September 2014 Thrive

nc

September 2014

THRiVE » NORTHERN COLORADO WELLNESS

KIDDO crusaders Health clerks in our schools are on the front lines of treating our children when they get sick. See how they handle this tough task. Page 8.

» INSIDE: DAYTIME HABITS AFFECT SLEEP • SMART DRIVING CAN PAY OFF • SEPTEMBER EVENTS

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August 27, 2014

y

ydo I Where turn when it comes

My family’s health? is that

to my health?

I’VE NEVER even heard of that Is it

DISEASE.

medication

safe?

treatable?

What’s the latest

technology?

Who doI TALK TO

y

I have terrible heart burn.

Do I need to see my doctor about this?

y

2

about this?

What are my OPTIONS

now?

Heart burn is often due to acid reflux, or gastroesophageal reflux (GERD). This is a very common problem. Fortunately, there are many excellent treatment options available, ranging from medications, to minimally invasive surgery.

Acid reflux occurs when acid from your stomach enters your esophagus rather than your intestinal tract, causing irritation to the lining of the esophagus which is perceived as heart burn.

Heart burn is the most common symptom of acid reflux. Other symptoms include coughing, a sour taste in your throat, hoarseness of your voice, and frequent clearing of your throat. In some cases, chronic obstructive lung disease (COPD) and asthma may be due to acid reflux.

Ask the

Expert

Lifestyle changes, dietary modification, and medications can adequately treat most cases of acid reflux.

Surgical treatment of acid reflux can be used as an alternative to medications, or when medications do not adequately control acid reflux.

Minimally invasive surgical techniques for control of acid reflux recreate the body’s natural barrier to acid reflux, and has over a 90% patient satisfaction rate.

If you have acid reflux, ask your provider about seeing a Banner Health surgeon today.

Molly Decker, D.O.

Michael Harkabus, M.D. Jason Ogren, M.D.

Samuel Saltz, D.O.

Robert Vickerman, M.D.

Specializing in General Surgery 1800 15th St., Suite 200, Greeley Appointments: (970) 352-8216 www.BannerHealth.com/BMG-GreeleySurgery Accepting Kaiser Permanente Members

August 27, 2014

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SEPT. HEALTH EVENTS « PAD Screening (Peripheral

Vascular Disease), 1-3 p.m., Sept. 2 and Sept. 16, at Summit View Medical Commons, NCMC’s Peripheral Vascular Disease Screening program offers the education and prevention proven to be the best tools for fighting vascular disease and stroke.

Patients receive: ankle brachial index: evaluation of leg circulation, carotid artery disease screening: ultrasound of the carotid vessels, abdominal aortic aneurysm screening: ultrasound of the aorta, lipid panel voucher, health education with a Wellness Specialist, health information packet. The cost is $100 and includes all four screenings. Payment is due at the time of service. NCMC will not bill insurance.

Call (970) 350-6070 to schedule an appointment.

« Body Check... What you need to

know: Head to Toe, by appointment, Sept. 2 and Sept. 16, at Summit View Medical Commons, 2001 70th Ave. This head-to-toe health assessment gives you the tools to put your health first by receiving a comprehensive set of preventive health screenings. Invest in your health today!

« This screening includes: Health

Fair Panel (fasting blood workplease fast 10-12 hours), sleep questionnaire, lung function test, body composition, weight and body mass index, hip and waist measurements, health education with a wellness specialist, EKG with results read by a board-certified cardiologist, peripheral arterial disease screening includes: education about peripheral vascular disease, stroke, stroke prevention and osteoporosis prevention, ankle brachial index, ultrasound of the carotid vessels, ultrasound of the aorta (above four screenings are read by a board-certified radiologist), upon request: colorectal take-home kit, $10, upon request: prostate specific blood

antigen screening. Call (970) 3506070 to schedule an appointment.

Cost for a screening is $175. Payment is due at time of service, Wellness Services is not able to bill insurance.

All results are sent to your personal physician and to you.

« Heartsaver First Aid, 4-6:30 p.m.,

Sept. 4, at the Family FunPlex. This class is taught by the American Heart Association certified health care professionals, this First Aid class provides participants with an understanding of first aid basics, medical emergencies, injury emergencies and environmental emergencies.

Upon completion of the course, participants will receive a Heartsaver First Aid course completion card. The certification is valid for two years. For more information please call (970) 350-9401.

« Heartsaver CPR with AED, 7-9

p.m., Sept. 4, at the Family FunPlex in Greeley. The class is taught by American Heart Association certified health care professionals and covers adult and infant/child CPR, obstructed airway, the Heimlich maneuver, the use of a barrier device and AED hands-on training. Upon completion of the course, participants will receive a Heartsaver course completion card. The certification is valid for two years. Registration closes at noon, two days prior to class. The cost is $48 for CPR and $45 for first aid and combo cost is $88. Please call for more information (970) 350-9401.

« Yoga Basics, 4:30-5:30 p.m., Sept.

8-Oct. 13. NCMC Yoga Basics is an introduction to the foundational poses in a beginning yoga practice. This class will focus on careful physical alignment for the creation of a safe practice. This class is best suited for those with no physical limitations.

The cost is $48 for six weeks. For more information please call (970) 350-6633.

« Gentle Yoga, 4:30-5:30 p.m., Sept.

10-Oct.15 at NCMC. NCMC offers yoga classes with Yoga Alliance Certified Teachers. In Gentle Yoga, the postures are presented in an easy to follow, accessible manner with plenty of time for modifications and focus on breath work. An excellent class for seniors, those with chronic illness or injuries, those newer to yoga, or students wanting a gentle practice. The cost is $48 for six weeks. For more information call (970) 350-6633.

« Spirit Passport to Health Com-

munity Lecture, “Palliative Care: to relieve suffering always.” 6:30-7:30 p.m., Sept. 8, in the NCMC Auditorium, 1801 16th St., park in the east lot and use Entrance No. 6. Learn how to navigate the terrain of serious illness and the role of Palliative Care.

A new approach to medical care providing relief, comfort and support for individuals with serious disease or chronic illness and their families. Find answers to questions everyone wonders about, but are hesitant to ask.

The Spirit Community Lecture Series is designed for men and women.

Pre-registration is requested at (970) 392-2222 or email spirit.of.women@ bannerhealth.com

« Cooking Class, “Harvest Party”,

6-7:30 p.m. Sept. 10, in the Cardiac Rehab Kitchen at NCMC. Come and learn a variety of fun and healthy cooking options. These courses are taught by a registered dietitian and are a great way to modify your cooking habits and learn about heart healthy cooking. Recipes and samples are included! Do you have zucchini, tomatoes and other garden produce overflowing? We’ll help you find tasty new ideas to use your garden abundance. It’s always fun in this class to share your extras. We’ll have baskets if you want to bring extra produce for those without a garden to take a little home with them. The class will be taught by Mary Branom,

R.D. Cost is $10 for each class, unless otherwise noted. Payment due at the time of registration. If you are absent from the class, you will be charged the full amount. To register please call (970) 350-6633.

« Blood Tests, 7-8:45 a.m. Sept. 10

and Sept. 24 at NCMC via Entrance No. 6 and Sept. 17 at Johnstown Family Physicians, 222 Johnstown Center Drive. Wellness Services offers low-cost blood screenings open to community members; some immunizations are also available upon request and availability. Appointments preferred; please fast 12 hours prior to blood draw. To schedule an appointment, call (970) 350-6633.

Payment is due at the time of service, NCMC Wellness Services will not bill insurance.

« Heartsaver CPR with AED, 6-8

p.m., Sept. 11 at the Windsor Recreation Center, 250 11th St. This class is taught by the American Heart Association certified health care professionals, this class covers adult and infant/child CPR, obstructed airway, Heimlich maneuver, and the use of a barrier device. Upon completion of the course, participants will receive a Heartsaver course completion card. The certification is valid for two years. The cost is $48 and registration closes at noon, two days prior to class. Call (970) 674-3500 to register.

« CPR for Health Care Providers

(Recertification), 3-5:30 p.m., Sept. 15, in the Union Colony Room at NCMC. This class is designed for licensed and non-licensed health care providers who need to re-certify through the American Heart Association. The certification is valid for two years. The cost is $50. If you are absent from the class, you will be charged the full amount. Refunds will not be processed once classes have begun. To register, please call (970) 350-6633.

« Walk with a Doc, Sept. 21 at Sanborn

Park, 2031 28th Ave, meet on the West side of the park. Walk with a Doc (WWAD) is an international program where interested people meet at a park or public location (usually Saturday mornings) for an informal five-minute health talk, and a 30-minute walk (at your own pace). Families are encouraged to attend. There healthy snacks at the completion of the walk. Free Blood pressure checks are available for those interested. Upcoming walks are posted on the Walk with Doc www. website-WalkwithaDoc.org

« CPR for Health Care Providers

Skills Check, in the Wellness Conference Room, by appointment.

This class is designed for licensed and non-licensed health care providers who need to re-certify through the American Heart Association. The certification is valid for two years.

Renew your CPR certification by completing an online CPR module, which includes watching a video, reviewing content and an exam.

When the online module is complete and a Course Completion Certificate is printed, call Wellness Services to schedule a skills check. Please bring a copy of the Course Completion Certificate with you. The cost is $50 for CPR for Healthcare Providers and includes skills check with a certified American Heart Association instructor. Separate fee for online course, payable online. If you are absent from the class, you will be charged the full amount. Payment due at the time of registration. The class is located in the Wellness Conference Room, unless otherwise noted. To register, please call (970) 350-6633.

« CT Heart Score, 1-2 p.m., Monday-Friday at NCMC. CT Heart Score provides a non-invasive test that accurately measures the amount of calcified

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August 27, 2014

DRIVE SMART offers students a chance to win by focusing on their safe driving

By Tamara Pachl For The Tribune

Weld County schools are back in session, and sometime during the first half of the school year, many local high schools have scheduled a DRIVE SMART Weld County Teen Driver Safety presentation.

Coalition members, including law enforcement, Weld County Department of Public Health and Environment employees, local business representatives and Banner Health EMTs, voluntarily present the two- to three-hour DRIVE SMART Teen Driver Safety program to students.

The program focuses on creating awareness around the choices young drivers make before and during the time they get behind a steering wheel.

In addition to the high school presentations, schools and the students also are given opportunities to promote teen driver safety awareness through various contests and challenges supported by DRIVE SMART Weld County. Individual schools and students can win prizes, including scholarships and grant money.

The Team Challenge is an activity that could involve a school club, class or group of friends. The group can apply for a $500 min-grant that would empower the team to complete a teen driver safety project within their school. For example, projects can be centered on seat belt safety with a seat belt checkpoint set up at the entrance and exit of a school’s parking lot. Or, a no-texting-whiledriving campaign. Groups can create a video or host a rally. There are first- and second-place prizes.

The Poster Challenge is another way students can win cash. Students are able to create an original art poster using a safe driving theme. Themes should be tied into seat belt safety, distracted driving or no texting while driving. First

» For more For additional details about the mentioned programs, go to www. drivesmartweldcounty.com.

prize is $200, and the poster is reprinted and distributed to all Weld County high schools. Second place prize is $100 and there is a $25 prize for honorable mention.

Drive Smart Weld County receives support from State Farm and Allstate Insurance. State Farm is promoting its safe teen driver awareness campaign called Celebrate My Drive. Celebrate My Drive is about celebrating the freedom that comes with a driver’s license. Part of that freedom means making smart choices behind the wheel, which is why DRIVE SMART Weld County is helping spread the message of 2N2 — two eyes on the road, two hands on the wheel. It’s a simple habit that can reduce distracted driving and help new drivers build confidence on the road.

The program coincides with National Teen Driver Safety Week, Oct. 15-24.

From Oct. 15-24, high schools across the U.S. and Canada will be able to compete for prizes, including grants of $100,000, $25,000 and a private concert by Grammy nominated The Band Perry.

To participate, high schools must be registered to be eligible for prizes. High school administrators can go to www.celebratemydrive.com to complete a simple registration form. Participation is easy and tools and resources are available on the site to help rally students and community members to make safe driving commitments in support of registered high schools.

Tamara Pachl of State Farm is a DRIVE SMART coalition member.

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DAYTIME HABITS HOLD KEYS TO NIGHTTIME SLEEP

By Jason Webb For The Tribune

A good night’s sleep is important not only to be able to function well, but also because people who suffer from chronic sleep problems are more apt to suffer from serious diseases, according to the Centers for Disease Control and Prevention. Among those diseases are hypertension, diabetes, depression and obesity, as well as from cancer, increased mortality, and reduced quality of life and productivity.

Dr. Kelli Janata, is a pulmonologist and sleep specialist with North Colorado Medical Center. Among the patients she treats are those who complain of not feeling rested after sleep.

Correcting sleeping problems begins with ensuring the patient understands how their lifestyle affects their sleep habits. One of the first things Janata does is ask patients to track their activities in a detailed sleep diary.

“The patient tracks everything they do from the time they get up to the time they go to sleep,” Janata said. At the first appointment, she looks over the diary to see if she can find what could be causing the sleep problems.

“Just as the quality of our sleep impacts us during our waking hours, our daily activities affect how well we sleep,” Janata said. “It’s important to recognize and avoid certain activities that commonly cause people to have difficulty falling asleep or staying asleep.”

As an example, Janata notes that when people who suffer from insomnia take naps during the day, it throws off the body’s natural clock, or circadian rhythm, which tells the body when and how long to sleep. Also, while getting a workout in before bed may seem like a good idea, exercise produces adrenaline, which can make it more difficult to fall asleep, notes Janata.

Recent research shows the blue-green waves of light emitted by laptops, smart phones and tablets can stimulate the eyes and turn off production of the body’s natural sleep hormone, melatonin. Other potential daytime activities that have an impact on sleep include eating a high-fat diet and consuming stimulants, such as caffeine and nicotine, later in the day.

“Stimulants, like caffeine and nicotine, can delay the onset of sleep or can interrupt your sleep,” says Janata. “Also, drinking alcohol at night may help some people fall asleep, but the effects usually wear off in a few hours, leading to fragmented sleep.”

As the patient records activities in the sleep diary, a clearer picture of what could be causing the sleep disturbances takes shape. Janata can then work with the patient to change behaviors to help promote better sleep.

One of the key messages Janata stresses to her patients is that bed is for sleep rather than reading or watching television. Janata also advises patients not to get frustrated if they are having trouble falling asleep because it can make the problem worse.

“If you’re not asleep within 20 minutes, get up and do something boring,” says Janata. “I tell people to go to the living room and read the dictionary backwards starting at ‘z.’ ” Another important factor to getting a good night sleep is to make sure the room is at a comfortable, cool temperature, which stimulates the body’s production of melatonin. A hot shower three hours before bedtime can also help relax the body before falling asleep.

“Americans put sleep on the back burner, and we live in 24-hour society,” says Janata. “Sleep is vitally important. If you have problems sleeping, get help.”

Jason Webb is a public relations specialist for Banner Health.

Events from P.3

plaque in the arteries. The procedure begins with a fast, painless computed tomography CT exam. CT, more commonly known as CAT scanning, uses x-rays and multiple detectors to create interior images of the heart. The Heart Score program includes a 10-minute consultation with a Wellness Specialist, focusing on cardiac risk factor education, identification of non-modifiable and modifiable risks and lifestyle behavior change options. The cost is $199 and payment is due at time of service. NCMC Wellness Services is not able to bill insurance. To schedule an appointment please call (970) 350-6070.

« NCMC Adult Fitness, the

Adult Fitness Program is available to people in the community who are interested in starting an exercise program in a health care setting. The cost per month: individual $45 or couple (living in the same household) $80. For more information call (970) 350-6204.

« STAR, 5:30-7 p.m., Sept. 18 in

the Cancer Institute Conference Room at NCMC. Come and support, touch, and reach breast cancer survivors (Breast Cancer Support Group). For further information please contact, Betty Parsons at (970) 339-7137.

« Prostate Cancer Support

Group, 5:30-7 p.m. Sept.

18 in the Cancer Institute Conference Room at NCMC. For further information please

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contact: Julianne Fritz at (970) 350-6567.

« Pulmonary Rehabilita-

tion-Lung Disease Management, education and exercise, for more information and opportunities contact (97) 350-6924.

« Flu clinics, 7 a.m.-4 p.m.,

Sept. 22-Sept.25, at the NCMC Wellness Walk-in Clinic.

Flu shots available for ages 4-17 with parent present.

We accept Medicare Part B for the flu and pneumonia vaccines; please bring your Medicare Part B card with you to the clinic. The clinic offers, flu shots, $25, nasal flu mist, $35, pneumonia vaccine, $90, and Tdap vaccine, $55. NCMC will not bill insurance; we do accept cash, credit card or check.

Come Stay & Play!

Columbine Commons Assisted Living Windsor 449-5540

www.columbinehealth.com

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SUBSTANCE ABUSE, MENTAL ILLNESS CAN BE CHALLENGES FOR SENIORS

By Dee McClure For The Tribune

Seniors face significant life changes that put them at risk for mental health and substance use disorder challenges. Retirement, death or illness of loved ones, increased fears, physical ailments, loneliness and isolation, loss of career, and even medications can make one feel depressed or anxious, impacting energy, sleep, work, hobbies and relationships.

Older adults may also have little understanding of depression and anxiety, thinking that these emotions are a normal part of aging. Many can also miss the connection between these feelings and physical illness.

Depression and anxiety aren’t always identified by sadness and

» Mental illness One in four adults suffers from a diagnosable mental illness or substance use disorder. Many of these adults are seniors.

constant worry. Other symptoms to watch for: » Sleep disturbances (difficulty falling or staying asleep, oversleeping, or daytime sleeping) » Increased use of alcohol or drugs » Weight loss or loss of appetite » Social withdrawal or isolation (a reluctance to socialize or leave home) » Losing interest in family activities, hobbies or other pleasurable activities » Fatigue

» North Range Behavioral Health Peer Counseling Program (970) 347-2125 or (970) 347-2120 » Program started in 1976. » Serves hundreds of Weld County residents. » 14 Peer Counselors (including Spanish-speaking). » Clients can be seen in the privacy of their own home or apartment, assisted living, nursing facility or in the community. » No charge for program; funded by Weld County Agency on Aging.

» Hopelessness or helplessness » Loss of self-worth » Irritability » Neglecting personal care (forgetting meds, ignoring personal hygiene) » Excessive worrying or fretting over seemingly ordinary issues The good news is that regardless of age, you don’t have to

suffer with depression or anxiety.

For seniors, one effective way to address these challenges is peer counseling. Peer counselors are older adults trained to work with seniors and their families.

They provide encouragement and support, and they are often able to help older adults cope with the stress and problems that accompany aging. Unlike younger

counselors, they have usually experienced many of these same challenges and can relate effectively and easily with older adults.

There are many positive aspects to aging. It is challenging but healthy to grieve the losses that come with growing older. There is also joy and hope in realizing that there is always more to do and that your life has made a difference. While seniors face difficult challenges, they also have wonderful resilience, strong problem-solving skills, and wise perspectives and insights — all strengths that need to be recognized, embraced and celebrated.

Dee McClure is a licensed professional counselor and certified addiction counselor at North Range Behavioral Health.

Education center awards scholarships to health professionals Centennial Area Health Education Center is proud to announce the regional 2014 Health Professions Scholars.

The scholarships in the amount of up to $30,000 and were awarded to health care professionals who excel in leadership, service to others, and overall commitment to their profession and the rural communities.

The scholarship is for up to two years for professional study and is open to health professions students. Nurse practitioners, behavioral health, and physician assistants are favored for 75 percent of the scholarships. The other 25 percent go to other health fields.

This scholarship program is sponsored by The Colorado Health Foundation, the El Pomar Foundation and Colorado AHEC.

It is anticipated that over 114,000 rural and/or underserved individuals will be impacted by these scholars each year. The Centennial Area Health Education Center is proud to announce Linda Tuzzolino and Keli Sherman as the northeastern Colorado recipients of this distinguished honor.

Both students were selected based upon their Monica outstanding DANIELSleadership, comMIKA mitment to their For The professions and Tribune the region. Both have demonstrated leadership and hard work both in and out of the classroom.

Sherman attends the Univer-

sity of Colorado at Denver, where she has been admitted into the rural track of the physician assistant program. With the help of the program, she will prepare to start her career as a rural healthcare provider.

“I will use the knowledge and skills I have gained from shadowing, volunteering, and teaching Sherman to further my education and strive to be the best rural healthcare provider possible,” she said. Sherman will graduate in May 2017 Tuzzolino is a student at Regis University. Upon obtaining her credentials as a family nurse practitioner, she plans to work

in a community health clinic in a rural setting in eastern Colorado.

“This solidified my commitment to working with underserved patients,” she said.

“My hope is to serve in an area of great need providing people with the tools, support, and medical care that will empower them to make better health Tuzzolino choices in life.”

She plans to graduate in May 2016 We are pleased to sponsor both of these scholars. The Centennial Area Health Education Center is a nonprofit organization committed to education and professional advancement of cur-

rent and future health care workers. The Centennial Area Health Education Center jumped at the chance to partner with the Colorado Area Health Education Center and the El Pomar Foundation to implement this scholarship program and bring aid to some of our most outstanding healthcare professional students committee to serving the region.

CAHEC’s mission is to promote equity in health and health care through professional education with an emphasis on workforce development. To learn more about CAHEC and the scholarship programs we participate in, go to www.cahec.org.

Monica Daniels-Mika is the executive director of the Centennial Area Health Education Center.

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August 27, 2014

KIDDO CRUSAD

School health clerks on the front lines of treat

I

By CASEY KELLY ckelly@greeleytribune.com

t’s only the second day of school, but Billie Martinez Elementary School Health Clerk Blanca Rivera doesn’t have enough fingers on two hands to count the number of students she’s seen in the health office so far this year.

“Yesterday I had five kids. Today I’ve already passed that,” she said about 10 a.m., as one student rested in her office. “Right now I have one laying down with really bad allergies. He’s going home, and we’re referring him to a doctor.”

Rivera has been a health clerk at the school for six years, where she works with students suffering from both simple and serious health-related issues. Greeley-Evans School District 6 has more than 30 health clerks like Rivera who not only see ill students, but also help them take their daily medications and maintain the health offices at each of the district’s schools.

“In our district, we’re lucky that we have a trained health clerk in each of our school buildings,” said Maribeth Appelhans, lead school nurse consultant for the school district. “They are on the front lines every day, taking care of kids, doing first aid as needed, calling parents as needed. You name it, they do it.”

Rivera said the busiest part of her day is during the lunch hour, when many kids who require daily medications come to her office to get them. The lunch hour also is when she tends to see playground injuries from recess, such as scraped knees or finger injuries.

JOSHUA POLSON/jpolson@greeleytribune.com

BLANCA RIVERA HELPS A student pick out a book as he waits for his parents to pick him up from school Aug. 15 at Billie Martinez Elementary School in Greeley.

“It’ll get to where it’s nonstop sometimes,” Rivera said.

“Those are busy hours.”

She said she commonly sees kids for symptoms such as coughs, sore throats and fevers.

On the first day of school in mid August, she saw a young girl suffering from blisters

» Back-to-school healthy tips » Eat nutritious meals » Drink adequate fluids » Get enough sleep » Wash hands thoroughly,

caused by her new shoes and another whose mosquito bites

several times a day » Keep kids home when their symptoms indicate they may be contagious to others

were bleeding from scratching them too much.

Rivera said her job is not only to help kids with their health, but also cheer them up and make them feel comfortable at school. For instance, a girl new to the school came to her wheezing from her asthma to get her inhaler, and when she left Rivera’s office, she was

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ting sick students » When should you keep your child home from school? » Cough — Recommended for students experiencing severe, uncontrolled coughing or wheezing, or difficulty breathing. » Stomach ache — Recommended if the pain is severe, if the pain appears after an injury, or if the student had symptoms in addition to the stomach ache such as vomiting, fever, diarrhea, etc. » Fever — Recommended if the student has symptoms in addition to the fever such as a rash, sore throat, vomiting, diarrhea, etc. Student should be fever free for 24 hours without medication before returning to school. » Contagious illness — Students on antibiotics for contagious illnesses, such as strep throat, tonsillitis, bronchitis, pinkeye or pneumonia, must stay home until antibiotic has been taken for 24 hours. All skin lesions must be covered by a bandage or clothing during the school day. This may include impetigo, ring worm, scabies, and other fungal, bacterial or viral skin infections.

This is only a partial list of symptoms that may indicate your child should be kept home from school. For a complete list of symptoms and exclusions, go to http://tinyurl.com/kct49gg.

in a much better mood than when she arrived, Rivera said.

“When she left, I said ‘see you later.’ And she turned around and said ‘see you later, alligator.’ I thought that was cute for a new student,” Rivera said.

Some of the common illnesses seen in the schools are viruses such as the common cold and gastrointestinal viruses, Appelhans said. Children are checked for symptoms when they are ill and then health services staff follows specific guidelines from the Colorado Department of Public Health and Environment for either keeping them in school or sending them home.

Appelhans said the district’s health services department also works to prevent illness

and promote attendance. The district tracks students’ immunization records and follows up with parents if their child isn’t up to date with the state-required immunizations. The department works with parents to help get kids access to care, like with recent vaccination clinics coordinated by the Weld County Department of Public Health and Environment and Sunrise Community Health to offer free tetanus, diphtheria and pertussis vaccines to middle school students.

“I love the kids,” Rivera said.

“Sometimes they’re funny, sometimes they’re serious, but you have to make them laugh.

The main thing is to show them love. Some of them don’t get that at home, so we show it to them here.”

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Kids’ brains reorganize when learning math skills Associated Press WASHINGTON — Sometime in elementary school, you quit counting your fingers and just know the answer. Now scientists have put youngsters into brain scanners to find out why, and watched how the brain reorganizes itself as kids learn math.

The take-home advice: Drilling your kids on simple addition and multiplication may pay off.

“Experience really does matter,” said Dr. Kathy Mann Koepke of the National Institutes of Health, which funded the research.

Healthy children start making that switch between counting to what’s called fact retrieval when they’re 8 years old to 9 years old, when they’re still working on fundamental addition and subtraction.

How well kids make that shift to memory-based problem-solving is known to predict their ultimate math achievement.

Those who fall behind “are impairing or slowing down their math learning later on,” Mann Koepke said.

But why do some kids make the transition easier than others?

To start finding out, Stanford University researchers first peeked into the brains of 28 children as they solved a series of simple addition problems inside a brain-scanning MRI machine.

No scribbling out the answer: The 7- to 9-year-olds saw a calculation — three plus four equals seven, for example — flash on a screen and pushed a button to say if the answer was right or wrong. Scientists recorded how quickly they responded and what regions of their brain became active as they did.

In a separate session, they also tested the kids face to face, watching if they moved their lips or counted on their fingers, for comparison with the brain data.

ASSOCIATED PRESS

THIRD-GRADE TEACHER MELISSA GRIESHOBER teaches a math lesson at Silver Lake Elementary School in Middletown, Del., last year.

The children were tested twice, roughly a year apart. As the kids got older, their answers relied more on memory and became faster and more accurate, and it showed in the brain. There was less activity in the prefrontal and parietal regions associated with counting and more in the brain’s memory center, the hippocampus, the researchers reported.

The hippocampus is sort of like a relay station where new memories come in — short-term working memory — and then can be sent elsewhere for longer-term storage and retrieval. Those hippocampal connections increased with the kids’ math performance.

“The stronger the connections, the greater each individual’s ability to retrieve facts from memory,” said Dr. Vinod Menon, a psychiatry professor at Stanford and the study’s senior author.

But that’s not the whole story.

Next, Menon’s team put 20 adolescents and 20 adults into the MRI machines and gave them the same simple addition problems. It turns out that adults don’t use their mem-

ory-crunching hippocampus in the same way. Instead of using a lot of effort, retrieving six plus four equals 10 from long-term storage was almost automatic, Menon said.

In other words, over time the brain became increasingly efficient at retrieving facts. Think of it like a bumpy, grassy field, NIH’s Mann Koepke explained. Walk over the same spot enough and a smooth, grass-free path forms, making it easier to get from start to end.

If your brain doesn’t have to work as hard on simple math, it has more working memory free to process the teacher’s brand-new lesson on more complex math.

While the study focuses on math, Mann Koepke said cognitive development in general probably works the same way. After all, kids who match sounds to letters earlier learn to read faster.

Stanford’s Menon said the next step is to study what goes wrong with this system in children with math learning disabilities, so that scientists might try new strategies to help them learn.

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APPLE, GOOGLE, VCS INVEST IN HEALTH TECHNOLOGY

By Brandon Bailey

» HEALTH TECH FUNDING

San Jose Mercury News

It’s no coincidence that archrivals Apple and Google launched competing software initiatives this summer for wearable gadgets that track fitness and health.

Health technology is hot in the Bay Area, where some of the biggest tech companies and a swarm of startups are working on everything from doctor-recommendation apps and video diagnostic services to data-crunching analytics and cutting-edge DNA sequencing.

Hoping to capitalize on the power of mobile computing, artificial intelligence and new analytics software — as well as new laws and the sense that a bloated health care industry is ripe for new efficiencies — venture capital firms and big tech companies are pouring vast sums into new medical technology.

The pending “collision of new technology and the life sciences” will bring radical change to “what health care means and what it looks like, in the next 20 years,” said Bill Maris, managing partner of Google Ventures, the Internet giant’s in-house investing arm.

Some entrepreneurs want to change the way people interact with doctors and insurance companies. Others believe they now have the tools to unlock the genetic secrets of health and serious disease, and to identify effective treatments by analyzing mountains of data.

Venture capitalists poured a record $2.3 billion into digital health companies during the first half of 2014, according to a report by startup accelerator Rock Health, which identified six major types of health technology being funded: » Digital medical devices ($206 million) » Data collection and analytics ($196 million) » Consumer tools for buying health care or insurance ($193 million) » Software to help providers track patients’ health and treatment effectiveness ($162 million) » Software for tailoring treatment to patients’ genetic information ($150 million) Source: Rock Health 2014 Midyear Digital Health Funding Update

And some just want to help you lose a few pounds.

In just the first six months of 2014, investors put a record $2.3 billion into digital health startups — or slightly more than the $2 billion invested in all of 2013, according to a survey by Rock Health, which funds health tech companies.

Health companies are also hot on Wall Street: The Ipreo research firm counted 52 initial public offerings in the first half of 2014, compared with 53 in all of last year.

Some of the valley’s commercial tech giants have dabbled in health before. Intel has long promoted its processors for specialized devices that monitor patients at home and in clinical settings. Hewlett-Packard has sold commercial computer systems tailored to the needs of hospitals and biotech labs. IBM has studied public health data at its San Jose research lab.

Now, major tech companies are seeing gold in new consumer health products.

At its annual developer conference in June, Apple introduced a new “Health” app for tracking a user’s heart rate, sleep patterns, calorie intake and other health metrics. Apple also launched “Health Kit,” an Internet platform for app developers that can store data from different devices and share it with a user’s doctor or health system.

Three weeks later, Google announced its own initiative, called “Fit,” which includes developer tools and an online platform for collecting data.

Google co-founders Larry Page and Sergey Brin also have a long-standing interest in health research. Google Ventures is a longtime backer of 23andMe, the personal genetics startup led by Brin’s wife, Anne Wojcicki. While that firm has run into regulatory

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hurdles, Google launched a spinoff company last fall with the ambitious aim of combating “aging and associated diseases” on a cellular level.

Meanwhile, researchers at Google’s secretive X division are working on wearable medical devices, including a “smart” contact lens that monitors a wearer’s glucose level. The same team is building a database of genetic and molecular information from healthy volunteers, which they hope to analyze for useful medical knowledge.

Google Ventures is backing at least a dozen other life science companies, ranging from Doctor on Demand, a consumer service that arranges online video consultations, to Flatiron Health, which is hoping to mine useful information from digitized data collected by cancer-treatment providers and researchers.

Data-driven medicine is a key element of the Affordable Care Act, the federal law that implemented President Barack Obama’s health care reforms, which experts say is a major force behind the boom in new health technology. At Rock Health, managing director Malay Gandhi said he’s seen the impact in two ways: First is the wave of new online startups that provide ratings and information or help consumers find health-related services in new ways. These include startups such as San Francisco’s Stride Health,

a Web service that compares and recommends insurance plans, and Studio Dental, which describes itself as an “Uber for your teeth” because it lets users make appointments online with a dentist who comes to their workplace with a fully equipped van.

Second, Gandhi said, the law provides powerful financial incentives for doctors and hospitals to show the effectiveness of their care, which is sparking demand for new software to track and analyze patient data. Currently, experts believe as much as a third of health spending in the United States is wasted or unnecessary, said Ed Yu, a health industry expert at PricewaterhouseCoopers.

In yet another trend, Yu said he’s seeing a wave of new Bay Area startups that help drug retailers and other companies operate “social listening” websites, where patients and their families can share information with others who are affected by a particular disease.

Surveys show many consumers still have reservations about sharing health information online. The Federal Trade Commission has also raised concerns about health apps sharing data with advertisers or other third parties.

But tech companies are working on that, too. Mountain View, Calif., startup TrueVault makes software that helps app developers meet privacy and security standards required by federal health law.

What to do in northern Colorado.

August 27, 2014

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THINKING ABOUT HEALTH

PUSHING BACK ON HIGH DRUG COSTS?

By Trudy Lieberman Rural Health News Service

Many Americans have begun to realize they’re paying too much for prescription drugs. And maybe — just maybe — a national conversation on the topic has begun, sparked by the introduction last year of Sovaldi, touted as the most effective way to treat patients with hepatitis C. The problem is Sovaldi’s hefty price tag — $84,000 for a threemonth regimen — and the fact that insurers have begun factoring the price they are paying for the drug into the premiums all of us will pay for health insurance in the next few years. UnitedHealth Group announced it had already paid $100 million to cover Sovaldi for its policyholders in the first three months of this year.

To get an idea how Sovaldi could crowd out spending for other healthcare needs, let’s look at Oregon. One of the state’s Medicaid managed care organizations noted that if 30 percent, or 814 members out of a total of 2,466 with hepatitis C, got the drug, the cost would be about $68 million. Compare this to the $72 million the health plan spent for all its pharmaceuticals last year, and you get the point.

I have written about Sovaldi before in a “Thinking About Health”

column. Since then a Washington-based group called the National Coalition on Health Care, which counts insurers, employers, unions, providers, and faith-based organizations among its members, has launched the Campaign for Sustainable Rx Pricing.

CEO John Rother says it’s an effort to discuss possible solutions for rapidly escalating drug prices. Rother, who is the former chief lobbyist for AARP, and helped pass the Medicare prescription drug law a decade ago, knows a thing or two about drugs.

He told me that since the drug law passed, price increases have been held in check largely because of the greater use of generic substitutes. Not so any more with the debut of Sovaldi and with some 200 specialty drugs in the pipeline, which may be priced as high as Sovaldi. The country, he says, is headed down an unsustainable path when it comes to paying for medicines.

As a country we’ve rarely asked whether paying for these super high-priced drugs means we may have to forego other healthcare services.

Insurers, employers, Medicare and Medicaid have rarely blinked.

They’ve just paid the bills.

Nor have payers always carefully scrutinized the evidence that a new expensive medicine actually

did what the drug maker claimed it would do. They paid even when there was little evidence a drug was effective. This time it’s different.

The California Technology Assessment Forum, a private group funded by insurers, has recommended that Sovaldi be used only for the sickest patients. In Oregon the Center for Evidence-Based Policy established by the governor a decade ago and based at the Oregon Health & Science University has said there have been no long-term trials, and many of those trials that have taken place were laced with conflicts of interest. It recommends more comparative studies

and restricting use for now.

The U.S. has no official oversight agency like the National Institute for Health and Care Excellence — known as NICE — in the U.K., which evaluates new drugs and technologies and makes recommendations to the National Health Service.

NICE will complete its review in the fall. Meanwhile the British health service is paying the equivalent of $32 million to treat 500 of the sickest patients.

There’s zero chance the U.S. will adopt a NICElike organization any time soon. The Affordable Care Act prohibits the Patient-Centered Outcomes Research Institute,

created by the ACA, from considering costs when it evaluates the effectiveness of various treatments. And Medicare is not allowed to consider cost in deciding whether to cover a drug or a device. The government’s hands are tied.

Rother’s group will have to figure out a way to evaluate cost and effectiveness within the health system’s political boundaries. That won’t be easy, and the drug industry is pushing back.

Drug makers want the government to make insurers absorb the extra cost rather than passing them along to patients in the form of higher copays and coinsurance for those who need the drug.

That’s not really a solution, Rother says.

“High-cost drugs raise premiums and threaten funding for important health services. Ultimately the individual pays the costs one way or another. The fundamental problem is the unnecessary high prices of some drugs, not which pocket the consumer uses to pay for them.”

Editor’s note: 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 and the South Dakota Newspaper Association.

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TRiBUNE MEDiCAL DiRECTORY ACUPUNCTURE

PHYLLIS HAMAR, L.A.C.

Master of Science, Traditional Chinese Medicine NCCAOM Board Certified 710 11th Ave., Ste. 106 Greeley, CO 80631 970-539-0324

WESTLAKE FAMILY PHYSICIANS, PC 5623 W. 19th Street Greeley, CO Phone: (970) 353-9011 Fax: (970) 353-9135 Professionals: Richard Budensiek, DO; Janis McCall, MD; Frank Morgan, MD; Jacqueline Bearden, MD; Angela Mill, MD Website: www.bannerhealth.com

ALLERGY AND ASTHMA

COLORADO ALERGY & ASTHMA CENTERS, P.C. 7251 W. 20th Street, Bldg N, Ste 1 Greeley, CO 80634 Phone: (970) 356-3907

1136 E. Stuart St, Bldg 3, Ste 3200 Ft. Collins, CO 80525 Phone: (970) 221-1681 4700 E. Bromley Ln., Ste 207 Brighton, CO 80601 Phone: (303) 654-1234 www.coloradoallergy.com Professionals: Dr. Daniel Laszlo Dr. John James

NORTHERN COLORADO ALLERGY & ASTHMA

Greeley Phone: (970) 330-5391 Loveland Phone: (970) 663-0144 Ft. Collins Phone: (970) 221-2370 www.NCAAC.com Professionals: Dr. Vel Kailasam, MD Krishna C. Murthy, MD Loran Clement, MD Michael Martucci, MD

ALZHEIMER’S/SKILLED CARE

BONELL GOOD SAMARITAN 708 22nd Street Greeley, CO 80631 Phone: (970)352-6082 Fax: (970)356-7970 Web Site: www.good-sam.com

GRACE POINTE

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

MEADOWVIEW OF GREELEY

5300 29th Street Greeley, CO 80634 Phone: (970)353-6800 Web Site: www.meadowviewofgreeley.com

ASSISTED LIVING

BONELL GOOD SAMARITAN 708 22nd Street Greeley, CO 80631 Phone: (970) 352-6082 Fax: (970) 356-7970 www.good-sam.com

COLUMBINE COMMONS

BALANCE

LIFE CARE CENTER OF GREELEY- ASCENT 4800 25th Street Greeley, CO 80634 Phone: (970)330-6400 Professionals: Cozette Seaver, PT; Leslie Vail, PT

CARDIAC VASCULAR SURGERY

1475 Main Street Windsor, CO 80550 Phone: (970) 449-5540 Web Site: www.columbinehealth.com

GRACE POINTE

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

HEART FAILURE CLINIC (NCMC) DENTISTRY

5300 29th Street Greeley, CO 80634 Phone: (970)353-6800 Web Site: www.meadowviewofgreeley.com

ASCENT FAMILY DENTAL Scott Williams, DMD 3535 W. 12th Street, Suite B Greeley, CO 80634 Phone: (970)351-6095 www.dentalgreeley.com

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

JULIE KAVANAUGH, D.D.S.

AUDIOLOGY 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 Web Site: www.allabouthearing.com Professionals: Renita Boesiger, M. A., CCC-A Rachel White, M. A., CCC-A Cheryl Hadlock, M. S., CCC-A

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

UNC AUDIOLOGY CLINIC

Gunter Hall, Room 0330 Greeley, CO 80639 Phone: (970)351-2012/TTY Fax: (970)351-1601 Web Site: www.unco.edu/NHS/asls/clinic.htm Professionals: Diane Erdbruegger, Au.D., CCC-A; Erinn Jimmerson, M.A., CCC-A Jennifer Weber, Au.D., CCC-A

1800 15th Street, #310 Greeley, CO 80631 Phone: (970) 392-0900 Professionals: James H. Beckmann, MD; Harold L. Chapel, MD; John Drury, MD; Lin-Wang Dong, MD; Cynthia L. Gryboski, MD; Cecilia Hirsch, MD; Paul G. Hurst, MD; Brian Lyle, MD; Randall C. Marsh, MD; Arnold Pfahnl, MD; James E. Quillen, MD; Gary A. Rath, MD; Shane Rowan, MD; Ahmad Shihabi, MD; Stephen Zumbrun, MD (970) 350-6953 Missy Jensen, FNP-C

MEADOWVIEW OF GREELEY

ALPINE ALL ABOUT HEARING

CARDIOVASCULAR INSTITUTE (NCMC)

CARDIAC, THORACIC & VASCULAR SURGERY (NCMC) 1800 15th Street, Suite 340 Greeley, CO 80631 Phone: (970)378-4593 Fax: (970)378-4391 Professionals: Lyons, Maurice I. Jr. DO Richards, Kenneth M. MD Tullis, Gene E. MD

CARDIOLOGY

3400 W. 16th Street, Suite 8-E Greeley, CO 80634 Phone: (970)351-0400 www.drjuliekav.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

ENDOCRINOLOGY

ENDOCRINOLOGY CLINIC (NCMC) 1801 15th Street, Ste 200 Greeley, CO 80631 Phone: (970)378-4676 Fax: (970)-378-4315 www.bannerhealth.com Professionals: Nirmala Kumar, MD Kimberly Rieniets, MD Corinn Sadler, MD

FAMILY PRACTICE MEDICINE

BANNER HEALTH CLINIC 1300 Main Street Windsor, CO 80550 Phone: 970-686-5646 Fax: 970-686-5118 Providers: Jonathan Kary, M.D. Trina Kessinger, M.D. Anthony Doft, M.D.

BANNER HEALTH CLINIC

100 S. Cherry Ave., Suite 1 Eaton, CO 80615 Phone: (970)454-3838 Professionals: Marianne Lyons, DO Lance Barker, DO, Internal Medicine

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2014 BANNER HEALTH CLINIC

222 Johnstown Center Drive Johnstown, CO 80534 Phone: (970)587-4974 Professionals: Cara Brown, MD J.Matthew Brown, MD Joseph Gregory, MD Courtney Isley, MD Stephen Kalt, MD, Internal Medicine Thomas Kenigsberg, MD

FAMILY PHYSICIANS OF GREELEY, LLP-CENTRAL 2520 W. 16th Street Greeley, CO 80634 (970) 356-2520 Fax: (970) 356-6928 Professionals: Joanna H. Branum, M.D. Angela M. Eussen, PA-C Jennifer D. Dawson , D.O. Douglas A. Magnuson, M.D. Paul D. Lobitz, M.D. Lori A. Ripley, M.D. D.Craig Wilson, M.D.

FAMILY PHYSICIANS OF GREELEY, LLP-COTTONWOOD 2420 W 16th Street Greeley, CO 80634 (970) 353-7668 Fax:970-353-2801 Professionals: Stacey L. Garber, M.D. Amy E. Mattox, M.D. Christopher T. Kennedy, M.D. Daniel P. Pflieger, M.D. Mark D. Young, M.D.

FAMILY PHYSICIANS OF GREELEY, LLP-WEST 6801 W. 20th St., Suite 101 Greeley, CO 80634 (970) 378-8000 Fax: (970) 378-8088 Professionals: Nathan E. Bedosky, PA-C Ann T. Colgan, M.D. Daniel R. Clang, D.O. Tamara S. Clang, D.O. R. Scott Haskins, M.D. Mathew L. Martinez, M.D. Chima C. Nwizu, M.D Michelle K. Paczosa, D.O. Andrew P. Stoddard, M.D. Kyle B. Waugh, M.D. Charles I. Zucker, M.D.

KENNETH M. OLDS

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

WESTLAKE FAMILY PHYSICIANS, PC 5623 W. 19th Street, Greeley, CO Phone: (970) 353-9011 Fax: (970) 353-9135 Professionals: Richard Budensiek, D.O.; Jacqueline Bearden, MD; Tong Jing, MD; Janis McCall, MD; Frank Morgan, MD; David Puls, D.O. www.bannerhealth.com

August 27, 2014

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TRiBUNE MEDiCAL DiRECTORY DiRECTORY TRiBUNE MEDiCAL FUNERAL SERVICES

ALLNUTT & RESTHAVEN FUNERAL SERVICES

702 13th Street, Greeley, CO Phone: (970) 352-3366 650 W. Drake Road, Ft. Collins, CO Phone: (970) 482-3208 8426 S. College Avenue, Ft. Collins, CO Phone: (970) 667-0202 2100 N. Lincoln, Loveland, CO Phone: (970) 667-1121 1302 Graves Avenue, Estes Park, CO Phone: (970) 586-3101

GASTROENTEROLOGY

HEALTH AND FITNESS

INDEPENDENT ASSISTED LIVING W/SERVICES

WORK OUT WEST

NCMC - BEHAVIORAL HEALTH

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

Dr Patricia Al-Adsani, Child and Adolescent Psychiatry Banner Health Clinic-Internal Medicine 2010 16th Street, Suite C, Greeley, CO 80631 Banner Health Clinic- Windsor 1300 Main Street, Windsor, CO 80550

HOME HEALTH CARE

Shawn Crawford, LPC Banner Health Clinic 222 Johnstown Center Dr., Johnstown, CO 80534 Banner Health Clinic-Internal Medicine 2010 16th Street, Suite C Greeley, CO 80631

CARING HEARTS HOME HEALTHCARE 6801 W. 20th Street, Suite 207 Greeley, CO 80634 Phone: (970)378-1409

BLOOM AT HOME

COLUMBINE POUDRE HOME CARE

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

REHABILITATION AND VISITING NURSE ASSOCIATION

BONELL GOOD SAMARITAN

Elise Pugh, LPC Banner Health Clinic Westlake 5623 W 19th St, Greeley CO 80631 Banner Health Clinic 1300 Main Street Windsor, CO 80550

FOX RUN SENIOR LIVING

Susan Goodrich, LCSW Banner Health Clinic-Loveland Pediatrics Loveland Pediatrics, Loveland CO Banner Health Clinic- Windsor 1300 Main Street Windsor CO, 80550

1455 Main Street Windsor, CO 80550 Phone: (970) 460-9200 Web Site: www.columbinehealth.com/bloom 1455 Main Street Windsor, CO 80550 Phone: (970) 460-9200 Web Site: www.columbinehealth.com

2105 Clubhouse Drive Greeley, CO 80634 Phone: (970) 330-5655 Fax: (970) 330-7146 Web Site: www.rvna.info Professionals: Crystal Day, CEO

HOSPICE

HOSPICE OF NORTHERN COLORADO

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 Website: www.digestive-health.net

NORTH COLORADO GASTROENTEROLOGY (NCMC) 2010 16th Street, Ste. A Greeley, CO 80631 Phone: (970)378-4475 Fax: (970)378-4429 Professionals: Tong Jing, MD Mark Rosenblatt, MD Ahmed M. Sherif, MD Yazan Abu Qwaider, MD

MENTAL HEALTH SERVICES

Administration Office 2726 W. 11th Street Road Greeley, CO 80634 Phone: (970)352-8487 Fax: (970)475-0037

PATHWAYS HOSPICE

305 Carpenter Road Ft. Collins, CO 80550 Phone: (970)663-3500 Fax: (970)292-1085 Web Site: www.pathways-care.org Email: info@pathways-care.org

INDEPENDENT ASSISTED LIVING

GRACE POINTE

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

MEADOWVIEW OF GREELEY

5300 29th Street Greeley, CO 80634 Phone: (970)353-6800 Website: www.meadowviewofgreeley.com

708 22nd Street Greeley, CO 80631 Phone: (970)352-6082 Fax: (970)356-7970 Web Site: www.good-sam.com 1720 60th Avenue Greeley, CO 80634 Phone: (970)353-7773 Fax: (970)330-9708 Web Site: www.good-sam.com

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 Professionals: Danielle Doro, MD Giovanna Garcia, MD

MEDICAL EQUIPMENT & SUPPLIES

BANNER HOME MEDICAL EQUIPMENT (NCMC) Phone: (970)506-6420

COLUMBINE MEDICAL EQUIPMENT 1455 Main Street Windsor, CO 80550 (970) 460-9205 Web Site: www.columbinehealth.com

Renee Rogers, LMFT Banner Health Clinic 1300 Main Street, Windsor, CO 80550 Banner Health Clinic 303 Colland Drive, Fossil Creek Fort Collins, CO 80525

NORTH RANGE BEHAVIORAL HEALTH Adult Mental Health & Addictions Services 1260 H Street; 1306 11th Avenue; 1309 10th Avenue 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 Stabilization Services Crisis & Detox Services 1140 M Street, Greeley, CO 80631 970.347.2120 South County Program Adult, Children, & Family Mental Health & Addiction Services 145 1st Street, Fort Lupton, CO 80621 303.857.2723 Suicide Education & Support Services (SESS) Prevention, Education & Grief Support 2350 3rd Street Road, Greeley, CO 80631 970.347.2120 or 970.313.1089

2010 2014 NEPHROLOGY

GREELEY MEDICAL CLINIC

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

NEUROLOGY

CENTENNIAL NEUROLOGY Dr. David Ewing 7251 W. 20th Street, Unit C Greeley, CO 80634 Phone: (970) 356-3876

NEUROLOGY CLINIC (NCMC) 1800 15th Street, Suite 100B Greeley, CO 80631 Phone: (970) 350-5612 Fax: (970) 350-5619 Professionals: Barbara Hager, MD Todd Hayes, DO William Shaffer, MD Christy Young, MD

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TRiBUNE MEDiCAL DiRECTORY NEURO-SURGERY BRAIN & SPINE

BANNER HEALTH NEUROSURGERY CLINIC 1800 15th St., Suite 130 Greeley, CO 80631 Phone: (970)350-5996 Professionals: David Blatt, MD Beth Gibbons, MD

NURSING HOME REHABILITATION

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

COLUMBINE COMMONS HEALTH & REHAB FACILITY 1475 Main Street Windsor, CO 80550 Phone: (970) 449-5541 Web Site: www.columbinehealth.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 Website: www.drbradsmiles.com

ORTHOPEDICS

MOUNTAIN VISTA ORTHOPAEDICS 5890 W. 13th Street, Suite 101 Greeley, CO Phone: (970)348-0020 Fax: (970)348-0044 Web Site: www.bannerhealth.com Professionals: Randy M. Bussey, MD Riley Hale, MD Daniel Heaston, MD Thomas Pazik, MD Kelly R. Sanderford, MD Steven Sides, MD Linda Young, MD

OBSTETRICS & GYNECOLOGY

BANNER HEALTH GYN CONSULTANTS 1800 15th St., Suite 130 Greeley, CO 80631 Phone: (970)353-1335 Professionals: Susan Carter, MD

BANNER HEALTH OB/GYN CLINIC 2410 W. 16th Street Greeley, CO 80634 Phone: (970)352-6353 Professionals: Neil Allen, MD Laurie Berdahl, MD

WESTLAKE FAMILY PHYSICIANS, PC 5623 W. 19th Street Greeley, CO Phone: (970) 353-9011 Fax: (970) 353-9135 Professionals: Jacqueline Bearden, MD; Richard Budensiek, D.O.; Janis McCall, MD; Frank Morgan, MD; David Pols, D.O. 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 Professionals: Jeffrey Albert, MD Elizabeth Ceilley, MD Brian Fuller, MD Benjamin George, MD Samuel Shelanski, MD Kerry Williams-Wuch, MD Alice Wood, MD Ariel Soriano, MD

PEDIATRICS

BANNER HEALTH CLINIC 6801 W. 20th Street, Suite 201 Greeley, CO 80634 Phone: (970)350-5828 www.bannerhealth.com Professionals: Amanda Harding, MD James Sando, MD

PHYSICAL THERAPY

FRONT RANGE THERAPY

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

HOPE THERAPY CENTER (Formerly North Colorado Therapy Center) 2780 28th Avenue, Greeley, CO 80634 Phone: (970)339-0011 Website: 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 Website: NCRH@ernesthealth.com

PULMONARY/CRITICAL CARE

NORTH COLORADO PULMONARY (NCMC)

1801 16th Street, Greeley, CO 80631 Phone: (970)392-2026 Professionals: Kelli Janata, DO Robert Janata, DO David Fitzgerlad, DO Michael Shedd, MD Danielle Dial, NP

PEDIATRIC REHABILITATION

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

PERSONAL RESPONSE SERVICE

BANNER LIFE LINE (NCMC)

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

PROSTHETICS & ORTHOTICS

CERTIFIED PROSTHETICS & ORTHOTICS, LLC (GREELEY LOCATION)

1620 25th Avenue, Suite A, Greeley, CO 80634 Phone: 970-356-2123 Fax: 970-352-4943

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 Website: 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 Phone: (970)350-6160

COLUMBINE COMMONS HEALTH & REHAB FACILITY 1475 Main Street Windsor, CO 80550 Phone: (970) 449-5541 Web Site: www.columbinehealth.com

FRONT RANGE THERAPY

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

NORTHERN COLORADO REHABILITATION HOSPITAL

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

PEAKVIEW MEDICAL CENTER

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

RESPITE/ADULT DAY CARE

ELDERGARDEN ADULT DAY CARE 910 27th Avenue Greeley, CO 80634 970-353-5003 Website: www.eldergarden.org Sliding scale fee or no fee for Medicaid Enrollment process required

SKILLED CARE/REHAB

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2014 BONELL GOOD SAMARITAN 708 22nd Street, Greeley, CO 80631 Phone: (970)352- 6082 Fax: (970)356-7970 Website: www.good-sam.com

COLUMBINE COMMONS HEALTH & REHAB FACILITY 1475 Main Street Windsor, CO 80550 Phone: (970) 449-5541 Web Site: www.columbinehealth.com

GRACE POINTE

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

SPORTS MEDICINE

MOUNTAIN VISTA ORTHOPAEDICS 5890 W. 13th Street, Suite 101, Greeley, CO Phone: (970)348-0020 Fax: (970)348-0044 Web Site: www.bannerhealth.com Professionals: Randy M. Bussey, MD Riley Hale, MD Daniel Heaston, MD Thomas Pazik, MD Kelly R. Sanderford, MD Steven Sides, MD Linda Young, MD

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

NORTHERN COLORADO REHABILITATION HOSPITAL

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

UNC SPEECH LANGUAGE PATHOLOGY CLINIC

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

August 27, 2014

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Devices slice time, distance for patients via ‘telemedicine’

By Joe Smydo Pittsburgh Post-Gazette

— Concerned about a growth on his face, Mt. Lebanon, Pa., resident, Robert Johnston could have made an appointment with the dermatologist already treating him for other reasons.

Instead, he snapped photos of himself and the affected area, uploaded them to the doctor’s website and waited.

“I got feedback from him the same day. It was probably within three, four hours,” Johnston, 52, who required follow-up care at the doctor’s office, said.

Such is the promise of telemedicine, the use of technology to connect patients and health care providers who may be miles or even half a world apart. The growing trend is touted as a way to increase

PITTSBURGH

access to medical care, especially among patients in remote areas, and to bring efficiency to an overburdened health care system.

It is, said Robert McCaughan, vice president for pre-hospital care services at Allegheny Health Network, one more way to improve care. It already is being used in dozens of specialties and, at least in the Pittsburgh area, on the front lines of emergency medicine.

McCaughan this year helped to establish what the network is billing as the state’s first pre-hospital telemedicine initiative.

When paramedics answered a June 30 diabetic emergency call in Leechburg, Pa., they brought a doctor with them. So to speak.

After assessing 59-year-old Barbara Verdu’s condition, paramedics used an iPad to set up an on-thespot video consultation with an emergency department physician

at Allegheny Valley Hospital, in Natrona Heights, Pa. In the end, patient and caregivers agreed that Verdu had no need for a hospital visit, a decision that saved her time and money, put the paramedics back in service for other calls and helped to prevent overcrowding in the hospital emergency department.

It was an interesting experience, said Verdu, who had called 911 after waking up with low blood sugar.

“I was just so nervous because it wasn’t going up,” she said.

The number of telemedicine services is increasing around the country, and research supporting the initiatives is growing, too. In July, for example, the journal General Hospital Psychiatry published a University of Pittsburgh School of Medicine study showing that telephone follow-up helped patients manage symptoms of depression — and reduce medical costs — fol-

lowing coronary artery bypass graft surgery.

The telemedicine market includes not only services provided by local health care organizations such as Allegheny Health Network and UPMC but those offered by outof-state, investor-backed networks, such as 12-year-old, Texas-based Teladoc and six-year-old Florida-based MDLIVE. While the concept may sound new to patients, telemedicine originated with doctor-to-doctor telephone consultations and has been evolving for at least 25 years, said Natasa Sokolovich, executive director of telemedicine for UPMC. “It’s been around for longer than I think most people realize,” Sokolovich said. A shortage of psychiatrists helped give telemedicine a boost in the early 2000s, she said.

Technological advances — some that have improved diagnostics and

TRiBUNE MEDiCAL DiRECTORY SURGERY GENERAL & TRAUMA

BARIATRIC SURGERY (NCMC)

1800 15th Street, Suite 200, Greeley, CO 80631 Phone: (970)378-4433 866-569-5926 Fax: (970)378-4440 Professionals: Michael W. Johnell, MD

SURGERY WESTERN STATES BURN CENTER (NCMC) 1801 16th Street, Greeley, CO 80631 Phone: (970)350-6607 Fax: (970)350-6306 Professionals: Gail Cockrell, MD Cleon W. Goodwin, MD BURN

SURGICAL ASSOCIATES OF GREELEY PC (NCMC)

1800 15th St. Suite 210, Greeley, CO Phone: (970)352-8216 Toll Free: 1-888-842-4141 Professionals: Molly Decker, DO; Michael Harkabus, MD; Jason Ogren, MD; Samuel Saltz, DO; Robert Vickerman, MD

URGENT CARE

SUMMITVIEW URGENT CARE 2001 70th Avenue, Greeley, CO 80634 Phone: (970)378-4155 Fax: (970)378-4151 www.bannerhealth.com Professionals: Susan Beck, MD Thomas Harms, MD Susan Kelly, MD Amy E. Shenkenberg, MD Linda Young, MD

UROLOGY

MOUNTAIN VISTA UROLOGY

5890 W. 13th Street, Suite 106, Greeley, CO 80634 Phone: (970)378-1000 Professionals: Curtis Crylen, MD David Ritsema, MD James Wolach, MD www.bannerhealth.com

VEINS

VEIN CLINIC (NCMC)

1800 15th Street, Suite 340, Greeley, CO 80631 Phone: (970)378-4593 Fax: (970)378-4591 Professionals: Maurice I. Lyons Jr., DO Kenneth M. Richards, MD Gene E. Tullis, MD

others that have ensured the confidentiality of patient communication — also have fueled the surge.

But insurance hasn’t yet caught up with the technology. In some cases, patients have to pay out of pocket for telemedicine, though the fees may be no more than the copay for an office visit.

In November, UPMC established AnywhereCare, offering around-the-clock consultation on common ailments. Patients log on to a website, answer a series of questions and usually get a diagnosis and treatment plan from a nurse practitioner, physician assistant or physician within 30 minutes.

If follow-up questions are necessary, Sokolovich said, patient and practitioner may communicate by phone, email or a video conferencing capability built into the website.

So far, the service has had more than 2,100 patient visits.

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Deafness and Rocket Science money and he later recalled, “I ate just black bread didn’t have even potatoes and tea. Instead I was buying books, pipes, sulfuric acid

Edward Ciołkowskia was a Polish orthodox priest who was deported deep into the heart of Russia on the order of Alexander II because of his political activities. Edward Russianized his name and married an educated Tartar woman; they had 18 children of whom Konstantin was fifth. Living about 120 miles south of Moscow in the Spassky District, young Konstantin’s father became a forester, teacher and later a low level government official that provided a meager but adequate income for his family.

As most Russian children of the time, Konstantin often time spent away from the tyrannical clutches of parental discipline and enjoyed roaming through domestic corridors and wild gardens. About 1866, he contacted Scarlet Fever and became hearing impaired from the disease. While Scarlet Fever is a disorder that affects the eardrum and middle ear bones that can be repaired in the 21st century, at the time it was a serious hearing loss there was no amplification (hearing aids). Konstantin lost a significant portion of his hearing and became isolated from his peers.

By the age 14, he was suspended from school, having acquired only a few brief years of formal education. As a reclusive home-schooled child, Konstantin passed much of his time by reading books and became interested in mathematics and physics. As a teenager, he began to contemplate the possibility of space travel, considered folly at the time. Encouraged by the boy’s crafty designs, Konstantin’s father agreed to pay for his education in Moscow, but Konstantin failed to enter the technical school there and decided on his own to stay in Moscow and educate himself by reading books. His father sent him little

(for experiments) and so on.” Konstantin’s arrival in Moscow, however, coincided with great changes in Russian society, arts and sciences. It was the age of Tchaikovsky, Dosteovsky and Dimitri Mendeleev who developed the first periodic table of elements. Nikolai Zhukovsky did his pioneering work on aerodynamics. He was teaching himself at the Chertkovskaya Library in Moscow where a very strange and brilliant man named Nikolai Fyodorov (1829-1903), a library employee. Konstantin taught himself math, took an active interest

The thought led Konstantin to think about outer space and the subject came to dominate the rest of his life. At the library, Konstantin came across Nikolai Fedorov (1829-1903), whose theories,- cosmism, however bizarre, captured his imagination.

In 1865 From the Earth to the Moon a novel by Jules Verne was also creating a stir.

After three years in Moscow, Konstantin returned home and earned his living with private tutoring, and later passed official exams to get the position of a teacher at a state school. Before taking his first teaching job, however, he built a centrifuge with the idea of testing gravitational effects. Local chickens served as his test subjects. He later came to believe that colonizing space would lead to the perfection of the human race, with immortality and a carefree existence. He taught arithmetic and geometry in the local school in Borokvsk, a small town 70 miles south of Moscow. There, he married Varvara Sokolova and raised a family. In 1892, Konstantin was promoted to another teaching position in Kaluga (about 200 km, 120 miles south of Moscow) where he spent most of his life in a log house until his death in 1935.

two other scientists, Robert Goddard and Hermann Oberth derived many of his basic principles around the same time (independently), it

was Tsiolkovsky who would later be given credit for inspiring and informing the fledgling Soviet space program that beat the US into space. In 1917, after the Bolshevik Revolution led to the creation of the Soviet Union, his work received formal recognition and in 1921 he was awarded a lifetime pension from the state. He retired from teach-

ing to devote himself wholly to his space flight investigations. In 1935 he died at his home in Kaluga, Russia at the age of 78. Honors paid to him have included induction into the International Aerospace Hall of Fame, the naming of a lunar crater in his honor and the creation of the

Konstantin E. Tsiolkovsky Stat Museum of the History of Cosmonautics devoted to his work. In Russia, Konstanin Tsiolkovsky is known as the “the father of theoretical and applied cosmonautics”.

Not bad for a self-taught, hearing impaired recluse Rocket Scientist!

Author’s Bio:

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

Miller, a co-researcher at Michigan, that the noise-induced hearing loss prevention concoction could be available within two years.

in Fyodorov’s scientific philosophy of space travel and even began to wonder what could be done with all of the immense number of dead humans if and when they returned.

Of course, this story refers to Konstantin Tsiolkovsky the founding father of rocketry and cosmonautics. His Tsiolkovsky Formula, Robert M. Traynor is the CEO and practicing audiologist at Audiology published in 1903, established Associates, Inc., Greeley, Colorado with particular emphasis in accurate relationships between In another study funded by the Oklahoma Medical Research Foundation, amplification and operative monitoring. Dr. Traynor holds degrees researchers Dr.of Robert Floyd and retired surgeon, Dr. Richard Kopke, M.D., discovered a mass the rocket and its Army propelfrom University of Northern combination of two compounds stopped damage to the inner ear the caused by acute acoustic trauma – Colorado (BA, 1972, MA 1973, Ed.D., lant, the speed of the gas at exit, 1975),what thethe University of Phoenix something like an IED exploding.

Although they did not indicate compounds were they felt (MBA, 2006) as well as Post-Doctoral and rocket speed. Additionally, Study Northwestern University that,“This is a very exciting finding,” said Dr. Floyd, who holds theat Merrick Foundation Chair in Aging (1984). He taught Audiology at the he predicted many aspects of University Northern (1973-1982), University of Arkansas Research at OMRF. “The research is still at a pre-clinical stage, but we’reof hopeful that weColorado soon can begin space travel with stunning accutesting in humans. for Medical Sciences (1976-77) and Colorado State University (1982racy, describing many of the de1993). Dr. Traynor is a retired Lt. Colonel from the US Army Reserve, tails of space More recently, Dr. pressurized Kathryn Campbell's worksuits, at Southern Illinois University involves theand use of an Medical Service Corps currently serves as an Adjunct Professor of orbital stations, the use antioxidant calledspace D-methionine, a component of fermented protein Audiology at the University of Florida, the University of Colorado, and of solar power, life in low gravithe University of Northern Colorado. For 17 years he was an Audiology ty environments, a the need for Consultant to major hearing instrument and equipment manufacturers multi-stage rockets to achieve providing academic and product orientation for their domestic and escape velocity. Konstantin even international distributors. A clinician and practice manager for over predicted the advantages of com35 years, Dr. Traynor has lectured on most aspects of Audiology in over bining liquid hydrogen and liquid forty countries. oxygen for rocket fuel. Although that is found in yogurt and cheese. The antioxidant, in concentrated doses, has been found to improve some forms of hearing loss and even prevent hearing loss before the exposure to noise. "We've been able to show in animal studies that if we give it before and after noise exposure, that we can get pretty full protection from noise-induced hearing loss," Campbell said. According to Campbell and her colleagues will continue their studies by looking at the effects of