clinic (NCMC)

Cardiac, Thoracic & Vascular surgery (NCMC)

1800 15th Street, Suite 340 Greeley, CO 80631 Phone: (970)378-4593 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 P, Greeley, CO 80634 (970) 663-6878 www.reynoldsoralfacial.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) 353-9011 Fax: (970) 353-9135 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

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)378-4475 Fax: (970)378-4429 www.bannerhealth.com

5312 W. 9th St. Dr., Suite 120 Greeley, Co. 80634 Phone: 970-356-3922 www.touchstonehomehealth.com

independent assisted Living GRACE POINTE

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

independent assisted living w/services

infectious disease Breen, john f., md (NCMC)

1801 16th Street Greeley, CO 80631 Phone: (970)350-6071 Fax: (970)350-6702

internal medicine BANNER HEALTH CLINIC

2010 16th Street Greeley, CO 80631 Phone: (970)350-5660 www.bannerhealth.com

medical equipment & supplies Banner HOme Medical Equipment (NCMC)

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

Mental health services

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

Stephanie Carroll, LCSW, CACIII Banner Health Clinic 1300 Main Street, Windsor, CO 80550 Banner Health Clinic - Fossil Creek 303 Colland Dr Fort Collins, CO 80525 Elise Fair, LPC 5890 W. 13th Street #114, Greeley CO 80634 Susan Garvin, LCSW Banner Health Clinic -Loveland Pediatrics Loveland Pediatrics, Loveland CO Banner Health Clinic - Windsor 1300 Main Street Windsor, CO 80550 Renee Rogers, LMFT Banner Health Clinic 1300 Main Street, Windsor, CO 80550 Banner Health Clinic - Fossil Creek 303 Colland Dr Fort Collins, CO 80525

NEPHROLOGY Greeley medical clinic

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

NEUROLOGY

Suicide Education & Support Services Prevention, Education, & Grief Support 2350 3rd Street Road • Greeley, CO 80631 970.347.2120 or 970.313.1089 Additional Weld County Locations

www.NorthRange.org banner BEHAVIORAL HEALTH

FOX RUN SENIOR LIVING

1720 60th Avenue Greeley, CO 80634 Phone: (970)353-7773 Fax: (970)330-9708 www.good-sam.com

Dr. Patricia Al-Adsani, Child and Adolescent Psychiatry 5890 W. 13th Street #114 Greeley, CO 80634 (970) 392-5454 Shawn Crawford, LPC Banner Health Clinic 222 Johnstown Center Dr., Johnstown, CO 80534

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NEUROLOGY CLINIC (NCMC)

1800 15th Street, Suite 100B Greeley, CO 80631 Phone: (970) 350-5612 Fax: (970) 350-5619 www.bannerhealth.com

NEURo-SURGERY BRAIN & SPINE BANNER HEALTH neurosurgery clinic

1800 15th St., Suite 130 Greeley, CO 80631 Phone: (970)350-5996 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)353-1335 www.bannerhealth.com Banner Health OB/GYN Clinic

2410 W. 16th Street Greeley, CO 80634 Phone: (970)352-6353 www.bannerhealth.com banner health clinic

5623 W. 19th Street Greeley, CO Phone: (970) 353-9011 Fax: (970) 353-9135 www.bannerhealth.com

oncology & HemaTology cancer Institute (NCMC)

1800 15th Street, Greeley, CO 80631 Phone: (970) 350-6680 Toll Free (866) 357-9276 Fax: (970)350-6610 www.bannerhealth.com

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PRIME \\ OCT. 2015

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 Richter Orthodontics

1813 61st Avenue Suite 100 Greeley, CO 80634 Phone: (970) 392-1733 www.richterorthodontics.com

orthopedics Mountain Vista Orthopaedics

5890 W. 13th Street, Suite 101 Greeley, CO Phone: (970)348-0020 Fax: (970)348-0044 www.bannerhealth.com

pediatrics Banner Health Clinic

6801 W. 20th Street, Suite 201 Greeley, CO 80634 Phone: (970)350-5828 www.bannerhealth.com

pediatric rehabilitation Banner Rehabilitation Center

1801 16th Street, Greeley, CO Phone: (970)350-6160 Fax: (970)378-3858 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

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

Hope therapy center (Formerly North Colorado Therapy Center)

2780 28th Avenue, Greeley, CO 80634 Phone: (970)339-0011 www.GCIinc.org Professionals: Jeanne Rabe, PT; Jennifer Branson, PT Kryste Haas, OT; Molly Wuethrich, PTA Moni Kohlhoff, PT

Northern colorado rehabilitation hospital

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

pulmonary/critical care North Colorado Pulmonary (NCMC)

1801 16th Street, Greeley, CO 80631 Phone: (970)392-2026 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

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)350-6160 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

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)348-0020 Fax: (970)348-0044 www.bannerhealth.com North Colorado Sports medicine

1801 16th Street, Greeley, CO Phone: (970)392-2496

speech language pathology Banner Rehabilitation Center

1801 16th Street, Greeley, CO Phone: (970)350-6160 Fax: (970)378-3858 www.bannerhealth.com Northern colorado rehabilitation hospital

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

UNC Speech Language Pathology Clinic

Gunter Hall, Room 0330, Greeley, CO 80639 Phone: (970)351-2012/TTY Fax: (970)351-1601 www.unco.edu/NHS/asls/clinic. htm Professionals: Lynne Jackowiak, M.S., CCC-SLP Julie Hanks, Ed.D Patty Walton, M.A., CCC-SLP

surgery General & Trauma

Banner Health Surgical Associates (NCMC)

1800 15th St. Suite 210, Greeley, CO Phone: (970)352-8216 Toll Free: 1-888-842-4141 www.bannerhealth.com

urgent care SUMMITVIEW URGENT CARE (NCMC)

2001 70th Avenue, Greeley, CO 80634 Phone: (970)378-4155 Fax: (970)378-4151 www.bannerhealth.com

Urology Banner health clinic (NCMC)

5890 W. 13th Street, Suite 106, Greeley, CO 80634 Phone: (970)378-1000 www.bannerhealth.com

veins Vein Clinic (NCMC)

1800 15th Street, Suite 340, Greeley, CO 80631 Phone: (970)378-4593 Fax: (970)378-4591 www.bannerhealth.com

NextCare - Urgent Care

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

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PRIME \\ OCT. 2015

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