2008-10 Northern Colorado Medical & Wellness Magazine by Style Media & Design, Inc.

NORTHERN COLORADO

FIVE DOLLARS

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w w w. s t y l e m a g a z i n e c o l o r a d o . c o m PUBLISHER Lydia Dody CONTRIBUTING EDITOR Erica Pauly CREATIVE DIRECTOR Scott Prosser SENIOR DESIGNER Austin Lamb ADVERTISING SALES EXECUTIVES Jon Ainslie (970) 219-9226 Abby Bloedorn (970) 222-8406 Karen Christensen (970) 679-7593 Lydia Dody (970) 227-6400 Saundra Skrove (970) 217-9932 OFFICE MANAGER Ina Szwec

ACCOUNTING MANAGER Karla Vigil OFFICE ASSISTANT Ronda Huser CONTRIBUTING WRITERS Kevin Bachus MD, Allie Comeau, Julie Estlick, Greg Evans DDS, Angeline Grenz, Sarah Haugo DVM, Connie Hein, Corey Radman, Kay Rios CONTRIBUTING PHOTOGRAPHERS Dave Arns, Lydia Dody, Matthew Idler, Dana Milner, Todd Newcomer, Rod Pentico, Bob Willis 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’s 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 100 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.

Lydia’s STYLE Magazine

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OCTOBER 2008

CONTENTS 14 18 24 30 32 36 38 44 46 48 52 54 58 61 64

NORTHERN COLORADO MEDICAL & WELLNESS

Heart Of The Matter

Caring Hearts At-Home Health Care

Taking A Closer Look

Common Medical Conditions

Thriving In The Twilight Years

Good Samaritan Senior Living Resort

Raising Healthy Teens Mental and Physical Health

Treating Recurrent Miscarriages Dealing With Miscarrying A Child

No More Nerves Sedation Dentistry

HEART OF THE MATTER

TAKING A CLOSER LOOK

THRIVING IN THE TWILIGHT YEARS

BRIGHT & BEAUTIFUL

ENDODONTICS, PERIODONTICS, AND PROSTHODONTICS

HOME TO HEAVEN

Caring Hearts At-Home Health Care

Bright & Beautiful Cosmetic Dentistry

Bright Smiles Across Northern Colorado

Pediatric Dentists Making Check-ups fun

Start Smart

Infant Dentistry

Endodontics, Periodontics, and Prosthodontics Q & A Session

Pulse Fitness Center Group Fitness Classes

Happy Feet On Hardwood

Hot Spots To Burn Calories This Fall

Good Samaritan Senior Living Resort

Cosmetic Dentistry

Pet Dentistry

Why Our Pets Need Dentists Too

Saving Money At The Vet

Keep Your Pet Healthy and Cut Unneeded Costs

Home To Heaven

At-Home Pet Euthanasia

Q & A Session

(from left) Theresa Honesto, Branch Manager; Sheri Shovlin, CFO; Denise Swingle, Owner; Renee Lesser, Business Development & Marketing; Adrienne Roth, DON, the team at Caring Hearts at-home healthcare service.

Common Medical Conditions

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

At-Home Pet Euthanasia

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PUBLISHER’S LETTER May You Live All the Days of Your Life It is with feelings of such profound gratitude and great humility, that I want to thank all 500 guests who came to the 8th annual Hope Lives Gala this past weekend. And, I am especially grateful to the many caring members of our area medical practices for attending and showing their support for the women we serve diagnosed with breast cancer. Everyone’s presence was so very meaningful to us and to the many survivors who rely on the foundation for support and services to improve their healing and recovery. The gala was a magical night of tears, of sisterhood, and most of all A Celebration of Life. After many months of work and collaboration on the part of many, the Gala came together exquisitely. The creative and organizational genius of Rosalie Sinnett set the magical stage and manifested as the most beautiful decorations imaginable. The flowers from the artistic staff at Palmers were breathtaking. The innovative ideas and work put into the live and silent auctions by Julie Sathers, John Sinnett and their team created bidding excitement. The coordinating talents of Rochelle Pettigrew and Ken Sargent and their teams resulted in a seamless evening. Wes Sargent, MC, kept the evening moving along enthusiastically, as did Pat Young, our auctioneer. I was privileged to bestow the Champions of Hope awards to our

the patient

Enjoy reading this issue. I hope you use it for a reference and be sure you tell our advertisers you saw them in Style!

deserving honorees. The fashion show was phenomenal thanks to Laine Connolly, Debbie Lloyd, Nancee Testa, and Dave Arns. And, a very big thanks goes to the skillful coordination of the entire event by our hard working, Associate Director, Marsha Petrovic and her team of volunteers. Without our donors, sponsors, corporate table sponsors, providers, and volunteers we could not exist. We deeply value and appreciate them and everyone else who helped, no matter how small the contribution. The evening was a success in every way and helps us continue our needed services until a cure is found. Over the years I have become more and more interested in topics of a medical and wellness nature. Maybe it is because I am part of the many aging Boomers or maybe it is because I have two young daughters and want to stay young thinking and healthy to enjoy them. Regardless, the six issues a year that Style focuses on medical and wellness topics are among my favorites. As our population continues to age and requires more options in active senior living choices, the Good Samaritan Senior Living Resort at Water Valley has opened and is filling this need. Recently I attended the grand opening and toured this new state-of-the-art facility and was very impressed

with their Christian approach and their many building and program features. An aging population also has increasing healthcare needs and Caring Hearts offers those who want to stay at home, as many do, the ability to do just that. Read up on this company that offers many needed services in our region. Even as a young woman, I have always been a stickler for good dental health. In fact, in my twenties I decided to see a periodontal dentist to avoid gum issues and dentures in old age! Over the years, dentistry has come a long way in improved patient care, especially in making pediatric dentistry fun for kids. Get acquainted with various specialties and dentists in our area in the Dental Section of this issue. Dental health is also important for our furry family friends. Enjoy leaning about the importance of pet dentistry along with other interesting articles for pet lovers. Enjoy reading this issue. I hope you use it for a reference and be sure you tell our advertisers you saw them in Style! Wishing you and your pets good health!

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Lifestyle

AT-HOME HEALTH CARE Home health care should be considered for any person leaving the hospital after a serious illness or surgery, especially the elderly. - Denise Swingle, RN, Caring Hearts Home Health Care

HEART OF THE MATTER

BY CONNIE HEIN

Many people in Northern Colorado will tell you that Denise Swingle, RN, owner of Caring Hearts Home Health Care in Greeley, doesn’t just have a caring heart but a compassionate, selfless heart as well. They will say this humble lady has used her gifts and experience to improve the lives of hundreds of her patients in Northern Colorado.

arl Middleton, 73, and wife Lois, 82, are just two of the many people who have benefited from the personal services of Caring Hearts. Since the Middleton’s live in a rural area outside Eaton, it’s difficult for them to drive to town for medical care. When Lois sustained a leg injury that refused to heal, Jeff Peterson, MD, with Family Physicians of Greeley West, asked Swingle to help. After a year of vascular studies, infection cultures and infrared light therapy, Lois’ wound healed completely.

During this time, Swingle realized that Darl was showing signs of dementia, which was one reason Lois was unable to get consistent medical attention. The dementia also prevented Darl from addressing his own medical problems. He would make appointments with his Veterans Administration doctor or his primary care physician, and then fail to show up. Sometimes he would arrive at an unscheduled time and ask to be seen without an appointment. Neither doctor realized that the reason for the scheduling problem was dementia. Swingle

intervened as the liaison on Darl’s behalf. Thanks to the personal care of Caring Hearts, the Middleton’s are doing well and are now receiving consistent medical care at home and at their doctors’ offices. “I don’t know what we would have done without them,” Darl says of Swingle and her staff. “They always come in with a smile and never complain about anything we ask them to do.” Lois agrees with her husband that she doesn’t know what they would have done without the Caring Hearts staff. “If you don’t feel good, you

Lydia’s STYLE Magazine

will when they get there,” she says. “Having them just walk in the door makes us feel better. They have become like family to us,”. Like many people, the Middletons were resistant to home health care at first and were reluctant to let strangers into their home. It took several visits for the Middleton’s to trust Swingle, who wants to assure others like them that home health care is a safe and efficient addition to a recovery plan. She suggests using a service recommended by a doctor and says it’s always safest to choose an agency certified by Medica e and Medicaid. “Home health care should be considered for any person leaving the hospital after a serious illness or surgery, especially the elderly,” Swingle says. “Most insurance companies will cover the cost. It’s much cheaper and usually more effective than other alternatives, such as nursing home stays.” Swingle believes one of the greatest benefits of home health care is it usually does just what it did with the Middleton’s. It gets people back on track and feeling better so that visits to their phy-

sicians are more effective. The Caring Hearts staff first does a thorough evaluation of the patient and the premises. She says, “When caring for patients in their own homes, trained professionals will notice things that sometimes not even close family would see.” They check for things such as expired medications, old food, and anything in the home that might hinder the recovery of a patient. They also make recommendations for safety features throughout the patient’s home. When being released from a hospital after a serious illness or major surgery, patients are often under the care of more than one doctor or specialist, so it is easy for the patient to become confused about medication instructions. The home health care professional helps organize the patient, to make taking the proper medications at the right time easier and more efficient. Setting this up in the home is very valuable in aiding the recovery of a seriously ill patient. One of The Best Swingle and her employees were recently re-

warded for their hard work and devotion when they were honored as one of the top 100 home health care agencies in the country on the Home Health Care Elite (HHCE) list. This list is the defin tive compilation of the most successful Medicare and Medicaid certified home health care providers. Rankings are based on state-sponsored surveys. More than 100,000 home health businesses are reportedly assessed, based on patient-care outcomes. The state does not currently license home health businesses, but it conducts these surveys for Medicare and Medicaid certified agencies. The factors used to assess the agencies are primarily based on patient care outcomes. These outcomes include such things as whether, upon being discharged from home health care, the patient is better at walking, has less pain when moving around, is less short of breath, has to be admitted to the hospital less often and is more able to function without urgent medical care. Swingle says that to be included in the top 100 HHCE list out of over 100,000 agencies in

When caring for patients in their own homes, trained professionals will notice things that sometimes not even close family would see. - Denise Swingle, RN, Caring Hearts Home Health Care

the nation is something she is proud of and has worked very hard to accomplish. A big reason for her company’s success, she believes, is that, unlike most home health care companies, she hires actual employees rather than contract workers paid on a per-patient basis. “To have the staff be employees of the company with a steady paycheck and benefits makes them less likely to rush through a visit with any patient who needs care,” she says. Swingle started Caring Hearts in 2001 after working as a registered nurse for two other home health care companies that had closed their doors. When the last one closed, Swingle thought she knew just how to make such a business succeed and decided to use her knowledge and experience to start her own business. She and several friends continued caring for the patients they were already seeing as she began the process of becoming certified by the state and by Medicare and Medicaid. This took nine months, during which time Swingle paid her staff out of her own pocket so their patients could con-

tinue receiving the care they needed. Caring For Parents Sherri Shovlin, chief financial officer for Caring Hearts, adds that she believes the reason for the success of the company is that Swingle hires qualified people and then gives them the freedom to make recommendations about patient care. “All decisions are based on what is best for the patient,” she says. “In some cases we make no money on a patient, but we believe that if we give them the best care possible, they will come back to us if they need home health care again, and will tell their friends about us.” The Middleton’s are living proof of this philosophy. They believe Caring Hearts has saved their lives. “They were reluctant to let strangers into their home at first,” Swingle says. “But once I gained their trust, it did not take them long to see what a difference home health care could make in their overall health and wellness.

at the Greeley Medical Clinic Campus at Medical Center of the Rockies in Loveland in January, 2009. The acceptance by the Greeley Medical Clinic was not only an additional location but also a huge feat for the growing business. Renee Lesser, Corporate Director of Education for Caring Hearts says, “With the addition of our new location, this will allow our agency to accommodate its rapid growth into Northern Colorado. The opportunities for providing a continuum of care for our community will be well received, and we are thankful for being given this opportunity.” For more information about home health care you may call Caring Hearts Home Health at (970) 378-1409.

Connie Hein is a freelance writer living in Windsor and is the author of the Toliver in Time series of children’s books.

Expanding their reach Caring Hearts will be opening a new facility

Caring Hearts has 57 employees who offer much more than just nursing care for their patients. Caring Hearts’ Services: • Nursing Care • • Physical Therapy • • Occupational Therapy • • Speech Therapy • • Home Health Aide Services • • House Keeping Services • • Cleaning patient homes • • Cooking for patients •

Lydia’s STYLE Magazine

CARING HEARTS IS RANKED

IN THE TOP 100 HOME HEALTH AGENCIES IN THE NATION!

Medical

STAYING INFORMED Health treatment is always changing because of new medical findings. Doctors must spend a lot of time wading through new research and testing to figure out what these changes mean for us and our patients. - Jerome Smith, MD, Associates in Family Medicine-Big Horn Jerome Smith, MD, Associates in Family Medicine-Big Horn, keeps up to date with new medical findings.

TAKING A CLOSER LOOK

BY CONNIE HEIN

Osteoporosis is a woman’s disease, right? Wrong. Bioidentical hormone replacement therapy is always better than synthetic hormone replacement therapy, right? Well – not necessarily. Sometimes, in regard to our personal health, the things we think we know are the very things we need to take a closer look at.

s Jerome Smith, MD, Associates in Family Medicine-Big Horn, in Ft. Collins says, “Health treatment is always changing because of new medical findings. Doctors must spend a lot of time wading through new research and testing to figu e out what these changes mean for us and our patients.” We asked three local physicians to tell us about a few of the latest medical findings that have come to their attention. Some of the answers might surprise even the most savvy proponents of good health. From the information they gave us, we learned eight things that we thought we would share with you to help you become better informed about your own health care and that of your family. For instance, did you know that, along with

maintaining a healthy weight, and consuming a healthy diet, consistent exercise (added to normal activities) throughout your life, can actually be the difference between victory and defeat in the war against the “Big-Two Killers” in the U.S.: cancer and cardiovascular disease? Dr. Smith recently attended the 2008 American Academy of Family Physicians (AAFP) conference. He says one of the seminars at the conference focused primarily on the study of exercise and how to get patients to do it consistently. Dr. Smith says studies show that when patients add consistent exercise into their lives, rapid changes in health often occur and life threatening diseases may be prevented. Local physicians agreed that studies done over the past two years are showing an astounding difference in the overall health and well-being

of patients who consistently exercise, versus those who don’t. Studies show that exercise can indeed help prevent life-threatening diseases such as cancer, heart disease, and diabetes. According to Dr. Smith, one of the AAFP seminars he attended had a call to physicians to get involved in community exercise education for both adults and children. The writers of this study/seminar, Dr.’s Anthony Beutler and Brian Unwin, encouraged physicians to “Write very specific exercise/activity prescriptions when seeing patients with any health concerns.”

Their specific minimum guidelines For adults 18-65: Brisk walk for 30 minutes five times per week OR jog for 20 minutes three times per week AND weight resistance training 8-10 minutes twice per week.

Lydia’s STYLE Magazine

For older adults: Light muscle training exercises every day, AND light cardio exercises and 10 minutes of flexibility training (to include 1030 second stretch), three to four repetitions every day, AND balance exercises three times per week. These guidelines for older adults are found to result in fewer falls and fractures, and less frailty. For children: 60 minutes of moderate to vigorous activity each day (minimum). This time total can accumulate in small sessions and in a wide variety of sports and activities. Besides the lowered risk of life-threatening disease, the benefits of exercise for children are also behavioral. Tests indicate exercise promotes a better scholastic performance, a lower teen pregnancy rate, less smoking, and a higher sense of self-esteem. It was further reported that over the past 15 years, among youth, TV watching has risen 100 percent and biking has declined 45 percent. The result is increased childhood and youth obesity. Dr Smith says, “The plan of attack to change these figu es, as well as rising adult obesity figu es is to promote exercise and healthy eating.” Steven Broman, MD, Associates in Family Medicine East in Ft. Collins, agrees with these findings and says, “There is more and more evidence to indicate that a healthy attitude and lifestyle can prevent many of the diseases that we must treat with medications that have negative side effects.” He believes that along with daily exercise you should have a combination of five to nine servings of fruits and vegetables everyday and fish twice a week. He added, “Since Americans are so busy, it is not easy to follow these guidelines, so it is also wise to take fiber and fish oil supplements.” Did you know that there are approximately 300 days with sunshine every year in Northern Colorado, which makes it easier to maintain a healthy lifestyle? Dr. Broman explained that in places with more extreme weather conditions, such as the Midwest or Northeast, it is necessary to get exercise in health clubs or by walking in malls to stay out of inclement weather. “In Colorado there are very few days when a person cannot get out and walk for at least 20 minutes. And walking is free,” he reminds us. He says exercise is the number one thing people can do for themselves to prevent deadly diseases. His suggestion is, “If you can’t walk 20 minutes at first, start in five minute increments and then increase it until you are up to at least 20 minutes per day.” He says making this change can prevent or minimize the effects and severity of illnesses such as diabetes, cancer, arthritis, obesity, insomnia, and mood disorders such as depression. Did you know most physicians want to take a partnership approach with their patients instead of an authoritarian approach? Dr. Broman says, “While recommending lifestyle changes or medical treatments, most physicians now see their roles as less authoritarian as their predecessors. They want the relationship with patients to be a partnership where there is open communication, interaction, accountability, and responsibility by the patient for his/her health.” “In my opinion if patients would accept more

Northern Colorado Medical & Wellness

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responsibility to take care of themselves with adequate exercise and a healthy lifestyle, they would have a better quality of life and probably live longer. If more Americans approached their health in this way, medical costs in America would go down substantially,” reminds Dr. Broman. He suggests to all his patients with any health care concerns that the first step in recovery should be exercise, the second would be to stop smoking, if you are a smoker (even if you are just a social smoker and smoke very few, it is best to stop completely), and to eat healthy, which would include five to nine servings of a combination of fruits and vegetables daily; 25-35 grams of fiber; and fiber and fish oil supplements. He says to always consult your doctor with questions about these guidelines, but again stressed the need to take an active role in your health. Dr. Broman says that part of taking responsibility may be reading information about your health care, but there are many sources with varying opinions on most health topics, it is hard to know what to believe. He suggests visiting www. familydoctor.org, which is sponsored by the AAFP, or www.webmd.com. These sites have health, nutrition and weight control information, symptom checkers, physician locators, and lots of general medical information. He says, “They are great sources for reliable, medically sound information on the web, but do not use any website to make medical decisions without consulting your doctor.” He also adds, “With personal health care, communication is the most important factor. Communicating with and listening to your doctor is very important for your general health and wellness.” Did you know that people who have consistent yearly physical examinations are also more likely to have other screening tests done that can prevent or detect life threatening diseases such as cancer? The American Family Physician November 2007 publication stated that, “Of the 64,288 records reviewed, those who had preventative health examinations were more than three times more likely to receive colorectal cancer screening,” the study concluded. “Furthermore, women who had an examination were significantly more likely to receive a mammogram, compared with those who did not have an examination. Men who had an examination were significantly more likely to receive prostate testing than those who did not have an examination.” Dr. Smith concludes from the report that, “Preventative health examinations are associated with a significant increase in screening for colorectal, breast, and prostate cancers.” He added that these examinations can save lives through early detection of life threatening diseases. Did you know that, according to the AAFP, antibiotics are over-prescribed and over-used in American medicine? The Centers for Disease Control (CDC) reported that in 2002, 50 million antibiotics were prescribed inappropriately. Studies show that the problems associated with antibiotic overuse are, cost, adverse side effects, and the fact that bacterial strains are becoming resistant to antibiotics. Dr. Smith says, “Physicians need to address these problems by prescribing antibiotics less frequently, based on recent evidence for ear infections, sinusitis and bronchitis. The patient should be in formed of the nature of their infection and

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Steven Broman, MD, Associates in Family Medicine-East Fort Collins, discusses how our weather keeps us healthy.

If patients would accept more responsibility to take care of themselves with adequate exercise and a healthy lifestyle, they would have a better quality of life and probably live longer. - Steven Broman, MD, Associates in Family Medicine-East Fort Collins

More research will give us a clearer picture of male osteoporosis. We do know that risk factors in males and females for developing osteoporosis are not necessarily the same. - Thomas Nevrivy, MD, Associates in Family Medicine-West Fort Collins

Thomas Nevrivy, MD, Associates in Family Medicine-West Fort Collins, reveals that men can also suffer from osteoporosis.

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Curtis E. Crylen James W. Wolach MD MD

lack of data supporting antibiotics usage in many instances.” Did you know that lifestyle modification should always be the first step in managing menopausal symptoms? With so many concerns being raised about conventional hormone replacement therapies for pre- and post-menopausal women, Dr. Smith says many women are looking for alternative treatments for menopausal symptoms. He agrees with Walt Larimore, MD at the AAFP conference, who says, “Lifestyle modifications should be the first step in managing menopausal symptoms. Women who increase daily exercise, change to a healthy diet (eating fruits and vegetables, while decreasing saturated fat intake), and stop smoking can see a reduction in menopausal symptoms, an increase in their sense of well-being, and also have a lower risk for cardiovascular disease, breast cancer, and osteoporosis.” Dr. Larimore added that paced breathing and relaxation techniques as behavioral approaches to addressing hot flashes have shown promise in several studies and were found to be safe, warranting further investigation. According to Dr. Smith, studies are showing that if lifestyle changes do not bring relief from the symptoms, the next step should be to try natural remedies that, when tested, sometimes give minimal relief from symptoms. “If after trying these approaches there is little or no relief from symptoms,” he adds, “then a patient should discuss traditionally prescribed hormone replacement therapy medications with her doctor.” Did you know that bioidentical hormones, which have been promoted as safer than traditional hormone replacements, may not actually be any safer? Bioidentical hormones - particularly estrogen and progesterone - have been promoted as safer and more effective alternatives to more traditional hormone therapies, often by people outside the medical community. Dr. Smith says current research has failed to demonstrate any significant difference in the side-effect profiles of the two hormones. “Many bioidentical hormone formulations are not subject to FDA oversight and can be inconsistent in dose and purity,” according to Walt Larimore, M.D. who spoke at the AAFP conference. “As a result of unfounded but highly publicized claims,” he said, “patients have received incomplete or incorrect information regarding the relative safety and efficacy of hormone preparations that are referred to as bioidentical.” “Bioidentical hormones are defined as compounds that have exactly the same chemical and molecular structure as hormones that are produced in the human body,” he continues, “though any hormone can be made to be ‘bioidentical,’ the term is often used to describe formulations containing estrogens, progesterone, and androgens. As women seek safer treatments, they often request bioidentical hormones from their physicians.” Dr. Larimore says, “One review concluded, not only is there no evidence to support or refute this claim (that users of bioidentical hormone replacement therapy experience minimal side effects), but it is logical to assume that patients exposed to compounded estrogens and progestins would be at risk of dose-related side effects.”

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Dr. Smith’s advice is to talk this over with your physician if you have concerns about the prescribed hormone replacement therapy you are currently using. This will help you make an informed decision about any change that might be needed. Did you know that doctors have discovered that osteoporosis, which was always considered a woman’s disease, is also a threat to men? Thomas Nevrivy, MD, the Associates in Family Medicine on Horsetooth in Ft. Collins, says male osteoporosis is much more common than once thought. He says, “When one thinks of osteoporosis, most likely it’s pictured as a condition found only in women. However, a recent review article published by the American College of Physicians revealed that osteoporosis is ‘substantially underdiagnosed, under-treated, under-reported and inadequately researched’.” As the baby boomer generation continues to age, the rate of osteoporosis in men is expected to increase nearly 50 percent in the next 15 years. Hip fractures, which often are the result of osteoporosis, are projected to double or triple by the year 2040. Today the prevalence of osteoporosis in males is estimated to be seven percent in white males, five percent in African-American males, and five percent in Hispanic males. Data is lacking concerning other ethnic groups. Dr. Nevrivy says osteoporosis is diagnosed in two ways. The first method is the occurrence of a fragility fracture, which usually happens when there has been prolonged decrease in bone density or quality (i.e., osteoporosis). The fragility fracture occurs in a fall from a standing height or lower. The second diagnostic method involves measuring bone mineral density (BMD). This is usually obtained by performing a low-energy Xray (DXA) scan. “More research will give us a clearer picture of male osteoporosis,” Nevrivy says, “We do know that risk factors in males and females for developing osteoporosis are not necessarily the same. Males 70 or older have the highest risk of osteoporosis. Low body weight, recent year’s weight loss of 10 percent or more, physical inactivity, chronic use of cortisone-like meds, and previous fragility fractures are the most common risk factors. Other situations which can play a role in osteoporosis include spinal cord injury, cigarette smoking, poor calcium intake, and treatments that lower male testosterone levels.” Dr. Nevrivy includes, “Based on these fin ings, if you feel you may be at risk go talk with your physician. He or she can help determine if screening is appropriate and when to start the screening process. By age 65 at least six percent of men have osteoporosis so screening before that age seems reasonable.” Some of what we learned from our physicians was new and exciting; some was further documentation and clarification of what most of us already knew. All of our doctors agreed, though: the bottom line is that information and knowledge brings power.

Connie Hein is a freelance writer living in Windsor and is the author of the Toliver in Time series of children’s books.

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Lifestyle

SENIOR LIVING RESORT The new residents coming in feel embraced by the Parduns and the others who moved in as we opened. In fact, the Parduns may be Water Valley’s best marketing tool. There is a core group of residents with a very welcoming attitude that attracts new residents. - Kim McCloud, Marketing Associate Water Valley Senior Living Resort

Kim McCloud, Marketing Associate for Good Samaritan Senior Living Resort at Water Valley, with Harvey and Louise Pardun.

THRIVING IN THE TWILIGHT YEARS

BY ANGELINE GRENZ

Nestled in a green valley just south of Windsor is the grand Water Valley Senior Resort. The senior community is a micro-city offering countless amenities with lake, golf course and green vistas available out every window. From banking to the beauty salon, seniors need only stroll down the handsome corridors of the complex to access all their daily needs.

ater Valley Senior Living Resort opened their doors September second. Waiting outside were several seniors who moved in that same day. The senior resort is the newest addition to Good Samaritan Society’s programs and to the very popular Water Valley South community. The senior apartment complex is only the first stage of a campus that promises to serve seniors of all levels of health in a pampered setting. “This is not what people think of when they think of senior living,” promises marketing associate Kim McCloud.

The resort’s first phase is a beautiful building with five stories, five towers, and 116 apartmentstyle residences. The maintenance-free apartments range in size from one bedroom, one bath to two bedrooms, two baths and are available for a monthly rent. The largest model is over 1,300 square feet; the smallest is a healthy 740 square feet. The apartments are attractive and spacious, with architectural details and vaulted ceilings. All apartments feature large rooms, full kitchens, washer and dryer, walk-in closets, and a large patio or balcony with spectacular views. Kitchens are equipped with a self-cleaning oven, micro-

wave, side-by-side refrigerator, garbage disposal and dishwasher. Bathrooms feature large walk-in showers with special safety features. In the couple months since Good Samaritan opened, almost 50 residents have made the transition to the senior resort. “The number of residents continues to grow every day,” according to marketing director Dawn Jensen. Among those who moved their furniture in the same day Water Valley Senior Living Resort opened its doors were Harvey and Louise Pardun of Saratoga, Wyoming. The Parduns, who no longer needed their large home and yard, wanted to move closer to their

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daughter in Denver. As they evaluated their choices, the Good Samaritan resort had several qualities that captured their attention. “We just fell in love,” said Louise, “everyone was so nice [when we came to visit] and the staff was so loving. We really didn’t have to look at other options.” Harvey adds with a smile, “before we knew it, we signed up and here we are.” Good Samaritan’s Christian background also helped make the decision an easy one for Louise, 84, and Harvey, 86. In fact, the Parduns make worship in the resort’s chapel a regular part of their daily activity. After an early breakfast, usually in the dining room, they head to devotions at 9:00 a.m. By ten, they are attending a fitness class taught by a trained instructor. The Parduns make their biggest meal of the day a late lunch at 1:00 p.m. and retire with a snack in their apartment in the evening. Unless, of course, they are attending one of the weekly activities scheduled by staff, such as they did Friday for a Cajun dinner and live band. “They keep us busy here; almost too busy,” jokes Harvey, a retired executive pilot who loves to tell stories from his colorful career. The Parduns, married for 61 years, were pleasantly surprised by the spaciousness of their onebedroom apartment and its open layout. When they sold their home in Wyoming, they packed up a small amount of furniture to bring with them to Water Valley. “We should have brought more than we did, the apartment is so nice and roomy.” Of course, the Pardun’s contemporary style works nicely in the apartment, which is filled with natural light from large windows and the double doors to the balcony. “And our apartment faces the lake,” says Louise, “I just love watching the pelicans and geese outside.” The Parduns make good use of all of Water Valley Senior Living Resort’s many amenities. Last month, they and several other residents were bussed to Estes Park to view the changing of the leaves and hear the elk bugle. Their daughter frequently makes the easy trip from Denver to Windsor to visit and the very social Parduns have wasted no time getting to know there fellow residents. “We enjoy the relationships we have made with the other old people,” says Harvey, with his sly grin, “we have similar interest, all of us having grown up during the Great Depression.” The Parduns’ congeniality is one of the main attractions of Water Valley Senior Living Resort, says McCloud. “The new residents coming in feel embraced by the Parduns and the others who moved in as we opened.” In fact, the Parduns may be Water Valley’s best marketing tool.“There is a core group of residents with a very welcoming attitude that attracts new residents.” While residents are generally seniors in good health and of good mobility, says McCloud, lifts and ramps are available for those in wheelchairs or with walkers. Good Samaritan allows for tenants to access home health care assistance if they have a need, she adds. Many residents get their daily dose of exercise just roaming the halls at the resort. Though leases can be made on a month to month basis, McCloud anticipates tenants will make Good Samaritan Senior Living Resort at Water Valley their home permanently. “I honestly

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Lifestyle

SENIOR LIVING RESORT

The Good Samaritan Senior Living Resort at Water Valley in Windsor was completed in September 2008.

think most will stay till they have to go to a nursing home. Those who can afford it will stay indefinitel .” Apartments at Water Valley range from $1,995 to $4,400 a month, for one person, based the size of residence. Rent includes all utilities, cable television, internet, and an emergency pendant service which provides residents with quick response in a health care crisis. Residents’ only expense is their choice of phone service. Bi-weekly housekeeping and linen service is included, along with all appliance, building and grounds maintenance. Rent is increased by $350 for the second resident in an apartment, which covers the cost of food. With an additional deposit, residents can bring up to two pets with them, says McCloud. A number of animals have already made Water Valley home, including several dogs and cats and a couple of parrots. Water Valley embraces the philosophy that “pets are good for seniors and help ease the apprehension of settling into a new place,” explains McCloud. Rent also includes a continental breakfast and residents’ choice of lunch or dinner daily. The allotment totals approximately $11.95 a day and is a way to encourage seniors to eat a couple healthy meals each day, says McCloud, adding that often seniors experience a loss of appetite and do not eat enough for healthy functioning. If residents do not use the full amount allotted for meals, they can spend the allowance at the beauty salon, coffee bistro or small shopping market. Inside, the complex is a grand lobby with natural rock walls leading to the concierge/activity desk. This area is referred to as Towne Centre and is the hub for activities, picking up the mail, and socializing. Towne Centre’s Signature Bank

The resort’s first phase is a beautiful building with five stories and five towers and 16 apartment-style residences. The maintenance-free apartments range in size from one bedroom, one bath to two bedrooms, two baths and are available for a monthly rent. The largest model is over 1,300 square feet; the smallest is a healthy 740 square feet.

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Lifestyle

SENIOR LIVING RESORT

Harvey and Louise Pardun, residents at the Good Samaritan Senior Living Resort at Water Valley, enjoy the restaurant with friends, Jon and Betty Miller, and relax at the restaurant.

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Harvey and Louise Pardun, residents at the Good Samaritan Senior Living Resort in Water Valley find time to browse through the library.

Harvey and Louise Pardun, residents at the Good Samaritan Senior Living Resort in Water Valley, still enjoy one another’s company.

Harvey and Louise Pardun, residents at Good Samaritan Senior Living Resort are proud of their modern and comfortable home.

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offers in-house banking three days a week. Towne Centre Market is available for sundries, groceries and other items. The salon/barber shop is open on Tuesdays and Wednesdays to offer a haircut and style. A fitness center, library, and game room offer options for down time, and are generally well-used by residents, says McCloud. The game room features card tables, chess and checkers, a billiards table, and is stocked with snacks for residents. The Activity Director organizes special dinners with live music every Friday evening and other special activities through the week. A sampling of the programs offered includes art classes, computer classes, craft activities, fishing, bird watching, movies, and dances. Breakfast, lunch and dinner are served in the dining room or coffee bistro. The dining room serves meals restaurant-style, complete with waiter, changing menu and white table cloth. Menu items range from wild mushroom bisque to grilled salmon with blueberry lemon compote to black forest cake. Harvey Pardun vouches for the quality of the food. “It is really good; they spoil us here.” With a nod healthy living, foot care clinics and blood pressure clinics are scheduled regularly. Residents also have access to Good Samaritan Society’s wealth of services. Active seniors have a slew of recreation choices outside the complex as well. Many have been treated to a trip on the New Liberty Belle River

Boat on the lake nearby. Residents also receive a complimentary membership to nine-hole Pelican Falls Golf Course next door. When they grow tired of these options, daily outings are planned to special locations throughout Fort Collins, Greeley, Windsor, Denver and beyond. Necessities, such as transportation to the supermarket and pharmacy, are scheduled several times a week for residents. Seniors can request transportation to their doctors appointments through the activities desk. Those who have retained their own car, can access it from the heated, covered garage below the complex via a garage door opener. When family comes to visit, they can stay in one of the resort’s four furnished two-bedroom guestrooms for a nominal fee of $85 a night. The fee includes a continental breakfast in the morning and their choice of lunch or dinner. Water Valley Senior Resort’s maintenance-free apartments are only the first phase. The complete vision is a small city, with several senior “villas” of patio-style homes, an assisted living facility, memory care and more. “This is the first of the larger resort-style properties for Good Samaritan,” according to Linda LeFever, executive manager, “Good Samaritan is looking towards the future. This is visionary.” Construction of the villas has already begun and they are expected to become available in 2009. At the same time, the Lind Family Prayer Garden, a park with walking path,

will be complete. The third phase of the complex will offer an assisted living facility and provide for appropriate care for senior in all levels of health. This portion is expected to be complete in 2010. A worship center and retreat and swimming pool are among the other planned additions to Water Valley. “We want to be a viable part of the Windsor area of Colorado and the property that seniors want to move to” added LeFever. The complex is well-placed. Water Valley South, a resort-style community, features several miles of walking trails, five lakes and two golf courses. The community’s planned Marina Doce lakeside retail center will be located just two miles from the senior resort. Among its amenities will be a marina, wellness center, hotel, restaurants and retail shops. Good Samaritan Society is a non-profit provider of senior care and services and provides housing for more than 27,000 seniors from all denominations. Good Samaritan was established in 1922 and they believe deeply in their motto “In Christ’s love, everyone is someone.”

Angeline Grenz is a freelance writer living in Fort Collins with husband Josh and petite St. Bernard, Bella.

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Counseling

THE YOUTH CLINIC James McGinnis, MD, The Youth Clinic, offers advice for raising healthy children.

Don’t let children eat when they are mad, sad or while they are bored; have them eat more slowly; don’t let them eat just because it is front of them. - James McGinnis, MD, The Youth Clinic

RAISING HEALTHY TEENS

BY ANGELINE GRENZ

After four decades in pediatric medicine, physician James McGinnis still wouldn’t call himself an expert on adolescents, but he comes pretty darn close. Dr. McGinnis has not only raised three daughters and is the proud grandfather of nine grandchildren, he has treated hundreds of children in his practice.

hile in college, Dr. McGinnis was poised to become an orthopedist or neurosurgeon. But a stint in Alaska working with children and watching his wife teach her first-grade class changed his mind. “I fell in love with working with kids,” he says. Today, after 34 years with The Youth Clinic, Dr. McGinnis is still going strong. He and his fellow physicians treat “babies from birth to adulthood. The criteria for exclusion from our practice are getting married, graduating college or emancipating.” So what does the good doctor think is the biggest challenge facing our children today? Obesity Epidemic From a physical health standpoint, he says,

“Clearly, the growing obesity problem.” Sedentary lifestyles and the fast-food society are the culprits. Obesity leads to a slew of associated diseases, from hypertension, high cholesterol, and joint disease, to the most frightening of all, diabetes. Colorado, Dr. McGinnis notes, has “finally fallen into the higher obesity pattern with a rate of more than 20 percent of our population that is obese. This pattern begins very early in life. Adolescence certainly begins to define what you are going to be in the future.” This is where parents’ lifestyle comes into play, explains Dr. McGinnis. If one parent is obese, a child has a 40 percent chance of being overweight. If both parents are, those numbers come up to 60 percent or 70 percent. “It can be difficult for parents to talk to their

children about obesity when they themselves are obese. But obesity most often does not happen in isolation. Parents must make a commitment to their kids and help children develop strategies” to make healthier choices in their lifestyle, the doctor says. Dr. McGinnis recommends guidelines for responsible eating. “Don’t let children eat when they are mad, sad or while they are bored; have them eat more slowly; don’t let them eat just because it is front of them.” Take a good look at your children’s “screen” time, says McGinnis. “It used to be TV time, but with video games and the Internet, that has changed. Parents need to set limits, and a family plan for screen time and exercise.” At a bare minimum, he suggests children get 20 minutes of aerobic exercise three or four times a week. “I

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don’t care what it is; just make them get off their tail and move.” Mental Health From a mental health standpoint, the pressures children face with regard to body image and sexuality are significant today, says Dr. McGinnis. “Kids are dealing with these issues at an earlier age due in large part to the media.” The media, he says, have taught children today to try to be mature much earlier than they are and has given them a need for immediate gratification. “There is a perception that children are maturing faster, but in fact for three generations they haven’t.” From a biologic standpoint, children are still reaching puberty and experiencing menstruation at the same ages as their parents did. “But the perception is they look a heck of a lot older,” Dr. McGinnis says. Teaching children to have a good body image and appropriately deal with sexuality requires healthy role models. “No question, kids are growing up sooner and not maturing sooner. Media has made role models for the pre-teen group of people who are prematurely sexual, and I am not sure they are always equipped to deal with the consequences of that sexuality.” He mentions popular icons, such as Brittany Spears and Miley Cyrus, who give children a warped sense of body

image and sexuality. His advice? “Talk with your kids about sexuality, and start early. Take control and be part of their relationships.” Be realistic. “My ideal would be abstinence, but that isn’t always going to happen. If you suspect they are sexually active, get over your issues with birth control and talk to them about it.” To combat negative body image and self esteem, “help children find something that makes them feel good about themselves.” Drugs And Alcohol Substance abuse also factors into the equation. “I worry about drugs and alcohol and the psycho-social effects associated with abuse, from social alienation to cultural violence,” Dr. McGinnis says. Hand in hand with drug and alcohol abuse are growing adolescent mental health issues. Typically, says Dr. McGinnis, these problems escalate when children reach the ages of 12 to 15. “Don’t ignore the signs. Sometimes parents try to dismiss these behaviors. But cutting and eating disorders are never ‘just stages they are going through.’ Get them help.” Dr. McGinnis says that although the stressors children experience today are the same as when his children were growing up, the outlets have changed in a more serious and potentially dangerous way. He suggests parents take an old-school

approach to parenting. “My kids had a father who would wait up till 2 a.m. They knew when there was a curfew. Kids need that; they need some sort of structure today. Those kids who are really at a loss are the ones whose parents say either directly or indirectly ‘get out of my life, just don’t bug me.’ I think those are sad kids.” On the bright side, he adds that just as children grow and mature, parents do, too. “I call it ‘parent development’ and it is a wonderful thing to watch as parents change from self-centered young adults to become people who truly care about and invest in their kids.” Although children face significant challenges, Dr. McGinnis says he is consistently impressed by the “the amazingly bright children I see today.” Despite a generation “facing increasing pessimism about our future, I have no doubt they will solve our energy crisis” and other societal issues. But the challenge is there. “It is certainly different from when I grew up and the sky was the limit. This next generation may not have the same benefits my generation had. There are going to be some challenges for them that weren’t so obvious for us.” Angeline Grenz is a Fort Collins writer.

Yo u r M e d i c a l H o m e Dr. John Guenther

Dr. Carole Anderson

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.

Seeing eye to eye with your kids is easy for Dr. Carole Anderson. Specializing in premature infants, she’s there at every age and stage. “Getting in tune with the entire family is my priority. It’s the best way for me to understand your child.”

Dr. Beth Ballard Dr. Beth Ballard loves kids. With four children of her own, she knows first-hand the challenges that every age presents. With more than twenty providers just like Dr. Ballard, the Youth Clinic has served northern Colorado families since .

For an appointment, call

970.482.2515 North Fort ColliNs 1200 East Elizabeth Street

lovelaNd 2695 Rocky Mountain Avenue, Suite 260

MAIN NUMBER (970) 267-9510 •

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south Fort ColliNs 1214 Oak Park Drive

• FAX (970) 207-9967

Reproductive Procedures

RECURRENT MISCARRIAGES After a thorough evaluation, a specific cause for miscarriage still cannot be found in 50 percent to 75 percent of couples. Fortunately, the prognosis for a successful delivery once normal pregnancy is achieved is still good. - Kevin Bachus, MD, Rocky Mountain Center for Reproductive Medicine, PC

TREATING RECURRENT MISCARRIAGES BY KEVIN BACHUS, MD, ROCKY MOUNTAIN CENTER FOR REPRODUCTIVE MEDICINE, PC

Probably one of the biggest disappointments an expectant couple can have is to receive the news that they have miscarried their pregnancy. Most couples, though, accept this as an unfortunate occurrence when it happens in isolation, but when it happens on a repeated basis it can be devastating.

ortunately, there are a number of tests and treatments that can be done to dramatically increase the chances of a successful pregnancy and happy delivery. The most widely accepted definition of repeated pregnancy loss is two consecutive miscarriages; however, this problem still needs evaluation even when normal deliveries are interspersed between multiple miscarriages. This can occur anytime up to 20 weeks (five months) of preg-

nancy, with the majority (80 percent) occurring in the first trimester (first 12 weeks) of pregnancy. The age of the mother can certainly have a large influence on the chances of a miscarriage (see fi ure 1 on page 35). When a couple comes to the Rocky Mountain Center for Reproductive Medicine, a detailed history is taken to identify clues as to the cause of the miscarriages. Predisposing factors can be menstrual abnormalities such as heavy bleeding, pelvic pain, exposure to environmental agents

and what type of treatment was given to prior miscarriages. Uterine Evaluation Once the history is reviewed, the evaluation begins with the physical exam, initially focusing on the uterus, as approximately 10 percent to15 percent of the time an abnormality is found. These abnormalities can be either congenital (being born with the problem) or acquired (developed over time as with the growth of a tumor,

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such as a polyp or fib oid.) The presence of both of these different types of abnormalities can be determined by a simple pelvic ultrasound and another procedure called a hystersalpingogram (HSG). Ultrasound is a painless method of using sound waves to see if tumors are present in the muscle of the uterus that could increase miscarriage rates. The HSG is an x-ray test that is better suited for finding abnormalities in the uterine cavity where the pregnancy attaches. Different techniques can be utilized to perform the HSG, and if done properly, discomfort is usually minimal. The HSG is also a very sensitive method for identifying congenital developmental abnormalities of the uterus such as a septum. Fortunately, the prognosis for these abnormalities is very good. These abnormal findings are commonly treated by outpatient surgery with a quick recovery and excellent prognosis for correcting the problem. If an abnormality is not yet found, blood work is done. Most of the blood tests focus on identifying factors that can adversely affect blood flow to the fetus. These can be immunologic in nature or a primary clotting disorder. Treatment for this involves an anticoagulant (blood thinner) that could be as simple as aspirin or as complex as injections of medications, such as Lovenox® or Heparin®. For the latter, it is very important that patients be closely supervised and monitored as, rarely, complications can occur. The treatment is usually continued throughout the pregnancy and sometimes beyond, depending on the abnormality found. It is probably wise to involve an individual versed in the complexities of these abnormalities for the remainder of the pregnancy, as other problems can occur in the second and third trimester that include impaired growth and early delivery. Interestingly, some of these abnormalities can be inherited. Other family members may, therefore, suffer from the same potential for problems and benefit from knowing the results of these test results. Finally, simple hormonal tests, such as those that reflect the function of the thyroid, should be evaluated. Genetic Causes Many miscarriages ultimately happen due to genetic abnormalities of the fetus. Two major classes of genetic abnormalities exist. The first involves random “bad luck” abnormalities of early embryo growth. Because they are so random, these types of genetic abnormalities can vary from pregnancy to pregnancy. For example, a fetus can exhibit too many chromosomes in the genetic makeup, such as Down Syndrome, or too few chromosomes, such as Turner Syndrome, and be different for each of the miscarriages. It is unknown why a miscarriage happens more often when the fetus is genetically abnormal. These types of random genetic problems are typically overcome with continued conception. Unfortunately, maternal age is a significant contributor to this particular problem, which ultimately manifests itself as an increasing difficulty with conception, as increased rates of miscar-

Northern Colorado Medical & Wellness

With appropriate treatment, as these three are a testament to, the problem of recurring miscarriages can be overcome.

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

(970) 493-6353 • (800) 624-9035 w w w. d r b a c h u s . c o m 33

Reproductive Procedures

RECURRENT MISCARRIAGES

Pre-operative image of a uterine septum. riages and as increased rates of births with genetic abnormalities. All of these would appear to occur because egg quality changes significantly for most women in their mid-30s. This fact leads most fertility clinics to encourage couples to be assertive in evaluation and treatment opportunities when this age is reached.

Post-operative image of a uterine septum. A second class of genetic problem is more insidious, as it is not a random process, but rather, preprogrammed on the genetic makeup of one or both of the parents such that the abnormality repeats itself in each successive pregnancy. An example of this type of problem is called a reciprocal balanced translocation, the presence of which

can be determined by checking the chromosomal makeup of each parent. This particular finding does not necessarily preclude the parents from having a healthy baby, but it can have significant implications for the couple with regard to genetic testing options with an ongoing pregnancy. After a thorough evaluation, a specific cause

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EFFECT OF AGE ON CONCEPTION & MISCARRIAGE RATES FIGURE 1. EFFECT OF AGE ON CONCEPTION RATES

EFFECT OF AGE ON MISCARRIAGE RATES

Kevin Bachus, MD, Rocky Mountain Center for Reproductive Medicine, PC

for miscarriage still cannot be found in 50 percent to 75 percent of couples. Fortunately, the prognosis for a successful delivery once normal pregnancy is achieved is still good. This is particularly true if the couple has a history of a prior successful delivery. Many fertility clinics offer such patients supplementary hormones (progesterone) to make certain that this critical hormone is present in adequate amounts in the first portion of the pregnancy with good results. As one might imagine, repeated miscarriages can be emotionally trying, and sometimes it is wise to seek emotional counseling to better cope with the stress it can invoke. Despite the multitude of tests, most evaluations typically proceed easily and quickly. In fact, once an abnormality is identified, treatment can be customized for that abnormality with an excellent prognosis for a normal, healthy delivery. Kevin Bachus, MD, is the only board certified infertility and reproductive endocrinology specialist serving the tri-state area of Northern Colorado, Wyoming, and Nebraska.

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Dentistry

SEDATIVE CARE

I give a little bit of the drug and let it react. It takes about 20 seconds and then we see what the response is and can then give a little more and watch the patient’s reaction. - Galen Geraets, DDS, Centre Family Dentistry

Galen Geraets, DDS, Centre Family Dentistry, administers IV sedation to his patient.

NO MORE NERVES

BY KAY RIOS

If your palms sweat and you start to hyperventilate at the thought of sitting in a dental chair, sedation dentistry offers a good alternative. “The most common cause of problems or complications in the dentist’s office are related to anxiety,” says Galen Geraets, DDS, Centre Family Dentistry. With anxiety, blood pressure can go up and a number of physical responses can occur, he says. “By reducing anxiety, you also reduce potential problems.”

edation dentistry, as the name implies, is used by specially trained dentists as means of providing a relaxing and anxiety-free experience for dental patients. With this technique, the central nervous system is altered with pharmaceuticals so that an overall calm and relaxed sensation is created. Sedative medications reduce the brain’s ability to feel anxiety or nervousness. But, unlike general anesthesia where a patient is completely unconscious, asleep, and unable to respond, patients under this form of sedation can respond to commands and breath on their own. Dentists typically use three forms of sedation.

Intravenous (IV) sedation medications are administered directly into the blood stream. Oral sedation occurs in the form of a pill. The third, and more commonly used, is nitrous oxide/oxygen sedation, also known as laughing gas. The office has been practicing sedation since 2004. This form has greater advantages than the pill form, he says. There’s a quicker response time and he can more easily gear it to a specific individual. “I give a little bit of the drug and let it react. It takes about 20 seconds and then we see what the response is and can then give a little more and watch the patient’s reaction. We don’t give them a lot at one time but in small doses. Oral sedatives

take about half an hour to take affect.” The drugs used for IV sedation are reported as more effective than the same drugs taken orally, and there is a more profound amnesia associated with this technique. Drugs used are typically in the benzodiazepine family, Geraets says. “There is also an opioid family that can be used and they will also help with pain control.” Sedation dentistry is especially useful for adult patients who have high anxiety or fear about dental visits or have had traumatic dental experiences in the past. It’s also effective for those who have difficulty getting numb, have strong gag refle es, sensitive teeth, or react to the noises and/or

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smells associated with dental procedures. The patient under IV sedation can still respond to questions even though they’ll have no memory of that conversation afterward. In this day and age of hectic lives and busy schedules, there is an added bonus to sedation in the dentist’s office. “People who have lots of work to be done can do it in fewer appointments,” Geraets says. “When someone’s not sedated, it’s hard to keep your mouth open for more than two hours. With sedation, we can do more work at one sitting. People with tight time schedules enjoy that.” The use of sedation dentistry is not new, Geraets says. “These drugs have been around for a long time but haven’t been used for all procedures. It’s common for oral surgeons to use it for removing teeth but it’s not been commonly used in general dentistry.” According to the Sedation Dentistry Directory, only about four percent of dentists nationwide have the training and licensing to provide IV Sedation. Because of need for specialized advanced training and the requirements for certification by the State Board of Dentistry, sedation is not com-

Northern Colorado Medical & Wellness

monly used in most dental offices. Dr. Geraets has met those requirements, “I went through a mini-residency where I learned the techniques of using sedatives, learned about pharmaceuticals involved and became licensed.” Any and all procedures can be done with sedation dentistry methods. “We can do anything: cleaning, fillings, crowns, root canals, extractions,” he says. He also works together with other specialists in his office. But like oral sedatives, IV sedation does not provide pain relief so an injection of a local anesthetic is also used. IV sedation is a very safe procedure. He says “These medications cause few complications and we always get clearance from the patient’s physician if that person has medical conditions. We do a ‘pre-op’ where we check blood pressure and vitals. During the procedure, we always monitor blood/ox, pulse, and blood pressure.” The effect of IV sedation wears off in about 45 minutes after it’s administered, he says. “The patient walks out of the office. Sedation dentistry is not, however, for everyone. “It’s for healthy people,” Geraets says. “For people who are sick or debilitated, I wouldn’t rec-

ommend it. And, again, if they are on medication, or have any health conditions, then we need clearance from their physician.” Age matters as well, he says. “I just generally use it on adults. If kids need this, then my feeling is that they are safer having it done in a hospital. The youngest I’ve done is 16.” The picture of a sedated population seated in dental chairs comes to mind but Geraets says he doesn’t see this as a national trend. “I don’t use it on all my patients. It’s really a small group of people who desire or require it,” he says. But he does add, “People are certainly happy to know it’s available.” Dr. Geraets can be reached at (970) 4071001.

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

Dentistry

COSMETIC PROCEDURES

BRIGHT AND BEAUTIFUL BY CONNIE HEIN

Ever wondered what the term “cosmetic dentistry” actually means and whether it would work for major or minor imperfections on your own teeth?

We start by doing a comprehensive exam and then diagnosing and caring for any immediate dental concerns. We then discuss any cosmetic procedures you feel might be necessary for a healthier-looking smile. - Steven Koehler, DMD, Family and Cosmetic Dentistry

Steven Koehler, DMD, Family and Cosmetic Dentistry, demonstrates the process of Lumineer® Dentistry.

e would like you to meet Steven J. Koehler, DMD, Family & Cosmetic Dentistry and Thomas F. Overton, DDS, Overton Center for Dental Arts, two local dentists who are working to bring beautiful smiles to Northern Colorado residents. They will answer that question and lots of others to help you make informed decisions about whether cosmetic dentistry is right for you. Dr. Steven J. Koehler is sometimes called “the

Lumineers dentist,” referring to a proprietary porcelain technology that removes tooth discoloration, changes the shape of teeth, closes spaces between them and gives them the appearance of having been straightened—all without braces. But he has emphasized many types of cosmetic dentistry in his practice since 1991. Dr. Koehler received extensive post-graduate training in cosmetic techniques and procedures, so many of the procedures he does are cosmetic

in nature. “If you’ve seen or heard of the ‘Extreme Makeover’ series on TV, you’re probably aware of the incredible changes in a person’s appearance that are possible with today’s cosmetic dentistry procedures,” says Dr. Koehler. “This is one of the fastest growing and most exciting areas of dentistry, and is a particular focus of our practice.” The Lumineers® by Cerinate® process—a contact-lens-thin porcelain technology—not only changes the appearance of teeth, but can also be

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Steven Koehler, DMD, Family and Cosmetic Dentistry, uses a mold from his patients’ mouths to fit the Lumineers®.

Before Lumineer® Dentistry. bonded to existing crowns and bridgework without replacing them. These procedures are applied without drilling, shots or pain. There is no removal of sensitive tooth structure, so it is a comfortable process, even for patients with low tolerance for pain. Most of these procedures can be accomplished in just a few days and are clinically proven to have a 100 percent retention rate, without discoloration, for at least 20 years. Dr. Koehler says we are fortunate to live in an age when technology can help make all types of dental care faster, better and more painless than ever. This includes preventative and restorative dentistry as well as cosmetic dentistry. He adds, “Besides doing cosmetic procedures, we are also very prevention oriented and are committed to preventing, not just treating, all the dental concerns of our patients. We provide all the services you’d expect from a general and family dental practice, and a few that many general dentists don’t offer.” According to Dr. Koehler, clients who are good candidates for cosmetic dentistry are, “Any patient with good oral health makes an ideal candidate for most cosmetic procedures.” When asked what a new patient can expect on a first visit, Dr. Koehler says, “We start by do-

Northern Colorado Medical & Wellness

After Lumineer® Dentistry.

Dentistry

COSMETIC PROCEDURES ing a comprehensive exam and then diagnosing and caring for any immediate dental concerns. We then discuss any cosmetic procedures you feel might be necessary for a healthier-looking smile.” In the Family & Cosmetic Dentistry office many high-tech tools are used to help take better care of patients’ dental needs. Among these are intraoral video camera imaging, digital X-rays with significantly less radiation than traditional X-rays, laser cavity detection, and computerized patient education systems. He believes this kind

of technology allows his patients to be more involved in diagnosis and treatment. He says these high-tech procedures help prevent many potential problems, and can be used to treat existing problems in their early stages in order to minimize cost and discomfort and to prevent loss of tooth structure. “We’re constantly looking for cutting edge technologies to help us produce a positive experience for our patients. If something better comes along, from a technology standpoint, you can bet

we’ll have it.” He and his staff love the cosmetic aspect of the practice. “These procedures are things that people want to do instead of something – like a root canal – that they have to do.” He added that he and his staff love watching patients who have had procedures that have changed not only their smile, but their whole attitude. “It often changes their personality and gives them more self-confidence. It is amazing to watch the transformations,” he said. Dr. Koehler received his Bachelor of Science degree, with honors, from Auburn University and his Doctor of Dental Medicine (DMD) degree from the Medical College of Georgia School of Dentistry. He served two years on active duty in the Air Force, and has been in private practice since 1976. He is a member of the American Dental Association, Colorado Dental Association, Larimer County Dental Society, Academy of General Dentistry and Academy of Cosmetic Dentistry. He earned the prestigious Fellowship of the Academy of General Dentistry in 2000 by completing over 500 hours of post-graduate continuing education and passing a rigorous examination covering all phases of general dentistry. Dr. Koehler entered the dentistry profession because, as he puts it, “I wanted to do something medical that helped people and where I could work with my hands.” He added that the idea of being his own boss and setting his own hours and standards was also appealing to him. In 1995 he moved from a large practice in Atlanta and purchased a smaller one in Ft. Collins. His practice was so large that it would have been very hard to downsize, so he sold the business to his partner. “I wanted to have a smaller practice so I could give more personal attention to each patient.” Dr. Koehler has been married to his wife, Jan, for 37 years, and they have two grown children, Valerie, a dental hygienist in his office, and Matt, a physician. They were blessed with the birth of their first grandchild, Teagan Grace Miller, in June 2006. The other member of the family is Murphy, their golden retriever. When we asked Dr. Koehler about his daughter who now works with him, he said, “I had reservations about hiring family at first, but she is so great at her job that I would have hired her even if she wasn’t my daughter. She graduated first in her class and already had great experience when she came to us. She is great with patients and we are fortunate to have her.” He added, “I have a wonderful staff that loves people and puts patients’ health and welfare above anything else.” Dr. Thomas F. Overton says he is passionate about cosmetic dentistry because, “Your smile is the first thing to create a lasting impression.” Laughter, happiness, joy, friendliness, and success, these are just a few of the things he says are expressed with a smile. Which is why he has such passion about wanting every patient to feel good about their smile. He believes helping his patients have a great smile is a precious gift to them. “It’s amazing to watch the transformation of our patients who receive cosmetic dentistry procedures. This is a very rewarding part of my job.”

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Tom Overton, DDS, Overton Center For Dental Arts, P.C. verifies his patient’s tooth brightness after her BriteSmile® treatment.

It’s amazing to watch the transformation of our patients who receive cosmetic dentistry procedures. This is a very rewarding part of my job. - Thomas F. Overton, DDS Overton Center For Dental Arts, P.C.

Dr. Overton says he knew at age 12 that he wanted to be a dentist. He thinks that was primarily because when he was a young child he had what he referred to as, “A very cool dentist who seemed to always be having fun.” Overton had to have two root canals done at age 17 that were caused from injuries sustained in flag football. He said he didn’t mind the procedures because he was so fascinated by how the dentist was working on his teeth. After that, he was sure this was the job for him. “I was excited about becoming a dentist like mine who loved his job, and even more excited that I actually knew what I wanted to do for a living before I went to college.” Dr. Overton is a Colorado native originally from Denver. His undergraduate education was

Northern Colorado Medical & Wellness

done at Hastings College where he received a Bachelor of Science degree in biology. He then attended University of Nebraska College of Medicine School of Dentistry, graduating in 1994. He has received hundreds of hours of continuing education in the fields of cosmetic and restorative dentistry, taking many classes every year; and he continues to stay at the forefront of technology by having the latest equipment. The Las Vegas Institute for Advanced Dental Studies has recognized Dr. Overton as a “Master Esthetic Dentist” because of his excellence in neuromuscular dentistry and full mouth restoration He is a Member of the American Academy of Cosmetic Dentistry, American Dental Association, Colorado Dental Association, and Larimer County

Dental Society. He and his wife of 12 years, Stacy, live in Ft. Collins with their two dogs, Brodey and Shiloh. Dr. Overton began his dental career over 14 years ago and has specialized in cosmetic procedures for the last 10 years. He says these procedures make up close to 50 percent of his practice. “This is the part of the practice I am most passionate about and enjoy the most,” he says. “I love seeing how the procedures transform people’s lives.” Chris Cook, who has been Dr. Overton’s office manager for seven years, says that with Dr. Overton even a simple cavity filling is a cosmetic procedure. “I am so impressed when watching the care he takes to do even a simple filling. He uses tiny brushes and instruments to construct

and blend the filling so it looks like part of the natural tooth.” She added, “People don’t know how detailed he is even with simple dental procedures such as filling a cavit .” One of Dr. Overton’s many cosmetic specialties is teeth whitening. One of the procedures he uses has received the attention of fashion magazines and news media nationwide. It whitens quickly and comfortably and without messy trays and weeks of treatments. He says, “Even after your first appointment, which usually takes about an hour, you’ll leave the office flashing a whiter, brighter smile.” He also specializes in Empress porcelain veneers, all-porcelain bridges and crowns, full mouth reconstruction, and neuromuscular dentistry procedures. Neuromuscular dentistry is the art and science of relaxing the position of the muscles in the head and neck to place the jaw into an optimal physiologic position to efficiently do restorative procedures. Dr. Overton says 30 years of research have shown this technique to be effective in finding the optimal jaw position before restorative dentistry, which increases the longevity of restorations. He reminds his patients that even with all the new technology at his fingertips, one of the keys to achieving and maintaining a healthy smile is to have regular dental exams and cleanings. Prevention is always the best defense against dental problems, he says, and much cheaper than fixing them later. He adds that his caring, experienced staff helps design at-home dental care plans for patients, emphasizing custom schedules that fit each person’s specific needs. They work hard to ensure that patients keep a beautiful smile for a lifetime. Dr. Overton says the goal for him and his staff, when a patient enters the Overton Center, is to give the person a relaxing, comfortable visit, listening carefully to them and offering help and guidance with all dental needs. For Dr. Overton, dentistry is a mission, with a goal to help achieve the pride and self-confidence that each and every human being deserves. He says, “Creating world-class smiles changes lives forever. Your smile lets you show others how you feel. It’s a window to the world of your inner health and beauty.” Even though Dr. Koehler and Dr. Overton specialize in slightly different areas of cosmetic dentistry, they are both very committed to their patients’ overall health and well-being and are passionate about what they are doing. Both dentists emphasized that having good dental hygiene and regular dental check-ups is first and foremost the way to have a healthy smile throughout your life. But they both agreed that with all the new technology, cosmetic dentistry can truly change a person’s life, attitude and self esteem. Both dentists welcome new patients; there is no need for a referral. Readers interested in cosmetic dentistry can reach Dr. Thomas Overton at (970) 223-6677 or visit www.Overtoncenter.com, or Dr. Steven J. Koehler at (970) 223-6101 or www.smileftcollins. com.

Connie Hein is a freelance writer living in Windsor and the author of The Toliver in Time series of Children’s books.

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Thank You

Notes

My whole experience with Dr. Koehler and his staff was definitely a positive one! I had ‘Lumineers’ done on my front teeth. Dr. Koehler and his staff did such a nice job working with me and explaining the process. Dr. Koehler was very careful, precise, and detailed throughout the entire procedure. He took lots of time on every little adjustment to make my teeth look perfect. He wanted to make sure my smile was natural. My business photo now reflects my new improved smile. - Rita Greywood “Dear Dr. Overton and staff, Thank you for giving me the opportunity to live the life I dreamed was possible. Your expertise and skills have impacted my life forever. I feel that I now project the TRUE person I have been inside. You have opened a new world to me. Thank you. I would also like to thank you for making my wedding photo’s beautiful.” Thank you. - Abby “Dear Dr. Overton, This letter is written to thank you and your staff for the fabulous results I obtained from the BriteSmile teeth whitening procedure I had in May. The entire process took less than two hours and, although very minor risks were thoroughly explained to me, I suffered absolutely no discomfort during or following the procedure. I am incredibly happy with the results and would recommend BriteSmile to anyone wanting whiter teeth both quickly and simply. A special thank you for all your caring and patience.” - Lisa

Northern Colorado Medical & Wellness

Dentistry

PEDIATRIC PROFESSIONALS Louis Gerken, DDS, Loveland Pediatric Dentistry, welcomes children to his office with bright colors and a friendly staff.

makes kids actually want to come back? For starters, all three dentists use the ‘tell, show, do’ method, a common technique among pediatric dentists. The dentist tells the child about the procedure by using small words that the child understands, also called ‘pedo lingo.’ The dentist then shows the child what tools he or she will be using and why. Some dentists physically show the child the procedure on a stuffed animal or doll. Of course, each dentist has his own “tricks of the trade” as well.

BRIGHT SMILES ACROSS NORTHERN COLORADO

BY ERICA PAULY

The odor of sterile plastic gloves and fluoride intoxicate you as you watch your child walk farther down the hall behind the nurse in white. Your child looks back with frightened eyes while all you can do it sit and wait.

aking children to the dentist should not be a difficult task, but rather, a consistent and fun one. Forty-one percent of U.S. children have tooth decay in their baby teeth, according to a report by the Centers for Disease Control and Prevention (CDC). Getting the kids into the dentist before tooth decay happens is vital for prevention, but so is finding a great pediatric dentist who will ease both yours and your child’s fears.

Three local pediatric dentists, Louis Gerken, DDS, Loveland Pediatric Dentistry, Kent Obermann, DDS, Tooth Zone and Stephen Pauly, DDS, All-Star Smiles, have made it a priority to ease the fears of parents and children alike when they visit the dentist. Each make seeing the dentist such an exciting experience that children are asking their parents when they get to go to the dentist again. What is each of these dentists doing that

Getting Tropical in Loveland After graduating from Creighton University School of Dentistry, Dr. Gerken moved to Northern Colorado and has been practicing pediatric dentistry for 29 years. It’s no surprise that Dr. Gerken is accustomed to anxious parents and children entering his building for the first time. His office, located at 2800 Madison Square Drive in Loveland, is painted in vibrant colors that welcome you upon entering. Murals of palm trees and bright pink stuffed flamingos greet you at the door. Nervous children can wander over to the television playing a Disney movie, while parents check them in. Dr. Gerken opens the door to the exam room with a friendly smile and a silly tie when he calls the children in. On the walk to the exam room he tells them what he will be doing. “I tell them I’m going to explore their teeth. Along the way there may be wind (air syringe), and sometimes we use sleepy water (shots). When they know certain things will occur, they are less likely to be afraid,” says Gerken. Dazzling stuffed animals hang from the lights in the exam room where Dr. Gerken works. It’s an open bay room, which helps ease anxiety because the children are able to see other children next to them and see that everything is all right. Dr. Gerken’s assistants also provide cool sunglasses for the children. Sandee Mosqueda is well familiarized with Dr. Gerken’s office after bringing her three children there for 17 years. “My kids have never been scared to come. I admire Dr. Gerken and what he does for those who don’t have health care,” says Mosqueda. In fact, more than 108 million children and adults lack dental insurance in the United States, according to the U.S. Department of Health and Human Services, and Dr. Gerken, Dr. Pauly and Dr. Obermann have all implemented different programs to help. Zone of Laughter Dr. Obermann, a graduate of the University of Iowa College of Dentistry, moved to Fort Collins in 1982 with his wife and two children. Tooth Zone,

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Kent Obermann, DDS, Tooth Zone, brings laughter to patients across Northern Colorado.

which has three locations in Northern Colorado, is geared 100 percent toward the children. The flashing construction lights and play pit beckon the children as they enter, while the ‘Quiet Zone,’ which is stuffed with couches, beckons the parents. (But according to sources, some fathers occasionally make their way to the game room to play the arcade games and the Wii.) Like Dr. Gerken, Dr. Obermann provides an open bay so kids can see each other, which relieves anxiey. Dr. Obermann also offers a private room for patients who either want privacy for handicap purposes or for an emotional patient. The private room is painted in shades of blue and green and has a window to let in the happy sun. Although parents are asked to wait in the waiting area, Tooth Zone will occasionally let parents back with their children. Dr. Obermann’s ambition is to serve the children that walk through his doors in any way possible. “You have to be willing to roll around on your hands and knees—whatever it takes to make the kids laugh,” he says. Lisa Christopherson, mother to four of Dr. Obermann’s patients and former employee says, “Not only would I recommend taking all my children there, but having two children on the autism spectrum has made finding a dentist a difficult task. But Dr. Obermann handles special needs better than anyone I’ve ever met.” Smiling Like An All-Star After graduating from the Loma Linda School

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- Kent Obermann, DDS, Tooth Zone

of Dentistry in Loma Linda, Caif., Pauly furthered his education by completing courses at the UCLA School of Pediatric Dentistry. A month after finishing school, Dr. Pauly moved to Fort Collins with his wife and three sons. He began his pediatric practice in 1982, and has brought over 69,000 ‘all-star smiles’ to Northern Colorado. Located at 1513 Riverside Road, Pauly’s building is a homey brick structure welcoming new and returning patients. So homey, in fact, that many of his patients began seeing him as infants and are now long past needing a pediatric dentist. More than 800 of Dr. Pauly’s patients are older than 18 and don’t plan on leaving. “We brought Justin, our son, here 14 years ago when he was only three. Dr. Pauly was great with him, and now Justin is 17 and still sees Dr. Pauly. We don’t know what we will do if we have to find another dentist,” says Diane Bauer-Felix, mother to two of Pauly’s patients. The longevity and loyalty of patients speak highly of Dr. Pauly, as does his understanding attitude and flexibility to allow parents to go into the exam room with their children. This is a sensitive issue for dentists and parents alike. “For the initial visit, it is important to me for the parent to be in the exam room. It helps all of us get to know each other, and it helps my patients and their parents to see what I am doing and how I interact. I tell them the plan so that everyone is on the same page,” says Dr. Pauly, who continues: “However, for any procedure that is intensive,

For the initial visit it is important to me for the parent to be in the exam room. It helps all of us get to know each other. - Stephen Pauly, DDS, All-Star Smiles

You have to be willing to roll around on your hands and knees—whatever it takes to make the kids laugh.

I ask the parents not to come back. Usually, the parents are always more nervous than the child. Of course they mean well, but sometimes they attempt to answer for their child, or if the kid fusses for any reason, the parents panic. Being trained, I know the difference between being scared and being hurt. I need 100 percent of my attention to go to my patient. I can’t talk with a parent and fully concentrate on the child at the same time.” For parents like Bauer-Felix, accompanying her children to the exam room made all the difference when she first met D . Pauly. “When Justin was three, Dr. Pauly let me go in the back and explained everything to us both. My kids have never been afraid to go to the dentist, and neither of them has ever had a cavity,” BauerFelix continues. Dr. Pauly also employs a little entertainment to relax his patients. Kids can play arcade games, or admire themselves on the “All-Star Smiles Wall” where he displays pictures of patients showing off their pearly whites. Nor does Dr. Pauly wear clinical garb outfit that shouts serious and sterile, but instead dresses in colorful shirts. As these three specialists prove, white lab coats are out, a new breed of dentists is in.

Erica Pauly is contributing editor for Style Magazine. Steve Pauly is her father-in-law.

Stephen Pauly, DDS, All-Star Smiles, keeps parents up to date by allowing them in the exam room for the initial visit.

Dentistry

INFANT CARE Greg Evans, DDS, Big Grins, focuses on preventive dentistry beginning when children are infants.

Walker Heutzenroeder, 5, gets a dental checkup. (Walker is the son of a Big Grins employee)

START SMART

BY GREG EVANS, DDS

In order to meet the challenges of today’s circumstances, dentistry has changed. In the specialty of pediatric dentistry, some changes have been dramatic. Keeping up with the specialty is, well, like keeping up with my children!

he latest buzz in pediatric dentistry is what is happening to our mindset. We are weaning from the antiquated notion that we can surgically repair teeth. Lately, we have begun to confront dental caries as a ‘chronic disease process’ much like asthma or diabetes. Paradigm shifting research out of California’s San Francisco School of Dentistry is teaching pediatric dentistry to manage this bacterial disease process long term in order to keep it in remission, and we are focusing on prevention with new fervor. A movement is now happening in Colorado, the first in the nation, to incorporate medicine and dentistry together to attack dental caries before it starts. Caring for Colorado, a private, non-profit foundation in conjunction with the Rose Foundation and Delta Dental is sponsoring a statewide, multi-million dollar initiative called “Cavity Free at Three.“ Its emphasis is on treating pregnant women for dental disease, which in turn, may lessen infant morbidity. Further, infant dental care is instituted with the pediatrician to identify highrisk children or behaviors and stop the cycle of mother –to-infant bacterial transmission and caries. Linda Reiner, director of ‘Cavity Free at Three,’ is hopeful that this prevention based initiative will spread beyond community clinics and eventually save tax payers millions of Medicaid dollars as well as preventing missed school and needless suffering. The Journal of the American Dental Association published a landmark study showing preg-

nant mothers who rinsed with an anti-bacterial mouthwash for the last three months of pregnancy not only reduced the bacteria counts and cavities in their own mouths after birth, but they reduced the bacteria in their infants’ mouths as well. Cavities are not genetic, but the specific bacteria that cause them are passed from parent to child. Infant dental care is the key for parents to understand and stop this cycle from occurring. And the timing is crucial, at or before the arrival of the first baby tooth The strategy is a simple one. Cavity Free at Three is now educating our medical colleagues to prevent dental caries in infancy and recognize the signs a disease process may be starting. This effort begins at the well-established well-baby checks. Education on bottle use, infant tooth brushing, the timing and use of toothpaste and referral to a dentist can all be covered in a proactive and positive light. It is then that the partnership with dentistry comes into play. Pediatric dentists are leading the call to see children below age three and prevent disease, not just when they have enough teeth to clean and can sit still. Both the American Academy of Pediatrics and the American Association of Pediatric Dentists advocate for children to establish a “dental home” by age one. Examining children on the laps of parents fosters involvement, educates them about a child’s oral anatomy and growth, and anticipates development, both mental and physical. Far too often my dental colleagues and I treat

children with toothaches or abscessed teeth before their third or fourth birthdays. When extensive or invasive treatment is required to ward off pain in young children, nobody thinks dentistry is fun. Furthermore, it is difficult to bring a child back around to a positive dental attitude once they have had a bad experience. For high-risk kids, who also have language and access barriers, it is nearly impossible to overcome bad dental experiences. The popular press, with little argument from organized dentistry, misinterpreted census results in the late 1980s and lured us into believing cavities were decreasing. In fact, the opposite is now true. Pediatric dentistry is seeing a reemergence of high rates of cavities in children across the country and across all socio economic lines. That is where we have to emphasize our role as teachers and establish long-term relationships built on trust with families. Our challenges, however, are great. Our children eat more convenience foods and drink more pop than ever before. Rising obesity and rising dental caries are symptoms of the same problem. This isn’t the same old same old; children’s lives have changed as much as their parents’ have. Prevention may not be flash , but certainly, we must use the technology and knowledge we have recently gained to change those circumstances for our children. They deserve it. Dr. Evans is the Pediatric Dentist at Big Grins and Diplomate, American Board of Pediatric Dentistry.

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Dentistry

DENTAL Q & A Richard Lindeberg, DDS, MS, Associates in Periodontics, specializes in treatment of the gums.

UP TO DATE WITH ENDODONTICS, PERIODONTICS AND PROSTHETICS BY ALLIE COMEAU

How Do I Keep My Teeth? Richard Lindeberg, DDS, MS Associates in Periodontics www.periofortcollins.com

Richard Lindeberg, DDS, MS, Associates in Periodontics, specializes in periodontics, or treatment of the gums, tissue, and bones that support the teeth. Dr. Lindeberg received his Doctor of Dental Surgery at the University of Iowa in 1972, where he’s from, and his certificate in Periodontics there in 1974. After graduation, when pondering where to settle, Dr. Lindeberg and his wife decided they preferred Colorado to Iowa. They’ve been in Fort Collins ever since. “We love Fort Collins,” he says.

“I’ve been practicing here for 34 years. My wife and I raised three daughters here and they all went to either University of Colorado or Colorado State University and are still here. In fact, they keep us quite busy still.” Dr. Lindeberg has always been fascinated with periodontics. He considers the field both exciting and challenging. “Treating gum problems has always been exciting to me. It can be challenge, but it’s always interesting. I truly enjoy helping people save their teeth,” says. Dr. Lindeberg.

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Since incorporating dental implants into his periodontal practice in 1984, Dr. Lindeberg has seen major improvements in the results for people with advanced periodontal disease. Because periodontal disease can cause tooth loss and subsequently bone loss, implants have become an imperative part of periodontology. “Dental implants have become an increasingly important part of our practice as more patients realize the benefit they have in regards to maintaining gum and bone structure.” Dr. Lindeberg’s practice, Associates in Periodontics, consists currently of himself and his partner, David Johnson, DDS, MS. But the two are tentatively expecting a third doctor to join the practice later this year. “The practice is expanding and growing all the time,” says Dr. Lindeberg. Both Dr. Lindeberg and Dr. Johnson are devoted to saving teeth and smiles by keeping gums and bone structure healthy. The most important way to prevent gum disease is by taking care of your gums every day. “Hands down the most important thing you can do to prevent gingivitis is to brush and floss daily,” says Dr. Lindeberg. “Gingivitis is an inflammation and infection of the gums and preventing it is key to your dental health.” If a patient sees red, irritated, bleeding, or receding gums, Dr. Lindeberg says it’s time to make an appointment. “A lot of times dentists will notice the start of gingivitis during the twice-

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yearly cleanings. But a patient might notice those things before that. Persistent bad breath can be another possible sign of gingivitis.” It’s important to act promptly where gingivitis is concerned. “Gingivitis is being linked to all sorts of systemic health problems, including pre-term births and heart disease,” says Dr. Lindeberg. “Not only is gum health vital to oral health, it is to general health as well.” What do I need to be doing daily? Brushing and flossing. You can’t rely on the toothbrush to get in between the teeth – you need to be flossing as well. We also recommend using toothpicks to clean behind and in between teeth. How often should I see a dentist? You should see a dentist for a cleaning twice a year if you aren’t having any problems. We see our patients 3-4 times a year during treatment. What are the most common causes of tooth loss in seniors? The most common cause is periodontal disease and subsequent infection, followed by dental decay, root canal failures, teeth breaking down and trauma. How do you prevent gingivitis? Brushing, flossing, and periodic checkups are the best way to prevent gingivitis. Using an essential oil mouthwash, like Listerine, also helps. If you’re gums are red, painful, bleed easily, or if you have persistent bad breath, these may be signs of gingivitis.

Are implants a good solution for lost teeth? Yes. Implants are made of Titanium, the same metal used for knee replacements, and are bio-compatible and easily accepted into the bone. How does nutrition affect the future of my teeth? If you have a well-balanced diet, you won’t see any nutritional issues. On the other hand, lack of proper nutrition could possibly further bone loss and decay and make you more susceptible to infection because your immune system is compromised. How do genetics affect them? About 30% of the population carries a gene marker that makes them more susceptible to periodontal disease. If you have a family history of gum or periodontal disease, you should be extra vigilant. How do you treat periodontal disease? Deep cleaning, or scaling, is done over 2-4 sessions. After that, we re-evaluate to see if further treatment, such as surgery or regenerative treatment, is necessary. In extreme cases, extraction of the affected tooth is necessary and an implant would be used to replace it. Why is gum health so important? Besides keeping your teeth in place, your gums affect other aspects of your health as well. Studies are being done now linking periodontal disease to a host of other problems, such as heart disease, stroke, pancreatic cancer, and pre-term births.

Dentistry

DENTAL Q & A Root Canals David Jones, DDS, MS and Kelly Jones, DDS, MS Endodontic Specialists of the Rockies www.coloradorootcanal.com

David Jones, DDS, Endodontics Specialists of the Rockies does a root canal procedure on Bill Peters. David Jones, DDS, MS, Endodontist, Endodontic Specialists of the Rockies, greets his nervous patients with a comforting smile and a steady hand. Having a root canal is not usually a joyous occasion, but Dr. Jones attempts to make it as quick and painless as possible. Dr. Jones received his undergraduate degree at Carson-Newman College in 1987 and then continued his training at the University of Tennessee, which is where he met his wife, Dr. Kelly Jones. After practicing general dentistry for more than seven years, Dr. Jones received his endodontics certificate from the University of Maryland in 1998. After two years of practicing in Minnesota, Dr. Jones and his family made their way to Loveland. The couple was drawn to Northern Colorado because of the practice, but they also loved the area so much, they decided to move here with or without job offers. The husband and wife duo began at Endodontic Specialists, and after three years, the practice grew seven-fold. Dr. Jones’ friendly approach to endodontics mirrors his home life. He and his wife, Kelly, and two sons, Ryan and Riley, reside in Fort Collins where he has been a football and baseball coach

for both sons. The family enjoys skiing together and playing sports. Dr. Kelly Jones specializes in endodontic treatment, or root canals. Dr. Jones graduated with her Doctor of Dental Surgery from the University of Tennessee and received her endodontic certificate at the University of Minnesota in 2000. She feels every patient deserves the right to be well-informed and educated about their diagnosis. “We’re big on patient education in my practice and explaining to patients exactly what’s going on in terms they can understand. We want them to understand their diagnosis and why they do or don’t need a root canal,” she says. Dr. Kelly Jones answered a few tricky root canal questions for us. Why are root canals necessary? Root canals are often necessary to preserve and maintain teeth. If an infected tooth is left to further decay, it will eventually require extraction. Are they permanent? Root canals are permanent unless you have recurrent decay that gets reintroduced back into the canal space. If you have decay that gets under the crown margin or in a crack, it can require further treatment.

Natural Teeth & Dentures: Prosthetic Dentistry Scott Perkins, DDS, MS

How have root canal techniques evolved? The anesthetics are better; we have better rotary instruments, cleaning and shaping instruments; and we use digital x-rays, microscopes, and ultrasonics to find hidden canals. Are they painless? We try to make it as painless as possible--your average root canal is not an uncomfortable experience. You’re anesthetized and the nerve tissue is numb. Most patients walk out of the office amazed at how easy and comfortable the procedure was. How do root canals contribute to good dental health? They allow you to maintain the natural tooth structure and to preserve your teeth. There is no substitution for your natural teeth. How do you determine who needs one? By listening to the patient’s symptoms, observing the tooth, performing pulpal diagnosis, and taking x-rays, we’re able to determine if the damage to the nerve tissue is reversible or irreversible. If it’s irreversible, we know a root canal is necessary. If it’s not, it may just be a crack or cavity. What are the alternatives? The only alternative to a root canal is extraction of the tooth.

Scott Perkins, DDS, MS, is a Doctor of Prosthodontics, or a specialist in prosthetic dentistry. He specializes in the replacement, restoration, and rehabilitation of natural teeth. Dr. Perkins graduated from the Marquette University School of Dentistry in 1985 and completed his Certificate in Prosthodontics residency there in 1987. Immediately after graduation from Marquette University in Wisconsin, Dr. Perkins moved to Denver where he practiced for less than a year before moving to Fort Collins. He’s been practicing here for the past 20 years. “I started a practice in Denver but found I didn’t care much for the city and so I branched out to Fort Collins and have been here ever since.” Originally from San Diego, California, Dr. Perkins now considers Fort Collins home. “I made it halfway home from Wisconsin to San Diego after graduating college and just haven’t had any desire to leave,” he says. There are three distinct areas in Dr. Perkins’ field; maxillofacial prosthetics, which deal with defects of the head and neck, fixed prosthetics which include crowns, bridges, and implant-supported crowns and bridges, and removable prosthetics which includes full dentures and partial dentures. “Maxillofacial prosthetics includes reconstruction from

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birth defects of the head and neck or post-cancer reconstruction like replacing the roof of the mouth for example,” he says. “I don’t do much of that type of work these days. I did more of that type of surgery when I was hospital-based.” Focusing now mainly on fixed and removable prosthetics, Dr. Perkins enjoys the challenges that come inherent in his specialty. No two cases are the same and that’s what keeps him interested. It’s also what prompted him to study the field of dental prosthetics in the first place. “I honestly didn’t feel that general dentistry could hold my attention,” he says. “I liked the challenge that came along with the prosthetic specialty and the room it allows for creativity.” Because the future of prosthetic dentistry is becoming increasingly complex, remaining interested in the field is pretty much guaranteed. “The trend we see in prosthetics these days is that we’re getting more and more complex cases as general dentists do more and more of what a prosthodontist used to do,” he says. “Due in part to the economy and general dentists having less ‘traditional’ work to do, we are starting to see less of the routine cases. So by the time someone is referred to me, they most likely have a pretty complicated issue they’re dealing with.” When looking to the future, Dr. Perkins sees implants as playing a large role. “Implants have become an incredibly important part of prosthetic dentistry,” he says. “Implants are becoming the new standard of care now, rather than just full

dentures alone. The success rate is so much higher with dental implants than conventional full dentures.” And as for patient care, Dr. Perkins strives to provide the highest standard of care and believes in empowering the patient with information. “We strive to provide the highest standard of care that can be provided, without dictating care,” says Dr. Perkins. “We present information and options to the patient and empower them to make decisions regarding their care.” When are partials needed? Partial dentures are used when a patient has some, but not all, of their natural teeth. Partials can also be used if a patient chooses to get implants to replace the missing teeth or can be used with a combination of natural teeth and implants. The need for partials depends on the patient and the number of natural teeth they have. When are dentures needed? Dentures are used as a last resort, but offer a cost benefit to some patients. It’s preferable to keep the natural teeth or to use implants, but if a patient’s bone or gum tissue isn’t capable of supporting teeth, dentures may be the only affordable option. How are dentures fitted for comfort/ efficiency Immediate dentures are made in advance of the teeth being removed so the patient can transition to dentures immediately after extraction. Conventional dentures, on the other hand, are used when a patient already has dentures and/or their teeth have already been

removed. If the patient is happy with their existing dentures, those can be copied. If not, we can make a mold of their jaw, do a bite registration, use a face form and wax molds, and even use old photos to get the right shape. Can they be avoided? Alternatives to dentures include implants, which are the most preferable, root canals, bridges, crowns, and reconstructive work. But sometimes the cost of these alternatives makes dentures the only option. What are their limitations/advantages? Dentures have no advantages over natural teeth, but are definitely better than having no teeth. If a patient has suffered by having no teeth, dentures can be a wonderful tool for them. Limitations include reduced chewing efficienc , not being able to eat certain foods, and the hassle of maintenance. Describe how dentures are best maintained. Dentures need to be cleaned daily and taken out eight hours for every twelve they’re worn. This is to assure the gum tissue stays healthy and isn’t suffocated, so to say, by the dentures. How have the techniques for making dentures evolved? The general techniques are tried and true, so they haven’t really changed. The real advancement has been in the materials. The stones, impression materials, the acrylics, and the bonding materials have all been significantly improved. Allie Comeau is a Fort Collins freelance writer.

VISION PRINTING Northern Colorado Medical & Wellness

Wellness

GROUP FITNESS CLASSES Pulse Group Fitness Classes Body Pump is the strength and endurance training class where muscle is targeted. Low on complexity but high in fun, it has all of the benefits of traditional weight training combined with time efficienc , predictability and great music. Body Combat is the workout with punch, a high-energy cardio class that combines moves from a wide range of martial arts disciplines. Here you punch and kick your way to increased fitness levels. This is suitable for beginners as well as those looking for an athletically challenging class. Body Step is a cardio fitness class using a step platform to shape and tone the legs and glutes, improve coordination, bone density, posture and agility. This class is broken down into tracks with specific goals (cardio/toning/strength), and its predictability helps you improve with each class. Body Step is suitable for anyone who wants an energetic and exciting results-oriented workout.

GROUP FITNESS CLASSES

BY MICHELLE CROTEAU

Do you want to get in better shape? Well, who doesn’t? But even the most dedicated people can run into pitfalls. These problems could be boredom, confusion or loneliness. The answer for you is to try group fitness classes. Group fitness classes are a fun way to exercise to music with other people who have the same goals.

oining a group fitness class no longer requires a neon leotard and leg warmers. Fitness centers these days are inviting students of all ages and any fitness backgrounds to join in on the classes. Though the music still blares, the classes have changed from being solely aerobic, to lifting weights, practicing yoga, learning hip dances, and kickboxing. Working out alone can be disheartening and is usually harder to stay committed to, but including group fitness classes to the plan is usually more fun, and the workouts seem to fl . Working out alone can be disheartening and is usually harder to stay committed to, but including group fitness classes to the plan is usually more fun, and the workouts seem to fl . Nowdays there are a variety of classes offered for all fitness levels. These classes are easy to follow, but challenging enough for your body so you continuously see results. The results you see are in direct proportion to the time you spend in the classes. Most classes run from 30 to 60 minutes. Remember that you need “cardio” classes to

Body Flow will change the way you feel forever. You will stand straighter and feel stronger. You will experience flexibilit , balance, improved core strength and a lengthening of your muscles for flexibilit . The smooth transitions create a harmonious workout between breath and movement, awareness and concentration, action and relaxation. Body Jam is the dance workout that unlocks your dancing instincts. The emphasis is on having fun while breaking a sweat. You will combine the latest dance styles and aerobic moves with great music to produce a cardio fitness experience at the cutting edge of modern exercise trends. Body Attack is a high-energy cardio workout inspired by sports training. It incorporates running, lateral moves, plyometrics, push-ups and core training throughout the class.

burn fat and keep your heart healthy, “strength” training classes to improve muscle tone and build strong bones, and “flexibility” classes to elongate muscles and keep joints mobile. Branded classes, like Les Mills’ classes, are choreographed to music so you can easily learn the moves and become familiar with the music. Such programs include Body Pump, Body Combat, Body Step, Body Flow, Body Attack, Body Jam and RPM. Non-branded programs have certified aerobic instructors putting music and choreography together independently. Both programs are beneficial. Varying your workouts with different group fitness classes will keep your body strong, toned and changing. Balancing your exercise program with cardio, strength training and flexibility classes will ensure that you remain healthy, alert and strong for a long and happy life.

Target Zone hits those tricky sticky zones: the abs, lower back and the legs! Feel the 30-minute burn as you work through specifically designed exercise progressions. Similarly, Core Strength is a 30-minute class targeting abs, obliques, and lower back.

Michelle Croteau is the group fitness manager at the Fort Collins Pulse.

Tai Chi is meditation in motion, working the whole body, stimulating your circulation and your health.

Fabulous 50s is a class where certified instructors lead participants in a variety of aerobic conditioning, hi/lo, step, weight training and stretching activities. A wonderful class for members aged 55 and older. Indoor Cycling combines music and simulated mixed terrain provide cardio training for all fitness levels. It is athletic, motivating, safe and mentally challenging.

Pilates is a mat class targeting the powerhouse, abs, hips, back and glutes.

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Michael P. Curiel, MD

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Wellness

CARDIOVASCULAR EXERCISE

Bowling at Chippers Lanes is fun and burns more calories than you may think.

HAPPY FEET ON THE HARDWOOD

BY ERICA PAULY

With colder weather heading quickly to Northern Colorado, indoor activities are beckoning its residents. We’ve found three different activities on hardwood that burn calories while you’re busy having fun.

ow about going bowling this autumn? Flitting across the lit floor with a marbled ball in hand, you’ll be burning more calories than if you were mowing your lawn. According to Nutristrategy Nutrition and Fitness, an online system that tracks and maintains individual fitness goals, you can burn up to 260 calories in one hour of bowling. With two locations in Fort Collins alone, Chippers Lanes is a convenient and fun place tospend quality time. In 2003, Matt Hoeven moved to Fort

Collins with his wife and daughters, Abbott, now seven years old; Gretta, now five years old; and Evelyn, now three years old. After purchasing the two alleys in Fort Collins, 830 North College Avenue (484-4777) and 217 West Horsetooth Rd. (226-6327), Hoeven renamed them after his late-brother and hero, Chip. Five years later, both alleys are booming and Hoeven has opened a third alley in Broomfield, Colorado. His goal; ten allies in ten years, and he is well on his way. Both alleys in Fort Collins offer league bowl-

ing, but the North College location is usually filled with families most nights till around nine. When the families head home at nine, the college students head in until 11:00 for a late night of fun. The Horsetooth location is busy with league bowlers and families as well. The leagues and camps offered are all over the map. Chippers Lanes offers a five-year old peewee bowling camp, junior league bowling, High School bowling league, Greek league bowling, and very competitive travelling league teams. “There are not many places nowadays where

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There are not many places nowadays where families can go together and have a great time. We are open on New Year’s this year, calling it ‘all you can bowl’, so there is an option for families to do something together. - Matt Hoeven, Chippers Lanes

families can go together and have a great time. We are open on New Year’s this year, calling it ‘all you can bowl’, so there is an option for families to do something together.” says Hoeven. Not only are the alleys packed with families, college students, and leagues, but the alleys are also filled with Non-Profit Organizations and fundraising events. Chippers Lanes is known for their Black-Tie Bowling and Bridesmaid Bowling fundraising event around Northern Colorado. Chippers Lanes is the perfect hardwood hot spot to visit this fall, with the family or with friends. The glistening maple- wood floor is sure to keep your blue and red bowling shoes gliding game after game. A Cheap Skate Sailing along the hardwood, as if floating, the clunk of your roller skates on the wood creating a soothing rhythm. Add 1980s music and 30 other skaters, and you’ve found yourself on one of the hardwood floors in Fort Collins that will keep your feet happy and your heart pumping this fall. Remember lacing up old brown roller skates with too-long laces and pulling up your socks? The smell of shoe spray filled the air while you steadied yourself on the edge of the wall surrounding the rink. It was the only thing separating you from the floor packed full of dancing skaters. Believe it or not, roller skating for one hour can burn up to 600 calories, which is the same number of calories you burn jogging for 60 minutes at five mph or less, according to Nutristrategy. Rollerland Skate Center is a classic Fort Collins favorite. November 16 will mark the 28th year

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3538 JFK Parkway, Ste 2, Fort Collins • (970) 223-0442 fortcollins@frosch.com 55

Wellness

CARDIOVASCULAR EXERCISE

Rollerland throws private parties and much more for skating fun.

anniversary for the rink. It all began as a dream for Edward Trevina and his wife Mary, and today, Rollerland is run by five of Edward’s six children. All six children grew up skating and working at both rinks, the other in Brighton called, “Wagon Wheel,” is run by Edwards daughter, Jhantel, and her husband. Jondon and Jathan, two of Edwards three sons, took over Rollerland in 2003. Their sister, Tawnika teaches private lessons upon request. All three grew up skating in every arena from roller derby to speed skating; so running the rink is in their blood. The rink may look like concrete, but the floor is made of three-quarter inch sheets of tongue and groove boards. The sheets, known as rollerboard, are laminated boards made from recycled paper. According to Jondon Trevina, “The rollerboard is good for falling on.” Which should ease any fears of getting going a little too fast to turn. Rollerland offers open skating daily, at $5 per person, and accommodates public and private birthday parties or special events. It further offers Tiny Tot (children under six years old) skating on Wednesday mornings from 10:00 to 12 noon for $2.50 per child. Adult skating is offered on Wednesday nights from 8:30 to 10:30 for $4 per person, and skate lessons are also available by request. For further information, call 482-0497. The Dancer Guy Another option to get your heart rate up this season is to slip on those dancing shoes. Moving rhythmically along a dance floor will keep your mind occupied with counting your steps to the beat, rather than counting the 440 calories burned (estimated for a150-pound person) in one hour, according to ProHealth, an online weightloss resource. “Dancer Guy” Dave Arns, a Fort Collins dance instructor, can help. He offers salsa lessons above

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Dave Arns’ at-home dance studio where he teaches more than 15 varieties of dance.

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the Rio Grande restaurant on Mountain Avenue every Tuesday evening, plus private lessons and group lessons out of his home. With a builtin dance floo , Arns offers an eclectic variety of dance lessons. HAVE IT YOUR WAY We’ll Design a Party that Fits! Dancing was introduced to Arns in 1998 CORPORATE RETREATS when he had to learn the lindy hop, a form of PRIVATE WHOLE HOUSE RENTALS TEAM BUILDING swing dancing, for an ‘Encore! Encore!’ perforMULTIPLE CATERING OPTIONS mance. “I was 100 percent into it from then on BIRTHDAY PARTIES We’ll Handle the Details! out,” says Arns. He performed in a few more CASH BAR, OPEN BAR OR DRINK TICKETS RETIREMENT PARTIES shows, and in May of 1999, he began teaching OPEN 7 DAY A WEEK! AND WE’LL CLEAN UP!!! 9am - midnight dance. The small variety of dances soon exploded into a wide variety, and further into more than College Center Horsetooth Center Broomfield Center 15 options. 830 N. College • 484-4777 217 W. Horsetooth • 226-6327 100 Nickel St. • 303-466-9700 The dances Arns offers vary in physical activity and difficult , depending on the dance and rhythm. The most difficult dance is the shimsham, which is a swing line dance. It involves coordination and balance while managing quick movements. “Some of my students only come for the exercise,” says Arns, “the weight loss incentive is a big 3744 South Timberline Road, Suite 102 • Fort Collins, CO 80525 • (970) 495-0506 factor for some of my students. My students say there is more excitement with dancing than there is with going to the gym.” When the snow comes this winter, put on those dancing shoes and hit something more exciting than the treadmill at the gym to work up a sweat and work off the calories. Our Physicians at Front Range Pain Medicine specialize in treating pain Arns’ fees range from $20 per person per with interventional pain management practices. hour to $60 per person per hour for private inOther Agencies Holding Events: struction. He further offers public classes, which SAVA • Kids at Heart • Spirit Crossing cost $30 per person for five hours of instruction. OUR GOALS ARE TO: Arns teaches swing, Latin, ballroom Bowland forcountry Life Suicide Prevention dances, with many different versions of each. PTO’s from multiple Poudre & Thompson - Treat, if possible, the source of the pain He also offers group classes found at: www. Valleylesson, School dancerguy.com. To schedule a private callDistricts • Foothills Gateway - Offer interventional treatment options Timberline Church • Vineyard Church 207-9176.

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Katrina Hurricane Victims • Childsafe numerous others...

- Promote healthy activities and preventative care

Erica Pauly is Contributing Editor for and Style Magazine.

- Return patients to the most functional and productive lifestyle possible - Coordinate multidisciplinary approaches, if indicated

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Veterinary Care

PET DENTISTRY

The serious nature of dental disease in our pets can’t be overestimated. It is believed that 80 percent of dogs and 70 percent of cats have some dental disease by age three.

PET DENTISTRY BY SARAH HAUGO, DVM, VCA FORT COLLINS ANIMAL HOSPITAL

We have all heard about the importance of going to our dentist twice a year for regular, professional cleaning and care. Most of us would never consider starting our day, leaving our house or putting our children to bed each night without brushing our teeth. Can you imagine what our mouth would feel like if we never brushed our teeth?

e assume not brushing our teeth would lead to dental disease; maybe a “cavity” or two, or the loss of our teeth over time; which is exactly what happens to our furry members of the family. However, just like we treat and prevent dental disease in ourselves and our children, there are many things we can do to help our four-legged family members. The serious nature of dental disease in our pets can’t be overestimated. It is believed that 80 percent of dogs and 70 percent of cats have some dental disease by age three. What’s more

important is that dental disease can have a huge impact on our pet’s overall health. Diseased teeth and gums are a chronic source of infection in the body, almost like an open wound that won’t heal. Since the infection is in the mouth, every time a pet swallows or eats, they are consuming infective bacteria. The bacteria are absorbed by the liver, heart, kidneys, and lungs and can lead to serious health problems. In fact, the bad breath you smell is actually billions of bacteria living underneath the gum line in a pet’s mouth. The disease process starts with the formation of plaque on the teeth. Plaque is a thin bacte-

rial film that attaches to the teeth, and if left in place long enough it can be mineralized into a concrete-like substance called calculus. This calculus is a yellow or brown-tinged material seen on a pet’s teeth. Although plaque can be easily removed with brushing alone, calculus is adhered to the tooth and needs to be professionally removed. If not removed, bacteria continues to build up underneath the gum line, which will eventually destroy the tissue around the tooth. This makes the tooth susceptible to infection and it can even fall out. This is a very painful process for our pets. Even though they can’t tell us about

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This dog has severe oral disease and will likely lose many of these teeth. These teeth appear to be so infected they are only held in place by the plaque and tarter.

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Veterinary Care

PET DENTISTRY The process of removing the tartar and plaque is called “scaling” and is often performed with an ultrasonic scaling tool. Some dental “cleanings” for pets stop there.

their discomfort, there is something we can do to help them. Start with a professional veterinary dental cleaning. A thorough cleaning involves cleaning every surface of the teeth, including the side of the teeth that face the tongue and underneath the gum line. As you can imagine, it is impossible to clean pet’s teeth this thoroughly while they’re awake, so pets are safely anesthetized for the procedure. This way veterinarians can clean and inspect their entire mouth, prevent them from swallowing or inhaling any of this infected material, and deal with painful or sensitive teeth without them feeling discomfort. The process of removing the tartar and plaque is called “scaling” and is often performed with an ultrasonic scaling tool. Some dental “cleanings” for pets stop there. Although the teeth may look clean, if not followed by polishing, scaling alone may cause plaque and tartar to build up even faster than before. The process of scaling creates small ridges in the enamel of the teeth which can attract plaque. To prevent this, VCA Animal Hospital polishes the tooth with a special paste. Most of us have had our teeth polished every time we see our dental hygienist, and it is a critical step in a professional cleaning. VCA Fort Collins Animal Hospital follows the cleaning with a flu ride application to strengthen the tooth, and end by applying a barrier sealant product to coat the

teeth. These products help to desensitize the teeth so pets are more comfortable and allow you to better care for their teeth at home. In addition to the cleaning, x-rays or dental radiographs of the mouth can be taken. It is impossible to determine the health of our roots without a radiograph, since only 50 percent of a tooth is visible above the gum line. This is especially important in pets because they can’t tell us which teeth have been causing them pain. With the radiograph we can identify diseased teeth and formulate a treatment plan which may involve special antibiotics, sealants, or extraction/removal. Sometimes, a tooth looks normal while the dog is awake, but underneath the gum, there is a severe infection or abscess. This can result in bone loss and the tooth will need to be extracted. Although owners don’t notice any signs of pain before the procedure, some note that the pet “started to eat hard food again, and seemed overall much happier and energetic” after the dental procedure. Remember that dental care will not only help to improve our best friend’s breath, but it is a critical step in helping them live longer, healthier, and pain-free lives. Sarah L. Haugo, DVM is a veterinarian at the VCA Fort Collins Animal Hospital.

Veterinary Care

FINANCIAL ADVICE

SAVING MONEY AT THE VET BY JULIE ESTLICK

Pets are beloved members of many front range families, and knowing how to maintain their health is key to lowering veterinarian bills and keeping our furry friends pain-free through all the phases of their life.

Most area veterinarians agree that the top five prevention strategies pet owners should follow are similar to those for humans: • Get a yearly physical exam for your pet. • Establish an adequate exercise routine for both outdoor and indoor animals. • Feed pets a high-quality, nutritious diet. • Provide proper dental care and regular cleanings. • After a full round of kitty and puppy vaccines, get boosters only when necessary and tailored to your individual pet.

ccording to Catharine Speights, DVM, Owner, Countryside Animal Hospital in Fort Collins, an annual exam gives you a chance to discuss any changes you’ve noticed in your pet. These appointments should include screening blood work and fecal testing to help identify the early stages of diabetes or kidney disease and find gut parasites or worms. “Vet and owner can talk about any concerns they have and find things that the owner may not know are there,” adds Dr. Speights. “If we see you regularly, we can learn the lifestyle of the family and help with prevention of things like Giardia (a water-borne parasite found in streams and ponds on the front range).” Fecal testing of cats and dogs is strongly

Northern Colorado Medical & Wellness

recommended for any household with babies or young children with prying fingers or family members who have suppressed immune systems. Some parasites and diseases can transfer from animal to human. Vaccine Issues While you may balk at paying $50 to $150 for blood work and $25 for parasite screening, it’s a better investment than annual vaccine boosters, which research has shown is often unnecessary and can even be dangerous to some animals’ health. Pets that receive the full set of puppy or kitten vaccines beginning at six to eight weeks are much healthier, and it is imperative to follow those guidelines. However, boosters are another story.

Studies of vaccines over the past 15 years revealed that cats often develop soft tissue fiber sarcomas, or tumors, and inflammation from too many shots in the “scruff” between the shoulder blades. Rather than pouring all the vaccines into one spot, veterinarians now inject them on the shoulder or elbow, so if a lump develops it’s clear what vaccine was placed there, Speights says. Similarly, dogs used to receive all shots in the neck and now the American Animal Hospital recommends vaccinating in the limbs. Research by Dennis Macy of Colorado State University, among others, also led veterinarians to rethink the effectiveness of yearly vaccines and their duration. The immune system has a memory, and every time you give a vaccine the system mounts a response that can lead to autoimmune

Veterinary Care

FINANCIAL ADVICE disease or kidney failure down the road. “The American Association of Feline Practitioners created a list of core and specialist vaccines to aid vets,” says Colorado State University Assistant Professor of Veterinary Medicine, Rebecca RuchGallie, DVM, MS. She also oversees the Community Practice and Shelter Medicine clinic within the James L. Voss Veterinary Teaching Hospital. Most core vaccines like FVRCP (for feline distemper and respiratory ailments) are now boostered every three years rather than yearly, and

most dog vaccines are also safely boostered every three years. Specialist vaccines are specific to your animal’s lifestyle. Exercise & Nutrition Once your pets get a clean bill of health, keep them on the right track with adequate exercise. “Obesity is a huge problem in both dogs and cats,” notes Speights. “If we can keep them fit from the start then there are fewer problems later on.”

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Obesity is a huge problem in both dogs and cats. If we can keep them fit from the start then there are fewer problems later on. - Catharine Speights, DVM, Countryside Animal Hospital in Fort Collins

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Dogs should be walked once or twice daily for 20 to 30 minutes to keep their bodies in good condition. Cats need interactive toys, scratch toys and time set aside to play with them. Proper training and modeling good behavior aids in bonding with your pet, says pioneering holistic vet Allen Schoen, DVM, M.S, an affiliate faculty member at CSU’s vet school and author of the book Kindred Spirits, among others. “So many animals are given up on because they act a certain way. Sometimes dogs are just `dogging’ and cats are ‘catting’ or acting on instinct. We need to provide positive reinforcement, love and compassion so they can be our best kindred spirit possible,” adds Dr. Schoen. All the exercise will build up a healthy appetite, so the next step is paying attention to what you’re feeding Fido and Fluffy. Shelling out a few extra bucks to get quality, high-end food with fewer fillers can avoid health problems like kidney disease and diabetes down the road, vets say. You’ll also clean the cat litter and the yard less often. Eric Boehmer, DVM, owner of Animal Hospital of Colorado in Fort Collins, sees two common mistakes owners make--feeding pets food that is loaded with sodium and giving too many “treats” of table scraps or inappropriate foods. Several brands of premium pet food offer balanced diets, but don’t just fill up the bowl or you may end up with a fat cat or dog. Most veterinarian offices have a chart that indicates how many calories your pet should consume based on their weight and activity level. “The foundation of a holistic approach to pet health is good nutrition,” Schoen says. “The Natural Cat magazine has good recipes for homemade, organic food and Whole Dog Journal evaluates commercial dog foods once a year so you can pick one with better ingredients. Getting your pet on a high-quality, easily digestible diet from the start is one of the best things you can do for their long-term health.” Boehmer always recommends the Hills T/D Diet food for healthy adult cats because of the special coating that scrubs the surface of the teeth as the cat chews, which adds a couple years between vet cleanings. Teeth & Gums Regular tooth brushing is required for pets to remove carbohydrates and sugar from their system. “Bacteria becomes plaque within 24 hours and the immune system tries to mount a response,” explains Ruch-Gallie of CSU. “This causes infection and problems with joints, liver, heart and kidney disease. So start tooth brushing as early as possible—before six months on baby teeth—to make it a positive experience for everyone.” Schedule dental cleanings every few years, depending on the animal’s genetics, teeth and breath. Again, it’s all about preventing painful, expensive health problems as they age. “With proper food, dental hygiene, and blood work we’re seeing pets live healthier, longer lives,” Boehmer says. Julie Estlick is a freelance writer living in Fort Collins with her husband and young son.

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Veterinary Care

LETTING GO Kathleen Cooney, DVM, takes BooBoo from home to Heaven.

We had to do this for our own dog a few years ago. Our dog was enjoying himself, lying under the aspen tree, and then he went peacefully. I was really able to see the impact it had on my husband who wouldn’t have been comfortable grieving in public. This is the way it always should be. - Kathleen Cooney, DVM, Home to Heaven

HOME TO HEAVEN

BY COREY RADMAN

Jenny Janiec slept on the floor with her cats last night. She and her husband, Ian, had decided, finally, that now was the time to release their sickest friend, BooBoo from his pain.

ooBoo had diabetes for the last three years of his life, and though he was well cared for, the Janiecs felt that the treatments themselves had become as much of a burden to him as his symptoms. So with great guilt and worry, Jenny and Ian decided that today would be his last. This would be the last day he would eat his favorite treats, the last day he would snuggle with his best feline buddy, Walter, the last day little Grace from next door would pop by to pat him on the head, the last day he would have to shoulder the burden of pain.

Today BooBoo lay on the grass and felt the autumn sun on his face. Today Ian and Jenny held him one last time. Today was the last time they would have to prepare themselves for what they had known was coming for many months. Finally, they could whisper their goodbyes and know that their beloved friend could rest. BooBoo was known through the neighborhood to everyone as a friendly cat. He was the kind of cat that could easily be played with by even the smallest neighborhood children, who loved to pick him up and hug him tight around his Oreo-colored middle. “I called him BooBoo because he seemed so

cool and mellow, like a jazz musician,” Ian says. He was the kind of cat who could saunter through any pet door on the block and be offered a treat instead of the business end of a broom. On his last day, many of those neighbors brought gifts of tuna for him to enjoy, one more time. Relief “His heart has stopped,” whispered Dr. Kathleen Cooney as she folded up her stethoscope. She was asked by the Janiecs to help end BooBoo’s pain. A veterinarian specializing in euthanasia, Dr. Cooney is known through the region for her fla -

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ing red hair and peaceful, gentle grace. Upon entering the Janiec’s home, Dr. Cooney observed BooBoo’s listless eyes, and flat, patchy coat and said, “I can see without even touching him that you’re making the right decision.” Relief had finally arrived Dr. Cooney’s four years in veterinary medicine have included surgery and internal medicine, but when her own dog was euthanized at home, she began to see another need in the veterinary field. “We had to do this for our own dog a few years ago. I had a colleague come help us in our front yard. Our dog was enjoying himself, lying under the aspen tree, and then he went peacefully. I was really able to see the impact it had on my husband who wouldn’t have been comfortable grieving in public. This is the way it always should be,” she says. Dr. Cooney contrasts that occasion to pet euthanasia experiences that she witnessed while working in clinics in her home state of Michigan. “We helped a woman with her dog, and I remember that there was no place for her to sit or lie down. So she just lay down on the cold, sterile floor of the clinic and sobbed with him.” Dr. Cooney feels there is a more compassionate way for both pets and their people. Thus, her business, Home to Heaven, specializes in peaceful, pain-free euthanasia for pets of all kinds. She explains that she first administers a sedative injec-

Northern Colorado Medical & Wellness

tion for the animal, which helps the pet to relax and drift off to sleep. Then a euthanasia solution, usually administered through a catheter, is given to stop the heart. Dr. Cooney encourages families to share their feelings, and she always takes the time to listen to their stories and questions. She also finds it helpful for the other family pets to be included, so they, too, can understand what is happening to their friend. “It is really about what the family wants,” she says.

Jenny Janiec signs the release form for Dr. Cooney to administer treatment to BooBoo.

Dr. Cooney and Jenny Janiec spend the last moments with BooBoo.

Tomorrow With BooBoo gone, the Janiec household begins thinking about tomorrow. What will it be like without their beloved “cool cat?” The other felines in the family will certainly miss him, as will his entire family, both in the house and up and down the block. But as Jenny says with tears in her eyes and her voice cracking, “You want their love to go on forever… but sometimes you just have to open your eyes and see that letting go is a gift.” Dr. Cooney can be reached at (970) 4126212, or at www.hometoheaven.net. Corey Radman is a writer and mother who lives in Fort Collins. The editors express their condolences to the Janiecs as well as their thanks for the couple’s cooperation in this story.

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