2008-03 Northern Colorado Medical & Wellness

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Bariatric Surgery Success Robert Quaid, MD

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publisher’s letter

Each for their own reasons, these men and women came to a point in their lives where quality of life was so compromised that they made the ultimate commitment to change.

the patient

A Season of Transformation

When my daughter Meredith moved back home, I didn’t know that I would also inherit the care and feeding of two additional dependants.

Lily is a frisky delightful miniature Shih Tzu, who wouldn’t sit still long enough to photograph, weighs just a few pounds and loves to carry around her toys. She is fun and precious and easy to care for. Now Gus is another story. A very big and ominous looking Victorian Bulldog, Gus looks like he would take your leg off if you got near him, but in reality, would prefer to just slobber all over you. He is all muscle and if he happens to step on an already sore foot, it really really hurts. If he chooses to lunge across an icy driveway, you better hold on for dear life and be prepared to slide (or fall). What do you do? I guess just fix the sprinkler wiring, the redwood bench, the compressor frame, the broken planter and re-sod the back yard. What we do for our kids!

As our attention turns to the first signs of spring and outdoor activities, Mike Chellson’s interest in motorcycle racing comes to mind. This competitive and intense sport is what the new trim and fit Mike enjoys. Just a few years ago he weighed in at 450 pounds and couldn’t think of attempting any exercise while today, a trim 168 pounds, he is an elite athlete. I must say that when Amy Brewster, MD, mentioned him to me as an interesting interview, I wasn’t thrilled about an early morning appointment on Saturday (my only day

to not get up to an alarm clock). But three hours went by in a flash and I was totally enthralled with his motivation, dedication, self-discipline, and personal charm. Do read about his journey in The Transformation of Mike To Fit and Healthy and watch for the follow up article in the May Medical & Wellness issue on how he and Amy Brewster, Plastic Surgeon, dealt with the pounds of extra skin that resulted in his massive weight loss.

Another very inspirational event that Pam Brock, Vice-President, Marketing & Strategic Planning, Poudre Valley Health Systems invited me to was the annual celebration fashion show of those patients who have gone through Bariatric Surgery.

I didn’t know exactly what to expect, but was quickly mesmerized by the life-changing weight loss of these hard working committed patients.

Each for their own reasons, these men and women came to a point in their lives where quality of life was so compromised that they made the ultimate commitment to change. And, change they did. Be inspired by reading their stories and learn about the compassionate and highly competent surgical team at Poudre Valley Hospital in Bariatric Surgery Success.

Wishing each of you good health,

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Northern Colorado Medical & Wellness

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11

March 2008

CONTENTS 14 20 24 28 32 38 40 44 46 48 50 54

northern colorado medical & wellness

Bariatric Surgery Success

Northern Colorado Surgical Associates, P.C. & Bariatric Center of the Rockies surgeons improve lives at Poudre Valley Hospital.

The Transformation of Mike To Fit And Healthy

An inspiring story of hard work paying off.

Greeley Medical Clinic, PC

Celebrating their 75th Anniversary.

Raising Standards in Elder Care NCMC’s nursing staff raises the bar.

CSU Animal Cancer Center

Benefitting Humans through research.

Two Hospitals, Two Specialties, One Campus

Northern Colorado Rehabilitation Hospital and Northern Colorado Long Term Acute Hospital.

14

Bariatric Surgery Success

Northern Colorado Surgical Associates, P.C. & Bariatric Center of the Rockies surgeons improve lives at Poudre Valley Hospital.

20

The Transformation of Mike To Fit And Healthy

An inspiring story of commitment & hard work.

Occupational Health Services

Businesses benefit from Banner Health’s support.

Retiring in Style

MacKenzie Place offers active seniors resort living.

Allergies? Don’t Suffer! Get Help!

What to do about those itchy eyes.

How Pearly Are Your Whites?

Lumineers offer a quicker fix.

Total Vein Care

Steven L. Kaufman relieves leg pain.

Chris Cribari, MD

32

CSU Animal Cancer Center

Benefitting humans through research.

44

Retiring in Style

MacKenzie Place offers active seniors resort living.

Taking care of families.

on the cover

Robert R. Quaid, MD, Bariatric Medical Director, PVH, prepares Jamie Huxoll for a Lap-Band® surgical procedure.

50

Total Vein Care

Steven L. Kaufman, MD relieves leg pain.

Cover photo by Dana Milner.

12

The articles in this issue of Northern Colorado Medical & Wellness are for your general knowledge and not as a substitute for medical advice or treatment. If you have any questions or concerns about your health, please contact your doctor or healthcare provider.

54

Chris Cribari, MD Taking care of families.

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Weight Loss

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We are truly privileged to be part of such a life saving service. All of us have a lot to celebrate.

- Robert R. Quaid, MD, FACS, Northern Colorado Surgical Associates, P.C. Bariatric Medical Director, Poudre Valley Hospital

Bariatric Surgery Success

by LYNN M. Dean

It was a cold December evening, and the patients and staff of the Northern Colorado Surgical Associates, P.C. and the Bariatric Center of the Rockies were gathered for their annual holiday party featuring good food, fun and a fashion show at Poudre Valley Hospital.

T

he air was electric with excitement and celebration. Cameras flashed.

One by one the models paraded onto the stage, as the emcee described their ensembles. Donna Kelley twirled and whirled as she gave the audience a good view of the stylish clothes that skimmed her trim, yet curvaceous body. Amidst whistles, hoots and howls, Derek Taylor aped for the crowd as well as the camera as he showed off his handsome,

14

muscular physique. And then, quick as lightening, a bubbly four-year-old captured the hearts of the audience as he recognized his mother, and ran to encircle her with his delicate arms. After a quick hug, the impatient youngster, with a gentle insistent tugging motion, proudly escorted the petite Joy Archer to the stage.

Joy is used to her son’s exuberance. What she isn’t used to is the fact that sometimes her kids and other family members don’t recognize

her, even when she’s just feet away. “I went to pick up my daughter, Hannah, from school one day and she didn’t even recognize me standing there,” she shares. “Even my mom can’t find me in a crowd.”

In reality, Joy is just now starting to recognize herself. “Every once in a while I’ll catch a glimpse of myself in a mirror or window and say, ‘Oh, that’s right, I remember now.”

What Joy, Derek, Donna and the other models remember each time they catch sight of themselves in a mirror is that they’re not who they used to be– at least in physical form. They’re not morbidly obese anymore.

Someone once commented to Joy that she didn’t look like herself. Her response: “I look more like myself that I ever have before. I’m not trapped in there any more!”

“They’re like butterflies coming out of their cocoons,” says Becki Mudgett, RN Bariatric Program Coordinator for Northern Colorado Surgical Associates. “That’s what we get to see every day.”

Together Joy, Derek, and Donna have lost 581 pounds. Their transformations were all made possible with the help of the doctors who make up the Bariatric team of Northern Colorado Surgical Associates, P.C. (NCSA): Dr. Robert Quaid, Dr. James Dickinson, Dr. Stefan Pettine and Dr.

Michael Roller. “We are truly privileged to be part of such a lifesaving service,” says Dr. Quaid. “All of us have a lot to celebrate.”

“We were the first weight loss center in the Rocky Mountain Region,” says the NCSA. “Since 1994 we’ve performed over 2000 surgeries.”

The NSCA help people achieve these remarkable weight loss results with two types of weight loss surgeries: Gastric Bypass Surgery and Lap-Band® Surgery.

“Roux-en-Y Gastric Bypass Surgery is considered the “gold standard” of weight loss surgery,” says the NCSA. In this procedure, usually done laparoscopically, doctors create a small stomach pouch, about the size of an egg, by sectioning off part of the stomach. The surgeon then creates a by-pass around parts of the stomach and small intestines (the duodenum). “This limits the amount of nutrients and calories your body absorbs,” says the NCSA. “It also restricts your ability to eat sweets. Patients typically lose a lot of weight in the first year, maintain their weight loss over time, and typically lose about 60 percent of their excess weight.”

“Lap-Band® Surgery is a less invasive, less complicated operation,” says the NCSA. “As a result it has fewer risks and is being performed with increasing frequency in the United States.

In this procedure, the surgeon places an adjustable, removable band around the stomach to create a small pouch at the top. This limits the amount of food that can be eaten at any given time, but unlike Gastric Bypass Surgery, it does not limit the types of food that can be consumed.

“At first, patients lose weight more slowly than they do with Gastric Bypass,” explains the NCSA. “However, patients’ eventual weight loss after four years is about the same.”

Of course, not everyone needs, or should have bariatric surgery. It is meant to be a “last resort” measure for the morbidly obese – people with a body mass index (BMI) of 40 or higher. People like Derek Taylor and Donna Kelley.

Now at a sleek 180-190 pounds, Derek weighed 460 pounds before his surgery. “I tried just about every diet on the market, in one way or another,” he explains. “Diets do work if you stick with them. But diets are designed to help you lose 20, 30, or 40 pounds. When you’re morbidly obese, that little weight loss really doesn’t make you feel any better.”

According to the NCSA, there is a limit to how much weight a morbidly obese person like Derek can lose and keep off. “There is no good way to lose weight once you get over a certain weight,” said Dr. Roller who explains that diets typically help people lose only 10 to 20 percent of their body mass. For morbidly obese people, “maintaining only a 22 pound weight loss provides no medical benefit.”

Derek’s motivations for weight loss were clear.

He was a volunteer firefighter, and although he could do the job, he couldn’t live up to his own expectations for himself. “I didn’t use my weight as an excuse for anything,” he says. “But it kept me from doing things as well as I wanted to do them.” Derek also wanted to be able to “horse around” with family and friends without the fear

Northern Colorado Medical & Wellness

of hurting them.

“One day all the different things piled up,” he explains. At 22, he decided to have Gastric Bypass Surgery, which was performed by Dr. Pettine in October, 2005. He has since lost 270 pounds.

“Some mornings I still wake up and think that I’m 450 pounds. But then I go into the closet, put on my 32 (inch) waist pants and my size medium shirt and I’m happier than a pig in a pigpen.”

Like Derek, Donna Kelley had tried everything to lose weight- WeightWatchers, Jenny Craig, Optifast. “But I couldn’t maintain the weight loss,” she says. “I always gained it back.”

At 386 pounds, Donna was in constant pain and hated looking at herself in the mirror. It was her doctor that suggested she consider bariatric surgery. “Becki [Mudgett] was the first one I talked to about it,” she says. “And before I knew it, things got started. I’m a very prayerful person and I asked God, ‘If this is supposed to happen, please make it very clear to me and open these doors.’”

He answered her quickly. “I had gotten this packet of paperwork to fill out,” she explains.

“The first time I looked at it, I was overwhelmed.

This is too much, I said to myself. This is too hard.

But later, after that prayer, I picked it up again and it was so easy to fill out that I completed it in a half hour.”

Dr. Quaid performed Donna’s Gastric Bypass surgery in March, 2006, and she has since lost 211 pounds. “I’m not in pain anymore. My feet don’t hurt, my knees don’t hurt, I’m not out of breath. I fly up the stairs. I just can’t sit still anymore. I have to be moving.”

But, like her fellow patients, the surgery has affected more than just her health. “Emotionally this has been an incredible journey. It’s been enlightening,” she says. “I’m stronger knowing what Donna wants, what Donna needs. I had written on the calendar the day my surgery was scheduled, ‘Donna’s new life begins.’ Now I have to face things head-on. I can’t turn to food anymore. Now I feel the sky’s the limit. God’s opening all kinds of doors and providing for me, and if I can share that with one other person, then I want Him to use me for that. You have to be true to yourself, and look deep inside and ask for God’s help.”

Although this life-changing surgery is usually

“My blood pressure was through the roof... I had tightness and shortness of breath... It hurt to lift up kids... I can do anything I want now.”

- Joy Archer

Before

15

“My weight kept me from doing things as well as I wanted to do them.”

“My feet don’t hurt, my knees don’t hurt, I’m not out of breath.”

- Donna Kelely

- Derek Taylor

Before Before

reserved for the morbidly obese, people like Derek and Donna, people with a body mass index as low as 35 who have other serious health issues like high blood pressure or diabetes can also qualify.

Joy Archer weighed “only” 220 pounds and had a BMI of less than 40. But her blood pressure was really high, and no matter what she tried, she just couldn’t keep the weight off.

“Every day was a constant struggle of not eating too much, not eating the wrong things, not eating too much of the wrong things, feeling guilty for eating the wrong things,” she explains all in one breath. “So whether I was heavy or thin, food always consumed my thoughts.”

At night, she had to fight other demons. “My blood pressure was through the roof and I would go to bed at night worrying about dying,” she confesses. Each time her head hit the pillow, Joy wasn’t sure she’d wake up the next morning.

“There were times when I had tightness and shortness of breath. Things that shouldn’t happen to you at 35.”

Her job as a home childcare provider also took a toll on her. “It hurt to lift up kids to change them,” she says. “My back hurt and it was difficult to play with the kids on the floor.”

But it was thinking about her own children that convinced her to do something about her weight. “My daughter, Hannah, plays competitive soccer and I couldn’t run around with her,” she says. “And David (that boisterous four-year-old) is a live-wire. If you can’t chase him down, you’re going to lose the battle.”

16

So at the end of December, 2006, Joy Archer had Gastric Bypass surgery performed by Dr. Roller. Since then she’s lost 120 pounds. “I’m thrilled because I’m not miserable around food anymore. I can do anything I want now. I can run with my daughter. I can touch my toes. I can tie my shoes easily. I can fold myself into a pretzel.”

Many people think that Joy and Derek and Donna took the easy way out. But truth be told, Gastric Bypass and Lap-Band® surgeries require a lot of commitment, work and sacrifice on the part of those who qualify and choose to undergo them.

Before and after surgery, patients are required to meet with a nutritionist and a psychologist to ensure that they are ready for the surgery and prepare themselves for the changes that lay ahead. Most bariatric surgery procedures are performed in a hospital setting, with a two-tothree day hospital stay. Bariatric Center of the Rockies, centered at Poudre Valley Hospital, is a joint effort between the surgeons, the NCSA staff and the specially trained surgical and clinical staff at Poudre Valley Hospital. The Center is accredited as a Bariatric Center of Excellence by the American Society of Metabolic and Bariatric Surgery (ASMBS), and several insurance companies.

Centers of Excellence are so recognized because of surgical quality, volumes of surgeries and patient outcomes.

“It changes your whole way of eating,” says Donna. “You have to eat slowly. You have to learn to chew, chew, chew. You have to watch

your sugar intake. But your whole life changes when you get healthy. I just can’t believe how wonderful I feel.”

“You have to do this for yourself,” adds Derek.

“You can’t do it because someone else wants you to do it, or you want to impress somebody. It’s an entire lifestyle change.”

“I still don’t think it’s for everyone,” agrees Joy. “It’s a huge mental adjustment and you have to be ready to take care of yourself, do what they tell you to do, and be prepared for the mental challenges ahead.”

But those that choose to undergo such drastic measures and follow the guidelines reap the benefits. They’re released from their cocoons of fat and, like the beautiful butterflies they are, they soar to new heights.

Lynn M. Dean is a freelance writer living in Northern Colorado.

“Light for Life,” a monthly bariatric support group, established by NCSA and hosted at Poudre Valley Hospital, welcomes those who have undergone bariatric surgery and those who are considering this life-changing surgery.

Monthly seminars are also held for those considering surgery.

Please call 1-866-495-7579 or go to www.pvhs.org to receive an information packet.

Fort Collins, CO 970.482.6456 888.699.6272 (toll free) www.ncsurgical.net

Northern Colorado Surgical Associates, P.C. Surgical care since 1956 BARIATR I C CENTER OF THE ROCKIES f'OUDRE VA L LEY HOSPITAL

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Northern Colorado Surgical Associates’, P.C.

Gastric Bypass Team of Surgeons James M. Dickinson, MD, FACS Dr. James Dickinson earned his medical degree from the University of Kansas School of Medicine in Kansas City. He completed his residency in general surgery at the University of North Carolina in Chapel Hill. Dr. Dickinson has extensive training and experience in laparoscopic surgery and traditional open procedures, with special interests that include obesity surgery, endocrine surgery, inflammatory bowel disease, and oncologic surgery. Dr. Dickinson is board certified by the American Board of Surgery.

Stefan M. Pettine, MD, FACS Dr. Stefan Pettine earned his medical degree at the University of Colorado Health Sciences Center School of Medicine. He completed his internship and residency at Madigan Army Medical Center in Washington. He then took a teaching staff position at Darnall Army Community Hospital, where he commanded the 555th Forward Surgical Team. Dr. Pettine has extensive training in minimally invasive and bariatric surgery. He is certified by the American Board of Surgery. Dr. Pettine is also a Fellow of the American College of Surgeons and a member of the American Society of Bariatric Surgeons.

Robert R. Quaid, MD, FACS Dr. Robert Quaid earned his medical degree from Indiana University Medical School.

He completed his residency in general surgery and a fellowship in Surgical Critical Care at Butterworth Hospital in Grand Rapids, Michigan. Dr. Quaid’s interests include obesity surgery, surgery of the thyroid, minimally invasive treatment for varicose veins, and advanced laparoscopic procedures. Dr. Quaid is certified by the American Board of Surgery and is board certified in Surgical Critical Care. He is also a Fellow of the American College of Surgeons and a member of the American Society of Bariatric Surgeons.

Michael Roller, MD, FACS Dr. Michael Roller earned his medical degree at the University of New Mexico School of Medicine and completed his surgical residency at Keesler Medical Center at Keesler Air Force Base in Mississippi. After four years of Air Force Service, he completed a minimally invasive surgery fellowship in non-cardiac thoracic surgery at the University of Pittsburgh.

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Inspired Individuals

Personal Triumph Mike enjoying life after his 282 pound weight loss on a trip to the Australian Rainforest in October 2007.

I learned that the scale is not the measure of good health; more importantly, percentage of body fat and blood work is the true measure.

- Michael Chellson

The Transformation of Mike To Fit and Healthy

by Lydia Dody

As long as he could remember, Michael Chellson saw himself as an obese man and was plagued with low self-esteem, an introverted personality, and found himself always in the background at social and athletic activities.

I

wasn’t very friendly with people and couldn’t make eye contact.

I didn’t like myself much and I suppose this didn’t make me too likable to others either.”

Mike is an engaging 49 year-old attorney who works as counsel for a medical device company.

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His career has kept him very medically informed and quite aware that his 450-pound physique was not healthy but, unfortunately, that wasn’t enough motivation to make him change his lifestyle.

But in July 2003, something did happen which changed his life. “I experienced the nexus of my

life. I was at work when I suddenly slumped to my side and got amazingly dizzy. I couldn’t speak and I vomited all over my associate who was trying to help me. My friend immediately knew that every minute is critical for stroke victims so managed to shove my heavy 450-pound body into a wheelchair and get me to a hospital ER.” “I was compulsive about my work then and was a true workaholic. So much so that when I could finally utter a few words, my first comments in ER were to the guy who brought me to the hospital. ‘Aren’t you supposed to be at work?’”

“I’m not that way now, but sure was then,” he quips.

“My dizziness continued for 3 months resulting in a total lack of balance,” he continued. “The left side of my face had minor paralysis, and my vocal chords were affected so I could no longer sing. In fact, I couldn’t walk, my speech was slurred, and my cognitive ability was like thinking through a fog. Ten months of intense therapy followed and I continued to improve little by little. I was lucky and ultimately became the poster child for stroke recovery, or so says my doctor.”

Of course, recovery is relative. Mike had not only faced death and won, but now faced the probable transition from the hospital to a nursing home so that he could get the constant care he

Today Mike’s passion is motorcycle racing and he competes in a four state region.

Mike before his weight loss in July 2004 with wife Sandie.

still required. He was too well to continue in the hospital but not well enough to go home. Trying to be convincing, “I showed the hospital staff I could handle stairs by doing them one at a time on my buttocks, and won the right to go home.

I couldn’t bear the idea of being with people waiting to die in a nursing home.”

“It was at that moment that I vowed to myself I would do anything it took to get healthy.”

At 43 Mike was suffering from diabetes, hypertension (170/120), high cholesterol, and was morbidly obese. He didn’t want to die, but, he was a prime candidate and he knew it. So in May 2004, Mike embarked on his own program of nutrition and activity to turn his health around and become able to function on his own.

“From a nutrition standpoint, I eliminated all white powder from my diet such as refined flour, sugar, and derivatives. I made small changes one at a time. I love chocolate and treat myself to a Chocolate Kiss every couple of days; just one that is, instead of a 2 pound bag that I would inhale before. I didn’t drink anything with sugar in it, and I didn’t eat fast food. I ate low fat or no fat foods - although I did eat foods with good fats such as nuts and salmon. I seldom ate fried foods.

And, only ate carbohydrates when I planned to be physically active. I love vegetables so 75 percent

Northern Colorado Medical & Wellness

of my diet consisted of vegetables and grains.”

His program started working immediately as 5-pound increments of weight loss started falling off of him almost effortlessly.

“And, most importantly, I started a discipline that I continue to this day. I write down everything that goes into my mouth because I am convinced that you can’t manage what you don’t measure.”

“I learned that the scale is not the measure of good health; more importantly, percentage of body fat and blood work is the true measure.

Knowing your LDL/HDL figures is important in making sure your ratios are right. I didn’t weigh myself daily because I didn’t want to set myself up for failure.”

Between May and August, Mike lost 60 pounds but couldn’t even see the difference and he knew that he wouldn’t reach his goal until he added activity. That summer Mike bought a mountain bike and started biking in his neighborhood. The first day he was huffing, puffing and sweating just biking 400 yards. But that did not discourage him and each day he got back on the bike. “Some days, I only went 6 inches further than the day before, but I didn’t give up.” When the weather permits Mike now bikes 15 miles, three days a week.

Mike weighing 450 pounds in July 2004.

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Inspired Individuals

Personal Triumph

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“When the weather got cold and snowy and I couldn’t bike, I joined a health club and discovered the elliptical cardio machine. My first day I could only do 5 minutes on level one and now I regularly do one hour on level 15. As time progressed and I got more fit, I started doing a weight training routine designed for me.”

“One year later, when I got to 250 pounds, I felt fit enough to return to a sport I loved.

Motorcycle racing (motocross) is something I continue to do now at least weekly. I compete in Colorado, Nebraska, Kansas, and Wyoming and look forward to introducing my grandson to this sport.” Mike is a very fit athlete and is now compulsive about his exercise regimen.

By late 2006 Mike hit 185 pounds, a loss of 265 pounds in 2½ years. When I asked Mike how others reacted to his enormous weight loss, he said that people definitely noticed and often commented on how he seemed more confident and more personable. He spoke about discovering that he had charisma and people were drawn to him. He commented on being able to confidently look people in the eyes. “There has been a huge difference in my relationships. And, my love life improved dramatically too,” he said with a smile, as he talked about his supportive wife.

Interestingly, Mike said that, even though he lost all that weight, when he looked into a mirror, he still saw fat Mike. For 30 years he had brainwashed himself to think that health and size didn’t matter and that his value was what was inside of him as a person. This notion that appearances didn’t matter was a protective belief and it took quite some time for him to come to accept the new fit Mike.

Over time, Mike increased his exercise intensity with more weights, more sets, more miles, and longer tougher cardio workouts. He continued with his original nutrition plan and his daily journaling.

Today Mike stands 5’10” and weighs 168 and is completely free of diabetes and hypertension, with a blood chemistry, which his doctor has called, “outstanding.” In fact, he said his doctor ordered him to gain a few pounds so that when he races, and burns up 4000 calories in a day, he has some cushion.

Asked what kept Mike motivated, he answered, “I have to be healthy and fit to be able to share my love and passion for life with my grandchildren and future great grandchildren.

That keeps me going.”

Mike’s approach to good health and weight loss was so successful, he is currently exploring ways to be able to share his success with others.

If you are interested in communicating with him, he welcomes your email at a-hugh-manbeing@ hotmail.com.

Watch for our May Northern Colorado Medical and Wellness issue where we follow Mike Chellson in his next phase of excess skin Body Contouring with Plastic Surgeon Amy Brewster, MD, Mountain Vista Plastic Surgery.

Lydia Dody is the Publisher of Style Magazine and is now inspired to take off her pesky 15 pounds.

I write down everything that goes into my mouth because I am convinced that you can’t manage what you don’t measure.

- Michael Chellson

Mike shares his

success tips Discover what hunger truly feels like and only eat then.

Don’t succumb to appetite.

Have an overall objective and set short-term goals.

One day doesn’t matter; so don’t beat yourself up if you fall off the wagon. Tomorrow you will do better.

Be disciplined about journaling everything that goes in your mouth.

Activity is essential.

You must change your life; not go on a diet, as diets inevitably fail.

Northern Colorado Medical & Wellness

23

Lifelong Medical Care

Comprehensive Care

Sanjay Gupta, MD begins an examination.

Greeley Medical Clinic, P.C. Celebrates 75th Anniversary Greeley Medical Clinic is one of the oldest independent, multi-specialty practices in Colorado. Currently celebrating 75 years of serving patients, this physician-owned and governed practice employs over 400 individuals including 70 providers representing 18 medical specialties, and is the largest medical group practice in Northern Colorado.

H

ow do you describe a multi-specialty group practice?

Dan Zenk, MD, President of the group offers one description.

“When multiple elements work together in unison, the whole is greater than the sum of its parts. Now apply this simple principle to the delivery of healthcare. That’s our group practice.”

The concept is a deceptively simple way to deliver excellent healthcare. Bundle all together in one state-of-the-art electronic medical record and location the physicians, surgeons, and diagnostic services that a patient will need in his or her lifetime. Patients have routinely described GMC as “one stop shopping,” a very convenient way to meet all of their medical needs.

24

GMC’s physicians and staff strive to provide quality medical care in a manner which places the highest value on human dignity in a professional, caring and friendly environment. According to Barbara Yosses, Chief Executive Officer, “Greeley Medical Clinic’s mission is to provide coordinated patient-centered care.”

What is coordinated patient-centered care?

As the name implies, coordinated patientcentered care focuses on what each patient needs and provides it through centralized record keeping, communication, and an attention to detail that puts the patient first. It requires visionary leadership to construct a better way of meeting the challenges of healthcare, but GMC’s unique

multi-specialty medical group demonstrates the benefits of coordinated resources and focused expertise to their patients daily.

Imagine GMC’s cadre of internal medicine physicians, general surgeons, orthopedists, pediatricians, ENTs, family practitioners, physical therapists, oncologists, other specialists, and even a pharmacy … all sharing vital information, digitized diagnostic results, and treatment knowledge through one electronic medical record for each patient, available 24/7.

In GMC’s full range of healthcare services, there’s something for everyone in the family – moms, dads, grandparents, toddlers, teenagers, and even those who haven’t arrived yet in our world. Urgent care facilities have convenient, extended hours to provide vital and prompt care to patients in need of “unexpected” medical services.

Healthcare for a lifetime Yosses sees broad life-long benefits for their patients, “In GMC’s full range of healthcare services, there’s something for everyone in the family.”

For every phase in life, GMC has an associate to assist you. From newborns’ pediatricians to the comprehensive care of a family practitioner or internist, or even more specialized needs like an ENT to diagnose and treat ear infections, or a dermatologist to direct acne and skin care, you will find a skilled physician at GMC. When it comes to preventive care such as screenings for bone density, cancers (breast, colon, or prostate), or gynecological, orthopedic or surgical concerns, GMC addresses each discipline with specialty-specific associates.

Aging has unique conditions that may require a rheumatologist to treat arthritis, an audiologist to address hearing loss, internists, gastroenterologists, urologists, or pulmonologists. All are part of GMC’s family of specialists.

A patient-centered approach Recently a patient in severe pain called GMC, hoping to be seen the same day. There was no time available in an already full schedule, but an off-duty orthopedist agreed to see the patient anyway.

The patient’s adult children were so impressed

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Comprehensive Care with the care their mother received, they took the time to write. “The physician was very thorough and spent considerable time evaluating and making treatment recommendations. Our mother got better care than we have received from any doctor to date, and we feel more positive about the recommendations we received than we have in a long time.”

They went on to mention how the assistant took their mother’s pain to heart, going “above and beyond” on her behalf. They summed up

their gratitude for GMC, “You rock!”

That’s the kind of patient-centered care all 8 of GMC’s locations throughout Greeley and Loveland provide. With 2008’s planned expansions, it will be even more convenient for area patients.

The medical group is expanding its current facility from the south office building to a new north office building to be built on the north side of the Medical Center of the Rockies (MCR) campus at Centerra with the help of cutting edge architectural firm Boulder Associates. Plans for the “Medi-

cal Clinic at Centerra, P.C.” as it is called, include 40,000 square feet of custom-designed space featuring the “pod” concept. This floor plan allows for optimal patient flow and improved staff efficiency. Patient waiting “living rooms” have spectacular views of the Rocky Mountains.

About 20 primary care physicians, sub-specialists, and surgeons will be taking care of patients at the new location by November 2008. In addition to physician exam and surgical procedure rooms, there will be space allocated for a Coumadin clinic, as well as laboratory, imaging, and audiology.

The medical group’s main campus is located in Greeley directly across the street from North Colorado Medical Center (NCMC). Outstanding healthcare can be delivered to the community easily with the close proximity of two major healthcare providers (NCMC in Greeley and MCR in Loveland). GMC’s multiple office facilities allow for easy-to-access healthcare, and physicians with privileges at both hospital systems give patients in Northern Colorado additional choices and flexibility.

Dan Zenk, MD, sums up this medical group’s role in providing healthcare for this region: “Physicians of all kinds working together to share expertise and do more of what they do best: take care of patients. As a multi-specialty group, GMC makes healthcare work better in Northern Colorado.”

For information, locations, or class and events schedule, visit: http://greeleymedclinic.com

26

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NICHE at NCMC

Geriatric Nursing

Julie Simmons, RN, BC, NHA, TCU manager examines an elder patient.

Raising Standards in Elder Care

by Laura Lee Carter

Experts in health and elder care have begun discussing the upcoming “elder tsunami.” Americans age 65 and older make up only 12% of the U.S. population today. But in less than three years, when the Baby Boomer generation begins to turn 65, that percentage will increase to a full 20% of total population very quickly. The fact that so many Baby Boomers will begin turning 65 and thus start commanding an enormous share of the nation’s healthcare resources is going to catch many by surprise. Much as we all talk about it, most are not prepared for this gigantic demographic shift.

J

ulie Simmons, the Clinical Manager at the Transitional Care Unit (TCU) of Greeley’s North Colorado Medical Center (NCMC), has studied these numbers in detail and has consequently begun to inaugurate some important and timely changes within her unit, and throughout the hospital. With the realization that at any one time around fifty percent of the patients at NCMC are age 65 and over, and recognizing that this number will only go up as Baby Boomers age, the administration decided to take immediate action to prepare properly for this upcoming reality.

NCMC sent Julie Simmons, TCU Care Coordinator Stefanie O’Neill, RN, and Stephanie Morones, BA, to the John A. Hartford Foundation Institute for Geriatric Nursing Conference last February, to learn more about becoming involved in their NICHE or “Nurses Improving Care for Health System Elders” Program. NICHE is a national

28

hospital-based program which assesses nurses’ attitudes and knowledge about care for the older adult, offers effective nursing models of geriatric care for better outcomes, and addresses protocols key to geriatric clinical conditions.

After the conference, a decision was made at NCMC to focus more energy on providing superior service to their elder population. Simmons states, “We are only the 2nd NICHE facility in Colorado, after Boulder Memorial Hospital, to add extra emphasis to properly caring for this patient group which makes up around half of our clientele now, and will be even more important in our future.”

Objectives for the new NCMC program include improving nurses’ competence and satisfaction working with hospitalized elders, improving clinical outcomes and customer satisfaction scores, and maximizing retention of nurses with enriched job satisfaction. In this way, NCMC

hopes to set a regional example of superior care for older adults and demonstrate responsiveness to the specific needs of the Northern Colorado community.

The new program, recently instituted at NCMC, is called “Age Matters” and its mission is “to achieve systematic nursing change that will benefit hospitalized older patients,” according to TCU Care Coordinator O’Neill. Last summer monthly geriatric training sessions on the skills needed to work successfully with elder patients, were added to the offerings for personnel who provide direct patient care.

Employee training is extensive, with staff members receiving eight contact hours of NICHE instruction. In addition, O’Neill states, “We have administered the Geriatric Institutional Assessment Profile (GIAP) which is a tool used to measure our hospital’s readiness for geriatric education and practice change.”

We are only the 2nd NICHE facility in Colorado to add extra emphasis to properly caring for this patient group [older adults] which makes up around half of our clientele now….

- Julie Simmons, RN, BC, NHA

The institution of the NICHE program at NCMC has also had a regional impact, especially in the training of new nurses. O’Neill points out, “Our curriculum has been added to Banner Health’s Western Region New Graduate Nurse Orientation Program.” This means that all new Banner Health nurse graduates receive NICHE training, extending as far as hospitals in Colorado, Nebraska and California.

How do the employees of the NCMC Transitional Care Unit feel about their new training opportunities and the changes this has led to in their work life? Ruby Armitage, the TCU Activity Director, with a specialty in occupational therapy, came to the field of elder care because of her love of working with older members of our society.

She finds it exciting to watch fellow workers learn more about the special needs of their elders. She has been thrilled to learn more about how elder patients compensate for the deficits of aging. She states, “The training has helped us all to be much more empathetic to the special needs of our older patients.”

Sandra Valencia, an LPN with 12 years of experience, feels that the most profound aspect of the NICHE training for her was the “Virtual Dementia Tour.” This activity provided staff members with special goggles which imitated the effects of cataracts and glaucoma, and various other apparatus that simulated arthritis and hearing deficits, and then took them through a course of different activities. Through this “virtual tour” the participants experienced first hand the difficulties of completing simple daily tasks while confronting various degrees of impairment, thus greatly increasing their sensitivity and awareness of agerelated functional and communication barriers.

O’Neill can hardly believe the changes she has seen in her staff by providing them with NICHE training. She feels that, “We have far surpassed my expectations for change in less than one year of participation.” She has been astounded at the high level of support and cooperation on all levels at NCMC, and has experienced no obstacles to its full success so far. In addition, O’Neill states, “We have raised funds from the NCMC Volunteers and Foundation for tools and staff education. All TCU nurses and Certified Nursing Assistants (CNAs)

Northern Colorado Medical & Wellness

have received NICHE’s “Geriatric Resource Training” and now serve as much needed teachers for other areas of the hospital which may be facing commonly misunderstood syndromes that are specific to the elder patient.”

Future plans for the program are determined

by GIAP ratings. According to O’Neill, “Our GIAP scores indicate that NCMC nurses and CNAs are eager for more education on geriatric nursing practice. We will continue to educate our nursing staff at our monthly training sessions, with the understanding that our 2008 goal is to educate 20% of nurses and aides in each practice area so that they may serve as a resource to their immediate colleagues.”

Laura Lee Carter is a local freelance writer. Please see her website at: LauraLeeCarter.com and her blog: MidlifeCrisisQueen.com

Stefanie O’Neal, RN, BSN, Care Coordinator in the NICHE unit, Stephanie Morones, Business Associate & Julie Simmons, RN, BC, NHA, TCU Manager

29

POUDRE VALLEY

HEALTH SYSTEM

We're here

Veterinary Medicine

Cancer Research Susan M. LaRue, DVM, PhD, Daniel Gustafson, PhD, and Susan E. Lana, DVM, MS comfort “Angel” a Great Pyrenees sitting by the Varian Trilogy System for radiation therapy.

CSU Animal Cancer Center Benefits Humans

by Kay Rios

The work going on inside Colorado State University’s (CSU) Robert H. and Mary G. Flint Animal Cancer Center (ACC) gives a whole new meaning to the term “human-animal bond.”

T

he services provided in the 35,000 square foot annex at the James L. Voss Veterinary Teaching Hospital are readily apparent. With clinicians, scientists, nurses, technicians, and support staff, the ACC handles over 7,000 appointments and more than 1,500 new animal cancer patients each year, diagnosing and providing treatment with surgery, radiation, and chemotherapy. Clients can also access natural medicines and therapies for their pets in the Shipley Natural

32

Healing Center or, if need be, they can receive bereavement counseling.

Behind the scenes, a bustling cadre of researchers look at new and better ways of treating animal cancers and also finding ways to translate that into human treatment. Stephen Withrow, DVM, and ACC Director says, “Six million dogs in the U.S. will get cancer this year. It’s the leading cause of death in cats and dogs. And if you study bone cancer in dogs, you learn about bone cancer in kids. So what we are doing here may contribute

to healing in humans. Cancer is cancer; parts is parts,” he says. “It is translational back and forth, species to species.”

Withrow knows whereof he speaks. His research has led to collaborations with researchers at the National Cancer Institute and the Children’s Oncology Group. A limb-sparing surgical technique he developed to treat osteosarcoma (bone cancer) in dogs has been widely adopted to treat human cancer. That work has significantly increased the likelihood that children with bone

Stephen J. Withrow, DVM, ACC Director, discusses the cancer surgery done on “Woody” an 8 yearold Vizsla owned by Carol and Bob Zuerzher of Sheridan, Wyoming.

cancer can be cured.

Withrow says, “The National Cancer Institute and the FDA both recognize that these spontaneously occurring cancers in pet animals are more relevant to study than in mice or cells because it’s real world.”

“The idea that the mouse is the gold standard for study is absurd and not based on any scientific reality; it’s just based on convention,” adds Daniel Gustafson, PhD, CSU associate professor, and director for research at the ACC. “The metabolic rate of a mouse is so much higher than a human’s so drug doses are much different. There’s also a difference from dogs to humans but dogs have a body surface area to volume ratio as well as a basal metabolic rate more similar to humans than to mice so it’s more realistic to use dogs.”

The similarities help translate treatments.

Susan LaRue, DVM, PhD, professor of radiation oncology in the department of Environmental and Radiological Health Sciences at CSU says that radiation tolerance is the same in dogs as in humans. “Tumors in animals are heterogeneous tumors: not the same all the way through. And you don’t see that when you do experiments with mice. You see one tumor a hundred times. But, our patients have the same complex tumors as humans and our patients can be monitored the same as humans because of their size.”

“Even when an animal succumbs to cancer, much can be learned from autopsies. Pet owners are more willing to allow autopsies so that data doesn’t get buried. They are also more open to putting pets in clinical trials as long as they are humane. The Animal Care and Use Committee oversees all of the clinical trials to ensure that treatments are humane and that relevant questions are being asked,” Withrow says.

In determining which drugs would be appropriate for clinical trials, Gustafson looks at drugs already on the market as well as new drugs just coming out. “You may have one drug that can kill the tumor and a newer one that is not as toxic. It may shrink the tumor but not necessarily kill it. So the question is, ‘how do you get the mechanism of the old drug and combine it with the new one in an way that enhances the treatment effects and minimizes the side effects.”

Susan E. Lana, DVM, MS, and associate professor in the CSU College of Veterinary Medicine and Biomedical Sciences is the head of the clinical section, supervising residents and technicians in the clinic and also overseeing

Northern Colorado Medical & Wellness

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Cancer is cancer; parts is parts.

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Northern Colorado Medical & Wellness

clinical trials. Clinical trials have three phases and, she says, “We do all of those phases. Phase I is typically a toxicity trial; [we ask] is it toxic to patients, what organs are affected and what doses can be used? Phase II usually looks more specifically at the type of tumor where this would work.”

Phase III is traditionally a “head to head” com-

paring something new with something already being given or a combination of the two. In all of the trials, Lana says, “We have to be comfortable with the science. Do the questions make sense? Is it something our patients will tolerate? We want to meet both our patients’ and our sponsors’ needs.” With clinical trials, she says, “There’s always something new.”

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ROBIN DOWNING, DVM C ERT IF IED V ETERIN ARY ACUP UNCTU RIST DIPLOM AT E, A M ERICAN ACADEM Y OF PAIN MANAGEMENT CERTIFIED CANIN E REHABILITATION PRACTITIONER

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That “something new” is not just in the drugs arena but also involves equipment. In fact, the ACC received one of the most versatile tools available to oncologists last September. The Varian Trilogy System, LaRue says, “is the only one of its kind in any vet hospital in the world. And it’s state-of-the-art even for humans. It’s not just for client animals but it’s also for translational research.”

“The system offers flexibility that allows radiation treatment of very large fields or very small fields, superficial or deep,” she says. “You can create treatments as fine as if you were sculpting with a scalpel. People don’t know the best way to use it yet so we’ll be leading the way in advancing this type of therapy not only for our patients but also for humans.”

“CSU has always been a leader in radiation therapy. Even before we got this system, we were delivering sophisticated radiation. When we got this machine, we were still at the top of our game but this jumps us leaps and bounds ahead. It puts us in a tremendous technological position and will help raise the quality of veterinary care across the country,” says LaRue. Current day activities are a far cry from the beginning of the cancer effort. In 1978, when the Vet Hospital moved to its site on Drake Road, Withrow says, “All you had to do was teach, see clients and be good at your specialty. The dynamics changed around 2000. We realized we needed more room if we really wanted to treat cancer.

Twenty years ago, it was just me,” Withrow says.

“Now, ninety people work for me.”

In the fall of 2002, the ACC opened, thanks to private donors and a grant from the National Cancer Institute. And there may be more expansion in the future. “There’s a possible collaboration with Poudre Valley Hospital for a robotics learning center,” Withrow says. In addition, a $10 million proposal to expand research, development and application of new cancer treatments just went to CSU’s Academic Enrichment Program Committee. If approved, the ACC would become an international leader in basic cancer biology and translational research.

Withrow and crew are looking at a variety of opportunities. “You can’t do research in isolation nor should you. The University has recognized that we need to embrace the private sector and the business world.”

Withrow sees such collaborations as a winwin. “The benefit of all of this is that we can provide better services to our clients, do better outreach, and at the same time, enhance our teaching mission.”

Kay Rios is a freelance writer based in Fort Collins. She is currently a doctoral candidate in Educational Leadership at Colorado State University.

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Northern Colorado Medical & Wellness

37

Specialized Patient Care

Long-term Rehab Carrie Gooch leaves Northern Colorado Rehabilitation Hospital after recovering from meningitis.

Two Hospitals, Two Specialties, One Campus

by Jason Webb

Carrie Gooch was a vibrant, out-going 28-year-old young woman. She had everything going for her: she had a solid job as a supervisor in a warehouse, was engaged to be married, and enjoyed time with her friends. Then, she got sick.

I

t started in October 2007 with a stiff neck and a really bad headache. Her doctor told her it was simply an ear infection. A few days later, a chiropractor suggested she might have meningitis. She did. A trip to the emergency room and a spinal tap proved she had the viral strain of the disease.

She had the option of going home or being admitted to the hospital, and she decided to go home. A couple weeks later, her fiancé rushed her to the ER. “She became incoherent, and she was acting crazy,” says Mary Gooch, Carrie’s mother.

The meningitis was worse, and Carrie was in serious trouble. Medical Center of the Rockies admitted her and put her in the intensive care unit. She quickly fell into a coma. She missed Halloween,

38

Thanksgiving, her brother’s birthday, and her own birthday.

According to Mary, Carrie was put on a ventilator, a feeding tube, and had a tracheostomy.

Doctors thought she would be in a permanent vegetative state and weren’t sure if she would live. But, she did, and she proved a lot of people wrong by regaining her ability to walk, talk, and even go back to work part time. She was able to do this because of two incredible resources available to the Front Range and beyond: The Northern Colorado Rehabilitation Hospital and the Northern Colorado Long Term Acute Hospital.

The acute care campus is located just east of I-25 on US 34. It serves a large region, including parts of Wyoming, Nebraska, and the Northern Colorado Front Range. The campus has two

separate and distinct hospitals. On one side is Northern Colorado Long Term Acute Hospital (NCLTAH), which provides medical care for patients who have been discharged from acute care hospitals but still need medical attention. On the same campus, Northern Colorado Rehabilitation Hospital (NCRH) helps patients recover from injuries and illnesses and regain their independence.

Neither hospital, however, does drug or alcohol rehabilitation.

NCLTAH often admits patients, like Carrie, from intensive or critical care departments from local area hospitals. “We provide 24/7 acute medical care,” says Daniel Asadi, DO, who is the medical director for the hospital. “The patients we care for are sick enough to be in a hospital for a long period of time because they have complications or they are transferred to our facility to get the care that is adequate for a longer period of time.”

Where most large acute hospitals care for patients for an average of five days, the NCLTAH usually cares for patients for an average of 25 days. “We are a layer just below the hospital that cares for those patients who need another place to go to in the process of getting better,” says Asadi.

Brooks Stewart, the CEO of NCLTAH, adds, “Many patients would not do well in a less acute level of care because of their medical problems.”

However, once a patient is admitted to the 20-bed acute care hospital, the patient has access to an array of medical services. Stewart states the major difference between her hospital and a short term acute hospital is the function. “We do not have an emergency room, an operating room, or obstetrics. But, we have the services needed to provide quality medical care,” says Stewart. “We do not diagnosis the patients,” adds Asadi. “That’s done in the large acute care hospitals in our communities.

The unique aspect of the NCLTAH, which opened in July of 2007, is the ratio of patients to nurses. Stewart notes that for the patients needing high observation, the ratio can be one to two patients per nurse and our medical/surgical unit ratio can range from three to five patients per nurse. While doctors, nurses and dieticians all make up the professional team in the NCLTAH, both Asadi and Stewart believe the patient and the family make up a part of the team as well. In fact, the family is often included in the patient’s progress meetings. “Everyone takes this work personally,” says Asadi. “People trust us with their lives. It’s a unique privilege.”

Within a short time of being at NCLTAH, according to Mary, her daughter had all of the tubes

Many patients would not do well in a less acute level of care because of their medical problems.

- Brooks Stewart, CEO, NCLTAH

Brooks Stewart, CEO, NCLTAH

removed. “Dr. Asadi really did a lot for Carrie, and he still does,” says Mary. Carrie also believes the rest of the staff was superb. “They are very personable, and they genuinely care,” she says.

The other side of the hospital campus is the Northern Colorado Rehabilitation Hospital, NCRH, which opened in August of 2005. “Our goal is to get people home,” says Dennis Shelby, the CEO of the Rehabilitation Hospital. “That is what rehabilitation is all about.” To send patients home, the staff focus on improving each patients functional level to be able to return home as independent as possible and be safe.

The Northern Colorado Rehabilitation Hospital certainly achieves what they set out to do for their patients. “We currently discharge 82.6 % of our patients home,” says Shelby. “The national average is around 77%.” Those outcomes have paid off. Recently, NCRH was ranked in the top 10% of rehabilitation hospitals across the country for outstanding care that is effective, efficient, timely, and patient centered.

The 40-bed inpatient rehabilitation hospital

is capable of providing rehabilitation to patients who have had a stroke, brain injury, spinal cord injury, amputation, orthopedic surgery, and many other conditions, injuries, and illnesses. Patients who stay in the rehabilitation hospital will receive three hours of rehabilitation a day and have access to a state of the art 6,000 square foot rehabilitation gym, a warm water therapy pool, and specialized rooms that allow the staff to train and test a patient’s functional ability. The outpatient program also offers a host of other programs to help improve the patients’ quality of life.

“Every patient that comes to our hospital for treatment receives a functional assessment and an interdisciplinary care plan,” says Joseph Jacob, MD, the medical director of the rehabilitation hospital on the campus. “We try to look through the clinical issues and the functional issues in a way that we can ensure success at home.” Jacob also notes that it’s not just physical aspects they take into account with their patients, but they also look at the social aspects that the patient and their family may face.

“Our staff is very passionate about what they do,” says Jacob. Their passion shows through the number of people who have had care at the rehabilitation hospital: more than 1800 in two and ½ years. When a patient is ready to discharge home, a special overhead page alerts staff to gather in the lobby to say goodbye and congratulate the patient.

Carrie was one of the patients able to go home. Everyone lined up in the receiving line and applauded her as she walked through the Northern Colorado Rehabilitation Hospital’s main doors.

While she has some short-term memory loss, Carrie says, “I’m feeling good. I’m about where I was before I got sick.” She attributes that to the care she received at Northern Colorado Long Term Acute Hospital and Northern Colorado Rehabilitation Hospital.

Jason Webb is a freelance writer who calls Johnstown home.

We currently discharge 82.6 % of our patients home.

The national average is around 77%. NCRH was ranked in the top 10% of rehabilitation hospitals across the country.

- Dennis Shelby, CEO, NCRH

Northern Colorado Medical & Wellness

Dennis Shelby, CEO, NCRH

39

Healthy Employees

Work-place Health Susan Arbini, Banner Occupational Health Services Sales Liaison (middle) shown here with Roxane Smith, Greeley senior manager for Work Site Wellness (left), and Joan French, senior manager of the Greeley clinic (right).

Everything we do is geared to help businesses be successful.

- Susan Arbini Banner Occupational Health Services Sales Liaison

Occupational Health Services Help Businesses

by Kay Rios

A healthy workforce is a productive workforce. That’s the thinking behind Banner Occupational Health Services (BOHS).

B

y offering programs aimed at reducing medical costs and improving, or maintaining the health of employees, companies can gain a competitive edge, says Susan Arbini, Banner Occupational Health Services Sales Liaison. That’s where BOHS comes in.

“Businesses are having a harder time making it and they’re trying to do more with less, so they need to reduce work comp injuries and hire people who can physically do the job. Because our clinics are so well-rounded, we can provide the services needed to accomplish that,” she says.

Operating under the Banner umbrella, two

40

clinics currently work with local employers. Located at 1703 East 18th Street, Suite 4 in Loveland, and at 1800 15th Street, Suite 100B, in Greeley, the clinics offer a wide variety of possibilities, says senior manager of the Greeley clinic, Joan French.

“There’s everything from injured worker care and pre-employment physicals to respiratory clearance evaluations, breath alcohol testing, and drug testing.” Loveland clinic senior manager, Betty Stevens, adds, “Both clinics provide work comp injury care including eye injuries, lacerations, bumps and bruises, sprains, and strains. Arbini states, “We have a strong return to work philosophy, thus saving employers lost time and money.”

The Loveland site also offers travel vaccinations, reports Kristen DeQuasie, BOHS sales representative. In addition to workers’ comp injury care, both locations offer employee health services such as pre-employment physicals. Greeley already had an audiology booth for hearing tests and Loveland has just added one, Stevens says.

“We’ve got ours this past fall and we just love it.

We can test in several languages and it’s all computerized.”

Certified technicians staff both clinics along with a physician who is either board certified in occupational medicine or has a master’s degree in public health.

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Northern Colorado Rehabilitation Hospital (NCRH) ranked in the top 10% of 827 rehabilitation facilities ranked in t he IRF database of Uniform Data System for Medical Rehabilitation (UDSMR). NCRH was cited for care that is effective, efficient, timely and patient-centered.

At our state-of-the-art facility overlooking the Rocky Mountains, we treat and ca re for patients who have suffered functional deficits from traumatic events such as amputations, stroke or any other debilitating illness or injury. We are the only freestanding rehabilitation hospital in Northern Colorado.

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Healthy Employees

Work-place Health

Sheryl Fahrenbruch, Loveland senior manager for Worksite Wellness.

In addition to the many services offered at the clinics, a wellness team also takes the show on the road. Traveling to employer’s work-sites, Sheryl Fahrenbruch, the senior manager for Worksite Wellness in Loveland, says, “We can set up blood draws or do drug screening, check bone density, give immunizations or teach CPR on-site.”

In Greeley, that effort is organized by senior manager for Work Site Wellness, Roxane Smith.

“We offer our programs on-site for the convenience of the employer and employees. That includes things like employee blood pressure, flu shots, and consultations. We also offer classes and we do presentations on a variety of topics based on the needs of the employer. For example, around the holidays, employees can have extra stress so we can do classes on stress management.”

Much of the efforts of both Loveland and Greeley teams centers on health education, says DeQuasie. “We can provide information on things like West Nile and bloodborne pathogens. And if an employer has an idea, they can call and request a class on it. These guys have a wide knowledge base and they can put something together specifically designed for that employer.”

Arbini says that health issues can be addressed before they become a problem. “The health risk assessment that’s usually done in conjunction with the blood work will provide a comprehensive profile of what the risk factors are and what

42

Betty Stevens, Loveland clinic senior manager.

needs to be worked on.”

That can also help the employer with an overview, adds Smith. “An employer might find that there’s a greater percentage of high blood pressure so then we can look at what their overall risks are as a company. They can then focus on how to impact that area and compare it from year to year.”

Fahrenbruch says that they offer mini-health fairs for employers where employees can not only get flu shots but also have blood draws, chair massages, and general information. “It’s usually done during the company’s open enrollment for health benefits,” she says. Registrations are always high for flu shots.”

Because they are certified in a number of occupational and health related areas, the teams can also provide prevention techniques and do on-site evaluations of workstations. “We can do ergonomic testing either for an individual or by looking at the whole worksite,” Arbini says. “We may have someone call and ask us to look at all of the desks for the secretaries in the company and tell them what they can do to make it more risk-free.”

The clinics and the on-site programs are not aimed at the general public but are offered through contractual agreements with businesses.

The clinics work with local as well as national companies and with government agencies as well. There are, however, health fair activities in

Kristen DeQuasie, BOHS sales representative.

which the wellness staff is involved and where the general population can take part.

For example, Greeley’s staff were recently involved in the 50 Plus Health Fair at the Island Exhibition Hall this past fall. The Loveland staff will be working the Loveland Community Health Fair that will be held at the McKee Conference and Wellness Center on April 26, 2008. McKee Medical Center is the main sponsor of the event, joined by other sponsoring partners such as the Reporter Herald, the Chamber of Commerce, and the City of Loveland. (For more information, visit www.

BannerHealth.com.)

“It’s a chance for the community to be screened for different illnesses. If people have a better understanding of the illnesses they may be at risk for and why they’re at risk, they can take steps to lower those risks,” says Fahrenbruch.

That’s the idea behind the fair and also behind BOHS’s efforts.

“We’re a great asset to the local businesses,” Arbini says. “Everything we do is geared to help them be successful and that’s made possible because we are so flexible and can either have them come to us or we can go to them.”

Kay Rios is a freelance writer based in Fort Collins. She is currently a doctoral candidate in Educational Leadership at Colorado State University.

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Active Seniors

Resort Retirement Laury Dennis, General Manager, MacKenzie Place, promises friendly people 24 hours a day.

I wasn’t looking for a job here, but I feel this is where the Lord wanted me to be. I’m also happy to be a part of something new and different.

- Laury Dennis, General Manager MacKenzie Place

Retiring in Style

by Alice Ashmore

Imagine a retirement community that includes an elegant restaurant, room service, spa and salon treatments, turn-down service, a concierge, travel service and all the amenities of a first-class hotel.

A

re you thinking of the southern climes of Palm Springs or Scottsdale? Instead, think just south of Harmony Road.

MacKenzie Place, Fort Collins’ latest entry into retirement living, offers all these amenities and more. The property is operated by Leisure Care based in Seattle and the MacKenzie Place concept takes luxury retirement living to a new level.

“This is a different way to retire. We’re all about having fun and a quality of life,” says General Manager Laury Dennis. “This is an adult resort retirement community.” The new facility opened in early March 2008 at 4750 Pleasant Grove Drive, just south of Harmony and west of McMurry.

The campus includes: Craftsman-style homes

44

called The Cottages, for purchase by those ages 55 and over; The Terrace, featuring independent living apartments, and The Arbours assisted living apartments.

Demand is strong in Fort Collins for this type of resort living. Fully half of the phase one Cottages were sold six weeks before MacKenzie Place opened and range in price from $294,000 to $480,000.

“They’re buying a lifestyle, including a restaurant, swimming pool, outdoor fire pits, parties, dancing…,” says Dennis. “Our Café’ Bistro serves breakfast, and then turns into a bar after lunch.”

The stylish room also provides high-speed wireless Internet service for residents who may want to watch the stock market or send e-mail from

their laptops.

The various Cottage floor plans are sized from 1,300 to 1,972 square feet. Many feature fireplaces and lofts and all come with upgraded features, including slab countertops, nine-foot ceilings and attached two-car garages.

Although currently just under construction, people and pet-friendly parks and green spaces are planned throughout the campus. MacKenzie Place is a smoke-free environment, offering plenty of opportunities to enjoy the fresh air.

The Terrace features 95 independent living apartments with over thirty different models, including one, two, and three-bedrooms. “Some even have five-piece baths,” says Dennis. Each apartment in The Arbours also features a full

MacKenzie Place, Cottages for those 55 and over.

kitchen, washer, dryer and a microwave.

Chef Ray Padilla moved to MacKenzie Place from another Leisure Care property. Padilla’s culinary credentials include: executive sous chef at the Paris Hotel and in-suite dining chef at The Venetian in Las Vegas. The 32-year old enjoys the more relaxed environment of luxury senior living.

“I’m having fun. I love interacting with the residents.”

He envisions his restaurant turning a few heads in town too. “I’m going to make a big impact here.” The state-of-the-art kitchen holds everything Padilla needs to perfect his creations.

The restaurant will be accessible to the general public on a limited basis and Padilla is eager to show his range of talent. “There’s no limit to what I can do – from wedding receptions to private parties.” MacKenzie Place even offers on-site event planning to its guests.

Padilla’s position with Leisure Care offers him time with his family that the fast-paced Vegas lifestyle did not. “I have two boys. I wanted to be a dad on the weekends.”

Paul Chinchilla, Director of Guest Services, says the options for residents are endless. “They can have room service, assistance from the concierge, fresh flowers delivered daily, and turndown service at night.”

He notes, “A lot of images come to mind when you hear the words ‘retirement home.’

Most of those images are of a nursing home.

We’re changing that image completely.”

The Village Center at The Terrace features a full restaurant and pub, billiards room, library, indoor heated pool, personalized wellness services, a ballroom, continuing education classrooms and a chapel and meditation space. The list of amenities continues. Guests can also enjoy a theater with stadium style seating and excellent acoustics, a swimming pool and opportunities to exercise

Northern Colorado Medical & Wellness

Chef Ray Padilla and Paul Chinchilla, Guest Services Director love interacting with residents.

both the body and mind. The PrimeFit™ center boasts the latest in exercise equipment as well as specially trained instructors. Afterwards, residents can treat tired muscles to a massage from one of the on-site massage therapists.

A BrainFitness™ center allows guests to keep their older brains agile. “We utilize PositScience, a San Francisco based-company,” says Chinchilla.

They’ve taken the fundamentals of fitness and applied it to the brain,” says Dennis. Residents enrolled in the program commit to one hour of “exercise” five times a week for two months. A casual observer might think class members were playing video games.

“The computer program keeps you mentally stimulated,” says Chinchilla. “It adapts to the individual to maximize results. The program helps individuals regain their cognitive ability.” At the end of the class, participants show measurable improvement. “On average, they regain between seven to ten years of mental age,” says Chinchilla. “I’ve done the program myself and I felt my memory actually improved; especially my short term memory.

The retirement resort offers some special options for guests who enjoy getting away. A travel program called TLC by Leisure Care™ offers competitively-priced group tours to wide-ranging destinations like Maui, Napa, Australia, Italy and Sedona. Employees will also help residents plan individual travel to whatever destination they choose.

At the center of the resort sits a massive, timber-framed lodge made warm and intimate with exposed wood and a massive fireplace. The Lodge serves as a gathering spot for community.

In addition to luxury assisted living apartments, The Arbours houses a secure Alzheimer’s unit. “We have 26 secure apartments in our Memory Care unit,” says Dennis. The apartments

Inviting great room in the main lodge.

are still assisted living facilities. “We don’t do skilled nursing.”

The Memory Care unit has its own dining area and an expansive garden where residents can enjoy each other and the Colorado sunshine. Our philosophy is “person centered care.” says Dennis. “The staff knows and learns the essence of that person.”

Dennis comes to MacKenzie Place from the non-profit world as former head of the Alzheimer’s Association. “I started as the only person at the Alzheimer’s Association in 1996.” Under her direction, the Alzheimer’s Association grew and flourished. “I was part of the local chapter that merged with Denver.”

Her role at MacKenzie Place seems to be a perfect fit. “I wasn’t looking for a job here, but I feel this is where the Lord wanted me to be. I’m also happy to be a part of something new and different.”

Dennis feels a special affinity for Alzheimer’s patients. “I discovered it when I worked as an LPN (Licensed Practical Nurse). I’ve always loved working with seniors and people with dementia.”

With a high staff-to-resident ratio, the MacKenzie Place community offers highly individualized attention to all guests. The resort promises, “Friendly people 24 hours a day.”

Chinchilla hopes MacKenzie Place will become more than just a resort retirement community. “We want this to be a common gathering area in Fort Collins for people fifty-five plus.” One thing is certain; those who chose to live at Mackenzie Place will be retiring in Style.

Alice Ashmore is a Loveland-based freelance writer and a regular contributor to Style.

45

Allergy - Immunology

Allergy Relief

People can have allergies throughout the year due to indoor allergens such as dust, mold, and animal dander.

- Vel Kailasam, MD

Allergies?

Don’t Suffer!

Get Help!

by Lynn M. Dean

Your nose is stuffy. You’ve been sneezing like crazy for the past two weeks. Your eyes are so itchy and watery you want to rip them from their sockets. You ask yourself: “When will this stupid cold go away?”

C

hances are it won’t. You’re probably not suffering from a cold, but rather allergies. “Sometimes it’s a little hard to tell,” says Northern Colorado Allergy and Asthma Clinic’s William A. Lanting, MD. “A cold is an isolated, short-term event. You feel crummy for a week, but then it goes away. If there’s been congestion for more than seven to ten days, or if there is eye involvement– itchiness or redness– that speaks to allergies.”

Vel Kailasam, MD, Lanting’s colleague at the Northern Colorado Allergy and Asthma Clinic, agrees. “With a cold you won’t have itchy eyes, and you won’t be sneezing as much as you would with allergies.” He says it’s more likely that instead of a cold, some allergen, such as an animal dander or plant pollen, is triggering your attacks.

According to Lanting, up to 33 percent of the population suffers from nasal allergies and an-

46

other 10 percent suffer from asthma which can be exacerbated by allergies.

Attacks can happen a few times a year, and you might even be experiencing subtle symptoms year-round and not even know it. You notice only when the symptoms are at their worst. Lanting asks his patients, “Has your nose ever been perfect? Or do you always have something going on?” He says some people don’t even remember what “perfect” is.

“Seasonal allergies are more common in the spring, summer and fall,” explains Kailasam. “But people can have allergies throughout the year due to indoor allergens such as dust, mold, and animal dander.”

These attacks can manifest themselves with a variety of symptoms. According to Lanting, in addition to those already discussed, these symptoms include excess mucus and nose blowing, post nasal drip, cough, throat clearing, mouth breathing,

sore throat, nausea, and breathing issues.

If you’re still not sure whether you have a persistent cold or allergies, a visit to your doctor can help you sort things out. According to Lanting, the doctor will look for discoloration of the tissue in your nose, mouth and throat, and swollen lymph glands. “These speak more to infection.”

So, you’ve decided you probably have allergies. Then, if you’re like many people, you’ve resigned yourself to these annual bouts of suffering and pill popping in hopes of a little bit of relief.

“One of the problems with allergies is that people think they have to put up with them,” laments Lanting. “Because most allergies are genetic, they see it as a curse. But there is something that can be done. They can be ‘perfect’ again.”

The first step is to find out what you’re allergic to. “We do skin testing for allergens that are predominant in this part of the country,” says Kailasam. “Once we know what the triggers are, you can avoid them, or if you cannot avoid them, you can do allergy injections to reduce the sensitivities to the allergens.”

“Although we have less flora and fauna to set off allergies here in Colorado,” explains Lanting, “We still have a mix of grasses, trees, weeds, alfalfa, corn, and sugar beet pollens. We have to tailor our advice depending upon what sets people off.” agrees Kailasam. “Avoidance measures are good for dust, mold and animals, but certain allergens, like pollen, can’t be avoided.”

But even if you can’t avoid an allergen, you don’t have to suffer. Immunotherapy, or allergy injections, can reduce your sensitivity to the allergens, and there are new medicines available that do a better job of controlling the symptoms.

“Immunotheraphy works up to 75 percent of the time,” says Lanting. “Injections are longterm and have lasting benefits,” agrees Kailasam “After a few years of allergy injections, you might

Irritants Can Mimic Allergies Allergy symptoms aren’t always caused by allergies. They can be caused by irritants in our environment. For example, when a bug flies up your nose, your eyes start to water, you start sneezing up a storm, and if you’re lucky, you flood that critter out with lots and lots of mucus. Likewise, when you get a speck of dirt or an eyelash in your eye, it starts to water, tears drain down through your nose and you reach for a tissue as you furtively try to remove the

offensive object.

Many irritants aren’t nearly as obvious as the bug, eyelash, or speck of dirt. Even so, these tiny particles still elicit a big, allergiclike response. “The same symptoms occur with both entities (allergens and irritants) and people can have a combination of allergic and non-allergic reactions,” explains Dr. William A. Lanting of the Northern Colorado Allergy and Asthma Clinic. “With allergies you have a reac-

tion when your body makes antibodies– histamine- against them. Chronic nose symptoms that aren’t helped by antihistamine are caused by irritants.”

In these situations, according to Lanting, over-the-counter drugs containing antihistamine are a waste of money because there is no histamine to block. So what’s a sufferer to do? A visit to an allergist can help you sort it all out.

If there’s been congestion for more than seven to ten days, or if there is eye involvement– itchiness or redness– that speaks to allergies.

- William A. Lanting, MD

not even need treatment.” As for those needles, “they’re very fine and go into the fatty tissues,” he soothes reassuringly.

But if you just can’t handle the idea of all those little sticks, you can still get relief. “Some people don’t like shots,” says Kailasam “There are a lot of new medicines out there that don’t cause drowsiness.” Although they may still be accompanied by some side effects, drug therapy can control the symptoms temporarily.

“Quality of life is important,” concludes Lanting. “If you have allergies you compromise your quality of life. You can live a wonderful, symptomfree life. You can run, and breathe and play. With the proper regimen you can be perfect. You can be normal again.”

Lynn M. Dean is a freelance writer living in Northern Colorado.

Northern Colorado Medical & Wellness

47

Dental Technology

Cosmetic Dentistry Steven J. Koehler, DMD holds a Lumineer.

How Pearly are Your Whites?

Steven J. Koehler, DMD applies Lumineers on patient Rachel Collins. Kim Severson assists.

by Jason Webb

Relax. Getting the smile you’ve always dreamed of is a lot easier than you might think, and it doesn’t involve a drill or horrible shots. In fact, would you believe it if someone told you that you can have that bright, white smile in under a month without braces?

I

magine seeing a dentist only three times and walking out with a glamorous smile rather than seeing an orthodontist every month for a couple of years. Many people are finding they can have that smile through cosmetic dentistry.

Some people avoid going to the dentist because they worry about shots, drilling or other uncomfortable procedures. Others may just never have had the financial wherewithal to afford getting the smile they wanted. However, Steven Koehler, DMD, uses a system that creates beautiful smiles! Lumineers is a veneer product that requires little to no filing of healthy enamel. “Lumineers is a fantastic product. If people wanted to get their teeth fixed but were fearful of the shots and having their tooth structure removed, now they don’t have to worry,” says Koehler.

Probably the biggest difference between Lumineers and traditional veneers is the preparation.

According to the Lumineers website, the veneers are custom made for each patient and only require a little etching of the teeth to place. “There’s

48

no discomfort,” says Koehler, who admits that he loves doing Lumineers because it can be a good challenge and can be incredibly rewarding for the patient. “We don’t have to file down any teeth like with traditional veneers, so it’s totally reversible.”

Koehler describes Lumineers as very thin, custom-made porcelain veneers that are placed on top of the patient’s natural teeth. Cerinate, the company that produces Lumineers, has skilled technicians, according to Koehler, and it stands behind its products, providing a five-year warranty on Lumineers that even covers breaking.

Koehler also notes Lumineers are not new to dentistry. “They’ve been around for a while and have a 20-year track record,” says Koehler.

The way Lumineers work is simple and the process is very quick. The first patient visit allows Koehler to get acquainted with the patient and evaluate whether he or she is a candidate for Lumineers. Also, Koehler and his staff will take preliminary impressions and snap some photos.

During the second visit, Koehler and his staff take

impressions, which are used by the Lumineers laboratory to make the custom porcelain. The third visit is when the Lumineers are placed.

“The procedure takes about an hour to an hour and a half,” says Koehler. “I place each Lumineer individually.” After the veneers are in place, they are cured with a light so the adhesive will bond. Koehler then finishes, contours and polishes the Lumineers, and the patient leaves the office with a dazzling smile.

Several patients have left Koehler’s office at 4745 E. Boardwalk, grinning from ear to ear, and Kim Severson has seen most of them. Severson, who has worked with Koehler for 10 years as a dental assistant, says some patients cried when they saw their new smile while others practically did cartwheels. Having seen the amazing results on several patients, Severson decided she wanted to try them, too. Even though Severson had a nice smile, she felt she could use a freshening up, and about a year and a half ago, Severson got her Lumineers. “I love them,” she says.

Koehler and Severson both say the people in-

Lumineers is a fantastic product.

If people wanted to get their teeth fixed but were fearful of the shots and having their tooth structure removed, now they don’t have to worry.

stained and cannot benefit from bleaching can be corrected with the veneer system, giving the patient a youthful smile. However, it isn’t just about giving this patient a straight, white smile.

Severson says, “We really try to look out for the best interest of the patient. It’s often a balancing act between getting the natural-looking smile the dentist wants and the really white smile the patient wants.”

Not everyone is a candidate for Lumineers, however, as Koehler is careful to point out. The cases Lumineers can treat range from teeth that

are small, or slightly crooked, have gaps, or are severely stained. Koehler says Lumineers cannot fix drastically misaligned teeth, so it is best to consult with a dentist familiar with the Lumineers product. If you would like to see if you’re a candidate for Lumineers, call Koehler’s Fort Collins office at (970) 223-6101.

Jason Webb is a freelance writer who calls Johnstown home.

- Steven J. Koehler, DMD Family Cosmetic Dentistry

terested in getting Lumineers share one common trait: they are people that are in the public eye, people who rely on their smiles to help them do their jobs. Both of them, however, believe anyone can benefit from getting their smiles rejuvenated and can even have a boost in confidence. While some people may not notice much change in personality, others do undergo a slight transformation – particularly those who rarely showed their natural teeth. “At the follow-up visit, most patients come in all smiles,” says Severson.

Severson, who says she may have gotten more confidence after getting her Lumineers, also believes that Koehler is the perfect choice for anyone interested in getting Lumineers. With two decades working with dentists, Severson can pick out a quality dentist, and she firmly believes Koehler is top-notch. “Certain dentists are artists,” she says. “They have an eye and skill for cosmetic work.” When it comes to Koehler, Severson sees a perfectionist, a dentist who is truly excited about cosmetic dentistry.

Koehler has done cosmetic dentistry for nearly 20 years and only picked up Lumineers about three years ago. In that span of three years, he has placed Lumineers on more than 35 patients, which consists of 300 to 400 individual Lumineers.

He enjoys every minute of it. “It’s very techniquesensitive,” says Koehler. “It can be very technically challenging, but it’s very satisfying to have a role in transforming someone’s smile.”

For the price one would ordinarily pay for orthodontic treatment, he or she could get Lumineers that will net the same end result – a nice, straight smile – in much less time. Severson and Koehler also note that teeth that are permanently

Northern Colorado Medical & Wellness

49

Total Vein Care

Vein Treatment Steven L. Kaufman, MD, PhD performs radio frequency ablation on a patientâ&#x20AC;&#x2122;s leg.

Our goal in treating people with vein disease is to improve their quality of life by relieving symptoms and by avoiding skin ulcerations and blood clots. Cosmetic improvements are the gravy.

- Steven L. Kaufman, MD, PhD

Total Vein Care

by Richard Yount

For years, treatment of vein disease focused on leg swelling and blood clots. Superficial venous reflux, failure of the valves in the veins to maintain the blood flow from the lower extremities to the heart, was rarely treated because of the high morbidity associated with vein stripping, the traditional treatment.

S

ince venous reflux is a progressive condition, untreated patients often develop skin complications and blood clots. Over 25 million persons in this country suffer from symptomatic venous reflux, which involves twice as many people as coronary artery disease and five times as many as peripheral arterial disease. Yet in spite of the potential consequences, less than one in ten people seek treatment.

50

Steven L. Kaufman, MD, PhD performs radio frequency ablation on a patient’s leg, one of the many services available at Total Vein Care.

Assisting the procedure are Angie Thiel, Ultrasound Tech and Becky Pherson, Medical Assistant.

Venous Insufficiency Valve failure in venous reflux disease results in pooling of blood in the feet and elevation of pressure in the superficial veins. Normally only 10% of the blood in the lower extremities is in the superficial veins. However, up to half of the venous blood can pool in the superficial veins, making return to the heart highly inefficient.

The resulting increase in venous pressure can lead to serious consequences. Symptoms of venous reflux include aching pain, heaviness, fatigue, itching, and burning in the legs. This becomes more pronounced after prolonged standing and immobility. It is no wonder that teachers, factory workers, and hair dressers would experience worsening of their symptoms as the day wears on. Furthermore, untreated venous reflux also leads to varicose veins and further progression causing skin changes and, in extreme cases, ulceration.

The risk factors for vein disease are heavily influenced by genetics. Approximately 80% of patients with signs and symptoms of venous reflux have a family history of the disease, which is 3 times more common in women than in men. Interestingly, recent research on genetics has found increased levels of certain enzymes that lead to the weakening of the vein wall, dilation of the vein, and ultimately valve failure. Multiple pregnancies also increase the risk as does age and long periods of immobility.

In spite of the evolution of our knowledge and development of minimally invasive treatments, two-thirds of all surgeries for venous reflux still involve vein stripping, a painful procedure that results in significant patient recovery and down time. Education of patients, primary care physicians, and the surgeons who actually deliver the care is necessary in order to provide the best results with the least morbidity, using modern treatment methods.

Ultrasound has revolutionized the diagnosis and treatment of vein disease. “We are able to pinpoint exactly where the bad valves are,” Kaufman said. Ultrasound has also led to the development of the newer technologies and is required to implement them.

Venous Stasis Ulceration The veins of the legs consist of deep and superficial systems, which are connected by a multitude of perforating veins, each containing a single

Northern Colorado Medical & Wellness

Amy Hulstrom, M.S., PA-C, Kevin E. Bachus, M.D., FACOG, Shari Olson, Ph.D., Bonnie Overholser, PA-C

(970) 493-6353 • (800) 624-9035 w w w. d r b a c h u s . c o m 51

Total Vein Care

Vein Treatment

valve. Valve failure in any one of these can lead to the development of skin ulceration. 70% of leg ulcers, typically found just above the ankles, are the result of venous reflux, often involving the perforators. Failure to diagnose and treat the reflux often leads to prolonged wound care and recurrent ulceration. The magnitude of this problem is impressive. Approximately 500,000 people suffer from venous ulceration. Wound care alone can cost a patient over $10,000 per year. “In this

country we spend $2.5 billion to treat leg ulcers and 2 million work days are missed as a result,” Kaufman said.

Treatment Techniques After a thorough workup including diagnostic ultrasound and a trial of conservative therapy consisting of leg elevation, exercise, weight loss, avoidance of prolonged standing, and a trial of compression stockings, a patient may be consid-

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Alissa R. Ferguson, D.M.D. H. Arthur Missirlian, D.D.S.

ered for surgical therapy if conservative measures are not helpful.

The Closure® procedure, FDA approved in 1999, employs radiofrequency energy to heat the vein and close it from the inside. Alternatively, endovenous laser (EVL) systems are available. Both energy sources effectively close refluxing veins with over 90% efficiency over the long term, in contrast to vein stripping in which failures occur at a rate of over 30%. Closure® and EVL are similar with respect to speed and cost but their main difference results from the different energy intensities. Closure® heats the vein wall at 120°C while the tip of the laser (EVL) fiber reaches 700°C. Kaufman, a Closure® proponent, states: “The higher temperature of the laser results in vein perforation with pain and bruising that are not features of the Closure® procedure. Consequently, most if not all patients need pain medication after a laser procedure but rarely after a Closure® procedure.”

The minimally invasive procedures are carried out in the office under local anesthesia. Kaufman explains: “After accessing the vein and positioning the catheter with the help of ultrasound, tumescent anesthetic is delivered around the vein.

The large volume of fluid serves as a heat sink for absorption of heat from the vein wall during treatment, protecting the surrounding tissues.”

The Closure® procedure ordinarily takes about 20 minutes. A compression stocking is then applied and the patient walks out of the office. Three days later, a follow-up ultrasound is done to make sure there is no clotting, which occurs less than 1% of the time. During this visit, patients rarely complain of any pain and are relieved when the compression stocking is removed for the final time.

“I wish I’d had this done 20 years ago,” was the sentiment of Amy Mullins of Loveland who had the Closure® procedure on one leg. “I had a major vein that looked like a knotted rope. I called my son’s dermatologist and they referred me to Total Vein Care and Dr. Kaufman. I was expecting all kinds of pain but when he told me ‘this won’t hurt,’ it didn’t! I walked out after surgery and the next day went shopping on Pearl Street. There was no downtime…it was unbelievable!”

A. J. Wedell, of Fort Collins and winters in Arizona, had venous reflux in both legs. His physician caught it early and referred him to Kaufman. “I have nothing but the highest regard for Dr. Kaufman. They were 45 minute procedures about a week apart and I walked out and had no complications. My doctor had said it was only going to get worse so I was really pleased. Dr. Kaufman has a very effective website and I researched the procedure on it.”

Reach Total Vein Care at (970) 498-8346 or at www.totalvein.net.

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Medical Profile

Chief of Surgery The care received at this Level 2 trauma center MCR goes beyond the accident victims and other patients who arrive by car, ambulance or air transport.

It extends to the family members of those patients as well.

- Chris Cribari, MD

Chris Cribari, MD:

Taking Care of Families

by Lynn M. Dean

“It’s always hard to tell a ten-year-old boy that his father has died. Or to tell parents that their fifteen-year-old boy, who was not supposed to be out on the roads that night, is now paralyzed or has suffered a lifechanging injury,” says Chris Cribari, MD, Chief of Surgery at the Medical Center of the Rockies (MCR) and the Medical Director of the MCR Trauma Program. “But it’s part of the job. Sometimes it’s the most challenging part of my job– the most emotionally gut wrenching aspect of my job.”

I

t’s also the part of his job that Cribari finds the most fulfilling. “I think early on in your medical career you realize that many things are out of your control and that you can still make a difference by providing comfort and improving the patient’s quality of life to the best of your ability, even if you may be unable to cure the cause. Often patients have sustained non-survivable injuries. Our role then, is to help the family come to terms with their loss.”

While taking care of the families of trauma victims keeps Cribari here in Northern Colorado, it was his own father’s illness that brought him home to Fort Collins. Home to the town where

54

he was raised. Home to the place he’d left years before to attend medical school.

Cribari has always loved science. He always knew he wanted to be a doctor. “It was probably Alene Patterson at Fort Collins High School that influenced me the most,” he says.

So after he graduated from Colorado State University, he packed his bags and headed to the Baylor College of Medicine in Houston, Texas. “I was impressed by the clinical exposure the students got there,” he explains. “It’s the world’s largest medical center.”

It wasn’t long before he realized he wanted to be a surgeon. “It’s a very diverse field and I was lucky to train under surgical giants.”

Soon he honed in on cardiovascular surgery.

“Many of the pioneers of cardiovascular surgery were in Houston. Obviously they influence your choices. After my residency, I stayed at Baylor and did a fellowship in vascular surgery with Dr. Stanley Crawford, one of the pioneers of aortic reconstruction.”

Cribari then joined the United States Air Force and taught surgery at Kessler Medical Center in Biloxi, Mississippi. He was in the process of deciding where he would set up his practice next when he got that fateful call in 1993.

“My dad was ill,” he says. “So I came back to Fort Collins (and co-founded) the Surgical Specialists of the Rockies.”

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While it was an illness that brought him home, it was the love for his family that kept him here.

“There’s not too many nicer places to live than Fort Collins,” explains this father of three. “I think it is still a good place to raise a family.”

But he enjoyed his work here, too. “One of the reasons I stayed in Fort Collins was because of the great people I got to work with. We’re very blessed to have a number of excellent nurses here, especially with the nursing shortage. But PVHS (Poudre Valley Health System) has really addressed this crisis. The quality of nursing at PVH (Poudre Valley Hospital) and MCR is excellent as shown by the numerous awards they’ve received.”

Many thought Cribari, after training under and working with the masters of his craft, was too overqualified to practice here. They thought his talents would be put to better use in a larger metropolitan area. But they didn’t know what lay ahead. They didn’t know that a new regional hospital was on the horizon.

“I think the challenge of getting a new hospital up and running was unique,” he explains.

“The medical staff at PVH was intimately involved from the beginning in the planning and design process, and I think it’s contributed to MCR’s success. It’s one of the best designed and equipped trauma centers in the United States. But probably more importantly, care here goes beyond bricks and mortar. It’s the people that work at PVH and MCR that have made a huge difference. It’s really all those excellent pieces put together that allows us to be a trauma center verified by the American College of Surgeons.”

Even so, the care received at this Level 2 trauma center MCR goes beyond the accident victims and other patients who arrive by car, ambulance or air transport. It extends to the family members of those patients as well. Cribari and his staff not only designed state-of-the-art medical facilities, they also designed comfortable areas where family members can wait, areas where they can eat and work and sleep, areas where they can talk with doctors in private, and areas where they can receive both bad and good news.

“As parents, it’s always our worst nightmare when our kids get out on the road,” he explains.

“I look at it as my duty to get in touch with family.”

And it’s his work with these families that have made him appreciate his own even more. “I don’t want to receive a call from the trauma surgeon at the hospital,” he says. “Nobody does. But, I think the reality of life is that we have to not fear what might happen tomorrow, but instead, cherish every day.”

He urges us to do the same.

Lynn M. Dean is a freelance writer living in Northern Colorado.

56

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