Create Summer 2013 by Littleton Adventist Hospital

Create Your health. Your life.

Celebrating your health

summer 2013

Wise Choice for PROSTATE Cancer

Low Testosterone’s Link to Diabetes

Back-toSchool

Tips from Knees to Nutrition FREE Men’s Health Screenings David Schrier, MD, medical oncologist (left), and Jim Fagelson, MD, FACS, urologist and surgeon at Littleton Adventist Hospital

One out of every 10 Colorado adolescents between the ages of 10 and 17 is obese, according to the 2011/12 National Survey of Children’s Health. Factoring in children who are overweight, that number jumps to one out of every four.

Littleton Adventist Hospital brings specialized care to the people of South Denver in the complex areas of trauma, cancer, neurology, cardiology, orthopedics, women’s services, and more. We are part of Centura Health, the state’s largest health care network. The purpose of this publication is to support our mission to improve the health of the residents of our community. No information in this publication is meant as a recommendation or as a substitution for your physician’s advice. If you would like to comment or unsubscribe to this magazine, please email create@centura.org. 7700 S. Broadway Littleton, CO 80122

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Nutrition Tip:

Want your children to do better at math? Be sure they are eating a nutritious breakfast. According to

a study published in the Archives of Pediatric and Adolescent Medicine, children who regularly ate breakfast improved their math scores. Yet, nearly half of all children don’t always eat breakfast, according to a separate study by the Academy of Nutrition and Dietetics Foundation. A healthy breakfast should include lean protein to maintain energy until lunch and a whole-grain carbohydrate for brain power. Nutrition is the eighth guiding principle of the CREATION Health Lifestyle, an Adventist wellness program that is supported by medical research to result in longer, healthier lives. To learn more about the science of nutrition, go to creationhealth.com.

An extra shot in the arm Setting up those back-to-school physicals? While you’re there, ask your doctor about a few extra recommended vaccines, encourages Terry Krause, MD, a family medicine physician at Highlands Ranch Medical Associates. Meningococcal: Recommended for ages 11-18. The virus, which causes a form of meningitis, is potentially deadly. HPV: Recommended for ages 11-13. This three-stage vaccine protects against the disease that causes nearly 100 percent of cervical cancers in women and 80 percent of tonsil and tongue cancers in men. Flu: Good for all children over 6 months of age. Get it as soon as it becomes available (usually in October), as it lasts a full year.

Protecting your teen’s knees The number of knee injuries in teens has quadrupled over the past decade, sidelining teens at a critical time in their athletics and potentially setting them up for early arthritis as adults. The problem starts in childhood, Dr. Michael Fuller says Michael Fuller, DO, an orthopedic surgeon and sports medicine specialist at the Center for Orthopedics in Littleton. “We’re seeing a wave of earlier and earlier participation in competitive sports,” Fuller says. “Kids are playing at a very high level before their bodies have developed the large muscles that help control the ligaments in the knees.” That is not to say that playing sports at a young age is bad, Fuller adds. Instead, the problem is playing for hours and hours each week, and playing the same sport yearround. Some tips for preventing injury include: • Vary your child’s sports • Give your child time to play, not just sports • Belong to a club that varies and limits training, particularly before age 12

Learn More Join the experts from the Center for Orthopedics on Oct. 2 to learn more about the causes and prevention of knee injuries. See page 7 for details. Or learn more at centerfororthopedics.org.

Cover photo: ©Ellen Jaskol; This Spread: ©iStockphoto.com/IvonneW, Portrait ©Ellen Jaskol; Opposite page: ©iStockphoto.com/BlackJack3D

IN Good Health

IN BRIEF

Low testosterone and diabetes:

What’s the link?

Low testosterone has long been known to cause lifestyle problems, including fatigue, depression, and decreased sex drive. But new research is showing a strong

link between low testosterone and diabetes. “We don’t yet understand which one causes the other, but we know there is an association between low testosterone and diabetes and obesity,” says Kent Lofley, DO, a family medicine physician at Highlands Ranch Medical Associates. A recent study, for instance, found that treating low testosterone in men resulted in a 25 percent improvement in insulin sensitivity. Treatment also decreased body fat and increased lean muscle in diabetic patients. Between 5 percent and 20 percent of men over the age of 50 are believed to have lower-thannormal testosterone levels. Age is the biggest risk factor — half of all men will suffer from low testosterone at age 80. Men are more likely to have low testosterone if they are overweight or have diabetes. Although researchers don’t know which comes first, they do know that a man with diabetes is twice as likely to suffer from low testosterone. Doctors diagnose low testosterone with a blood test and treat it with an injection or a patch. A new testosterone injection has been developed that lasts three months, Lofley says. Potential side effects include acne, balding, and/or increased body hair. While rare, men also can develop polycythemia, a condition caused by elevated red blood cells that can cause headaches, shortness of breath, or dizziness.

FREE

SCREENING

Men who are feeling tired, weak, and experiencing erectile dysfunction, inability to orgasm, or lowerthan-normal sex drive — especially if they are overweight or have diabetes — should see their doctor to be tested for low testosterone.

Men can be tested for low testosterone levels with a simple blood draw at our Men’s Health Challenge, taking place at Littleton Adventist Hospital on Sept. 22. See details on page 7.

The do’s and don’ts of head injuries in kids Take children with these signs to the ER after a hit to the head: • Unconscious • Vomiting • Confusion/memory loss • Slurred speech But what if your child gets hit but doesn’t have any of those signs? “If your child is not steadily improving after

the injury, they need to be seen,” recommends Mark Elliott, MD, medical director of the emergency department at Littleton Adventist Hospital. “Most kids should do better in the first two hours. Anyone who has any lingering symptoms over a two-day period should at least be seen by their physician.” Just as important as knowing when to seek care is knowing when to let children resume activity.

Parents and coaches should use a “graduated return to play.” “On the first day, your child should do nothing,” Elliott explains. “Each day, they gradually do more. If any activity creates a headache, you go back and start over.” This should be done over a minimum of one week, but it may take some children longer to recover. Recovery time should be discussed with your physician.

Still Have Questions? If you’re unsure whether your child needs to be checked by a doctor, call the Centura Health Nurse Line at 303-777-6877. To learn more about concussions, visit cdc.gov/concussion.

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With prostate cancer, it’s nice to know you have

options.

Simple health issues have clear solutions. Broken arm? Cast. A cut? Hold pressure. A deep cut? Stitches. But when you’re dealing with something more complex,

such as a cancer diagnosis, it’s not always so easy. Men who are diagnosed with prostate cancer today have access to more information and options than ever before. “One thing about prostate cancer in general is that if you have early-stage disease, the options are wide open to you,” explains Jim Fagelson, MD, FACS, a urologist and surgeon at Littleton Adventist Hospital. These options may include radiation treatments and surgery. For men who are diagnosed with more advanced disease, these options also may be accompanied by chemotherapy (medications) or hormone treatments.

What to think about

It’s important to remember that not all prostate cancers are the same. “It can be mild or aggressive,” says David Schrier, MD, a medical oncologist at Littleton Adventist Hospital. “And prostate cancer can be like a chronic disease. It doesn’t always need to be treated.”

Surgery

One thing about prostate cancer in general is that if you have early-stage disease, the options are wide open to you

Brachytherapy

External beam radiation

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He adds that 60 percent of men older than age 60 will be diagnosed with prostate cancer — and that increases to 70 percent of men over age 70. Working with their doctors, men should consider their age (and life expectancy), the cancer itself, any other health issues, and the quality of life they desire.

Watchful Waiting

Are you young, or do you have an aggressive cancer? Men who

Dr. Jim Fagelson, Urologist

Active surveillance is recommended for: Dr. David Schrier, Oncologist

Would you rather avoid surgery? Radiation therapies are also effective against prostate cancer. External beam therapy involves directing high-powered X-rays at the cancer. Meanwhile, brachytherapy utilizes tiny seeds implanted in the prostate to release low doses of radiation over a period of time. Like surgery, radiation carries side effects, which may include erectile dysfunction, painful or frequent urination, as well as loose stools or pain when passing stools. Are you coping with late-stage disease? If the cancer has been caught in a later stage or the

cancer has spread, radiation or surgery may be accompanied by chemotherapy or hormone therapy. When he works with men who have advanced-stage prostate cancer, Schrier talks to them about their quality of life and expectations. While medications are available, some are very expensive and don’t drastically increase life span while also creating side effects that diminish a man’s quality of life. “When you have no drug options that extend survival and you have a good quality of life, watching and waiting can be the best thing,” Schrier says. Particularly for men who are in their 70s or 80s, forgoing treatment might make the most sense. “When you put older patients through chemotherapy without extending life, you have to wonder if you’re doing more harm than good,” he adds. “Good intentions can result in unintended consequences.”

For men with early-stage prostate cancer, treatment options include:

option

Surgery A prostatectomy is the removal of the prostate gland as well as some surrounding tissue.

option

External Beam Radiation Usually requiring five days a week for several weeks, this targeted radiation treatment involves directing high-powered X-rays at the cancer.

Men are known for taking action. And while a cancer diagnosis might spur many men to take control, others might find solace in waiting. Watchful waiting — also referred to as active surveillance — may be the preferred option for some men with prostate cancer.

• Men who are older or have other serious health problems • Men with slow-growing cancer • Men who have an elevated PSA level but a negative biopsy • Men whose biopsy shows little cancer or low-grade cancer For some men with mild, slowgrowing disease, treatment might never be necessary. It’s important to actively monitor the cancer to know for sure, says Jim Fagelson, MD, FACS, a urologist and surgeon at Littleton Adventist Hospital. David Schrier, MD, a medical oncologist at Littleton Adventist Hospital, says it’s important to consider the stage of the disease and the number of years a man can expect to live. “If you have prostate cancer at 78, do you want to possibly lower the quality of the last two to 10 years of your life with potential side effects of treatment like impotence and incontinence?” he asks.

option

Brachytherapy During this treatment, tiny radioactive seeds are implanted into the prostate tissue. The seeds deliver a low dose of radiation over a period of time.

Online Prostate Assessment If you are experiencing urination problems, it could be a sign of prostate trouble. Go online to mylittletonhospital.org/ prostate to check your symptoms and find out if you should seek care. And to learn more about robotic prostatectomy surgery at Littleton Adventist Hospital, visit mylittletonhospital.org/robotic-surgery. create | mylittletonhospital.org | 5

Opposite Page Photo: ©Getty Images/Newton; This page: Portraits ©Ellen Jaskol, ©iStockphoto.com/njnightsky

are younger and those with an aggressive cancer, Fagelson says, tend to be better candidates for prostatectomy, a surgery to remove the prostate gland. Some men are concerned about the possible side effects associated with the surgery. These include urinary incontinence and erectile dysfunction. Surgery has been made easier and lowered the risks of side effects with the development of robotic systems that help the surgeon be more precise than ever. Fagelson and other surgeons utilize the da Vinci® robotic system at Littleton Adventist Hospital to perform prostatectomies. “Prior to robotic surgery, the side effects were more prevalent,” he says. “With the robot, we’re able to minimize the side effects compared to traditional surgery. And the side effects are more easily tolerated or treated if they do occur. It’s a completely different ball game (than in the past).”

Living VIBRANTLY Your key to a better, healthier life

Join us for a day to celebrate women, their courage and their zest for life. This FREE event will be filled with tips for maintaining good health — giving you tools to live, love, and play at your best! The day will get a laughter-filled start with keynote speaker Nancy Sharp. Sharp, author, Huffington Post blogger, and es massag chair FREE nationally known speaker, draws from her own transformative story of courage and Exclusive giveaways and drawings renewal to inspire women around the ts country to harness their courage and live exper ng leadi from e Health advic boldly. “Courage enables us to keep showing up and push beyond our limitations, even in the face of loss, disappointment, and change,” says Sharp.

Spa-la-la! Win a FREE spa gift certificate!

Register by Aug. 31 to be entered in a drawing for a day at the spa. Call 303-777-6877 or visit southdenverhealth.org/ expo-registration.

Nancy Sharp, Keynote Speaker

Women’s Wellness Date | Sat, Sep 7 Time | 9 a.m.-2 p.m. Location | The Newman Center for the Performing Arts, University of Denver, 2344 E. Iliff Ave. Cost | FREE (free parking available in the garage)

Reserve Your Space Today for This Special Event online at southdenverhealth.org/womens-expo.

expo schedule 9a.m. Doors open 10 a.m. Kick off the day with keynote speaker

SEP 7

University of Denver Newm an Center

Nancy Sharp who will present: Living Vibrantly— Your Key to a Healthier, Better Life

9 a.m.- 2 p.m. Visit with experts throughout the day to learn about sleeping better, stress relief, bone and joint health, and much more! Then pick from these talks:

11 a.m. H ormones: What You Need to Know to Stay Balanced; Dr. Vandna Jerath, OB/GYN 11:30 a.m. Top Tips to Keep Your Heart Healthy; Dr. Cinthia Bateman, cardiologist

Noon Gurgles, Grumbles, and Growls — What Is Your Stomach Trying to Tell You?; Dr. Patrice Michaletz-Onody, gastroenterologist

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1 p.m. Lose Your Belly Fat and Help Your Heart — Cooking Demonstration; Dr. Richard Collins, The Cooking Cardiologist

1 p.m. Yoga — Learn How to Strengthen Your Mind, Body, and Spirit

A Women’s Wellness Expo, hosted by Castle Rock, Littleton, Parker, and Porter Adventist Hospitals

Free health tips and seminars

ca le nda r

SUMMER 2013 Men’s Health Challenge

Ladies, we all know what it’s like trying to get our men to the doctor for a checkup — nearly impossible! So Littleton Adventist Hospital has a cure — we’ve set up a tailgate party celebrating his health. Bring your husbands, brothers, dads, sons, and friends to Littleton Adventist Hospital’s annual Men’s Health Challenge. To lure him in, there will be booths with some of his favorite activities — from golfing to fly-fishing, antique cars to motorcycle clubs. And what’s a tailgate party without a grill? Dr. Richard Collins, better known as The Cooking Cardiologist, will demonstrate some tips and tricks to barbecue cooking. In between all the festivities, we’ll have specialists on hand to discuss topics like low testosterone, skin cancer, and any other health questions or concerns he may have. He also can get caught up on all his wellness screenings because they are FREE during the event! Some of the screenings that will be available include: • Blood pressure • Blood draw • Prostate exam All of this takes place on a Sunday in September — but don’t worry, we’ve carefully chosen a day that won’t interfere with a Broncos game!

Date | Sun, Sep 22 Time | 10:30 a.m.-2 p.m. Cost | FREE Location | Littleton Adventist Hospital (in the parking lot outside of the outpatient center, just east of the main entrance)

September is Prostate Cancer Awareness Month. Prostate cancer affects one in six men. If it’s detected at an early stage, the five-year survival rate is nearly 100 percent, according to the American Cancer Society.

Date | Thu, Sep 19 Time | 6-8 p.m. Location | The Recreation Center at Southridge, 4800 McArthur Ranch Road, Highlands Ranch Register | 303-777-6877, option 1

Childbirth Preparation Class Join other expectant parents in a fun and relaxing environment to learn what to expect during childbirth and how to recognize the signs of labor. A reunion for all participants also will be scheduled! This is a four-week class available Sundays, Mondays, and Saturdays. For a complete list of dates, times, and locations, go to mylittletonhospital.org/ classes-and-events. Cost | $70 per couple Register | 303-777-6877, option 1

Knee Injury Prevention Join Dr. Timothy Lehman, orthopedic surgeon and sports medicine specialist at Center for Orthopedics for a FREE seminar about the causes of knee injuries, who is most at risk, and how to prevent them. For more info, go to centerfororthopedics.org. Date | Wed, Oct 2 Time | 6-7 p.m. Location | Littleton Adventist Hospital, Conference Room 1 Register | 303-777-6877, option 1

INNOVATIVE ASTHMA TREATMENT Adult patients who suffer from severe, persistent asthma are invited to a FREE seminar on bronchial thermoplasty. BT is a new long-lasting, nondrug procedure that delivers controlled energy to the lungs and decreases the muscle’s ability to constrict the airways, resulting in fewer asthma attacks. For more info, go to mylittletonhospital.org/bt. Dates | Thu, Oct 10 Time | 6-7 p.m. Cost | FREE Location | Littleton Adventist Hospital, Conference Room 1 Register | 303-777-6877, option 1

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The Many Faces of Breast Health Come ask our panel of experts about your risk factors, what you can do to help prevent breast cancer, current treatment options, and what to expect after treatment. You will also have the opportunity to speak one-on-one with physicians during this FREE seminar. Registration required.

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Denver, CO Permit NO. 4773

7700 S. Broadway Littleton, CO 80122

Centura Health complies with the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973, and no person shall be excluded from participation in, be denied benefits of, or otherwise be subjected to discrimination in the provision of any care or service on the grounds of race, religion, color, sex, national origin, sexual preference, ancestry, age, familial status, disability or handicap. Copyright © Centura Health, 2013.

Retraining brains after stroke With it well proven that medically based rehabilitation therapy can help retrain the brains of stroke patients, it might be easy to believe that brain training exercises can make us smarter. But that’s not the case, at least for the many online brain training programs. A study published in Developmental Psychology this year reviewed 23 studies and found that memory training games improve short-term memory but do not improve broader skills like reading and math.

Learn More Littleton Adventist Hospital also offers outpatient physical, occupational, and speech therapy. To learn more or to schedule an appointment, call 303-730-5883.

80%

Once thought to be almost like stone after a certain age, research has found that our brains are very pliable and can be reformed and retrained at any age and even after injury, of strokes are caused by a including strokes. clogged artery that stops Eighty percent of strokes are caused by a clogged artery that stops oxygen-laden blood from oxygen-laden blood from getting to the brain. Within minutes, portions getting to the brain. of the brain begin dying from the lack of oxygen. However, with the right rehabilitation, brain cells — called neurons — can form new connections and take over the lost functions, even if they are in completely different parts of the brain. “The brain has amazing neuroplasticity that allows it to recover,” says Stephanie Grabe, PT, MPT, director of the new inpatient rehabilitation program at Littleton Adventist Hospital. The brain recovers in several ways. Existing brain cells can grow new connections to take over functions they previously didn’t handle. Partially damaged cells can heal. Or other parts of the brain can be trained to take over the missing functions. Studies have found that the faster rehabilitation starts, the bigger the potential gains. Littleton Adventist Hospital starts rehabilitation in acute care within 24 hours if the patient is medically stable and can now move the patients quickly into its new 17-bed inpatient rehabilitation unit. The new unit offers physical, speech, and occupational therapy services for patients recovering from stroke, orthopedic injuries, head injuries, hip fractures, joint replacements, spinal cord injuries, deep brain stimulation surgery, and other conditions. Littleton Adventist Hospital starts rehabilitation in acute care within 24 hours if the patient is medically stable and can now move patients quickly into its new 17-bed inpatient rehabilitation unit.

Does brain training work?