2014-01-MEDICAL

JANUARY 2014

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Northern Colorado ww w . m e Medical d i c a l&aWellness n d w e l2014 lness.com www.stylemagazinecolorado.com

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Northern Colorado Medical & Wellness 2014

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The Voice of Northern Colorado for

30 Years.

s t y le me d ia a n d d es i g n , i n c .

| 970.226.6400 |

w w w. s t y l e m a g a z i n e c o l o r a d o . c o m w w w. m e d i c a l a n d w e l l n e s s . c o m Publisher Lydia Dody | lydia@stylemedia.com Managing Editor Angeline Grenz angie@stylemedia.com creative director Scott Prosser Senior Designer Lisa Gould digital director / Business DEVELOPMENT 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 Photographer Marcus Edwards Photography Contributing Writers Heidi Kerr-Schlaefer, Corey Radman, Kay Rios, Brad Shannon, Carl Simmons, Elissa J. Tivona, Michelle Venus Affiliations Fort Collins Area Chamber of Commerce Greeley Chamber of Commerce 2014 Style Magazines January-Northern Colorado Medical & Wellness Magazine and McKee Medical Center & North Colorado Medical Center Medical Directory February-Style March-Northern Colorado Medical & Wellness April-Style May-Northern Colorado Medical & Wellness June-Style July-Northern Colorado Medical & Wellness Magazine and University of Colorado Health Medical Directory August-Style September-Women’s Health & Breast Cancer October-Northern Colorado Medical & Wellness November-Holiday Style December-Best Of & Winter Activities 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 more than 275 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 ©2014 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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Lydia’s STYLE Magazine

It’s going to be a great year!

New issues & more topics.

Style – Where We Wanted to Be

Thankful for Style

There are people who get you at first glance… then, there are fewer people who take action to support you in any way possible and go the extra mile. Lydia Dody and her team at Style Magazine listened attentively to our dream, believed it was real and made it live in their Nov./Dec. issue (see article “Cakes and Sweet Treats”). There is no doubt that Lydia leads a team of professionals to produce a top-quality magazine for our community.

Style is exactly where we wanted to be. Thank you, Lydia and team, for your expert and stylish production.

I am thankful for all of you at Lydia’s, who make such a difference for the women in our community.

Polly Bennett Fort Collins

oops!

february

HOME IMPROVEMENT, REAL ESTATE ANd EXPANdEd ABOUT TOWN

March

NortherN Colorado MediCal & WellNess

aPrIL

GOLF & LANdSCAPING

Jaio Osborne, Owner/Chef, Cocolé, www.lecocole.com

May

Holiday Thank-Yous

FAMILY FOCUS

Thank you to the Style staff for letting us be a part of the “Healthy Sides to Make & Take” recipes in the Nov./Dec. issue (Lydia’s Style Magazine).

Have a wonderful holiday season.

JuNe

BUSINESS & BUILdING, ART & CULTURE

Dave and Gay Daggett Tastebuds Café and Catering

JuLy

NortherN Colorado MediCal & WellNess

I loved the Style Magazine Holiday Nov./ Dec. issue. And I really liked how the recipes all turned out (“Healthy Sides to Make & Take”). It was really a fun issue. Thanks again for the opportunity!

auGuST

FOOd & RESTAURANT, EXPANdEd ABOUT TOWN COVERAGE

Nancy Stilson-Herzog Fitter Fort Collins Health & Wellness The articles and photos in the Nov./Dec. magazine look so sharp. I wanted to let you know how much we like the look of the magazine with our story (Business Profile: “The 3C’s of Real Estate”) and our holiday ad. Thank you for the hard work to get this attractive magazine out to our Northern Colorado area.

Lucy Homan C3 Real Estate Solutions We love the article and it looks so nice! (“Goldworks: Crafting Memories,” Nov./Dec. 2013 Lydia’s Style Magazines) We are very pleased with the article showcasing our business. We really appreciated all of the hard work from you and how smooth the process was – thanks so much!

Sandy Linenberger, Owner Goldworks

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In our Holiday 2013 issue of Lydia’s Style Magazine, we misspelled the name of the location of the Estes Park wedding that took place during the September flood, Della Terra Mountain Chateau. We greatly regret the error.

Della Terra Mountain Chateau is a wedding venue nestled in the Colorado Rocky Mountains in Estes Park. You can find more information about them by visiting their website at www. dellaterramountainchateau.com or calling (970) 586-2501.

SePTeMber

WOMEN’S HEALTH & BREAST CANCER

OcTOber

NortherN Colorado MediCal & WellNess MeN’s health

NOVeMber

we love to hear from readers. send your comments and suggestions to:

angie@stylemedia.com Phone: 970.226.6400, ext.215 Fax: 970.226.6427 www.stylemagazinecolorado.com

HOLIdAY & WEddING

deceMber

BEST OF STYLE & WINTER ACTIVITIES

Lydia’s STYLE Magazine

Northern Colorado Medical & Wellness 2014

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CONTENTS

Northern Colorado Medical & Wellness

JANUARY 2014

page 8

page 48

page 12

page 50

From Our Readers Publisher’s Letter

page 14 on the cover

On our cover: CEO of Banner Health North Rick Sutton stands on the grounds of the Banner Fort Collins Medical Center, which is scheduled to open in spring 2015.

Cover photography by Marcus Edwards Photography.

Introduction Letter: Rick Sutton, Chief Executive Officer, Banner Health Northern Colorado

page 16

Banner Health’s Regional Expansion

page 20

McKee Cancer Center’s Linear Accelerator Hits the Target

page 24

24

40

New Neurosurgery Procedures Offered at Banner

page 27 physician directory page 40

Care Coordination Heads Off Trouble

page 43

47

54

Seizures – Causes and Treatment

page 47

Quit for Good Living with Thyroid Disorders

page 54

Minimally Invasive Surgery Options

page 58

Community Health Programs Expand in Loveland

page 63 wellness magazine page 66

Is Sitting Killing You?

page 70

Trendy Schmendy, What You Should Really Be Eating

page 72

Taking Out the Trash: Liver Health After the Holidays

page 74

Family Focus: Karate Kids

page 78

Cosmetic Dentistry: Building Smiles

Annual CT: A New Screening Protocol for Smokers

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

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Lydia’s STYLE Magazine

publisher’sletter

A Commitment to Excellence In Healthcare We are proud to bring you this 9th annual edition of Northern Colorado Medical & Wellness Magazine and Directory in collaboration with McKee Medical Center and North Colorado Medical Center (NCMC), both part of the Banner Health Western Region.

The issue features timely and informative articles on healthcare innovation, technology, facilities and the latest in patient services. The comprehensive directory included in this magazine is a very easy-to-use reference

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guide of physicians and healthcare support, organized by specialty, with privileges at McKee and NCMC. It is a pleasure to work with and feature the many accomplishments and services available at these two Banner Health Western Region facilities. This 2014 issue features interesting articles about innovative healthcare services and advancements in care and facilities at both hospitals. Greeley-based NCMC is the largest hospital in Northern Colorado with 378 licensed beds and, together with 115 beds at McKee Medical Center in Loveland, the two facilities and their expanding number of employed physicians are a significant provider of healthcare services in Northern Colorado.

Additionally, Banner Health has expanded its services in Fort Collins with its new Health Center on Drake Road, which opened in September with physicians in family/internal medicine, pediatrics and allergy.

Furthermore, in April 2015 a new hospital and medical campus will open on East Harmony Road and Lady Moon Drive in Fort Collins. It will include an emergency department and 24-bed hospital, along with an outpatient clinic and surgery suites. In fact, our cover featuring Rick Sutton, CEO, Banner Health Northern Colorado, was photographed inspecting the project at the new hospital site shortly after the groundbreaking.

Sutton, in his letter to our Northern Colorado readership, reiterates his ongoing commitment to provide high-quality, efficient and cost-effective care as the horizon of healthcare continues to change. His focus continues in five basic areas: Employee Engagement, Patient Satisfaction, Quality Healthcare, Physician Friendly Service and Financial Strength. His leadership has, once again, resulted in Healthgrades recognizing NCMC and McKee for medical excellence in 12 impor-

tant five-star rated categories. Despite the recent insurance coverage challenges many of us face, we can be confident in the quality of care we have from the physicians, healthcare professionals and hospitals of the Banner Health system.

As the health landscape continues to change, criteria that will be closely monitored in the future will be the readmission statistics of hospitals. Because of the importance of keeping patients from needing to be readmitted Banner Health is putting a big emphasis on their care coordination department, which exists to ensure patients receive the resources they need both in the hospital and after discharge. Based on their low readmission statistics, Banner is addressing this issue very well.

For many of us, the start of a new year leads to those New Year’s resolutions to lose weight and become more healthy. Personally, now that I have resumed working out again after my recent hip replacement, I’m going to commit to eating healthier and spend less time sitting. You’ll find our Wellness articles interesting as we speak about super foods, detoxifying the liver, and not sitting too much. I must say, they sure got my attention.

We hope you find the articles in this issue interesting and informative and use the Directory throughout the year as a reference. We appreciate our partnership with Banner Health and thank the management team, physicians and health professionals for their contributions.

Wishing each of you good health in the New Year.

Lydia@stylemedia.com

Lydia’s STYLE Magazine

Dear Northern Colorado Reader, This 9th annual issue of theD January Northern Colorado Medical & Wellness ear NortherN ColoraDo reaDer ,

Rick Sutton

Chief Executive Officer

Magazine and Physician Directory an excellent source of healthcare As is I approach my first anniversary as Chiefinformation.

Executive Officer at McKee Medical Center, a Banner Health facility, I am care honored There are informational articles about various aspects of innovation, patient andto be associated with services such an outstanding medical team, and to lead this technology of Front Range Banner Health and facilities. organization into the We also provide you with the latest update on future. developments and progress of our We all are very aware that the health care environment we live in services along with some thoughts on what to expect in 2014. is about to change dramatically. I assure you that the McKee team will Banner Health operates North Center (NCMC) in Greeley, the meetColorado that change,Medical and continue to deliver high-quality, compassionate largest hospital in Northern Colorado licensed beds,and andsurrounding owns McKee Medical health care with to the378 people of Loveland communities.

Center (MMC), a 115-bed hospital in Loveland.

Between twocommunity facilities with andhealth our care McKee has been providing the these Loveland network of employed physicians throughout ourMany localofcommunities, Health for the past 30 years. you were born Banner at McKee, and probably more of you have received health care at McKee over the past three provides a full scope of healthcare services in Northern Colorado. decades.

We have always been the community hospital for Loveland, One of our priorities is to continually plan for offering quality services and facilities and have established vital relationships with this community. that meet the healthcare needs of individuals and businesses in the northern Front Range Yet, we recognize that as the landscape changes, so must McKee. communities.

We have a world class team at McKee, and we are prepared to move A new Banner Health Center opened September on West Drake Road in Fort forward.

Be in assured your hospital team provides excellent care in all Collins. Physicians and staff specializing family/internal medicine, andcontinue aspects of the in health care continuum.

We havepediatrics made, and will allergy are taking appointments to meet you and servethat your needs.

Lab and to make, strategic decisions willhealthcare move us into the future, and put your hometown hospital in a position of continued strength. imaging services are also available at the Center.

We haveFort compiled priorities that everyone Groundbreaking for the new Banner Collinsfive Medical Center occurredatinMcKee has committed to work toward, with the outcome increased October. The new hospital and medical campus on East Harmony Roadofand Lady quality care and a wonderful hospital experience at the core. The five areas Moon Drive will complement services currently offered at McKee Medical Center and are: Employee Engagement, Patient Satisfaction, Quality Outcomes, North Colorado Medical Center.

It is expected to open in April 2015. The Banner Fort Physician Friendly and Financial Strength.

Collins Medical Center will include department, 24-bed unit, We an are emergency committed to ensuring thata all staff atinpatient McKee are highly labor and delivery rooms, surgical services, outpatient clinic and support services. engaged, determined and committed to give you the best care possible.

A $60 million Master Campus Plan project currently at NCMC We believe that having highlyunderway engaged staff results inwill the ability to provide higher quality lower 1952 turnover, increased productivity and result in infrastructure and utility upgrades to thecare, original facility as well as a a more effective organization overall. new laboratory, pharmacy and kitchen. New 3D breast imaging technology has been Wethrough also arethe concentrating on our patient satisfaction to make introduced to Northern Colorado Summit View Breast Imaging Center. your experience at McKee one of the best in the country. At McKee The North Colorado Med Evac medical air transport fleet has added a third helicopter, we are compared nationally to other hospitals in the country, and are stationed in Akron, to enhance services in northeastern Colorado. consistently placing in the top one-third of all hospitals participating in The Banner Health and McKee Medical Centersurvey.

Foundation partnership with Sunrise, the patient satisfaction Inc. led to the opening of a new and largerimportance facility foristhe Community Health Of utmost ourLoveland ability to deliver quality health care, and Stones according to our metrics, you can be assured that quality health Center and the McKee Stepping Adult Day program. care is something that you will receive executive at our hospital.

A new leadership model was implemented to create a single team responsible We also ensure that our staff members areoperating highly trained and that for McKee, NCMC and the Fort Collins hospital while on-site chief officers we provide state-of-the-art technology so you receive the best health handle the day-to-day operations at individual facilities. care in the market. You deserve that, and at McKee Medical Center, Healthgrades®, a well-known independent rating agency that evaluates hospital that is what you will experience. quality based on an analysis of publically-reported data, recognized both McKeeto We also continue to results work hand-in-hand with our physicians and NCMC with five-star ratings awards variety of service lines. Patient ensureand theyquality are pleased with in theacare their patients are receiving.

We are satisfaction and patient safetymaking also were at high levels. and supplies are available to sure recognized that all necessary equipment them as they provide health care to this community.

The entire Banner healthcare team in Northern Colorado continues to focus on our McKee continues to be financially strong due toHealthcare, the support of the five basic priorities: Employee Engagement, Patient Satisfaction, Quality community, physicians, and staff, and we’re well prepared Physician Friendly Service and Financial Strength. This focus allows us to be a to grow with this community in the future. responsible healthcare organization and good stewards of your healthcare resources. In It boils down to this: Your community hospital is a physician the year ahead, healthcare willfriendly continue to change.

Wehighly will focus onstaff eliminating costs in facility, employing engaged members that provide our organization while maintaining the level highofquality which weyou areand recognized. the highest quality for health care to your family.

We appreciate the opportunityWe to serve yourstrive healthcare and will always to ensureneeds that you willare notcommitted have a betterto health careand experience than thecare one for youyou, will have McKee. Quality providing high-quality, efficient cost-effective youratfamily and your health care at your hometown hospital – that’s what we’re all about. friends.

May God bless you, the United States military and the United States of America.

Rick Sutton, MS, FACHE Chief Executive Officer McKee Medical Center

Sincerely,

Sincerely, Rick Sutton Sutton, Chief Rick Executive Officer Executive McKeeChief Medical Center Officer

Banner Health Northern Colorado

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Lydia’s STYLE Magazine

CEO Rick Sutton looks toward the future with Banner’s expansion into Fort Collins: the Banner Fort Collins Medical Center, set to open in spring 2015.

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Lydia’s STYLE Magazine

banner health’s

regional expansion

By Elissa J. Tivona

Amid the swirling changes in the nation’s healthcare system, Fort Collins residents can add one more to the list: Choice.

In spring 2015, Banner Health will open the new Banner Fort Collins Medical Center, a hospital designed to meet Banner’s growing patient base in Fort Collins and the surrounding area.

“We want to expand into the Fort Collins market because that’s where we see a growing number of our patients. When we talk about expanding care, we really want to focus on expanding access to the latest technology,” says Rick Sutton, who was recently promoted to chief executive officer for Banner Health in Northern Colorado. Sutton knows the area well; he previously served five years as chief executive officer at North Colorado Medical Center and three years as the chief executive at McKee Medical Center in Loveland.

Banner has 24 hospitals in seven states and has agreements with most major health insurance companies such as Blue Cross Blue

Shield, Humana, Cigna, United Healthcare, Aetna, etc. In Northern Colorado, Banner is also the exclusive provider of hospital services for Kaiser Permanente members in the region.

Since expanding into Northern Colorado in 2012, Kaiser’s membership in the area has grown to more than 10,000 members who may select from a primary physician network that includes physicians from Banner Health and Kaiser.

Bringing more physicians and specialists to the region Banner’s $86 million Fort Collins campus is under construction on a 28-acre parcel at the corner of Harmony Road and Lady Moon Drive.

It will open with 24 inpatient beds, surgical services, an emergency department, labor and delivery rooms, medical imaging and more. Scott Baker, president of operations for Banner Medical Group in the organization’s Western Region, says Banner was drawn to that location not only because of the rapid growth of its patient population in the southeast corridor of Fort Collins but also its proximity to Interstate 25.

Baker says medical specialties planned for the Harmony campus are based on several immediate community healthcare needs, primarily obstetrics and gynecology, general surgery, pulmonary medicine and cardiology. The hospital will also have a specialty clinic attached to offer expanded outpatient services.

“Currently, we have about 220 healthcare providers across the Front Range between Greeley, Loveland and Fort Collins. We expect that to grow… Over the next 18 months we’ll grow by 20 to 25 providers,” adds Baker.

The hospital follows the new Banner Health Center that opened in September on West Drake Road in Fort Collins. That facility features two family medicine providers, an allergist and a physician who is board certified in both internal

Loveland Greeley Medical Magazine & Directory 2014

medicine and pediatrics. Lab and imaging services are also available at the Center.

Banner services offer high-end innovation Banner Health is known for innovative healthcare services, such as the Banner iCare™ Intensive Care program and advanced electronic medical records system, both of which will be available at the new Fort Collins hospital.

The Banner iCare Intensive Care program is a remote monitoring system for some of the most vulnerable patients in the hospital. While each hospital has critical care physicians in-house, vital signs of all ICU patients throughout the Banner system are transmitted to central locations (similar to air traffic control centers) where they are monitored 24/7 by highly specialized critical care doctors and nurses. When they pick up subtle variations in a patient’s condition, these specialists work with the ICU staff at the bedside to determine an appropriate course of action as quickly as possible. This additional layer of care has helped Banner save lives and reduce the length of time intensive care patients stay in the hospital.

Banner is also one of the leading health systems in the country to achieve the final implementation of electronic medical records (EMRs). From a patient perspective this means information flows seamlessly among all Banner facilities in Colorado.

“Our EMRs keep the information flowing between physician clinics, hospitals and specialists … [including] images and lab results.

Keeping that all on the EMR creates efficiencies for patients and reduces duplication of procedures, which creates a better, safer environment for patients,” says Baker. All these efficiencies work together to lower costs.

Baker points out that, from a quality of care perspective, the biggest problems typically occur

17

Scott Baker, President of Operations, Banner Medical Group Western Region

in hand-offs of patients between services, like from an office-space doctor to a hospitalist or from a hospitalist to a cardiologist. Patients can suffer negative consequences if hand-offs are not done appropriately. When a patient stays within an integrated system, many more checks and balances are in place.

The result, Sutton explains, is an “increase in the ability for patients to receive cutting-edge services close to home, and not have to travel to Denver or another location to receive that high-end type of service.”

The benefits of a large health system Banner Fort Collins Medical Center will be Banner’s fifth hospital in Colorado behind North Colorado Medical Center (NCMC) in Greeley, McKee Medical Center in Loveland, East Morgan County Hospital in Brush, and Sterling Regional MedCenter in Sterling. This broad base allows the system to provide local services in each community at appropriate levels and specialty services as needed. For instance, Banner will have specialists come to Fort Collins to do procedures at the new hospital, but unique specialty care like open heart surgery will continue to be done at NCMC and some specialized cancer treatments will be divided between NCMC and McKee, according to Paul Matthews, public relations director for patient care services at Banner Health Western Region.

With significant resources such as iCare ICU, EMR, surgical robots at both McKee and NCMC, advanced cancer care at multiple facilities, and the new electrophysiology lab at the CardioVascular Institute at NCMC, Banner has the right technology to provide you with excellent

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Lydia’s STYLE Magazine

When you look at the outcomes that the hospitals in both Loveland and Greeley are achieving, they’re knocking it out of the park with excellent patient care.

- Rick Sutton, CEO, Banner Health Northern Colorado

patient care.

All these practices have gained Banner Health national recognition. For example, NCMC has been listed by three major independent ratings agencies – IMS Health, Truven Health Analytics and Becker’s Hospital Review – among the top 100 hospitals nationally for the last two years in a row and both NCMC and McKee have been recognized with five-star ratings and quality awards from Healthgrades, the independent rating agency that ranks healthcare providers.

In April 2013, Truven Health Analytics named Banner Health one of the top five large healthcare systems in the United States.

Bringing it back home “When you look at the outcomes that the hospitals in both Loveland and Greeley are achieving, they’re knocking it out of the park with excellent patient care” says Sutton. That same high level of service is headed towards Fort Collins. As the new hospital changes the literal landscape of that eastern Fort Collins corridor, it will change the healthcare landscape at the same time.

Patients will have access to local providers for outpatient care and access to Banner’s specialists from across the region. Baker sums up Banner’s commitment this way, “We are here to serve the needs of the patient, whatever those needs may be, from pediatric care to end-of-life care. We want to partner with them and provide them with the best experience possible.”

Elissa Tivona is a freelance writer based in Fort Collins.

Northern Colorado Medical & Wellness 2014

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medical

cancer care

Dr. Elizabeth Ceilley, medical director of radiation oncology at the McKee Cancer Center, explains that the TrueBeam linear accelerator’s capabilities mean faster, more pinpointed radiation treatment for patients.

mckee cancer center’s linear accelerator

hits the target

By Kay Rios

With advances in technology, radiation therapy is now more effective, has reduced side effects and offers greater convenience for patients. And McKee Cancer Center is on top of those advances with its TrueBeam STx linear accelerator. This technology allows radiation therapy to be more exact.

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But, to understand the TrueBeam’s offerings, it’s helpful to first take a quick look at cancer and radiation therapy. Since cancer is made up of the body’s own cells, the idea is to create an environment where the body can heal itself. Radiation therapy, a noninvasive outpatient procedure, damages the DNA of tumor cells so that the cell won’t be able to complete its next mitosis. As the tumor cell dies, the immune system can more easily dispense with the dead cells.

Stereotactic treatment falls into two categories. Stereotactic Radiosurgery (SRS) involves the brain and Stereotactic Body Radiation Therapy (SBRT) includes other areas of the body. In both cases, stereotactic radiation therapy allows a larger dose of radiation to

Lydia’s STYLE Magazine

McKee Cancer Center is one of the few cancer centers in the state to have the TrueBeam linear accelerator technology.

be used. It can match the shape of the tumor so that it spares surrounding healthy tissues, says, Elizabeth Ceilley, M.D., medical director of radiation oncology at McKee Cancer Center.

With the TrueBeam STx linear accelerator, delivery of the radiation dosing is much more precise, so that higher doses can be given. This, in turn, further reduces possible damage to surrounding healthy tissue damage and shortens treatment times, she explains.

TrueBeam uses precise image-guided radiosurgery to target tumors even when they’re in motion or when surrounding tissue or organs change position. “For example,” Dr. Ceilley says, “the location of the prostate can vary based on how full the bladder or rectum is at any given time. If the rectum is full of air, we make the appropriate shifts to avoid treating the rectum and prevent under dosing the prostate.” Additionally, TrueBeam’s sophisticated respiratory monitoring system synchronizes beam delivery with the patient’s respiration.

“Because it’s so precise, some of the most complex and advanced cancers can be treated with radiation therapy. This will pinpoint the exact treatment location,” Dr. Ceilley says. In addition, TrueBeam can outdo similar technology, like the CyberKnife, which does not have soft tissue imaging capabilities. It is also much faster and more versatile than CyberKnife.

There are more benefits. The TrueBeam system can deliver treatments up to 50 percent faster so that even complex radiosurgery that would typically take 40 minutes to an hour can be completed in just five to 20 minutes.

“Conventional treatment takes 44 sessions

Northern Colorado Medical & Wellness 2014

but, because this technology is so reliable and precise, we can do it in five sessions.”

And, as a tumor shrinks over the course of treatment, the imaging helps change the focus.

“With this technology, we can be incredibly accurate and doctors have the flexibility to customize treatments for patients, making them very individualized,” she says. “It’s fairly new equipment and it’s absolutely the latest and greatest. McKee Cancer Center is one of the first few in the state to have it. We’ve been treating patients with it for almost a year.”

Dr. Ceilley says that, while the TrueBeam can be used for many cancers, it’s not for all cancers. She uses prostate cancer as the example.

“It’s only for low and low-intermediate risk prostate cancers.”

But that doesn’t mean that all cancers treated with this must be low risk. “It’s effective for metastatic disease in many locations but typically the liver, adrenal glands and lung, and use of this in the brain is common.” The best bet is to have the discussion with the oncologist to see if it’s appropriate, she says.

Use of the TrueBeam is also useful for patients who have previously had radiation therapy and may not have been eligible for more treatments, she says. “We’re seeing more recurrences because people are living longer.

Where they may not have been able to have radiation again, this makes it possible because we can target exactly.”

This approach has become more popular, she says. “Medicare and insurance companies have started to cover it and more people are leaning to this newer treatment.”

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Richard Hough, age 72, is one of those patients who opted for the TrueBeam method.

His diagnosis of prostate cancer was a shock.

“I stay lean and mean, never had surgery.

I never even had the flu. I started taking 5 mg of blood pressure medicine at 70 but no other issues.”

But, as a result of his yearly check-up, his PSA came back high. “I was a 5.4.” His doctor thought it was concerning. “My doctor sent me to the urologist and I had biopsy.”

They did 12 biopsies, he says. “That wasn’t fun. Out of the 12, they found one positive and the urologist said it might not show up for years. So I went for a year and, in that time, it had gone up to 8.4. So my doctor sent me to Dr. Ceilley.”

Dr. Ceilley explained his options. “She said they could remove it. I didn’t think I wanted to do that. Then I thought I’d go through the seeds and she told me about this other option.”

“She was very thorough,” his wife, Jan, says. “But it was his decision.”

Hough decided he wanted to go the TrueBeam route (or Star Wars as he’s dubbed it).

There was, however, an obstacle: insurance.

“Medicare has started paying for it but Humana wanted him to have the seeds,” Jan says. “But Dr. Ceilley went to bat for us and wrote letters to the insurance company and they finally agreed. I can’t tell you how much her help meant.”

Hough had the markers put in place in June of this year and began treatment in July. “I had five treatments every other day for two weeks at McKee.” The treatment was easy, he says.

“You lay there for half an hour each time and

banner health regionalizes

cancer treatment options

By Kay Rios

As a means of better serving cancer patients, Banner Health has moved to a more regionalized approach in Northern Colorado.

Banner’s cancer team offers comprehensive cancer care at North Colorado Medical Center in Greeley, McKee Medical Center in Loveland and Sterling 22

Dr. Ceilley can track a patient’s breathing and organ movement and pinpoint radiation treatment to reduce any radiation exposure to healthy organs.

they put your music on. And you don’t feel anything. And there weren’t any side effects.”

Hough goes back in January for another PSA test and a prostate check-up and he’s already positive about the results. Some of his positive attitude comes from his experience at McKee. Both he and his wife praise Dr. Ceilley and the staff at the Cancer Center. “Everybody right from the first day was so supportive and gave us the emotional extra support. Her staff treated me like a king.”

“He came out of every treatment with a smile on his face. They just don’t go at it with a doomsday attitude. And we met so many people on this same cancer journey and it became a community,” Jan adds. “There was a graduation ceremony at the end of his treatment. They ring a bell three times and we were both ready to cry.”

Hough’s reason for agreeing to have his case publicized is altruistic, his wife says. “We just hope that it will encourage other people to get their check-ups and not wait. Do it early, in your 50s. It’s simple and you can monitor it.

We also want them to realize there are other treatments out there and they should look at all of them.”

“Medical advances are better and better,” Hough agrees and he also stresses the need to stay on top of things. “Stay aware and informed. I procrastinated but I was lucky.”

Kay Rios, Ph.D., is a freelance writer based in Fort Collins. She is currently working on a play, two novels, and a collection of essays.

Regional MedCenter in Sterling.

“The benefit of regionalization for the patient is that they have more treatment options, in the same network, with the same doctors,” says Elizabeth Ceilley, M.D., medical director of radiation oncology at McKee Medical Center.

The team includes three radiation oncologists, five medical oncologists and experts in urology, surgery, gynecology and other specialties.

“We (the oncologists) alternate going to Sterling to see patients and attend tumor board (an interdisciplinary team of physicians, oncology nurses, clinical research specialists, and others involved in patient care who discuss each patient’s case and make recommendation about the best course of treatment),” Dr. Ceilley says. “So, let’s say a patient from Sterling needs to come to McKee for a specialized treatment

that is not available in Sterling. He can still have his original work-up and subsequent follow-up in Sterling, with me, closer to home.”

In addition to tumor board, a multidisciplinary team of oncology providers meets weekly with their counterparts at Banner MD Anderson Cancer Center in Gilbert, Ariz., to review patient cases.

“It’s an even broader scope of expertise,” Dr. Ceilley says.

Regionalization allows for more available services in Northern Colorado.

“The three centers can support more technologies, and thus more treatment options, than one could. For example, some specialized services are based at McKee and some are based at NCMC.” The regional approach works well, she says. “Northern Colorado patients do not have to have to go to Denver to get the cancer care they need. It’s all right here.”

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Northern Colorado Medical & Wellness 2014

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medical

Neurology

Dr. David Blatt brings state-of-the-art neurosurgical treatments to Banner Health in Northern Colorado.

new neurosurgery procedures

offered at banner

By Brad Shannon

If you live in Northern Colorado, and have a neurological concern, you now have local access to state-of-the-art neurosurgical treatment right here at home with a visit to Banner Health’s North Colorado Medical Center (NCMC) in Greeley, or McKee Medical Center in Loveland.

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This enhancement of services is due to Dr. David Blatt’s decision to join Banner Health in 2011 as the head of the NCMC Banner Health Clinic specializing in neurosurgery, brain and spine. A graduate of the University of Cincinnati College of Medicine, he completed his surgical internship and neurosurgical residency at the University of Florida College of Medicine.

Dr. Blatt focuses on state-of-the-art neurosurgical techniques, including minimally

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invasive surgery on the brain and spine, intrinsic spinal cord surgery, spinal fusion and instrumentation, and cervical artificial disc replacement.

Dr. Blatt is board certified, had four years of med school and seven years of neurological training, and has been in practice for more than 18 years. He was joined in the practice in August by Dr. Beth Gibbons, and they are supported by Physician Assistant Kai Stobbe.

Together, they bring the latest in neurological evaluation, diagnosis and treatment to patients in Northern Colorado and the surrounding region. That includes brain surgeries for tumors, injuries, hydrocephalus and pain, along with more common treatments for back, neck and spine problems and sports injuries.

Banner’s neurological team applies their expertise, the newest technology and patientcentered care to help improve the quality of life of those they treat, with the goal of getting them back to doing everything they could do before their neurological setback. Some of the more common conditions they treat include disc herniation and spinal degenerative conditions, like spinal stenosis.

Dr. Blatt brought his family to Colorado in 2009 after growing to love his visits here as a kid. “We’d visit my cousins here when I was young, and I always wanted to live here. In the end, North Colorado Medical Center’s people drew me here. The staff takes ownership in the hospital, the teamwork is excellent and it was a great opportunity to build a neurosurgery program with outstanding support from the administration.”

“Coloradans are active, and, like me, many of our patients spend a lot of time outdoors, and ski, hike, bike and more,” says Dr. Blatt.

“The idea of neurological surgery, of operating on the spine or brain, is scary to a lot of people, but our goal is always to get people back to what they were able to do before. Most of the time, we are able to accomplish that.”

One trend he sees in his patient population is an increase in older, active Coloradans whose expectations are different. “Degenerative spinal conditions are more common in older folks.

We are seeing more patients who are older who have been active, for work and play, their entire lives. They don’t want to slow down, or just sit on the porch. We see ranchers in their 80s who have worked hard their entire lives, and they expect to keep that up.”

While all surgeries have some level of risk, sometimes degenerative conditions or an injury to the back or spine won’t respond to nonsurgical treatment. That can lead to loss of range of motion, debilitating pain and a loss of the ability to do a wide range of activities.

When that happens, surgery can help a patient get back to what they enjoy doing. Dr. Blatt’s use of minimally invasive techniques, when possible, means less blood loss, less damage to muscles and surrounding tissues, less pain, a reduced chance of complications and ongoing problems, and faster healing and recovery.

“For many, we can complete a procedure

Northern Colorado Medical & Wellness 2014

and send them home the same day, and make a huge improvement in their lives. I love those people, they are fun to take care of and are very grateful when we are able to help them get back to what they love.” It’s these changing patient expectations, not just the new things he and his team are doing, that continues to help drive their field forward, Dr. Blatt notes.

Together, Dr. Blatt and his team evaluate, consult and treat patients for all neurological conditions, including brain and pituitary tumors; adult cervical, thoracic and lumbar degenerative diseases of the spine; spinal trauma, spine and spinal cord injury; disk herniation; trigeminal neuralgia; spine tumors; meningioma; vascular malformations; and spinal stenosis.

The expertise of the team is supported by the latest in specialized equipment at NCMC, where equipment enables the treatment of complex tumor and spine cases. Image-guided navigation systems enable the doctors to precisely track their location in the brain or spine at all times. New minimally invasive approaches for decompressing nerves in the lumbar spine and performing spinal fusion procedures are unique to the region.

This equipment, combined with a large, experienced staff of dedicated doctors, nurses, technicians and support personnel from admitting through prep, the operating room and recovery, as well as in the intensive care unit, makes NCMC a facility of choice for those with neurological and other concerns.

One unusual condition Dr. Blatt specializes in treating is trigeminal Neuralgia, where a blood vessel compresses the trigeminal nerve at the base of the brain. The resulting facial pain can be debilitating, and impact a patient’s ability to eat, drink, talk, chew or even brush their teeth.

In cases where medication does not provide relief, or has negative side effects, there are three main approaches to treatment. In some cases, radiosurgical treatment, using focused radiation and no incision, provides relief. Other times, a procedure using a needle to treat the nerve works well. For the most challenging cases, the best results are seen using delicate microvasular decompression surgery via a special operating microscope that allows Dr. Blatt to move the vessel away from the nerve, providing significant relief of pain and an improved quality of life almost immediately.

Dr. Gibbons joined the local practice in August. She graduated from the University of Michigan Medical School and completed her residency and internship at University of Vermont/Fletcher Allen Healthcare. Dr. Gibbons specializes in treating brain tumors, meningiomas and spine problems, including neck and back problems, disk herniation, spinal stenosis, spinal fusions, minimally invasive procedures, hydrocephalus, head and spine trauma, and carpel tunnel.

Asked about her decision to bring her career to Northern Colorado, she explained, “I chose NCMC/Banner for the fantastic staff, supportive

environment and caring attitude towards patients. Staff here has been so welcoming and made my transition to working here easy and enjoyable. I’m excited to work here to build a neurosurgical practice and be part of the expansion and growth now underway. I look forward to starting the clinic in Loveland, and eventually expanding to Fort Collins.”

Physician Assistant Kai Stobbe earned his undergraduate degree at Red Rocks Community College in Lakewood, and his master’s degree at St. Francis College in Pennsylvania.

He’s board certified and specializes in neurosurgery, spine surgery and pain management, and has 15 years of experience.

Drs. Blatt and Gibbons and PA Stobbe see patients once a week in Loveland, and from 8 a.m. to 5 p.m. Monday through Friday at their Greeley office. Some surgeries, primarily simpler procedures done on an outpatient basis, are performed at McKee Medical Center in Loveland. That includes minimally invasive spine surgery, lumbar and cervical spinal fusion and discectomy, artificial disc placement and carpal tunnel and ulnar nerve decompression.

More complex cases, including work on the brain and any that require a hospital stay, are handled at NCMC. That includes treating adult degenerative spine disease, disc herniation, minimally invasive brain and spine surgery, brain and spine tumors, hydrocephalus, placing artificial discs, spinal fusion and trauma treatment, and chiari malformation (where brain tissue extends into the spinal cord) and syringomyelia (where a fluid-filled cyst develops in the spinal cord).

Dr. Blatt expects to continue to grow the Loveland practice, along with Dr. Gibbons and Stobbe, and they look forward to the opening of the new Banner Health hospital in Fort Collins, scheduled for April 2015.

The new Loveland Neurosurgery Clinic is held at the Aspen Clinic, 2923 Ginnala Drive, Loveland. Hours are 9 a.m. to 4 p.m. every Wednesday. Call (970) 350-5996 for more information or to set an appointment.

Brad Shannon is a freelance writer who lives in Loveland, Colorado.

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Lydia’s STYLE Magazine

banner health mckee medical center north colorado medical center

medical

directory

Northern Colorado Medical & Wellness 2014

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Lydia’s STYLE Magazine

Northern Colorado Medical & Wellness 2014

mckee medical center north colorado medical center & banner health

medical

Allergy-Immunology Clement, Loran, MD 2121 E. Harmony Rd., Ste. 350 Fort Collins, CO 80528 ..............970-221-2370 Culver, William, MD 2923 Ginnala Dr. Loveland, CO 80538 ..................970-669-6660 George, Anna, MD 702 A W. Drake Rd. Fort Collins, CO 80526 ..............970-229-4600 James, John, MD 1136 E. Stuart St., Bldg. 3, Ste. 200 Fort Collins, CO 80525 ..............970-221-1681 Kailasam, Velusamy, MD 1130 38th Ave., Ste. 2 Greeley, CO 80634 .....................970-330-5391 Lanting, William, MD 8223 W. 20th St., Ste. B Greeley, CO 80634 .....................970-978-4114

directory 2014

Burson, Michael, MD PO Box 419 Loveland, CO 80539 ..................970-635-4163

Carmosino, Mario, MD 1801 16th St. Greeley, CO 80631 .....................970-350-4819

Weitenberner, Nicholas, MD 1801 16th St. Greeley, CO 80631 .....................970-350-4819

Dunn, Cory, MD 5802 Wright Dr. Loveland, CO 80538 .......970-212-0530

Elliott, Keith, MD 1801 16th St. Greeley, CO 80631 ......................970-350-4819

Audiology

Halbert, Richard, MD 5802 Wright Dr. Loveland, CO 80538 .......970-212-0530

Faszholz, Mark, MD 1801 16th St. Greeley, CO 80631 .....................970-350-4819

Hamner, Harry, MD 5802 Wright Dr. Loveland, CO 80538 .......970-212-0530 Libby, Arlene, MD 5802 Wright Dr. Loveland, CO 80538 .......970-212-0530 Neuhauser, Thomas, MD 5802 Wright Dr. Loveland, CO 80538 .......970-212-0530 Nerby, Craig, MD 5802 Wright Dr. Loveland, CO 80538 .......970-212-0530

Laszlo, Daniel, MD 1136 E. Stuart St., Bldg. 3, Ste. 200 Fort Collins, CO 80525 ..............970-221-1681

Pizzi, Catherine, MD 5802 Wright Dr. Loveland, CO 80538 .......970-212-0530

Martucci, Michael, MD 2121 E. Harmony Rd., Ste. 350 Fort Collins, CO 80528 ...............970-221-2370

Walts, Michael, MD 5802 Wright Dr. Loveland, CO 80538 .......970-212-0530

Murthy, Krishna, MD 2121 E. Harmony Rd., Ste. 350 Fort Collins, CO 80528 ..............970-221-2370

Wilkerson, James, MD PO Box 419 Loveland, CO 80539 .................970-635-4163

Pace, Robert, MD 6801 W. 20th St., Ste. 206 Greeley, CO 80634 ....................970-353-0155

Worcester, Heath, MD 5802 Wright Dr. Loveland, CO 80538 .......970-212-0530

Anatomic & Clinical Anesthesiology Pathology Abston, Phillip, MD Allen, Patrick, MD PO Box 419 Loveland, CO 80539 ..................970-635-4163 Barner, Ross, MD 5802 Wright Dr. Loveland, CO 80538 .......970-212-0530 Bee, Christopher, MD 5802 Wright Dr. Loveland, CO 80538 .......970-212-0530

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The medical health provider list has been provided by McKee Medical Center and North Colorado Medical Center. This Medical Health Provider Directory is current as of 12/20/2013.

1800 15th St., Ste. G10 Greeley, CO 80631 .....................970-396-6994

Filby, Paul, MD 2000 Boise Ave Loveland, CO 80538 .................970-350-4819 Foley, Kevin, MD 2000 Boise Ave Loveland, CO 80538 ..................970-350-4819 Gaca, Julie, MD 1801 16th St. Greeley, CO 80631 .....................970-350-4819 Gengler, Jeffrey, MD 1801 16th St. Greeley, CO 80631 .....................970-350-4819 Hagebak, Robert, MD 1801 16th St. Greeley, CO 80631 .....................970-350-4819 Hildebrand, Laura, ANP 1801 16th St. Greeley, CO 80631 .....................970-350-4800 Lloyd, Alan, MD 2000 Boise Ave Loveland, CO 80538 .................970-350-4819 Michael, Christopher, MD 1801 16th St. Greeley, CO 80631 .....................970-350-4819 Miles, Regina, FNP 1801 16th St. Greeley, CO 80631 ......................970-350-4819

Dice, Noel, AuD 5881 W. 16th St. Greeley, CO 80634 ....................970-313-2740 Skordas, James, AuD 6500 29th St., Ste. 106 Greeley, CO 80634 ....................970-330-5555 Swope, Karen, AuD 2528 W. 16th St., Ste. 100 Greeley, CO 80634 .....................970-352-2881 Traynor, Robert, EDD 2528 W. 16th St., Ste. 100 Greeley, CO 80634 .........970-352-2881

Burn Medicine Beltz, Janet, FNP 1801 16th St. Greeley, CO 80631 ....................970-350-6071 Cockrell, Gail, MD 1801 16th St. Greeley, CO 80631 ......................970-350-6304 Garber, Rebecca, FNP 1801 16th St. Greeley, CO 80631 .....................970-350-6304 Goodwin, Cleon, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6304

Cardiology Beckmann, James, MD 1800 15th St., Ste. 310 Greeley, CO 80631 .....................970-392-0900

Nesbit, Michael, MD 1801 16th St. Greeley, CO 80631 .....................970-350-4819

Boyce, Lynn, FNP 1800 15th St., Ste. 310 Greeley, CO 80631 .....................970-392-0900

Blair, Sarah, MD 2000 Boise Ave. Loveland, CO 80538 .................970-350-4819

Rose, Erin, MD 1801 16th St. Greeley, CO 80631 .....................970-350-4800

Bruce, Todd, PA-C 1800 15th St., Ste. 310 Greeley, CO 80631 ......................970-378-4593

Callahan, Vicki, MD 1801 16th St. Greeley, CO 80631 ....................970-350-4819

Song, Yo-Jun, MD 1801 16th St. Greeley, CO 80631 .....................970-350-4819

Chapel, Harold, MD 1800 15th St., Ste. 310 Greeley, CO 80631 .....................970-392-0900

Balestrieri, Francis, MD 2000 N. Boise Ave. Loveland, CO 80538 .................970-350-4819

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Cohen, Andrew, MD 1444 S. Potomac, Ste. 300 Aurora, CO 80012 .....................303-750-0822

Lyle, Brian, MD 1900 N. Boise Ave., Ste. 200 Loveland, CO 80538 .................970-203-2400

Rowan, Shane, MD 1800 15th St., Ste. 310 Greeley, CO 80631 ......................970-392-0900

Dearmont-Olson, Jodi, FNP 1800 15th St., Ste. 310 Greeley, CO 80631 .....................970-392-0900

Marinello, Laura, PA-C 1800 15th St., Ste. 310 Greeley, CO 80631 .....................970-392-0900

Critical Care Medicine

Dong, Lin-Wang, MD 1800 15th St., Ste. 310 Greeley, CO 80631 .....................970-392-0900 Drury, John, MD 1405 S. 8th Ave., Ste. 104 Sterling, CO 80751 .....................970-526-8181 Giansiracusa, Richard, MD 2555 E. 13th St., Ste. 100 Loveland, CO 80537 ...................970-613-1745 Gryboski, Cynthia, MD 1800 15th St., Ste. 310 Greeley, CO 80631 .....................970-392-0900 Hinze, Brenda, PA-C 1800 15th St., Ste. 310 Greeley, CO 80631 .....................970-392-0900 Hirsch, Cecilia, MD 1800 15th St., Ste. 310 Greeley, CO 80631 ......................970-392-0900 Hurst, Paul, MD 1800 15th St., Ste. 310 Greeley, CO 80631 .....................970-392-0900

Marsh, Randall, MD 1900 N. Boise Ave., Ste. 200 Loveland, CO 80538 ..................970-203-2400 Quillen, James, MD 1900 N. Boise Ave., Ste. 200 Loveland, CO 80538 ..................970-203-2400 Rath, Gary, MD 1800 15th St., Ste. 310 Greeley, CO 80631 .....................970-392-0900 Shihabi, Ahmad, MD 1800 15th St., Ste. 310 Greeley, CO 80631 .....................970-392-0900 Webb, Peter, PA-C 1800 15th St., Ste. 310 Greeley, CO 80631 ......................970-392-0900 Zumbrun, Stephen, MD 1800 15th St., Ste. 310 Greeley, CO 80631 .....................970-392-0900

Jensen, Ruth, FNP 1800 15th St., Ste. 320 Greeley, CO 80631 .....................970-350-6953

CardiologyElectrophysiology

Lease, Anne, FNP 1800 15th St., Ste. 320 Greeley, CO 80631 .....................970-350-6953

Pfahnl, Arnold, MD 1800 15th St., Ste. 310 Greeley, CO 80631 ......................970-392-0900

Northern Colorado Medical & Wellness 2014

Fitzgerald, David, DO 1801 16th St. Greeley, CO 80631 .....................970-392-2026 Fitzgerald, Michael, NP 1900 Boise Ave., Ste. 220 Loveland, CO 80538 ..................970-203-2120 Golden, Gregory, DO 1900 Boise Ave., Ste. 220 Loveland, CO 80538 ..................970-203-2120 Groves, Robert, MD 1801 16th St. Greeley, CO 80631 .....................970-392-2026 Janata, Kelli, DO 1801 16th St. Greeley, CO 80631 .....................970-392-2026 Janata, Robert, DO 1801 16th St. Greeley, CO 80631 .....................970-392-2026

Dermatology Bair, Sarah, MD 776 W. Eisenhower Blvd.

Loveland, CO 80537 ..................970-667-3116 Baird, Kristin, MD 1551 Professional Ln., Ste. 135 Longmont, CO 80501 ................303-532-2810 Blattner, Mary, MD 5881 W. 16th St., Ste. E Greeley, CO 80634 ....................970-313-2734 Castle, Stephen, DO 7251 W. 20th St., Bldg. E Greeley, CO 80634 .....................970-330-6075 Hoover, Aaron, MD 6500 29th St., Ste. 106 Greeley, CO 80634 ....................970-556-9319 Lillis, Patrick, MD 776 W. Eisenhower Blvd.

Loveland, CO 80537 ..................970-667-3116 Mahlberg, Matthew, MD 776 W. Eisenhower Blvd.

Loveland, CO 80537 ..................970-667-3116

Kukafka, David, MD 1900 Boise Ave., Ste. 220 Loveland, CO 80538 .................970-203-2120

Ear, Nose & Throat (Otolaryngology)

Nallamothu, Ravindra, MD 1900 Boise Ave., Ste. 220 Loveland, CO 80538 ..................970-203-2120

Bieganski, Andrea, PA-C 1120 E. Elizabeth St., Bldg. F-101 Fort Collins, CO 80524 ....970-221-1177

Shedd, Michael, MD 1801 16th St. Greeley, CO 80631 .....................970-392-2026

Eriksen, Christopher, MD 1120 E. Elizabeth St., Bldg. F-101 Fort Collins, CO 80524 ....970-221-1177

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Gill, Sarvjit, MD 3820 N. Grant Ave. Loveland, CO 80538 .......970-593-1177

Demers, Nicholas, DO 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Nace, Bradley, PA-C 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Wolf, Ryan, PA-C 1801 16th St. Greeley, CO 80631 ....................970-350-6244

Gupta, Sanjay, MD 6500 29th St., Ste. 106 Greeley, CO 80634 ....................970-330-5555

Dixon, Mark, MD 2000 Boise Ave. Loveland, CO 80538 .................970-635-4071

Nemejc, Charles, PA-C 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Endocrinology

Peterson, Thomas, MD 5881 W. 16th St. Greeley, CO 80634 ....................970-313-2740

Dugan, Lauren, DO 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Nettles, Andrea, PA-C 2000 Boise Ave. Loveland, CO 80538 .................970-635-4071

Ricci, Megan, PA-C 3820 N. Grant Ave. Loveland, CO 80538 .......970-593-1177

Emme, Siegfried, FNP 2000 Boise Ave. Loveland, CO 80538 .................970-635-4071

Paules, Melissa, PA-C 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Robertson, Matthew, MD 1120 E. Elizabeth St., Bldg. F-101 Fort Collins, CO 80524 ....970-221-1177

Fallon, Michael, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Peacock, Seth, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Sabour, Sarmad, MD 6500 29th St., Ste.106 Greeley, CO 80634 .....................970-330-5555

Fuhrmann, Eric, MD 2000 Boise Ave. Loveland, CO 80538 .................970-635-4071

Pedigo, Thomas, PA-C 1801 16th St. Greeley, CO 80631 ......................970-350-6244

TerKonda, Raj, MD 1925 W. Mountain View Ave. Longmont, CO 80501 ................720-494-3120

Geohring, Jerold, PA-C 2000 Boise Ave. Loveland, CO 80538 ..................970-635-4071

Price, T. Chris, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Wold, Stephen, MD 1120 E. Elizabeth St., Bldg. F-101 Fort Collins, CO 80524 ....970-221-1177

Grossman, Lauren, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Ranniger, Stacie, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Wright, Christopher, PA-C 6500 29th St., Ste. 106 Greeley, CO 80634 .....................970-330-5555

Hanck, Jill, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Reghitto, Michael, MD 2000 Boise Ave. Loveland, CO 80538 .................970-635-4071

Zacheis, David, MD 3820 N. Grant Ave. Loveland, CO 80538 .......970-593-1177

Hernandez, Caleb, DO 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Saint, Elva, FNP 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Emergency Medicine

Huntington, Michael, MD 2000 Boise Ave. Loveland, CO 80538 ..................970-635-4071

Shedd, Regina, MD 2000 Boise Ave. Loveland, CO 80538 .................970-635-4071

Albert, Nils, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Iwanicki, Janetta, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Sovndal, Shannon, MD 1801 16th St. Greeley, CO 80631 ......................970-350-6244

Allison, Erik, DO 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Johar, Jasjot, MD 2000 Boise Ave. Loveland, CO 80538 .................970-635-4071

Stevinson, Brad, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Arguello, Daniel MD 2000 Boise Ave. Loveland, CO 80538 .................970-635-4071

Kruger, David, DO 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Sundheim, Scott, MD 2000 Boise Ave. Loveland, CO 80538 ..................970-635-4071

Bassett, Kenneth, DO 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Ledges, Matthew, MD 1801 16th St. Greeley, CO 80631 ......................970-350-6244

Tate, Ian, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Bogart, Trina, MD 2000 Boise Ave. Loveland, CO 80538 .................970-635-4071

Lee, Jennifer, PA-C 2000 Boise Ave. Loveland, CO 80538 ..................970-635-4071

Todaro, Matthew, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Brant, Dennis, PA-C 1801 16th St. Greeley, CO 80631 ....................970-350-6244

Lowe, Robert, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Trent, Stacy, MD 1801 16th St. Greeley, CO 80631 ......................970-350-6244

Cooper, Brian, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Maldonado, Ryan, PA-C 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Vanetti, Carol, MD 1801 16th St. Greeley, CO 80631 .....................970-346-1567

Corson, Thomas, DO 2000 Boise Ave. Loveland, CO 80538 .................970-635-4071

McNally, Thomas, PA-C 2000 Boise Ave. Loveland, CO 80538 .................970-635-4071

Wageman, David, DO 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Budensiek, Richard, DO 5623 W. 19th St., Ste. A Greeley, CO 80634 ......................970-353-9011

Dannemiller, Elisa, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Melton, Natasha, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Walters, Jeannine, DO 2000 Boise Ave. Loveland, CO 80538 .................970-635-4071

Cabrera, Anthony, MD 3880 N. Grant Ave., Ste. 140 Loveland, CO 80538 ..................970-203-0047

Deason, Janna, FNP 2000 Boise Ave. Loveland, CO 80538 ..................970-635-4071

Morrow, Gregory, PA-C 2000 Boise Ave. Loveland, CO 80538 ..................970-635-4071

Watson, Susan, DO 1801 16th St. Greeley, CO 80631 .....................970-350-6244

Caldwell, Nancy, FNP-C 1230 14th St. SW Loveland, CO 80537 ...................970-619-3999

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Hergert, Teresa, FNP 1800 15th St., Ste. 210 Greeley, CO 80631 .....................970-378-4676 Izon, Meriam, MD 2121 E. Harmony Rd., Ste. 300 Fort Collins, CO 80528 ..............970-295-0010 Kumar, Nirmala, MD 1800 15th St., Ste. 210 Greeley, CO 80631 .....................970-378-4676 Rieniets, Kimberly, DO 1800 15th St., Ste. 210 Greeley, CO 80631 .....................970-378-4676 Sadler, Corinn, MD 1800 15th St., Ste. 210 Greeley, CO 80631 ......................970-378-4676 Speed, James, MD 1800 15th St., Ste. 210 Greeley, CO 80631 .....................970-378-4676

Family Medicine Allen, Thomas, MD 295 E. 29th St. Loveland, CO 80538 .................970-669-6000 Bakanauskas, Egle, MD 1455 Main St., Ste. 100 Windsor, CO 80550 ....................970-686-3950 Bearden, Jacqueline, MD 5623 W. 19th St., Ste. A Greeley, CO 80634 .....................970-353-9011 Bender, John, MD 4674 Snow Mesa Dr., Ste. 140 Fort Collins, CO 80528 ..............970-482-0213 Bradley, Robert, MD 1455 Main St., Ste. 100 Windsor, CO 80550 970-686-3950 Branum, Joanna, MD 2520 W. 16th St. Greeley, CO 80634 .....................970-356-2520 Brewer, Gay, PA-C 401 10th St. Berthoud, CO 80513 .................970-532-4910 Brooks, Lesley, MD 2930 11th Ave. Evans, CO 80620 ......................970-353-9403 Brown, Cara, MD 222 Johnstown Center Dr. Johnstown, CO 80534 ...............970-587-4974 Brown, Matt, MD 222 Johnstown Center Dr. Johnstown, CO 80534 ...............970-587-4974

Lydia’s STYLE Magazine

Carey, Michael, MD 1455 Main St., Ste. 100 Windsor, CO 80550 ....................970-686-3950

Hailey, Mark, MD 1230 14th St. SW Loveland, CO 80537 ..................970-619-3999

Leonard, Brian, DO 1600 23rd Ave. Greeley, CO 80634 .....................970-356-2424

Paczosa, Michelle, DO 6801 W. 20th St., Ste. 101 Greeley, CO 80634 ....................970-378-8000

Clang, Daniel, DO 6801 W. 20th St., Ste. 101 Greeley, CO 80634 ....................970-378-8000

Haskins, Robert, MD 6801 W. 20th St., Ste. 101 Greeley, CO 80634 .....................970-378-8000

Ley, James, MD 5881 W. 16th St. Greeley, CO 80634 ....................970-313-2700

Patrick, Amy, PA-C 2701 Madison Square Dr. Loveland, CO 80538 .................970-663-0722

Clang, Tamara, DO 6801 W. 20th Street, Ste. 101 Greeley, CO 80634 ....................970-378-8000

Hathaway, Courtney, MD 1600 23rd Ave. Greeley, CO 80634 .....................970-346-2833

Linder, Benjamin, MD 1600 23rd Ave. Greeley, CO 80634 ....................970-346-2833

Pearce, Darla, FNP-C 100 S. Cherry Ave., Ste. 1 Eaton, CO 80615 .......................970-454-3838

Colgan, Ann, MD 2520 W. 16th St. Greeley, CO 80634 .....................970-356-2520

Hellman, Philip, MD 1600 23rd Ave. Greeley, CO 80634 .....................970-346-2833

Lobitz, Paul, MD 2520 W. 16th St. Greeley, CO 80634 ....................970-356-2520

Peterson, Jeffrey, MD 6801 W. 20th St., Ste. 101 Greeley, CO 80634 ....................970-378-8000

Cook, Jeffrey, MD 1600 23rd Ave. Greeley, CO 80634 ....................970-356-2424

Hepp, Heidi, MD 2701 Madison Square Dr. Loveland, CO 80538 .................970-663-0722

Lyons, Marianne, DO 100 S. Cherry Ave., Unit 1 Eaton, CO 80615 .......................970-454-3838

Pflieger, Daniel, MD 2420 W. 16th St. Greeley, CO 80634 .....................970-353-7668

Coonrod, Rita, MD 1600 23rd Ave. Greeley, CO 80634 ....................970-356-2424

Hoffmann, Julie, MD 3880 N. Grant Ave. Loveland, CO 80538 ..................970-203-0047

Magnuson, Douglas, MD 2520 W. 16th St. Greeley, CO 80634 .....................970-356-2520

Powell, Patricia, MD 2930 11th Avenue Evans, CO 80620 ......................970-353-9403

Corona, Joseph, MD 5881 W. 16th St. Greeley, CO 80634 ....................970-313-2700

Hollos, Lori, MD 2701 Madison Square Dr. Loveland, CO 80538 ..................970-663-0722

Mallory, Patrick, DO 1548 N. Boise Ave. Loveland, CO 80538 .................970-669-9245

Puls, David, DO 5623 W. 19th St., Ste. A Greeley, CO 80634 ....................970-353-9011

Dallow, Kurt, MD 1600 23rd Ave. Greeley, CO 80634 .....................970-356-2424

Isley, Courtney, MD 222 Johnstown Center Dr. Johnstown, CO 80534 ................970-587-4974

Martinez, Matthew, MD 6801 W. 20th St., Ste.101 Greeley, CO 80634 ....................970-378-8000

Rangel, Keith, MD 1455 Main St., Ste. 100 Windsor, CO 80550 ....................970-686-3950

Dawson, Jennifer, DO 2520 W. 16th St. Greeley, CO 80634 ....................970-356-2520

Jacob, Prema, MD 3850 N. Grant Ave., Ste. 100 Loveland, CO 80538 .................970-776-1862

Mast, Eric, DO 1600 23rd Ave. Greeley, CO 80634 .....................970-346-2833

Reents, William, MD 1230 14th St. SW Loveland, CO 80537 ...................970-619-3999

DeMoor, Sarah, MD 2930 11th Ave. Evans, CO 80620 .......................970-353-9403

Janasek, Mitchell, MD 1230 14th St. SW Loveland, CO 80537 ..................970-619-3999

Mattox, Amy, MD 2420 W. 16th St. Greeley, CO 80634 ....................970-353-7668

Ripley, Lori, MD 2520 W. 16th St. Greeley, CO 80634 .....................970-356-2520

Detterer, Shari, FNP-C 303 Colland Dr. Fort Collins, CO 80525 ...............970-461-8031

Jeffers, Wayne, MD 1600 23rd Ave. Greeley, CO 80634 ....................970-356-2424

McCabe-Lentz, Jennifer, MD 1230 14th St. SW Loveland, CO 80537 ...................970-619-3999

Risenhoover, Edwin, MD 295 E. 29th St. Loveland, CO 80538 .................970-669-6000

Doft, Anthony, MD 1300 Main St. Windsor, CO 80550 ....................970-686-5646

Kary, Jonathan, MD 1300 Main St. Windsor, CO 80550 ....................970-686-5646

McCall, Janis, MD 5623 W. 19th St., Ste. A Greeley, CO 80634 .....................970-353-9011

Rommereim-Madden, Daphne, MD 1600 23rd Ave. Greeley, CO 80634 ....................970-356-2424

Dubin, Jeremy, DO 3320 W. Eisenhower Blvd.

Loveland, CO 80537 ...................970-669-2849

Kasenberg, Thomas, DO 295 E. 29th St. Loveland, CO 80538 ..................970-669-6000

McGarr, Mitzi, FNP 1600 23rd Ave. Greeley, CO 80634 ....................970-356-2424

Schaffer, Scott, MD 303 Colland Dr. Fort Collins, CO 80525 ..............970-461-8031

Fahrenholtz, Herbert, MD 1600 23rd Ave. Greeley, CO 80634 .....................970-356-2424

Kenigsberg, Thomas, MD 222 Johnstown Center Dr. Johnstown, CO 80534 ...............970-587-4974

Morgan, Frank, MD 5623 W. 19th St., Ste. A Greeley, CO 80634 ....................970-353-9011

Schmalhorst, Brian, MD 5881 W. 16th St. Greeley, CO 80634 ....................970-313-2700

Finnoff, Gregory, DO 2930 11th Ave. Evans, CO 80620 ......................970-353-9403

Kennedy, Christopher, MD 2420 W. 16th St. Greeley, CO 80634 .....................970-353-7668

Myers, Michelle, MD 1801 16th St. Greeley, CO 80631 ....................970-378-4529

Schulte, Dorothy, FNP 1600 23rd Ave. Greeley, CO 80634 .....................970-356-2424

Flake, Zachary, MD 2701 Madison Square Dr. Loveland, CO 80538 .................970-663-0722

Kessinger, Trina, MD 1300 Main St. Windsor, CO 80550 ....................970-686-5646

Nedom, Jessica., FNP 2930 11th Ave. Evans, CO 80620 ......................970-353-9403

Schwerin, Kari, FNP 1600 23rd Ave. Greeley, CO 80634 ....................970-356-2424

Frickman, C. Elmo, MD 3320 W. Eisenhower Blvd.

Loveland, CO 80537 ...................970-669-2849

Kimball, Allison, MD 1600 23rd Ave. Greeley, CO 80634 ....................970-346-2833

Noordewier, Edwin, MD 1900 16th St. Greeley, CO 80631 .....................970-350-2454

Sheppard-Madden, Dena, MD 401 N 10th St. Berthoud, CO 80513 .................970-532-4910

Garber, Stacey, MD 2420 W. 16th St. Greeley, CO 80634 ....................970-353-7668

Kirker, Mary, MD 630 15th Ave., Ste. 103 Longmont, CO 80501 .................303-776-0600

Nwizu, Chima, MD 6801 W. 20th St., Ste.101 Greeley, CO 80634 ....................970-378-8000

Smith, David, MD 1600 23rd Ave. Greeley, CO 80634 ....................970-356-2424

Grauerholz, Brent, MD 1900 16th St. Greeley, CO 80631 .....................970-350-2454

Kriley, Thomas, MD 1600 23rd Ave. Greeley, CO 80634 ....................970-346-2833

Ogden, Samuel, MD 1600 23rd Ave. Greeley, CO 80634 ....................970-356-2424

Snodgrass, David, MD 2701 Madison Square Dr. Loveland, CO 80538 ..................970-663-0722

Gregory, Joseph, MD 222 Johnstown Center Dr. Johnstown, CO 80534 ...............970-587-4974

Kurth, Jay, DO 702-A W. Drake Rd. Fort Collins, CO 80526 ..............970-229-4600

Oligmueller, William, MD 5881 W. 16th St. Greeley, CO 80634 .....................970-313-2700

Squires, Rhonda, FNP 1600 23rd Ave. Greeley, CO 80634 ....................970-356-2424

Guiroy, Jessica, MD 303 Colland Dr. Fort Collins, CO 80525 ...............970-461-8031

Larson, Amanda, DO 1600 23rd Ave. Greeley, CO 80634 ....................970-346-2833

Orozco-Peterson, Marilu, MD 811 E. Elizabeth St. Fort Collins, CO 80524 ..............970-224-1596

Starks, Casey, MD 1600 23rd Ave. Greeley, CO 80634 .....................970-356-2424

Northern Colorado Medical & Wellness 2014

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Stoddard, Andrew, MD 2520 W. 16th St. Greeley, CO 80634 .....................970-356-2520

Kading, Steven, MD 1900 16th St. Greeley, CO 80631 ......................970-350-2470

Crane, John, MD 1900 N. Boise Ave., Ste. 300 & 410 Loveland, CO 80538 .................970-667-2009

Wood, Alice, MD 2050 N. Boise Ave., Ste. B Loveland, CO 80538 .................970-679-8941

Taylor, Grant, DO 702-A W. Drake Rd. Fort Collins, CO 80526 ..............970-229-4600

Knuthson, Amber, PA-C 2010 16th St., Ste. A Greeley, CO 80631 .....................970-378-4475

Englert, Thomas, MD 1900 N. Boise Ave., Ste. 300 & 410 Loveland, CO 80538 .................970-667-2009

Hospice & Palliative Care

Trevino, Julia, MD 2930 11th Ave. Evans, CO 80620 .......................970-353-9403

Langer, Daniel, MD 2555 E. 13th St., Ste. 220 Loveland, CO 80537 ...................970-669-5432

Nelson, Brian, MD 1925 W. Mountain View Ave. Longmont, CO 80501 .................720-494-3130

Unrein, Tanya, FNP 1600 23rd Ave. Greeley, CO 80634 ....................970-356-2424

North, Crystal, DO 2555 E. 13th St., Ste. 220 Loveland, CO 80537 ..................970-669-5432

Hematology-Oncology Hospitalist

Reynolds, Kara, PA-C 2010 16th St., Ste. A Greeley, CO 80631 .....................970-378-4475

Datko, Farrah, MD 2315 E. Harmony Rd., Ste. 110 Fort Collins, CO 80528 ..............970-212-7600

Rosenblatt, Mark, MD 2010 16th St., Ste. A Greeley, CO 80631 .....................970-378-4475

Ehrman, Sheryl, FNP 1801 16th St. Greeley, CO 80631 .....................970-350-6680

Sears, Stephen, MD 2555 E. 13th St., Ste. 220 Loveland, CO 80537 ..................970-669-5432

Gale, Pamola, FNP 2050 N. Boise Ave. Loveland, CO 80538 ..................970-679-8900

Sherif, Ahmed, MD 2010 16th St., Ste. A Greeley, CO 80631 .....................970-378-4475

Garrison, Mitzi, FNP 615 Fairhurst St. Sterling, CO 80751 ....................970-526-5555

Volk, John, MD 2930 11th Ave. Evans, CO 80620 .......................970-353-9403 Walker, Justin, MD 2930 11th Ave. Evans, CO 80620 ......................970-353-9403 Wallace, Mark, MD 2930 11th Ave. Evans, CO 80620 ......................970-350-4674 Waugh, Kyle, MD 6801 W. 20th St., Ste. 101 Greeley, CO 80634 .....................970-378-8000 Wilson, D. Craig, MD 2520 W. 16th St. Greeley, CO 80634 .....................970-356-2520 Young, Mark, MD 2420 W. 16th St. Greeley, CO 80634 .....................970-353-7668 Zeigler, Azure, FNP-C 1230 14th St. SW Loveland, CO 80537 ...................970-619-3999 Zucker, Charles, MD 6801 W. 20th St., Ste. 101 Greeley, CO 80634 ....................970-378-8000

Gastroenterology Abu Qwaider, Yazan, MD 2010 16th St., Ste. A Greeley, CO 80631 ......................970-378-4475 Ciarvella, Amber, PA-C 2010 16th St., Ste. A Greeley, CO 80631 .....................970-378-4475 Compton, Rand, MD 3702 Timberline Rd., Bldg. A Fort Collins, CO 80525 ...............970-207-9773 Dowgin, Thomas, MD 3702 Timberline Rd., Bldg. A Fort Collins, CO 80525 ..............970-207-9773 Dunphy, Rebecca, MD 3702 Timberline Rd., Bldg. A Fort Collins, CO 80525 ..............970-207-9773 Durkan, Mark, MD 3702 Timberline Rd., Bldg. A Fort Collins, CO 80525 ..............970-207-9773

Strong, Lewis, MD 2555 E. 13th St., Ste. 220 Loveland, CO 80537 ...................970-669-5432

General Dentistry Edgren, Bradford, DDS 3400 W. 16th St., Bldg. 4-V Greeley, CO 80634 .........970-356-5900 Ferrara, Nicole, DDS 2975 Ginnala Dr., Ste. 100 Loveland, CO 80538 ..................970-663-1000 McIntyre, Peter, DDS 595 Chapel Hills Dr., Ste. 105 Colorado Springs, CO 80918 .....719-475-2511 Mioduski, Ted, DDS 2975 Ginnala Dr., Ste. 100 Loveland, CO 80538 ..................970-663-1000 Mioduski, Theodore, DDS 2975 Ginnala Dr., Ste. 100 Loveland, CO 80538 .................970-663-1000

Geriatric Medicine Al-Adsani, Wasl, DO 1801 16th St. Greeley, CO 80631 .....................970-378-4529

Gynecology Brooks, Roberta, PA-C 1800 15th St., Ste. 220 Greeley, CO 80631 .....................970-353-1335

George, Benjamin, MD 2050 N. Boise Ave., Ste. A Loveland, CO 80538 .................970-679-8941 Hinman, Mary, NP 2500 Rocky Mtn Ave., N MOB Loveland, CO 80538 ..................970-203-7080 Kemme, Douglas, MD 1675 18th Ave., Ste. 3 Greeley, CO 80631 .....................970-347-5780 McFarland, Ross, MD 2315 E. Harmony Rd., Ste. 110 Fort Collins, CO 80528 ..............970-212-7600 Medgyesy, Diana, MD 2315 E. Harmony Rd., Ste. 110 Fort Collins, CO 80528 ..............970-212-7600 Moore, James, MD 2315 E. Harmony Rd., Ste. 110 Fort Collins, CO 80528 ..............970-212-7600 Romero, Paolo, MD 2121 E. Harmony Rd., Ste. 150 Fort Collins, CO 80528 ..............970-493-6337 Shelanski, Samuel, MD 2050 N. Boise Ave., Ste. A Loveland, CO 80538 .................970-679-8941 Soriano, Ariel, MD 1800 15th St., Ste. A Greeley, CO 80631 .....................970-378-3894 Stone, Michael, MD 1675 18th Ave., Ste. 3 Greeley, CO 80631 .....................970-347-5780

Allen, David, MD 305 Carpenter Rd. Fort Collins, CO 80525 ....970-663-3500

Asadi, Shahram, DO 2000 N. Boise Ave. Loveland, CO 80538 ..................970-203-6770 Barzdukas, Sherri, FNP 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Bruntz, Cara, FNP 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Campbell, Richard, DO 1801 16th St. Greeley, CO 80631 ......................970-378-4529 Chen, Edward, DO 2000 Boise Ave. Loveland, CO 80538 .................970-203-6770 Cramer, Shane, PA-C 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Dawson, Judd, DO 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Demeke, Tesfaye, MD 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Emerson, Barbara, MD 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Finnoff, Greg, DO 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Fisher, Myka, FNP 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Floyd, Chelsea, PA-C 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Fuller, Alexander, FNP 1801 16th St. Greeley, CO 80631 ......................970-378-4529 Goehring, Jerold, PA-C 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Harris, Marciann, FNP 2000 Boise Ave. Loveland, CO 80538 ..................970-203-6770

Burke, Robert, MD 2500 Rocky Mtn Ave., Ste. 150 Loveland, CO 80538 .................970-493-7442

Stroh, Ann, DO 2500 Rocky Mtn Ave., N MOB Loveland, CO 80538 .................970-203-7080

Hipp, Naomi, MD 2000 Boise Ave. Loveland, CO 80538 .................970-203-6770

Holland, Rodney, MD 3702 Timberline Rd., Bldg. A Fort Collins, CO 80525 ..............970-207-9773

Burket, Charles, MD 1900 16th St. Greeley, CO 80631 .....................970-350-2403

Theuerkom, Linda, FNP 2050 N. Boise Ave., Ste. A Loveland, CO 80538 .................970-679-8941

Kalfon, Barry, MD 1801 16th St. Greeley, CO 80620 ....................970-378-4529

Jing, Tong, MD 2010 16th St., Ste. A Greeley, CO 80631 ....................970-378-4475

Carter, Susan, MD 1800 15th St., Ste. 220 Greeley, CO 80631 .....................970-353-1335

Williams-Wuch, Kerry, MD 2050 N. Boise Ave., Ste. A Loveland, CO 80538 .................970-679-8941

Loecke, Steven, MD 1801 16th St. Greeley, CO 80631 .....................970-378-4529

34

Lydia’s STYLE Magazine

Loftin, Andrew, PA-C 1801 16th St. Greeley, CO 80631 .....................970-378-4529

Barker, Lance, DO 100 S. Cherry Ave. Unit 1 Eaton, CO 80615 .......................970-454-3838

Marino, Edward, PA-C 1801 16th St. Greeley, CO 80631 ......................970-378-4529

Berntsen, Mark, MD 1900 16th St. Greeley, CO 80631 .....................970-350-2438

Mills, Angela, MD 1801 16th St. Greeley, CO 80631 .....................970-378-4529

Cash, Robert, MD 1900 16th St. Greeley, CO 80631 .....................970-350-2438

Myers, Brandon, FNP 1801 16th St. Greeley, CO 80631 .....................970-378-4529

Christiansen, Dana, MD 1900 16th St. Greeley, CO 80631 .....................970-350-2438

Norman, Edward, MD 2000 Boise Ave. Loveland, CO 80538 ..................970-203-6770

Cuervo, Julia, MD 2923 Ginnala Dr. Loveland, CO 80538 ..................970-669-6660

Pearson, Antony, MD 2000 Boise Ave. Loveland, CO 80538 ..................970-203-6770

Demian, Cristina, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6087

Peck, Ryan, MD 2000 N. Boise Ave. Loveland, CO 80538 ..................970-203-6770

Doro, Danielle, MD 2010 16th St., Ste. C Greeley, CO 80631 ......................970-350-5660

Powell, Mary, FNP 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Reinhardt, Marcus, MD 1801 16th St. Greeley, CO 80631 ......................970-378-4529 Smith, Peter, MD 2923 Ginnala Dr. Loveland, CO 80538 ..................970-669-6660 Stafford, Neil, MD 4401 Union St. Johnstown, CO 80534 ................970-619-3663 Tallman, Marsha, MD 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Taylor, Grant, DO 702-A W. Drake Rd. Fort Collins, CO 80526 ..............970-229-4600 Tucker, Douglas, DO 1801 16th St. Greeley, CO 80631 ......................970-378-4529 Valin, James, MD 7251 W. 4th St. Greeley, CO 80634 ....................970-506-6610 Whaley, Jason, PA-C 1801 16th St. Greeley, CO 80631 .....................970-350-6087 Zhang, Shu, MD 1801 16th St. Greeley, CO 80631 .....................970-378-4529

Infectious Diseases Breen, Jack, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6360

Ebens, John, MD 1900 16th St. Greeley, CO 80631 .....................970-350-2438 Garcia, Giovanna, MD 2010 16th St., Ste. C Greeley, CO 80631 .....................970-350-5660 Hoffmann, Jeffrey, MD 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Honea, Bertrand, MD 2000 Boise Ave. Loveland, CO 80538 ..................970-593-6099 Kalt, Steven, MD 222 Johnstown Center Dr. Johnstown, CO 80534 ................970-587-4974 Keefe, Kevin, DO 2923 Ginnala Dr. Loveland, CO 80538 ..................970-669-6660 Manyam, Padmaja, MD 2923 Ginnala Dr. Loveland, CO 80538 ..................970-278-1862 Randle, Michael, MD 1900 16th St. Greeley, CO 80631 .....................970-350-2438 Rhoads, Phillip, MD 702-A W. Drake Rd. Fort Collins, CO 80526 ..............970-229-4600 Stadnyk, Sheldon, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6639 Tello, Robert, MD 2923 Ginnala Dr. Loveland, CO 80538 ..................970-669-6660 Thompson, Keith, MD 4800 25th St. Greeley, CO 80634 ....................970-330-6400

Zenk, Daniel, MD 1900 16th St. Greeley, CO 80631 .....................970-350-2438

Licensed Professional Counselor Carver, Laura, LPC 1019 39th Ave. Ste. D Greeley, CO 80634 .....................970-624-0420 O’Shea, Linda, LPC 8213 W. 20th St. Greeley, CO 80634 ....................970-346-9057

Maternal Fetal Medicine Harper, Teresa, MD 12631 E. 17th Ave., Mail Stop B198-5 Aurora, CO 80045 ......................303-724-2032 Hobbins, John, MD 12631 E. 17th Ave., Mail Stop B198-5 Aurora, CO 80045 .....................303-724-2032 Scott, Julie, MD 12631 E. 17th Ave., Mail Stop B198-5 Aurora, CO 80045 .....................303-724-2032

Medical Oncology George, Benjamin, MD 1800 15th St., Ste. A Greeley, CO 80631 .....................970-378-3894 Kanard, Anne, MD 2121 E. Harmony Rd., Ste. 150 Fort Collins, CO 80528 ..............970-493-6337 Shelanski, Samuel, MD 2050 N. Boise Ave., Ste. A Loveland, CO 80538 ........970-679-8941 Soriano, Ariel, MD 1800 15th St., Ste. A Greeley, CO 80631 .....................970-378-3894

Midwife Bottone-Post, Carolyn, CNM 1647 18th St. Loveland, CO 80538 ..................970-663-9523 Davidson, Linda, CNM 1647 18th St. Loveland, CO 80538 ..................970-663-9523 Dean, Cynthia, CNM 1647 18th St. Loveland, CO 80538 .................970-663-9523 Komorowski, Janelle, CNM 1647 18th St. Loveland, CO 80538 ..................970-663-9523 Labreck, Traci, CNM 1647 18th St. Loveland, CO 80538 ..................970-663-9523 Valasek, Patti, CNM 1647 18th St. Loveland, CO 80538 .................970-663-9523 Von Nieda, Heidi, CNM 1900 N. Boise Ave., Ste. 300 & 410 Loveland, CO 80538 .................970-667-2009

Neonatal Medicine Barrett, Wendelyn, NNP 1801 16th St. Greeley, CO 80631 .....................970-350-6585 Benjamin, Kathleen, NNP 1801 16th St. Greeley, CO 80631 .....................970-350-6585 Box, Judith, NNP 1801 16th St. Greeley, CO 80631 ......................970-350-6585 Evans, Ruth, NNP 1801 16th St. Greeley, CO 80631 .....................970-350-4659 Gibbs, Michelle, NNP 1801 16th St. Greeley, CO 80631 .....................970-350-6585

Internal Medicine

Waln, Curtis, MD 2010 16th St., Ste. C Greeley, CO 80631 .....................970-461-8031

Williams-Wuch, Kerry, MD 1800 15th St., Ste. A Greeley, CO 80631 .........970-378-3894

Harris, Stacy, NNP 1801 16th St. Greeley, CO 80631 .....................970-350-6585

Asadi, Shahram, DO 4401A Union St. Johnstown, CO 80534 ................970-619-3400

Webster, Douglas, MD 2923 Ginnala Dr. Loveland, CO 80538 ..................970-669-6660

Wood, Alice, MD 2050 N. Boise Ave., Ste. B Loveland, CO 80538 .................970-679-8941

Howald, Kimberly, NNP 1801 16th St. Greeley, CO 80631 .....................970-350-6585

Northern Colorado Medical & Wellness 2014

35

McCarney, Linda, NNP 1801 16th St. Greeley, CO 80631 ....................970-350-6585

Hager, Barbara, MD 1800 15th St., Ste. 100B Greeley, CO 80631 .....................970-350-5612

Obstetrics/Gynecology Ophthalmology (OB/GYN) Adams, John, MD

Musick, Melda, NNP 1801 16th St. Greeley, CO 80631 .....................970-350-6585

Hayes, Todd, DO 1800 15th St., Ste. 100B Greeley, CO 80631 .....................970-350-5612

Allen, Neil, MD 2410 W. 16th St. Greeley, CO 80634 ....................970-351-0298

Wolf, Vicky, NNP 1801 16th St. Greeley, CO 80631 .....................970-350-6585

Jensen, Judd, MD 499 E. Hampden Ave., Ste. 360 Englewood, CO 80113 ...............303-781-4485

Berdahl, Laurie, MD 2410 W. 16th St. Greeley, CO 80634 ....................970-352-6353

Katuna, Bruce, MD 2217 Harvard Ct. Longmont, CO 80503 ................303-776-5298

Brooks, Roberta, PA-C 2410 W. 16th St. Greeley, CO 80634 ....................970-352-6353

Lampe, Emily, MD 499 E. Hampden Ave., Ste. 360 Englewood, CO 80113 ...............303-781-4485

Franco, Jonathan, MD 1900 N. Boise Ave., Ste. 300 & 410 Loveland, CO 80538 .................970-667-2009

Pratt, Robert, MD 499 E. Hampden Ave., Ste. 360 Englewood, CO 80113 ...............303-781-4485

Garza, Phillip, MD 2410 W. 16th St. Greeley, CO 80634 .....................970-352-6353

Schmitt, Joseph, MD 295 E. 29th St., Ste. 240 Loveland, CO 80538 ..................970-669-2668

Hiratzka, Paul, MD 2410 W. 16th St. Greeley, CO 80634 .....................970-352-6353

Shaffer, William, MD 1800 15th St., Ste. 100B Greeley, CO 80631 .....................970-350-5612

Hofmeister, Jennifer, PA-C 1900 N. Boise Ave., Ste. 300 & 410 Loveland, CO 80538 ..................970-667-2009

Ahuja, Nilesh, MD 1600 Specht Point Dr., Ste. 127 Fort Collins, CO 80525 ....970-493-7733

Shah, Ravi, MD 9235 Crown Crest Blvd., Ste. 200 Parker, CO 80138 .....................303-840-5051

Howell, Elizabeth, MD 1900 N. Boise Ave., Ste. 300 & 410 Loveland, CO 80538 ..................970-667-2009

Holler, Pamela, NP 1600 Specht Point Dr., Ste. 127 Fort Collins, CO 80525 ....970-493-7733

Siegel, Jeffrey, MD 1800 15th St., Ste. 100B Greeley, CO 80631 .....................970-350-5612

Huff, Jenna, MD 1900 N. Boise Ave., Ste. 300 & 410 Loveland, CO 80538 ..................970-667-2009

Neonatology

MacRitchie, Amy, MD 13121 E. 17th Ave., ED 2 SO MS 8402, Rm 4304 Aurora, CO 80045 .....................303-724-2840 Wilkening, Randall, MD 13121 E. 17th Ave., ED 2 SO MS 8402, Rm 4304 Aurora, CO 80045 .....................303-724-2840 Wright, Jason, MD 13121 E. 17th Ave., ED 2 SO MS 8402, Rm 4304 Aurora, CO 80045 .....................303-724-2840

Nephrology

Merritt, Jason, MD 1600 Specht Point Dr., Ste. 127 Fort Collins, CO 80525 ....970-493-7733

Spencer, Byron, MD 499 E. Hampden Ave., Ste. 360 Englewood, CO 80113 ..............303-781-4485

Muelken, Kevin, MD 1600 Specht Point Dr., Ste. 127 Fort Collins, CO 80525 ....970-493-7733

Spillers, Steven, MD 1715 N. Weber St. Colorado Springs, CO 80907 .....719-955-6481

Rademacher, Donald, MD 1900 16th St. Greeley, CO 80631 .....................970-350-2438

Tam Sing, Jeffrey, MD 9235 Crown Crest Blvd., Ste. 200 Parker, CO 80138 .....................303-840-5051

Simmons, Richard, MD 1600 Specht Point Dr., Ste. 127 Fort Collins, CO 80525 ...970-493-7733 Singer, James, MD 1600 Specht Point Dr., Ste. 127 Fort Collins, CO 80525 ......970-493-7733 Teruel, Mark, MD 1600 Specht Point Dr., Ste. 127 Fort Collins, CO 80525 .......970-493-7733

Neurology Bandi, Srinivas, MD 2923 Ginnala Dr. Loveland, CO 80538 .................970-669-6660 Bartt, Russell, MD 499 E. Hampden Ave., Ste. 360 Englewood, CO 80113 ..............303-781-4485

Wagner, Jeffrey, MD 499 E. Hampden Ave., Ste. 360 Englewood, CO 80113 ...............303-781-4485 Young, Christy, MD 1800 15th St., Ste. 100B Greeley, CO 80631 .....................970-350-5612

Neuroradiology Jess, Sarah Jane, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Reese, Mark, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757

Nuclear Medicine

O’Neal, Jean-Pierre, MD 2410 W. 16th St. Greeley, CO 80634 ....................970-352-6353 Revoal, Alana, DO 2410 W. 16th St. Greeley, CO 80634 .....................970-352-6353 Slack, Kenneth, MD 1900 N. Boise Ave., Ste. 300 & 410 Loveland, CO 80538 ..................970-667-2009 Sokolowski, Irene, MD 1900 N. Boise Ave., Ste. 300 & 410 Loveland, CO 80538 .................970-667-2009 Stoltz, Michelle C., MD 2410 W. 16th St. Greeley, CO 80634 .....................970-352-6353

Occupational Medicine Brogmus, Donna, MD 1703 E. 18th St., Ste.3 Loveland, CO 80538 ..................970-278-4580

1701 61st Ave. Greeley, CO 80634 .....................970-351-6216 Carter, Douglas, MD 1931 65th Ave., Ste. C Greeley, CO 80634 .....................970-352-1877 Cecil, Jennifer, MD 2902 Ginnala Dr., Ste. 1 Loveland, CO 80538 ..................970-669-8998 Crews, Kent, MD 1725 E. Prospect Rd. Fort Collins, CO 80525 ..............970-221-2222 Crews, Michael, MD 1701 61st Ave. Greeley, CO 80634 .....................970-351-6216 Foe, Elaine, MD 1931 65th Ave., Ste. C Greeley, CO 80634 .....................970-352-1877 Jeng, Samuel, MD 1616 15th St. Greeley, CO 80631 .....................970-352-6688 Kirk, John, MD 3650 E. 15th St. Loveland, CO 80538 .................970-669-1107 Patron, Mark, MD 1615 Foxtrail Dr., Ste. 100 Loveland, CO 80538 ..................303-261-1600 Uyemura, Matthew, MD 1616 15th St. Greeley, CO 80631 .....................970-352-6688 Weeks, Jeffrey, MD 1931 65th Ave., Ste. C Greeley, CO 80634 ....................970-352-1877 Willoughby, Brian, MD 255 Detroit St. Denver, CO 80206 .....................303-320-5700

Orthopedics Baer, Robert, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ...970-493-0112 Beard, David, MD 3470 E. 15th St. Loveland, CO 80538 .......970-663-3975 Benz, Robert, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ...970-493-0112

Frisbie, Kenneth, PA-C 1517 16th Avenue Ct. Greeley, CO 80631 .....................970-350-6810

Biggs, William, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ....970-493-0112

Gilstrap, Laura, MD 1517 16th Avenue Ct. Greeley, CO 80631 .....................970-350-6810

Browne, Deborah, PA-C 5285 McWhinney Blvd., Ste. 145 Loveland, CO 80538 ..................970-669-8881

Chang, Ira, MD 499 E. Hampden Ave., Ste. 360 Englewood, CO 80113 ...............303-781-4485

Gunderson, Deborah, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757

Hebard, James, MD 1703 E. 18th St., Ste.3 Loveland, CO 80538 .................970-278-4580

Bureau, Christopher, PA-C 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

Fanale, Christopher, MD 499 E. Hampden Ave., Ste. 360 Englewood, CO 80113 ...............303-781-4485

Singer, Charles, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757

Smith, Cathy, MD 1517 16th Avenue Ct. Greeley, CO 80631 ......................970-350-6810

Bussey, Randy, MD 5890 W. 13th St., Ste. 101 Greeley, CO 80634 .....................970-348-0020

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Lydia’s STYLE Magazine

Chamberlain, Satoru, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 .....970-493-0112

Lehman, Dale, PA-C 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

Young, Eric, MD 3830 N. Grant Ave. Loveland, CO 80538 ..................970-776-3222

Hill, Amanda, MD 4901 Thompson Parkway Loveland, CO 80534 ..................970-207-7171

Clark, C. Dana, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ....970-493-0112

Martin, Dale, MD 3470 E. 15th St. Loveland, CO 80538 .......970-663-3975

Zabler, Lance, FNP 5890 W. 13th St., Ste. 101 Greeley, CO 80634 .....................970-348-0020

Kolanz, M. Meshelle, MD 5881 W. 16th St. Greeley, CO 80634 .....................970-313-2700

Crawford, Matthew, PA-C 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

McFerran, Mark, MD 3470 E. 15th St. Loveland, CO 80538 .......970-663-3975

Pain Management

Konda-Sundheim, Rachel, MD 2021 N. Boise Ave. Loveland, CO 80538 ..................970-669-3298

Dhupar, Scott, MD 6200 W. 9th St., Ste. 1-B Greeley, CO 80634 ....................970-353-5959

McRae, Nancy, PA-C 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

Clemens, Orrie, MD 2001 S. Shields St., Bldg. L Fort Collins, CO 80526 ...............970-221-0565

Donner, Edward, MD 5285 McWhinney Blvd., Ste. 145 Loveland, CO 80538 .................970-669-8881

Nettles, Ryan, PA-C 5890 W. 13th St., Ste. 101 Greeley, CO 80634 .....................970-348-0020

Hompland, Scott, DO 1300 Oakridge Dr., Ste. 130 Fort Collins, CO 80525 ..............970-377-9555

Driscoll, Kathryn, PA-C 3470 E. 15th St. Loveland, CO 80538 .................970-663-3975

Pazik, Thomas, MD 5890 W. 13th St., Ste. 101 Greeley, CO 80634 .....................970-348-0020

McCeney, Michael, MD 4901 Thompson Pkwy.

Loveland, CO 80534 ..................970-207-7171

Durbin, Mark, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ....970-493-0112

Peterson, Bret, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 .....970-493-0112

Morrow, Kenyon, MD 1023 39th Ave., Ste. L Greeley, CO 80634 .....................970-352-7366

Gaida, David, PA-C 5890 W. 13th St., Ste. 101 Greeley, CO 80634 ....................970-348-0020

Pettine, Kenneth, MD 4795 Larimer Parkway Johnstown, CO 80534 .....970-669-8881

Wagner, Jan, MD 1175 58th Ave., Ste. 200 Greeley, CO 80634 ....................970-495-0444

Patrick, Jenny, MD 2555 E. 13th St., Ste. 130 Loveland, CO 80537 ..................970-663-5437

Grey, Sean, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ....970-493-0112

Pfiffner, Zachary, PA-C 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

Palliative Care

Pedersen, Robert, MD 5881 W. 16th St., Ste. A Greeley, CO 80634 ....................970-313-2700

Grossnickle, Mark D., MD 1900 16th St. Greeley, CO 80631 ......................970-350-2427

Remley, Michelle, PA-C 5890 W. 13th St., Ste. 101 Greeley, CO 80634 ....................970-348-0020

Hale, Riley, MD 5890 W. 13th St., Ste. 101 Greeley, CO 80634 ....................970-348-0020

Rusnak, Michael, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ....970-493-0112

Hartman, Ryan, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ....970-493-0112

Sanderford, Kelly, MD 5890 W. 13th St., Ste. 101 Greeley, CO 80634 .....................970-348-0020

Heaston, Daniel, MD 5890 W. 13th St., Ste. 101 Greeley, CO 80634 .....................970-348-0020

Seiler, Steven, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ....970-493-0112

Hoffman, Brian, PA-C 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

Sides, Steven, MD 5890 W. 13th St., Ste. 101 Greeley, CO 80634 .....................970-348-0020

Houghton, Michael, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ...970-493-0112

Synder, Joshua, MD 1900 16th St. Greeley, CO 80631 .....................970-350-2427

Hunter, Brett, MD 1900 16th St. Greeley, CO 80631 .....................970-350-2427

Tartaglia, Louis, MD 1708 N. Boise Ave. Loveland, CO 80538 ..................970-669-6880

Jackson, Wesley, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ....970-493-0112

Thornton, Michael, PA-C 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

Javernick, Matthew, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

Townsend, Kimberly, PA-C 6200 W. 9th St., Ste. 1-B Greeley, CO 80634 .....................970-353-5959

Kennedy, Amy, PA-C 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

Trumper, Rocci, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ....970-493-0112

Driscoll, Amy, MD 5881 W. 16th St. Greeley, CO 80634 .....................970-313-2700

Kindsfater, Kirk, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ....970-493-0112

Veronie, Daniel, PA-C 5890 W. 13th St., Ste. 101 Greeley, CO 80634 ....................970-348-0020

Dubynsky, Orest, MD 1601 25th Ave. Greeley, CO 80634 .....................970-356-2600

Kraemer, Jason, PA-C 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

Wolf, Troy, PA-C 3470 E. 15th St. Loveland, CO 80538 ..................970-663-3975

Harding, Amanda, MD 6801 W. 20th St., Ste. 201 Greeley, CO 80634 .....................970-350-5828

Northern Colorado Medical & Wellness 2014

Fried, Robert, MD 1801 16th St. Greeley, CO 80631 .....................970-378-4529 Kilzer, Helen, MD 2000 Boise Ave., 3rd Fl C Wing Loveland, CO 80538 .................970-203-6688 Mayer, Patricia, MD 2726 W. 11th Street Rd. Greeley, CO 80634 ....................970-475-0040 Ringel, Marc, MD 2726 W. 11th Street Rd. Greeley, CO 80634 .....................970-352-8487

Pediatrics Brown, Bridget, MD 2555 E. 13th Street, Ste. 130 Loveland, CO 80537 ..................970-663-5437 Bruce, Robert, MD 2555 E. 13th St., Ste. 130 Loveland, CO 80537 ..................970-663-5437 Chmura, Kathryn, MD 6801 W. 20th St., Ste. 201 Greeley, CO 80634 .....................970-350-5828 DeLeon, Hector, MD 2950 E. Harmony Rd., Ste. 190 Fort Collins, CO 80528 ..............970-207-7171

Marler, McKay, MD 2555 E. 13th St., Ste. 130 Loveland, CO 80537 ..................970-663-5437 Mead, Andrea, MD 2555 E. 13th St., Ste. 130 Loveland, CO 80537 ..................970-663-5437 Moore, Christopher, MD 5881 W. 16th St. Greeley, CO 80634 .....................970-313-2700 Norman, Jennifer, MD 2555 E. 13th St., Ste. 130 Loveland, CO 80537 ...................970-663-5437

Quintana, Michael, MD 2021 N. Boise Ave. Loveland, CO 80538 ..................970-669-3298 Ryan, Joseph, MD 5881 W. 16th St. Greeley, CO 80634 ....................970-313-2700 Ryschon, Timothy, MD 1635 Fox Trial Dr. Loveland, CO 80538 ..................970-744-3668 Sando, James, MD 6801 W. 20th St., Ste. 201 Greeley, CO 80634 ....................970-350-5828 Teruel, Katherine, MD 2555 E. 13th St., Ste. 130 Loveland, CO 80537 ...................970-663-5437 Ward, Michelle, MD 4901 Thompson Parkway Loveland, CO 80534 ..................970-207-7171 Wiesner, Mark, DO 555 Prospect Ave., Ste. B Estes Park, CO 80517 ................970-586-2200

Pediatric-CardiologyTelemedicine Brescia, Samuel, MD 10099 Ridgegate Pkwy, Ste. 300 Lone Tree, CO 80124 ................303-860-9933 Christensen, Douglas, MD 10099 Ridgegate Pkwy, Ste. 300 Lone Tree, CO 80124 ................303-860-9933 Davidson, Jesse, MD 13123 E. 16th Ave B100 Aurora, CO 80045 .....................720-777-3365 DiMaria, Michael, MD 13123 E. 16th Ave B100 Aurora, CO 80045 .....................720-777-4420

37

Fonseca, Brian, MD 13123 E. 16th Ave B100 Aurora, CO 80045 .....................720-777-2944

Pouliot, Matthew, DO 4795 Larimer Parkway Johnstown, CO 80534 ...............970-669-8881

Howley, Lisa, MD 13123 E. 16th Ave B100 Aurora, CO 80045 ....................720-777-2943

Reichhardt, Gregory, MD 2001 70th Ave., Ste. 205 Greeley, CO 80634 ....................970-392-2490

Jaffer, Zubeir, MD 1746 Cole Blvd., Ste. 150 Lakewood, CO 80401 .................303-914-8800 Jone, Pei-Ni, MD 13123 E. 16th Ave B100 Aurora, CO 80045 ....................720-777-2944 Landeck, Bruce, MD 13123 E. 16th Ave B100 Aurora, CO 80045 ....................720-777-2971 Miller, David, MD 10099 Ridgegate Pkwy, Ste. 300 Lone Tree, CO 80124 ................303-860-9933 Nydam, Jane, MD 10099 Ridgegate Pkwy, Ste. 300 Lone Tree, CO 80124 ...............303-860-9933 Pettersen, Michael, MD 10099 Ridgegate Pkwy, Ste. 300 Lone Tree, CO 80124 ................303-860-9933 Schaffer, Michael, MD 13123 E. 16th Ave B100 Aurora, CO 80045 .....................720-777-2942 Truong, Uyen, MD 13123 E. 16th Ave B100 Aurora, CO 80045 .....................720-777-2943

Swartz, Nathan, MD 4401 Union St. Johnstown, CO 80534 .....740-350-6134 van den Hoven, Raymond, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

Podiatric Medicine & Surgery

Psychiatry-Child Al-Adsani, Patricia, MD 2555 E. 13th St. Loveland, CO 80537 ...................970-663-5437 1300 Main St. Windsor, CO 80550 ....................970-686-5646 2010 16th St., Ste. C Greeley, CO 80631 ....................970-350-5660

Psychology Barr, Thomas, PhD 1800 15th St., Ste. 200 Greeley, CO 80631 .....................970-378-4433 Bromley, Susan, PSYD 1750 25th Ave., Ste. 101 Greeley, CO 80634 .....................970-353-3373

Atherton, Stacy, DPM 1305 Sumner St., Ste. 200 Longmont, CO 80501 ................303-772-3232

Bruns, Daniel, PSYD 1610 29th Avenue Pl., Ste. 200 Greeley, CO 80634 .....................970-352-8311

Atwood, Thomas, DPM 2122 9th St., Ste. 3 Greeley, CO 80631 .....................970-353-5800

Derk, Jane, PhD 3400 16th St., Ste. 5 YY Greeley, CO 80634 ....................970-351-6406

Burns, Michael, DPM 2001 S. Shields St., Bldg. F Fort Collins, CO 80526 ..............970-493-4660 Fowler, Troy DPM 1600 23rd Ave. Greeley, CO 80634 .....................970-346-2833

Villavicencio, Karrie, MD 13123 E. 16th Ave Aurora, CO 80045 .....................720-777-2944

Hatch, Daniel, DPM 1931 65th Ave., Ste. A Greeley, CO 80634 ....................970-351-0900

Younoszai, Adel, MD 13123 E. 16th Ave B100 Aurora, CO 80045 .....................720-777-2943

Hecker, Thomas, DPM 2500 E. Prospect Rd. Fort Collins, CO 80525 ....970-493-0112

Physical Medicine & Rehabilitation

Hoang, Katie, DPM 1600 23rd Ave. Greeley, CO 80634 ....................970-346-2833

Arrogante, Revelyn, MD 4401A Union St. Johnstown, CO 80534 .....970-619-3400

Hunt, Nathan, DPM 3470 E. 15th St. Loveland, CO 80538 .......970-663-3975

Bender, John, DO 1300 Oakridge Dr., Ste. 130 Fort Collins, CO 80525 ..............970-377-9555

Knutsen, Chad, DPM 3850 N. Grant Ave., Ste. 130 Loveland, CO 80538 ..................970-667-0769

Feldman, Alicia, MD 2620 E. Prospect Rd., Ste. 160 Fort Collins, CO 80525 ..............970-221-1919

Schulte, Robert, DPM 3850 N. Grant Ave., Ste. 130 Loveland, CO 80538 .................970-667-0769

Jacob, Joseph, MD 1437 N. Denver Ave. Loveland, CO 80538 ..................970-290-7992 1900 16th St. Greeley, CO 80631 .....................970-353-1551

Schultz, Peter, DPM 1440 N. Boise Ave. Loveland, CO 80538 ..................970-278-1440

Jewell, Dawn, PSYD 1610 29th Avenue Pl., Ste. 200 Greeley, CO 80634 ....................970-352-8311 Smith, Marilee, PSYD 1750 25th Ave., Ste. 200 Greeley, CO 80634 ....................970-351-6688 Thwaites, Gregory, PhD 2001 70th Ave., Ste. 205 Greeley, CO 80634 ....................970-392-2190

Radiation Oncology Albert, Jeffrey, MD 2050 N. Boise Ave., Ste. A Loveland, CO 80538 .................970-679-8941 Ceilley, Elizabeth, MD 2050 N. Boise Ave., Ste. B Loveland, CO 80538 ..................970-679-8900 Fuller, Brian G., MD 1801 16th Street Greeley, CO 80631 .....................970-350-6680 Kantorowitz, David, MD 2050 N. Boise Ave., Ste. B Loveland, CO 80538 .................970-679-8900

Radiology

Craven, Winfield, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Desruisseau, Richard, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Dunphy, Thomas, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Fleener, Christopher, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Florant, Tracy, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Fuller, Samuel, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Geraghty, Michael, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Harris, John, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6860 Hayes, Amy, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Howshar, Mark, MD 2003 Bluegrass Cir. Cheyenne, WY 82009 .................307-634-7711 Johnson, Paul, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Koplyay, Peter, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Kreider, Dan, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6860 Limbaugh, Kevin, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Markel, Curtis, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757 Mills, Andrew, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757

Bauerle, Gary W., MD 1801 16th St. Greeley, CO 80631 .....................970-350-6860

Pacini, Richard, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757

Vaardahl, Michael, DPM 1931 65th Ave., Ste. A Greeley, CO 80634 ....................970-351-0900

Berkowitz, Bruce, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757

Paquelet, Jean, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757

Webb, Emily, DPM 1927 Wilmington Dr., Ste. 102 Fort Collins, CO 80528 ..............970-416-9009

Bodenhamer, John, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757

Peck, Steven, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757

Martin, Rebekah, MD 1390 S. Potomac St., Ste. 128 Aurora, CO 80012 .....................303-306-2438

Psychiatry

Contreras, Jaime, MD 2008 Caribou Dr. Fort Collins, CO 80525 ...............970-484-4757

Quickert, Timo, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6860

Nieves, Ricardo, MD 1437 Riverside Ave. Fort Collins, CO 80524 ..............970-692-5550

Parker Lynda, MD 1300 Main St. Windsor, CO 80550 ...................970-674-3154

Cook, Philip, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6860

Raque, James, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6860

Lanig, Indira, MD 4401 Union St. Johnstown, CO 80534 .....970-619-3449 Lockwood, Bruce, MD 1300 Oakridge Dr., Ste. 130 Fort Collins, CO 80525 ..............970-377-9555

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Lydia’s STYLE Magazine

Ruderman, Richard, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6860

Surgery-Cardiothoracic & Vascular

Gibbons, Beth, MD 1800 15th St., Ste. 130 Greeley, CO 80631 .....................970-350-5996

Caragol, Jennifer, MD 2001 70th Ave., Ste. 110 Greeley, CO 80634 ....................970-378-4155

Weinstein, Stanley, MD 2008 Caribou Dr. Fort Collins, CO 80525 ..............970-484-4757

Lyons, Maurice, DO 1800 15th St., Ste. 340 Greeley, CO 80631 ......................970-378-4593

Guiot, Bernard, MD 3830 N. Grant Ave. Loveland, CO 80538 ..................720-320-8440

Harms, Thomas, MD 2001 70th Ave. Greeley, CO 80634 .....................970-378-4155

Richards, Kenneth, MD 1800 15th St., Ste. 340 Greeley, CO 80631 .....................970-378-4593

Stobbe, Kai, PA-C 1800 15th St., Ste. 130 Greeley, CO 80631 .....................970-350-5996

Mercer, Jeannette, MD 2555 E. 13th St., Ste.110 Loveland, CO 80538 .................970-461-6140

Tullis, Gene, MD 1800 15th St., Ste. 340 Greeley, CO 80631 .....................970-378-4593

Turner, Donn, MD 1313 Riverside Ave. Fort Collins, CO 80524 ....970-493-1292

Milano, William, MD 2555 E. 13th St., Ste.110 Loveland, CO 80538 .................970-461-6140

Surgery-General

Wirt, Timothy, MD 1313 Riverside Ave. Fort Collins, CO 80524 ....970-493-1292

Shenkenberg, Amy, MD 2001 70th Ave. Greeley, CO 80634 .....................970-378-4155

Surgery-Oral & Maxillofacial

Urology

Weissmann, Jeffrey, MD 2008 Caribou Dr. Fort Collins, CO 80525 ...............970-484-4757 Wiedeman, Marjorie, MD 1801 16th St. Greeley, CO 80631 .....................970-350-6860

Sports Medicine Anderson, Thomas, DO 3470 E. 15th St. Loveland, CO 80538 .......970-663-3975 Ross, Vincent, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 .....970-493-0112 Sachtleben, Thomas, MD 3470 E. 15th St. Loveland, CO 80538 ........970-663-3975 Yemm, Stephen, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ....970-493-0112 Young, Linda E., MD 5890 W. 13th St., Ste. 101 Greeley, CO 80634 .....................970-348-0020

Surgery-Assistant Anderson, Thomas, DO 3470 E. 15th St. Loveland, CO 80538 ..................970-663-3975 Bundy, Jeffrey, PA-C 1120 E. Elizabeth St., Bldg. F-101 Fort Collins, CO 80524 ....970-221-1177 Coburn, Thomas, MD 4795 Larimer Parkway Johnstown, CO 80534 ................970-669-8881

Blomquist, Thomas, MD 1900 N. Boise Ave., Ste. 420 Loveland, CO 80538 .......970-669-3212 Collins, Jerome, MD 1900 N. Boise Ave., Ste. 420 Loveland, CO 80538 .......970-669-3212 Decker, Molly, MD 1800 15th St., Ste. 200 Greeley, CO 80631 ..........970-352-8216 Ehrman, Donovan, FNP 1800 15th St., Ste. 200 Greeley, CO 80631 .....................970-352-8216 Harkabus, Michael, MD 1800 15th St., Ste. 200 Greeley, CO 80631 .........970-352-8216 Keeler, Bradford, MD 1900 N. Boise Ave., Ste. 420 Loveland, CO 80538 ........970-669-3212 Ogren, Jason, MD 1800 15th St., Ste. 200 Greeley, CO 80631 .........970-352-8216 Roeder, Tenley, ACNP 1800 15th St., Ste. 200 Greeley, CO 80631 .....................970-352-8216

Bley, Justin, DMD 1707 61st Ave., Ste. 102 Greeley, CO 80634 ....................970-506-0350 Mellin, Richard, MD 3400 16th St., Bldg.1S, Ste. A Greeley, CO 80634 .....................970-353-5826 Murphy, Aric, MD 1136 E. Stuart St., Bldg 3, Ste. 240 Fort Collins, CO 80525 ..............970-420-6848 Owen, Zachary, DDS 2998 Ginnala Dr. Loveland, CO 80538 .................970-669-4802 Zulian, Michael, DDS 2800 Madison Square Dr., Ste. 2 Loveland, CO 80538 .................970-669-6850

Surgery-Plastic Boustred, Allister, MD 2315 E. Harmony Rd., Ste. 160 Fort Collins, CO 80528 ..............970-493-8800

Saltz, Samuel, DO 1800 15th St., Ste. 200 Greeley, CO 80631 .........970-352-8216

Brewster, Amy, MD 2020 Lowe St., Ste. 202 Fort Collins, CO 80525 ..............970-266-0456

Schmidovรก, Karin, MD 1900 N. Boise Ave., Ste. 420 Loveland, CO 80538 .......970-669-3212

Chapman, Jeffrey, MD 2315 E. Harmony Rd., Ste. 160 Fort Collins, CO 80528 ..............970-493-8800

Shults, Christopher, PA-C 1800 15th St., Ste. 200 Greeley, CO 80631 .....................970-352-8216

Gonyon, Denis, MD 4450 Union St. Johnstown, CO 80534 ...............970-624-7979

Yemm, Stephen, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

Tyburczy, Joseph, MD 1800 15th St., Ste. 200 Greeley, CO 80631 .....................970-352-8216

Schutte, Warren, MD 2500 Rocky Mtn Ave., Ste. 2130 Loveland, CO 80538 .................970-372-2310

Surgery-Bariatric

Vickerman, Robert, MD 1800 15th St., Ste. 200 Greeley, CO 80631 .........970-352-8216

Tsoi, Christopher, MD 2315 E. Harmony Rd., Ste. 160 Fort Collins, CO 80528 ..............970-493-8800

Johnell, Michael, MD 1800 15th St., Ste. 200 Greeley, CO 80631 .....................970-352-8216

Surgery-Neuro

Urgent Care

Stoneburner, Joshua, PA-C 1800 15th St., Ste. 200 Greeley, CO 80631 ....................970-378-4433

Blatt, David, MD 1800 15th St., Ste. 130 Greeley, CO 80631 .....................970-350-5996

Beck, Susan, MD 2555 E. 13th St., Ste. 110 Loveland, CO 80538 .................970-461-6140

Toth, Stephen, PA-C 1800 15th St., Ste. 200 Greeley, CO 80631 .....................970-378-4433

Coester, Hans, MD 1107 S. Lemay, Ste. 240 Fort Collins, CO 80524 ..............970-495-7421

Corcoran-Kelly, Susan, MD 2555 E. 13th St., Ste. 110 Loveland, CO 80538 .................970-663-5437

Ross, Vincent, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112 Sachtleben, Thomas, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112 Sobel, Roger, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 ..............970-493-0112

Northern Colorado Medical & Wellness 2014

Crylen, Curtis, MD 5890 W. 13th St., Ste. 106 Greeley, CO 80634 .....................970-378-1000 Malcom, Troy, DO 1925 W. Mountain View Ave. Longmont, CO 80501 .................303-776-1234 Manion, Sean, MD 1925 W. Mountain View Ave. Longmont, CO 80501 ................303-776-1234 Ripoll, Emilia, MD 5890 W. 13th St., Ste. 106 Greeley, CO 80634 .....................970-378-1000 Ritsema, David, MD 5890 W. 13th St., Ste. 106 Greeley, CO 80634 ....................970-378-1000 Wolach, James, MD 5890 W. 13th St., Ste. 106 Greeley, CO 80634 ....................970-378-1000

Wound Care Services Atherton, Stacy, DPM 1900 Boise Ave., Ste. 210 Loveland, CO 80538 .................303-772-3232 Beltz, Janet, FNP 1801 16th St. Greeley, CO 80631 ....................970-350-6071 Blomquist, Thomas, MD 1900 Boise Ave., Ste. 210 Loveland, CO 80538 .................970-669-3212

The medical health provider list has been provided

by McKee Medical Center and North Colorado Medical Center. This Medical Health Provider Directory is current as of 12/20/2013.

Bold lettering indicates more information is available in ads.

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medical

coordination of care

Registered nurse and McKee Medical Center case manager Sandy Haller consults with a patient prior to discharge, part of the continuum of care that ensures patients needs are met outside of the hospital setting.

care coordination

heads off trouble

By Corey Radman

Barbara Maggard of Loveland was caught in a revolving door of hospitalizations.

She is 69-years-old and has an ileostomy (surgical opening in the small intestine to bypass the colon). Early in 2013, she was hospitalized twice due to intestinal flu.

40

Maggard’s electrolyte balance is tricky to manage. Sometimes she gets dizzy.

In September she fell and broke her ankle, necessitating another extended hospital stay. She went to Good Samaritan Society for rehab, but developed an infection there and returned to McKee Medical Center for stabilization.

She’s home now, clunking around the house in a boot while her ankle heals and is relieved that home healthcare can come to her for follow up.

Maggard says having multiple hospitalizations in a year is frustrating as is the bed-hopping from hospital to rehab and back. As a retired licensed practical nurse who worked in nursing homes quite a bit, she is well equipped to avoid the obvious pitfalls of post-hospital care, but sometimes conditions worsen no matter how prepared we are. Without McKee’s care coordination services, she says, it would have been much more difficult to manage.

Banner Health’s care coordination department exists exactly for situations like Barbara Maggard’s: to help patients navigate the ins and outs of a system that keeps changing while they use it. That gift of knowledge and organization is crucial to the patients as well as the hospital. The first priority of hospital staff is always to ensure patient healing, but cost must also be factored in.

Readmissions are expensive for hospitals.

Lydia’s STYLE Magazine

Nurse Robin Crowley, part of the care coordination department at McKee, helps to ensure the best patient care to minimize readmissions to the hospital.

Systemic Costs In 2010, the Robert Wood Johnson Foundation reported that the national rate of readmission to hospitals ranged between 11.4 and 18.1 percent depending on where you live. Among the elderly population, readmissions skyrocket to one in five discharges coming back within 30 days. This “revolving door of healthcare” results in $26 billion dollars in annual Medicare charges. For this reason, the Affordable Care Act now penalizes hospitals that exceed expected readmission rates for Medicare patients.

The penalty program began in October 2012 and is a tough love approach to forcing hospitals to account not only for patient care while admitted, but ensuring their success after they leave. The first round of penalties were handed down last August. Banner Health’s two Front Range hospitals, McKee Medical Center and North Colorado Medical Center (NCMC), both avoided any penalties.

McKee’s Public Relations Director, Paul Matthews, says, “Patient care is always our highest priority.

We have focused extensively on readmission rates and we will continue to make it a high priority.”

Care coordination departments with staffs of eight at McKee and 30 at NCMC are proof of that commitment. The staffs in these departments are a mix of registered nurses and social workers whose job it is to ensure that patients can get the resources they need both in the hospital and after discharge. The departments have existed as long as the hospitals have, but – now more than ever – their services are crucial to the system’s success within the new regulations.

Juggling Act Sandy Haller, RN, BSN, case manager, is on the front line working with patients. “There’s a lot going on for the hospitalized patient,” she says. “So many different specialists come through

Northern Colorado Medical & Wellness 2014

41

Nurse Debbie Kroll provides case management services at North Colorado Medical Center.

their room: surgeons, therapists, case managers, nurses...” Haller says it’s her job to ensure that patients have a point person that can help coordinate the discharge plan and see to it that patients have the resources they need. “Just to see that look of ‘Ah, everything’s going to be ok,’ when we’ve got a plan in place and they understand what’s going to happen. That’s the satisfying thing

for me,” she says.

Kathy Kimball, BSN, MSN and director of case management at NCMC, explains, “[A good plan] reduces length of stay.” Those who haven’t got those details pre-planned “tend to be a little overwhelmed. And because of that, their pain level is up. Sometimes they are having to problem solve while sick in bed. That takes more time.”

The hours add up and could become another day before all the pieces of the pie come together.

“For patients who don’t have that planned out, we have people like Sandy [Haller] who can help them figure it out.” Kimball says offering that service eases patients’ minds and ensures their success upon discharge.

Theresa Lindahl is an RN and interim senior manager for Case Management at McKee. “Healthcare reform has really impacted how we deliver care. It truly is about community partnerships... and transitions in care.” She lists the number of resources outside the hospital system that they now strive to actively participate with. From nursing homes (Skilled Nursing Facilities) to home healthcare agencies, Medicare caseworkers and primary care physicians, the cast of participants is large. That’s why it is important that a case management provider help patients understand what’s what. Lindahl says that handoff to postcare providers is the key. “Handoffs are important.

More is not always better. The important thing is that we’re not duplicating services and confusing the patients more.”

Care managers are seeking to head off the kinds of things that cause a patient to relapse or develop complications. Commonly, small details are the root cause of a readmission. For instance, sometimes patients don’t understand discharge instructions, can’t fill a prescription, or feel better and skip follow-up appointments with their primary care doctor. Those instances are far too common and are the reason that patients get check-up calls from nurses after discharge. They are trained to listen for any details that might be a sign of an oncoming problem.

Highest Risk History has shown that patients with the highest likelihood of post-discharge complications had heart failure, AMI (heart attack) or pneumonia.

Therefore, hospitals carefully track and report those statistics. Based on the reported numbers, Banner is doing well.

McKee reported rates of readmission between 13 and 16.7 percent in 2012. In 2013 (through October), the range was 9.4 to 15 percent. At NCMC, the numbers tell a similar story. Eight to 14 percent for readmissions in 2012 versus 9 to 15 percent in 2013.

It is true that hospitals can’t always anticipate a patient’s worsening condition. Sometimes people get a little better and then get much worse. But what they can do, and are doing in Northern Colorado, is make sure that those cases don’t occur because of poor follow up care.

Maggard, veteran of the healthcare system from all perspectives, echoes the concerns of healthcare administrators. “I do think processes are getting smoother all the time. I can see improvements in coordination. But I would urge older patients not to be afraid to ask questions – even two or three times. That way you can get the answer you need.”

Corey Radman is an award-winning healthcare and alternative health writer who contributes regularly to this magazine. Find her at www. fortcollinswriter.com.

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Lydia’s STYLE Magazine

MEDICAL

seizures When everything is working correctly, the impulses are discharged in an orderly manner – very organized and coordinated, not unlike elaborate choreography. But if there is one misstep in the dance, if the impulses’ discharges are out of sync, then the brain and body respond.

The response might be just a twitch of the fingers or the leg muscles. Or a momentary lapse in concentration; perhaps a strange taste in the mouth. But in some instances, the misfire is so severe that the individual loses consciousness, the limbs jerk wildly and uncontrollably and there may be loss of bladder control. This can go on for as long as 20 minutes.

This is what seizures can look like.

For the person with a seizure disorder – and their friends and families – a seizure disorder can be alarming and troublesome. But with proper medical attention, the frequency of seizures can be lessened or even eliminated and life can take on a normal hue. But first, it’s important to understand more about the causes and types of seizures.

Types of seizures

Dr. Barbara Hager finds passion in discovering what makes patients tick and helping them to return to their best health; she is a neurologist and epilepsy specialist with Banner Health’s Neurology Clinic in Greeley.

seizures

causes and treatment

By Michelle Venus

The brain is a complex network, controlling the body’s functions through a series of electrical impulses that make sure everything is doing its job, whether it’s a heartbeat or hiccups or lifting a glass and taking a drink.

Northern Colorado Medical & Wellness 2014

Seizures are classified in two main categories: generalized and partial. Dr. Barbara Hager, neurologist and epilepsy specialist with Banner Health’s Neurology Clinic in Greeley, explains, “For most people, when they think of seizures, it is the full-body convulsion. That’s a generalized seizure and it involves the entire brain. Partial seizures involve just a part of the brain and are much less dramatic. Someone observing a partial seizure may not even know it’s happening. It’s that subtle.”

Epilepsy is perhaps the most common and well-known cause of seizures, though they can occur due to different health issues such as trauma to the brain caused from a stroke, heart attack or head injury, infections (encephalitis or meningitis, for example), congenital conditions or brain tumors. Even damage caused by Alzheimer’s disease or toxemia during pregnancy can cause seizures.

Partial Seizures Partial seizures are classified even further as simple or complex. A simple partial seizure is identified by involuntary limb or muscle twitching, vision changes, vertigo or experiencing strange tastes or phantom smells. The person maintains consciousness and is aware of what is happening.

The symptoms of a complex partial seizure are similar, but include a loss of awareness or consciousness. Patients often stare into the distance or lose focus. They may repeat actions over and over again, such as walking in circles or making repeated and automatic gestures such as picking at clothing, lip smacking or wringing the hands.

Generalized Seizures Because they involve greater areas of the brain, generalized seizures have a greater impact on the body. They are classified as:

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•

•

•

Petit Mal or Absence seizures are characterized by brief and sudden lapses of consciousness and can be as discreet as staring out into space for a few moments, excessive blinking or eye rolling. Absence seizures are more common in children than in adults. While they appear to be mild, they should be taken very seriously as they can be dangerous under certain conditions.

Children who have petit mal seizures should be closely monitored in the bath and while swimming to prevent drowning accidents, which could occur if the child loses consciousness.

The symptoms of Myoclonic seizures include jerking or twitching of the limbs on both sides of the body, indicating that both sides of the brain are involved.

Tonic-clonic seizures, also known as Grand Mal, are what Dr. Hager describes as a full-body convulsion. Symptoms may include loss of consciousness, shaking or jerking of the body, and loss of bladder control. The person may experience an aura, which is an unusual sensation at the start of a seizure and may include the perception of an odd smell or sound, or unusual stomach sensations. Grand Mal seizures can last anywhere from 5 to 20 minutes.

Diagnosis and Treatment After a seizure, it is necessary to see a doctor or neurologist. The patient’s medical history (and that of family members) will be taken and symptoms will be noted. The doctor will perform a physical exam which may include blood tests or a lumbar puncture (spinal tap) to rule out infections or conditions like liver or kidney damage, an electroencephalogram (EEG), which evaluates the brain’s electrical activity or magnetic resonance imaging (MRI), which uses magnetic waves to record images of the brain to determine if there is physical or structural damage.

Once the underlying cause is determined, the patient and doctor together will determine the best treatment options. The goal of any therapy is to control the occurrence of seizures, stop any future episodes and keep drug side effects to a minimum. This may require trying different medications or combinations of medications before the right therapy is found.

If medications aren’t successful, another option is vagus nerve stimulation (VNS). Vagus nerves are on each side of the body, originating in the brainstem and running through the neck to the chest and abdominal area. A device is surgically implanted under the skin of the patient’s chest and a wire is threaded from the device to the left vagus nerve. The device is programmed to produce weak electrical signals that travel along the vagus nerve to the brain at regular intervals, helping to prevent the electrical impulse misfires that trigger seizures.

“This can be a very effective treatment,”

44

says Dr. Hager. “The device regulates brain activity and keeps everything operating at a more normal level. More often than not, the seizures stop.”

First Aid for Seizures Most seizures stop on their own. That being said, a patient can be injured during a seizure.

When a seizure occurs, the primary objective is to keep the patient safe. Below are guidelines for helping the patient safely through a seizure: •

Try to prevent a fall. Lay the person on the ground in a safe area. Clear the area of furniture or other sharp objects.

•

Cushion the person’s head.

•

Loosen tight clothing, especially around the person’s neck.

•

Turn the person on his or her side. If vomiting occurs, this helps make sure that the vomit is not inhaled into the lungs.

•

Look for a medical I.D. bracelet with seizure instructions.

•

Stay with the person until he or she recovers, or until you have professional medical help.

•

If a baby or child has a seizure during a high fever, cool the child slowly with tepid water. Do not place the child in a cold bath. You can give the child acetaminophen (Tylenol) once he or she is awake, especially if the child has had fever convulsions before.

Call 911 or your local emergency number if: •

This is the first time the person has had a seizure.

•

A seizure lasts more than 2 to 5 minutes.

•

The person does not awaken or have normal behavior after a seizure.

•

Another seizure starts soon after a seizure ends.

•

The person had a seizure in water.

•

The person is pregnant, injured or has diabetes.

•

The person does not have a medical ID bracelet (instructions explaining what to do).

•

There is anything different about this seizure compared to the person’s usual seizures.

Michelle Venus is a freelance writer based in Fort Collins.

about

Dr. Hager In many respects, the brain is the final frontier of the human body. It controls thoughts, emotions and movement. For Barbara Hager, M.D., the brain is a fascinating place along with the entirety of the nervous system.

“I find neurology to be the most interesting field of study from a disease and disorder aspect,” she explains. “The brain and the nervous system — which also includes the central and peripheral (nerves throughout the body) nervous systems — is very complicated.

Most patients don’t fully understand how it all functions. Being able to give them answers and help them through any problems they may be facing is very gratifying.”

Finding the right treatment can be tricky.

Take, for instance, epilepsy. All anti-epileptic medications have some sort of side effect, the most common being fatigue, drowsiness and cognitive side effects. “In some patients it can be very difficult to get their seizures under control because they cannot tolerate the available medications,” says Dr. Hager.

“As more treatment options become available, whether they be medications, surgery or implanted devices, we have a better chance of controlling seizures. A few decades ago, there were only a handful of medications out there to treat epilepsy, now there are over 20, with new ones being tested all the time. While I am also interested in researching the causes of epilepsy and ways to localize the source of the seizures, in the end what benefits and affects patients most is what can we do to treat them effectively.”

Dr. Hager is new to Greeley. She recently joined the Banner Health Neurology Clinic, where she focuses on diseases and disorders such as epilepsy, seizures, neuropathies, headaches and migraines, Parkinson’s Disease, stroke and multiple sclerosis.

After graduating from the University of Texas Medical Center at Houston, Dr. Hager went on to Pennsylvania Hospital in Philadelphia, where she completed her internship. It was during her residency at George Washington University in Washington, DC, that her interest in neurology was piqued.

Dr. Hager completed a fellowship in clinical neurophysiology/epilepsy at the University of Chicago.

She and her stay-at-home husband and 2-year-old daughter moved to the area in August. Patients may notice a growing baby bump; Little One #2 is due in May. When she’s not treating patients, Dr. Hager loves to travel, hike and read. Interesting fact: “I speak Polish.”

Lydia’s STYLE Magazine

46

Lydia’s STYLE Magazine

MEDICAL

lung cancer

annual CT:

Dr. Gene Tullis explains new recommendations that may help smokers catch lung cancer at earlier stages with lung screenings.

a new screening protocol for smokers

By Corey Radman

It’s safe to say that smokers have been warned about the risks of smoking. Annual lectures at the doctor’s office, regular reports in the news, even the Surgeon General’s warning labels on the cigarettes themselves all thump out a steady drumbeat of potential diseases that a smoker may contract.

Northern Colorado Medical & Wellness 2014

It’s highly unlikely that smokers have avoided the knowledge that smoking can cause lung cancer, the leading cause of cancer death in the United States. But for those who have continued to smoke, beyond possessing the knowledge there wasn’t much to do about it besides quitting. That could soon change. In July, a leading medical journal published new recommendations for lung cancer screenings that could make it easier to catch lung cancer at eariler stages and potentially save thousands of lives every year.

Tough to Catch Lung cancer remains asymptomatic until late stages. By the time someone begins showing signs of a problem, like coughing blood, the cancer has progressed to an advanced stage. Treatment at these stages has a much lower rate of success and cure.

According to the American Cancer Society, lung cancer is the leading cause of cancer death in the United States for both men and women. It far outstrips breast cancer (14 percent of female cancer deaths) or prostate and colo-rectal cancers combined (19 percent of male cancer deaths). Lung cancer totals 27 percent of all deaths from cancer in this country.

“The five year survival rate from lung cancer (depending on stage at presentation) is less than 16 percent with advanced stages in the U.S. compared to over 90 percent for other cancers (breast, colon, prostate). Regular smokers lose at least a decade of life expectancy,” says Gene Tullis, M.D., cardiovascular and thoracic surgeon with Banner Health’s CardioVascular Institute of North Colorado. He says, “We want to try

47

to identify lung cancer at earlier stages. If we get a patient with stage 1A cancer – that means it hasn’t spread to the lymph nodes or other organs - that patient might have over a 75 percent chance at five-year cure.”

New Recommendation

quit

for good

By Corey Radman

A national survey on health showed that nearly 69 percent of current smokers would like to quit. Just over half of smokers have tried to quit in the last year, but only 6 percent of smokers did so successfully.

Some smokers hesitate to lean on gum, patches or other treatments because they prefer to go it alone or they consider it somehow weak to use assistance. If you are a smoker trying to quit, stop that kind of thinking! The odds are stacked against you. It just makes sense to bring to this battle all the firepower available to you. Use of effective treatments can double your chances for success.

The Centers for Disease Control rates the combination of counseling and medication as the best way to stack the odds in your favor. Other methods that can help include hypnosis, which offers a means to retrain the brain to despise cigarettes, and acupuncture, which is highly effective in detoxing and reducing cravings for cigarettes. Whatever method you choose, don’t underestimate the power of intention. Decide once and for all that you will be a non-smoker. That mindset is how you start.

resources • Smokefree.gov

• 1-800-QUIT-NOW offers phone counseling and advice on quitting.

• Nicotine replacement devices may be free to low cost with rebate offers. See smokefree.gov.

• Former Fort Collins hypnotist, Donna Varen, offers online self-hypnosis programs

48

for cessation. Absolutehypnosis.com • Licensed Therapist, Ginger Schmidt works with recovery issues. Apurposefulpath.com or (970) 682-8844 • Acupuncturist, Lindsay Herrera specializes in detox acupuncture. (970) 402-0575 • Clinical Hypnotherapist, Sandi Y. Squicquero specializes in smoking cessation. medhypnosis1. com or (970) 674-0191

This is part of the reason that the U.S. Preventive Services Task Force (USPSTF) issued a draft recommendation in July supporting annual lowdose CT screening for high-risk individuals, ages 55 through 79, who have a 30 pack-year history or who have quit in the past 15 years. A pack year is calculated by multiplying number of packs smoked per day by the number of years smoking.

So, a two-pack-a-day smoker can get to 30 packyears in 15 years. The Annals of Internal Medicine showed that screening with low-dose computed tomography (LDCT) can identify lung cancers at earlier stages. This could result in a decrease of lung cancer mortality by 20 percent. Currently most major physician associations or colleges are now supporting the position that this type of screening can catch tumors in early phases.

Dr. Tullis explains that while X-rays have been commonly used for this type of screening, “they don’t show small early lesions. We get much more information by doing CT scans.” He elaborates that while the dosage of radiation is higher in these scans versus X-rays, the risk of smoking creates a much greater concern than the annual radiation would.

Insurance and Medicare have yet to cover this type of a screening, “but that’s the hope,” Dr. Tullis says, who compares this new way of screening high-risk patients to annual mammography or colonoscopy screening. “My hope is, now that this has been validated by USPSTF, at some point it’s got to move to being covered by insurance... much like mammography and colonoscopy. If we were able to get everybody who meet these criteria screened, there would be 12,250 deaths that we avoid each year.”

Banner Health currently offers CT lung screenings at North Colorado Medical Center, 1801 16th St., Greeley, for an out-of-pocket cost of $199. Screening is intended for people between ages 55 and 79 who have a 30-pack-year history of smoking. The test is painless and takes about 15 minutes. Results will be mailed to you and your primary physician, if you designate one. To schedule an appointment, call (970) 350-6070.

Banner also intends to offer the program at McKee Medical Center and Sterling Regional MedCenter in early 2014. Details on those programs will be announced soon.

Corey Radman is an award-winning writer who specializes in health and alternative wellness articles. She can be reached at www.fortcollinswriter.com.

Lydia’s STYLE Magazine

Maximizing Care Through Accurate Diagnosis Serving patients in northern Colorado for more than 35 years Providing unrivaled comprehensive diagnostic services to our community

Ross Barner, MD

Christopher Bee, MD

Craig Nerby, MD

Cory Dunn, MD

Thomas Neuhauser, MD

Richard Halbert, MD

Carrie Pizzi, MD

Wentzell Hamner, MD

Michael Walts, MD

Arlene Libby, MD

Heath Worcester, MD

www.summitpathology.com Northern Colorado Medical & Wellness 2014

49

medical

thyroid

living with

thyroid disorders

By Michelle Venus

It is estimated that 20 million Americans have some form of thyroid disease. Most of them are women, though thyroid disorders impact people of all ages and ethnicity.

50

Consider your thyroid gland command central. It works in conjunction with other endocrine glands such as the pituitary, and releases hormones that regulate metabolism. More simply put, it tells your cells how to perform their individual tasks and how to interact with other hormones.

This is a big deal. The hormones are chemicals that race through your body via the blood stream. Think of them as keys that only fit into very specific locks — in this case the cells that they are assigned to interact with. When the key works, so does the body system. Say it’s

an organ, such as your liver or your digestive tract; if the key is a little bent and doesn’t fit into the lock properly or at all, then the systems malfunction. That can cause a cascading effect that impacts the entire body.

Let’s start with Thyroid 101: an explanation of what this all-important gland actually does.

First, the butterfly-shaped thyroid is located in the front of your neck, just below the Adam’s Apple, and reacts with every cell in your body.

All cells have receptors for T3 and T4, the hormones the thyroid releases into the body.

Thyroid hormones (TH) regulate metabolism,

Lydia’s STYLE Magazine

body temperature and directly affect brain functions, the digestive tract, the cardiovascular system, bone metabolism, red blood cell metabolism, gall bladder, liver function, glucose (sugar) metabolism, lipid (fats) and cholesterol metabolism, and protein metabolism. What’s metabolism? In a nutshell, it’s all the chemical reactions that take place in your body and keep it functioning properly.

If just one aspect of thyroid function goes off kilter, the whole body can go awry. Typically the thyroid either produces too much or too little TH, resulting in hypothroidism or hyperthyroidism. But what does that mean for the patient who suffers from a thyroid disorder?

And what’s the difference between hypo- and hyperthyroidism?

Hypothyroidism: Putting the brakes on body functions Hypothyroidism occurs with an underproduction of TH. When TH levels drop, so, too, do energy levels. Symptoms include feeling tired, weak or depressed. The skin and hair become dry, and nails become more brittle. Sometimes the hair literally falls out.

Patients report weight gain that is unresponsive to exercise (if he or she has enough energy to exercise) and diet. Cold sensitivity increases. The brain gets “fuzzy” and memory is impacted. Menstrual periods can be heavier and last longer and more cramping can occur.

Blood pressure is elevated.

People suffering from hypothyroidism often become constipated; the gut just doesn’t have its former gastric motility, the contractions of the smooth muscles that move food through the digestive system. Constipation is one of the most common symptoms of hypothyroidism.

Often a sluggish thyroid is attributed to Hashimoto’s Disease, an autoimmune disease that attacks the thyroid and can actually destroy the gland over time, says James Speed, M.D., an endocrinologist with Banner Health’s Endocrinology Clinic.

“Hashimoto’s Disease is the most common cause of hypothyroid disorder. It primarily affects middle-aged women — in fact, women are much more likely than men to have a thyroid disorder at some point in their life.”

Hyperthyroidism: Too much of a good thing When too much TH is produced by the thyroid, the result is hyperthyroidism. Hormones course through the body causing the heart rate to speed up or become irregular. Patients may become moody and anxious. They often report weight loss, even though they haven’t changed their diets. Often they experience hand tremors and have trouble breathing while at rest. Insomnia is common and so are bouts with diarrhea. Menstrual cycles become less frequent and lighter.

Patients often feel overheated and are especially sensitive to warmer temperatures. They sweat more, and more frequently, and the skin can be warm, red and itchy. For older women,

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Dr. James Speed, endocrinologist at Banner Health’s Endocrinology Clinic, examines a patient’s thyroid for abnormalities.

this can be attributed to the hot flashes associated with menopause.

Graves’ Disease is an autoimmune disease that commonly causes hyperthyroidism. Frequently, goiters (an enlargement of the thyroid) develop. The patient may suffer from exophthalmos, a bulging of the eyeball. Exophthalmos can be especially dangerous if left untreated and the eyelids cannot close during sleep, causing corneal dryness leading to damage.

As with hypothyroidism, more women than men develop hyperthyroidism. According to Dr. Speed, women are six to eight times more likely to develop a thyroid condition than their male counterparts, especially when they hit the half century mark.

Nodules and Cancer Thyroid nodules are solid or fluid-filled lumps that form within the gland. Most of them are benign and don’t have any symptoms. Sometimes, however, they grow large enough to press against the windpipe, making it difficult to swallow or causing shortness of breath. In some cases, thyroid nodules produce additional thyroxine, a hormone secreted by the thyroid gland, resulting in sudden and unexplained weight loss, nervousness and a rapid or irregular heartbeat.

Thyroid cancer is rare, though it seems to be increasing. Early in the disease, there are no symptoms. As it progresses the patient may

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notice a lump that can be felt through the neck’s skin, changes to the voice (including increased hoarseness), difficulty swallowing, a painful neck and/or throat, and swollen lymph glands. It is unclear what causes thyroid cancer.

Diagnosis and treatment Oftentimes, thyroid conditions go undiagnosed for a long time, as the symptoms are confused as part of the normal aging process and have developed over time. Thyroid disorders are diagnosed by having a thorough physical examination which includes taking blood and testing it for TH levels. A test, called the thyroid stimulating hormone (TSH) test, can identify thyroid disorders even before the onset of symptoms. The Journal of the American Medical Association found that screening for mild thyroid failure in women and men over age 35 is as cost-effective as screening for more common problems such as high cholesterol or high blood pressure. Ultrasound may be used to rule out nodules or cancer.

The goal of thyroid disease treatment is to restore TH levels to normal. Hypothyroidism is treated with a drug called levothyroxine. This is a synthetic hormone tablet that replaces missing thyroid hormone in the body. With careful monitoring, explains Dr. Speed, a physician will adjust the patient’s dosage accordingly. When the correct dosage is achieved, patients are able to return to their normal lifestyles.

Hyperthyroidism, generally more difficult to diagnose and to treat, requires the normalization of thyroid hormone production. Treatment could involve drug therapy to block hormone production, radioactive iodine treatment that disables the thyroid, or even thyroid surgery to remove part or the entire gland. The most popular treatment is radioactive iodine. This therapy often results in hypothyroidism, requiring the use of levothyroxine (a synthetic replacement hormone) in order to restore normality.

According to Dr. Speed, alternative treatments and practices have not been able to produce the same results as prescription medications. He also advises using synthetic replacement hormones over those developed from animal thyroids. “The synthetic hormones are more consistent and stable,” he says. “When an animal thyroid is used, you never know quite what you’re getting; it’s very dependent on the individual animal and their own health and hormone levels. It’s just not as reliable.”

“Thyroid diseases are life-long conditions — they can’t be healed or reversed,” says Dr. Speed. “But with careful management, patients with thyroid disease can live healthy, normal lives.”

Michelle Venus is a freelance writer based in Fort Collins.

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medical

minimally invasive surgery

minimally invasive

Kai Stobbi, physician assistant at Banner Health’s Neurology Clinic, consults with patient Marvin Somero, who is recovering from a lumbar spine minimally invasive fusion.

surgery options

By Heidi Kerr-Schlaefer

No one likes the word surgery. It brings to mind all sorts of instruments we’d rather not contemplate.

However, put the words “minimally invasive” before surgery, and suddenly the topic seems less frightening.

While minimally invasive surgical techniques have been around for decades, advancements in recent years have resulted in increasingly shorter hospital stays, faster recovery times and, in some cases, incisions so small that they are nearly scarless.

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Surgeons in Northern Colorado have been conducting minimally invasive surgeries for several decades. Surgical procedures using scopes with cameras on one end have been used since the 1980s. The development of a video computer chip that showed the magnification and projection of images onto a television screen allowed minimally invasive laparoscopic surgery to become integrated into the discipline of general surgery.

According to “A brief history of endoscopy, laparoscopy, and laparoscopic surgery,” an article published in the U.S. National Library of Medicine/National Institutes of Health’s PubMed.gov (1997), “The rapid acceptance of the technique of laparoscopic surgery by the general population is unparalleled in surgical history. It has changed the field of general surgery more drastically and more rapidly than any other surgical milestone.”

Thomas Blomquist, M.D., FACS, of Loveland Surgical Associates at Banner Health, has watched and participated directly in the progression of minimally invasive surgery from the laparoscopic procedures of the ‘80s to the robotic-assisted surgery of today.

“When I started doing laparoscopic cholecystectomies [gall bladder removal] in 1992 the patient would stay in the hospital five days, then three days, then two,” says Dr. Blomquist. “By 1998, laparoscopic cholecystectomy patients

were only staying overnight and today, 98 percent of them go home the same day.”

Throughout the 1990s and the 2000s, minimally invasive surgery became more sophisticated and was applied to more and more types of operations. In addition to laparoscopy there was arthroscopy, thoracoscopy and laryngoscopy.

An arthroscopy is a surgical procedure orthopedic surgeons use to visualize, diagnose and treat problems inside a joint. In a thoracoscopy a doctor is examining, taking a biopsy or treating problems with the thoracic cavity, also known as the chest cavity. A laryngoscopy allows the doctor to look at the back of the throat, voice box and vocal chords.

Today, Sue Carter, M.D., FACOG, FACS, of the Rocky Mountain Rehabilitation Institute, does 99 percent of her gynecological surgeries laparoscopically or robotically. In the case of extensive cancer, she may do an open surgery, but this only occurs about two or three times per year.

“The first major surgery I started doing as minimally invasive was in 1987, here at North Colorado Medical Center,” says Dr. Carter. “I started taking out ovaries, appendixes and gall bladders through just a small incision.

“Minimally invasive surgery has been going on and is very prevalent in gynecology. We really pushed the minimally invasive surgical approach.

It’s not really new for us,” she adds.

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In the late 2000s, the American Association of Gynecological Laparoscopists released a strong statement. They advised gynecologists who didn’t know how to do minimally invasive surgery to refer their patients to someone who did as opposed to proceeding with an open surgery.

“Minimally invasive surgery goes on all over the world and in every training program. In fact, if you come out of training and can’t do laparoscopy, you are probably not employable,” says Dr. Blomquist.

While minimally invasive surgery has become the law of the land, there are still situations where a surgeon has to do an open surgery.

There are always exceptions and there are still areas of the body where minimally invasive surgical procedures just won’t work, the eyes, for instance. However, even neurosurgeons at the University of Chicago have discovered minimally invasive endoscopic procedures result in less pain, a quicker recovery, fewer side effects and less brain trauma.

The next phase of minimally invasive surgery is robotic assisted surgery. The benefits of minimally invasive surgery done laparoscopically have been less blood loss, less pain and less infection.

Now, with robotics the benefits appear to be even greater.

The robots allow surgeons a three-dimensional view, something previously impossible. A simple scope allows only a two dimensional view, but a robot allows surgeons to see plains they haven’t seen before.

“You can do dissections more elegantly and more precisely because you can see three dimensionally and work in a very small space,” explains Dr. Blomquist.

Certain fields quickly embraced robotic surgery. After all, gynecologist and urologist are often working in tight spaces, so the threedimensional visualization and complete articulation of the arms of the robot allows precision like never before.

Also, the number of ports needed to access the inside of a patient continues to decrease with the use of robots. For instance, single site gall bladder removal is now available. In the past, doing a gall bladder laparoscopically required the doctor to make four incisions. These incision sites, made through muscle, were painful during the patient’s recovery.

Today, the surgeon buries the incision site in the belly button and does the entire surgery robotically through that single incision. The procedure is performed by a robot equipped with specialty instruments designed specifically for this operation.

“We’ve done several of them and in my experience the patient has less pain and virtually an invisible scar. Our younger, female patients love it,” says Dr. Blomquist.

Dr. Carter echoes Dr. Blomquist’s sentiments, and although she can’t prove is scientifically yet, (2010 reports are only just now being released) she believes her robotic patients do better than her laparoscopic patients.

“I think this is why,” she says. “When you put an instrument in the abdomen, and you have to move that instrument around because you are trying to reach here or there, there’s a lot

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Patient Somero’s scarring from his procedure is minimal, two small incisions on either side of the spine.

Thomas Blomquist, M.D., FACS Loveland Surgical Associates at Banner Health

Sue Carter, M.D., FACOG, FACS Rocky Mountain Rehabilitation Institute

more movement at the local site of each port, whereas the robot is stationary. There’s very little local trauma to the tissues around the port, so the pain, I’m finding, is markedly decreased.”

There are some disadvantages around robotic surgery. The biggest may be the surgeon’s inability to feel the tissue he or she is working with. In a laparoscopic procedure, when the surgeon tugs he or she can feel it, but in robotic surgery the surgeon has lost his or her ability to feel with his or her fingers. Therefore, it’s a skill developed over time.

“Like every other skill, what comes with time is the ability to translate with your eye and know visually how hard you are pulling,” says Dr. Blomquist.

Robotic surgery isn’t the best option for every patient, but Dr. Blomquist believes it should be a tool available in the surgeon’s toolbox. It’s not one size fits all when it comes to surgery and it’s up to your surgeon to decide what the best option is for you, but having flexibility is important.

He encourages patients to educate themselves, but also recommends only researching sites ending in .edu and .org. Dr. Blomquist’s practice has educational materials available and refers patients to credible websites.

“It can be very hard for us to have to unwind misinformation,” he says. “Robotic surgery is new stuff, and it is cutting edge in terms of recovery and pain. What you are really choosing is your surgeon and your healthcare. That’s ultimately what you have to be comfortable with.”

Where is minimally invasive surgery headed in the future? Much of the future will be driven by payers. If a robotic surgery saves time and money, insurers will want their clients to choose the robotic option, and they may even want a specific surgeon in on the procedure.

For instance, we may begin seeing experts in certain fields being called in to assist remotely on difficult or specialized cases. If there’s an expert surgeon in Tennessee who has performed advanced robotic surgery since 2004, his complication rate is .01 percent and his patient’s pain scores are in the 99th percentile, your insurance company may want this expert in Tennessee to assist in your surgery because he’s the best value.

Robotic surgery will continue to evolve, and realistically the next step will likely be robots that allow the surgeon to “feel” the tissue.

While we’re not at the point where doctors can perform robotic surgery from afar without a qualified surgeon in the room with the patient, someday this too may be reality. There’s little doubt the U.S. Military is working on this currently, after all, it was the government who first began researching robotic surgery technology for military applications.

“We flew to the moon and back with less computing power than is in an iPhone by 100 fold,” says Dr. Blomquist. “God knows where we’ll be in the next 30 years.”

Heidi Kerr-Schlaefer is a full-time freelance writer and founder of HeidiTown.com, the place for entertaining information on Colorado festivals and travel.

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Wellness

community programs

Mitzi Moran, president and CEO of Sunrise Community Health, stands outside of the new building Loveland Community Health Center will share with Stepping Stones Adult Day Program at 302 Third Street in Loveland.

community health programs

expand in loveland

By Heidi Kerr-Schlaefer

After years of standing empty, the former Hewlett Packard building at 302 Third Street in Loveland received new life in December. Collaboration between several organizations including the McKee Foundation, resulted in a plan that came together nearly seamlessly for the benefit of the entire community.

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Two Loveland nonprofits needed room to grow and when they realized their goals coincided, they decided to partner. Loveland Community Health Center, operated by Sunrise Community Health, and Stepping Stones Adult Day Program, operated by McKee Medical Center, joined forces to seek out a location where both could expand their reach and services to the Loveland community. With the help of the McKee Foundation, these nonprofits have attained their goal.

Founded in 1981 to support McKee Medical Center and its affiliates, the McKee Foundation started a capital campaign in 2010 to raise funds for the expansion of Stepping Stones. The foundation had been raising funds for Loveland Community Health Center (LCHC) since the center opened in 1997, and had money set aside specifically for LCHC. Since the idea was

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to find a building the organizations could share, the foundation’s money specified for LCHC was incorporated into the overall renovation of the empty facility on Third Street.

Stepping Stones Stepping Stones, a community outreach program of McKee Medical Center, opened in 1995, utilizing 675 square feet at First Christian Church in downtown Loveland. The program provides daytime care for a wide range of people, including elderly who are often suffering from memory or other health issues, and younger adults who have a medical condition that requires aroundthe-clock assistance.

“We provide a wide range of activities, meals and some nursing services,” says Angel Hoffman, program manager at Stepping Stones. “Then, at the end of the day they go home with their families, and that is a key component of Stepping Stones.”

With the assistance of adult day programs, families may be able to prevent their loved ones from entering a long term facility prematurely and sometimes they can avoid ever putting their family member into a long term care facility.

These folks may continue living with their families for the rest of their lives, which is often the wish of those facing incurable diseases, especially at a young age.

In the last few years, Stepping Stones has been full to capacity and has had to turn people away.

Twenty individuals are currently on a waiting list.

In December, the organization moved from the church into 6,000 square feet in the building located at 3rd Street SE. Originally a Hewlett Packard campus, the building has 48,000 square feet and is located on a little over six acres.

The move allows Stepping Stones to grow the number of individuals they serve and expand the program’s offerings.

“The challenge at the church location is that we were in one room. We were serving someone who is 20 years old alongside someone who is 80 or 90, and they have very different needs,” says Hoffman. “We’re really excited about having an opportunity to tailor programing to people’s specific needs.”

Adult day programs have been scientifically proven to decrease the stress on caregivers.

During a study at Penn State, researchers took mouth swabs of caregivers to monitor their cortisol levels. Cortisol is the stress hormone. On the days that caregivers knew they were taking their family member to an adult day program their cortisol dropped significantly.

While Stepping Stones provides different types of activities during the day such as pet therapy, music therapy and arts and crafts, the crux of the program is socialization.

“Yesterday we had a group playing a balloon game around a table and they were laughing so hard that a few were almost in tears,” says Hoffman. “It’s so nice to hear because that’s what our program is about.”

With the baby boomer population aging, the need for Stepping Stones will only grow. According to the Alzheimer’s Association the projected

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Dr. Mockler examines a patient at Loveland Community Health Center, which is expected to see more than more than 7,000 people in 2014.

Angel Hoffman is the program manager for Stepping Stones Adult Day Program.

for low-income individuals and families.

The program is supported by federal grants, but over 60 percent of their monies come from patients either through Medicaid, Medicare, Colorado Indigent Care Program, Child Healthcare Program or the patients themselves. If a patient doesn’t qualify for any of the programs, they make payments according to LCHC’s sliding fee scale, which is determined by a variety of parameters including family size, income and medical expenses.

“We’ve been outgrowing our space at LCHC for the last two or three years,” says Mitzi Moran, president and CEO of Sunrise Community Health.

“We started looking for property quite some time ago and purchased the old HP building in June 2012.”

The contribution for the building on 3rd Street SE came from multiple sources: $2 million came from Banner Health, $1 million from the McKee Medical Center Foundation, Sunrise contributed another $1 million, $150,000 came from Caring for Colorado and $2 million from Colorado Health Foundation. The City of Loveland contributed $693,000 in waived fees and direct cash support.

“All of those sources made this a reality. If we hadn’t had this support we either couldn’t have done it or we would have had to do something much, much smaller that wouldn’t have met the community’s needs,” says Moran.

The need is great. According to Moran, about 27,000 individuals in Loveland (not counting the greater Loveland area) are likely to struggle with accessing insurance. That’s nearly one in every

three individuals. Last year LCHC served about 7,000 people. The new space means LCHC nearly doubles in size.

At the new facility, LCHC has grown from 16 exams rooms to 24 and from five dental labs to nine. The pharmacy and X-ray departments are larger, and they have the ability to add 12 more exam rooms in the future. The unused area of the building, the previously mentioned 15,000 square feet, will be developed as need occurs and funds are raised.

The Loveland community has embraced LCHC and Stepping Stones, and that’s important because as Moran, Johnson Haffner and Hoffman all point out, this is about the overall health of the entire community. If individuals are healthy they can work. If a child is healthy they perform better in school.

“A healthy workforce and healthy schools lead to a healthy community. It all ties together and it’s all connected,” says Johnson Haffner.

“We’re all in this big boat together, and when we can care for those in our community who need our help I think it’s important to do so. It’s important to take care of our neighbors, friends and community.”

total number of Coloradans age 65 and older with Alzheimer’s disease will be 110,000 by 2025.

The number of Coloradans with Alzheimer’s in 2010 was just 72,000.

The McKee Foundation’s capital campaign goal was to raise $1.2 million for Stepping Stones, and they raised $1.5 million. The additional money will go into a scholarship fund for individuals who wish to attend Stepping Stones. Currently, the program is covered through Medicaid’s Home & Community Based Services (HCBS). Some people have long term care insurance that covers the cost through an adult day component in the plan, while others pay for Stepping Stones privately.

“Loveland has embraced this so wholeheartedly. Everything has been so perfectly suited. The timing was right, the mission was right and the vision came together. It’s all worked really well,” says Julie Johnson Haffner, executive director of the McKee Foundation. “I couldn’t have planned it any more perfectly.”

Loveland Community Health Center Both Loveland Community Health Center and Stepping Stones were landlocked in their old facilities, but they will now have room to grow.

LCHC has moved from 15,000 square feet of space at 450 Cleveland Avenue into approximately 27,000 square feet in the renovated HP building. There’s an additional 15,000 square feet available for future expansion.

Loveland Community Health Center, provides medical, dental and behavioral health services

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Heidi Kerr-Schlaefer is a full-time freelance writer and founder of HeidiTown.com, the place for entertaining information on Colorado festivals and travel.

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wellness

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Wellness

lifestyle

is sitting

killing you?

By Angeline Grenz

If you have ever needed a reason to boost your activity level consider the latest research that says sitting multiple hours a day is literally killing you.

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According to a 2012 University of Sydney study published in the Archives of Internal Medicine, people who sit for 11 hours or more a day have a 40 percent greater risk of death. For those sitting between eight and 11 hours a day, that risk is 15 percent higher than it is for people who sit for four hours or less a day.

Ouch. For all of you calculating how many hours you are sitting every day (at the office and in front of the television), this is your wake up call. “Sitting too much during waking hours may literally be killing people,” says Pierre Onda, M.D., internal medicine physician and director of Health & Wellness Services for Kaiser Permanente Colorado.

This particular study interviewed 222,497 Australian men and women and points to findings that say the increase in likelihood of death crosses all causes of mortality – meaning if you have heart disease, diabetes or another health

risk, it will kill you sooner if you spend the majority of your day sitting.

Past research has foreshadowed some of these very concerning statistics. Dr. Onda cites a Harvard study that found sitting in front of the television for just two hours a day can increase your risk of diabetes by 20 percent and heart disease by 15 percent. Multiply hours in front of the T.V. and those percentages can climb up to 112 percent for diabetes and 115 percent for a cardiovascular event. Sitting too much has also been linked directly to increases in colon and breast cancers.

A staggering finding in the new study indicates that the increased risk is independent of whether or not you exercise. The study found that those who exercise 150 minutes a week – the recommended minimum – still had the same increased risk of death. The findings were also independent of other risk factors: nationality, gender, age, smoking status, etc.

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Of the 5,405 deaths that occurred during a follow-up of the Austrialian study, 373 (6.9 percent) were linked to excessive sitting, says Dr. Onda. Sitting’s harmful impact on our health actually rivals or surpasses the increased risk of death attributed to smoking. It is that important to your health to not only recognize the danger, but to take steps now to combat these alarming numbers.

Dr. Onda, who is passionate about promoting health and wellness in the workplace, recommends four easy changes that can help you sit less even when you are trapped at a desk for long periods of time.

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Take the stairs wherever they are available.

“If you climb one to two flights of stairs for five minutes a few times a day, that could equal to four to five pounds worth of calories burned per year,” says Dr. Onda.

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•

•

Go for a walking meeting. If your business meeting consists of just two or three people, take it outside and walk a few blocks while you talk. Dr. Onda and his staff endeavor to hold walking meetings whenever they are able. If you can’t walk or your meeting consists of a larger group of people, choose instead to stand at your next meeting.

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Incorporate “instant recesses” into your day. Get up from your desk and do some spontaneous stretches, take a quick walk around the block, just move, says Dr. Onda. These mini breaks are most successful when they can be organized and lead by a designated person on behalf of the office.

Get an adjustable desk that allows you to stand during your workday. “Standing’s micromovements are much better for you than sitting,” says Dr. Onda. He has an adjustable desk at his office and he spends at least half of his day standing at the desk. “Generally, I stand the first half of the day, then adjust my desk and sit for the second half.” Standing desks are a fantastic way to decrease the hours you spend sitting, but they are an investment. Most standing desks range in cost from $500 to $1,000.

The most successful campaigns are those

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Dr. Pierre Onda, internal medicine physician and director of Health & Wellness Services for Kaiser Permanente Colorado

that engage the entire company, adds Dr. Onda.

He cites statistics that show while people are driven a little by the information they receive (about 5 percent will make changes based on information alone) most people make changes

when workplace policy and environment encourage them to do so. “Employers really need to model this behavior for employees. Changes in culture are a big driver toward promoting healthier behaviors.”

However, if you are going it alone in an office that has not embraced the benefits of encouraging healthy lifestyle practices, there are small changes that can help you. “I try to get up every 15 minutes, even if it is only for two to three minutes,” says Dr. Onda. He recommends setting a reminder on your computer or downloading an app to help you remember to get up and move.

Healthier employees result in fewer sick days and increased productivity. Kaiser Permanente offers employers an opportunity to engage their entire workforce in better health habits through its HealthWorks program. HealthWorks features a customizable suite of services designed to help companies and their employees assess overall health, develop proactive health and wellness programs and receive one-on-one coaching from experts. These services are available online and on-site.

For tips designed to improve your health on the job and at home, visit www.kp.org and click on the Health & Wellness tab.

Angeline Grenz is managing editor for Northern Colorado Medical & Wellness Magazine.

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Wellness

nutrition labels. They have taken a nice, pure beverage and turned it into a sugary drink. If you can make it or get it, homemade kombucha is very good for you.

trendy schmendy,

what you should really be eating

By Corey Radman

A quick waltz through Whole Foods Market will undoubtably discombobulate the average consumer.

Provided you can safely make it past the self-serve cookie bar, the number of chia seeds, coconut products and that stock of dandelion leaves in the produce aisle will have you wondering... what? We’re eating that now?!

Even experts disagree on what foods are good for you or not, though they all land safely in the yes column on whole foods and leafy greens. (Yes, even the dandelions.) We asked both a Registered Dietician and a Master Certified Nutritionist about the latest trendy foods. Here’s who they are and what they said.

A word about the two disciplines: Registered Dieticians are more in line with established medical strictures and rely mostly on long-term medical data. Nutritionists are not licensed by the state of Colorado and cannot bill insurance. Their advice still draws from medical research, though they lean more toward functional medicine and newer studies from new thinkers.

Melissa Wdowik, PhD, Registered Dietician Kendall Anderson Nutrition Center at CSU Kathy Westover, MA, Medical Nutrition Therapist To Your Health Nutrition, LLC and professor at The Nutrition Therapy Institute in Denver

What approach should consumers take when confronted with wave after wave of dietary trends?

MW: It’s worth considering new foods, but

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don’t jump on every new trend without researching the medical studies (not just testimonials and advertising). Medline/PubMed and WebMD are credible sources. Beware of blogs.

KW: If I could give every person one hint about what to eat, it would be skip everything that comes in a package. The trendy, processed foods are not helpful to the human body.

Is there one food item people should toss in the trash right now?

MW: Sugary cereals. If it has sugar or white flour, don’t buy it.

KW: Everything that has sugar. I eat a Paleo diet with very little fruit. I feel better at age 60 than ever before. I’ve turned myself into a fat burner instead of a sugar burner. We’re not supposed to have as many carbohydrates... and that’s the reason we are so obese in this country.

Kombucha, the fermented, probiotic tea is pervasive. Is it really good for us?

MW: Bottled, commercially prepared kombucha usually has added sugar and juices. Read the

KW: I hate commercial kombucha, mostly because of the way they produce it. It’s got added sugar. It should not be pasteurized, but the FDA requires it. Most people are not getting any benefit from it at all. I used to buy kombucha out of the back of a friend’s car. That’s completely illegal, but that’s how it was meant to be produced – in small batches with live cultures.

How about other fermented foods like sauerkraut, kimchi and fermented yogurt?

MW: It’s interesting to see this ancient process for preserving foods come back. One serving a day can help the digestive system grow healthy bacteria. It can be helpful for IBS or diarrhea.

KW: People can really overdo it with ferments.

My clients who are drinking a full bottle of kombucha every day and then eating sauerkraut at lunch and kimchi with dinner are actually promoting growth of bacteria in the wrong place (the small intestine, which should be sterile). A suggested serving size is 1/3 cup a day of any one ferment.

Coconut Oil, Yes or No?

MW: That’s a multi-layered question. Although coconut oil is saturated fat, it is absorbed differently than other fats like butter or lard. Technically that’s true, but those studies are flawed.

[The potency of the oil used in the studies is different than what most consumers buy. Check the coconut oil article at Center for Science in the Public Interest for more details.] There’s not enough evidence to show that it is beneficial for heart health. In fact, it may be detrimental.

Bottom line, if you like the taste, you could substitute it for other fats, but only small amounts of saturated fats are safe. I would rather see people choosing monounsaturated fats like peanut, olive and canola oil.

There is also a link between improved brain health and coconut oil, however, I urge people to tread with caution on new evidence. Those are very new studies. People have jumped on bandwagons before only to find that claims are proven false. Remember margarine vs butter?

Use common sense. If it’s a real food, there is nothing wrong with eating small amounts of it.

KW: Coconut oil is one of my favorite things.

It got a bad name because it was hydrogenated.

Extra Virgin Coconut Oil in form of butters, oil and dried are so full of medium chain triglycerides.

The size of this molecule cannot be used for anything but fuel in the body. We burn it more efficiently than glucose. It also creates a fatty acid hydroxy buterate. It goes into the brain, converts to a ketone, and it is as good a fuel in the brain as glucose. Coconut oil is helping people with Alzheimer’s, Parkinson’s and ALS. Make sure the label says Extra Virgin Coconut Oil. Nutiva and Dr. Bronner’s make excellent coconut oils. I recommend three to four tablespoons per day. Use it to cook with or in baking. I find it

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too oily to eat plain, but coconut butter is yummy.

It’s good for weight loss. Our bodies don’t need sugar, but fat to burn fuel. Start teaching your body to burn stored fat.

Ch-Ch-Ch Chia

MW: Chia seeds are beneficial, comparable to flax seeds. They have a nice flavor and do contain fiber, which fills you up. But be cautious of claims that they will help with weight loss. Dr. Oz often suggests this, but there is no evidence that making a pudding of them and eating it daily will promote weight loss. It’s just as easily attributed to placebo affect. But for their antioxidants and fiber, I say sure. Eat them.

KW: Chia seeds are high in Omega 3 fatty acids (like flax seed), but you need to grind them up with a coffee grinder to access that nutrient. It’s one of the downsides of using plant-based sources for this fatty acid. The human body usually can’t break them down. They are also mucilaginous, so they turn into a Jell-O-like substance and are good for your gut. To be honest though, they get stuck in my teeth when I grind them into a smoothie. I usually just use flax seed instead.

Is Gluten Free (GF) eating really necessary?

MW: There are certainly people who, after a biopsy and blood test, are determined to have celiac disease and should definitely not eat gluten.

Additionally, there is a spectrum of people who are gluten intolerant at various levels. It can cause digestive symptoms, headaches, backaches, autoimmune problems... The only way to know for sure is to eliminate gluten. But so many people do that without the guidance of a dietician, and the data gets very murky. They often don’t know what’s helping and what’s causing symptoms.

I don’t recommended that people go GF to lose weight because so often they turn to the convenient, pre-packaged foods that are not helpful.

KW: Based on my hours and hours of study and an eight-day gluten summit, I think most people should not be eating gluten. If you have a healthy, intact digestive tract, the gluten passes through and goes out with the trash at the end of the day.

But my guess is 80 percent of the U.S. population has some form of leaky gut syndrome... In this way, gluten sneaks into the body and the immune system mounts an attack. Even the fancy gluten substitute foods (like GF pretzels or oat crackers) are all still made with some form of flour. It’s still a grain and still converts to sugar. Bottom line: eat more vegetables. They’re better for you.

While both of these nutrition experts agree that processed foods are abhorrent, there is a lot of variation around saturated fat and gluten.

Science will eventually give us more definitive answers, but until then, be cautious. Consult a professional. And don’t self-diagnose.

Corey Radman writes health and alt-health articles for a number of publications. Find her at www. fortcollinswriter.com.

Northern Colorado Medical & Wellness 2014

71

Wellness

liver health

taking out the trash:

liver health after the holidays

By Carl Simmons

The holidays are over, but the food hangover lingers on – maybe other kinds of hangovers as well. For that matter, all those chemicals you used to get the house clean for the holidays are still setting off allergic reactions like crazy. You’d really like to start feeling normal again.

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Plus, it’s a new year. You’re once again ready to “clean house” with your body – and this time, mean it. But how do you get started “detoxing” your body?

When it comes right to it, detoxification starts with the liver. That’s its job, in fact.

In more medical terms: The principle function of the liver to filter the blood from the digestive tract before it gets to the rest of the body. Therefore, it’s your first line of defense in protecting the rest of your body.

“There’s hundreds of jobs the liver does, but to boil it down, it detoxifies the body – not just waste but all the chemicals we take in during the day. You have to take the trash out,” says Kathryn Plummer, ND, of Sage Holistic Health in Loveland.

“There are three major functions the liver performs: it detoxes the body; it produces cholesterol – which is usually touted as an evil thing, but your body needs it to produce hormones, promote cell health and promote nervous-system health; and it stores sugar, for energy for the body.”

There are any number of signs that your liver may not be functioning as well as it could. On the more serious end is jaundice (yellowing of the skin). But for those of us who are relatively healthy and just want to get healthier, it might also manifest itself through symptoms such as oversensitivity to smells and foods, a bad taste in

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mouth and/or halitosis, low energy or fatigue.

Those symptoms might also pop up during the two phases of the detoxification process.

In phase 1, Dr. Plummer says, the liver “helps package up toxins and makes them water-soluble, but it can also make them more toxic; phase 2 make the wastes more inert, less toxic and more easily disposed of. Most people are sluggish during phase 2.”

There are a number of foods and supplements on the market that help with the detoxifying process and promote liver health. (See the sidebar in this article for a fuller list.)

“We do everything to promote health through lifestyle and diet change,” Dr. Plummer says. “All cruciferous vegetables are helpful to liver health. However, if you steam them, you take out some of their natural liver-healthy qualities. Just adding one sprig of a raw cruciferous vegetable to your steamed vegetables, though, is amazing in ‘re-naturing’ it and making it liver-supportive.

“The three supplements I recommend most to my patients are ginger, turmeric and SGS (sulfuraphone glucosamine),” she adds. “SGS is found in all cruciferous vegetables, especially in the seeds. There are a lot of things that are great for the liver, but different things work better for different folks. I recommend ginger because it also helps with digestion, and turmeric also works as an antioxidant; in other words, they’re useful for more than just liver health.”

In addition to dietary changes, many people purchase different types of cleanses, especially at the beginning of their diets. “I’m not in love with store-bought cleanses,” Dr. Plummer adds. “They might help some people but they tend to be laxative-based and focused on one particular part of the body. They might be too harsh for many of my patients. I’d probably look at the container and say, ‘It’s not for you.’”

More natural cleanses include water or juice fasts, as well as hypo-allergenic diets, where people eliminate different parts of their diets to determine what foods they might react to adversely (such as dairy or meat).

Any significant fasting, however, should only be done be for a limited time, and only with your doctor’s approval.

The goal of any dietary change is to get healthy. However, helping your liver to function at its maximum level, in order to eliminate the toxins already in your body, is ultimately the first step to having a healthier body – as well as a great first step in living healthier in all areas of your life.

Therefore, Dr. Plummer says, “literally cleaning house and doing ‘mental cleansings’ can also be very helpful in detoxifying your life.

In addition to eating healthy, be sure to drink clean water, reduce your stress and get lots of restful sleep and exercise.”

Carl Simmons is a freelance writer based in Loveland.

Northern Colorado Medical & Wellness 2014

liver-healthy foods and supplements To get your liver functioning at its peak, consider eating and/or using the following (and checking with your doctor):

foods: •

Cruciferous vegetables – including broccoli, cauliflower, kale, Brussels sprouts, cabbage and artichoke

•

Onions – including anything from the onion family such as garlic, shallots and leeks

•

Fruits – especially grapefruit, avocados, apples, lemons and limes

•

Green tea

•

Beets

•

Carrots

•

Coffee – yes, coffee. While caffeine can indeed be considered a toxin, research has also linked coffee-drinking to decreased liver disease. So tread carefully.

•

Whole, plant-based, unprocessed foods in general

spices/supplements: •

Ginger

•

Turmeric

•

SGS (sulforaphane glucosamine)

•

Milk thistle

•

NAC (N-Acetyl L-Cysteine)

•

Dandelion

•

Licorice

•

Black cumin (also called black seed)

•

Borotulu bark

•

Chanca piedra

Sources: WebMD.com, Sage Holistic Health, wholefoodsmagazine.com

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family f o cu s

Karate

Kids

There’s just something about the martial arts. It benefits kids in ways that other sports may not. Sure, all sports foster team work and overall health benefits.

But martial arts give the kiddos much more than that.

Kate Austin-Groen, mother of 7-year-old Ivan, has watched her son’s confidence and athletic capabilities grow since he started taking karate classes in August at Karate West, where he just earned his first degree white belt. “Ivan likes his karate class because it’s an essential part of his Ninja training,” she explains. “Honestly, I like it because the injury level is low. Also, it’s fun for him and he’s made new friends. I like the discipline aspect and the good life skills that he can apply in other areas.” For Kate, the balance, strength and flexibility that Ivan is developing can translate to other sports in the future.

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By Michelle Venus

“Martial arts can be practiced at any age,” says Kim Yee, owner of Karate West. “We have students as young as 5 years old and students well into their 70s — we’re a very family-oriented school.” Kim and his wife, Lou Ann, opened their midtown dojo in 1978. “Our students learn skills that make a difference in their everyday lives, such as protecting themselves against bullies.” Martial arts students are taught to manage situations without the use of violence, learning ways to assess threats and redirect verbal assaults, and mobilize the audience, which is a critical factor in empowering the bully.

Self-defense is what most people immediately associate with martial arts. Proper form along with punching, kicking, blocking and evasion techniques are major components in training.

Matt Lopez, general manager at TITLE Boxing Club in Fort Collins, believes that self-defense skills build confidence in even the shyest kids.

“At our club, students are taught skills that are life-changing,” he says. “When a child knows that he or she has the ability to stand up against a bully, it makes them much less susceptible to bullying behavior. Bullies pick out the kids who retreat. When they don’t retreat, they put an end to bullying.” Many martial arts schools incorporate personal safety and stranger awareness in their curriculum. Karate West even teaches abduction response as part of their class — and not just for youngsters — women are taught these skills as well.

TITLE Boxing Club offers boxing, kick boxing and Power Hour classes, all led by professional and semi-pro mixed martial arts fighters. Kiddos as young as 8 can join parents and siblings in class. Instructors gear the classes to individual levels. “We provide students with boxing gloves and hand wraps (that give the wrists extra support) with every membership. Every class has different exercises and active rest periods

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family • kids • play • fun • health • activities

Northern Colorado Medical & Wellness 2014

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that keep burning calories even after the class.

You’re still burning calories when you go home and sit on the couch.”

While the martial arts are typically individual sports, team work is often part of the curriculum. Activities are planned so that the children support each other and build upon individual successes. Dojo owners put students of various abilities and levels together. “One of our students, Spencer Hawk, has no arms and his legs were amputated above the knees,” states Seth Sykes of Sykes Family Martial Arts.

“But he’s out there with the best of them. The whole class works with him and each other to be their best.”

Martial arts students develop many skills that benefit them in all aspects of everyday life. Self-discipline and concentration have a starring role in the classroom. Many parents and teachers notice improved study skills and grades. Focus is stronger and the memory and retention skills utilized in martial arts classes come into play in academic settings as well.

Personal responsibility is important in the martial arts. “Ivan’s class starts with a chant about keeping their bodies healthy and being responsible for completing homework and chores. He’s taught values that go beyond the karate class,” says Katie.

Michelle Venus is a freelance writer based in Fort Collins.

Find Your

Dojo

Karate West

3725 S. Mason St., Fort Collins (970) 237-5284 www.karatewestinc.com Classes: Karate (all levels), Kickboxing, Brazilian Jiu-Jitsu, Fight Club

Inner Wave Pencak Silat 4103 S. Mason St., Fort Collins (970) 817-4266 www.fortcollinssilat.com

Classes: Silat for kids and adults (a variety of martial arts indigenous to the Malay Archipelago and the Malay Peninsula, with a focus on healing and meditation) Women’s Self Defense, Weapons Training Tama Yoga, Close Quarter Combat Supra Medisitra

Aikido of Fort Collins 3521 S. Mason St., Fort Collins (970) 215-8562 www.aikidooffortcollins.com

Classes: Aikido, Bokken, Iaido, Zazen

Krav Magna Institute 232 E Monroe Dr, Fort Collins (970) 225-6655 www.kravmagacolorado.com

Classes: Karate, Krav Magna, (Self Defense technique, originally designed for military and law enforcement), Wrestling, Fight Skills Gym Conditioning, Functional Strength

Tran’s Martial Arts

3524 S Mason St., Fort Collins (970) 493-3838 www.transfortcollins.com Classes: Tae-Kwon-Do, Samarai Sword Martial Arts, Combat Ninjutsu Self Defense (Kids, Adults and Family classes)

Trials Martial Arts & Fitness 2649 E. Mulberry St., Ste A#12, 13, (970) 472-9177 www.trialsmma.com

Classes: Submission Grappling / Grappling Technique, Wrestling, Brazilian Jiu Jitsu, Kick Boxing / Kick Boxing Technique MMA Technique, Team Training, Enduro Fit, Enduro Kick Boxing, Little Champs and Champs Kids Programs

Bring this Coupon & Receive

1 FREE Healthy Meal Smoothie • Herbal tea • Aloe drink

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Lydia’s STYLE Magazine

Sykes Family Martial Arts 5800 S. College Ave., Fort Collins (970) 267-0490 www.sykeskarate.com

Classes: Karate, Jiu-Jitsu, Self Defense, including bullying prevention, anti-abduction workshops and women’s workshops, Mixed Martial Arts

TITLE Boxing Club

4360 S. College Ave, Fort Collins (970) 449-0170 www.fortcollins.titleboxingclub.com Classes: Boxing, Kickboxing, Power Hour Workout, Personal Training

Ivan

Northern Colorado Medical & Wellness 2014

77

Wellness

dentistry

cosmetic dentistry:

building smiles

By Kay Rios

The old saying, “Smile and the world smiles with you,” certainly holds true but dental issues may mean that some smiles are slow in coming. Thanks to modern cosmetic dentistry, however, many concerns can be addressed.

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“We have many new techniques in cosmetic dentistry,” says Sandra Hunter, DDS, FAGD at Front Range Dental Center. “In the past you basically had two choices: either porcelain fused to metal (PFM) or gold crowns. Now we also have all porcelain, veneers, no prep veneers (Lumineers, DURAthin veneers, Vivaneers to name a few) and the use of tooth-colored resin in place of gold or silver fillings.”

The focus in dentistry has moved toward conservative methods, Dr. Hunter says. That often means saving tooth structure, which is important.

She explains, “When you touch a tooth, it’s not reversible. People are living longer and we want to maintain their own teeth as long as possible.”

One way is to use veneers. “It’s almost like a fake nail,” she says. “Veneers have been around for a long time but we now have different types and some don’t involve preparation. That means in many cases, we don’t need to take away tooth structure.”

The most conservative approach is in the use

of composites, which are synthetic resins used as restorative materials. They offer such characteristics as strength, easy handling, wear resistance and excellent aesthetics. There are many benefits to composites. “This can be done chairside, no lab is involved and usually within an hour to a few hours of labor, teeth can be restored.”

In addition, bond strength has increased, allowing composites to be used in more situations.

Fewer appointments, less chair time and lower cost to the patient also add to the advantages.

Composites add to the tooth rather than subtract from the structure. And multiple colors can be incorporated, enhancing aesthetics. “It doesn’t take an artist but, in the right hands, these can be incredible,” she says. “Depending on the case, composites can last many years and can in some cases be better than crowns. They are phenomenal and have become my preference.”

A number of other changes have taken place in the world of dentistry. In orthodontics, there are invisible options: Invisalign and other companies

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use aligner trays made of smooth, comfortable and virtually invisible plastic that are worn over the teeth without metal brackets or wires. There are also lingualized braces, which are placed on the inside of the teeth.

Bleaching remains popular. “It’s a good option if you want to look younger. Coffee, tea and wine can stain teeth so you can bleach teeth back to their original color or lighter,” Dr. Hunter says.

Over the counter products also work. “They are similar to what we use in the office, just not as strong.” In-office options can be done in an hour or take-home packages are also available. In-office options can give a lighter and more even result.

Another area is gum surgery. If gums are too prominent, they can be re-contoured or, if they have receded, grafting can often help.

And, with an increasing population of seniors, dentures have been given more focus. “Implants are becoming common as an aid in supporting dentures. Conventional dentures may not hold well and now you can use multiple implants that will hold them in place so you don’t have to take them out at all.”

Implants have become more popular, not only to support dentures, but to replace individual teeth or multiple teeth. It’s all case dependent, she says.

“It depends on how close the sinuses are and how much bone there is. Implants are fantastic.

In the past, if you lost one tooth, you would be looking at a bridge. But that meant impacting the structure on the surrounding teeth.”

Implants are definitely a viable solution to a number of situations. “The success rate of implants

Northern Colorado Medical & Wellness 2014

Sandra Hunter, DDS, FAGD, at Front Range Dental Center, finds her artistic calling in creating beautiful smiles.

is very high. And then, you can crown them. They don’t decay; they can protect the bone and are highly aesthetic. It’s rare to see a case fail,” she says.

The Computer Aided Design/Computer Aided Manufacture (CAD/CAM) is a new development.

“To make crowns, you usually need an impression that’s sent to a lab and it takes a couple of weeks to come back. But with CAD/CAM, you make a digital impression with the CAD, send to the CAM and it makes the crown. You can also color the crowns to match surrounding teeth.”

Dr. Hunter worked with a dentist in California who is a leading expert in CAD/CAM. “This is very expensive equipment to own and isn’t widely available. But it’s beginning to be adopted and is definitely a wave of the future.”

Overall, Dr. Hunter sees cosmetic dentistry as art. “I went into dentistry because I love art and this was a good way to combine art with science.

That’s why I like composites so much.”

In fact, Dr. Hunter studied art starting at a very young age and decided to go into dentistry as a way to use her artistic skill. “I saw it as art and I knew I would have a great career.”

She has proven her worth, not only as a dentist, but as an artist as well. She is an awarded member of the Guild of Natural Science Illustrators, a signature member in the Colored Pencil Society of America and a member of the Botanical Society of America. She has illustrated for lectures in cosmetic dentistry and is the author/illustrator of Beatrice Visits the Dentist. “Dentistry has turned into a fabulous form of art,” she says.

Kay Rios, Ph.D., is a freelance writer based in Fort Collins. She has spent more than her fair share of time in a dental chair and could be driving a very expensive sports car had she not felt it more important to pay attention to her teeth.

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