Create Summer 2014 by Littleton Adventist Hospital

SUMMER 2014 • Volume 2, Issue 3

Your health. Your life.

THAN A

WAITING GAME

LEARN WHAT’S REALLY IMPORTANT IN AN ER

a n d ...

CLOSER KIDS Page 2

MEASLES OUTBREAK Page 3

SEXUAL ASSAULT PROGRAM Page 3

PRECISION SPINE SURGERY Page 7

IN GOOD HEALTH

2+2

DOCTOR’S

BAG DR. MEGAN HALDY Centura Health Physician Group — Denver Tech Center, 8200 E. Belleview, Suite 100 Megan Haldy, DO, is a family practice physician specializing in primary care for all ages. A native of Colorado, Dr. Haldy served in the Peace Corps in El Salvador and volunteered in Quito, Ecuador. “While traveling, I maintained my relationships with friends and family because we had a foundation in trust and respect. A similar approach can be helpful to parents as children age — a strong foundation is the key.”

To schedule an appointment with Dr. Haldy, call 303-770-6500.

EVOLVING YOUR RELATIONSHIP WITH YOUR KIDS

Summer is a great time to polish your relationship skills with your children before the new school year begins. Studies show that interpersonal relationships between parents and children impact children’s self-esteem, success in school and work, behavior, and even the rate of cancer for children later in life. The trick is to evolve your relationship as your child ages, says Megan Haldy, DO, a board-certified family physician at the Centura Health Physician Group — Denver Tech Center. “Give them more independence — with limitations — to learn and grow, while building trust,” Haldy recommends. Parents with children transitioning from elementary to middle school should try these tips to help maintain positive relationships: • Compromise. Your child might be more embarrassed about your involvement in their activities, so consider helping with the school fundraiser rather than chaperoning a dance. • Stress safety. While giving your child more independence, stay focused on safety. Insist your child checks in when arriving at a friend’s and hold your ground on curfews and rules. • Ask questions and listen. You might not always get a response, but it will reinforce your interest and demonstrate you can listen without giving advice.

Limit children 2 and older to 2 hours of screen time daily

Screen time — whether on a computer, phone, or TV — hinders frontal lobe development, the part of the brain that makes decisions, thinks through consequences, and gleans insight, according to new research published in Psychology Today. As a result, lifelong consequences can occur, including the inability to create meaningful relationships.

Interpersonal relationships are the sixth guiding principle of the CREAT ION Health Lifestyle, a n Adventist wellness progra m supported by medical research. Learn more a bout CREAT ION lifestyle principles at creationhealth.com.

Happy Mother

= Happy Children

1 in 5 Americans will suffer from depression at some point in their lives Are you blue? Untreated depression among parents can lead to problems in their children, including poor performance in school, increased emergency room visits, poor peer relationships, and childhood depression, according to a report from the Institute of Medicine and the National Research Council. 2 | SUMMER 2014 • Create

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Summer school for parents

COLORADO’S

low measles vaccination rate CAUSE FOR ALARM

SANE Support New Littleton Adventist Hospital program provides support to sexual assault victims

easles, a disease that was nearly eradicated in the U.S., is on the rise again due to low vaccination rates. And Colorado is at the forefront of that dangerous trend. Colorado had the lowest measles, mumps, and rubella (MMR) vaccination rate in the nation among kindergartners in 2012, the latest data that is available. This puts the state well below the “safe herd” immunity threshold for measles. Herd immunity occurs when a population reaches a level of immunity to a disease either by vaccination or previous infection that makes widespread outbreak unlikely. “Low immunization levels have led to increasing measles infections throughout the country, meaning outbreaks are likely in our area,” says Leslie Tourangeau, MD, a pediatrician in Pediatric Emergency Care at Littleton Adventist Hospital. Measles is a highly contagious disease that spreads via air. It causes a cough, fever, runny nose, and rash all over the body, and leads to severe complications in 30 percent of cases, including pneumonia, encephalitis (inflammation of the brain), and blindness. Death rates are close to one in 500 people. Most susceptible are infants too young to be vaccinated, children with compromised immune systems, and those unable to be vaccinated for medical reasons. “I have read numerous studies on vaccine benefits and side effects and fully vaccinated my children, because I have watched children Littleton Adventist die from vaccine-preventable diseases,” Tourangeau says. “Side Hospital is part effect risks of the MMR vaccine are so small compared to the risks of Centura of contracting measles and subsequent complications.” Health Children’s The MMR vaccine is administered at 12-15 months of age and Network. at 4-6 years. Only one out of 1 million doses of the MMR vaccine causes a severe reaction, according to the Centers for Disease Control and Prevention. Littleton Adventist Hospital’s Pediatric Emergency Care is open weekdays 4 p.m.-midnight and weekends noon-midnight. If you have questions about your child’s health, call the Pediatric Emergency Care advice line at 303-795-KIDS.

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. Create is published four times annually by Littleton Adventist Hospital.

ne in four Colorado women and one in 17 men will experience sexual assault in their lifetimes. A critical piece to victim recovery — and also prosecution of the perpetrator — is a timely and official clinical examination. This service is now available at Littleton Adventist Hospital through a new Sexual Assault Nurse Examiner (SANE) Program in the hospital’s emergency department. “Historically, the closest place victims could go to get a thorough exam was Porter Adventist Hospital,” says Christine Miller, RN, MS, director of emergency and critical care services at Littleton Adventist Hospital. “The last thing we want is someone to come in and then have to go somewhere else to get a proper exam — chances are high that they will just give up. With the SANE Program, we will be able to treat victims right here.” The SANE Program, which is backed by local police, provides sexual assault victims with a SANE registered nurse who has completed specialized education and clinical experience in the medical forensic (scientific methods to investigate crimes) care of patients. SANE nurses not only collect important evidence and serve as expert witnesses in trial, but they also act as a resource for victims. The program is funded through donations to the Littleton Adventist Hospital Foundation and has a private, SANE-designated room close to the emergency department, which has been remodeled for the program and outfitted with $41,000 in special equipment. “The SANE Program has had great success in increasing reporting rates across the country,” Miller says. “It’s centered on giving victims back control and offering them support well after they leave the hospital.”

 

Approximately 60 percent of sexual assault victims never report the crime to police. The majority of sexual assaults are committed by someone the victim knows.

You can provide ongoing support for the SANE Program by making a donation at littletonhospitalfoundation.org.

7700 S. Broadway | Littleton, CO 80122 | mylittletonhospital.org create | mylittletonhospital.org | 3

total THE

package

All ERs are not created equal

With billboards and advertisements promoting short emergency room (ER) wait times, it might be tempting to choose one based on how fast you can be seen. But the reality is that not all ERs are created equally, and consumers should know what to look for when it comes to their health. Here we take a look at what you should check for in an ER. While you may not need any of these services, it’s good to know the level of expertise available. Trauma Designation

ER physicians at Littleton Adventist Hospital serve as medical directors for all South Denver EMS agencies, creating a close bond between first responders and the trauma center. 4 | SUMMER 2014 • Create

What is it? Trauma centers, as designated as level I, II, or III by the American College of Surgeons, indicate a hospital’s ability to provide in-house emergency trauma care. To maintain verification, hospitals must make continued improvements in trauma care, including ongoing education of staff and physicians. Dr. Mark Elliot Why should you care? Trauma centers offer specialized care in neurosurgery, orthopedics, anesthesiology, and critical care, ensuring patients get the best care for complicated health problems as quickly as possible. What does Littleton Adventist Hospital offer? As a level II trauma center, Littleton Adventist Hospital provides 24-hour coverage by surgeons, including orthopedic trauma surgeons and neurosurgeons. “We have the same capabilities as level I trauma centers in the state, the only difference being a focus on research,” says Mark Elliott, MD, medical director of emergency services at Littleton Adventist Hospital. While some level II trauma centers must refer cardiac patients to a level I center, Littleton Adventist Hospital can handle most complex cardiac cases. Littleton Adventist Hospital also is part of the Centura Health Trauma Network, the region’s largest and most comprehensive network of trauma care and emergency services. “We feel confident in taking any patient we transport to Littleton,” says Michael Simon, emergency medical services (EMS) captain at Littleton Fire Rescue who has worked in the field for more than 30 years. “Littleton Adventist Hospital has it all — trauma and neurosurgical expertise, a cardiac cath lab, and a stellar stroke program.”

Minutes Average wait time (vs. 28 minutes nationally)

Littleton Adventist Hospital’s ER treated 34,000 patients in 2013, while the Pediatric Emergency Care Center saw nearly 4,000 children — that’s nearly half the total population of the greater Littleton area. Here are some vital stats on the program:

Stroke Center

What is it? A Stroke Center, as designated by The Joint Commission, follows proven techniques and practices for quickly and effectively treating stroke, the leading cause of disability among adults in the U.S. Why should you care? Stroke Centers adhere to strict guidelines for stroke treatment, such as administering blood-clotting medication within 60 minutes of the patient’s arrival. A patient’s likelihood of recovering from a stroke is substantially increased if they are treated at an accredited Stroke Center. What does Littleton Adventist Hospital offer? Littleton Adventist Hospital is a Primary Stroke Center with advanced capabilities. The hospital is one of a few facilities in Colorado with a CT scanner in its ER, enabling it to quickly diagnose and treat strokes. In addition, the hospital has 24/7 interventional neuroradiology coverage, which ensures timely treatment for stroke patients requiring endovascular intervention. “With strokes and emergencies, minutes matter; that’s why we focus on urgent, quality care,” says Christine Miller, RN, MS, director of emergency and critical care services at the hospital.

Chest Pain Center

Minutes Heart cath door-to-balloon time (vs. 90 minutes nationally)

What is it? A Chest Pain Center, as recognized by the Society of Chest Pain Centers, meets or exceeds benchmarks for cardiac care and, in particular, heart failure and heart attacks. Why should you care? Chest Pain Centers provide specially trained staff coupled with leading-edge technology to treat heart failure and heart attacks as quickly as possible, giving patients a better chance of survival. What does Littleton Adventist Hospital offer? Littleton Adventist Hospital was the first hospital in Colorado to become accredited by the Society of Chest Pain Centers. Its door-to-balloon time — the time from when the patient enters the ER to the time the patient’s arteries are opened — is 34 minutes faster than the national average.

No. 1

in Colorado for coronary interventional procedures, ranking by Healthgrades

Pediatric ER

What is it? A pediatric ER is solely for children, staffed with pediatricians and specially trained nurses. Why should you care? Many injuries and illnesses affect children differently than adults. A pediatric ER ensures that children receive care tailored to them in a setting that is more inviting to children than a regular ER. What does Littleton Adventist Hospital offer? In partnership with Rocky Mountain Hospital for Children, Littleton Adventist Hospital’s Pediatric Emergency Care offers comprehensive pediatric care by board-certified pediatricians and certified pediatric nurses. It is open weekdays from 4 p.m.-midnight and weekends noon-midnight in a space specially designed for kids, within the hospital’s main ER.

Alert Programs

What is it? Alert programs are utilized by EMS to inform ER staff of life-threatening events to prepare services and provide quicker care upon arrival in the ER. Why should you care? Alerts enable ERs to prepare staff and equipment to quickly treat patients upon arrival, resulting in more efficient care and the ability to save more lives during life-threatening events. What does Littleton Adventist Hospital offer? Littleton Adventist Hospital is one of only a few facilities to offer special alert categories for stroke, trauma, cardiac, and sepsis. Alerts inform the ER prior to the patient’s arrival and ensure that the necessary specialty physicians and tests are immediately available. “Our alert programs allow for quick mobilization of resources from many departments within the hospital to provide the most rapid care when minutes can make a difference,” Miller says.

Star Rating for stroke treatment by Healthgrades

URGENT CARE OR ER? WHICH ONE TO CHOOSE AND WHY

Every ailment and injury can seem like an emergency, but many times the ER can be bypassed for urgent care. “The best rule of thumb is that if you think your primary care doctor could treat the injury or illness — and your primary care is not available — then it might be appropriate for the urgent care. More serious illnesses or injuries should go to the ER,” says Mark Elliott, MD, medical director of emergency services at Littleton Adventist Hospital. Elliott offers a head-to-toe checklist for reasons to visit the ER:  Head — weakness in face, slurred speech, sudden and severe headache, visual changes, high fevers (particularly with a rash)  Chest — severe chest pain, racing heart or palpitations, significant shortness of breath or wheezing  Belly — severe pain, testicular pain, uncharacteristic vaginal bleeding (i.e., with pregnancy), severe pain associated with vomiting  Trauma — head injury with loss of consciousness and/or persistent vomiting, broken bone or bone out of place, significant laceration PHOTOS: ©ELLEN JASKOL

ER VITAL SIGNS

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Balance Your

HEALTH FROM FOOD TO FITNESS Women’s Health & Wellness Expo offers interactive forum to learn about diet, inflammation, memory loss, and much more

When it comes to nutrition, there’s an endless supply of information. Come get answers to your questions about diet — along with many other health and wellness topics — at the second annual Women’s Health & Wellness Expo on Friday, Oct. 3, from 8 a.m.-noon at the Parker Arts, Culture and Events (PACE) Center. Participants can choose “tracks” that include keynote speakers, discussion groups, an interactive vendor area, and fitness classes. “This year, we have added more options so that there is something for everyone, whether you want to come and ask questions, get in a workout, or learn about major health topics,” says Marti Steger, community outreach coordinator at Porter Adventist Hospital. Porter, Littleton, Parker, and Castle Rock Adventist Hospitals are presenters of the Women’s Health & Wellness Expo. Other hot topics to be covered at the expo include stress reduction, breast care, skin care, and memory loss. The half-day expo is free, and attendees will get insights on the latest health topics, free recipes and handouts, a workout, and more! “We hope that the expo is the beginning of a long-lasting tradition for women’s health,” Steger says.

WOMEN’S HEALTH & WELLNESS EXPO Date: Friday, Oct. 3 • Time: 8 a.m.-noon Location: Parker Arts, Culture and Events Center (PACE), 20000 Pikes Peak Avenue, Parker, CO 80138 Cost: FREE Info and Registration: southdenverhealth.org/womens-expo

6 | SUMMER 2014 • Create

pop pills BEFORE YOU

Three things all women need to know about supplements

Supplements are all the rage, but just because you can purchase most everything over the counter does not mean that you should. “There’s no way to tell what supplements you may need without considering your age, diet, lifestyle, and how well you are absorbing minerals and vitamins, which can only be understood with a proper blood test and exam,” says Susan Buckley, RDN, CDE, a member of the health and nutrition team at South Denver Cardiology. Buckley recommends considering these three things when it comes to supplements:

Start with fruits and vegetables Fruits and vegetables contain dozens of compounds, while supplements may focus on only one or two. Aim for five to 10 servings of fruits and vegetables a day. Remember, serving sizes may be smaller than you think (1/2 cup of cooked broccoli or carrots; 1 cup of lettuce).

Consider drug interactions

Embrace probiotics

Certain medications interfere with the absorption of vitamins and minerals. For instance, vitamin B12, which helps prevent anemia and keeps nerve and blood cells healthy, is hindered by proton pump inhibitors. Coenzyme Q10, which works as an antioxidant and produces energy for cell growth, is depleted with the use of cholesterol-lowering medications (statins).

Probiotics are “good bacteria” that promote a healthy digestive system. Found in foods like yogurt, miso soup, and kefir, many people need a higher dose of probiotics than foods alone can provide. Antibiotics kill natural probiotics. “Roughly 70 percent of our immune system is in the gut, so if we lack enough good bacteria, we are more susceptible to disease,” Buckley says.

You should discuss all supplements with your doctor or pharmacist to avoid medication interactions.

Fruits and veggies to go! Put serving sizes of veggies and fruits in containers that you can grab for a snack, take to work, etc. “Part of eating healthy is making it convenient,” Buckley says.

LEARN MORE about supplements at the Women’s Health & Wellness Expo presented by Centura Health on Oct. 3!

Gluten-free, supplements, probiotics.

Back to

Business

‘Yes’ for spine surgery Spine surgery for people suffering from herniated discs in the lower (lumbar) spine leads to improved functioning and reduces long-term pain and disability, when compared to nonsurgical treatment, according to an eight-year study recently published in Spine. Herniated discs are one of the most common sources of back pain.

NEW SPINE SURGERY TECHNOLOGY INCREASES PRECISION, REDUCES HOSPITAL STAYS

Learn More To learn more about when the right time for back surgery is and whether you are a candidate for minimally invasive surgery, attend a FREE seminar on Sep. 17 with Dr. Guiot. See back cover for details.

DBS

Millimeters matter in brain surgery One of only a few facilities in the world to offer asleep deep brain stimulation (DBS), Littleton Adventist Hospital recently became the first facility in the world to perform asleep DBS using the Mazor Robotics Renaissance Guidance System. The patient had been recently diagnosed with Parkinson’s disease and suffered from tremors. DBS involves implanting very small electrodes into the brain that deliver tiny electrical signals to target areas that control movement, interrupting patterns that cause tremors in patients with Parkinson’s disease, essential tremor, and dystonia. DBS has been shown to improve symptoms and reduce the need for medications. “Using the Renaissance system provides even more accurate electrode placement, with better results,” explains David VanSickle, MD, PhD, the neurosurgeon who performed the procedure. “It also allows me to perform the procedure quicker, with reduced complication rates.” To learn more about the benefits of DBS, go online to mylittletonhospital.org/dbs.

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When it comes to spine surgery, precision matters. Even a tiny variance could have a significant impact. Littleton Adventist Hospital’s new Mazor Robotics Renaissance™ Guidance System — the latest addition to its repertoire of state-of-the-art equipment — leads to more accurate placement of implants, reduced complication rates, and shortened hospital stays. “We purchased the Mazor in January 2014 with the intent of pioneering asleep deep brain stimulation but knowing that other Dr. Ben Guiot physicians could and would use it for spine,” says Amy Maxe RN, BSN, MBA, director of orthopedics and neurosciences at Littleton Adventist Hospital. The hospital’s advanced robotic surgery program is supported by Centura Centers for Clinical Innovation, extending advanced health technologies across Colorado and western Kansas. In March, Ben Guiot, MD, a neurosurgeon at Littleton Adventist Hospital, performed the first complex open spine surgery utilizing the Renaissance guidance system at the hospital. “By using Renaissance, I was able to plot the surgical procedure before I entered the operating room,” Guiot says. “The guidance system is like having a precise map to follow in surgery.” With the Renaissance system, surgeons are able to see a three-dimensional view of the patient’s spine and build a plan before ever entering the operating room. During surgery, the Renaissance also provides a stable platform around the patient’s spine, helping to eliminate any motion during surgery. In a study of 112 cases conducted by Mazor and published in the European Spine Journal in 2011, surgeons’ use of this technology compared to freehand surgery resulted in:  Improved implant accuracy  Reduced complication rates, reoperations, and postop narcotic use  Reduced average length of stay in the hospital Surgeons can use the guidance system for a variety of spine surgeries, from minimally invasive procedures to complex spinal deformity cases. Surgeons also can use it for brain surgeries, including deep brain stimulation for Parkinson’s and essential tremor, and tumor removal.

Portercare Adventist Health System NON-PROFIT ORG US POSTAGE

PAID

DENVER, CO PERMIT NO. 4773

7700 S. Broadway Littleton, CO 80122

Littleton Adventist Hospital is part of Centura Health, the region’s leading health care network. Centura Health does not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, and marital status in admission, treatment, or participation in its programs, services and activities, or in employment. For further information about this policy contact Centura Health’s Office of the General Counsel at 303-804-8166. Copyright © Centura Health, 2014.

SUMMER 2014 MAMMOS, MOCKTAILS, AND MORE Join us for Happy Hour! Get your annual mammogram and enjoy mocktails, refreshments, and more! Event is held the last Wednesday of the month. Dates | Weds, Jul 30, Aug 27, Sep 24 Time | 4-7 p.m. Location | The Breast Center at Littleton Adventist Hospital Registration required | 303-738-2767

GIRL TALK This 3-hour class recommended for girls 9-12 years old and a parent/guardian focuses on the physical changes of puberty and menstruation, sexuality, and sexual reproduction. Learn the facts from Littleton Adventist Hospital OB/GYNs in a relaxed atmosphere designed to encourage communication within your family regarding family values and decision making as well as promoting positive self-esteem. Date | Thu, Aug 7 Time | 6-9 p.m. Location | Littleton Adventist Hospital, Conference Room 3 Register | 303-777-6877, option 1 or mylittleton hospital.org/classesand-events

LIVING WELL WITH PARKINSON’S Join Dr. Mihaela Alexander, neurologist, as she shares how you, and caregivers, can live well with Parkinson’s disease. Date | Wed, Aug 13 Time | 6-7:30 p.m. Location | Littleton Adventist Hospital, Conference Room 1 Register | 303-777-6877, option 1 or mylittleton hospital.org/classesand-events NEW OPTIONS IN CARPAL TUNNEL TREATMENT Join Dr. Carlton Clinkscales, orthopedic hand and upper extremity surgeon, as he shares how to recognize the signs and symptoms of carpal tunnel and describes a new, minimally invasive procedure available

to treat carpal tunnel syndrome. Date | Wed, Aug 20 Time | 6-7 p.m. Location | Littleton Adventist Hospital, Conference Room 1 Register | 303-777-6877, option 1 or mylittleton hospital.org/classesand-events

WEIGHT-LOSS SURGERY Learn about the types of weight-loss surgery, and whether you are a candidate with bariatric surgeon Dr. Josh Long. Date | Wed, Sep 3 Time | 6-7 p.m. Location | Littleton Adventist Hospital, Conference Room 1 Register | 303-777-6877, option 1 or mylittleton hospital.org/classesand-events

RELIEVING HERNIATED DISC PAIN Surgery may be the best option if you are suffering from a herniated disc. Join Dr. Bernard Guiot, neurosurgeon, to learn why and whether you are a candidate for minimally invasive or robotic-guided surgery. Date | Wed, Sep 17 Time | 6-7 p.m. Location | Littleton Adventist Hospital, Conference Room 1 Register | 303-777-6877, option 1 or mylittleton hospital.org/classesand-events

FREE health classes