OCTOBER 2011
TREATING
LUPUS
LIVING WITH
BIPOLAR DISORDER
S P E C IA L
SENIORS EDITION ww w . m Medical e d i c& a Wellness landw ellness.com Northern Colorado 2011
| www.stylemagazinecolorado.com
A S T Y L E M E D I A A N D D E S I G N , I N C . P U B L I C AT I O N : : E S T. 1 9 8 4
2
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2011
3
Northern Colorado Medical & Wellness 2011
5
6
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2011
7
7 s t y le me d ia a n d d e s i g n , i n c .
| 970.226.6400 |
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 w w w. m e d i c a l a n d w e l l n e s s . c o m Publisher Lydia Dody | lydia@stylemedia.com Editor Angeline Grenz | angie@stylemedia.com creative director Scott Prosser Senior Designer Lisa Gould digital director Austin Lamb | austin@stylemedia.com Advertising Sales EXECUTIVES Jon Ainslie (970) 219-9226 Lydia Dody (970) 227-6400 David Knight (970) 619-9846 Saundra Skrove (970) 217-9932 Office Manager/About Town Editor Ina Szwec | ina@stylemedia.com Accounting Manager Karla Vigil Circulation manager Trisha Milton Copy Editor Corey Radman Contributing Writers Julie Estlick, Jon Geller, DVM, Connie Hein, Heidi Kerr-Schlaefer, Marty Metzger, Corey Radman, Carl Simmons, Tracee Sioux, Elissa J. Tivona PhotographerS Marcus Edwards, Brent Yoder Contributing photographer Lydia Dody Affiliations Fort Collins Area Chamber of Commerce Loveland Chamber of Commerce & Visitors Center 2011 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-Northern Colorado Medical & Wellness Magazine and Poudre Valley Health System Physician Directory 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 150 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) 2266400, ext. 208. Fax (970) 226-6427. E-Mail: ina@StyleMedia.com ©2011 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.
8
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2011
9
CONTENTS
Northern Colorado Medical & Wellness
OCTO B ER 2 0 1 1
18 Back from Childhood: Dealing With Shingles
38 Home Instead Senior Care is Helping Families
22 Defining and Treating Pain
42 Maintaining Oral Health as You Age
48 Cutting Edge Laser Cataract Surgery
58 All Join Hands… and Exercise
10
on the cover: Glenn Fox cuts a handsome figure next to his 2002 Honda Gold Wing touring motorcycle. Fox is one of this generation’s motorcycle-loving seniors. Read about his story on page 31 of this magazine. Cover photography by Brent Yoder.
12 14 18 22 26 31 34 38 42 48 50 52 54 56 56 57 58 63 66
Publisher’s Letter
The Truth About Lupus
Back from Childhood: Dealing With Shingles Defining and Treating Pain
Living with Bipolar Disorder
Feeling the Wind in Your Hair
Senior Services Across Northern Colorado Home Instead Senior Care is Helping Families Maintaining Oral Health as You Age
Cutting Edge Laser Cataract Surgery
Aging’s Impact on Your Eyes
The Latest in Hearing Technology
Web Connects Patients & Caregivers
The Importance of Calcium
Benefits of Bone Density Testing
Get Fit, Give Back Calendar
All Join Hands… and Exercise
The Ladybug Fund for Emergencies
Physician Spotlight: James Danforth, M.D. Devoted to Family Medicine
The articles in this issue of Northern Colorado Medical & Wellness are presented for your general knowledge and are not a substitute for medical advice or treatment. If you have any questions or concerns about your health, please contact your doctor or healthcare provider.
Lydia’s STYLE Magazine
Publisher’s Letter
Young at Heart Looking at our cover it is hard to believe that our handsome cover model is 77 years old. Young looking, fit and sporting a beautiful Gold Wing motorcycle, Glenn Fox has a remarkable story to tell. Read “Feeling the Wind in Your Hair” to learn about his near-fatal crash and decision to get back on a bike after recovering. Now that I am officially a senior citizen, I am doing everything to push back the clock. And, speaking to other new seniors, many share my conviction to stay young thinking and engaged in life. As they say, age 50 is today’s 40, and 60 is today’s 50. Just take a peek at “All Join Hands…and Exercise” to see how some active seniors stay fit by square dancing several times a week. Robyn and Bud Phillips took up dancing a year ago, and now you can see them on various dance floors four times a week. They invited me to one of their dances at Club Tico and I immediately got caught up in the challenge of trying to keep up with the other dancers in my square. It was lots of fun and great exercise! The October Northern Colorado Medical & Wellness has become our annual issue with a focus on senior health and lifestyle. Active seniors have an improved quality of life these days because of the many new innovations and aids to maintaining good health. One significant improvement in cataract surgery can be found at Eye Center of Northern Colorado. It is the first practice in Colorado, and only the twelfth in the nation, to get the LenSx laser. This is a significant advancement in precision and offers greater margins of safety. Read “Cutting Edge Laser Cataract Surgery.” And, for those of you finding that your hearing might need assistance, look over “The Latest in Hearing Technology” for a current overview of some of the state-of-the-art appliances now available. Keeping a healthy and attractive smile is now easier than ever before with the new techniques and technology available today. Read what area dental professionals say in “Maintaining Oral Health As You Age” for informative advice about preserving oral health and enhancing your smile. This issue is packed with lots of great information to help you stay informed about health and wellness topics. I hope you enjoy reading the many interesting articles that relate to staying healthy and keeping a high quality of life as we age. In good health, lydia@stylemedia.com
12
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2011
13
MEDICAL
Lupus
Sue Worrell, diagnosed with lupus 23 years ago, stands near the finish line of the 2011 Walk for Lupus Now at City Park in Denver. The walk raised over $77,000 for lupus research.
T he T r u th A bo u t L U P U S By Heidi Kerr-Schlaefer
T
wenty or more years ago, a diagnosis of lupus was much more ominous than it is today. With early diagnosis, drug management and healthier lifestyles, lupus patients can live full lives, but this doesn’t mean there aren’t bumps along the way, and the disease is often misunderstood.
What is Lupus?
Lupus is an autoimmune disease, meaning it affects the body’s immune system, the part of the body that fights off viruses, bacteria and germs. A lupus patient forms antibodies that start attacking the body’s cells, primarily the DNA, or they attack the protein encapsulating the DNA. It is estimated that between 1.5 to 2 million Americans have some form of lupus. “The fundamental problem is that your body is making antibodies that it shouldn’t make,” says Michael Thakor, M.D., F.A.C.R., of the Arthritis & Rheumatology Clinic of Northern Colorado. Medical science has not discovered the trigger for lupus, although there is a genetic component to the disease. Drug induced lupus does occur, which leads some to believe there is an outside trigger that, along with the right genetic factors,
14
will cause lupus to develop. While genetics play a part, it’s not a simple dot-to-dot connection. If you have the lupus it is not a given that your children will inherit the disease. “The chances increase, but it’s not that great,” says Dr. Thakor. “It’s a complex genetic process and we don’t understand it completely.” Patients with lupus often make different antibodies, and therefore symptoms can vary between sufferers of the disease. However, people with lupus do tend to make a specific group of antibodies and when a doctor suspects a patient may have the disease the doctor will test for these. According to the Lupus Foundation there are four forms of lupus with the most common being systemic lupus erythematosus. It can be mild or severe and the more serious complications involve the internal organs. Drug induced lupus occurs when lupus-like symptoms develop from prescription drug use. Symptoms are similar to systemic lupus, although internal organs are rarely affected. Cutaneous lupus erythematosus is related to the skin only, causing rashes and lesions. Approximately 10 percent of patients with this form of the disease will develop systemic lupus.
Neonatal lupus is extremely rare, and affects the unborn infants of mothers with lupus. The mother’s antibodies began attacking the infant while it is still in the womb, and while some babies are born with rashes, liver problems or low bloodcell counts, these medical condition often disappear within months and have no lasting effect. In rare instances the baby is born with serious heart defects. It is important to note, however, that most mothers with lupus give birth to healthy babies. For unknown reasons, certain ethnic groups, including Hispanics, African Americans and Asians, tend to develop a more severe type of lupus. It is also much more common in women than in man. In fact, one male develops lupus for every three female lupus patients. “The single biggest misconception about lupus is that it’s a fatal disease and in fact it’s generally not fatal,” explains Dr. Thakor. “It is a chronic illness that we manage – it can be fatal, but that’s actually a very rare thing, particularly in this day and age.”
Diagnosis
Some people have mild lupus only affecting their skin, however, in others it can be severe
Lydia’s STYLE Magazine
and even life threatening. Organ damage is more likely to develop in a young lupus patient, although, as Dr. Thakor points out, there are no absolutes with lupus. “There’s a spectrum of the disease,” says Dr. Thakor. “Most people are more in the middle.” The most typical indications of lupus are joint pain, fatigue and rash. However, other parts of the body can be affected including the cardiovascular system, gastrointestinal system, musculoskeletal system, nervous system and renal (kidney) system. There can also be blood disorders, as well as oral disease. The American College of Rheumatology has developed clinical and laboratory criteria to help physicians diagnose lupus, but even these 11 criterions do not always fit every patient. There are some strong indicators that would lead a doctor to suspect lupus, they include joint pain, fatigue, rash, blueness of the fingers after cold exposure, and hair loss, but the real red flags are the classic butterfly rash, severe anemia, protein in the urine or fluid building up on the heart or lungs. For a list of the eleven criteria, visit www. MayoClinic.com/health/lupus. The multitude of symptoms and affected areas of the body can make lupus difficult to diagnose, and the process of diagnoses often takes time. Unfortunately, a lupus test can come back as indeterminate, or as a false positive, and sometimes even as a false negative. “That’s why it can sometimes take years to get a diagnosis,” says Dr. Thakor.
Treatment
The drug Plaquenil, originally an anti-malaria drug, has become the foundation of lupus treatment for years because it helps joint pain, fatigue and rash, and it may stop the progression of the disease. “There are very few drugs actually approved for the treatment of lupus,” says Dr. Thakor. “Plaquenil is very often our first treatment.” Immunosuppressant drugs, such as steroids, are often prescribed to lupus patient. Today, the side effects of steroid use is often more harmful to patients than their disease, because long-term steroid use can result in heart problems, including heart attack. According to an article published in 2008 by the Lupus Foundation, heart disease is now the leading cause of death among people living with autoimmune disease. The first new drug approved in 56 years specifically for the treatment of lupus came out in March of this year. While this is an exciting development in the treatment of lupus, there is still uncertainty surrounding the drug Benlysta. “It seems to work on the milder symptoms, but it is incredibly expensive at over $30,000 a year, and there’s some debate as to how many people really benefit from it,” says Dr. Thakor. He goes on explain the real excitement over the introduction of Benlysta is that it may help minimize steroid use in lupus patients. But the true benefits are still being explored. “We don’t entirely know where it’s going to fit in because it’s so expensive, and if over time it seems like not a lot of patients are benefiting from it, is it worth it?” questions Dr. Thakor. “But, if a lot of patients do benefit and we’re able to
Northern Colorado Medical & Wellness 2011
15
Michael Thakor, M.D., Arthritis & Rheumatology Clinic of Northern Colorado
control symptoms without steroids, maybe five years from now we’ll be using it widely.”
Living with Lupus
Lupus patients often recall being misdiagnosed with other medical conditions, as was true for Mary Montanye, age 62. She was diagnosed in 1995, while living in California. “I had had all kinds of symptoms for years and no doctor could really figure out what was wrong with me,” she recalls. “They were always treating the symptoms but never getting to the bottom of it.” Suffering from nine of the 11 criterions set by the American College of Rheumatology, Montanye’s doctor finally decided she had one of three things: cancer, multiple sclerosis or lupus. After this frightening list of possibilities, Montanye was referred to a rheumatologist who eventually diagnosed her with lupus. At the time, Montanye was a psychotherapist specializing in abused and neglected children – an extremely demanding career. Stress is one of the major causes of lupus flares. Due to a secondary diagnosis of osteoporosis, Montanye couldn’t go on the usual steroid treatment for her disease. She did start taking Plaquenil and she began doing intense research on lupus. “What I was looking for were the things I could do myself, the things that I had some control over,” says Montanye. Within three years of her diagnosis, Montanye and her husband made the life-altering decision
16
Lydia’s STYLE Magazine
to take an early retirement and move to a cabin on the woods outside of Fort Collins. She also made some drastic lifestyle changes, including eating a healthy, vegetarian diet and exercising regularly with a trainer. Five years ago, after discovering that eating dairy seemed to cause her lupus to flare, Montanye cut all dairy products from her diet and within two weeks her pain was gone. Today, she is virtually pain free and is off all medications, even pain relievers. “I would tell someone who was recently diagnosed with lupus that they have more power over how they feel than they think they do,” she says. “It’s going to take some work on their part. They need to do as much research on their own as they can about diet, stress alleviation and exercise. “Lupus will change your life, but it’s not a death sentence,” she adds. One of the biggest life adjustments Sue Worrell had to make after her lupus diagnosis was to avoid sunshine. Sun can actually cause lupus flares, and this can be difficult for patients living in Colorado. Worrell started having aches and pains along with low-grade fever and fatigue in her late 20s. “When I went to the doctor he’d just say, ‘You’ve just got a touch of the bug,’” remembers Worrell. Like Montanye, Worrell was also facing stress in her life. She was a working single mother of two children. It took a year for her doctors to reach the diagnosis of lupus. Twenty-three years later and still working full-time, Worrell has kept her disease in check with Plaquenil and a positive mindset. She calls herself “one of the lucky ones” because none of her internal organs have been affected by lupus. However, this doesn’t mean Worrell isn’t active in the search for a cure. Each year she puts together her Foxy Ladies team for Walk for Lupus Now, a Lupus Foundation of American event in Denver. “I enjoy contributing to the walk and my team usually does quite well in getting contributions. I’m proud of them every year,” says Worrell. People with lupus often look much better than they actually feel and this can be difficult for friends and family to understand. Both Montanye and Worrell talked about the guilt they have experienced over the years due to missing family functions, work or other events. “There’s a lot of guilt,” says Montayne, “especially for women because we have to take such good care of ourselves when we have this diseases, and that takes time away from our friends and family – but if we don’t take good care of ourselves we’ll have no time for anyone.” To learn more about lupus, visit the Lupus Foundation of America online at www.Lupus.org.
Heidi Kerr-Schlaefer is a journalist and freelance writer from Northern Colorado. She is also the Mayor of HeidiTown.com, a blog about Colorado events and festivals.
Northern Colorado Medical & Wellness 2011
17
MEDICAL
Shingles
B ac k fro m C hildhood :
D ealing W ith S hingles
M
any people contract chickenpox during their childhood. If that childhood was decades ago, long before the varicella vaccine, it may be time to prepare against another virus: shingles. Shingles is most common in people over the age of 50, and chances of it occurring increase with age. Some experts estimate that half of those who live to the age of 85 will
18
experience shingles at some point in their lives. However, shingles only occurs with those who have previously had chickenpox. “It almost sounds like a bad science-fiction movie from the ‘50s,” says John L. Bender, M.D., FAAFP, of Miramont Family Medicine in Fort Collins, “but what happens is: we get chickenpox, and it’s head-to-toe; but the virus continues to live on inside us, lying dormant in one nerve. There are 12 pairs of cranial nerves and 31 pairs of spinal nerves, and the virus could be in any one of those nerves – but it’s
By Carl Simmons
only in one of them, and there’s no way to know which one until there’s a outbreak. A person goes for years without any symptoms, and then something happens to the immune system – stress, a cold, advancing age – and the virus reactivates.” When that happens, the results are usually much more painful than chickenpox. “Unlike when you got it 50 years earlier, when it was chickenpox and just irritation, shingles appear in a band of blisters along that one nerve,” Dr. Bender says. “It could come across one
Lydia’s STYLE Magazine
S pinal nerves C1 C2 C3 C4 C5 C6 C7 C8
I ntracranial N erves Optic Nerve
Cervical Nerves
Trochlear Nerve Abducens Nerve
Olfactory Nerve Oculomotor Nerve Trigeminal Nerve
T1
ç
Shingles are painful and generally cause blisters on the skin. The real danger, however, lies in possible complications such as encephalitis, facial paralysis and healing or balance problems.
T2 T3
Thoracic Nerves
T4 T5 T6 T7
The chickenpox virus can lie dormant in one nerve somewhere in the 12 pairs of cranial nerves or 31 pairs of spinal nerves – and there is no way to know which one until you have an outbreak of shingles.
ç
side of the chest, or across the forehead and eyes, depending on what nerve it’s located in.” Usually, effects of the disease last up to six weeks. However, for about 10 percent of patients, the pain continues long after the blisters have cleared (known as postherpetic neuralgia), and the pain can potentially be lifelong. Also, if the disease occurs in or around an eye (ophthalmic shingles), it can cause painful infections that can result in a loss of vision. It’s also possible, depending on which nerves are affected, that shingles can cause encephalitis, facial paralysis, or hearing or balance problems. Because of these possible complications, early identification is key. Also, not all shingles cases occur when you’re older. Jessica Jaques, who works at Miramont’s Wellington office and is still in her 30s, contracted shingles about a year ago. “I noticed that the back of my head was starting to hurt; I had a lot of neck pain,” Jaques shares. “I saw a physician two or three days later. They checked the back of my head and looked at my scalp, and discovered that it was shingles. “I was very surprised,” she adds. “I had never experienced that kind of pain before and I had no idea what it could be. My dad had gotten shingles in his 50s, and working in a doctor’s office I’ve seen cases of it, but I never would have guessed that’s what it was.” Treatment with anti-viral medications within 72 hours of the first symptoms is critical to reducing the effects of the disease, both shortterm and long-term. In Jacque’s case, the disease was caught and treated in time. “The medications worked,” she says. “Within four or five days, the pain was already far less than it had been.” “Medications don’t cure the disease,” Dr. Bender points out, “but it does relieve symptoms, so that patients only feel the effects of the disease for three weeks instead of six. It
Northern Colorado Medical & Wellness 2011
T8 T9 T10 T11 T12 L1 L2 L3 L4 L5
Lumbar Nerves S1 S2 S3 S4 S5 So
Facial Nerve
Sacral Nerves
Glossopharyngeal Nerve Vargus Nerve
Vestibulocochlear Nerve Spinal Accessory Nerve Hypoglossal Nerve
Coccygeal Nerve
19
John L. Bender, M.D., Miramont Family Medicine
also reduces the likelihood of chronic pain from postherpetic neuralgia.” Fortunately, shingles is nowhere as contagious a disease as chickenpox. “It can be spread,” Dr. Bender says, “but only if a person comes in contact with the blisters. Then they could catch the virus, but if so, they would get it as chickenpox.” Also, immunization is available in one of two forms – either via the chickenpox (varicella) vaccine administered usually during childhood or the shingles (varicella-zoster) vaccine, which Dr. Bender routinely gives to patients 65 or older. “Getting the chickenpox vaccine during childhood might prevent it indirectly, but we wouldn’t know whether someone received lifelong protection from a chickenpox vaccine until he or she was around 80,” he says. Aside from vaccination, Dr. Bender says, there’s no simple way to avoid shingles, besides “staying healthy and keeping stress to a minimum. If your immune system is impaired, you’re more prone to get it.” “Long term,” he adds, “if we want to eradicate this disease, we need to vaccinate all children for chickenpox and all adults over 65 with the varicella-zoster vaccine.” Personal experience has made Jaques a believer. “Absolutely get the shingles vaccine,” she says. “People have absolutely no idea how much more painful it is to get shingles than it is to get vaccinated. Shingles is not fun to have.”
Carl Simmons is a freelance writer and editor in Loveland and author of the six-book Biblestudy series Growing Out: From Disciples to Disciplers (Group Publishing). You can learn more about Carl at carlsimmonslive.com.
20
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2011
21
MEDICAL
Pain Management
Defining and Treating Pain By Angeline Grenz
P
hantom pains are the sensations amputees sometimes suffer where they feel pain in the missing limb. The pain can be an ache in a hand long gone. The pain is difficult to define – does it rest in a limb no longer attached to the body? Or does the pain come from a more cerebral place? Phantom pain gives us a good example of the correlation between pain in our mind and pain in our body. The two, research is showing, are more interconnected than previously realized, making the expression “it is all in my head” carry a greater meaning for those 50 million Americans suffering from chronic pain. New research is suggesting that pain is a biopsychosocial phenomenon – containing physical, psychological and emotional components, and pointing to a conclusion that unless each component has been treated appropriately, chronic pain sufferers may not experience relief.
A New Definition for Pain
“Stress affects you physically and having a medical condition is very stressful,” says Daniel Bruns, PsyD, health psychologist at Health Psychology Associates in Greeley. “The two interact, so it is my job is to understand that interaction and how to best help a person.”
22
Daniel Bruns, PsyD, Health Psychology Associates, Greeley
George Girardi, M.D., Front Range Pain Medicine, Fort Collins
Dr. Bruns works primarily with medical patients. He became interested in the psychology of pain when working with a patient over two decades ago who had a severe pain disorder and had undergone multiple surgeries with no improvement. “The patient began to have additional problems due to the surgeries,” recalls Dr. Bruns. “It turned out that the pain was stress related. From the outset this patient didn’t get the right kind of care. What he got was very expensive, and made him worse.” Dr. Bruns has spent 25 years researching and studying the psychosocial aspects of pain. His research has impacted national medical treatment guidelines and workers’ compensation laws in California, Colorado, Montana and Oklahoma. He has developed assessment tools for diagnosing pain and was recently awarded a distiguished national award, the Timothy Jeffrey Award for Outstanding Contributions to Health Psychology by the American Psychological Foundation. “Pain is a paradox in many ways,” says Dr. Bruns. “Everybody knows what pain is – except for scientists. We can’t exactly figure out what it is. There are some things about pain that are seemingly very simple but turn out to be incredibly complicated. “The simplistic model is that pain is always caused by tissue damage,” Dr. Bruns continues. “But it turns out from everything we know, that
is not true.” Yet, pain is one of the single most common reasons a person goes to see a doctor. “It is a subjective experience, which is invisible to tests,” he says. Consider the International Association for the Study of Pain’s (IASP) definition of pain: Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” IASP adds this caveat to their definition: “Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life… It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional experience.” “They [the IASP] concluded that pain has a dual nature,” says Dr. Bruns. “Part of pain is a sensory experience – like touch or taste – and the other part is an emotional experience, like depression or anxiety. People don’t realize that. Neurologically, pain is wired into our emotions.”
Learning More About the Brain
Scientists are using functional magnetic resonance imaging (fMRI) scans to learn more about how our brain interprets pain. Functional MRIs can be used to map changes in the brain in response to neural activity. These scans can reveal what the brain is doing during various situations, such
Lydia’s STYLE Magazine
as while feeling pain. One of the conclusions from functional MRI testing, says Dr. Bruns, is that the sensory system can actually become wired to the memory system – enabling a memory to activate pain. “In chronic pain states, the brain actually begins to rewire itself,” says Dr. Bruns. “If a patient recalls a traumatic accident, it can actually reactivate the pain that was experienced.” These new neural connections wire together the pain center and the emotional center, and wire these together to other parts of the brain, like the motor center. Dr. Bruns looks for ways to return pain to a sensory experience. Cognitive therapies can work at a neurological level by altering dysfunctional connections, and creating new, more functional ones.
The Pain is in Your Head
Today, there are people who have severe pain and doctors find nothing wrong with them physically. This leaves many people fearing that unexplainable pain is “all in their heads,” says Dr. Bruns. He references a person with phantom pain from an amputated hand: the nerve that used to go to your hand is now misbehaving; your nervous system is not working right. “In a way you could say that it is in his head, but that does not mean the pain is not real. All of our perceptions are in our head.” Pain specialist, George Girardi, M.D., with Front Range Pain Medicine in Fort Collins, concurs, “Pain is in your head – it is what is ultimately telling you what hurts – but that doesn’t mean it is not a real pain.” Dr. Girardi emphasizes that just because the source of pain does not show up on an MRI, it does not mean there is no physical source of pain. Conditions such as scarring can pull on nerves and create pain, and there exists “failed back surgery syndrome,” where a doctor may have corrected the problem, but the patient still has pain. To that end, Dr. Girardi and other pain specialists are charged with determining what they call “the pain generator” – the source of the pain. While a portion of pain’s path through the body is well understood by physicians, such as the path different types of pain take along nerves to the spinal cord and then on to the brain, when pain hits the brain the process is still much of a mystery. “We are very familiar with the course that pain takes,” says Dr. Girardi. “But once it gets up to the central nervous system, the brain, and how pain is processed – I am not sure we know that much about that.” Because many people worry that their pain is imagined, they often hesitate to seek help after the physical symptoms have been treated. They worry the pain is a sign of a mental health issue and that stigma often keeps patients from seeking Dr. Bruns’ help. “People worry about it being ‘all in their head’ and feel tremendous shame over that. It shouldn’t be that way.” Dr. Bruns is challenged with helping patients understand the interconnected nature of mind and body and how behavior treatment can help. “A lot of people don’t understand what is going on medically. I have to explain what is happening
Northern Colorado Medical & Wellness 2011
23
so that they can understand and know how they can improve.”
Treating Chronic Pain with Behavioral Therapy
“How most people cope with pain is very individualized,” says Dr. Girardi. “There is definitely an emotional component.” He adds that addressing the psychosocial aspect of pain is a must for patients who are treated for chronic pain for several months or longer. As a general rule of thumb, Dr. Bruns says at around three months most injuries begin to resolve (broken legs, throwing your back out), “but if it goes on beyond this period, if a person is not improving and there is not an obvious
reason why, then it is probably evolving into a biopsychosocial condition.” Dr. Bruns looks at the emotions and social factors that cause trauma beyond the tissue damage. “The brain is not designed to distinguish between intense emotional and physical pain. If you don’t address the emotional pain, you can’t get better,” he says. In a very practical sense, treating that dynamic of pain can include probing areas such as stress, depression and difficulty sleeping. Dr. Bruns works with his patients on relaxation training by helping them to reduce muscle contraction pain and spasms. He teaches pain management techniques that can be used in place of medications, and introduces techniques, such as calming exercises,
to help people find natural ways to sleep better. Finally, he offers counseling for anxiety, depression and posttraumatic stress disorders. “There is no question that chronic pain syndromes lead to a lot of emotional distress (like stress and depression) that interfere with work, family lives, etc.,” says Dr. Girardi. “When you add in medications, they can create depressive symptoms and make people lethargic. A lot of the medications also have hormonal side effects, such as narcotics that can lead to erectile dysfunction. It can be a cascading effect.” Dr. Girardi emphasizes the importance of having a good support structure while being treated for chronic pain. Family and friends have an important role in motivating a patient to follow their treatment program and can offer assistance in areas of lifestyle that may be permanently altered. Adequate sleep is an important factor as well. “Chronic [pain] conditions are much more likely to develop in people who sleep poorly,” says Dr. Bruns. “Our research has found that depression, sleep and pain are a cluster of symptoms, and if you can make any one of those better, you tend to make the others better.” Behavioral sleep techniques have been found to work better over the long term than sleep medications for people who are struggling with insomnia. The therapy involves both developing good habits [like setting a good sleep schedule] and weeding out poor ones [like watching TV while trying to fall asleep]. “Over the course of time, these practices are often more effective than medications,” he says. Dr. Bruns also encourages people to be as active as they can. If not, bodies can get weaker and weaker. “Being active helps your body recover,” he says. “Use the Goldilocks principle: in rehabilitation, some people will try too hard and that sets them back; some people won’t do enough and that sets them back. Find that just-right amount of activity.” Dr. Bruns also points out a danger of opioids and pain relievers. “What people don’t realize is that these can also cause pain.” They tamper with your pain sensory system and cause pain when you go through withdrawal, he explains, pointing to patients who have been in pain for years and could not get over their chronic pain until they discontinued use of their medications. “As soon as their pain medication would wear off, they would feel withdrawal pain. But they were thinking they were still treating their original pain.” Dr. Bruns also employs cognitive behavioral therapy for pain patients to help them learn that they can “control how they feel by controlling how they think.” Cognitive behavioral therapy has been found in some instances to be as effective as elective surgery to relieve pain. “The fact that such different techniques are both effective [surgery and behavioral therapy] is remarkable.” The two, however, are not mutually exclusive. “Sometimes a patient needs both,” he says. Angeline Grenz is editor for Northern Colorado Medical & Wellness Magazine.
24
Lydia’s STYLE Magazine
MEDICAL
Bipolar Disorder
L iving with
B ipolar D isorder By Tracee Sioux
B
ipolar disorder is being diagnosed more often than ever before, primarily because doctors and psychiatrists are getting better at recognizing the symptoms and diagnosing it correctly. Bipolar disorder is a biochemical medical disorder of the brain; it is also called a mood disorder and was formerly known as manic-depressive disorder. It can be destructive and costly to those who suffer from it. Bipolar disorder manifests as profound depression in most people most of the time, but at other times, a mania or hypomania manifests, causing them to be euphoric, irritable, impulsive, have racing thoughts, excessive energy, incredible creativity, insomnia and erratic behavior. Bipolar disorder is a genetic disease, which means that most of the time it is inherited, though some people may get the disorder from a spontaneous gene mutation. The median onset of bipolar disorder is 17 years old. It is something a person is born with and it seems to come on as the child’s brain chemistry shifts into adult brain chemistry.
Bipolar Type I and Bipolar Type II
“Bipolar I is the one that people are most
26
familiar with because people see it on TV,” explains Tammas Kelly, M.D., psychiatrist and director of the Depression and Bipolar Clinic of Colorado in Fort Collins and clinical professor of psychiatry at George Washington University in Washington, D.C. “That’s when people have full blown manic attacks that usually have some type of psychotic component to them or they get into severe trouble immediately because they are so hyper and up. Only .5 percent to 1 percent of the population has Bipolar I.” Bipolar Type II is the far more common type of disorder. It is the lesser-known disorder because Bipolar Type I was recognized long before Bipolar Type II, which was classified in 1992. It is a less extreme form, though it can still have a serious impact on someone’s life. “Bipolar II disorder effects about 5 percent of the population and that’s where the ups are not as severe and it’s much harder to detect,” explains Dr. Kelly. “A classic example would be somebody who is euphoric and full of energy, their mind is racing and they can think of a lot of new ideas about how to do things. They’ll be the life of the party; they’ll want to joke all the time. That’s the bright side of hypomania. There’s not much harm in that, unless somebody starts spending a lot of money they don’t have or they think they can get back into drinking if
they’ve previously had drug or alcohol problems. “The dark side of mania is that there’s a lot more irritability,” Dr. Kelly continues. “They can’t concentrate because their mind is going so fast. They might become physically abusive or get into trouble with the law or their spouse.” There is a third bipolar category, Bipolar NOS (Not Otherwise Specified), meaning the person displays bipolar characteristics, but does not fit the criteria of Bipolar Type I or Bipolar Type II. This diagnosis is often used when other psychiatric criteria are also present, such as some forms of residual schizophrenia, some forms of psychosis, or the doctor isn’t presented with enough information to classify a patient as Bipolar Type I or Type II.
Treatment
There is a great deal of research about how to treat Bipolar Type I, according to Dr. Kelly. Unfortunately, there is almost no research at all about how to treat Bipolar Type II. There are no Food and Drug Administration (FDA) approved treatments for Bipolar Type II, either. Bipolar Type I is treated with approximately four medications at a time, including a combination of mood stabilizers, such as Depakote, Lithium, Lamictal or Tegretol and anti-psychotics, such as Seroquel.
Lydia’s STYLE Magazine
Psychiatrists are left to their own experience, networking with other mental health professionals and reading what little literature there is on the topic in treating Bipolar Type II, explains Dr. Kelly. Some medications used to treat Bipolar Type II include Lamotrigine, Lamictal, Trileptal and Abilify. “Bipolar II is the predominate type of bipolar that I treat,” Dr. Kelly says. “I have one of the largest research projects and scientific papers on how to treat Bipolar II disorder. That particular research paper was on high doses of thyroid medication. Adding high dose thyroid treatment can be very helpful to bipolar patients.” Antidepressant medications can be very harmful to patients with bipolar disorder, says Dr. Kelly. “[On antidepressants] some patients will immediately feel worse, anxious, agitated and more depressed,” he explains. “Some will feel more euphoric. Some patients will be pushed into a hypomanic episode or manic episode. Some medications will work for a period of time, for a week or a year and then will stop working. Many patients will try three or four antidepressants before someone will decide that maybe they don’t have depression; maybe they have bipolar disorder. A lot of people are misdiagnosed. We try to stay away from antidepressants for the vast majority of bipolar patients.” Dr. Kelly also recommends psychotherapy for treatment of all types of bipolar as an adjunct to medication. Psychotherapy can help patients develop strategies to fight depression, such as getting exercise or socializing, and assist patients in developing skills such as breathing exercises or meditation to calm their minds in hypomanic or manic states. It can also help patients resolve issues from their past, issues in their marriage or issues impacting their job performance. “Psychotherapy is invaluable in the treatment of all types of bipolar as an adjunct,” explains Dr. Kelly. “The people who do the best are the people who do a combination of medications and talk therapy. For 98 percent of people, it’s a lifelong illness. They don’t necessarily need psychotherapy for life, but to get to a stable position and minimize the impact of the illness, a couple of years of therapy can be very helpful.” The first place to start is psycho-education, says Dr. Kelly. Becoming knowledgeable about a diagnosis gives it less control over your life. The book, Why Am I Still Depressed?, by Jim Phelps will put people’s understanding of bipolar disorder “way ahead of the game,” says Dr. Kelly.
The Importance of Treatment
“Untreated or under-treated bipolar disorder can decrease a person’s life span by 25 years,” says Dr. Kelly. “There are a number of factors [that contribute to this], some we don’t understand. The number one cause is actually cardiovascular disease that kills people early. We don’t know why. There are also a number of suicides. People, when they’re manic or hypomanic, do risky things. About 50 percent of people with any type of bipolar disorder have had some type of drug or alcohol problem in their life. They may be
Northern Colorado Medical & Wellness 2011
27
Tammas Kelly, M.D., psychiatrist and director of the Depression and Bipolar Clinic of Colorado in Fort Collins
self-medicating and/or using because part of the illness is to seek out pleasurable things and people’s judgments are impaired.” The Depression and Bipolar Support Alliance gives some possible explanations for the link between bipolar disorder and cardiovascular disease on their website: “Research over the past two decades has shown that people with heart disease are more likely to suffer from depression than otherwise healthy people, and conversely, that people with depression are at greater risk for developing heart disease. Furthermore, people with heart disease who are depressed have an increased risk of death after a heart attack compared to those who are not depressed. Depression may make it harder to take the medications needed and to carry out the treatment for heart disease.” “Depression and anxiety disorders may affect heart rhythms, increase blood pressure, and alter blood clotting,” they continue. “They can also lead to elevated insulin and cholesterol levels. These risk factors, with obesity, form a group of signs and symptoms that often serve as both a predictor of and a response to heart disease. Furthermore, depression or anxiety may result in chronically elevated levels of stress hormones, such as cortisol and adrenaline. As high levels of stress hormones are signaling a ‘fight or flight’ reaction, the body’s metabolism is diverted away from the type of tissue repair needed in heart disease.” Bipolar is also a significant social problem. “Of the people who land in jail, about 50 percent probably have a bipolar mental illness,” says Dr. Kelly. “I worked in the jail part-time for three years and the psychologist who worked there for over 15 years estimated
28
Lydia’s STYLE Magazine
that half the population had bipolar disorder.” Bipolar disorder plays fairly across every race, creed, religion and socio-economic line. However, it’s so destructive that otherwise talented, creative, smart people end up far worse on the socio-economic scale than where they started. “What happens is, if it’s not treated properly or not treated at all, they can slide down the social scale and they don’t end up in very good positions,” Dr. Kelly explains. “They tend to lose jobs and lose marriages.”
Living with Bipolar Disorder
The Fort Collins Chapter of the Depression and Bipolar Support Alliance, facilitated by Marc Rope, gives people with a bipolar diagnosis an opportunity to learn from each other and support each other. “I try to get people there who really want to get better; it’s not just a whine party, so to speak,” says Rope. “We talk about coping skills and strategies to survive the illness. We offer a place where people can come that gives them hope. It’s a place of learning and sharing, so people can achieve a life again. We focus on getting treatments that will improve our lives and effectively treat the disorder.” Rope’s own life has been severely impacted by Bipolar NOS. “I was depressed my entire life,” recounts Rope. “I got on antidepressant medication and it switched me from depression to mania, but I didn’t recognize it as mania. I was happy, excited and energized. I thought it was a good thing. For the first time in my life – I was in my late 30s – I was actually happy. I didn’t know what that felt like for almost 40 years, to be truly happy and enjoy life. It was an amazing time for me. “It was euphoric hypomania and it lasted for three years and I would have gone on being that way,” he continues, “except I couldn’t sleep for more than three hours a night. After three years of sleep deprivation I had a psychotic break. I started having delusions and hallucinations. It was pretty horrible. I was committed to a hospital for three weeks. I was married for over 20 years, we had a house, she had three kids, I had my dream job. I lost it all. I was too disabled to go back to my job. We got divorced and sold the house.” Still, Rope has not lost hope that he will find the right medication combinations and have a meaningful life. He sees people in his support group do it every day. “I see amazing people in our group who are very high functioning. They still continue to have a functional life, having a job and a marriage, and it’s a fantastic thing. I’m always very impressed by that and I hope to someday get beyond my limitations and get my life back.” The Fort Collins Chapter of the Depression and Bipolar Support Alliance support group meets Mondays from 6:30 - 8:30 p.m. at the American Legion Hall. Tracee Sioux is a freelance writer and can be found at www.linkedin.com/in/traceesioux.
Northern Colorado Medical & Wellness 2011
29
l Seniors Sectio n a i c e Sp
Feeling the Wind
in Your Hair
I nsi d e this Edition: 31 – Feeling the Wind in Your Hair
R
By Tracee Sioux
iding motorcycles, says Glenn Fox, is the closest he can get to flying now. This sprightly 77-year-old took up riding about 5-and-a-half years ago, when an old friend he flew with in the Navy invited him to ride. He liked it so much he went to Tri-City Cycle and bought his first bike.
42 – Maintaining Oral Health as You Age
34 – Senior Services Across Northern Colorado
48 – Cutting Edge Laser Cataract Surgery
38 – Home Instead Senior Care is Helping Families
50 – Aging’s Impact on Your Eyes
Northern Colorado Medical & Wellness 2011
31
allow riders to converse with each other directly are among the popular choices.
After Fox’s 10 years flying for the Navy in the 1960s, during which time he had driven a little moped, he flew for 35 years for Continental Airlines. When he was forced to retire by regulation at 60 years old, he stayed on as a test pilot for another six years. He has given up flight for the joy of speed on two wheels. Fox averages 1,000 miles a month on his bike. “I ride like you would drive your car,” he says. “When I go shopping, I do it on my motorcycle. I ride a Gold Wing, it’s the top of the line big Honda motorcycle with built-in saddle bags, a trunk, an AM/FM stereo, and reverse because it’s pretty heavy if you’re parked down hill and you have to push it back by yourself.” Fox’s wife Marjorie used to ride with him, but she has since retired her own little Honda.
Active Alternatives
“Miracle Man” Rides Again
Three years ago Fox had a near-fatal motorcycle crash in which he broke 33 bones, punctured a lung, broke his pelvic bone in three places, broke all of his ribs, broke his wrist, had to be revived three times, spent 15 days in ICU at Medical Center of the Rockies, 15 more in the hospital after ICU and another month in a rehabilitation at Northern Colorado Rehab Center. Doctors dubbed him the “Miracle Man,” because they did not expect him to survive. Yet he bought a new bike and continues to be an avid rider. “If you step off a curb and break your ankle, you don’t quit walking. If you have a car accident, you don’t quit driving. If you cut your finger, you don’t quit slicing tomatoes,” Fox explains. Fox’s motivation stems from the “the open freedom” he experiences while riding. “You’re not surrounded by metal and steel and people. It’s very much like flying an airplane, except you don’t get airborne. When you’re flying on a turn, you have to bank it in the airplane and it’s the same kind of principle when you go around a turn on a motorcycle. You feel free. Maybe you feel a little younger. When I ride a motorcycle, I feel better at the end of the day than I would if I drove a car. And the air-conditioning is free.” Fox has been married to Marjorie for 25 years and they vacation for months at a time at Lake Havasu City, Arizona. Fox frequently makes extended motorcycle trips to Washington, Minnesota, Wyoming – wherever the wind takes him. Fox is also an avid skier and often rides his bike in the winter, suiting up in his ski gear for warmth.
Seniors Invigorated
Fox is not the only senior citizen to feel energized by the wind in his hair. In fact, there is an entire community of senior motorcyclists who enjoy the sport. “You get old ‘cause you quit ridin’ – you don’t quit ridin’ ‘cause you get old,” says Richard “Wiff” Withey, 68, president of the 40+ Motorcycle Club in Fort Collins. The sport is keeping seniors young and invigorated, and it’s a way for them to be social, keep their brains active and their bodies in great shape. The 40+ Motorcycle Club has 68 members and Withey estimates that 50 of them are seniors, both men and women. They ride every Sunday, sometimes participating in a charity poker run
32
At 77-years-young, Glenn Fox has no plans to give up motorcycling – despite a near fatal motorcycle accident three years ago.
and sometimes doing a 100-mile putt. Around 25 or 30 members make the Sturgis Motorcycle Rally every year in South Dakota. “We all just really enjoy riding. There’s a few more of us riding trikes instead of two wheelers now, but we’re still riding,” says Withey. He owns a BMW, an Italian Motoguzzi and a Kawasaki. When asked how riding makes him feel, Withey becomes poetic, “‘In the sky an eagle glides, a biker rides. One’s on wings, one’s on wheels, but each one knows how the other feels.’ [author unknown] That’s how we feel about riding. It’s also my epitaph.” The 40+ Motorcycle Club meets Sundays at 9 a.m. in front of King Soopers on 2325 College Ave. in Fort Collins. Call (970) 223-1794 for more details. There is an open invitation to join them. They also go for ice cream on the second Monday of the month.
Senior Sales an Upward Trend
Brady Welton, owner of Tri-City Cycle in Loveland, says about 20 percent of his business is made up of seniors. Seniors tend to come to his store because he has many different makes and models they can try. This is important because seniors aren’t as strong as they were in their younger years and they need to make sure they can lift the bikes, back them up, move them and safely handle them before they buy. According to Welton, seniors tend to buy touring models with features like cruise control, airbags, navigation systems, iPods, radios and comfort features. “Seniors like our store because they are pretty specific about what they can handle,” says Welton. “We’re selling to a lot more seniors than we were in the past. I’m not sure why, but it’s absolutely keeping them young and they are definitely having a lot of fun, taking vacations, taking their wives with them. They just love it.” New technological gear and accessories are a huge hit with seniors, adds Welton. Gear such as heated riding pants, gloves and jackets; helmets with iPods and radios built in; and helmets that
Motorcycling might not excite every senior. For seniors who wish to be active, but are looking for another avenue of enjoyment, the options abound in Northern Colorado. Visiting one of the many gyms in the Northern Colorado may be a great start to finding a new activity. Area gyms that participate in the SilverSneakers program include Miramont Lifestyle Fitness, Fort Collins Club, 24 Hour Fitness, Orchards Athletic Club, Gold’s Gym Loveland and Chilson Recreation Senior Center. SilverSneakers is a seniors fitness program that is both active and social, and is covered by many insurance programs. Activities include rock climbing, yoga, biking, tennis, water sports, group fitness, potluck socials, hiking and personal training. To find out more about the SilverSneakers program visit www.silversneakers.com, call your insurance provider or visit one of these gyms. There are several senior centers and programs in the area that offer pools, tracks, gymnasiums, educational classes, sports tournaments, nutritional lunches, outdoor adventures and dance lessons. Visit one near you:
Fort Collins Senior Center
www.fcgov.com/recreation/senior-center 1200 Raintree Drive, Fort Collins (970) 221-6644
Chilson Senior Center – Loveland www.ci.loveland.co.us 700 East Fourth Street, Loveland (970) 962-2783
Greeley Senior Activity Center
www.greeleygov.com/recreation/SeniorCenter 1010 6th Street, Greeley (970) 350-9440
Estes Park Senior Center
www.estesnet.com/seniorcenter 220 Fourth Street, Estes Park (970) 586-2996
Windsor Community Recreation Center
www.windsorgov.com 250 N. 11th Street, Windsor (970) 674-3500
Aspen Club
www.pvhs.org/aspenclub 1224 Doctors Lane, Fort Collins 2500 Rocky Mountain Avenue, Loveland (Inside Medical Center of the Rockies)
The Seasons Club
www.bannerhealth.com At McKee Medical Center 200 Boise Avenue, Loveland (970) 635-4097
Tracee Sioux is a Fort Collins freelance writer and can be found at www.linkedin.com/in/traceesioux .
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2011
33
seniors section
Senior Services
Linda Gabel, owner of Seniors Helping Seniors in Fort Collins
S enior S ervices A cross
northern colorado
M
enachem Mendel Schneerson said, “Because time itself is like a spiral, something special happens on your birthday each year: The same energy that God invested in you at birth is present once again.” If we thought of birthdays and aging this way – as something energizing and wonderful, a gracious gift of another day or another year – we would not only be more content as we age, but would enjoy fuller lives. With each year, we gain wisdom, and often more patience, understanding and insight. These are treasures that make the aging experience precious. But no less important is to spend our silver years living in comfort with all the amenities our gray hair has earned us. Across Northern Colorado are several dedicated services that are providing just that. Here is a sample from our region:
Seniors Helping Seniors
Linda Gabel, owner of Seniors Helping Seniors (SHS) in Fort Collins, says the
34
opportunities are symbiotic for caregivers and care receivers in the nationwide SHS organization. “Seniors Helping Seniors’ services are truly a ‘way to give as well as to receive,’” says Gabel, quoting SHS’ tagline. SHS is a non-medical, in-home organization that offers services such as cooking, light housekeeping, companionship, personal grooming, shopping, doctor visits, transportation, shopping, yard work, mobility assistance, house maintenance and small repairs, overnight stays (24-hour care), respite care and Alzheimer/dementia care. They also provide periodic long-distance check-ins. The company is licensed by the State of Colorado. A number of their caregivers have had training and experience, and specialize in caring for those with memory loss. According to Gabel, an aging client appreciates someone who can connect with them as a friend as well as a caregiver when checking in on them with a visit once or twice a week for a few hours or for an entire day. Social isolation and companionship are major challenges for seniors so the opportunity to have this social connection with their caregiver is important.
By Connie Hein
While visiting, the SHS provider may also do a load of laundry, change the linens, check the fridge, clean the bathroom, take out the trash or maybe just cook a nutritious meal and leave leftovers for lunches. “We work with each client and their families to contour our services to best fit their needs and to give them all the peace of mind they require,” says Gabel. “We match the caregiver’s personality and interests with those of the client’s to ensure that a relationship develops.” Gabel purchased the SHS franchise and opened her business in early 2010. Although there are over 150 franchises in the U.S., the Northern Colorado franchise in one of only two in Colorado. For the previous 25 years she worked in financial management at universities. “After so many years in the business world,” Gabel says, “I felt like I was sleepwalking through life. After several life changes, I decided to use the rest of my life doing something where I could give back to others.” SHS was the perfect business for Gabel because she could help others as well as provide for
Lydia’s STYLE Magazine
The Caring Hearts Home Healthcare Team
her retirement. “Seniors Helping Seniors is like a family to me,” she says. “The concept brings a sense of freedom to the care receivers and a sense of purpose to the caregivers – and friendship to both.” Seniors understand each other and can relate to all the changes that are a natural part of aging. These changes can be hard to adjust to, but are made easier with affordable help from compassionate caregivers, who understand what aging is like, adds Gabel. “Young families are active and busy with their own lives and families, or live far away and are not always able to help their aging loved ones as much as they would like,” says Gabel. “SHS can be there when loved ones cannot, yet will provide that loving care that is so important.” Dramatic growth in the population over 75 in Northern Colorado will continue as more Boomers choose to retire in this desirable area of the country. “As our population ages, services for seniors, especially those provided by SHS, will fill a critical need in our communities,” she says.
Northern Colorado Medical & Wellness 2011
This is what SHS is all about – seniors sharing what they’ve learned, something they’re good at, or just a little friendship with someone who needs their wisdom, expertise and kindness. For more information on opportunities for care receivers or care providers, readers may call (970) 631-8251 or visit www.seniorshelpingseniors.com/larimercountyco.
Caring Hearts Home Healthcare
When seniors need more extensive medical and non-medical in-home services there are many things to consider when choosing a company. According to Jill Gardiner, business development director at Caring Hearts Home Healthcare (CHHH), each person has different needs and must take the time to find the provider that is right for them. CHHH provides medical and non-medical services in Greeley, Loveland, Fort Collins and surrounding areas. Among the many services provided by CHHH are physical therapy, occupational therapy, speech therapy, medical social work, disease management, blood draws, restorative nursing and medication
management. The non-medical assistance includes medication reminders and checkins, laundry, grooming, dressing, oral care, assistance with showers and errands/grocery shopping. Their services also include meeting with families and physicians prior to a loved one entering a facility to help with the transition. “We can also help make decisions about the type of facility or healthcare service that would be best for them.” Besides providing so many service choices, there are several other things that set CHHH apart in the home healthcare field, says Gardiner. First, they are the only full-service, Medicare-certified home healthcare agency in Northern Colorado founded and operated by nurses. “Our nurses are caring, compassionate and highly trained individuals who take their jobs very seriously,” Gardiner says. “This enables CHHH to take on more acute, complicated cases.” This also allows them to provide many different types of services and combined services to suit each situation and need. Another valuable aspect of care at CHHH is
35
Hillcrest Senior Living Residences in Loveland offers a variety of senior living options – in a beautiful, luxurious setting.
personal contact available 24/7 to answer calls for patients with immediate needs. CHHH clients can call and speak to a nurse at any time, not an automated phone service. “It is a comfort for our clients to know there is someone they can talk to for immediate assistance day or night,” Gardiner says. Part of the CHHH mission is to educate the public as well as physicians about the benefits and advantages of home healthcare for patients needing extra support to be able to stay in their homes rather than a more costly alternative. “Often aging seniors are not aware of the many options they have for care,” Gardiner says. “Being able to get the help you need to stay in your home can be a great alternative to costly live-in facilities even for short term stays for healing after hospitalization.” This can bring comfort, dignity and a better quality of life. “Not all situations are right for in-home care,” she says. “But the CHHH staff is trained to analyze each situation and make recommendations for the care that is best for each client.” Each care recipient is set up for continuing
care with the same caregiver every time. “This creates trust and continuity for the patient,” she says. “We have a very low turn-over rate with our employees, which also builds trust between our providers and clients.” CHHH is the only home healthcare agency in Northern Colorado to be listed among the nation’s top agencies two years running. “We credit this honor to our staff focus and experience in providing the best care possible at home,” Gardiner says. “We believe to be given this honor consecutively shows we are listening to the needs of seniors in the community and are providing them with quality care.” Their clients are happy, too. Says long time client, Rose Sanderson, “I have been using Caring Hearts on and off for many years. I would never pick another home healthcare agency...I recommend Caring Hearts to anyone that needs medical help at home!” For information on the services provided by CHHH call (970) 378-1409 or visit www. caringheartshh.com.
Hillcrest Senior Living Residences
For seniors ready for a live-in facility, Northern Colorado offers locally owned and managed Hillcrest Senior Living Residences in Loveland, which gives seniors many choices for levels of care and living in comfortable luxury. Sarah Harlow, general manager of Hillcrest, says the community has been carefully and thoughtfully designed to combine the best of carefree living with the added comfort that comes from knowing that experienced help is close at hand. The Hillcrest community, she says, can respond to the changing needs of residents with their different levels of care. Hillcrest has 58 luxury one- and two-bedroom independent living apartments for those who want to enjoy all the benefits of living at Hillcrest and are still very self-sufficient. Independent efficiency apartments are available for those who are fairly independent and can generally care for themselves, but would like their meals prepared and may need some extra housekeeping or other non-medical services. Fourteen assisted living units are available for those individuals who may need protective medical assistance and/or help with their CONTINUED TO PAGE 62
36
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2011
37
seniors section
Senior Services
Home Instead Senior Care employee Gayle Adams assists Patricia Hess in her daily activities.
H o m e I nstead S enior C are
is H elping F a m ilies
T
hree heel clicks of her ruby slippers and simultaneous chanting of that famous movie mantra sent Dorothy and Toto back to Auntie Em. But it doesn’t take a wizard. Soldiers on battlefields or hibernating bears in their lairs know – there’s no place like home. In 1994, Paul and Lori Hogan were in the midst of a family quandary. His grandmother, Eleanor Manhart, was in her 90s and needed some assistance in day-to-day living. Since she was healthy enough to remain in a home setting, she moved in with Hogan’s mother, Catherine. There should’ve been plenty of hands to provide help. Mrs. Manhart had about a dozen children and 60 relatives living within a five-mile radius. But adults had jobs and family responsibilities; grandchildren were involved in school and extracurricular activities. It was difficult to schedule non-medical support and constant companionship for the elderly lady, who lived to be over 100. If this was Mrs. Manhart’s challenging predicament, what about those seniors with little or no family nearby?
38
Hogan, who was in franchise development with Merry Maids at the time, soon recognized seniors’ unique needs and left to start a company designed to help meet those needs. One night in bed, he came up with its name. And so, Home Instead Senior Care was founded. After about six months, relatives in other areas of Nebraska and elsewhere expressed interest in the Omaha-based company. Hogan decided to franchise just 11 months post-inception and the following growth was seemingly endless. By 2011, Home Instead had 1,000+ franchises, including 16 in foreign countries and Hogan had been honored as an International Franchise Association Entrepreneur of the Year. Home Instead began offering services in Northern Colorado in February 2001 when John and Katha Maguire opened a franchise based in Fort Collins. The impressive response kept the Maguires extremely busy and Katha also worked as a physician’s assistant. When she became pregnant with the couple’s sixth child, they decided their plate was too full. Meanwhile, Maguire’s brother, Mike, was working at Home Instead’s Corporate Office in Omaha.
By Marty Metzger
Upon learning that John and Katha were seeking a buyer for their franchise, Maguire and his wife, Carol, jumped at the chance to remain with Home Instead while relocating to Northern Colorado. They had fallen in love with the area during visits and had honeymooned in Estes Park. So, in March 2006, they purchased the franchise. Maguire says it’s never been merely a business opportunity for them. Besides his position with corporate, Carol had started as one of the company’s Omaha caregivers in 1995 and eventually worked in the franchise office. And while Home Instead is definitely a business, its philosophy focuses on families’ specific situations as much as on the bottom line. “Home Instead always places the relationship above the task,” explains Maguire. Those tasks run the gamut, but with one common goal: to provide seniors a way to happily remain in a home environment with home comforts, familiarity and normalcy. Some of the company’s services are meal prep, light housekeeping, companionship, personal hygiene assistance and transportation. Getting from here to there is a tricky proposition for people
Lydia’s STYLE Magazine
who are no longer able to drive, especially where public transport is sorely lacking or non-existent. Trips to doctor appointments, shopping, church, social engagements and outings are no problem for Home Instead clients. Caregivers offer great flexibility, with some having even been chauffeured to Estes Park for elk bugling or to view the aspen leaves turn. Home Instead can provide services 24/7 or for just an hour per week. Some clients call for Home Instead caregivers after falls that leave them just temporarily unable to manage the activities of daily living. Since the Northern Colorado franchise serves Larimer, Weld and Morgan counties, rural as well as urban families can take advantage of its wide array of services. From pet care to something as simple as a chess partner, Home Instead can supplement the quality of a senior’s lifestyle. Maguire recalls meeting with one client’s daughter before matching him with a caregiver and asked if there was any special request. The woman chuckled and quipped that it sure would be nice to find someone who could cook Hungarian for her elderly father, a native of that country. Amazingly, one Home Instead caregiver did indeed know the traditional meals of Hungary and the perfect match was made. The Northern Colorado Home Instead staff numbers over 200 dedicated and well-trained people who are the cream of the caregiver crop. Less than 10 percent of applicants are hired. Home Instead exceeds Colorado’s standard for background checks. Their job seekers must pass a Social Security number nationwide skip trace to scan for any offense. Background checks are performed not just in the U.S., but worldwide for criminal, motor vehicle or domestic charges, as well as convictions. And, all Home Instead caregivers are licensed, bonded, insured and drug tested. Maguire is pleased with the differences between his company and approximately 30 other Northern Colorado agencies offering similar services. Home Instead provides their caregivers cutting edge, state-of-the-art training programs through the backing of the national franchise. Also, prematch meetings review a client’s health, hobbies, interests and needs. For example, some prefer a young caregiver for their energy and enthusiasm. Others prefer an older one who shares similar memories or values. Three out of every four requests for services comes from a female family member, usually a daughter or daughter-in-law, says Maguire. That’s because caring for a senior generally becomes the responsibility of these women. Gradually, compounding duties and stresses can change their primary roles as family members to that of full-time caregivers. Maguire recalls receiving a grateful message from one such woman who felt as if she had lost a previous relationship. She said, “Thank you for letting me be a daughter again!” Another appreciative daughter is Barbara Pratt. Her mother has been a very satisfied Home Instead client for 1.5 years. Says Pratt, “We find Home Instead to be consistently compassionate, flexible, caring and ethically sound. They’re also competitively priced in the marketplace. I’d be very comfortable recommending
Northern Colorado Medical & Wellness 2011
39
John Maguire, owner of Northern Colorado Home Instead Senior Care
Home Instead to anyone with a family member needing in-home care.” Maguire is excited to announce the expansion of Home Instead’s existing Alzheimer’s Caregiver Training Program (ACTP). In October 2011, a 1,000 square foot training center will open next-door to the company’s Fort Collins office. A new training program custom-made for U.S. and international franchises will be offered to staff caregivers and, eventually, to family caregivers as well. The material is a collaboration between the University of North Carolina Center for Aging Research and Educational Services and world-renowned author David Troxell, PhD. (The Best Friend’s Approach). Alzheimer’s is only one of 100+ types of dementia, says Hogan. In excess of 60 percent of the 200+ clients Home Instead helps monthly have some form of dementia or a memory loss issue. The new program will include multi-layered books, role-playing, videos and group presentations. Its 12 modules, or phases, will stretch over approximately eight weeks, after which time each caregiver will receive a certificate of completion through the University of North Carolina at Chapel Hill. Maguire recounts advice from guest speaker Richard Taylor, PhD., author of Alzheimer’s From the Inside-Out. Dr. Taylor, who has a form of dementia, had twice in the past four years spoken to Home Instead caregivers and family members about what it’s like to live with the disease. He strongly emphasized the importance of creating a life purpose. It’s very apparent that Home Instead’s Fort Collins franchise owners already heartily practice that wise counsel. And their life purpose brings fulfillment. Maguire says, “For our team, the greatest satisfaction is hearing from families how Home Instead has improved their lives.” “Click, click, click,” the ruby slippers remind, “There’s no place like... Home Instead.” Marty Metzger, a Fort Collins resident, has worked as a freelance writer for 23 years.
40
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2011
41
seniors section
Oral Health
James B. Troxell, DDS, MS, PLLC, Troxell Oral and Maxillofacial Surgery in Fort Collins
Maintaining O ral H ealth
as Y o u A ge
A
ging can do a real number on our bodies, but did you know that problems in your teeth and gums could affect your heart and vice-versa? From medications that upset the Ph balance in the mouth to arthritic hands that have trouble maneuvering a toothbrush, proper dental care for seniors can be tricky, particularly when they are suffering from other medical conditions. Fortunately, Fort Collins is home to awardwinning dental specialists using state-of-the art scanning equipment and labs to serve an older, but still active population. “Dental care for seniors often has different considerations than for a child or the middle aged,” says Dr. James B. Troxell, of Troxell Oral and Maxillofacial Surgery in Fort Collins. “Someone may have had good oral health and the occasional filling or a crown into middle age, then as seniors they begin to develop many
42
By Julie Estlick
other issues that influence their health,” he says. “Add to that not taking care of themselves well, and oral health suffers. It’s all interrelated.” In fact, at least half of people over age 55 have some form of periodontal disease (gum disease), and almost 1 in 4 seniors over 65 have lost all their teeth, according to the American Academy of Periodontology (AAP). Gum disease leads to tooth loss and bad breath. The condition known as xerostomia, or dry mouth, is a major culprit. Severe dry mouth is a side effect of medications (taken for conditions such as pulmonary disease, kidney disease; even antidepressants can impact the mouth) that leaves the mouth without enough saliva to wash away food from your teeth. This may lead to tooth decay or gum disease. Health issues many seniors may experience like chronic anemia and diabetes can cause bleeding and swollen gums, and result in bone loss around the teeth as well. Not all news is bad: fewer smokers, proper diet, fluoride applications and better awareness
of oral health have allowed seniors to keep their natural teeth longer, Dr. Troxell points out. At the same time, as people are living longer with other medical considerations, new challenges to their oral health are cropping up, says Dr. Troxell. The bottom line is that complacency with oral health can harm overall wellness. “If a person doesn’t take care of their mouth throughout their lives, they put themselves at risk for developing systemic health issues, including pneumonia, stroke and Alzheimer’s disease,” cautions Dr. Richard Lindeberg, of Associates in Periodontics in Fort Collins. “All this is due to the inflammatory nature of gum disease and the bacteria that goes with it.” (The AAP has published similar findings.)
Be Proactive
As they age, seniors should ramp up care to keep those pearly whites healthy. More frequent visits to a dental hygienist or deeper cleanings under the gums or between the teeth may be recommended. If maintenance does slip and gum disease or tooth decay develops, advanced procedures like bone grafts and implants are available to try to save your teeth. A routine patient assessment should always be first on the checklist for your oral surgeon or periodontist (a dentist who specializes in gum diseases and dental implants) to see what treatments are best suited to your needs and that
Lydia’s STYLE Magazine
your level of health can handle. The assessment includes a thorough medical history, so make sure to let your dentist know about any medical conditions and all medications and herbal supplements you’re taking. A treatment plan is written based on this information and the work that needs to be done, and most specialists will work as a team with your regular dentist and physician to ensure your overall health is protected. For example, if you have a hip or knee replacement antibiotics are required before dental surgery to avoid any infection. A patient on blood thinners may need a simple blood test before treatment for an extraction so they don’t have to stop their vital medication. “These considerations are done to ensure patients the healthiest outcomes possible with their dental procedures,” Dr. Troxell says. “The public needs more of an awareness of the importance of oral health as it relates to their general health,” he continues. “We know we’ll have better outcomes for our patients if we look at the overall picture of a person’s health.” The first step may just be maintenance. One nonsurgical option is a simple professional dental cleaning, including scraping of the teeth to dislodge plaque between the teeth and beneath the gum line that brushing and flossing alone can’t reach. Another option for those with more difficult situations is scaling and root planing. This is a method of thoroughly cleaning the root surfaces that eliminates plaque and tartar from deep gum pockets and also smoothes the tooth root to remove bacteria.
Bone Grafting and Implants
When those options fail, bone grafting may be suggested to save the tooth. Bone is grafted on to reduce deep pockets and rebuild the bone around the tooth, Dr. Lindeberg explains. Infection, trauma or gum disease can all lead to bone loss, and our jaws deteriorate as we age. If the tooth can’t be saved, an option might be to graft bone to the jaw to support a surgical dental implant. An implant is an artificial tooth root made of a threaded titanium rod that goes into the jaw and turns like a wood screw. A temporary prosthetic tooth is put on top while the tissue heals around the implant and then a crown or bridge is cemented on later. The dental implant acts as a stimulant to the bone, allowing the bone level to remain healthy. Chewing up and down stimulates the root structure, which in turn stimulates the bone attached to it. Dr. Lindeberg now uses a modern CT scanner machine for a 3-D rendering of the jaw that helps in the precise placement of implants. “It takes five minutes for a scan,” he says. “Surgeries are less invasive and recovery periods are shorter because we have a picture of the bones in the mouth.” The benefits of implants are three-fold. First, there is less pain, as the implant area is sealed and not as sore as exposed bone after a pulled tooth. Second, patients maintain better function because their chewing and speech is not as impaired; dentures can float around when you speak and fall out over dinner, implants don’t. Third, a more natural appearance leads
Northern Colorado Medical & Wellness 2011
MA RC
Position your ad in the
11 H 20
MAY 201 1
OCTOBER 2011
Northern Colorado Medical & Wellness Magazine Spaces are filling up fast. Call your sales representative
TODAY! 226.6400
W EL LN
FOR TH ES S E FAMILY
TH E M
YS TE RY OF AUTIS M
E K N E TS A L EMEN C TOT
LA
REP
HUM
AN-
CHILDH
D
BON PET
com do. ora col ine g a z 984 1 ma y l e N : : E S T. .st w w B L I C AT I O | w PU o m N, INC. s.c SIG n e s AND DE ell d w E MEDIA n a L TY cal A S edi w.m ww
THE
OOD OBESIT Y
TREATING
www. medic aland welln ess.c A STYL om | E MED www. IA AND DESIG style N, INC maga . PUBL zinec I C AT I O N :: ES olora T. 1 9 8 4 do.co m
LUPUS
LIVING WITH
BIPOLAR DISORDER
S PEC IAL
SENIORS EDITION ww w . m Medical e d i c& a Wellness landw ellness.com Northern Colorado 2011
| www.stylemagazinecolorado.com
A S T Y L E M E D I A A N D D E S I G N , I N C . P U B L I C AT I O N : : E S T. 1 9 8 4
STYLE MEDIA & DESIGN 211 W. MYRTLE, SUITE 200 | FORT COLLINS
Express Flu Clinics
Spend less time in line and more time with your family this year by schedulling your family’s flu vaccines at one of our upcoming Express Flu Clinics. Parents of Youth Clinic patients can log on to our website at www.youthclinic.com and select a date and time that meets your family’s busy schedule. Our automated reminder system will automatically send an email reminder 2 days prior to your family’s appointment. Avoid the lines this year and schedule your family’s appointment at an Express Flu Clinic.
Flu Mist
Protect your children all year long without a shot. Flu-mist is a live nasal flu vaccine that takes the “ouch” out of the annual flu shot. Certain chronic conditions may not qualify, so ask your doctor if Flu Mist is right for your child. The Youth Clinic also carries preservative free flu shots as an alternative to FluMist.
The Advisory Committee on Immunization Practices (ACIP) and the Center For Disease Control (CDC) recommend the vaccination of all children 6 months through 59 months of age as well as household members.
Register Now at www.youthclinic.com North Fort Collins 1200 E. Elizabeth St. South Fort Collins 1214 Oak Park Dr. Loveland 2695 Rocky Mountain Ave. Suite 260 Main Number (970) 267-9510 43
Richard Lindeberg, DDS, MS, Associates in Periodontics in Fort Collins
to higher self-esteem. “Implants really have improved people’s quality of life,” says Dr. Zachary Owen, of Summit Oral and Implant Surgery in Loveland. “Implants can be used to replace one or two teeth as well as your entire arch – they are very versatile and can be suited to each individual’s needs.” One misperception about implants is that you need an implant for each individual tooth. Dental prosthetics or multiple teeth can be bridged onto two or more implants or a denture can be secured by using just two implants. “There are multiple options available to people and your time is never wasted coming in for a consult to see what might work best for you,” says Dr. Owen. The success rate [for non-smokers] of osseointegration, where the bone fuses to the titanium implant, is more than 90 percent, according to Dr. Owen. Implants will easily last 20 years, he says, but the gum around the implant can recede and get infected so it’s important to take care of them just like your natural teeth with regular brushing, flossing and checkups.
New Options for Dentures
As mentioned above, combining dentures
44
that snap onto dental implants can provide a level of comfort and chewing ability that patients who wear traditional dentures do not have. Another favorable option for denture wearers are soft-lined dentures. For the latest in look and comfort in dentures, we turn to Dr. Ryan McCall, of McCall Dentures in Fort Collins. His boutique practice focuses mainly on providing the most comfortable, aesthetic dentures and implants, and stresses personalized care. With his onsite, full-service lab, Dr. McCall’s office is able to make premium dentures customized for each patient. There are two types of dentures, complete and partial, If you have all of your teeth removed, you get a complete set. If you have some natural teeth in good shape, you’re looking at a partial denture. The majority of Dr. McCall’s patients get removable “over dentures” in which dental implants are placed that have an attachment on top that fits into the dentures. The dentures then snap down on top of the implants like a trailer hitch, and can be popped out to be cleaned. The advantage to these overdentures is that they do not float around the mouth like traditional dentures often do, providing greatly
increased comfort and the ability to chew. Fixed dentures, on the other hand, are cemented on and can’t be removed. A big selling point to fixed dentures is that you can chew more like natural teeth and enjoy the taste and texture of food more than traditional dentures because they do not move and the taste buds on the roof of your mouth are not covered up, says Dr. McCall. Partial dentures fill in the spaces created by a few missing teeth and prevent other teeth from shifting. Lightweight flexible partials made of resin are popular because you don’t see metal hooks when you smile. Strong teeth and good bone are needed to support a partial denture. Dentures can be made out of porcelain, acrylic and composite materials, among others. The soft-lined dentures are more comfortable and stable than hard dentures, Dr. McCall says. They can even be customized in a number of ways, such as with different shapes and colors of teeth, a space in front, a slanted tooth or darker gums. Dr. McCall and his team can even re-create the look of patients’ original teeth, if an earlier picture is available. Dr. McCall’s team requires five appointments to create a set of permanent dentures. “You want to make sure they are perfect,”
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2011
45
Ryan McCall, DDS, PC, McCall Dentures in Fort Collins
Just a couple titanium implants can support an entire arch of teeth. he stresses. Dr. McCall advises patients who have recently had their teeth extracted to get temporary dentures that are used for aesthetic purposes while the gums heal and shrink. Upon full healing permanent dentures should be created. Dentures should last 5 to 10 years depending on care, and some up to 25 years.
Home Care Aids
All dentists stress that old age doesn’t have to lead to decaying teeth if you take care of them properly. If you have trouble using a
46
Dr. McCall specializes in the latest options in dentures.
Zachary Owen, DDS, Summit Oral and Implant Surgery in Loveland
regular toothbrush on natural teeth or prosthesis, try lengthening your reach by taping a tongue depressor on the end. Or switch to an electric toothbrush. Here’s a tip Dr. Troxell shares with his patients: SonicCare for Kids toothbrush has a bigger, wider handle. It’s also easier for a caregiver to help out with than the slim handle version, he says. The Waterpik electric water flosser is another aid. It was developed right here in Fort Collins and is recommended for patients who don’t have the dexterity to work floss through their teeth. Saliva replacement products on the
market for dry mouth include soft lozenges that bring the Ph level up by stimulating saliva. Avoid lemon drops though, they have sugar in them – and we all know where that leads. Continue to invest in your smile, even in your senior years. As Dr. Lindeberg says, borrowing a phrase from a well-respected colleague, “A healthy mouth is equated to a healthy life.”
Julie Estlick is a freelance writer, mom and tooth brushing police in her Fort Collins home.
Lydia’s STYLE Magazine
Maximizing Care Through Accurate Diagnosis
Christopher Bee, MD
Heather Carney, MD
Cory Dunn, MD
Richard Halbert, MD
Wentzell Hamner, MD
Carrie Pizzi, MD
Summit Pathology welcomes board certified pathologist Dr. Carrie Pizzi to our practice. Arlene Libby, MD
Ingerlisa Mattoch, MD Thomas Neuhauser, MD
Northern Colorado Medical & Wellness 2011
Michael Walts, MD
w w w. s u m m i tp a th o l o g y. c o m
47
seniors section
Cataract Surgery
Randal Smith, M.D., Eye Center of Northern Colorado
CUTTING EDGE
laser cataract s u rgery
P
ope Boniface VIII had a problem. He needed a painter with skills great enough to equal the grandeur of St. Peter’s Basilica. The Pope sent a courtier around the region asking for samples from the best painters of the day. Giotto di Bondone sent back his best work, a free hand painting of one perfect red circle. He got the job. Rare is the human hand that can create an absolutely perfect circle, which is why the story of Giotto is so amazing. That challenge still applies in life today, especially for ophthalmic surgeons. Surgeons who perform cataract surgery strive to create a perfectly round opening in the eye, much the same way Giotto did – except with a blade, on elastic tissue, inside the eye. The procedure of creating a perfect opening in the eye, called a capsulotomy, is one of the trickiest parts of cataract surgery. However, capsulotomies just got a whole lot better with the development of the LenSx laser by Alcon because now the laser creates the incision.
48
By corey radman
FDA approved for cataract surgery in 2010, the LenSx laser is an image-guided femtosecond laser. It uses a high-repetition rate laser source to make the required corneal and lens incisions for cataract surgery that have typically been performed by a surgeon and a scalpel. Eye Center of Northern Colorado (ECNC) is the first practice in Colorado, and only the twelfth in the nation to get a LenSx laser. “In my 18 years as an eye surgeon, this is the greatest advance that has come along,” says Randall Smith, M.D., eye surgeon with ECNC. “With the laser, precise imaging is used to visualize the cornea, iris and lens, which allows preplanned incisions to be placed in the cornea and on the front of the lens with new precision. This provides a higher standard for cataract surgery with potentially greater margins of safety,” he explains.
What is a Cataract?
To back up a bit, a cataract is a natural clouding of the lens in the eye. Everyone, if they live to be old enough, will eventually get a cataract. The lens’s job in the eye is to focus light on the retina
(the back of the eye), the same way a camera lens focuses light. As collagen in each lens ages, it can become so cloudy that light can no longer pass through easily, making one’s sight blurry. People with cataracts may first notice glare in their night vision or difficulty with reading. Oncoming headlights can be a problem. According to Alcon, “Cataracts can be the reason sharp images become blurred, bright colors become dull, or seeing at night is more difficult.” It may also be why reading glasses or bifocals that used to help become ineffective. Cataracts cannot be corrected through diet. Some medications have been shown to cause cataracts. The fix? Surgery, but don’t be put off by that term. Cataract surgery is minimally invasive, with emphasis on the minimal part. “The stress of cataract surgery is similar to a brisk walk across an intersection,” smiles Dr. Smith. Patients receive a topical anesthetic (eye drops) to numb the eye and intravenous sedation for help with relaxation during the surgery; they remain awake through the surgery. The surgeons make sure to communicate with patients as they go, making the procedure as stress-free as possible.
Lydia’s STYLE Magazine
Dr. Smith adds that cataract surgery is typically blood free because the incisions are placed in the edges of the clear cornea where few blood vessels exist. He sums up the typical reaction from his patients: “Most people wonder why they were so worried about having cataract surgery,” says Dr. Smith. If anything, Dr. Smith says, patients report that they might feel mild irritation, “like a hair in your eye,” he explains. “Very few people describe the process as painful.”
Procedure
The goal of Custom Laser Cataract Surgery with the LenSx is two-fold: to replace the clouded cataract and to correct astigmatism while they are working on the shape of the eye anyway. “All the laser steps are performed before the surgeon uses any traditional instruments,” Smith explains. “The laser is coupled to the eye and the structures are scanned. The surgeon precisely places all the locations of treatment. The laser then creates the capsulotomy incision on the surface of the lens, divides the interior of the old, clouded lens into pieces, creates two tiny incisions in the cornea and finally places relaxing incisions to reshape the cornea.” The surgeon then removes the lens pieces with gentle suction. An acrylic lens implant (IOL) is injected into the front of the eye to replace the natural lens. IOLs are designed to allow patients to see better at distances than they did before. “The biggest difference between now and 15 years ago,” says Dr. Smith, “is that the typical patient now aims to be as free of their glasses as possible. If someone is going to be glasses free, they need a perfectly shaped cornea and a perfect lens.” Gary Foster, M.D., is a colleague of Dr. Smith’s at ECNC and has been providing eye surgeries for 19 years. He explains: “The precision of the laser is particularly good at decreasing astigmatism by taking an egg shaped eye and reshaping it to a round sphere, thus allowing it to focus more accurately.” Dr. Smith agrees: “By combining this type of surgery with multi-focal lenses, 80 percent or more of patients can be free of glasses for driving and reading.” Dr. Foster contrasts traditional cataract surgery to LenSx custom laser cataract surgery, stating, “With traditional cataract surgery, the surgeon judges the anatomy looking through a microscope and free hands the surgery using steel blades. The unique feature of the LenSx is the real-time imaging of the cornea coupled with the precision of the laser. The procedure is customized to the patient’s eye. The imaging system presents the exact anatomy of the patient’s eye on the screen. We then can design exactly the depth and location of the surgery on the screen, and when we step on the foot pedal the laser delivers the plan with exquisite precision.” “The laser is on for maybe 45 seconds,” Dr. Foster estimates. “The laser’s use does not lessen the total time of a surgery, but it does decrease the amount of time the surgeon has to spend inside the eye,” ultimately reducing risk to the patient. Dr. Foster, who typically does 30 to 40 cataract surgeries every week, says, “The laser is CONTINUED TO PAGE 50
Northern Colorado Medical & Wellness 2011
49
CONTINUED FROM PAGE 49
Human Eye Anatomy
Gary Foster, M.D., Eye Center of Northern Colorado
Aging’s Impact on Your EYES
I
t happens to everyone. Your reading material migrates progressively farther and farther away from your eyes as the years pass. Or you notice that your favorite small person (say that 2-year-old grandchild) will press right against your nose to say hello, and you have to move them away from your face to regain focus and comfort. It turns out that one to two inches away from the face is a perfectly acceptable focal distance for the typical toddler. “The only things we [adults] do up close like that are kiss babies and remove splinters, so we may not notice the gradual change in vision over time,” says Gary Foster, M.D. and ophthalmic surgeon at Eye Center of Northern Colorado (ECNC). Dr. Foster explains the difference in your grandchild’s vision versus yours. “Every year a person lives, the lens in the eye grows less flexible and less able to focus. A typical 1-year-old can focus at one inch from the face; a 2-year-old at two inches away. We don’t usually notice those changes until around age 44, when we realize the distance at which we hold a book has moved. Then again at age 55, computer screen distances become a problem. That pattern progresses until age 65, when the lens doesn’t change shape at all any more.” That lengthening in focal distance is called presbyopia. It happens to most adults and can usually be corrected with glasses or multifocal contact lenses. Surgery can also fix it. But beyond the usual age-related vision changes and a need for glasses, there are other reasons to see an eye care provider every two to three years, as recommended. Diabetics should note that they need an annual visit instead of biannual. Dr. Foster describes three eye ailments that commonly impact older adults. • “The most common eye surgery in the United States is for cataracts (because most people need it twice – once on each eye),” Dr. Foster says. “It is also the number one treatable cause of blindness in the world, especially in developing
50
By corey radman
countries,” where eye doctors are scarce. Cataracts are explained more in the adjacent article. • “Dry eye is very common and escalates with age,” says Dr. Foster. Typical patients are usually perplexed when they are diagnosed with dry eye because the main symptom they experience is too much tearing. “Their eyes are borderline too dry all the time,” he says, “So when a person with dry eyes steps outside in the wind, or into the current from a heat vent, for example, their eyes become so dry that they are hit with a flood of emergency tears all at once. And the tears start running down their face.” Doctors usually treat dry eye with either over the counter moisture drops, or a prescription eye drop called Restasis, which makes the eye produce more tears on its own. • One other common vision problem is Agerelated Macular Degeneration (AMD). The center of the retina, called the macula, is the place where we do our most sensitive viewing. It is the part of your eye that controls all your reading and face recognition. “AMD can have a profound impact on lifestyle,” says Dr. Foster. According to the National Institute of Health, AMD is the leading cause of blindness in Americans over age 65. There are two varieties, wet and dry. Dr. Foster explains that research has shown vitamins in general and lutein in particular help slow the advance of dry AMD. Lutein is found in dark leafy greens as well as eggs and corn. Recent advances in technology have allowed the successful treatment of many patients with wet AMD. We are fortunate to have two fellowship trained retinal specialists in Northern Colorado that excel in these treatments, Drs. Kent Crews and Arthur Korotkin with ECNC. This list is by no means all-inclusive of every age-related eye condition. For more information on eye health and patient education, see www. eyecenternoco.com or the National Eye Institute at www.nei.nih.gov.
Cataracts are the result of natural aging of the eye lens, where it becomes cloudy and begins to make sight blurry. instantly better than what I will ever be able to deliver using experience and a microscope.” Alcon reports that incisions with the laser are up to 10 times more accurate than with a handheld blade. Dr. Smith agrees that the laser creates far more consistent and precise results, which will ultimately result in better vision for patients.
Risks and Exceptions
Dr. Smith explains that all surgery has inherent risks. For cataract surgery those risks include possible infection or swelling of the retina. “The ability to perform several steps of cataract surgery with the laser appears to reduce overall risk,” he notes. He encourages his patients to consider cataract surgery when their overall seeing has become poor enough that it impacts their daily lives. Dr. Foster cautions that not every patient with cataracts is a candidate for LenSx, like those with glaucoma, undersized pupils or scars. “Custom, ‘bladeless’ laser-assisted cataract surgery is a quantum leap forward in our ability to deliver what our patients want most – precision and ultimately the joy that comes from vision. We are pleased that we have been selected to introduce this advancement to Colorado in general and to our patients in particular,” he says. Additionally, insurance does not currently pay for the laser surgery. Dr. Smith explains: “Medicare and insurance currently consider the laser portion of cataract surgery to be primarily a refractive procedure [similar to LASIK surgery] and, as such, it is not covered. The patient typically pays an upgrade fee to cover only the non-covered portion of their surgery.” So handheld blade surgery won’t completely disappear, however for those who are able, Drs. Foster and Smith are optimistic about the potential for better vision for patients in the long-term. Corey Radman is a writer and mother who lives in Fort Collins. She can be reached via her website at www.fortcollinswriter.com.
Lydia’s STYLE Magazine
Comprehensive, Compassionate Care for the Whole Family Sanjay K. Gupta, MD, FACS Board Certified in Otorhinolaryngology
Recipient of the American Academy of Otorhinolaryngology Board of Governors 2010 National Practitioner of Excellence Sarmad Sabour, MD Otorhinolaryngology Training at the University of Cincinnati Doctor of Medicine, University of Texas Health Science Center at San Antonio Bachelor of Science, University of Texas
James D. Skordas, AuD, FAAA, CCC-A Board Certified Doctor of Audiology Clinical Doctorate in Audiology, University of Florida Masters of Audiology, University of Wyoming
Nose and Sinus • Balloon Sinuplasty • Allergy • Ear Problems Head and Neck Surgery • Thyroid Surgery • Snoring and Sleep Apnea Balance Problems • Hoarseness • Speech and Voice Problems Audiology and Hearing Aids • Adult and Pediatric
Front Range ENT Is Growing! Added services include: • Allergy testing and treatment including both oral and injection therapies • Full speech and voice evaluation and therapy for adults and children • A full range of evaluations and treatment for sleep apnea, headache, Therapeutic Botox, and Latisse • We have expanded our Audiology Department to include new space for diagnostic testing and hearing aids
Tammy Odell, AuD, FAA, CCC-A Board Certified Doctor of Audiology Clinical Doctorate in Audiology, Arizona School of Health Sciences Masters of Audiology, University of Wyoming
• Coordinated medical care with Ear, Nose and Throat physicians • Comprehensive hearing exams for all ages • Full line of 100% digital hearing instruments in all sizes and styles • Custom ear pieces for swimming, hearing protection and hearing aids • Tinnitus (ringing in the ear) assessment • Electronic evaluations of the auditory nerve • Intra operative nerve monitoring for surgical patients for head & neck surgery.
6500 29th Street, Suite 106 | Greeley, CO 80634 | 970.330.5555 | www.frontrangeent.com
Our ears are precious. Not only do they balance out large noses, but they also give us the power to enjoy Mozart and Jay-Z or hear oncoming cars before we step off the curb. But with approximately 17 percent of American adults reporting some degree of hearing loss, these precious slabs of skin are not invincible. Those 36 million people can benefit from these products, designed to help individuals hear clearly in a wide array of settings. The fine local hearing centers featured here carry a wide variety of manufacturers and products. Here is a sampling of the latest in technology:
Lyric Hearing Aid The first and only extended wear hearing aid that is invisible once placed by a trained hearing professional. They can be worn for up to four months and eliminate the need to clean your hearing aid or change the batteries. The Lyric hearing aid is worn 24/7 so you can sleep, shower and workout with this technology.
Audigy AGXOd The AGXOd series meets the core needs of first-time hearing aid users. This is the smallest fully wireless hearing solution designed to deliver immediate acceptance and benefits. The AGXOd series features the Audigy Speech Path Technology, 360° Sound Experience and RISE 2 wireless technology. Available from: Hearing Rehab Center www.hearingrehabcenter.com Fort Collins: (970) 482-5700 | 1217 E. Elizabeth St., Unit 9 Loveland: (970) 593-9700 | 2980 Ginnala Dr., Suite 102
Smart Alert System The Smart Alert System from Unitron Hearing allows you to hear sounds in your home even when you are in a different room. It alerts you, via your hearing aids, when the doorbell rings, the smoke detectors go off and even when the phone rings. At nighttime, a device will shake your bed when any of these situations arise. The Smart Alert System gives you the safety you need at home.
Available from: Front Range Ear, Nose, Throat & Audiology (970) 330-5555 www.frontrangeent.com 6500 29th St., Suite 106, Greeley
Starkey SoundLens SoundLens features Starkey’s most advanced technology in a fully customizable, digital hearing aid. SoundLens features PureWave Feedback Eliminator, virtually eliminating buzzing and whistling. The deep insertion fitting into the ear canal means it is completely invisible. Starkey Wi Series The Wi Series is Starkey’s most advanced family of hearing aids on the market; featuring Spectral IQ, SurfLink Media Device and the advanced HydraShield2 oleophobic coating that makes your hearing aid resistant to wax, water, sweat and corrosion. The Wi Series allows patients to collaborate with their audiologist, using downloadable apps and an iPad in the office to assist in the programming process. Available from: Advanced Otolaryngology (970) 493-5334 www.advancedotolaryngology.com 2001 South Shields St., Bldg. E, Suite 101, Fort Collins
52
The Mini Mighty Moxi The Moxi 20 is one of the most advanced hearing instruments in its class, with the easy LearnNow system that allows you to set your preferred settings and a special phone feature that allows you to hear your caller’s voice clearly in both ears without the need for a separate accessory.
Widex Mind440 featuring ZEN The Mind 440 hearing aid features the Widex ZEN program, which uses fractal technology and harmonic sounds for sufferers of tinnitus. This technology generates soothing sounds to relax patients and distract attention from their tinnitus.
Phonak Audéo S IX The Audéo S series offers premium performance for all life’s needs. The device offers a fuller spectrum of audible sounds, automatically zooms in on voice in the front and cuts down on noise from the sides and back, and helps you hear well even when you can’t face the speaker. Available from: Audiology Associates (877) 499-HEAR www.hearingtime.com 4775 Larimer Parkway, #100, Johnstown 2528 W. 16th Street, #100, Greeley
Widex Clear440 The Clear440 offers wireless interear technology that enables the hearing aids to communicate with each other instantly and constantly. Clear440 offers the ultimate in natural sound quality. Available from: All About Hearing www.alpineent.com Fort Collins: (970) 221-3372 | 1124 E. Elizabeth St., #E-101 Loveland: (970) 461-0225 | 3820 North Grant Ave.
Marsona 1288A Marsona is the ultimate in sound conditioning for people suffering from ringing in the ears (tinnitus). Choose from eight base sounds then mix with any eight overlay sounds to customize your personal sound environment. Comes with optional multi-use stereo headphones, which work with the Marsona, CD players, TVs, most MP3 players and iPods.
Oticon Intiga Intiga is the latest in super tiny, ultra sleek, high-performance hearing devices. Intiga’s high-speed sound processing chip allows you to differentiate sounds easier, so you can understand and participate more, even in difficult listening situations.
Available from: Independent Audiology (970) 817-2300 www.independentaudiology.com Fort Collins: 1014 Centre Ave. and 4674 Snow Mesa Dr., #140 | Wellington: 7950 6th Street
ConnectLine ConnectLine is a range of devices that help you connect your hearing instruments wirelessly to cell phones, landlines and TVs – anything with Bluetooth. The devices work with any Oticon hearing instrument.
Oticon Chili The Oticon Chili is the newest generation of super power hearing instruments, taking new approaches in audiology, connectivity and reliability in a slim, comfortable device using a 13-size battery. The device effortlessly connects to phones, TV and audio devices.
Available from: Advanced Hearing Services (970) 221-5249 | www.bakerhearing.net 2001 S. Shields St., Bldg. J2, Fort Collins
Northern Colorado Medical & Wellness 2011
53
wellness
Patient Care Websites
A website that allows family to remain updated during healthcare crises kept Esther Sadeh’s only surviving sibling, who lives in Tel Aviv, informed daily during Sadeh’s emergency brain tumor surgery.
W eb C onnects
Patients & Caregivers By Elissa J. Tivona
I
n 2009, Esther Sadeh was rushed to Poudre Valley Hospital’s emergency room where a CAT scan and MRI revealed a mass deep in the left hemisphere of her brain. Although Fort Collins is 7,439 miles from Tel Aviv, when Israeli Sara Grosman learned her only surviving sibling was diagnosed with a life-threatening brain tumor, no amount of distance could diminish her immediate panic and urgent need for accurate and timely information. Complex medical crises like Esther’s have given rise to the development of patient care websites like Caring Bridge and Lotsa Helping Hands. Over the years, these Internet tools have helped thousands of family and friends
54
of critically ill individuals share support and information about a patient’s progress for the duration of a significant health challenge. Regardless of a patient’s diagnosis, any involved individual can choose to set up a “caring bridge” patient website by following four simple steps listed under the CREATE tab at www.caringbridge.org. “The act of documenting a medical situation on a website is a useful way for patients or their caregivers to process what’s going on,” says Nina Rubin, licensed clinical social worker at Poudre Valley Hospital’s Counseling Department. “It gives them a sense of control.” In the first month, Esther’s diagnosis changed dramatically. Following a delicate biopsy of the tumor, originally thought to be an inoperable
glioma, doctors determined she had a primary CNS lymphoma, a more treatable tumor type. It could have taken hours on the phone to give timely medical explanations to every worried relative and friend. Instead, regular updates were posted on the website. Whether around the corner or around the world, interested individuals accessed the journal entries 24/7, without putting unintended pressure on family members. Esther reports, “The website kept telling about my situation. My sister in Israel could check in every day to see how I was doing.” Tidhar, Esther’s younger son, explains, “We were overwhelmed! There was no way my brother or I had time to answer questions personally. We could barely keep up with what was happening medically… with trying to understand our options and her changing diagnosis.” Caring Bridge provided an easy way to keep in touch without contacting everyone individually. Another feature typical of patient care sites is a guestbook where visitors log in and leave messages of support and loving thoughts. These notes made a profound impression on the Sadeh family. Tidhar and wife Didi both enthused, “We had no idea how much Mom meant to her community. Even people she hadn’t talked to in years came forward with offers to help.” In addition, the website helps organize the voices of concern into one easily accessible location. Visitors can share recommendations of helpful complementary resources such as treatment options, nutritional counseling, support services and the like. However, Rubin cautions, “Families are often overwhelmed by the outpouring of communications from friends and family.” Although well intended, advice can be a mixed blessing. The site’s resource recording function allows patients and trusted healthcare advisors to decide preferred treatments for themselves. Most importantly, in cases requiring extended care, a web tool is invaluable. As in Esther’s case, the caring bridge expanded the family’s ability to identify and schedule help over the course of time. Esther’s sudden loss of mobility was especially challenging. Thinking back, Tidhar reflects, “My brother and I were juggling fulltime jobs. At times neither of us could get free to drive her to appointments. That’s when Mom’s website was a tremendous help.” The family posted requests, and those checking the site volunteered to meet them. Simple offers like driving Esther to doctor and clinic appointments, running errands, making hospital visits or responding to an unanticipated need provided welcome respite and helped ease the way through protracted medical ordeals. Tidhar adds, “I think this all works best when you have a designated ‘ringleader’ – even someone outside the family who understands the medical situation and has time to update journal entries regularly.” Another example of a caregiving website
Lydia’s STYLE Magazine
requiring focused leadership is Lotsa Helping Hands. This application allows for a designated community coordinator to establish a group calendar and to assign dates and times for critical tasks such as meal delivery, rides, visits or other tasks requested by the family in need. The coordinator extends an email invitation to willing volunteers with instructions on how to access the site. Members then use the calendar to sign up and commit to scheduled tasks. As time passes and the situation changes, tasks can be added, revised or removed and community membership may be expanded by request. Patient-care Internet resources make it easier than ever to create willing communities of caring whenever an urgent need arises. By reaching out on the web, families discover they don’t have to make the difficult journey alone. Today, after more than a year of treatment resulting in remission of the brain tumor, the Sadeh’s expansive circle of family and friends happily agree.
Elissa J. Tivona is a writer and international educator in Fort Collins. Regular posts of media that matter appear on her blog at www.tivonaconsulting.com/harmony/. Her book chapter will be featured in Expanding Peace Journalism (Sydney University Press: 2011).
LINKS TO POPULAR PATIENT CARE WEBSITES: • www.caringbridge.org — “Free, personal and private websites that connect people experiencing a significant health challenge to family and friends, making each health journey easier.” • www.lotsahelpinghands.com — “Free, private, web-based communities for organizing friends, family and colleagues — your ‘circles of community’ — during times of need. Easily coordinate activities and manage volunteers with our intuitive group calendar.” • www.mylifeline.org — “Free, personal websites for cancer patients, survivors and their caregivers.” • www.carepages.com — “A social media solution that improves patient outcomes.” Northern Colorado Medical & Wellness 2011
55
T he I m portance of C alci u m age 9 and up.) Dr. Hendrick adds that there is currently some controversy around the RDA’s recommendation for vitamin D – “Many feel the RDA and upper limit are way too low.” Here are the RDA guidelines for vitamin D:
C
alcium is important to our bones, but this dietary staple is found to have even more benefits that promote good health. But how much calcium is necessary to reap these benefits, what is the best source of calcium and what do you need to know about calcium supplements?
Calcium helps build up our bones during childhood and slows down bone loss as we age. Age 30 is considered a pivotal age for our bones, where we reach peak bone mass. Build up your bones as much as possible until you reach age 30, and prevent as much bone loss after that. But calcium has also been found to help promote organ health and function. And research also suggests that without adequate calcium in your diet, you are more likely to be overweight. Further medical benefits of calcium, according to Creighton University Medical Center, include helping with the clotting of our blood and controlling nerve impulses and dysfunctions. There is also a tie between calcium and the endocrine and exocrine glands. Additional claims (still being studied), say calcium can decrease the risk of colorectal cancer, reduce high blood pressure, relieve menstrual symptoms and prevent premature labor and birth. The Recommended Dietary Allowance (RDA) for calcium intake is as follows: •
0-6 months – 200 mg
•
7-12 months – 260 mg
•
1-3 years – 700 mg
•
4-8 years – 1,000 mg
•
9-13 years – 1,300 mg
•
14-18 years – 1,300 mg
•
19-50 years – 1,000 mg
•
51-70 years – 1,000 mg (males)/1,200 mg (females)
•
71+ years – 1,200 mg
56
Calcium is best taken in through diet, but the typical glass of milk is only one avenue, and it may not even be the best option. One of the highest sources of calcium is actually plain, low fat yogurt. An 8-ounce serving of yogurt has 42 percent of our daily value (DV). Six ounces of orange juice has 38 percent; 3 oz. of sardines canned in oil (with bones) contains 32 percent and 8 ounces of reduced-fat milk contains 30 percent. Other great options: salmon (look for wild caught varieties), fortified soy products, cheddar and cottage cheeses, kale, turnip greens and more, and many of these lack the saturated fat present in milk. When looking at calcium supplements to add to your dietary intake, consider that all supplements are not created equal. Vitamin D is a necessary addition, and many sources say you need approximately 1,000 IU (international units) per day. Also avoid supplements or fortified foods loaded with too much retinol, or vitamin A, which can be harmful to bones. A recent study from New Zealand’s University of Aukland has indicated that there may be a correlation between calcium supplements and an increased risk of heart attack. While the study has left many physicians unconvinced of the potential danger, many underscore that the best sources of calcium are found in our diets, not in a calcium supplement. “In my opinion, Coloradoans are taking in adequate calcium but vitamin D is still deficient in almost every age group,” according to Dr. James Hendrick, with the Center for Bone Health in Fort Collins. “Vitamin D is cheap; it is a small pill and has a long shelf life.” Dr. Hendrick recommends as much as 1,000 to 2,000 IU for people over 60 and adds, “The upper limit is unlikely to harm anyone.” (The Tolerable Upper Intake Level, which cautions against excessive nutrient intake, is 4,000 IU/day of vitamin D for individuals
•
0 to 12 months – 400 IU
•
1 to 13 years – 600 IU
•
14 to 18 years – 600 IU
•
19 to 50 years – 600 IU
•
51 to 70 years – 600 IU
• Over 70 – 800 IU A final word on calcium supplements involves the type of calcium you choose to take. Calcium carbonate needs an acidic environment to be absorbed into the body and most people over 50 may not have an acidic enough stomach to absorb it correctly (or anyone who takes an acid reliever). Calcium citrate, on the other hand, is “a lot more forgiving,” says Dr. Hendrick, and he recommends it if you are in doubt. Timing can also affect calcium intake. The body absorbs it more efficiently if it is taken in smaller doses at one time; around 500 to 600 mg at one time is advisable. Don’t take an iron supplement at the same time you take your calcium pill and ask your physician about possible medication interactions with calcium supplements. Do not overload on calcium; excessive calcium can cause complications ranging from constipation to kidney stones. Whether your breakfast is a hearty bowl of cereal, you prefer the travel-friendly carton of yogurt, or you simply reach for a supplement, make sure you gain the health benefits provided by the appropriate amount of calcium in your diet. And don’t forget its sidekick – vitamin D.
Benefits of bone density
testing
F
ragile bones break easily. It is an unavoidable truth as we age: if we do not have strong bones we are at greater risk for fractures and breaks. A bone density test can help you establish your bone’s health and act on any weakness before they become debilitating. A broken bone in a senior can be much more serious and painful than those that occur in our younger years. Consider: “The risk of dying from a fractured hip resulting from a weak bone is 20 percent,” says Dr. James Hendrick, with the Center for Bone
Lydia’s STYLE Magazine
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.
6 – World Run Day 2011, all Colorado cities, all day long run that begins at 9 a.m., visit www.runday.com for details
october 22 – Owen’s Warrior Run 5K run/ walk, 10:00 a.m., Greeley Central High School, Greeley
12 – Veteran’s Day 5K, 9:00 a.m., the Oval at Colorado State University, Fort Collins. www.veterans.colostate. edu/5k. Benefitting the Veteran Scholarship Fund at CSU
23 – t2coaching Indoor Triathlon #1 (of 5 in a series), 7:30 a.m., Fort Collins Club, www.t2coaching.com.
24 – NCMC Turkey Trot, 2k/5k, 9:00 a.m., North Colorado Medical Center, Greeley
29 – 2nd Annual Phantom 4-Miler, 9:00 a.m., Embassy Suites, Loveland. Race in your costume! www. phantom4miler.com, benefitting the Denkai Animal Sanctuary. 29 – 2nd Annual Running of the CSU Triathlon Halloween 5K, 9:00 a.m., the Oval at Colorado State University, Fort Collins, www.csutri.com, benefitting the CSU Triathlon Team. 30 – 3rd Annual Spooktacular Race 5K Run/Walk, 9:00 a.m., Spring Canyon Community Park, Fort Collins, benefitting Children’s Speech and Reading Center.
Saturday, November 5 Don’t Miss the Heart Center Half Marathon, Rebound Sports & Physical Therapy 10K and 5K, and the Healthy Kids Run Series on Saturday, November 5, 2011. The Heart Center Half Marathon starts at the Medical Center of the Rockies and finishes at Boyd Lake. The race begins at 8:30 a.m. Not ready for a half marathon? Try the Rebound 10K or 5K races at Boyd Lake State Park, which begin at 8:30 a.m. Kids can enjoy the Healthy Kids Run Series with the short course beginning at 8:00 a.m. and the long course at 8:15 a.m. All participants can enjoy the free pancake breakfast. The events benefit the Boyd Lake State Park and High Plains Environmental Learning Center. Visit www.lovelandhalfmarathon.com for more details.
no v e m ber
Northern Colorado Medical & Wellness 2011
24 – Turkey Trot, 5K, 8:30 a.m., McKee Medical Center, Loveland, www.mckeefoundation.com december 3 – Jingle Bell Run/Walk 5K, 9:00 a.m., the Oval at Colorado State University, Fort Collins, www.jinglebellrunnortherncolorado.kintera.org, benefitting the Arthritis Foundation.
4 – t2coaching Indoor Triathlon #2 (of 5 in a series), 7:30 a.m., Fort Collins Club, www.t2coaching.com.
5 – Heart Center Half Marathon, 10K and 5K, and Healthy Kids Club, 8:00 a.m., Boyd Lake State Park, Loveland, www.lovelandhalfmarathon.com, benefitting the Boyd Lake State Park and High Plains Environmental Learning Center
Health in Fort Collins. “A year after a broken hip about one third of seniors are still in a nursing home, 60 percent still require daily help. It is a big deal.” Bone density tests can help you understand how strong your bones are and where there may be a risk. “All parties [doctors and insurance companies] agree that all women over the age of 65 should have a bone density screening,” according to Dr. Hendrick. The National Osteoporosis Foundation also recommends a bone density test if you are a male over the age of 70, if you have broken a bone after age 50, if you are a women of menopausal age with risk factors, a man age 50 to 69 with risk factors, or are a woman of postmenopausal age under 65 with risk factors. Osteoporosis risk factors include: being female, older in age, having a family history of osteoporosis or broken bones, being thin, having low sex hormones, low vitamin D and calcium intake, an inactive lifestyle,
24 – Thanksgiving Day Run 4 Mile Run/Walk and Kids Race, 9:00 a.m., Downtown Fort Collins, (970) 266-0219
19 – 5th Annual Sleigh Riders Motorcycle Toy Run, 11 a.m., Centennial Park, Greeley, www.srtoyrun. com, benefitting Santa Cops of Weld County
smoking, high alcohol consumption and more. Visit the Foundation’s website, www. nof.com, for a complete list of risk factors. A bone density test is quick and easy. The test involves a simple X-ray of the hip or spine using a dual energy X-ray absorptiometry machine. “This is like a standard X-ray but the dose [of radiation] is super low,” says Dr. Hendrick, adding that you would have to have 10 bone density tests to equal the radiation found in a single chest X-ray. A peripheral test can also be taken that measures the bone density in the wrist or arm and Dr. Hendrick advocates for both types of tests to be thorough; “they each give different information.” The actual test takes as little as five minutes and there is no prep needed. Dr. Hendrick estimates that insurance covers about 99 percent of the patients he sees for the testing. If a bone density test reveals that you have weak bones, there are some options to build up your bones. As Dr. Henrick explains
it, “Your bones are part of a very dynamic organ. All the time, they are constantly being broken down and rebuilding. Over time [after age 30], they begin to break down faster than they build up.” Female hormones and estrogen-like drugs can be prescribed. Other medications include bisphosphonates, such as Fosamax, that work to slow the natural break down of the bone. Another medication, Forteo, works to stimulate the body to replace or build up bones faster. Dr. Hendrick advises not to wait until your later years to be concerned about your bone health. “Personally, I think a lot of the problem with osteoporosis in the elderly is that they never achieved their genetic potential in the first place,” he says. “When you are in your youth, it is not on your radar.” He recommends making bone health a priority for your children with proper calcium intake from childhood on. To find out more, read “The Importance of Calcium” located on the previous page.
57
wellness
Exercise
Local square dancers Robyn and Bud Phillips can’t get enough! They started with lessons in March 2010, and soon formed a square dance club with other students called Ponderosa Promenaders. Today they usually dance up to four times a week. “We love our new-found hobby. It has become a passion in our lives. It gives Bud and I something to enjoy together,” says Robyn.
all join hands... and exercise By Elissa J. Tivona
H
ow many times have we gone to visit our family doctors for an annual physical, only to hear those fateful words, “You really need to get more exercise...”
Okay, okay – we know that, and we’ve tried. Honest! We’ve tried getting up early for a brisk walk; we’ve tried working out to DVDs in front of the TV; we’ve even considered joining a local gym. Here’s the good news. There’s another option that might just move regular physical workouts to the top of your list of favorite activities: square dancing! Just ask Bobbye Semryck, who put on her square dance shoes for the first time at a youthful 74 years of age. Today, at 78, she’s hooked. Semryck was first introduced to the social benefits of square dancing after her husband passed away. At a Senior Center program for
58
people coping with the loss of their spouses, an acquaintance sat down beside her and asked if she wanted to try square dancing. Semryck hasn’t looked back since. That acquaintance is her friend, Stan Wamhoff, and they’re currently serving their third year of a two-year term as co-presidents of the Fort Collinaders square dance club. “The best part of square dancing is the friendships,” says Semryck. “This is an outing that people of all races, occupations, ages… all walks of life can enjoy. It’s a happy atmosphere for happy people!” Cindy and Bill Focht are co-presidents of the Square Dusters, another popular local club. They point out that the benefits of square dancing extend far beyond the social. Cindy says, “Square dancing is very good exercise; your heart really gets going… and it’s not hard on the body like jogging.” Semryck adds, “If you do every dance it
equals five miles of walking… but it’s much, much more fun.” Health experts at the Mayo Clinic confirm these claims. A 1994 Mayo Clinic Health Letter cited exercise studies that included dancing. “During a half hour of dancing you can burn between 200 and 400 calories.” The newsletter explains that the number of calories burned is based on the total distance traveled. The report continues, “In one study, researchers attached pedometers to square dancers and found that each person covered five miles in a single evening.” Square dance is uniquely American in form, evolving from a mix of national dances brought by European settlers from their old world to the new and over the years spiced smartly by African and even some Native American dance steps. With widespread industrialization and urbanization in North America, the number of people enjoying
Lydia’s STYLE Magazine
this social pastime dropped, but it never completely faded from the social scene in rural America. In the 1940s, a resurgence of interest in square dancing swept the country and has been growing ever since. In 1947, Colorado State University (then, Colorado A&M College) was at the forefront of this hot new trend with the formation of a college club called the Aggie Haylofters. Fort Collins resident Ben Favre was among those who started the Haylofters, and at 88 years of age he and wife, Phil, are still attending dances locally. To the uninitiated, square dancing can appear a little daunting. But Cindy and Semryck say not to let that stop you. Each of the local clubs offers lessons on a regular basis. In the course of 10 weeks, newcomers pick up the majority of the 45 basic moves (known as calls) used regularly. Within a short time, novices are mixing together with experienced dancers as they all “join-hands-and-circle-left” or “do-sa-do” their partners to the lively beat of current country and popular music. Even the dress code has been updated. At most clubs you see women who enjoy wearing the traditional short wide skirts with layered petticoats, dancing alongside women with long flowing prairie skirts. Many contemporary square dancers also point out that an additional benefit of square dancing, especially for people who continue dancing into their elder years, is the mental concentration required. Typically, groups of dancers start in sets of four couples arranged in a square or circle. Once the music starts, the caller’s job is to direct dancers through a series of patterns by stringing together the individual calls. Each discreet dance round, known as a tip, is different, so dancers have to stay mentally alert to follow the constantly changing directions. “Everyone has to be thinking and moving together,” says Semryck. “A lot of [callers] really love to mix it up,” and that includes popular local callers like Roger Schappell and Kim Hohnholt. And what about when you take that European vacation you’ve been saving for? No worries. There are square dance clubs all over the globe where you can make instant friends with locals while you “promenade” the hall. The added bonus? All the calls are in English. So take heed, square dancing may be just what the doctor ordered: friendship, fitness and fun in one package. Dancers like to say, “If you can walk and shake hands, you can square dance.” But they add enthusiastically, even walking isn’t required anymore. More and more folks wheel in to join the fun!
Elissa J. Tivona is a writer and international educator in Fort Collins. Regular posts of media that matter appear on her blog at www.tivonaconsulting.com/harmony.
Northern Colorado Medical & Wellness 2011
59
60
Square
Dancing
For detailed information on square dance lessons and clubs in the Northern Colorado Region go to www.squaredancing.com/NEASDC or contact the club nearest you:
Northern
Colorado Fort Collins Clubs: The Square Dusters Cindy and Bill Focht (970) 351-6737 The Fort Collinaders Stan Wamhoff (970) 484-5800 Bobbye Semryck (970) 206-0585 Fort Morgan | Edwin and JoAnne Cook (970) 483-6286 Greeley | Jeff and Kris Nance (970) 506-9848 Haxtun | Rachelle and Keith Davis (970) 774-6573 Livermore | Cal and Carol Bruxvoort (970) 482-8261 Longmont | Joan Bristol (303) 678-7711 Loveland | Ralph and Linda Goble (970) 498-8997
Wyoming Cheyenne | Dave Guille (307) 638-3541 Laramie | Lew and Linda Lyon (307) 742-5960
61
CONTINUED FROM PAGE 36 activities of daily living such as medication management, showering, dressing, escorts, etc. An additional 10 secure memory care units are for those with Alzheimer’s and dementia that require supervision for activities of daily living. Respite care is available for those who want a short-term stay after release from a hospital with an injury or serious illness. Hillcrest is a beautiful facility with upscale apartments that have high-end features and amenities. The luxury apartments at Hillcrest’s independent community feature full kitchens, private laundry, balconies with views in many apartments, ample closet space and even a fireplace in most units. Granite countertops and stainless steel appliances are among the many sumptuous standard features, and each fireplace has a unique, hand carved mantle. The independent living apartments are soundproof for privacy and range in size from 805 to 1,445 square feet. Eighty-two years old is the average age in the independent living residences at Hillcrest, with the youngest resident being 64 and the oldest 99 years old. They accept seniors starting at 55 years old. Harlow encourages those interested in Hillcrest to come and spend two nights free of charge in their guest suite. “We really want our residents to make the best decision and this gives them the opportunity to experience exceptional senior living. “Even though this is a beautiful and efficient
62
living environment, it is the residents and staff inside the walls of the building that make the difference,” Harlow continues. “That is what makes the residents walk in the door and feel like, ‘Ahh, I’m home.’” Harlow has worked in senior living facilities for over 15 years and believes that the team they have built at The Hillcrest is exceptional within the retirement industry. “Our mission is to be resident-focused,” she says. “We achieve that by hiring the best, most compassionate employees, and creating a warm and caring atmosphere that ensures safety, security, engagement, wellness and a sense of family. The Hillcrest has an activity program that offers a wide range of options for all levels of care. Whether it is going on outings, attending educational seminars, watching movies or participation in a resident-run activity, there is always something that attracts residents. “We encourage residents to use their various life skills within the Hillcrest community,” Harlow continues. “There are many things that set Hillcrest apart, but most of all it is the feeling of value, a sense of purpose and family among the residents and staff,” says Harlow. For more information about The Hillcrest Senior Living Residences of Loveland, readers may call (970) 593-9800 or visit www. hillcrestofloveland.com. Connie Hein is a freelance writer living in Windsor.
Lydia’s STYLE Magazine
veterinary
Emergency Care
the ladybug fund for emergencies
By Jon Geller, DVM
When Wendy Smith* found her Yorkshire terrier, Aspen, collapsed on the floor, she went into a panic. Aspen was her certified therapy dog and constant companion, and the thought of anything happening to her was unimaginable. Wendy, who is disabled, picked Aspen up and rushed her to Veterinary Emergency Hospital in Fort Collins for medical treatment. Her anxiety was even more heightened because she knew she had no funds to pay for emergency visit, and she was worried she might have to put Aspen down if she could not afford treatment.
Northern Colorado Medical & Wellness 2011
63
Most Fort Collins residents are aware that emergency treatment will always be provided at the human hospital, regardless of ability to pay. It’s somewhat different in the veterinary medicine world, where only initial emergency stabilization is mandated by law and more extensive treatment must be paid for at the time of service. With less than 5 percent of pet owners having Pet Health Insurance, many are faced with agonizing and distressing decisions when confronted with large estimates for veterinary emergency care. Fortunately, thanks to a local pet owner who made a large donation as a memorial for her dog, Ladybug, help is available. In 2005, this pet owner brought Ladybug to the Fort Collins Veterinary Emergency Hospital for medical treatment. While there, she began to observe the number of pet owners who were confronted by unexpected costs related to emergency veterinary care and who had to make the difficult decision between their beloved pet and a prohibitively expensive procedure. Moved by her observations, Ladybug’s owner made a generous donation earmarked to help other pet owners who could not otherwise afford this emergency care. The donation led to the creation of a new nonprofit, The Ladybug Fund, which helps pet owners with financial hardship pay for emergency care for their pets. A Board of Directors was formed, and the Ladybug Fund achieved IRS 501(c)3 status in 2008. The Fund is now able to provide immediate funding for emergency care to pet owners who qualify. Currently, the Fund is available at three veterinary hospitals in Northern Colorado: Veterinary Emergency and Rehabilitation Hospital in Fort Collins, PETS Emergency in Greeley, and Friendship Animal Hospital in Fort Collins. But the plan is for the fund to expand as it builds so that it is eventually available at many hospitals statewide. As with any other nonprofit, it is important not to use funds faster than they are coming in. The Ladybug Fund has helped hundreds
64
Lydia’s STYLE Magazine
of patients just like Aspen over the past two years. Many donations to The Ladybug Fund come in small $2 to $3 amounts through contributions to the participating hospitals, but some larger pet-related foundations and veterinary organizations and companies have provided larger grants. Like Ladybug’s owner, it can be difficult to watch pet owners struggle with life and death decisions that are often determined by financial circumstances. All donations are matched by the veterinary hospital providing the service, doubling the impact of contributions. In addition, all Ladybug board members work as unpaid volunteers, so that over 95 percent of contributed funds go directly for medical care of needy pets. Smith was able to receive immediate use of some Ladybug Funds due to her medical circumstances and disability. Aspen had ingested an overdose of a strong narcotic that was meant for Smith, and, fortunately, the effects could be reversed by giving an intravenous injection of a reversal agent, but the process had to be repeated several times. When Aspen finally went home later that night, she was completely normal. Thanks to the Ladybug Fund, she could be reunited with her owner and resume her duties as a therapy dog. More information about the Ladybug Fund can be found at www.theladybugfund.org and on Facebook on The Ladybug Fund page. *Names have been changed for privacy.
Established in 1989 5815 E. Hwy. 14 Ft. Collins, CO 80524
(970) 482-7557
Mon-Fri 9:00 AM to 6:00PM Sat 9:00 AM to Noon Cremation & Burials Caskets • Markers • Urns
Dr. Geller is an emergency veterinarian at Fort Collins Veterinary Emergency Hospital and Pets Emergency in Greeley, as well as a freelance writer. His work has appeared in Dog Fancy Magazine, Bottom Line Personal, and Mother Earth News. In addition, he has a current blog at thebark.com and medhelp. org and answers dog owners’ questions online at Dogchannel.com.
Even small donations can help and 100 percent of your contribution will pay for emergency care for the pets of clients with a financial hardship. Visit www.theladybugfund.org for more information.
Northern Colorado Medical & Wellness 2011
65
Physician spotlight
James Danforth, M.D.
D evoted to
FA M ILY M ED I CI NE By Marty Metzger
W
hen James Danforth graduated from medical school in 1974, he entered a paper world of chart notes and journals. When Dr. Danforth retired from active practice in September 2011, he exited a desktop, laptop and handheld world of linked computers. What a difference 37 years has made! After meriting his medical degree at Wayne State University in Detroit, Dr. Danforth had a three-year family practice residency at Group Health Cooperative of Puget Sound in Seattle, then relocated to Colorado when med school friend Muni Barash, M.D., contacted him. Dr. Barash, who was working at the new McKee Medical Center in Loveland, was returning to Denver and urged his friend to replace him at McKee. Dr. Danforth had also received a letter from Dr. Dennis Elo, asking new doctors to come to Loveland. A love for the mountains clinched Dr. Danforth’s decision, and he made the move in 1977. He spent one year working in McKee’s emergency room. He then worked with Drs. Keith Sutton and Boake Baird at Loveland Medical Clinic from 1978 to 1980. In 1980, Dr. Danforth and Dr. Nancy Ashbach co-founded Columbine Family Practice Center in
66
Loveland, which has now grown to six providers who attend to the healthcare needs of approximately 15,000 patients. For 15 of the practice’s 31 years, he delivered babies and those babies are now second generation patients. Most career paths widen with time, but Dr. Danforth’s occupational trail fanned out into a virtual superhighway. He’s spent 31 years at Columbine Family Practice. He became the original director of Hospice of Larimer County, the county’s first hospice, in 1980. Now called Pathways Hospice, it has expanded to 150 patients at any given time, according to Dr. Danforth. He’s gratified that Pathways has added a fivebed, inpatient facility at McKee, the only such accommodation in Larimer or Weld counties. Dr. Danforth’s long association with McKee included a 1983-1984 term as the hospital’s Chief of Staff and, for a number of years, he was a member of its Ethics Committee. He also was president of the Larimer County Medical Society in 1990. The doctor volunteers with the National Sports Center for the Disabled at Winter Park where, coupling skiing talent to his pediatrics background, he’s taught the snowy skill to kids from Children’s Hospital for six years. And, civic-minded Dr. Danforth served as the original chairman of the Loveland Open Lands Advisory Commission from 1996 until 2002. Dr. Danforth and wife, Linda, have been
married for 34 years and have two sons. Brian, 31, is a chemical engineer in Portland, Ore., and Kyle, 28, serves as an academic adviser at the University of Colorado in Denver. At 64, Dr. Danforth retires from a medical practice but not from the profession. He remains co-director at Pathways Hospice. In May 2010, he journeyed to Quito, Ecuador for a medical mission with the University of Colorado. Dr. Danforth hopes to volunteer medically in other parts of the world as well. He will continue at Winter Park teaching children the freedom of conquering the slopes. And, he intends to volunteer at area schools as a mentor to students struggling with a subject. More plans include participation in church activities with Namaqua Forum, sponsored by Namaqua Unitarian Universalist Church. He and Linda like to travel and enjoy cycling, particularly Rails to Trails (a nationwide program that converts obsolete railroad tracks to a re-surfaced network of crushed rock paths for fat tire bikes). Community growth and evolution of medical mindsets and technologies loom large in Dr. Danforth’s rearview mirror. When he arrived in Loveland, the small community of 24,000 souls had offered wonderful opportunities to incoming physicians at then 1year-old McKee. After all, a mere 15 M.D.s practiced in the small community. The shared support and camaraderie of doctors at McKee largely influenced his decision to remain in Loveland, says Dr. Danforth. “Big transitions have occurred,” he reports about his career in medicine. He recalls originally handwriting chart notes and researching strictly in textbooks and journals. Now, physicians enter and access “chart” notes online, where most research also occurs. Organizations representing multiple specialties care for populations of patients, as per the Mayo Clinic model, healthcare is moving from a volume- to value-based system and diagnostic procedures have multiplied exponentially. He says that working in a family practice rather than a specialty field allowed him a closer bond with patients. “It’s an asset for both patient and physician to have that connection,” Dr. Danforth remarks. “We see problems from their onset and, due to the ongoing relationship with the patient, can better work as a team to resolve them.” Born and raised in the Detroit area, he took to Colorado like the proverbial water-loving duck. “It’s been a great pleasure to practice medicine in Loveland for 34 years,” Dr. Danforth happily declares. The experienced doctor offers old-time wisdom: “If I can provide one piece of advice to new family physicians, it’s to remember that people function as members of families. In this computerized age, it’s important to learn about the whole person. That’s one of the most rewarding parts of family practice.” Families to whom Dr. Danforth has devoted so many caring years most likely feel that they, too, have been greatly rewarded.
Marty Metzger, a Fort Collins resident, has worked as a freelance writer for 23 years.
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2011
67
PRSRT STD U.S. POSTAGE
PAID
DENVER, CO PERMIT NO. 5377
www.stylemagazinecolorado.com 211 W. Myrtle St., Suite 200 Fort Collins, CO 80521
CHANGE SERVICE REQUESTED