2012-05 Northern Colorado Medical & Wellness Magazine by Style Media & Design, Inc.

MAY 2012

Keeping Kids

Active

Breastfeeding

Support

H a v e Yo ur

He a lthies t Pregnancy E v er w Colorado w w . m Medical e d i c &a Wellness landw ellness.com Northern 2012

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Northern Colorado Medical & Wellness 2012

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w w w. s t y l e m a g a z i n e c o l o r a d o . c o m 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 Managing 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 Connie Hein, Heidi Kerr-Schlaefer, Logan Martinez, Sarah Maurer, Marty Metzger, Erica Pauly, Corey Radman, Kay Rios, Heather Schichtel, Carl Simmons, Tracee Sioux, Michelle Venus, Susan Wight, DVM PhotographerS Marcus Edwards, Brent Yoder Affiliations Fort Collins Area Chamber of Commerce Loveland Chamber of Commerce & Visitors Center 2012 Style Magazines January-Northern Colorado Medical & Wellness Magazine and McKee Medical Center & North Colorado Medical Center Physician 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 225 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 ©2012 Style Media and Design Inc. All rights reserved. The entire contents of Style Magazine are copyrighted and may not be reproduced without the expressed written consent of the publisher. Style Media and Design Inc. is not responsible for unsolicited material. All manuscripts, artwork, and photography must be accompanied by a SASE. The views and opinions of any contributing writers are not necessarily those of Style Media & Design Inc.

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Northern Colorado Medical & Wellness 2012

CONTENTS

Northern Colorado Medical & Wellness

May 2012

16 Pregnancy Advice from the Experts

30 Keep Kids Active

20 Midwives, Doulas & the Natural Birth

34 The Chronic Lyme Disease Mystery

54 Character Building in Athletics

60 Pet Rehabilitation: A Movement Who’s Time Has Come

on the cover: Sharis Ainslie, with son Connor, shows off her very pregnant physique just a week from her due date. Ainslie says her healthy lifestyle was key for a healthy pregnancy. Photography by Marcus Edwards.

10 12 16 20 26 30 34 38 40 44 45 46 50 52 52 53 54 56 56 60 64 65 66

Publisher’s Letter Medical Innovations in Northern Colorado Pregnancy Advice from the Experts Midwives, Doulas & the Natural Birth Breastfeeding Support Keep Kids Active The Chronic Lyme Disease Mystery Teeth May Provide Stem Cell Salvage Teens and Self Injury – Prevent the Cycle Zap That Zit Tanning Bed Dangers A Deeper Look into Orthodontics Fun Meets Lifelong Fitness Adult Sports Leagues Baby on Board Get Fit, Give Back Calendar Character Building in Athletics Teaching Children the Joys of a Garden Kid Friendly Events in Northern Colorado Pet Rehabilitation: A Movement Who’s Time Has Come Rattlesnake Danger Canine Officer Cyrus Physician Spotlight: Orest Dubynski, M.D., For the Love of Children

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.

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Northern Colorado Medical & Wellness 2012

Publisher’s Letter

Healthy & Fit When we started planning this Northern Colorado Medical & Wellness May issue with a family focus, we wanted to feature a pregnant mom on the cover and instantly Sharis Ainslie and her son, Connor, came to mind. Beautiful Sharis is wife to our sales and marketing executive, Jon Ainslie, and is an active and accomplished businesswoman heading Park Place Interiors in Windsor. Sharis was full term at the photo shoot and was

very ready to bring Briar Lily into the world. Their daughter arrived soon after on April 7; mom, baby and Jon are doing well, except for a little sleep depravation. Today women have many choices in the birthing experience, including traditional hospital delivery, midwife-guided delivery in the hospital or at home, and doula-supported pregnancy. Be sure to read “Midwives, Doulas & The Natural Birth” to learn about these varied choices. It has been really fun learning about the many resources available to women giving birth. We interviewed a variety of professionals to see what their advice might be on several key topics. Read “Pregnancy Advice From the Experts” to learn about the top questions pregnant women are asking physicians today. On the other side of child bearing, an important topic in the public eye these days is the increasing rate of obesity in our children. Colorado, once known to be one of the healthiest states in the country, is now ranked 29th among states in childhood obesity. Read “Keep Kids Active” to learn about fun ways to keep kids moving and fit. Check our Kid Friendly Events calendar for fun family activities in Northern Colorado. Staying fit is important at any age and we enjoyed learning about the little known sport of rowing. Read “Fun Meets Lifelong Fitness” for a peek at this healthy pursuit. Summer is also the time that many of us

participate in rides, runs and walks to get some exercise while supporting our favorite nonprofit organizations. Check our Get Fit, Give Back Calendar for a schedule of events that make a difference in our region. I invite you to join me in running or walking to support one of my favorite causes at the Pink Boa 5K Run/Walk and increase awareness, celebrate life and raise funds for Hope Lives! The Lydia Dody Breast Cancer Support Center. The event is May 19 at 8:30a.m., at the Front Range Village on Harmony. Register for this inspiring and fun annual event at www.hopelives.org. This non-profit is the only one in the state that provides post-diagnosis support to women in Northern Colorado diagnosed with breast cancer. To date it has provided over 13,500 free services to women since 2001. I hope to see you there! I trust you will enjoy the family focus of this issue and also notice that we redesigned and updated our cover to be more contemporary and stylish. The publishing of magazines is a constantly evolving process and my talented creative team is always actively working on ways to improve and stretch their creativity. I hope you like our fresh new look! Enjoy our beautiful spring!

lydia@stylemedia.com

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Northern Colorado Medical & Wellness 2012

MEDICAL

Innovation

medical inno vations in

nort h ern colorado By Tracee Sioux

orthern Colorado has a significant, though understated, pharmaceutical and pharmaceutical product industry. Many of their innovations are topsecret to prevent idea snatching. The pharmaceutical industry is ripe with competition, looking to develop, or steal, the next big technological advancement or product that will hit the lucrative pharmaceutical market. Style takes a look at three major players in the medical industry who are inventing and selling innovative products, employing hundreds of people and making a significant economic impact on our region. Some of them even gave us an inside look at the products coming down the pipeline in the near future.

Eldon James

Loveland-based Eldon James and its subsidiary EJ Biomed are tubing and fittings manufactures. They make plastic tubing for the auto, food and beverage, biofuel and pharmaceutical industries. There has been a media roar about plastics and the toxins Bisphenol A (BPA), Polyvinyl chloride (PVC) and di(2-ethylhexyl)phthalate (DEHP), an endocrine-disrupter. The obvious culprits have been water bottles, microwaving Tupperware and food containers. Yet, other sources of BPA haven’t received as much attention, though they are just as detrimental to our health and the environment. Medical products such as intravenous IV medical tubing, through which patients receive food, hydration, medication and blood

transfusions, sometimes for extended periods of time, leach BPA, DHEP and PVC into patients. The high temperatures that are used to create these pliable plastics are carcinogenic. These toxins have been linked to early puberty, cancer, heart disease, low sperm count, infertility and a plethora of other illnesses and diseases. Eldon James, way Eldon James’ innovations in non-toxic and anti-microbial plastic ahead of the curve in tubing have been a boon to the medical community. finding BPA, DHEP and PVC alternative plastic compounds, has 10 types of medical tubing environment. [Eldon James] has been on the without these toxic chemicals already on the forefront of this change,” says Marcia Coulson, owner of the 25-year-old company. “We’re just market. They have been producing these products overjoyed and very busy helping medical manufor three years in response to consumer and legisfactures replace their fittings and tubing.” lative demand in Europe, where the international Eldon James also offers medical tubing with corporation conducts a vast amount of business. Riding the first wave toward cleaner plastics a literal silver lining. Silver has been shown to is proving to be lucrative in the U.S. market as be very effective in preventing bacterial growth. The company sells anti-microbial medical tubes well. Kaiser Permanente, a mammoth medical to hospitals and medical supply manufacturers. corporation, adopted a policy in January 2012, stating that they will no longer be purchasing “Nurses really like our anti-microbial drainage medical tubing containing PVC and DHEP. As the tube,” notes Coulson. “It prevents bacteria from largest medical purchaser yet to do so, it purchases going back into the patient and it helps odors 4.9 million IV tubing sets annually. The move is that come from the tubing resulting from bacteria expected to save Kaiser almost $5 million a year. growth, as well. It’s better for the patient and “Kaiser said they recognize that the products everyone else around them.” they buy have a direct effect on health and the The latest exciting innovation in the Northern

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Colorado plastics industry is a breast-feeding device designed to warm and deliver mother’s milk for premature infants that contains extremely low levels of leachables. The device is used for premature babies, and those otherwise unable to eat on their own, and works with a peristaltic intravenous pump. It pinches off the tubing to allow for small doses, and the milk can be delivered intermittently with rollers that control the flow. The product, developed for an unidentified company, is currently in the FDA approval process. “Our tubing was selected and passed all the testing, our innovation helped their innovation,” says Coulson. “The dosing has to be very, very accurate and extremely precise. We have to be sure it’s not giving the baby milk too fast, which can cause further trauma.” Eldon James is moving to a new 75,000-square -foot headquarters building at a Denver location in the next six months. The building will house larger clean rooms for medical manufacturing and additional capabilities in every department. “The future looks bright, there’s a lot we’re excited about and things keep getting better,” Coulson says.

Water Pik

In 1955 Gerald Moyer, DDS, a Fort Collins dentist, had a radical thought: what would flushing out the bacteria between the teeth and gums do for gum health in his patients? He began experimenting with the idea in his garage over the ensuing four years. In 1959 Dr. Moyer teamed up with John (“Matt”) Mattingly, a hydraulic engineering professor at Colorado State University. The two experimented with a pump and motor system for three years; on the 146th try they finally invented the “Octopus” and were granted a patent. Dr. Moyer began lending the original device to patients. One of those patients was Gene Rouse, a businessman who solicited $50,000 in seed money from local investors and became the first president of the company, Water Pik, Inc. in 1962. This year is Water Pik’s 50th anniversary and they have continuously created various water pulsation products to meet the needs of their customers with a time honored combination of innovation and science. “The initial intuitive idea began with this dentist who was looking at people with gingivitis and periodontal disease,” remarks Richard Bisson, president and CEO of Water Pik since 2006. “America arguably has the most highly evolved dental care in the world, yet 75 percent of adults have gingivitis or periodontal disease.”

Water Pik celebrates their 50th anniversary in 2012. Their sonic Water Flosser is one of their most popular products.

Northern Colorado Medical & Wellness 2012

Gingivitis and periodontal disease (inflammation of the gums) can cause so much deterioration that teeth fall out and can also cause diabetes, heart disease and immune diseases. The American Dental Association (ADA) recommends brushing with fluoride toothpaste twice a day and cleaning between teeth daily with floss or an interdental cleaner. Water Pik invented the interdental cleaner. The Water Flosser gets blood circulating in the gums, which helps diabetic patients as well. “Before 35 it’s all about the brushing to prevent cavities,” remarks Bisson. “After 35 it’s all about gum health.” Water Pik continues to improve on its banner product offering various cleaning attachments, which include a tongue scraper, a rotating toothbrush and various heads which allow a person to get into small crevices and beneath gums to flush out the pockets that create gum disease. Last year it released a green children’s Water Flosser. A Water Flosser that can be used in the shower is also in the pipeline. They have even come up with a travel-sized Water Flosser for people on the go. Water Pik didn’t stop with flossing. It was also the first company to develop sonic toothbrushes over 15 years ago. In June, the company will release the Waterpik® Complete Care model which marries the sonic toothbrush to the Water Flosser in one machine. “We’re rolling out a shower Water Flosser that will knock your socks off,” says Bisson. “You can control the pressure that’s coming out and it will go with 85 percent of shower heads. You can shower and water floss simultaneously. It takes less counter space and there is no motor noise. We hope it saves time and that people will use it more frequently, every time they shower.” This isn’t the first time Water Pik has ventured into the shower, having invented the first pulsating shower head. The company has also developed an innovative electric sinus wash, the Neti Pulsator by Waterpik® SunuSenseTM, for sinus infections and allergy sufferers. “While our competitors put out a new product every 10 years, we’re putting one or two out

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Tolmar, a Fort Collins-based pharmaceutical company, has developed and manufactured a wide range of generic drugs, cancer drugs and dermatology products.

annually,” says Bisson, mentioning that the company sells in over 100 countries around the world. The company employs 165 people in Fort Collins; Bisson is proud that the average tenure of an employee is 17 years and a third of its employees have been there for over 20 years.

Tolmar

Tolmar is a Fort Collins pharmaceutical company started by four scientists in 1990. Though Tolmar does own the proprietary prostate medication, Eligard, most of their products are generic medications. You won’t see a commercial or be able to ask for a prescription for one of their products because Tolmar invents, develops, manufactures and sells new drugs to big pharmaceutical companies. Tolmar itself has no brand name. Tolmar has 22 prescription topical dermatology products. Their product line covers a vast range of diseases from acne to actinic keratosis, a pre-curser to cancer. They have over 20 products in development right now, with three or four in clinical testing and several in the FDA approval process. The company has other injectible products targeting cancer, including very specific cancers, such as prostate cancer. These products are sold to oncologists and urologists by large brand name companies. Tolmar is quite hush-hush about their product line in order to both honor their confidentiality agreements with customers and to avoid giving away their innovative product ideas to competitors. “Pharmaceutical companies and their products are very, very, very confidential,” notes Mike Duncan, CEO of Tolmar. “We always have new products in development, specifically in the field of dermatology, but generic products are even more confidential than brand name products.” Tolmar employs 385 employees in Fort Collins and recently joined Zila, a dental product manufacturer. Tracee Sioux is the author of Love Distortion: Belle, Battered Codependent and Other Love Stories.

Northern Colorado Medical & Wellness 2012

P regnancy A d v ice from t h e

E x perts By Corey radman

Lydiaâ&#x20AC;&#x2122;s STYLE Magazine

If you are pregnant, congratulations! There are tomes you can read that will tell you everything there is to know about pregnancy changes from top to bottom, from your hair follicles to your toenails. This is not that article. Being a magazine, we have to get to the point a bit faster. Style surveyed five regional maternal care experts and asked them about their top issues. With the abundance of resources available, we asked, what do pregnant women really need to know or consider? Here’s what they said.

Green Around the Gills: Nausea and Fatigue

Kim Lenderts, Certified Professional Midwife (CPW)

“Morning sickness is a myth,” smiles Lenderts sympathetically. She has been working with moms and babies since 1992 (she started her career as a lactation specialist) and has been a full-time midwife for five years. “Nausea can last all day. My first rule of thumb for moms is to start the day with a really good source of protein before your feet hit ground.” (And yes, she says, breakfast in bed, served by someone else is an excellent idea.) “Eggs are perfect,” says Lenderts. “They are a healthy, inexpensive and really digestible lean protein.” “I really like moms to have 30 grams of protein to start the day. That level will elevate and establish their blood sugar for the rest of the day. Then, keep the protein up through the day at snacks and meals. It seems like good protein helps regulate blood sugar levels much better than something like saltine crackers,” she explains. Hydration can also help alleviate nausea. “Sometimes moms who are having trouble keeping anything down don’t want to eat at all, which makes things worse.” For that situation, Lenderts suggests keeping hydrated with something that can help replace trace minerals. Her favorite? Coconut water because it is natural and full of potassium and electrolytes, which are helpful in oral hydration. Quality hydration is important for nausea, but it’s also important when fatigue crushes a mom’s energy levels. In addition, Lenderts recommends B vitamins to combat weariness. “They are especially helpful in keeping up energy levels and dealing with fatigue.” Lenderts prefers that her patients get those nutrients from food over supplements. B6, folate (not folic acid) and B12 top her list of nutrients to include in the diet. “Yes,” she says, “many of these vitamins and minerals are included in prenatal supplements, but we don’t always know if Mom came into her pregnancy B deficient, especially if she was or is maintaining a vegetarian/vegan diet.” B vitamins are mainly found in meat sources. “The first thing I do for moms-to-be who are vegetarian or vegan is hand them a list of plant-based high-protein foods. I say, ‘You are going to have to work really hard as a vegetarian to get B vitamin that is easily absorbed and digestible.” Second to eggs, legume/brown rice combinations are excellent complete protein

Northern Colorado Medical & Wellness 2012

sources, she says. Oh, and sleep helps combat fatigue too, she says. “Your body is working really hard; it’s growing a whole other organism plus its support system (the placenta). It’s a lot of work. I think that sleep is really important and wish we were set up in a way to support moms to take time off of work or get community support to care for their other children when they need it.” In an ideal world, a nap a day is suggested. Lenderts counsels moms to seek advice from their healthcare provider if vomiting or fatigue is preventing them from making it through the day. Other first trimester issues to call your doctor or midwife about include weight loss or bleeding.

HOW Many More Pounds? Jennifer Reeve, M.D.

Depending on your perspective, this could be good or bad news, but according to OB/GYN, Dr. Jennifer Reeve (who is currently transitioning her practice to The Women’s Clinic of Northern Colorado), you only need an extra 300 calories a day to maintain a healthy pregnancy. “That’s about half a sandwich and a glass of milk,” she explains. “Yes, you are growing a baby, but really the increased metabolic needs are not huge. Unfortunately, it’s not license to go nuts with food.” Typical recommended weight gain depends, again, on where you start. “For women who are underweight (a BMI of under 20) they should gain 28 to 40 pounds. For an average sized woman with a BMI of 20 to 25, weight gain should be about 25 to 35 pounds. And an overweight woman whose BMI starts at 25 to 30, should gain about 15 to 25 pounds,” she lists. But, but, the cravings!? Dr. Reeve smiles as she explains, “Those cravings are really adaptations to shuttle nutrition to the baby. So you have fluctuations in your blood sugar and the natural response is to eat... often something sugary.” But, she notes, cream-filled Zingers cause a surge/spike cycle with your blood sugar. So skip the donuts and aim for something with protein. “Crackers and cheese, an apple with peanut butter on it... not Ben and Jerry’s.” Dr. Reeve actually finds the fitness level in exercise-savvy Colorado a refreshing change from Ohio where she did her residency. “My typical patient here usually wants to know if she can continue her current level of exercise. For the most part, that answer is yes unless there are high-risk factors to consider like a history of preterm labor, vaginal bleeding or other conditions like heart disease,” she says. Fitpregnancy.com is one of the doctor’s favorite websites for the exercise question because of the safe, varied suggestions. In general, she says, running is safe if you were already doing it before getting pregnant. Ditto for weight lifting. And, she suggests, look into yoga. However, there are limits. “There does come a point when, due to your expanding uterus, certain exercises don’t work any more.” (Goodbye road bike.) She says, steer away from high fall-risk sports like downhill skiing or the potential abdominal trauma from something like soccer. And no scuba diving. Period. Beyond that, talk with your doctor and don’t

Jennifer Reeve, M.D., OB/GYN, The Women’s Clinic of Northern Colorado, Fort Collins

Jonathan Franco, M.D., OB/GYN, OB/GYN Associates, Loveland

be afraid to start exercising even after a pregnancy has begun. Walking or other moderate exercise at least three days a week is good for your overall health. “Exercise helps with your mood and your coping skills, and can build your endurance for labor and delivery. I can see the emotional difference between women who are exercising and those who aren’t.” Additionally regular exercise can help lower a mom’s risk for obesity, which can lead to gestational diabetes.”

Back to Front

Trenton Scott, Doctor of Chiropractic (DC)

Dr. Trenton Scott treats many pregnant women (as well as the Eagles hockey team) in his Loveland practice, Scott Family Health. His experience with pregnant patients, plus his wife’s four pregnancies, has given him insight into a missing facet of prenatal care. He says, “For pregnant women with back pain, often times, the suggestion is to stretch through the pain. Somewhere around 50

Trenton Scott, D.C., of Scott Family Health, says many pregnant women do not realize the importance of gentle chiropractic adjustments to relieve back pain.

percent of all pregnant women will experience prolonged back pain, but I think a majority of those can be prevented.” He continues that chiropractic adjustments and massage paired with exercise can make all the difference. “And I’m not talking about partner massage where the husband says, ‘Oh, I’ll do that honey,’ and rubs for five minutes.” A licensed massage therapist and 60 minutes can work wonders. Dr. Scott co-authored the book, The Other Side of Pregnancy, specifically about back pain in pregnancy. In it he explains, “The hormone relaxin causes your ligaments to loosen to get ready for the baby’s growth and delivery, making your muscles do extra work to compensate. Throughout your pregnancy, the muscles and ligaments of your pelvis relax, softening and stretching to increase the size of your pelvis to accommodate your baby. Several joints, especially in your spine, will also become less stable and show signs of separation and movement to make room...” All of this change, he says, is usually the culprit in prenatal lower back pain. It’s normal to see lower back pain at week 25 to week 32 of the gestation, but if it doesn’t resolve after a week or two, chiropractic

adjustment can help. “The load on those lower discs can be so heavy,” he says, “that two or three gentle adjustments are sometimes really necessary.” Back pain doesn’t have to be acute, he reiterates. If it extends beyond the usual couple of weeks or is extreme, call a chiropractor. He knows that the stereotypes of a chiropractor suggest harsh twisting, but he says he’s really very gentle. His wife thinks so, too.

Career First, Baby Second Jonathan Franco, M.D.

Dr. Franco would first like to apologize on behalf of his profession for the existence of the phrase, “Advanced Maternal Age.” Referring to any expecting mother aged 35 or older as “advanced” is insulting, he says. (Also, he’s over 40 himself and knows how it feels.) “Can we just use the phrase, ‘Women over 35?’” He wisely requests. At OB/GYN Associates in Loveland, Dr. Franco sees moms of all ages, but notes that the trend in moms over 35 is growing. And he thinks it’s wonderful! “I think women who have delayed having children to their thirties often have accomplished more. They’ve finished degrees,

started careers and businesses and I believe they’re better prepared both emotionally and physically to deliver healthy babies. And now we have even more ways to ensure that healthy outcome.” He recommends meeting with a healthcare provider before trying to get pregnant. “Always review family history and OB/GYN history with your provider. And everyone should be on 800 micrograms of folic acid, daily. It is shown to be very effective in the prevention of spina bifida,” he says. Screening for chromosomal abnormalities is the standard of care for women over 35 because the chances of having a baby with Down Syndrome (or Trisomy21) rise sharply the older a mom gets. At age 37, the risk is 1 baby in 227. By age 40, the rate goes up to 1 in 106. “It’s a real risk,” Dr. Franco says. “In years past, we had amniocentesis to address this issue, but now we can screen with a simple blood test.” MaterniT21 is a new blood test that has been shown to be 99.1 percent accurate in detecting Trisomy21 in mom’s bloodstream. It can be performed at any point after 10 weeks gestation and doesn’t carry the risks to the fetus that amniocentesis does.

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Dr. Franco reports that moms-to-be in this age group often assume they will have to undergo an amniocentesis, which is a needle that passes into mom’s uterus to extract as small amount of amniotic fluid. This can cause a certain amount of anxiety. Dr. Franco’s practice began using MaterniT21 earlier this year, shortly after it became available. He is thrilled to offer the less invasive technique. “It’s highly accurate and noninvasive to the baby,” he says. “Now, we can tell you with 99 percent certainty that you don’t have a Down Syndrome baby.”

helped her gain an appropriate amount of weight during pregnancy. “Being active and maintaining a healthy weight contributes to high energy levels during pregnancy,” continues Dr. Worford. “Appropriate weight gain also helps with delivery and postpartum recovery. A mother who has not gained an excessive amount of weight tends to have a smoother delivery. Ask Sharis; she did fantastic!” Dr. Worford also offers these healthy tips for newly pregnant women: • Prenatal care: “A healthy pregnancy requires regular check-ups with a healthcare provider. Blood pressure, weight gain and fetal growth are among the many things monitored.”

Emotional Roller Coaster

Stephanie Rayburn, Birth Mentor

With pregnancy and childbirth, the unexpected is usually the rule. This is a scary proposition when the stakes are high, as they are in childbirth. It’s that no-man’s land that lured Stephanie Rayburn to teaching Birthing from Within classes through her business, Birth Passages. “My primary goal is to give a context for the complete variety of experience. There’s no way to know, going into birth, exactly what will happen. Even though the likelihood of there being medical surprises is diminished in a healthy pregnancy, it’s still going to happen,” she says. Well-planned and prepared parents assume a certain outcome. “But, there is always something that does not match their visual outcome. And that’s where trauma happens,” she explains. Trauma is what she is trying to head off. “Parents can feel like they did everything right, made the right choices... that they were in control. Then, when things go awry – and it can even be a little something – to that person they feel like they failed, or someone they care about failed. They feel guilty or ashamed or angry. That creates trauma.” Rayburn isn’t saying that being prepared is wrong, but she says, “It’s good if parents can have a context for being able to lose control and still be ok with themselves as parents.” Rayburn teaches mindfulness as a primary tool for avoiding suffering. Mindfulness is a means of staying focused on what’s in front of you, rather than imagining how you might like things to be different. It works for daily struggles, but also for labor, Rayburn says. “From my perspective it’s not about making the pain go away, it’s about lessening the suffering. It’s about being able to experience the labor without making a story about it because that’s where suffering occurs.” Rayburn’s classes are set up in small groups. They cover the usual topics of anatomy, stages of birth and pain control. She also customizes each session to best fit the parents. She says her parents are often aiming for a natural birth experience; however, the skills taught are appropriate for all expectant parents no matter their birth plan. Her best advice for moms and dads? “Have a solution-focused mind set. And remember you are a resourceful person.”

Corey Radman is a mom of two and a regular contributor to Style Magazine.

Northern Colorado Medical & Wellness 2012

• Exercise: “Exercise regularly while pregnant. It helps with proper weight gain, energy level and emotional outlook. Walking and swimming are wonderful exercises for pregnant women.”

o u r co v er

model Sharis Ainslie was the model of a healthy pregnancy. The 33-year-old is part owner of family business Park Place Interiors in Windsor, and married to Style’s own Jon Ainslie, advertising and marketing executive. Sharis has one son, Connor, age 10, and was a full 39 weeks pregnant at the time of the photo shoot for our May cover. Sharis was happy, healthy and full of energy on that beautiful spring day and just a week and a half later, she went into labor. On Saturday, April 7, Sharis and Jon welcomed Briar Lily Ainslie to the world, a healthy 7 pound, 1 ounce little girl. The delivery went well, and Sharis and Briar were able to return home a couple days later. As business owner and busy wife and mother, Sharis worked full time right up to her due date, both inside and outside of the home. “She is amazing,” said Jon at the cover shoot, “she never sits down.” “I can’t complain,” said Sharis. “I am a little older than my first pregnancy, so I have a few more aches and pains, but nothing serious.” She attributes her healthy pregnancy to an overall healthy lifestyle. She has always watched what she and her family eats and exercises regularly, though she stopped any intense exercise at around four months of pregnancy. “I would still walk once in a while and I never really sit down when I am at home,” she adds. Throughout her pregnancy, she put on between 25 to 30 pounds, the recommended amount for an average weight woman. “Sharis was already healthy prior to her pregnancy,” says Sharis’ OB/GYN Cherie Worford, M.D., with A Woman’s Healing Center in Fort Collins. “She made my job easy. Because she was able to participate in many activities, it

• Weight gain and diet: “These go hand-inhand. Eat a healthy, well-balanced diet. Enjoy being pregnant and splurge a little. However, a gallon of ice cream in one sitting is not such a good idea. Ideal weight gain in pregnancy is based on pre-pregnancy weight and BMI. If you are underweight, recommended weight gain is 28 to 40 pounds; if you are normal weight, recommended weight gain is 25 to 35 pounds; if you are overweight, 15 to 25 pounds; and if you are obese, less than or equal to 15 pounds.” • Folic acid: “Folic acid is used by your developing baby to help his or her spinal cord and brain develop correctly. Folic acid works if taken before pregnancy and during the first few weeks of pregnancy, often before you know you are pregnant. You should take 400 micrograms of folic acid daily, prior to and during pregnancy.” • No smoking: “Smoking is associated with preterm labor, low birth weight, intrauterine growth restriction and placental abruption.” • No alcohol: “Alcohol is a known teratogen (meaning it can cause birth defects). There is no known safe threshold. Ideally once you have decided to attempt pregnancy you should not consume alcohol.” • Sleep: “Ha! A bit of an oxymoron, I know, but try to get as much rest as possible. Sleep helps with nausea, healthy weight gain and overall well-being during pregnancy.” A Woman’s Healing Center is two-physician practice. Dr. Worford and her partner, Christine Skorberg, M.D., FACOG, specialize in individualized care for their patients. “Having a small allwomen practice helps us have close relationships with our patients,” says Dr. Worford. They offer a child birth education course every month. The course is $75 to attend and is open to the community. Visit www.awomanshealingcenter.com for more information.

MEDICAL

Pregnancy

Dylon MacEachran found her midwife and doula were key to providing her and her husband the birthing experience they wanted.

M idwi v es , D o u las

& t h e N at u ral B irt h

here are few professions so shrouded in mystery as midwives and doulas. Despite having been around since the beginning of time, these two jobs are often misunderstood and plagued by myths. There are nurse-midwives and direct entry midwives. The first has a degree in nursing and midwifery, while the latter has exclusively studied midwifery. Direct entry midwives, commonly called certified professional midwives

(CPM), train outside the hospital setting. Women who want a natural birth often seek out midwives; a nurse-midwife if they plan to give birth in a hospital, and a certified professional midwife if they want to birth their baby at home. Nurse-midwives can perform home deliveries, but in Colorado they mostly work in a hospital or birth center. Linda L. Davidson, a certified nurse-midwife (CNM), worked for 20 years as a labor nurse before studying midwifery. She has been a CNM for 15 years, works at Banner Women First in Loveland, and delivers babies at McKee

By Heidi Kerr-Schlaefer

Medical Center. McKee has a 20-year history of midwifery and has a supportive nursing staff. A nurse-midwife can offer personalized, flexible, health-focused care that includes many educational components. They can spend more time with each patient, and have the ability to include an obstetrician if necessary. “In early care we start by emphasizing how normal labor and birth is for most women,” says Davidson. “Our philosophy is that for most women, most aspects of their pregnancy

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are normal and healthy – not necessarily a medical condition to be treated, but an aspect of health to be supported.” While many women find Banner Women First once they become pregnant, they frequently stay on as patients. A woman can get all her gynecologic needs met at the clinic, including family planning, annual exams, breast health and menopausal care. Davidson provided prenatal care for Dylon MacEachran prior to MacEachran giving birth in September. Davidson’s certified nurse midwife partner Janelle Komorowski delivered the baby boy. MacEachran and her husband, Hugh, wanted an experience that was less clinical, and they didn’t want to have anything done that wasn’t medically necessary during the pregnancy or birth. “Hugh and I really felt like nature has already built in me the ability to have a baby and so we really wanted to work with people who felt the same way,” says MacEachran. This sentiment is typical of many of Davidson’s patients. While Caesarean section rates are at an all time high of 30 percent, there are still many women who opt to have a natural, or as natural as possible, birth. More and more obstetricians are adding midwives to their clinics. In addition, many medical schools have nurse-midwives on faculty where they contribute to physician knowledge of the normal aspects of human labor and birth. “Most physicians who have had faculty input from a nurse-midwife mention it and say how helpful it was and how much they appreciated getting that part of their education,” says Davidson. MacEachran hadn’t expected to have so much control over the decision-making surrounding her pregnancy. She and her husband decided exactly what they wanted their pregnancy and birth to look like and Davidson supported it. “We chose not to have an ultrasound, because when we spoke with the midwives, everything was going beautifully. It was great that we never had to use any doctors because it meant that we were having a healthy and normal pregnancy,” says MacEachran. At the suggestion of Banner Women First, the MacEachrans also decided to use a doula. “I would never have a baby without my doula, she’s part of our lives now,” says MacEachran. Jennifer Ivans has been a certified doula for three years. She was not the MacEachran’s doula, but she and her partner, Rebecca Watkins, have served families throughout Northern Colorado. When she tells people that her profession is a doula, Ivans says about 50 percent of the time she gets a blank stare. She’d like to see this change and is working to get the word out about doulas through her new position as president of the Northern Colorado Doula Association. A doula is not a midwife and there is no nationally required certification, something else Ivans would like to see change. The scope

Northern Colorado Medical & Wellness 2012

Jennifer Ivans, certified doula

Beth Karberg, certified professional midwife

of service of a certified doula is to provide emotional and physical support, evidencebased information, to encourage informed consent and to facilitate open communication with the birth team. “I don’t make decisions, I don’t give advice, I don’t perform clinical procedures or assessments,” says Ivans. She and Watkins created a card to help people understand what a doula is, and it reads: “A doula is a professional labor support companion offering uninterrupted physical and emotional and informational assistance. She is experienced in the natural physiology of birth and will encourage you, reminding you that your body is strong and capable.” Once hired, Ivans and Watkins meet with their clients several times prior to the birth, and will be there during the entire birthing process. They also do several postnatal visits. They are most frequently asked whether fathers or partners can be part of the process. “I love dads. I love to be the one that makes the dad the hero,” says Ivans. “I show him how to rub her back just so, I make sure he is the one handing her the water bottle so she can stay hydrated during birth. I give a partner the tools to help out in an effective way.” A common misconception about doulas is that they only work with people who want a natural birth, but they actually work with all different types of birth plans, including

women who are having c-sections. Research has shown that having a doula decreases the need for medical intervention during birth, makes labor go faster, increases breast-feeding rates, increases bonding between baby and mother and has even been shown to increase marital satisfaction. “I would recommend using both a doula and a midwife. They serve different purposes, but they work really well together,” says MacEachran. Beth Karberg is a certified professional midwife with 17 years of experience who delivers babies in her client’s homes. Her specialty is natural birth and she believes certified professional midwives are the experts in the natural birth process. “I believe it is the safest for both mom and baby to support that natural process in low-risk, healthy women and 90 percent of women fit into that category,” says Karberg. Women come to Karberg because they want personalized care and someone who has time to listen to them. They also want to work with someone who believes birth is a normal, natural process. One of the biggest myths about homebirth is that it is only for super fit hippie women or radical, pain-loving women. Karberg works with women across political spectrums and of all different shapes, sizes and fitness levels. A myth about homebirth midwives is that they don’t have very much training, but this

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Northern Colorado Medical & Wellness 2012

is far from the truth. “I did six years of training,” says Karberg. “And while it wasn’t on a campus I studied the same textbooks that nurse-midwives study, and I spent a lot of time, probably just as many hours and probably more clinic hours doing my training.” Certified professional midwives do not have prescriptive authority; however, they do have access to prescribing a limited list of prescriptive medicines that are routinely used in pregnancy and birth. “My clients don’t want medical intervention unless it’s clearly needed. They want to be as far away from that as they can be. They want to be in their own space and have a private experience with people they know during their labor and birth,” says Karberg. With all of these tools at their disposal, women are becoming more and more empowered during their pregnancy by surrounding themselves with people who believe in their ability to do what is simply natural for a woman to do – give birth.

Linda Davidson, certified nurse-midwife with Banner Women First in Loveland, helps new mothers have a more natural birth experience.

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.

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6500 29th Street, Suite 106 | Greeley, CO 80634 | 970.330.5555 | www.frontrangeent.com Northern Colorado Medical & Wellness 2012

MEDICAL

Breastfeeding

breast f eeding

s u pport By Heather Schichtel

rom the time women find out they are pregnant, many have ideas of how their pregnancy and birth will proceed; often these plans included breastfeeding. Breastfeeding makes sense to many new families; it is the perfect balance of nutrients between mother and child, and creates a bonding experience. From an economical and efficiency standpoint, families who breast-feed do not have to pay $100 a month for formula and there are no late-night bottle warmings. Breastfeeding makes sense; it is what mother and child have been doing together since the beginning of time. Ironically, as natural as breastfeeding should be, it can be frustrating, tiring and even frightening, especially those first couple weeks. Fortunately for Northern Colorado families, there is a wealth of support to make breastfeeding as natural as Mother Nature intended.

Wee Steps

Kelli Robinson is a lactation educator at Medical Center of the Rockies and works with a program within Poudre Valley Health System (PVHS) called Wee Steps. Wee Steps is invested in helping mothers successfully breast-feed. New mothers are scheduled an appointment with a lactation consultant when they are discharged from the hospital, and seen during baby’s first week of life. This is an outpatient appointment where a nurse will take baby’s weight, talk about any problems or concerns for mom and baby, and, most importantly, assess how breastfeeding is going. This program is free and available to moms. As mother and child progress and situations change, the Wee Steps program is there to help moms who intend to go back to work and still successfully breast-feed. Wee Steps also offers ongoing breastfeeding assistance, including breast pump questions, feeding support, weight checks, milk supply questions and

with the weaning process, making this change successful for both. Robinson was a labor and delivery nurse for 15 years before finding her true passion within the Wee Steps program. “This is a very different program from other hospital systems,” Robinson says. “It is at no cost to the family and we are truly committed to helping the mom and new baby especially in the first couple weeks when everyone is adjusting to home life, as well as offering ongoing support through Wee Steps or a breastfeeding support group.” Karen Moore is an International Board Certified Lactation Consultant at PVHS and speaks highly of the support provided in Northern Colorado. “Not only is breastfeeding the best source of nutrition for newborns and infants, it also provides immunologic protections against many infections. There are also studies that show breast-fed babies have less allergies later in life,” Moore says. “From decreased obesity to higher

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cognitive scores in school, you can’t negate the positive outcomes from breastfeeding.” A breast-fed baby will learn to self-regulate feedings; pulling away when they are full by being allowed the chance to feed more often. Breast-fed babies become the ultimate ‘small meal eaters.’ The American Academy of Pediatrics now advise that moms breast-feed exclusively for six months and supplement with other foods for one year. In comparison, the World Health Organization recommends breastfeeding up to two years of life. Support that Wee Steps provides includes making sure the baby has a healthy latch, is gaining weight properly, that mom has a good supply and both are doing well in a home environment. Wee Steps offers one-on-one and group support where moms can get together and guide each other through this process. “I love to see a group sitting together with a 6-month-old, a 3-month-old and a newborn. Everyone is providing support; the new mom feels like she can do this as she listens to the other mothers. The mom of the 3-month-old is learning about starting solid foods from the mom of the 6-month-old. It’s how it should be; everyone supporting everyone else,” states Robinson. Support groups are offered at Medical Center of the Rockies, McKee Medical Center and Poudre Valley Hospital. In fact, if you are a new mother in Larimer County, you could attend a support group five days a week throughout the community. At times that level of support is absolutely needed in order for mom and baby to be successful. “This is not always easy,” Moore says. “Those first couple weeks can be difficult. This is where we step in and access how the mom is doing. Most importantly, someone needs to mother the moms. Are they resting enough? Are they eating properly? Are they tired and need some additional emotional support so they have the necessary resources to feed their baby? We want to help mothers find a healthy situation for both herself, her baby and her family.” At this time a lactation consultant can step in and make sure mom is getting the confidence and support she needs; because a happy mom equals a happy baby.

The Milk Bank

There are instances where the need for breast milk becomes imperative and a breast milk donor is needed. This can be when a baby is born premature and the mother’s milk has not come in yet or when mom’s milk supply is not quite what it should be. Fortunately, Colorado has the Mother’s Milk Bank, which services not only the Front Range but provides milk in 117 cities and 29 different states. The Mother’s Milk Bank began in 1984 when a mother lost her milk supply. She had been living in a state that had a milk bank prior and decided to start one in Colorado. Approximately 90 percent of donated milk goes to premature babies. Dr. Jeffery Hanson, medical director of Presbyterian St. Luke’s, says, “Mother’s milk is liquid gold to babies who are fighting for their lives. It can mean the difference between life and death.” Premature babies face an even higher

Northern Colorado Medical & Wellness 2012

risk of infection because their immune system is even more premature. The antibodies and other protective factors in breast milk are incredibly beneficial. Donors go through phone screening, family screening and a blood draw to ensure they are proper milk donors. Once donors are approved, they can pump in their homes and drop off milk at Wee Steps in Fort Collins and Loveland. Donors must be healthy, they cannot be on any medication nor can their baby be sick. “We are always looking for donors,” says Loraine Lockheart at the Mother’s Milk Bank of Denver. “These are very special people who know the precious gift of mother’s milk to these babies.” Milk is chosen from different donors and mixed together. It is then pasteurized slowly to ensure nutrients remain but bacteria are killed off.

Lactation Support

Kelli Robinson, lactation educator at Medical Center of the Rockies’ Wee Steps program

As more research is released about the benefits of breastfeeding, new parents are listening. In 2000, 70 percent of new moms were breastfeeding their babies. In 2008 that number had increased to 75 percent. As part of the Healthy People 2020 Initiative, the national goal is to have 81.9 percent of new mother’s breastfeeding by 2020. As this number increases society is changing to accommodate new moms. In 2010, President Obama made an amendment to the Fair Labor Standards Act requiring employers to provide reasonable time for new mothers to express milk

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Karen Moore, lactation consultant at Poudre Valley Health System

for her nursing child while at work. Providing support as babies get older is important. While 75 percent of mothers start breastfeeding immediately after baby’s birth, only 15 percent of moms are breastfeeding exclusively at 6 months of age. The consultants at Wee Steps do what they can to support moms through any stage of breastfeeding. “Sometimes a mom is only able to breast-feed for a short period of time. In these circumstances, our job is to support that mother and point out her success during the time. Even that first little bit of colostrum a baby gets is formulated differently and provides immunities to the baby, as well as protects the digestive system and provide long term health benefits,” says Robinson. “Whatever mom can do is important, even if it’s only for a week or two.” Wee Steps also encourages skin to skin contact for all babies; breast-fed or bottle fed. “Feeding, no matter breast or bottle fed, is an important time for mother and baby to bond,” says Moore. What is most important, through the support at Wee Steps or any other lactation support group, is that new families are finding a sense of community within their medical system. It takes a village to create balanced healthy children and balanced healthy moms. The team at Wee Steps is there to make sure both mom and baby get the best start possible.

Heather Schichtel is a freelance writer and marketing professional. You can follow her story on www.samsmom-heathers.blogspot.com

Northern Colorado Medical & Wellness 2012

MEDICAL

Active Kids

Jim Switzer, president of Colorado Football Academy, has been coaching children for two decades. He emphasizes the importance of regular physical exercise for children to prevent injuries during sports.

keep kids acti v e

he word “epidemic” usually refers to a significant increase in the prevalence of some condition in a short period of time. With childhood obesity rates having tripled in the U.S. over the last few decades, it is easy to see why the word is being used in this case. Colorado is frequently named one of the healthiest states in the country with low obesity rates in adults, but many may be surprised to learn that we do not do as well when it comes to obesity rates in children. In 2007, Colorado had the third lowest child obesity rate in the country, but just five years later, the state is ranked 29th among states in childhood obesity (ages 10 to 17). The national increase is due in part to less physical activity being provided in schools and a society that has

become collectively more sedentary over the last 20 to 30 years. Students in the Poudre School District get an average of 51 minutes of physical education every week. The recommendation from the National Association for Sports and Physical Education is 150 minutes a week. “We are one of the only states that doesn’t have requirements for physical education in schools. For being one of the healthiest states, Colorado is not at the forefront of policy around what’s best for our kids,” says Laurie Zenner, manager of Healthy Hearts Club, a community health program sponsored by Poudre Valley Health System. Meshelle Kolanz, M.D., at Peakview Medical Center in Greeley, has been a pediatrician for 17 years. Dr. Kolanz has personally witnessed an increase in childhood obesity leading to more frequent diagnosis of pre-diabetes, high blood

By Heidi Kerr-Schlaefer

pressure, high cholesterol and other diseases often associated with much older patients. “Obese children are more likely to be depressed and have anxiety. They have knee and back pain and often suffer from low selfesteem,” says Dr. Kolanz. She recommends that all children, including teenagers, get at least an hour a day of physical activity. It not only prevents obesity, but also improves motor skills and cardiovascular endurance, increases muscle tone and vitamin-D levels, and is good for vision development. Studies show physical activity and physical fitness levels are directly linked to academic achievement. “The act of playing with other kids also develops social skills and teaches problem solving – all the skills you need as an adult,” says Dr. Kolanz. Just as out of shape adults are more prone to injury, so are children. With their joints and growth plates already being stressed by obesity,

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if a child slips and falls playing a sport or playing in the neighborhood, they are more likely to get hurt. Jim Switzer has been coaching kids for 20 years, and is the current president of Colorado Football Academy and vice president of Northern Colorado Pop Warner. He says children who aren’t physically active on a regular basis are prone to mild injuries such as pulled muscles and strained tendons. Childhood obesity is a serious subject, and is resulting in grave health consequences, but how can the problem be solved? It may seem like the answer is straightforward, but it isn’t quite so simple. “It’s an easy thing to see obesity, but it’s a really hard thing to treat,” says Dr. Kolanz. “If a child is obese, it’s likely the child’s parents are obese. We are working to change the entire family’s lifestyle and that’s really difficult to do.” Experts believe parents should lead by example. Encouraging your children to be active is difficult if you spend all of your time in front of a television or computer screen. Dr. Kolanz’s number one piece of advice to families is to cut down on screen time. “If parents would actually calculate their kids’ screen time, they’d be shocked,” she says. “How much would we get done as adults if we turned off that stuff? It’s the same thing with kids. If their screen time gets cut out, they will get up and go outside and play or build something.” Virginia Clark is the obesity prevention supervisor for the Coalition for Activity and Nutrition to Defeat Obesity (CanDo). CanDo works to engage community members and organizations in obesity prevention efforts through education, support and advocacy. They often work in conjunction with Healthy Kids Club. “Physical activity doesn’t mean you have to do something complex. Simple is good,” says Clark. “Those 60 minutes a day can be broken up. Go on a 10-minute walk after dinner and that counts towards the total day’s activity.” Clark recommends parents find things they can do with their children. Choose activities that provide exercise and family bonding time like riding bikes, walking the dog or just going to play at the local park. Healthy Kids Club has lots of opportunities for families to get involved in physical activity throughout the year, like a run series for children starting at age 5. There are nine local runs that have a free, one-mile Kids’ Fun Run on the same day. “It’s wonderful for families,” says Zenner. “Often the parents will run the mile with their kids. It not only proves to all of them that they can do it, it proves that exercising as a family can be a lot of fun.” Starting in May, families can register for Fit Families on the Move, a popular Healthy Kids Club summer program providing low cost activities for families. Register on their website for $5 per family member and then participate in free family swims, mini golf, bowling and much more. “We put together this whole calendar of fun things families can do and our goal was to make this accessible to all and affordable,” says Zenner. Team sports can be an effective way for a

Northern Colorado Medical & Wellness 2012

child to remain active and learn other life skills as well, but it’s not always easy identifying the right sport for your child. Coach Switzer recommends finding something your child feels passionate about. “Try lots of different sports if you have to,” he says. “You don’t want to force them into a sport they don’t like because it might turn them off to that sport for good.” If your child doesn’t enjoy team sports there are lots of other activities such as dance, golf or martial arts. Local recreation centers around Northern Colorado offer an array of classes and this is the perfect way for your child to try out activities at a relatively low cost. Childhood obesity is a complex issue, and

people like Clark and Zenner stress that everyone has a role to play. As a parent this may mean limiting television time, or hosting a birthday party focused around active games instead of sweets. A parent-teacher organization should consider doing fundraisers such as walk-a-thons instead of selling cookies, and schools can create alternative rewards for children other than food-related incentives like pizza parties. “I think we all have a role to play and it’s really important that all of us as community members ask ourselves, what can we can do to promote physical activity for our kids?” says Clark. At the end of the day, adults should lead by example. There is no better way to change your child’s habit than by changing your own.

Meshelle Kolanz, M.D., Peakview Medical Center in Greeley

It starts with a simple walk, and with over 300 days of sunshine every year in Colorado, it’s always a good day to get outside and enjoy time with your kids. Online resources mentioned in this article: •

Coalition for Activity and Nutrition to Defeat Obesity (CanDo), www.candoonline.org

•

Healthy Kids Club, www.pvhs.org/ healthykidsclub

•

Colorado Football Academy, www.coloradofootballacademy.com

•

Northern Colorado Pop Warner Association, www.nocopopwarner.com/

Recreation Centers in Northern Colorado City of Fort Collins Recreation www.nxtbook.com/nxtbooks/fortcollins/ recreator_2012spring City of Loveland, Chilson Recreation Center www.ci.loveland.co.us/index.aspx?page=257 City of Greeley Recreation www.greeleygov.com/Recreation/Documents/ Newsletter/MarchLL.html

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.

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A C T I V E

We all have a role to play in helping kids get their recommended 60 minutes of activity a day. What Can I Do? • As a mom, I can walk or bike to school with my kids. •

As a teacher, I can use extra recess time or activity breaks for rewards.

•

As a grandparent, I can play with my grandkids at the park.

•

As a doctor, I can talk to every patient at every visit about getting enough physical activity.

•

As a PTA president, I can coordinate active fundraisers like bike- and walk-a-thons instead of selling candy.

For more information about YOU can do, visit www.CanDoOnline.org Northern Colorado Medical & Wellness 2012

MEDICAL

Ly m e D i s e a s e

Courtney Scheffler and her daughter, Sophia, share a fun moment together. Both have been diagnosed with chronic Lyme disease and participate in a strict medical regimen.

t h e c h ronic

lyme disease mystery

yme disease hasn’t been much of a buzzword in Colorado. But that does not mean we are immune. While the specific tick that carries this disease generally resides in humid places, what about families who leave the state for summer vacations and return with Lyme disease? What is it and how is it treated?

Lyme disease was named after an outbreak of arthritis in children in Lyme, Connecticut, in the 1970s. In time, it was discovered that each of these children had been bitten by a specific species of tick, the Ixodes tick. Dr. William Burgdorfer found that a spirochete, a helical shaped bacteria, was transmitted by the ticks and was the cause of infection.

Acute Lyme Disease

Peter Smith, M.D., at Banner Health’s Aspen Medical Center, says, “There is a lot we don’t know about Lyme disease. We know that the Ixodes tick transmits it, which do not habituate in Colorado, which is why we do not see many

cases in Colorado. Most of the cases that are seen are families who have traveled outside the state and then returned and have been diagnosed.” Dr. Smith adds, “This type of tick is common in the east coast and mid-west, where it is humid. Anyone visiting those areas of the country is susceptible to the disease.” Dr. Smith continues, “Once the tick has attached to its host it can transmit the bacteria into the host system.” After this happens, the bacteria can grow into the blood stream and then cause Lyme disease. It can show up as a rash on the body that grows out and around the original location as time continues. If left untreated, the disease reaches deep into the host system and turns into joint pain, like arthritis. It can ultimately cause many neurological and musculoskeletal problems. But it is treatable if caught early. Dr. Smith says, “We can definitely treat this disease if it is caught early on. We give two to four weeks of antibiotics and that is usually quite successful.” Dr. Smith explains further, “If someone has gone untreated for a long time, it becomes difficult to diagnose and difficult to treat.”

By Erica Pauly

Chronic Lyme Disease

If the disease goes untreated for weeks to months, then the symptoms become more severe and become chronic Lyme disease. According to Daniel Kinderlehrer, an M.D. in Boulder, Lyme disease has three stages. The first stage occurs about a week after the tick attachment. In a minority of patients, a bullseye rash will develop where the tick has bitten. Stage two develops within two weeks with flu-like symptoms such as fever, headaches, muscle aches, joint pains and fatigue. Once a person enters the third stage, they are beginning to experience chronic Lyme disease. The third stage symptoms usually begin within a few months after the tick attachment, but can occur months or even years later. The symptoms include neurological complaints such as fatigue, shooting pains, confusion, poor balance, headaches, sensitivity to light and noise, tingling, sleep disorders and mood complaints such as anxiety, depression, irritability and even fits of rage. Sufferers often describe musculoskeletal problems like weakness and intense muscle and joint pain. Dr. Kinderlehrer continues, “I’ve seen many people

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who reach stage three without ever experiencing stages one and two.” Many people go to their local family doctor for these symptoms and are misdiagnosed with fibromyalgia, Chronic Fatigue Syndrome, depression, anxiety or autoimmune disorders such as multiple sclerosis, rheumatoid arthritis and lupus. Dr. Kinderlehrer adds that one reason misdiagnosis frequently occurs is due to the fact that doctors are not as familiar with Lyme disease because the presence of the Ixodes tick is unusual in Colorado (according to data compiled by the Centers for Disease Control and Prevention and Colorado State University instances are rare or nonexistent). Dr. Smith concurs, stating that it is likely physicians miss the diagnosis because it is a disease they run into so infrequently. Dr. Kinderlehrer does contradict those who would say the tick does not exist in Colorado, although he acknowledges that the probability of contracting Lyme disease in Colorado is much smaller than other parts of the U.S. He sees patients from all over the U.S., but at least half of his patients live in Colorado and states that a percentage of them have contracted the disease within Colorado’s borders. Once the disease has reached the chronic level, Dr. Kinderlehrer works with his patients to find an individual treatment plan. “Each person is different so every treatment plan is specific to their needs.” He treats his patients with a combination of antibiotics and herbs, as well as addressing imbalances in hormones, digestion, nutrition and so forth. “There is no test to

Northern Colorado Medical & Wellness 2012

determine if the infection is 100 percent gone, but we do hope to cure people, or at least get them symptom free.” He compares it to cancer. It can be gone for a time, but no one knows for sure if it has been completely cured. Symptoms of Lyme can relapse, particularly under stress or physical trauma, and patients need to go back on treatment. While the vast majority of Dr. Kinderlehrer’s patients have been ill for years before getting treated, he emphasizes that the standard 10 day to 3 week course of antibiotics prescribed for acute Lyme disease actually fails in as many as 50 percent of patients. This can be due to a number of factors, perhaps most importantly the presence of co-infections, other infections that inhabit the mid-gut of the Ixodes tick and can be transmitted when the tick attaches. He adds that tick attachments less than 24 hours old can also transmit infection, contrary to popular belief. He strongly suggests using tick repellants such as picaridin, checking for ticks if you have been outdoors and learning the proper way to remove attached ticks.

Diagnosed in Northern Colorado

For Berthoud resident Courtney Scheffler and her children, the diagnosis of Lyme disease has had an immense impact on their lives. Courtney was bitten by a tick at the age of 16 and thought nothing of it. But eventually a rash developed on her arm. Years later she was still suffering and in 2004, she recalls, “It was like a hammering into my joints. I went to a rheumatologist and they

couldn’t find anything wrong. They told me it was just stress.” The rash eventually turned to lesions covering her body and still, doctors were unable to give her a diagnosis. “It was 2008 when everything was going downhill,” she recalls. “I was exhausted all the time, I had constant headaches and was guzzling down energy drinks to just stay awake.” By this time, her mental state was also affected. She remembers, “One day I was trying to take the kids to the park and got completely lost. I had no idea where I was. I knew something was just off. I’d been an athlete most of my life and I could barely get out of bed in the morning.” After a family vacation in Vail that year, Courtney was in so much pain that she stumbled into an acupuncturist office, which turned out to be the answer to her prayer. “She knew within five minutes that it was chronic Lyme disease.” Courtney then visited a doctor in Colorado Springs that gave her an official diagnosis. “I started my treatments and, four years later, I am not completely cured but I’m finally at least 50 percent back to my old self.” Two of her four children had been complaining of joint problems while Courtney was going through her different diagnoses. She recalled previous doctors diagnosing her daughter, Sophia, with growing pains from the joint aches and headaches that had yet to desist. The biggest and most concerning issue was with Sophia’s eyesight. Courtney states, “She had always had eye problems, but in 2011 she lost about half of her eyesight in her left eye.” Courtney took

both children to the same acupuncturist who had helped her three years earlier. This past November, both children were diagnosed with chronic Lyme disease. Her acupuncturist believes that the disease was passed from Courtney to her children during pregnancy or through breast milk. While Courtney is relieved to finally have an accurate diagnosis for her and her two children, the cost both physically and financially has been significant. They still return regularly to Vail for treatment. The children spend three and a half hours in the infrared sauna, one hour of cranial sacral therapy and one to two hours of acupuncture. Both of the children miss school, so this is made up on off hours throughout the week or with the help of a tutor. Due to all the work involved in treatment and the physical exhaustion caused by the disease, Courtney’s husband (who is the step-father to Courtney’s children), Phillippe, is now a full-time dad and has remained at home making meals, taking the kids to school, doing laundry and being the sole caregiver to their other two children. Phillippe says, “Before the diagnosis I was just so frustrated seeing them in pain. Once we finally got an answer we were relieved. But then all of the treatment began and it’s been a tough road. It’s an every day, every moment thing and we all just know we’re in this for the long haul.” When Courtney’s ex-husband and father to the two diagnosed children, Matt Kathol, found out about the diagnosis he was at an understandable loss. “First my son was diagnosed and I was trying to figure out how to handle it. Then Sophia was diagnosed and I just thought, now what?” But Kathol sprung into action to help financially and raise awareness about chronic Lyme disease. He created the Kathol Kids Foundation and has organized several events to raise funds and awareness. The next event will be a silent auction held at Countryside Liquor in Loveland from May 14 through 31. He says, “There will be a book at the store with many items that have been donated by some big liquor, wine and beer distributors. The auction will last two weeks and anyone (over the age of 21) can come in and place their bid for any of the products.” A benefit breakfast will also be held on Sunday, June 3 at the Applebee’s in Loveland from 8:00 to 10:00 a.m. All proceeds will go to the Kathol Kids Foundation. To learn more about upcoming events visit: www. katholkidsfoundation.com. While most diagnosed cases aren’t from ticks residing in Colorado, anyone can be susceptible to contracting Lyme disease. There is still much to learn about chronic Lyme disease. The danger does exist that even if treated with three weeks of antibiotics, acute Lyme disease can evolve into chronic Lyme disease. Always be sure to check for ticks of any kind and have them safely removed as soon as possible. To learn more about diagnosis and treatment for chronic Lyme disease, visit www.ilads.org (International Lyme and Associated Disease Society) and www.lymediseaseassociation.org. Erica Pauly is a freelance writer living in Loveland. She is also the Office Operations Manager at GrowSecure Inc., Insurance and Financial Services.

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MAXIMIZING CARE THROUGH ACCURATE DIAGNOSIS Christopher Bee, MD

Arlene Libby, MD

Cory Dunn, MD

Richard Halbert, MD

Wentzell Hamner, MD

Ingerlisa Mattoch, MD Thomas Neuhauser, MD

Michael Walts, MD

Carrie Pizzi, MD

www.summitpathology.com Northern Colorado Medical & Wellness 2012

MEDICAL

Innovation

James B. Troxell, DDS, holds up the StemSave container used to collect and transfer stem cells to be cryogenically preserved.

T eet h M ay P ro v ide

S tem C ell S al v age

ince the 1950s researchers have been excited about the potential uses of stem cells. Stem cells have the unique ability to transform into any cell – organs, skin and hair, muscle, neural cells, tendons and blood. New research has revealed potentially viable stem cells can be found within the pulp of the teeth. In the 1970s doctors began using stem cells from bone marrow to treat leukemia and other blood diseases. Speculation about the potential for stem cells to cure disease is widespread; there has been hopeful progress in the quest for cures for neurodegenerative disease, bladder disease, autoimmune disease, anemias, leukemias and other blood diseases and even the healing of heart tissue. There are

believed to be over 500 clinical applications for stem cells. New medical treatments using stem cells are currently being investigated for formerly difficult or once-impossible to treat conditions including Parkinson’s disease, brain injuries, heart disease, diabetes, arthritis, muscular dystrophy, leukemia, Crohn’s disease, multiple sclerosis, periodontal disease, injuries and even cosmetic and anti-aging applications. Because stem cells are, in many cases, the patient’s own cells, there is less risk of the body rejecting the cells as foreign, as sometimes happens with a transplant. In 2000 scientists at the National Institutes of Health reported that they had been able to harvest stem cells from third molars or wisdom teeth, discovering an easily harvested source for research and potential treatment

By Tracee Sioux

of a variety of diseases. The stem cells are contained in the pulp of the tooth. Stem cells have been located in deciduous teeth or baby teeth and permanent adult teeth. Additionally, umbilical stem cells create hematopoietic blood cells, which at this point are believed to best treat blood diseases, while adult stem cells of the tooth are mesenchymal, meaning they can be used to heal and restore skin, bone, cartilage, muscles, nerves and other tissues when injured. Many believe, based on current research, that dental pulp stem cells are some of the most powerful stem cells in the human body, growing at a faster rate for longer periods of time. Younger teeth are richer in stem cells than older teeth. The optimal time to harvest wisdom teeth is in the teenage years. It is already common practice for dentists to

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recommend the removal of wisdom teeth as a matter of course because many adults do not have room for the teeth and they often cause problems. “Many times [wisdom teeth] fail to erupt properly due to a lack of space,” says James B. Troxell, DDS, oral and maxiofacial surgeon in Fort Collins. “They are often removed because they are a common source of infection and discomfort and possible pathologic changes.” People now have the option to have their teeth cryogenically banked, a move that could be used for your future medical therapy. StemSave is a cryogenic stem cell bank which safely stores baby teeth, permanent teeth and wisdom teeth in the event that a future need were to develop. “We have controversy with embryonic stem cells; these are not embryonic stem cells,” points out Dr. Troxell. “We’re taking from tissue that would otherwise be disposed of, but now it can be harvested and preserved. Harvesting the umbilical cord is more expensive, and it’s much easier to harvest the tooth than doing a bone marrow procedure.” Dr. Troxell harvests the teeth and express ships them to StemSave in a special container. The teeth are tested to be sure they are viable. To be viable a tooth must have a healthy pulp and be free of infection. Once viability has been established, StemSave cryogenically freezes the tooth to a negative 196 degrees Celsius. It is believed the tissue may be preserved indefinitely with this method. This procedure is not yet commonplace. People don’t necessarily know of its availability and it is still a very new area of science with much research yet to be done. “I feel it is important to provide an awareness and offer this service. But, like the umbilical cord, you’re saving the stem cells not knowing if they are going to be used,” notes Dr. Troxell. “It’s similar to having an insurance policy.” StemSave is FDA approved and endorsed by the American Association of Oral Maxillofacial Surgeons. When compared to other methods of acquiring and preserving stem cells, the recovery of stem cells from teeth is the most affordable and least invasive. Dr. Troxell is very excited about the potential for improving lives with the recent discoveries in stem cell research and regenerative medical treatment. With the rapid advancements in medicine over the last few decades it is not difficult to imagine that what might be considered a miracle today may be commonplace treatment in the future. The banking of stem cells, with its unknown potential, could eventually benefit the life of yourself or someone you love.

Tracee Sioux is the author of Love Distortion: Belle, Battered Codependent and Other Love Stories. She works as a writer and does public relations, social media and marketing for prestigious publications, corporations, small businesses and soloprenuers.

Northern Colorado Medical & Wellness 2012

MEDICAL

Mental Health

T eens and S el f - I nj u ry

P re v ent t h e C ycle

ld school thinking says selfinjury among teens, such as cutting and burning behaviors, stem from some sort of abuse. Though that stigma may still haunt these adolescent problems, enlightened mental health practitioners now realize that the majority of these behaviors are often caused by other factors: inability to express strong emotions, a feeling of being disengaged from their surroundings and low self-esteem. How can parents prevent their teens from cycling into these behaviors? And how can healthy communication within the family dynamic create a safe haven for teens in trouble? Find out what guidance local therapist Jennifer Reed and licensed psychologist Patty Al-Adsani, M.D., (who prefers to be called “Dr. Patty”) offer parents. “It used to be, if you saw self-injury in a child, you thought abuse. That is not the way it is anymore,” says Dr. Patty, with North Colorado Medical Center Behavioral Health in Greeley. In the children she treats currently, the majority of cutters have not experienced a history of abuse. In her practice, Dr. Patty sees a significant amount of cutters, reflecting a nationwide trend. Self-cutting or other injurious behavior with teens and pre-teens occurs in between 13 to 24 percent of kids, according to Dr. Patty. She most often

sees cutting, though eraser burns and other types of burning are not uncommon. Self-injury is predominantly a female behavior; however, when found in males, Dr. Patty says it is often significantly more serious and more difficult to manage. Typically these behaviors happen in kids around ages 13 to 16.

Why Cutting?

What leads to these behaviors? “Lots and lots of kids who cut struggle with handling more aggressive feelings – anger, jealousy, frustration, those kinds of feelings,” she says. “Kids who cannot manage those feelings well – who don’t get what they want and become really angry – that can be a warning sign because every kid their age should be able to accept the word ‘no’ and limits without a lot of arguing anymore.” Fort Collins family therapist Jennifer Reed agrees. “I am seeing more cutting and bulimia in my practice, usually centered around self-esteem issues, some dysfunction in the family or a lack of positive role models, and an inability to express themselves in a healthy way.” Dr. Patty has also noticed that many times, cutting behaviors can be centered around boygirl issues – dating at an early age – and not as much around home issues. She advocates that parents restrict relationships between young teens, such as dating at 13 and 14, because they are not yet developmentally ready to handle issues

By angeline grenz

surrounding those relationships. In addition both practitioners feel that the rise in cutting may be due in some small portion to peer pressure. “It almost feels a little trendy among some groups,” says Reed. Both add that often, young women are exposed to cutting first by a friend who is already cutting. The reason emotions can escalate to the point of cutting is because “these feelings are exceptionally intense, out of control and overwhelming, and children feel like they will self destruct if they feel them. Most of them become numb so that they no longer feel much of anything,” she explains. Dr. Patty emphasizes that other behaviors, such as bulimia and anorexia can have similar causes as cutting. Bulimia is most closely associated with self-injurious behaviors because often they are caused by the same family dynamics. Cutting, burning and bulimia are motivated by a desire for a release. Anorexia, on the other hand, is more often about the need to be in control and recent studies point to that anorexia is on the rise with teen males. However, anorexia, cutting and bulimia are related. “They all center around need to control one’s feelings and when that is not possible, controlling one’s environment (anorexia) or finding a release (cutting and bulimia).” Dr. Patty cautions, however, that there is no real “standard” family dynamic that exactly fits any self-destructive behavior.

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Northern Colorado Medical & Wellness 2012

“Both can have a sense of feeling out of control with their lives,” says Dr. Patty, “but with anorexia they feel a need to have rigid control over their lives – so eating and exercise get rigidly controlled. Self-cutting and bulimia give them more of a sense of release.” Dr. Patty points out that self-injurious behaviors can be closely linked to personality disorders, but it can be difficult to diagnose because of age. “A personality is not fully developed until we get to around age 18. It is difficult to diagnose a personality disorder [younger than that].” She also highlights the difference between a personality disorder and mental illness. “A personality disorder is the way your personality is built. You may be able to function well based on your personality – make good choices, have good impulse control, things like that – or you may not, picking destructive relationships, poor impulse control, self destructive behaviors.” She contrasts this with someone who has a mental illness, like bipolar disorder, who has a perfectly healthy personality but then has a dis-regulated mood associated with it. “They are two totally different things,” she points out, “but either one can be associated with self destructive behaviors.”

What to Look For

Behaviors that parents can look for include: being withdrawn, irritable or angry, defiant, lots of boy-girl relationship issues (generally at a muchtoo-young age to handle them, adds Dr. Patty), and lots of mood issues, whether new or they have exhibited them for some time. Drug and alcohol use are additional risk factors. Very quick personality changes are indicators, “if parents are saying, ‘all the sudden they are like a different kid.’” Sometimes it takes parents a long time to realize that the behaviors are a problem. “People assume that it is adolescence,” says Dr. Patty. “Kids are not generally significantly defiant and if they are, they quickly return [to normal] with appropriate redirection. They are not typically super moody. Parents assume that it is normal and respond with more and more discipline, which works temporarily, but then the mood takes over again and they get worse.” “It also takes a pretty checked-in parent to notice these behaviors,” adds Reed. “There can be a lot of denial that goes on with the parents, too.” But, she adds, there are signs for parents, if they look for them. Reed advocates for parents to find support among their peers as well. Young families can start this when their children are young at local parents groups and then they will have the benefit of growing with these parents as their children grow. If parents notice these behaviors, the first step would be to talk with your child. “Turn off radios, turn off TVs… in the car, make sure your teenager is right next to you and turn the radio off – it is an amazing thing to do to get your teenager to talk to you.” At home, play a game and talk to your child, she also advises. “Don’t sit them on the couch and try to talk to them. Play a game, a fun game and not a video game. The more you distract them, the more they will let you know what is going on. As long as it is around a fun environment, they will be more likely to talk.” Do not expect lines of communication to open

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when the child is being punished. “You have to be in a situation where you are engaging them, and it may take a few times,” she says. If they refuse to talk, a school counselor is a good next choice. “Be accepting of all of your child’s feelings,” says Reed. “Do not judge them and do not take what they tell you personally.” But that is not all, “teenagers need a lot of affirmation and they need a lot of love.” Reed adds that this age group of young women and men is undergoing many changes, physical and emotional. “They are also trying on new identities and looking for more privacy,” she says. “Parents are not always ready for these changes and sometimes resist it themselves and that can add to the conflict in the family.” If parents notice cutting or burning or other injurious behavior, call a therapist first, says Dr. Patty. Often, mild cases can be handled with a therapist’s intervention. Only in more serious cases, and with the possible need for medication, do parents need to take their child to a psychiatrist. One sign of a more serious behavioral problem would be many cuts or cutting that is very deep and leaves a scar, though Reed emphasizes that serious cutters most often cut where no one is likely to see. If a parent notices serious changes in their child’s personality, Dr. Patty says, “Always have a conversation about whether a child is having thoughts about hurting him or herself. Right up front; just ask the question. Kids will not be upset that parents ask. Many times parents don’t know until an attempt has occurred because nobody asks. Everyone is afraid to ask that question.” The primary treatment is therapy. Kids must learn to manage their feelings, controlling them, working through emotions and talking about those feelings. The goal is for young adults to learn to manage all of their feelings, including anger, frustration and those that stem from delayed gratification. TeensHealth.org offers some structured ideas to help teens that are struggling with the compulsion to cut. They recommend teens become aware of what situations trigger the need to cut and make a plan for what to do when they feel the urge. Most often, that means finding an activity to distract them from the behavior: call a friend to discuss another topic, go for a walk or run, play with a pet or participate in another activity that can sooth and calm. Untreated, cutting and other behaviors may drop off as a child reaches later teen years, but this is often only to be replaced with other outlets such as alcohol or drug abuse, poor relationship choices and more. “It can absolutely manifest into other behaviors,” says Reed. A final piece of advice from Dr. Patty: “Interact [with your kids] when things are going well. Many times what happens is parents talk when there is problems or conflict and it doesn’t go very well. As kids get older, sometimes parents think they don’t need them anymore and they withdraw, but your kids actually need your more through ages 13 to 18 than they did at 8, 9 or 10.” Angeline Grenz is editor for Northern Colorado Medical & Wellness magazine.

Northern Colorado Medical & Wellness 2012

wellness

Skin Care

zap t h at zit A pimple is a pimple is a pimple. Or maybe not. Acne occurs in an estimated 85 percent of teens and is a leading cause of teen angst. Just when boys and girls are starting to look good to each other, zits start sprouting on noses, chins and foreheads. But what is a zit, anyway? What causes them? And more importantly, how can they be zapped? It’s the hormones. Plain and simple. Once your child hits puberty, the hormones start to go crazy – and that is medical terminology. For some teens, that boiling stew creates excess sebum (the skin’s natural oil) production. Coupled with makeup and oftentimes poor cleansing habits, the skin erupts. The result: acne. Acne comes delivered in several different packages, from mild to very severe. The medical name, Acne Vulgaris consists of the following: Whiteheads – A whitehead is the result of a completely blocked pore, which traps sebum, dead skin cells and bacteria, causing small raised white spots on the skin’s surface.

By MICHELLE VENUS

Blackheads – A blackhead happens when a pore is partially blocked with sebum, bacteria and dead skins cells, allowing these irritants to oxidize and cause a dark-colored plug of gunk. Both blackheads and whiteheads are considered non-inflammatory acne. Inflammatory acne is more severe, can lead to scarring and is often painful: Papules – Inflamed, tender red bumps are the hallmarks of papules. They have no head and squeezing them will only increase the likelihood of scarring. Papules occur when white blood cells enter the follicle (pore) and cause inflammation. Pustules – Pustules occur when the white blood cells from the papule reach the surface of the skin. They look like a red circle with a raised white or yellow center. Even though the temptation to pop this garden variety zit is high, resist doing it yourself. Improper extractions can lead to further inflammation and scarring. Nodules and cysts are the most severe forms of acne. Typically, they are much larger than papules and pustules and lie deep beneath the

skin’s surface. Nodules – Large, hard bumps are the hallmarks of nodules. These lesions are under the skin and should never be squeezed or picked at. This is dermatologist/esthetician territory only. Cysts – Like a nodule, but filled with puss. Squeezing cystic acne will cause the infection to become deeper, more painful and more difficult to treat. Again, only professionals should perform treatment. Now that we’ve covered Acne 101, let’s talk about how to zap it for good. First and foremost, developing good hygiene practices will solve many problems. Use appropriate products. “You need to understand your skin; is it dry? Combination, meaning oily in the T-zone but not on the cheeks? Oily all over? Make sure you start with a good cleanser, followed by a toner and then a moisturizer,” says C.J. Weimer, licensed esthetician at Barcelona Clinical Spa and Salon in Fort Collins. She stresses the difference between a toner and an astringent: toners don’t contain drying alcohol. Mostly water combined

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with nourishing ingredients, toners are made for different types of skin. While a moisturizer may seem contrary for oily skin, it’s actually very beneficial. Products that dry out the skin tend to trigger higher sebum production, resulting in a vicious cycle. Adding the right moisturizer to your routine helps to alleviate that problem. If a consistent cleansing regimen doesn’t solve the problem, it’s time to visit a dermatologist or esthetician. Both are trained in extractions, a sterile procedure that eliminates debris that has accumulated in the follicle. Extracting lesions at home is ill advised, as it could lead to further infection and scarring. Clinical spas use a combination of specialized products and equipment to combat teen acne. Deep cleansing facials are a good start. A trained and licensed esthetician applies the products, performs extractions and flushes out the pores. Oftentimes a high frequency or bluelight device will be used to kill off any remaining Propionibacterium acnes. For less severe acne, another treatment to consider is microdermabrasion. Tiny crystals are used to abrade the skin, removing the topmost layer of dead cells. The crystals and dead skin are vacuumed away, opening up clogged pores and releasing all the goop. Microderm on more severe acne is not recommended as it may exacerbate the condition. According to Anne Marie Feilinger, esthetician with Harmony Laser Center, their HydraFacial provides many of the same results as microdermabrasion and allows the esthetician to infuse the skin with healing serums. “Congested pores are cleaned out and the skin is smooth and glowing afterwards,” she says. Diana Hermann, L.Ac, studied Traditional Chinese Medicine (TCM) in China. She is a firm believer that acne is a result of systemic problems and looks at the body as a whole before treating just the acne. “People often come to me as a last resort,” Hermann says. “They’ve tried everything else and nothing is working. But a chronic skin problem can’t be solved just by putting product on the skin. We need to address the root issues of the energetic imbalance.” Once Hermann has determined what the underlying causes are, she’ll mix up an herbal remedy. She has also developed Zi Zai, a line of skin care products based on TCM using Chinese herbs. “I was given ancient recipes from the doc I studied under in China,” Hermann states. “It was called something like Skin One. It is the basis of all the products in Zi Zai.” Each and every practitioner could not stress the use of sunscreen strong enough. C.J. Weimer suggests putting it on your children as part of their regimen starting in toddlerhood. “Teach your children good skin care practices right from the start,” she suggests. “Make good hygiene and sunscreen use a daily habit.” Weimer recommends every person use sunscreen every day in every season. “You use moisturizer every day,” she says. “Use sunscreen every day. It’s the best thing you can do for your skin.” Michelle Venus is a freelance writer who works and lives in Fort Collins with her children and two dogs.

Northern Colorado Medical & Wellness 2012

tanning bed dangers By MICHELLE VENUS

Melanoma is the deadliest form of skin cancer, and yet according to an American Academy of Dermatology survey, 86 percent of indoor tanning respondents do so knowing the risks that they may ultimately succumb to this preventable disease. And most do it for vanity, with 87 percent of the respondents to the survey stating they believe that they look better with bronzed skin. Additionally, indoor tanners run the risk of premature aging. The irony is that this group is more concerned about wrinkling than their non-tanning counterparts: 42 percent versus 28 percent. A secondary and equally alarming statistic is that 48 percent of indoor tanners know someone who has or has had skin cancer. “It’s absurd that many people who indoor tan are doing it for cosmetic reasons because that tan can actually accelerate the aging process and can lead to melanoma – the deadliest form of skin cancer,” says dermatologist Ronald L. Moy, MD, FAAD, president of the Academy. Culturally, a “healthy glow” is more attractive than paler skin, and society promotes that ideal in the media through advertising, fashion layouts and television programs. “Teens often report feeling a sense of invincibility, which explains why their actions often do not mirror their knowledge of certain behaviors – like tanning,” explains Moy. “Our survey confirms that teens are more concerned with their current looks than their future health, even though they realize that skin cancer is a risk factor of their behavior. If this behavior trend continues and young women’s attitudes toward tanning do not change, future generations will develop more skin cancers earlier in life and the consequences can be fatal.” A Mayo Clinic study found an eightfold increase in first-time diagnoses of melanoma in young women aged 18 to 39 years between 1970 and 2009. Colorado is one of the few states that does not regulate the use of tanning beds by minors. California was the first to completely ban teens under 18 from using commercial UV tanning beds and at least 30 states now have some form of age-based restrictions in place. This year’s Colorado Bill 1170, sponsored by Democratic Rep. Cherylin Peniston of Westminster, would require a parent’s permission in order for a person under 18 to use a tanning bed with UV exposure. For children under 14, parents would have to be present while their children use a tanning bed. Prevention is the first step in avoiding skin cancer of any kind. Here are some guidelines to help your skin stay safe and looking young. • • • • •

•

• • •

Seek the shade, especially between 10 a.m. and 4 p.m. Do not burn. Avoid tanning and UV tanning booths. Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses. Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher every day. For extended outdoor activity, use a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher. Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours or immediately after swimming or excessive sweating. Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months. Examine your skin head-to-toe every month. See your physician every year for a professional skin exam.

May is Melanoma/Skin Cancer Detection and Prevention Month. Visit www.skincancer.org/ skin-cancer-information/melanoma for more information about this disease.

wellness

Orthodontics

a deeper look into

O rt h odontics

ention the word orthodontics and the image that appears in most people’s minds is that of braces as a quick fix. Few in the general public understand what a thorough orthodontic treatment means. It’s not just about addressing surface aesthetics, orthodontic treatment also improves malocclusions (bad bites), which can occur as a result of tooth or jaw misalignment. They affect the way someone smiles, chews and even cleans his/ her teeth. According to the American Association of Orthodontists, untreated malocclusions can result in a variety of problems. Crowded teeth are more difficult to properly brush and floss, leading to tooth decay and/or gum disease. Protruding teeth are more susceptible to accidental chipping and cross bites can result in uneven tooth wear from unfavorable growth. Open bites can create speech impediments. By correcting these issues, orthodontic work not only creates a nice smile, it contributes to overall health. To be fully effective, any orthodontic work should include a thorough treatment plan and

require a thorough exam, says Bradford N. Edgren, DDS/MS from Orthodontic Associates of Greeley. “You can’t treat what you don’t diagnose and you can’t diagnose what you don’t know.” For that reason, Dr. Edgren says he takes extra time with each case. “I don’t like to rush. If you rush, you may miss something.” “The initial clinical exam is extensive,” he says. “We discuss the patient’s chief complaint and expectations before I look in the mouth.” Next, Dr. Edgren takes a Cone Beam Computed Tomography (CBCT) image, which involves the use of a rotating X-ray scanner and a digital computer to take images of the head. Using CBCT imaging, cross sectional images of the facial skeleton and teeth can be produced. The CBCT is a compact, faster and substantially lower dose version of the regular CT and represents a significant advance in imaging capabilities for dentistry. The CBCT provides a complete three-dimensional view of the maxilla, mandible, teeth and supporting structures. With this scan, Dr. Edgren can see a three dimensional view – coronal, sagittal and axial, as well as a panoramic image. “It clearly shows the underlying

By Kay rios

matrix of the bone,” he says. It’s important to take that into consideration, Dr. Edgren maintains. “I take an X-ray of the hand so I can determine the carpal index; that is the patient’s skeletal age and with that, I can predict how the face and jaws will grow without treatment.” It’s an important part of the orthodontic evaluation. “If you are not taking the skeletal components into account, you will have a hard time moving the teeth to where they need to be. Skeletal age can be one of the most critical pieces of information used when predicting growth and treatment plans. Beauty is only skin deep but ugly goes all the way to the bone. The underlying matrix of bone is the limiting element in beauty and in orthodontics.” The diagnostic records include a blue print/ tracing of the patient’s scanned image; and a growth forecast, based upon the hand X-ray, of where that patient’s face will grow, based on age, sex and race. Dr. Edgren superimposes one over the other, offering an idea of how the face will change with age. “It’s 85 to 90 percent accurate and it is essential for orthodontic treatment planning. For example, if a patient has an

Lydia’s STYLE Magazine

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An example of the comprehensive images Dr. Edgren uses to develop a treatment plan for his patients.

overbite and I hold the upper teeth in place, I can use remaining forward, lower jaw growth to correct the bite. I can’t constrict the lower jaw but I can expand the upper arch.” With overcrowding in a young mouth, it’s not helpful to just pull baby teeth, he says. “That’s an antiquated thinking process and can cause other issues.” The point, Dr. Edgren explains, is to create a bite that is functional. “If it is functional, it will most likely be aesthetic. If you have asymmetry and you correct it early on, you will reduce the chance of asymmetry later on. Form follows function.” Dr. Edgren feels that patients should not only become educated, he also says that it’s important for orthodontists as well. “We need to stay current with changes in the field.” Dr. Edgren practices what he preaches and not only stays ahead of the learning curve, he teaches continuing education courses and lectures on both Cone-Beam Technology and on Analysis of Facial Growth and Development. New changes in the field occur all the time and, if the orthodontist stays up to date, the patients benefit by saving time and money. But that doesn’t mean that the exam, the plan or the treatment should ever be rushed. Though Dr. Edgren says an orthodontist can help patients at any age, he also says there is an optimal time to begin treatment. Starting

Lydia’s STYLE Magazine

Bradford Edgren, DDS/MS, Orthodontic Associates of Greeley

treatment by the age of 7 ensures the greatest result and the least amount of time and expense. In fact, the American Association of Orthodontists recommends an initial orthodontic evaluation should occur at the first sign of orthodontic problems or no later than age 7. If this happens, orthodontic treatment may not be necessary, but, with a vigilant exam, itâ&#x20AC;&#x2122;s easier to anticipate the best time to begin treatment. Even when orthodontic intervention is not necessary, an orthodontist can monitor growth and development and begin treatment at the ideal time. Seven is considered the optimal age for screening because this is when the first adult molars erupt, and the back bite is established. During this time, the front-to-back and side-to-side tooth relationships can be easily evaluated. And, if required, intervention can have direct results in several ways. It can create room for crowded, erupting teeth, impact facial symmetry by influencing jaw growth and reduce the risk of trauma to protruding front teeth. In addition, it can reduce the need to remove teeth and reduce treatment time with braces. But, Dr. Edgren says, the first step is to make the appointment with an orthodontist and start the discussion. Kay Rios, Ph.D., is a freelance writer in Fort Collins.

Northern Colorado Medical & Wellness 2012

wellness

Fitness

F u n M eets L i f elong Fitness

imee Jensen had caught the rowing bug. After losing her mother in March 2005, the former mountain guide was looking for a physical challenge to buoy her spirits. So she signed up for a Learn to Row event with the Fort Collins Rowing Association (FCRA). As her boat slipped across the surface of Horsetooth Reservoir, Jensen and her boat mates fell into a hypnotic rhythm. Gliding beneath the towering red hogbacks, she was completely in the moment. Rowing seemed exactly what she needed. Jensen was keen to sign up for a novice course, but there was a problem. She’d just been diagnosed with breast cancer. The rowing season would run May to November – straight through her scheduled surgery and radiation treatments. She shared her concerns with FCRA co-founder Howard Hissrich, who was guardedly optimistic. “He said, ‘We’ll figure something out,’” she recalls. “Let’s get you rowing, and let’s keep that going for as long as we can.” When the latest crop of novices gathered at Horsetooth before sunrise, Jensen was among them. She seized the oars and never looked back.

A Sport for All Skill Levels

Fort Collins rowers brim with an infectious passion for their sport – and they’re eager to share

By Sarah Maurer

the bliss. FCRA co-founder Mark Berkner even has an elevator pitch. “Rowing is a blast!” he tells potential recruits. “Come on out and try it!” FCRA’s membership includes about 50 master (post-college) rowers ranging from hobbyists to high-level competitors as well as Colorado State University’s Crew Club. Their diversity underscores FCRA’s goal to provide rowing opportunities for all ages and skill levels. A number of factors contribute to rowing’s addictiveness – an outdoor setting, camaraderie, health benefits. But when asked to explain the sport’s appeal, members speak not of practicalities but transcendence. “It’s sort of a Zen-like separation from the rest of life,” says founding member Eric Stevens. “You’re out there in this otherworldly environment – breathing hard, getting your heart rate up, feeling the sweat form, gliding over the water with the mountains and the red rocks of Horsetooth in the background.”

Rowing Association Forms

When Berkner set eyes on Horsetooth Reservoir, it was love at first sight. Berkner, who won a bronze at the 1987 world championships and was an alternate on the 1992 Olympic team, heard of Fort Collins years before he arrived. While training on Philadelphia’s Boathouse Row, he met a woman who had driven cross-country with her shell lashed to the top of

her VW bus. Born far from rowing’s East Coast epicenter, she’d launched her career in CSU’s fledgling crew program. In the early 90s, Berkner accompanied his wife to Fort Collins when she interviewed for a judicial clerkship. “I went up and took a look at Horsetooth, and I prayed she got the job,” he says. “It’s remarkable rowing water, absolutely world class.” Berkner got his wish, but lost Philadelphia’s tight-knit rowing community. For years, the champion pairs rower trained alone. He met other rowers at Horsetooth, and they talked about organizing a club. When Hissrich, another a high-level competitor, arrived in town, rowers began gathering in increasing numbers, with CSU Crew as their nucleus. In 2005, the FCRA formally incorporated as a nonprofit. Today, Berkner throws himself into FCRA with abandon, despite a busy off-water schedule as an attorney and business owner. He’s a self-proclaimed zealot of rowing, whether he’s scouring the country for an affordable safety launch or coaching the CSU club. “I’ll be doing it until I keel over,” he says of his chosen sport. “Somewhere around 100.”

A Lifelong, Healthy Pursuit

Berkner’s aspiration to row past the century mark is no joke. The longevity of rowers is legendary. Oarsmen like to quote a 1960s study of

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Harvard University alumni. The study found the subjects who had rowed crew in college lived longest. Like cycling, rowing tends to be a lifelong pursuit. A significant percentage of oarsmen pick it up later in life, often as a second or third sport. Berkner estimates that the average age of FCRA’s recruits is in the 50s. Stevens, an M.D., is enthusiastic about the benefits of rowing across the lifespan. “It’s a pretty high intensity exercise, so it’s an excellent cardiovascular workout,” says the former national champion who practices pulmonary critical care medicine with Northern Colorado Pulmonary Consultants. “It’s also a pretty good strength workout.” Having a medical condition shouldn’t put rowing out of reach, Stevens says, though it’s important to get clearance from a doctor. Proper technique and training can be used to work around a wide range of issues. One of FCRA’s most active members is in his early 70s. He rows daily and is a world champion on the ergometer (rowing machine), despite multiple joint replacements. The benefits of rowing go far beyond the physical, as Aimee Jensen learned her first season. She remembers coach Molly Johnson as a model of patience who held the boat steady hour after hour as her charges flailed about. Gradually the group found its rhythm. Jensen rowed hard, barely pausing for surgery and plugging along through seven weeks of radiation. “I think I needed it so badly, I just did it,” says Jensen, who admits she’s not really one for talk therapy. “I didn’t really consider it an option not to.” The regular regimen of outdoor exercise and teamwork held her on course. “When you have people waiting for you at 5:30 in the morning, you’re not going to weenie out,” she says. “They’re counting on you to get your row in it.” She liked that her teammates were less concerned about her illness than in her oar skills. At some point during the summer, she opened up about her condition. “It was like, ‘Oh, okay. When are we rowing again?’” she recalls. The response was balm to her soul.

Learn to Row Now

As another season approaches, FCRA is looking to the future. Berkner is in recruiting mode, encouraging the curious to sign up for a Learn to Row clinic. (For details, see www.fcrowing.org.) Jensen, now a certified coach, hopes to create an adaptive rowing program for cancer survivors who desire an active form of coping. And the group is already gearing up to host the 2012 Horsetooth Ache, a 90-minute, 13-mile race across the reservoir. “It’s an ache for sure!” Jensen says. Above all, members encourage anyone with an interest to give rowing a try, no matter their age, condition or experience. “We want this to be truly a community rowing association,” Jensen says. “It’s given us so much. We want to pay it forward.”

Sarah Maurer is a Denver-based freelance writer specializing in health and wellness topics. Learn more about her work at www.sarah-maurer.com.

Northern Colorado Medical & Wellness 2012

adult sports leagues By Logan Martinez

Adult sports leagues range far and wide in Northern Colorado. Whether one is interested in easing into a sport or is a hardcore athlete, there are opportunities for all. And even better, not only do adult sports leagues offer an opportunity to stay fit, they are great potential socializing and networking opportunities. One popular option is the adult Indoor Soccer League held at The Edge Sports Center in Fort Collins. The league is open to participants 18 years of age and older and features men’s, women’s or coed leagues for eight-week sessions. The leagues occur continuously throughout the year and the cost is $725 per team. The Edge Sports Center also offers a drop-in adult

baby on board By corey radman

Believe it or not, it is actually possible to both grow a person and continue a healthy exercise regimen... albeit, a little more slowly than before your pregnancy. On Colorado’s hyper-fit front range, the sight of a third trimester baby bump jogging down the road isn’t out of the question, nor should it be, says Jennifer Reeve, M.D. The OB/GYN from The Women’s Clinic of Northern Colorado actively encourages her patients to keep up their favorite activities, and suggests that women who don’t regularly work out still consider beginning some light movement.

soccer league. Phil Ebersole, owner of Edge Sports, says many people come and get involved in house teams (teams made up of players that sign up individually) and enjoy the experience so much they continue to sign up as the same team. “The [house team] is how many individuals get involved in the league and typically they are made up of new people in town or students,” Ebersole says. “It is also a great way for them to meet other players and get on a team. Sometimes those house teams bond really well. We had a house team ‘Green’ one time and they stayed together and called themselves ‘Not Easy Being Green’ as their team name.” The leagues get players involved socially; Ebersole says many of the teams go out for drinks or dinner after practice. “A large part of the adult soccer thing is social,” Ebersole relates. “The people love to play, but you can tell by the fact that they come early to talk, and hang around afterwards or go out and get a drink or something to eat, that they interact more than for the hour of the game, so the social interaction is a big deal.” If soccer isn’t one’s preference, Edge Sports also offers flag football leagues, or the City of Fort Collins offers ultimate Frisbee leagues hosted at the Edge Sports facility. Of course, the City of Fort Collins has a wealth of organized leagues available. Take, for instance, their Adult Outdoor Volleyball

League available for players 16 years of age and older. This league is also organized into women’s, men’s or coed, lasting for 7 weeks. The cost is $44 for a doubles team or $84 for a 4 person team. The City of Fort Collins is preparing registration for doubles men’s, women’s, or coed or four-person women’s and coed volleyball teams. Teams can register at any of four locations, including the Senior Center, Mulberry Pool, EPIC or the Northside Aztlan Community Center. If one is interested but can’t pull a team together, Volleyball League Director Ralph Mirelez says the league will write down their name on a free agent list for others looking for a volleyball partner. What he says is most attractive about the outdoors league is the attraction of enjoying the cool evening air on a soft green court. The leagues play on grass, rather than an indoor wood court, says Mirelez. Whether interested in competition or just time to meet new people, Mirelez says the sport brings together a variety of interests. “Some leagues tend to be competitive and some just come to have fun; it isn’t just for one or the other,” Mirelez says. Registration opens May 14 and the sevenweek league begins June 11. The city also offers adult softball leagues; check out www.fcgov.com/sports to learn more about other league opportunities.

Beginners:

exercising women should be able to carry on a conversation without gasping. “Your heart rate should be no more than 70 to 80 percent of your maximum,” she says. The top no-no’s of pregnancy exercise are scuba, horseback riding and skiing because of the pressure and the risk for falling. Beyond that, the sky’s the limit... well maybe not sky diving, but you get the idea.

“Some moderate activity three to seven days per week is good for your overall health. Thirty minutes a day helps your mood and your coping skills,” says Dr. Reeve. She suggests: walking, swimming, elliptical trainer machines... etc. “Just do something,” she says. The American Pregnancy Association website seconds those suggestions and adds a few more. Kegels, they say, strengthen the pelvic floor muscles and cut down on dreaded bladder leaks and hemorrhoids. Also on the list: stair climbing machines (remember to hold the rails for balance), yoga and biking, especially stationary bikes because of the reduced risk for falls.

Regular Athletes:

Of course, double-check with your doctor to be sure your particular routine is best for your health and your baby, but generally speaking, keep doing what you’ve been doing. Running, weight lifting, aerobic classes and biking are all on Dr. Reeve’s approved list. “Listen to your body,” she counsels. “If something hurts because of the changing angles of your hips or spine, then don’t do it any more, but it’s probably not going to hurt you or your baby,” she says. Dr. Reeve explains that medical texts used to recommend keeping your heart rate under 140 beats per minute while exercising during pregnancy. “But that is too low for many women,” she says. “Use the talk test instead,” suggests Dr. Reeve. The talk test means that

Hardcore:

Pregnant athletes who train long distances (like marathons or ultras) should keep in touch with their doctors. “They may need to take it easy if a baby isn’t growing appropriately,” says Dr. Reeve. The other note of caution she adds is to athletes who train above 6,000 feet in altitude. These two categories of pregnant athletes may be at risk for delivering small babies.

General Recommendations:

Check your shoes to be sure they haven’t traveled too many miles and still provide good traction and support. Speaking of support, take care of the girls – ensure that your sports bra properly fits your expanding breasts. Drink lots of fluid as you go. And revel in the joy of continuing your exercise routine under Colorado’s blue skies. The American Pregnancy Association urges women to, “Stop exercising if you have any vaginal bleeding, dizziness, faintness, shortness of breath, contractions or nauseous feelings.”

Lydia’s STYLE Magazine

G et Fit, G i v e B ack C alendar 5 – A Walk in the Park, 9 a.m. registration, Chapunga Sculpture Park, Loveland, benefitting the Huntington’s disease Society of America Rocky Mountain Chapter, www.firstgiving.com

may 26, 2012

The Fort Collins Children’s Triathlon and Family Fun Run This one-of-a-kind family wellness event will be held on May 26, beginning at 6:00 a.m. at O’Dea Core Knowledge Elementary in Fort Collins. The triathlon is for children ages 6 thru 13, and parents can participate side-by-side with their kids. The event is open to anyone who wants to come, with different age category waves ending with a wave for parents with strollers. After the races will be a breakfast, obstacle course, inflatables and live music. “We want to promote healthy family lifestyles, which is why families can participate together in each event,” says Ryan Joyal, race director and 5th grade teacher at O’Dea Core Knowledge Elementary. “Getting outside together as a family is a great way to keep families healthy and happy, and it doesn’t have to require a lot of work or special equipment.” All proceeds go back to the school to support their ongoing wellness activities such as running club, kids yoga, before school fitness and Eco Week among others. Visit their website at www.fortcollinschildrenstriathlon. com to register, volunteer or become a sponsor.

Staying active benefits your health, but through nonprofit support, it also benefits the community. So, train up for these marathons and other events to really make a difference. m ay 5 – Cinco-Cinco 5K Run/Walk, 8:30 a.m., The Oval at CSU, Fort Collins, in memory of Gil Gutierrez, CSU Ombudsman, www.cincocinco.colostate.edu 5 – MS Walk, 1 or 3 mile walk, 7:30 a.m., Edora Park, Fort Collins, benefitting the Colorado-Wyoming Chapter of the National Multiple Sclerosis Society, www.nationalmssociety.org

Northern Colorado Medical & Wellness 2012

5 – 10th Annual Bob Turner Classic 5K Run/Walk, 8 a.m., Turner Middle School, Berthoud, benefits Turner Middle School athletic and technology programs, registration ends May 4 at 11:59 p.m., www.fc.thompson.k12.co.us/~tms/ 6 – Colorado Marathon, Half Marathon, 10K & 5K, 6:15 a.m. and 7 a.m., Bus Pickup, Fort Collins, benefits multiple area non-profits, www. thecoloradomarathon.com 12 – Run for Orphans 5K, 8 a.m., The RanchLarimer County Fairgrounds, Loveland, benefitting different non-profit organizations supporting orphans, www.runfororphansrace.org 12 – Quad Rock 25/50 mile run, 5 a.m., Lory State Park, Fort Collins, www.gnarrunners.com 12 – New Vision 5K Walk/Run, 8 a.m., Boyd Lake State Park, Loveland, to provide staff and students with a wellness program at New Vision Charter School, www.newvisioncharterschool.org

Medical Center, www.bannerhealth.com 26 – Fort Collins Children’s Triathlon and Family Fun Run, 6 a.m., O’Dea Core Knowledge Elementary, Fort Collins, www.fortcollinschildrenstriathlon.com 26 – Pelican Fest Triathlon, 8 a.m., Board Walk Park, Windsor, www.t2coaching.com 27 – Memorial Day 5K Run/Walk, 8:45 a.m., Hughes Stadium, Fort Collins, supports CSU student veterans, www.adultstudents.colostate.edu june 1 - 2 - 3 – Relay for Life, Weld County, Fort Collins, Loveland, benefits American Cancer Society, check website for exact times and dates, www. relayforlife.org 2 – Sierra’s Race Against Meningitis 5K & Kids Run, 9 a.m., Crossroads Church, Loveland, provides awareness and free vaccinations against Meningitis in Northern Colorado, www.sierrasraceagainstmeningitis.com 9 – 22nd Annual Fire Hydrant 5K Walk/Run & Pet Expo, Larimer Humane Society, Fort Collins, www. larimerhumane.org

13 – Crazy Legs 10K Trail Run, 7 a.m., Devil’s Backbone, Loveland, to promote non-pavement races, www.crazylegsraceseries.info

17 – Father’s Day 5K, 8 a.m., Old Town Square, Fort Collins, presented by Primrose School, www. fcgov.com/recreation

14 – A Day in May Predict 5K, 8:30 a.m., Walt Clark Middle School, Loveland, www. fc.thompson.k12.co.us

17 – 2012 Estes Park Marathon, 7 a.m., Estes Park Middle School, Estes Park, www.epmarathon.com

19 – Hope Lives! Pink Boa 5K Run/Walk, and Kid’s Fun Run, 8:30 a.m. Front Range Village, Fort Collins, benefiting The Lydia Dody Breast Cancer Support Center, www.hopelives.org 19 – A Soldiers Silent Cry 2nd Annual 5K, 11 a.m., Spring Creek Park, Fort Collins, benefitting soldiers who suffer from mental disabilities after combat, www.asoldierssilentcry.com 19 – MS Walk, 1 or 3 mile walk, 7:30 a.m., Chapunga Sculpture Park, Loveland, benefitting the Colorado-Wyoming Chapter of the National Multiple Sclerosis Society, www.nationalmssociety.org

30 - July 1 – Full Moon Open, 7 a.m., Horsetooth Reservoir, Fort Collins, registration closing date June 23 at 11:59 p.m., largest bass tournament in Colorado, limited to first 50 teams that register, www.centennialbass.homestead.com july 4 – Race Against Cancer, 7:15 a.m., 1500 10th Avenue, Greeley, all proceeds benefit Rocky Mountain Cancer Rehabilitation Institute in Greeley, www.unco.edu/rmcri 15 – Urban Assault Ride, 9 a.m., New Belgium Brewing Company, Fort Collins, bicycle obstacle course event series, www.urbanassoultride.com

19 – Family Medical Clinic Fit Family 5 mile, 9 a.m., 380 Community Drive, Estes Park, www. fitfamily5mile.org

20 – Relay for Life of Estes Park. 4 p.m., Estes Park High School Stadium, benefits American Cancer Society, www.relayforlife.org

20 – Fort Collins Triathlon & Duathlon, 7 a.m., 1801 Riverside Avenue, Fort Collins, www.fortcollinsclub.net/events/triathlon

28 - 29 – Annual Human Race 5K/10K, 8 a.m., Old Town, Fort Collins, www.register.thelastmileracing.com

20 – Community Classic Bike Tour, 6:30 a.m., McKee Medical Center, Loveland, benefitting Stepping Stones Adult Day Program at McKee

29 – Loveland Little Sprint Triathlon 2012, 8 a.m., Mountain View High School, Loveland, benefitting Banner Health, www.mckeefoundation.com

family f o cu s

Character Building

in Athletics By Connie Hein

From the moment of his birth, to the end of his short journey of life, everyone knew there was something special about Nicholas. “He was the picture of a bouncing baby boy from his very first breath,” says his father Bill Greenwood, “and lived his life that way, always vibrant, loving and supportive of those around him.” Nicolas was Bill and Bernadette Greenwood’s third child. “He was a shining star, excelling at everything he tried, especially athletics,” Bill says. “He had everything necessary to make a great athlete and loved nothing more than sharing his skills of speed, agility and accuracy to help his four siblings and other children to achieve success in many different sports and activities.” In 2008 5-year old Nicolas was involved in an accident at the Greenwood’s Livermore ranch; injured when he fell from a trailer that ran over his little body. He was flown to Children’s Hospital in Denver where he remained in a coma for 10 days. He turned 6 years old while he was in the hospital and passed away on May 22, 2008. “We knew after Nicolas’ death that our lives would never be the same,” Bill says, “but we had no idea how drastically things would change.” The Greenwoods had always wanted children and planned their lives around living away from the hustle of a big city, preferring the solitude of nature on their acreage near Livermore. “We knew when we saw the place near the North Fork of the Poudre River that this was where we wanted to raise our family,” Bill says. The Greenwoods had both been collegiate athletes and coaches, so they loved the outdoors and sports and, as their five children were born, began teaching them early the value of sports in their lives, especially the sport of wrestling. “We would all wrestle around on the living room floor for hours at a time,” Bill says. “Teaching our children what it means

to compete with good sportsmanship and to handle themselves with grace whether they won or lost.” After Nicolas’s death the Greenwoods went from teaching their own children the lessons learned from sports, to teaching these concepts to hundreds of children in the community in honor of their son. “Through a friend who wanted to do a benefit wrestling tournament in honor of Nicolas’s life, and help with medical bills,” Bill says, “we found a way to give back to the community in honor of our son.” This is how Fort Collins based nonprofit GRIT (Grace, Righteousness, Intensity and Toughness) Athletics was born. The GRIT mission is to inspire and provide people of all ages with a rich life through athletic opportunities and a variety of sports competitions, while developing skills for challenges along the way. The GRIT Wrestling Club offers boys from ages 5 through 14 several levels of participation and competition at different times of the year. The GRIT Running Club is a coed program helping participants to run at different levels for training purposes or to just get in shape and have some fun with other runners of all ages. Bernadette says they chose the location for the GRIT Athletics Center on Blue Spruce in North Fort Collins because there are many children in the area that might not be able to participate in other athletic programs for financial reasons. “We want every child to have the opportunity to experience the joys and satisfaction of learning and excelling in wrestling or in the running club,” she says. Bill says the term “grit” started out as just another word for toughness among their young sons. “While learning the sport of wrestling on our living room floor, Nicholas and his two older brothers developed mental and physical toughness – grit.” Bill says these traits are a perfect description of how Nicholas lived his life; accepting

God’s grace, striving to live a righteous life and displaying great intensity and toughness in anything he did. They hope to help people of all ages develop that power and endurance, along with other life skills, to help clear hurdles during their life race. Bernadette says they miss Nicolas every day, but are so thankful for his life. She says the most important lesson for their family has been that in life there are many trials, but they can take comfort in their Christian faith. For information about GRIT programs, visit www.gritathletics.com. The annual GRIT Green Grass Fundraiser and Celebration will be held on June 16, 2012, at the Old Livermore Hotel. The name of the fundraiser is in honor of Nicolas who loved bluegrass music. When a song would come to a close, he would say, “more green grass daddy, play more green grass!” There are many other athletic programs available in Northern Colorado that strive to teach young people character building through competitive and non-competitive sports and other outdoor activities. Connie Hein is a freelance writer and the author of the Toliver in Time series of children’s books.

a partial list of Youth Activity Clubs CHAMP (character in Athletics, Make it a Priority), www.champfc.com Fort Collins Baseball Club www.fortcollinsbaseballclub.org Fort Collins Soccer Club www.soccerfortcollins.org Fort Collins Youth and Recreation Program, which has a variety of sports and activities including football, basketball, volleyball, tennis and cheerleading, www.fcgov.com. Dance Express www.danceexpressfc.org Dance Factory in Greeley www.dancefactorylb.com Thompson Soccer League in Loveland www.thompsonsoccer.org Weplay.com has an extensive list of Larimer County sports opportunities. Windsorgov.com gives information on a variety of sports leagues.

Lydia’s STYLE Magazine

kids • play • fun • health • activities

Northern Colorado Medical & Wellness 2012

family f o cu s

Teaching Children

The Joys of a Garden By Style Magazine Staff

Flowers blooming, trees budding, grass growing. It is that time of year again and kids are eager to be outside in the backyard. It is also a great time for parents to begin teaching their children the lifelong joys of gardening. Jack Fetig, owner of Alpine Gardens, says gardening with his children are some of his favorite memories. Alpine Gardens is a proud supporter of the Loveland Youth Gardeners, a nonprofit dedicated to cultivating an interest in gardening and sustainability in young people. “My kids are grown up now but many of my

fondest memories are of our gardening adventures,” Fetig recalls. “We used our garden for food, for learning how things grow, for learning how to be responsible for living things. When your 8-year-old is bringing you pictures of flowers that he wants to plant next year, you know you have them hooked.” Teaching kids to garden takes patience but there are tricks and tools to keep them going. “Early on their attention span was short and we tried to keep it as fun as we could, letting them wander when they lost interest,” Fetig says. “As they grew older they watered, weeded, picked and were truly useful in the garden.”

Try something new with these family-friendly activities in Northern Colorado.

An article by Jo Frederiksen, a Colorado State University Cooperative Extension master gardener, says that allowing children to help plan and plant the garden can be enjoyable. She says it is important to keep the size of the garden appropriate for the ages of the children. For 2 to 4 year olds, planting a half packet of seeds and one to two tomato plants can make for a large, but manageable garden in their eyes. Children ages 5 to 8 years can tackle a larger garden plot with more variety, giving them the opportunity to see the different ways plants grow. Teaching children to garden can be a fun and enjoyable task, but the children will need tools to suit their size and ability. KidsGardening.org recommends purchasing kid-sized tools and taking the time to teach children how to use them properly; smaller garden gear is safer and makes the experience more fun. Don’t forget the fun of the harvest, even if your garden isn’t as lush as you wish. “Even though I am a professional not all of our gardens were wonderful successes in terms of produce,” recalls Fetig, “Many times we went to farms to pick sweet corn from ‘real fields’ but it was all part of the fun.” A relaxed, family experience with a little learning in the mix will make for lasting memories and a lasting skill, as Fetig well knows. “Pulling weeds, watching butterflies, seeing the tomato horn worm who ate our tomato plants overnight and watering each other with the sprinkler are all part of gardening. I can’t wait to continue the fun with my grandchildren.”

14 - 15 – Read and Seed Garden Markers and story time, 2 to 4 year olds, Gardens at Spring Creek, Fort Collins, 10 a.m. or 11 a.m., no registration required, parent or caregiver participation, www.fcgov.com/gardens 21 - 22 – Read and Seed Marigold Planting and story time, 2 to 4 year olds, Gardens at Spring Creek, Fort Collins, 10 a.m. or 11 a.m., no registration required, parent or caregiver participation, www.fcgov.com/gardens

events in northern colorado may 4 - 11 - 18 - 25 – Ready! Set! Grow! All Natural Fun gardening classes, 4 and 5 year olds, Gardens at Spring Creek, Fort Collins, 9:30 a.m., $40 per month for four Fridays, pre-registration required, www.fcgov.com/ gardens 6 - 13 - 20 - 27 – Vineyard Children’s Garden, no age specifications, 1201 Riverside Avenue, Fort Collins, 2 p.m., helping with planting,

weeding and watering, pre-registration required on website, www.meetup.com/ The-Growing-Project-Fort-Collins/events/ 7 - 8 – Pressed Flower Cards Crafts and story time, 2 to 4 year olds, Gardens on Spring Creek, Fort Collins, 10 a.m. or 11 a.m., $3 per child, no registration required, parent or caregiver participation, www.fcgov.com/ gardens

23 - 27 – Loveland Sports Camp, 6 to 12 year olds, Thompson R2J School District Students Only, Thompson Valley High School, Loveland, 8 a.m. to 4:30 p.m., $125 per child, www. lovelandsportscamp.com/fees.html 28 - 29 – Read and Seed Sit Upon and story time, 2 to 4 year olds, Gardens at Spring Creek, Fort Collins, 10 a.m. or 11 a.m., no registration required, parent or caregiver participation, www.fcgov.com/gardens 28 - July 11 – Northern Colorado Soccer Club 3v3 6 week summer soccer team camp, all ages, 3527 W. 12th St. Suite 105, Greeley, Mondays and Wednesdays throughout the six weeks, excluding week of 4th of July, $70 per child, must register in teams of five or more players, www.northerncoloradosoccer. org/camps

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kids • play • fun • health • activities PRESCHOOL/PREKINDERGARTEN SUMMER CAMPS To learn & explore pick from 6 t wo week thematic camps SCHOOL-AGE SUMMER CAMPS To have fun & learn pick from 12 one-week thematic camps

FOR INFORMATION & TO REGISTER CALL LOVELAND: 2755 North Garfield, Loveland, CO 80538 • 970-663-0754

FORT COLLINS: 1100 Rocky Mtn. Way, Fort Collins, CO 80526 • 970-223-5437 3506 Lockwood Drive, Fort Collins, CO 80525 • 970-223-3888 4703 McMurry Ave., Fort Collins, CO 80525 • 970-377-0407 4755 Royal Vista Circle, Fort Collins, CO 80528 (Windsor exit) • 970-223-0056

Northern Colorado Medical & Wellness 2012

june 3 - 10 - 17 - 24 – Vineyard Children’s Garden, no age specifications, 1201 Riverside Avenue, Fort Collins, 2 p.m., helping with planting, weeding and watering, pre-registration required on website, www.meetup. com/The-Growing-Project-Fort-Collins/events/

11 - 12 – Read and Seed Butterflies and story time, 2 to 4 year olds, Gardens at Spring Creek, Fort Collins, 10 a.m. or 11 a.m., no registration required, parent or caregiver participation, www. fcgov.com/gardens

18 - 22 – Junior Weeknight Northern Colorado Summer Tennis Camp, University of Colorado, Greeley, 5 p.m. to 7 p.m., $150 per child, other registration dates available, uncbears.com/ information/camps/index

4 - 6 - 11 - 13 – Mad Scientist Camp, 4 through 6 year olds with adult supervision or 7 years old and up, Youth Center, Estes Park, registration open May 2 through May 30, www.estesvalleyrecreation.com

11 - 15 – All About Bees Summer Camp, 6 to 11 year olds, Gardens at Spring Creek, Fort Collins, 9 a.m., $125 per week session, pre-registration in person or by phone required, www.fcgov.com/gardens

4 - August 17 – Mountain Kids Summer Day Camp, various age group camp availability, Mountain Kids, Fort Collins, 7:15 a.m. daily, $240 per week per child, $50 registration fee prior to May 15, $75 registration fee after May 15, www.mountain-kids. com/fort_collins/summer-camp/

18 - 21 – Princess Camp, 3 years old and up, Youth Center, Estes Park, 9 a.m. to 11 a.m., $40 per princess in-district or $54 per princess non-district, registration open May 2 through June 12, www. estesvalleyrecreation.com

25 – Read and Seed Bird Mosaic and story time, 2 to 4 year olds, Gardens at Spring Creek, Fort Collins, 10 a.m. or 11 a.m., no registration required, parent or caregiver participation, www.fcgov. com/gardens

4 - 8 – Art in The Garden Summer Camp, 6 to 11 year olds, Gardens at Spring Creek, Fort Collins, 9 a.m., $125 per week session, pre-registration in person or by phone required, www.fcgov.com/gardens 4 - 5 – Bird House Building and story time, 2 to 4 year olds, Gardens at Spring Creek, Fort Collins, 10 a.m. or 11 a.m., no registration required, parent or caregiver participation, www.fcgov.com/gardens 8 - 15 - 22 - 29 – Ready! Set! Grow! Celebrate Summer gardening classes, 4 and 5 year olds, Gardens at Spring Creek, Fort Collins, 9:30 a.m., $40 per month for four Fridays, pre-registration required, www.fcgov.com/gardens

18 - 22 – Tiny Tots Northern Colorado Summer Tennis Camp, 3 to 7 years old, University of Colorado, Greeley, 8 a.m. to 8:45 a.m., $75 per child, other registration dates available, www.uncbears. com/information/camps/index 18 - 22 – Nature Detectives Summer Camp, 6 to 11 year olds, Gardens at Spring Creek, Fort Collins, 9 a.m., $125 per week session, pre-registration in person or by phone required, www.fcgov.com/ gardens

25 - 28 – Pirate Camp, 3 to 13 year olds, Youth Center, Estes Park, 9 a.m. to 11 a.m., $40 per child in-district or $54 per child non-district, registration open May 2 through May 30, www. estesvalleyrecreation.com 25 - 29 – Gardeners and Chefs I Summer Camp, 6 to 11 year olds, Gardens at Spring Creek, Fort Collins, 9 a.m., $125 per week session, preregistration in person or by phone required, www. fcgov.com/gardens

18 - 19 – Read and Seed Day Lilies and story time, 2 to 4 year olds, Gardens at Spring Creek, Fort Collins, 10 a.m. or 11 a.m., no registration required, parent or caregiver participation, www.fcgov.com/gardens

Lydia’s STYLE Magazine

Northern Colorado Medical & Wellness 2012

veterinary

Rehabilitation

Jessica Rychel, DVM, Fort Collins Veterinary Emergency & Rehabilitation Hospital

p e t r ehab i l i tati o n: A Movement Who’s Time Has Come

decade ago, the idea of pet rehabilitation was welcomed with raised eyebrows and skepticism. Today, it’s not only accepted, but encouraged among many veterinary professionals. “This is a discipline whose time has come,” says Robin Downing, DVM, CVPP, CCRP, DAAPM, of Windsor Veterinary Clinic and The Downing Center for Animal Pain Management. “I had become frustrated that I could provide pain relief to a point, but not as far as I liked. The interest [in rehabilitation] was driven by the terrific impact physical therapy has played with humans, alleviating crippling or chronic pain. It seems like a logical extension to apply this to animals. We can improve mobility and even extend life expectancy.”

“It used to be, ‘Physical therapy for dogs? You guys must be crazy!,’ but now it’s become more common, and veterinarians have become much more supportive of the process,” adds Kara Keesling, DVM, CCRP, CVA, at Animals in Motion. “My job is fun, and it is rewarding to collaborate with colleagues.” “I started specializing in canine mobility issues on dogs seven years ago, and the results have been amazing,” Dr. Keesling adds. “It becomes a wellness-type approach, as well as preventive – keeping the animal from developing a chronic problem. What has attracted me and made me very passionate about canine rehabilitation are the results. The outcomes sell themselves. The patients often heal themselves; they just need a little guidance. It’s been extremely rewarding.” There are several reasons to consider physical therapy for pets. “In general, I would use

By Carl Simmons

physical therapy for any type of mobility or performance issue; rehabilitation is not always associated with lameness,” Dr. Keesling says. “For example, I work with a lot of canine athletes who might be knocking down bars while jumping or might not be as fast as they could be. “One of the milestones in my career has been the number of dogs’ knees I’ve rehabbed – in February I worked on my 1,000th knee. It was exciting, because I feel it’s the most common orthopedic problem with dogs,” she adds. For Jon Geller, DVM, DABVP, of Fort Collins Veterinary Emergency & Rehabilitation Hospital, “The two main times would be after an injury, or for senior pets that are beginning to show their age. Another common instance would be with pets that are very overweight or have mobility issues due to arthritis.” There are also a variety of methods, or

Lydia’s STYLE Magazine

modalities, used in the field of pet rehabilitation. Dr. Geller indicates that there are six main ones: •

•

Physical therapy – Customized exercises, and specialized props such as therapy balls or cavaletti poles (used in canine or equine sports), are used for this method. Laser therapy, or phototherapy – This method uses light to reduce pain and inflammation in pets, and speeds up healing. Medical acupuncture – “It’s similar to human acupuncture,” says Dr. Geller. “One difference is that it’s science-based, based on neural anatomy versus Chinese medical accupoints.”

•

Medical massage – “There’s a certification for canine massage, as well as for canine rehabilitation,” says Dr. Geller. “It should be performed by a certified practitioner.”

•

Extracorporeal shockwave therapy – A machine delivers a series of impacts to a specific part of the body. “It can be painful, which is why sedation is needed, but it’s also very therapeutic for wound healing and recovery from injury,” says Dr. Geller.

•

Hydrotherapy, including underwater treadmills – “It’s extremely beneficial in helping animals recover normal motor function,” says Dr. Geller.

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“Water is a very healing thing,” adds Dr. Downing. “Most owners don’t understand that dogs use a completely different set of muscles for swimming as they do for walking. It allows animals to do several things – they use a full range of motion; they’ll keep their hind legs on the treadmill a little longer, which helps normalize their gait; it allows animals to use their muscles without bearing the full amount of weight; and the water also has a hydrostatic effect. Anyone who’s done aqua aerobics will tell you it’s a lot harder than they thought it would be. There’s more resistance. And it’s just plain fun. We have both cats and dogs that use underwater treadmills, and their owners can see progress right away.” However, Dr. Downing is quick to add, “Rehabilitation doesn’t equal pain management. It’s certainly about restoring mobility, but it’s not appropriate to deal with rehabilitation without first dealing with the pain. So first, we set the stage by making sure we’ve taken care of their discomfort. Then we can initiate a more aggressive approach to physical therapy.” Owners also play a part in the rehabilitation process. “My philosophy is to get the owners involved as soon as possible,” Dr. Keesling says. “In the very first appointment, I make sure owners are willing to be involved. At every assessment, I tell them, ‘This is a team effort, so if you’re not willing or able to put in the time each day, maybe we shouldn’t waste your time and money on this.’ But most owners are very willing to do the work.”

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“Owners play a major role in rehabilitation, because they’ll get specific instructions on things they can do with the pet at home,” adds Dr. Geller. “A restriction activity could be as important as an exercise component. They might do a range of motion exercises such as laying their dog down and doing some stretching and rotation exercises, or applying cold or heat to a joint. “My own cat, Thomas, fell out of a tree when he was very young, hit a branch and broke his leg,” he adds. “His broken bone was fixed, and then he went into his full rehab. He got all the modalities I mentioned, and he recovered quickly, fully and without any lingering effect. It was very firsthand for me, and he’s running around the house as we speak.” Dr. Downing also discusses a memorable patient and her treatment. “We had a Labrador retriever, Shiloh, that was kicked by a horse when she was two. The client was badly advised; they said ‘Just put your dog in a cage for two months and she’ll be fine.’ And then a year later, she got in a tangle with another horse and tore the other ACL. By the time I saw her, she couldn’t walk across the floor. Her owners couldn’t even pet her; she

Kara Keesling, DVM, Front Range Veterinary Hospital

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Robin Downing, DVM, Windsor Veterinary Clinic and the Downing Center for Animal Pain Management

would try to bite them because of the pain of being touched. We were her last stop; the owners were asking, ‘Do we need to put her down? You’re our last hope.’ “The first thing we did was break her pain pharmacologically. Once we had her pain reduced, we introduced other modalities, because now we could get near her. We initiated laser; we did balance work; acupuncture, treadmill. It took months, but we were able to get her from where she couldn’t walk across the room to being able to walk the perimeter of their 100-acre farm, as well as do the other normal things a dog can do. She was able to live until 11 or 12 years of age. We basically doubled her age. I could not have done that without physical rehabilitation.”

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). Find out more about Carl at carlsimmonslive.com.

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rattlesnake

danger By Susan Wight, DVM

s the weather warms, more people and their pets will venture out and run the risk of an encounter with a common inhabitant of our area: the Prairie Rattlesnake. This snake is not as aggressive as other species elsewhere in the country, but it will bite if surprised or agitated. They tend to rattle a warning if something approaches too closely, and this rattle is sometimes what attracts our furry friends, to their detriment. At VCA Veterinary Specialists, we have had patients bitten along bike trails in Loveland and Fort Collins, along Devil’s Backbone trail and even in backyards near rural areas. We can see rattlesnake bite victims as early as March and as late as October. While snakes tend to hide

during the heat of the day, they are more likely to be out and looking for food during cooler mornings and early evenings. Rattlesnakes live where their food lives, so they can be common in the foothills, near prairie dog towns or anywhere that rodents may live. They are less common at higher altitudes, but we have seen victims from the Estes Park and Red Feather Lakes regions. Rattlesnake bites are painful and there is usually an immediate indication that a bite has occurred. Dogs and cats will jump back and often vocalize, and some of them will try to fight back, even sustaining multiple bites. The venom of the Prairie Rattlesnake leads to pain and swelling at the bite site (often very dramatic swelling), interference with the blood clotting system (leading to bleeding), and damage to local tissues (causing loss of tissue at the bite region). The swelling can be dramatic enough to cause concern over a patient’s airway, or further compromise blood supply if the bite is on a limb. If your pet is bitten, the most important thing you can do is not to panic. Gather your pet and get them to a veterinary hospital as quickly as possible. There is no type of first aid you should attempt; it only delays getting to the hospital. Don’t attempt a tourniquet, or cutting the bite site to remove the poison. Minimize your pet’s activity and anxiety and transport them as soon as possible. The patient will be assessed and administered some pain medication immediately. Diagnostic tests determine if envenomation has occurred (many bites are “dry bites” meaning no venom was injected), and whether abnormalities are already developing. An IV fluid therapy is used to treat shock and dehydration, continue pain medication and, in some cases, administer specific antivenin. Rattlesnake antivenin is useful in moderate to severe envenomations to reduce pain, swelling and effects of the venom on blood cells/platelets and blood clotting proteins. Not all patients require antivenin; your veterinarian will determine its necessity. The major drawback is the cost, though it often allows earlier release from the hospital. Most patients will make a good recovery, though fatalities have occurred. Cats are bitten less often than dogs, though their bites can be more severe simply due to their smaller size and the relatively larger dose of venom per pound. The best treatment is avoidance. While out hiking or walking your pets keep them on leash to avoid contact with a rattlesnake hiding beneath a bush or rock. Most dogs are bitten when off leash and roaming a short distance from their human companions. While there is a vaccine that has been developed to try and prevent the problems caused by envenomation, its effectiveness has not yet been proven. Dogs that are vaccinated and get bitten still require immediate assessment by a veterinarian. Know where the nearest veterinary emergency hospital is located, just in case, and keep your four-legged friends safe! Susan Wight, DVM, is an emergency veterinarian for VCA Veterinary Specialists of Northern Colorado, located in Loveland.

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veterinary

Pet Tails

Canine Officer Cyrus

law enforcement professional’s death brings loss not only to friends and family, but also to the broader community. Such was the case on November 9, 2011, when Fort Collins Canine Unit officer “Cyrus” lost a battle with cancer, one adversary the talented fellow couldn’t rout; however, it’s said that every dog has his day and Cyrus had many victories over other big challenges. Whelped in October 2004, the Belgian Malinois puppy was brought to the U.S. by an Indiana importer. For four-and-a-half years, the dog was trained and used for performance true to his herding breed instincts. Cyrus became a titled sporting dog for the ability to bark and hold prey. Enter Fort Collins Canine Unit Trainer Rick Mainwal. In 2008, he “interviewed” Cyrus and three other of the Indiana imports for a position as his next four-pawed partner. Cyrus, the best candidate, was selected to trade herding bliss for a new outlook on life as a canine patrol dog. Although the third of his breed in the Fort Collins Canine Unit, Cyrus was the first Malinois Mainwal worked with. He says it took about eight months to refine required skills. The biggest problem was to re-train the already expertly trained sporting dog. Forget bark and hold. Learn instead to find and bite. Forget high prey drive: it’s unacceptable for an attacking police dog to abandon suspect pursuit for an impromptu squirrel chase! Cyrus latched onto the new concepts. And, because multi-use dogs offer officers the best “bang for the buck,” he was eventually crosstrained for all facets of canine patrol work:

Northern Colorado Medical & Wellness 2012

tracking, building and open-area suspect searches, evidence recovery, officer protection and drug detection. Mainwal, owner as well as trainer, says his dog truly loved to work and served the community with all he had. Daily training at home and sessions at the police-training site kept him eager, sharp and fit. He displayed his enthusiasm by spinning in circles whenever he and Mainwal left for work. Triumphs and their rewards kept Cyrus yearning for more. One such victory came in March 2011 when Loveland police requested canine assistance. A suspect with existing warrants began a car chase that ended with him crashing and running. Tracking skills and bite training served Cyrus well as he aptly pulled the fleeing culprit from a bushy hiding place. In October, a car-stop yielded illegal methamphetamines and ingredients used in their manufacture when Cyrus scented them. Mainwal says that, to a degree, Cyrus was also a family dog. He stressed, though, that handlers must be careful not to turn canine unit dogs into pets. He describes Cyrus as a typical, strong-willed Malinois with latent “McFly” (think of the movie Back to the Future) tendencies. “Cyrus was a knucklehead who made you shake your head. He was out there in his own world, a real goofball,” recalls Mainwal with a chuckle. “You’d watch him and go, ‘Hello? McFly?’” For example, at home on Mainwal’s acreage, if you set your water bottle down near Cyrus, he’d grab that plastic container and merrily zoom into the livestock pasture. There, he’d inevitably get head-butted by a goat and return with an angry goose attached to his hind end. Even though

By Marty Metzger

each encounter ended badly, he repeated his McFly performance time and time again! But that charming exuberance began to wane. Maura Buckner, D.V.M. of Moore Animal Hospital (who are the official veterinarians for the Fort Collins K-9s), reports Cyrus began having vomiting episodes in May 2011. In late October 2011, he became anemic and an ultrasound confirmed the diagnosis to be a neoplasia called B-cell (or high grade) lymphoma in Cyrus’ gastrointestinal tract. The best course of treatment, says Dr. Buckner, would have been through Colorado State University’s veterinary oncology department; however, decline was so rapid that on the morning of November 9, 2011, Mainwal awoke to find Cyrus lying on the floor beside the bed, unable to get up. He raced his dog to his vet. Cyrus moved very painfully, still unable to stand. Mainwal and Dr. Buckner decided the kindest thing would be to humanely euthanize the gallant canine. The cancer that ended Cyrus’ life is normally seen in dogs (which can be genetically predisposed) between 5 and 10 years of age, advises Dr. Buckner. Early treatment can add about six months to their lives. She adds that Cyrus was a great dog; always a pleasure to work with and he will be missed. Mainwal now works with his fifth patrol dog; his first, 14-year-old Dutch Shepherd “Kaya,” is retired at the Mainwal home. But Cyrus’ happy zest for life and work will be long remembered.

Fort Collins resident Marty Metzger has been a freelance writer since 1987.

Physician spotlight

Orest Dubynski, M.D.

f or t h e lo v e

of children

r. Seuss said, “A person’s a person no matter how small.” Orest Dubynski, M.D., or “Dr. Duby” as his small patients at The Children’s Health Place in Greeley affectionately know him, embraces this timeless piece of wisdom. In fact, it is unquestionably what motivates him to treat staff and patients (no matter how small) with kindness, dignity and respect. Dr. Duby’s pediatric career spans more than three decades. He is dedicated to making the quality of patient care the best it can be. And he attributes his amazing staff with making that possible. “I have a great staff dedicated to quality patient care. I could not do what I do without all of them.” Dr. Duby’s practice is so comprehensive in its care that it has become the first Weld County independent pediatric practice to earn the honored designation as a Certified Medical Home for Children. “Medical Home” doesn’t mean a home in the traditional sense, but the designation indicates the approach a doctor’s office takes to

By Connie Hein

providing total, holistic primary care in an environment where the staff gets to know the family, the child and each child’s health history. He believes a big part of giving comprehensive care is being an educator. People often don’t understand the importance of having a pediatrician for their children, says Dr. Duby. Pediatricians do three additional years of training after medical school. “General practitioners are taught a broad scope of medical information to treat patients of all ages,” he says. “The training for treating children is much more specific.” A significant part of pediatrics is to teach parents how to raise contented children so there is peace in the home, says Dr. Duby. “I start teaching parents from their first well-baby visit how to keep the life of a young child as simple and uncomplicated as possible,” he says. “Infants and young children should have what I refer to as ‘cookie-cutter’ days – having most of their days very much alike.” It’s hard for children to deal with even slight changes in their routines. “Children don’t do well with changes or surprises they don’t understand, and are not equipped to handle,” he says. “This creates chaos that could be prevented with a few

simple parenting guidelines.” Another part of Dr. Duby’s comprehensive pediatric care is through his work with many charitable organizations. He is on several community boards and does regular community outreach. This has included coordinating blood drives and clothing drives for newborn layette programs. He works diligently to connect families to these valuable resources available in the community. He also leads by example to encourage the preservation of the natural resources of our planet. This includes recycling and conservation in his practice and incorporating green features during the remodeling of the The Children’s Health Place office building. Dr. Duby’s compassion for people stems from his immigration to America at a young age, struggling with language and cultural barriers. Born of Ukrainian parents in Germany at the end of WWII, Dr. Duby came to Chicago at age 3.“I’m honored to give [my patients] the opportunity to express themselves and be clearly understood when it comes to the all-important health and well-being of their children.” Dr. Duby and his staff speak fluent Spanish and he is popular among the large Hispanic population in Greeley and the surrounding areas. During medical school he assumed he would be a surgeon because he had always been so good with his hands, until he did his pediatric rotation. “I wasn’t impressed with the pediatrics teacher, so I left to get training from a passionate pediatrician and saw how big an impact that he had on children’s lives,” he says. “Then I was hooked.” From his immigration to America as a small boy, then his medical training in Spain (where he had to first learn the Spanish language) to his family and medical practice, he says his life has been a great adventure. “I wake up happy every morning and am grateful for another day to impact children’s lives,” Dr. Duby says. Important elements to this happy life, even with a busy medical practice, says Dr. Duby, are taking time to enjoy his family and nature. This includes his wife, Susan Mock, his two sons and the Rocky Mountains. When Dr. Duby and his wife are not working, (Mock is the owner of The Stitchin’ Den in Estes Park) or volunteering in their community, they are avid hikers, backpackers and horseback riders. “I fell in love with the mountains when I came here to visit from Chicago as a young boy,” he recalls. “I am so grateful to live near this beauty of nature.” He enjoys climbing up mountains (with a 60-pound pack on his back), and sitting on a boulder and reflecting, “Thank you, God, for creating this magnificent beauty, thank you for putting me in it and thank you for giving me the ability to appreciate it.” Or as our other famous doctor would put it, “Today is your day! Your mountain is waiting. So... get on your way,” according to Dr. Seuss. For information about The Children’s Health Place, readers may call (970) 356-2600 or visit www.thechildrenshealthplace.com.

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

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