2009-07 Northern Colorado Medical & Wellness Magazine and PVHS Physician Directory by Style Media & Design, Inc.

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2009 | 2010

VOLUME XI

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UPVHS HELPS LEAD THE WAY IN CREATING A VIBRANT, WORLD-CLASS COMMUNITY." PVHS is at the heart of Fort Collins: taking care of us and inspiring us to engage in the great, healthy lifestyle opportunities at our doorstep. Whenever I have the privilege to represent what's great about Fort Collins, I'm proud to tell the story of PVHS . The Baldrige Award just shows the nation what we've known all along . Congratulations, friends.

POUDRE VALLEY HEALTH SYSTEM pvhs.org

Darin Atteberry Fort Collins City Manager

Fellowship Trained Spine Intervention and Pain Management Procedures under Fluoroscopic Guidance Fellow, American Academy of Physical Medicine and Rehabilitation Subspecialty Board Certification in Pain and Sports Medicine Diplomate, American Board of lnterventional Pain Physicians Diplomate, American Board of Electrodiagnostic Medicine Certified, McKenzie Mechanical Diagnosis and Treatment of the Spine

Fort Collins Medical Magazine & Directories 2009 2010

Sabrina was treated to all-around great care when having her baby at McKee Medical Center. She received personal phone calls from her physician, Dr. Howell, to inform her of test results in the days leading up to her delivery. And she was able to relax before and after the birth of her baby in a private jetted tub . The caring staff even provided free massages and delicious cookies to help make her comfortable. But it wasn't just about Sabrina. Her whole family enjoyed the experience of the new baby together in a spacious and relaxing labor, delivery, recovery and postpartum room. McKee Medical Center provides a private, feel-good atmosphere where you can welcome your baby into the world. McKee Medical Center. Remarkable health care inspired by you.

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McKee Medical Center www.BannerHealth.com, keyword: McKee Maternity路 2000 N. Boise Ave.路 Loveland (970) 669-4640 路Job opportunities: 866 -377-5627 (EOE/AA) or www.BannerHealth .com Banner Health is the leading nonprofit health care provider in northern Colorado.

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Publisher’s Letter Providing WorldClass Healthcare

It is with special pride and a great deal of enthusiasm that we publish our 11th annual Fort Collins Medical & Wellness Magazine and Directories in collaboration with Poudre Valley Health System (PVHS). This issue gives us the opportunity to revisit the exceptional management of PVHS, and this year has truly been an outstanding one. Rulon Stacey, President and CEO, and his management team have always been committed to providing world-class healthcare to our region. Naturally, this cannot be accomplished without the commitment of engaged employees who share the values, vision, and mission of PVHS. One goal set by the team has now been achieved. After a 10-year pursuit, the System has been awarded the Malcolm Baldrige National Quality Award, the highest Presidential honor given to United States businesses and organizations for performance excellence. This award is bestowed by the National Institute of Standards and Technology to recognize manufacturing, small business, service, educational, and healthcare organizations that meet rigorous criteria and demonstrate excellence. The award examined leadership, strategic planning, customer service, workforce development, knowledge and process management, and clinical regulatory and financial results. President Obama will present the prestigious award to PVHS leaders and staff members in Washington, D.C., in 2009. Congratulations to all 4,000 employees who made this award possible!

Stacey’s leadership and employee commitment has brought more accolades to the System: PVH was presented with the American Nurses Association’s highest award for excellence in nursing and, in 2009, it again received the Magnet Award for Nursing Excellence by the American Nurses Credentialing Center. In addition, PVHS was named as one of the 100 Best Places to Work in healthcare by Modern Healthcare and Thomson Reuters has voted PVHS one of the Top 100 Hospitals for five consecutive years. These many awards again point to how fortunate we are to have the exceptional healthcare provided by the physicians and healthcare professionals in our area. One such service is the PVH Cleft Clinic, which provides world-class cleft lip and palate reconstruction. Read about plastic surgeons, Dr. Mark Boustred and Dr. Christopher Tsoi, and their team’s sensitive approach to early assistance in this important corrective intervention for young children. Each year 700,000 people suffer a stroke and stroke is the leading cause of serious disability. Read “Stroke Prevention, Treatment, and Recovery” to learn from Dr. Gerald McIntosh, neurologist, and Dr. Chad Stoltz, cardiologist, about strokes and the award-winning care PVH provides to stroke victims. Keeping families together is the goal of the Poudre Valley Hospital and Medical Center of the Rockies birthing centers. Enjoy reading about the exceptional “Teamwork in the Nursery” and how the PVH NICU Level IIIA nursery team works with families and partners with the newly-remodeled nursery at MCR on a case-by-case basis. The goal of this publication is to inform you of new technologies, new methods of diagnosis, and the latest in treatment modalities. Our desire is to inform you about medical facilities, services, protocols, introduce you to exceptional physicians and healthcare providers, and emphasize the importance of prevention. Enjoy reading about “The Surgery Centers of Northern Colorado” and how they ease the trauma of surgery. Learn about “The PVHS Network” of neighborhood clinics providing more options for your family’s healthcare. Be introduced to “Virtual Colonoscopy - A Screening Alternative,” a non-invasive diagnostic procedure. In the Wellness section of this issue, become informed with “Alcohol’s Impact on Your Health,” be introduced to pain management through “The Rossiter Approach,” and learn the importance of good sunglasses to protect eyes in “Sunshine’s Dark Side.” This Fort Collins Medical & Wellness issue is full of useful and interesting information. It also includes an easy-to-use Physician’s Directory divided by specialty and physician name. My hope is that this issue will support you in taking care of yourself and your loved ones. May you enjoy this issue and keep it as a resource guide to help manage and maintain your health throughout the year. Wishing each of you good health,

lydia@stylemedia.com

2009 | 2010

VOLUME XI

TABLE

CONTENTS

Medical Magazine & Directory

Wellness Magazine & Directory

8 12

Kettlebells - Total Body Workout

Alcohol’s Impact on Your Health

The Rossiter Approach

Sunshine’s Dark Side

86 88

Accurate Medical Records Save Lives Wellness Directory

Publisher’s Letter Introduction Letter

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

Introduction Letter

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

16 24

Bringing Home Baldrige PVHS Looks to the Future

Stroke Prevention, Treatment, and Recovery Move with the Music: Neurologic Music Therapy New Ways to Learn PVH Cleft Clinic - World-Class Cleft Lip and Palate Reconstruction

30 31 32 35 39

Physician Directory Introduction Letter

55 62 66 91

The Surgery Centers of Northern Colorado Teamwork in the Nursery Front Range Pain Medicine Expands The PVHS Network More Options for Your Family’s Care

Virtual Colonoscopy A Screening Alternative

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

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

We take your health to heart. You can take comfort in knowing that the skilled physicians at the CardioVascular Institute are specially trained to perform the latest procedures equipped with the most advanced imaging technology-like our 64-slice CT scanner to provide the clearest possible picture of your heart. And our Cardiac Alert Program offers quicker care for emergency heart situations due to outstanding coordination between paramedics , cardiologists, and the ER. At the CardioVascular Institute, you can feel confident knowing that your heart's in the right place. This level of care wouldn't be possible without the skill of our CardioVascular Institute physicians. Jim Beckmann , MD Harold L. Chapel , MD Lin-Wang Dong , MD Cynthia L. Gryboski , MD

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

Dear Medical & Wellness Magazine Reader:

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

Poudre Valley Health System has continued to grow to meet the needs of the 900,000 people we serve in northern Colorado, southern Wyoming and southwestern Nebraska, a geographic area similar in square mileage to the state of Florida. During the last two years, our growth has included: purchasing Loveland Urgent Care, which offers urgent care, family medicine and occupational health; opening Foxtrail Family Medicine, Loveland, owned by PVHS and managed by the Associates in Family Medicine; purchasing a family practice clinic in Milliken, owned by PVHS and managed by the Greeley Medical Clinic; completing a second medical office building for physician groups that want to be located next to the Medical Center of the Rockies, Loveland; constructing the Redstone Building on the PVHS Harmony Campus, Fort Collins, now occupied by physician offices and the PVHS corporate offices; completing the Westbridge Medical Suites building on the Poudre Valley Hospital campus, Fort Collins, with occupants including the Women’s Clinic of Northern Colorado, Associates in Family Medicine, PVH’s administrative offices, and Twenty Three Trees, the region’s highest quality medical and wellness spa; opening a four-story employee parking garage at PVH so more ground-level parking is available for patients and visitors who want to park near the hospital’s entrance; and a significant upgrade of PVH to enhance patient care areas. Our expansion activities have been carefully planned with the strategic goal of offering easily accessible world-class services to our patients. Establishing clinics throughout the region, for example, is an important step in providing this easy access. In addition, PVHS has entered into joint ventures with a variety of physician groups over the last decade. This allows the health system and private physicians to work more closely together to meet patient needs. Much of what we have accomplished over the last decade can be traced back to our quest to achieve world-class excellence by following management and operational principles recommended by the National Institute of Standards and Technology through its Malcolm Baldrige program. The Baldrige method encourages companies to improve work processes and efforts in customer service, financial performance, employee and vendor relations, and, in the case of healthcare providers, medical quality. PVHS first applied for the prestigious annual Malcolm Baldrige National Quality Award in 1999. Established by Congress, the Baldrige Award is the nation’s highest honor that recognizes private businesses, governmental agencies and healthcare organizations for achieving sustainable performance excellence. We continued to apply for the award annually, not with the sole goal of winning, but with the overriding mission of improving the way we take care of patients and conduct the business of health care. Our journey along the Baldrige path helped the health system evaluate, refine, reorganize, and enhance our work processes. In late 2008, we were notified that PVHS was one of only three organizations and the only healthcare organization to win the coveted award for that year. The award is a tremendous validation that PVHS provides high-quality services that rival the best healthcare organizations in the world. Of the more than 50 national awards and honors that PVHS has received since 2004 for clinical quality and business operations, the Baldrige award is at the very top of the list for its national prominence. As you may already know, healthcare reform will have a huge impact on the nation’s medical industry. Thanks to our Baldrige journey, PVHS is in many ways better prepared for reform than most other healthcare organization. The self-evaluation and knowledge we gained through our Baldrige journey helped us improve work processes, establish a health records network for PVHS and local physicians, and, among other many benefits, focus our emphasis on maintaining world-class care. I would like to suggest that you read the letter on healthcare reform written by Stu VanMeveren, chairperson of the PVHS board of directors, and published in this magazine. His letter will give you more insight into the way PVHS approaches healthcare reform. Finally, as you make your journey through the next year and beyond, please remember that Poudre Valley Health System is here for you.

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

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

Dear Medical & Wellness Magazine Reader:

Stu VanMeveren Chairperson, Board of Directors Poudre Valley Health System

You can’t turn on your television or radio today without hearing about healthcare reform. Although we are the richest nation in the world, we are by far not the healthiest. A high percentage of our citizens are unhealthy because they are overweight or obese. Cancer, heart disease, diabetes, and other ailments plague our population at high rates. More than 40 percent of our population is under insured or uninsured. At times our emergency rooms are jammed. Many go without healthcare, exacerbating their health problems. As a nation, we’ve talked for decades about healthcare reform. Now it is becoming quite evident that healthcare reform in one form or another is on its way. It remains to be seen what the cost will be and how it will be paid for. We are all concerned about the impact it will have on our economy, the national debt, and the overall availability and quality of our healthcare. My volunteer work as a board member for Poudre Valley Health System has helped me understand what healthcare reform means. Once you get past all the political dialogue, the complexities and the jargon, it can simply boil down to this: We want to have healthcare coverage for all Americans and we want to provide it in the least expensive way, with the highest quality of patient care. That’s a tall order. Here’s what we can likely expect as healthcare reform settles into place in the coming years: Government programs such as Medicare will offer less reimbursement to hospitals, physicians and other providers, who care for patients covered by the programs. This will have a major impact on the healthcare industry, where more than 50 percent of America’s hospitals already are losing money. Meanwhile, the number of persons needing healthcare, as the Baby Boomer Generation ages, will keep increasing. As a result, providers will have to offer care to more people but will unlikely receive a corresponding increase in revenue. The upshot? The healthcare industry will have less money, so it will need to work smarter and harder to still maintain quality. A larger effort will have to be directed to preventive care. As a way to contain costs and enhance care, the healthcare industry will focus on integration. This will require an increase in the use of electronic health records so hospitals, physician offices and other appropriate providers will have secure and immediate electronic access to the medical records of their patients. Integration also means hospitals and health systems throughout a geographic region will need to form closer working relationships or partnerships. This will create an economy of scale scenario, where all must work together rather than all working separately. The healthcare industry will become more transparent. This is an absolute necessity. Public access to a hospital’s patient care outcomes, quality measurements, compliance information, and other records will be necessary to maintain quality. Without the ability of the public to keep abreast of such measurements, it might be tempting for a healthcare organization to save on expenses by cutting staff and other services, resulting in a lower level of care. Given what healthcare reform means nationally, what could be the local impact on the region’s major healthcare provider, Poudre Valley Health System? PVHS is well-prepared. Fortunately, the health system has already honed many work processes, established an electronic health records system and is committed to making patient care outcomes and other important measurements of quality available to the public. Much of this preparation was the result of a decade-long journey undertaken by PVHS to weave principles and work methods of the National Malcolm Baldrige program into the basic fabric of the health system. (Be sure to read Rulon Stacey’s letter in this publication on the PVHS Baldrige journey.) The road ahead will be challenging for all healthcare organizations, including PVHS. Nonetheless, PVHS is committed to continue to improve upon the world-class healthcare that it now offers. We intend to continue developing our electronic health records system to keep pace with the need of patients and local physicians and other healthcare providers. Meanwhile, we look forward to forming more alliances with other healthcare providers in the region as a way to broaden our reach of services and numbers of patients. As I mentioned earlier, we already are committed to transparency. You can find our quality data and other measurements on www.pvhs.org or, for that matter, on Websites operated by the Colorado Hospital Association and federal agencies. In the near future, even more data will be available on www. pvhs.org as we expand our transparency. All in all, these are exciting and challenging times for the healthcare industry. Whatever the path healthcare reform will take, be assured that PVHS will meet the challenge in a way that will benefit our patients and our regional community.

Stu VanMeveren Chairperson, Board of Directors Poudre Valley Health System

Fort Collins Medical Magazine & Directories 2009 2010

www.youtube.com/user/PoudreValleyHealth

LITY Your locally owned leader in health care is a national role model for excellence. Poudre Valley Health System has received the 2008 Malcolm Baldrige National Quality Award- the highest Presidential honor given to United States businesses and organizations that demonstrate performance excellence. Thank you to our treasured patients and families, incredible volunteers, staff and physicians, and the many regional organizations who support us in achieving our vision to provide worldclass health care .

Were herefor you.

POUDRE VALLEY HEALTH SYSTEM

medical

PVHS

PVHS representatives attending the Malcolm Baldrige National Quality Award ceremony in Washington, D.C., where President Obama will present the award: Warren James, M.D., Priscilla Nuwash, MBA and Director of Process Improvement, Melisa Smith, R.N., volunteer Mary Carlson, D.V.M., Rulon Stacey, Ph.D., President and CEO, and Gerald McIntosh, M.D.

Bringing Home Baldrige

by Corey Radman

It is 6 a.m. just before Thanksgiving, 2008, and the Poudre Valley Hospital System senior staff is already in the office. They are waiting for a call, a call that has failed to come three times before. But this year, they hope, is going to be different. The System has spent 10 years in pursuit of the highest goal an American business can aim for, the Malcolm Baldrige National Quality Award. Each year since they first applied in 1999, they have undergone intense external evaluation and received feedback for improvement in seven different focus areas: leadership; strategic planning; customer service; workforce development; knowledge and process management; and clinical, regulatory and financial re-

sults. This would be the fourth year they made it to the final evaluation process, where up to eight trained examiners conducted four-daylong site visits and interviewed more than 350 staff, physicians, and volunteers. This was the day when they were scheduled to hear the results of all that effort by so many people. The protocol required the organization’s “highest ranking officer” (President and CEO, Rulon Stacey, Ph.D.) be available for a call

from the U.S. Secretary of Commerce by 6 a.m. Mountain Time. Three times before, Stacey and his staff had waited for this call, only to be notified mid-morning they were not a recipient of the award. But not this year. When the phone rang just after 7 a.m. that day in November, Stacey’s Executive Assistant,

The people who work here are like family; I love these people. Rulon Stacey, Ph.D., President and CEO

Christy Ricks, answered with hopeful anticipation. “Hello, this is the Secretary of Commerce’s office calling for Dr. Stacey please,” said the voice in Washington, D.C. “Yes!” breathed Ricks, as she transferred the call. As she and the rest of the team gathered in Stacey’s doorway, silently celebrating while he accepted congratulations on the phone, the autumn sun’s rays were just peeking up over the horizon. A new dawn had begun for PVHS. The Baldrige Award is bestowed by the National Institute of Standards and Technology (NIST) to recognize manufacturing, small business, service, education, and healthcare organizations that demonstrate sustainable performance excellence. President Obama will present the award to PVHS leaders and selected staff in a 2009 ceremony yet to be scheduled. In Pursuit of Excellence In 1997, Rulon Stacey and the PVHS board of directors made the collective decision to pursue The Baldrige Award, knowingly biting off a sizeable goal. In order to be successful, the organization would have to entirely change its approach to management and self-evaluation. The Baldrige process itself requires setting, meeting, and sustaining measurable progress. The application is 50 pages long with 250-plus questions requiring solid proof of improvement in each of the seven categories. Few organizations receive the award the first year they apply; applicants understand that the Baldrige program is a long-term commitment dedicated to creating businesses that can demonstrate quality improvement and a commitment to ex-

cellence. The beautiful crystal award is a secondary goal. With such a daunting process in front of them, Stacey proposed his father’s workhorse philosophy. Learned as a teenager picking cherries in Provo, Utah’s river bottoms, Stacey’s father explained that one could put all their effort into a huge push the first few hours of the first day and have a respectable harvest. Or they could keep a slower, steadier pace that would sustain for several weeks and earn many more bushels of cherries. “For us, it’s the process of getting better that is important. We didn’t have a specific percentage of improvement in mind each year; we just wanted the slope to be positive,” explains Stacey. With the workhorse philosophy in mind, PVHS began working toward small milestones each year. Asked to point to specific examples, Stacey says, “How about 5,000 different things? It was a lot of people all doing their part that made it work.” World-class Communication The vision of PVHS is to provide world-class healthcare. To help employees and volunteers understand and support that vision, Stacey points to the leadership’s communication strategies that, in part, enabled their success. “I attend all the new employee orientations and tell them what I tell everyone who works here, ‘This has got to be the very best place you have ever worked.’ If staff has suggestions for how to make it better, I give them my home phone number. Other senior staff also have open-door policies to hear suggestions and

problems so we can make sure this really is the very best place any of us have ever worked.” Stacey continues: “When CEOs of other companies ask me about our Baldrige success, I talk about Servant Leadership,” (a philosophy written about by Robert Greenleaf). “If you look at companies with long-term successful models, the leaders view their workforce as customers and themselves as providers of a service. I tell my senior staff, ‘If you believe your employees don’t have to like you – they just have to get the job done – you have got to go elsewhere. Here we provide a service. We are going to treat employees like family. We’re going to be happy in their successes and sad in their failures. We’re going to make this place like coming home,” he says. Success All that effort has certainly produced results that have caught the eye of executives nationwide, according to senior staffers. PVHS started their journey with employee turnover rates at 25 percent annually. Rates in recent years have been around seven to eight percent (even before the recession). In 2008, Modern Healthcare voted PVHS one of the Top 100 Best Places to Work in Healthcare. Additionally, the system ranks in the top 10 percent nationally for inpatient mortality, patient satisfaction, and in the top three percent for employee satisfaction. Thomson Reuters has voted PVHS one of the Top 100 Hospitals for five consecutive years. Stacey’s eyes sparkle with pride and emotion when he attributes the system’s successes to his staff. “I believe that what put us over

Baldrige asks what are your approaches? How do you deploy them? How do you learn from them? How do you measure them so you know you are accomplishing your goal? Priscilla Nuwash, MBA, Director of Process Improvement

Fort Collins Medical Magazine & Directories 2009 2010

The relationship [between administrators and physicians] has been the key thing that has allowed this medical community to be as good as it is. Warren James, M.D., FACOG, Chief of Staff, MCR, physician with The Women’s Clinic of Northern Colorado

the top was when we really, truly believed that these are our patients. That’s everyone – from me, to the doctors and nurses, to our cooks and housekeepers – who all said, ‘These are my patients, and I provide world-class healthcare.’” Talking to staff throughout the organization, one finds a common thread of passion for this vocation and enthusiasm about the health system. These are people who are constantly in search of ways to improve, who take those thoughts with them, even when their workday is finished. Thinking Time Priscilla Nuwash, MBA and Director of Process Improvement, has changed out of the day’s business attire and into her Frisbee-throwing jeans. Her sheepdogs, Yoko and Blue, happily chase the well-chewed plastic discs across the field that is her backyard, but her mind is only partially there in the native grass. She is thinking about customer satisfaction. In her five years as a Baldrige examiner and leader of process improvement at PVHS, she has led and witnessed innumerable changes that built the path to current success. She cites the patient discharge phone calls as one example that drastically improved patient loyalty to the system, a system that took a lot of Frisbeethrowing time (and the efforts of many people) to get just right. PVHS policy now requires that a hospital representative call all recently discharged patients to check in, make sure they understood the doctors’ instructions, and ensure they are feeling well. That effort paid off: it created an opportu-

nity for patients to provide direct feedback about their experience in the hospital and fostered loyalty to the system. “Now when we track our patient satisfaction, we don’t just track satisfaction from a level of one to five,” says Nuwash, “we break down the top box into smaller percentages. Those in the ‘highly satisfied’ box should be tracked incrementally.” “Our top box scores (meaning those who rate us in the highest category possible) are at 80 to 90 percent. The industry says that 60 percent exceeds expectation,” Nuwash explains. Of the many changes Nuwash is proud of, the top box scores are one of her favorites. “It means that Northern Colorado residents aren’t just happy with the care we give, they rave about us.” Nuwash is quick to dispel the myth that the Baldrige approach has cost the system in dollars. “‘How much does it cost?’ is the first question we get in presentations to other corporations. We found that when we made this the way we do business, it wasn’t a cost at all. The return on investment has been proven.” She cites their enormous drop in staff turnover rates as a huge savings: “When you start multiplying the cost of losing employees, it really adds up. We figure the cost of replacing a nurse is $100,000.” Perks Since being honored with the Baldrige award, PVHS has been included in a top-notch group of nationally known corporations called the BAR group (Baldrige Award Recipient group). “Now we get to learn from other recipients and we can all push each other to that

higher level,” says Nuwash. Members of senior administration have been invited to speak on their best practices at conferences across the country and around the world. Rulon Stacey and Pam Brock, Vice President of Marketing and Strategic Planning, addressed an audience in Abu Dhabi in March. Nuwash reports that representatives of corporations beyond healthcare have approached PVHS with congratulations. “Here we are in Northern Colorado and we are honored with national recognition, not just for quality or great technology, but for covering the whole spectrum of needs for our community.” Nuwash and performance excellence manager, Sonja Wulff, are part of the team that has kept PVHS on track in their quest for greatness. Nuwash is a believer in the process, “Baldrige is unique because each feedback report we get tells us how to improve.” (As opposed to other awards that give no feedback whether you win or lose.) “Even our winning application had 32 suggested improvements that PVHS is working on this year,” she says. “No one is perfect, but with Baldrige, every single year there are ways to improve.” Engaged in Excellence In addition to suggesting improvements, Baldrige also notes an organization’s strengths; one core competency of PVHS is employee engagement. Melisa Smith, R.N., would agree. Like many of her fellow employees, her passion for her job laps over into her personal time. Even as she drives home from her night shift in the post trauma department at Medical Center of the Rockies, she

Our physician staff was much more involved than the industry average. Why? Because we have an outstanding group of physicians who are willing to work on [process improvement] projects. Gerald McIntosh, M.D., Chief of Staff, PVH, physician with Neurology Associates of Northern Colorado

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Staff at the hospital keeps a positive attitude and constantly strives to make things better for themselves and the patients. In that way, we keep making care better. Melisa Smith, R.N., MCR Post Trauma Unit

calls the day nurses to relay a forgotten detail or suggestion. “I love taking care of patients and doing it for PVHS,” she states. “The system has been so supportive of me. I started as a housekeeper at PVH and worked my way up as I went to school.” “The administrators here are always very helpful to nurses and doctors. Any time there is a concern they’re right there to assist.” That cooperation makes it clear to medical staff that patient care is a top priority. “I also love that they are so accessible. Rulon [Stacey] is fun to talk to. It’s nice not to fear the CEO, even though he’s so important,” she says. Smith, along with 20 other lucky volunteers, employees, and physicians, won the lottery to be included in the award ceremony in Washington, D.C. They hope to travel there soon, but are awaiting a call from President Obama’s schedulers. Smith represents the workforce when she beams with pride about the accomplishments of recent years. “People here have always provided great healthcare, but morale went way up when we started to be recognized for it. Finding out that we are the cream of the crop has made it fun to be at work.” Physicians fill a special role in any health system, and finding ways to work with these independent partners is often a challenge for hospitals, which is why Chiefs of Staff exist: to act as liaisons between physicians and hospital administration. Asked if they ponder work issues while on relaxation time, both Chiefs for PVH and MCR give a slightly chagrined, “I’m afraid so.” Warren James, M.D., FACOG, is Chief of Staff at Medical Center of the Rockies (MCR) and a physician with The Women’s Clinic of Northern Colo-

rado. He thinks about work and how to make it better all the time, he says - even while deer hunting along the Platte River. Sitting silently in a deer stand watching the morning mist rise, he’s mulling over the best way to implement site marking – a new system that requires surgeons to mark in indelible ink the portion of the body being operated on (the right kidney, not the left, for example). Dr. James reports that extra steps like these (and the extra paperwork) for physicians make a long day, but asked if it’s worth it he says emphatically, “Yes. Ultimately, processes like these result in better care for patients.” Gerald McIntosh, M.D., spends long days caring for patients both at the hospital and in his medical practice, Neurology Associates of Northern Colorado. He acts as his fellow physicians’ representative as Chief of Staff at PVH. When he gets a chance, he says, he unwinds by bicycling the big hills west of Fort Collins on an Orbea carbon fiber road bike. With inclines of eight percent or more, it can be hard to think about anything except forward motion, but thoughts of process improvement dog him there like his MCR counterpart on the plains. McIntosh refers to a recent example of improvement: “Physicians and nurses began working with staff to reduce the number of patient falls. On the neurology floor, we noticed that falls were common for patients with neurologic impairments. We now identify potential fall victims and have installed video monitoring systems in the rooms. We have a fall alert system to notify staff when a patient looks like they might get out of bed.” In the first two quarters of this year, there have been no falls. Dr. James attributes PVHS’ success to a number

What is the Malcolm Baldrige Award? In the 1980s, the United States was seeing more international business competition than ever before. So much so that the Federal government instituted a program to foster better business practices. In 1987, the Malcolm Baldrige National Quality Improvement Act was passed (Public Law 100-107). Named for the Secretary of Commerce under President Reagan, the law forged a public-private partnership that fosters strategic planning for quality improvement programs through a commitment to excellence. Initially targeting manufacturing and services, the government recognized that these sectors were essential to the well-being of the national economy and its ability to compete effectively in the global marketplace, according to the National Institute of Standards and Technology. Since those early years, NIST has also added categories in manufacturing and healthcare. In 2008, PVHS was one of 43 healthcare organizations that applied for the MBNQA. It was the only one honored in that category.

You’ve got to give back to your community. Sometimes it’s better to give your time than to write a check. Mary Carlson, D.V.M., Volunteer at PVH

Pam Brock, PVHS Vice President of Marketing and Strategic Planning, explains to professionals in Abu Dhabi the efforts that led to their achieving the Malcolm Baldrige National Quality Award in 2008.

of changes. “It’s multi-factorial; not just one person or segment made the difference. The Chiefs of Staff’s relationship between administrators and physician groups has helped. And the culture coming from the administration is open. They want to work with us, which engenders the reverse. When physicians feel administrators want to collaborate, it makes it easier to trust and partner.” Previous Baldrige feedback reports noted room for system-wide improvement in physician engagement. Dr. McIntosh observes that through collaborative problem-solving with the Chiefs, listening and responding to doctor concerns, and investing in better systems (like the digital medical records system that enables doctors to view patient charts and imaging scans from their offices or even their homes), the physician engagement is drastically improved. A 2008 survey conducted by Gallup showed that physicians working with PVHS ranked 91st in the nation for engagement and 99th for loyalty to the system, which places PVHS in the top one percent nationally. Dr. James sums up the admirable accomplishments of the system with regard to its physician partners: “I am most proud of the relationship between administrators and physicians. I have seen in other systems that executives and doctors are like they are on two teams – competitive. Things don’t work effectively that way. We just don’t seem to have that here. That one relationship has been the key thing that has allowed this medical community to be as good as it is.” Working Together As important as direct patient care is, a huge asset to the hospital system is its volunteer corp. So admired and valued are they that even former physicians join the ranks and together log thousands of hours each year. Mary Carlson, D.V.M., whacks the golf ball

with the force and determination that drives everything she does, even her volunteering at PVH’s information desk. She thinks with satisfaction about the people she made smile today. “On someone’s worst day, I can make it a little better.” Just a smile, a kind word, or a funny wheelchair ride makes a difference for her patients. As a volunteer with PVH for four years and long-time community volunteer and activist, Carlson has a good vantage point on the system’s track record. She has been a patient herself and had several close family members admitted to the hospital. She believes the care provided by the system has been exceptional. “Everybody is so proud of the job they do there,” she says. “We are all made to be as important as everybody else. We are all equally important to the vision. I think we do provide world-class healthcare.” It took over 4,000 employees all working toward the same vision to achieve the Malcolm Baldrige National Quality Award. And, at the day’s end, everyone involved in PVHS’ success is still thinking about how to make it better. They exercise, they spend time with their families, they throw Frisbees, and they provide world-class healthcare – every day.

Rulon Stacey, PVHS President and CEO, addresses a group of professionals. He and Pam Brock, PVHS Vice President of Marketing and Strategic Planning, were invited to speak in Abu Dhabi in March 2009.

Epilogue A new day has come. Rulon Stacey is again up with the sun, running along Horsetooth Road, limping from his gimpy knee, but persevering like the work horse his father taught him to be. He’s distracted by the pain, but he can’t stop now. He is working out a plan... a plan that will help PVHS maintain its impressive trajectory toward the future of healthcare. Corey Radman is a writer and mother of two who lives in Fort Collins.

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Medical

PVHS

Looks to the Future by Corey Radman

Poudre Valley Health System has just completed an amazing run of success. In the last two years, the organization has opened Medical Center of the Rockies in Loveland and completed construction on a $35 million improvement at the Poudre Valley Hospital campus in Fort Collins, including a recently opened four-story parking garage and medical office building west of the hospital.

PVHS has also received numerous, high profile awards, not the least of which is the top Presidential honor for business in the country, the 2008 Malcolm Baldrige National Quality Award. With all that accomplished, one might ask, “What else is there to do?” “We’re going to continue to provide worldclass healthcare every day,” says PVHS President and CEO, Rulon Stacey, Ph.D. And that’s no small thing. PVHS’ hospitals are consistently recognzied for being among the best in the nation for quality of care. “We’re thrilled to have been honored with the Malcolm Baldrige award, but for us, it was really about the process of getting better,” says Sta-

Westbridge Medical Suites, the $35 million improvement project at the Poudre Valley Hospital campus, included a four-story parking garage, a medical office building, and sky bridge to PVH’s main building.

cey. “Going through the Baldrige process helped us develop into an organization focused on performance excellence.” Stacey explains that even though PVHS is not eligible to apply for Baldrige again for five years, they will continue to seek out external reviewers to help provide the kind of feedback that ensures ongoing improvement. Growing Cautiously In addition to providing excellent healthcare, PVHS has plans to continue expanding – though plans are long range at this point. “We’re going to grow into what we have just completed,” says Vice President of Marketing and

Strategic Planning, Pam Brock, with a smile and a well-earned sigh of relief. But resting on current success is not in the PVHS culture. Brock is already hard at work on future plans: “We will continue to improve outpatient services and ambulatory services in this area. We are also just beginning relationships with rural clinics that will provide specialties to outlying areas on an a regular basis.” Brock explains that rural communities like these don’t have the demand for specialists to live there full-time, but still have occasional needs that aren’t currently being met. “So, for example, an orthopedist might travel there once a week, or once a month,” she says. Brock expects to have

solidified many of those relationships within the next year. A Third PVHS Campus? According to Brock, the system is also planning to announce a request for proposals that seeks offerings from architectural planning groups who specialize in healthcare. PVHS is interested in putting together a master plan that might someday include a third campus. “We have no definite plans for any building just now,” she says, “but if the right opportunity presents itself there might someday be an eastern plains or mountain campus.” Like many health systems, PVHS is exploring the concept of a healthcare campus. “The healthcare campus of the future will be different than just a hospital,” says Brock. “There will be doctors’ offices, wellness services, and medical fitness facilities for rehab and outpatient therapy. But there will also be family events.” Brock points to Robert Wood Johnson and the Mayo Clinic as examples. “These are places where families come to recreate and enjoy a healthy life together,” she says. How Big Will PVHS Get? Asked if there is a danger of PVHS becoming one of the “big guys” that swallows up smaller healthcare providers, Brock says no. “Our mission is to remain independent and locally-owned. We don’t have a corporate headquarters far away in another state, and no stockholder base counting on a profit margin. The profits are reinvested into providing quality healthcare.” However, she notes, they have no maximum cap on growth. “Because there are so many opportunities to partner with others, we don’t want to set an artificial number.” Stacey is optimistic that a larger system will be more advantageous in the coming years with the potential change to the nation’s healthcare system. “We think that to be successful in the future, the payer systems are going to favor larger systems and organizations that can integrate better with their physicians.” Streamlining will be key to survival, he thinks. “We’ve had the lowest costs over the last few years and yet still maintain the highest quality.” Continued Excellence Stacey points to goals that will continue to improve the system as it exists now. “We have worked very hard to increase integration with our physician partners, but we need to do more. We will continue to upgrade information systems that can be shared. That will keep costs low and quality high,” he says. “We’ll also continue to look for ways to partner with local employers. The ones we work with now, by providing preventative care, save significant amounts of money. We hope to extend those types of services to other businesses in the area.” Baldrige Bounce One other perk in the near future is the opportunity for members of senior management to share their best practices. Because of the Baldrige award, PVHS is now frequently invited to speak across the nation and around the world about what makes large organizations run well. The invitations run the gamut from healthcare systems

to universities to governments. “Rulon [Stacey] and I were invited to speak in Abu Dhabi last March and met several government and healthcare officials there,” says Brock. “It was the trip of a lifetime!” PVHS is also hosting a series of workshops to share their best performance excellence practices. The workshops are already filling up. Two-day sharing workshops are scheduled through the end of 2009 and into April of 2010. They will focus on leadership, strategic planning, customer focus, measurement, workforce, and process management. For those who can’t travel to Colorado, webinars will cover the same concepts in a condensed format, and are planned into next year. More information can be found at www. pvhs.org. With so many recent honors it might seem like time for PVHS to ease up, but all signs from leadership point to continued perseverance to their mission to provide quality, innovative, and comprehensive world-class healthcare that exceeds expectations every time. Corey Radman is a writer and mother of two who lives in Fort Collins.

We’re thrilled to have been honored with the Malcolm Baldrige award, but for us it was really about the process of getting better. Going through the Baldrige process helped us develop into an organization focused on performance excellence. - Rulon Stacey, Ph.D., President and CEO of Poudre Valley Health System

Fort Collins Medical Magazine & Directories 2009 2010

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STROKES

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

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Chad Stoltz, M.D., cardiologist with the Heart Center of the Rockies

Stroke Prevention,

Treatment, and Recovery

By Allie Comeau

When someone suffers a stroke, the onset is usually sudden and without warning. What happens next may mean the difference between life and death. That is why it is critical to know as much as possible about the prevention, symptoms, and treatment of strokes before they occur – because time is of the essence. 28

To begin any discussion about stroke prevention and treatment, we first need to understand what happens when you have a stroke. “A stroke is essentially the loss of brain function due to a disturbance in the blood supply to the brain,” says Chad Stoltz, M.D., cardiologist with the Heart Center of the Rockies (MCR). Dr. Stoltz stresses how prevalent strokes are in our society. “Each year an average of 700,000 people suffer a new or recurrent stroke. Over 150,000 of these people will die. On average, someone has a stroke every 45 seconds and someone dies of a stroke every three minutes. Stroke is the leading cause of serious long-term disability, causing functional limitation in more than 1.1 million Americans.” Strokes seem to be gender blind, though six in 10 stroke deaths are women. Causes of Stroke There are two basic types of strokes. An ischemic stroke is the most common type, occurring in between 80 to 85 percent of stroke patients. “An ischemic stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is blocked by a blood clot. If the blood vessel is blocked for an extended period of time it can cause irreversible damage or even death,” says Dr.

Stoltz. “The second type is a hemorrhagic stroke. This occurs when a weakened blood vessel within the brain bursts or ruptures. This too can cause irreversible brain damage or death.” While the type of stroke can vary, the risk factors generally don’t. “Both types of strokes have similar risk factors, although hypertension or high blood pressure is more strongly associated with hemorrhagic stroke,” says Gerald McIntosh, M.D., neurologist with Neurologic Associates of Northern Colorado. Diabetes, elevated cholesterol levels, cigarette smoking, lack of physical activity, a previous stroke, heavy alcohol consumption, obesity, and an unhealthy diet are the other major risk factors for both types of strokes. Certain heart conditions can also predispose one to having a stroke. “If you’ve had a history of heart disease, then you have a risk for stroke,” says Dr. McIntosh. “There’s also what we call a cardiogenic stroke which can occur in patients who have certain heart conditions, like atrial fibrillation.” That’s what happened in Dr. McIntosh’s case – his atrial fibrillation, undiagnosed until five years ago, eventually caused a stroke. The risk with atrial fibrillation, a rhythm disturbance in the heart, is that small clots can form in the heart and travel to the brain. Because atrial fibrillation often goes unnoticed until something goes wrong, Dr. Stoltz recommends keeping upto-date with doctor visits. “Evaluations by your primary care doctor should be performed on a routine basis for ongoing risk assessment and modification,” he says. In some cases, stroke victims will get advance warning of an impending stroke. A Transient Ischemic Attack (TIA), also known as a “warning stroke” or a “mini-stroke,” has the same symptoms of a stroke but only lasts less than 24 hours. Not all strokes are preceded by a TIA, but onethird of TIA’s are followed by a stroke. Therefore, a TIA should be considered a predictor of an impending stroke. “If you have risk factors and/or you’ve had a stroke or a TIA, there are measures you can take to prevent having a stroke or a recurrent stroke,”

says. Dr. McIntosh. “With a combination of lifestyle modifications such as maintaining an exercise program, a weight-control program, and a diet program, and with certain medications, like blood thinners, anti-platelet agents, statins to control cholesterol, and ACE-inhibitors to lower blood pressure, we can effectively reduce the stroke risk by 50 percent.” Time is Critical Because time is precious during a stroke, it’s important to be aware of the symptoms. “Patient and public awareness is very important for early recognition of a stroke. Time is critical and every second counts to prevent progression of a stroke,” says Dr. Stoltz. “Symptoms often occur suddenly and may involve numbness or weakness of the face, arm, or leg on one side of the body. There may be confusion or trouble speaking. A person may have trouble walking and have loss of balance or dizziness. There may also be trouble seeing in one or both eyes. Finally, a sudden severe headache may accompany any one of these symptoms.” If you notice any of these symptoms in yourself or someone you love, call 911 immediately. “When you have any symptoms where your neurologic function is suddenly disrupted on one side, you need to see a doctor right away,” says Dr. McIntosh. Acute treatment at the hospital will depend on the type of stroke. “If a CT scan shows a hemorrhagic stroke, steps will be taken to control blood pressure,” says Dr. McIntosh. “If there’s no hemorrhage, we know it’s either an ischemic stroke or a TIA. An MRI would then be ordered that would show whether there was an ischemic stroke or risk of an impending one.” In the case of an ischemic stroke, treatment varies depending on the cause of the stroke. “There are medications which may be useful, including blood thinners such as aspirin or Coumadin,” says Dr. Stoltz. “There’s also a clot-busting drug that can be given within a few hours of the onset of a stroke caused

Hemorrhagic Stroke

Ischemic Stroke

A hemorrhagic stroke is caused by a bursting blood vessel in the brain that spills the blood into the brain.

by a clot that can reduce long-term disability significantly. There are medications to control cholesterol, blood pressure, and diabetes. Finally, there are many endovascular/catheter based procedures or surgeries that can prevent recurrences.” It’s important to note and tell the attending physician the exact time stroke symptoms began in order to facilitate successful treatment. There’s only a small window of opportunity doctors can use certain drugs, the clot-busting drug in particular. “Tissue Plasminogen Activator (TPA) breaks apart blood clots and, if we give enough of it within the first three hours of an ischemic stroke, we can restore circulation to the area of the brain that’s blocked,” says Dr. McIntosh. “But there’s a risk of turning an ischemic stroke into a hemorrhage if the damage to the brain is too extensive.” Dr. McIntosh recommends calling 911 for an ambulance as soon as you notice symptoms. “If you’re within the city/county area you are better off calling 911 and riding to the hospital in an ambulance (rather than driving yourself) so we can begin treatment.” PVH notes in a newsletter that patient care outcomes are often improved if a stroke victim is transported in an ambulance, where medical care can be given on the way to the hospital. Recovery After suffering his own stroke three years ago, Dr. McIntosh now has firsthand knowledge of stroke treatment from a patient’s perspective. “It has definitely been useful to me,” he says. “My own stroke recovery has helped me to better understand the process of rehabilitation.” He looks fully recovered to the untrained eye, but Dr. McIntosh says the left side of his body is forever changed. “I have to pay special attention to my left side. If you walk too close to me, I may bump into you,” he says with a smile. After acute treatment, recovery begins in the hospital after three to five days of initial stabilization. “We begin rehabilitation early to get people

TIA Stroke

An ischemic stroke is the most common type and occurs when a blood vessel carrying oxygen to the brain is blocked by a blood clot.

A Transient Ischemic Attack (TIA), known as a “warning stroke,” has the same symptoms of a stroke but only lasts 24 hours. A TIA is considered a predictor of a stroke.

Images reprinted by permission of National Stroke Association, www.stroke.org.

Fort Collins Medical Magazine & Directories 2009 2010

e v o M

s u i c M Neurologic

w it h t h e

It has been said that music has the transformative power to heal. All it takes is a visit to Sarah Johnson’s neurologic music therapy exercise class to confirm that statement beyond a shadow of a doubt. Johnson, a neurologic music therapist at Poudre Valley Hospital and adjunct faculty at CSU, helps stroke victims and others with neurological problems regain and maintain their motor skills. One of the first graduates of CSU’s Master of Music Therapy program, Johnson has been working as a PVH therapist since 1987. She and Ruth Rice, a PVH physical therapist and CSU research associate, have been assisting stroke patients in their music therapy classes for over 10 years. Johnson invited Style to sit in on one of her group exercise sessions at the CSU University Center for the Arts. It was evident from her wide smile and contagious enthusiasm that she loves what she does. “Most of these folks have finished outpatient therapy but want to stay strong and maintain their independence,” says Johnson. “The music helps them be active and remain physically fit. For many of them, it’s also the one time a week they get out and about.” “We’re not here to do rhythm band,” she says, jokingly referring to the instruments they use in class. “It’s not about whacking instruments. We’re using the instruments and the music as a rhythmic structure and a tool to organize movement.” In other words, patients move to the music. And people love music. Music therapy uses that response to create movement and help patients regain motor patterns they may have lost due to a stroke or disease. “Music is a compelling force. We listen to it. Music therapy is all about using music to achieve non-musical goals. At its core, music therapy is about functionality.” All of the exercises in the class – bicep curls, leg lifts, swaying side to side, and arm punches – serve a purpose. They mimic motions patients use in real life. When stroke patients who have lost partial movement repeat these motions in time with music, the movements become more fluid, succinct, and effective.

Music Therapy by Allie Comeau

Before long, patients are able to more easily tie their own shoes, sit up straight, and steady themselves. “We’ve done a lot of research here [at the Center for Biomedical Research in Music at CSU] about how our brains and bodies process music, specifically rhythm, and how music helps us to retrain our brains and bodies,” says Johnson. “We use the properties of the music to organize, access, and pattern their neuromuscular responses.” Research conducted at the Center for Biomedical Research in Music is a collaborative effort between CSU and PVH. Neurologic music therapy also enables patients to more easily relearn basic skills such as walking. The rhythmic structure of music provides a beat for the patients to move to, helping to regulate gait and lengthen stride, normalizing their gait patterns. “We use music to structure and reorganize walking,” says Johnson. “Walking is intrinsically rhythmic. Stroke victims who have been walking all their lives already have that motor pattern, so what we’re trying to do is reactivate or rebuild neuromuscular pathways to generate that walking pattern again.” Patients with neurologic diseases like Parkinson’s and multiple sclerosis, people with traumatic brain injuries, children with developmental delays or autism, and orthopedic patients also benefit from improved balance, strength, flexibility, independence, muscle tone, and mobility that music therapy facilitates. At PVH, Johnson works with all of these types of patients. “Most of the work I do is cooperative. I work with OT’s (occupational therapists), PT’s (physical therapists), and speech therapists in a multidisciplinary group at the hospital every day and we get as many of our patients together as possible.” The patients in the exercise class mingle happily with Johnson, Rice, and their assistants after class. The patients maintain varying levels of independence. Sally, paralyzed on her left side from a stroke she suffered in 2000, walks a mile and a quarter everyday now and was a torchbearer for the last Olympic Games. “I wouldn’t have been able to do either of those things without the help of this class,” she says. Another patient, Bob, suffered a stroke in 1998 and has been coming to the music therapy class ever since. “Music has helped me walk better,” he says. “There’s just something about music that makes you want to walk on.” Gerald McIntosh, M.D., a neurologist with Neurology Associates of Northern Colorado, works extensively with stroke patients and suffered through his own stroke three years ago. Dr. McIntosh has seen the benefits of the exercise classes and has similar sentiments with regards to music’s power to heal. “Music therapy is relatively magical,” he concludes.

Rehabilitation is a team effort. We discharge patients only when they are able to perform basic life skills. - Gerald McIntosh, M.D., Neurologic Associates of Northern Colorado

at a functional status as rapidly as possible,” says Dr. McIntosh. “Being active soon after a stroke is good for your mood and prevents complications. The first phase of rehabilitation lasts two to four weeks and can be done in a home-care program or outpatient program depending on the severity of the stroke.” Dr. McIntosh and the rehabilitation and recovery team at PVH, made up of occupational therapists, physical therapists, speech therapists, music therapists, counselors, pharmacists, and nutritionists, work as a team during the recovery process. “Rehabilitation is a team effort. We discharge patients only when they are able to perform basic life skills,” he adds. “Most people do better at home as long as there isn’t a risk for complications or falls.” Recovery is dependent on many factors, the largest being the extent of damage caused by the stroke. “The size of the area in the brain that’s permanently damaged determines the fixed neurologic deficit and that, to a large part, determines the amount of recovery,” says Dr. McIntosh. Recovery for one patient may be drastically different from the next. “A stroke can produce paralysis, visual disturbances, memory loss, and even affect behavior,” says Dr. Stoltz. “These disturbances can be minor and isolated problems or major problems that produce long-term disability. Prompt recognition and treatment of a stroke is critical to

Illustrative diagram of the brain’s motor and sensory function. Sudden changes to these functions can indicate a stroke.

New Ways to LEARN

By Connie Hein

reduce permanent disability and even death.” Stroke Care in Northern Colorado In Northern Colorado, we are fortunate to have some of the finest stroke treatment and recovery specialists in the state. Dr. McIntosh has been practicing in Fort Collins since 1979. His subspecialty is neurologic rehabilitation, which concentrates on stroke and stroke rehabilitation. In addition to his practice and being Chief of Staff at Poudre Valley Hospital (PVH), he’s the medical director for LifeSkills Rehabilitation Center at PVH. “I’ve been interested and involved in strokes and stroke rehabilitation for the last twenty years,” he says. Dr. McIntosh and the stroke team at PVH received an American Stroke Association award in February of this year for their new rapid-response stroke alert program. The award recognizes that PVH has a comprehensive system in place for rapid diagnosis and treatment of stroke patients admitted through the emergency room. “We do our best to ensure everybody gets the best treatment possible as soon as possible when they come in,” says Dr. McIntosh. Kathi Patterson, PVH’s stroke program coordinator, says this also includes providing patient education in managing risk factors. “Studies have shown that patients who are taught how to manage their risk factors while still in the hospital reduce their risk of a second stroke,” she says. Dr. Stoltz has been practicing cardiovascular medicine since 2005, after graduating from the University of Nebraska and completing his Interventional Cardiology fellowship at the University of Wisconsin, Madison. He is board certified in internal medicine, cardiovascular medicine, interventional cardiology, echocardiography and nuclear cardiology. He has also recently implemented a carotid artery stenting program in Northern Colorado and is a chosen investigator for the CHOICE carotid artery stenting study. For stroke prevention, treatment, and recovery, awareness is paramount to the best possible outcome. By spreading the word about stroke recognition to family and friends, you just might save the life of someone you love. Allie Comeau is a freelance writer, copywriter, and blogger living in Fort Collins, CO. Email her at alliecomeau@gmail.com.

Fort Collins Medical Magazine & Directories

Miracles seem to be occurring at the corner of Harmony and Lemay in Fort Collins. But while the word “miracle” comes to mind, the word “science” also applies. What is actually happening is that the trainers at the one-year-old business, LearningRx, are helping stroke and traumatic brain injury (TBI) victims make astonishing changes in their lives by applying ground-breaking testing and training techniques. Nate Jorgenson, of Fort Collins, is one of those individuals. On October 1, 2004, Nate was involved in a near-fatal car accident that resulted in a fractured cervical vertebrae and extensive brain hemorrhaging. His mother, Debbie Jorgenson, says, “One day he was a handsome, sociable 26-year-old young man pursuing a career in computer network engineering and in a moment, our lives changed forever.” After two weeks in a semi-coma at Poudre Valley Hospital’s Neuro-Intensive Care Unit, three months in Denver at Craig Hospital, which specializes in TBI, and almost two years at the Center for Neurorehabilitation Services in Fort Collins, Debbie says Nate had made great progress in his healing, but was still not able to live independently. “Nate’s learning problems made him feel stupid and gave him little hope of achieving his goal of becoming a personal fitness trainer. He was not able to retain the information necessary to become certified.” She says they were facing a new reality and wondering, “Where do we go from here and what do we do now?” A friend who had helped Debbie raise funds for her newly-formed Shared Journeys Brain Injury Foundation helped answer that question when she told Mike Winchell, co-owner of LearningRx, about Nate’s struggles. Winchell contacted Debbie and told her they had many testimonials from TBI victims who experienced life-changing progress through their program and said he was confident they could help Nate. “After talking with Mike and co-owner, Don Cassidy, I was convinced that the program could help and I enrolled Nate at the end of May,” says Debbie. Cassidy says after assessing Nate, they found he had virtually no long-term or short-term memory, and therefore could not retain information because certain parts of his brain were damaged.

When starting with a new patient, Winchell says, they do an assessment to determine the results of the brain damage. Nate scored very low on auditory and visual processing tests along with his lack of memory. When processing and retention is that low, it takes intensive brain training for patients to get back to where they were before the injury or stroke, says Winchell. With visual processing in a healthy brain, a person can imagine descriptions that are in books by reading them and creating visual images of the scene in their mind. A person with brain damage from stroke or injury may not be able to do that. The patient must be retrained, as they are doing with Nate, using pictures that correlate with names or words. In trauma or stroke cases, Winchell says, certain areas of the brain are dead or impaired. With brain training, though, other areas can start picking up the slack for the damaged portions. He adds, “With this training the brain will actually create new pathways and will figure out a way to do what you ask it to do.” Debbie says she has been amazed by the program. “Nate actually notices the improvements he is making instead of just being told that he is improving. It has only been two months and Nate is like his old self again. He has confidence in his ability to move forward to pursue goals for his life with passion and pride.” Debbie says his progress has been an inspiration to her and everyone around Nate. “Many people say they have watched him become stronger and happier and are inspired to make changes in their own lives.” Winchell and Cassidy agree that Nate is an inspiration. “We all love seeing him, getting a hug, and visiting with him whenever he comes in,” says Cassidy. “He inspires me every day. If someone like Nate can overcome a traumatic injury and move forward to pursue his goals in life with such a positive attitude, I can do the same as I move through this time in my life starting a new business.” For more information about LearningRx call 970-672-2020 or visit www.LearningRx.com/Fort-Collins. For more information about the Jorgenson’s foundation to help brain injured individuals, visit www.sharedjourneysfoundation.org.

medical

CLEFT LIP AND PALATE

XXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXX XXXXXXXXXXXXXXX

PVH Cleft Clinic

World-Class Cleft Lip and Palate Reconstruction

by Allie Comeau

As the most common birth defect in the world, cleft lip and palate affects one in 700 live births. Fortunately, cleft lip and palate is also highly treatable with reconstructive surgery that can significantly improve facial appearance and function. Thanks to the caring practitioners at the Poudre Valley Hospital (PVH) Cleft Clinic, children born with this alltoo-common oral-facial defect have access to a superior team of surgeons and therapists to ensure success of treatment. 32

When a baby is born with cleft lip and/or palate it basically means that the mouth and lips did not fuse together properly during early fetal development. Deb Brohard, speech pathologist with PVH’s Children’s Therapy Services, is the coordinator of the PVH Cleft Clinic and works with Christopher Tsoi, M.D., and Mark Boustred, M.D., both plastic surgeons with Northern Colorado Plastic Surgery, to provide children and families affected by cleft lip and palate the best treatment available, right here in Fort Collins. Having a child born with cleft lip and palate is a challenge but the team at PVH ensures the reconstructive process goes as smoothly as possible. “The team approach is so important,” says Dr. Tsoi, a board-certified plastic surgeon who has been practicing in Fort Collins since 1992 and has done overseas cleft missionary work. “There are many aspects. We have access to genetic counseling and social work in addition to surgical support. In Fort Collins, we have a complete team and are registered members of the Cleft Palate Society.” The team is made up of plastic surgeons, a speech therapist, feeding specialists, an occupational therapist, a pediatric dentist, an audiologist, an orthodontist, an otolaryngologist, a registered nurse, a social worker, a pediatrician, and a nutritionist. Helping Children and Parents The Cleft Clinic team becomes involved as soon as a family finds out they have a child with a cleft lip and palate, either in utero or after birth. (Ultrasound can diagnose cleft lip so there is a chance parents may know before birth.) “If a cleft lip has been diagnosed by ultrasound, my practice is to see the parents before birth to counsel them and show them pictures of other children who have had cleft lip repairs. This helps the parents tremendously, relieves anxiety, and gives the family a game plan,” says Dr. Boustred, an internationally known plastic surgeon from South Africa who has performed cleft lip and palate surgery all over the world. “It makes a big difference.” Genetics play a role in cleft lip and palate, and avoiding certain medications and drugs during early pregnancy may lower the risk. “There are two factors that contribute to the formation of cleft lip and palate: environment and genetics,” says Dr. Tsoi. “We now know certain things like retinoid acne medications, anti-convulsant drugs, cigarette smoke, and alcohol can contribute to the formation of cleft lip and palate.” “There are certain genes that cause cleft lip and palate but in the majority of cases we just don’t know what has caused it,” continues Dr. Boustred. “There’s even been recent research linking maternal diabetes, stress, and obesity to facial defects.” When a baby with cleft lip and palate is born at PVH, Brohard is the first to meet with the infant and parents. “I’ll visit the parents in the hospital with a packet of information and make sure feeding is going well,” she says. “Then I’ll alert the plastic surgeon, otolaryngologist, and pediatric dentist so they can get in touch with the family within 24 hours to introduce themselves and alleviate any concerns the parents might have.” “The first thing we do is to make sure the baby can eat and drink properly,” says Dr. Tsoi. “Many times a baby with cleft lip and palate

won’t be able to generate adequate suction pressure to feed. So our first priority is to make sure the baby is getting nutrition and the mother feels comfortable doing the feeding.” After the initial newborn period, the family will meet with the entire team at the same time to formulate a plan. The initial surgery takes place sometime after the baby is three months old. “The first surgery is so important because it sets the whole stage for the final result,” says Dr. Boustred. “Parents need to be sure that they have the first surgery done by a team that really knows what they’re doing and consistently gets good results.” Continuing Care Depending on the size and severity of the cleft, the first surgery will usually be followed by several more until the child is fully grown, including possible revision surgery before the child enters school at five to six years of age. “It’s a sensitive time. We want to make sure the child is accepted well by his or her peers,” says Dr. Tsoi. “We don’t want the cleft lip and palate to become a point of contention that takes away from other development.” Dr. Boustred notes that the expectations of surgery are much higher than they were even 10 years ago. “We’re doing a lot less surgeries now because we have better techniques and are getting better results right off the bat,” says Dr. Boustred. “For example, performing nose repair at the same time as lip repair can produce better results. We also have new techniques that focus more on the muscles of the palate and restoring anatomy and function. We are getting away from surgeries that cause excessive scarring. There are also growth impact studies that give us a good idea of which types of surgery negatively impacted the child’s growth.” After surgery there is other work to be done, most often with speech. “Sometimes there are problems with speech, even though the palate cleft is closed, and a small number of children may need additional surgery,” says Dr. Boustred. Ongoing speech evaluation is very important and that’s where Brohard comes in. “When the baby starts talking between the age of 10 and 12 months, it’s my job to look at language development, appropriate speech sound production, intelligibility, and resonance,” she says. “The ultimate goal is good speech.” Children with cleft lip and palate may be in speech therapy for years, as they grow and go through additional surgeries. “I feel like we do a really good job here in optimizing their speech and intelligibility,” she says. “There may be a structural limit to speech development, but our goal is that someone who doesn’t know these kids will be able to understand 85 to 90 percent of what they’re saying.”

The PVH Cleft Clinic has done amazing work repairing cleft lip and palate. Here are a few of the children they have been able to help.

World-class Reconstruction in Northern Colorado “The goal of the Cleft Clinic is to offer world-class cleft lip and palate reconstruction in Northern Colorado,” says Dr. Boustred, who came to Fort Collins in August 2008, from Pennsylvania State University, where he was professor and director of the craniofacial unit. He’s considered an expert in the field. “I’m confident we can offer patients here the same services they can get anywhere else, only we can offer CONTINUED ON PAGE 68

Fort Collins Medical Magazine & Directories 2009 2010

If you're having ababy, were herefor you. If you're expecting a baby, the team of physicians and birthing center professiona ls at Medical Center of the Rockies are here to ensure that you and your baby have a safe, comfortable delivery. We look forward to being part of your specia l day. PVHS was one of only

TAKE A TOUR Come take a tour of our state-of-the-art

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the entire United States to earn this honor and

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was the only 2008 health ca re recipient.

PHYSICIAN’S

SURGEON’S

PRECISION

Specialists in Spine and Brain Surgery Since 1978

NEUROSURGERY & ORTHOPAEDIC SPINE SERVICES ALL IN ONE PRACTICE

WHEN

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The blend of both neurosurgery and orthopaedics in one practice is unique to the region! This allows our surgeons to offer patients the best and most comprehensive care from both disciplines. • We

use the same precision and respect for nervous tissue required for brain surgery in your spine surgery.

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use the latest technological advances in spine care, such as cervical and lumbar disc replacement, minimally invasive surgery, and kyphoplasty.

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routinely work together assisting each other in the surgical procedure.

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we now have over 95 years of neurosurgical and orthopaedic spine experience and more combined continuing education than any other spine practice in our region.

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practice has a spine and brain surgeon on call for emergencies 24 hours, 7 days a week, at all local hospitals, and provide the brain and spine surgery trauma coverage for regional trauma centers at NCMC and MCR.

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work in all of the hospitals and surgery centers in the tri-city region thereby allowing you to choose the facility most convenient for you and your family.

We are in network with all the major insurance carriers in our region, ensuring that you will be able to maximize your insurance benefits.

New patients and referrals are welcome.

Ft. Collins:

1313 Riverside Ave. • (970) 493-1292

Greeley:

2001 70th Ave. • (970) 356-4488 Donn M. Turner, M.D. • Timothy C. Wirt, M.D. Hans C. Coester, M.D. • Douglas W. Beard, M.D.

Loveland:

2500 Rocky Mountain Ave. Ste. 360 • (970) 669-0470 (800) 458-0306 • www.brain-spine.com

ADVANCED OTOLARYNGOLOGY, PC. Pediatrics & Adult Sinus & Nasal Disease Endoscopic Sinus Surgery Meniere’s Disease & Balance Disorders Hearing & Diseases of the Ears Head & Neck Surgery

Mark Loury, MD, F.A.C.S. Board Certified Former Faculty of John’s Hopkins Hospital

Listed in “Best Doctors in America” and “America’s Best Doctors”. Patients Choice Recipient 2008 Nationally Recognized Expert in Sinus & Nasal Disease.

Voice Disorders Snoring & Sleep Apnea Coblation Tonsillectomy Injection Snoreplasty

Brooke Benton, PA-C Child Health Association/Physician Assistant Program, University of Colorado Health Sciences Center of Denver

Focus on General Ear, Nose & Throat

EAR, NOSE &THROAT DISORDER SPECIALISTS

Fort Collins Medical Magazine & Directories 2009 2010

2001 S. Shields, Building E, Suite 101 970.493.5334 Fort Collins, CO toll free: 1.866.493.5334 37

When it's a face you love, -............_. .:;,.

were herefor you.

Serious injuries to the face require highly specialized trauma care_ And the fact is, the facial surgeons with the most experience create the best possible outcomes_ Our physician specialists provide the expertise you need for serious facial injuries_ Uniquely skilled to restore both delicate aesthetics and function, the expert team at Trauma Center of the Rockies gives extraordinary care, 24/7_ Specia lized response at a moment's notice and the best ca re in the region for trauma patients_ Trauma Center of the Rockies is part of Medical Center of the Rockies in Loveland_

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

Dear Medical & Wellness Magazine Reader:

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

The vision of Poudre Valley Health System is to “provide world-class healthcare.” That’s a huge statement. What does it mean? How do we determine that we provide world-class care? PVHS defines “world-class” as providing healthcare equal to or better than medical services offered by the nation’s top 10 percent of best healthcare providers. Most of those best providers are perennially recognized in the healthcare industry as world-class organizations: Mayo Clinic, Johns Hopkins Hospital, Cleveland Clinic, and Massachusetts General Hospital, to name four. We measure our health system against those providers by comparing patient satisfaction, length of patient stays, patient safety goals, mortality rates, hospital-acquired infection rates, cancer detection rates for mammography screenings, the number of patient falls, outcomes of sick babies in the neonatal intensive care unit, complications for such orthopedic procedures as joint replacements, and many other patient-care indicators. We also make comparisons in non-clinical areas, such as employee turnover, compliance and legal measures, staff and physician satisfaction, recycling efforts, earnings versus expenses, and a multitude of other measurements. Some of the categories listed above may sound scary to persons unacquainted with the workings of healthcare. Mortality rates, fall rates, infections — yes, those bad things can happen in any hospital. The challenge is to keep the rates at a minimum, most preferably zero. This is a challenge in which PVHS has been exceedingly successful. Here’s a brief look at some of our measurements and rankings, as tracked by organizations that are highly respected in the healthcare industry: PVHS patient satisfaction ranks in the top one percent of U.S. hospitals (there are approximately 5,000 hospitals in the nation), according to the U.S. Centers for Medicare and Medicaid Services (CMS). PVHS care of heart attack patients ranks in the national top 10 percent, again according to CMS. In 2008 and 2009, Poudre Valley Hospital was the nation’s No. 1 hospital for nursing quality, according to the American Nurses Association. PVHS ranks among the top three percent of U.S. hospitals for employee satisfaction and engagement, according to a national database of more than 1,000 hospital organizations. (A side note: Modern Healthcare named PVHS in its 2008 list of the best 100 places to work in healthcare.) PVHS ranks in the top one percent of U.S. hospitals for physician satisfaction and loyalty, according to Gallup, which conducts physician satisfaction surveys for the healthcare industry. PVHS was named one of only three U.S. organizations and the only healthcare organization to receive the 2008 Malcolm Baldrige National Quality Award, an honor established by Congress to recognize organizations with the best performance excellence. Finally, and this honor was announced in July 2009, PVH was named one of the 50 best hospitals that offer orthopedic care. The ranking came through U.S. News & World Report’s annual list of the nation’s best hospitals. I could continue on with a long list of national awards and honors — more than 50 since 2004 — but I think you understand what I’m saying: PVHS is a world-class organization, providing world-class care. With that thought in mind, this question begs to be heard: How did we get this way? It was a 10-year journey. We used management and operational principles recommended through the national Malcolm Baldrige program. We conducted self-evaluations, underwent well-planned enhancements in our work processes, and developed the important mindset that we will be the very best. That, simply put, was our journey. The critical energy that fueled the journey came from the dedication of local medical professionals and PVHS staff members. Unlike many of the nation’s healthcare organizations, PVHS employs only a very tiny handful of physicians. In the meantime, there are more than 650 private physicians and 200 allied healthcare professionals who have privileges at our two hospitals. These providers own their practices or work for private practices. The providers work in close collaboration with the PVHS staff of 4,300 employees to offer world-class patient care. Unfortunately, this type of collaboration is lacking in some hospitals elsewhere in the U.S. The result in those hospitals: poor quality patient care. In our case, the needs of the patient are the driving forces. All of us in the regions of northern Colorado, southern Wyoming and southwestern Nebraska served by PVHS are very fortunate to have topquality, highly skilled, compassionate physicians and allied healthcare professionals ready to treat us. The same quality, skills and compassion can be found in PVHS staff members — like the physicians and allied professional, they are among the best in the world. On behalf of PVHS and local physicians and allied healthcare professionals, I want to promise that our commitment to provide you world-class care will continue. It’s what we do.

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

Fort Collins Medical Magazine & Directories 2009 2010

WHAT WE KNOW ABOUT AND DIET- THE LATEST IN MEET THE EXPERTS M IHO SCOIT, M .D . PAOLA ROMERO , M .D . ANNE KANARD, M .D . REGINA BROWN, M .D . MAITHEW SORENSEN , M .D . T RICIA SMIKAHL, PA--C

Free to the general public.

Please reserve early as space is limited. Light refreshments, coffee and tea service.

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

at the POUDRE VALLEY HOSPITAL HARMONY CAMPUS 2121 E. Harmony Rd. Suite 150, Fort Collins www.cancerhealth.com 970.493.6337

FORT COLLINS

ALLERGY/IMMUNOLOGY

PHYSICIAN’S &SURGEON’S Eisenmenger, Michael J., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Salimbeni, Julio C., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Culver, William G., MD 2001 S. Shields St., Bldg. H.............. 498.9226 See ad on page 92

Fife, Jason D., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Serell, Sean M., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Gondalia, Lakhman L., MD Cheyenne, WY.................................... 307.778.2015

Ford, Troy A., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Stenbakken, Gelerie D., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

James, John M., MD 1136 E. Stuart St., Bldg. 3-200.......... 221.1681 See ad on page 69

Harrison, William L., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Velasco, Stephen E., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Hodges, Kathleen A., MD 1236 E. Elizabeth St., Ste.1......................224.2985

Vizena, Annette D., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Horne, Stephen G., MD 1236 E. Elizabeth St., Ste.1......................224.2985

Wagner, Jan Gillespie, MD 1175 58th Avenue, Ste. 202 (Greeley).......495.0300

Keate, Tyler L., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Watrous, Dwain D., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

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

Weiner, Kelli L., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Krohn, Douglas, MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Williams, Daniel K., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Lichon, Amy, DO 1236 E. Elizabeth St., Ste.1......................224.2985

Williams, Wendy M.H., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Kailasam, Velusamy, MD 2121 E. Harmony Rd., Ste. 350......... 221.2370 See ad on page 97 Kujawska, Anna, MD 2001 S. Shields St., Bldg. H.............. 498.9226 See ad on page 92 Lanting, William A., MD 2121 E. Harmony Rd., Ste. 310............... 227-4611 Laszlo, Daniel J., MD 2001 S. Shields St., Bldg. H.............. 498.9226 See ad on page 92 Murthy, Krishna C., MD 2121 E. Harmony Rd., Ste. 350......... 221.2370 See ad on page 97

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

Seeley, Janet K., MD 2001 S. Shields St., Bldg. H......................498.9226

Markus, Jennifer L., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Vedanthan, P. K., MD Lakewood, CO........................................... 303.238.0471

Martinez, Alice, MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

ANESTHESIOLOGY Alessi, Richard D., Jr. MD 1236 E. Elizabeth St., Ste. 1.............. 224.2985 See ad on back cover Bobo, Russell W., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985 Carline, Marylida, MD 1236 E. Elizabeth St., Ste. 1.....................224.2985 Cochran, Thomas S., Jr. MD 1236 E. Elizabeth St., Ste. 1.....................224.2985 Deringer, Michael A., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Miller, Justin D., MD 1236 E. Elizabeth St., Ste.1......................224.2985 Moss, William E., DO 1236 E. Elizabeth St., Ste. 1.....................224.2985 Neff, William A., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985 Olsen, Kimberlee J. MD 1236 E. Elizabeth St., Ste. 1.....................224.2985 Perschau, Erik R., DO 1236 E. Elizabeth St., Ste. 1.....................224.2985 Raymond, Jeffrey MD 1236 E. Elizabeth St., Ste. 1.....................224.2985 Reed, Jay A., MD 3800 N. Grant Ave (Loveland)....................622.0608

Derrisaw, James, MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Richardson, Emily C., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Dunn, Duane L., MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Ryan, Kathleen D. MD 1236 E. Elizabeth St., Ste. 1.....................224.2985

Fort Collins Medical Magazine & Directories 2009 2010

CARDIOLOGY Ashmore, Roger C., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Austin, Wendy J., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Baker, William B., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Doing, Anthony H., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Dow, Tristan J., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Downes, Thomas R., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Green, C. Patrick, MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Johnson, C. Timothy, MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43

2009 directory*

Larson, Dennis G., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Luckasen, Gary J., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Miller, William E., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Myers, Gerald I., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Oldemeyer, John Bradley, MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Purvis, Matthew T., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Stoltz, Chad Lynn, MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Strote, Justin A., MD 2121 E. Harmony Rd., Ste. 100 ........ 221.1000 See ad on page 43 Tate, Charles, MD 2121 E. Harmony Rd., Ste. 100 ........ 221.1000 See ad on page 43 Treat, Stephen A., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Voyles, Wyatt F., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43 Whitsitt, Todd B., MD 2121 E. Harmony Rd., Ste. 100......... 221.1000 See ad on page 43

DERMATOLOGY Baack, Brad, MD 1120 E. Elizabeth St., Bldg. G2.................484.6303 Hultsch, Anne-Lise, MD 3726 S. Timberline Rd., Ste. 101..............221.5795 Kornfeld, Bruce W., MD 1006 Centre Ave.......................................482.9001 Sayers, Clinton P., MD 1120 E. Elizabeth St., Bldg. G2.................484.6303

West, B. Lynn, MD 3726 S. Timberline Rd., Ste. 101................221.579

EAR, NOSE & THROAT (OTOLARYNGOLOGY) Chand, Maria S., MD 1006 Centre Ave.......................................482.9001

Johnston, P. Scott, MD 1024 S. Lemay Ave...................................495.7000 Litel, Alexa L., MD 1024 S. Lemay Ave...................................495.7000 Luttrell, Matthew, MD 1024 S. Lemay Ave...................................495.7000 Olsen, Eric B., MD 1024 S. Lemay Ave...................................495.7000

Anderson, Robert Scott, MD 3519 Richmond Dr............................ 204.0300 See ad on page 44 Andreen, Kristin, MD 1025 Pennock Pl................................ 495.8800 See ad on page 90 Askew, Crystal D., MD 1918 S. Lemay Ave., Ste. A.......................494.4531

Cranor, J. David, MD 1124 E. Elizabeth St., Bldg. C...................484.0798 de la Torre, Rebecca A., MD 2032 Lowe St., Ste. 103...........................223.0193 DeYoung, Douglas B., DO 1024 Centre Ave., Bldg. E-100A...............484.0774 Duran, Christine B., MD 1212 E. Elizabeth St..................................482.2791

Patrick, Kenneth M., DO 1024 S. Lemay Ave...................................495.7000

Bailey, Austin G., Jr MD 1025 Pennock Pl................................ 495.8800 See ad on page 90

Repert, William B., MD 1024 S. Lemay Ave...................................495.7000

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

Gill, Sarvjit “Sarge,” MD 3820 N. Grant Ave. (Loveland)....................593.1177

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

2500 Rocky Mountain Ave. (Loveland)............495.8450

Fields, Jacqueline C., MD 315 Canyon Ave., Ste. 1............................472.6789

Gupta, Sanjay K., MD 6500 29th Street, Ste.105 (Greeley)..........330.5555

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

Beck, Susan M., MD 3850 Grant St., Ste 100 (Loveland)... 669.5717 See ad on page 90

Fritzler, Stace A., MD 2121 E. Harmony Rd., Ste. 370................221.2290

Loury, Mark C., MD, FACS 2001 S. Shields St., Bldg. E-101....... 493.5334 See ad on 37 & back cover

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

Bender, Edward L., MD 1212 E. Elizabeth St..................................482.2791

Geppert, Margo J., MD 2818 McKeag Dr........................................225.2811

Tremblay, Darren E., DO 1024 S. Lemay Ave....................................495.7000

Bender, John Lumir, MD 4674 Snow Mesa Dr., Ste. 140.................482.0213

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

Glazner, Cherie, MD 1025 Pennock Pl................................ 495.8800 See ad on page 90

Bermingham, Roger P., MD 1025 Pennock Pl................................ 495.8800 See ad on page 90

Conlon, William Sean, MD 1032 Luke St.............................................484.8686 Eriksen, Christopher M., MD, FACS 1120 E. Elizabeth St., F-101............... 221.1177 See ad on back cover

Robertson, Matthew L., MD 1120 E. Elizabeth F-101...........................221.1177 Runyan, Brad, MD 2121 E. Harmony Rd., Ste. 350......... 212.0169 See ad on back cover Smith, Bruce M., MD 2121 E. Harmony Rd., Ste. 350......... 484.6373 See ad on back cover Young, Dayton L., MD.............................. Fort Collins Zacheis, David H., MD 3820 N. Grant Ave. (Loveland)....................593.1177

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

EMERGENCY MEDICINE Apostle, Michael J., MD 1024 S. Lemay Ave...................................495.7000 Dellota, Kriss, MD 1024 S. Lemay Ave...................................495.7000 Farstad, David J., MD 1024 S. Lemay Ave...................................495.7000

ENDOCRINOLOGY Izon, Meriam P., MD 2121 E. Harmony Rd., Ste. 300................295.0010 Widom, Barbara, MD 1040 E. Elizabeth St., Ste. 101................ 224-3636

Garth, Alisha P., MD 1024 S. Lemay Ave....................................495.7000

FAMILY MEDICINE

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

Abrahamson, Bradley S., MD 1107 S. Lemay Ave. Ste. 200............. 484.1757 See ad on page 44

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

Abrahamson, Lara, MD 1635 Blue Spruce Dr.................................494.4040

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

Adamson, Theran B., MD 2021-D Battlecreek Dr..............................206.0851

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

Ahern, Caitlin M., MD Akron, CO........................................... 970.345.6336

Basow, William M., MD

Bethards, Kelby F., MD............................. Fort Collins Birnbaum, Bernard J., MD 1025 Pennock Pl................................ 495.8800 See ad on page 90

Duran, Matthew G., MD 1212 E. Elizabeth St..................................482.2791 Ferguson, David R., MD 3000 S. College Ave. Ste. 210..................266.8822

Goacher, Cynthia, MD 2121 E. Harmony Rd.................................297.6250 Gray, April K., MD 1918 S. Lemay Ave., Ste. A.......................494.4531 Grossman, Daniel R., MD 2121 E. Harmony Rd., Ste. 370................221.2290

Bresowar, Kristin, MD 1025 Pennock Pl................................ 495.8800 See ad on page 90

Haldy, Megan, DO 1025 Pennock Pl................................ 495.8800 See ad on page 90

Brewington, Flora Ho, MD 1124 E. Elizabeth, Bldg. C .......................484.0798

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

Brickl, Ian D., MD 1635 Blue Spruce Dr.................................494.4040

Henderson, Sandra E., MD 2025 Bighorn Dr................................. 229.9800 See ad on page 44

Broman, Steven D., MD 1107 S. Lemay Ave. Ste. 200............. 484.1757 See ad on page 44 Burnham, Linda A., MD 1918 S. Lemay Ave., Ste. A.......................494.4531 Butler, Lisa R., DO 1212 E. Elizabeth St..................................482.2791 Cawley, John, MD 1025 Pennock Pl................................ 495.8800 See ad on page 90 Choate, Miriam, MD 1025 Pennock Pl................................ 495.8800 See ad on page 90 Coburn, Thomas C., MD 1455 Main St., Ste.150, (Windsor).... 686.0124 See ad on page 44

Hiam, Sarah E., DO 1635 Blue Spruce Dr................................ 494-4040 Hill, Brian, MD 1025 Pennock Pl................................ 495.8800 See ad on page 90 Hoenig, Mark W., MD 2362 E. Prospect Rd., Ste. A....................495.0999 Hopkins, Jan H., MD 1120 E. Elizabeth St., Bldg. G-1...............493.2776 Jackson, Rebecca, DO 1025 Pennock Pl................................ 495.8800 See ad on page 90 Janasek, Mitchell J., MD 2121 E. Harmony Rd., Ste. 310............... 221.3855

At Medical Center of the Rockies, cardiologist Brad Oldemeyer and his team want to open the blocked arteries of heart attack patients as quickly as possible . Why? Because faster response times save lives.

They are part of a national initiative focused on reducing

For the lifesaving story of retired Poudre High School counselor Ray Gefroh, visit

the time it takes from a heart attack patient's arrival at the hospital doors to the moment a balloon catheter clears the blockage. The shorter this "door-to-balloon" time, the more likely the patient will survive and recover.

heartcenteroftherockies.com. In 2008, MCR's average door-to-balloon time for qualifying patients was 48 minutes -

well below

the national goal of 90 minutes, as set by the Center for Medicare and Medicaid Services and the Joint Commission . It's comforting to know that doctors like Dr. Oldemeyer have your future at heart.

MEDICAL CENTER OF THE ROCKIES POU D R E VALL E Y H EA LTH SYS TEM

Heart Center OF THE ROCKIES

For more information or to make an appointment, please call (970) 221-1000 or (800) 459-4521.

PO UD RE VAL L EY HEALT H SYSTEM

pvhs.org

heartcenteroftherockies.com

Jinich, Daniel B., MD 2001 S. Shields St., Bldg. E-201...............221.9991 Johns, Stacie L., MD 1635 Blue Spruce Dr.................................494.4040 Kaleta, Andrea D., MD 2025 Bighorn Dr................................. 229.9800 See ad this page Kauffman, Jeffrey N., MD 1124 E. Elizabeth St., Bldg. C...................484.0798 Kesler, James M., MD 3519 Richmond Dr............................. 204.0300 See ad this page

Lockwood, Stephanie R., MD 3519 Richmond Dr............................. 204.0300 See ad this page

McCarthy, Victoria A., MD 2001 S. Shields St., Bldg. I................ 221.5255 See ad this page

Loeb, Mark H., MD 2121 E. Harmony Rd., Ste. 310................221.3855

McCreery, Colleen R., DO 3519 Richmond Dr............................. 204.0300 See ad this page

Lopez, Joseph M., MD 1136 E. Stuart St., Bldg. 4, Ste. 202........221.5925 Lowther, Kelly H, MD 4674 Snow Mesa Dr., Ste. 140.................482.0213 Lupica, Michelle, DO 1025 Pennock Pl................................ 495.8800 See ad on page 90

McIntosh, Deric, DO 1025 Pennock Pl................................ 495.8800 See ad on page 90

Schmidt, David S., MD 2001 S. Shields St., Bldg. I................ 221.5255 See ad this page Schnee, Bradley K., MD 1625 Foxtrail Dr.................................. 619.6900 See ad on page 90

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

Seeton, James F., MD 2121 E. Harmony Rd., Ste. 310................221.3855

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

Serrano-Toy, Monica T., MD 2121 E. Harmony Rd. Ste. 370................ 221.2290 Shamis, Mason, MD 1025 Pennock Pl................................ 495.8800 See ad on page 90

Klinger, Susan K., MD 2025 Bighorn Dr................................. 229.9800 See ad this page

MacDonald, Nola A., DO 315 Canyon Ave., Ste. 3............................472.8008

Miller, Laurie A., MD 1635 Blue Spruce Dr.................................494.4040

Kuroiwa, Christina L., MD 8031 Campus Delivery..............................491.7121

Mallory, Patrick, DO 1548 N. Boise Ave. (Loveland)....................669.9245

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

Latter, Macy, DO 1025 Pennock Pl................................ 495.8800 See ad on page 90

Marchant, David R., MD 1025 Pennock Pl................................ 495.8800 See ad on page 90

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

Lembitz, Deanne D., MD

Mason, R. Anthony, MD

4630 Royal Vista Dr., Ste.7 (Windsor)...................530.0575

4630 Royal Vista Dr., Ste. 7 (Windsor)..................530.0575

Lesage, Margaret R., MD 1455 Main St,Ste. 150 (Windsor)...... 686.0124 See ad this page

Mayer, Paul T., MD 1635 Blue Spruce Dr.................................494.4040

Naqvi H. Faraz, MD 1025 Pennock Pl................................ 495.8800 See ad on page 90 Nevrivy, Thomas E., MD 3519 Richmond Dr............................. 204.0300 See ad this page Orozco-Peterson, Marilu, MD 811 E. Elizabeth St. .................................224.1596

Siple, Anne I., MD 1625 Foxtrail Dr.................................. 619.6900 See ad on page 90 Smith, Jerome I., MD 2025 Bighorn Dr................................. 229.9800 See ad this page Stephens, Floyd V., MD 1113 Oakridge Dr................................ 225.0040 See ad this page Stoddard, Andrew P., MD 2520 W. 16th Street (Greeley). ....................356.2520

Ottolenghi, David R., MD 2121 E. Harmony Rd., Ste. 310................221.3855

Sullivan, Donna L., MD 1025 Pennock Pl................................ 495.8800 See ad on page 90

Palagi, Patricia C., MD 3000 S. College Ave., Ste. 210.................266.8822

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

Podhajsky, Tim P., MD 2025 Bighorn Dr................................. 229.9800 See ad this page

Taylor, Grant, DO 608 E. Harmony Rd., Ste. 101........... 204.9669 See ad on page 61

Robinson, Anne L., MD 1107 S. Lemay Ave. Ste. 200............. 484.1757 See ad this page

Thieman, William J., MD PO Box 272369........................................297.6250

Rodriguez, Juan B., DO 4674 Snow Mesa Dr., Ste. 140.................482.0213

Thompson, Breanna, DO 1025 Pennock Pl................................ 495.8800 See ad on page 90

Rotman, Mark F., MD 2001 S. Shields St., Bldg. I................ 221.5255 See ad this page

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

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

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

Sachtleben, Thomas R., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23

Toth, Tiffany, DO 1025 Pennock Pl................................ 495.8800 See ad on page 90

Samelson, Scott G., MD 1025 Pennock Pl................................ 495.8800 See ad on page 90

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

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

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

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

Valley, George E., MD 3000 S. College Ave., Ste. 210.................266.8822

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

Van Farowe, Cynthia K., MD 3519 Richmond Dr............................. 204.0300 See ad on page 44

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

Weaver, Derek, DO 1025 Pennock Pl................................ 495.8800 See ad on page 90 Webber, Pamela, S., MD 1025 Pennock Pl................................ 495.8800 See ad on page 90 Weiskittel, Deborah A., MD 1113 Oakridge Dr................................ 225.0040 See ad on page 44 Weixelman, Janice M., DO 8017 First Street #C (Wellington)............568.4800 Wetherbee, Katharine, DO 1025 Pennock Pl................................ 495.8800 See ad on page 90 Wideman, JD, DO 2001 S. Shields St., Bldg. I................ 221.5255 See ad on page 44 Wilson, Fiona A., MD 1107 S. Lemay Ave. Ste. 200............. 484.1757 See ad on page 44

Durkan, Mark N., MD 3702 Timberline Dr., Bldg. A.....................207.9773 Holland, Rod R., MD 3702 Timberline Dr., Bldg. A.....................207.9773 Jenkins, Joseph X., MD 3702 Timberline Dr., Bldg. A.....................207.9773 Langer, Daniel, MD 3702 Timberline Dr., Bldg. A.....................207.9773 McElwee, Hugh P., MD 3702 Timberline Dr., Bldg. A.....................207.9773 Nosler, Michael J., MD 3702 Timberline Dr., Bldg. A.....................207.9773 Sears, Stephen, MD 2555 E.13th Street, Ste. 220 (Loveland)... 669.5432 Simmons, Robert A., MD 3702 Timberline Dr., Bldg. A.....................207.9773 Strong, Lewis R., MD 2555 E.13th Street, Ste. 220 (Loveland)... 669.5432 Witt, Peter C., MD

Winefrey, Ivory, MD 1025 Pennock Pl................................ 495.8800 See ad on page 90

See ad on page 99

Wozniak, Janell R., MD 1025 Pennock Pl................................ 495.8800 See ad on page 90

GYNECOLOGY

Ziegler, David, MD 1025 Pennock Pl................................ 495.8800 See ad on page 90

2500 Rocky Mnt Ave.NMOB (Loveland)... 350.2440

Lepine, Lisa, MD Boulder, CO........................................ 720.382.2621 Thayer, David O., MD Boulder, CO........................................ 303.443.2010

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

HEMATOLOGY/ONCOLOGY FAMILY PRACTICE/SPORTS MEDICINE Servi, Jane T., MD 2121 E. Harmony Rd., Ste. 290................224.9890 Yemm, Stephen J., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23

GASTROENTEROLOGY

Brown, Regina, MD 2121 E. Harmony Rd., Ste. 150......... 493.6337 See ad on page 40 Fangman, Michael P., MD P.O. Box 271040........................................217.5160 Kanard, Anne Margaret, MD 2121 E. Harmony Rd., Ste. 150......... 493.6337 See ad on page 40 Kemme, Douglas J., MD

2500 Rocky Mnt Ave.NMOB (Loveland) ��203.7080

See ad on page 99

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

Lininger, Thomas R., MD

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

Marschke, Robert F. Jr., MD 2315 E. Harmony Rd., Ste. 110................212.7600

1800 15th Street, Ste.C (Greeley)................. 378.4170

Fort Collins Medical Magazine & Directories 2009 2010

McFarland, Ross W., MD 2315 E. Harmony Rd., Ste. 110................212.7600

Ebens, John B, MD

2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050

Filipowski, Piotr J., MD 2121 E. Harmony Rd., Ste 300.................207.9958

Ellis, Robert H., MD................................. Fort Collins

Gaines, Jennifer L, MD 2121 E. Harmony Rd., Ste 300.................207.9958

Moore, James C., MD 2315 E. Harmony Rd., Ste. 110................212.7600

Hendrick, James D., MD 4674 Snow Mesa Dr., Ste. 100.................482.3712

Johnston, Christine G., MD 2121 E. Harmony Rd., Ste 300.................207.9958

Romero, Paolo, MD 2121 E. Harmony Rd., Ste. 150......... 493.6337 See ad on page 40

Hendrick, Jennifer M., MD 4674 Snow Mesa Dr., Ste. 100.................482.3712

Medgyesy, Diana C., MD 2315 E. Harmony Rd., Ste. 110................212.7600

Scott, Miho Toi, MD 2121 E. Harmony Rd., Ste. 150......... 493.6337 See ad on page 40 Shelanski, Samuel A., MD

See ad on page 99

Herrera, Xavier, MD 1100 Poudre River Dr................................224.9508 Homburg, Robert C., MD 1100 Poudre River Dr................................224.9508

2500 Rocky Mnt Ave.NMOB (Loveland)....203.7080

Juhala, Robert J., MD 4674 Snow Mesa Dr., Ste. 100.................482.3712

Sorensen, Matthew D., MD 2121 E. Harmony Rd., Ste. 150......... 493.6337 See ad on page 40

Knepper, Katherine L., MD 4674 Snow Mesa Dr., Ste. 100.................482.3712

See ad on page 99

Stone, Michael D., MD 1800 15th Street, Ste.C (Greeley)................. 378.4170

HOSPICE & PALLIATIVE CARE Allen, David K., MD 305 Carpenter Rd. . ........................... 292.0179 See ad on page 61

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

Lopez, William, Jr MD

2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050

See ad on page 99

Abbey, David M., MD 1100 Poudre River Dr................................224.9508

Orton, Lambert C., MD Steamboat, CO................................... 970.879.3327 Ow, Cathy L., MD 4674 Snow Mesa Dr., Ste. 100.................482.3712 Randle, Michael T., MD

2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050

See ad on page 99

Sunderman, Steve R., MD 607 Castle Ridge Ct...................................223.8922 Thompson, Keith S., MD

2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050

Zenk, Daniel R., MD

2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050

See ad on page 99

Christiansen, Dana L., MD

2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050

See ad on page 99

INTERNAL MEDICINE/HOSPITALIST Austin, William Bennett., MD 2121 E. Harmony Rd., Ste 300.................207.9958 Clipsham, Victoria A., MD 2121 E. Harmony Rd., Ste 300.................207.9958

NEONATOLOGY Hall, Daniel M., MD Aurora, CO......................................... 303.724.2840 MacRitchie, Amy N., MD PVH, 1024 S. Lemay Ave...........................495.8280 Paisley, Jan E., MD PVH, 1024 S. Lemay Ave...........................495.8282

INTERNAL MEDICINE/PEDIATRICS Drysdale, Christopher R., MD 4674 Snow Mesa Dr., Ste. 120.................266.3650 Lang, Christina, MD 4674 Snow Mesa Dr., Ste. 120.................266.3650 Simmons, Mark S., MD 4674 Snow Mesa Dr., Ste. 120.................266.3650

Satterwhite, Daniel J., MD PVH, 1024 S. Lemay Ave...........................495.8280 Thilo, Elizabeth H., MD Aurora, CO......................................... 303.724.2840 Wilkening, Randall B., MD Aurora, CO......................................... 303.724.2840

NEPHROLOGY

Heyborne, Kent D., MD Denver, CO......................................... 303.860.9990

2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050

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

Yoder, Elizabeth Anne, MD 2121 E. Harmony Rd., Ste 300.................207.9958

See ad on page 99

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

See ad on page 99

Thieszen, John M., MD 2121 E. Harmony Rd., Ste 300.................207.9958

MATERNAL & FETAL MEDICINE

See ad on page 99

Berntsen, Mark F., MD

Spannring, Mary M., MD 2121 E. Harmony Rd., Ste 300.................207.9958

Reinhardt, Marcus R., MD

2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050

See ad on page 99

Asadi, S. Daniel, DO 4401 Union St. (Johnstown)............. 219.2423 See ad on page 68

Reghitto, Charmaine, MD 2121 E. Harmony Rd., Ste 300.................207.9958

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

Alessi, Grace, MD

2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050

LumLung, Christine M., MD 2121 E. Harmony Rd., Ste 300.................207.9958

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

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

INTERNAL MEDICINE

Kopel, Charles S., MD 2121 E. Harmony Rd., Ste 300.................207.9958

Merritt, Jason L., MD 1600 Specht Point Rd., Ste.127........ 493.7733 See ad this page

Porreco, Richard P., MD Denver, CO......................................... 303.860.9990

Muelken, Kevin D., MD 1600 Specht Point Rd., Ste.127........ 493.7733 See ad this page

Stettler, R. William, MD Denver, CO......................................... 303.860.9990

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

Simmons, Richard E., MD 1600 Specht Point Rd., Ste127......... 493.7733 See ad on page 46 Singer, James R., MD 1600 Specht Point Rd., Ste.127........ 493.7733 See ad on page 46 Teruel, Mark A., MD 1600 Specht Point Rd., Ste.127........ 493.7733 See ad on page 46

Miller, Tamara A., MD 2121 E. Harmony Rd., Ste. 180................226.6111

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

Stern, J. Bradley, MD 1107 S. Lemay Ave. Ste. 300....................493.7442

Nash, Jerry D., MD 2121 E. Harmony Rd., Ste. 180................226.6111

James, Warren K., MD 1107 S. Lemay Ave. Ste. 300............. 493.7442 See ad on back cover

Tool, Audrey L., MD 1107 S. Lemay Ave. Ste. 300............. 493.7442 See ad on back cover

Jeffrey, Ransy L., MD 1107 S. Lemay Ave. Ste. 300....................493.7442

Tool, Kevin J., MD 1107 S. Lemay Ave. Ste. 300............. 493.7442 See ad on back cover

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

Vance, Maude M., MD 1107 S. Lemay Ave. Ste. 300....................493.7442

King, Angela, MD 1107 S. Lemay Ave. Ste. 300....................493.7442

Yeh, Eric M., MD 1107 S. Lemay Ave. Ste. 300....................493.7442

Schumann, Richard R. Jr., MD 2500 Rocky Mnt Ave., Ste.310 (Loveland)... 619.6000 Tolge, Celina F., MD 5890 W. 13th Street, Ste. 112 (Greeley).....353.2255

NEUROLOGY

OBSTETRICS/GYNECOLOGY

Allen, Timothy J., MD 2121 E. Harmony Rd., Ste. 270......... 221.1993 See ad on page 21 & 46

Beresford, Kaea, MD 1107 S. Lemay Ave. Ste. 300....................493.7442

Curiel, Michael P., MD 2121 E. Harmony Rd., Ste. 270......... 221.1993 See ad on page 21 & 46 Friedman, Sheri J., MD 1221 E. Elizabeth St., Ste.3......................482.4373

Carter, Susan D., MD 1800 15th Street, Ste. 220 (Greeley).........353.1335 Cloyd, David G., MD 1136 E. Stuart St., Bldg. 2, Ste. 100........493.5904

Kozak, Susan H., MD 1107 S. Lemay Ave. Ste. 300............. 493.7442 See ad on back cover Micetich, Kara L., MD 1107 S. Lemay Ave. Ste. 300............. 493.7442 See ad on back cover Priebe Philip N., MD 1107 S. Lemay Ave. Ste. 300............. 493.7442 See ad on back cover

Himes,Terry M., DO 2500 Rocky Mnt Ave., Ste.310 (Loveland).... 619.6000

Donnelley, Beverly E., MD 1107 S. Lemay Ave. Ste. 300............. 493.7442 See ad on back cover

McIntosh, Gerald C., MD 1221 E. Elizabeth St., Ste. 3.....................482.4373

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

Serniak, Elizabeth K., MD 1107 S. Lemay Ave. Ste. 300............. 493.7442 See ad on back cover

Meredith, Lawrence A., MD 310 E. 5th Street (Loveland).........................667.7664

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

Skorberg, Christine F., MD 1006 Luke St.............................................419.1111

Fort Collins Medical Magazine & Directories 2009 2010

OBSTETRICS/GYNECOLOGY/ INFERTILITY Bachus, Kevin E., MD 1080 E. Elizabeth St........................... 493.6353 See ad on page 45, page 63 and back cover

OCCUPATIONAL MEDICINE Holthouser, Michael G., MD 4674 Snow Mesa Dr., Ste. 200.................495.8450 Milliken, William J., MD 8010 S. CR 5, Ste. 101 (Windsor)................... 377.1300

Oâ&#x20AC;&#x2122; Toole, Kevin J., MD 4674 Snow Mesa Dr., Ste. 200.................495.8450 Scherr, Frederick P., MD 1025 Pennock Pl., Ste. 121......................495.8450 Yanagi, Ann K., MD 4674 Snow Mesa Dr., Ste. 200.................495.8450

ORTHOPEDICS Baer, Robert M., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23 Beard, David A., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23

Ophthalmology

Beard, Douglas W., MD 1313 Riverside Ave............................ 493.1292 See ad on page 36

Arnold, Patrick D., MD 1725 E. Prospect Rd.......................... 221.2222 See ad on page 47

Benz, Robert J., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23

Bashford, Kent P., DO 1725 E. Prospect Rd.......................... 221.2222 See ad on page 47

Biggs, William D., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23

Crews, Kent R., MD 1725 E. Prospect Rd.......................... 221.2222 See ad on page 47

Brackett, Bess E., MD PO Box 336694 (Greeley)...........................330.5400

Foster, Gary J., MD 1725 E. Prospect Rd.......................... 221.2222 See ad on page 47 Norris, Andrew M., MD 2121 E. Harmony Rd., Ste. 190................224.2020 Olsen, Karl E., MD 1725 E. Prospect Rd.......................... 221.2222 See ad on page 47 Reistad, Chet Erik, MD 1725 E. Prospect Rd.......................... 221.2222 See ad on page 47 Robinson, Matthew J., MD 1725 E. Prospect Rd.......................... 221.2222 See ad on page 47 Shachtman, William A., MD 1725 E. Prospect Rd.......................... 221.2222 See ad on page 47 Smith, Randall W., MD 1725 E. Prospect Rd.......................... 484.5322 See ad on page 47 Stevens, William W., MD 1725 E. Prospect Rd.......................... 221.2222 See ad on page 47

Bussey, Randy M., MD 5890 W. 13th Street (Greeley). ...................348.0020 Chamberlain, Satoru T., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23 Clark, C. Dana, MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23 Dhupar, Scott K., MD 1624 17th Avenue (Greeley)............................ 353.5959 Donner, E. Jeffrey, MD 3810 N. Grant Ave. (Loveland)....................669.8881 Duncan, Kenneth H., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23 Durbin, Mark B., MD 2500 E. Prospect Rd. . ...................... 493.0112 See ad on page 23 Grant, Michael P., MD 3810 N. Grant Ave. (Loveland)....................669.8881 Grey, Sean G., MD 2500 E. Prospect Rd......................... 493.0112 See ad on page 23 Grossnickle, Mark D., MD

2500 Rocky Mnt Ave.Ste.MOB (Loveland).203.7100

See ad on page 99

ORAL/MAXILLOFACIAL Felton, Rickey E., DDS 1008 Centre Ave., Ste. B...........................221.4633 Orr, Mark F., MD 2014 Caribou Dr., Ste. 100...................... 225.9555 Reynolds, Ralph R., DMD 2992 Ginnala Dr. (Loveland)........................663.6878

Houghton, Michael J., MD 2500 E. Prospect Rd. . ...................... 493.0112 See ad on page 23 Hunter, Brett P., MD

2500 Rocky Mnt Ave.Ste.MOB (Loveland).203.7100

See ad on page 99

Jackson, Wesley P., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23

Thurgood, David B., DDS 2001 S. Shields St. Bldg. J-3.................... 498.0196

Kindsfater, Kirk A., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23

Troxell, James B., DDS 1120 E. Elizabeth St., Bldg. B, Ste.3........482.6811

Knauer, Sally A., MD 2121 E. Harmony Rd., Ste. 290................224.9890

Mahon, John H., MD 2121 E. Harmony Rd., Ste. 260................221.2827 Martin, Dale R., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23 McFerran, Mark A., MD 2923 Ginnala Dr. (Loveland)............. 663.3975 See ad on page 23 Nelson, Garth C., MD 1020 Luke St.............................................493.2102 Pazik, Thomas J., MD 6801 W. 20th Street, Ste. 201 (Greeley)........... 330.1090 Pettine, Kenneth A., MD 3810 N. Grant Ave. (Loveland)...................669.8881 Reckling, W. Carlton, MD Cheyenne, WY......................................... 307.632.6637 Rusnak, Michael P., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23 Seiler, Steven J., MD 2500 Rocky Mnt Ave.Ste.MOB (Loveland).203.7100 Sides, Steven D., MD

2500 Rocky Mnt Ave.Ste.MOB (Loveland).203.7100

See ad on page 99

Sobel, Roger M., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23

Young, Eric E., MD 2121 E. Harmony Rd.,Ste. 260.................221.2827

Chaffin, D. Joe, MD

2555 E.13th Street,Ste.120(Loveland) �� 461.6091

See ad on page 23

Christian, James D., MD

ORTHOPEDICS /SPORTS MEDICINE Trumper, Rocci V., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23

2555 E.13th Street,Ste.120(Loveland) �� 461.6091

See ad on page 23

Archer, Deborah, MD 1635 Blue Spruce Dr.................................494.4040 Bailey, Amy C., MD 1200 E. Elizabeth St........................... 267.9510 See ad on page 65

2555 E.13th Street,Ste.120(Loveland) �� 461.6091

Ballard, Elizabeth A., MD 1200 E. Elizabeth St........................... 267.9510 See ad on page 65

Halbert, Richard E., MD

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

Dunn, Cory D., MD

See ad on page 23

2555 E.13th Street,Ste.120(Loveland) �� 461.6091

See ad on page 23

Hamner, H. Wentzell., MD

Brockway, Julie M., MD 1200 E. Elizabeth St........................... 267.9510 See ad on page 65

Girardi, George E., MD 3744 S. Timberline Rd., Ste. 102....... 495.0506 See ad on page 48

See ad on page 23

Crawford, Deborah D., MD....................... Fort Collins

Sisson, Charles B., MD 2809 E. Harmony Rd., Ste. 100................221.9451

See ad on page 23

PAIN MANAGEMENT

2555 E.13th Street,Ste.120(Loveland) �� 461.6091

Libby, Arlene L., MD

2555 E.13th Street,Ste.120(Loveland) �� 461.6091

Neuhauser, Thomas S., MD

2555 E.13th Street,Ste.120(Loveland) �� 461.6091

See ad on page 23

PATHOLOGY

Walts, Michael J., MD

Barksdale, Sarah Kay., MD

See ad on page 23

2555 E.13th Street,Ste.120(Loveland) �� 461.6091

See ad on page 23

Bee, Christopher S., MD

2555 E.13th Street,Ste.120(Loveland) �� 461.6091

See ad on page 23

Fort Collins Medical Magazine & Directories 2009 2010

Elliott, Max A., MD 1200 E. Elizabeth St........................... 267.9510 See ad on page 65 Guenther, John P., MD 1200 E. Elizabeth St........................... 267.9510 See ad on page 65

2555 E.13th Street,Ste.120(Loveland) �� 461.6091

Hanson, Vaughn W., MD 1200 E. Elizabeth St........................... 267.9510 See ad on page 65

PEDIATRICS

Hull, Lori J., MD 2001 S. Shields St., Bldg. G.......................484.4871

Anderson, Carole M., DO 1200 E. Elizabeth St........................... 267.9510 See ad on page 65

Markley, Jennifer L., MD 2001 S. Shields St., Bldg. G.......................484.4871

McGinnis, James G., MD 1200 E. Elizabeth St........................... 267.9510 See ad on page 65

Hecker, Thomas M., DPM 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23

McManigal, Jason, DO 1200 E. Elizabeth St........................... 267.9510 See ad on page 65

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

O’Brien, Barry G., MD 1200 E. Elizabeth St........................... 267.9510 See ad on page 65

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

Neagle, Mark B., MD 2121 E. Harmony Rd., Ste. 300......... 224.9102 See ad on page 95

Schaffer, Michael S., MD Aurora, CO......................................... 720.777.2942

Thomas, Michael I., DPM 1355 Riverside Ave., Ste. C............... 484.4620 See ad on page 97

Seidman, Marc H., MD 1635 Blue Spruce Dr.................................494.4040

Vaardahl, Michael D., DPM 1931 65th Ave., Ste. A (Greeley)................351.0900

Whitman, Douglas W., MD 1635 Blue Spruce Dr.................................494.4040

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

Wright, Jason T., MD 2555 E. 13th Street, Ste. 130 (Loveland)... 663.5437

PSYCHIATRY

Hargleroad, Jennifer K., DDS 2105 Bighorn Rd., Ste. 202......................493.2254 Van Tassell, Keith A., DDS 2001 S. Shields, Bldg. A .......................... 484.4104

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

See ad on page 95 Milchak, Richard J., MD

Schultz, Peter D., MD 1440 N. Boise Ave. (Loveland)........................ 278.1440

Evans, Gregory D., DDS 3221 Eastbrook Dr............................. 407.1020 See ad on page 49

Kukafka, David S., MD

O’Halloran, William D., DPM 1301 Riverside Ave...................................482.3668

Sampera, Kirsten M., MD 1200 E. Elizabeth St........................... 267.9510 See ad on page 65

PEDIATRIC/DENTISTRY

Hoyt, James D., MD 2121 E. Harmony Rd., Ste. 300..........................224.9102

Gottfried, Joseph M., MD 4601 Corbett Dr.................................. 207.4800 See ad on page 90 Heacock, Craig R., MD 4601 Corbett Dr.................................. 207.4800 See ad on page 90 Moreno, Hermann A., MD 4601 Corbett Dr.................................. 207.4800 See ad on page 90

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

Peters, Brent T., MD 2500 Rocky Mnt Ave.Ste. 300 (Loveland).............619.6100

Petrun, Mark D., MD, FCCP 2121 E. Harmony Rd., Ste. 300......... 224.9102 See ad on page 95 Stevens, Eric E., MD 2500 Rocky Mnt Ave.Ste. 300 (Loveland).............619.6100

Vassaux, Carlos R., MD 2121 E. Harmony Rd., Ste. 300..........................224.9102

Dunphy, Thomas R., MD 2008 Caribou Dr................................ 484.4757 See ad on page 7 & 19 Esola, Christine C., MD 2008 Caribou Dr................................ 484.4757 See ad on page 7 Fleener, Christopher M., MD 2008 Caribou Dr................................ 484.4757 See ad on page 7 & 19 Florant, Tracy H., MD 2127 E. Harmony Rd., Ste. 130......... 207.4700 See ad on page 7 & 19 Fuller, Samuel E., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19 Geis J. Raymond, MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19 Geraghty, Micahel J., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

Wallick, Kristin A., MD 2121 E. Harmony Rd., Ste. 300..........................224.9102

Gunderson, Deborah Z., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

RADIATION ONCOLOGY

Hayes, Amy S., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

Bryant, Michael H., MD 2121 E. Harmony Rd., Ste. 160..........................482.3328 Casey, William B., MD 2121 E. Harmony Rd., Ste. 160......... 482.3328 See ad on page 51

Howshar, Mark Edward, MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

Lim, Meng Lai, MD 2121 E. Harmony Rd., Ste. 160..........................482.3328

Jess, Sarah J., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

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

Lisella, Gwen H., MD 2121 E. Harmony Rd., Ste. 160......... 482.3328 See ad on page 51

Koplyay, Peter D., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

Pearson, Glenn E., MD 4601 Corbett Dr.................................. 207.4800 See ad on page 90

Petit, Joshua Henry, MD 2121 E. Harmony Rd., Ste. 160......... 482.3328 See ad on page 51

Luttenegger, Thomas J., MD, FACR 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

Jacob, Joseph P., MD 4401 Union St. (Johnstown). ......................619.3400

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

Markel, Curtis L., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

Lockwood, Bruce A., MD 1300 Oakridge Dr., Ste. 130.....................377.9555

Udupa, Usha R., MD 4601 Corbett Dr.................................. 207.4800 See ad on page 90

Simpson, C. Kelley, MD 2121 E. Harmony Rd., Ste. 160......... 482.3328 See ad on page 51

RADIOLOGY

Nieves, Ricardo A., MD 1301 Riverside Ave., Ste.2................ 692.5550 See ad on page 3

Mills, Andrew D., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7

Watanabe, Kenneth S., MD 4601 Corbett Dr.................................. 207.4800 See ad on page 90

Berkowitz, Bruce Andrew, MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

Pacini, Richard J., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

Wunder, Jeffrey A., MD Wheat Ridge....................................... 303.423.8334

Woodard, Timothy W., MD 4601 Corbett Dr.................................. 207.4800 See ad on page 90

Bodenhamer, John R., MD 2008 Caribou Dr. ............................... 484.4757 See ad on page 7 & 19

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

PULMONOLOGY

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

Peck, Steven H., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

Cox, Patrick R., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7

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

Craven, Winfield M., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

Reese, Mark F., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

PHYSICAL MEDICINE & REHABILITIATION Adamson, Carrie L., MD 2021 Battlecreek Dr..................................206.0851 Bender, John D., DO 1330 Oakridge Dr., Ste. 130.....................377.9555

PODIATRY Anderson, James C., DPM 1355 Riverside Ave., Ste. C............... 484.4620 See ad on page 97

Nagel, John K., MD 4601 Corbett Dr.................................. 207.4800 See ad on page 90

Breyer, Diana M., MD 2121 E. Harmony Rd., Ste. 300..........................224.9102

Burns, Michael J., DPM 2001 S. Shields St., Bldg. F.......................493.4660

DePriest, KIirk L., DO 2121 E. Harmony Rd., Ste. 300..........................224.9102

Hatch, Daniel J., DPM 1931 65th Ave., Ste. A (Greeley)................351.0900

Gunstream, Stanley R., MD 2121 E. Harmony Rd., Ste. 300..........................224.9102

Singer, Charles J., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

Ross, Vincent J., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23

Cribari, Chris MD 2315 E. Harmony Rd., Ste. 130................221.5878

Weinstein, Stanley W., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

Tutt, George O., Jr MD.............................. Fort Collins

Davis, Lawrence G. MD 2315 E. Harmony Rd., Ste. 130................221.5878

Weissmann, Jeffrey R., MD 2008 Caribou Dr................................. 484.4757 See ad on page 7 & 19

SURGERY/CARDIOVASCULAR

RHEUMATOLOGY Levine, James W., DO

2500 Rocky Mnt Ave. NMOB (Loveland).. 461.1880

See ad on page 99

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

Guadagnoli, Mark, MD

Loveland Surgery Center 3800 N. Grant Ave.............................. 622.0608 See ad on page 79

See ad on page 43

MCR Surgery Center

Lamounier, Fernando N., MD

2500 Rocky Mnt Ave., Ste. 200 (Loveland)...624.2250

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

2500 Rocky Mnt Ave.Ste.100 (Loveland). 624.1800

See ad on page 43 Stanton, Michael, MD

2500 Rocky Mnt Ave., Ste.360 (Loveland)...... 619.6176

2500 Rocky Mnt Ave. NMOB (Loveland).. 461.1880

SURGERY/ASSIST

SURGERY/GENERAL

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

Johnson, Robert V., MD 2500 E. Prospect Rd.......................... 493.0112 See ad on page 23

Bauling, Paulus C., MD 1029 Robertson St....................................482.2866

See ad on page 99

Thompson, John Stephen, MD

2500 Rocky Mnt Ave. NMOB (Loveland).. 461.1880

See ad on page 99

Kaiser, Dale C., MD 2500 E. Prospect Rd......................... 493.0112 See ad on page 23

Chiavetta, Thomas G., MD 2121 E. Harmony Rd., Ste. 250......... 482.6456 See ad on page 37

Dickinson, James M., MD 2121 E. Harmony Rd., Ste. 250......... 482.6456 See ad on page 37 Dubs, Steven, MD

2500 Rocky Mnt Ave.NMOB (Loveland)... 203.7250

See ad on page 99 Fraser, Lesley A., MD

2500 Rocky Mnt Ave.NMOB (Loveland)... 203.7250

See ad on page 99

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

2500 Rocky Mnt Ave.NMOB (Loveland)... 203.7250

See ad on page 99

Marty, Terri. MD 2315 E. Harmony Rd., Ste. 130................221.5878

SURGERY CENTERS

Kesler, Kelvin F., MD 1107 S. Lemay Ave. Ste. 300....................493.7442

Ogren, Jason W., MD 1800 15th Street, Ste. 210 (Greeley)........352.8216

Harmony Surgery Center 2127 E. Harmony Rd., Ste. 200......... 297.6300 See ad this page

Clear, Craig R., MD 2121 E. Harmony Rd., Ste. 250......... 482.6456 See ad on page 37

Ludwin, Gary A., MD 1107 S. Lemay Ave. Ste. 300....................493.7442

Collins, John A., MD 2315 E. Harmony Rd., Ste. 130................221.5878

Parsons, Sally A., MD 2315 E. Harmony Rd., Ste. 130................221.5878

Fort Collins Medical Magazine & Directories 2009 2010

2500 Rocky Mnt Ave.Ste.MOB(Loveland).203.7250

See ad on page 99

Brewster, Amy Hill., MD 2121 E. Harmony Rd., Ste. 360......... 266.0456 See ad on page 6

Pettine, Stefan, MD 2121 E. Harmony Rd., Ste. 250......... 482.6456 See ad on page 37

Chapman, Jeffrey K., MD 2315 E. Harmony Rd., Ste. 160......... 493.8800 See ad on back cover

Quaid, Robert R., MD 2121 E. Harmony Rd., Ste. 250......... 482.6456 See ad on page 37

Duncan, Diane, MD 1701 E. Prospect Rd.................................493.7445

Peetz, Michael E., MD

Roller, Michael D., MD 2121 E. Harmony Rd., Ste. 250......... 482.6456 See ad on page 37 Rubinson, Samuel M., MD 2315 E. Harmony Rd., Ste. 130................221.5878 Schiefen, James., DO 1900 16th Street (Greeley)........................350.2426 Turcios, Rosa E., MD 2315 E. Harmony Rd., Ste. 130................221.5878 Woodard, Scott, MD 555 Prospect Ave. (Estes Park)...............586.2200

Gonyon , Denis L., Jr. MD 4450 Union St., Ste. 100 (Johnstown)............ 624.7979 Tsoi, Christopher M., MD 2315 E. Harmony Rd., Ste. 160......... 493.8800 See ad on back cover

UROLOGY Brutscher, Stephen P., DO 2315 E. Harmony Rd., Ste.140.................484.6700

BE A PART OF THE 2010 | 2011

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

SURGERY/NEURO Coester, Hans C., MD 1313 Riverside Ave. . ........................ 493.1292 See ad on page 36 and back cover

Malcom, Troy J., DO

1925 W. Mountain View Ave.(Longmont). ..303.776.1234

Manion, Sean P., MD

1925 W. Mountain View Ave.(Longmont). ..303.776.1234

Sheinberg, Michael A., MD 1313 Riverside Ave...................................493.1292

Nasseri, Kevin K., MD 2315 E. Harmony Rd., Ste.140.................484.6700

SURGERY/OPHTHALMIC/ PLASTIC/RECONSTRUCTIVE

Turner, Donn M., MD 1313 Riverside Ave............................ 493.1292 See ad on page 36 and back cover

Phillips, George H., MD 1647 E. 18th Street (Loveland). .................669.9100

Reistad. Chet, MD 1725 E. Prospect Rd.......................... 221.2222 See ad on page 47 and on page 87

Wirt, Timothy C., MD 1313 Riverside Ave...............493.1292 See ad on page 36 and back cover

Soper, Timothy H., MD 2315 E. Harmony Rd., Ste.140.................484.6700 * Physician list provided by PVHS. Current as of 8.15.2009

Congratulates

POUDRE VALLEY HEALTH SYSTEM management, board of directors, physicians & staff on receiving the pinnacle of excellence, the Malcolm Baldrige National Quality Award

For Advertising Information Contact

970.226.6400

211 W. Myrtle St. STE 200 Fort Collins, CO 80521 www.stylemagazinecolorado.com

with ALICE is our advanced sleep diagnostic technology, providing you the most comprehensive sleep study available today and helping you get healthy, restful sleep . The path to healthy sleep is often the path to a healthier life . If you have concerns about your sleep, talk with your doctor or call us to learn if a sleep study may be right for you .

Now at our beautiful new Center! POUDRE VALLEY HOSPITAL SLEEP DISORDERS CENTER Westbridge Medical Suites 1107 S. Lemay Avenue, Suite 260 (970) 495-8670 The only accredited Sleep Disorders Center in Fort Collins, and nationally recognized for our sleep medicine standard of care.

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Quality

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POUDRE VALLEY HOSPITAL POUDRE VA LLEY HE A LTH S Y S TEM

pvhs.org

For excellent nursing care, were herefor you. Poudre Valley Hospital was recently re-designated a Magnet Hospital by the American Nurses Credentialing Center. We've been honored with this recognition since 2000, when we were the 18th Magnet Hospital in the entire country. Today, there are only 324 Magnet Hospitals in the U.S ., Australia, and New Zealand . Magnet status means PVH delivers exceptional nursing care . For your family, it means peace of mind.

pvhs.org

PVHS also received the prestig ious Malcolm Baldrige award for quality in 2008 .

Medical

Ambulatory Surgery centers

The Surgery Centers of

Northern Colorado by Laura Lee Carter

Have you ever wondered where the word “surgery” came from? It comes from Greek words meaning “hand work.” Surgery is a medical specialty that uses manual and instrumental techniques to investigate and/ or treat a pathological condition in order to help improve body function or appearance. Poudre Valley Health System (PVHS) physicians perform thousands of surgeries each year, 60 percent at Poudre Valley Hospital and the Medical Center of the Rockies, and the rest as less invasive outpatient procedures performed at local surgery centers. With the latest advances in technology and years of experience, these surgery facilities offer an array of surgical procedures in a caring environment outside of the normal hospital setting. Northern Colorado boasts a number of toprated ambulatory surgery centers (ASCs), also known as outpatient surgery facilities, in the area. An ASC is a healthcare facility that specializes in providing surgery, including certain pain management and diagnostic (e.g., colonoscopy) services, in an outpatient setting. In simple terms, ASC-qualified procedures include any procedure that does not require the immediate availability of blood bank, diagnostic laboratory, or advanced radiology services. With proper licensing, a number of our local ambulatory surgery centers also offer extended recovery care which may include a night or two following surgery. The staffing requirements for ASCs are the same as for hospitals, so patients receive the

same level of care. Procedures performed in ASCs are broad and, with technological advances, ever-expanding in scope. In an effort to cut costs in the 1980s and 1990s, many procedures that used to be performed exclusively in hospitals began taking place in ambulatory surgery centers. Knee, hip, shoulder, eye, spine, and other surgeries are currently performed in ASCs, with recent expansion into hysterectomies, gastric bypass procedures, and total joint replacements. In the United States today, more than 50 percent of colonoscopies are also performed in ambulatory surgery centers. ASCs rarely have a single owner. Physicians who perform surgeries in the center will often have an ownership interest in the facility and be involved in the management and development of center protocols, policies, and procedures. Occasionally, an ASC is entirely physician-owned. However, it is more common for health systems or local hospitals to partner with physicians and create joint venture relationships to better benefit the community. In the U.S. today, more than 22 million surgeries a year are performed in more than 5,000 ASCs.

Fort Collins Medical Magazine & Directories 2009 2010

Most ASCs are licensed, certified by Medicare, and accredited by one of the major healthcare accrediting organizations. All of our local surgery centers have contracts with the major health insurance companies. Accreditation organizations for ASCs provide standards of medical care, record keeping, and auditing of individual ASCs and require members to receive periodic surveys or audits every one to three years. In a survey/audit, a team of auditors examines standards of performance such as medical records, written policies and procedures, and compliance with industry standards. The three main accrediting agencies of ASCs are: the American Association for Accreditation of Ambulatory Surgery Facilities, the Accreditation Association for Ambulatory Health Care, and the Joint Commission for Accreditation of Healthcare Organizations. At the State level, the Colorado Ambulatory Surgery Center Association is committed to ensuring that surgery centers continue to thrive as a distinct model for the delivery of safe, affordable, and advanced surgical services to Colorado’s healthcare consumers.

Rebecca Craig, CEO, Harmony Surgery Center and MCR Surgery Center

Harmony Surgery Center

2127 East Harmony Road, Suite 200 Fort Collins | (970) 297-6300 www.harmonyasc.com The Harmony Surgery Center is a state-of-theart, multi-specialty facility that provides high-quality medical care, confidentiality, comfort, and efficiency for patients from Fort Collins and the surrounding area. The facility consists of four operating rooms, two gastroenterology rooms, a pain management room, and six private overnight extended recovery suites.

Separate admission and recovery areas have been designated to accommodate the patients’ privacy. The Center is conveniently located with labs, radiology (including MRI and CT scan services), a pharmacy, and a cafeteria within the same building. Harmony Surgery Center procedures range from epidural steroid injections and colonoscopies to surgical procedures such as laparoscopic cholecystectomies and laparoscopic gastric bypass, or banding surgery. According to Rebecca Craig, CEO and nurse administrator, the procedures presently performed at the Center break down into approximately 50 percent gastroenterology, 20 percent pain manage-

ment, and 30 percent surgical including general surgery, ENT (ear, nose, and throat), orthopedics, plastic surgery, urology, podiatry, maxillofacial, and ophthalmology. “We offer a quiet, confidential setting with an extremely low risk of infection and an excellent nurse-to-patient ratio. Our patients rave about coming to our facility because of our high quality care and customer focus,” says Craig. “We encourage patients to obtain an estimate ahead of time and be good healthcare consumers. We are confident we are a cost-effective alternative to the hospital setting. Our streamlined processes also work more efficiently with our customers’ time.” The Center is accredited by the Joint Commission and a member of the Colorado Ambulatory Surgery Center Association. They also hold a Convalescent Care license, allowing them to provide extended recovery care for patients with extensive surgical procedures or that require a longer recovery stay.

One of MCR’s state-of-the-art operating rooms.

MCR Surgery Center

Medical Center of the Rockies Campus South Medical Office Building 2500 Rocky Mountain Avenue, Suite 200 Loveland | (970) 624-2250 MCR Surgery Center is the newest PVHS surgery center, conveniently located on The Medical Center of the Rockies campus. Opened in April 2008, this facility is a joint venture partnership with Poudre Valley Health System and area physicians. With four operating rooms and state-of-theart equipment, their surgical specialties are cur-

rently: orthopedics, ENT, plastic surgery, podiatry, gynecology, general surgery, urology, maxillofacial, dental, and pain management as well as gastroenterology. Craig, who administers both the Harmony Surgery Center and the new MCR surgery facility notes, “Our highly experienced team shines and really makes an effort to go above and beyond for all of our customers. At both facilities, all of our registered nurses are Advanced Cardiac Life Support and Pediatric Advanced Life Support certified and many of our team members have achieved other specialty certifications in their area of expertise.”

“Customer service is our focus at both Harmony Surgery and MCR Surgery Center. We want our patients to feel that they have received the best, most personalized quality care at our Centers,” says Craig. “We try to efficiently discharge patients to allow them to return to their homes because research has shown that patients recover faster in the comfort of their own homes. However, if extended recovery care is needed, MCR Surgery Center has five private overnight stay suites which allow for a quiet, safe, and confidential recovery.” MCR Surgery Center is also Joint Commission accredited.

Mike Bergerson, CEO, Orthopeadic Center of the Rockies

Orthopaedic Center of the Rockies Outpatient Surgery and Recovery Center 2500 East Prospect Road Fort Collins | (970) 419-7050 Website: www.orthohealth.com The Orthopaedic Center of the Rockies opened in 1990 and added a third operating room and a 10-room Recovery Center in 1999. Surgical services range from arthroscopic surgery for outpatients to more involved joint replacement and spine surgeries that require an overnight stay in a private room in their Recovery

Center. More and more of their patients are taking advantage of this outpatient facility, as technology and surgery techniques have advanced. Their physicians have done thousands of surgeries in their Fort Collins Surgery Center. Many patients go home the same day, while others spend one or more nights in recovery. Their Recovery Center provides 10 private rooms and 24-hour nursing care for patients who need one or more nights of supervised recovery after surgery. Unlike large hospitals, the Recovery Center provides quiet comfort for patients and families. It also offers catered meals,

a TV in each room, and a spacious family lounge for relaxation. Mike Bergerson, the CEO of the Orthopaedic Center of the Rockies, states that their surgery center is “pretty unique nationwide. When you look at the total number of procedures we perform each year, ranging from arthroscopic cases to total joint replacements, we are outstanding nationally. I think this is because we provide a comprehensive continuum of care from initial diagnosis to surgery to a stay in the Recovery Center, where physical therapy can begin soon after the procedure is completed.” Approximately one third of their cases include an overnight stay. The Orthopaedic Center of the Rockies is Medicare certified and maintains an extremely minimal infection rate. They are happy to provide estimates to those who call ahead to compare prices.

Sue Sumpter, Administrator, Loveland Surgery Center

Loveland Surgery Center 3800 North Grant Avenue Loveland | (970) 622-0608 www.lovelandasc.com

The Loveland Surgery Center is staffed with friendly, experienced, caring professionals who provide the highest standard of care in a comfortable and professional atmosphere. It is a state-of-the art facility with three operating rooms, a room for minor procedures, and extended recovery suites for those who have surgery that requires an overnight

stay. The ASC provides services for spine, orthopedic, ENT, and pain management patients. They average over 3,100 cases annually, while achieving excellent patient satisfaction and low infection rates. Loveland Surgery Center participates with all major insurance plans. “We are excited that the high quality, compassionate care provided by the surgery center staff and affiliated physicians has earned us the designation of a Surgery Center of Excellence by Blue Cross Blue Shield,” says Sue Sumpter, Loveland Surgery Center Administrator. The physicians at this ASC are involved in clinical

research while helping local patients with their surgical needs. The Loveland Surgery Center is also a unique spine research surgery facility. The Loveland Surgery Center has the designation of being a site for new non-fusion spine device studies seeking FDA approval. The physicians are presently involved in 10 different FDA studies of experimental treatments, such as artificial disks. Kenneth Pettine, M.D., takes great pride in the Center’s involvement in groundbreaking spine research. “More spine research comes out of this facility than all Colorado hospitals combined. We are on the cutting-edge of evaluating new and innovative non-fusion spine implants.” The centers’ ownership is shared equally between physicians and National Surgical Care as their corporate partner. Loveland Surgery Center is accredited by Joint Commission and is a member of the Colorado Ambulatory Surgery Center Association.

Ross Alexander, CEO, Surgery Center of Fort Collins

Surgery Center of Fort Collins 1100 East Prospect Fort Collins | (970) 494-4800

The Surgery Center of Fort Collins (SCFC) is located at Lemay and Prospect Streets, blocks from the main campus of Poudre Valley Hospital. The Surgery Center was one of the first ASCs to open in Northern Colorado and was the first multi-specialty ASC in our region. SCFC also has a Convalescent Care license, which allows them to provide extended overnight care for patients needing a longer recovery stay.

The facility was designed to provide convenient, compassionate care to patients, with four operating rooms and one treatment room. There are four pre-operative beds, eight recovery beds, and two recently-remodeled convalescent rooms for patients requiring multi-night stays. Patient satisfaction surveys continually note the friendliness of the staff and the professional care they provide. The SCFC’s staff takes pride in providing excellent care in all aspects of a patient’s contact with the facility, whether it be providing information on estimate of charges, what to expect during their stay at the facility, and after discharge, or follow-up with insurance companies.

Ross Alexander, CEO, explains, “The physicians of the Surgery Center of Fort Collins are intimately involved in developing the protocols, policies, and procedures of the center. They are very familiar with the facility, the nursing staff, and the instrumentation, which results in a very beneficial working relationship for surgeons and staff to provide high quality, cost effective care.” Procedures performed at the facility include, but are not limited to: general surgery, ENT, pain management, plastic surgery, neurosurgery/spine, gynecological, and podiatric procedures. The Surgery Center is jointly owned by Centennial Surgery Center, Surgical Care Affiliates, and Poudre Valley Health System. The Center is a member of the Colorado Ambulatory Surgery Center Association and is accredited by the Accreditation Association for Ambulatory Health Care (AAAHC).

Dale Bergstrom, Clinical Director, Skyline Surgery Center

Skyline Surgery Center 2555 East 13th Street Loveland | (970) 461-6200

Banner Health’s McKee Medical Center, the Big Thompson Medical Group, Loveland Surgical Associates, the Orthopaedic Center of the Rockies, and several other independent physicians formed a partnership to build Skyline Surgery Center. The Skyline Surgery Center offers convenient,

high-quality, and cost-effective surgical services at its location in east Loveland. The Surgery Center provides orthopedic surgery, plastic surgery, general surgery, urologic, pain, and ophthalmic procedures. They also provide more extensive spine and total joint replacement procedures with convalescent care available in four overnight beds. Skyline Surgery Center provides patients with a restful, healing environment. “We offer a quiet,

comfortable setting,” explains Dale Bergstrom, Clinical Director. “We have a great nurse-topatient ratio, and most of our patients say that they would prefer to return here for future procedures.” The Skyline Surgery Center is presently certified by Medicare and is seeking accreditation from the Accreditation Association for Ambulatory Health Care.

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Fort Collins Medical Magazine & Directories 2009 2010

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medical

Nurseries

PVH’s team in charge of the nursery and Neonatal Intensive Care Unit: Dan Satterwhite, M.D., Neonatologist for PVHS, Barb Peters, Nurse Manager of PVH’s NICU, and Pat Bohling-Smith, Director of Women and Family Care at PVH.

Teamwork

in the NURSERY

by Erica Pauly

We all know that Northern Colorado is a top pick for most to retire, but with new renovations and top-notch nurseries, Northern Colorado is also the perfect place to give birth.

Recently, Style sat down with the team from Poudre Valley Health System who makes giving birth - and the care thereafter - a comfortable and smooth transition for the roughly 3,000 infants born at Poudre Valley Hospital and Medical Center of the Rockies each year. The team consists of Barbara Newell, RN, MHS, Director of Mother and Family Care at Medical Center of the Rockies; Pat Bohling-Smith, MS, RN, Director of Women and Family Care at Poudre Valley Hospital; Barb Peters, RN, Nurse Manager of the Neonatal Intensive Care Unit at Poudre Valley Hospital; and Dan Satterwhite, M.D., Neonatologist for Poudre Valley Health System.

Top Nursery from Denver to Montana Healthy newborns delivered at PVH and MCR are kept with mom throughout their stay at either facility. “Rooming-in” is part of PVHS’ philosophy, which is dedicated to delivering every possible ounce of care to the bedside of mom and baby; even baths are given to the infant within the room. Dads and siblings can visit the new baby at any time and post-partum rooms at both facilities are equipped with high definition televisions that can function as computer screens, allowing mothers to check email and access the GetWell network, which provides interactive entertainment and educational programs.

While healthy newborns and mothers are moved into the Women’s Care Unit at Poudre Valley Hospital (PVH) just hours after birth, any newborn requiring further attention is sent to PVH’s Neonatal Intensive Care Unit (NICU), where the highly trained staff and well-equipped nursery shines. The NICU is a Level IIIA facility, which allows them to provide care to critically ill infants. Infants requiring surgical interventions, such as cardiac surgery, are transferred to The Children’s Hospital in Denver. PVH is the only facility with a Level IIIA NICU from Denver to Billings, Montana. A Level IIIA NICU is able to treat babies delivered up to three months early and weighing as little

as two pounds and three ounces. Term babies with serious illness or organ failure are also cared for in the NICU. Sick and premature babies are treated in the NICU until they are well enough to go home or are transferred to the Newborn Nursery. The healthcare team is highly skilled and ready to treat any emergency, using state-of-the-art equipment and therapies. “There is a strong sense of teamwork and cohesion here, because you can have many people working with the infant at one time – the respiratory therapist, the physician, the Neonatal Nurse Practitioner (NNP), and the pharmacist,” says Bohling-Smith. Not to mention others on standby to work with the infant and parents: developmental specialists, lactation nurses, counselors, and occupational and physical therapists. “The key focus here is to keep the child with their family,” says Dr. Satterwhite. The nursery at PVH does just that. The NICU provides 19 beds, each with privacy curtains and chairs for parents to observe their little ones. Each child has a colorful nametag and usually photos of the family posted nearby. To promote family-centered care, PVH provides several family sleep rooms where parents can stay so they are close by. PVH also owns a home in Fort Collins, referred to as ‘The Pitkin House,’ where families from out-of-town are able to stay while their infant recovers at the hospital. The nursery is open 24-hours a day, seven days a week. Parents are encouraged to visit, spend time with their infants, and participate in their care. Bohling-Smith echoes Dr. Satterwhite’s sentiment, “Our motto: Keep mom and baby together.” For subspecialty care prior to delivery, a perinatologist conducts an on-site clinic one day a week and is available by phone 24 hours a day to consult with the obstetrician, family practice physician,

Dr. Satterwhite and Carol Wallman, NNP, look over their young patient, Matthew, in Poudre Valley Hospital’s Neonatal Intensive Care Unit.

Fort Collins Medical Magazine & Directories 2009 2010

or midwife, if necessary. Subspecialty care is also available after birth. Though PVH does not have a pediatric cardiologist on-site, with their close teamwork with Children’s Hospital in Denver, it seems as though they do. “We can do an echocardiogram to look at the structure and function of the heart and a pediatric cardiologist from Children’s Hospital will call us back with the diagnosis right then and there. This is another way we are able to keep moms and babies in their own community,” says Dr. Satterwhite, ensuring a tired mom doesn’t have to fight traffic to Denver to receive highly specialized care for herself or her baby. In order to keep mom and baby together, everyone must be on the same page from day one. Dr. Satterwhite says, “We work hard to make sure that parents are partners in the process. We start caring for the family even before the baby is born.” Even in the labor room, PVH is ready for anything. Dr. Satterwhite continues, “We try to replicate the NICU in the operating room.” The equipment from the NICU, as well as the staff, is on-hand the moment baby arrives and a NICU nurse is present at all PVH births. A WeeStep Further Once the new mother and her infant are released from PVH, the support and guidance continues across the new walkway over Lemay Avenue. On the first floor of Westbridge Medical Suites, WeeSteps awaits new mothers. WeeSteps is a free program provided by PVHS and available to new mothers beginning five days after their discharge from the hospital. The program includes breastfeeding support groups, lactation support, and weighing rooms, where a mother can bring in her infant to make sure proper weight gain is occurring. “This way, they don’t have to make a separate appointment at the doctor just to weigh their infant,” says Bohling-Smith. Eventually, yoga classes for new mothers will be offered at the same location. Across the hall from WeeSteps, mothers who need products and breastfeeding supplies can visit Twig Mom and Baby Care boutique with Twenty Three Trees Medical and Wellness Spa. Twig has all the amenities a new mom may need for a little extra help with breastfeeding, along with baby outfits, toys, and other goodies. Bohling-Smith says, “We think about everything from A to Z. What’s mom going to need? We’re here for the mothers and we take that to heart.” If extra pampering is

needed, Twenty Three Trees has many spa services to help mom relax. They will soon offer in-room massages for the new mother. Continuing Ahead in Loveland Keeping mom and baby together is also priority at Medical Center of the Rockies (MCR) in Loveland. A recent renovation to their nursery was completed in January of this year, overseen by Newell. In May 2008, a committee was formed to discuss what would be a part of the transition. Dr. Satterwhite, an educator, a nurse manager, two staff nurses, a respiratory therapist, two NNP’s, and Newell met to discuss everything from space requirements to colors schemes and lighting. A team of NNPs came from Children’s Hospital in Denver to train MCR staff on care and equipment transitions. “They did hands-on drills and helped reorganize everything to work more efficiently,” says Newell. Staff training was completed in January 2009. The MCR nursery will have NNPs on-site covering the nursery 24 hours a day beginning in September 2009. At MCR, any infant requiring further attention is sent to the Level I Special Care Nursery (SCN), which can care for newborns as early as 35 weeks (five weeks early). The Mother and Family Center at MCR includes four labor and delivery rooms, 10 post-partum rooms, a SCN with seven beds, including two beds in a separate room designated for patients requiring intensive observation and monitoring, or routine procedures like circumcisions. The post-partum rooms mirror hotel rooms. Pullout couches are available in rooms so families can stay together. A jet-tub is one of the few extra amenities provided in every room. The nursery’s new appearance and welcoming ambiance make it the perfect place for an infant to stay. Hues of yellow, blue, and green line the walls with monkeys, elephants, and giraffes dancing along the wallpaper. A rocking chair, new supply carts, privacy curtains, and dimmed lights add to the peacefulness. “We wanted it to be soft, comfortable, and cheerful,” says Newell. MCR also offers the WeeSteps program, located in the hospital’s lower level, with the same invaluable breastfeeding and lactation services as the PVH program. It is so popular, the weekly attendance at their support group has doubled in size in the past year. MCR also offers the Breastfeeding Support Group for moms whose babies are three months and older.

Barbara Newell, Director of Mother and Family Care at Medical Center of the Rockies

Working Together Teamwork is another similar trait between MCR and PVH. The service line from MCR to PVH is where strong communication and steadfast teamwork between both facilities is critical. Because the NICU is a higher-level nursery at the Fort Collins facility, MCR transfers infants to PVH when there is a need for further attention. “The cohesiveness of nursery care at both facilities is strongly supported by our neonatology group, which covers both PVH and MCR and cares for the sickest babies at each facility,” notes Dr. Satterwhite. “We have the same policies and the same practice expectations here [at MCR] as PVH. I also have regular meetings with Pat Bohling-Smith to make sure we are in unison,” says Newell, on how they make the transition go smoothly between each facility. Bohling-Smith adds, “And when we are able to finish helping the patient here [at PVH], we can send them back to MCR so the family can be helped in their own community.” It may not be too much longer before MCR is able to maintain more patients at their facility. The new nursery renovation is just the beginning of higher level of care for their infants. MCR is in the process of achieving IIA Special Care Nursery status, which would allow them to treat more infants in their nursery. All About The Family Whether mom chooses to deliver her newborn at PVH or MCR, it is no doubt the high quality care provided by the PVHS staff is what keeps mothers safe and comfortable during and after their labor. The teamwork coordinated between both facilities speaks volumes about the dedication and true heart of the staff. “We operate as a system together [MCR and PVH]. We work hard to keep families in their own communities. The key focus is to help each family as a whole,” concludes Dr. Satterwhite. Erica Pauly is a freelance writer who lives in Loveland with her husband, Brent.

Fort Collins Medical Magazine & Directories 2009 2010

Medical

ACUTE PAIN MANAGEMENT

Front Range Pain Medicine

Expands by Lynn M. Dean

What purpose does pain serve in your life? Bruce Belleville, M.D., (left) and George E. Girardi, M.D., of Front Range Pain Medicine, LLC

It’s a question Bruce Belleville, M.D., who just joined Front Range Pain Medicine, LLC, often poses to his patients on their first visit. Many times they look back at him quizzically. They don’t quite know how to answer. So he clarifies his question with this explanation: When you sprain your ankle, the pain is telling you not to walk on it. The same is true with injury-related back pain. It is not true of acute pain. “Acute pain is pain that no longer serves a useful purpose,” Dr. Belleville explains. “It is a common ailment that runs the gamut. It doesn’t leave anybody untouched. It is not a disease that afflicts just one segment of society. It can be injury related, illness related, or aging related.” Then he asks the patient again, “What purpose does pain serve in your life?” According to Kathryn Weiner, M.D., of the American Academy of Pain Management (AAPM), “Pain is a silent epidemic in the United States. An estimated 50 million Americans live with chronic pain caused by disease, disorder, or accident. An additional 25 million people suffer acute pain resulting from surgery or accident.” Just as there are different sources of pain, there are different components to it, says Dr. Belleville. “It’s a bio-pscyho-social model. There’s a biological component, a psychological component, and a social component.” He says that each component must be addressed. Dr. Weiner agrees. “Pain is complex and defies our ability to establish a clear definition. Pain is far more than neural transmission and sensory transduction. Pain is a complex mélange of emotions, culture, experience, spirit, and sensation. It is reason-

able to believe that unique characteristics of each individual impact their experience of pain.” “It offers a lot of challenges in diagnosis, treatment, and coordination of care,” adds Dr. Belleville. Those challenges are one of the reasons he and his family moved back to Colorado after spending several years in Montana. “We had lived here in the 1990s,” he says. “We felt it was time to come home.” In Montana, Dr. Belleville has a busy occupational health practice that morphed into a chronic pain practice. “When we wanted to come home it seemed logical to transfer those chronic pain skills into the practice here.” Dr. Belleville is one of only a few physicians in the country to be Board Certified in both Occupational Health and Pain Management. “One of my goals is to utilize my expertise in occupational health issues and my additional training in pain management. I think Fort Collins is a growing community and pain is a prevalent condition.” George E. Girardi, M.D., of Front Range Pain Medicine agrees. “I think Dr. Belleville’s joining the practice adds accessibility for patients because there will be another physician in town who is very experienced with chronic pain conditions and occupational health issues.” Finding a physician who can treat pain is a challenge not only in Fort Collins but also in communities across the United States. A study conducted by the AAPM and other partners, “Chronic Pain in America: Roadblocks to Relief,” found that people with chronic pain have trouble locating doctors who can effectively relieve their suffering. The study

Our goal here is to treat, if possible, the source of the pain, offer interventional treatment options, promote healthy activities, and preventative care. We strive to return patients to the most functional and productive lifestyle possible and to coordinate multidisciplinary approaches, if indicated. George E. Girardi, M.D., Front Range Pain Medicine, LLC

found that one out of four patients surveyed had changed doctors at least three times because they were still in pain. Some patients reported that their pain was often not taken seriously, many doctors were reluctant to treat their pain aggressively, and doctors lacked knowledge about how to treat pain. Front Range Pain Medicine has worked to fill this void in Fort Collins and the addition of Dr. Belleville will allow the practice to double its efforts. “Our goal here is to treat, if possible, the source of the pain, offer interventional treatment options, promote healthy activities, and preventative care,” says Dr. Girardi. “We strive to return patients to the most functional and productive lifestyle possible and to coordinate multi-disciplinary approaches, if indicated.” “Our office offers everything that you can find in any pain clinic in the world,” continues Dr. Girardi. “My goal is to try to help patients avoid chronic narcotic therapy. Most of the interventional techniques are mainly for spinal issues and cancer patients in pain.” In addition to being a Diplomat of the American Board of Pain Management, Dr. Girardi is also a Diplomat of the American Board of Anesthesia, allowing him to do many procedures that are not available elsewhere, including intrathecal drug delivery which gives patients pain relief through medicine administered directly into the bloodstream or spinal canal. “We’re the only office that can put in pumps to diminish cancer pain and spasticity and pumps for spinal cord stimulation.” Other procedures performed by Dr. Girardi include nerve root blocks, epidural steroid injections, facet injections, sacroiliac blocks, discograms, trigger point injections, and radiofrequency ablation. Up until this point, Dr. Girardi’s practice has been a procedural-based practice, but with the addition of Dr. Belleville, Front Range Pain Medicine will be able to broaden its base. “The practice currently focuses on interventional techniques to relieve pain without using medications, mainly narcotics, to treat it. But, there are a lot of problems I can’t help with interventional techniques,” he says. “And patients wait a long time to be seen.” He adds that Dr. Belleville will be a qualified gatekeeper who can assess patients and recommend interventional techniques, where appropriate. Dr. Belleville says his goal is to get the patient the treatment he or she needs. “I think we’re a growing community and pain is a prevalent condition. There is a need for someone who can treat pain with other options besides surgery or invasive procedures.” The practice will still focus on helping people avoid becoming overly dependent on narcotic drugs. “On a yearly basis we hear of some celebrity who dies and the question of drug abuse comes up,” says Dr. Belleville. He explains that celebrities aren’t the only ones experiencing these problems. “One of the goals of chronic pain management is to carefully monitor pain medications, and progress in management of pain, all the while attempting to do no harm.” Luckily, with the addition of Dr. Belleville, Front Range Pain Medicine will be a more wellrounded practice able to address not only the pain associated with work-related injuries and illness, but chronic pain as well. Together they can help patients overcome their pain and thrive. Lynn M. Dean is a Colorado writer and mother of three. Her work has won numerous first place awards from the Colorado Press Women.

Fort Collins Medical Magazine & Directories 2009 2010

CONTINUED FROM PAGE 33

The goal of the Cleft Clinic is to offer worldclass cleft lip and palate reconstruction in Northern Colorado. We have all the expertise we need right here. - Mark Boustred, M.D., Northern Colorado Plastic and Hand Surgery, P.C., and a member of the Poudre Valley Hospital Cleft Clinic

it in a more personable environment because we’re not a big clinic where you’re just another number,” he says. “We have all the expertise we need right here.” The expertise and experience Dr. Boustred brings to the PVH Cleft Clinic is undeniable. He’s published research in scientific journals and written entire chapters on techniques in cleft lip and palate reconstruction. “People think they have to go to Denver to find a surgeon if they have a child with a cleft lip and palate,” he says. “But that’s not the case. We can provide topnotch care here in Northern Colorado.”

John James, M.D.

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For Brohard and the rest of the team, the reward lies in helping families deal with something that may have seemed insurmountable at first. “The best part for me is when parents take a deep breath and realize this is something they can handle,” she says. “That we’re all here to help them through it.” Right here in Fort Collins. Allie Comeau is a freelance writer, copywriter, and blogger living in Fort Collins, CO. Email her at alliecomeau@gmail.com.

The team approach is so important. We have access to genetic counseling and social work in addition to surgical support. - Christopher Tsoi, M.D., Northern Colorado Plastic and Hand Surgery, P.C., and a member of the Poudre Valley Hospital Cleft Clinic

Fort Collins Medical Magazine & Directories 2009 2010

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If your baby is early, were herefor you. If your baby is born prematurely, the neonatal intensive care team at Poudre Valley Hospital is here for you. Staffed by neonatal specialist physicians, nurses and therapists, and equipped with the latest technology, the PVH neonatal intensive care nursery (NICU) provides the highest level of care for sick and premature babies in Northern Colorado . Breathe easy. We're here for you .

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Wellness

kettlebells

Kettlebells

Total Body Workout by Kay Rios

If time constraints are your excuse for not exercising, kettlebells might just be the answer to the workout dilemma.

“In only ten to thirty minutes with the kettlebell, you can accomplish what you would do in a one to two hour session in a gym,” says Ricardo Nieves, M.D., of Colorado Spine, Pain, and Sports Medicine, P.C., explaining the growing interest in the kettlebell workout. Made of cast-iron, a kettlebell resembles a cannonball with a handle. A Russian creation, the original kettlebells weighed one pood, the equivalent of 35 pounds, one and a half poods, 54 pounds, and two poods or 72 pounds, says Chris Brown, owner and head trainer at Emergent Fitness. “You can now get them in smaller increments in the American versions.” Kettlebells, so the story goes, were first used as counterweights in Russian farmers’ markets over 300 years ago. The farmers began swinging their weights and a new workout regimen was born. Pavel Tsatsouline, a former physical training instructor for the Soviet Special Forces, brought the workout to the U.S. He was contracted to work with the U.S. Marine Corps and the Secret Service and the word spread. In 2001, Dragon Door published Tsatsouline’s The Russian Kettlebell Challenge, and manufactured the first U.S.-made, Russian-style cast iron kettlebell. The swinging routine of the kettlebells is for anyone, says Brown. Different body types and fitness levels can be accommodated. “We teach a kids class for six to 12 year olds and they do kettlebell swings with light weights and focus on form. Age doesn’t matter because it’s easily scalable and these are functional movements.” “Kettlebells train the body for real life,” Nieves maintains. “For example, a young mother carrying

Ricardo Nieves, M.D., helps Kristina Stefka, M.D., improve her technique using kettlebells.

a baby in one hand and groceries in the other – not many exercises in the gym prepare you for that. With kettlebells, you’re activating the whole body.” The workout can be done every day, Brown adds. “This is a multi-joint, full body workout that includes cardio and flexibility.” While both Nieves and Brown share an understanding of the value of the kettlebell workout and both have received certification as kettlebell instructors, their approaches are different. Brown comes from a fitness world approach and Nieves from the medical arena. Brown uses kettlebells in his CrossFit workouts. CrossFit is a strength and conditioning program that combines timed intervals of weightlifting, squats, push-ups, and cardiovascular exercise. After Brown received his degree in computer sciences from New Mexico State, he relocated to Colorado and took a desk job where he gained 50 pounds. “I was 23 years old, my blood pressure was 180 over 90, and I was diagnosed as hypertensive.” As a teenager, he had met Tsatsouline in New Mexico at a kettlebell demonstration. “I remembered the kettlebells and I decided to give it a try. In nine months, I lost the weight and got my blood pressure, cholesterol, and resting heart rate back to a good point.” Nieves’ interest also stemmed from personal need. After receiving his medical degree, he completed his internship at the Mayo Clinic, and his residency in physical medicine and rehabilitation at Temple University Hospital in Philadelphia. He opened his practice and served as medical staff for the Olympic trials. But while he was helping others,

he found that his own workouts were lacking. “In 2006, I was bored working out in gyms. I was looking for something different and I found it on the Web. I bought some DVDs and kettlebells and imitated everything I saw. But then I received training with a certified instructor and realized what I was doing wrong.” Nieves, a Certified Strength and Conditioning Specialist with basic and advanced level Russian Kettlebell Certification, was invited to be an instructor at the main certification program in Denmark in 2008. He currently incorporates his extensive medical training, knowledge of strength conditioning, and kettlebell knowledge to provide specialized workouts to his patients. He is planning to open a facility where he will provide kettlebell instruction to the general public. While it’s easy to get started with kettlebells, with the equipment now readily available in stores and on the Internet, both Brown and Nieves stress using common sense. Proper instruction is required. “A kettlebell is like a dumbbell. But, you start swinging and it comes alive. It can hurt you. You need to be taught by a certified instructor to learn about attention to detail, positions, spine mechanics, proper breathing, and proper technique,” Nieves says. As with any workout, the moves need to be coupled with a healthy lifestyle, Brown adds. “Eating well is an important part of the training.” Kay Rios, Ph.D., is a freelance writer who spends many hours in front of a computer and is ever in search of the perfect workout.

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Fort Collins Medical Magazine & Directories 2009 2010

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Wellness

alcohol

Alcohol’s

Impact on Your Health

by Angeline Grenz

Wading through the complex subject of alcohol intake is a difficult chore. The discussion ranges from alcohol’s health implications, to social behaviors that contribute to drinking, to the frightening, and often incomprehensible, alcohol addiction.

Can moderate alcohol intake improve your health? Should you only drink red wine? Or does the teetotaler have it right: no alcohol is good alcohol? What trends do we see in an economic climate that has added significant pressure to the average family? How do college-age students fare as they fly the coop and enter a new phase of independence? What are the signs that alcohol has crossed the line from leisure time companion to addiction? These questions are not easily answered in a few words, but local experts from the medical and mental health communities give us their insight on how drinking behaviors are changing in our Northern Colorado community. The Physical Person Alcohol and our health: where do we draw the line? It is a tricky question, according to Christie Reimer, M.D., with Poudre Valley Internists.

Before the discussion begins, Dr. Reimer warns, “It is important to understand there have been no long-term ‘randomized controlled trials’ (what the medical community considers the goldstandard for determining benefits and risks) of alcohol consumption.” Furthermore, Dr. Reimer says the suggestive data collected creates only a definition of moderate drinking; a reference point for physicians, not an absolute standard. Moderate use, says Dr. Reimer, is defined as an average of 14 drinks per week for men younger than 65, and an average of seven drinks per week for women and men over the age of 65. Men should have no more than four to five drinks in one setting and women should have no more than three to four drinks in one setting. It is also important to know what a “drink” is: one drink is approximately 12 ounces of beer, five ounces of wine, or 1.5 ounces of hard liquor. Often, what makes up a single drink can be greatly overestimated.

“We have learned that there are some benefits of light to moderate amounts of alcohol intake,” she says. Among those benefits are the decreased risk of coronary heart disease, stroke, diabetes, gallstones, and overall mortality. “Those at the highest risk for heart disease probably benefit the most; there is a suggestion that the subgroup that may receive the greatest benefit from moderate alcohol intake is older men.” Although red wine does have a few health benefits thought to be associated with grape skins, the benefits touted above do not hinge on a certain type of alcohol. Beer, wine, or hard liquor – it does not make a difference, according to Dr. Reimer. Dr. Reimer warns that suggestive data for the benefits of moderate drinking may apply primarily to men, who have a higher risk of heart disease. “It is hard to know how to apply much of the information we have to women, especially since they are at increased risk of breast cancer,”

Immediate & Long-Term Effects of Alcohol on the Body Alcohol is absorbed through the entire GI tract, but mostly in the stomach and small intestine. While a small amount of alcohol is excreted in urine, sweat, and the lungs, most is metabolized by the liver.

Brain and Central Nervous System • Alcohol can act as a stimulant at low levels, but is generally a central nervous system depressant that causes impairment in judgment, loss of inhibition, balance, and motor coordination. At higher dosages, alcohol can cause blackouts and memory loss. Abnormal sleep patterns and an increase in snoring and sleep apnea can result. • Long-term exposure to alcohol can lead to depression and anxiety, permanent brain damage, stroke, delirium, and dementia, as well as peripheral neuropathy (numbness and tingling) and addiction.

Blood • Prolonged exposure to alcohol can lead to abnormalities in the production of all cell lines (red blood cells, white blood cells, and platelets).

Bones • Prolonged exposure to alcohol leads to an increased fracture risk due to osteoporosis and an increased risk of falls.

Breasts • Alcohol intake can increase the chances of breast cancer.* Women with a family history of breast cancer should consider avoiding alcohol. The risk may be partially offset with folate supplementation.

Stomach/Esophagus • Alcohol intake can cause nausea and vomiting. • Long-term effects include gastritis (inflammation), bleeding, ulcers, and cancer.

Muscles • Prolonged exposure can lead to weakness and loss of muscle tissue.

Lungs • Exposure to high volumes of alcohol may lower resistance to infection, cause breathing to stop, and even death. Heart • Prolonged alcohol intake can cause atrial fibrillation (a rhythm problem), hypertension (high blood pressure), acute myocardial infarction (heart attack), and cardiomyopathy (heart failure/weakened heart muscle). Liver • Alcohol can inhibit the creation of glucose, causing low blood sugars. • Long-term alcohol exposure can lead to alcoholic hepatitis (inflammation)*, cirrhosis of the liver, end-stage liver disease, and hepatoma (liver cancer). Pancreas • Long-term exposure to alcohol can lead to pancreatitis (inflammation) and pancreatic cancer. Intestines • Prolonged exposure to alcohol is associated with colon cancer. Reproductive Organs/Genitals • Alcohol can lead to an increased sex drive at low levels in both genders via disinhibition, primarily.

* most concerning

Contributions to medical text by Christie Reimer, M.D., Poudre Valley Internists

• Higher levels or long-term use can lead to decreased sex drive, erectile dysfunction, and difficulty reaching orgasm in both genders. • Drinking alcohol during pregnancy can lead to fetal alcohol syndrome* and prolonged exposure can lead to male and female infertility.

says Dr. Reimer. The studies done on mortality rates seem to be the most compelling. Data suggests that a moderate drinker (who has one or two drinks a day) lives longer on average than those who abstain completely or who drink in greater quantity, relates Dr. Reimer. Again, she warns that these studies are anecdotal. There is a segment of the population that should abstain from alcohol completely, says Dr. Reimer: “Women who are pregnant, or considering pregnancy; recovering alcoholics; those with chronic pancreas or liver disease, especially hepatitis C; those with a strong family history of alcohol dependence or abuse; those with a strong family history of breast cancer; and those whose occupation requires driving or operating machinery.” Further, she says, there are studies that suggest male and female fertility can be impacted by alcohol. “And, there is a definite link between alcohol and an increased risk of breast cancer.” In the end, advises Dr. Reimer, “a decision to abstain from alcohol or drink moderately should be individualized. One must take into account the risks associated with his or her medical problems, other medications, and social and occupational environments.” In our diagram on page 77, Dr. Reimer provides a short synopsis of how alcohol can impact the body, both in an immediate sense and from a long-term perspective. The possible physical impacts from alcohol intake refer only to prolonged exposure to the body and are not specific to persons suffering from an alcohol addiction.

The Social Drinker College drinking is one of the most concerning segments of the drinking population. The tragic fatalities that have resulted from binge drinking by partying college students, both locally and nationwide, has fueled public concern. Colorado State University has taken an aggressive route to help students understand the dangers and consequences of abusing alcohol. “We are always asked, ‘why is the college population so difficult?’” says Lisa Miller, Director of CSU’s Research and Health Promotion. “But our population turns over every four years.” And every year, a new group of freshmen must be educated about CSU and the community’s expectations, the risks associated with drinking, and smart strategies surrounding alcohol. “We try to take a thoughtful, multi-pronged approach to educating students,” says Miller, adding that a “hardcore, zero tolerance” tactic rarely works at the college level. Greater success comes from “educating students on a cognitive level: teaching decision-making strategies, messages of accountability, and encouraging early planning,” explains Miller. “We teach them things, like how to quantify a drink.” “We encourage students who plan to drink to have less than four or five drinks in one setting, to eat food before drinking, to alternate drinks with water.” One popular drinking ritual is “pre-funking,” the practice of doing several shots of hard alcohol before going out for the night. Students are educated about the dangers of such behavior and encouraged to make smart decisions, such as

who will be designated driver for the evening, before drinking begins. “Planning at the beginning of the evening always results in better outcomes.” Another key is to “spread messages around social norms. We have a growing population of non-users. Between 30 to 40 percent of students do not participate in drinking. But the perception is that everyone drinks.” Miller says students are choosing not to drink for a variety of reasons. A healthy lifestyle is one. Another, surprisingly, is the poor economy. Parents, says Miller, are telling their children that if they pay for the child’s college education, they expect them to stay focused and successful. The drinking behavior of CSU’s student population has remained relatively static in current years, says Miller. However, there is an increase in students’ use of stimulants and opiates on a nationwide level, says Miller, in part, due to greater availability. Do the drinking behaviors adopted during college years shape drinking patterns later in life? Possibly, says Miller. There is some data that suggests students considered high-risk drinkers at the college age continue to struggle with substance abuse into their 40s. And strong data supports the idea that students who learned decisionmaking at a young age were able “learn from mistakes and transfer that knowledge from one application to another” throughout their lives, says Miller. Ken Ash, M.D., a psychiatrist practicing in Windsor, says the age at which a person begins drinking may have a great impact on drinking behaviors later in life. Dr. Ash cites a recent Center for Disease Control study that found among children who started drinking at a young age, around 12 years old, more than half ended up with an alcohol addiction at some point in their adult lives. Addiction appeared less often in those who did not begin drinking until later in life, around age 20 or 21 years old. The Alcohol Addiction “There is a significant difference in alcohol abuse and addiction,” says Dr. Ash. “Think of the college students who drink too much. After enough negative consequences, they can cut back and drink socially. Others may try to cut back and cannot.” However, addiction can develop in a variety of ways, Dr. Ash adds. One can begin drinking socially “and after a period of time, the brain changes and drinking can no longer be controlled.” For others, addiction comes from strong genetic factors and the very first drink can be the one and only trigger. Abuse verses dependence, says Chris Meeker, Chemical Dependency Outpatient Program Coordinator at Mountain Crest Behavioral Healthcare Center, hinges on the answer to a variety of questions: Can you stop drinking at one or a couple drinks or do you always need more? Have you attempted to quit drinking but have never been successful? Do you think about drinking or acquiring alcohol all the time? Does alcohol get in the way of other relationships? “A person with an alcohol problem needs alcohol to feel normal and sees alcohol as the answer to their problems, rather than as something that creates more problems,” says Meeker. Meeker manages Mountain Crest’s outpatient programs. The Chemical Dependency Intensive Outpatient (CDIO) program is designed to provide CONTINUED ON PAGE 98

L=AN ~=

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Wellness

rossiter

The Rossiter

Approach

by Angeline Grenz

Connective tissue runs throughout the body, providing structure and support to our body’s composition. When we fall, work in a repetitive motion, or are in the unfortunate fender bender, often it is these connective tissues that take the brunt of the trauma. Though painful, connective tissue injuries can be relatively easy to correct and heal. All that is involved? A few good stretches, according to the creator of The Rossiter System. Founder Richard Rossiter demonstrates the Rossiter techniques’ ability to relieve pain on David Henre, Rossiter Instructor.

Call it a workout, not a therapy, says founder Richard Rossiter. This is because the Rossiter approach involves two-person connective tissue stretching. But while the therapist may provide the proper weight to the tissue, the patient does all the work. It is a system that allows you to stretch to your maximum capability and puts the proper spacing back into your damaged connective tissue. Rossiter says his approach can fix knee pain, carpal tunnel syndrome, elbow tendonitis, hand or foot problems, shoulder pain, sciatica, low back pain, knees, sprains, and strains. Even migraines and jaw problems can be alleviated. The pain relief offered by Rossiter’s approach comes without the invasive, and potentially harmful, side effects of surgery or injections. The exercises “provide a whole body stretch while doing a single technique” with the patient in full control, says Rossiter. Rossiter created his technique in the late 1980s, a product of his own search to find pain relief. While still in his 20s, Rossiter was employed as a bush pilot in Alaska. A mixture of childhood sports injuries, wartime injuries, and occupational stresses had left Rossiter with constant pain in his shoulders. Searching for something to alleviate the pain, he stumbled upon Rolfing, a technique that focuses on lengthening and restoring the body’s connective tissues. Rolfing enabled Rossiter to find relief from his pain and he applied to the Rolf Institute in Boulder,

Colorado. In 1987, he became a certified advanced Rolfer and established his own practice in Little Rock, Arkansas. Shortly after setting up his practice, Rossiter was able to help a local neurosurgeon with a painful back condition. Soon, Rossiter began to regularly receive referrals from the neurosurgeon. “He began to inundate me with his worst clients.” Clients who were in chronic pain but did not want risky surgeries, or who had already undergone a surgery but were still experiencing pain. “I was learning so much from working with his patients. I went to him and asked for carte blanche to find better, faster ways to fix people.” At the same time, Rossiter realized that he had an obligation to help these people before they went through invasive surgeries in search of pain relief. The Rossiter revelation came when he was teaching the Rolfing method to a married couple. The wife was diminutive in stature while her husband was very tall. Rossiter told her she would have to stand on him to get the leverage she needed to perform the stretch. And then it happened. “We got tremendous results.” He realized the stretch achieved by placing the weight of the foot on the patient’s body enabled them to stretch deeper. His modality was born. Rossiter stretches involve two people: the coach (or therapist) and the person in charge (patient). The way Rossiter works is the person in charge does the grinding and the pushing

and the coach leads the movement while applying weight. Thus, Rossiter’s technique lengthens the connective tissue, allowing pain-free movement by returning the proper space required for the body’s tissue to move and function properly. “I found in my practice, when a patient just laid there they didn’t get well. But when I asked them to participate and work with me, they experienced better, quicker, and longer-lasting results. And they started to take responsibility for their own recovery,” says Rossiter. He continues: “Patients in pain know how far to stretch. They even know when they are cheating.” By the end of a Rossiter session, “patients are also smarter about their own bodies.” While most of his more than 200 stretches involve weight from the coach’s foot, a handful of them do use weight from the elbow. The access point under the coach’s foot acts as the midpoint to the stretch, and the patient’s stretching movements engage connective tissue in multiple directions. “Think of connective tissue as thin threads throughout the body. Add pure weight with slow, deliberate motion and you get an immediate reaction. Combine the right movement with the right amount of weight and you get the right stretch.” Rossiter’s goal is to take his workout beyond gym rooms and therapists’ offices and move it right into the public arena. He offers courses in his stretching techniques to businesses that want to “take control of their healthcare costs.” By training

mind

body

spirit

mind body spirit

LeaAnn Haisch, City of Fort Collins crew chief for Parks and Recreation, has had 20 Rossiter workouts over the past two years to relieve her low back and hip pain. lay people, companies can help alleviate the aches and pains that send their employees to doctors, physical therapists, even surgeons. With Rossiter stretches, a person feels better, faster. This, in turn, cuts down on employee time lost to doctor’s visits or even permanent injury. “Companies can save up to 80 percent on their medical costs” by learning a few good stretches, says Rossiter. David Henre is a local, Level 1 Rossiter Instructor who teaches courses at The Other Club, Ltd., in Fort Collins. Henre is available for group training or to teach Rossiter to companies who want to take a new approach to keeping their employees well. According to Henre, the technique is easy to learn and requires little in the way of equipment. “All you need is a mat to lay on and a block or two to elevate a person to apply their weight in a more even fashion.” What is important, says Henre, are the benefits derived from Rossiter. “Structurally, when everything is out of balance, Rossiter can put the originally designed space back into the tissue and pain goes away. It is gone that fast.” Henre can be reached at (970) 376-7699 or coloradocore@yahoo.com. Additional information about The Rossiter System can be found at the Website: www.therossitersystem.com. Angeline Grenz is Editor for Style Magazine.

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body

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Fort Collins Medical Magazine & Directories 2009 2010

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Wellness

eye health

Sunshine’s Dark Side

by Kay Rios

Most everyone would agree with John Denver’s musical assertion that sunshine makes people happy but, while those wonderful rays are certain to lift moods and encourage outdoor activities, there’s also a dark side to the sun. XXXXXXXXXXXXXXXX Take the effect on eyes as an example. The sun’s XXXXXXXXXXXXXXXX ultraviolet rays, in regular doses, can certainly conXXXXXXXXXXXXXXXX tribute to the incidence of cataracts and conditions XXXXXXXXXXXXXXX such as pingueculae and pterygia. “Certain types of cataracts are more prevalent in parts of the world that have a great deal of sun,” confirms Randall Smith, M.D., ophthalmologist and cataract and refractive surgeon with Eye Center of Northern Colorado, P.C. A cataract is a clouding of the eye’s lens that lies behind the iris and the pupil. The lens is primarily made up of water and protein and the protein is arranged so that it keeps the lens clear and allows light to pass through. With aging, the protein may bunch together and cloud part of the lens. Over time, as the cataract grows, more of the lens is clouded. While sunlight itself does not cause cataracts, many studies have associated exposure to ultraviolet light with cataract development. Treatment for cataracts includes surgery with lens implants. “Surgery has become more straight forward,” Smith says. “Because of advanced equipment and improved techniques, along with foldable lens implants, a surgeon can perform the typical cataract surgery in a quick, painless manner. Surgery involves two tiny incisions, two millimeters or smaller, so that no stitches, or even shots, are required.” The lens implants have also improved, he says. “All of the lens implants have UV protection at this point. We even have lens implants that have a very slight yellow tint that filters out high frequency blue light thought to be potentially damaging to the eye. If we look at the lens of a four-year-old, it’s crystal clear. As the eye ages, the lens slowly becomes cloudier but it also filters out some UV light and the high frequency part of the light spectrum.

So a slightly yellow lens implant actually mimics a 20-year-old’s natural lens, giving the cataract patient great vision and extra protection. Such lenses even come in a version that can give patient glassesfree vision for all distances.” Two other conditions more directly related to damage by UV rays are pterygium and pingueculum. A pingueculm is a wedge-shaped benign growth on the conjunctiva, a thin, clear layer over the white of the eye. As sun damage worsens, the growth extends over the cornea and is then called a pterygium. “A pterygium can thicken and grow across the surface of the cornea, over the colored part of the eye, and become large enough to interfere with vision,” Smith says. “It is particularly bad in people who work outside consistently and have direct damage to the cells by the sun. Most people with this come in complaining of red, irritated eyes and feel like something is in the eye. If it’s mild, a doctor can just measure the size of the growth and follow it once a year. If it’s growing toward the center of the cornea, then it must be removed.” For this condition, removing the growth is fairly simple, Smith says, but “the recurrence rate can be as high as 40 percent if we simply excise it and do nothing else. So typically, we will take a graft from the patient’s own conjunctiva tissue under the lid and place it over the white of the eye where the pterygium was removed. This reduces the recurrence rate to less than five percent.” Another eye condition that causes concern is macular degeneration. “It’s the number one cause of irreversible sight loss for people over 65.” And while Smith says that it is not caused solely by sun exposure, good sunglasses may play some role in

slowing down its progress. “If a person comes in to our office at age 70 with macular degeneration, we can’t say what role sun damage played throughout their life versus them being genetically predisposed to the disease. To err on the safe side, I’d suggest that people wear sunglasses throughout their lives.” UV protection is essential for all eyes, Smith says. “Sunglasses should have 99 to 100 percent UV blocking. Darkness of the lens does not matter as much as the quality of UV coating.” Check the label, he says. “Sunglasses usually have a sticker indicating UV protection. Generally, a prescription lens will automatically come with high-level UV protection and a reputable optician will check the UV rating of sunglasses prior to dispensing the lenses. You can also bring in your own glasses and have the UV rating checked.” For those who like water sports, fishing, or skiing, he suggests polarization. “It blocks reflective light.” Smith stresses the need to see an eye doctor. “Skin cancers ranging from basal cell carcinoma to melanoma can be found around the eyes. Melanoma can also occur in the eye and can only be picked up during an eye exam, so it’s important to get a regular eye exam. We recommend every two years and then, beyond age 50, every year.” And cover those eyes, he says. “Even in an age where we can make people glasses-free, they should still wear sunglasses for protection.” Kay Rios, Ph.D., is a Fort Collins-based freelance writer and is currently at work on a collection of creative non-fiction and a mystery novel.

Wellness

medical records

Accurate Medical Records

Save Lives by Laura Lee Carter

She was just going out for a short bike ride around her local neighborhood in south Fort Collins. It didn’t really seem necessary to carry an ID, or even wear a helmet. Ten minutes later she was found lying on the ground unconscious on a bike path not far from Horsetooth Road.

The bystander who found her called 911 and an ambulance arrived soon afterwards. She was quickly whisked off to the emergency room at Poudre Valley Hospital. Her mind was constantly weaving in and out of consciousness. Luckily, she did remember her name and the moment she answered that question posed by an emergency room nurse, Poudre Valley Health System’s (PVHS) electronic medical records system provided the staff with her complete medical history. All the information they needed to contact her next of kin, and provide her with the best medical care necessary, was at their fingertips instantaneously. This is a true story. It happened to this writer only last May. My own up-close and personal stumble into a bad bike accident, leading to fractured ribs and traumatic brain injury, taught me how crucial it is for our local healthcare organization to have an excellent networked electronic records system. In an emergency, seconds save lives and accurate medical information is critical. Fortunately, PVHS rates in the top 100 for

Most Wired healthcare organizations nationwide, consistently achieving that rating for the past six years. Hospitals & Health Networks magazine recently announced: “PVHS is among the top 100 hospitals and health systems for using information technology to enhance patient care, improve quality, provide customer service, fulfill business processes, manage workforce issues, and assist with patient safety.” PVHS President and CEO Rulon Stacey, Ph.D., reports, “Our health system is continuing to expand its information technology while many of the nation’s healthcare organizations are slowing down on such capital investments due to the ailing national economy.” So, how can PVHS afford this type of capital investment at a time like this? According to Gary Kimsey, PVHS Marketing Specialist, they began creating their own electronic medical records system back in October 2005. “While maintaining the highest level of security, PVHS doctors and staff can access complete electronic medical records for all of their patients from Poudre Valley Hospital, the PVHS Harmony cam-

pus, Medical Center of the Rockies, and PVHS clinics located throughout Northern Colorado. This kind of information technology also provides seamless communication to doctors who choose to work from home and provides a huge time, money, and paper savings.” Kimsey explains, “Unlike many other health systems nationwide, PVHS has a huge advantage because, as a private, non-profit system, we invest our profits back into the organization. This re-investment has helped us to create new technologies, like our own networked electronic medical records system, long before most other healthcare systems nationwide.” PVHS’ advanced level of information technology not only expedites the transmission of medical records system-wide, their state-ofthe-art automation system enhances the accuracy and speed of lab tests, and automatically reviews medicines in each record to determine if a patient might have an adverse reaction to a certain medication. Why is this important? Mixing medications can be dangerous, or even deadly.

Reports from the Center for Disease Control (CDC) found that deaths from accidental drug interactions rose 68 percent between 1999 and 2004, continuing a steady climb since the early 1990s. According to the CDC, unintentional drug poisonings accounted for nearly 20,000 deaths in 2004, making this problem the second-leading cause of death in the United States after automobile accidents. The CDC reports, “Prescription drugs, especially prescription painkillers, are driving this prolonged increase.” People are mixing supplements, herbs, and over-the-counter medications with prescription drugs, unaware these different chemical substances will interact. For example, many started taking herbal medications like ginkgo biloba to improve their memory, unaware that it may also increase the risk of bleeding in the body. Some learned that St. John’s Wort might help with depression, but did not know that this supplement should not be taken with prescription strength antidepressants and anti-anxiety medications. Some take echinacea to enhance their immune system, only to discover that this herbal supplement can interact with Lipitor, Celebrex, and Aleve to increase the risk of liver damage. That is why it is so important to inform your primary physician of all supplements, herbs, homeopathic medications, over-the-counter medicines, and prescription drugs you are presently taking. Once this information becomes a part of your PVHS electronic medical record, if an emergency should arise, your caretakers have instantaneous access to information concerning all medications you are taking. In contrast with our local electronic medical records system, you might wonder about a new trend of creating online personal health records (PHR). For example, the American Health Information Management Association (AHIMA) recently launched the new myPHR.com Website where individuals may choose to input their own health information record for emergency access worldwide. Kimsey cautions readers about these new online medical record services. Here are a few crucial questions to ask before you decide to input your own health information into these systems. Who maintains your records and ensures they are accurate? How does this company make money? Exactly how secure is your information in these online systems? Fortunately, our medical records are safe and local with Poudre Valley Health System. They are networked throughout Northern Colorado and ready at a moment’s notice to increase patient safety and save lives. This advanced medical information system allows the staff at PVHS to easily analyze massive amounts of patient information to identify areas where patient care might be improved. That is one of the many reasons why PVHS was the only healthcare organization to receive the Malcolm Baldrige National Quality Award in 2008, an honor established by Congress to recognize the performance excellence of the nation’s top organizations. Laura Lee Carter is a freelance writer, counselor, speaker, and author of the new book: Midlife Magic: Becoming The Person You Are Inside. www.LauraLeeCarter.com

Fort Collins Medical Magazine & Directories 2009 2010

BRAIN LEARNING SOLUTIONS/TRAINING ::

Learning Rx 1100 Haxton Dr., Ste. 105, (FC)........970.672.2020 www.learingrx.com/fort-collins See ad on page 83 Open Pathways to Learning, LLC 1939 Wilmington Dr., Ste.102, (FC)...970.416.6330 www.OpenPathways.org See ad on page 69

CHIROPRACTOR ::

Spine Correction Center of the Rockies 1101 Oakridge Dr., Ste. A, (FC).......... 970.226.1117 www.spinecorrectioncenter.com See ad on page 82

CLEANING SERVICES ::

Porter Industries Northern Colorado. ............................. 970.667.5239 www.porterindustries.com See ad on page 75

DENTISTRY/COSMETIC ::

Overton Center for Dental Arts, P.C. 1220 Oak Park Dr., (FC). ..................... 970.223.6677 www.overtoncenter.com See ad on page 4 & page 72

DENTISTRY/ORTHODONTIC ::

HOME/MEDICAL EQUIPMENT (DME) ::

PAIN MANAGEMENT ::

Orthodontic Associates of Greeley, P.C. 3400 W. 16th St., Bldg 4-V, (Greeley). 970.356.5900 www.dredgren.com...........................888.356.5900 See ad on page 87

Mobility & More (KYTO, Inc. ) 1447 N. Denver Ave. (Loveland)..........970.461.8400 www.mymobility.biz See ad on page 82

Rossiter System - David Henre Northern Colorado...........................970.376.7699 email: coloradocore@yahoo.com See ad on page 81

DENTISTRY/PERIODONTICS ::

HOSPICE ::

Associates in Periodontics 1120 E. Elizabeth St., G4, (FC) ........970.221.5050 2996 Ginnala Dr., Ste.101 (Loveland) .970.221.5050 See ad on page 75

EDUCATION :: IBMC 3842 S. Mason St., (FC)....................970.223.2669 5400 W. 11th St., Ste. D (Greeley) ...... 970.356.4733 See ad on page 81 U.S. Career Institute 2001 Lowe St., (FC). .........................970.282.4521 www.uscareerinstitute.com...............877.563.5072 See ad on page 82

HEALTHCARE :: Columbine Health Systems www.columbinehealth.com................800.718.2224 See ad on page 92 Mountain Valley Health Care Northern Colorado...........................970.346.9700 www.mountainvalleyhealth.com.........800.368.7137 See ad on page 25

Hospice & Palliative Care of Northern Colorado www.hpcnc.org..................................800.564.5563 See ad on page 98 Pathways Hospice www.pathways-care.org....................970.663.3500 See ad on page 61

INSURANCE

Family Heritage Life Insurance Company of America www.familyheritagelife.com...............970.581.1257 See ad on page 65 Rocky Mountain Health Plans...........800.823.8356 See ad on page 83

MED SPA :: Twenty Three Trees Medical & Wellness Spa 1107 S. Lemay Ave., (FC)..................... 970.495.8400 Email: twentythreetrees@pvhs.org See ad on page 89 Xanadu Med Spa 1112 Oakridge Dr., Ste.106., (FC)........ 970.482.1889

www.xanadumedspa.com See ad on page 70

PROTECTIVE SERVICES/SECURITY :: Anlance Protection Ltd. info@anlance.com.............................. 970.484.8095 www.anlance.com............................... 800.767.6885 See ad on page 64

REHABILITATION HOSPITALS :: Northern Colorado Rehabilitation Hospital/ Northern Colorado Long Term Acute Hospital 4401 Union St. (Johnstown)........................... 970.619.3400

www.ernesthealth.com See ad on page 68

SPEECH/LANGUAGE THERAPY :: Speech & Language Stimulation Center, Inc. 317 N. Meldrum St., (FC). .................970.495.1150 www.speech-language-voice.com See ad on page 82

TEAS & HERBAL REMEDIES :: Cha Tao Tea 1 Old Town Square, (FC). ..................970.493.0773 www.chataotea.com See ad on page 63

NOW

OPEN

TWENTY THREE TREES MEDICAL & WELLNESS SPA

MEDICAL SPA

BROUGHT TO

YOU

PVHS

Twenty Three Trees is a new medical and wellness spa owned and operated by Poudre Valley Health System . Staffed by a physician and a licensed esthetician, nail technician and massage therapists to ensure the highest quality care and medical expertise, Twenty Three Trees will offer comprehensive services in a luxury spa setting . esthetic procedures I facials natural nail services

massage therapy

laser skin renewal

photofacial skin rejuvenation

Twenty Three Trees is located across the bridge from PVH in the new Westbridge Medical Suites . To be placed on our e-mail list to receive special introductory offers, e-mail

twentythreetrees@pvhs.org. To schedule a complimentary consultation or to make an appointment, call (970) 495-8400.

WHY

TWENTY

THREE

TREES?

During excavation for the Westbridge building, it was necessary for 23 trees to be removed, but all were relocated to the home gardens of PVHS employees. Twenty Three Trees Medical and Well ness Spa is located on the same grounds where the 23 trees once stood and carries on the same spirit of renewal. This summer, 23 new trees will be planted around the Westbridge building, bringing the story full circle .

POUDRE VALLEY HEALTH SYSTEM

- --l

Family Medicine Center

Foxtrail Family Medicine Medical Center of the Rockies

....-~路~:_____ ____ Wind sor Medical Clinic $

N;~ro~i

Milliken Family Clinic

Quality Award

~~008Awaro . . .R~cipient

POUDRE VALLEY HOSPITAL 1024 S. Lemay Avenue Fort Collins, CO 80524 (970) 495-7000 Toll-Free: (800) 252-5784 MEDICAL CENTER OF THE ROCKIES 2500 Rocky Mountain Avenue Loveland, CO 80538 (970) 624-2500 Toll-Free: (800) 252-5784 MOUNTAIN CREST 4601 Corbett Drive Fort Collins, CO 80528 (970) 207-4800 Toll-Free: (800) 523-1213

HARMONY URGENT CARE 2127 E. Harmony Road Fort Collins, CO 80528 (970) 297-6250 FAMILY MEDICINE CENTER 1025 Pennock Place Fort Collins, CO 80524 (970) 495-8800 WINDSOR MEDICAL CENTER 1455 Main Street Windsor, CO 80550 (970) 674-4900

LOVELAND URGENT CARE 3850 North Grant Avenue Suite 100 Loveland, CO 80538 (970) 669-5717 FOXTRAIL FAMILY MEDICINE 1625 Foxtrail Drive Loveland, CO 80538 (970) 61 9-6900 MILLIKEN FAMILY CLINIC 1760 Broad Street, Suite J Milliken, CO 80543 (970) 587-7999

medical

pvhs family care

The PVHS Network

More Options for Your Family’s Care by Kay Rios

It is a family affair in the Poudre Valley Health System (PVHS). PVHS is, in fact, a regional network of healthcare services for people in northern Colorado, southern Wyoming, and western Nebraska. While Poudre Valley Hospital (PVH) and Medical Center of the Rockies (MCR) are well-known as part of the system, additional locations provide family care to a broader expanse of citizens. Operating under the PVHS umbrella are the Family Medicine Center, Foxtrail Family Medicine, Harmony Urgent Care, Loveland Urgent Care, and the Milliken Family Clinic. Bringing them into the system was a natural pattern of growth, says Barb Yosses, PVHS Vice President of Ambulatory Services. “PVHS has been growing steadily over the past 10 years in Northern Colorado.” As PVHS has grown, its reputation has also grown, Yosses says, pointing to the number of awards received in recent years. The list is impressive. In 2008, PVHS won the Malcolm Baldrige National Quality Award, the highest Presidential honor given to United States businesses and organizations for performance excellence. In addition,

PVH was presented with the American Nurses Association’s highest award for excellence that same year and, in 2009, it again received the Magnet Award for Nursing Excellence by the American Nurses Credentialing Center. PVHS was named as one of the 100 Best Places to Work in healthcare by Modern Healthcare and, in 2008, Medical Center of the Rockies’ Surgical and Cardiac ICUs received the Beacon Award for Critical Care Excellence by the American Association of Critical Care Nurses. “All this has drawn national attention and attracted many physicians to this area,” Yosses explains. “Physicians are interested in working for a top-quality healthcare system. Patients, in turn, are interested in having their healthcare delivered by physicians associated with PVHS, so that if they become ill, they will be taken care of at a PVHS facility.” The demand was spurred by sheer numbers,

Fort Collins Medical Magazine & Directories 2009 2010

says Yosses. “With the population growth in this area of the country comes the need for more healthcare facilities where patients can receive individual care. PVHS has been working to grow a medical network that gives patients a place to receive healthcare close to home.” Currently, that care is provided at a number of locations in Fort Collins, Loveland, and Milliken. The Family Medicine Center (FMC) is located two blocks north of Poudre Valley Hospital at 1025 Pennock Place. FMC serves as a training site for PVH’s Residency Program. Each year, six new graduates are chosen from top medical schools across the country and, as part of the residency, they see patients at FMC, PVH, and in rural communities that may not have enough doctors. The oldest of the clinics, FMC opened in 1977. “Our mission is to train family physicians,” says Marcia Snook, FMC clinical coordinator. “In

doing so, we offer primary care in the family medicine model and that includes OB care, many in-office procedures, hospital care, integrated behavioral health, geriatrics, and lifestyle medicine.” FMC’s healthcare team provides medical care for community members who might otherwise go without healthcare, Snook adds. Foxtrail Family Medicine is one of the newest additions to PVHS, opening on August 20, 2008. Located just south of MCR at 1625 Foxtrail Drive, it provides a full-spectrum of primary medical care, including obstetrics, pediatrics, and geriatrics. “We see all ages and offer a variety of healthcare services to our patients in the Loveland area,” says Heather Smith, Foxtrail’s office manager. The location is also convenient for patients living in the Berthoud, Johnstown, and Windsor areas. Harmony Urgent Care’s service is designed to take care of minor injuries and illnesses, such as the flu, strep throat, strains, sprains, and minor fractures. Harmony Urgent Care is located at PVHS’ Harmony Campus on the southeast side of Harmony and Timberline Road in southeast Fort Collins. “We opened in 2001, so we’re coming up on our eighth full year,” says Jan Huff, clinic manager and RN. “We offer everything a family practice would except for those things that require continuity of care, such as diabetes and high blood pressure checks.” Huff stresses that, although they get a number of emergency cases (49 in July 2009 alone), Harmony Urgent Care is not an emergency room. “For accidents, broken bones, chest pain – those things – we transport them to one of our hospitals.” Harmony Urgent Care also works with occupational health patients, she says. “If workers have been injured on the weekend or in the evening, we can see them for the initial visit.” All patients are seen on a walk-in basis and do not need to make an appointment. Loveland Urgent Care and Loveland Family Practice combine urgent care, family practice, and occupational health services into one convenient location. “We’re a convenient walk-in medical clinic with doctors available seven days a week,” says Keith Miller, clinical supervisor. They treat non-life-threatening illnesses or injuries that need immediate attention. It is a full-service medical clinic providing care in all stages of life. Also housed in the same facility at 3850 North Grant Avenue in Loveland, the Loveland Family Practice offers the full range of primary care needs for all ages including physicals, screenings, and wellness services. “Both practices are departments of PVHS,” Miller says. Loveland Urgent Care opened in 2007 and was purchased by PVHS in 2008. The Milliken Family Clinic is committed to listening to and treating patients as individuals, answering questions regarding healthcare concerns, and ultimately helping patients to reach and maintain optimal health. The Clinic is located at 1760 Broad Street, Suite J, in Trader Junction at Centennial Crossing in Milliken. “The staff is leased by PVHS although they are Greeley Medical Clinic staff,” says Julie Netherton, patient care manager for Greeley Medical

As the community in Northern Colorado continues to grow, additional sites will be needed and PVHS intends to respond to that need.

- Barbara Yosses, Vice President of Ambulatory Services for Poudre Valley Health System

Fort Collins Medical Magazine & Directories 2009 2010

Clinic (GMC), P.C. The Milliken Family Clinic is a family practice, she says. “So we offer comprehensive care, health maintenance, and preventive services for all ages.” The facility was previously open under Banner Health but was taken over by PVHS and GMC in May of 2008. It’s a small practice, she says, with one family nurse practitioner and a lab on-site. There are a number of advantages to having this type of network, they all say. “Location is a big advantage for patients,” Huff says. “The clinics are strategically placed so they are as convenient as possible. I think we’re really doing a nice job in offering medical care throughout our community.” Snook says, “Being associated with PVHS allows our patients access to many services they may not otherwise be able to use. Having affordable, high quality care available close to home is a benefit to the community we serve.” “PVHS has such a great reputation and I think it’s a good thing for the people of Loveland who know about that reputation to have a contact here so they don’t have to drive to Fort Collins to get that care,” Miller adds. There’s more ahead, Yosses says. “As the community in Northern Colorado continues to grow, additional sites will be needed and PVHS intends to respond to that need.” Kay Rios, Ph.D. is a freelance writer based in Fort Collins. She can now officially be called Dr. Rios but, as the police informed her at the pharmacy, she still can’t write scripts.

medical

diagnostics

Technician Laura Schultz prepares patient Lisa Rigg to be scanned for her virtual colonoscopy.

Virtual Colonoscopy

A Screening Alternative

by Kay Rios

Doctors’ appointments are not on Glenna Cook’s list of things to do. A healthy and active woman, Cook figured she took care of business with exercise and diet so she didn’t need routine check-ups. And a colonoscopy? She didn’t see the need. The American Cancer Society would, however, disagree with Cook. Early detection is paramount and an optical colonoscopy can help prevent colorectal cancer by finding and removing polyps that could create a problem down the line. But, even though her mother died from colon cancer, Cook resisted. “I’m not a very cooperative patient,” she says. “My doc had been nagging since I turned 50 to get a colonoscopy.” But her doctor had the last word. As part of the maturation process, her thyroid had ceased

to function and she was put on a synthetic thyroid replacement. “When it came time to renew my prescription, he put his foot down. He wouldn’t renew until I came in for the yearly physical and all the other tests.” Those tests included the colonoscopy. It wasn’t just taking a day out of her life to get it done; there was the fear factor for Cook, who had heard several “horror stories.” During an optical colonoscopy, the doctor uses a colonoscope, which is inserted through the rectum into the colon. The colonoscope includes a video camera that connects to a dis-

play monitor to facilitate close examination of the inside of the colon. Special instruments can also be passed through the colonoscope to remove polyps. That procedure didn’t appeal to Cook. Then a friend told her about the virtual colonoscopy. This screening exam uses an advanced type of computed tomography (CT or CAT), which scans the colon and rectum. It produces detailed cross-sectional images and reformats them into 2-D and 3-D images that appear similar in detail to an optical colonoscopy, hence the term “virtual.”

Deborah Gunderson, M.D., and radiologist with Advanced Medical Imaging Consultants, P.C., (AMIC) at The Imaging Center, says there are a number of advantages to a virtual colonoscopy. “It is minimally invasive, anesthesia is not used, and it is quick and accurate. A bowel prep is still necessary since the inside of the colon needs to be very clean.” Cook met with her doctor, who agreed to the virtual route. At 8:30 a.m. on a Tuesday morning in July, she is at The Imaging Center on Harmony ready for the test. After filling out the requisite paperwork, she’s escorted back to the nurses’ station where a nurse asks how the prep went. “It blasted me into the end of the movie I was watching,” Cook says. “I can assure you there’s nothing solid left.” Cook confides that she is still nervous. “I still don’t know what to expect. They told me I’d be filled with carbon dioxide (CO2) like a balloon, and that’s just a little disconcerting. But they said there would be little discomfort and I’d just feel like I want to evacuate. And, at least, the machine is not invasive.” Cook’s procedure is guided by CT scan technicians, Laura Schultz and Bobbie Elliott, who are both certified in radiology and in CT scans. Cook lies on the CT bed, and her colon is filled with carbon dioxide gas via a small tube placed in the rectum. The slight expansion of the colon allows good visualization of the colon wall. Elliott explains that it will take about eight seconds with Cook lying on her back as she is scanned, and then she will turn over and will be scanned for another eight seconds. “The colon doesn’t lie flat, and air rises above the fluid, so that’s why the patient lies on her front and then on her back,” Schultz says. The prone and supine CT imaging is done to differentiate residual debris in the colon

Scans of the colon taken while the patient lies on her back and stomach.

Fort Collins Medical Magazine & Directories 2009 2010

The beauty of this method of colon cancer screening is that it does not take a day out of a patient’s life, compared to optical colonoscopy. Deborah Gunderson, M.D., Advanced Medical Imaging Consultants, P.C.

from a polyp and allow visualization of the entire colon wall, which could be obscured by residual fluids and solids. The technicians have both been doing this for a while. Elliott says she started in 1981. “It’s amazing how it’s changed.” Schultz agrees, In the old days, “if we got called in for an accident, we’d be there all night. It used to be a nightmare. We were using much older equipment then.” Newer technology not only allows a better look at the area scanned, it offers greater efficiency. “This is going to be a beautiful scan,” Elliott adds. “She is very clean,” she says, referring to the prep process Cook completed before the scan. The virtual colonoscopy is interpreted by a radiologist in both two-dimensional and threedimensional versions. The 2-D images reveal the colon and all of the other anatomy in the abdomen and pelvis. The 3-D images appear as though the viewer is traveling through the colon. Each crevice and fold is inspected, much like an optical colonoscopy. “It gives the same view as an optical colonoscopy,” Elliott says. It’s efficient, she adds. “I’ll have the first set to the radiologist before the patient gets out of the bathroom.” Cook gets up from the scan bed and retreats to the bathroom and, in fact, before she emerges, both sets have actually been sent to the radiologist. Cook is escorted back to the reception area where she is given a warm blanket, offered juice, coffee, or tea, and told to sit for a few minutes and relax. While the prep the night before wasn’t a ball of laughs, Cook says, “I feel fine, good really. I had some discomfort last night. And I got a little hungry yesterday. I had a hardboiled egg for breakfast yesterday and nothing else.” Still concerned about the CO2, Cook asks a nurse, “How do I dispose of the gas? I have a party this afternoon.” She is assured that it’s easily absorbed into the blood stream and the body will dispose of it within half an hour. She can make her party without any concerns. The entire process has taken 45 minutes and Cook walks out and drives off unassisted. “The beauty of this method of colon cancer screening is that it does not take a day out of a patient’s life, compared to optical colonoscopy,” Dr. Gunderson says. “Other benefits include the ability to assess other anatomy in the abdomen and pelvis. We have incidentally detected aortic aneurysms, ovarian masses, and renal stones.” The Imaging Center has been offering virtual CT scans since 2000, says Dr. Gunderson, who was responsible for bringing in the technology. “It was a new technique and, as I learned more about it, I thought it was going to be very valuable.” The Imaging Center is the only medical imaging facility in Northern Colorado and the surrounding region that offers virtual colonoscopy. The facility uses a state-of-the-art, 64-slice CT scanner and follows protocols used by other leading imaging programs. There are those patients for whom a virtual scoping is not appropriate. “Virtual colonoscopy is endorsed by the American Cancer Society for a specific colon cancer screening population,” states Dr. Gunderson. “This is intended for patients over the age of 50, without

Reluctant patient Glenna Cook found the virtual colonoscopy scan procedure to be relatively quick, with little discomfort.

symptoms. It is hoped that more people will be screened for colon cancer now that this technique is available, since 70% of patients above the age of 50 have not been screened by any other method.” There are drawbacks, however, because if a polyp or other mass is detected, it will need to be removed and additional imaging, tests, or biopsies may be necessary if any abnormalities are detected in other organs. Virtual colonoscopy coverage by Medicare is limited to specific conditions and private insurance coverage is variable. Prospective patients are advised to check with their insurance regarding virtual colonoscopy coverage. It is available to all patients for a fee of $700. As quality standards for this technique are developed, expansion of Medicare and private insurance coverage is expected. A short time later, Cook has received her results. She says, “I am extremely pleased with the outcome. I have no polyps and no cysts on my ovaries and that is a comfort to know.” She reflects on how easy the entire process was: “I didn’t even think the cleansing part was difficult and everything went so fast. I would absolutely encourage other people to get this test and I will certainly go again when it is time.”

Kay Rios, Ph.D., is a freelance writer based in Fort Collins. She writes for a variety of regional and national publications and is currently at work on a collection of creative non-fiction and a mystery novel.

Fort Collins Medical Magazine & Directories 2009 2010

CONTINUED FROM PAGE 78

Christie Reimer, M.D., Poudre Valley Internists

daily support to someone struggling with addiction. The program, which runs for 26 sessions (six to eight weeks), offers evening programs Monday through Friday, from 6:15 p.m. to 8:00 p.m., and is set up to allow patients the ability to continue working throughout their treatment. The group dynamic, lead by a facilitator, is interactive. “There are no ‘war stories.’ Talk is about recovery and is designed so people do not feel so alone.” Attendees are encouraged to utilize Alcoholics Anonymous (AA) programs offered in the community in conjunction with their treatment at Mountain Crest. “Any program worth their salt will refer patients to AA,” adds Meeker. “Those who combine CDIO and AA meetings are 50 percent more likely to stay clean.” CDIO alumni are invited back to attend Wednesday classes free of charge, as part of the continuum of care. Unfortunately, the current economy is no friend to those struggling with addiction. In addition to an increase in the number of substance abuse cases related to “people drowning their sorrows in a bottle of liquor or pills,” psychiatric admissions are up at Mountain Crest, says Meeker. “On the opposite end, some people are not following through with treatment because of cost.” Sadly, these ones miss out on the bigger picture created by their addiction. “They are not looking at the high financial cost (and intangible cost) of alcohol and drugs, especially when that is added up over a period of time.” As part of CSU’s efforts to educate and protect their student population, their CSU Health Network has published extensive information detailing alcohol’s effects on the body, self assessment tests to determine if alcohol consumption is a problem, and other important information that the entire community can benefit from. Please visit their Website at: www.health.colostate.edu and access Counseling Services. Angeline Grenz is Editor for Style Magazine.

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