Winter 2015 • Volume 3, Issue 1
Your health. Your life.
time to
share Speaking up about gyn symptoms could save your life
a n d ...
Why Rest is Good for You Page 2
Winter Health Tips for Kids Page 3
Radiation therapy close to home Page 6
6 steps to heart health Page 7
IN Good Health
Jump-start your health with a few more minutes of sleep
A restful place for students
Doctor’s
BAG Dr. Nancy Hooyman Internal Medicine Physician Centura Health Physician Group South Suburban Internal Medicine 7750 S. Broadway, Suite 100 Littleton, CO 80122 Hooyman moved to Colorado 17 years ago and has been practicing medicine for more than 30. She is boardcertified in internal medicine and geriatric medicine. “I enjoy working with older generations and their families,” she says. “It’s like being a detective, searching for things that will make their lives better.” Hooyman turns to fiction for relaxation. “Reading is a nice restful activity,” she says. “I’m a big reader. I enjoy contemporary fiction and memoirs. I like the quiet after working with lots of people during the day.”
To schedule an appointment with Dr. Hooyman at South Suburban Internal Medicine, call 303-347-9897. 2 | Winter 2015 • Create
40% Rest
Nearly half of Americans aren’t getting enough sleep, averaging just 6.8 hours nightly in 2013, according to Gallup. That compares to 7.9 hours in 1942! Chronic undersleeping is tied to heart disease, stroke, and diabetes — not to mention declines in cognitive abilities.
is the second guiding principle of CREAT ION Health, a n Adventist wellness progra m supported by medical research a nd promoted by Littleton Adventist Hospital. Learn more at creationhealth.com.
A new park opened this school year at Arapahoe High School in honor of Claire Davis, a student who died during the school shooting in December 2013. Clarity Commons, a collaboration of the high school, Littleton Adventist Hospital, and the Davis family, is an intimate park on the school grounds where students and faculty can rest between classes, study, and hold class discussion groups. Clarity Commons celebrates Claire’s love of life, the outdoors, and her ability to bring people together through her happy and optimistic spirit. The community is invited to experience Clarity Commons during nonschool hours. To share your support by purchasing a paver or bench, or for more information, go to claritycommons.org.
Getting less sleep in your golden years?
It’s a misconception that older adults need less sleep. In fact, older adults still require seven to nine hours of sleep just as younger adults do, according to the National Sleep Foundation. The problem is older adults tend to sleep in shorter durations and wake up more often throughout the night. Older adults are more likely to be dealing with chronic conditions that can keep them awake at night, such as heartburn, diabetes, renal failure, and respiratory disorders. Plenty of medications affect sleep as well. Talk to your doctor if you are having problems with sleep. And don’t forget to exercise. “Studies now show that exercise — even a little bit of walking or aerobic activity — can help with sleep,” Hooyman says. “Having balance is important. The key is finding the right combination between rest and physical stimulation and mental activity.”
Cover photo: ©shutterstock.com/Monkey Business Images;This pageclockwise: ©IStockphoto.com//eurobanks, /AleksandarNakic, /NAKphotos, /RTimages; Opposite Page: ©IStockphoto.com/irabell, /franny-anne
Rest your way to health
Dr. Kathy Vidlock
Put me back in, coach!
Wipe out whooping cough
W
hooping cough is on the rise again. It was very common before the vaccine was introduced in the 1940s, and then it almost disappeared. But in 2012, there were more than 48,000 reported cases of pertussis (whooping cough) — the most on record since 1955. Why the spike? “In the 1980s, vaccination rates declined,” says Leslie Tourangeau, MD, a pediatrician at Littleton Adventist Hospital. “Since then, we’ve seen a drastic increase in pertussis in the community.” The disease usually starts with mild cold symptoms, and then a severe cough appears. It isn’t typically fatal in adults, but it leads to coughing that can last for months and cause vomiting and fainting. It is much more serious in children, and can cause babies to stop breathing or need oxygen. “That’s why it’s important for everyone to get vaccinated,” Tourangeau says. “The cough may only be annoying to adults, but the true risk is to infants under age 1. About half of infants with whooping cough will need to be admitted to the hospital.” To protect your family, get everyone vaccinated against pertussis as soon as possible. If you think your child is having trouble breathing, seek medical attention.
Did you know the pertussis vaccine wears off? Boosters are recommended at age 11, during every pregnancy, and every 10 years after age 19. It usually can be given in combination with other vaccines, so talk to your doctor about what you need.
There’s nothing athletes hate more than being sidelined by an injury. But returning to play too soon after a concussion can have serious — even fatal — consequences. “There’s not a lot you can do to make [a concussion] go away faster,” says Kathy Vidlock, MD, a family and sports medicine physician at Highlands Ranch Medical Associates, “but there is a lot you can do that will make it go away slower. And not resting long enough is one of them.” That’s why it’s important for parents and coaches to follow the five steps for returning to play. Your child’s physician needs to sign off before starting the first step, and the protocol should be carried out under the guidance of a trained professional, whether an athletic trainer, physician, or physical therapist. Step 1: Light aerobic exercise Step 2: Moderate exercise Step 3: Noncontact activity (sports drills)
Baby-Friendly Littleton Adventist Hospital has long been baby-friendly, but now is working toward the official designation. As a baby-friendly hospital, you can feel comfortable knowing that Littleton Adventist Hospital will: Educate women on the benefits of breastfeeding Help mothers initiate breast feeding within one hour after birth Provide lactation assistance Allow mothers and infants to stay together 24 hours a day
Take a Tour Deciding where to deliver isn’t easy. Come see what amenities The BirthPlace at Littleton Adventist Hospital has to make you — and your baby — comfortable. Call 303-730-5810 to schedule a tour today.
Step 4: Practice Step 5: Competitive play
An ER just for kids Littleton Adventist Hospital has a special pediatric ER! It’s conveniently located just north of C-470 on Broadway. Call 303-795-KIDS to learn more.
create | mylittletonhospital.org | 3
The ‘other’ cancer
The symptoms of gynecologic cancers can be confusing and mimic other women’s health concerns, leading to later diagnosis. Here’s what all women need to know about gynecologic cancers.
M
Women who have a genetic disorder called Lynch syndrome are at very high risk for colon cancer as well as ovarian and uterine cancers. If you have close female relatives with ovarian or uterine cancer, talk to your doctor about screenings starting at age 35.
ost women by now know about the risk of breast cancer. But there’s another type of cancer that women need to be aware of — cancers of the female reproductive system, called gynecologic cancers. Approximately 95,000 women were diagnosed last year with gynecologic cancers, according to the American Cancer Society. About one-third of those women will survive less than five years. It’s not that cancers of the cervix, ovaries, uterus, vagina, and vulva are hard to treat or that they are incurable. Instead, it’s that many women are unaware of the signs and delay reporting them to their doctors. By the time of diagnosis, the cancer is often advanced. “Stage and type at the time of diagnosis determine prognosis, but it’s important to note that if detected early, at Stage I, the five-year survival rate is very high for most types,” says Glenn Bigsby, DO, a new gynecologic oncologist at Littleton Adventist Hospital. Take uterine (also known as endometrial) cancer, for instance. This is the most common form of gynecologic cancer, with nearly 53,000 women expected to be diagnosed in 2014. If found at the very earliest stage, Stage 1, five-year survival rates are 90 percent. If found at the latest stage, however, that rate drops to just 15 percent, according to the American Cancer Society. “I encourage women to see their doctors on a regular basis and tell them about anything out of the ordinary,” Bigsby says. “Sharing all symptoms with both your gynecologist and primary care physician helps them hone in on problems more quickly.”
95,000
Approximately women were diagnosed last year with gynecologic cancers.
4 | Winter 2015 • Create
A leading cause of death around the world, cervical cancer was once the leading cause of cancer deaths of women in the United States. Over the past four decades, the death rate has declined tremendously due to women getting regular cervical screening tests, most commonly known as “Pap smears,” that can detect and remove precancerous changes. Risk Factors • Human papillomavirus (HPV). Virtually all cases of cervical cancer are related to this common sexually transmitted disease. The best way to reduce this risk is to be vaccinated if you are under the age of 26 (and be sure to have your sons and daughters vaccinated at ages 11-13). If you are over 26 and were not vaccinated, get an HPV test and regular Pap tests. Use a condom if you are sexually active with partners who have not been tested. • Smoking. Smoking harms the cells of your cervix. Combined with HPV, your risk of developing cervical cancer is very high. • Other factors. HIV or other diseases that compromise the immune system, long-term use of birth control pills, and giving birth to three or more children. Vaginal and vulvar cancer, although extremely rare, share these same risk factors.
“I encourage women to see their doctors on a regular basis and tell them about anything out of the ordinary.” – Dr. Glenn Bigsby, Littleton Adventist Hospital gynecologic oncologist
One in a thousand
Uterine Cancer
Ovarian Cancer Although treatable, ovarian cancer is often not detected until it is advanced because women ignore or don’t report symptoms (see table). “Because ovarian cancer can be elusive, it’s critical to pay attention to your body,” Bigsby says. Seventy-five percent of all cases occur in women over the age of 60. Risk Factors • History of cancer. If you have had breast, uterine, or colorectal cancer; or a close family member had ovarian cancer, you are at higher risk. A strong family history could mean you have a genetic mutation, called BRCA1 or BRCA2, that places you at extremely high risk. (Littleton Adventist Hospital offers genetic counseling for women with a family history of cancer. Call 303-734-3969 for information.) • Other factors. Eastern European (Ashkenazi) Jewish heritage.
Uterine cancer is the most common of all the gynecologic cancers and one of the most curable, Bigsby says. It occurs most often in women after menopause. Risk Factors • Excess estrogen. Obesity is a risk factor for this cancer, as fat produces high levels of estrogen. Taking artificial estrogen after menopause without taking progesterone also increases the risk. • Other factors. No pregnancies; having five or fewer menses annually prior to menopause; taking Tamoxifen for breast cancer.
Gynecologic Cancer Symptoms Symptoms
Cervical Cancer
Ovarian Cancer
Uterine Cancer
Vaginal Cancer
Vulvar Cancer
Abnormal vaginal bleeding or discharge Pelvic pain or pressure Addominal or back pain Bloating Changes in bathroom habits Itching or burning of the vulva Changes in vulva color or skin, such as a rash, sores, or warts
Don’t Delay! Call your doctor right away if: • You have any abnormal vaginal bleeding between periods, after sex, or after menopause • You have any of the other signs and symptoms of gynecologic cancer for two weeks or longer The symptoms may be caused by something other than cancer, but the only way to know is to see a doctor.
Patients cared for by gynecologic oncologists have improved survival rates, according to several studies. Yet there are only about 1,100 of these specialists across the country. This month, one of those 1,100 — Dr. Glenn Bigsby — began practicing at Littleton Adventist Hospital and Parker Adventist Hospital. Gynecologic oncologists are obstetrician-gynecologists who have completed an additional three to four years of intensive training in surgical, chemotherapeutic, radiation, and research techniques for gynecologic cancers. Bigsby has nearly 20 years of experience as a gynecologist, earning his subspecialty training in gynecologic oncology in 2006. He specializes in using robotic surgery to remove cancerous tumors and has performed nearly 1,000 robotic surgeries. He sees patients at The Colorado Center for Gynecologic Oncology, PC, with offices in Parker and Littleton.
For more information or to schedule an appointment with Dr. Bigsby, call 303-955-7574.
create | mylittletonhospital.org | 5
Photo: ©Ellen Jaskol
Cervical Cancer
On Target
How Radiation Works Radiation targets quickly growing cancer cells and damages their DNA so they can’t grow and divide. Normal cells can repair themselves in a way that cancer cells can’t.
More precise radiation therapy means fewer side effects for people with cancer
Chances are likely that you might be sitting in a driverless car in the next decade. In addition to being safe, you’re sure to be hoping that the car will get you exactly where you want to go. Thankfully, these types of advancements have already occurred in radiation oncology. Today’s sophisticated multimillion dollar radiation therapy machines — coupled with highly trained cancer experts — can now deliver exactly the right amount of radiation directly pinpointed at cancerous cells with very little damage to surrounding tissue.
Ditch the Travel
“The word ‘radiation’ can scare us,” says Darlene Bugoci, MD, radiation oncologist at Littleton Adventist Hospital. “I tell my patients to think of radiation as medicine. If you don’t need it, we don’t prescribe it. If you need it, it can be lifesaving.” Just as medications have improved to reduce side effects, so has radiation therapy. The machine itself, called a linear accelerator, is the focus of improved treatment and decreased side effects. Parker Adventist Hospital’s Cancer Center and Porter Cancer Care Center at Porter Adventist Hospital offer the most advanced type of linear accelerator called the Varian TrueBeam. This machine offers several technological advancements that allow more precise dosing and placement of the radiation, including:
Custom contouring
Integrated imaging
360-degree access
The TrueBeam accelerator has what’s called a high-definition multileaf collimator. That’s a fancy term that basically means that the radiation beam can be shaped to match the cancer tumor and avoid healthy tissue. “By contouring the dose into the areas that we actually want to treat, that allows us to limit the side effects in a way we were not able to do before,” says Kelley Kovar, director of oncology at Littleton Adventist Hospital.
The linear accelerator has a built-in imaging system that can visualize the tumor during treatment. In the past, radiation oncologists had to plan a wide safety margin around the treatment area to account for the patient’s breathing and any changes in position from day to day. “Now, with image guidance, we can be much more confident in delivering the radiation to where we need it, so we can be more sparing,” Bugoci says.
To treat a tumor from multiple angles previously required stopping and starting the treatment. TrueBeam rotates around the patient to deliver radiation from nearly any angle. “We can treat anything in a 360-degree arc without stopping, which allows us to reduce the treatment time significantly,” Kovar says.
6 | Winter 2015 • Create
Littleton Adventist Hospital is part of the Centura Health Cancer Network, delivering integrated, advanced cancer care across Colorado and western Kansas. We provide radiation therapy in three South Denver locations to allow you to receive treatment close to home. (Opening Fall 2015) Radiation Oncology at Littleton Adventist Hospital Cancer Care Center 7700 South Broadway Littleton, CO 80122 Phone: 303-734-8740 Radiation Oncology at Parker Adventist Hospital The Cancer Center 9395 Crown Crest Boulevard Parker, CO 80138 Phone: 303-269-4975 Radiation Oncology at Porter Adventist Hospital Cancer Care Center 2555 South Downing Street Denver, CO 80210 Phone: 303-778-5714
Photos: ©Istock.com/LevKing, /walrusmail
A prescription for precision
Change of Heart Richard Collins, MD, The Cooking Cardiologist
What you can do to prevent heart attacks
We may talk about cheating death, but did you know that there’s actually a way to win — no cheating required. According to a 2013 report from the Centers for Disease Control and Prevention, about one in four deaths from heart disease and stroke under age 75 is preventable. And more than half of those preventable deaths occur in people under age 65. Colorado has one of the lowest preventable death rates in the country, but there’s still plenty of room for improvement. We asked Richard Collins, MD, a cardiologist at South Denver Cardiology, to show us the way. Start young
Eat right
“What we now realize is that heart disease begins at a young age — younger than what we thought,” Collins says. People in their 20s can have signs of heart disease, he points out, adding that risk factors are even showing up in adolescents.
Collins simplifies this advice down to three steps: Eat smaller portions; eat fewer animal products; and eat more vegetables, fruits, and whole grains. Vegetables in particular are important, he says, because they offer antioxidants, and the fiber helps counteract damaging cholesterol.
stop smoking
Cigarette smoke is blamed for 440,000 deaths related to heart disease and cancer, lung diseases, and more each year. Tobacco smoke harms blood vessels and affects the way the heart itself functions. Get moving
“You don’t have to become a marathoner,” Collins says. “Just light to moderate exercise is fine. You don’t even have to do it all at once.” In fact, a new study published in the Journal of the American College of Cardiology found that running just five to 10 minutes a day at a leisurely pace can reduce mortality and increase your life span.
Maintain a healthy weight
One recent study showed that overweight individuals have a 38 percent higher risk for heart attacks. Watch out for salt
Watch out for salt. High-sodium diets increase blood pressure and the risk for heart attack and stroke. But the problem isn’t table salt; restaurant meals and packaged foods have notoriously high sodium levels, Collins says. For instance, those skinless chicken breasts at your favorite restaurant are likely to have been soaked in salt water (brined) and contain more salt than you should eat in a day.
Gold-level care for heart attack patients Littleton Adventist Hospital provides some of the fastest care to heart attack patients in the Denver area. The hospital has earned STEMI Gold Plus recognition from the American Heart Association. This award demonstrates the hospital’s commitment to providing fast, highquality care to patients experiencing a heart attack known as an STelevation myocardial infarction (STEMI). The program looks at the percentage of patients who are treated in less than 90 minutes as well as medication protocols and the use of smoking cessation counseling.
CoQ10 and Statins While most people tolerate cholesterollowering drugs (statins) just fine, some may experience muscle aches. In those cases, a supplement called Coenzyme Q10 (CoQ10) may bring some relief, says Richard Collins, MD, a cardiologist at South Denver Cardiology. If you are taking a statin, talk to your doctor about whether CoQ10 is for you.
create | mylittletonhospital.org | 7
Portercare Adventist Health System Non-Profit Org US POSTAGE
PAID
Denver, CO Permit NO. 4773
mylittletonhospital.org
7700 S. Broadway Littleton, CO 80122
Littleton Adventist Hospital is part of Centura Health, the region’s leading healthcare 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, 2015.
Winter 2015
Free health classes
Heart-Healthy Nutrition and Cooking Class Demonstration Join Dr. Richard Collins, “The Cooking Cardiologist®,” along with Susan Buckley, RD, as they share their expertise on hearthealthy nutrition and cooking solutions. Dates | Wednesdays Time | 11 a.m.-noon; cooking demo, noon12:30 p.m. Location | The South Denver Heart Center, 1000 SouthPark Drive Littleton, CO Registration southdenver.com/ calendar-of-events
Mammos, Mochas, and Massages Get your annual mammogram and while you’re here, you can warm up with a mocha and relax with a chair massage. Bring your mom, sister, daughter, or friend — and make it a girls’ night out! Event is held the last Wednesday of the month. Dates | Weds, Jan 28, Feb 25, and Mar 25 Time | 4-7 p.m. Location | The Breast Center at Littleton Adventist Hospital Registration (required) 303-738-2767
Prevention and Early Detection of Gynecologic Cancers Dr. Glenn Bigsby, gynecologic oncologist, will discuss signs and symptoms of cancers of the female reproductive system, as well as risk factors and prevention tips. Date | Thu, Feb 5 Time | 6-7 p.m. Location | Littleton Adventist Hospital, Conference Room 1 Registration mylittletonhospital.org/ lahclasses or call 303-734-8612
An Introduction and Overview of Menopause OB/GYN Dr. John Stallworth, a certified menopause practitioner by the North American Menopause Society, will walk women through what to expect during the menopause transition, outline management options, and raise awareness of the predatory practices that take advantage of women going through this change. Date | Thu, Feb 26 Time | 6-7 p.m. Location | Littleton Adventist Hospital, Conference Room 1 Registration mylittletonhospital.org/ lahclasses or call 303-734-8612
Girl Talk This two-hour class, recommended for girls age 9-12 and a parent or guardian, focuses on the physical changes of puberty and menstruation, sexuality, and sexual reproduction. Learn the facts from Dr. Jessica McCullough, OB/GYN with Littleton Adventist Hospital and CHPG-Women’s Health at Littleton, in a relaxed atmosphere, designed to encourage communication within your family regarding family values and decision making, as well as promoting positive self-esteem. Dates | Thu, Jan 29, or Wed, Feb 18 Time | 6-8 p.m. Location | Littleton Adventist Hospital, Conference Room 3 Registration mylittletonhospital.org/ lahclasses or call 303-730-5810
Photo: ©istockphoto.com/Anthia Cumming
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 region’s leading healthcare 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 — Portercare Adventist Health System.