2008-07 Northern Colorado Medical & Wellness Magazine and PVHS Physician Directory by Style Media & Design, Inc.

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P U B L I C AT I O N : :

E S T.

1984

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all your ,

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were herefor you. Keep it in play with the Emergency Departments at Poudre Valley Hospital and Medical Center of the Rockies, open 24/7 . Our medical teams are standing by to fine tune your recovery and get you back to your team . And our two Urgent Care Centers help with minor injuries, with walk-in care available everyday. Harmony Urgent Care and Loveland Urgent Care are ready when your primary doctor's office isn't open or same-day appointments aren't available . Poudre Valley Health System . We're here for you .

Poudre Valley Hospital 1024 S. Lemay Avenue Fort Collins, Colorado 80524 970.495 .8560 Medical Center of the Rockies 2500 Rocky Mountain Avenue Loveland, Colorado 80538 970 .624. 1860 Harmony Urgent Care Center 2127 East Harmony Road, Suite 140 Fort Collin s, Colorado 80528 970 .297 .6250 Loveland Urgent Care 3850 Grant Avenue, Suite 100 Loveland, Colorado 80538 970 .669 .5717

POUDRE VALLEY HEALTH SYSTEM

www.pvhs.org

Fort Collins Medical Magazine & Directories 2008 2009

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Larry spent 32 years running a student recreation program, but after retirement, he ran into a heart problem. He experienced unusual chest pain on a mountain hike. Based on the results of a diagnostic procedure by his cardiac team, he was immediately scheduled for a triple bypass. As a member of North Colorado Medical Center's Board of Trustees , Larry knew that he could trust the hospital with his surgery. They've been nationally recognized as a Thomson 100 Top Hospital® for Cardiovascular Care, with innovative services including 64-slice CT technology for the most accurate diagnosis and a cardiac alert program that offers a positive outlook for long-term survival of heart attack patients. Thanks to the great technology, doctors and extensive cardiac rehab program following his surgery, Larry is able to move on with a healthy life.

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North Colorado Medical Center· www.BannerHealth.com, keyword: CVI • 1801 16th Street· Greeley (970) 352-4121 ·Job opportunities: 866-377-5627 (EOE/AA) or www.BannerHealth.com Banner Health is the leading nonprofit health care provider in northern Colorado.

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Affiliations Downtown Business Association Fort Collins Area Chamber of Commerce Loveland Chamber of Commerce Greeley Chamber of Commerce Windsor Chamber of Commerce 2008 Style Magazines January-Loveland/Greeley Medical & Wellness Magazine and Directory February-Building & Remodeling March-Northern Colorado Medical & Wellness March-Family, Community & Philanthropy April-Business of Northern Colorado May-Building & Remodeling - Home & Garden May-Northern Colorado Medical & Wellness June-Business & Building July-Fort Collins Medical & Wellness Magazine and Directories August-Women In Business September-Building & Remodeling Home Interiors & Entertainment October-Women Health & Breast Cancer October-Northern Colorado Medical & Wellness November-Holiday December-Winter/Wedding Style Media and Design, Inc. magazines are free monthly publications direct-mailed to homes and businesses in Northern Colorado. Elsewhere, subscriptions for 16 issues cost $24/year. Free magazines are available in stands at 75 locations throughout Northern Colorado. For ad rates, subscription information, change of address, or correspondence, contact: Style Media and Design Inc., 211 W. Myrtle St., Suite 200, Fort Collins, Colorado 80521. Phone (970) 226-6400. E-Mail: rhonda@StyleMedia.com ©2008 Style Media and Design Inc. All rights reserved. The entire contents of Style Magazine is copyrighted and may not be reproduced without the expressed written consent of the publisher. Style Media and Design Inc. is not responsible for unsolicited material. All manuscripts, artwork, and photography must be accompanied by a SASE. The views and opinions of any contributing writers are not necessarily those of Style Media & Design Inc.

North Colorado Medical Center is proud to have achieved Magnet™ recognition status from the American Nurses Credentialing Center. Receiving this distinction for providing the highest quality of nursing practice and patient care is a rare honor. Less than 300 hospitals nationwide have received this status. We're pleased to recognize all of the people who made this happen. But we'd like to especially recognize the dedicated and compassionate nurses who are committed everyday to making a difference in ANCC MAGNET RECOGNITION people's lives.

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Job opportunities: www.BannerHealth.com or 866-377-5627 Banner Health is the leading nonprofit provider of health care in northern Colorado.

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We welcome your comments By phone: 970.226.6400 By fax: 970.226.6427 By email: info@stylemedia.com www.stylemagazinecolorado.com Grateful for the Opportunity Dear Lydia, Thank you for the opportunity to write the article about infertility in the May issue of Northern Colorado Medical & Wellness. This article gave me the opportunity to explain infertility issues many couples face when they make the decision to have a child. Because more and more women have decided to pursue their careers first, many of them are faced with infertility issues because of their age. Fortunately there are many options these days so the outcomes are very positive. Thank you for doing such a great job designing the article and taking the photograph. Your publication is high quality and always very informative. I always make sure to read each one I receive. ~ Kevin Bachus, MD Rocky Mountain Center For Reproductive Medicine, PC

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Beautiful and Colorful Issue You did it again Corey, Thanks so much for such a great article about the Sharp Flats Loft Tour in your June Magazine. Style is always a quality publication and you did it again. ~ Karel Applebee, Fort Collins Symphony Guild

Dear Lydia, I wanted to let you know how happy I am with the June Business & Building issue of Style Magazine. I read the entire magazine. I am especially thrilled with the fashion pages where you featured my store, Dress Code II. It was so beautiful, colorful, and full. Thanks to you, your photographer, and your design department for working so hard to make our page look so wonderful. I love the issue! ~ Anna Zherdeva, owner of Dress Code II

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Fort Collins Medical Magazine & Directories 2008 2009

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Publisher’s Letter Zeal For Excellence It is with appreciation and a great deal of enthusiasm, that we publish our 10th annual Fort Collins Medical & Wellness Magazine and Directories in collaboration with Poudre Valley Health System. Over the years we have followed the leadership of Rulon Stacey, Kevin Unger, George Hayes and their executive teams, and admired their vision for

our region’s future healthcare needs. Their sincere commitment to World-Class Healthcare is a key contributor to our high quality of life, and to our national reputation for being the best place to live in the country. Naturally, this cannot be accomplished without the commitment of employees that share the values, vision, and mission of PVHS. We are honored to feature three long-term employees whose passion for their job is exemplified in their achievements. Commitment such as theirs is just one more reason Poudre Valley Hospital is designated as a Magnet Hospital for Nursing Excellence and, for the fifth consecutive year, has been named as one of the 100 Top Hospitals in the nation by Thomas Healthcare. Read about these three exemplary team members, their love for their career and commitment to the hospital and the patients they serve. The goal of this publication is to inform you of new technology, new methods of diagnosis, and in the latest in treatment possibilities. Our goal is to educate you regarding the latest medical protocols, to introduce you to exceptional physicians and healthcare providers, and to emphasize the importance of prevention. Good health is of interest to everyone, but especially to the aging Baby Boomers and retirees living in the Northern Colorado Front Range. On a personal note, my retired mother recently tripped on her back step, and due to her mild osteoporosis, she broke her arm, requiring surgery and rehabilitation. This has been quite the ordeal for a woman in her 80’s! Mindfulness of our need for calcium and exercise is imperative; read Osteo-

porosis and You to learn about prevention, diagnosis, and treatment of this condition. Medical research in health and wellness continues to improve treatment options and outcomes for patients. Read Miraculous Treatment for Macular Degeneration for insight into a devastating condition that now has wonderful and positive outcomes. Pain Management Therapies offers innovative options for those suffering from chronic pain. Also, please join us in welcoming Dr. Doug Beard, orthopedic surgeon, to Front Range Center for Brain & Spine Surgery, P.C. who will add so much to their comprehensive spine care. Dr. Thomas Overton works his magic to perfect and whiten in Brighter Smiles. And… obviously Meredith is a non-smoker; be sure to read Thank You for NOT Smoking. We know that finding a physician’s contact information can sometimes be frustrating. Therefore, we’ve compiled the PVHS physician list by specialty and physician name. Keep this publication handy as a convenient reference for the entire year. To your health,

lydia@stylemedia.com (970)227-6400

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Fort Collins Medical Magazine & Directories 2008 2009

- Lauri Thompson - Manager

VOLUME X

TABLE

CONTENTS

Medical Magazine & Directory

Wellness Magazine & Directory

11 13 17

Brighter Smiles

Thank you for NOT smoking

Healthy Tidbits: Trans Fats

Disease Prevention Through Exercise

Wellness Directory

20 26 34 40 43 49

63 69 74 99 102 108 112

From the Readers Publisher’s Letter Introduction Letter

Rulon F. Stacey, President and CEO, Poudre Valley Health System

Introduction Letter

Stu VanMeveren, Chairperson, Board of Directors, Poudre Valley Health System

All About Teamwork Winning Partner The Changing Face of Family Medicine Surgical Synergy Means Better Spine Care Physician Directory Introduction Letter Dr. William A. Neff, Chief Medical Officer, Poudre Valley Health System

Pain Management Therapies Diagnostic Electrophysiology for Heart Arrhythmia Miraculous Treatment for Macular Degeneration Solutions for Erectile Dysfunction Osteoporosis and You An Unfathomable Disease: Dealing with Alzheimer’s Alzheimer’s is a Family Affair 14

Style Magazine offers these editorials for your general knowledge and not as a subsititue for medical advice or treatment. If you have any questions or concerns about your health, please contact your doctor or healthcare provider.

112

BOARD

M.D., PH.D., F.A.C.S. CERTIFIED GENERAL SURGEON

Get caught with a great pair of legs!

Wefehere

for you.

When you need medical care, the professionals at Poudre Valley Health System are here for you. Whether you need inpatient care at Poudre Valley Hospital or M edical Center of the Rockies, or you need o utpatient services at one of our many clinics and diagnostic or surgery centers, our exceptional physicians and staff are standing by. Compassionate care is w hat you deserve and what we t ake pride in delivering. We're here for you.

P O U D R E VA L L E Y H E A LT H S Y S T E M

Dear Medical & Wellness Magazine Reader:

Rulon F. Stacey, Ph.D., FACHE President/Chief Executive Officer Poudre Valley Health System

During the last decade, Poudre Valley Health System has been on a path of continued growth as a way to meet the healthcare needs of the regionâ&#x20AC;&#x2122;s rapidly increasing population growth. We opened an ambulatory care center and medical office building on the Harmony Campus in 2000 and continued the growth there with the construction of a medical plaza for physician clinics and, in 2007, a medical office building. In 2007, the Medical Center of the Rockies was opened; since then, two medical office buildings have been constructed. In the meantime, Poudre Valley Hospital underwent a significant renovation and expansion between 1999 and 2003, and currently is in the midst of a major construction project that will result in a new medical office building, expanded surgical area, parking garage, and other increased health services. The driving force behind all of these expansion activities stems back to the early 1990s when there was only Poudre Valley Hospital, which was governed by a public entity, the Poudre Valley Hospital District. Back then, the districtâ&#x20AC;&#x2122;s board of directors conducted a major study that looked at the future of healthcare on the national, regional, and local levels. The study determined that the best way to move ahead was to keep decisions regarding local healthcare in local hands rather than selling the hospital to a national hospital chain interested in gaining access to healthcare dollars in Northern Colorado. The hospital district board developed a plan that resulted in the creation of Poudre Valley Health System, a private nonprofit corporation. The reason: As a public entity that received revenue from property taxes, the hospital district was forbad by state law to enter into ventures with private corporations such as physician groups. Back then, physician groups were considering building their own hospitals, surgery centers and other facilities. What that would have meant was, simply, that PVH would have remained a medium-sized community hospital that would likely have become financially challenged and been forced to sell out to a national chain. As a private nonprofit corporation, Poudre Valley Health System has been able to enter into joint ventures with a variety of physician groups. This has meant that all of us have benefited by having pieces of the proverbial pie rather than only a few of us gaining all of it. Much more importantly; though, it is the people of our region have benefited the most. Because we have a vigorously growing medical community, more family practice physicians and specialty doctors have settled in Northern Colorado. There are more healthcare facilities than would have existed if PVH had remained merely a medium-sized community hospital. Now, we have many more healthcare opportunities for community members, and there is less need for patients to leave the community for specialized healthcare since they can now receive most types of specialized care locally.All in all, the PVHS expansion over the last decade has been a win-win for everyone. We live in a magnificent community and we have high quality healthcare to match the high quality of life.

Rulon F. Stacey, Ph.D., FACHE President/Chief Executive Officer Poudre Valley Health System

Fort Collins Medical Magazine & Directories 2008 2009

Ifyour baby is early, were herefor you. If your baby is born prematurely, the neonatal intensive care team at Poudre Va lley Hospital is here for you. Staffed by neonatal specialist physicians, nurses and th erapist s, and equipped with the latest technology, the PVH neonatal intensive care nursery (NICU) provides the hig hest level of care for sick and premature babies in Northern Colorado. Breathe easy. We're here f o r you .

P O U D R E VA L L E Y H E A LT H S Y S T E M

Dear Medical & Wellness Magazine Reader:

Stu VanMeveren Chairperson, Board of Directors Poudre Valley Health System

With 4,100 employees, two hospitals, the Harmony Campus, clinics throughout Northern Colorado, and joint ventures with more than a dozen local healthcare providers, Poudre Valley Health System is the major medical provider in Northern Colorado, Wyoming and Southwestern Nebraska. Because of the multitude of healthcare services that we offer throughout the region, it’s vitally important for the health system, local physicians, and other healthcare providers to maintain synergies that encourage all of us to work closely together. Over the years I’ve found that this certainly happens! Our healthcare environment continues to encourage cooperation, collegiality, trust, and quality. For you, this means easy access to the highest quality healthcare. PVHS employees pride themselves on providing world-class care. It’s for you—their neighbors, friends, family members, community—that they are driven to excel. Our staff likes people. We don’t produce cars or build homes or manufacture widgets. We provide healthcare for people, and we want everyone to receive the best. That’s a reason why we have one of the nation’s most highly trained staffs. Our employee turnover rate is among the lowest in the nation for healthcare organizations. This is a great benefit for you because longevity of employment translates into more experience and higher quality healthcare service. As a result of our excellent staff and the synergies that we have with the physicians and healthcare providers in the region, PVHS and its services have been recognized and honored time and again. Here are a few examples: During each of the last five years, Poudre Valley Hospital was named one of America’s 100 Top Hospitals by Thomson Healthcare, the nation’s leading independent company that tracks the performance of hospitals in the U.S. In 2008, PVH was the first and only hospital in the nation to ever receive the American Nurses Association’s prestigious Award for Outstanding Nursing Quality, an honor that recognized PVH’s sustained excellence in nursing quality. In each year since 2004, Poudre Valley Health System was recognized by Hospitals & Health Networks, the journal of the American Hospital Association, as one of the nation’s 100 most wired and 25 most wireless organizations. This national recognition is for the health system’s use of information technology to address key areas involving safety and quality, customer service, business processes, workforce issues, and public health and safety. During the same period, the national magazine Information Week named PVHS to its annual list of the 500 companies that are the most innovative users of information technology. In addition, the health system was the first corporation to receive the Colorado Performance Excellence Peak Award, the state’s highest award for performance excellence. The award recognizes excellence in the way PVHS approaches its business of healthcare and uses information, results and customer feedback for making improvements. Of course, as wonderful as such honors may be, they are not what we’re all about. Our vision is to provide you with world-class healthcare. We want to nurture you back to good health if you become ill. We care. We’re here for you. That’s what Poudre Valley Health System is all about.

Stu VanMeveren Chairperson, Board of Directors Poudre Valley Health System

Fort Collins Medical Magazine & Directories 2008 2009

medical

PVHS

Eileen Angeli, R.N., Neonatal Intensive Care Unit (NICU), PVH, holds an infant.

All About Teamwork

The Employees of PVHS by Allie Comeau

Providing the kind of award-winning patient care Poudre Valley Health System (PVHS) is known for, isn’t easy. It takes passion, dedication, and above all, teamwork, as exemplified by these six exceptional employees. A typical day for employees at PVHS varies greatly, not only due to their various positions on staff, but also due to the ever-changing needs of their patients. This day-to-day variation keeps nurses, coordinators, therapists, and even graphic designers on their toes at all times. Each position at PVHS, while vastly different, is crucial to the network as a whole. PVHS is indeed the sum of its many parts, including hundreds of dedicated employees.

Speaking of dedication, Paul Poduska, Infection Control Coordinator at Poudre Valley Hospital (PVH), has been on staff for 40 years. Poduska first arrived at PVH back in 1968 and “did whatever needed to be done” during those first few years. “I worked in every single department except dietary,” he says with a smile. “They wouldn’t let me in there because I burned everything.” Forty years later, few people remember that he burned things, but everyone knows Poduska.

He’s in charge of ensuring the hospital stays infection free. As you can imagine, this job can be pretty intense, but you can tell he thoroughly enjoys it. “It’s definitely a challenge, but I love it,” says Poduska. “The really interesting thing is that the field is always changing, there’s always something more to learn.” Learning, and then sharing what he’s learned, is the most important reason for his position. “Most of my job is education and re-education,” he says. “I enjoy conducting ori-

The really interesting thing is that the field is always changing, there’s always something more to learn. I enjoy conducting orientations with new staff and teaching them the fundamentals of infection control and epidemiology. - Paul Poduska, Infection Control Coordinator

entations with new staff and teaching them the fundamentals of infection control and epidemiology.” Poduska met his wife, Nancy, while working at PVH and considers the hospital to be like a second home. “I met Nancy on her first day at work when she couldn’t find the time clock, even though it was right behind her. It was then I knew I had to meet her,” he says lovingly. Nancy, Director of Special Services in Nursing, supports her husband in many ways at the hospital. “She covers my back when I’m not around,” he says. “Between the two of us, we’ve definitely made Poudre Valley our home.” It’s not just his wife that provides support, though. According to Poduska, the entire team at

PVH excels at teamwork. “That’s what makes PVH one of the top hospitals in the country and why I’ve chosen to be here so long,” he says. “The administrators here have supported me in every endeavor I’ve introduced, so long as I have sufficient evidence as to why it’s necessary.” Openness and a respect for Poduska’s knowledge have helped make him, and his wife, feel at home here over the past 40 years. Joann Kresl, R.N., M.ED, and Staff Development Coordinator in the Clinical Education Department, offers similar sentiments as to why she’s chosen to remain at PVH for so long. An R.N. for 50 years, Kresl has enjoyed 37 years of support, flexibility, and collaboration at PVH. “That’s the beauty of being an R.N. at PVH,” she says. “You

have so many options, so many avenues you can take, so many different ways you can direct your career with the support of the hospital.” Kresl’s esteemed career is a great example of that flexibility. “I’ve had experience on just about every floor of the hospital,” she says. This varied experience serves her well in her latest role as Staff Development Coordinator. “We work pretty much hospital wide here in the Education Department,” she says. Kresl teaches and coordinates classes for new nurses, preceptors, and nurse interns. “The nice thing about my job is that it combines my education background with my nursing skills,” she says. Kresl insists she learns as much from her “students” as they do from her. “I’m the guide on the side, not the sage on the stage,” she

The nice thing about my job is that it combines my education background with my nursing skills… I’m the guide on the side, not the sage on the stage. We all learn from each other, everyone has something to offer. - Joann Kresl, R.N., M.ED, Staff Development Coordinator

Fort Collins Medical Magazine & Directories 2008 2009

Teamwork is so important here… We take part in the rounds, communicate well with one another, and all have our roles to play. - Michelle James, O.T.

says. “We all learn from each other, everyone has something to offer.” The most important thing Kresl relays to the new nurses is PVHS’s high standard for patient care. “I tell them to put themselves in the patient’s shoes,” she says. “Most patients are sick, scared, vulnerable, and feel like they’re losing control. It’s up to us to make them comfortable and to do whatever we can to get them through this difficult time.” While her teaching responsibilities have removed her from the daily patient interactions she so loved as an R.N., Kresl takes solace in the fact that she’s able to reach so many more people in her new role. “I can truly impact the quality of patient care by providing other nurses with the education they need to provide competent care.” Liz Ghent, a first-year R.N. at PVH, can attest to that. Ghent, an R.N. in the float pool (meaning she works wherever she’s needed), says she’s already learned so much more than she did in school, from the other nurses and staff at the hospital. “I’m always asking questions and everyone

here is so willing to answer them and help in any way they can,” she says. “We have a common goal here to take care of our patients and we have to work together to get it done.” Ghent, who interned at PVH while attending school at Front Range Community College, chose to work in the float pool so she could learn about every floor of the hospital. “I love the variety that comes with this position,” she says. “Every day is different, filled with new challenges and new faces.” Ghent credits the tremendous value placed on teamwork at PVH for her success. “I love the constant learning and just hope each day that I’m able to handle whatever’s thrown my way.” With the support of fellow nurses and other staff, there’s no doubt she will. Teamwork is also what enables Michelle James, an occupational therapist at Medical Center of the Rockies (MCR), to care so effectively for her patients. James, who’s been an OT for 13 years, has patients on all floors at MCR, but specializes in acute trauma. Having such a diverse set of patients, means she needs to work in close

proximity with other nurses, physical therapists, doctors, and discharge planners. “We help patients with basic life skills, either in their rooms or in the in-patient therapy center,” she says. “We often work together with the physical therapists during consultations and rehabilitation.” Working together is imperative in her position, as she needs to collect information from doctors and nurses as well as supply those caregivers with her own data. “We do a lot of coevaluations at the hospital,” she says. “We’ll meet a patient together with a physical therapist and possibly a speech therapist to take an extensive family history and then we evaluate their treatment plan together.” James carries a cell phone with her while on duty to field calls from fellow therapists, nurses, or discharge planners seeking input on her patients. “Teamwork is so important here,” she says. “We have a great relationship with the nurses, planners, and doctors. We take part in the rounds, communicate well with one another, and all have our roles to play.”

We have a common goal here to take care of our patients and we have to work together to get it done. - Liz Ghent, R.N.

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Patients benefit from these various roles tremendously, as they get the combined knowledge of so many different specialists involved in their care. “Everyone here is committed to patient care and goes above and beyond to ensure patients are comfortable and receiving the very best care possible.” That commitment combined with the teamwork and mutual respect of fellow employees, are a few of the reasons James is so happy at PVHS. “I’ve worked other places where it wasn’t always like that. PVHS is a much more cohesive unit than other healthcare systems.” Kyle Stopperan, graphic designer and multimedia specialist at PVHS, wholeheartedly agrees. While his duties vary greatly from the medical staff, Stopperan enjoys the mutual respect shown at PVHS just as much as anyone. “I really like everyone I work with and that makes the job so much more enjoyable,” he says. “It’s not always like that. I feel very lucky.” In addition to enjoying his co-workers, Stopperan absolutely loves his work. “I do all the advertising and informational brochures,” he says. “Each day is different and I really enjoy that. One day I’ll create an ad for a paper or magazine, the next day I’ll work on a medical brochure. Right now I’m working on an ad campaign for MCR.” Stopperan greatly enjoys seeing his ads go to print, knowing they may possibly influence someone’s healthcare decision. “I really enjoy seeing my creative work published. That’s the best part of the process, seeing the final product,” he says. Stopperan was drawn to PVHS because he knew it was a great place to work. “I’d heard what a great work environment they have at PVHS and that’s the reason I chose to work there,” he says. “The benefits are great and the people are really nice and easy to work with.” Working around people who enjoy what they do goes a long way towards creating a positive work

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Fort Collins Medical Magazine & Directories 2008 2009

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I really like everyone I work with and that makes the job so much more enjoyable. It’s not always like that. I feel very lucky - Kyle Stopperan, Graphic Designer and Multimedia Specialist

environment. “It’s a laid-back environment where you’re pushed to do your best work. It’s a great combination,” he says. “But the people are really the best thing about PVHS.” If you were to ask Eileen Angeli, an R.N. in the neonatal intensive care unit (NICU), she’d tell you a similar story. Angeli, who’s been at PVH for 30 years, is absolutely in love with her job. “I feel so lucky to have found my passion. I love nursing and, in particular, I love being in the neonatal unit,” she says. “Every day I feel like I can make a difference in someone’s life.” And make a difference she does, by caring for premature babies as young as 28 weeks. “It’s so rewarding, after you’ve cared for a baby and the parents, to watch them all go home,” she says. “We form a real bond with the families we care for. It’s very special.” Caring for pre-term babies isn’t always easy, Angeli tells me, but the support she receives at the hospital helps tremendously. “Luckily, most of our babies go home healthy,” she says. “And that’s so rewarding. But there are days when things get hectic, say with more babies admitted than we’ve planned on. That’s when teamwork really plays a role.” Thankfully, the team at PVH is always there for one another and ready to lend support any way they can. “We’re all dedicated to world-class care here at PVH. That’s everyone’s first priority,” she says. “The patients come first and we all pitch in to make sure they get the very best care we can provide. That desire (to give the best care) becomes the focus.”

“We try to involve the parents as much as possible when their child is in the NICU,” she says. “We want them to help us determine the course of care. We listen to them, hear their concerns, and make them a part of the process.” Caring for the parents is just as important as caring for the children themselves. “A big part of my job is comforting the parents and empowering them at a very scary time in their lives.” It’s not hard to see why Angeli was named an Employee of the Year. The bond she forms with both the babies and the parents is a strong one. She’s even a godparent to a set of twins that she cared for in the NICU when they were newborns. “I’ve remained close to that family and have become very good friends with them,” she says. “I was honored that they asked me to be a godparent and feel blessed I was able to care for the twins during those first weeks of life.” Perhaps feeling blessed is the best way to sum up the work experiences of these six employees; blessed to be doing what they love, to be part of such an incredible healthcare system, and to have each other for support. Their dedication, teamwork, and high standards of care make PVHS what it is – one of the top healthcare systems in the country.

Allie Comeau is a freelance writer and copywriter living in Fort Collins with her husband and two dogs. Email her at alliecomeau@gmail.com

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Pam Brock, Vice President of Marketing & Strategic Planning, Poudre Valley Health System with Kevin Unger, President/CEO, Poudre Valley Hospital display the artists’ renderings for the new PVH Medical Pavilion.

A Winning Partnership for

Women and Families by Allie Comeau

If you’ve driven by Poudre Valley Hospital (PVH) lately, you’ve surely noticed all the construction happening across the street. It doesn’t look like much now, but those mounds of dirt will soon give way to a full-service women and family healthcare facility with easy access to PVH.

It gives us an opportunity to become much more efficient in regards to patient care,” says Dr. Serniak. “Being connected to the hospital will enable us to be more available for surgery, for obstetrics, and for the types of patient care that we can’t provide in the office. - Audrey Tool, M.D., The Women’s Clinic of Northern Colorado Elizabeth Serniak, M.D., with Audrey Tool, M.D., of The Women’s Clinic of Northern Colorado.

Easy access is an understatement. You won’t even have to worry about crossing Lemay Avenue to get back and forth between PVH and the new facility, named PVH Medical Pavilion. In fact, you’ll be crossing high above Lemay Avenue. Connected by a third-floor breezeway, this new building and PVH are sure to create a winning healthcare partnership for the women and families of Northern Colorado. Scheduled for completion in about a year or so, the efficient new space will house The Women’s Clinic of Northern Colorado; PVH departments of perinatology and urogynecology services; a specialty retail store, focusing on health-related products; a medical spa; PVH administrative offices, and more. Kevin Unger, President/CEO of PVH, was clearly excited about the new facility when we sat down to talk about it. “The new four-story medical building is going to be extremely beneficial for the women of Northern Colorado,” he says. “This is an exciting partnership between The Women’s Clinic of Northern Colorado and PVH. It’s going to be a magnet for women in Northern Colorado.” Unger continues, “We’re always looking for ways to enhance our relationships with local physicians and view this as a great opportunity for all of us.” Drs. Beth Serniak, Audrey Tool, and Kevin Tool of The Women’s Clinic of Northern Colorado are equally excited about the new partnership. “It gives us an opportunity to become much more efficient in regards to patient care,” says Dr. Serniak. “Being connected to the hospital will enable us to be more available for surgery, for obstetrics, and for the types of patient care that we can’t provide in the office.” Dr. Kevin Tool agrees. “We’ll be more readily available to our patients,” he says. “We’ll still have someone dedicated to the hospital, but it will make it easier for us to see our patients before and after surgery and deliveries.”

This convenience will benefit women with high-risk pregnancies especially. Perinatology services in the new building will enable high-risk pregnant women to receive care right here in Fort Collins. “Women have traditionally had to travel to Denver for care during high-risk pregnancies,” says Pam Brock, VP of Marketing & Strategic Planning for PVHS. “If you’re high-risk and seven months pregnant, traveling to Denver once a week is certainly not ideal. Now those women will

Fort Collins Medical Magazine & Directories 2008 2009

be able to receive care right here in Fort Collins.” Perinatology, combined with the neonatal intensive care unit at PVH, will make a substantial difference for high-risk women and their babies. “High-risk women can feel comfortable knowing they can receive care across the street at The Women’s Clinic of Northern Colorado, deliver their babies here at PVH, and if the babies need it, they’ll have the benefit of the neonatal intensive care unit.” Since 2004, most premature babies

The new PVH Medical Pavilion makes progress day by day.

haven’t needed to travel to Denver for care, and instead were taken care of at PVH. “We’re able to care for babies born as early as 28 weeks gestation,” says Brock. “The goal is to keep patients in Fort Collins so they don’t have to go to Denver for care or delivery,” adds Dr. Audrey Tool. Making it easier for the patients is what this new project is all about. “If we need to admit a patient to the hospital, we can just walk them right over,” says Dr. Audrey Tool. “It’s going to be more efficient for both providers and patients.” Dr. Kevin Tool agrees. “By consolidating all services into one location, patients won’t have to drive all over town or make several appointments at different places.” Across Lemay Avenue is about as far as women will have to go once the new building is com-

plete. “The Women’s Clinic of Northern Colorado providers will be able to see patients, cross the breezeway for a delivery, and walk right back to the office,” says Unger. “They’ll have convenient access to inpatient, outpatient, and hospital support services as well.” “Better access to our patients will allow for more continuity of care,” says Dr. Kevin Tool. “We can provide a better service now by being able to work both in the office and at the hospital.” Dr. Serniak agrees this will improve provider care. “We may even be able to do more of our own deliveries,” she says. “It will be incredibly convenient – we’re eliminating the commute.” The convenience she speaks of doesn’t end with the close proximity to PVH. A committee of providers and staff members, including Dr.

Tool and Dr. Serniak, played an integral role in designing the layout of the new building, down to details like furniture and equipment location. “We’ve made the patient care rooms more private, the waiting rooms more comfortable, and even placed exam tables in such a way as to further promote privacy and comfort,” says Dr. Audrey Tool. The building itself is a feat of engineering, complete with an overhead pedestrian walkway. “We’ve learned that designing a building is sort of like working a miracle,” says Brock. “We’ve been through so many revisions. It’s been very interesting.” It will be even more interesting watching the crews install the walkway in September. “They’re going to build the walkway over on Robertson Street and then lift it into place with cranes,” says Unger. “It should be fun to watch.” Installation of the walkway may be fun to watch, but once installed, it will add a whole new level of convenience for both employees and patients. There will be additional visitor parking available in the east lots, employees can finally forego crossing Lemay Avenue, and both can enjoy the benefits of having the full scope of hospital services located only steps away. Men and children will also benefit from the new facility, Brock says. “While the Pavilion focuses primarily on women’s services, there will also be services for men and children, and possibly primary care providers,” she says. “We don’t want to leave anyone out.” The combination of providers at PVH and The Women’s Clinic of Northern Colorado will be beneficial for both organizations. “The Women’s Clinic of Northern Colorado will benefit from a host of support services at the hospital and, in turn, they may help lighten the load in emergency services by possibly being available to see patients who come to PVH.” The additional resources available to each association will benefit everyone involved and add to the efficiency of the new collaboration. Undoubtedly, the biggest benefit will be to the women of Northern Colorado. “The new building is going to be a one-stop shop for women’s services. It’s going to be a regional draw,” says Unger. “Women will be able to get everything they require either right here or across the street.” Brock agrees, adding, “That’s why we also wanted to include a retail store, so patients can buy what they need for care without having to drive all over town. We’ll carry special medical items they may have trouble acquiring elsewhere.” The retail store, carrying items like aluminumfree deodorant for patients receiving chemotherapy, special newborn items, breastfeeding products, and mastectomy products, for example, will be readily accessible to patients in the new building and PVH. “We’ll offer hard-to-find products for the couple with a newborn or the patient with special needs,” says Brock. “We want to accommodate our patients and make everything easier for them.” Another convenient (and luxurious) feature of the new healthcare building will be the medical spa. “We’ll also be offering a full-range of traditional spa services,” says Brock. “Massage, pedicures, manicures, skin-care treatments, and even injectables like Botox.” Along with pampering patients in the spa, the clinicians will also be able to visit patients in their rooms across the street at PVH. “New mothers can benefit from a

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The Women’s Clinic of Northern Colorado providers will be able to see patients, cross the breezeway for a delivery, and walk right back to the office. They’ll have convenient access to inpatient, outpatient, and hospital support services as well. - Kevin Unger, President/CEO, Poudre Valley Hospital

relaxing massage or a relative could treat them to a manicure and pedicure following the birth of their babies,” says Brock. “The spa will also carry a line of signature PVH spa products, like lotions and specialized cosmetic products for people with skin problems.” The medical spa adds a whole new level of comfort and convenience to the healthcare system. “I think patients will really enjoy the medical spa – who doesn’t like a med-spa?” says Dr.

Serniak. “People can also be confident in the spa services because they’ll be medically directed and supervised.” Employees may also benefit from services at the medical spa, if they can ever find the time. “I wouldn’t mind taking my breaks at the spa,” says Dr. Serniak with a smile. Urogynecology, the treatment of female incontinence, is another service that will be offered in the new building. “Many people don’t know there are solutions to the problem of inconti-

nence,” says Brock. “It’s a widespread problem that, fortunately, is totally treatable. Women just aren’t aware because it tends to be an embarrassing issue.” Whether through reconstructive surgery or physical therapy, there are several options available for treatment of this problem. “We want to work with local physicians to promote awareness by enhancing the services that are already available in Northern Colorado.” PVH’s program for new moms, Wee Steps,

View of the PVH Medical Pavilion as it will appear looking northwest from Lemay Avenue. Designed by Boulder Associates and constructed by Swingerton Builders, the pavilion is expected to open in spring 2009.

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will also be housed in the new womenâ&#x20AC;&#x2122;s facility. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;ve had this program for awhile, now,â&#x20AC;? says Brock. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s a program that helps new moms with everything from lactation to basic newborn care. It helps new moms out at what is a very tender time in life. Itâ&#x20AC;&#x2122;s been extremely helpful.â&#x20AC;? And with a new building only â&#x20AC;&#x153;wee stepsâ&#x20AC;? from PVH, new moms, and women in general, are in for one serious healthcare upgrade.

Allie Comeau is a freelance writer and copywriter living in Fort Collins with her husband and two dogs. Email her at alliecomeau@gmail.com

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Perinatology, combined with the neonatal intensive care unit at PVH, will make a substantial difference for highrisk women and their babies. Highrisk women can feel comfortable knowing they can receive care across the street at The Womenâ&#x20AC;&#x2122;s Clinic of Northern Colorado, deliver their babies here at PVH, and if the babies need it, theyâ&#x20AC;&#x2122;ll have the benefit of the neonatal intensive care unit. - Pam Brock, Vice President of Marketing & Strategic Planning, PVHS

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From skiing to soccer, Dr. John Guenther has seen his share of sports injuries. with two children of his own, he also knows first-hand that an ounce of prevention is worth a pound of cure.

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Medical

Community

The Changing Face of

Family Medicine by Lynn M. Dean

When you or a family member is sick, you want to see the doctor. You don’t want to see someone you don’t know who doesn’t know you. You don’t want to fill out a pile of paperwork detailing your medical history every time you walk in the door. No, you want to see your doctor– your family practitioner-- not someone who always has to be “brought up to speed” on what’s going on. According to a recent survey conducted on behalf of the American Academy of Family Physicians (AAFP) you are not alone. “American women want a healthcare system in which they and their families can conveniently obtain preventive services, see their personal physicians the day they become sick, and receive coordinated follow-up care if they require hospitalization or care from other physicians,” said the AAFP. “That is not what they encounter when they seek healthcare.” According to the AAFP, nearly 60 percent of respondents said they face challenges in obtaining healthcare for themselves and their family mem-

Shari Detterer, FNP-C, Nurse Practitioner, Milliken Family Clinic sees patients of all ages. bers. “These findings point to some of the most important cost-drivers in America’s healthcare system,” said Jim King, M.D., President of the AAFP. “A system that is difficult to navigate and relies on patients to deliver tests and communicate diagnoses leads to fragmented care, duplication of tests and sometimes unnecessary procedures– all of which steadily drive up the cost of healthcare for the nation as a whole.” What American women really want– what you really want– is a patient-centered medical “home.” “This concept is taking hold across the country,” says Dr. King. “Family physicians are at the forefront in developing this model of personalized, top quality healthcare that every patient deserves.” “The preference has always been to have the

patient in continuity,” agrees Susan Beck, M.D., the Family Practice Director at Poudre Valley Health System’s Loveland Family Medicine, part of the new Loveland Urgent care practice established at Highway 287 and 37th Street. “Otherwise care gets fragmented. It gets difficult for all the care givers. You need one person who’s a central information keeper. That’s really what the family practice is.” Unfortunately, as you may have noticed, there are fewer and fewer family physicians available to coordinate this care. Often, local practices are so overflowing with patients that if you’re not one of the first callers of the day, all the “sick” slots are full and you’re forced to seek medical treatment in an urgent care setting. “There is limited access,” agrees Dr. Beck.

With PVHS support comes other benefits. “This clinic is a little bit different because it’s not family practice– it’s integrated family practice, urgent care, occupational medicine and physical therapy. - Susan Beck, M.D., Family Practice Director, Loveland Urgent Care “I think existing family practitioners are getting squeezed out of practice because it is difficult, economically, for them to have a viable practice. Generally, family physicians are not well reimbursed --the cost of overhead and malpractice insurance continues to increase. Reimbursements from insurance providers do not. Over the past year I’ve seen two physicians choose to close up shop because of the complexities of insurance documentation and pre-certification for procedures. The economics of family practice are difficult.” It’s a national trend. “All agree the nation is grappling with a deepening shortage of primary care physicians,” says the AAFP. The need for family physicians is expected to skyrocket by 2020, when the nation will need 139,531 family physicians according to the AAFP’s 2006 Physician Workforce Report. “That means our residency programs must be graduating more than 4,400 new family physicians each year,” adds Dr. King. Yet in 2008, only half that number chose to enter family medicine residency programs. “It’s a hard job,” explains Dr. Beck. “There is so much information, so many specialties you have to master, and ongoing education just to sustain you in your career.” She adds that insurance companies don’t take this knowledge base into account when determining reimbursement schedules. “If you look at medicine in general, insurance reimburses for procedures and interventions. It does not reimburse for prevention and the inter-relationships that you need to develop to be a good doctor. It does not reimburse you for the time you have to spend with patients. A lot of medical schools are pretty frank about the reality of family medicine and what you’re not going to get paid for. ” Poudre Valley Health System (PVHS) has noted the trend, especially in the Loveland area, and taken steps to stem the outgoing tide by forming collaborative partnerships with local family physicians. “As soon as we opened the doors of the Medical Center of the Rockies, physicians began coming to us, saying there are not enough family physicians in the area,” says Pam Brock, Vice President of Marketing & Strategic Planning, PVHS. “We realized that we had to do something. By working with physicians and clinics throughout

the area, we’re working not only to preserve the quality of healthcare, but strengthen it as well.” “It’s vitally important for people to maintain good health,” adds Rulon Stacey, PVHS President and CEO. “Easy access to physicians who offer family and primary care is crucial. Our health system’s commitment is to provide people with world-class healthcare that is affordable and convenient.” “One of the pieces of our strategy has always been to partner with physicians whenever we can,” says Brock. “We have the Family Medicine Center (in Fort Collins) and they bring in new residents each year. “That’s a wonderful opportunity. Unfortunately, there are fewer and fewer of them. We want to guarantee the supply of family practice physicians by working closely with them, not setting up structures that will make them leave the area.” Dr. Susan Beck is a product of PVHS’ proactive efforts to attract and keep the best and the brightest family physicians. She did her residency at the Family Medicine Center and then worked with PVHS at both Harmony Urgent Care and Mountain View Family Practice in Fort Collins before leaving earlier this year to open Loveland Urgent Care. With PVHS’ purchase of Loveland Urgent Care in June, Dr. Beck has come full circle and now is the Family Practice Director of the new Loveland Urgent Care located at 3850 Grant Avenue in Loveland. The Health System contracts with providers like Dr. Beck. “Our purchase of Loveland Urgent Care is a tremendous opportunity to expand healthcare for residents of Loveland and nearby areas,” says Stacey. “The clinic will help provide a continuum of PVHS healthcare in Loveland.” He says the health system plans to expand family medicine at the clinic and add physical therapy to complement the clinic’s current occupational health services. In addition, hours of operation are planned to be increased later this summer. Dr. Jim Seeton, who along with Dr. Beck, is one of Loveland Urgent Care’s founding physicians, says PVHS is recognized as the region’s leader in quality patient care, as evidenced by many national honors the health system has received for quality in patient care and business services. “Any time a top organization like PVHS establishes a presence in a community, everyone

Fort Collins Medical Magazine & Directories 2008 2009

benefits,” he says. With PVHS support comes other benefits. “This clinic is a little bit different because it’s not family practice– it’s integrated family practice, urgent care, occupational medicine and physical therapy,” explains Dr. Beck. “The hope is that this [level of integrated services] will ensure internal and financial stability by providing a lot of different services using the same overhead structure. PVHS has given us the opportunity to try this [new model of service].” Partnerships such as this one also provide more access to care across all income levels. “One of the advantages to partnering with a healthcare system is that you can provide indigent care,” says Dr. Beck. “You can take “all comers”– Medicare, Medicaid, and uninsured patients. In private practice, in order to keep your doors open, you have to pay your bills. There is a lack of access for (these patients). This is a nice solution.” Pam Brock agrees. “The beauty of Loveland Urgent Care is that we can provide care to people who would normally have to go to the emergency room. Instead, they can get in to a more easily accessible clinic.” PVHS has a long history of such efforts. All of PVHS’ facilities, including the Family Medicine Center and Harmony Urgent Care in Fort Collins, take “all comers.” Stacey says the purchase of Loveland Urgent Care is an important step in the health system’s goal to establish primary care clinics throughout the region. In mid-May, PVHS purchased the Milliken Family Clinic and contracted with the Greeley Medical Clinic to operate the service in the town of Milliken in Weld County. “Milliken is a beautiful, vibrant community that has been well-served by the Milliken Family Clinic,” said Stacey. “Our goal is expand healthcare opportunities for residents of the town and nearby areas.” Barbara Yosses, Greeley Medical Clinic’s CEO, says Milliken area residents will continue to benefit from convenient access to healthcare. “We’ll be there to meet the unexpected medical needs of community members and provide their important ongoing healthcare services,” she says. “I think it’s a great opportunity to work with PVHS. They have a great reputation. The strength they have as a hospital system and the strength we have as a

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

Another part of our mission is to remain independent. By that, we mean we don’t want to be owned by a large health system located somewhere else. We don’t want to send our dollars out of the community. By partnering with physicians, we strengthen both the system and the physicians. We’ve created alliances between a well-respected and trusted health system and physicians who have been practicing in the community. By working together we share technologies– share new ideas. - Pam Brock, Vice President of Marketing & Strategic Planning, PVHS

Fort Collins Medical Magazine & Directories 2008 2009

medical group– it’s a nice combination. I think we complement one another.” Pam Brock agrees. “The bottom line is that we’re not in the business of managing clinics, we’re in the business of providing world-class healthcare. We want to hire or work with the right people to manage them. Greeley Medical Clinic knows how to run a clinic.” The Milliken Family Clinic was originally established by the Hall-Irwin Corporation in an effort to provide low-cost healthcare for its employees and their families. Shari Detterer, has worked in the clinic since its inception. She will continue her services, even with the new ownership. “As Milliken continued to grow, we found that we needed additional healthcare expertise and resources,” said Michael Job, Hall-Irwin’s cor-

porate systems manager. “We’re delighted that PVHS and the Greeley Medical Clinic have offered to become leaders in the healthcare of our community. They both have outstanding reputations for providing high quality, affordable care.” “The difficulty has been not being able to have afternoon hours,” say Shari Detterer, FNP-C, who will stay on to provide medical care at the clinic. “PVHS is committed to our growth and expansion of hours, services and providers to meet our growing community and population needs. We have a mixture of clientele. About 30 percent are Hall-Irwin employees and their families. The remaining 60 to 70 percent are community-based patients who run the gamut from pediatric to geriatric, acute care to chronic disease management, and preventative care to urgent care.”

“Milliken Family Clinic has had a strong start in the community thanks to Shari’s healthcare expertise,” Stacy adds. “She’ll play an important role in our plan to grow and expand services.” Barbara Yosses explains the plan is to increase services at the Milliken Family Clinic through the addition of a primary care physician and expand hours of operation beginning in midsummer beyond the current hours of 6:30 a.m. to 1:30 p.m. five days a week. PVHS’ expansion efforts throughout the region are mission driven. “PVHS is committed to providing people with healthcare that is easily accessible,” Stacey points out. “Establishing local clinics throughout the region is a key factor.” “Our primary service area is the I-25 corridor, but we serve patients from four states: Colorado, Wyoming, Nebraska, and Kansas,” explains Brock. “Northern Colorado is where we are looking for expansion opportunities. We don’t want to do too much too fast or too far away. We need to make sure our efficiencies stay strong.” But, she points out, each expansion has been, and will continue to be well thought out. “We make very strategic decisions about who we will work with and where those clinics might be. We always look at need in the area. If there is no need for a clinic, there is no need for us to be there. We don’t want to saturate the market. We want to take services where they need to be. We listen to our physicians. That’s a big source of information for us.” “Another part of our mission is to remain independent,” she continues. “By that, we mean we don’t want to be owned by a large health system located somewhere else. We don’t want to send our dollars out of the community. By partnering with physicians, we strengthen both the system and the physicians. We’ve created alliances between a well-respected and trusted health system and physicians who have been practicing in the community. By working together we share technologies– share new ideas.” That said, Brock feels there is a difference between saturation versus competition– especially the home-grown variety. “Competition makes health systems stronger,” she explains. “Everyone wants to be the best. Everyone wants to provide great quality healthcare. Competition forces us to look at our competitors, see what they’re doing really well, and try to match that quality. We have to ask ourselves how they get that outcome. It keeps us on our toes, especially around costs. We have to make sure that we keep our costs as low as possible. We have to make sure we’re not duplicating services.” PVHS will continue to seek out collaborative opportunities. “We have ongoing efforts to expand the health system is smart ways,” says Brock. “We want to work with our physicians in Loveland and beyond. We are actively looking for ways to expand access to family practice and other kinds of healthcare. For us, it’s a long term vision for healthcare in the area. We want to connect these communities, clinic to clinic and hospital to hospital, so that we make sure that we provide a good network of healthcare in the region.” Lynn M. Dean is a freelance writer living in Northern Colorado.

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Fort Collins Medical Magazine & Directories 2008 2009

medical

spine care

Winfield Craven, M.D., Medical Director, Department of Radiology, Medical Center of the Rockies, stands in front of angiographic equipment, which uses imaging to diagnose and treat medical conditions.

XXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXX XXXXXXXXX

Hans Coester, M.D., sits with friend and fellow surgeon Douglas Beard, M.D. enjoying a break between surgery.

Surgical Synergy Means

Better Spine Care by Corey Radman

When you see them together, they look like two friends who enjoy goofing around. Laughing and joking about a spine model that was put together incorrectly, you can tell that these two men entertain and respect each other. At first glance, they could be any two guys – but they aren’t.

Half an hour from now these two “guys” will operate on a patient’s spine. Working with precision around nerves that connect the brain to the body, they will fuse together two vertebrae in a woman’s back. Talking to Hans Coester, M.D. and his colleague, Douglas Beard, M.D., it is immediately clear that their goal is excellent patient care. Dr. Beard even arrived at the interview for this story post-surgery with vertebra sketches on his scrub pant leg. Embarrassed, he explained that he had been discussing a procedure with a patient’s family member, and made a quick sketch to help them better understand. Compassion combined with experience and superior skill is why so many people choose Drs. Coester and Beard to operate on their spines. They, with their colleagues at Front Range Center for Brain & Spine Surgery, P.C., Drs. Tim Wirt, Donn Turner, and John Viola, have earned a regional reputation as exceptional surgeons. The Doctors Douglas Beard, M.D. is a Fort Collins native (son of Donald Beard, M.D. who founded the Fort Collins Youth Clinic). Dr. Doug Beard is certified by the American Board of Orthopaedic Surgery.

I think what people really want is a highly skilled physician who has good judgment and who is thoroughly up to date with new technology - one who would make the same recommendations to a patient that he would to his own family. - Hans Coester, M.D., Front Range Center for Brain & Spine Surgery, P.C. His career has included service at the Orthopaedic Center of the Rockies in Fort Collins, as well as partnership at Center for Spinal Disorders in Thornton, Colorado. After eight years of commuting via I-25 to the Denver area practice, sometimes two times a day, Dr. Beard says with relief, “I’m happy to be back home.” The arduous commute aside, Dr. Beard notes his enthusiasm to be joining the practice at Front Range Center for Brain & Spine Surgery, P.C. “FRBS seemed to be a natural fit. Hans [Coester] and I are excited about the ability to bounce complex ideas off of each other. The ability to discuss and talk things over, can only improve patient care.” Hans Coester, M.D. is a neurosurgeon certified by the American Board of Neurological Surgery. He has a reputation for providing excellent care, and has served patients in Northern Colorado at Front Range Center for Brain & Spine Surgery, P.C. since 1992. He says, “A college friend has been telling me for 16 years that Doug and I should work together.” And now they finally are. Actually the two have consulted with each other on cases for many years. Dr. Coester compliments his friend and colleague: “I think that Dr. Beard is a highly skilled surgeon, a smart physician with good judgment, and a fine human being. It’s very rewarding to be around all those qualities.” Come Together Dr. Beard’s arrival at FRBS brings an orthopedic surgeon’s perspective to spine surgery. Nancy Timmons, Administrator at FRBS, explains that Dr. Beard’s expertise will also enable FRBS to help patients with spinal deformities like scoliosis. “Overall,” she indicates, “we’ve received some really positive feedback from the medical community about having Dr. Beard here. We’re happy to have such a skilled and well respected surgeon join us.” That Dr. Beard is joining a neurosurgery practice at all is unique. FRBS is the first practice in Colorado to combine the orthopedic and neurosurgery specialties. He says, “It’s not common place, though we are beginning to see it in more places around the country.” “It’s going to have a positive impact on our ability to share ideas in pain management and other new concepts. It’s always better to have more opinions and share the wealth… it means

better patient care,” says Dr. Beard, who is keen on the new partnership. “I enjoy lighting up the eyes of the other physicians around town who are so amazed that these two specialties are coming together.” Front Range Center for Brain & Spine Surgery, P.C. is a full-service neurosurgical practice that offers comprehensive clinical expertise to patients throughout Northern Colorado, Western Nebraska, Wyoming, and Western Kansas. They have served the region since 1978. Their five surgeons are regional experts in the non-surgical and surgical treatment of spinal and intracranial pathology, and treatment of problems concerning the peripheral nerves. Founding members of the practice, Drs. Wirt and Turner were instrumental in the decision to bring Dr. Beard aboard, and are pleased to have this new perspective available to their team. Dr. Wirt explains, “Front Range Brain & Spine has always stayed abreast of the changes in spine care. Adding the ortho-spine component was the next natural step.” Ortho or Neuro? Many patients with back pain ask the question, “What’s the difference between a neurosurgeon and an orthopedic surgeon?” Both types of surgeons do back surgeries, they often attend many of the same conferences, trainings, and contribute to many of the same journals. Increasingly, the two specialties are sharing expertise, and international scientific organizations like the North American Spine Society and the Cervical Spine Research Society have recently opened their doors to specialists from both areas. There are differences as well. According to Dr. Wirt, “Only neurosurgeons are trained during their six to seven year residency to perform procedures inside the lining of the spinal canal called the dura.” Thus, spinal cord tumors and diseases like spina bifida are still within the domain of a neurosurgeon (as well as brain surgery, of course). Likewise, orthopedic surgeons usually treat deformities of the vertebrae like scoliosis, as well as other joints in the body. Trauma cases with broken backs and necks also require the expertise of a neurosurgeon. Timmons explains that both Poudre Valley Hospital System and North Colorado Medical Center in Greeley call on Drs. Wirt, Turner, Viola, and Coester for these emergencies through the trau-

ma system. Dr. Coester hears the ortho or neuro question frequently from patients: “I think what people really want is a highly skilled physician who has good judgment and who is thoroughly up to date with new technology - one who would make the same recommendations to a patient that he would to his own family. I don’t think it really matters what label [a surgeon has]. What really matters is their level of commitment and understanding of the patient’s problem.” Dr. Coester suggests that patients find a surgeon who performs spine surgery on a routine basis and who has routinely good outcomes. “Who do you want for your spine surgery: a surgeon who does a particular surgery once a year, or an excellent physician who does that spine surgery multiple times every week?” The benefit to patients from this change is shared expertise and increased choice. Dr. Turner states that the group has always embraced the concepts of advocacy and education. “Patients should feel free to ask about their surgeon’s training, the focus of their medical practice, and their board certifications. Ask for details about any recommended surgeries, and whether all options have been presented.” Doctors place great value on patient education. Don’t be afraid to ask. Future of spine care More and more, both orthopedic surgeons and neurosurgeons are striving to use procedures that are less invasive thus requiring smaller incisions. Some spinal problems can be solved through new cervical or lumbar disc replacements rather than disc fusions. These advancements can often result in better preservation of a patient’s range of motion post-surgery. Dr. Beard is enthusiastic about new procedures: “The opportunities are limitless. We’re trying to stop or arrest the aging process that affects us all in the discs. The lengths of hospital stays will be shorter, involve less pain, and lower costs.” Dr. Coester indicates that FRBS practice members are also pursuing opportunities to expand the use of motion preservation devices. The future of spine care has arrived. The experts at FRBS are at the forefront and will continue to be so. Corey Radman is Editor at Style Magazine.

I’m happy to be back home. FRBS seemed to be a natural fit… The ability to discuss and talk things over [with colleagues], can only improve patient care. - Douglas Beard, M.D., Front Range Center for Brain & Spine Surgery, P.C.

Fort Collins Medical Magazine & Directories 2008 2009

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PHYSICIAN’S

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WELCOMES TO OUR PRACTICE

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â&#x20AC;&#x153;By combining the latest in scientific research and innovative technology, a team inter-disciplinary approach to resolving spine issues, and a commitment to caring compassionate individualized patient care, Front Range Center for Brain & Spine Surgery, P.C. offers the finest spine care available. I am proud to be joining this team!â&#x20AC;? ~ Dr. Douglas Beard ~

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Fort Collins Medical Magazine & Directories 2008 2009

Ifyou're having ababy, were herefor you. If you're expecting a baby, the team of physicians and birthing center professionals at PVHS are here to ensure that you and your baby have a safe, comfortable delivery. State-of-the-art birthing centers are located at both Poudre Valley Health System hospitals -at Poudre Valley Hospital in Fort Collins and Medical Center of the Rockies in Loveland . We look forward to being part of your special day.

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Take a Tour! Come take a tour of our state-of-the-art birthing centers. Call (970) 495-7500 for a schedule of upcoming tour dates at Poudre Valley Hospital and Medical Center of the Rockies.

The Women’s Clinic has been serving Northern Colorado for over 30 years. We offer a full range of services from gynecological and obstetric care to robotic assisted surgery.

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P O U D R E VA L L E Y H E A LT H S Y S T E M

Dear Medical & Wellness Magazine Reader:

William A. Neff, M.D. Chief Medical Officer Poudre Valley Health System

Since I am new to the position of Chief Medical Officer for Poudre Valley Health System, I would like to use a few words to introduce myself to you. I was appointed to the position in April. The position is new to PVHS, but I am not new to the issues and opportunities facing healthcare in our area. I have been an anesthesiologist in Fort Collins since 1990 and have been active in the medical community. I sat on the PVHS board of directors from 2004 until I resigned to become the Chief Medical Officer. Most recently I was the board chair. The vice chair, Stu VanMeveren, replaced me in that leadership role. Enough, though, about me. I want to emphasize to you that physicians and healthcare providers in Northern Colorado are among the best in the world. On the day that I wrote this letter to you, there were 499 family practice and specialty physicians on Poudre Valley Hospital’s medical staff and 370 on the Medical Center of the Rockies medical staff. In addition, PVH had 129 allied healthcare providers, such as psychologists, nurse practitioners and other healthcare providers, while MCR had 81. Many of the physicians and allied health professionals hold privileges at both hospitals. To put these numbers in perspective, our community has more healthcare providers per capita than most similarly sized populated areas of the United States. With the interest that consumers have vigorously expressed in receiving high quality medical care, there is a tremendous need for every healthcare organization in the nation to continually improve and prove quality. Our goal at PVHS is to continue to offer high quality medical services that have perennially resulted in the health system being recognized as one of the nation’s top healthcare providers. One way we maintain this reputation—which we have gained thanks to the magnificent efforts and skills of our employees and members of the medical staffs—is to pay close attention to clinical standards and ensure that they are focused on evidence-based medicine. We also recognize the need to monitor clinical outcomes data on an ongoing basis as a way to measure the quality of provided care and ensure we continually find ways to make improvements. In addition, we encourage consumers to take time to make informed decisions about their healthcare. One way to do this is by reviewing online websites that track patient care outcomes in individual hospitals in the United States. The Colorado Hospital Report Card, for example, is a tool to help consumers make informed decisions about healthcare. It provides the public with clinical data to help measure the quality of healthcare in Colorado hospitals. The report card, which is maintained by the Colorado Hospital Association, can be found at HYPERLINK “http://www.cohospitalquality.org” www. cohospitalquality.org, where you can conduct an interactive search to compare information from specific hospitals. Healthcare is important to every person. That’s why the PVHS staff, physicians, and allied healthcare providers strive to provide the best service in the world. On behalf of PVHS, I want you to know that we’re here for you and for helping you maintain good health!

Dr. William A. Neff Chief Medical Officer Poudre Valley Health System

Fort Collins Medical Magazine & Directories 2008 2009

FORT COLLINS

ALLERGY/IMMUNOLOGY

PHYSICIAN’S &SURGEON’S Krohn, Douglas, MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985

Gondalia, Lakham L., MD Cheyenne, WY ................................... 800.437.5443

Lichon, Amy, DO 1236 E. Elizabeth St., Ste.1 .....................224.2985 Marks III, Sandy C., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985

Kailasam, Velusamy, MD 2121 E. Harmony Rd., Ste. 350 ... 221.2370 See ad on page 67 Lanting, William A., MD 2121 E. Harmony Rd., Ste. 350 ... 221.2370 See ad on page 67 Laszlo, Daniel J., MD 2001 S. Shields St., Bldg. H ....... 498.9226 See ad on page 104 Murthy, Krishna C., MD 2121 E. Harmony Rd., Ste. 350 ... 221.2370 See ad on page 67 Seeley, Janet K., MD 2001 S. Shields St., Bldg. H ....... 498.9226 See ad on page 104 Vedanthan, P.K., MD Lakewood, CO............................................303.238.0471

ANESTHESIOLOGY Alessi, Richard D., MD 1236 E. Elizabeth St., Ste. 1 ...... 224.2985 See ad on back cover Bobo, Russell W., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Carline, Marylida, MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Cochran, Thomas S., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Deringer, Michael A., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Dunn, Duane L., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Ford, Troy A., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Harrison, William L., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Hodges, Kathleen A., MD 1236 E. Elizabeth St., Ste.1 .....................224.2985 Horne, Stephen G., MD 1236 E. Elizabeth St., Ste.1 .....................224.2985 Kirsch, Timothy E., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985

directory

Koepp, Jeffrey, MD 1236 E. Elizabeth St. Ste. 1......................224.2985

Culver, William G., MD 2001 S. Shields St., Bldg. H ....... 498.9226 See ad on page 104

James, John M., MD 1136 E. Stuart St., Bldg. 3-200 .. 221.1681 See ad on page 91

2008

Markus, Jennifer L., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Martinez, Alice, MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Miller, Justin D., MD 1236 E. Elizabeth St., Ste.1 .....................224.2985 Moss, William E., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Neff, William A., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Perschau, Erik R., DO 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Raymond, Jeffrey MD 1236 E. Elizabeth St., Ste. 1.....................224.2985 Reed, Jay A., MD 3800 N. Grant Ave.....................................622.0608 Richardson, Emily C., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Salimbeni, Julio C., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Serell, Sean M., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Stenbakken, Gelerie D., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Thomas, Christopher D., DO ......................... Greeley Thornton, Margaret N., MD .......................... Greeley Velasco, Stephen E., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Vizena, Annette D., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Wagner, Jan Gillespie, MD 1175 58th Avenue, Ste. 202 (Greeley) ......495.0300 Weiner, Kelli L., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Williams, Daniel K., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985 Williams, Wendy M.H., MD 1236 E. Elizabeth St., Ste. 1 ....................224.2985

CARDIOLOGY Ashmore, Roger C., MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98

Baker, William B., MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98 Beckmann, James H., MD 1800 15th St.,Ste. 310 (Greeley)...................... 392.0900 Chapel, Harold L., MD 1800 15th St., Ste. 310 (Greeley) .................... 392.0900 Doing, Anthony H., MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98 Downes, Thomas R., MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98 Green, C. Patrick, MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98 Gryboski, Cynthia L., MD 1800 15th Street (Greeley) ........................392.0900 Hurst, Paul G., MD 1800 15th Street (Greeley) ........................392.0900 Johnson, C. Timothy, MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98 Larson, Dennis G., MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98

Rath, Gary A., MD 1800 15th St., Ste. 310 (Greeley) .................... 392.0900 Stoltz, Chad Lynn, MD 2121 E. Harmony Rd., Ste. 100 .. 221.1000 See ad on page 81 & page 98 Strote, Justin A., MD 2121 E. Harmony Rd., Ste. 100 .. 221.1000 See ad on page 81 & page 98 Tate, Charles, MD 2121 E. Harmony Rd., Ste. 100 .. 221.1000 See ad on page 81 & page 98 Treat, Stephen A., MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98 Voyles, Wyatt F., MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98 Whitsitt, Todd B., MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98

DENTISTRY/GENERAL Hargleroad, Jennifer K., DDS 1025 Garfield St. ..................................... 493.2254

Luckasen, Gary J., MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98

DENTISTRY/PERIODONTICS

Miller, William E., MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98

Lindeberg, Richard W., DDS, MS 1120 E. Elizabeth, G4 ............... 221.5050 See ad on page 89

Myers, Gerald I., MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98

DERMATOLOGY

Oldemeyer, John Bradley, MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98

Baack, Brad, MD 1120 E. Elizabeth St., Bldg. G2 ................484.6303 Hultsch, Anne Lise, MD 3726 S. Timberline Rd., Ste. 101 .............221.5795

Purvis, Matthew T., MD 2121 E. Harmony Rd., Ste. 100 ... 221.1000 See ad on page 81 & page 98

Kornfeld, Bruce W., MD 1006 Centre Ave. .....................................482.9001

Sayers, Clinton P., MD 1120 E. Elizabeth St., Bldg. G2 ................484.6303 West, B. Lynn, MD 3726 S. Timberline Rd., Ste. 101 .............221.5795

Hanck, Jill L., MD 1024 S. Lemay Ave....................................495.7000

FAMILY PRACTICE

Johar, Jasjot S., MD 1024 S. Lemay Ave...................................495.7000

Abrahamson, Bradley S., MD 1221 E. Elizabeth St., Ste. 4 ...... 484.1757 See ad on page 24

Johnston, P. Scott, MD 1024 S. Lemay Ave...................................495.7000

EAR, NOSE & THROAT (OTOLARYNGOLOGY) Chand, Maria S., MD 1006 Centre Ave. .....................................482.9001 Conlon, William Sean, MD 1032 Luke St. .......................... 484.8686 See ad on page 50 Eriksen, Christopher M., MD, FACS 1120 E. Elizabeth St., F-101 ...... 221.1177 See ad on page 83 and back cover Gill, Sarvjit “Sarge,” MD 3820 N. Grant Ave. (Loveland) ...... 593.1177 See ad on page 83 Gupta, Sanjay K., MD 1900 16th Street (Greeley) ........................350.2426 Loury, Mark C., MD, FACS 2001 S. Shields St., Bldg. E-101 . 493.5334 See ad on back cover Peterson, Keith E., MD 2528 W. 16th Street (Greeley) ....................356.4646 Peterson, Thomas T., MD 2528 W. 16th Street (Greeley) ....................356.4646 Robertson, Matthew L., MD 1120 E. Elizabeth F-101 ............ 221.1177 See ad on page 83 Runyan, Brad, MD 2121 E. Harmony Rd., Ste. 350 ... 212.0169 See ad on back cover Schaffer, Stephen B., MD 2001 S. Shields St., Bldg. E-101 . 493.5334 See ad on back cover Smith, Bruce M., MD 2121 E. Harmony Rd., Ste. 350 ... 484.6373 See ad on back cover Woodson, Trudi., MD 5881 W. 16th Street (Greeley) ....................313.2740

Litel, Alexa L., MD 1024 S. Lemay Ave...................................495.7000 Luttrell, Matthew, MD 1024 S. Lemay Ave...................................495.7000 Olsen, Eric B., MD 1024 S. Lemay Ave...................................495.7000 Patrick, Kenneth M., DO 1024 S. Lemay Ave...................................495.7000 Repert, William B., MD 1024 S. Lemay Ave...................................495.7000

Abrahamson, Lara, MD 1635 Blue Spruce Dr. ...............................494.4040 Adamson, Theran B., MD 2021-D Battlecreek Dr..............................206.0851 Ahern, Caitlin M., MD 2127 E. Harmony Rd., Ste. 140 ...............221.3855 Anderson, Robert Scott, MD 3519 Richmond Dr. .................. 204.0300 See ad on page 24 Andreen, Kristin, MD 1025 Pennock Pl ......................................495.8800

Solley, Matthew C., MD 1024 S. Lemay Ave...................................495.7000

Askew, Crystal D., MD 1918 S. Lemay Ave., Ste. A ......................494.4531

Springfield, Tracy J., MD 1024 S. Lemay Ave...................................495.7000

Bailey, Austin G., MD 1025 Pennock Pl. .....................................495.8800

Teumer, James K., DO 1024 S. Lemay Ave...................................495.7000

Bakanauskas, Egle A., MD 1300 Main St., (Windsor)......................... 686.5646

Turner, Daniel T., MD 1024 S. Lemay Ave...................................495.7000

Basow, William M., MD ............................ Fort Collins

Updegraff, Jeffrey G., MD 1024 S. Lemay Ave...................................495.7000

Beck, Susan M., MD 2121 E. Harmony Rd., Ste. 310 ... 221.3855 See ad on page 37

Weil, Lawrence J., MD 1024 S. Lemay Ave...................................495.7000 Wideman, Eric DO 1024 S. Lemay Ave...................................495.7000 Wood, Ian O., DO 1024 S. Lemay Ave...................................495.7000

Bell, Sarah J., MD 1635 Blue Spruce Dr............................... 490.4040 Bender, Edward L., MD 1212 E. Elizabeth St.................................482.2791 Bender, John L., MD 4674 Snow Mesa Dr., Ste. 140.................482.0213 Bermingham, Roger P., MD 1025 Pennock Pl. .....................................495.8800

Cranor, J. David, MD 1124 E. Elizabeth St., Bldg. C ..................484.0798 de la Torre, Rebecca A., MD 2126 Milestone Dr. ................... 282.8266 See ad on page 94 DeYoung, Douglas B., DO 1024 Centre Ave., Bldg. E-100A ..............484.0774 Duran, Christine B., MD 1212 E. Elizabeth St.................................482.2791 Duran, Matthew G., MD 1212 E. Elizabeth St.................................482.2791 Ferguson, David R., MD 3000 S. College Ave. Ste. 210 .................266.8822 Fields, Jacqueline C., MD 315 Canyon Ave., Ste. 1 ...........................472.6789 Fritzler, Stace, MD 2121 E. Harmony Rd., Ste. 370 ...............221.2290 Geppert, Margo J., MD 2818 McKeag Dr.......................................225.2811 Glazner, Cherie, MD 1025 Pennock Pl. .....................................495.8800 Goacher, Cynthia, MD 2121 E. Harmony Rd., Ste.140. ...............221.3855 Gray, April K., MD 1918 S. Lemay Ave., Ste. A ......................494.4531 Haldy, Megan, DO 1025 Pennock Pl ......................................495.8800

Bethards, Kelby F., MD ............................ Fort Collins

Haskins, R. Scott, MD 6801 W. 20th Street, Ste. 101 (Greeley) ....378.8000

Izon, Meriam P., MD 2121 E. Harmony Rd., Ste. 300 ... 295.0010 See ad below

Birnbaum, Bernard J., MD 1025 Pennock Pl. ....................................495.8800

Hawley, Laura K., MD 1025 Pennock Pl ......................................495.8800

Bresowar, Kristin, MD 1025 Pennock Pl ......................................495.8800 Brewington, Flora Ho, MD 1136 E. Stuart St. ...................................224.0754 Brickl, Ian D., MD 1635 Blue Spruce Dr. ...............................494.4040

EMERGENCY MEDICINE

Broman, Steven D., MD 1221 E. Elizabeth St., Ste. 4 ...... 484.1757 See ad on page 24

Apostle, Michael J., MD 1024 S. Lemay Ave...................................495.7000 Dellota, Kriss, MD 1024 S. Lemay Ave...................................495.7000

Burnham, Linda A., MD 1918 S. Lemay Ave., Ste. A ......................494.4531

Farstad, David J., MD 1024 S. Lemay Ave...................................495.7000

Bursten, Marian S., MD Casper, WY ........................................ 307.265.8300

Green, Gabriel E., DO 1024 S. Lemay Ave....................................495.7000

Butler, Lisa R., DO 1212 E. Elizabeth St.................................482.2791

Hallahan, Tara A. DO 1024 S. Lemay Ave...................................495.7000

Connally, Patricia A., DO 2127 E. Harmony Rd.,Ste. 140 ................221.3855

ENDOCRINOLOGY

Zacheis, David H., MD 1120 E. Elizabeth St., F-101 ...... 221.1177 See ad on page 83

Green, Jason T., DO 1024 S. Lemay Ave....................................495.7000

Coburn, Thomas C., MD 1455 Main St., Ste.150, (Windsor) 686.0124 See ad on page 24

Widom, Barbara, MD 1040 E. Elizabeth St., Ste. 101 ............... 224-3636

Carroll, Cory D., MD 1040 E. Elizabeth, Ste. 102 .....................221.5858 Cawley, John, MD 1025 Pennock Pl ......................................495.8800

Helgeson, Heidi E., MD 1025 Pennock Pl. .....................................495.8800 Henderson, Sandra E., MD 2025 Bighorn Dr....................... 229.9800 See ad on page 24 Hiam, Sarah E., DO 1635 Blue Spruce Dr. .............................. 494-4040 Hill, Brian, MD 1025 Pennock Pl ......................................495.8800 Hoenig, Mark W., MD ............................... Fort Collins Hopkins, Jan H., MD 1120 E. Elizabeth St., Bldg. G-1...............493.2776 Hornung, Diana L., MD 1635 Blue Spruce Dr. ...............................494.4040 Jackson, Rebecca, DO 1025 Pennock Pl ......................................495.8800 Janasek, Mitchell J., MD 2121 E. Harmony Rd., Ste. 310 .. 221.3855 See ad on page 37 Jinich, Daniel B., MD 2001 S. Shields St., Bldg. E-201 ..............221.9991

Paolo Romero, MD :: Matthew Sorensen, MD Regina Brown, MD Anne Kanard, MD :: Miho Toi Scott MA, MD

at the POUDRE VALLEY HOSPITAL HARMONY CAMPUS 2121 E. Harmony Rd. Suite 150, Fort Collins â&#x20AC;˘ www.cancercenteroftherockies.com

970.493.6337

Kaleta, Andrea D., MD 2025 Bighorn Dr....................... 229.9800 See ad on page 24 Kauffman, Jeffrey N., MD 1124 E. Elizabeth St., Bldg. C ..................484.0798 Kesler, James M., MD 3519 Richmond Dr. ................... 204.0300 See ad on page 24 Klinger, Susan K., MD 2025 Bighorn Dr....................... 229.9800 See ad on page 24 Kuroiwa, Christina L., MD 315 Canyon Ave., Ste. 1........................... 472.6789 Latter, Macy, DO 1025 Pennock Pl ......................................495.8800 Lembitz, Deanne D., MD 4630 Royal Vista Dr., Ste.7 (Windsor) ...530.0575

See ad on page 90

Lesage, Margaret R., MD 1455 Main St,Ste. 150 (Windsor) ... 686.0124 See ad on page 24 Lockwood, Stephanie R., MD 3519 Richmond Dr. ................... 204.0300 See ad on page 24 Loeb, Mark H., MD 2121 E. Harmony Rd., Ste. 140 ...............221.3855 Lopez, Joseph M., MD 1136 E. Stuart St., Bldg. 4#202 .............221.5925 Lundeen, Anna C., MD 1025 Pennock Pl. .....................................495.8800 Lunianski, David, DO 1025 Pennock Pl ......................................495.8800 Lupica, Michelle, DO 1025 Pennock Pl ......................................495.8800 Lowther, Kelly H, MD 4674 Snow Mesa Dr., Ste. 140.................482.0213 MacDonald, Nola A., DO 315 Canyon Ave., Ste. 3 ...........................472.8008 Maes, Elizabeth J., MD 1025 Pennock Pl. .....................................495.8800 Mallory, Patrick, DO 1548 N. Boise Ave. (Loveland) ...................669.9245 Marchant, David R., MD 1025 Pennock Pl. .....................................495.8800 Mason, R. Anthony, MD 4630 Royal Vista Dr., Ste. 7 (Windsor) ..530.0575

See ad on page 90

McCarthy, Victoria A., MD 2001 S. Shields St., Bldg. I ........ 221.5255 See ad on page 24 McClellan, Danielle, MD 1025 Pennock Pl. .....................................495.8800 McCreery, Colleen R., DO 3519 Richmond Dr. ................... 204.0300 See ad on page 24 McIntosh, Deric, DO 1025 Pennock Pl ......................................495.8800

Mercer, Jeannette Y., MD 2555 E. 13th Street, Ste.110 (Loveland) .. 461.6140

Sullivan, Donna L., MD, FAAFP 1025 Pennock Pl. .....................................495.8800

Chase, Jerry A., MD 2555 E.13th Street, Ste. 220 (Loveland) .. 669.5432

Merkel, Lawrence A., MD 2121 E. Harmony Rd., Ste. 370 ...............221.2290

Sunthankar, Shivalini M., MD 1014 Centre Ave. .....................................482.8881

Compton, Rand F., MD 3702 Timberline Dr., Bldg. A ................... 207.9773

Monaco, Julie A., MD 1635 Blue Spruce Dr. ...............................494.4040

Taylor, Grant, DO 4674 Snow Mesa Dr., Ste. 140.................482.0213

Dowgin, Thomas A., MD 3702 Timberline Dr., Bldg. A ....................207.9773

Murphy, Lawrence E., MD 1113 Oakridge Dr. .................... 225.0040 See ad on page 24

Thieman, William J., MD 2121 E. Harmony Rd., Ste. 140 ...............221.3855

Dunphy, Rebecca C., MD 3702 Timberline Dr., Bldg. A ....................207.9773

Nevrivy, Thomas E., MD 3519 Richmond Dr. ................... 204.0300 See ad on page 24 Orozco-Peterson, Marilu, MD 811 E. Elizabeth St. .................................224.1596 Ottolenghi, David R., MD 2121 E. Harmony Rd., Ste. 310 ... 221.3855 See ad on page 37 Palagi, Patricia C., MD 3000 S. College Ave., Ste. 210 ................266.8822 Podhajsky, Tim P., MD 2025 Bighorn Dr....................... 229.9800 See ad on page 24 Robinson, Anne L., MD 1221 E. Elizabeth St., Ste. 4 ...... 484.1757 See ad on page 24 Rodriguez, Juan B., DO 4674 Snow Mesa Dr., Ste. 140.................482.0213 Rotman, Mark F., MD 2001 S. Shields St., Bldg. I ........ 221.5255 See ad on page 24

Thorson, Steven J., MD 1212 E. Elizabeth St.................................482.2791

Durkan, Mark N., MD 3702 Timberline Dr., Bldg. A ....................207.9773

Tippin, Steven B., MD 2025 Bighorn Dr....................... 229.9800 See ad on page 24

Holland, Rod R., MD 3702 Timberline Dr., Bldg. A ....................207.9773

Towbin, Michael M., MD 1217 Riverside Ave.................................. 482.7800

Jenkins, Joseph X., MD 3702 Timberline Dr., Bldg. A ....................207.9773

Unger, Mark S., MD 1113 Oakridge Dr. .................... 225.0040 See ad on page 24

Langer, Daniel, MD 3702 Timberline Dr., Bldg. A ....................207.9773

Valley, George E., MD 3000 S. College Ave., Ste. 210 ................266.8822 Van Farowe, Cynthia K., MD 3519 Richmond Dr. ................... 204.0300 See ad on page 24 Weaver, Derek, DO 1025 Pennock Pl ......................................495.8800 Webber, Pamela, S., MD 1025 Pennock Pl. .....................................495.8800 Weiskittel, Deborah A., MD 1113 Oakridge Dr. .................... 225.0040 See ad on page 24

Lynch, Kathryn L., MD 2555 E.13th Street, Ste. 220 (Loveland) .. 669.5432 McElwee, Hugh P., MD 3702 Timberline Dr., Bldg. A ....................207.9773 Nosler, Michael J., MD 3702 Timberline Dr., Bldg. A ....................207.9773 Sears, Stephen, MD 2555 E.13th Street, Ste. 220 (Loveland) .. 669.5432 Simmons, Robert A., MD 3702 Timberline Dr., Bldg. A ....................207.9773 Strong, Lewis R., MD 2555 E.13th Street, Ste. 220 (Loveland) .. 669.5432

Rubright, Jon S., MD 3519 Richmond Dr. ................... 204.0300 See ad on page 24

Weixelman, Janice M., DO 168 Main St. (Red Feathers Lakes) ................881.2885

Sachtleben, Thomas R., MD 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57

Wilson, Fiona A., MD 1221 E. Elizabeth St., Ste. 4 ...... 484.1757 See ad on page 24

Samuelson, Scott, MD 1124 E. Elizabeth St., Bldg. C ..................484.0798

Winfrey, Ivory, MD 1025 Pennock Pl ......................................495.8800

Sands, Arthur C., MD 1021 Robertson St...................................482.0666

Wozniak, Janell R., MD 1025 Pennock Pl. .....................................495.8800

Lepine, Lisa, MD Boulder, CO ....................................... 303.440.9320

Schmidt, David S., MD 2001 S. Shields St., Bldg. I ........ 221.5255 See ad on page 24

Zucker, Charles I., MD 6801 W. 20th Street, Ste. 101(Greeley) .....378.8000

Thayer, David O., MD Boulder, CO ....................................... 303.440.9320

FAMILY PRACTICE/SPORTS MEDICINE

HEMATOLOGY/ONCOLOGY

Servi, Jane T., MD 2121 E. Harmony Rd., Ste. 290 ...............224.9890

Brown, Regina, MD 2121 E. Harmony Rd., Ste. 150 ... 493.6337 See ad on page 52

Yemm, Stephen J., MD 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57

Fangman, Michael P., MD P.O. Box 27140 .........................................217.5160

Seeton, James F., MD 2121 E. Harmony Rd., Ste. 310 ... 221.3855 See ad on page 37 Serrano-Toy, Monica T., MD 2121 E. Harmony Rd. Ste. 370 ............... 221.2290 Shamis, Mason, MD 1025 Pennock Pl ......................................495.8800 Smith, Jerome I., MD 2025 Bighorn Dr....................... 229.9800 See ad on page 24

2500 Rocky Mnt Ave.Ste. 340 (Loveland) 619.6030

See ad on page 115

GYNECOLOGY

Kanard, Anne Margaret, MD 2121 E. Harmony Rd., Ste. 150 ... 493.6337 See ad on page 52

Stephens, Floyd V., MD 1113 Oakridge Dr. .................... 225.0040 See ad on page 24

GASTROENTEROLOGY

Stoddard, Andrew P., MD 1124 E. Elizabeth St., Bldg. C ..................484.0798

Burgert, Stephen L., MD 2555 E.13th Street, Ste. 220 (Loveland) .. 669.5432

Fort Collins Medical Magazine & Directories 2008 2009

Witt, Peter C., MD

Kemme, Douglas J., MD 1900 16th Street (Greeley) ........................353.3722 Lininger, Thomas R., MD 1900 15th St. (Greeley)...........................378.4170

Marschke, Robert F. Jr., MD 2315 E. Harmony Rd., Ste. 110. ..............212.7600 Medgyesy, Diana C., MD 2315 E. Harmony Rd., Ste. 110. ..............212.7600 Moore, James C., MD 2315 E. Harmony Rd., Ste. 110. ..............212.7600 Romero, Paolo, MD 2121 E. Harmony Rd., Ste. 150 ... 493.6337 See ad on page 52 Scott, Miho Toi, MD 2121 E. Harmony Rd., Ste. 150 ... 493.6337 See ad on page 52 Sorensen, Matthew D., MD 2121 E. Harmony Rd., Ste. 150 ... 493.6337 See ad on page 52 Shelanski, Samuel A., MD 2050 N. Boise Ave., Ste. A (Loveland)........667.7870

Allen, David K., MD 305 Carpenter Rd. ................... 292.0179 See ad on page 76 Asadi, S. Daniel, DO 1021 Robertsono St.................................482.0666

Zenk, Daniel R., MD 1900 16th St. (Greeley)............................350.2438

Berntsen, Mark F., MD 2500 Rocky Mnt Ave.Ste.340 (Loveland) 619.6030

See ad on page 115

Bush, James F., MD ................................. Fort Collins

INTERNAL MEDICINE/HOSPITALIST

Cash, Robert L, MD 1900 16th Street (Greeley) ........................350.2438

Austin, William Bennett., MD 2121 E. Harmony Rd., Ste 300 ................207.9958

Christiansen, Dana L., MD 7251 W. 20th Street, Ste. K (Greeley) ........353.4322

Clipsham, Victoria A., MD 2121 E. Harmony Rd., Ste 300 ................207.9958

Currie, James B., MD 7251 W. 20th Street, Ste. K (Greeley) ........353.4322

Espinosa, Amy J., DO 2121 E. Harmony Rd., Ste 300 ................207.9958

Ebens, John B, MD 1900 16th Street (Greeley) .............................. 350.2438 Ellis, Robert H., MD................................. Fort Collins

Stone, Michael D., MD 1900 16th Street (Greeley) ........................378.4170

Tryggestad, David I., MD 1900 16th St. (Greeley)............................350.2438

Griffin, Daniel, MD 1006 Robertson St...................................482.3820 Hendrick, James D., MD 4674 Snow Mesa Dr., Ste. 100.................482.3712 Hendrick, Jennifer M., MD 4674 Snow Mesa Dr., Ste. 100.................482.3712 Homburg, Robert C., MD 1100 Poudre River Dr...............................224.9508 Juhala, Robert J., MD 4674 Snow Mesa Dr., Ste. 100.................482.3712 Khera, Sukhjinder K., MD 1006 Robertson St...................................482.3820

Gaines, Jennifer L, MD 2121 E. Harmony Rd., Ste 300 ................207.9958 Johnston, Christine G., MD 2121 E. Harmony Rd., Ste 300 ................207.9958 Kopel, Charles S., MD 2121 E. Harmony Rd., Ste 300 ................207.9958 LumLung, Christine M., MD 2121 E. Harmony Rd., Ste 300 ................207.9958 Reghitto, Charmaine, MD 2121 E. Harmony Rd., Ste 300 ................207.9958 Spannring, Mary M., MD 2121 E. Harmony Rd., Ste 300 ................207.9958 Yoder, Elizabeth Anne, MD 2121 E. Harmony Rd., Ste 300 ................207.9958

Knepper, Katherine L., MD 4674 Snow Mesa Dr., Ste. 100.................482.3712 Loecke, Steven, MD 1900 16th Street (Greeley) ........................350.2438 Lopez, William, MD 1006 Robertson St...................................482.3820

INFECTIOUS DISEASES Cobb, David K., MD, FACP 2121 E. Harmony Rd., Ste. 380 ... 224.0429 See ad above LiaoOng, Jacob C., MD 2121 E. Harmony Rd., Ste. 380 ... 224.0429 See ad above Peskind, Robert L., MD 2121 E. Harmony Rd., Ste. 380 ... 224.0429 See ad above

INTERNAL MEDICINE/PEDIATRICS Drysdale, Christopher R., MD 4674 Snow Mesa Dr., Ste. 120.................266.3650

Lynch, Michael J., DO 1101 Oakridge Dr., Ste. B.........................223.1199

Lang, Christina, MD 4674 Snow Mesa Dr., Ste. 120.................266.3650

Orton, Lambert C., MD Steamboat, CO .................................. 970.879.3327

Simmons, Mark S., MD 4674 Snow Mesa Dr., Ste. 120.................266.3650

Ow, Cathy L., MD 4674 Snow Mesa Dr., Ste. 100.................482.3712

Widness, Craig P., MD 4674 Snow Mesa Dr., Ste. 120.................266.3650

MATERNAL & FETAL MEDICINE Heyborne, Kent D., MD Denver, CO ........................................ 303.860.9990 Porreco, Richard P., MD Denver, CO ........................................ 303.860.9990 Stettler, R. William, MD Denver, CO ........................................ 303.860.9990

NEONATOLOGY Barry, James S., MD Aurora, CO ........................................ 303.724.2840 Hall, Daniel M., MD Aurora, CO ........................................ 303.724.2840 MacRitchie, Amy N., MD PVH, 1024 S. Lemay Ave..........................495.8280 Paisley, Jan E., MD PVH, 1024 S. Lemay Ave..........................495.8282 Satterwhite, Daniel J., MD PVH, 1024 S. Lemay Ave..........................495.8280 Thilo, Elizabeth H., MD Aurora, CO ........................................ 303.724.2840 Wilkening, Randall B., MD Aurora, CO ........................................ 303.724.2840

Randle, Michael T., MD 2500 Rocky Mnt Ave.Ste.340 (Loveland) 619.6030

See ad on page 115

Reimer, Christina, MD 4674 Snow Mesa Dr., Ste.100..................482.3712

FORT COLLINS NEUROLOGY, P.C. DIPLOMATES, AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY

Reinhardt, Marcus R., MD 2500 Rocky Mnt Ave.Ste.340 (Loveland) 619.6030

See ad on page 115

INTERNAL MEDICINE Abbey, David M., MD 1100 Poudre River Dr...............................224.9508 Alessi, Grace, MD 4674 Snow Mesa Dr., Ste.100..................482.3712

Stafford, Neil K., MD 1100 Poudre River Dr...............................224.9508

Timothy J. Allen, MD

Sunderman, Steve R., MD 607 Castle Ridge Ct. .................................223.8922 Thompson, Keith S., MD 1900 16th St. (Greeley)............................350.2438

Michael P. Curiel, MD

2121 East Harmony, Ste. 270 | Fort Collins, CO 80528 | [970] 221-1993 | FAX: [970] 221-9170

NEPHROLOGY

Hayes, Karen E., DO 1224 E. Elizabeth St.................................221.4977

Merritt, Jason L., MD 1600 Specht Point Rd., Ste. I ...... 493.7733 See ad on page 54

Hayes, Kimberly W., MD 1136 E. Stuart St., Bldg. 2-#100............493.5904

Muelken, Kevin D., MD 1600 Specht Point Rd., Ste. I ...... 493.7733 See ad on page 54

Hoffman, Mark F., MD 1136 E. Stuart St., Bldg. 2-#100............493.5904

Rademacher, Donald R., MD 1900 16th Street (Greeley) ......................350.2438

James, Warren K., MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47, page 78 & back cover

Simmons, Richard E., MD 1600 Specht Point Rd., Ste. I ...... 493.7733 See ad on page 54

Jeffrey, Ransy L., MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47 & page 78

Singer, James R., MD 1600 Specht Point Rd., Ste. I ...... 493.7733 See ad on page 54

Kieft, Larry D., MD 1136 E. Stuart St., Bldg. 2-#100............493.5904

Teruel, Mark A., MD 1600 Specht Point Rd., Ste. I ...... 493.7733 See ad on page 54

NEUROLOGY Allen, Timothy J., MD 2121 E. Harmony Rd., Ste. 270 ... 221.1993 See ad on page 29 & page 54 Curiel, Michael P., MD 2121 E. Harmony Rd., Ste. 270 ... 221.1993 See ad on page 29 & page 54 Friedman, Sheri J., MD 1221 E. Elizabeth St., Ste.3 .....................482.4373 Himes,Terry M., DO 2500 Rocky Mnt Ave., Ste.310 (Loveland) ... 619.6000 McIntosh, Gerald C., MD 1221 E. Elizabeth St., Ste. 3 ....................482.4373 Meredith, Lawrence A., MD 310 E. 5th St. (Loveland).........................667.7664 Miller, Tamara A., MD 2121 E. Harmony Rd., Ste. 180 ...............226.6111 Nash, Jerry D., MD 2121 E. Harmony Rd., Ste. 180 ...............226.6111 Schumann, Richard R. Jr., MD 2500 Rocky Mnt Ave., Ste.310 (Loveland) ... 619.6000 Tolge, Celina F., MD 5890 W. 13th Street, Ste. 112 (Greeley).....353.2255

King, Angela, MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47 & page 78 Kozak, Susan H., MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47, page 78 & back cover Ludwin, Gary A., MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47 & page 78 Micetich, Kara L., MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47, page 78 & back cover Priebe Philip N., MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47, page 78 & back cover Serniak, Elizabeth K., MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47, page 78 & back cover Stauffer, Christine F., MD 1006 Luke St. ...........................................419.1111 Tool, Audrey L., MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47, page 78 & back cover Tool, Kevin J., MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47, page 78 & back cover Vance, Maude M., MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47 & page 78

OBSTETRICS/GYNECOLOGY/ INFERTILITY Bachus, Kevin E., MD 1080 E. Elizabeth St. ................ 493.6353 See ad on page 37, page 55 and back cover

OBSTETRICS/GYNECOLOGY Beresford, Kaea, MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47 & page 78

OCCUPATIONAL MEDICINE

Cloyd, David G., MD 1136 E. Stuart St., Bldg. 2, Ste. 100 .......493.5904

Holthouser, Michael G., MD 1330 Oakridge Dr. ....................................495.8450

Donnelley, Beverly E., MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 28, page 47, page 78 & back cover

Scherr, Frederick P., MD 1025 Pennock Pl., Ste. 121....................495.8450

Fort Collins Medical Magazine & Directories 2008 2009

Milliken, William J., MD 5441 Boeing Dr., Ste.100 (Loveland) ........... 613.1000 Yanagi, Ann K., MD 1380 Oakridge Dr.. ...................................495.8400

OPHTHALMOLOGY Arnold, Patrick D., MD 1725 E. Prospect Rd. ................ 221.2222 See ad below Bashford, Kent P., DO 1725 E. Prospect Rd. .............. 221.2222 See ad below Crews, Kent R., MD 1725 E. Prospect Rd. ................ 221.2222 See ad below Foster, Gary J., MD 1725 E. Prospect Rd ................. 484.5322 See ad below Norris, Andrew M., MD 2121 E. Harmony Rd., Ste. 190 ...............224.2020 Olsen, Karl Erik, MD 1725 E. Prospect Rd ................. 221.2222 See ad below Reistad, Chet Erik, MD 1725 E. Prospect Rd. ................ 221.2222 See ad below Robinson, Matthew J., MD 1725 E. Prospect Rd. ................ 221.2222 See ad below

Shachtman, William A., MD 1725 E. Prospect Rd. ................ 221.2222 See ad below

Beard, Douglas W., MD 1313 Riverside Ave................... 493.1292 See ad on page 44

Smith, Randall W., MD 1725 E. Prospect Rd. ................ 484.5322 See ad below

Beard, David A., MD 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57

Stevens, William W., MD 1725 E. Prospect Rd. ................ 221.2222 See ad below

Benz, Robert J., MD 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57

ORAL/MAXILLOFACIAL Felton, Rickey E., DDS 1008 Centre Ave., Ste. B ..........................221.4633

Biggs, William D., MD 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57 Brackett, Bess, MD PO Box 336694 (Greeley) ..........................330.5400

Orr, Mark F., MD 2014 Caribou Dr., Ste. 100 ..................... 225.9555

Bussey, Randy M., MD 5890 W. 13th St. (Greeley)........................348.0020

Reynolds, Ralph R., DMD 2992 Ginnala Dr. (Loveland) .......................663.6878

Chamberlain, Satoru T., MD 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57

Thurgood, David B., DDS 2001 S. Shields St. J3 .............................. 498.0196 Troxell, James B., DDS 1120 E. Elizabeth St., Bldg. B, Ste.3........482.6811

ORTHOPEDICS

Baer, Robert M., MD 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57

Dhupar, Scott K., MD 1800 15th Street, Ste. 320 (Greeley) .......... 353.5959 Donner, E. Jeffrey, MD 3810 N. Grant Ave. (Loveland) ...................669.8881 Duncan, Kenneth H., MD 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57 Durbin, Mark B., MD 2500 E. Prospect Rd. ............... 493.0112 See ad on page 57

Grant, Michael P., MD 3810 N. Grant Ave. (Loveland) ...................669.8881 Grey, Sean G., MD 2500 E. Prospect Rd. ............... 493.0112 See ad on page 57 Grossnickle, Mark D., MD 2500 Rocky Mnt Ave.Ste. 340 (Loveland) 619.6030

See ad on page 115

Houghton, Michael J., MD 2500 E. Prospect Rd. ............... 493.0112 See ad on page 57 Hunter, Brett P., MD 2500 Rocky Mnt Ave.Ste. 340 (Loveland) 619.6030

See ad on page 115

Jackson, Wesley P., MD 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57 Kindsfater, Kirk A., MD 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57 Knauer, Sally A., MD 2121 E. Harmony Rd., Ste. 290 ...............224.9890 Magsamen, Benedict F., MD 3805 S. Centennial Dr ..............................226.4465 Mahon, John H., MD 2121 E. Harmony Rd., Ste. 260 ...............221.2827 Martin, Dale R., MD 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57

McFerran, Mark A., MD 2923 Ginnala Dr. (Loveland) ......... 663.3975 See ad above

ORTHOPEDICS /SPORTS MEDICINE

Nelson, Garth C., MD 1020 Luke St. ...........................................493.2102

Trumper, Rocci V., MD 2500 E. Prospect Rd. ................ 493.0112 See ad above

Pazik, Thomas J., MD 6801 W. 20th Street, Ste. 201 (Greeley)........... 330.1090

PAIN MANAGEMENT

Reckling, W. Carlton, MD Cheyenne, WY ........................................ 307.632.6637

Derrisaw, James, MD 3744 S. Timberline Rd., Ste. 102 495.0506 See ad on page 58

Seiler, Steven J., MD 2500 Rocky Mnt Ave. Ste.340 .... 619.6030 See ad on page 115 Sides, Steven D., MD 1900 16th Street (Greeley).............................. 350.2427

Girardi, George E., MD 3744 S. Timberline Rd., Ste. 102 495.0506 See ad on page 58 McCeney, Michael H., MD 2001 S. Shields St., Bldg. L ......................221.1919 Sisson, Charles B., MD 1136 E. Stuart St., Bldg. 4-104 ...............221.9451

Sobel, Roger M., MD 2500 E. Prospect Rd. ................ 493.0112 See ad above Watkins, John J., MD 2500 Rocky Mnt Ave. Ste.340 .... 619.6030 See ad on page 115 Young, Eric E., MD 3810 N. Grant Ave. (Loveland)....................669.8881

PATHOLOGY Jones, David L., DO 1024 S. Lemay Ave...................................495.8740 Singer, Donald A., MD 1024 S. Lemay Ave...................................495.8740 Staszak, Christopher, MD 1024 S. Lemay Ave...................................495.8740

Fort Collins Medical Magazine & Directories 2008 2009

Brockway, Julie M., MD 1200 E. Elizabeth St. ................ 267.9510 See ad on page 33 Crawford, Deborah D., MD ...................... Fort Collins

PEDIATRIC/DENTISTRY

Pettine, Kenneth A., MD 3810 N. Grant Ave. (Loveland) ..................669.8881

Sanderford, Kelly R., MD 5890 W. 13th Street, Ste. 101(Greeley) .....348.0020

Williams, James Elmer, MD 1024 S. Lemay Ave...................................495.8740

Browning, Michael P., DDS 383 W. Drake Rd., Ste. 103 ......................377.2500 Evans, Gregory D., DDS 3221 Eastbrook Dr. ..................................407.1020 Van Tassell, Keith A., DDS 2001 S. Shields, Bldg. A .......................... 484.4104

Elliott, Max A., MD 1200 E. Elizabeth St. ................ 267.9510 See ad on page 33 Guenther, John P., MD 1200 E. Elizabeth St. ................ 267.9510 See ad on page 33 Hanson, Vaughn W., MD 1200 E. Elizabeth St. ................ 267.9510 See ad on page 33 Hull, Lori J., MD 1200 E. Elizabeth St ................. 267.9510 See ad on page 33

PEDIATRICS Anderson, Carole M., DO 1200 E. Elizabeth St ................. 267.9510 See ad on page 33 Archer, Deborah, MD 1635 Blue Spruce Dr. ...............................494.4040

Markley, Jennifer L., MD 2001 S. Shields St., Bldg. G......................484.4871 McGinnis, James G., MD 1200 E. Elizabeth St. ................ 267.9510 See ad on page 33 Oâ&#x20AC;&#x2122;Brien, Barry G., MD 2001 S. Shields St., Bldg. G......................484.4871

Ballard, Elizabeth A., MD 1200 E. Elizabeth St. ................ 267.9510 See ad on page 33

Sampera, Kirsten M., MD 1200 E. Elizabeth St. ................ 267.9510 See ad on page 33

Booth, Richard R., M 2001 S. Shields St., Bldg. G......................484.4871

Schaffer, Michael S., MD Aurora, CO ........................................ 720.777.2942 Seidman, Marc H., MD 1635 Blue Spruce Dr. ...............................494.4040

because

ITâ&#x20AC;&#x2122;S ABOUT YOUR PAIN Our Physicians at Front Range Pain Medicine specialize in treating pain with interventional pain management practices. OU R G OALS AR E TO: - Treat, if possible, the source of the pain - Offer interventional treatment options - Promote healthy activities and preventative care - Return patients to the most functional and productive lifestyle possible

George E. Girardi, MD Board Certified

- Coordinate multidisciplinary approaches, if indicated

P RO C E DU R E S &QJEVSBMT t /FSWF 3PPU #MPDLT 5SBOTGPSBNJOBM *OKFDUJPOT 1FSJQIFSBM /FSWF *OKFDUJPOT t 3BEJP 'SFRVFODZ -FTJPOJOH t *%&5 %JTD #JBDVQMBTUZ %JTDPHSBQIZ t 4QJOBM $PSE 4UJNVMBUJPO Deb Dennis

Physicianâ&#x20AC;&#x2122;s Assistant

James Derrisaw, MD Board Certified

4PVUI 5JNCFSMJOF 3PBE 4VJUF t 'PSU $PMMJOT $0 t Whitman, Douglas W., MD 1635 Blue Spruce Dr. ...............................494.4040 Wright, Jason T., MD 2555 E. 13th Street, Ste. 130 (Loveland) .. 663.5437

PHYSICAL MEDICINE & REHABILITIATION Adamson, Carrie L., MD 2021 Battlecreek Dr. ................................206.0851 Bender, John D., DO 1330 Oakridge Dr., Ste. 130 ....................377.9555 Jacob, Joseph P., MD 4401 Union St. (Johnstown) .......................619.3400 Lockwood, Bruce A., MD 1300 Oakridge Dr., Ste. 130 ....................377.9555 Wunder, Jeffrey A., MD Wheat Ridge ...................................... 303.423.8334

PODIATRY Anderson, James C., DPM 1355 Riverside Ave., Ste. C ........ 484.4620 See ad on page 66 Burns, Michael J., DPM 2001 S. Shields St., Bldg. F ......................493.4660

Hatch, Daniel J., DPM 1931 65th Ave., Ste. A (Greeley)... 351.0900 See ad on page 109 Hecker, Thomas M., DPM 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57

PSYCHIATRY Gottfried, Joseph M., MD 4601 Corbett Dr........................................207.4800 Heacock, Craig R., MD 4601 Corbett Dr........................................207.4800

Knutsen, Chad M., DPM 2001 S. Shields St., Bldg. F ......................493.4660

Moreno, Hermann A., MD 4601 Corbett Dr........................................207.4800

Moore, Harold Randall, DPM 1217 E. Elizabeth St., Ste. 11 ..................472.8700

Nagel, John K., MD 4601 Corbett Dr........................................207.4800

Oâ&#x20AC;&#x2122;Halloran, William D., DPM 1301 Riverside Ave. .................................482.3668

Oddy, Richard A., MD 120 Bristlecone Dr....................................224.5209

Schulte, Robert C., DPM 2001 S. Shields St., Bldg. F ......................493.4660

Pearson, Glenn E., MD

Schultz, Peter D., MD 1440 N. Boise Ave. (Loveland) ........ 278.1440 See ad on page 109

Straumanis, Eric J., MD 1762 Hoffman Dr. (Loveland)........................... 663.3030

Thomas, Michael I., DPM 1355 Riverside Ave., Ste. C ........ 484.4620 See ad on page 66 Vaardahl, Michael D., DPM 1931 65th Ave., Ste. A (Greeley)... 351.0900 See ad on page 109

4601 Corbett Dr........................................207.4800

Udupa, Usha R., MD 4601 Corbett Dr........................................207.4800

Gunstream, Stanley R., MD 2121 E. Harmony Rd., Ste. 300 ...........224.9102 See ad on page 60 Hoyt, James D., MD 2121 E. Harmony Rd., Ste. 300 ...........224.9102 See ad on page 60 Kukafka, David S., MD 2500 Rocky Mnt Ave.Ste. 300 (Loveland) 619.6100

See ad on page 60

Milchak, Richard J., MD 2500 Rocky Mnt Ave.Ste. 300 (Loveland) 619.6100

See ad on page 60

Neagle, Mark B., MD 2121 E. Harmony Rd., Ste. 300 ...........224.9102 See ad on page 60 Negron, Ana M., MD 2121 E. Harmony Rd., Ste. 300 ...........224.9102 See ad on page 60 Peters, Brent T., MD

Watanabe, Kenneth S., MD 4601 Corbett Dr........................................207.4800

2500 Rocky Mnt Ave.Ste. 300 (Loveland) 619.6100

Woodard, Timothy W., MD 4601 Corbett Dr........................................207.4800

Petrun, Mark D., MD, FCCP 2121 E. Harmony Rd., Ste. 300 ...........224.9102 See ad on page 60

Webb, Emily Huang, DPM 1927 Wilmington Dr., #102 .....................416.9009

See ad on page 60

Stevens, Eric E., MD 2500 Rocky Mnt Ave.Ste. 300 (Loveland) 619.6100

PULMONOLOGY Breyer, Diana M., MD 2121 E. Harmony Rd., Ste. 300 ...........224.9102 See ad on page 60

See ad on page 60

Vassaux, Carlos R., MD 2121 E. Harmony Rd., Ste. 300 ...........224.9102 See ad on page 60

Wallick, Kristin A., MD 2121 E. Harmony Rd., Ste. 300 ...........224.9102 See ad on page 60

Gunderson, Deborah Z., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7 Hayes, Amy S., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7

RADIATION ONCOLOGY Casey, William B., MD 2121 E. Harmony Rd., Ste. 160 ...........482.3328 See ad on page 45 Klish, Marie D., MD 2121 E. Harmony Rd., Ste. 160 ...........482.3328 See ad on page 45 Lim, Meng Lai, MD 2121 E. Harmony Rd., Ste. 160 ...........482.3328 See ad on page 45 Lisella, Gwen H., MD 2121 E. Harmony Rd., Ste. 160 ...........482.3328 See ad on page 45

Howshar, Mark Edward, MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7 Jess, Sarah J., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7

Dunphy, Thomas R., MD 2008 Caribou Dr. ..................... 484.4757 See ad on page 7 Fleener, Christopher M., MD 2008 Caribou Dr. ..................... 484.4757 See ad on page 7 Florant, Tracy H., MD 2127 E. Harmony Rd., Ste. 130 ... 207.4700 See ad on page 7 Fuller, Samuel E., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7 Geis, J. Raymond, MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7 Geraghty, Micahel J., MD 2008 Caribou Dr ....................... 484.4757 See ad on page 7

Peck, Steven H., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7 & page 23

Dubs, Steven, MD

SURGERY CENTERS

Singer, Charles J., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7 Stears, Robert L., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7 Weinstein, Stanley W., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7 Weissmann, Jeffrey R., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7

See ad on page 115

Fraser, Lesley A., MD 2500 Rocky Mnt Ave.Ste.340 (Loveland) 619.6030

See ad on page 115

Kaufman, Steven L., MD 1136 E. Stuart St., Bldg. 4-#102 498.8346 See ad on page 15 Lee, James S., MD 6801 W. 20th Street, Ste. 202 (Greeley) ....350.0948 Livengood, Joseph C., MD

SURGERY/ASSIST Johnson, Robert V., MD 2500 E. Prospect Rd. ................ 493.0112 See ad on page 57 Kaiser, Dale C., MD 2500 E. Prospect Rd. ............... 493.0112 See ad on page 57 Kesler, Kelvin F., MD 1106 E. Prospect Rd. ................ 493.7442 See ad on page 47 & page 78 Tutt, George O., MD ................................ Fort Collins

Peet, Gary J., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7 Reese, Mark F., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7

Dickinson, James M., MD 2121 E. Harmony Rd., Ste. 250 ... 482.6456 See ad on page 45 2500 Rocky Mnt Ave.Ste.340 (Loveland) 619.6030

Luttenegger, Thomas J., MD, FACR 2008 Caribou Dr. ...................... 484.4757 See ad on page 7

Paquelet, Jean R., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7

Craven, Winfield M., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7 & page 23

Thompson, John Stephen, MD 239 W. 67th Court (Loveland) .....................461.1880

Surgery Center of Fort Collins 1100 E. Prospect Rd. ................ 494.4800 See ad on back cover

Pacini, Richard J., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7

Contreras, Jaime H., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7

Cribari, Chris MD 1148 E. Elizabeth St. ................ 221.5878 See ad on back cover

Koplyay, Peter D., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7

Simpson, C. Kelley, MD 2121 E. Harmony Rd., Ste. 160 ...........482.3328 See ad on page 45

Bodenhamer, John R., MD 2008 Caribou Dr. ..................... 484.4757 See ad on page 7

Thakor, Michael S., MD 2121 E. Harmony Rd., Ste. 361 .............. 267.9799

Harmony Surgery Center, LLC 2127 E. Harmony Rd., Ste. 200 ... 297.6300

Markel, Curtis L., MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7

Berkowitz, Bruce Andrew, MD 2008 Caribou Dr. ...................... 484.4757 See ad on page 7

Collins, John A., MD 1148 E. Elizabeth St.................................221.5878

Klingelheber, Bob F., DO 2008 Caribou Dr. ...................... 484.4757 See ad on page 7

Mackey, Winona R., MD 2121 E. Harmony Rd., Ste. 160 ...........482.3328 See ad on page 45

RADIOLOGY

Murray, Garvin C., MD 239 W. 67th Court (Loveland) .....................461.1880

SURGERY/CARDIOVASCULAR Guadagnoli, Mark, MD 2500 Rocky Mnt Ave.Ste.100 (Loveland) 624.1800

See ad on page 81 & page 98

Lamounier, Fernando N., MD 2500 Rocky Mnt Ave.Ste.100 (Loveland) 624.1800

See ad on page 81 & page 98

Stanton, Michael, MD 1148 E. Elizabeth St................................ 221.5878

2500 Rocky Mnt Ave.Ste.340 (Loveland) 619.6030

See ad on page 115

Ogren, Jason W., MD 1800 15th St., Bldg. 210 (Greeley) .........352.8216 Parsons, Sally A., MD 1148 E. Elizabeth St.................................221.5878 Peetz, Michael E., MD 2500 Rocky Mnt Ave.Ste.340 (Loveland) 619.6030

See ad on page 115

Pettine, Stefan, MD 2121 E. Harmony Rd., Ste. 250 ... 482.6456 See ad on page 45 Quaid, Robert R., MD 2121 E. Harmony Rd., Ste. 250 ... 482.6456 See ad on page 23 & page 45 Roller, Michael D., MD 2121 E. Harmony Rd., Ste. 250 ... 482.6456 See ad on page 23 & page 45 Rubinson, Samuel M., MD Denver, CO ...................................................303.831.6100 Turcios, Rosa E., MD 1148 E. Elizabeth St.................................221.5878 Woodard, Scott, MD 555 Prospect Ave. (Estes Park) ..............586.2200

SURGERY/OPHTHALMIC/ PLASTIC/RECONSTRUCTIVE SURGERY/GENERAL Bauling, Paulus C., MD 1148 E. Elizabeth St.................................221.5878

Reistad. Chet, MD 1725 E. Prospect Rd. ................ 221.2222 See ad on page 56

RHEUMATOLOGY

Blomquist, Thomas M., MD 1900 N. Boise Ave., Ste. 420 (Loveland)....669.3212

Levine, James W., DO 1900 16th Street (Greeley) ........................350.2433

Chiavetta, Thomas G., MD 2121 E. Harmony Rd., Ste. 250 ... 482.6456 See ad on page 45

SURGERY/PLASTIC/ RECONSTRUCTIVE

Clear, Craig R., MD 2121 E. Harmony Rd., Ste. 250 ... 482.6456 See ad on page 45

Boustred, Allister Mark, MD 2315 E. Harmony Rd., Ste. 160 ...............493.8800

Mayer, Patricia A., MD 2121 E. Harmony Rd., Ste. 361 .............. 267.9799

Fort Collins Medical Magazine & Directories 2008 2009

Northern Colorado Pulmonary Consultants, P.C.

Chapman, Jeffrey K., MD 2315 E. Harmony Rd., Ste. 160 ... 493.8800 See ad on back cover Duncan, Diane, MD 1701 E. Prospect Rd. ...............................493.7445 Gonyon , Denis L., Jr. MD 5881 W. 16th Street (Greeley) ....................313.2760

Pulmonary Disease

Critical Care

Sleep Disorders

Tsoi, Christopher M., MD 2315 E. Harmony Rd., Ste. 160 ... 493.8800 See ad on back cover

SURGERY/NEURO Coester, Hans C., MD 1313 Riverside Ave. ................. 493.1292 See ad on page 44 and back cover Turner, Donn M., MD 1313 Riverside Ave................... 493.1292 See ad on page 44 and back cover

Diana Breyer, M.D.

Stan Gunstream, M.D.

James Hoyt, M.D.

David Kukafka, M.D.

Viola, John J., MD 1313 Riverside Ave................... 493.1292 See ad on page 44 Wirt, Timothy C., MD 1313 Riverside Ave................... 493.1292 See ad on page 44 and back cover

UROLOGY Brutscher, Stephen P., DO 2315 E. Harmony Rd., Ste.140 .... 484.6700 See ad on page 31 Rick Milchak, M.D.

Mark Neagle, M.D.

Ana Negroâ&#x20AC;&#x2122;n, M.D.

Brent Peters, M.D.

Eddy, Michael J., MD 1647 E. 18th Street (Loveland) ..... 669.9100 See ad on page 31 Everett, Randy W., MD 2315 E. Harmony Rd., Ste.140 .... 484.6700 See ad on page 31 Goodman, Gary R., MD 1900 16th Street (Greeley) ........................350.2491 Lee, Michael R., DO 2315 E. Harmony Rd., Ste.140 .... 484.6700 See ad on page 31

Mark Petrun, M.D.

Eric Stevens, M.D.

Carlos Vassaux, M.D.

Kristin Wallick, M.D.

LOVELAND 2500 Rocky Mountain Ave., Ste 300 Loveland, CO 80538 970.619.6100

Nasseri, Kevin K., MD 2315 E. Harmony Rd., Ste.140 .... 484.6700 See ad on page 31 Nemeth, Clifford J., MD 1647 E. 18th Street (Loveland) ..... 669.9100 See ad on page 31 Phillips, George H., MD 1647 E. 18th Street (Loveland) ..... 669.9100 See ad on page 31 Soper, Timothy H., MD 2315 E. Harmony Rd., Ste.140 .... 484.6700 See ad on page 31

* Physician list provided by PVHS. Current as of 7.1.2008

When your life depends on it, were herefor you. No one e xpects to suffer a serious injury, but if you do, you want the best surgeons and trauma specialists around.

Our extraordinary team at Medical Center of t he Rockies' t rauma center saves lives 24/7 w ith breakt hrough techn ologies. From board-cert ified surgeons to imaging specialists to trauma nurses and case managers, we're here for you. Trauma Center of t he Rockies is part of t he new M edical Cent er of the Rockies in Loveland. Response at a moment's notice and t rauma care like no other in the region.

en life bites... take me to

EMERGENCY

DEPARTMENT

MEDICAL CENTER OF THE ROCKIES POUDRE VALLEY HEALTH SYSTEM

pvhs.org

LOVELAND, COLORADO

1-25 and Highway 34

(970) 624-2500

medical

Pain Management

Peter Koplyay, M.D., Radiologist, Advanced Medical Imaging Consultants, uses high-tech imagery machinery to diagnose before administering treatment.

Pain Management

Therapies

by Angeline Grenz

The trauma of a serious accident or sports injury can often leave a patient struggling with spine pain long after the more obvious injuries have been bandaged and healed. Spinal injuries can take months or even years to mend, and while the body is slowly repairing itself, the pain can be debilitating—if, indeed, the body can ever fully heal itself. Two groups of doctors can provide pain relief, depending on the type and degree of pain, without invasive surgery or prolonged use of narcotic medications. Radiologists use advanced imaging to pinpoint areas of pain and administer relief through steroid injections. Intervention Pain Specialists also provide relief from spinal pain through steroid injections and other procedures such as radiofrequency ablation and spinal cord stimulation. Pain management techniques are not without risk and individuals should thoroughly investigate each procedure with a physician specialized in pain therapy to find their best option.

Injections Radiologists use an array of imaging technologies to diagnose and treat disease. Peter Koplyay, M.D., Radiologist with Advanced Medical Imaging Consultants, specializes in pain management for bone, joint, and neurological pain. Fluoroscopy allows Dr. Koplyay to use real-time imagery to pinpoint the exact location of the pain and guide his needle to the point where it will provide the most relief. For spinal pain, Dr. Koplyay often administers an epidural steroid injection containing an anti-inflammatory, such as cortisone. Cortisone injections numb pain and decrease swelling around injured spinal disks, areas of arthritis, selective nerve root ends, sacroiliac joints at the base of the spine, or facet joints along the spine. The injection is a mixture of short and long acting steroids that work for several weeks

Fort Collins Medical Magazine & Directories 2008 2009

to several months to reduce pain. According to Dr. Koplyay, most injections can provide up to six months of relief. “The injection allows the body time to hopefully fix itself,” according to Dr. Koplyay. A good candidate for steroid shots are those who have had a flare up in the back or nerve pain that is reasonably acute. “Something that generally has an abrupt onset,” he adds. These patients often need just one shot to ease the pain while the body heals itself. Those who suffer from chronic arthritis or disk bulge flare-up are also good candidates, says Dr. Koplyay, “but they tend to come back after a few months for another shot.” A patient can safely have three shots in a year’s time, but Dr. Koplyay warns that the shots themselves do not fix the root problem. Someone who needs surgery, for instance, can only buy

A good candidate for steroid shots are those who have had a flare up in the back or nerve pain that is reasonably acute. These patients often need just one shot to ease the pain while the body heals itself. Those who suffer from chronic arthritis or disk bulge flare-up are also good candidates. Peter Koplyay, M.D., Radiologist, Advanced Medical Imaging Consultants pain relief for a limited amount of time. Side effects from the steroid injections include a somewhat suppressed immune system and a change in glucose metabolism. Ablation While injections have successfully allowed a patient in pain to lead a normal life and avoid surgery, their benefits are limited. Patients who have more severe arthritis in the joints and spine, nerve impingement, whiplash victims, or those with degenerative disk disease may see short-lived pain relief from steroid injections and be better candidates for a procedure called radiofrequency ablation. This procedure involves the insertion of a needle into the nerves that serve a joint. “The nerves are heated to the point that they ‘blow up’

or essentially disintegrate,” according to James Derrisaw, M.D., anesthesiologist with Interventional Pain Specialist at Front Range Pain Medicine, LLC, Board Certified in Pain Medicine and Anesthesiology. By burning the nerve endings near the joint, pain sensors are destroyed and patients experience a measure of relief from chronic pain. Ablation is an outpatient procedure and requires three days of pain medication. In about a week “patients feel a whole lot better,” says Dr. Derrisaw. The procedure generally lasts three to six months; sometimes a year “if you are lucky.” For Matthew Guerrero, radiofrequency ablation has been the only treatment to provide him with any relief from spinal pain. In 2003, Guerrero was involved in a life-altering automobile ac-

cident. A very active man in his thirties, Guerrero has had to learn to live with constant pain since his accident. “I suffered quite a bit of trauma in the accident and herniated a couple of disks.” Guerrero spent a year in physical therapy and on pain medication before he sought out a pain specialist. His search brought him to Dr. Derrisaw. “I am only 35. I didn’t want to rush into surgery or continue on pain medications,” explains Guerrero. He tried cortisone injections and local blocks, but nothing worked for any length of time. Dr. Derrisaw recommended radiofrequency ablation. Although Guerrero has to have the procedure done every few months, he is now able to participate in the activities he loves, such as basketball, softball, and golf. “I have improved drastically. I have more flexibility, range of motion, and

James Derrisaw, M.D., Anesthesiologist and Interventional Pain Specialist, Front Range Pain Medicine, LLC demonstrates a spinal cord stimulation.

Radiofrequency ablation. This procedure involves the insertion of a needle into the nerves that serve a joint. The nerves are heated to the point that they ‘blow up’ or essentially disintegrate The nerves are heated to the point that they ‘blow up’ or essentially disintegrate. - James Derrisaw, M.D., Front Range Pain Medicine, LLC a lot more pain tolerance.” “Now, I am able to keep my pain medications low. My long term goal is to avoid surgery with the ablation procedure, physical therapy, rest and some medication,” says Guerrero. He finds the procedure to be “painless and pretty quick. Recovery time is nothing.”

Spinal Cord Stimulation While ablation can hold pain at bay for a time, some patients may eventually have to look at new techniques to manage pain. “When it gets to the point that ablation only helps for a month or two, nerves find another tract through the body, or the

body continues to hold on to the memory of the pain, it is time for the patient to consider something else,” according to Dr. Derrisaw. The next step for patients may be a new procedure called spinal cord stimulation. Physicians are calling this procedure the “digital drug” that can bring pain relief when medication, steroid injections, and radiofrequency ablation have failed. The procedure involves implanting electrodes into the epidural space near the spinal cord. The electrodes are connected to a battery device that is implanted much like a pacemaker. The device emits a faint vibration that overrides the pain. Candidates receive a trial implant in an outpatient surgery, lasting from five to seven days, to determine if the spinal cord stimulation will work for them. If the procedure is a success, a permanent unit is implanted, a procedure requiring an overnight hospital stay. Once implanted, the battery lasts seven years on average. Like ablation, the procedure buys patients time, allowing them to continue without surgery. According to Dr. Derrisaw, current thinking among many pain specialists is that surgery can lead to an increase in pain. “In the next ten to twelve years after surgery, the spine can become more unstable and the patient may need to have more disks fused.” For

Matthew Guerreo, patient of Dr. Derrisaw, now plays golf without pain.

some patients, Dr. Derrisaw concludes, surgery may have no true benefit over physical therapy and medication, especially on young patients like Guerrero. Living with spinal pain robs many of the joys of an active lifestyle. Many too, whether young or old, feel surgery is a last resort, choosing to turn to surgical techniques only when all other methods of pain management have been exhausted. Todayâ&#x20AC;&#x2122;s techniques can be life changing. Procedures like a pinprick of cortisone pain relief, cauterizing nerve endings to dull the bodyâ&#x20AC;&#x2122;s pain sensors, or sending messages to the body to override the pain are all options available to help patients return to a relatively normal life. By consulting with pain specialists like Dr. Koplyay or Dr. Derrisaw, patients can tap into the latest technology to help them live better lives, in spite of their spinal pain. Angeline Grenz is freelance writer living in Fort Collins.

Fort Collins Medical Magazine & Directories 2008 2009

medical

Cardiology

Tim Johnson, M.D., Cardiologist, Heart Center of the Rockies, listens for a healthy heart beat and steady breathing.

A Return to Normal

Diagnostic Electrophysiology for Heart Arrhythmia by Angeline Grenz

Claude Wheeler was 58 when he had his first heart attack, the first one he knew about, anyway. His doctor told him it was likely he had had at least one mini heart attack in the past without even realizing what was happening.

Fort Collins Medical Magazine & Directories 2008 2009

At that time, his doctor told him his heart was no good. But Wheeler already knew that; his father had died of heart disease at age 73, his uncle at 70, and his brother at 55. After Wheeler’s first diagnosed heart attack, the doctor inserted stents into his arteries and sent him home hoping this treatment would last six months, before he would need to return for bypass surgery. The stents lasted only six weeks. Less than a year later, in January 1999, he had a clogged bypass and had to find a new solution to keep his heart functioning. Wheeler’s doctor determined his heart’s electrical system was misfiring. Wheeler needed a combined pacemaker and defibrillator system to regulate his heartbeat. Wheeler’s heart, while being regulated against beating too fast or too slow, was still working too hard. Like any muscle in the body, the harder the heart worked, the bigger it got. Because his heart was continually overworked, he felt sluggish all the time. Again, Wheeler’s heart needed some help. This time Wheeler visited Timothy Johnson, M.D., cardiologist with the Heart Center of the Rockies. Diagnosis Through a process called diagnostic cardiac electrophysiology, Dr. Johnson was able to study Wheeler’s heart and the electrical system which kept it beating. This study is performed on persons who have been diagnosed with a heart

Through diagnostic electrophysiology we hope to help diagnose the problem, find a cure for some people, or install a device into others that will keep them alive and return them to normal or near-normal functioning for many years. - Timothy Johnson, M.D., Heart Center of the Rockies

A sample pacemaker that would be implanted by Timothy Johnson, M.D., Cardiologist, Heart Center of the Rockies.

arrhythmia, faint repeatedly, or those who continually feel their heart racing. Diagnostic electrophysiology helps doctors to determine the location causing the irregular heartbeat and the best method for treating the arrhythmia. “The diagnostic electrophysiology is performed by inserting an intravenous line (IV) into one of the large veins of the body, typically the legs. Then a small tube with wires, called a catheter, is placed inside the vein up into the heart and the electrical signals from the heart are recorded,” according to Dr. Johnson. During the study, the heart is stimulated and allows physicians to pinpoint the areas of stress. The study can last anywhere from one to three hours. Treatment If the physician determines the heart is beating too fast, they may prescribe ablation therapy where the heart tissue surrounding the arrhythmia is cauterized in a small area to prevent misfiring. “This often cures people of a problem that would have sent them to the hospital or surgery,” Dr. Johnson explains, adding “the procedure is 95 to 99 percent successful.” Specialists may also elect to implant a defibrillator into a patient whose heart is beating too rapidly. The defibrillator administers electrical shocks to bring the heartbeat back to normal.

A drawing of a heart with three leads; the leads deliver small electrical signals to correct the timing of the heart.

Defibrillators are composed of wires inserted into the heart, usually through the large vein under the collarbone. The wires are connected to a generator, which is placed under the skin in the chest region. The generator is roughly the size of a small beeper. The defibrillator’s “mini-computer” interprets signals coming from the heart and detects any dangerous or life-threatening misfires in the heart’s electrical workings. When a misfire is detected a shock is immediately administered. “It is like having a paramedic following you around with paddles all the time,” says Dr. Johnson. When the heartbeat irregularity is causing the heart to beat too slowly, the cardiologist may recommend a cardiac resynchronization device, such as a pacemaker. A pacemaker is also inserted into the chest. “The pacemaker provides a backup system in case your natural system fails,” says Dr. Johnson, “Pacemakers get the heart back to beating as good as a healthy heart should.” Ablation, implanted defibrillators, and pacemakers require out-patient surgery. Recovery time is generally short, with restrictions on heavy lifting and sports for up to two weeks. Patients who have had a device inserted into their chest are warned against lifting the arm near insertion over their head. Otherwise, recovery is quick with few complications. Ablation therapy most often cures the prob-

A sample defibrillator.

lem. Defibrillators and pacemakers aid the heart in returning to near-normal function. Today’s implanted devices allow a patient to be monitored constantly. If a patient’s device is required to give them a shock to return the heartbeat to normal, that information is sent to directly to the physician. “We are able to have that information within twenty-four hours,” according to Dr. Johnson. Doctors can be fully informed of the functioning of their patient’s hearts before they come in for their scheduled check-ups. Applied Science Dr. Johnson determined Wheeler had a substantially weakened heart muscle. “He was considered to have heart failure. His heart was not pumping efficiently, leaving him weak, tired and short of breath.” Dr. Johnson inserted a third wire into Wheeler’s chest that assisted his heart in pumping at a normal level. The upgraded system, called cardiac resynchronization therapy (CRT), continually monitors Wheeler’s heartbeat and adjusts to help the heart beat in a more synchronized, natural way. For Wheeler, the results of the procedure have been phenomenal. Wheeler’s CRT took place in February 2007. “I definitely have more energy now. I can exercise and I feel more relaxed.” The unit is the size of a beeper and was inserted near

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his heart. The device is continually monitored from a machine next to Wheeler’s bed, and collects information, which it instantly sends to his physician. “It provides a wonderful safety factor. My doctor can automatically see what is going on. It is like someone watching over you twenty-four hours a day,” says Wheeler. The device’s monitoring system has cut down on the number of office visits Wheeler must make. Now, he only has to go into the office if the device needs to be adjusted. Having CRT has drastically changed Wheeler’s quality of life, giving him peace of mind and a powerful new zeal for living. He carefully monitors what he eats, does not smoke or drink, and works in harmony with the device he feels has saved his life. He only regrets “these advances in medicine were not available when my father and brother died of heart disease.” As advances in cardiac medicine continue, Dr. Johnson says more patients are being given the opportunity to live longer, healthier lives. “Through diagnostic electrophysiology we hope to help diagnose the problem, find a cure for some people, or install a device into others that will keep them alive and return them to normal or near-normal functioning for many years.” Angeline Grenz is freelance writer living in Fort Collins.

Fort Collins Medical Magazine & Directories 2008 2009

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OpHthalmology

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Kent Crews, M.D., Vitreo-Retinal Surgeon, at Eye Center of Northern Colorado, P.C., explains what happens to the eye when macular degeneration occurs.

Miraculous Treatment for

Macular Degeneration by Connie Hein

When Maxine Schwartz, an artist/sculptor from Greeley, began seeing strange reflections and shadows while doing everyday tasks around the house and began having a hard time with her detailed artwork, she immediately contacted her optometrist. He diagnosed her with macular degeneration, and referred her to Kent Crews, M.D., a Vitreo-Retinal Surgeon at Eye Center of Northern Colorado, P.C. 74

For many years the prognosis for wet AMD was grim. Although having injections can seem like a hassle, the alternative may be losing your vision permanently. - Kent Crews, M.D., Eye Center of Northern Colorado, P.C.

Ocular Coherence Topography Scans showing a patient who was treated for macular degeneration. Patient’s eye before treatment showing a fluid build up under the retina. Schwartz is just one of thousands diagnosed with the disease each year. The Macular Degeneration Foundation, Inc. reports that, “Another case of adult macular degeneration is diagnosed every three minutes in the United States of America.” The condition is a common symptom of the body’s aging process. Younger people, including infants and young children, do develop macular degeneration, though rarely. They do so in clusters within families, because of inherited, genetic conditions. The macula is a small area in the center of the retina near the optic nerve. Age related macular degeneration (AMD) is a deterioration or breakdown of the macula. About 85 – 90 percent of AMD cases are the dry, or atrophic form, in which yellowish spots of fatty deposits called drusen appear on the macula. This form cannot be treated. The rest of AMD cases are the wet form, so called because of leakage into the retina from newly forming blood vessels in the part of the eye behind the retina. Normally, blood vessels in the choroid bring nutrients to, and carry waste products away from, the retina. Sometimes the fine blood vessels in the choroid, underlying the macula begin to proliferate. When this happens, they leak, and cells in the macula are damaged

Patient’s eye post Avastin treatment showing absorption of fluid.

or killed. The principal symptom of macular degeneration is reduction or loss of central vision, with retention of peripheral vision. However AMD can cause different symptoms in different people. Sometimes only one eye loses vision while the other eye continues to see well for many years. The condition may be hardly noticeable in its early stages. But when both eyes are affected, reading and other close duties can become difficult. Symptoms of Macular Degeneration Include: • Distorted vision such as straight lines appearing crooked and irregular • Blurry distance and/or reading vision • Dark gray spots or blank spots in your vision • Size of objects may appear different for each eye • Colors may not look the same for each eye Dr. Crews suggests that after the age of 60 we should all make it a habit to check each eye regularly by simply covering one eye when reading, and then covering the other and doing the same thing. In early cases with spotty macular cell damage or dysfunction, the brain cleverly learns

Fort Collins Medical Magazine & Directories 2008 2009

to compensate and fill in the missing part of the picture. Thus, most people do not seek help until the disease is fairly advanced. The best advice Dr. Crews has for people experiencing any of these changes in vision is to seek help from your regular eye doctor. As with any other vascular disease, early detection makes a big difference in successful treatment. The newest and most successful treatment for AMD comes in the form of the drugs Avastin and Lucentis. Avastin therapy was initially used for cancer treatment. Maxine Schwartz, has been treated with Avastin injections for about a year with excellent results. Schwartz says she is so grateful for the treatment and care from Dr. Crews and his staff. “Dr. Crews is such a great man. I am so glad God brought him into my life and that he knew about the new treatment.” Schwartz’s vision problems made it very hard for her to do the work she loves, so for her this new drug treatment therapy was truly a miracle. “I would encourage anyone with a change in vision to have their eyes checked immediately. I think my treatments have been successful because I caught it early.” The Avastin therapy treatment that Dr. Crews has administered for Schwartz is what he refers

Maxine Schwartz, artist/sculpture enjoys returning to her bas relief artwork after successful macular degeneration treatment. to as a miracle drug for patients. He has worked with patients with this disease for over 15 years. “I remember how depressing and hard it was to have to tell thousands of sometimes otherwise healthy patients diagnosed with AMD that there was nothing I could do to help them.” He knew these patients were losing not only their quality of life, but in some cases their independence. There had been expensive laser treatments using the drug Visudyne that had a small success rate, but because of the risk involved, few patients were even good candidates. Dr. Crews never used the procedure himself because of the expense for the patient and the low success rate. Then around 2005 there was a new drug called Macugen that was fairly successful in slowing down the loss of vision caused by AMD, but did nothing to recover vision already lost. The miracle came about a year later when doctors using Avastin to slow down tumor growth in cancer patients started research using the drug for AMD. Dr. Phil Rosenfeld of Miami started giving the drug as an injection in the body which was not very effective, and caused many side effects. But when he began testing the drug by injecting it directly into the eye, he saw a remarkable improvement in AMD. Dr. Crews told us, “It became an overnight sensation for retina doctors everywhere who knew the research was being done, but expected the process to be much slower. It was truly a miracle treatment like I had never seen.” Crews explains that Avastin is not actually a drug, but an antibody. It is injected directly into the cavity of the eye. There is generally little or no pain from the injection since there is an anes-

thetic given before the treatment. Current recommendations call for 2-3 injections spaced about a month apart. Some patients have an immediate and dramatic response and do not require further injections for many months. Others show a less impressive response, but still benefit from injections spaced every 1-3 months. For some patients this “maintenance therapy” can go on for years. In a very few cases, there is little or no response to therapy. In these cases, Crews sometimes tries Lucentis, which is a form of Avastin that has been molecularly cut in half. This makes it easier to reach the small blood vessels under the retina. It is much more expensive, and usually no more effective than Avastin, so is infrequently used by Dr. Crews. He adds, “For many years the prognosis for wet AMD was grim. Although having injections can seem like a hassle, the alternative may be losing your vision permanently.” For Maxine Schwartz and patients like her who want to continue living a full, active life and be able to enjoy their passions, Avastin is truly a miracle. For more information on AMD, its symptoms and treatments, contact your eye professional, or Eye Center of Northern Colorado, P.C., (970) 221-2222. Or visit www.eyesight.org a site funded by the Macular Degeneration Foundation. Connie Hein is a freelance writer living in Windsor and the author of the Toliver in Time series of children’s books.

Fish Oil Eye Health Omega-3 fatty acids are found in fatty fish and other foods. Their importance in heart disease prevention is well documented. Now new research suggests that eating fish or taking fish oil may help slow or prevent age-related macular degeneration (AMD). A Health Alert published by University Health Publishing for Johns Hopkins Medicine states, “Eating oily fish like salmon, herring, tuna, and mackerel one to three times a week appears to cut the risk of agerelated macular degeneration. In a study at the University of Sydney Eye Clinic in Australia, researchers followed nearly 3,000 men and women for five years. Those who ate fish once a week had a 40% reduced risk of early age-related macular degeneration compared with those who ate fish only once a month; those who ate fish three times a week had a reduced risk of late AMD.” Kent Crews MD, a Vitreo-Retinal Surgeon at Eye Center of Northern Colorado, P.C. believes that fish oil is great. He and his family take it regularly for general good health. “Anything that is good for your heart health is also good for your eye health. Macular degeneration is basically a vascular problem as is heart disease.” However, he does not necessarily agree with the Australia study. “When it comes to AMD, supplements get more attention than they deserve. There is not enough research to prove that fish oil or any other supplement has any direct affect on AMD.” Instead he encourages everyone to work on all aspects of a healthy lifestyle to promote good eye health. His suggestions include eating a healthy diet, regular exercise, no smoking, maintaining a healthy blood pressure (130/80 or less), and keeping blood cholesterol at low levels.

Fort Collins Medical Magazine & Directories 2008 2009

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Wellness

Dental

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Tom Overton, D.D.S., verifies his patient’s tooth brightness after her BriteSmile® treatment.

Brighter Smiles by Jason Webb

You may remember an episode of Friends where David Schwimmer’s character, Ross, gets his teeth whitened. The comical results left Ross with teeth so heavily bleached they literally glowed in the dark. Of course, that kind of stuff only happens on television, and whitening your teeth won’t let you read a book by them in the dark. But, how does it work? Is one system better than others?

Most people know about the various home teeth whitening systems – the strips, trays, and toothpastes – which do get some results. Most of these systems use a peroxide base that bleaches the stains out of the teeth. Unfortunately, these systems usually only whiten the teeth by one or two shades. That may work for some people, but to get truly dramatic results, expect a trip to a cosmetic dentist, like the one at the Overton Center for Dental Arts, P.C. Tom Overton, D.D.S., says his practice has whitened teeth for people as young as 14 and as old as 86. He believes one of the chief benefits of a whiter smile is the dramatic improvement in self-confidence, since people smile more readily when they have nice, white teeth. “I would recommend teeth whitening for anyone except for the really young,” says Dr. Overton. Considering the range of cosmetic procedures available, whitening your teeth is the least invasive option for improving your looks. It doesn’t hurt like plastic surgery, orthodontics or many other cosmetic improvements, but the results can make a huge difference for someone who is insecure about his or her smile. A dentist has the advantage of having unique

One of the chief benefits of a whiter smile is the dramatic improvement in self-confidence, since people smile more readily when they have nice, white teeth. “I would recommend teeth whitening for anyone except for the really young. - Tom Overton, D.D.S., Overton Center for Dental Arts, P.C. tools and processes incorporated into their practice, allowing them to provide significantly better results than the over-the-counter products. At the Overton Center, patients can choose between two different systems: The $600 BriteSmile® System and a $350 tray system. “Both systems work equally as well, but the length in time for each is the main factor,” says Dr. Overton. BriteSmile®, an in-office treatment, takes just shy of two hours to complete. “We put a gel on your teeth and use a high-intensity light to activate it,” explains Dr. Overton. “This takes about twenty minutes, and then we clean off the gel and do it again.” After three or four cycles of applying the gel and activating it with the light, the patient can go home. The process is generally comfortable for the patient, because sensitive gums are protected from the gel and the light. Before the patient leaves, Dr. Overton suggests certain tips for care. “The teeth are dehydrated after having the treatment done. As they rehydrate, it’s best to avoid dark colored drinks for 24 hours.” The results make skipping that cup of morning coffee well worth it. “Typically, BriteSmile® treatments lasts for three years.” Maintaining your new BriteSmile® is as easy as brushing your teeth. Tom Kaufman, a Ph.D. in Educational Administration, decided to freshen up his smile using the BriteSmile® system not very long ago, and he hasn’t regretted it since. The 68-year-old retired junior high school principal had seen the results

Dr. Overton is lighting up smiles all over town.

one of his sons had from BriteSmile®, and he knew it was the right choice for him. “The office was very efficient,” Kaufman says. “They knew what they were doing and were very careful of taking care of my gums during the process.” Kaufman had tried the standard whitening toothpastes, but had never ventured into the realm of whitening treatments. When faced with choosing between the trays and BriteSmile®, the choice was simple. “I didn’t want to mess with the trays because I’m pretty busy,” says Kaufman. “I prefer to spend the money and get it done right away.” The results for Kaufman were more than what he expected. Most patients’ teeth whiten by six shades, which is average with the BriteSmile® method, but for Kaufman, his teeth whitened by a full 10 shades, based on shade matching tests done before and after the procedure. The alternative to BriteSmile® uses trays that the patient wears over their teeth. Tray whitening with the Overton Center is very similar in concept to the over-the-counter tray systems. With the store-bought trays, you put a small amount of gel into each tray and place them over your teeth. For tray whitening with a cosmetic dentist, the process starts with an impression of the teeth, and then, a laboratory manufactures custom trays. “Custom trays fit better and get the gel up next to the teeth, allowing a higher concentration,” says Dr. Overton, and consequently, they use less gel. “With the trays, the patient takes them home and wears them there,” says Dr. Overton. “They wear them for 15 minutes a day for 14 days.” By putting a small amount of hydrogen peroxidebased gel into each tooth’s spot in the tray, the gel can coat the teeth more evenly than the storebought brands. As the patient wears the tray, the gel penetrates the teeth and begins to whiten them. Because a laboratory custom-designs each tray to fit individual patients, they have proven to be more effective than the whitening trays commonly found at the grocery store. Early in May, Shawn Debauch decided to take the plunge and try teeth whitening. He had considered getting his teeth whitened, but heard about mixed results with the over-the-counter products. “My teeth had some stains from coffee drinking, and the staff at Dr. Overton’s recommended the tray whitening,” says Debauch. “I thought the procedure was really good. It definitely made a difference.” Through the two weeks of wearing the trays,

Fort Collins Medical Magazine & Directories 2008 2009

Debauch, who runs the communications division of one of the largest electrical contractors in Colorado, would put the trays in after brushing his teeth at night and sit and read a book. “I had played football, so the trays were nothing compared to a mouth guard,” says Debauch. The only two negatives Debauch can think of are the taste of the gel, which he admits isn’t that bad, and the fact that too much gel in the tray can cause a slight, temporary burning sensation. “I can’t think of any real negatives to say about it. It was well worth the price.” When asked about potential side effects with teeth bleaching, Dr. Overton says no studies have shown problems with the procedures. Plus, since a BriteSmile® treatment or custom tray whitening only come from a qualified dentist, patients can safely whiten their teeth with incredible consistency. Potential patients should know, however, that whitening affects yellow stains more easily than gray ones, which are commonly caused by tetracycline antibiotics. If you look in the mirror and want to see a brighter white smile, teeth whitening may be for you. You can call the Overton Center for Dental Arts, P.C. at (970) 223-6677 to schedule an appointment for any regular or cosmetic dental work. Jason Webb is a freelance writer who lives in Johnstown.

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BriteSmile has a single purpose: Brightening lives by brightening smiles. Now is the perfect time to look and feel better about yourself with a whiter, healthier, and more conﬁdent smile. Let's face it — one of the ﬁrst things you notice about people is their smile. When you meet someone with a bright, natural smile, it catches your attention. However, over time, nature's aging process and your lifestyle (smoking or drinking coffee, tea, or wine) can stain or discolor your teeth.

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Wellness

Pulmonary Health

Smoking

Thank You For Not by Meredith Dody-Hettler

“Genocide, that’s what it was, enough to make you weep, if you had a heart, the thought of so many of these … victims, their lives stubbed out upon the ashtray of corporate greed.” -Thank You For Smoking author, Christopher Buckley.

Cigarettes are efficient. Not only do they generate billions of dollars, but it only takes them 365 days to kill half a million people. Think about it this way, if killing people was an industry, Big Tobacco would hold the monopoly. Do me a favor. Stop and pull ‘smoking’ out of your brain’s filing cabinet real quick. I know where you’ve filed it; with the other ‘bad for you’ things, like sunburn, weight gain, dehydration etc., that any new reason WHY they’re bad we’ve essentially tuned out. What do you have in your smoking file? Is there substantial evidence to support your decision to be (and stay) smoke free? I’d like to offer praise for those who abstain, as well as information and courage for those who are brave enough to take the first step to quitting. Did you know that cigarettes are special? Yes, according to the American Cancer Society, “cigarettes are the only legal product whose advertised and intended use -- smoking -- is harmful to the body and causes cancer.” Ask people why smoking is bad and most will say, “Because you can get lung cancer.” Newsflash: most smokers are not living long enough to get lung cancer. Lighter fluid, batteries, vinegar, sewer gas, poison, carbon monoxide, rocket fuel, paint, ammonia, insecticide, toilet cleaner, industrial solvents, candle wax and barbeque lighters. What a tasty little cocktail. These are just some of the chemicals you inhale when you smoke. Gross. Go clean your house with those chemicals. Do you have safe sex? Do you ask for a sober ride when you need one? Do you buckle your seatbelt? Do you have a smoke detector and a fireproof safe in your home? The majority of us answer yes to each question. Why? Prevention. Keep your answers in mind and ponder this:

Fort Collins Medical Magazine & Directories 2008 2009

smoking slaughters more people than AIDS, alcohol, drug abuse, car crashes, murders, suicides, and fires – combined. When smoking cigarettes is the most preventable cause of early death in the United States, why is it we, as a whole, are more consistently and proactively trying to prevent those things which are to a greater extent unpreventable? Fort Collins has been breathing clean air for about five years now. It was in 2003 that the Fort Collins Smoking Ban went into full effect, prohibiting smoking in most public establishments. By 2006, the entire state of Colorado became smoke free with the passage of the Colorado Clean Indoor Air Act; law which mandated local government ordinances be no less restrictive than their statewide counterpart. Thus, to align the smoking restrictions set by the city with those set by the state, Fort Collins had to eliminate the exemptions they’d previously made in the ban’s 2002 debut. According to the CDC, the major players in smoking related deaths are: lung cancer (killing roughly 124,000), heart disease (108,000), and the “chronic” lung diseases, which include emphysema, bronchitis, and chronic obstruction of the airways (90,000). Lung issues such as chronic obstructive pulmonary disease (COPD) are responsible for that un-mistakable smokers cough, which

should be evaluated by a physician to establish the extent of airway damage. Enter Brent Peters, M.D. A graduate of the University of Kansas School of Medicine, Dr. Peters will be joining the practice at Northern Colorado Pulmonary Consultants, P.C. in July, where he will be treating patients with pulmonary diseases and dealing with those with decreased pulmonary functionality. “COPD is non-reversible condition, which is due to constant inflammation.” Symptoms include: Shortness of breath (dyspnea) persisting for months to years, wheezing, decreased exercise tolerance, and cough (with or without phlegm). Dr. Peters just moved to Fort Collins, Colorado from Iowa, where he taught at the University of Iowa. While on faculty in Iowa, Dr. Peters focused on pulmonary, critical care, and occupational medicine where he both evaluated for, and managed lung transplantation procedures. Of the 2000 lung transplants per year, 50% were necessary because of COPD conditions began worsening in patients. COPD poses such a threat because any respiratory infection, becomes a potentially life-threatening sickness. For those patients, it is not just a matter of getting put on antibiotics and then going on with their lives. Dr. Peters stated that there is more to be learned about COPD, although in the patients he sees,

roughly 90% of those he diagnoses with COPD are smokers. Diagnosing the condition is done at Northern Colorado Pulmonary Consultants, P.C., at their Pulmonary Function Lab. Here, the physicians determine how well patients’ lungs are functioning, and just how well they’re breathing. Lung disease/cancer should not be the only life-threatening concern for the smoking population; circulatory disease is responsible for a great number of the smoking-related deaths everyday. In the previously mentioned chemical cocktail, maybe you noticed that the infamous nicotine was not mentioned. I’m sure you didn’t know that I was referring to it when I listed insecticide as one of the nasty ingredients in a cigarette. Nicotine is the addictive component in cigarettes, and is far more powerful than one might imagine. Faster than an intravenous administration of a drug (IV), inhaling nicotine takes only 6 seconds to reach the brain. Nicotine is also single handedly responsible for the whirlwind of physiological symptoms of withdrawal, which is why it is hard to quit. Not only addictive, but nicotine, along with carbon monoxide, pose the biggest threat regarding the onset of circulatory disease. Nicotine is classified as a stimulant, which means that immediately following that first puff, both your blood pressure and heart rate go up. To exacerbate the

COPD (chronic obstructive pulmonary disease) is a non-reversible condition, which is due to constant inflammation.” Dr. Peters stated that … roughly 90% of those he diagnoses with COPD are smokers. - Brent Peters, M.D., Northern Colorado Pulmonary Consultants, P.C. problem, is the fact that nicotine is a powerful vasoconstrictor (decreasing the diameter of the arterial vessels). Imagine trying to force more water, at a much faster speed, through a smaller pipe. Eventually the stress would cause the waterway to leak, or the pipe would burst, right? Our “waterways” are our arteries, and, instead of water, they transport oxygen and nutrients to all parts of the body. Without proper sustenance (oxygen and nutrients), our extremities will rot, and in the case of Buerger’s disease, amputation of limbs can soon follow. As if this could get anymore dismal, but the induced stress on the arteries causes stores of cholesterol and fat to be released into the blood, thus posing significant risk for clogs to form in the arteries. Not only does smoking destroy the body of the smoker, but also it does significant damage to the non-smoking population. So, before anyone tries to argue the point about how smoking is your right, let’s talk about secondhand smoke. Secondhand smoke is serious, especially when children are exposed to it because their lungs, brain and bodies are still developing. The American Lung Association reports that 35% of children

(21 million) are growing up in a smoking home. They also report noticeable levels of a nicotine breakdown product in their blood. Secondhand smoke kills thousands of non-smokers every year, and while it may be your “right” to smoke, it is not your right to harm others in doing so. Too bad the progressive damage is only evident internally. If the grotesqueness could be seen on our external bodies, I think more people would quit in order to preserve their appearance for the general public. Imagine going to meet up with clients with a black and sticky limb? Yuck. Or, how could someone take you seriously with a disintegrating, bloody, body part? Talk to me about quitting….. A common roadblock to quitting is in breaking down the “it won’t happen to me” attitude. Some interesting research has been conducted, findings that bring up reasons other than lung cancer to encourage smokers to kick the habit. Are you aware that quitting smoking greatly lowers the chances of complications during any surgery? How about the fact that every single non-smoking day shows marked improvement in immune function? Stopping smoking is one of

the greatest factors in enhancing sexual functioning. Non-smokers are viewed as better and more sophisticated, more self-disciplined, more mature, more dateable, wiser, more attractive, and younger than smokers, even by smokers! A humorous quote I read recently read: “I decided to give up cigarettes in two stages. First I’m going to give up smoking my cigarettes… and then I’ll give up smoking other people’s.” In reality, smoking cessation is a day-by-day feat to accomplish. Taking it one day at a time, using nicotine replacement therapy in addition to counseling, rewarding yourself for small milestones, and having a supportive friend or family member to cheer you on, all greatly enhance the chances for success. Within only 20 minutes, the body starts to repair itself from smoking-induced trauma. Why not start now? Meredith Dody-Hettler is a 24-year-old, who credits her competitive figure skating training and it’s mandatory focus on healthy living, for being the reason she has developed such a passion for heath & wellness.

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Fort Collins Medical Magazine & Directories 2008 2009

Healthy Tidbits:

Trans Fats The Monster Behind the Zero by Erica Pauly

Just when we thought that saturated fat was our biggest enemy, trans fats made their entrance. According to Melissa Wdowik, the Director of Colorado State University’s Nutrition Center, “Trans fats were created by food companies to save on costs and spoilage. They are less expensive than other fats and they will keep a long time without going bad.” Since the FDA now requires all products to be labeled with the amount of trans fats in each serving, we as consumers have been bombarded with new information about fat content. But for those of us who shop for the idyllic “zero” label on our groceries, reading beyond that label can be shocking when it comes to trans fats. Though the FDA requires trans fats to be labeled on foods, they allow up to .49 grams of trans fats per serving before a company has to label their product. According to Jenifer Bowman, Registered Dietitian at Heart Center of the Rockies, “It’s a good thing that the FDA [requires com-

panies to label their products with the amount of trans fats in them], but we still have to read the ingredient list for hydrogenated or partially hydrogenated fat.” Even if a label claims that a food has zero trans fats, the ingredient list is more specific. If partially hydrogenated fat or hydrogenated fat is written anywhere on the ingredient list, you can be sure that there is .1 to .49 grams of trans fat in each serving of your food. So what exactly is hydrogenated fat? Bowman explains, “It is a man made fat. You take liquid oil and turn it into a solid by adding hydrogen to it. Since it is man made, our body doesn’t need it; that is why there is no recommended daily amount.” Therefore, our bodies are better off without any trans fats at all. Trans fats are usually hiding in nutrient poor foods like fast food and frozen fried foods. With more people on the lookout for trans fats, people like Melissa Wdowik, are approached with many questions, concerns and interest on the topic of trans fat. “People do seem to know [what trans fat means] and know to watch out for it on labels. What they often don’t understand is the fact that a food can have up to .49 grams per serving, so eating several servings of that food can contribute a lot of trans fat to the person’s intake.” Both Wdowik and Bowman suggest that consumers read every ingredient in the product to look for “hydrogenated fats,” rather than the overall assessment of trans fat content. So the next time you are about to buy your favorite ‘zero trans fat’ product, you may want to take a closer look and read the ingredient list; a monster may be lurking.

John James, M.D.

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Erica Pauly is Editorial Intern for Style Magazine.

Wellness

Disease Prevention

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Jimmie Laney, CFT, SAF, Personal Trainer, works out with client Holly Huett-Faatz at Pulse Fitness Center.

Disease Prevention

Through Exercise by Jimmie Laney, CFT, SAF

Having trouble finding the right incentive to get out and exercise? Well, perhaps these facts will get you motivated. The number of people in the United States who are overweight or obese has reached epidemic proportions.

Now this may not necessarily come as a big surprise to some of you. After all, these findings are mentioned in the news regularly. Yet most of us are doing very little, if anything, to combat this emerging health threat. According to the National Institutes of Health, it is estimated that more than 60% of American adults are considered to be overweight and approximately 20% are obese. These rates are rising each year and it is believed that if these trends continue, all Americans will be significantly overweight by the year 2030. Notice that I didnâ&#x20AC;&#x2122;t say most Americansâ&#x20AC;ŚI said ALL Americans! Likewise, the potential health risks that are associated with being overweight or obese have also significantly increased. There is a 33% rise in those who suffer from diabetes as a result from being overweight in the past decade alone! Heart disease and hypertension are also rising at an alarming rate. In fact, the National Institutes of Health also states that approximately 400,000 people die in America each year as a result of disease and weight related health problems. This number is also predicted to rise dramatically within the next few decades. What makes this statistic even more

disturbing is that these deaths are mostly preventable. In addition to diabetes and heart disease, a myriad of other diseases and health problems can develop, diseases such as certain types of cancers, depression/anxiety, fatigue, osteoporosis and osteoarthritis - to name but a few. If we recognize the problem, how do we solve it? What can you do to take charge of your health and develop a strategy for successful weight management. There are several options available. First and foremost, become active! One of the primary reasons for our nation’s health problems is the inactive and sedentary lifestyle that many of us lead. Many of us rarely make the time or the effort to be more active. On average, Americans exercise only 15 minutes per day and watch more than 150 minutes of television. There are very simple things that you can do to help yourself become more active. For example: have you ever gone to the grocery store or the shopping mall and spent 15 minutes driving around the parking lot looking for a space that was as close as possible? Next time, try parking at the far end of the lot and walking to the building instead. Ever taken your car to the car wash? Sure, we all have! Next time your car is dirty, grab a bucket and rag and wash it yourself. When you’re at the airport or in a large office building, use the stairs instead of the elevator or escalator. Believe it or not, these simple changes in everyday lifestyle habits can make a significant difference in the long run. For those of you who may be considering joining a gym to begin a regular workout routine, remember to start out slow and take it easy. A well-rounded exercise program should consist of resistance or weight bearing exercises that are specifically designed to target all the major muscle groups of the body. In addition to resistance training, cardiovascular or aerobic exercise should also be included as well. Riding the stationary bike and/or walking on the treadmill are great ways to accomplish this. A certified personal fitness trainer can help you put together a regimen that is custom tailored to your specific needs and goals Physical activity in weight management and disease prevention is just as important as developing a sensible and well balanced diet. Does this mean that you need to deprive yourself of the “good” foods that you enjoy? Absolutely not! You can still eat the foods that you like, just do so sensibly and in moderation. If you think that this may be difficult for you to do, you may want to consider meeting with a registered dietician or nutritionist. They may have some simple ideas and suggestions to help you develop a balanced and realistic eating program that you can stick to. Remember that ultimately, the key to your healthy future is in your hands. Don’t think of it as dieting and exercising for a specific period of time. Rather, you should develop healthy lifestyle habits, and then make them a permanent part of your life. If you get frustrated and discouraged, that’s okay…we all do. Just remind yourself that it will take time to adjust and see significant results. After all, Rome wasn’t built in a day. Rest assured that you are doing the right thing and it’s going to pay off! Jimmie Laney is available for one-on-one personal training at Pulse Fitness Center at (970) 490-1300.

Fort Collins Medical Magazine & Directories 2008 2009

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With food prices increasing and incomes falling, maintaining a healthy and balanced diet has become an increasingly expensive lifestyle to sustain. According to Melissa Wdowik, the director of the Colorado State University Nutrition Center, â&#x20AC;&#x153;Fruits and vegetables are the first things to go when money is an issue.â&#x20AC;? When the fruit and vegetables are removed, the sugar and fat move in to fill the gap. But continuing to shop and eat healthy may not be as expensive as you think. Melissa has a few easy tips on how to cut costs while still maintaining your health. She says, â&#x20AC;&#x153;Plan ahead and stick to your list. This can eliminate extra money spent on junk food or impulse buys. Instead of eliminating fruits and vegetables, buy produce that is on sale, and buy just enough that you wonâ&#x20AC;&#x2122;t waste any of it. As a supplement to fresh produce, try frozen fruits and vegetables. Donâ&#x20AC;&#x2122;t shop when you are hungry, everything looks enticing on an empty stomach. Buy the store brand because typically you cannot taste the difference. Also remember that beans and eggs make very nutritious and inexpensive low-fat protein alternatives.â&#x20AC;? In order to cut costs on shopping trips, Melissa also suggests cutting down on soft drinks, bottled water, and juice drinks. By sticking with tap water, a consumer will save money and put fewer calories in their body; a win-win situation. Colorado State University offers a weight management class to the community that also includes many ideas for eating on a budget. For more information about the Nutrition Center or to find out more about the Weight Management class offered by CSU, you can visit www.fshn.cahs.colostate.edu/nutritioncenter.asp online. Erica Pauly is Editorial Intern at Style Magazine.

2008

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DENTISTRY/ENDODONTICS ::

Anthony F. Girardi, DDS 1331 E. Prospect Rd., Bldg. B-1.....970.482.4916 2996 Ginnala Dr., Ste. 101 (Loveland) 970.461.1994 See ad on page 83 David M. Jones, DDS 1331 E. Prospect Rd., Bldg. B-1.....970.482.4916 2996 Ginnala Dr., Ste. 101 (Loveland) 970.461.1994 See ad on page 83

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David Clark Johnson, DDS, MS 1120 E. Elizabeth St., G4 ...............970.221.5050 2996 Ginnala Dr., Ste. 101 (Loveland) 970.221.5050 See ad on page 89 Richard W. Lindeberg, DDS, MS 1120 E. Elizabeth St., G4 ...............970.221.5050 2996 Ginnala Dr., Ste. 101 (Loveland) 970.221.5050 See ad on page 89

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menâ&#x20AC;&#x2122;s health

Solutions for

Erectile Dysfunction by Connie Hein

Watching even a minimal amount of television these days can make you feel like an expert on erectile dysfunction (ED) treatments. In the many advertisements for Viagra, Levitra, and Cialis, the handsome man takes a little pill. Then the beautiful woman and handsome man have big bright smiles and are seen enjoying fun, relaxing activities in warm, beautiful settings. Fort Collins Medical Magazine & Directories 2008 2009

After talking with local experts about ED, it turns out to be a bit more complicated than that. Our experts agree that the choices men make in life can lead to degeneration of the erectile tissue and blood flow in the penis and the development of ED. Smoking, drug use or alcohol abuse, particularly over a long period of time, will compromise the blood vessels of the penis. Lack of exercise, high cholesterol, hypertension, and a sedentary lifestyle may also contribute to the development of ED. Correction of these conditions will improve overall health, and may in some individuals correct mild ED. If changes in lifestyle do not help, then seek assistance from your doctor. According to Saul Hopper Ph.D. and Licensed Clinical Psychologist in Ft. Collins, almost all men experience ED in varying degrees at different points in their lives, and the treatment for ED is often not as simple as taking a pill. ED is not necessarily just a physical dysfunction, but can also be an emotional problem. Dr. Hopper believes that men and women view sex in such different ways that ED can in part be caused by something as simple as a lack of communication between partners. He says, â&#x20AC;&#x153;Men buy into many cultural myths about the erection during intercourse. For most men it is like a competition they brag about in the

Dr. Phillips believes that the three drugs prescribed for ED are all very effective. The drugs are taken approximately 30 minutes before intercourse… If erectile function returns with the oral medications and the patient is satisfied, no further diagnosis and treatment are necessary. - George Phillips, M.D., Urology Center of the Rockies

locker room. It is something they feel they must perform or achieve. With women the actual act of penetration in sex is not always the most satisfying part of intercourse.” These differences make life difficult when a man does start experiencing ED. He often starts having feelings of inadequacy, which then distracts him so that he is unable to concentrate on the pleasure of the sexual experience. Dr. Hopper adds, “Even when his partner honestly assures him that it is not important that he perform, the man thinks his partner is just being kind and trying to make him feel better.” Men need to be able to take the pressure off themselves and just enjoy the experience of being with their partner and learn how to give and receive

pleasure. Spouses need to understand that a lack of desire for them is not the reason for the ED. The stronger the desire for his partner the more pressure the man feels to perform. It becomes a vicious cycle. Dr. Hopper does couples counseling and is often in a position of explaining to men that having meaningful, satisfying, sexual experiences has more to do with learning to relax and enjoy one’s partner without all the pressure to perform and achieve. Men and their partners can experience considerable relief from learning to shift their focus, and to reframe how they approach sex. When asked about the drugs on the market today for ED, Dr. Hopper says he believes them to

be very effective and added, “There have been definite benefits to the drug companies spending millions to advertise drugs such as Viagra, Levitra, and Cialis.” The advertising has been instrumental in getting men to talk to their doctors about ED. This has probably been a factor in the early detection of other serious illnesses that may be associated with ED. “The drug companies started using the term ‘erectile dysfunction’ instead of impotence that had carried such negative connotations. This change in attitude has made men feel better about discussing ED with their physicians.” Hopper adds that the only negative part of the Viagra craze is some men’s continued mis-

ED is not necessarily just a physical dysfunction, but can also be an emotional problem. … Men and women view sex in such different ways that ED can in part be caused by something as simple as a lack of communication between partners. - Saul Hopper Ph.D. Licensed Clinical Psychologist

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perception. When men believe the only way to satisfy a woman has to do with the size and duration of their erection and do not address any other relational challenges, the medication is not going to be very effective. Sometimes when men take prescription medications for ED they make more demands on the women in their lives without making any changes in intimacy which causes relationship problems. George Phillips, M.D., one of the partners at Urology Center of the Rockies with offices in Fort Collins and Loveland, agrees with Dr. Hopper, that there is usually a combination of physical and emotional problems associated with ED. He says “If while doing the patient history we find there are emotional factors such as depression that have not been dealt with, we recommend getting them taken care of as part of the treatment plan.” He believes that the three drugs they do prescribe for ED are all very effective. The drugs are taken approximately 30 minutes before intercourse. Viagra, the drug that has been on market the longest, should not be taken on an empty stomach. Levitra and Cialis are equally as effective as Viagra and can be taken anytime. The effects of Viagra and Levitra last from 3-6 hours while Cialis may last up to 36 hours. Dr. Phillips says that recently the manufacturer of Cialis has promoted using it in smaller doses on a daily basis to make sexual relations more spontaneous. But this is a new concept that he has not tried with patients. He prescribes the drug that seems to best fit the needs of the individual. If erectile function returns with the oral medications and the patient is satisfied, no further diagnosis and treatment are necessary. If the initial treatment response is inadequate or the patient is not satisfied, then further steps may be taken. Dr. Phillips says that men who find the drugs to be ineffective have another option: an injection of arterial dilator medication directly into the base of the penis approximately 5-15 minutes before intercourse. He says this is a stronger drug and often works when the oral medications fail, but most men are not excited about giving themselves injections. The last resort is usually a penile prosthesis which uses pumps and cylinders inside the penis. He says, “This procedure has come a long way in the past 20 – 25 years… Patients are generally very satisfied with the results.” Erectile dysfunction is very complicated in terms of its scope of emotional and physical ramifications. Symptoms may include weakness, fatigue, and low levels of sexual desire, lack of energy, mood disturbances, and depression. Drs. Hopper & Phillips agreed that generally ED can be successfully treated with a combination of lifestyle changes, counseling, and medical treatments. The first action for men experiencing any of the symptoms should be to see their doctor who will help them make informed decisions about their treatment options. For more information on treatments for ED, call Dr. Saul Hopper at (970) 221-0118 or Dr. George Phillips or any of the qualified physicians at the Urology Center of the Rockies at (970) 484-6700. Connie Hein is a freelance writer in Windsor and author of the Toliver in Time series of children’s books.

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medical

Women’s Health

XXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXX XXXXXXXXX Angela King, M.D., FACOG, The Women’s Clinic of Northern Colorado and a staff member demonstrate a bone density test.

Osteoporosis

and You

by Laura Lee Carter

Osteoporosis is a disease where bones become fragile and more likely to break as we age. If not prevented or left untreated, osteoporosis can progress painlessly throughout the years, until a stressed bone suddenly and surprisingly breaks. That is why it is called the “silent disease.” 102

According to Rob Baer, M.D. at Orthopaedic Center of the Rockies in Fort Collins, “Your first sign of problems may well be a fracture.” Any bone can be affected, but of special concern are fractures of the hip and spine. A hip fracture almost always requires hospitalization and major surgery. It can impair a person's ability to walk unassisted and cause prolonged or permanent disability or even death. Dr. Baer cautions, “Of those who suffer a hip fracture, 25 percent will die within one year, and another 25 percent cannot walk across a room unaided after six months.” Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain, and deformity. Osteoporosis, which means “porous bone,” is a disease characterized by low bone mass and structural deterioration of bone tissue. According to Dr. Baer, “With osteoporosis, the bone maintains the same mineral composition, but the spaces are larger in between, thus severely weakening the bone structure.” Put in simpler terms, osteoporosis is a condition where the bones become so vulnerable that they can fracture from minor falls, or even from something as simple as a sneeze. Spinal fractures may initially be felt or seen in the form of severe

We all reach peak bone strength in our 20s. Any treatment after that cannot reverse the disease, only prevent further bone loss. - Rob Baer, M.D., Orthopaedic Center of the Rockies

back pain, loss of height, or spinal deformities such as stooped posture, but in many cases, a vertebral fracture can occur with no pain. Prevention About 85-90 percent of adult bone mass is acquired by age 18 in girls and 20 in boys. Building strong bones during childhood and adolescence is the first step in preventing osteoporosis later in life. Dr. Baer states, “We all reach peak bone strength in our 20s. Any treatment after that cannot reverse the disease, only prevent further bone loss.” Preventative measures include supplementing daily with calcium and vitamin D, regular weightbearing and muscle-strengthening exercise, minimal use of tobacco or alcohol, and bone density testing as we age with proper medications if needed. Dr. Baer recommends a total of 1200 mg of calcium and 400 IU of vitamin D daily. Maude Vance, M.D., a new OB/GYN doctor at The Women’s Clinic of Northern Colorado, is very pro-active in her fight against osteoporosis. “It is very important for women to be aware of their risk factors for osteoporosis, and talk to their doctor about screening and potential treatments to help prevent fractures.”

Prevalence Osteoporosis is a major public health threat for an estimated 44 million Americans, or 55 percent of the people 50 years of age and older. In the U.S. alone, 10 million individuals are estimated to already have the disease and another 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis. In addition, Dr. Baer points out, “These figures are increasing with changing demographics, and will only go up as the baby boomer generation ages.” While osteoporosis is often thought of as an older person's disease, it can strike at any age, but, according to Dr. Baer, it is also inevitable in any of us, if we live long enough. Females have a 4 to 1 chance of developing osteoporosis in their lifetime, compared to men. The reasons for this are unclear but probably correlate with women’s smaller bone structure, genetics factors, and others relating to estrogen production. Women can lose up to 20 percent of their bone mass in the five to seven years following menopause, making them even more susceptible to osteoporosis. Of the 10 million Americans estimated to have osteoporosis at this time, eight million are women and two million are men. Significant risk for developing osteoporosis has been reported in people of all ethnic back-

grounds. The greatest risk is thought to be among Caucasian and Asian women age 50 and older, but osteoporosis is under recognized and under treated in patients of every race and background. Today, ten percent of Hispanic women age 50 and older are estimated to have osteoporosis, and 49 percent are estimated to have low bone mass. When compared with other ethnic/racial groups, risk is increasing most rapidly among Hispanic women. Costs Experts predict that costs related to osteoporosis-related fractures among Hispanics will increase from $754 million in 2005 to $2 billion per year in 2025. Costs for all osteoporosis-related fractures will increase from an estimated $19 billion in 2005 to over $25 billion by the year 2025. Risk Factors Factors that increase the likelihood of developing osteoporosis and broken bones are: being female, being older, a family history of osteoporosis or broken bones, having a small build, certain race/ethnicities such as Caucasian, Asian, or Hispanic/Latino, a history of bone fractures, low sex hormone levels, especially testosterone in men or estrogen in women past menopause, missed

It is very important for women to be aware of their risk factors for osteoporosis, and talk to their doctor about screening and potential treatments to help prevent fractures. - Maude Vance, M.D. The Women’s Clinic of Northern Colorado

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periods (amenorrhea), diet, low calcium intake, low vitamin D intake, excessive intake of protein, sodium or caffeine, a sedentary lifestyle, smoking, alcohol abuse, extended use of certain medications such as steroids, and certain diseases such as anorexia nervosa, rheumatoid arthritis, gastrointestinal diseases and others. Fractures Approximately one in two women and one in four men over age 50 will have an osteoporosis related fracture in their remaining lifetime. Fractures due to osteoporosis are most likely in the hip, spine and wrist, but any bone can be affected. According to estimated figures, osteoporosis was responsible for more than 2 million fractures in 2005, including approximately: 297,000 hip fractures, 547,000 vertebral fractures, 397,000 wrist fractures, 135,000 pelvic fractures, and 675,000 fractures at other sites. The number of fractures due to osteoporosis is expected to rise to more than 3 million by 2025. An American woman with a hip fracture is at four times the risk of suffering a second one, and these types of injuries often lower a patient’s quality of life. The rate of hip fractures is two to three times higher in women than men; however, the one year mortality rate following a hip fracture is nearly twice as high for men as for women. A woman's risk of hip fracture is equal to her combined risk of breast, uterine and ovarian cancer. Diagnosis Today, specialized tests called bone mineral density (BMD) tests can measure bone density in various sites within the body. Experts recommend a type of BM.D. test using a central DXA (dual energy x-ray absorptiometry). A DXA test can determine if you have low bone density before a fracture occurs, predict the chances that you will fracture bones in the future, and help your healthcare provider decide if future treatment is needed. If you are diagnosed with osteopenia, this means you have lower bone density than you should for your age group. According to Dr. Baer, this condition can usually be managed with some lifestyle changes and adjustments in supplementation. In the near future, some DXA machines will be able to provide a report that gives information on a person’s “Absolute Fracture Risk.” This report will incorporate a person’s bone mineral density results, age and some of the important risk factors for osteoporosis and fractures. The information in this report will be used to help determine your risk of breaking a bone in the next 10 years. Medicare reimburses for BMD testing every two years. Although the statistics seem overwhelming, awareness of osteoporosis has grown exponentially in the past few years. There has been a fivefold increase in office visits for osteoporosis (from 1.3 to 6.3 million) in the past 10 years. Although there is no cure for osteoporosis, it can be treated with a number of effective medications which substantially reduce loss of bone density. With prevention and vigilance, some fractures and other disabilities may be avoided in the future. Laura Lee Carter is a Fort Collins writer and copy editor. For more information see her website at: www.lauraleecarter.com

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New Discoveries about

Vitamin D

by Laura Lee Carter

Most of us already know how important calcium is in making and keeping our bones strong. As we get older, our bones start to thin bit by bit, so they become less dense, more brittle, and more likely to break.

When this thinning advances to a certain point, itâ&#x20AC;&#x2122;s called osteoporosis. Each year in the United States there are two million bone fractures associated with osteoporosis, and 300,000 of those breaks will involve a hip. For years, high calcium intake has been understood as the best way to prevent osteoporosis and related fractures, but recent research suggest there were a few flaws in that reasoning. Yes, calcium is still essential in keeping bones strong. Most of us need 800 to 1,200 milligrams of calcium each day through consuming dairy products and supplements. More than that is not recommended because it can interfere with absorption of phosphorus, another crucial bone strengthener. However, new research is showing how vitamin D may figure even more prominently in the health equation. Calcium supplementation is not all that beneficial if vitamin D intake is low. The body needs vitamin D to absorb calcium, and between 30 to 60% of us have less than optimal vitamin D levels in our blood. According to a recent article in the Harvard HealthBeat, vitamin D is unique because we canâ&#x20AC;&#x2122;t get very much of it naturally through diet, thus many Americans are deficient. Harvard Medical School now finds that the benefits of vitamin D extend far beyond its reputation for building healthy bones. Studies suggest that adequate amounts of vitamin D may lessen the risk of several types of cancer and may also play a role in preventing high blood pressure, multiple sclerosis, and even schizophrenia. Low blood levels of vitamin D have been linked with high blood pressure in several studies. Further research is underway to clarify these findings. But correlations between high blood levels of vitamin D and cancer prevention are much more conclusive at this time. A 2007 study comparing cancer rates in sunny countries with those in less sunny climes found that vitamin D intake through sunlight exposure may lower the risk of several forms of cancer, especially those found in the stomach, colorectal, liver, gallbladder, pancreas, lung, breast, prostate, bladder, and kidney.

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Like calcium, vitamin D plays a crucial role in keeping bones strong and healthy, but supplementing with calcium does little good if your vitamin D levels are insufficient. Recent research shows that older people who take 700 to 800 IU per day of vitamin D appear to reduce their risk of all fractures including broken hips. Vitamin D deficiency can lead to muscle weakness, which can increase your risk of bone fractures. How do we get enough vitamin D? The recommended dietary intake of vitamin D increases as we age from 200 IU for those under age 50, to 400 IU up to age 70, and 600 IU for those over 70. However, most experts now recommend getting at least 1,000 IU of vitamin D per day from safe sun exposure, eating vitamin D-rich foods and supplements. Some foods that are rich in vitamin D include fatty cold-water fish (salmon, tuna, sardines, etc.), eggs, and fortified foods like breakfast cereals, some juices and milk products, but youâ&#x20AC;&#x2122;d have to eat a lot of these to raise your blood levels. Furthermore, Dr. Walter C. Willett, chair of the Harvard School of Public Health, cautions against over consumption of dairy products because of recent studies linking high dairy consumption with the development of ovarian and prostate cancer. Instead consider adding brief sun exposure when the sun is least damaging before 10 a.m. and after 4 p.m. But, unless you live in the southern U.S. and spend a fair amount of time outdoors, some kind of supplementation will be needed to achieve the full beneficial effects of vitamin D in your blood stream. Remember that most daily multiple vitamins contain at least 400 IU of vitamin D, and many calcium pills also contain added vitamin D. A combined daily dosage of 1,000 IU of vitamin D, should take care of your minimum needs while benefiting your bones, and possibly preventing some cancers and other problems. Laura Lee Carter is a Fort Collins writer and copy editor. For more information see her website at: www.lauraleecarter.com

Studies suggest that adequate amounts of vitamin D may lessen the risk of several types of cancer and may also play a role in preventing high blood pressure, multiple sclerosis, and even schizophrenia.

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medical

Geriatrics

Yvonne Myers, Health Systems Coordinator, Columbine Health Systems works with her patients.

An Unfathomable Disease:

Dealing with Alzheimer’s by Jason Webb

Alzheimer’s is a degenerative disease, the most common form of dementia. Early in the disease, sufferers show signs of memory loss, but as it progresses, many experience loss of language, mood swings, and sensory loss. It’s a debilitating disease, affecting roughly 4.5 to 5 million people across the country. Experts believe that by 2050, 14 to 15 million people will suffer from the disease. Yet, it is also difficult to diagnose.

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Over the age of 65, 1 percent to 2 percent of people are diagnosed. By age 75, the percentage jumps to 15, and by age 85, 30 percent to 50 percent of people show signs of Alzheimer’s disease. - Michael Curiel, M.D., Fort Collins Neurology

Michael Curiel, M.D., of Fort Collins Neurology, sees patients suffering from various forms of dementia and pseudo-dementia. “The first thing is to rule out other possibilities,” says Dr. Curiel. That takes time. “Currently, there are no blood tests sensitive enough to detect [Alzheimer’s],” so the process of elimination calls for testing for other possibilities – like brain tumors or depression. If all other possibilities are ruled out and the patient fits the profile, than Alzheimer’s is diagnosed. In later stages of the disease, an MRI can show changes to the brain. Alzheimer’s can be caused by many factors, but according to Dr. Curiel, a genetic predisposition often determines whether or not a patient is at risk. Other relevant factors include obesity, a lack of exercise, high blood pressure, and diabetes. The disease has a slightly higher incidence in women than men, and it is rare in people under 50. However, the chances increase as the patient ages. Over the age of 65, 1 percent to 2 percent of people are diagnosed. By age 75, the percent-

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Let us take care of the tough stuff. When you come, you get to be the daughter or the son. - Laury Dennis, General Manager MacKenzie Place Laury Dennis, General Manager, MacKenzie Place and Ashley Haga discuss patient care. age jumps to 15, and by age 85, 30 percent to 50 percent of people show signs of Alzheimer’s disease. “A lot of people get natural changes to their memories,” says Curiel. “Stress and depression can cause memories to get worse.” For Karen Christensen’s father, Willard, the signs worried her, so she took him to see the doctor. After several examinations, he was diagnosed with Alzheimer’s six years ago. Some time after that, Christensen was taking her mother, Berniece, to the outlet mall in Loveland. “We had been there hundreds of times together, but this time she asked me which side J. Crew was on,” recalls Christensen. “That’s when I knew she had it, too.” Having one loved one suffering from this terrible disease is bad enough, but having both parents diagnosed is unfathomable. Still, Christensen, who appreciates the support she gets from friends and family, put her parents first and made the decision to take care of them as best she could. While many children choose to put their parent into a nursing home or assisted living facility, Christensen – a member of the Style Media & Design team – and her siblings chose to keep their parents in their own home. “I just couldn’t put them in a facility,” admits Christensen. “Even though it has been difficult, I wanted them to be home where they know where they are.” To help ensure the well being of her parents, Christensen and her siblings moved caretakers into their parents’ home to provide constant care. As Christensen’s mother’s memory started to fail, it was extremely important to have someone with them at all times. For example, Berniece began forgetting how to cook,

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even though she used to love preparing meals. Christensen’s mother began to withdraw, and her father lost his inhibitions. Her father also began hoarding food, taking leftovers to save for later only to leave them in unusual places. Many Alzheimer’s patients display these signs. Eventually, some Alzheimer’s patients become belligerent and may suffer from other behavioral issues,

which is why professional care is crucial. To help Christensen’s parents battle the effects of the disease, a care taker keeps them active, taking them for one to two mile walks every day as long as the weather is pleasant. “Physical exercise can help improve brain function,” says Dr. Curiel, which is why it is so important to not let patients just sit in a dark room. However, not everyone has the means to keep

their parents in their own home while battling Alzheimer’s. Thankfully, there are facilities in Northern Colorado that can partner with families to care for their loved ones as they progress through the different stages of the disease. “The family has to know they’re not in it by themselves,” says Yvonne Myers, the Health Systems Coordinator for Columbine Health Systems. “Alzheimer’s is a disease where you truly need help.” That is exactly what Columbine Health Systems offers. The expansive Columbine Health System offers 300 units of independent living, 149 apartments of assisted living, and 450 beds in their 4 skilled nursing facilities. Among the facilities designed for Alzheimer’s patients is New Mercer Commons, 947 Worthington Circle. “We are completely equipped to handle most cases. “As professionals, we can help families and have for the past 37 years,” says Myers. New Mercer is divided into four different units, which separate patients depending upon the disease’s progression. With semi-private and private rooms that patients and their families can decorate and an enclosed courtyard with raised flowerbeds, each unit is designed to stimulate and care for patients with various forms of dementia. “Let us take care of the tough stuff,” says Myers. “When you come, you get to be the daughter or the son.” Trained staff – including personal care providers, activity directors, an RN, and social workers – monitor residents and ensure they are safe, well cared for and having fun, with stimulating activities 24-hours a day. They all are trained to care for the elderly, and specifically for those with memory loss. New Mercer works closely with the Gerontology Program

at Colorado State University, and has many employees and interns from that program. Across town, a new community has recently opened. MacKenzie Place, 4750 Pleasant Oak Dr., is a senior living facility with 95 apartments for independent living, 26 for assisted living, and 26 for memory care. While many amenities cater to seniors who are in independent living, MacKenzie Place also provides care for residents with Alzheimer’s. “We’re capable of taking residents currently in the beginning stages of the disease,” says Laury Dennis, the general manager of the facility. The Memory Care unit at MacKenzie Place is staffed with nurses and resident assistants who have gerontology training that specifically deals with dementia. Complete with a small kitchen and activity areas, the Memory Care unit provides a warm, caring environment and plenty of physical and mental stimulation. An enclosed courtyard allows the residents to go out and get fresh air, too. “It’s the nurse’s and the R.A.’s job to find activities for each individual,” says Dennis. Whether it’s quietly working on a puzzle or dancing, the Memory Unit staff ensures patients are kept busy. Unfortunately, facilities like New Mercer and MacKenzie Place are merely temporary. Alzheimer’s is a terminal disease. Christensen did everything she could for her father, but, regrettably, he passed away at the end of May. While it rarely directly causes the patient’s death, Alzheimer’s opens the door for other causes. No cure exists, and only a limited number of medications are on the market. “A combination of drugs can help slow the disease, but not stop it,” says Dr. Curiel, who also states medications for behavior problems or insomnia should only be used sparingly, since they can exacerbate the development of Alzheimer’s. The Alzheimer’s Association, a voluntary health organization, exists to help families and patients who suffer from the disease. The organization’s goal is to eliminate Alzheimer’s. A driving force behind much of the research in the field, the Alzheimer’s Association not only provides educational materials and information, but also organizes support groups and family counseling. Various events throughout the year help to increase awareness and raise funds to support further research. To contribute to the Northern Colorado Chapter or to get more information about the disease, call (970) 472-9798. The medical community spends countless hours each year trying to find a cure, but it will take time. New medications take years to come on the market, according to Dr. Curiel, even as new research offers promise. Focusing on different enzymes commonly found in the brain, researchers hope to establish a link between enzymes and Alzheimer’s, and then find a way to block them or provide a vaccination against them. Even with a tremendous research push created by the baby boom generation, a cure is still far off, according to Dr. Curiel. His best advice is preventative measures like exercise, eating right, and participation in mentally stimulating activities. “Take care of your body!” Jason Webb is a freelance writer who lives in Johnstown.

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Fort Collins Medical Magazine & Directories 2008 2009

Dr. James W. Wolach

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medical

Geriatrics

Alzheimer’s:

A Family Affair

by Maureen McVicker Trump, Psy.D.

Alzheimer’s disease is a family tragedy. As former Supreme Court justice Sandra Day O’Connor remarked in speaking of her husband’s condition “It may directly attack only one member of the family, but every member of that family feels the effects. Every member loses something.” Alzheimer’s is a terrifying disease that invades families and leaves them changed forever. It plagues families with physical, psychological, and financial problems. Alzheimer’s disrupts normal patterns and roles creating a need for the development of creative coping skills to deal with a whole range of new and scary challenges. It is estimated that 70 percent of Alzheimer’s patients are cared for by their families. Family members may have widely different opinions about how to care for a loved one. Conflicts over caretaking responsibilities may arise and add to a caretaker’s burden. A primary caregiver can feel resentment toward other family members who are seen as not contributing their share. Brothers and sisters may disagree greatly on issues affecting the entire family. It is not unusual for old patterns of relating and interacting to interfere and

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amplify current problems. Caregivers eventually begin to experience “caretaker burnout,” adding to overall family stress. Their failure to take care of their own needs has an impact that affects the entire family. Studies show caretakers tend to experience high blood pressure and a heightened susceptibility to diseases related to stress. Use of alcohol and tobacco may increase. Exercise routines are put on hold. All of these can result in depression and fatigue. Caretaking may go on for many years getting progressively more demanding, and requiring more time, money, and energy. Caregivers may begin to ask, “How can I give any more, when there just isn’t any more of me?” Relationships break apart under unbearable strains. The stress of Alzheimer’s cuts across all gen-

erations. Children in the family are also dealing with Alzheimer’s. They sense the anxiety and live with disrupted schedules. They are afraid for their future and wonder if they will become “like grandma.” Because so much time and energy is required to care for the patient, children can feel abandoned and afraid. Lack of interaction with their parents leaves them lonely and angry. Parents may then have to deal with depressed or acting out children. Yet, despite all the challenges, families often report that they are drawn closer together around the care for their relative with Alzheimer’s. They find ways to manage the situation and overcome many of the effects of living with this insidious disease. Not all is grim, and families still have fun times doing the things they enjoy. In her book Voices of Alzheimer’s, Eileen Kay

offers many useful suggestions from her own experience caring for her mother. According to Kay, one of the key factors is becoming informed. Caregivers should read library books, find information on the internet, and contact the Alzheimer’s Association.* Educate yourself and your family about what to expect, and how things will change. Accept the reality of the situation and learn all you can about it. It is also crucial to keep lines of communication open within the family. Families use regularly scheduled meetings to promote understanding and cooperation. These meetings have rules that provide a place for all to be heard and not criticized. Together, make a plan with your family and assign duties. For example, one family member may handle legal matters and have power of attorney. Deciding such issues ahead of time within the family, prevents future misunderstandings. It is best to “share the care.” Families of Alzheimer’s patients can find help in community resources that make a tremendous difference in family coping. Support groups for the patient and family are highly recommended. Living with Alzheimer’s leaves many families feeling isolated. Support groups provide the camaraderie and comfort of regularly being around people who know exactly what you are going through. Research has found that families who attend counseling and educational programs experience less stress. Caregiver family therapy is a short term talk therapy model that seems particularly effective. Longer term individualized counseling appears to reduce the burden and depressive symptoms of caregivers. Counseling can assist family members in discovering strategies that help them gain a sense of control, and improve their quality of life. Families who function well with family members with Alzheimer’s, live in the moment with their loved one. They schedule time for family activities and plan for fun times together. Their focus is on enjoying what they can as long as they can. Veteran caregivers have an invaluable piece of advice for new caregivers. They say to do whatever it takes to get at least one night off a week. Do not let the disease consume your life. Individuals and families require respite from the constant demands of caring for an Alzheimer’s patient. Taking time off is not a selfish act. It is a necessary time when caregivers can recharge, restore their spirit, and renew relationships. Alzheimer’s disease is indeed a family tragedy, but it need not destroy families. Some report they have developed stronger personal ties, and found a new sense of fulfillment and purpose in caring for a loved one with Alzheimer’s. They have pulled together through tough times. They have found a way through this heartbreaking experience, one which they will never forget. *Alzheimer’s Association Northern Colorado Alzheimer’s Chapter: 415 Peterson St., Fort Collins, 80524 970-472-9798 24 hour help line: 1-800-272-3900 www.alz.org Dr. Maureen McVicker Trump is a Jungian psychotherapist and writer in Fort Collins, CO.

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