2010-07 Northern Colorado Medical & Wellness Magazine and PVHS Physician Directory

& MEDICAL WELLNESS FORT

M A G A Z I N E

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$7.00

D I R E C T O R I E S

2010 | 2011

VOLUME XII

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Comprehensive Care for Your Child 1!1 Poudre Valley Health System offers many services for children in Northern Colorado. When you need infant and pediatric care, our expert team is here for you. Some of our services include:

Birthing Services You may choose to have your baby at Medical Center of the Rockies (MCR) in Loveland or Poudre Valley Hospital (PVH) in Fort Collins.

Both hospitals have compassionate staff to care for you and your baby throughout your labor, delivery and postpartum time.

Pediatric Surgery In July, PVH will welcome Dr. Gregg Ford, a pediatric surgeon who has been in practice for over 20 years. Dr. Ford will bring specialized pediatric surgical services to Northern Colorado .

Neonatal Intensive Care Unit (NICU) PVH has a state-of-the-art Level lila NICU for babies with special care needs and is the only NICU of its kind between Denver and Billings, Montana. The NICU team understands the stresses that come when a baby is in the NICU and is here to care for your baby and support your family.

Cleft Lip/Palate Clinic At PVH, we understand that learning your baby has cleft lip or palate can be very difficult.

Our team of experienced cleft specialists includes surgeons, pediatric orthodontists and dentists, physician specialists, therapists and many others .

For more information, call our team coordinator at 970.495.8421 or go to cleftclinic.pvhs.org.

All of these services mean one very important thing for you and your family: you can keep your child close to home and receive world-class care in your own community.

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Fort Collins Medical Magazine & Directories 2010 2011

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Jim Beckmann, MD

Hal Chapel, MD

Arnold Pfahnl, MD

Gary Rath, MD

Lin-Wang Dong, MD

John Drury, MD

Ken Richards, MD Ahmad Shihabi, MD

Cyndi Gryboski, MD Cecilia Hirsch, MD

Gene Tullis, MD

Steve Zumbrun, MD

We're right here with the right care for your heart everyday. Having a healthy heart has such a tremendous impact on your ability to lead an active, fulfilling life. Isn't it comforting to know that the full-time cardiologists and other heart care professionals at the CardioVascular Institute of North Colorado can provide you with a wide range of treatments and procedures? Whether it's an immediate need, a planned procedure, or rehabilitation to get your heart back in shape, our highly-trained experts can provide you with the care you need including, but not limited to: • Emergency assessment and treatment • Diagnosis and treatment of heart conditions

• Electrophysiology including pacemaker and defibrillator placement

• Heart failure clinic

• PAD (Peripheral Arterial Disease) diagnosis and treatment

• Cardiac catheterization, coronary angiogram, angioplasty and stent placement

• Vein screenings and treatment

• Advanced cardiovascular surgery

• Ongoing follow-up care in our clinic

• Thoracic and Vascular surgical procedures

Put your heart in the right place. Call 970-203-2400 for an appointment.

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Banner Health

CardiaVascular Institute of North Colorado ·

McKee Medical Center North Colorado Medical Center www. BannerHealth .com/CVI

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w w w. s t y l e m a g a z i n e c o l o r a d o . c o m Publisher Lydia Dody Editor Angeline Grenz creative director Scott Prosser Senior Designer Lisa Gould Advertising Sales EXECUTIVES Jon Ainslie (970) 219-9226 Abby Bloedorn (970) 222-8406 Karen Christensen (970) 679-7593 Lydia Dody (970) 227-6400 Saundra Skrove (970) 217-9932 Office Manager Ina Szwec Accounting Manager Karla Vigil Office Assistants Ronda Huser, Trish Milton Contributing Writers Sandra Cowan, Lynn Dean, Connie Hein, Kimberly Lock, Corey Radman, Kay Rios, Laura Sebastian, Graciela Sholander Photographer Warren Diggles Contributing Photographers Marcus Edwards Affiliations Fort Collins Area Chamber of Commerce Loveland Chamber of Commerce & Visitors Center 2010 Style Magazines January-Loveland/Greeley Medical & Wellness Magazine and Directory February-Style March-Northern Colorado Medical & Wellness April-Style May-Northern Colorado Medical & Wellness June-Style July-Fort Collins Medical & Wellness Magazine and Directories August-Style September-Women’s Health & Breast Cancer October-Northern Colorado Medical & Wellness November/December-Holiday Style Style Media and Design, Inc. magazines are free monthly publications direct-mailed to homes and businesses in Northern Colorado. Elsewhere, a one year subscription is $25/year and a two year subscription is $45/year. free magazines are available at over 140 locations throughout Northern Colorado.

For ad rates, subscription information, change of address, or correspondence, contact: Style Media and Design Inc., 211 W. Myrtle St., Suite 200, Fort Collins, Colorado 80521. Phone (970) 226-6400. Fax (970) 226-6427. E-Mail: ronda@StyleMedia.com Š2010 Style Media and Design Inc. All rights reserved. The entire contents of Style Magazine are copyrighted and may not be reproduced without the expressed written consent of the publisher. Style Media and Design Inc. is not responsible for unsolicited material. All manuscripts, artwork, and photography must be accompanied by a SASE. The views and opinions of any contributing writers are not necessarily those of Style Media & Design Inc.

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VOLUME XII

2010 | 2011

T A B L E

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Medical Magazine & Directory 10 13

Publisher’s Letter Introduction Letter Rulon F. Stacey, Ph.D., President and CEO, Poudre Valley Health System

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

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Prescription for Future Healthcare

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Passionate Staff Fuels NICU

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Introducing Dr. Gregg Ford, Pediatric Surgeon Our Cover Model

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Good Night, Sleep Tight

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Subspecialties Improve Cardiac Health

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Just in Case: AEDs in public spaces save lives

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Physician Directory

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

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Finding Solutions for Epilepsy Patients

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Urgency or Emergency?

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Mental Health on the Go

65

Mountain Crest Behavorial Healthcare Center

68

Standing Ready: OCR’s Foot and Ankle Team

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OCR Offers Cutting-edge Ankle Surgery

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Physician Profiles: Get to Know Area Physicians 8

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Sclerotherapy – Treating Spider Veins

103

The Surgery Center of Fort Collins Receives AAAHC Accreditation

Wellness Magazine & Directory 74 78

For Erica’s Sake: Stop the Distracted Driving Teens Behind the Wheel

76 80

Revolution in Fitness

81 82

Get Fit, Give Back Calendar The Community Comes Together to Help a Child

86 88

Practice Makes Perfect Wellness Directory

A New Way to Train/Head to the Pool

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.

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Connect with us:

Publisher’s Letter Excellence in care We are very proud and honored to publish this 12th annual Fort Collins Medical & Wellness Magazine and Directories in partnership with Poudre Valley Health System (PVHS).

This annual issue has continued to feature the development and expansion of PVHS along with their commitment to provide world-class patient healthcare. This commitment is clearly evidenced by the numerous national awards that have been bestowed upon PVHS through the years.

Rulon Stacey, President and CEO, shared with us that PVHS has received 75 national and regional awards since 2003 for patient care and business operations. “Such awards are important to note because they let you know how others in the healthcare industry and elsewhere rate our services,” he explains.

In 2010, the American Nurses Association named Poudre Valley Hospital the best hospital in the nation for consistently achieving outstanding patient outcomes tied directly to high quality care by the nursing staff. For the second year, the cardiac intensive care unit at the Medical Center of the Rockies received the Beacon Award for Critical Care Excellence awarded by the American Association of Critical-Care Nurses.

And, the most prestigious, the Malcolm Baldrige National Quality Award was bestowed upon PVHS in 2008 recognizing quality and performance excellence.

These awards for excellence are clearly the result of an exceptional leadership team, a visionary board of directors, world-class physicians, and 4,300 engaged and committed employees dedicated to the values, mission and vision of PVHS. Collectively, the residents of our region benefit from this level of commitment to excellent patient care. No wonder Money Magazine has again selected Fort Collins as No. 6 of the 100 Best Small Cities in the nation, grading the health category with an A. At the PVH Neonatal Intensive Care Unit (NICU) exceptional nursing care is critical to the survival of their tiny patients. Learn about this Level IIIA NICU,

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the only one between Denver and Billings, Montana, in “Passionate Staff Fuels NICU.” Meet the physicians, staff and new pediatric surgeon, Dr. Gregg Ford, who care for these special infants.

Meet our 3 pound, 3 ounce cover infant, Nevaeh, her mother, Lindsay, and family. Read about their challenging health journey and success story. With the exceptional care she has received in the NICU, Nevaeh is well on her way to her optimal size and development for release to go home. We wish this lovely family good health and much happiness with their adorable infant.

I was surprised to learn that more than two-thirds of American children experience regular sleep problems. As I reflect back on my two daughters when they were young, I remember nightly issues around going to bed late, sleepwalking and difficulty getting up early for their skating training. Perhaps they could have been helped with a sleep study, but one didn’t exist then. As medical research continues to evolve, sleep disorders in children has become a new area of examination and treatment for Northern Colorado Pulmonary Consultants. Read “Good Night Sleep Tight” to learn about sleep issues and consider a sleep study if you think your school-aged child might need some help.

In recent years, many people have experienced more and more challenges in their personal and professional lives. It isn’t surprising that this has led to more mental health and substance abuse issues at all ages. We are fortunate to have Mountain Crest Behavioral Healthcare Center in our community and now the addition of a Mobile Assessment Team (MAT) that provides on-site intervention on behalf of individuals who need crisis stabilization. Read “Mental Health On the Go” to become more familiar with the mental health services available here.

As our region continues to be on the leading edge of medical care and treatment options, new procedures for improved outcomes continue to evolve. Learn about “Cutting Edge Ankle Surgery” now being done at the Orthopaedic and Spine Center of the Rockies. This can certainly improve the quality of life for someone needing relief from pain and ease in walking.

Quality of life for epilepsy patients can also be improved. Get acquainted with Dr. Sheri Friedman at Neurology Associates of Northern Colorado, a specialist dedicated to finding treatment options for her patients. Read “Finding Solutions for Epilepsy Patients” to learn about symptom management options for improved quality of life.

The subject of life brings me to a very sensitive subject I need to personally address. Distracted driving is a serious issue today and can easily cause tragedy.

Read “For Erica’s Sake: Stop the Distracted Driving Epidemic” and take the pledge. I am.

We hope you enjoy reading the many informative and interesting articles about health, wellness and the exceptional healthcare providers we have in our region. This issue is full of useful information including an easy-to-use Physician’s Directory divided by specialty and physician name. Please keep this issue for reference throughout the year as a resource guide to help you manage and maintain your good health. We are exceedingly proud of our medical community and the world-class care available in this region.

Wishing each of you good health,

lydia@stylemedia.com

"DEVOTED TO SAVING YOUR TEETH AND SMILE WITH PERIODONTICS AND DENTAL IMPLANTS." ASSOCIATES IN PERIODONTICS

Richard W. Lindeberg, D.D.S., M.S. David Clark Johnson, D.D.S., M.S. Jennifer Merritt, D.D.S.

FORT COLLINS Elizabeth Medical Park 1120 East Elizabeth, G4 LOVELAND 2996 Ginnala Dr., Ste 101

970.221.5050 RICHARD W. LINDEBERG, D.D.S., M.S.

JENNIFER MERRITI, D.D.S.

Fort Collins Medical Magazine & Directories 2010 2011

DAVID CLARK JOHNSON, D.D.S., M.S.

www.periofortcollins.com

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We keep you: U.S.News named Poudre Valley Hospital one of the 50 best hospitals in the nation for orthopedic care.

PVH was the only hospital in the Rocky Mountain region to make the list.

At PVH, we keep you moving.

D Hiking D Biking D Skiing D Running

~II of the above

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9 Regional Orthopedic Center POUDRE VALLEY HOSPITAL

pvhs.org

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: I’d like to share some great news about our employees and the care you receive at Poudre Valley Health System.

PVHS has more than 4,300 employees who work closely with 600 local physicians to provide patient care. These employees and physicians are among the world’s best in healthcare. They are caring. They have the expertise. They are wonderful people!

The patient care that you receive from them is unparalleled in Northern Colorado, in the West and, for that matter, almost anywhere in the world. Let me offer five of many examples that I could use to back up my statement: •

In 2010, Poudre Valley Hospital was named by the American Nurses Association as the best hospital in the nation for consistently achieving outstanding patient outcomes that are tied directly to high-quality care by the nursing staff. This was the third year in a row that PVH received this honor. Considering there are more than 5,000 hospitals in the U.S., this is a tremendous accomplishment!

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For the second year in a row, the American Association of Critical-Care Nurses presented the cardiac intensive care unit at the Medical Center of the Rockies with the Beacon Award for Critical Care Excellence. In 2009, the MCR unit was the first Colorado ICU ever to receive the award.

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PVHS is one of only eight healthcare organizations to receive the Malcolm Baldrige National Quality Award. Established by Congress, this elite annual award recognizes the nation’s top organizations in quality and performance excellence across a range of factors. The Baldrige award is one of 75 national and regional awards received by PVHS since 2003 for patient care and business operations. Such awards are important to note because they let you know how others in the healthcare industry and elsewhere rate our services. Recognitions are also important signals that alert you to the high quality of care that you can expect from our employees.

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Each year we receive hundreds of letters from patients and their families complimenting our staff members and local physicians. These letters are important indicators that we are on the right track of providing world-class care.

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In addition to measuring clinical quality and financial strength, we formally measure what our patients think about the care they receive, and we compare our results to hundreds of other hospitals’ results by working with Avatar International, an independent firm that conducts patient satisfaction surveys in the United States. Each year Avatar releases statistics on patient satisfaction in all of the healthcare organizations that it serves. As it has been in previous years, patient satisfaction with services at MCR and PVH is among the best in the country. Both hospitals continue to receive annual Avatar awards for exceeding patient expectations. This year – 2010 – was the eighth straight year that PVH received the award and the third year in a row that MCR, which opened in 2007, received the award.

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

This is an exciting – and challenging – time for healthcare in the United States. There are many opportunities to excel and continue to make improvements and enhance patient care. I’d like to encourage you to learn more by reading the letters from Dr. William Neff, PVHS chief medical officer, and Stu VanMeveren, published elsewhere in this Medical & Wellness issue.

I want to thank you for trusting PVHS for your care. Our commitment is to be here for you with world-class healthcare.

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

Fort Collins Medical Magazine & Directories 2010 2011

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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.

MCR is nearly twice as fast as the national standard at getting the average heart attack patient from the hospital doors to a life-saving balloon catheter to clear the blockage.

It's comforting to know that doctors like Dr. Oldemeyer take your future to heart.

For more information

MEDICAL CENTER OF THE ROCKIES POUDRE VALLEY HEALTH SYSTEM

or to make an

Heart Center of the Rockies POUDRE VALLEY MEDI C AL GROUP

www.pvhs.org

appointment, please call (970) 221-1 000 or (800) 459-4521 .

www.heartcenteroftherockies.com

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

Some of the nation’s foremost leaders in nursing visited Poudre Valley Health System in the spring of 2010. Their purpose was to view our community case management program in action.

The program – the recipient of the 2009 Magnet Prize, the nation’s top award for innovative nursing programs and practices – assists patients with managing their chronic conditions. Many clients have inadequate support systems and financial resources. The program provides them with a safety net to deal with complex issues that may otherwise result in avoidable visits to the hospital, emergency room or healthcare providers.

Thanks to the program, patients can remain in their homes, skilled nursing facilities or other appropriate environments as opposed to making unnecessary emergency room visits and hospital stays. The program has shown a cost savings well above the PVHS cost to maintain the program.

The community case management program is one of many outstanding PVHS patient-care programs and is representative of the way healthcare – nationally and locally – is headed.

Innovative, cost-saving reform is necessary. Recent healthcare reform legislation is one of the more complex issues to ever come out of Congress. But the underlying goals are fairly simple: provide quality healthcare to more people while controlling costs.

As it is implemented over the next few years, reform legislation will have a huge impact on the healthcare industry. Even before this new legislation, hospital after hospital around the nation, many in financial difficulties, were being purchased by national healthcare companies, in many instances with less than stellar results for patients.

Our region is fortunate because the roots of local healthcare reform began growing in the mid-1990s when PVHS was created. At the time, the PVHS board of directors decided local communities could best decide issues about local healthcare. This philosophy – still the guiding light for the current PVHS board – has worked out well beyond our expectations.

With advice and feedback from patients, as well as local physicians and the community at large, PVHS has developed healthcare abilities, efficiencies and a workforce that shine brightly in Northern Colorado and throughout the nation. This is evidenced by the many national awards that have been bestowed upon PVHS, including the prestigious Malcolm Baldrige National Quality Award in 2008.

As a result of local control and years of focusing on quality and improvements, we have a huge lead on the many complicated aspects of healthcare reform that may cause severe stress on other hospitals and health systems. It’s efforts like our community case management program and many others at PVHS that have put us in a good position in the healthcare industry.

On behalf of the PVHS board of directors, I assure you that you will continue to receive world-class healthcare from our health system.

Stu VanMeveren Chairperson, Board of Directors Poudre Valley Health System

Fort Collins Medical Magazine & Directories 2010 2011

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medical

PVHS

Leading heathcare at Poudre Valley Health System: Kevin Unger, PVH President and CEO, Rulon Stacey, PVHS President and CEO, and George Hayes, MCR President and CEO.

Prescription for Future

Healthcare

by Sandra Cowan

Having access to a world-class healthcare system right in your city’s backyard is something many people throughout the nation and world would love. Poudre Valley Health System (PVHS) provides just that in Northern Colorado.

PVHS is a private, locally owned, not-forprofit healthcare organization serving residents of Northern Colorado, Nebraska and Wyoming.

PVHS is comprised of Poudre Valley Hospital (PVH), Medical Center of the Rockies (MCR), and Mountain Crest Behavioral Healthcare Center, and includes numerous outpatient clinics and services, among them the new Poudre Valley Medical Group, created to help PVHS remain successful in these times of healthcare reform.

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This regional medical hub covers a service area of 50,000 miles, an area equivalent to the size of the state of Florida.

“We exist to provide world-class healthcare,” says Rulon Stacey, president and CEO of PVHS. He defines his vision as performing in the top 10 percent of the available national database. The PVHS goal for the future is first and foremost to provide patients with the best care in the world.

“We’ve been trying to distinguish ourselves

clinically for 10 years and have done this nationally and internationally with the care and the services we provide,” says Stacey.

PVHS scrutinizes model organizations of excellence around the globe to improve performance in quality healthcare.

“We measure ourselves against benchmarks from many different national organizations, such as the Institute for Healthcare Improvement, to assess how we’re doing nationally,”

says Stacey. “We’ve scoured the globe to find out what the best practices are and then adopted them here.”

The awards PVHS has received – 75 national and regional honors since 2003 – are critical external verifications of the organization’s internal progress. In 2008, PVHS was one of only three recipients and the only healthcare organization to receive the Malcolm Baldrige National Quality Award. Only eight healthcare organizations have ever received the annual Baldrige award, which Congress established in 1987 to honor the nation’s top organizations in quality and performance excellence across a range of factors.

PVH is only the seventh hospital ever to be designated as a Magnet hospital three times.

The Magnet designation recognizes quality patient care, nursing excellence and innovations in professional nursing practice.

For the second year in a row, the American Association of Critical-Care Nurses presented the cardiac intensive care unit at the Medical Center of the Rockies with the Beacon Award for Critical Care Excellence. In 2009, the MCR unit was the first Colorado ICU ever to receive the award.

“Sure, I’m proud of all our awards,” says Stacey. “But, they really mean that the process improvements that we’ve made over the past decade are working. I know there are people alive today because of processes that we’ve put into place to provide better patient care.”

Patients are satisfied along with staff. Stacey notes that PVHS has the lowest employee turnover rate in the country and among the highest physician satisfaction rate in the country.

In 2008 and 2009, PVHS received a bond upgrade from Moody’s Investors Services for “our commitment to continue on our path of spending wisely, appropriately expanding our services and improving our patient-care processes,” Stacey said.

Moody’s Investor Services stated, “The improvement reflected the health system’s good financial performance, growth in liquidity, favorable patient volume trends, market share and physician loyalty.”

Clinical Integration PVHS is working toward excellence in a rapidly transitioning healthcare industry while keeping costs down. A major step is the integration of physicians and care providers into a new multi-specialty group called Poudre Valley Medical Group (PVMG). Currently, the group consists of about 60 physicians and providers, and by summer’s end will total more than 100. Stacey estimates that by 2011 the number will be closer to 200 physicians and providers, spanning different geographical, clinical and specialty areas to provide a spectrum of services for patients.

“PVHS is on the path to be prepared when the tide turns in 2014 (when many health reform initiatives go into effect) by creating integrated networks with physicians,” Stacey explains. It’s Stacey’s belief that healthcare reform will favor organizations that are more integrated. “Integration to us means a full clinical integration model where all aspects of the health system can work to the benefit of the patient. That means doctors, hospitals, physical therapists,

and long term and immediate caregivers can share information and work to increase quality while reducing costs to the patient.”

“With healthcare reform, we know we’ll have to figure out how to do more with less,” says Kevin Unger, president and CEO of PVH. “The bottom line is to be more efficient. Closer alignment with the doctors will allow us to do that.

We’ll continue to provide the highest quality care at an affordable cost. We’ve been working on that for a decade now and we’ll stay the course.”

Whether physicians and providers become employed with PVHS or maintain their private practices, the focus will be to align and work with them to benefit all involved, points out George Hayes, president and CEO of MCR. “If a physician decides to remain independent, we want to be able to offer them services, such as connecting them to our electronic medical records, offering them management assistance, or other services to help them meet their patients’ needs and be a part of the health system,” says Stacey.

Hospital Goals PVHS developed six strategic objectives to help the organization accomplish its vision. The strategic objectives range from hiring and cultivating top-notch employees and expanding the health system’s market position to building collaborative partnerships with physicians, providing superior clinical outcomes, offering outstanding customer service, and improving financial performance. Both hospitals and every PVHS department embody these strategic efforts and share the common corporate values of quality, compassion, confidentiality, dignity/ respect, equality and integrity.

Each hospital has goals and plans for the future that tie back to the PVHS strategic objectives.

MCR is pursuing designation as a Magnet hospital, the gold standard that measures nursing care outcomes. Other goals are continued improvement in patient satisfaction and clinical outcomes, such as timely administration of antibiotics, vaccinations and counseling on smoking cessation, along with many other core measures of performance. To achieve excellence, sustaining good performance is key. And providing an excellent patient experience is essential.

“MCR will continue to see growth in the volume of services, looking at options for expansion. As patient volumes continue to grow and the need arises, we plan to finish some of the shelled areas that were left empty for future use back when MCR opened in 2007,” says Hayes.

Specific goals for PVH in 2010 and 2011 include planning for the expansion of departments to meet capacity needs. As of early summer 2010, PVHS is still in the master-planning stage, so expansion decisions have yet to be made. Contenders are high-patient-volume areas such as emergency services, intensive care, orthopedics, and women and family care.

There is also a multi-year effort underway to garner community financial support to build a PVH cancer center, probably on the PVHS Harmony Campus in southeastern Fort Collins.

“We’re looking to streamline what we have

Fort Collins Medical Magazine & Directories 2010 2011

and use it to its fullest capacity before we actually begin bricks and mortar construction,” says Unger. “The key influence in our decision making will revolve around how we can best meet the needs of patients in the future.”

For PVHS as a whole, other goals are to continue to strengthen clinical outcomes and move forward in upgrading health information technology in ways that conform to new health reform standards. Five years ago PVHS was one of the nation’s early adopters of electronic health information technology to assist in providing patient care, enhance safety and create more efficient business and customer service operations.

Impacts of Healthcare Reform Healthcare reform issues will affect everyone in the coming years and, at the moment, there are many unanswered questions related to what degree Americans will be impacted.

“Most of the focus of healthcare reform will impact hospitals and the American health system beginning in the year 2014,” says Stacey.

“That sounds like it’s a long time away, but the reality is that healthcare as an industry and PVHS in specific have many huge challenges to conquer before then.”

Here’s how Moody’s Investor Service believes healthcare reform will impact hospitals: There will be an initial positive effect because more people will have access to an ability to pay; in 2014, revenue will decrease and weaken the amount of federal reimbursements that hospitals receive; insurance companies will have an expanded role and negotiations on insurance payments to healthcare organizations will become more complex; stand-alone hospitals will benefit by consolidating with larger organizations.

Unger and Hayes agree that the bottom line for PVHS is to be more efficient, with a greater focus on preventative care and good clinical outcomes.

“It’s all about the patients,” Unger emphasizes.

Stacey estimates that more than 200,000 physicians will be needed nationally by 2020.

Healthcare reform, he says, will require providers to offer more patient benefits without offering more reimbursement to those providers, thus enhancing the current physician shortage. This impending shortage has created a new trend that generates an increase in other healthcare specialists: physician assistants, registered nurses and nurse practitioners with primary care responsibilities. The decreasing numbers of physicians comes at a time when millions of baby boomers are reaching the retirement years and beyond.

“We’ve moved into an exciting – and challenging – time for healthcare in the United States and in our region,” Stacey concludes.

“For PVHS, there are many opportunities to excel and many opportunities to continue to make improvements and enhance patient care.”

Sandra Cowan is a freelance writer who lives in Fort Collins.

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medical

NICU

Passionate Staff Fuels

NICU

by Angeline Grenz

A healthy, vital newborn weighs an average of 6 pounds, 2 ounces to 9 pounds, 2 ounces. A 28week premature newborn, however, generally weighs just a little over 2 pounds, fitting easily in the palms of your cupped hands.

Neonatologist Jan Paisley, M.D., examines baby Nevaeh.

Without a doubt, infants this size and weight would not survive without specialized care. Fortunately, that care can be found right here in Northern Colorado at Poudre Valley Hospital’s (PVH) Neonatal Intensive Care Unit (NICU). Premature babies are just one segment of the population the NICU cares for everyday. They also care for critically distressed or diseased babies in their state-of-theart facility.

The PVH NICU is the only Level IIIA NICU between Denver and Billings, Montana. With the addition of pediatric surgeon Gregg Ford, they will be able to assist younger, more critical babies and hope to achieve the next designation level in the near future.

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But designations only tell part of the story. What is truly amazing is the NICU staff. Nurses who talk about their jobs with pride, voices thick with tears.

A particular nurse who is teased because when the call for help goes out in the NICU, she has been known to plow down her colleagues to get to the infant in distress. A neonatologist who, after years as a pediatrician, went back for specialized training and has been instrumental in helping the NICU achieve the designation it has today.

These NICU staff members are indicative of the dedication and passion that is present in the unit every single day. Without such commitment it would not be possible for the unit to function at such a high level.

Mechanics of a NICU PVH’s NICU is presently a Level IIIA, as rated by the Colorado Perinatal Care Council. They received the designation in February 2006. The NICU can care for babies born at 28-weeks gestation or older, those born with respiratory problems, infections, low blood-sugar, jaundice, cleft lip or palate, and syndromes or chromosome abnormalities.

The NICU’s staff consists of three full-time neonatologists: Daniel Satterwhite, M.D., medical director of the NICU, Jan Paisley, M.D., and Amy MacRitchie, M.D., plus one part-time neonatologist from the Youth Clinic, Carole Anderson, D.O. A respiratory therapist is also on hand if needed.

During the day, the NICU is staffed with a

NICU nurses Cindy Tusa and Claire Reed take care of Nevaeh in one of the NICU’s Level III units, designed to care for critical babies with state-of-the-art resusitation and monitoring equipment.

neonatologist, neonatal nurse practitioner and specially trained nurses. During evening hours, a pediatrician – often from the Youth Clinic – and nurse practitioner staff the unit. Additionally, a base team of eight nurses and one or two unit assistants are always on hand.

Within the NICU, there are three main sections: Transition, the Level II nursery and the Level III nursery. Transition is where the NICU nurses attend deliveries and assist in transitioning the baby from the delivery room to the Women’s Care Unit if they are healthy, or into the NICU if they are under distress.

A NICU nurse attends all deliveries at PVH, a

level of care that is not available at many hospitals with a lower-level nursery. Many of the NICU staff can also go on loan to Medical Center of the Rockies’ Level I Special Care Nursery, should the need arise. The neonatologists, Drs. MacRitchie, Paisley and Satterwhite, also work at both hospitals.

The Level II portion of the NICU is for the feeders and growers: premature infants (any baby born before 37 weeks gestation) who are doing well and just need assistance with the processes of sucking, swallowing and breathing. There are 14 Level II beds in the NICU and the concentration in this area is a calm, quiet environment for babies to

Fort Collins Medical Magazine & Directories 2010 2011

grow. Lights are kept dim, the temperature steady and the noise level low. “We unofficially call it the cave,” jokes Cindy Tusa, NICU nurse and unit educator, “because it is so dark and quiet at night.”

Many distressed babies may spend a night or two in Level III before they are transferred to the Level II. Level III is designed for more critical babies or babies born at 28-weeks gestation. There are five Level III spaces, including an isolation unit for the protection of a baby with an extremely weak immune system, or the other NICU babies from an infant with a potentially contagious condition.

Level III spaces have state-of-the-art resuscitation, respiratory, warming and monitoring equipment. While a nurse may be assigned three Level II babies to monitor during their shift, critical Level III babies will each have one nurse dedicated to their care.

When necessary, overflow spaces are available for Level II or III babies. Average numbers are somewhere around two infants in the Level III and 12 in the Level II. Those numbers, as the NICU nurses will attest to, can change in minutes. “One reason why I like my job,” says Tusa, “is that there is no typical day.” In fact, one busy day last summer saw 28 infants in the NICU at the same time.

NICU nurses rotate between assignments in Transition, Level II and Level III. If they attend a birth of a NICU baby in Transition, they can request to be the primary nurse throughout that infant’s stay, a process that benefits both the nurse invested in the baby’s care, and the family, who depends heavily on the nursing staff for training in how to care for their infant.

“This way the nurse gets to know the parents really well and develop a relationship with them,” says Tusa. “This helps when it comes to educating parents, and the nurses get to share in successes with parents. It is extremely rewarding for both.”

Similarly, the PVH NICU has an “open” model for their pediatricians. Normally, an infant’s primary care physician will start care of the infant before they are discharged from the NICU. However, under the PVH model, they can be involved from birth onward. “This is something unique to our unit,” says Dr. Paisley. “We encourage and welcome the baby’s primary care physician into the NICU to be involved with the infant from the beginning.”

This early relationship between the pediatrician and baby helps make the family more comfortable and, according to Dr. Paisley, studies have shown that when pediatricians are active in the infant’s care from the beginning, infants are less likely to have to be readmitted into the hospital.

Pediatrician John Guenther, M.D., of the Youth Clinic in Fort Collins, says the open system is one that works for everyone. “It is extremely gratifying to work with my patients through their illness and see them healthy. We [pediatricians and NICU staff] work quite happily together. It is a team process in the NICU.” PVH continues to keep a working relationship with Children’s Hospital, as well. A Children’s Hospital pediatric cardiologist visits PVH to see infants once a month, and Children’s team of perinatologists and neonatologists are available for consult as needed. “We can send echos and cardiograms electronically to Children’s and hop on the phone for a verbal consult whenever we need to,” according to Dr. Paisley.

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Dr. Guenther from the Youth Clinic is one of the pediatricians who regularly attend to babies in the NICU.

Preparing for an Upgrade Currently, neonates needing surgery or those born before 28 weeks gestation are transferred to Children’s Hospital prior to birth, if the condition is known in advance. Rarely, though it does happen, some infants must be flown to Children’s after birth if the condition cannot be treated by the NICU. However, the addition of pediatric surgeon Gregg Ford to the NICU staff will allow the NICU to keep even more infants in the community and allow PVH to care for even younger preemies. Dr. Ford, who practiced in Fort Collins over a decade ago, returned to the area in mid-June to become Northern Colorado’s first pediatric surgeon.

“We will be able to do surgeries, with the exception of heart surgeries, and be able to increase our level of care – it is very exciting,” according to Barb Peters, NICU nurse manager. Dr. Ford’s addition to the staff will make PVH eligible for a Level IIIB designation. The only level higher is IIIC, which is equipped to handle cardiac surgeries and other heart procedures.

“Dr. Ford brings tremendous experience to PVH and he will help keep many more babies here in our community,” says Dr. Paisley. In addition, Dr. Ford brings with him a specialty in pediatric laparoscopic surgery.

Hands-On in the NICU The nurses in the NICU are generally soft spoken, using gentle tones to soothe sick babies.

They are focused on the infant’s developmental care, carefully tracking stress signals and signs of distress that are distinctive in infants: hiccupping, sneezing, holding their breath, slowed heart rates, floppy limbs with no tone and splayed fingers.

Nurses are also trained to position infants in a way that resembles being in the uterus: swaddled with arms curled towards their face and legs curled toward their abdomen, boundaries created CONTINUED ON PAGE 102

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Introducing Dr. Gregg Ford,

Pediatric Surgeon

by Angeline Grenz

The arrival of pediatric surgeon Gregg Ford to the Poudre Valley Health System will have a great impact on the Northern Colorado community. Dr. Ford fills a need for a pediatric surgeon, long overdue for our region. He will be instrumental in helping Poudre Valley Hospital’s (PVH) stellar Neonatal Intensive Care Unit (NICU) to achieve the next designation level.

By employing a pediatric surgeon, PVH is now eligible for an upgrade: from a Level IIIA to IIIB. Level III NICUs care for the sickest of babies.

The highest designation possible is the Level IIIC, which can perform cardiac and open-heart procedures.

Dr. Ford is the first and only pediatric surgeon in Northern Colorado. A population of 250,000 can support one pediatric surgeon. With an area population upwards of 500,000 people, a need existed.

Dr. Ford arrived in Fort Collins in mid-June after a two-week drive from Anchorage, Alas-

ka. With him comes wife Angie, 18-month-old twins (a boy and a girl) and Buddy, their puppy.

But Dr. Ford is no stranger to the area. He practiced general surgery in Fort Collins more than a decade ago with friend and colleague Chris Cribari, M.D. During those years, Drs. Ford and Cribari helped to set up PVH’s Trauma Center. At the time, Dr. Ford had a desire to expand the trauma center to include pediatrics, but “the timing wasn’t right yet.” His career path moved him away from Fort Collins, but Dr. Ford (a traveler by nature) says he has been “trying to get back ever since. I decided it is time to settle my family somewhere and you can’t find a better place.”

Dr. Ford, born in Texas, describes himself as a “product of a military family.” He spent a good chunk of his youth in Germany, high school in Honolulu and returned to Texas for college (San Marcos) and medical school (Houston). After his own stint in the military, he wound up in Biloxi, Mississippi, where he met Dr. Cribari. After a teaching career at Tulane and Texas A&M, “I decided I wanted to see what private practice was all about. I phoned my old friend and wound up in Fort Collins.”

Dr. Ford will provide PVH the ability to handle more complex care for sick pediatric patients, such as those born with congenital anomalies.

“The population is right for a pediatric surgeon and PVHS is a system dedicated to doing complex pediatric care,” he says.

Dr. Ford will be able to perform surgeries that were previously referred to Children’s Hospital in Denver. Often, these surgeries are very straightforward with a great success rate, says Dr. Ford, but ongoing care post-surgery can take 2-3 months. For parents who must work and live in Northern Colorado, it can create a true hardship to commute to Denver several days a week to visit their recovering infant and still meet their responsibilities.

“Often it can divide families, and parents aren’t able to get good bonding time with their infant,” says Dr. Ford. He hopes he can keep a large number of infants in the area for local care, so that “everyone gets to stay right here in the community.”

Dr. Ford also brings to PVH some cuttingedge surgical innovations, particularly in the realm of laparoscopic procedures for neonates.

“This is minimally invasive expertise that previously only adults had been privileged to receive,” he says.

As he gets organized in his new position, PVH is also gearing up for an expanded scope of care, purchasing new equipment and educating their NICU staff. With the addition of Dr. Ford, NICU Nurse Manager Barb Peters says they will be able to care for babies earlier than 28 weeks gestation, starting at 27 weeks and moving to even younger as staff is educated and equipment put in place.

After he settles in, Dr. Ford anticipates a full dance card as he moves into his role at PVH, providing pediatric services. But, he hopes to have enough downtime to truly enjoy all Northern Colorado has to offer. “Both my wife and I are outdoor folks,” he says. They enjoy gardening and canning fruits together and purchased a piece of property in Larimer County with mountain views to raise their children and have a little space to stretch out. 

medical

NICU

Nevaeh’s family: Grandpa and Grandma, Mark and Cindy Swihart, Mom Lindsay and Dad Clay Bryant.

Our Cover Model

by Angeline Grenz

Baby Nevaeh (heaven, spelled backwards) makes a poignant cover model for this issue. However, the picture doesn’t tell the whole story.

Nevaeh was born a diminutive 3 pounds, 3 ounces on May 24 by emergency C-section at Poudre Valley Hospital. Her original due date was July 20. Because of her premature birth and low birth weight, Nevaeh was immediately sent to PVH’s NICU for care.

But little Nevaeh, and her mother, Lindsay, began their fight for life much earlier. In November 2009, Lindsay Bryant and her husband Clay found out the happy news that they would soon be parents for the first time. Lindsay was working as a registered nurse. Clay was finishing his active duty at Whitman Air Force base in Missouri.

It was also in November, however, that Lindsay noticed a swollen lymph node in her neck. The Bryants were at the same time planning to move to Fort Collins to be near Lindsay’s parents, Mark and Carla Swihart. Because of a change in insurance, it was January before Lindsay could get back to see a physician. In the meantime, she became more

22

nauseated and started to have difficulty breathing.

On February 22, just four months pregnant, she went to her OB/GYN to have the lump biopsied.

She was told that she had stage III Hodgkin’s lymphoma, a cancer of the lymphatic system, and she was admitted to the hospital that night to begin treatment. They found two softball-sized tumors in Lindsay’s chest, pressing on her lungs and heart and causing the difficulty in her breathing.

“They told me I didn’t have time to weigh several treatment options,” says Lindsay, “I had the choice to go to Denver or stay at Poudre Valley Hospital. I chose to stay. This hospital is near and dear to me. Both my mother and I were born here.

And I have volunteered here in the past.”

Lindsay had to begin chemotherapy while pregnant with Nevaeh. Together they went through eight treatments. Lindsay’s OB/GYN, Karen Hayes, D.O., and oncologist Miho Scott, M.D., were working closely together to help Lindsay make it

through both her cancer treatments and her pregnancy.

But on May 22, Lindsay’s vision began to blur, she started to retain fluids and her blood pressure skyrocketed – the symptoms of preeclampsia.

“When I went in to the hospital, they admitted me immediately and told me I was going to have the baby tonight.”

Since May, Lindsay comes as often as possible to the NICU to feed and bond with her little daughter, who is steadily growing, having gained a pound since birth. Neveah is projected to go home in a few weeks, after she gains the strength to feed appropriately. She has begun “nippling” (taking a bottle) and is rapidly gaining strength.

Neveah receives donated breast milk through a PVH program, which has fulfilled one of Lindsay’s wishes, because she cannot breastfeed her daughter due to the chemotherapy. “When you think about having a baby,” says Carla, “you have visions of what it will be like; it has not been that way for Lindsay [because of her illness], so the donated breast milk is a big relief.”

When Lindsay visits Neveah or goes on one of her many doctors’ visits, her husband or parents always accompany her – a tight-knit family who says they “do cancer by committee.” Currently, Lindsay’s health only allows her about one visit a day, so the NICU staff steps in with regular phone calls to update her on her daughter’s progress.

Indeed, it is easy to see that a true rapport exits between Lindsay, her family and the NICU staff, as they call to each other by first name, laugh over jokes and embrace over good news. “When I come here, it is like coming to a second home. These nurses are like my family now,” says Lindsay.

As Lindsay, Clay and her parents look forward to the day when Neveah can come home with them, Lindsay’s health continues to improve as well. She has three more chemotherapy treatments to go and her softball-sized tumors have been reduced to marble size. Lindsay plans on celebrating her 25th birthday at the end of August cancer-free.

In the meantime, with thanks to her family, doctors and the PVH NICU staff, Lindsay says she is truly “the most blessed cancer patient here.” 

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medical

PEDIATRIC MEDICINE

Good Night

Pediatric sleep problems affect two-thirds of American children, according to the National Sleep Foundation.

Sleep Tight Morning arrives and you avoid creeping into your child’s room to get him up, knowing that the nerveshattering whining and fighting are about to begin.

Instead, you cling to your coffee cup for a few moments longer, enjoying the calm before the storm.

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by Corey Radman

Is this your house? If so, it’s possible that your child has more than just a case of the morning cranks. More than two-thirds of American children experience regular sleeping problems, according to the National Sleep Foundation. Additionally, children with sleep problems rob their parents of rest as well, some as much as 200 hours every year.

“For school-aged kids, a healthy night should be about 8-10 hours of fairly continuous sleep,” says Mark Petrun, M.D., who provides pulmonary care and treats sleep disorders at Northern Colorado Pulmonary Consultants. “They might get up once to get a drink or go to the bathroom, but in the morning well-rested kids should feel refreshed.”

Dr. Petrun says that there is sometimes a disconnect in parental expectations about sleep. Many times, he says, the problems parents see are clashes of lifestyle rather than a true disorder.

“Sometimes the hour that kids wake up is not the one you would like them to wake up,” he says.

“Before deciding that it’s a problem behavior, first ensure that your child’s sleeping habits are appropriate for his age.”

Another common conflict comes from late work schedules that push dinner and bedtimes later than they should, which Dr. Petrun also advises against.

“You wouldn’t short your kids the food they need to grow. Don’t be tempted to keep them up late, either,” he counsels.

If you have determined that your child is sleeping the required number of hours and still feels tired in the mornings, or is falling asleep at school in the afternoons, it is possible that there is indeed a problem.

“Indicators of sleep problems can manifest in a child’s behavior,” says Aaron Skalicky, Ph.D., licensed psychologist and founder of the NeuroDevelopment Center of Colorado. “For example: inattention, hyperactivity, mood swings and anxiety can all be related to sleep problems.”

Dr. Skalicky says that adequate sleep is a basic

requirement for healthy development. Without it, a child’s ability to take advantage of opportunities for social and academic growth can be at risk.

Because sleep can be the underlying cause or a contributor to so many behavioral issues, he suggests that parents who are worried about sleep ask their pediatrician or a behavioral specialist to help evaluate the issue. He reports that some children who present with ADHD symptoms can improve their overall functioning through better sleep.

“Recently, one child was having mild nocturnal seizures, and several others have had apnea, which were interrupting restful sleep all night long,” he says. “No wonder they had problems staying on task through the day.” After correctly diagnosing and treating the sleep problem, daytime issues became more manageable for the child and for the parents.

Dr. Skalicky suggests that a child’s sleep habits be included in the list of important considerations for any developmental healthcare provider.

Warning Signs Dr. Petrun advises that parents consult a physician if they observe any of the following warning signs of irregular sleep: •

Appearance of labored breathing during sleep

•

Snoring (“It is never normal for a child to snore – it is almost always indicative of an anatomical problem,” says Dr. Petrun.)

•

Trouble sleeping through the night

•

Unusual events during sleep (like night terrors or sleep walking)

•

Difficulty staying awake during the day

•

Unexplained decrease in daytime performance

•

New or worsened behavioral problems during the day

Sleep Disorders The science of pediatric sleep is still quite young.

“Very few studies have been done on children,” says Dr. Petrun. However, some sleep disorders are more common in children than adults.

Insomnia of childhood is actually not a disorder, but a behavioral issue, says Dr. Petrun. “Sleep is natural, but the ability to go to sleep is learned.”

When kids can’t get to sleep, it can be a matter of parental routines that set kids up to fail. “Set limits with firm bedtimes and routines to help children associate sleep with certain activities like brushing teeth and reading stories. It’s the same with adults.

Bedtime should be routine and precipitated by being calm. Go to sleep and wake up at the same time every day,” he says, for the best success at falling asleep.

Snoring is the cause of half or more of all pediatric sleep problems. “Snoring is a diagnosis, not a symptom,” explains Dr. Petrun. The National Sleep Foundation reports that, “Loud and regular nightly snoring is often abnormal in otherwise healthy children.” In 2002, the American Academy of Pediatrics began recommending that all children with snoring problems be screened and that a diagnosis be conducted to determine if a child is experiencing normal primary snoring or obstructive sleep apnea syndrome.

“Snoring is almost always an anatomic problem,” says Dr. Petrun, “like a narrow pharyngeal inlet (back of throat). Some kids just have narrow faces in their mandible area (where a mustache would be).” That kind of bone structure makes the nose

Fort Collins Medical Magazine & Directories 2010 2011

27

and throat narrow. Recently a new treatment called rapid maxillary expansion has proven effective. It involves a metal expander used in the roof of the mouth to stretch that space. “It fixes approximately 80 percent of those treated,” says Dr. Petrun, “but it must be used on kids before their center line fuses, at about age 11.”

Dr. Petrun explains that the traditional tonsillectomy is no longer supported by the medical literature.

“Fifty out of 100 kids who had tonsillectomies still have snoring issues,” he says.

Parasomnias are abnormal nocturnal activities like sleep walking or having night terrors. The National Sleep Foundation reports that parasomnias affect children much more than adults, and are most common when a person is sleep deprived.

Dr. Petrun’s own child had night terrors. He recalls, “Nothing has ever freaked me out quite like being woken by my screaming child. It was like his legs were being pulled out of their sockets. After my own heart rate calmed down, there wasn’t anything to do but help him calm down, too.”

During a parasomnia episode, the child is still asleep and getting their required rest. “Nothing really needs to be done to fix the problem, just make sure they are safe,” Dr. Petrun advises. He explains that these behaviors are the result of an immature nervous system. Some studies have indicated that the brain’s repetitive motion generators stimulate the walking or screaming. Children generally grow out of parasomnia as they mature.

Contrary to myth, it is not harmful to wake a person who is experiencing a night episode like sleep walking, and doing so may even prevent harm. “In fact, people have been known to leave their houses, and even drive, in some cases,” Dr. Petrun says.

Northern Colorado Pulmonary has traditionally treated adult patients,

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Dr. Petrun and his team at Northern Colorado Pulmonary Consultants have begun to integrate pediatric sleep disorder treatment into their practice.

but is currently building relationships with pediatric specialists in the area to create a comprehensive treatment team including ear, nose and throat specialists, as well as oral surgeons. They anticipate the ability to offer full treatment for school-aged children – including overnight studies in their sleep lab – by the end of summer 2010. 

Corey Radman is a writer and mother of two who lives in Fort Collins.

How much sleep do kids need?

Birth to 1 year – approx. 15 hrs/day 1-3 years – 12 to 14 hrs/day 3-6 years – 10 to 12 hrs/day 7-12 years – 10 to 11 hrs/day 12-18 years – 8 to 9 hrs/day

Fort Collins Medical Magazine & Directories 2010 2011

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Medical

heart health

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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Subspecialties Improve

Cardiac Health Treatment, and Recovery

By Angeline Grenz

An estimated 81,100,000 American adults (greater than one in three) have one or more types of cardiovascular disease (CVD), according to the American Heart Association. This staggering statistic underscores the need for continued research and skilled physicians to tackle the number one killer in the United

By AllieStates.

Comeau

Combating CVD takes a multi-pronged approach, and the field of cardiac medicine varies widely in focus to properly meet this challenge. Cardiac medicine covers a variety of areas, including interventional cardiology, which focuses on catheterization (the plumbing, says one doctor); electrophysiology, focusing on the electrical wiring of the heart – making sure everything fires correctly; and preventive cardiology, which focuses on how to prevent CVD or a cardiac event.

30

Within these specialties are many subspecialties and programs that make a sizeable impact in our community’s heart health. In the realm of interventional cardiology, we have the Poudre Valley Health System (PVHS) and Heart Center of the Rockies’ (HCOR) joint Cardiac Alert program. In the realm of electrophysiology, HCOR offers an Electrophysiology Study and Device Clinic. And, one of the latest initiatives in preventive medicine is the Sports Cardiology Clinic.

Here is an overview of each of these excellent programs and the doctors that are dedicated to their success.

essential. Dr. Purvis urges the public to always call the EMS when they have chest pains or heart attack symptoms. “We shave an average of 30 minutes off of D2B when someone calls the EMS [rather than being driven to the emergency room],” he says.

For Dr. Purvis, the lifesaving minutes gained by PVHS’ Cardiac Alert program represent his attraction to this type of medicine.

“The ability to make an impact on someone’s health so quickly is one of the reasons I went into interventional cardiology,” he says.

Electrophysiology Studies and Device Clinic

Opposite: Dr. Matthew Purvis is one of eight interventional cardiologists who work with Poudre Valley Health System’s Cardiac Alert program to reduce response times and save lives. Above: Dr. Johnson monitors heart arrhythmias to determine if patients need a pacemaker or implanted cardioverterdefibrillator installed at Heart Center of the Rockies.

Cardiac Alert Cardiac Alert programs, such as those present at Poudre Valley Hospital (PVH) and Medical Center of the Rockies (MCR), are not new to the medical arena – many hospitals have a program like this integrated into their regular processes. However, MCR’s program has managed to place itself in the top 10 percent of hospitals for their door-to-balloon times (D2B).

Door-to-balloon time refers to the time it takes from the moment a heart attack patient arrives at a hospital’s door to the point where the patient’s blocked coronary artery is opened in the cardiac catheterization lab. The Cardiac Alert program is comprised of a set of protocols that have been put in place when a person displays heart attack symptoms. The protocols begin with the first responders and follow through to the interventional cardiologists.

Through the Cardiac Alert program, vital minutes are shaved off of response times, starting with the ambulance crews. When a 911 call is received and cardiac arrest is suspected, crews immediately activate the Cardiac Alert system. When they arrive on the scene, they perform an EKG on the patient. From the EKG they can determine if the patient is having a cardiac event, begin treating accordingly and alert MCR that a cardiac patient is on his or her way to the hospital.

Upon arrival, the patient bypasses the emergency room and heads straight to the catheterization lab, where the interventional team is assembled and waiting.

“This way, we cut out the middle man,” says Matthew Purvis, M.D., one of eight interventional cardiologists on call at MCR. “Time is muscle,” he adds. In other words, minutes saved in response time means a better chance for survival and preservation of heart muscle.

PVHS ambulance crews are instructed to bring cardiac arrest patients to MCR whenever possible, because of MCR’s top-of-the-line cath lab.

“We prefer to do procedures here because of the equipment, but we do have full capacity at PVH,” says Dr. Purvis.

In a cardiac event, minutes can save lives. National studies released in 2005 determined patients with D2B times of 90 minutes or less had their chance of survival greatly improved. The goal was set for Cardiac Alert programs across the nation to meet the 90-minute or less target in 2008 by the D2B Alliance, a national quality campaign sponsored by the American College of Cardiology. MCR has exceeded that goal, with a median D2B time of 48 minutes.

“We are in the top 10 percent of Cardiac Alert programs – the average for these programs overall is 65 minutes,” says Dr. Purvis.

Dr. Purvis credits this success to the entire team at MCR, which continually works to refine their process and shave even more valuable minutes off of the D2B times.

“This is a community process between EMS, emergency room staff and cath lab staff that has evolved over time to become seamless. The synergy is quite remarkable.”

This synergy starts with the paramedics, who make the first diagnosis from the field with the EKG. “Doctors must be able to have faith in that component,” says Dr. Purvis, adding that local paramedic crews stand out in this manner, always looking for feedback after every case. Once the patient arrives at the cath lab, the cardiac crew takes over. “People here are so vested in what they do. There is an eagerness to always do better.”

Calling 911 in a possible cardiac emergency is

Fort Collins Medical Magazine & Directories 2010 2011

Electrophysiology (EP) refers to the proper functioning of the heart’s electrical system. When there is an irregularity – either beating too fast or too slow – there may be a need for an electrophysiology study to determine the cause of the abnormal rhythm (arrhythmia), if a device is needed, and what sort of device is best suited for the particular patient.

HCOR’s EP Study combines several tests, including electrocardiograms (ECG or EKG) and echocardiograms, to determine the cause of the arrhythmia. The study is performed in the catheterization lab, with catheters sent into the chambers of the heart to record the electrical impulses. Electrodes are used to induce an arrhythmia so that the cardiologist can observe the dysfunction and find its origin.

State-of-the-art technology in the cath lab gives cardiologists the best view of the heart. One such piece of technology is a 3-D mapping system, according to Timothy Johnson, M.D., who specializes in electrophysiology. The system uses a catheter that moves from the leg up to the heart and creates a 3-D map of the chambers of the heart. The map is merged with a general CT scan to make sure the two match the shape of the heart.

“It looks just like a video game, but enables us to see multiple areas of the heart and go around and mark areas for further examination,” says Dr. Johnson.

A patient is a candidate for an implanted device like a pacemaker or implanted cardioverter-defibrillator (ICD) if they have a heart rhythm that is too slow or too rapid. Patients are also examined for the presence or absence of congestive heart failure. Symptoms can range from palpitations to lightheadedness or fainting.

Pacemakers are generally implanted in patients who have an irregular heartbeat, pausing too long between beats, says Dr. Johnson. The device will send an electrical impulse to keep the heart beating regularly. The patients are usually not at risk of cardiac arrest.

ICDs, however, help monitor the heart function of patients with a more serious arrhythmia, those who may be at risk of heart failure. The implanted device assists hearts that beat too rapidly, sensing the irregularity and sending an electrical impulse to reset the heart to its normal rhythm. It can also serve the pacemaker function if the beating slows.

ICDs were once reserved for patients with severe congestive heart failure, but today’s findings show even mild cases, when coupled with a bundle branch block, greatly benefit from an ICD implant. Bundle branches are present in the heart and serve an important function in the cardiac electrical system. A block hinders the heart’s ability to pump efficiently.

“Now even mild cases of congestive heart failure can have the advantage of protection against dangerous or fatal heart rhythms,” says Dr. Johnson.

Another option is catheter ablation, used in the instance of a patient with tachycardia, where there is an abnormal electrical pathway, called a re-entry

31

circuit. The extra electrical impulse causes the heart to beat more frequently. In these cases, radio-frequency energy passes through the catheter to cauterize the tip of the re-entry circuit and stop interference with the heart’s normal beat.

HCOR’s EP device patients have access to the Device Clinic program, under the direction of Dr. Johnson, where follow-up care is provided after the device is implanted. HCOR staff has received specialized training to work with the devices and are available for monitoring and education.

Today’s ICDs are designed with the ability to interface with a unit that records activity and alerts HCOR staff if there is an incidence where a shock is administered, if equipment needs serviced, or if batteries are running low. The information can be sent directly to HCOR and is available for a physician’s review. “The information is automatically sent to the Clinic. The patient does not even have to come in and we can see what is wrong with them,” says Dr. Johnson.

participate in the sports that they love.

The Sports Cardiology Clinic can help screen and evaluate the heart health of athletes age 18 and older.

The clinic begins with a thorough review of the patient’s medical history and symptoms, their athletic history and goals, and a complete physical exam. On an as-needed basis, Dr. Green may add additional tests including an electrocardiogram, echocardiography, cardiovascular CT or other lab testing.

After compiling the information, Dr. Green can make a recommendation to the patient regarding competition, level of exertion during exercise and other physical fitness recommendations. Dr. Green was able to help one of his patients, a 41-year-old male competing at a high level that experienced a small heart attack, to determine safe parameters for physical activity.

“He wanted to know, ‘When can I race again?’” recalls Dr. Green. After evaluation and testing, Dr. Green was able to recommend that his patient slow his competition level down to a safer level. “I recommended that he not compete to try to set records, and put limits on Sports Cardiology Clinic his exertion levels.” With Dr. Green’s help, the patient continues to participate in the sports he loves.

For a segment of the population, physical exercise can present more dangers than benefits if that individual When a physically fit man exercises, his risk of a is unaware he or she has a heart condition. In the heart attack transiently increases seven times compared news today, it is not unheard of for a young, competito being at rest. But a sedentary man’s risk is much tive athlete to die unexpectedly from sudden cardiac higher – he is 50 times more likely to have a heart attack arrest. At other times, a physically-fit individual in his during exercise compared to being at rest. Individuals at risk can benefit from the screening program. Risks include: family history of sudden death at a young age (less than 45 years old), shortness of breath beyond the normal level for the activity, heart palpitations, dizziness or fainting, or unexplained decline in performance.

Sudden death in persons over age 35 while exercising is most often caused by atherosclerotic plaque buildup in the arteries. Despite this, Dr. Green says the benefits of exercise outweigh the increased risk of heart attack: “There is no population that does not gain benefit from exercise.” However, he cautions, those with risk factors need guidelines on exertion and duration of physical activity.

There is a small percentage of the younger population that is also at risk. A young competitive athlete that dies suddenly while exercising often suffers from hypertrophic cardiomyopathy. Though the incidence is rare, often these young athletes are asymptomatic until the fatal event.

Dr. Green encourages young athletes with a family history of heart disease to consider evaluation at the clinic. He has recently been working with Colorado State University’s Head Athletic Trainer Dr. Green’s Sports Cardiology Clinic is designed to help athletes of all ability levels workout safely if they have cardiac risk factors.

Terry Dezeeuw to develop a screening program for the university’s young athletes.

The Sports Cardiology Clinic is meant or her mid-40s may still need to workout under the for people of any age, at any level of competition, from supervision of a specialist due to significant risk factors recreational to professional. A sedentary person who for heart disease. would like to take up an exercise program also benefits With that in mind, HCOR recently implemented a from the evaluation.

Sports Cardiology Clinic under the leadership of sports cardiologist Patrick Green, M.D. Dr. Green is an avid For more information about any of these programs, marathon runner and “budding triathlete.” It was Dr. visit HCOR’s website at www.heartcenteroftherockies.

Green’s interest in competitive sports and the recognition com or call (970) 221-1000.  of an unmet need in the community that compelled him to initiate the program six months ago as a way for athletes to tackle potential heart problems and still Angeline Grenz is editor of Style Magazine.

Just in

Case

AEDs in public spaces save lives

by Angeline Grenz While playing basketball last year, on the last day of school, Fossil Ridge High School student Stephen Arnold collapsed, his heart failure immediate and fatal. The young man’s tragic death lingered in the minds of his classmates throughout those summer months.

When classmate Lisa Parker returned to school in August 2009, she felt compelled to make something positive come from the tragedy.

“Stephen’s death brought about an awareness that cardiac failure can happen to anyone, anywhere regardless of age,” she says. “He was supposed to graduate with us this year. We wanted to do something to bring us [his classmates] closure and help people become more aware.” Parker’s advisory class, a group of students who met once a week throughout their Fossil Ridge experience, decided to honor their classmate by raising funds to place an AED in every school he had attended.

An AED is an automated external defibrillator, a portable electronic device that can be used to shock someone whose heart has gone into a life-threatening arrhythmia. AEDs are completely self-contained, automated units. “Foolproof,” Parker calls them. In fact, they are so user-friendly that they actually talk you through the process. The units, usually housed in a glass case in public spaces, are voice activated; and the shock, if not needed by the individual, is harmless.

What’s more, AEDs keep track of data that can be helpful for emergency crews. And in the instance of cardiac arrest, every second is valuable. “Time is critical to survival,” says cardiologist Timothy Johnson, M.D., with Heart Center of the Rockies (HCOR). “You CONTINUED ON PAGE 62

32

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ORTHOPAEDI C & SPIN E C EN T ER

O F TH E ROCKI ES

2500 E. Prospect Rd. I Fort Collins, CO 80525 970-493-0112 I Toll-Free: 800-722-7441

New Loveland Location: 3470 E. 15th Street I Loveland, CO 80538 970-663-3975 I Toll-Free: 888-663-3975

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Fort Collins Medical Magazine & Directories 2010 2011

33

World-class neurology care.

The sub-specialty trained and board certified or board-eligible neurologists at Neurology Associates of Northern Colorado are experts in their field, but what truly sets them apart is compassion for their patients.

Specializing in: • • • • • • •

Epilepsy Traumatic brain injury Alzheimer's disease Parkinson's disease Multiple sclerosis (MS) Amyotrophic lateral sclerosis (ALS) Neurorehabilitation

Call 970.482.4373 to make an appointment with: • Gerald Mcintosh, M.D. • Sheri Friedman, M .D. • Paramjit Kaur, M.D. We're located just one block north of Poudre Valley Hospital : 1221 E. Elizabeth Street, Suite 3 Fort Collins, CO 80524

Were herefor you. ~ Gerald C. Mcintosh, M.D.

9 Neurology Associates of Northern Colorado POUDRE VALLEY MEDICAL GROUP

122 1 E. Eliza beth Street, Suite 3 Fo rt Collins, C O 8 05 24 I (9 70) 4 82 -43 7 3 www.clinics.pvhs.org

PHYSICIAN’S

SURGEON’S

D

T

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R

E

C

O

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FRONT RANGE CENTER for BRAIN & SPINE SURGERY, P.C. Specialists in Neurological Surgery Since 1978

NEUROSURGERY & ORTHOPAEDIC SPINE SERVICES

~

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Thomas G.Chiavetta, MD

Robert R. Quaid, MD

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Stefan M. Pettine, MD

Michael D. Roller, MD

Northern Colorado Surgical Associates, P. C. Surgical care since 1956

Providing surgical care using least invasive methods.

2121 E. Harmony Rd. , Ste. 250, Fort Collins 1970.482.64561888.699.6272 (toll free) I www.ncsurgicaf.net

Brooke Benton, PA-C Child Health Association/Physician Assistant Program, University of Colorado Health Sciences Center of Denver Focus on General Ear, Nose & Throat

Fort Collins Medical Magazine & Directories 2010 2011

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

Natalie Phillips, Au. D.

listed in "Best Doctors in America" and "America's Best Doctors".

Patients Choice Recipient 2008 Nationally Recognized Expert in Sinus & Nasal Disease.

Focus on Hearing & Balance Disorders and Tinnitus Treatment

Board Certified Doctor of Audiology

37

We take athletes to heart.

At Heart Center of the Rockies, our goal is to keep adult athletes healthy, active and safe.

That's why we offer a sports cardiology program that screens athletes for heart problems that increase the risk of heart attack during vigorous exercise. Catching these problems can mean the difference between running the extra mile or sitting on the sidelines.

Make an appointment with sports cardiologist

C. Patrick Green, M.D., today. Call 970.221.1000 in Fort Collins or 970.624.1800 in Loveland.

~ Dr.

C. Patrick Green

Heart Center of the Rockies POUDRE VALLEY MEDICAL GROUP

2121 E Harmony Rd, Suites 100 and 200 Fort Collins, Colorado 80528 I 970.221 .1 000 www.heartcenteroftherockies.com

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

During the last year, the public has heard a lot about healthcare reform.

One of the main strategies commonly talked about is “physician-hospital integration.�

This is a complex strategy, but the basic idea is for physicians and hospitals to work more closely together to enhance healthcare while controlling costs.

Physician-hospital integration exists in various forms. In some instances, for example, physicians become employees of a hospital rather than remaining independent doctors with private medical practices. In another example of other models that exist for physician-hospital integration, a hospital might not purchase a medical practice but instead enter into contracts with physicians from that practice to provide medical services.

Whatever the model, integration is now and will become more important to an organization’s ability to survive in the healthcare environment.

Nationwide, the strategy is intended to lead to higher quality patient care; increased safety and efficiency; and more transparency. It will also decrease medical errors and fragmented care, and lower costs. By physicians and hospitals working more closely together, the coordination of patient care will also be improved, and such healthcare reform initiatives as electronic medical records, accountability, expanded health coverage and more affordability are much more likely to be achieved.

Poudre Valley Health System is moving forward on a well-planned course to bring about physician-hospital integration in Northern Colorado.

In early 2010, the Neurology Associates of Northern Colorado became part of our health system, followed by the Heart Center of the Rockies and other medical clinics.

I encourage you to keep informed about national and local issues related to healthcare. These are important matters for you and your family.

Remember, too, that PVHS will continue to provide you with world-class care.

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

Fort Collins Medical Magazine & Directories 2010 2011

39

FORT COLLINS *Physician’s and surgeon’s list provided by PVHS. This list is current as of 6/24/2010.

ALLERGY/IMMUNOLOGY Culver, William G., MD 2001 S. Shields St., Bldg. H ...........498.9226 Gondalia, Lakhman L., MD Cheyenne, WY. ......................307.778.2015 James, John M., MD 1136 E. Stuart St., Bldg.3, Ste.3200 ..221.1681 See ad on page 104 Kailasam, Velusamy, MD 2121 E. Harmony Rd., Ste. 350 .....221.2370 See ad on page 92 Kujawska, Anna, MD 2001 S. Shields St., Bldg. H ...........498.9226 Lanting, William A., MD 2121 E. Harmony Rd., Ste. 310 .....227.4611 Laszlo, Daniel J., MD 2001 S. Shields St., Bldg. H ...........498.9226 Murthy, Krishna C., MD 2121 E. Harmony Rd., Ste. 350 .....221.2370 See ad on page 92 Vedanthan, P. K., MD Lakewood .....................................303.238.0471

PHYSICIAN’S &SURGEON’S Harrison, William L., MD 1236 E. Elizabeth St., Ste.1 ...........224.2985

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

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

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

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

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

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

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

Kirsh, Timothy E., 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 D., 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

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

CARDIOLOGY

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

Ashmore, Roger C., MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38

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

ANESTHESIOLOGY

Miller, Justin D., MD 1236 E. Elizabeth St., Ste.1 ...........224.2985

Alessi, Richard D., Jr. MD 1236 E. Elizabeth St., Ste.1 ..........224.2985 See ad on the back cover

Moss, William E., DO 1236 E. Elizabeth St., Ste.1 ...........224.2985

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

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

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

Reed, Jay A., MD 3800 N. Grant Ave. (Loveland) ..........622.0608

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

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

Eisenmenger, Michael J., MD 1236 E. Elizabeth St., Ste.1 ...........224.2985

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

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

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

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

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

40

Austin, Wendy J., MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38 Baker, William B., MD 940 Central Park Dr. (Steamboat) .....221.1000 See ad on page 14 & on page 38 Doing, Anthony H., MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38 Dow, Tristan J., MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38 Downes, Thomas R., MD 2121 E. Harmony Rd., Ste. 100 .....221.1000 See ad on page 14 & on page 38 Green, C. Patrick, MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38 Johnson, C. Timothy, MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38 Larson, Dennis G., MD 2121 E. Harmony Rd., Ste. 100 .....221.1000 See ad on page 14 & on page 38 Luckasen, Gary J., MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38

2010 directory*

Miller, William E., MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38 Myers, Gerald I., MD 940 Central Park Dr.(Steamboat) .....221.1000 See ad on page 14 & on page 38 Oldemeyer, John Bradley, MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38 Purvis, Matthew T., MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38 Stoltz, Chad Lynn, MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38 Strote, Justin A., MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38 Tate, Charles W., III MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38 Treat, Stephen A., MD 2121 E. Harmony Rd., Ste. 100 ....221.1000 See ad on page 14 & on page 38 Whitsitt, Todd B., MD 2121 E. Harmony Rd., Ste. 100 .....221.1000 See ad on page 14 & on page 38

DERMATOLOGY Baack, Brad, MD 1120 E. Elizabeth St., Bldg. G2 .....484.6303 Benzmiller, James A., MD 1120 E. Elizabeth St., Bldg. G2 .....484.6303 Hultsch, Anne-Lise, MD 3726 S. Timberline Rd., Ste. 101 ....221.5795 Kalajian, Andrew H., MD 1120 E. Elizabeth St., Bldg. G2 .....484.6303 Kornfeld, Bruce W., MD 1006 Centre Ave. .........................482.9001 Sayers, Clinton P., MD 1120 E. Elizabeth St., Bldg. G2 .....484.6303 West, B. Lynn, MD 3726 S. Timberline Rd., Ste. 101 ....221.5795

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

Chen, Arthur F., MD 5881 W. 16th Street (Greeley). .........313.2740 Conlon, William Sean, MD 1032 Luke St. ..............................484.8686 Eriksen, Christopher M., MD, FACS 1120 E. Elizabeth St., F-101 .........221.1177 See ad below & the back cover Gill, Sarvjit “Sarge,”, MD 3820 N. Grant Ave. (Loveland) .........593.1177 See ad below Gupta, Sanjay K., MD 6500 29th Street, Ste.106 (Greeley) .330.5555 Loury, Mark C., MD, FACS 2001 S. Shields St., Bldg. E-101 ....493.5334 See ad on page 37 & the back cover Robertson, Matthew L., MD 1120 E. Elizabeth St., F-101 .........221.1177 See ad below Runyan, Brad, MD 2121 E. Harmony Rd., Ste. 350 ....212.0169 See ad on the back cover Smith, Bruce M., MD 2121 E. Harmony Rd., Ste. 350 ....484.6373 See ad on the back cover Young, Dayton L., MD ................Fort Collins

Zacheis, David H., MD 3820 N. Grant Ave. (Loveland) ..........593.1177 See ad below

Philbeck, G. Ken, MD 1024 S. Lemay Ave. ......................495.7000

ENDOCRINOLOGY Izon, Meriam P., MD 2121 E. Harmony Rd., Ste. 300 ....295.0010

EMERGENCY MEDICINE

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

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

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

Dellota, Kriss, MD 1024 S. Lemay Ave. ......................495.7000

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

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

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

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

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

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

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

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

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

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

Weil, Lawrence J., MD 1024 S. Lemay Ave. ......................495.7000

Anderson, R. Scott, MD 3519 Richmond Dr. .......................204.0300 See ad on page 42

Luttrell, Matthew, MD 1024 S. Lemay Ave. ......................495.7000

Wideman, Eric W., DO 1024 S. Lemay Ave. ......................495.7000

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

Olsen, Eric B., MD 1024 S. Lemay Ave. ......................495.7000

Wood, Ian O., DO 1024 S. Lemay Ave .......................495.7000

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

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

Yanagi, Ann K., MD 4674 Snow Mesa Dr., Ste. 200 .....495.8450

Bakanauskas, Egle A., MD 1455 Main St., Ste.100 (Windsor) ....686.3950

Fort Collins Medical Magazine & Directories 2010 2009 2011 2010

Widom, Barbara, MD 1040 E. Elizabeth St., Ste.101 .......224.3636

FAMILY MEDICINE Abrahamson, Bradley S., MD 1107 S. Lemay Ave. Ste. 200 ........484.1757 See ad on page 42 Abrahamson, Lara, MD 1113 Oakridge Dr.. .......................225.0040 See ad on page 42 Adamson, Theran B., MD 2021-D Battlecreek Dr. .................206.0851 Ahern, Caitlin M., MD Akron, CO .............................970.345.6336

41

Ferguson, David R., MD 3000 S. College Ave. Ste. 210 .......266.8822 Fields, Jacqueline C., MD 315 Canyon Ave., Ste. 1 ................472.6789 Fritzler, Stace A., MD 2121 E. Harmony Rd., Ste. 370 .....221.2290 Geppert, Margo J., MD 2818 McKeag Dr.. .........................225.2811 Glazner, Cherie, MD 1025 Pennock Pl. .........................495.8800 Goacher, C. Lee, MD 3820 N. Grant Ave., Ste.100 (Loveland) ..624.5150 Gray, April K., MD 1918 S. Lemay Ave., Ste. A ...........494.4531 Grossman, Daniel R., MD 2121 E. Harmony Rd., Ste. 370 .....221.2290 Haldy, Megan, DO 1025 Pennock Pl. .........................495.8800 Haskins, R. Scott, MD 6801 W. 20th St., Ste.101 (Greeley) .378.8000 Henderson, Sandra E., MD 2025 Bighorn Dr. ..........................229.9800 See ad this page Hoemberg, Lyndsay, DO 1025 Pennock Pl. .........................495.8800 Hoenig, Mark W., MD 2362 E. Prospect Rd., Ste. A .........495.0999 Basow, William M., MD 2500 Rocky Mountain Ave. (Loveland) ...495.8450 Beck, Susan M., MD 3850 Grant St., Ste. 200 (Loveland) ..624.5170 Belleville, Bruce R., MD PO Box 271307 ..........................Fort Collins Bender, Edward L., MD 1212 E. Elizabeth St. ....................482.2791 Bender, John Lumir, MD 4674 Snow Mesa Dr., Ste. 140 .....482.0213 Bermingham, Roger P., MD 1025 Pennock Pl. .........................495.8800 Bethards, Kelby F., MD ................Fort Collins Birnbaum, Bernard J., MD 1025 Pennock Pl. .........................495.8800

Broman, Steven D., MD 1107 S. Lemay Ave. Ste. 200 .........484.1757 See ad this page Burnham, Linda A., MD 4674 Snow Mesa Dr., Ste. 140 .....482.0213 Butler, Lisa R., DO 1212 E. Elizabeth St. ....................482.2791 Cawley, John, MD 1025 Pennock Pl. .........................495.8800

Jinich, Daniel B., MD 2001 S. Shields St., Bldg. E-201 ....221.9991 Johns, Stacie L., MD 1635 Blue Spruce Dr. ...................494.4040 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

Choate, Miriam, MD 1025 Pennock Pl. .........................495.8800

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

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

Latter, Macy, DO 1025 Pennock Pl. .........................495.8800 Lembitz, Deanne D., MD 4630 Royal Vista Dr., Ste.7 (Windsor) ...530.0575

Bradley, Robert C., III, MD 1455 Main St., Ste.100 (Windsor) ...686.3950

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

Bresowar, Kristin, MD 1025 Pennock Pl. .........................495.8800

DeYoung, Douglas B., DO 1024 Centre Ave., Bldg. E-100A ...484.0774

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

Duran, Christine B., MD 1212 E. Elizabeth St. ....................482.2791

Levine, Pamela R., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7180 See ad on page 107

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

Duran, Matthew G., MD 1212 E. Elizabeth St. ....................482.2791

Litel, Alexa L., MD 2127 E. Harmony Rd. ....................297.6250

42

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

Lockwood, Stephanie R., MD 3519 Richmond Dr. .......................204.0300 See ad this page Loeb, Mark H., MD 2121 E. Harmony Rd., Ste. 310 .....221.3855 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 MacDonald, Nola A., DO 315 Canyon Ave., Ste. 3 ...............472.8008 Mallory, Patrick, DO 1548 N. Boise Ave. (Loveland) ..........669.9245 Marchant, David R., MD 1025 Pennock Pl. .........................495.8800 Mason, R. Anthony, MD 4630 Royal Vista Dr., Ste. 7 (Windsor) ..530.0575 Mayer, Paul T., MD 1635 Blue Spruce Dr. ....................494.4040 McCarthy, Victoria A., MD 2001 S. Shields St., Bldg. I ............221.5255 See ad this page McCreery, Colleen R., DO 3519 Richmond Dr. .......................204.0300 See ad this page McIntosh, Deric, DO 1025 Pennock Pl. .........................495.8800 Mercer, Jeannette Y., MD 2555 E. 13th St., Ste.110 (Loveland) ..461.6140 Merkel, Lawrence A., MD 2121 E. Harmony Rd., Ste. 370 .....221.2290 Miller, Laurie A., MD 1635 Blue Spruce Dr. ...................494.4040 Monaco, Julie A., MD 1113 Oakridge Dr. ........................225.0040 See ad this page Murphy, Lawrence E., MD 1113 Oakridge Dr. ........................225.0040 See ad this page Naqvi, H. Faraz. MD 1025 Pennock Pl. .........................495.8800 Nevrivy, Thomas E., MD 3519 Richmond Dr. .......................204.0300 See ad this page Nystrom, Robert R., MD 1455 Main St., Ste. 150 (Windsor) ....686.3950 Oldson, Benjamin, DO 1025 Pennock Pl. .........................495.8800 Orozco-Peterson, Marilu, MD 811 E. Elizabeth St. .......................224.1596 Ottolenghi, David R., MD 2121 E. Harmony Rd., Ste. 310 ....221.3855

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

Thompson, Breanna, DO 1025 Pennock Pl. .........................495.8800

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

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

Podhajsky, Tim P., MD 2025 Bighorn Dr. .........................229.9800 See ad on page 42

Thompson, Heidi, MD 1025 Pennock Pl. .........................495.8800

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

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

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

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

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

Tippin, Steven B., MD 2025 Bighorn Dr. ..........................229.9800 See ad on page 42

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

Romero, Paolo, MD 2121 E. Harmony Rd., Ste. 150 .....493.6337 See ad on page 44

Robinson, Anne L., MD 1107 S. Lemay Ave. Ste. 200 ........484.1757 See ad on page 42 Rodriguez, Juan B., DO 4674 Snow Mesa Dr., Ste. 140 .....482.0213 Rotman, Mark F., MD 2001 S. Shields St., Bldg. I ............221.5255 See ad on page 42 Rubright, Jon S., MD 3519 Richmond Dr. .......................204.0300 See ad on page 42 Rutledge, Katie, MD 1025 Pennock Pl. .........................495.8800 Sachtleben, Thomas R., MD 2500 E. Prospect Rd. ....................493.0112 See ad on page 33 Samelson, Scott G., MD 1025 Pennock Pl. .........................495.8800 Samuelson, Scott J., MD 1124 E. Elizabeth St., Bldg. C .......484.0798 Sands, Arthur C., MD 1021 Robertson St. ......................482.0666 Schmidt, David S., MD 2001 S. Shields St., Bldg. I ............221.5255 See ad on page 42 Schnee, Bradley K., MD 1625 Foxtrail Dr. ...........................619.6900 Seeton, James F., MD 2121 E. Harmony Rd., Ste. 310 .....221.3855 Serrano-Toy, Monica T., MD 2121 E. Harmony Rd. Ste. 370 .....221.2290 Siple, Anne I., MD 1625 Foxtrail Dr. ...........................619.6900 Smith, Jerome I., MD 2025 Bighorn Dr. ..........................229.9800 See ad on page 42 Stephens, Floyd V. Jr. MD 3519 Richmond Dr. .......................204.0300 See ad on page 42

Toth, Tiffany, DO 1025 Pennock Pl. .........................495.8800 Towbin, Michael M., MD 1217 Riverside Ave. ......................482.7800

McElwee, Hugh P., MD 3702 Timberline Dr., Bldg. A ..........207.9773

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

North, Crystal M., DO 2555 E.13th St., Ste. 220 (Loveland) ..669.5432 See ad on page 93

Van Farowe, Cynthia K., MD 3519 Richmond Dr. .......................204.0300 See ad on page 42

Nosler, Michael J., MD 3702 Timberline Dr., Bldg. A .........207.9773

Wetherbee, Katharine, DO 1025 Pennock Pl. .........................495.8800

Sears, Stephen R., MD 2555 E.13th St., Ste. 220 (Loveland) ..669.5432 See ad on page 93

Webber, Pamela, S., MD 1025 Pennock Pl. .........................495.8800

Simmons, Robert A., MD 3702 Timberline Dr., Bldg. A .........207.9773

Weiskittel, Deborah A., MD 1113 Oakridge Dr. ........................225.0040 See ad on page 42

Strong, Lewis R., MD 2555 E.13th St., Ste. 220 (Loveland) ..669.5432 See ad on page 93

Weixelman, Janice M., DO 8017 First Street #C (Wellington) ......568.4800

Witt, Peter C., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...350.2440 See ad on page 107

Wideman, JD, DO 2001 S. Shields St., Bldg. I ............221.5255 See ad on page 42

Scott, Miho Toi, MD 2121 E. Harmony Rd., Ste. 150 .....493.6337 See ad on page 44 Shelanski, Samuel A., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7080 See ad on page 107 Sorensen, Matthew D., MD 2121 E. Harmony Rd., Ste. 150 .....493.6337 See ad on page 44 Stone, Michael D., MD 1800 15th Street, Ste. C (Greeley) ....378.4170 Stroh, Ann L., DO 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7080 See ad on page 107

HOSPICE & PALLIATIVE CARE Allen, David K., MD 305 Carpenter Rd. ........................292.0179 See ad on page 59

INFECTIOUS DISEASES

Lepine, Lisa A., MD Boulder, CO ...........................720.382.2621

Cobb, David K., MD, FACP 2121 E. Harmony Rd., Ste. 380 .....224.0429

Thayer, David O., MD Boulder, CO ...........................303.443.2010

LiaoOng, Jacob C., MD 2121 E. Harmony Rd., Ste. 380 .....224.0429

HEMATOLOGY/ONCOLOGY

Peskind, Robert L., MD 2121 E. Harmony Rd., Ste. 380 .....224.0429

Wisthoff, Mark, DO 1025 Pennock Pl. .........................495.8800

Brown, Regina J., MD 2121 E. Harmony Rd., Ste. 150 .....493.6337 See ad on page 44

INTERNAL MEDICINE

Wright, Brandon, MD 1025 Pennock Pl. .........................495.8800

Fangman, Michael P., MD P.O. Box 271040 ...........................217.5160

FAMILY PRACTICE/SPORTS MEDICINE

Kanard, Anne Margaret, MD 2121 E. Harmony Rd., Ste. 150 .....493.6337 See ad on page 44

Wilson, Fiona A., MD 1107 S. Lemay Ave. Ste. 200 .........484.1757 See ad on page 42 Winfrey, Ivory, MD 1025 Pennock Pl. .........................495.8800

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

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

Yemm, Stephen J., MD 2500 E. Prospect Rd. ....................493.0112 See ad on page 33

Thieman, William J., MD PO Box 272369 ..........................Fort Collins

Langer, Daniel A., MD 2555 E.13th St., Ste. 220 (Loveland) .669.5432 See ad on page 93

Unger, Mark S., MD 1113 Oakridge Dr. ........................225.0040 See ad on page 42

Stoddard, Andrew P., MD 2520 W. 16th Street (Greeley) ..........356.2520

Taylor, Grant M., DO 608 E. Harmony Rd., Ste. 101 .......204.9069

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

Kemme, Douglas J., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7080 See ad on page 107

Abbey, David M., MD 1100 Poudre River Dr. ...................224.9508 Alessi, Grace, MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7050 See ad on page 107 Asadi, S. Daniel, DO 4401A Union St. (Johnstown) ...........619.3656

GASTROENTEROLOGY

Lininger, Thomas R., MD 1800 15th Street, Ste. C (Greeley) ....378.4170

Berntsen, Mark F., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7050 See ad on page 107

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

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

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

Fort Collins Medical Magazine & Directories 2010 2011

43

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

POUDRE VALLEY HOSPITAL HARMONY CAMPUS 2121 E. Harmony Rd. Suite 150, Fort Collins 路 www.cancercenteroftherockies.com 44

970.493.6337

Christiansen, Dana L., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7050 See ad on page 107

Zenk, Daniel R., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7050 See ad on page 107

Ebens, John B, MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7050 See ad on page 107

INTERNAL MEDICINE/ HOSPITALISTS

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

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

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

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

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

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

Herrera, Xavier, MD 1100 Poudre River Dr. ..................224.9508

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

Homburg, Robert C., MD 1100 Poudre River Dr. ...................224.9508 Juhala, Robert J., MD 4674 Snow Mesa Dr., Ste. 100 ......482.3712 Khera, Sukhjinder K., MD 1107 S. Lemay Ave., Ste. 240 .......495.7410 Knepper, Katherine L., MD 4674 Snow Mesa Dr., Ste. 100 ......482.3712 Loecke, Steven, MD 1900 16th Street (Greeley) ..............350.2438 Lopez, William, Jr. MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7050 See ad on page 107

Johnston, Christine G., MD 2121 E. Harmony Rd., Ste 300 .....207.9958 Kopel, Charles S., MD 2121 E. Harmony Rd., Ste 300 .....207.9958 LumLung, Christine M., MD 2121 E. Harmony Rd., Ste 300 .....207.9958 Mills, Angela M., MD 2121 E. Harmony Rd., Ste 300 ......207.9958 Reghitto, Charmaine, MD 2121 E. Harmony Rd., Ste 300 .....207.9958 Shah, Zulfiqar A., MD 2121 E. Harmony Rd., Ste 300 .....207.9958 Spannring, Mary M., MD 2121 E. Harmony Rd., Ste 300 .....207.9958

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

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

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

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

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

INTERNAL MEDICINE/PEDIATRICS

Randle, Michael T., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7050 See ad on page 107

Capes, Geoffrey G., MD 4674 Snow Mesa Dr., Ste. 120 .....266.3650

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

Reinhardt, Marcus R., MD 1900 16th Street (Greeley) ...........350.2438

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

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

MATERNAL & FETAL MEDICINE

Thompson, Keith S., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7050 See ad on page 107

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

Himes, Terry M., DO 2500 Rocky Mtn Ave., Ste.310 (Loveland) .619.6000 Jacobs, Marianne, MD 295 E. 29th Street, Ste. 240 (Loveland) ..669.2668 Kaur, Paramjit, MD 1221 E. Elizabeth St., Ste.3 ..........482.4373 See ad on page 34

Satterwhite, Daniel J., MD PVH, 1024 S. Lemay Ave. ..............495.8280

McIntosh, Gerald C., MD 1221 E. Elizabeth St., Ste. 3 .........482.4373 See ad on page 34

Thilo, Elizabeth H., MD Aurora, CO ............................303.724.2840

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

Wilkening, Randall B., MD Aurora, CO ............................303.724.2840

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

NEPHROLOGY

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

Merritt, Jason L., MD 1600 Specht Point Rd., Ste.127 .....493.7733 Muelken, Kevin D., MD 1600 Specht Point Rd., Ste.127 ....493.7733 Rademacher, Donald R., MD 1900 16th Street (Greeley) ...........350.2438 Simmons, Richard E., MD 1600 Specht Point Rd., Ste.127 ....493.7733 Singer, James R., MD 1600 Specht Point Rd., Ste.127 ....493.7733 Teruel, Mark A., MD 1600 Specht Point Rd., Ste.127 ....493.7733

NEUROLOGY Allen, Timothy J., MD 2121 E. Harmony Rd., Ste. 270 ....221.1993 See ad on page 7 & below Curiel, Michael P., MD 2121 E. Harmony Rd., Ste. 270 ....221.1993 See ad on page 7 & below Friedman, Sheri J., MD 1221 E. Elizabeth St., Ste.3 ..........482.4373 See ad on page 34

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

OBSTETRICS/GYNECOLOGY Beresford, Kaea N., MD 1107 S. Lemay Ave. Ste. 300 ........493.7442 Carter, Susan D., MD 1800 15th St., Ste. 220 (Greeley) .....353.1335 Cloyd, David G., MD 1136 E. Stuart St., Bldg. 2, Ste. 100 ..493.5904 Donnelley, Beverly E., MD 1107 S. Lemay Ave. Ste. 300 ........493.7442 See ad on page 58 & the back cover Hayes, Karen E., DO 1224 E. Elizabeth St. .....................221.4977 Hayes, Kimberly W., MD 1136 E. Stuart St., Bldg. 2, Ste. 100 ...493.5904 Hoffmann, Mark F., MD 1136 E. Stuart St., Bldg. 2, Ste. 100 ....493.5904

Drysdale, Christopher R., MD 4674 Snow Mesa Dr., Ste. 120 .....266.3650

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

Sunderman, Steve R., MD 607 Castle Ridge Ct. ....................223.8922

NEONATOLOGY

Heyborne, Kent D., MD Denver, CO ............................303.860.9990 Porreco, Richard P., MD Denver, CO ............................303.860.9990 Stettler, R. William, MD Denver, CO ............................303.860.9990

Fort Collins Medical Magazine & Directories 2010 2011

45

James, Warren K., MD 1107 S. Lemay Ave. Ste. 300 .........493.7442 See ad on the back cover Jeffrey, R. Lee, MD 1107 S. Lemay Ave. Ste. 300 ..........493.7442 Kieft, Larry D., MD 1136 E. Stuart St., Bldg. 2, Ste. 100 ..493.5904 King, Angela K., MD 1107 S. Lemay Ave. Ste. 300 ........493.7442 See ad on the back cover Kozak, Susan H., MD 1107 S. Lemay Ave. Ste. 300 .........493.7442 See ad on the back cover Micetich, Kara L., MD 1107 S. Lemay Ave. Ste. 300 ........493.7442 See ad on the back cover

Yanagi, Ann K., MD 4674 Snow Mesa Dr., Ste. 200 ......495.8450

OPHTHALMOLOGY Arnold, Patrick D., MD 1725 E. Prospect Rd. ....................221.2222 See ad on page 47 Bashford, Kent P., DO 1725 E. Prospect Rd. .....................221.2222 See ad on page 47 Crews, Kent R., MD 1725 E. Prospect Rd. .....................221.2222 See ad on page 47

Priebe Philip N., MD 1107 S. Lemay Ave. Ste. 300 ........493.7442 See ad on the back cover

Foster, Gary J., MD 1725 E. Prospect Rd .....................221.2222 See ad on page 47

Roberson, Nicole M., MD 1006 Luke St. ................................419.1111 See ad on page 87

Korotkin, Arthur, MD 1725 E. Prospect Rd ......................221.2222 See ad on page 47

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

Norris, Andrew M., MD 2121 E. Harmony Rd., Ste. 190 .....224.2020

Skorberg, Christine F., MD 1006 Luke St. ................................419.1111 See ad on page 87 Stern, J. Bradley, MD 1107 S. Lemay Ave. Ste. 300 ........493.7442 See ad on the back cover

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 & page 97

Tool, Audrey L., MD 1107 S. Lemay Ave. Ste. 300 .........493.7442

Robinson, Matthew J., MD 1725 E. Prospect Rd. .....................221.2222 See ad on page 47

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

Shachtman, William A., MD 1725 E. Prospect Rd. ....................221.2222 See ad on page 47

Vance, Maude M., MD 1107 S. Lemay Ave. Ste. 300 ........493.7442 See ad on the back cover

Smith, Randall W., MD 1725 E. Prospect Rd. ....................221.2222 See ad on page 47

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

OBSTETRICS/GYNECOLOGY/ INFERTILITY

46

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

ORAL/MAXILLOFACIAL Bley, Justin C., DMD 1707 61st Avenue, Ste. 201 (Greeley) ....506.0350

Bachus, Kevin E., MD 1080 E. Elizabeth St. ....................493.6353 See ad this page, 27 & the back cover

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

OCCUPATIONAL MEDICINE

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

Holthouser, Michael G., MD 4674 Snow Mesa Dr., Ste. 200 .....495.8450

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

Milliken, William J., MD 8010 S. CR 5, Ste. 101 (Windsor) .....377.1300

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

O’Toole, Kevin J., DO 4674 Snow Mesa Dr., Ste. 200 .....495.8450

Troxell, James B., DDS 1120 E. Elizabeth St., Ste. G3 .......482.6811

ORTHOPEDICS Baer, Robert M., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33 Beard, David A., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33 Beard, Douglas W., MD 1313 Riverside Ave. ......................493.1292 See ad on page 36 & the back cover Benz, Robert J., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33 Biggs, William D., MD 2500 E. Prospect Rd. ....................493.0112 See ad on page 33 Chamberlain, Satoru T., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33 Clark, C. Dana, MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33

Duncan, Kenneth H., MD 2500 E. Prospect Rd. ....................493.0112 See ad on page 33 Durbin, Mark B., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33 Grant, Michael P., MD 3810 N. Grant Ave. (Loveland) ..........669.8881

Javernick, Matthew A., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33

Rusnak, Michael P., MD 2500 E. Prospect Rd. ....................493.0112 See ad on page 33

Kindsfater, Kirk A., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33

Seiler, Steven J., MD 2500 E. Prospect Rd. ....................493.0112 See ad on page 33

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

Sides, Steven D., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7100 See ad on page 107

Grey, Sean G., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33

Mahon, John H., MD 2121 E. Harmony Rd., Ste. 260 .....221.2827

Grossnickle, Mark D., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7100 See ad on page 107

Martin, Dale R., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33

Snyder, Joshua T., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7100 See ad on page 107

Hartman, Ryan L., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33

McFerran, Mark A., MD 3470 E. 15th Street (Loveland) ........663.3975 See ad on page 33

Sobel, Roger M., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33

Houghton, Michael J., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33

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

Young, Eric E., MD 3830 N. Grant Rd. (Loveland) ...........776.3222

Dhupar, Scott K., MD 1624 17th Avenue (Greeley) ............353.5959

Hunter, Brett P., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7100 See ad on page 107

Donner, E. Jeffrey, MD 3810 N. Grant Ave. (Loveland) ..........669.8881 See ad on page 96

Jackson, Wesley P., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33

Fort Collins Medical Magazine & Directories 2010 2011

Pettine, Kenneth A., MD 3810 N. Grant Ave. (Loveland) ..........669.8881 See ad on page 96 Reckling, W. Carlton, MD 800 E. 20th Street, Ste. 300 (Cheyenne, WY) .....................307.632.6637 See ad on page 96

ORTHOPEDICS/SPORTS MEDICINE Trumper, Rocci V., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33

47

PAIN MANAGEMENT Girardi, George E., MD 3744 S. Timberline Rd., Ste. 102 .....495.0506 See ad this page Sisson, Charles B., MD 2809 E. Harmony Rd., Ste. 100 .....221.9451

PATHOLOGY Bee, Christopher S., MD 2555 E.13th St., Ste.120 (Loveland) ..461.6091 See ad on page 52 Chaffin, D. Joe, MD 2555 E.13th St., Ste.120 (Loveland) ...461.6091 Christian, James D., MD 2555 E.13th Street,Ste.120 (Loveland) .461.6091 See ad on page 52 Dunn, Cory D., MD 2555 E.13th St., Ste.120 (Loveland) .461.6091 See ad on page 52 Halbert, Richard E., MD 2555 E.13th Street,Ste.120(Loveland) .461.6091 See ad on page 52 Hamner, H. Wentzell., MD 2555 E.13th St., Ste.120 (Loveland) .461.6091 See ad on page 52 Libby, Arlene L., MD 2555 E.13th Street, Ste.120 (Loveland).461.6091 See ad on page 52 Neuhauser, Thomas S., MD 2555 E.13th Street, Ste.120 (Loveland) ..461.6091 See ad on page 52 Walts, Michael J., MD 2555 E.13th St., Ste.120(Loveland) ..461.6091 See ad on page 52

PEDIATRICS Anderson, Carole M., DO 1200 E. Elizabeth St ....................267.9510 See ad on page 104 Archer, Deborah, MD 1635 Blue Spruce Dr. ....................494.4040 Bailey, Amy C., MD 1200 E. Elizabeth St .....................267.9510 See ad on page 104

Guenther, John P., MD 1200 E. Elizabeth St. .....................267.9510 See ad on page 104 Hanson, Vaughn W., MD 1200 E. Elizabeth St. ....................267.9510 See ad on page 104 Hull, Lori J., MD 2001 S. Shields St., Bldg. G ..........484.4871 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 104 McManigal, Jason, DO 1200 E. Elizabeth St. ....................267.9510 See ad on page 104 O’Brien, Barry G., MD 1200 E. Elizabeth St. .....................267.9510 See ad on page 104 Sampera, Kirsten M., MD 1200 E. Elizabeth St. ....................267.9510 See ad on page 104 Schaffer, Michael S., MD Aurora, CO ............................720.777.2942 Seidman, Marc H., MD 1635 Blue Spruce Dr. ....................494.4040 Whitman, Douglas W., MD 1635 Blue Spruce Dr. ....................494.4040

PEDIATRIC/DENTISTRY Evans, Gregory D., DDS 3221 Eastbrook Dr. ......................407.1020 Galm, Katherine S., DDS 2800 Madison Sq. Dr., Ste.1 (Loveland) .669.7711 Guido, Joseph, DDS 383 S. Drake Rd., Ste. 102 ............377.2500 Hargleroad, Jennifer K., DDS 2105 Bighorn Rd., Ste. 202 ..........493.2254 Van Tassell, Keith A., DDS 2001 S. Shields St., Bldg A ............484.4104

Ballard, Elizabeth A., MD 1200 E. Elizabeth St. ....................267.9510 See ad on page 104

PHYSICAL MEDICINE & REHABILITATION

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

Adamson, Carrie L., MD 2021 Battlecreek Dr., Unit D .........206.0851

Brockway, Julie M., MD 1200 E. Elizabeth St. .....................267.9510 See ad on page 104

Bender, John D., DO 1330 Oakridge Dr., Ste. 130 .........377.9555

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

48

Elliott, Max A., MD 1200 E. Elizabeth St. ....................267.9510 See ad on page 104

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

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

Northern Colorado Pulmonary Consultants, P.C.

Nieves, Ricardo A., MD 1437 Riverside Ave. ......................692.5550 See ad on page 3 Primack, Scott J., DO Greenwood Village ................720.875.0551

Pulmonary Disease

Critical Care

Sleep Disorders

Wunder, Jeffrey A., MD 3555 Lutheran Pkwy.,Ste.320 (Wheat Ridge) .............................303.423.8334

PODIATRY Anderson, James C., DPM 1355 Riverside Ave., Ste. C ...........484.4620 See ad on page 102 Burns, Michael J., DPM 2001 S. Shields St., Bldg. F ...........493.4660 See ad on page 97 Hatch, Daniel J., DPM 1931 65th Ave., Ste. A (Greeley) ......351.0900

Diana Breyer, M.D.

Kirk DePriest, D.O.

Stan Gunstream, M.D.

James Hoyt, M.D.

David Kukafka, M.D.

Rick Milchak, M.D.

Mark Neagle, M.D.

Brent Peters, M.D.

Mark Petrun, M.D.

Eric Stevens, M.D.

Carlos Vassaux, M.D.

Kristin Wallick, M.D.

Hecker, Thomas M., DPM 2500 E. Prospect Rd. ....................493.0112 See ad on page 33 Hunt, Nathan A., DPM 2500 E. Prospect Rd. .....................493.0112 See ad on page 33 Knutsen, Chad M., DPM 2001 S. Shields St., Bldg. F ...........493.4660 See ad on page 97 O’Halloran, William D., DPM 1301 Riverside Ave. ......................482.3668 Overman, Jared L., DPM 1355 Riverside Ave., Ste. C ..........484.4620 See ad on page 102 Schulte, Robert C., DPM 2001 S. Shields St., Bldg. F ...........493.4660 See ad on page 97 Schultz, Peter D., MD 1440 N. Boise Ave. (Loveland) ..........278.1440 Thomas, Michael I., DPM 1355 Riverside Ave., Ste. C ..........484.4620 See ad on page 102 Vaardahl, Michael D., DPM 1931 65th Ave., Ste. A (Greeley) .......351.0900 Webb, Emily Huang, DPM 1927 Wilmington Dr., #102 ..........416.9009

PSYCHIATRY Gottfried, Joseph M., MD 4601 Corbett Dr. ..........................207.4800

Pulmonary Disease | Asthma | Emphysema COPD | Hypoxia | Critical Care | Sleep Disorders | Pulmonary & Exercise Testing FORT COLLINS 2121 E. Harmony Rd., Ste 300 Fort Collins, CO 80528 970.224.9102

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

Heacock, Craig R., MD 4601 Corbett Dr. ..........................207.4800

Fort Collins Medical Magazine & Directories 2010 2011

49

Moreno, Hermann A., MD 4601 Corbett Dr. ..........................207.4800 Nagel, John K., MD 4601 Corbett Dr. ..........................207.4800 Oddy, Richard A., MD 2629 Redwing Rd., Ste. 275. ........622.0588 Pearson, Glenn E., MD 4601 Corbett Dr. ..........................207.4800 Sehr, David S., MD 120 Bristlecone Dr. .......................224.5209 Straumanis, Eric J., MD 1762 Hoffman Dr. (Loveland) ...........663.3030 Udupa, Usha R., MD 4601 Corbett Dr. ..........................207.4800 Watanabe, Kenneth S., MD 4601 Corbett Dr. ..........................207.4800 Woodard, Timothy W., MD 4601 Corbett Dr. ..........................207.4800

PULMONOLOGY Breyer, Diana M., MD 2121 E. Harmony Rd., Ste. 300 ......224.9102 See ad on page 49 DePriest, Kirk L., DO 2121 E. Harmony Rd., Ste. 300 ....224.9102 See ad on page 49

Gunstream, Stanley R., MD 2121 E. Harmony Rd., Ste. 300 ....224.9102 See ad on page 49

Vassaux, Carlos R., MD 2121 E. Harmony Rd., Ste. 300 .....224.9102 See ad on page 49

Hoyt, James D., MD 2121 E. Harmony Rd., Ste. 300 ....224.9102 See ad on page 49

Wallick, Kristin A., MD 2121 E. Harmony Rd., Ste. 300 .....224.9102 See ad on page 49

Kukafka, David S., MD 2500 Rocky Mountain Ave., Ste. 300 (Loveland) .........................................619.6100 See ad on page 29 & page 49 Milchak, Richard J., MD 2500 Rocky Mountain Ave., Ste. 300 (Loveland) .........................................619.6100 See ad on page 49 Neagle, Mark B., MD 2121 E. Harmony Rd., Ste. 300 .....224.9102 See ad on page 29 & page 49 Peters, Brent T., MD 2500 Rocky Mountain Ave., Ste. 300 (Loveland) .........................................619.6100 See ad on page 49 Petrun, Mark D., MD, FCCP 2121 E. Harmony Rd., Ste. 300 .....224.9102 See ad on page 29 & page 49 Stevens, Eric E., MD 2500 Rocky Mountain Ave., Ste. 300 (Loveland) .........................................619.6100 See ad on page 49

RADIOLOGY Berkowitz, Bruce Andrew, MD 2008 Caribou Dr. ...........................484.4757 See ad on page 5

RADIATION ONCOLOGY

Bodenhamer, John R., MD 2008 Caribou Dr. ..........................484.4757 See ad on page 5

Bryant, Michael H., MD 2121 E. Harmony Rd., Ste. 160 ....482.3328 See ad below

Contreras, Jaime H., MD 2008 Caribou Dr. ...........................484.4757 See ad on page 5

Casey, William B., MD 2121 E. Harmony Rd., Ste. 160 .....482.3328 See ad below

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Lisella, Gwen H., MD 2121 E. Harmony Rd., Ste. 160 .....482.3328 See ad below

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Petit, Joshua Henry, MD 2121 E. Harmony Rd., Ste. 160 .....482.3328 See ad below

Fleener, Christopher M., MD 2008 Caribou Dr. ..........................484.4757 See ad on page 5

Simpson, C. Kelley, MD 2121 E. Harmony Rd., Ste. 160 .....482.3328 See ad below

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Fuller, Samuel E., MD 2008 Caribou Dr. ..........................484.4757 See ad on page 5 Geis, J. Raymond, MD 2008 Caribou Dr. ..........................484.4757 See ad on page 5 Geraghty, Michael J., MD 2008 Caribou Dr ...........................484.4757 See ad on page 5 Gunderson, Deborah Z., MD 2008 Caribou Dr. ..........................484.4757 See ad on page 5 Hayes, Amy S., MD 2008 Caribou Dr. ..........................484.4757 See ad on page 5 Jess, Sarah J., MD 2008 Caribou Dr. ..........................484.4757 See ad on page 5 Koplyay, Peter D., MD 2008 Caribou Dr. ...........................484.4757 See ad on page 5 Luttenegger, Thomas J., MD, FACR 2008 Caribou Dr. ...........................484.4757 See ad on page 5 Markel, Curtis L., MD 2008 Caribou Dr. ..........................484.4757 See ad on page 5 Mills, Andrew D., MD 2008 Caribou Dr. ...........................484.4757 See ad on page 5 Pacini, Richard J., MD 2008 Caribou Dr. ..........................484.4757 See ad on page 5

RHEUMATOLOGY Levine, James W., DO 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...461.1880 See ad on page 107 Mayer, Patricia A., MD 2121 E. Harmony Rd., Ste. 361 .....267.9799 Murray, Garvin C., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...461.1880 See ad on page 107 Thakor, Michael S., MD 2121 E. Harmony Rd., Ste. 361 .....267.9799 Thompson, John Stephen, MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...461.1880 See ad on page 107

SURGERY CENTERS Harmony Surgery Center, LLC 2127 E. Harmony Rd., Ste. 200 .....297.6300 Surgery Center of Fort Collins 1100 E. Prospect Rd. .....................494.4800 See ad on the back cover

SURGERY/ASSIST Johnson, Robert V., MD 2500 E. Prospect Rd. .....................493.0112 Kaiser, Dale C., MD 2500 E. Prospect Rd. .....................493.0112 Ludwin, Gary A., MD 1107 S. Lemay Ave. Ste. 300 .........493.7442

Paquelet, Jean R., MD 2008 Caribou Dr. ..........................484.4757 See ad on page 5

Ross, Vincent J., MD 2500 E. Prospect Rd. .....................493.0112 See ad on page 33

Peck, Steven H., MD 2008 Caribou Dr. ...........................484.4757 See ad on page 5 & page 84

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

Peet, Gary J., MD 2008 Caribou Dr. ..........................484.4757 See ad on page 5 Reese, Mark F., MD 2008 Caribou Dr. ..........................484.4757 See ad on page 5 Singer, Charles J., MD 2008 Caribou Dr. ...........................484.4757 See ad on page 5 Weinstein, Stanley W., MD 2008 Caribou Dr. ...........................484.4757 See ad on page 5 Weissmann, Jeffrey R., MD 2008 Caribou Dr. ...........................484.4757 See ad on page 5

SURGERY/CARDIOVASCULAR Douthit, Mark B., MD 2500 Rocky Mountain Ave., Ste.100 (Loveland) .........................................624.1800 See ad on page 14 Guadagnoli, Mark D., MD 2500 Rocky Mountain Ave., Ste.100 (Loveland) .........................................624.1800 See ad on page 14 Matthew, Thomas L., MD 2500 Rocky Mountain Ave., Ste.100 (Loveland) .........................................624.1800 See ad on page 14 Stanton, Michael W., MD 2500 Rocky Mountain Ave., Ste.360 (Loveland) .........................................619.6176 See ad on page 92

Fort Collins Medical Magazine & Directories 2010 2011

SURGERY/GENERAL Bauling, Paulus C., MD 1025 Garfield St., Ste. B ................482.2866

Fraser, Lesley A., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7250 See ad on page 107

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

Hunter, John M., MD 2315 E. Harmony Rd., Ste. 130 .....221.5878

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

Kaufman, Steven L., MD 1136 E. Stuart St., Bldg. 4, Ste.102 ....498.8346

Clear, Craig R., MD 2121 E. Harmony Rd., Ste. 250 ....482.6456 See ad on page 37 & page 84 Collins, Jermone S., MD 1900 N. Boise Ave., Ste. 420 (Loveland). 669.3212 Collins, John A., MD 2315 E. Harmony Rd., Ste. 130 .....221.5878 Cribari, Chris, MD 2315 E. Harmony Rd., Ste. 130 .....221.5878 Davis, Lawrence G., MD 2315 E. Harmony Rd., Ste. 130 .....221.5878 Dickinson, James M., MD 2121 E. Harmony Rd., Ste. 250 .....482.6456 See ad on page 37 Dubs, Steven, MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7250 See ad on page 107

Keeler, Bradford R., MD 1900 N. Boise Ave., Ste. 420 (Loveland) ..669.3212 Lee, James S., MD 6801 W. 20th St. Ste. 202 (Greeley) ..350.0948 Livengood, Joseph C., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7250 See ad on page 107 Marty, Terri, MD 2315 E. Harmony Rd., Ste. 130 .....221.5878 Ogren, Jason W., MD 1800 15th St., Ste. 210 (Greeley) .....352.8216 O’ Holleran, Lawrence W., MD 1616 E. 19th St., Ste. A (Cheyenne, WY) ...........................307.637.5600 Parsons, Sally A., MD 2315 E. Harmony Rd., Ste. 130 .....221.5878

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Peetz, Michael E., MD 2500 Rocky Mountain Ave., N. Medical Office Bldg. (Loveland) ...203.7250 See ad on page 107 Pettine, Stefan M., MD 2121 E. Harmony Rd., Ste. 250 .....482.6456 See ad on page 37 Quaid, Robert R., MD 2121 E. Harmony Rd., Ste. 250 .....482.6456 See ad on page 37 & page 84 Roller, Michael D., MD 2121 E. Harmony Rd., Ste. 250 .....482.6456 See ad on page 37 & page 84 Rubinson, Samuel M., MD 2315 E. Harmony Rd., Ste. 130 .....221.5878 Schiefen, James C., DO 1900 16th St. (Greeley) ...................350.2426 Schmidova’, Karin, MD 1900 N. Boise Ave., Ste. 420 (Loveland) ..669.3212 Turcios, Rosa E., MD 2315 E. Harmony Rd., Ste. 130 .....221.5878 Woodard, Scott, MD 555 Prospect Ave., (Estes Park) .........586.2200

SURGERY/NEURO Coester, Hans C., MD 1313 Riverside Ave. ......................493.1292 See ad on page 36 & the back cover Mimran, Ronnie Isaac, MD 1313 Riverside Ave. ......................493.1292 See ad on page 36 Sheinberg, Michael A., MD 1313 Riverside Ave. ......................493.1292 See ad on page 36 Turner, Donn M., MD 1313 Riverside Ave. ......................493.1292 See ad on page 36 & the back cover Viola, John J., MD 1313 Riverside Ave. ......................493.1292 See ad on page 36 Wirt, Timothy C., MD 1313 Riverside Ave. ......................493.1292 See ad on page 36 & the back cover

SURGERY/PEDIATRIC Ford, E. Gregg, MD 1107 S. Lemay Ave., Ste. 240 ........495.7420 See ad on page 2

Eddy, Michael J., MD 1647 E. 18th Street (Loveland) .........669.9100

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

Everett, Randy W., MD 2315 E. Harmony Rd., Ste.140 ......484.6700

Brewster, Amy Hill, MD 2020 Lowe St., Ste. 202 ...............266.0456 See ad on page 51

Girdler, Benjamin J., MD 2315 E. Harmony Rd., Ste.140 ......484.6700

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

Lee, Michael R., DO 2315 E. Harmony Rd., Ste.140 ......484.6700

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

Malcom, Troy J., DO Longmont ..............................303.776.1234

Gonyon , Denis L., Jr. MD 4450 Union St., Ste.100 (Johnstown) ......624.7979

Manion, Sean P., MD Longmont ..............................303.776.1234

Schutte, Warren P., MD 2126 Milestone Dr., Ste.101. ........372.2310 See ad on page 94

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

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

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

UROLOGY

Soper, Timothy H., MD 2315 E. Harmony Rd., Ste.140 ......484.6700

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

*Physician’s and surgeon’s list provided by PVHS. This list is current as of 6/24/2010.

Christopher Bee, MD

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2127 E. Harmony Road #140 Fort Collins, CO 80528 I 970.297 .6250 www.pvhs.org

Open 8 a.m. to 8 p.m . daily.

Call for holiday hours.

Medical

epilepsy

Finding Solutions for

Epilepsy Patients

by Graciela Sholander

If you’ve never before heard the term “epileptologist,” you’re not the only one. Unless you have personal experience with epilepsy, either directly or through someone you’re close to, you probably won’t know that this term means a doctor who specializes in the treatment of epilepsy.

That’s exactly what Sheri Friedman, M.D., does, and Northern Colorado is fortunate to have an epilepsy specialist of her caliber dedicated to serving the region. As lab director of Neurology Associates of Northern Colorado, now under the umbrella of Poudre Valley Health System (PVHS), Dr. Friedman is working to build a strong epilepsy base that gives local patients the options they need.

“The research and medication options in this field are always expanding,” she says. “New medications are in development all the time. Our office is actually involved in the research of new medications.”

Dr. Friedman is also involved in evaluating patients to determine who is a good candidate for brain surgery. Another option that’s become more

Epilepsy research continues to evolve. Dr. Sheri Friedman (above with patient Terri Burbridge), with Neurology Assoicates of Northern Colorado, is a specialist dedicated to developing research on the latest epilepsy medications.

readily available in recent years is the vagus nerve stimulator (VNS), sometimes called the pacemaker for epilepsy. With epilepsy encompassing such a broad spectrum of types, symptoms and triggers, Dr. Friedman takes the time to learn each patient’s particular case and determine just the right treatment for optimum results.

What Is Epilepsy?

Epilepsy is a condition characterized by repeated seizures. Which begs the question: what exactly is a seizure? Think of a seizure as what results when electrical signals malfunction in the brain. This surge of electrical activity can affect how the person feels

Fort Collins Medical Magazine & Directories 2010 2011

or acts for a short period of time.

Many different types of epilepsy exist – literally hundreds – depending on the source of the seizure in the brain and the associated suite of symptoms.

Names of some of the more common types include temporal lobe, absence and occipital lobe. Speaking in broader terms, all types of epilepsy fit into two major categories.

“There’s generalized and there’s focal,” explains Dr. Friedman. “Focal seizures are the ones that we often think of when someone has a brain injury.

The seizure starts in one area of the brain. These are the ones where people might start with an aura [sensation that indicates seizure onset], a smell, a sense of déjà-vu – those are focal. Some of these

55

can generalize, where they spread and the person shakes on the floor.

“Generalized epilepsy starts on both sides of the brain at once, and the person goes unconscious,” she continues. “Something goes wrong with the communication in the cells of the brain. Generalized epilepsy is not because of a brain injury; it’s because something goes haywire in the way the cells talk to each other. Intermittently they fire on both sides of the brain. The person goes unconscious for a few seconds. If it spreads quickly, the person can fall on the floor and shake. Generalized epilepsy we inherit. Focal epilepsy is acquired.”

Pinpointing the cause of a specific case may be difficult to impossible. Epilepsy can be hereditary, or it can be the result of an injury or infection. In some cases the cause can be environmental, or for unknown reasons the individual may have an imbalance in the brain’s chemistry. Sometimes epilepsy can be triggered by other disorders, such as a tumor or stroke.

Treatment Options Because there are so many different types of epilepsy, and because each patient has a unique combination of symptoms, sensitivities and goals, treatment can vary greatly from one person to the next. An epileptic seizure in the brain can manifest as any number of bodily symptoms, including a sense of being out of it, staring off into space for a few seconds, experiencing muscle twitches or having severe convulsions. Not everyone with epilepsy shakes and convulses. Many do lose consciousness.

Customizing treatment is important in helping each individual get their specific symptoms under control.

Dr. Friedman sees a lot of patients who are referred to her from neurologists. Many of these are cases of epilepsy that are especially difficult to manage. Primary care doctors, including pediatricians, often refer to her patients who’ve reported their very first seizure. In addition, Dr. Friedman treats patients who live in the area but were originally evaluated by specialists in Denver or out of state.

One physician who often refers patients to Dr. Friedman is Tamara Miller, M.D., with Advanced Neurology of Colorado. She specifies some of the instances when she might refer an individual to Dr. Friedman: “Patients with uncontrolled seizures, those who still have seizures after taking medicine, and especially women who are pregnant and experience uncontrolled seizures. About five percent of my patients exhibit epilepsy symptoms.”

Dr. Miller finds that the vagus nerve stimulator (VNS), which a patient can use to ward off seizures as soon as early symptoms appear, offers hope in many hard-to-treat cases. “It’s a device that’s surgically implanted into a patient’s chest, kind of like a pacemaker, and can be programmed in the doctor’s office. The vagus nerve stimulator is a good option for patients who are on multiple medicines and are bothered by many side effects, but are still having seizures. Many VNS patients are able to get off some of their medication.”

Dr. Friedman has seen very positive results with VNS treatment. “By continuously or intermittently sending a signal to the brain,” she explains, “it reduces seizures.”

The other main treatment options available are medication and surgery.

“Most people will respond well to seizure medicine as long as you pick the right one for the seizure

56

“Most people with epilepsy don’t have anything wrong with their brain. The brain functions perfectly well, but it simply has a glitch.”

– Sheri Friedman, M.D., neurologist with Neurology Associates of Northern Colorado

type,” Dr. Friedman says. “But there’s a fraction of people who won’t respond to any medication, and they end up seeing me because these are the ones with seizures that are difficult to control. We try medications, but at some point we start considering other options.”

Some patients are good candidates for surgery.

These individuals are first carefully monitored, with their seizures recorded. If the seizures are localized to a particular spot on the brain, then surgery can remove this part.

“We can get a person up to 75 to 85 percent seizure-free after surgery,” she says. “That is a big deal for patients who aren’t well-controlled, and it’s safer than continuing to have frequent seizures.”

In some instances, the seizures stop altogether and the person is cured of epilepsy following surgery.

Taking A Holistic Approach For the most part, though, treatment of epilepsy is about management.

“Most people with epilepsy don’t have anything wrong with their brain,” Dr. Friedman emphasizes.

“The brain functions perfectly well, but it simply has a glitch. These individuals just need medicine to dampen over-activity of cells in the brain.

The majority are fine as long as they take their medication and avoid things that can aggravate their condition.”

Dr. Friedman tackles the challenge of finding out what triggers the glitch that causes epilepsy in her patients, including evaluating lifestyle factors. “Part of my job is to figure out what triggers a seizure. There are things people don’t think about that can make the brain more irritable. For example, drinking high caffeine and energy beverages can be shown to lower the seizure threshold.

A very common problem is sleep deprivation. In young people especially, the combination of not sleeping enough, not eating well, and drinking too much alcohol or caffeinated drinks can lead to more seizures. I do a lot of counseling about life choices so that my patients don’t have to take as much meds.”

When Dr. Friedman treats children, she has the added dimension of counseling their parents, who are naturally concerned about how epilepsy and the associated medications will affect their kids in the long run. Dr. Friedman takes the time to address these fears and help parents raise confident, independent children.

“I let them know that they can’t sleep with them every night, they can’t keep them from sports, and they can’t follow them around constantly,” she says. “As parents, they have to let their child develop into a normal child and become a normal adult.”

A Patient’s Story One of Dr. Friedman’s long-time patients is Terri Burbridge, an active retiree who noticed her first seizure when she was in the eighth grade.

“At that time, I thought they were normal little funny things all kids had in junior high because it’s

58

Terri Burbridge, a patient of Dr. Friedman’s, has responded well to the implantation of a vagus nerve stimulator to reduce the occurence of her seizures.

such a stressful time in your life,” says Burbridge.

“They happened periodically. I would space out for a minute or two, and then I would be back. I wasn’t diagnosed until I was 28.”

She’s experienced grand mal seizures at different points in her life, including shortly after the birth of her son in 1979. This is the type of seizure that involves both loss of consciousness and violent muscle contractions. Because of her seizures, in the late 1980s, she voluntarily stopped driving.

“I realized I didn’t want to kill anyone else, maim anyone else, or kill or maim myself, so I voluntarily quit driving. I am very learned as far as the bus system is concerned, and my husband is good about giving me plenty of rides as well.”

After seeing countless doctors throughout her life, Burbridge feels Dr. Friedman is the best she’s ever had.

“She has worked on my different medications, and she understands that I’m very sensitive to changing them. She has been careful in how she’s changed the dosages, making sure I don’t experience reactions to these changes. She’ll find different medicines like long-acting ones instead of twice-a-day pills, and she’ll put me on timerelease ones. All of this has been very helpful.”

Although Burbridge was a promising candidate for brain surgery, she opted against this. Instead, in 2006 she had a VNS implantation. “I went ahead and had this done, and it’s been marvelous.

I still am on medications, but I now have very few seizures, and the ones I have are only at night.

“Dr. Friedman has been a godsend. She is so kind and careful; if I have concerns, she spends time and listens. I have recommended lots of people to her. She constantly is giving of her energy and her time. She’s just there for you. I couldn’t ask for a better doctor.”  Graciela Sholander is a local freelance writer and coauthor of Dream It Do It: Inspiring Stories of Dreams Come True, available at www.dreamitdoit.net.

Fort Collins Medical Magazine & Directories 2010 2011

59

medical

EMERGENCY CARE

Urgency or

Emergency?

While making dinner, you have a little incident with a knife and your ring finger. You need medical attention – but where do you go? Johnny’s school just called to tell you he fell at the playground and injured his arm. No bones are protruding but you can just tell that it is broken. Where do you to take him to receive medical attention? Your spouse says his back hurts. Within 20 minutes the pain is excruciating – what should you do?

60

by Kimberly Lock

These questions are faced daily by people trying to make the important decision about where to receive medical treatment in an emergency.

While the first response to the above scenarios may be to rush to the emergency room, it isn’t always necessary. Emergency rooms are qualified to handle all emergencies, but many minor emergencies may be less expensive and more conveniently treated at an urgent care facility.

“Urgent care is best for more minor emergencies or things that are likely to be handled with a single visit,” says James Sprowell, M.D., executive director of Associates in Family Medicine in Fort Collins.

According to the Urgent Care Association of America, “Urgent care centers have a broader and deeper scope of services than retail clinics, but are not equivalent to emergency departments.

Urgent care ideally helps in reserving the nation’s emergency room resources for more serious,

Scott Johnston, M.D., emergency department medical director, Poudre Valley Hospital life-threatening conditions.”

Urgent care facilities provide services when patients are unable to see their primary care physician or in a minor emergency situation. They are often affiliated with the local hospital, but can also be independent centers.

Assisting ERs with the Workload As the ultimate destination in acute care, the emergency room often tops people’s lists when they are injured. This creates long waits to see the doctor if the condition appears to be minor.

Urgent care facilities have waits as well, but the main purpose of urgent care is to ease patient loads at emergency rooms.

“Three years ago, the Harmony Urgent Care elected not to open on New Year’s Day,” says Scott Johnston, M.D., medical director of the emergency department of Poudre Valley Hospital in Fort Collins. “We saw a record number of patients that day. There definitely is a benefit to patients when urgent care facilities treat minor problems and provide injury care.”

Patients appreciate the availability of emergency medicine in the area and that there are options and tiers of care depending on the severity of the medical need.

“We think urgent care can take some of the stress off of ERs and help with crowding,” says Adam Musgrave, P.A.-C, of Skyline Urgent Care in Loveland. “We free up the doctors to see more of the serious stuff.”

The time of day an emergency occurs does seem to matter when it comes to wait times.

Both facilities see an increase in patient numbers first thing in the morning, after lunch and dinner – which is partially attributed to kitchen accidents – and close to urgent care closing time.

The end of day increase seems to be caused by people whose problems started earlier in the day

Jamie Teumer, D.O., emergency department medical director, Medical Center of the Rockies

but delayed seeking treatment (perhaps due to school or work), while the morning tends to be busy with people whose problems began the night before.

Insurance Plays a Role In Decision-Making When making a decision about where to receive medical attention, people sometimes wonder, “How much is this going to cost me?” The cost of insurance deductibles influences where people go to seek medical attention, and sometimes it leads people to make incorrect choices.

When people base their decision solely on where they have a lower deductible, they aren’t looking at the whole picture.

“If they are thinking about insurance first instead of the severity of the emergency … they are gambling with their health,” says Jamie Teumer, D.O., emergency room medical director for Medical Center of the Rockies in Loveland.

“They often end up with two deductibles if their injury requires a trip to the emergency room” The thing to remember is to evaluate the injury first, then consider insurance coverage.

“A lot of people are aware of medical costs,” says Trina Bogart, M.D., emergency room medical director for McKee Medical Center in Loveland.

“I understand that insurance companies often set a smaller co-pay for urgent care to encourage people to go there. But if you go to an urgent care and present with something that is out of their scope of practice, you are wasting valuable time on top of the money.”

On the opposite end of the spectrum, some people head straight to the emergency room because they lack insurance or because they are on Medicaid, which some urgent care facilities don’t accept.

“The emergency room is a full-service department equipped to handle the full spectrum of

Fort Collins Medical Magazine & Directories 2010 2011

emergencies,” Dr. Johnston says.

“At the emergency room we see all customers at all income levels and we do our best to provide care independent of anyone’s ability to pay,” continures Dr. Johnston. “As doctors we only see the patients, we are blinded from who their insurance provider is or if they even have insurance.”

Where To Go When Emergency rooms and urgent care facilities both offer triage services to determine how serious a patient’s situation is. Urgent care can handle X-rays and other minor medical tests of extremities, but if an MRI or CT scan is required the patient is usually sent to the hospital. Cuts, colds, sprains, strains, infections and most fractures can be handled at an urgent care.

However, if you experience chest pain, abdominal pain, head trauma, blurred vision, difficulty breathing or swelling of the lips and tongue you need to go to the emergency room. If the injury involves a broken bone, and the bone is obviously dislodged and not in the correct position, head straight to the emergency room to have it examined and treated.

“If it is a true emergency and someone is experiencing trouble breathing or chest pain come directly to the emergency room,” says Dr. Teumer.

“We have a good relationship with the urgent care facilities in town which is great for patients,” he continues, “If you are experiencing an emergency and have concerns about where to go, call the urgent care to see if they can help you before you go to the emergency room.”

Kimberly Lock is a freelance writer who enjoys spending time with her husband and three kids in the Colorado outdoors.

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CONTINUED FROM PAGE 32

Local

Urgent Care F acilities Fort Collins

Windsor

Associates in Family MedicinE Urgent Care 3519 Richmond Drive Fort Collins, CO | (970) 204-0300

GeneralCare Medical Clinic 9952 Eastman Park Dr. Windsor, CO | (970) 674-0814

Open 8 a.m. to 9 p.m. Monday-Saturday, and 9 a.m. to 9 p.m. on Sunday. Major holidays excepted.

Physicians are on call 24 hours a day, 7 days a week.

GeneralCare treats acute injuries. They require payment at time of service and do not accept insurance or Medicare.

On-site services include care for acute injuries and illnesses such as cuts, flu and sports injuries.

Greeley

Harmony Urgent Care 2127 East Harmony Road Fort Collins, CO | (970) 297-6250

NextCare Urgent Care 2928 W 10th Street Greeley, CO | (970) 351-8181

Open 8 a.m. to 8 p.m. daily. Call for holiday hours.

Harmony Urgent Care offers services for minor injuries and illnesses, such as the flu, strep throat, strains, sprains and minor fractures.

GeneralCare Medical Clinic 620 South Lemay Avenue Fort Collins, CO | (970) 482-6620 Open Monday-Friday 8 a.m. to 7 p.m., Saturday 9 a.m. to 5 p.m. and Sunday 10 a.m. to 2 p.m.

GeneralCare treats acute injuries. They require payment at time of service and do not accept insurance or Medicare.

Loveland Loveland Urgent Care 3850 North Grant Ave., Suite 100 Loveland, CO | (970) 669-5717 Open Monday-Friday 8 a.m. to 6 p.m., Saturday 9 a.m. to 5 p.m. and Sunday 9 a.m. to 3 p.m.

Loveland Urgent Care services include care for minor injuries and illnesses such as colds, flu, sprains, headaches, stomach aches, non-life threatening cuts, minor infections and wounds, sports injuries and physicals for school or sports. X-ray available on site.

Skyline Urgent Care 2555 East 13th Street, Suite 110 Loveland, CO | (970) 461-6140 Open Monday-Friday 8 a.m. to 8 p.m., Saturday and Sunday 9 a.m. to 5 p.m., closed Thanksgiving and Christmas Day Skyline provides X-ray, laboratory/EKG, minor trauma and wound care, respiratory care, minor orthopedic care and treatment, and treatment of colds, flu, fever and infections.

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Open Monday-Friday 7 a.m. to 3 p.m.

Open Monday-Friday 8 a.m. to 8 p.m., Saturday and Sunday from 10 a.m. to 4 p.m.

NextCare provides walk-in medical clinics to treat any non-life-threatening illness or injury that needs immediate attention.

Urgent Care West (Greeley Medical Clinic) 2001 70th Avenue, Suite 110 Greeley, CO | (970) 378-4155 Open Monday-Saturday 7 a.m. to 7 p.m., Sunday 10 a.m. to 5 p.m.

Treats minor conditions such as sore throats, broken bones, workman`s compensation injuries, and more.

Urgent Care Main Campus (Greeley Medical Clinic) 1900 16th Street Greeley, CO | (970) 350-2454 Open Monday-Saturday 7 a.m. to 7 p.m., Sunday 10 a.m. to 5 p.m.

Treats minor conditions such as sore throats, broken bones, workman`s compensation injuries, and more.

E s t e s Pa r k Timberline Medical Urgent Care Clinic 131 Stanley Avenue, Suite 202 Estes Park, CO | (970) 586-2343 Open Monday-Friday 8 a.m. to 6 p.m., Saturday 9 a.m. to 1 p.m.

Treating minor emergencies, strains and sprains.

are more likely to survive if you are at a public place, like an airport, than at home because of the availability of an AED and because someone sees you go down.”

Statistics show that survival rates decline by 10 percent for every minute of delay after the onset of sudden cardiac arrest. A person is thought to have the best chance of survival if an AED is used within three minutes after the onset of cardiac arrest.

“The challenge,” according to Deirdre Cook, Fossil Ridge High principal, “is not how to use the AED, but to teach awareness, so that the first response is, ‘You call 911, I’ll go get the AED.’” Four AEDs now reside on the Fossil Ridge campus, in athletic areas and gathering places, and students have been trained in how to use the devices.

Dr. Johnson concurs: “Just having the device does not save lives if no one knows where they are. There needs to be a push to get more AEDs in more public places.”

Parker and her classmates hope their efforts will encourage others to install AEDs wherever the public gathers in large numbers. “The scary truth is that sudden cardiac arrest is not age discriminate. AEDs are necessary anywhere large numbers of the public congregate,” Parker says.

Parker’s advisory class raised the money to place AEDs in all of Stephen’s former schools (Timnath Elementary, Zack Core Knowledge Elementary, Kinard Core Knowledge Middle School and Fossil Ridge High School). Intel Corporation in Fort Collins, where Stephen’s father is employed, donated one AED unit.

Parker and her classmates raised the remaining $6,000, with the last $300 donated by Poudre School District. The AEDs will be installed in the schools this summer and ready and waiting when school starts in August. 

medical

BEHAVIORAL HEALTH

The Mobile Assessment Team: Betty Vail and Kristen Ward, with Mountain Crest Behavorial Healthcare Center, and Ken Kirchoff (center) with Fort Collins Police Services

Mental Health

On the Go

by Laura Sebastian

There are few things more frightening and exhausting than an emergency room visit. No matter how kind the medical staff or how good the care, it’s a visit people dread. For people with mental health issues, it can be an even more terrifying prospect. The cost, the wait, the anxiety of what will happen to them, all of these are exacerbated for an individual suffering from thoughts of suicide or other forms of severe mental distress.

Though in crisis and despite the urging of friends or family, many are so frightened they simply refuse to go.

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But in December 2008, these individuals, and those who care about and for them, were offered an alternative: the Mobile Assessment Team. The Mobile Assessment Team (MAT) is part of Mountain Crest Behavioral Healthcare Center, which is a service of Poudre Valley Health System and its crisis assessment centers.

MAT was created for many reasons: to provide on-site intervention on behalf of individuals who need crisis stabilization, to improve patient care and to lower costs and save time for both the patient and the medical community in general. It can be utilized by physicians’ offices on behalf of their patients, schools on behalf of students in crisis, and medical clinics and various community agencies, such as the police, who are called to crisis situations.

The program is both the brainchild and the dream of Kristen Ward, coordinator of psychiatric assessment services at Mountain Crest.

“During my schooling in Texas, I did emergency mental health assessments in ERs,” Ward says. “I saw

there was a need for mental health professionals to deal with people in the midst of an emotional crisis. Nurses and doctors are fabulous, but they’re trained to deal with medical issues. In an emergency room they don’t have the specific training needed or the time needed to sit down and talk to people in emotional crisis.”

Ward, now in her ninth year with Mountain Crest, certainly possesses this training. A licensed clinical social worker, she holds a Bachelor of Science degree in social work from Abilene Christian University in Abilene, Texas, and a Master of Science and Social Work degree from the University of Texas in Austin, Texas. She believes the crisis intervention MAT offers is extremely important.

“When someone needs help for mental health or substance abuse issues, it’s crucial that they speak to someone who’s sympathetic, knowledgeable and can quickly get them the proper help,” she says, “whether that means admitting them to Mountain Crest, arranging outpatient care or, in some situations, sending them to the ER or to detox. The team comes equipped with resources at their fingertips, so a person in crisis isn’t left on their own to find the help they need. I believe MAT has such an important job because we’re the first people a distressed person is going to come into contact with.

“Let me give you an example of how MAT works,” Ward continues. “We had a young girl who told her teacher she was suicidal. The school called us and we went to the school to help. We were able to evaluate the situation and develop a really good, solid crisis plan with therapists and psychiatrists, put the plan in place, and the family and the child were able to avoid hospitalization and the emergency room. And all of her care was put into place while on-site at the school.”

Though there are other mobile assessment programs around the country, they are primarily located in big cities such as New York, which boasts a whopping 23 mobile crisis intervention units. But for a city of Fort Collins’ size, the service is unique.

“It began when I traveled with a representative from the police department to Houston to study a mobile assessment team there,” Ward says.

“We also took bits and pieces from programs in Boston, San Diego and Denver. Poudre Valley Health System, which Mountain Crest is part of, has been unbelievably supportive. They’re doing this as a community benefit, so the service is free. Right now, MAT is available to physicians’ offices, medical clinics, urgent care clinics, schools and community agencies such as mental health clinics, probation, group homes and the police, but we’d like to expand it so the general public can call us too.”

Among the MAT’s biggest supporters has been Betty Vail, coordinator of outpatient services at Mountain Crest. Vail, who has been with Mountain Crest for six years and in her current position for five years, says she, too, would love to see the program expand.

“It’s a great service for the patients as well as the clinic staff here,” Vail says. “We interact with MAT quite a bit. When our staff is really busy MAT can step in right away to help. We see 90 to 100 patients on some days so the team can not only help a doctor keep his or her schedule but can also help the patient who needs immediate assessment. It’s better patient care and more efficient.”

Mountain Crest Behavioral Healthcare Center

4601 Corbett Drive, Fort Collins, Colorado | (970) 207-4800 or 1-800-523-1213 Mountain Crest Behavioral Healthcare Center is a service of Poudre Valley Hospital and one of the jewels of Poudre Valley Health System (PVHS). The structure opened in 1989 as a charter facility, and was purchased by PVHS in 1998. In the years that have followed, Mountain Crest has grown in the services it offers and the volume of clients served.

Mountain Crest offers many services in addition to MAT. The facility’s stated dedication is to “Help people with mental health and substance abuse problems achieve a balanced life and the highest level of health and well-being.”

They offer assistance with: • • • • • • • • • • • •

Behavioral health emergencies Adolescent or school problems Family issues Stress-related symptoms Depression and mood disorders Anxiety or panic attacks Alcohol and substance abuse problems Work-related problems or financial pressures Suicidal concerns Mid-life crisis Postpartum depression Questions about medications

Their comprehensive programming includes: • • • • • •

Adult inpatient and medical detoxification for substance abuse Adolescent inpatient and partial hospitalization Addictive disease evening recovery program for adults Adolescent residential treatment and in-home wrap around services for families of troubled adolescents 24-hour crisis intervention and crisis stabilization with confidential assessment TEAM Challenge, a corporate and community team-building ropes course

Mountain Crest provides services to those in Northern Colorado, western Nebraska and southern Wyoming, offering both outpatient and inpatient programs. The hospital is equipped with 24 beds – 16 for adults, and eight for adolescent care – and the average length of an inpatient stay is between three and five days.

“The most common problems we deal with are mental issues. Many of the people we see have a cooccurring diagnosis, meaning they have a mental issue and an underlying substance abuse issue,” says Kristen Ward, coordinator of psychiatric assessment services. “Patients are assigned a care coordinator, so when they leave here, they’re already set up for post-discharge treatment. We’ll also assist patients who don’t have insurance in finding care with community services that offer a sliding scale or other options.”

The hospital works cooperatively with each client in order to design an individualized plan of treatment, and considers community support systems and family involvement to be very important. In fact, they state that, “Focusing on the strength of families is a cornerstone of our treatment philosophy.

Families usually know their loved ones best, which makes them a valuable member of the treatment team. Whether helping parents of teens strengthen their effectiveness or assisting a family in adapting to the needs of an aging parent, our goal is to support the strength in families to create lasting solutions to mental health problems.”

If you or a loved one needs help, Mountain Crest offers 24-hour crisis intervention and crisis stabilization with confidential assessment. 

Fort Collins Medical Magazine & Directories 2010 2011

65

At this time, MAT responders (who are licensed mental health professionals) are available Monday through Friday, from 9 a.m. to 5 p.m., but plans are in the works to expand both staff and hours in the near future. The goal is to make the program available to all members of the community 24 hours a day, seven days a week. This would mean that an individual could call from his or her home if he or she (or a friend or family member) is in crisis, and the assessment team would come over, talk to the person in the comfort of his or her home and decide then and there what is the best course of treatment. Until this is available, there is always around-the-clock help to be found at Poudre Valley Health System’s two mental health and substance abuse crisis assessment centers, located in the emergency rooms at Poudre Valley Hospital in Fort Collins and Medical Center of the Rockies in Loveland.

MAT is a natural outgrowth of these crisis assessment centers. The centers were opened in 2005 as a collaborative effort between the main mental healthcare providers in the community and various community agencies such as the police.

The centers’ purpose was to have one point of entry for anyone seeking mental health services.

“At that time we said, ‘Anyone needing mental health services will go through the Crisis Assessment Center, be screened there, and then sent to the proper place.’ In 2005, we were seeing about 125 people a month, now it’s jumped to 300,” Ward says.

This created a large number of patients flooding the ER at Poudre Valley Hospital who didn’t necessarily need to go to the ER. “The goal is to provide a quicker response,” Ward says. “We try to avoid having people wait for hours in the ER and get a big bill in order to get appropriate referrals. Our goal is also not to tie up an ER that’s already busy, and to free up our first responders like the police. To do this, we go out into the community and provide emergency mental health services and triage for individuals acutely suffering from things like depression, suicidal ideation, incapacitating anxiety, mood disorder symptoms and severe situational stress.”

Those who are not considered good candidates for MAT and should indeed go to the ER include: intoxicated individuals who have significant withdrawal symptoms; agitated, aggressive individuals, those with significant psychosis or mania; those needing medical clearance or treatment; and those who pose an elopement (flight) risk.

An example of how the community agencies work together to make the program work can be seen in MAT’s collaboration with the police department.

“We’ve been very successful in developing our partnerships, especially with the police department,” Ward says. “I don’t think our police department gets enough credit for what it does.

The MAT program wouldn’t be successful if we didn’t have such good collaborative relationships with them and with our other community providers.”

Ken Kirchhoff, a 31-year veteran of the Fort Collins Police Services, is a participant in this collaborative effort and serves as MAT’s police liaison with Poudre Valley Health System’s Crisis Assessment Center and Mountain Crest.

“Police officers are the first responders to most calls for assistance,” Kirchhoff says. “They have the authority to take a person into protective

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Mountain Crest’s Mobile Assessment Team can step in to intervene during a crisis situation, often preventing the need to go to the emergency room.

Finding help in a crisis: • For the general public, call the Poudre Valley Hospital Crisis Assessment Center at: (970) 495-8090 • For the professional community, call the Mobile Assessment Team at: (970) 430-0837 

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Fort Collins Medical Magazine & Directories 2010 2011

“

custody, transport them to a treatment or assessment facility, and have the person evaluated based on [the officers’] observations and investigation.”

“As Fort Collins has grown,” continues Kirchhoff, “so has our case load with these types of issues. As a result, we were all hoping to positively impact this situation for our own agencies as well as for the members of the community that need our assistance. When the Mobile Assessment Team is working, it enables our officers to receive consultation in the field regarding people in crisis and it frees officers up to return to their policing district and other calls for service.”

“MAT is an excellent, much-needed program,” Ward says. “It’s a wonderful collaborative effort between our community providers, Poudre Valley Heath System and Mountain Crest. MAT is also a truly innovative program and our partners have given us the support we need to make it work,” Ward says. “We want the professional community to know we’re here and we can help.”

970-631-6832 info@vows4two.com 67

Medical

ORTHOPEDIC

Standing Ready:

Dr. Houghton was instrumental in organizing Orthopaedic and Spine Center of the Rockies’ Foot and Ankle Team.

OCR’s Foot and Ankle Team As I stepped out of my front door and down the first step, my ankle rolled outward and I simultaneously heard and felt a loud pop. “That can’t be good,” I thought to myself. Within hours, I was sitting in an exam room at the Orthopaedic and Spine Center of the Rockies.

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“You’ll want to take off that shoe, too,” the nurse advised me, pointing to my ‘good’ foot.

“He’ll want to examine both feet.”

A few minutes later the doctor walked in. “Hi, I’m Dr. Jackson.” He shook my hand and then sat down to examine my swollen foot. “Does this hurt?” he asked repeatedly, gently pressing at different points on my foot and ankle. He then turned to look at my X-rays, which had already been loaded onto a nearby monitor in the exam room. “You broke your fifth metatarsal,” he said, adding that I might want to consider surgery (the five metatarsals are long bones in the foot). “Let’s splint you up and I’ll see you in 10 to 14 days. We’ll see how your foot is doing, take a few more X-rays, and then decide.”

“Surgery. I don’t have time for surgery,” I thought

by Lynn M. Dean

to myself. But at least I knew I was in good hands.

Wesley Jackson, M.D., is part of the Foot and Ankle Team at the Orthopaedic and Spine Center of the Rockies. The team includes Michael J. Houghton, M.D., Thomas Hecker, DPM, and most recently, Nathan Hunt, DPM. Both Dr. Jackson and Dr. Houghton are board-certified orthopedic surgeons who have completed specialized fellowship training in athletic and reconstructive foot and ankle surgery.

Dr. Hecker and Dr. Hunt are podiatrists. Dr. Hecker is board-certified in Podiatric Medicine and Surgery.

Dr. Hunt specializes in Podiatric Medicine and Surgery, as well as Diabetic Foot and Wound Care; he is joining the team this month.

The team is unusual because it includes both orthopedic surgeons and podiatrists who work

Orthopaedic and Spine Center of the Rockies’ Foot and Ankle Team:

Illustration courtesy of Wright Medical

together to serve the needs of patients. The team was the brainchild of Dr. Houghton, who himself brought expertise in cutting-edge treatments like ankle replacements with him to the OCR 13 years ago. The practice now offers five different types of ankle replacement, depending upon the level of deformity in the ankle. He was the first in the state to be able to do these types of surgery.

But Dr. Houghton also envisioned something more. He felt there was an advantage to expanding the practice in order to be able to treat all of the associated foot and ankle problems patients experience.

“When I first came to OCR, I approached the group with an idea to add in podiatry to start our vision of the foot and ankle team,” he says. “Traditionally it had been an orthopedic-only group, but my partners were intrigued by the idea. It took two or three years for the plan to formulate.”

Dr. Hecker was the next person added to the foot and ankle team.

“We’ve been working together for the past eight or nine years,” Dr. Houghton says. “He brought in a podiatric perspective in treating and managing food and ankle problems that meshed with my orthopedic approach.

“Dr. Jackson joined the team four years ago as the second orthopaedic foot and ankle specialist, and now Dr. Hunt.”

“We’re very excited about Dr. Hunt’s acceptance of our offer to come join the team,” Dr. Houghton explains. “He has just spent two years doing a fellowship focused on diabetic foot and ankle management and limb salvage. He has also been a co-investigator in two National Institutes of Health grants funding clinical trials in treatment and prevention of diabetic neuropathic foot wounds.

Dr. Hunt is going to bring a level of understanding and expertise that is unmatched.”

“I’ve been involved with clinical and bench-top research over the past two years on diagnosing and treating problems of the foot and ankle that are somewhat unique to patients with diabetes,” explains Dr. Hunt. He hopes to continue his research in Colorado. “I’m excited about joining OCR. I think it’s an opportunity to collaborate with experts in the field, so as a group we can offer world-class care.”

“There is no other group in the state where podiatry and orthopaedics work so closely together,” says Dr. Houghton. “We are trying to create the most comprehensive foot and ankle team in the Rocky Mountain Region. We are putting together a team that can serve patients who have any type of foot or ankle problem, both non-surgically and surgically.”

These problems include degenerative arthritis of the ankle and foot, athletic related injuries, malalignment problems that manifest in the foot and ankle, tendon disorders and bio-mechanical problems, as well as problems associated with systemic illnesses like diabetes.

Before such a team existed, patients had to decide whether to go to the podiatrist or to the orthopedist.

“There has traditionally been a podiatry versus orthopedic approach,” says Dr. Houghton. “But what we want to do here is create a team that works together to use the strengths of both disciplines to meet the needs of the patients. It’s something we’re very excited about.”

There are many advantages to this kind of a set-up.

“If a patient is scheduled to see me and I

Thomas Hecker, DPM

Cutting-Edge

Ankle Surgery Michael J. Houghton, M.D.

Nathan Hunt, DPM

Wesley Jackson, M.D.

CONTINUED ON PAGE 104

Fort Collins Medical Magazine & Directories 2010 2011

When Michael Houghton, M.D., joined the Orthopaedic and Spine Center of the Rockies (OCR) 13 years ago, he brought with him more than the concept for the Foot and Ankle Specialty Team. He also brought unparalleled expertise in cutting-edge treatments like ankle replacement surgery.

“I was fortunate that when I was applying for a fellowship I was selected to go to a center that was one of only two or three in the country that was doing ankle replacement surgery,” he says. “When I came to Fort Collins I brought that knowledge and skill set with me to the state. Our only limitation back then was that the early designs did not accommodate all ankle conditions and deformities.”

OCR was one of the very first places in the region to do ankle replacement surgery.

“I started doing them in 1999,” Dr. Houghton says. “At that time we really had only one type of ankle replacement implant available to us. Unfortunately, the original ones did not tolerate any type of deformity in the ankle. If a patient came in with an arthritic ankle and I didn’t feel we could serve them with that one type of ankle replacement, we could only offer them a fusion or a brace. The difficulty with fusion is that it takes away motion and can lead to premature wear and tear on other joints in the foot that participate in balance. Now we have about five types of ankle replacement available that can accommodate many types of deformities.”

“For years total ankle replacements have lagged behind knee and hip replacements,” agrees Wesley Jackson, M.D., who also performs ankle replacement surgery at OCR with Dr. Houghton. Dr. Jackson explains that even though many new ankle replacement implant designs have been used in Europe for more than a decade, and they mimic those used in hip and knee replacements, each must still go through the rigorous experimental trials required by the FDA. That takes time.

It didn’t help matters that the early replacements implanted in the United States failed because, following the lead of hip and knee replacements, early ankle implants were cemented into the bone. “They CONTINUED ON PAGE 105

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TWENTY THREE TREES MEDICAL & WEL LNESS SPA POUDRE VALLEY HE ALTH SYSTEM

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VISIONARY HEALTHCARE

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Taking healthcare from good to great

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YISIONARY HEALTHCARE A BLOG BY RULON STACEY

Social media gives instant access to PVHS

ARCHIVES

by rstacey

June 2010 (6)

When I went to Israel in June for an international patient safety summit, I brought northern Colorado with me .

April 2010 (9)

I chronicled the trip with words and pictures on my blog, giving readers a taste of everything from the region's food to the world's take on current patient-safety topics.

CATEGORIES

May 2010 (10) March 2010 (17)

Aging population ( 4) Awards (2)

Social media is changing the way we communicate with each other. It's also changing the way Poudre Valley Health System communicates with patients, customers and the community.

You can follow us on Facebook and Twitter for customer service help, news and updates. Our YouTube channel includes videos about health and wellness, as well as services PVHS offers the community. The photos on our Flickr page show visitors what we're doing to make this a healthy community.

Corporate accountability (3) Electronic health records (3) Employee engagement (3) employee turnover (3) Greeley Medical Clinic (1) Healthcare reform (22) Hospital errors (7) International Patient Safety Collaborative (5)

I started the blog, Visionary Healthcare, in March to keep the community, PVHS employees and the healthcare industry updated on how we're meeting the challenge of healthcare reform. Healthcare delivery will change nationwide, statewide and communitywide, and the blog allows readers to find out first-hand what PVHS is doing to ensure that our patients and community receive world-class care.

LEED (1) Malcolm Baldrige National Quality Award (6) Medical marijuana (1) Patient safety (12) Patient satisfaction (9) Physician integration (8)

The blog, which you can find at www.visionary.pvhs.org, has been viewed nearly 30,000 times. Readers have left about 130 comments, including my own reactions as we discuss the important topic of health care.

I encourage you to visit the blog or any of our other channels and join the conversation. Your suggestions and feedback help us better care for the community.

Best, Rulon

PVH Cancer Network (2) Quality improvement (18) Talent Management (3) Uncategorized (10) Welcome (1)

Wellness

AWARENESS

Stop the Distracted Driving Epidemic

For Erica’s Sake

by Corey Radman

The child-sized bicycle lay crumpled in a blue and pink heap against the curb, its reflector pedal spinning in the wind, freed from the weight of its rider. Just moments before, this glittery bike had ferried a nine-year-old girl almost all the way home … until she was hit.

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On November 25, 2008, a Ford Expedition traveling at 25 miles per hours struck Erica Forney as she pedaled home from school. She flew over the top of the SUV, landing on her head in the street behind the 5,000-pound vehicle. The driver, Michelle Smith, had just finished a phone call and was hanging up, according to police comments at the scene. She reported that she never saw Erica, nor did she realize she had hit anything, only hearing a thump. The thump was, of course, a small girl who was yards away from her driveway.

“She couldn’t have been more than 10 or 15 pedals away from safety,” says Erica’s mother, Shelley Forney, whose voice trembles every time she recalls the accident. The grief on this mother’s face speaks of the hole in her life that will never be repaired. A year and a half after the death of her middle child, her “shredded heart” is still very raw.

“Erica was the sparkle in my life,” Forney remembers. “She was the kind of person who could just

walk into a room and light it up.” Erica’s nickname, Sunshine, was taken from the song that described her personality, “You Are My Sunshine.” When that song is played, instead of a smile of recognition, Forney now feels a stab of pain, remembering the sweet voice she will never hear again.

“Now, there is a huge black hole in our home. Now, there is a space in front of the TV where she used to sit between her sisters.

There is an empty seat at the table where she is supposed to be … she is supposed to just BE, supposed to exist!” Forney exclaims, leaning forward with emphasis. “I keep going around that hole in my home each day… it’s just wrong for a child with a full life in front of her to be taken because of a phone call.”

Advocate for Change Since Erica’s death, Forney has been speaking out about the impact the accident had on her family. An advocate for a total cell phone ban, Forney has appeared all over Colorado, testified before the Colorado Legislature, lobbied Congress members in Washington, D.C. and has even been invited to tell her story on The Oprah Winfrey Show. In conjunction with Oprah’s “No Phone Zone,” campaign launched in May, Winfrey came to the Forney’s home in April to film a public service announcement (viewable at www.oprah.com).

On her April 30 show, Oprah said, “I met Shelley and Darren Forney . . . and today I’m asking you to stand up for them and all the families who’ve been devastated by these senseless accidents that don’t have to happen . . . How many more have to die before we take our stand? Let their lives be our light.”

Forney wishes the No Phone Zone pledge on Oprah’s website advocated for a complete ban rather than give readers a multiple choice option. Currently the pledge gives people the option to give up just texting and hand-held phones, or go completely cell phone free, but she is pragmatic about the lengthy process of behavior change.

“I realize that it’s going to take a long time to educate the public to change this behavior,” she says. “They think it’s just a slight distraction, not a big deal, but Oprah is right when she says it’s ‘America’s new deadly obsession.’”

Forney and five others formed the non-profit advocacy group Focus Driven to bring attention to the cause. All six board members have lost family members to distracted driving accidents. Working from different states, the group seeks to support victims, encourage lawmakers to pass bills and raise public awareness.

“I think if people would really listen to the stories of victims and realize that it could be them, they would see how dangerous this behavior really is,” Forney says.

It Could Be You According to a 2008 National Highway Traffic Safety Administration (NHSTA) report, nearly 6,000 people in the U.S. were killed in crashes that involved distracted driving. The same year, Colorado State Patrol (CSP) found that 4,961 crashes in the state were caused by inattentiveness to driving, 33 of which caused fatalities.

Sgt. John Hahn of CSP indicates that crash rates in

driver, the things a driver has to pay attention to in order to pilot the car safely, it’s a lot,” he continues. “They have to monitor the cars in front, back and all around them, their speed, the traffic control devices, pedestrians, stop and yield signs … driving is a task that requires your undivided attention.

“People who think that they can handle the distractions in their car and still drive, often don’t realize the full risk until it’s much too late.”

“Erica was the sparkle in my life. She was the kind of person who could just walk into a room and light it up.”

Erica’s mother – Shelley Forney

Colorado are declining. In year-to-date statistics for 2010 compared to 2009, inattentive driver caused crashes are down 9.7 percent. Why? “I can’t say with certainty, but I think the heightened awareness from media stories on distracted driving, the recent state ban on texting while driving, as well as solid enforcement has helped,” he says.

NHSTA defines distracted driving as anything that takes your eyes off the road, your hands off the steering wheel or interrupts your concentration while driving.

Colorado law bans any texting while driving, but does not prohibit hand-held cell phones for anyone over 18 years old. Sgt. Hahn says CSP’s job is to enforce the laws that the citizens of the state and their representatives pass; however, he discourages drivers from engaging in any activity that makes it harder to give due regard to others on the road.

“Distracted driving can be caused by many different factors,” he says. “I once pulled over a driver who was eating a bowl of cereal when he nearly rear-ended the car in front of him. It’s not technically illegal to eat cereal and drive, but it is absolutely required that drivers take precautions for the safety of others around them.

“If you look at the number of tasks required of a

Fort Collins Medical Magazine & Directories 2010 2011

Hands-Free, Brain-Free?

A University of Utah study found that motorists who talk on either a hand-held or hands-free phone are just as impaired as if they were driving drunk. Cell phone users had slower reaction times than drivers with .08 blood alcohol level, and slower reaction to vehicles braking in front of them.

The study’s lead author, David Strayer, Ph.D., says, “People can’t multitask as well as they think they can. Just like you put yourself and other people at risk when you drive drunk, you put yourself and others at risk when you use a cell phone and drive. The level of impairment is very similar.” The study concludes that cell phone use while driving is not safe. Period.

NHSTA’s website reiterates that hands-free cell devices are not risk-free. “The available research indicates that cell phone use while driving, whether it is a hands-free or handheld device, degrades a driver’s performance.

The driver is more likely to miss key visual and audio cues needed to avoid a crash.”

Forney freely admits that she was also on her phone as she drove home the evening Erica was hit. But, never again will she talk and drive.

“People think it can’t happen to them,” she says. “They think they are better drivers than those that they see on the news. Michelle Smith wasn’t a bad driver. She just made a bad decision. And that’s all it takes to end a life.”

“You can’t look at Erica’s story without it moving you, without coming to the conclusion that this tragic outcome was completely preventable,” Sgt. Hahn, father of three, says. “We have the responsibility as drivers to make it home safely to our families. The roads are filled with people who also have someone waiting for them at home.”

For more information and a pledge to drive cell phone free, see www.focusdriven.org

Take the pledge. oprah.com/nophonezone Corey Radman is a writer and mother of two who lives in Fort Collins.

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Teens

Behind the Wheel

by Corey Radman

More teens die in car crashes than by any other means.

According to the National Highway Traffic Safety Administration (NHTSA), motor vehicle crashes account for 35 percent of all deaths in young adults ages 15 to 20 years old.

This was especially true in Larimer County between 2005-2007 (the most recent available data) when 12 teens lost their lives in crashes.

The county was number one in Colorado for teen traffic-related fatalities.

Why So Many?

Christine Cerbana is Director of the Colorado Family Education Resources & Training center at CSU. She teaches the BrainWise curriculum authored by Patricia Gorman-Barry, PhD. BrainWise simplifies the neuroscience of the young adult brain by labeling two developmental stages: “Lizard and Wizard Brain.” Lizard Brain is a reference to gut-level reactions, versus the well thought out plan of a Wizard Brain.

“Teens have no brakes,” Cerbana explains.

“By nature, they are risk takers, and are driven by emotion, not strategy. Because their brains are not fully mature until they are 25 years old,

76

they are not yet ready to plan far ahead.” “[That the human brain doesn’t fully mature until 25] is something that we all know, anecdotally, is true, but the research proves it,” says Janet Werst, an educator from PVHS’ Community Health department.

Werst also heads the Teen Motor Vehicle Safety Coalition of Larimer County. She agrees with the ideas in the BrainWise curriculum and points to further consistent data in national traffic statistics. For example, NHTSA notes that the crash rates of 16-year-olds are three times that of 17-year-olds and five times that of 18-year-olds.

Cerbana suggests that this delay in maturation may be one reason why rental car companies refrain from renting to individuals under 25.

“We’re able to show through brain research what crash statistics demonstrated long ago,” she says.

“Young adult drivers are still driven by emotion.”

Three Pronged Approach The shocking death rates on the highways were what spurred NHTSA to create a three pronged approach to lowering highway death rates. “These three things save lives: increasing seat belt use, implementing graduated driver licensing (GDL) laws, and reducing teens’ access to alcohol,” states the agency’s website. In 1999, Colorado approved the GDL law that requires teenagers to go through stages before they can obtain a full drivers license. The three stages are: an instruction permit, a minor license, then the full drivers license.

Local officials like Werst are working in tandem with these national standards to save lives on the road. In its first three years, the Teen Motor Vehicle Safety coalition helped to educate 1,000 parents and 3,000 teenagers through public education speeches. During that period, Larimer County’s teen seat belt usage improved by 34.7 percent to 95.1 percent usage.

“It’s hard to evaluate all the factors that played into this success,” reports Werst, “but we know that education and awareness really make a difference.”

Nicole Teel, a colleague of Werst’s at PVHS, serves as DUI Prevention Coordinator. She reports that in 2009, PVHS awarded 135 drivers education scholarships with CDOT grant funding. The recipients were required to commit to volunteer activities and attend educational presentations throughout the community to promote safe driving. The Coalition also provided nearly $5,000 in mini scholarships to local high schools to develop peer-to-peer education campaigns in schools.

What Works?

“The things that really impact teen attitudes towards safe driving are parents and peers,” Werst says. “Parents are extremely influential in their teenager’s decision making – both in words and example. You’ve got to model that seat belt usage as well as talk about it.”

Teel also suggests the following three important rules for parents to keep in mind: “Enroll your teenager in GDL and Driver Education courses. Supervise their driving and have clear ground rules with consequences. Be patient and positive through the learning process.”

Werst encourages parents to stay engaged when teaching their teens about driving. “We recommend using parent/teen contracts to enforce safe behavior and spell out consequences for breaking the rules. This means that parents don’t dictate, but discuss the family’s rules. ‘These are my priorities. This is the law.

This is the family rule. This is what will happen if you break a rule like getting caught driving passengers.’” Write it down, then have everyone agree and sign the contract, Werst says.

Proactive parents can take advantage of resources in the community aimed at helping their teens become skilled and safe drivers.

Look for more workshops from the PVHS Teen Motor Vehicle Safety Coalition in the 2010 fall semester at area high schools. Their goal is to speak at every high school in Larimer County.

Corey Radman is a mother and freelance writer from Fort Collins.

Fort Collins Medical Magazine & Directories 2010 2011

77

WELLNESS

FITNESS

Revolution in Fitness

Poudre Valley Medical Fitness opens November 2010 in Windsor.

Poudre Valley Medical Fitness (PVMF) is currently under construction in the beautiful Water Valley subdivision in Windsor. It will be the first medical wellness and fitness center in Northern Colorado, and one of just a few in the western part of the country.

78

by Connie Hein

Under the supervision of medical director Patrick Green, M.D., PVMF will offer both the supervision and resources necessary to exercise safely and effectively for recovery and rehabilitation, as well as lifelong good health. Dr. Green, who is a cardiologist at the Heart Center of the Rockies, says he is very excited about the new facility as an extension of the Poudre Valley Health System. “This is one more facet of care in the PVH system that strives for not only excellent healthcare, but prevention of illness and disease through education about healthy lifestyles,� says Dr. Green.

He says PVMF will target two categories of clients. The first will be the population that is recovering from acute injury or illness or dealing with chronic medical problems such as hypertension, heart disease, diabetes and obesity.

The second targeted group will be clients of

any age that are healthy and active and want help with education and motivation to maintain a healthy lifestyle to prevent disease and illness.

Older clients that want to maintain good health may feel more comfortable joining a supervised medical fitness facility as opposed to joining a regular fitness center.

“We will have classes, seminars and credentialed staff to help meet the needs of both of these target groups,” says Dr. Green.

Since the facility will serve such a diverse group of people, it will be easy for family members of patients using the facility for recovery to join their loved ones in being active and maintaining their own good health.

Dr. Green says being the medical director of this facility will give him a vehicle to educate clients on the importance of exercise and activity as part of a healthy lifestyle.

“I talk with every one of my patients about exercise every time I see them in my office,” he says. “I believe that telling them once that exercise is very important in prevention of illness and disease is not enough.”

He says people need to hear this message continually from their healthcare providers so they will start thinking about exercise differently and make decisions about what to do to have a more active lifestyle. He says eating sensibly and exercising are two of the most important factors in maintaining a good quality of life, but people need education and knowledge.

Dr. Green says the facility will give him and the staff not only the opportunity to educate clients about these factors in their lives, but demonstrate proper exercise techniques and help with motivation, encouragement and evaluation.

“I am thrilled to be part of this facility that will help so many in the area,” he says.

Rebecca Crocker, manager of PVMF, says the two-story facility will offer group fitness classes and seminars, free weights, computerized fitness tracking, physical therapy, cardiac rehabilitation, a warm water therapy pool, lap pool and many other amenities.

Having these amenities available for injury recovery, physical therapy and rehab, as well as healthy, active clients, will give the center a unique atmosphere. A person that is recovering from an injury with physical therapy might be working alongside a person training for a marathon. Crocker says this is proven to be valuable for both clients.

“This brings encouragement and inspiration to both people as they watch each other work through different experiences in their lives,” she says.

This is one of the things that differentiate a medical wellness and fitness center from a regular fitness center. She says there are six key factors that make the difference: medical oversight and documentation; qualified, certified, degreed staff that stay in their scope of practice; clinical integration of professionals, including patients’ healthcare providers; measured outcomes and quality focus; highly documented cleanliness and maintenance; and individual customer evaluation and support.

Crocker says all of these factors become great motivators for clients to work hard to get or stay healthy.

Part of the function of the facility will be a cardiopulmonary rehab center similar to the ones

Dr. Patrick Green, Medical Director, Poudre Valley Medical Fitness

provided at Medical Center of the Rockies (MCR) and Poudre Valley Hospital (PVH).

Suza Ault, nurse manager for MCR, PVH and PVMF, says the cardiopulmonary portion of the center will provide phase three and four outpatient programs, which are considered maintenance programs for patients who have had cardiac episodes and want a program to help them through the chronic disease. She says the center will be set up for physical therapy so there will be lots of equipment that can be shared with cardio-pulmonary rehab patients.

Ault says they hope the Water Valley center will be a gathering place for all things healthy, from physical rehabilitation to yoga and other healthy mind and body education.

“We also hope this will be the starting and gathering place for training and education for local running and walking clubs that are already established in Northern Colorado,” she says.

Since Windsor is such a central location, the hope is to serve people in all the surrounding communities and areas including Windsor, Loveland, Timnath, Severance, Greeley and Fort Collins.

The center will open in late November, but membership pre-sales and medical screenings and seminars began June 1 at 400 New Liberty Road in Water Valley, Windsor.

Crocker says there are standard, family and couples memberships that all include an initial and follow-up health and fitness evaluation and exercise prescription to help clients determine and reach their goals. The center is also set up for all types of physical therapy and rehab prescribed by physicians.

For more information, contact Rebecca Crocker at (970) 674-6500.  Connie Hein is a freelance writer living in Windsor and author of the Toliver in Time series of children’s books.

Fort Collins Medical Magazine & Directories 2010 2011

79

A New Way to Train In an age of technology and machinery, it’s easy to get caught up in the hype of the latest gadget to help you recover from injury or stay fit. But the physical trainers at Integrative Physiotherapy take a more hands-on approach in their work, with tried and true kinetic chain training exercises that help return and improve natural mobility.

Integrative Physiotherapy’s John Kummrow, DPT, has spent years developing specialized exercises that “follow the entire motion chain to mimic real-life movements that are as mechanically efficient as possible,” based on the body’s kinetic chain, he says. Kummrow works with personal trainer Dan Harmon in offices located at LifeFit24 in Fort Collins.

Kummrow illustrates his philosophy with an exercise he calls “the water ski.” Rather than a ho-hum wall squat, Kummrow has his patients take a more dynamic approach. Using cable handles to provide a bit of balance, patients use their core and leg strength to squat lower than a normal squat, while engaging their abdominal muscles.

The challenging exercise simultaneously becomes a stretch while it strength trains.

The exercise can also be scaled back for elderly patients with extreme limits in mobility, or those recovering from injury without full range of motion. For those patients, Kummrow can have them do the motion seated, practicing the proper form and stability.

“It is motion to move to a better you,” says Kummrow, borrowing from Integrative’s tag line.

He developed many of the exercises he uses with his patients after suffering from his own semi-pro football injury. The injury was severe: his shoulder was dislocated, tearing multiple muscles and arteries in his neck along the way. Kummrow created his own rehabilitation program, and now

Head to the pool

has full mobility in his arm and neck, though his dreams of a neurosurgery career were destroyed.

Kummrow incorporates martial arts and acrobatic elements, as well as trigger point massage, skeletal alignment (without popping, he says), and other modalities into his therapy sessions. He also incorporates a homeopathic style of medicine into his practice and recommends organic diets to his patients.

Kummrow and Harmon use the kinetic chain training in their therapy sessions and often work in a hands-on manner, helping patients through movements while maintaining proper form. They

people with arthritis and pregnant women.

As with any other exercise, technique is important. For novice-level swimmers, lessons for learning or improving strokes would be beneficial.

While swimming is a full body workout, learning a variety of strokes means you can get more out of swimming, as each stroke uniquely works the different muscle groups.

There are four basic strokes used in swimming:

Whether you’re looking to cool down or shape up, swimming is a great summer activity. It’s ideal for all ages and activity levels, and can be fun and relaxing even as it gives you a workout.

There are many advantages to swimming over other types of exercise. It’s low-impact, because buoyancy decreases the weight and strain on joints.

It works almost all the major muscle groups at once.

Holding your breath can help improve circulation without significantly increasing your heart rate.

Many runners and other non-aquatic athletes cross train with swimming. Injury rehabilitation also utilizes swimming, and it is recommended for

80

tend to stay away from other “machine modalities,” such as using ultrasound, preferring a more natural method.

Pain during a session can be a good thing, adds Kummrow. “Pain isn’t always a limiter, but sometimes a processing signal. Often pain is the last symptom to go and you will get function back first.” He adds that this is not a “no pain, no gain” theory. Rather, the pain must have qualifiers (When does it hurt? Why?) and those qualifiers direct treatment.

Kummrow has worked with patients as young as 2 years old and into their 80s, and those recovering from injury to professional athletes that need to perform. The driving force behind his exercises is the fact that “motion is ageless. It is something we are not supposed to lose.” He and Harmon have worked together for more than a decade and have retained many of the same patients during those years, helping them recover from injury first then to maintain their fitness goals thereafter.

For more information about Integrative Physiotherapy, call John Kummrow at (970) 581-1262 or Dan Harmon at (970) 420-8729.

Backstroke: True to its name, this is the only major stroke that involves floating on the back. The arms move in an alternating windmill, while the legs move in an alternating flutter kick. This is the easiest stroke in terms of breathing, but the hardest in terms of navigating. This stroke especially works your back muscles. The backstroke burns the same calories as running a 12-minute mile (596 calories/hour, based on a 155-pound person).

Breaststroke: This is a more advanced stroke, as breathing, arm movement, and leg kicks need to be properly coordinated. The arms start positioned together in front of your chest, then push straight out, sweep away, and pull back.

The legs kick in a frog-like manner. This stroke most strongly works out the thighs and pectorals.

The breaststroke burns the same calories as running a 10-minute mile (744 calories/hour, based on a 155-pound person).

Butterfly: This is also an advanced stroke, as it requires a lot of strength. The arms move together fully extended, while the legs move in a dolphin kick, with the overall goal of having your body undulate through the water. This stroke focuses most on the trapezius, abdominal muscles and leg muscles. The butterfly burns the same calories as running a 9-minute mile (818 calories/ hour, based on a 155-pound person).

Frontal crawl: Also called freestyle, this stroke is essentially the backstroke on your belly. The arms move in an alternating windmill, and the legs move in an alternating flutter kick. This is fastest stroke in swimming, and works the triceps and glutes the most. The frontal crawl burns the same calories as the butterfly stroke Even if you’re not interested in swimming as exercise, it’s still great recreation. Swimming is fairly accessible, with swim classes of all levels for all ages, from infants to

Get Fit, Give Back Calendar Many of these great events donate a portion of their proceeds to local and national non-profits.

So get off the couch, strap on your tennis shoes and get out there for a worthy cause.

AUGUST

Run for Hope 5K July 24 – Run for Hope 5K, 8 a.m., City Park, Fort Collins, benefitting the Caring for Carcinoid Foundation and the PVH Cancer Center, www.runforhope.net.

1 – Fort Collins Human Race, 8 a.m., Old Town, Fort Collins 6 – Wild West Relay, 5 a.m., Anheuser Busch Tour Center, Fort Collins, www.wildwestrelay.com

Visit www.runforhope.net for more details.

12 – Mountain Avenue Mile, 6:30 p.m., Old Town, Fort Collins, www.mountainmile.com 15 – Horestooth Open Water Swims, 7 a.m., Horsetooth Reservoir, Fort Collins, benefitting TEAM Fort Collins, www.horsetoothswim.com 19 – Birdies on the Green Ladies Golf, 2 p.m., Olde Course, Loveland, benefitting the McKee Medical Center Foundation 21 – Tour de Cure, time T.B.A., Boulder County Fairgrounds, benefitting the American Diabetes Association, www.diabetes.org/ coloradotourdecure 21 – Peachy Cheeks on the Move 5K Walk/Run, 8 a.m., St. Michael’s Town Square, Greeley, benefitting Hospice and Pallative Care of Northern Colorado 28 – Loryfest 8K Trail Race, 9:30 a.m., Lory State Park, Fort Collins, www.withoutlimits.com

september

6 – Colorado Run 5K/10K, 8:30 a.m., CSU Oval, Fort Collins, benefitting the Discovery Science Center, www.coloradorun.com seniors. Best of all, most cities have a public pool with affordable rates, as well as neighborhood pools that you may already have access to if you pay homeowner’s association fees.

These are the locations of the city pools in the area: City Park Pool 1599 City Park Drive, Fort Collins 80521 Mulberry Pool 424 W. Mulberry, Fort Collins 80521 Edora Pool Ice Center 1801 Riverside Ave., Fort Collins 80525 Winona Pool 1615 East 4th Street, Loveland 80537

9 – Fort Collins Triathlon & Duathlon, 7 a.m., EPIC, Fort Collins, timberlinetiming.com 10 – McKee Masters Golf Tournament, 8 a.m., Mariana Butte Golf Course, Loveland, benefitting Stepping Stones Adult Day Care at McKee Medical Center 19 – 9th Annual Crossroads Half Marathon and 5k, 8 a.m., Buckingham Park, Fort Collins, www. footoftherockies.com 20 – TEES fore TWO Golf Tournament, 7 a.m., Fort Collins Country Club, benefitting ChildSafe and Front Range Exceptional Equestrians, www. childsafecolorado.org/events.htm 25 – Running of the Bulls, 10 a.m., Lake Shore Lodge, Estes Park, benefitting Partners Mentoring Youth, estesparkcvb.com/events.cfm

october

Greeley Recreation Center 651 10th Ave., Greeley 80631

2 – Bacon Strip 4 & 10 Mile, 9 a.m., Fort Collins, janewelzel.com

Family FunPlex 1501 65th Avenue, Greeley 80634

3 – Blue Sky Marathon and Half Marathon, 7 a.m., Soderberg Trailhead, near Fort Collins, www.blueskymarathon.com

Centennial Outdoor Pool 2315 Reservoir Road, Greeley 80634 Chimney Park 200 East Chestnut Street, Windsor 80550 Calorie information obtained from the Harvard Heart Letter.

9 – Flame Out 5K Run/Walk, 9 a.m., fire station at Spring Park & Matthews, Fort Collins, www. footoftherockies.com

16 – Harvest Night 2 Mile Race, time T.B.A., N. Lake Park, Loveland, www.footoftherockies.com 31 – Spooktacular Race 5k Run/Walk, 9 a.m., Spring Canyon Community Park, Fort Collins, benefitting the Children’s Speech & Reading Center, www.csrckids.org

16 – CSU Homecoming Race 5K, 8 a.m., CSU Oval, Fort Collins, www.footoftherockies.com

Fort Collins Medical Magazine & Directories 2010 2011

81

Wellness

the BILLY LOTT project

The Community Comes Together to Help a Child “Hi, my name is Billy Lott and I am 10 years old. I like to play football, hunt and play with my friends. I was just diagnosed with cancer.”

Billy says when he was diagnosed with leukemia it changed his life.

“One of the things that would make it better would be to have a room of my own,” he writes in a letter about his only wish.

He says having a room of his own in the family home he shares with his parents and five siblings would give him much needed peace and quiet to recover from the treatment of his disease. Having his own room would also make it possible for him to have his friends in for sleepovers, which would make him feel like an ordinary, healthy kid again. And, he says a room of his own would help him do the schoolwork that he must make up because of his extensive time at the hospital.

“I would be so grateful to have a room of my own and it would make a positive impact on my life,” he writes. “Thanks for everything. Love, Billy Lott.”

Kim Bashaw, an emergency room nurse at Poudre

82

by Connie Hein

Valley Hospital (PVH), heard about Billy’s wish from his mother, Sheri Lott, her co-worker. She and several employees at PVH put together a brochure with Billy’s story, which was circulated throughout the community in hopes of setting up a team of people to help fulfill Billy’s wish.

Kim’s husband Mat Bashaw, a superintendent for FCI Constructors, www.fciol.com, also spread the word.

Because of his contacts in the construction industry, Mat got the ball rolling on the project to finish the basement and give Billy his own room.“We wanted Billy to have a room of his own to recover from the disease, concentrate on school work and just be an ordinary 10-year-old boy hanging out with friends,” says Mat. Kim wrote a letter for the brochure explaining the Lott’s situation, along with Billy’s wish, which was passed out to all who donated time and materials within the community, including the Denver-based WISH organization, www.wishesarepossible.org, which donated the money for the permit.

According to Kim, 16 years ago, just six weeks after giving birth to her second child, Sheri Lott was diagnosed with non-Hodgkin’s lymphoma. Sheri fought for her life and beat her disease. Sheri and her husband Rob then went on to have four more children, for a total of six. They purchased their dream home and were getting ready to finish the basement when their two-year-old child was struck by a car.

“The event hit the family hard financially as well as emotionally. They were driving back and forth to Children’s Hospital in Denver for many months of rehabilitation,” Kim says.

Four years later came the diagnosis of Billy’s leukemia.

“Billy will undergo approximately three years of intense chemotherapy through a port in his chest as well as in his spine, bi-monthly bone marrow aspirations and several trips to Children’s Hospital in Denver for treatments, labs and doctor visits,” Kim says. Sheri adds that Billy is currently about five months into his treatment plan, and is experiencing the pain and illness common to chemotherapy. “It will be a long haul,” says Sheri, “but Billy is a trooper. This is making him grow up faster than he should.”

Just before Christmas 2009, Rob lost his job along with his medical benefits, which has made a hard situation even worse. But, through the goodness and generosity of many community members, Billy’s wish will come true.

Harry Poehlmann of Poehlmann Construction and Basements-4-You, www.poehlmannconstruction.com, heard about the basement project from Pete Medina, a salesman at Sutherlands Lumber. “He emailed me the brochure with Billy’s wish and asked if I could help with the project.”

Poehlmann says after he read Billy’s story, there was no doubt that he wanted to help. “We are not

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AFTER .

The basement remodel will provide the Lott family with two additional bedrooms, a bathroom and a play area.

Billy Lott sits in his new room. The basement is expected to be complete in August and ready for Billy to move in.

only a construction company, but also a basement finishing company, so this project seemed to be a perfect fit for us.”

Since Mat works as a superintendent on a job in Parker, Colorado, it was difficult for him to take on the project in Fort Collins without some help, so Poehlmann offered his services as general contractor. He contacted his employees and subcontractors who said they would be happy to help with this important job.

“The construction industry has been hit hard by this economy and many of us are struggling just to keep our businesses open,” he says. “I didn’t know who would be able to assist me or what amount of help I could count on.”

Even though the residential construction industry is having a hard time, Poehlmann says subcontractors didn’t hesitate to pitch in and give time and materials to do something positive to help this little boy have his wish.

Poehlmann says there have been over 60 people and businesses who have volunteered time and services to the project. They have done the wiring and electrical, heating, drywall, texturing and finishing, cabinets and countertops.

“All labor and supplies going into the finishing of the basement have been 100 percent donated,” he says.

“This confirmed what I already knew,” Poehlmann continues, “that I have some of the best employees and Northern Colorado boasts some of the best subcontractors that anyone could ask for.”

84

Mat says, “When Poehlmann got involved the project really got off the ground quickly. He called on his employees and sub-contractors and acted as the general contractor.”

It was through many hours on his part that the project has gone smoothly, Mat says. “All the contractors have worked quickly to get every portion of the project done as soon as possible so that Billy can enjoy his new room.”

Though Billy is just 10 years old, he seems to understand that what people are doing to help him is a big deal, says Mat. “He is such a great kid, and so cheerful and funny,” Mat says. “He brings his dog down to the basement and talks to him about how they will soon be moving into a brand new room.”

Poehlmann says this project for Billy has given him something positive to embrace and put his energy into.

“It makes me very grateful that even though times are economically hard for us, all the important things in my life are right, so I wanted to help someone else to make their lives better also,” he says.

Poehlmann has three sons that have been part of this process, too. He believes they have learned a lot from the experience. They have met Billy and have an appreciation for the challenges he faces. He says his sons are all very active in sports and have thought about how they would feel if they couldn’t participate because of an illness.

Kim’s son, Jadon, age 11, also helped in the project

Harry Poehlmann, owner of Basements-4-You, acted as general contractor for the project. by preparing materials for the work to begin. “I feel good about helping Billy because a kid my age shouldn’t have to suffer from cancer and the treatments,” he says. “That makes me want to help him out as much as I can.”

Poehlmann says the Lott family has been amazing throughout the process. “They are so positive and upbeat. They are an inspiring family. All their kids are great and positive even under their tough circumstances.”

He says Billy is a great kid and is very grateful for what everyone is doing for him. He seems more concerned that his illness will interrupt life in his family than anything he is going through personally.

Mat Bashaw has also witnessed the family’s gratitude for the people that are sacrificing so much to help them, even when many are having a hard time even paying their own bills.

Poehlmann says when he asked Billy if there was anything special he would like in the room, such as a special color, Billy told him he wanted it orange – the color of the leukemia hope ribbon. He says that will give him hope.

“Everyone has just been so amazing,” says Sheri Lott.

“I can’t put into words what it will do for our family.

Billy is so excited. It is certainly a bright spot in his day.”

The basement is expected to be complete in August, and the Lotts are currently choosing paint colors and other finishing details. Billy says he can’t wait to have “a place to chill and hang with friends and a place to go where it is quiet when I am sick.” Billy, who currently shares a room, will have some much needed private space in the basement, which will include two bedrooms, a bathroom and play area.

“We have so many people to thank,” says Sheri.

“But ‘thank you’ seems so minimal compared to what people have given us.”

The Lott’s story has inspired many from the community to help. On August 14, a fundraiser will be held at City Park in Fort Collins, sponsored in part by doctors from Northern Colorado Pulmonary Consultants and local retailers and restaurants. The event will include local bands, a soccer tournament, carnival, as well as silent and live auctions. For more information visit http://battleforbilly.webstarts.com.

Readers interested in donating directly for Billy’s medical treatment can do so at an account set up for Billy at Wells Fargo Bank. The fund is called the Billy Lott Miracle Fund.  Connie Hein is a freelance writer living in Windsor and the author of the Toliver in Time series of children’s books.

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Wellness

DENTISTRY

Perfect

Practice Makes

by Kay Rios

Something about John Morehouse, DDS, inspires confidence. Perhaps it’s his laid back manner, his reassuring smile and quiet demeanor. It could also be the calm surroundings in his office. “We don’t run around from room to room, rushing patients in and out.

The staff and I concentrate on one person at a time and we like to create a relaxed atmosphere so the patient feels comfortable,” he says.

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John Morehouse, DDS, posing with his staff (top), has 40 years experience practicing general dentistry.

In any case, even for someone who has spent many hours in a dentist’s chair and breaks out in a cold sweat at the idea of a dental appointment, something about Morehouse breaks down that fear barrier. He even offers nitrous oxide at no charge just for the comfort of his patients.

Granted, he’s had 40 years of practice to hone his skills. But it appears to be more innate in Morehouse.

It’s as if he was destined to be in this field. And, in some ways, that may be true, since his path started when he was growing up in Gross Point, Michigan.

“I had a childhood dentist that I liked a lot and I saw how much he enjoyed his work,” he recalls.

“I got to know how things worked in his office and just became interested.”

With that direction in mind, he entered the University of Detroit School of Dentistry, married

his high school sweetheart, Mary (who became a dental hygienist), and in 1967 he graduated from the dental school. He practiced dentistry in Detroit for six years, and was an instructor in the crown and bridge department at the dental school for five years.

During that time, he and his wife had four children (Ann, Mary, Susie and Johnny). Then, in 1973, an opportunity came up that the Morehouse family couldn’t resist.

“A friend and I had talked about coming to Colorado and we heard about a practice for sale in Fort Collins,” he says.

The town had 45,000 people at the time, and it seemed like a good place to raise children, so they jumped at the chance and headed west. Not too much later, child number five, Laura, was born in Fort Collins.

Morehouse hasn’t regretted a moment of either the decision to move to Fort Collins or becoming a dentist.

“I’ve enjoyed the work and I really like the people,” he says. “The best part of being a dentist is relating to the clients and being able to follow something through to completion. There are clear cut results and positive changes that we can make in people’s lives.”

The changes can be far reaching, Morehouse knows. “Periodontal problems have been linked to heart disease, problems with blood vessels and to diabetes.”

Good dental health also contributes to good health overall, he says, acknowledging how it can boost self-esteem. Healthy teeth make happy smiles.

During the time he’s been in Fort Collins, he’s not only seen the town change, he’s also seen a lot of changes in the field of dentistry. “At one time there was a lot of tooth preparation with low speed drills and no anesthetics to speak of. It was not fun for the patient.” That’s not the case any more, he says. As the field of dentistry evolves, Morehouse continually attends courses and seminars to stay current with the changing technology.

The biggest change, he says, is in the use of adhesive bonding. Bonding uses a tooth colored resin as an alternative to silver fillings and veneers.

Bondings can be used on teeth that are decayed, cracked or stained. Implants are another important change, replacing missing teeth and partial dentures, he says.

“Overall, the interest and ability to save teeth has grown,” he says. “At one time, the thought was that everyone would lose their teeth, but now the focus is on saving them. We rarely make full dentures.

“The field has expanded and is much more complex,” he continues. “Because of that, no one can be good at everything. The days of the do-it-all dentist are passed.” Based on that knowledge, Morehouse has also narrowed his scope a bit. “I used to do a lot of endodontics (root canals) but now I focus on fillings, crowns, bridges, dentures, partials and implant restoration. There’s nothing more enjoyable to me than completing a full mouth cosmetic case and greatly improving someone’s smile.”

And while Morehouse easily talks about the practice and the field of dentistry, getting him to talk about his accomplishments is, pardon the expression, like pulling teeth. For example, he refuses to brag about the volunteer work he’s done. He has, on quite a few occasions, donated his time to work on Project Self Sufficiency (PSS) clients, even taking on cases that included extensive restoration.

He will admit with a shy smile that his patients appreciate his work. “We get a lot of comments on our easy injections. They say they don’t even know it’s happening.”

His daughter, Susie, who occasionally works at the office, confirms that his style not only wins over patients but also keeps them in the fold. “He’s had patients that have been with him for 30-plus years and their teeth are still in excellent condition.

Patients constantly let us know how happy they are.”

Morehouse adopts a humble response, simply saying, “A lot of it is just understanding the patient.” 

Kay Rios, Ph.D., is a freelance writer in Fort Collins.

She writes for a variety of publications and is currently at work on a collection of creative non-fiction and a mystery novel.

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medical

physician profiles

Physicians Profiles:

Get to Know Area Physicians

by Laura Sebastian

Northern Colorado boasts some of the finest healthcare facilities around, and quality facilities attract excellent doctors. We’d like to introduce you to five of them. All are part of a new generation of physicians ranging in practice from oncology and internal medicine to geriatrics and surgery, and all work within the Poudre Valley Health System’s various facilities in Fort Collins, Loveland and Greeley. They found their way into medicine via different paths, but a love of their profession and their patients is a common thread, as is a love of Colorado itself.

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Dr. Sukhi Khera

Specialty: Internal Medicine Sub-Specialty: Geriatrics Poudre Valley Medical Group Internal Medicine Fort Collins | (970) 495-7410

Sukhi Khera, M.D., 40, divided her youth between India and England. Her father worked in customs in England, where she was born, and the family traveled back and forth between the two countries. She was also one of those fortunate souls who knew, even as a child, exactly what she wanted to do with her life.

“I remember in fifth grade being given an assignment to write an essay on what we wanted to do when we grew up,” she says. “I wrote that I wanted to be a doctor. I just knew.”

Dr. Khera’s medical education began at Dayanand Medical College, in Punjab, India. A five-year program that included one year of mandatory internship, upon graduation she received her M.B.B.S. degree, the equivalent of a medical degree in this country.

She stayed on at Dayanand Medical College for another year, working in the area of ambulatory care in rural and urban clinics and learning about the diagnosis and management of diseases, especially infectious diseases.

In 1996, Dr. Khera moved to America to continue her training, serving a three-year residency in internal medicine at New York Hospital Medical Center in Queens, New York, followed by a fellowship in geriatrics at Case Western Reserve University in Cleveland, Ohio. Board certified in both internal medicine and geriatrics and with 10 years of practicing behind her, she began working with the internal medicine branch of Poudre Valley Medical Group in Fort Collins in May of this year.

“My husband, Karamjeet, is a research pathologist in veterinarian medicine, so we moved from Connecticut, where I had been practicing medicine, to Fort Collins when he found a job here. We’d lived in Fort Collins and I’d practiced internal medicine here before, from 2004 to 2008. I loved Fort Collins then and I’m very happy to be back now.”

A self-described “mountain person,” Dr. Khera also enjoys yoga and hiking with her husband and their dog, Blue, a Siberian husky they rescued from a Denver shelter.

When she’s not enjoying that crisp mountain air or twisting herself into a yoga pretzel, Dr. Khera is dedicated to her new and growing practice, where she screens for and treats general adult illnesses, as well as cares for geriatric patients with such issues as memory impairment and dementia, urinary incontinence, balance and gait issues, medication management, failure to thrive, and depression.

“I enjoy so many aspects of medicine,” Dr. Khera says. “I like meeting people and I enjoy the detective work involved in making a diagnosis. Of course, I like all my patients, but I’m especially fond of elderly people, and have been from a young age. Growing up, my grandfather lived at home with us, so I’ve always found relationships with the elderly to be very satisfying. I like talking to them and caring for them. I feel I understand them.”

Because she treats the elderly, Dr. Khera deals often with patients facing end-of-life issues and

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decisions, help with which she feels is a crucial aspect of the care she provides.

“I feel strongly about talking to my patients about end-of-life care,” she says. “I try to help them make those difficult decisions such as whether they want resuscitation, artificial nutrition or hydration so their families don’t have that burden and they can be reassured that their wishes will be honored.”

Dr. Lawrence Davis

Specialty: General Surgery Sub-Specialty: Trauma and Acute Care Surgery Surgical Specialists of the Rockies Fort Collins | (970) 221-5878

Long ago, Lawrence Davis’, M.D., father, also a doctor, was doing missionary work providing family medical care in Guadalajara, Mexico. It was there that Davis was born, though he would later grow up in Riverside, California. Though he moved away from Mexico, witnessing the work his father did there made a lasting impression.

“I always looked up to my father and what he did,” Davis said. “And I wanted to take care of people too when I grew up.”

What cemented his future in the healing arts was an accident Davis had while in high school in which his ear was badly injured.

“It required multiple surgeries, and I became interested in surgery because of what I went though, the good care I received, and the positive impact those surgeries had on my life,” he said. “I’ll always remember the surgeon who took care of me.”

Davis, 39, received his Bachelor of Science degree in biology from the University of California in Riverside, California, and went on to receive his medical degree in 1998 from Indiana University’s School of Medicine in Indianapolis, Indiana. His surgery internship and surgical residency were served at the University of California-affiliated San Joaquin General Hospital in Stockton, California, where he was honored by being named chief surgery resident.

Additionally, in 2007, he was inducted as a Fellow of the American College of Surgeons.

Davis had fond memories of traveling through Fort Collins on the way to vacation in Estes Park each year while growing up. He and his wife, Deborah, continued the vacation tradition, eventually deciding to move to Fort Collins with their two sons, Luke, 13, Cooper, 7, and their little Wheaten terrier, Kai. “We’re a family big on soccer, and Colorado is big on soccer too, so that was another deciding factor,” he says. “I coach and my boys play. We also hike and mountain bike. And I run and train for 5Ks. I love Fort Collins, love all the activities and the fact that it’s close to Denver.”

Davis is skilled in trauma and critical care surgery, as well as thoracic and vascular surgery, though at his current job at the Surgical Specialists of the Rockies in Fort Collins (where he has been since May 2009) he no longer performs thoracic surgeries. Instead, he focuses on trauma and critical care surgery, as well as general and elective surgeries.

Some of the surgeries Davis performs include gastric,

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colon, gallbladder, hernia and vascular access surgeries, as well as breast and colon cancer surgeries.

Though acute care and trauma surgery is far different from his father’s family practice medicine, it is a perfect fit for Davis.

“I’ve always found trauma and acute care intriguing,” he says. “And it is tremendously gratifying and humbling to know you were involved in saving someone’s life.”

Dr. John Hunter

Specialty: General Surgery Sub-Specialty: Trauma Surgery Surgical Specialists of the Rockies Fort Collins | (970) 221-5878

The world of surgery came vividly alive for John Hunter, M.D., late one night while he was still in training during his first surgery rotation.

“I was planning on going into primary care medicine,” Hunter says, “But one night when I was on call in a VA hospital in Dallas, that all changed.

I was doing my rounds, checking on my patients, and there was this strange illumination around an operation that was in progress. The surgeon had injected the patient with something called Fluorescein, which exhibits intense fluorescence and is used in medicine for diagnostic purposes. They had turned on a black light and the healthy part of the woman’s exposed abdominal tissue was glowing.

The surgeon could then see the dead tissue that needed to be removed. It was just fascinating, not just visually in that CSI kind of way, but riveting too because that surgeon had this woman’s life in his hands.”

The son of a math teacher (his father) and a cancer research scientist (his mother), Hunter, 36, grew up in Houston. It was his mother’s work that initially drew him to medicine.

“Because of her, I studied science in college and then decided to go to medical school,” he says. “I didn’t want to be too specialized, but after that night at the VA hospital I knew I wanted to be a surgeon. The beauty of general surgery is the rich variety of problems encountered, but also the opportunity to be involved in more general patient care than some more narrow specialties.”

Hunter received his Bachelor of Arts degree in biology from Rice University in Houston, Texas, and his medical degree from the University of Texas Southwestern Medical School in Dallas. He went on to fulfill his general surgery residency at Scott and White Memorial Hospital in Temple, Texas, becoming board certified in surgery with training in trauma, cancer and abdominal surgery. He previously practiced general surgery at Scott and White Clinic in College Station, Texas, and was an Associate Professor of Surgery at the Texas A&M Health Science Center, also in College Station, Texas.

It was in January of this year that Hunter, who now practices at the Surgical Specialists of the Rockies in Fort Collins, moved to Fort Collins with his wife, Allison, and the couple’s menagerie of adopted/rescued animals, which Hunter calls “the gang.” They include: dogs Sammy (found in a grocery parking lot), Jackson (found malnourished

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and living in the wild), “The Weasel” (a dog who showed up on the couple’s driveway), and Dizzy (who has distemper but is doing well); and cats “Big-head Todd,” a feline-leukemia-positive gray cat with a “huge” head adopted from the Humane Society, and “Salter-Harris,” an orange tabby who was hit by a car and nursed back to health (“He is usually sweet but occasionally craves human flesh,” Hunter jokes.). Oh, and their bird, Mica, surrendered by a previous owner who could not afford to amputate a cancerous wing. It may come as no surprise that Hunter’s wife is a resident at Colorado State University’s School of Veterinary Medicine.

Of course Hunter’s love of all creatures includes the human variety, and he finds great satisfaction in caring for them.

“My favorite thing about my career is when things go well and my patients get to go home,” he says. “Or, even when we may not be able to cure someone, knowing I’ve helped alleviate their pain and given them a better quality of life. And I try to make sure I spend as much time as needed talking to a patient, listening to them, getting their questions answered and getting my information across to them. That is extremely important to me.”

Dr. Daniel Zenk

Specialty: Internal Medicine Special Interests: Preventive Medicine, Infectious Diseases & Sports Medicine Medical Clinic at Centerra, Loveland Greeley Medical Clinic, Greeley Centerra | (970) 203-7050 Greeley | (970) 353-1551

Science was always the favorite subject of Daniel Zenk, M.D., 45.

“My mother used to remind me that since I was little I’d said I’d go into medicine,” he says. “And I do remember wanting to make a difference in the world, wanting to take care of people.”

Zenk, 45, grew up with five siblings in the small farming town of Sibley, Iowa. His parents grew corn and soy beans, and Zenk and his siblings worked alongside them. To this day, Zenk still has a love of planting.

Sure of his medical path, he attended Briar Cliff College in Sioux City, Iowa, graduating summa cum laude with a Bachelor of Science degree in chemistry, and went on to earn his medical degree from the University of Iowa College of Medicine in Iowa City in 1991.

“I chose to stay in generalized internal medicine because I wanted to interact with my patients over the years, not just see them once or twice as a subspecialist does,” Zenk says.

With this goal in mind, he served his internal medicine residency at the Gunderson Clinic and LaCrosse Lutheran Hospital in LaCrosse, Wisconsin, and then went on to serve a residency in internal medicine at the University of Iowa Hospital and Clinics in Iowa City, Iowa, where he was named Resident of the Year in 1993. He is board certified in internal medicine.

Straight out of his residency in 1994, Zenk was hired at the Greeley Medical Clinic, where he still

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practices. Growing up, he and his family had spent their vacations skiing in Colorado, and when he married his wife, Susan, they decided to move here. Susan is a physical therapist, who is currently a stay-at-home-mom to the couple’s four children, sons Alex, 16, and Max, 5, and daughters Madison, 13, and Annika, 9. The family, who lives with their dog and five cats on five acres near Greeley, enjoys all there is to do in the outdoors.

“We picked Colorado because we ski, all my kids do,” Zenk says. “Camping too, boating, water skiing. And I like to fish and ride my motorcycle.”

In addition to his work at the Greeley Medical Clinic, Zenk is also a staff physician at the Medical Center of the Rockies in Loveland and at the North Colorado Medical Center in Greeley.

“My focus is on everything from coughs to colds to critical illness requiring treatment in intensive care,” Zenk says. “The whole gamut of care for adults.”

Despite his busy practice, he has served in multiple capacities for the North Colorado Medical Center and, since 2003, has served as president and chairman of Greeley Medical Clinic, as well as being on its board of directors. Additionally, he was an Assistant Clinical Professor at the University of Colorado Department of Medicine for several years.

“I’ve been at Greeley Medical Clinic for 16 years, my whole career,” he says. “And what I love most about my particular field is that I see my patients over a long period of time, so we really get to know each other.”

“Recently, when my mother died, a number of my past and present patients saw her obituary and sent cards and called. I was really humbled by their kindness. They become friends and almost family.

It’s a two-way street of respect.

“I’m lucky to have a career I love. I could see staying here forever. I may be one of those people that has just one job and keeps it forever.”

Dr. Ann Stroh

Specialty: Oncology & Hematology Medical Clinic at Centerra, Loveland (970) 203-7080

A native of Stuart, Iowa (pop. 1,500), Ann Stroh, D.O., 38, grew up on a farm with three older brothers, her business executive father and her homemaker mom. It was after her father had a heart attack when she was nine that she felt her first pull towards a career in medicine.

“At that time, kids weren’t allowed on the ward where my dad was, and I so wanted to go in and help,” Stroh says. “He survived the heart attack, but later, when I went to college, he got sick with lung cancer. Seeing him go through that convinced me I wanted to be a doctor.”

Stroh attended Central College in Pella, Iowa, where she obtained a Bachelor of Arts degree in pre-med, and then went on to earn

96

her Doctor of Osteopathy degree from Des Moines University in Des Moines, Iowa in 2001.

Her internal medicine residency was served at the University of Iowa’s satellite facility at Iowa Methodist Medical Center in Des Moines, where she was named Senior Medicine Resident of the Year in internal medicine, as well as chief resident of internal medicine. Stroh continued her training, becoming a Hematology/Oncology Fellow at the University of Iowa in Iowa City, Iowa, and board certified in both internal medicine and oncology. She has been practicing for four years, and joined the Greeley Medical Clinic in September of 2009.

Stroh had initially considered becoming a surgeon, but during an outpatient rotation in oncology, she found a new inspiration.

“These were people getting outpatient treatment, so I got to see firsthand that cancer was by no means always a death sentence,” she says. “Many people survive and thrive.”

This realization, in addition to the heartbreaking side of cancer she saw her father go through, was what made her ultimately decide to focus on oncology and hematology (which includes blood disorders such as leukemia, lymphoma, anemia and blood clotting disorders).

Before moving to Colorado, Stroh worked at three Des Moines, Iowa facilities: as a physician at Medical Oncology and Hematology Associates, as a co-investigator at the Iowa Oncology Research Association, and as Associate Medical Director of Breast Cancer Treatment at the John Stoddard Cancer Center. Though Stroh had planned on practicing in Iowa permanently, she ended up changing her mind.

“I was in the process of getting a breast cancer treatment center up and running, and I was so busy I never saw my children, who were nine months old and five years old at the time,” she recalls. “My aunt lived in Loveland and we used to vacation in Estes Park so I knew I liked the area. I checked out the Greeley Medical Clinic and applied for an opening they had.

They asked me to interview and I was hired.

It just kind of happened.”

So, in 2009, Stroh and her husband, Chris, who is in the construction business, moved to Fort Collins with their children, Carly, now 7, and Ben, now 3. Along with them came their two dogs, Bear, a Labrador, Greta, a Rottweiler mix, and Maggie and Mini, the cats. (“I’m a huge fan of animals,” she says. “I would love to have a farm someday so I could rescue them.”)

When asked what her favorite part of her work is, Stroh replies, “What comes to mind is my bond with my patients. You get so close to your cancer patients that you become part of their lives. I even still keep in contact with some of my patients back in Iowa.”

She is also passionate about being there for her cancer patients, whether or not they choose to undergo treatment.

“I make sure they understand that we’re always there for them, even if they don’t chose to do chemo,” she says. “It’s what we call ‘comfort care.’ I don’t want patients to think that just because they choose not to do treatment I won’t still see them. Even for those who are too ill to come into the office, I’ll still follow their care. The day I’m not deeply invested in my patients is the day I should not be an oncologist.” 

Fort Collins Medical Magazine & Directories 2010 2011

97

medical

SCLEROTHERAPY

Dr. Tollefson, medical director of Twenty Three Trees Medical and Wellness Spa, reduces the appearance of spider veins with a sclerotherapy treatment.

Sclerotherapy

Treating Spider Veins Experts say there is little that can be done to prevent those annoying, tiny spider veins that appear on the legs and faces of 40 to 50 percent of Americans. Fortunately, there are simple, painless procedures available to get rid of the unsightly skin discolorations.

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The short story is that spider veins occur when blood leaks backward into a vein and collects there.

Michelle Tollefson, M.D., medical director of Poudre Valley Health System’s Twenty Three Trees Medical and Wellness Spa in Fort Collins, says for treatment of spider veins on the legs, a simple injection of a concentrated saline and numbing solution into the vein causes the vein walls to swell and seal shut.

This stops the flow of blood to the tiny vein, which is then absorbed into the body and disappears.

For facial veins, which usually appear around the nose area, an Intense Pulse Light or Laser treatment is most effective.

“At Twenty Three Trees, we offer both of these options,” says Dr. Tollefson. “Our free consultation is designed to help patients decide which will be the most effective procedure.”

She says the process of injecting a saline-based

by Connie Hein

solution into spider veins – called sclerotherapy – has been done safely and successfully for many years.

The solution used at Twenty Three Trees is a mixture of saline solution and a numbing agent.

“This combination makes the process virtually pain free,” Dr. Tollefson says. “Though sometimes there is a small amount of bruising at the sight.” For best results, patients are provided with compression stockings to wear for a week after the procedure.

There is no significant pain or downtime after the sclerotherapy. “We encourage patients to walk around and go back to work or to their normal activities right after the procedure.” Dr. Tollefson says the amount of time the actual injection procedure takes depends on the number of small veins to be treated.

In addition, “Most small spider veins are not medically bothersome but are undesirable cosmetically,” Dr. Tollefson says, “so removal is not generally

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considered a medical expense,” and most insurance companies will not cover the cost. However, she says sclerotherapy procedures are relatively inexpensive, costing $350 or less.

At Twenty Three Trees, the procedure fee covers not only the actual injection procedure, but also the pre-treatment consultation, pictures taken before and after, compression support stockings and a two-week post procedure follow-up visit.

“If similar spider veins start to show up again, it is best to do touch-up treatments on the area as often as necessary, which takes less time and is less expensive,” Dr. Tollefson says.

However, if the veins become larger, and swollen or painful to the touch, greater risk of circulatory problems is present. “If the veins are larger than

about 3 millimeters in diameter, I refer them to another doctor who treats larger vein problems,” says Dr. Tollefson.

Robert Quaid, M.D., general surgeon and vein disease specialist at the Vein and Laser Center of Northern Colorado in Fort Collins, says there is little a person can do to prevent spider veins because the most common reason for this condition is genetics.

“The condition is typically inherited, but is more prevalent in women because of pressure on the legs during pregnancy and common hormone fluctuations,” he says.

He says the condition occurs when blood leaks backward into a vein and collects there. Veins carry oxygen-depleted blood from the body back to the heart. The squeezing of leg muscles pumps blood

Robert Quaid, M.D., The Vein and Laser Center of Northern Colorado

back to the heart from the lower part of the body.

Veins have valves that act as one-way flaps, and these valves prevent the blood from flowing backward as it moves up the legs. If the one-way valves become weak, that is when blood can leak back into a vein and collect there. This blood reflux enlarges the vein and it becomes a spider or varicose vein.

Another cause of spider veins, according to Dr. Quaid, can be blunt trauma to the skin. The spider veins in a traumatized area can be tied to other vein problems and should be checked by a vein specialist.

Dr. Quaid uses a vein light ultrasound to check for a larger vein problem that is supplying the spider veins. If found, these would then be treated with a laser or sclerotherapy.

Dr. Quaid injects a solution called Polidochanol when performing sclerotherapy. He says this was recently approved by the FDA for use in the U.S., but has been successfully used for many years in Europe, providing positive treatment results with no pain.

He says both the laser or sclerotherapy procedures are done in approximately 30 minutes. “We don’t like the procedure to go over 30 minutes for the comfort of the patient.”

In addition to more traditional therapies, there is Vein Wave, which Dr. Quaid considers another important option in treatment. It involves inserting a tiny wire into the vein. The wire sends out radiofrequency energy, which causes the vein wall to shrink and seal. Then, just as in sclerotherapy, the vein dies, while healthy veins nearby restore the normal flow of blood to the area. Dr. Quaid believes this therapy is best used for very small veins on the face.

Even though there is little a person can do to prevent spider veins, Dr Quaid suggests wearing sunscreen and living a healthy, active life can’t hurt.

He says diligence in watching for any changes or soreness in spider veins, as well as treatment of the veins is important to overall vein health. 

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

100

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101

CONTINUED FROM PAGE 20 by blankets, and soft pressure on the head when they change or feed babies to give them a sense of security. And, of course, low lights, warm surroundings and a quiet environment.

Especially with Level III infants, nurses try to perform hands-on, bedside duties every three hours to give infants long periods of good, undisturbed rest, says NICU nurse Claire Reed. This “clustered care” scheduled around feeding times means less periods of stress on the baby, says Peters, who has been in the PVH NICU since 1983, and became NICU nurse manager in 2004.

Cuddle time is a privilege reserved for parents, and skin-on-skin contact is recommended for 30 to 60 minutes once or twice a day to help with the bonding process between parents and baby.

“Even good things can be too stimulating for a sick infant, so we save cuddle time for mom and dad and limit our interaction with the baby,” explains Tusa.

The bedside behaviors practiced by the nursing staff are part of the substantial education that nurses share with parents. “We have a constant teaching role,” says Reed, “from giving a bath to feeding a preemie.”

The relationship with parents and nurses is one of the most vital to develop in the NICU. “It is so important to help parents feel comfortable, establish with them that they can ask any question, and help them feel like they are in the loop when it comes to care,” Reed continues. “We want to put them at ease and give them some measure of control.”

That careful consideration of the parents during this stressful time often creates lasting relation-

ships, which the “wall of graduates” attests to – a large billboard crammed with the smiling faces of toddlers, children and teenagers whose parents regularly send “updates” to the NICU staff. The hospital also organizes a “preemie reunion” every summer. The 2010 Preemie Reunion will be held at PVH on August 28. All NICU graduates are welcome to attend and can RSVP by calling (970) 495-8293.

The Team Dynamic Within the NICU, teamwork is paramount.

The NICU team must work together to ride the tide between adrenaline-pumping life or death emergent situations and long bouts of quiet nurturing spent at the bedside of sick babies. This constant change in energy level requires a team that can work together seamlessly.

“It is a total team effort here,” says Reed, who has worked in the NICU for four years. Reed, who attended nursing school after spending ten years at home with triplets, knew exactly where she wanted to practice. “I always wanted to be in the NICU working with babies and families.”

Today, Reed still enjoys the challenges and triumphs of her job. “There is a sense of fulfillment in what I do, watching the progression of a very ill baby until they are ready to go home,” she says with tears in her eyes. “From the neonatologists to the bedside nurses, we work so well together, and PVHS has been an awesome employer, always recognizing the work we do.”

Tusa moved to PVH from the pediatric department of Children’s Hospital over six years ago.

She says the two sides of her job – the adrena-

Barb Peters, NICU nurse manager, has worked with the NICU for 27 years.

line-laden one and the calm, nurturing component that enables her teach a new mother how to breastfeed for the first time – come together to create a dynamic of care that she truly enjoys.

Tusa, whose co-workers tease her about knocking people over on the way to respond to a NICU emergency, says her entire team shares that dedication to the job. “This staff is amazing. They are able to jump in and help whenever necessary.”

Drs. Guenther and Paisley concur. Dr. Guenther, who has some of his former pediatric patients giving birth to their own babies, has watched the NICU develop over the years. “I admire the staff and team in the NICU. That their concern is first and foremost the wellbeing of the infants really shows. This is one of the best NICUs, outside of a teaching hospital, in the Rocky Mountain West. There are not too many that can match what ours does.”

Dr. Paisley, a former Youth Clinic pediatrician, decided to obtain her Fellowship in neonatology at University Hospital and Children’s Hospital in Denver, while PVH was still a Level II NICU. “I had always enjoyed doing that part of pediatrics,” she says. When she finished her fellowship, she became the first neonatologist on staff at the NICU. “Because we are a smaller NICU, we do a lot better job at communicating and we have more interaction with parents than most,” says Dr. Paisley. In fact, with just three neonatologists on staff, she says they come to know the babies and families very well.

“We have the best equipment and our staff is unmatched,” Dr. Paisley continues. “Our teamwork and expert approach – I have never seen anything else like it.”

Angeline Grenz is editor at Style Magazine.

102

Medical News-

The Surgery Center of Fort Collins Receives AAAHC Accreditation Surgery Center of Fort Collins has achieved Accreditation by the Accreditation Association for Ambulatory Health Care (AAAHC).

Accreditation distinguishes this surgical center from many other outpatient surgical facilities by providing a safe work environment and the highest quality of care to patients.

Status as an accredited organization means the Surgery Center of Fort Collins has met nationally recognized standards for the provision of quality healthcare, set by the Accreditation Association. More than 4,500 ambulatory healthcare organizations across the United States are accredited by AAAHC. Not all ambulatory healthcare organizations seek accreditation; not all undergoing the on-site survey are granted accreditation.

“We believe our patients deserve the best,” stated Ross Alexander, CEO of the Surgery Center of Fort Collins. “AAAHC, an independent, not-for-profit organization, has closely examined our facility and procedures. It means that we as an organization care enough about our patients to strive for the highest quality ambulatory care possible.”

Ambulatory healthcare organizations seeking accreditation by the AAAHC undergo an extensive self-assessment and on-site survey by the Accreditation Association’s expert surveyors – volunteer physicians, nurses and administrators who are actively involved in ambulatory healthcare. The survey is consultative and educational, presenting best practices to help an organization improve its care and services.

“Going through the process challenged us to find better ways to serve our patients, and it is a constant reminder that our first responsibility is to our patients and the quality of care we provide,” said Alexander.

Surgery Center of Fort Collins

1100 E. Prospect Rd., Fort Collins 80525 (970) 494-4800 Fort Collins Medical Magazine & Directories 2010 2011

103

CONTINUED FROM PAGE 69

John James, M.D.

FORT COLLINS

1136 E. Stuart St., Bldg. 3, Suite 3200 Ft. Collins, CO 80525 (970) 221-1681

GREELEY

7251 W. 20th St., Bldg. N, Suite 1 Greeley, CO 80634 (970) 356-3907

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Partnering with Parents Parents need to know they have an Ally that will be there for them as their child develops.

The Youth Clinic emphasizes preventive medicine with their patients; preferring to enhance and maintain health. With children of our own, we understand the challenges and joys of parenthood firsthand and we are eager to share your experience.

If you are looking for a lasting partnership with friendly Physicians, come visit the Youth Clinic.

Caring for your child runs in our family.

For an appointment call:

970-482-2515 Loveland 2695 Rocky Mountain Ave., Suite 260 South Fort Collins 1214 Oak Park Dr. North Fort Collins 1200 E. Elizabeth St.

Dr. Houghton examines an X-ray from a patient’s total ankle replacement.

recognize their symptoms, problems, or conditions do not require surgical expertise, I can walk 10 feet across the clinic and ask Dr. Hecker to come and see the patient and offer his help to them. So instead of seeing just one doctor, the patient gets a comprehensive evaluation on the spot,” explains Dr. Houghton. “Likewise, if Dr. Hecker sees a patient and he thinks that patient needs major reconstructive surgery, I can then see the patient, do the reconstruction, and refer the patient back to Dr. Hecker to complete the whole course of treatment for them, including orthotics.”

The team approach is about combining the entire spectrum of palliative and curative foot and ankle care, and making it easily accessible in one practice.

“You don’t need to leave OCR,” says Dr. Houghton. “We meet once a week to reviews X-rays and work together to come up with optimal solutions.

We try to design a treatment based on what the patient wants and what would be best for that individual person. For example, if someone has a condition like mid-foot arthritis, and they are not a good candidate for surgery because of poor circulation, then we will design a treatment plan to help them maintain their function such as a custom-made brace or orthotics to help them with their arthritis.”

Doctors outside of OCR can access the expertise of the foot and ankle team easily for their patients as well.

“We want other physicians to feel comfortable referring their patients to us,” says Dr. Houghton.

“We will work closely with patients’ family doctors or other healthcare providers. We’ll provide the best comprehensive care for their patients who have foot and ankle problems. After treatment, these patients will return to the care of the referring physician.”

Dr. Hunt’s experience dealing with the foot and ankle issues of diabetic patients will likely be a popular resource for other podiatrists and physicians whose patients suffer from this all-too-common disease. With the addition of Dr. Hunt, the OCR foot and ankle team can more easily keep up with patient demand for this unique cooperative service, and meet the needs of even more patients in the area. 

Come visit our newly remodeled North location today!

Main nuMber (970) 267-9510 • Fax (970) 207-9967

www.youthclinic.com 104

Lynn M. Dean is a Colorado writer and mother of three. Her work has won first place awards from the National Federation of Press Women and Colorado Press Women.

CONTINUED FROM PAGE 69 failed in about two years,” laments Dr. Houghton.

“The ankle is more complex in its motion. Because of these failures, ankle replacements were not utilized again until the early 1990s. The newer replacements have a porous coating so that the bone will grow into them and bond with them.”

These ankle replacements are often the last hope many patients have of relieving excruciating pain and once again leading normal lives.

“The ankle replacements became of interest to provide patients with ankle arthritis (osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis) with pain relief, maintain their motion and preserve those other joints,” explains Dr. Houghton.

“Typically patients reach a point where their pain increases to a certain level, or their function is limited. That drives them to look for an answer or an option.”

The operation is not easy. Nor is recovery.

“Compared to hip and knee replacements, it is a more complicated surgery because of the anatomy of the ankle, and the challenges associated with the complex movement of the ankle joint,” says Dr. Houghton. “Because hip and knee replacements are cemented in, those joints are as strong as they are going to be the first day you put them in.”

Dr. Houghton explains that with ankle replacements, patients must wait until the bone grows into the implant before they can put any weight on their new ankles. “The length of recovery is the hardest part,” he says. “There’s usually about six weeks of very limited weight bearing, then gradually they’ll start a period of weight-bearing and physical therapy. People improve rapidly for six months and then gradually continue to improve for up to one year.”

Of course these implants are not quite “as good as new.” There are some lifestyle restrictions associated with ankle replacement implants. “We asks that patients avoid jogging, jumping and lifting more than 50 pounds,” adds Dr. Houghton.

And not everyone is a candidate for this type of surgery. “If someone has had an infection in the ankle, we would recommend not doing a replacement,” Dr. Houghton says. “Or if a patient is really young, we encourage them to wait as long as possible.”

Since Dr. Houghton joined the practice in the late 1990s, doctors at OCR have performed over 400 successful implant operations. “The science behind it is progressing and there are more implants available than ever before. The evolution continues to the point that each year it seems that modifications are being made and improvements continue to be made to help with outcomes and longevity,” he says. “OCR has become the place for people to come for this type of surgery. We get referrals from orthopaedic surgeons in Denver, Steamboat and La Junta. We’ve had people come from Kansas, Nebraska, Montana, Wyoming and New Mexico.”

Dr. Houghton has been called on to share his wealth of knowledge with his colleagues and has taught courses and workshops sponsored by professional orthopedic organizations. In the end, it is all worth it.

“I have found them to be extremely satisfying for the patients and the surgeon,” he says smiling.

“It’s one of those things you can do for patients that make a significant impact on improving their lives. That thought really makes your day. If you’re having a bad day, that thought can turn your day around 180 degrees.” 

Fort Collins Medical Magazine & Directories 2010 2011

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