JANUARY 2015
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Northern Colorado ww w . m e Medical d i c a l&aWellness n d w e l2015 lness.com www.stylemagazinecolorado.com
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Northern Colorado Medical & Wellness 2015
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THE VOICE OF NORTHERN COLORADO FOR
31 YEARS.
s t y le me d ia a n d d e s i g n , i n c .
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w w w. s t y l e m a g a z i n e c o l o r a d o . c o m w w w. m e d i c a l a n d w e l l n e s s . c o m PUBLISHER Lydia Dody | lydia@stylemedia.com MANAGING EDITOR Angeline Grenz angie@stylemedia.com CREATIVE DIRECTOR Scott Prosser SENIOR DESIGNER Lisa Gould DIGITAL DIRECTOR / BUSINESS DEVELOPMENT Austin Lamb | austin@stylemedia.com ADVERTISING SALES EXECUTIVES Jon Ainslie (970) 219-9226 Debra Davis (917) 334-6912 Lydia Dody (970) 227-6400 David Knight (970) 619-9846 Elaine Ryan (970) 541-4915 OFFICE MANAGER/ABOUT TOWN EDITOR Ina Szwec | ina@stylemedia.com ACCOUNTING MANAGER Karla Vigil CIRCULATION MANAGER Trisha Milton COPY EDITOR Michelle Venus PHOTOGRAPHER Marcus Edwards Photography CONTRIBUTING PHOTOGRAPHERS Bridget Eldridge CONTRIBUTING WRITERS Malini Bartels,Kyle Eustice, Heidi Kerr-Schlaefer, Kay Rios, Brad Shannon, Michelle Venus AFFILIATIONS Fort Collins Area Chamber of Commerce Greeley Chamber of Commerce Loveland Chamber of Commerce 2015 STYLE MAGAZINES January-Northern Colorado Medical & Wellness February-Style March-Northern Colorado Medical & Wellness April-Style May-Style June-Style July-Northern Colorado Medical & Wellness August-Style September-Women’s Health & Breast Cancer Style October-Northern Colorado Medical & Wellness November-Holiday Style December-Best Of & Winter Activities Style Style Media and Design, Inc. magazines are free monthly publications direct-mailed to homes and businesses in Northern Colorado. Elsewhere, a one year subscription is $25/year and a two year subscription is $45/year. Free magazines are available at nearly 300 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 ©2015 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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years to come. Thank you for your trust and confidence in our practice. Drs. Radtke, Eckhardt, Hunter and Trang THANK YOUS
30TH ANNIVERSARY/BEST OF
Thank you so very much for the delightful evening on Thursday, and for honoring us in the "Best of Fort Collins" awards! Warm congratulations on 30 years of Style. Amazing how fast the years go by. I remember being in the fashion show shortly after we moved here when the magazine was in its infancy. Wow! What a journey it has been and look how much you have contributed to our community on so many levels. "Best of Style" special edition magazine (December 2014) will make it easy to find out where to go for the best goods and services in our town. Congratulations to all the winners and nominees. Bas Bleu is deeply honored and grateful for the recognition! Thank you, Lydia Dody and Style Magazine, for all you do for our community and for hosting a wonderful celebration with yummy food and drink by Mainline! Much love, Wendy Ishii
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Awesome party! Thanks so much for including us.
Wanted you to know what a healing event Hope Lives was for me. Your kindness and effort through Style Magazine has enhanced my life in a wonderful way. Marti Kunter
Fusion Massage, Fort Collins I came across your December issue of “Best Of” at the Old Town Library. I love this new Style Magazine. The Best Of is a beautiful magazine and so timely since I have been looking for a handyman. I cut out the Best of Handyman winners, have them on my refrigerator and plan to call after the holidays. Thank you for creating this special issue. Well done.
I can tell you the photos and beautiful storytelling have been loved by everyone I’ve shown the piece to! (“A Delicious Weekend in Boulder,” December 2014, Lydia’s Style Magazine.) Erin Byrne, Communications Coordinator Boulder Convention and Visitors Bureau
Sincerely, Willow Davy, Laporte We would like to thank the readers of Style Magazine for voting Front Range Dental Center the Best Dental Practice in Northern Colorado. We started our practice four years ago, and we are truly honored by this recognition. We will continue to create healthy smiles for
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Hidden Braces Dr. Brandon Owen, DDS, MS
In addition to conventional orthodontics for children and adults, we are one of the most experienced clinics in the country with lingual “hidden” braces. This is the most esthetic way for us to enhance your smile (often for the same price as outside braces).
Dr. Adam Timock, DDS
We are pleased to announce our new partner Dr. Adam Timock, DDS Dr. Timock's research on 3D imaging has been published internationally and received special recognition by the American Association of Orthodontics. Both Dr. Owen and Dr. Timock are certified by the American Board of Orthodontics, an honor achieved by only 20% of practicing orthodontists.
In addition to clinical practice, Dr. Owen works with GAC DentSply on DEVELOPING the next generation of braces and lingual (behind the teeth or “hidden”) braces making orthodontic treatment significantly faster with even better results. Dr. Owen LECTURES around the world to orthodontists about lingual and digital orthodontics. He does RESEARCH at the U. of Alberta with one of the most advanced orthodontic labs in the world.
2009-2014
Dr. Owen’s Professional Accolades: • Diplomate of the American Board of Orthodontics • Member of the College of Diplomates of the ABO • 5280 “Best Orthodontists” list every year 2009-Present
Come by and see us at our second location in Windsor! Dr. Adam Timock, DDS
Dr. Brandon Owen, DDS, MS
Two Locations: 3221 Eastbrook Dr. Suite A-103
Fort Collins, CO 80526
(970) 224-4358 www.owenorthodontics.com
1180 Main Street Suite 6
Windsor, CO 80550
CONTENTS
Northern Colorado Medical & Wellness
JANUARY 2015 Page 10
From Our Readers
Page 14
on the cover
Julie Johnson Haffner, McKee Medical Center Foundation Executive Director, and Chris Kiser, North Colorado Medical Center Foundation President, have been at the forefront of the Heart Safe City campaigns in their respective communities. Loveland hopes to achieve the designation in 2015; Greeley achieved the status in 2013. Read more on page 26 in “Creating a Heart Safe Community.” Cover photography by Marcus Edwards Photography.
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Page 16 Introduction Letter:
Page 42
Rick Sutton, Chief Executive Officer, Banner Health Northern Colorado
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Sutton To Head Three Northern Colorado Banner Health Hospitals
Gynecologic Oncology Options Grow at Banner
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Page 24
Specialty Focus Aids in Diagnosis and Treatment Options
Page 26
Creating a Heart Safe Community
Page 30
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Treating an Enlarged Prostate
Publisher’s Letter
Page 22
26
Page 34
Venous Issues Impact Millions Behavioral Health: A Priority at Banner Health
Page 46
HPV: The Silent Infection
Page 50
In The News
wellness magazine Page 54
Loveland Community Health Center Update
Page 56
Lingual Braces Offer Versatility
Page 58
Healthy Winter Skin
Bronchoscopy: GPS for the lungs
Page 62
Page 32
Page 68
Lung cancer 411
Lighten Up
Hearing Tech
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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publisher’sletter
EXPANDING AND IMPROVING HEALTHCARE IN NORTHERN COLORADO Welcome to our 10th annual edition of the Northern Colorado Medical & Wellness Magazine. We are honored to collaborate with McKee Medical Center and North Colorado Medical Center (NCMC), which are part of Banner Health Northern Colorado, to bring our readers this timely and in-
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formative publication. Although in the past we have included a medical directory in this issue, we are asking our readers to now access the Internet for current directory information. The many advancements in healthcare services available at the two Banner Health Northern Colorado hospitals are impressive. Greeley-based NCMC is the largest hospital in Northern Colorado with 378 licensed beds and, together with Loveland-based McKee with 115 beds and the soonto-open Banner Fort Collins Medical Center, expands the network to be a significant provider of healthcare services in our region. The three facilities and the ever-expanding network of Banner Medical Group physicians have broadened the Banner Health scope of care in our region. Rick Sutton, CEO of Banner Health Northern Colorado, in his letter to our Northern Colorado readership proudly announced that Healthgrades recognized both McKee and NCMC with five-star ratings and quality awards in a variety of clinical service lines. Both facilities were also included in its list of America’s 100 Best Hospitals and each was named a Distinguished Hospital for Clinical Excellence. He shared that the Banner Health partnership with Kaiser Permanente has been extended to 2022. In addition, both Aetna and Humana Inc. have announced agreements with Banner Network Colorado. These alliances are important to the overall healthcare coverage of our Northern Colorado residents in the face of a continually changing and confusing healthcare horizon. Sutton continues to reiterate his ongoing commitment to provide high-quality, efficient and cost-effective care as healthcare continues to change. With Sutton’s leadership and commitment to excellence, we can be confident in the quality of care we have from the physicians, healthcare professionals and hospitals of Banner Health Northern Colorado. Upon learning of the health system’s many advancements and expansion of healthcare services, several stood out as
making a significant difference in the lives of our residents. Our cover featuring Julie Johnson Haffner, McKee Medical Center Foundation Executive Director, and Chris Kiser, NCMC Foundation President, highlights an important public health project partnership designed to educate area residents on the dangers of sudden cardiac arrest, teaching citizens to recognize symptoms and learn how to administer CPR and use an AED. Be sure to read “Creating a Heart Safe Community” to fully understand and appreciate the importance of this initiative. When fully implemented, it could save thousands of lives. Another impressive addition to McKee Cancer Center is Jennifer Rubatt, M.D., FACOG, a gynecologic oncologist whose skills and extensive training provide patients greater care closer to home; she is the only gynecologic oncologist in Northern Colorado. Read “Gynecologic Oncology Options Grow at Banner” to learn about this unique specialty and approach to treating cancers that affect 95,000 women in the U.S., according to the American Cancer Society. Another important new technology in diagnosing lung disease and lung cancer opens up a whole new frontier in pulmonology. Be sure to read “Bronchoscopy: GPS for the Lungs” to learn about the electromagnetic navigational bronchoscope Dr. Rob Janata is using at NCMC to reduce diagnostic risks during procedures. We hope you find the articles in this issue interesting and informative about new technology, innovation and patient care at the Banner Health Northern Colorado facilities. We thank the management team, physicians and health professionals for their contributions to this annual issue. Wishing each of you good health in the New Year. Lydia@stylemedia.com
Lydia’s STYLE Magazine
Dear Northern Colorado Reader, It is a pleasure to make the 2015D Banner Edition available communityrmembers ear N ortherN Cto oloraDo eaDer,in Northern
Rick Sutton
Chief Executive Officer
Colorado in cooperation with Northern Medical & Wellness Magazine . Throughout this at AsColorado I approach my first anniversary as Chief Executive Officer issue, you will find informational articles about the innovation, patient care and technology that Banner McKee Medical Center, a Banner Health facility, I am honored to be Health provides to our Northern Colorado communities. associated with such an outstanding medical team, and to lead this I also want to reflect on recent highlights and share our plans for the months ahead as we begin a organization into the future. new year. We all are very aware that the health care environment we live in Banner Health operates North Colorado Medical Center (NCMC) in Greeley, the largest hospital is about to change dramatically. I assure you that the McKee team will in Northern Colorado with 378 licensed beds, and owns McKee Medical Center, a 115-bed hospital in meet that change, and continue to deliver high-quality, compassionate Loveland. Between these two facilities, the Banner Fort Collins Medical Center opening in the spring, health care to the people of Loveland and surrounding communities. our network of Banner Medical Group physicians and our relationships with independent physician McKee has been providing the Loveland community with health care practices throughout our local communities, Banner Health provides a full scope of health care services for the past 30 years. Many of you were born at McKee, and probably in Northern Colorado. more of yourating have agency received health at McKee over the past three Healthgrades®, a well-known independent that rankscare health care providers based decades. We have always been the community hospital for Loveland, on an analysis of publically-reported results data, recognized both McKee and NCMC with five-star and have established vital relationships with this community. ratings and quality awards in a variety of clinical service lines. The agency included both facilities in Yet,and we each recognize that asa the landscape changes, McKee. its list of America’s 100 Best Hospitals™ was named Distinguished Hospital so formust Clinical We have a world class team at McKee, and we are prepared to move Excellence. Patient satisfaction and patient safety were also recognized at high levels. forward. Be assured yourwithin hospital provides excellent care in all Banner Health recognizes hospitals and physician clinics theteam system each year by presenting of the health care continuum. We have made, and will continue “Banner’s Best of the Best” Awardsaspects for exceptional performance. to make, strategic decisions that will (Banner move us Medical into the Groupfuture, and put Both McKee Medical Center and Pediatrics at Banner Health Clinic hospital in amaking position of continued strength. Greeley) received “Banner’s Best ofyour the hometown Best” Awards in 2014, it six out of seven years that compiled five priorities that everyone at McKee has either McKee or NCMC have receivedWe thishave honor. committed work Fort toward, withMedical the outcome increased Excitement continues to grow about the newtoBanner Collins Center of scheduled to quality care andacute-care a wonderful hospital at beds, the core. The five areas open April 6, 2015. It will be a full-service, facility with experience 22 in-patient medical imaging, are: Employee Engagement, Patient Satisfaction, Quality Outcomes, surgical care, women’s services, laboratory, emergency services and critical care. The campus also will Friendly and Financial Strength. include a Banner Health Center forPhysician medical specialists. You will be invited to tour the new facility are committed to ensuring that all staff at McKee are highly during public events scheduled near theWe opening date. engaged, determined and committed give you 2013 the best possible. The Banner Health Center on Drake Road in Fort Collins opened in to September andcare continues Weofbelieve thatclinic having highly engagedthe staff resultsfloor, in the ability to to grow. We recently doubled the size the inside space by finishing second adding provide higher care, lower productivity 8,000 thousand square feet, so we can continue toquality add physicians. Weturnover, continueincreased to focus on recruiting and more effective organization overall. physicians in all specialties to servearesidents throughout Northern Colorado. We$60 also are concentrating onPlan our project patientatsatisfaction to make We are entering the final stages of the million Master Campus NCMC. New laboratories have been completed and at NCMC and McKee. Thebest NCMC Institute youropened experience at McKee one of the in theCancer country. At McKee has launched a multimillion dollarwe expansion projectnationally and the hospital’s of an are compared to other kitchen hospitalsis in the the midst country, and are upgrade. A new inpatient pharmacy is also currently consistently placingunder in theconstruction. top one-third of all hospitals participating in The Banner Health partnershipthe withpatient Kaisersatisfaction Permanente has been extended to 2022. In addition survey. to Kaiser Permanente providers, Kaiser membersiswill todeliver have access to Banner OfPermanente utmost importance ourcontinue ability to quality health care, Health medical providers for both and primary and specialty care. They will also to receive hospital according to our metrics, you can becontinue assured that quality health care in Northern Colorado at NCMC, and, that whenyou it opens, Banner Collins Medical Center. care isMcKee something will receive at Fort our hospital. The Aetna organization announcedWe an Accountable Care collaboration with also ensure that our staff members areBanner highlyNetwork trained and that Colorado (BNC) in northern Colorado as well as the introduction of the Aetna Whole product we provide state-of-the-art technology so you receiveHealth the best health in Colorado effective Jan. 1, 2015. care Aetna Banner theMedical members inselected the market. YouNetwork deserve Colorado that, and to at serve McKee Center, of Aetna Whole Health in Larimerthat andisWeld arrangement between Aetna and BNC is whatcounties. you will The experience. designed to enhance care and control costs through an emphasis wellness and close of to We also continue to workonhand-in-hand with coordination our physicians care for members. ensure they are pleased with the care their patients are receiving. We are Humana Inc. also announced amaking new Accountable Care agreement with Banner Network sure that all necessary equipment and supplies areColorado available to covering individuals and families purchasing insurance Weldcare andto Larimer counties through Connect them as they provide in health this community. for Health Colorado and through Humana commercial maintenance organization McKee continues health to be financially strong due to the(HMO) support of the health plans for small employers. The arrangement will offer more personalized care and wellness community, physicians, and staff, and we’re well prepared to grow with programs focusing on individual preventive care, chronic and disease management. this community in the conditions future. The entire Banner health care team It in northern Colorado to focus onhospital our fiveisbasic boils down to this:continues Your community a physician priorities: Employee Engagement, friendly Patient Satisfaction, Quality Healthcare, Physician Friendly Service facility, employing highly engaged staff members that provide and Financial Strength. We appreciate the opportunity to serve yourcare health careand needs and are the highest level of quality health to you your family. committed to providing high-quality, efficient and cost-effective care for you, your family and your We will always strive to ensure that you will not have a better health friends. care experience than the one you will have at McKee. Quality health We are truly excited about the facilities and services available to you through Banner Health care at your hometown hospital – that’s what we’re all about. Northern Colorado. We look forward to the new relationships we will develop with patients and businesses in 2015.
Rick Sutton, MS, FACHE Chief Executive Officer McKee Medical Center
Sincerely, May God bless you, the United States military and the United States of America. Sincerely,
Rick Sutton Sutton, Chief Rick Executive Officer Executive McKeeChief Medical Center Officer
Banner Health Northern Colorado
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Rick Sutton, CEO of Banner Health Northern Colorado
sutton to head three northern colorado
banner health hospitals By Angeline Grenz
Rick Sutton has that Southern charm, the type where you can imagine him issuing a directive in the politest of terms with his friendly smile. And, well, you just want to listen to him.
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While that easy manner makes for a pleasant work environment, Sutton isn’t counting on charm to create a successful medical system in Northern Colorado, especially not with two—soon to be three—hospitals under his purview. Rather, he relies on his management team and a system of consistency that dominates processes throughout Banner Health in Northern Colorado. “I manage with a great team,” says Sutton. “We huddle every day and we have laid out the strategy pretty clearly, so everyone understands which direction we are going. I think that when you have a clear vision of where the organization is going, decision-making is much easier.” The “huddle” Sutton is referring to is a daily morning teleconference with his team of key leaders from the hospitals and Banner Medical Group to discuss variations from their established protocol and where unexpected challenges come
up. “One thing we have really done in Northern Colorado is to create a team that has limited variation within the system. When you limit variation, so many decisions have already been made, so we just have to execute. In this manner, we manage by exception.” Banner Health restructured its Northern Colorado operations in October 2013, when Sutton was named CEO of Banner Health Northern Colorado, managing both the North Colorado Medical Center (NCMC) and McKee Medical Center—and soon Banner Fort Collins Medical Center. Each of the respective hospitals has its own chief operations officer: Wendy Sparks at NCMC, Michelle Joy at McKee and John D’Angelo at Banner Fort Collins. The restructure was founded on regionalizing processes and procedures throughout the Banner system. “Since then we have worked hard to create open communication and break down
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barriers affecting performance. We sink or swim together as a team, and this attitude allows us to move forward,” says Sutton. “There is no paralysis by analysis.” Decreasing variation and increasing reliability have been the hallmarks of Sutton’s efforts since 2013, and have led to a decrease in the likelihood of errors or mistakes by creating regionalization of processes and policies. “Which means we can focus on treating patients and running hospitals.” Throughout last year and into 2015, Sutton says they will continue to focus on these directives. “We have knocked the easy things out,” he says. But streamlining will continue until it has enveloped all departments and systems throughout the Banner Northern Colorado health system—even down to the equipment, says Sutton. Think about the need to cover a shift, he adds, where a specialist may go from one hospital to another to help out. With standard protocols, policies and even equipment, Banner providers will be able to help out wherever they are needed, “and not miss a beat.” In addition to providing better care overall, says Sutton, this philosophy increases efficiency and saves money. The efforts continue to yield results. Consider some of the awards taken home by NCMC, McKee and the Banner Medical Group: • The Joint Commission, responsible for accreditation of healthcare organizations in the U.S, recently recognized McKee Medical Center and NCMC as 2013 Top Performers on Key Quality Measures. The recognition focuses on clinical quality and patient safety. They were among nine Banner Health hospitals nationwide to receive the recognition. • The Leapfrog Group, an independent industry watchdog that grades hospitals on patient safety, gave both NCMC and McKee “A” grades for the second year in a row. • McKee Medical Center and Greeley’s Banner Health Clinic specializing in Pediatrics both received Banner’s Best of the Best award for consistent, overall high performance. • McKee was recognized for its patient experience in April by receiving Healthgrades’ 2014 Outstanding Patient Experience Award, putting the hospital in the top 15 percent of the 3,000 hospitals eligible for the award. • McKee and NCMC were named two of Healthgrades’ America’s 100 Best Hospitals™ in 2014, placing them in the top 2 percent of all hospitals in the U.S. • The hospitals were also awarded these Healthgrades honors in 2014: Distinguished Hospital Award for Clinical Excellence, 2014 Critical Care Excellence Award and the 2014 Pulmonary Care Excellence Award. But beyond 2014’s recognitions, Sutton points out that both NCMC and McKee have consistently displayed a high level of quality by being recognized as Banner’s Best of the Best hospitals in the last six out of seven years. And Banner Health, on a
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national scale, has been repeatedly recognized for its accomplishments. “Banner Health has been named a top health system by Truven Health Analytics in three of the last five years,” he adds. The opening of the Banner Fort Collins Medical Center is slated for early April 2015. The new hospital is being built from the ground up to mirror the high quality and standards of its two Banner predecessors. A brand new hospital provides the ability to implement tried and true processes on a completely clean slate. Beyond the construction of the Fort Collins hospital, Banner has been busy in Northern Colorado. NCMC is in the midst of a $60 million master campus plan that will continue through 2015. McKee will complete a number of construction projects in 2015, including a lab project and other infrastructure improvements. And the Banner Medical Group of clinics has been expanding both in locations and providers. In fact, the Banner Medical Group currently has 32 physician openings and Banner is committed to add new clinics throughout the region as the need arises. As a former military man, the sort of precision needed to successfully run multiple hospitals and grow a large group of medical clinics isn’t completely foreign to Sutton. But while he focuses his team hard on patient outcomes, he always remembers that there are people behind the numbers. “When you deliver these kinds of outcomes you are changing people’s lives. The community is counting on that, and it takes an army of people to achieve these outcomes, but the outcomes are always important to somebody. When we hear that we did a great job—that makes me happy.”
Angeline Grenz is managing editor for Northern Colorado Medical & Wellness.
a little about rick Sutton is married to Bonnie and they have two grown children, Andy and Ben. Andy is currently in medical school and Ben is at the University of Northern Colorado. Rick met his wife while attending college at Ole Miss. HIs first CEO position was at a Banner facility in Ogallala, Nebraska. From there, he transferred to a Banner facility in Phoenix before landing in Northern Colorado. The Suttons love the outdoor life and spend as much of their free time as they can in Alaska hunting and fishing. When Rick Sutton migrated to Colorado in 2005, he made a commitment to live in the town where he works. When he was CEO of McKee, he lived in Loveland. When he was CEO of NCMC, he lived in Greeley. Later, when he became CEO of multiple hospitals, Sutton relocated to Windsor to be within an easy commute to any of the hospitals under his purview. “It has always been a priority to live in the town where I work… now I can get to any of the three hospitals pretty easily.”
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MEDICAL
ONCOLOGY
Dr. Jennifer Rubatt, Gynecologic Oncologist at McKee Cancer Center
gynecologic oncology options
grow at banner By Kay Rios
With the newest addition to its medical staff, Banner Medical Group is now offering increased options for women in Northern Colorado. Jennifer Rubatt, M.D., FACOG, is a gynecologic oncologist who began working at the McKee Cancer Center in October. Her unique specialty will allow women with gynecological cancer to receive care closer to home rather than traveling to Denver. There are additional benefits, Dr. Rubatt says. “We’re the only cancer-related surgeons who do our own chemotherapy. With breast, colon and many other cancers, surgical and chemotherapy treatment are separate. It makes my specialty unique and that’s why I treasure it. I don’t think that will ever be the case in other cancer areas because treatment regimens continue to change and grow. And because it’s very difficult to keep up with all that information, it falls to the oncologist
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and not the surgeon. In my area, we have a focused disease set of gynecological cancers and that makes it easier to keep up to date on standards of care.” Dr. Rubatt encourages women to pay attention to signs that may indicate gynecologic cancer. The American Cancer Society estimates that close to 95,000 women in the U.S. will be diagnosed with cancers of the female reproductive organs this year and over 28,000 women will die in 2014 from gynecological
cancers. Five main types of cancer affect a woman’s reproductive organs: cervical, ovarian, uterine, vaginal and vulvar. Signs and symptoms are different for everyone and each one has its own indicators. Screening and regularly conducted self-examinations can result in the detection of certain types of gynecologic cancers in their earlier stages, when treatment is more likely to be successful and a complete cure is a possibility. Dr. Rubatt’s training began with a bachelor of science in genetics and zoology from the University of Wisconsin-Madison. She received her medical degree from the Medical College of Wisconsin and followed that with a fouryear residency in obstetrics and gynecology at the Medical College of Virginia in Richmond. After this, she devoted herself completely to gynecologic cancer with a two-year ovarian cancer research fellowship at Duke University followed by a three-year fellowship at Magee Women’s Hospital in Pittsburgh. There she received her subspecialty training, including rigorous and comprehensive surgical training in gynecologic oncology, which included learning
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the da Vinci Robotic platform. “I had always wanted to do something surgically oriented. I really liked my surgical clerkships but the patient relationships weren’t what I wanted,” she says. “I wanted to be close to my patients and be more directly connected. That’s when I got interested in obstetrics and gynecology. I could follow patients throughout their lives. Once I was in training for that, I also found that working with cancer patients was greatly rewarding. They have incredible emotional and physical needs. It was a good fit for me as a provider.” She joined Cancer Centers of North Carolina, a private practice in Raleigh, North Carolina, and was affiliated with them for three years. This opportunity allowed Dr. Rubatt to develop her own patient style and focus on community-based practice. “I am very patientcentered in my care and I want to work with the patient every step of the way. I want to teach them about diagnostic and treatment plans and follow them through their treatment plans.” She was then hired by Banner to come to McKee Medical Center. “I felt this would be a good opportunity to start a practice. This is a newer field in Northern Colorado and, because the population in this area is growing, I felt it was a good opportunity to provide care.” Her specialty offers her everything she was looking for in a career, she says. “I love surgery but I also like the patient relationship I get in the office. I chose this specialty because you are the captain of the ship and can help direct the patient into treatment plans that make sense for them, even if that means palliative care.” Dr. Rubatt says most of her surgeries are robotic, using the da Vinci platform. “I use that because it’s so beneficial for the patient. There’s less discomfort, less blood loss and a shorter patient stay. The 3D vision of the robotic platform is especially important when I am doing a lymph node dissection. It helps the view and leads to a better surgical outcome for the patient.” She’s happy to be part of the Banner system, but is also excited about building relationships with other practitioners in the area, she says. “There’s a great patient base and referral system here and that’s very important. We want to work closely with all the physicians in Northern Colorado so that our patients receive coordinated care every step of the way. It’s especially helpful for the patient because it helps them start the process of coping.” There’s another benefit to being in the Banner system. “I am not a business person so I can be a gynecologic oncologist delivering high quality evidence-based medicine. I can focus on the patient primarily and on business second.”
Kay Rios is a freelance writer based in Fort Collins.
Northern Colorado Medical & Wellness 2015
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Specialty Focus Aids in Diagnosis and Treatment Options By Kay Rios Ovarian cancer causes more deaths than any other cancer of the female reproductive system and is more difficult to diagnose in earlier stages, according to Banner’s gynecologic oncologist Jennifer Rubatt, M.D. Ovarian cancer begins in the ovaries and there are many theories about its causes. Some of them are based on things that alter the risk. For example, pregnancy and birth control pills both lower the risk of ovarian cancer. Since both reduce the number of times the ovary releases an egg during ovulation, some researchers believe there may be some
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relationship between ovulation and the risk of developing ovarian cancer. Tubal ligation and hysterectomy also lower the risk of ovarian cancer. One possible explanation is that some cancer-causing substances may enter the body through the vagina, passing through the uterus and fallopian tubes to reach the ovaries. So, removing the uterus or blocking the fallopian tubes affects the risk. About 20 percent of ovarian cancers are found at an early stage. When ovarian cancer is found early at a localized stage, about 94 percent of patients live longer than five years after being diagnosed. “Early diagnosis is difficult because symptoms are very vague,” Dr. Rubatt says. “It is usually diagnosed in stage three or higher. There can be pressure or a feeling of fullness in the pelvic area, abdominal bloating and feeling full more quickly at meals. Changes in normal bowel or bladder patterns can also be a symptom. These are all GI symptoms and the patient will usually see a gastroenterologist initially.” No effective screening exists for ovarian cancer, Dr. Rubatt says. “Combining blood tests with ultrasound has been tried but it didn’t indicate the existence of cancer at an earlier stage, so it didn’t affect our ability to cure it. As the patients’ symptoms progress, an ultrasound or a CT scan will be done and then we can see fluid or a mass in the belly.” Ovarian cancers have different prognoses at different stages and are treated differently, and, according to the American Cancer Society, being operated on by a gynecologic oncologist more likely assures accurate staging, the process of determining
the severity of the cancer and whether it has spread. During the surgery, tissue samples are gathered from different parts of the pelvis and abdomen and examined under the microscope. Treatments for ovarian cancer include surgery, chemotherapy, hormone therapy, targeted therapy (described by the National Cancer Institute as treatments that interfere with “specific molecules that are involved in the growth, progression and spread of cancer”) and radiation. There are screening tests for other gynecological cancers. For example, cervical cancer can be detected with repetitive pap smears. But it all starts with a gynecological exam, Dr. Rubatt says. “Even if you’ve reached 65 and have had negative pap smears all your life, you still need an annual and a pelvic exam because there are other things that can occur and there’s a higher incidence as you age because of menopausal changes. Drying skin of the vulva and other areas can cause benign disease that can be treated. Also, the incidence of vulvar cancer goes up after age 70. It’s rare but it’s like skin cancer on the external genitals and even if it’s small, it can be detected during a pelvic exam. “The one message I would like to get out is that if you are a women, even if you had a physical, you need to see a gynecologist and have a pelvic exam yearly. Along with that,” Dr. Rubatt says, “my advice is to eat healthy, exercise and don’t smoke.”
Kay Rios is a freelance writer based in Fort Collins.
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2015
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MEDICAL
COMMUNITY OUTREACH
creating a
Tim Zimmerman, paramedic with Thompson Valley EMS, has worked closely with McKee Medical Center Foundation to place AEDs in schools throughout the Loveland community.
heart safe community By Kay Rios
When Thompson Valley High School freshman baseball player Tommy Lucero collapsed in the outfield last spring, his teammates immediately knew something was wrong. They called for help, and two coaches came running. Jay Denning called 911 and directed someone to retrieve the automated external defibrillator (AED) inside the school. Chad Raabe, a former EMT, checked Lucero’s vital signs and found no pulse or respiration, then started cardiopulmonary resuscitation (CPR). Raabe spoke with the emergency dispatcher and did compressions on the 14-year-old for four to six minutes, never getting a pulse. Meanwhile, the AED, kept in the school building a few
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hundred yards away, was still being retrieved. The ambulance arrived, took over treatment, and transported Tommy to McKee Medical Center in Loveland, where he was treated and stabilized, then airlifted to Children’s Hospital in Denver. There, he had open heart surgery a week later to correct a previously undiagnosed birth defect. Last summer, one of Vergent Products’ 100 employees collapsed at work. While there was
not an AED available on site at the time, a member of the company’s safety committee, team members who are trained in emergency and first aid care, performed CPR until paramedics arrived. The employee later had surgery. Both were extremely lucky. In each case, without someone close by who had been trained and knew what to do immediately, these incidents would have been fatal. Instead, Lucero returned to school, played baseball over the summer, and was part of the TVHS golf team this past fall, and Vergent welcomed back their colleague after a short recovery. Those are just two reasons why Tommy’s parents, Tom Lucero and Julie Kruit, and Vergent Products Owner and VP of Client Engagement, Diana Precht, are enthusiastic supporters and participants in the McKee Medical Center Foundation’s initiative to designate Loveland
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Left: Tommy Lucero, center, with his parents Tom Lucero and Julie Kruit. Right: Diana Precht, one of the owners of Vergent Products in Loveland, and Tracy Ireland, the employee who performed CPR on his co-worker.
and surrounding areas a Heart Safe Community. “Tommy is stronger than ever, and it is all because his coaches knew what to do,” says his father. Precht notes, “We’re grateful to have our team member back, and that we have people on our team who are trained and prepared to deal with a cardiac emergency.” This public health project is a partnership of the McKee Medical Center Foundation, McKee Medical Center, CardioVascular Institute of North Colorado, Loveland Fire Rescue Authority, Thompson Valley EMS, Loveland Police Department, Loveland Emergency Communications and Thompson School District. It follows in the footsteps of the NCMC Foundation’s work to earn the American Heart Association’s designation of Greeley as a Heart Safe City. The City of Greeley was designated as an official “Heart Safe City” in 2013 by the American Heart Association. The award represents a partnership between the City of Greeley, Banner North Colorado Paramedic Services, the Greeley Fire Department, NCMC’s CardioVascular Institute, the NCMC Foundation and numerous philanthropic donors. The Heart Safe City initiative in Greeley included placement of AEDs in every school and public gathering place throughout the city, including the airport, shopping centers, swimming pools, theaters, police cars, museums and other high-use areas. According to NCMC Foundation President Chris Kiser, “Over $100,000 was raised through a grass roots, community-wide fundraising effort sponsored by the NCMC Foundation to make sure that an AED is readily available.” The program also provided certified CPR training to 238 city employees and also funded free, non-certified
Northern Colorado Medical & Wellness 2015
CPR training to area residents. Greeley was the second city in Colorado to receive the designation. In the Loveland area, the initiative focuses on the footprint of the Thompson Valley Health Services District (which roughly matches the area of the Thompson School District), which includes 450 square miles and more than 100,000 people. This community-wide effort will educate area residents on the dangers of sudden cardiac arrest (SCA). That includes teaching citizens to recognize symptoms and learn how to administer CPR and use an AED. The end goal is to improve survival rates from SCA, a leading cause of death in the U.S. More than 400,000 people suffer SCA outside of a hospital setting, with 88 percent occurring at home. Less than a third of SCA victims receive CPR immediately from bystanders. Most do not survive, and more than 325,000 lives are lost each year. “The Heart Safe Community initiative is all about meeting a critical public need,” says Julie Johnson Haffner, executive director of the McKee Medical Center Foundation. “When someone’s heart stops beating, the best chance that individual has to survive is for bystanders to call 911, administer CPR and shock the heart into a normal rhythm with an automated external defibrillator.” Once the heart stops, brain death begins to occur in just 4 to 6 minutes. Chances of survival are reduced by 7 to 10 percent with every minute that passes without CPR and the use of an AED. Current survival rates are around 8 percent. If more people were educated in CPR, and AEDs were more widely available in our community, survival rates could be as high as 50 percent. Seattle’s Heart Safe City program raised survival rates to
more than 60 percent. Public CPR classes are planned, both in-depth Heart Saver courses where participants receive certification, as well as shorter refresher courses. The goal is to train 500 community residents in CPR and AED usage. “We want to train people just like you to respond quickly and save someone’s life,” says Haffner. “Most people don’t survive cardiac arrest, and an immediate response can make all the difference. The life you save is likely to be a loved one.” There have typically been six CPR training courses a year provided by Thompson Valley EMS. In 2015, the goal is to conduct 12 courses, and cover the $25 per student cost with funds raised so the course is free for attendees. “Having an AED available is great, but when you know CPR, you take that knowledge with you everywhere you go,” says Mark Turner, Training Captain for Thompson Valley Medical Services. “You can treat someone immediately, without an AED, and save a life.” The initiative also calls for the placement of AEDs in public gathering spots throughout the city of Loveland in places like shopping malls, swimming pools, schools, grocery stores, theaters, museums, golf courses and police cars. These devices are designed to be easy to use, are equipped with simple step-by-step user instructions, and will be maintained by Thompson Valley EMS. AEDS in the community will also be tracked and logged, and emergency dispatchers can inform those who make a 911 call if there is an AED nearby they can use. The Foundation has already donated 32 AEDs, which cost approximately $1,800 each, to the Thompson School District, ensuring that every
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school building, athletic field and swimming pool has one. Schools can’t use state funds to acquire AEDs, and rely on philanthropic gifts to get them. “In Tommy’s case two things were clear,” says Tom Lucero. “First, the coaches knew what to do, which is why Tommy is alive today. Second, the AED was too far away. For every other parent, every other student, everyone in this community, the importance to me of putting as many AEDs as possible out there, and training as many people as possible in CPR and AED use is, literally, a life-or-death issue.” The partnership plans to assist non-profit entities in purchasing AEDs, and will coordinate the purchase and installation of the devices for interested private businesses. Fundraising efforts are ongoing, with more than $200,000 raised through the McKee Classic Bike Tour, the Foundation’s Annual Gala, and Thanksgiving Day Turkey Trot run. Precht, who is also a member of the McKee Medical Center Foundation Board, emphasizes the need for CPR training and regular refresher courses. “Like anything, if you don’t use that knowledge and those skills—while we hope you never have to—it’s important to refresh and renew them, and increase your comfort level if you ever need them.” If you would like to contribute to the Loveland-area Heart Safe Community Program, please contact the McKee Medical Center Foundation at (970) 635-4001. The McKee Foundation will post upcoming CPR training class schedules at www.mckeefoundation.com, and publicize them throughout the community. Courses will also be listed with the American Heart Association at www.heart.org, where you will also find online courses and demonstration videos on how to save a life. Thompson Valley EMS asks that any organization in the community that has an AED device on the premises to contact Paramedic Tim Zimmerman at (970) 775-7126. Thompson Valley EMS will add the location of the device into its database and will conduct regular checks to ensure the device is functioning properly. Brad Shannon is a freelance writer based in Loveland.
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What is an AED? An automated external defibrillator (AED) is a lightweight, portable device that delivers an electric shock through the chest to the heart. The shock can stop an irregular rhythm and allow a normal rhythm to resume in a heart in sudden cardiac arrest (SCA). Most sudden cardiac arrests result from ventricular fibrillation: a rapid, unsynchronized heart rhythm starting in the heart’s lower pumping chambers (the ventricles). The heart must be “defibrillated” quickly, because a victim’s chance of surviving drops by 7 to 10 percent for every minute a normal heartbeat isn’t restored. With training, it is safe and easy for non-medical personnel to use an AED. A built-in computer checks a victim’s heart rhythm through adhesive electrodes and calculates whether defibrillation is needed. If it is, the device lets the user know to press the shock button.
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MEDICAL
INNOVATION
Dr. Rob Janata, Pulmonologist and Critical Care Physician, North Colorado Medical Center
bronchoscopy:
GPS for the lungs By Michelle Venus
Treating the lungs is tricky business. Dr. Rob Janata, pulmonologist and critical care physician with North Colorado Medical Center (NCMC) in Greeley, knows this only too well. The delicate organ carries oxygen throughout the body via the bloodstream and releases carbon dioxide into the air on exhale.
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In order to do this effectively, the lungs are composed of an intricate system of tissue and membranes (the bronchi and the bronchioles) that form—for lack of a better term—branches, much like those of a tree, that stretch throughout the lung’s twin lobes. The surface area of these branches would cover about half a tennis court (1,076.3 square feet) if they were stretched out flat. It’s those branches and the twigs that stem off that make working on lungs so tricky. If a lesion is discovered on the outer periphery of the lung,
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where the twigs are minute and meandering, it can be difficult to access the lesion to biopsy the tissue and get an accurate diagnosis. So how does your doctor get deep into the lung to the lesion? There was a time when the only way to reach a tumor was through a major surgical procedure which involved putting the patient under general anesthesia and cutting them open to access the mass. It’s an invasive procedure and increases the risk for complications. A less invasive procedure is the bronchoscopy, where physicians examine the major air passages of the lungs through a thin, lighted tube called a bronchoscope. Doctors use bronchoscopies to evaluate the lungs and collect small tissue samples to diagnose lung disease and lung cancer. Traditional bronchoscopy can’t reliably reach the outer recesses of the lungs, where nearly two-thirds of all lung lesions are found. But what if a technology existed that allowed the pulmonologist to maneuver through the maze of bronchi—more efficiently, less invasively and with less risk to the patient—to take a look at those hard-to-reach nodules that were once only reachable via a tough surgical procedure? It does exist. It’s called electromagnetic navigational bronchoscopy, and it’s changing the way Dr. Janata does his job. Recently NCMC acquired an electromagnetic navigational bronchoscope. This revolutionary equipment opens up a whole new frontier in pulmonology. “It’s like the GPS system in your car,” explains Dr. Janata. “First, we take a CT scan of the affected area. Then we create a virtual three-dimensional roadmap with proprietary software that guides us through the branches of the lung, directly to the lesion.” A tiny, flexible catheter, outfitted with specific instruments, makes its way through the bronchoscope—which, due to its size, can only go so far into the lung— and then through the maze of bronchioles to the lesion where it then collects tissue to be biopsied. The pulmonologist can leave markers for the surgeon, which helps to minimize how much of the lung needs to be cut out when the mass is removed. Electromagnetic bronchoscopy is an outpatient procedure; typically the patient goes home later that day, often only with a scratchy and sore throat due to the insertion of the bronchoscope. “We’ve had this system in place for about three months,” says Dr. Janata. “And already we’ve used the procedure on eight patients. Navigational bronchoscopy helps reduce problems such as pneumothorax, when the lung collapses because it’s been punctured. It loses air, just like a balloon. This procedure—while still invasive, just less so—reduces the risk, which is very good for our patients. Very, very good.” GPS for the lungs. It’s cutting edge innovation that’s right here in Northern Colorado. And it can make a huge difference for patients facing a potentially serious disease.
Michelle Venus is a freelance writer based in Fort Collins.
Northern Colorado Medical & Wellness 2015
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MEDICAL
LUNG CANCER
lung cancer
411
By Michelle Venus
More people die every year from lung cancer than from the combined number of breast, colon and prostate cancer deaths. According to the American Cancer Society’s estimates for 2014, more than 220,000 new lung cancer cases will have been diagnosed nationwide with an expected 159,260 deaths due to the disease. The report estimates that approximately 2,540 Coloradans will have received a lung cancer diagnosis. Compared to California, Florida and Texas, whose respective diagnosis estimates are 18,780, 17,960 and 14,980, Colorado’s numbers look pretty good. But for 2,540 families, that number is way too high. The good news is that lung cancer is preventable. The easiest way to not get it is to never smoke. About 90 percent of lung cancers are a direct result of tobacco use. For those people who smoke two or more packs of cigarettes per day, one in seven will die of lung cancer. Other causes of lung cancer include passive smoking (the inhalation of tobacco smoke from sharing living or working space with smokers), and exposure to asbestos fibers and to radon, a chemically inert gas that is a natural decay product of uranium in the soil. Radon can seep into a home through cracks in the foundation,
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and while the gas is found everywhere, Colorado has higher concentrations than other parts of the country. You can have your home tested for radon, and if the results show unsafe levels, a mitigation system can be installed that will vent the gas out of your home, considerably lessening the risk to you and your family. Early stage lung cancer does not typically present with symptoms. When symptoms do appear, they are usually due to blocked breathing passages or the spread of cancer further into the lung or the cancer has metastasized to other parts of the body.
Lung cancer symptoms may include: •
Chronic, hacking, raspy coughing— sometimes with bloody mucus
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Recurring respiratory infections, including bronchitis or pneumonia
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Increasing shortness of breath, wheezing or persistent chest pain
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Hoarseness
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Swelling in the face and neck
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Pain and weakness in the shoulder, arm or hand
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Fatigue, weakness, loss of weight and appetite, intermittent fever, severe headaches and body pain
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Difficulty swallowing
If you are experiencing any of these symptoms for an extended period, it is best to seek the advice of your physician who can rule out other causes. He or she can refer you to a pulmonologist or other specialist if that is determined to be the next best step in your care and treatment. Banner Health currently offers annual low-dose CT lung screenings at an out-of-pocket cost of only $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 (844) 217-7843. Michelle Venus is a freelance writer based in Fort Collins.
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Northern Colorado Medical & Wellness 2015
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MEDICAL
PROSTATE HEALTH
Dr. David Ritsema, Urologist, Banner Health Clinic
treating an
enlarged prostate By Brad Shannon
If you are or know a man of a certain age, you no doubt have seen information about the challenges that can occur with aging male anatomy. One prime concern is prostate cancer; but the prostate can also have other, non-cancerous problems that can be concerning.
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One such condition is benign prostatic hyperplasia, or an enlarged prostate. As men age, many develop this condition, which is the enlargement of the prostate gland. As the prostate grows, it begins to squeeze the urethra, which can cause a variety of problems. Dr. David Ritsema, urologist with the Banner Health Clinic, notes that the condition appears earlier and more often than you might think. “It’s fairly common. We typically see patients beginning in their 50s, and the incidence increases with age. A rough guideline is that BPH occurs in about 10 percent more men with each decade. So, 50 percent of men in their 50s have prostate enlargement, 60 percent of men in their 60s and so on.” Symptoms Ritsema describes are obstruction—when urinating, men will experience a weak stream, they will have to go more often, they will not be able to fully empty their bladder. “The stream will start and stop, they may have to go more often, particularly in the middle of the night, and they may feel they have to push or strain to urinate.” In the worst cases, patients are unable to urinate at all, and must have a catheter put in place. The natural process of the prostate gland enlarging is a bit of a mystery. “We’re not completely certain why it happens in some men, and not in others. We know that hormones affect the prostate, along with other
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molecules, like growth factors, which also have an impact. There is a hereditary component. Development of symptoms is also tied in some way to the smooth muscle in the prostate.” Unfortunately, Dr. Ritsema notes, there are no reliable ways to avoid benign prostatic hyperplasia at this time. “It can be hereditary, and you can’t alter that. No studies to date have shown any effect on the condition from diet, exercise, and there is only a possible benefit from physical activity and lack of obesity.” If you suspect you may have an enlarged prostate, Ritsema says to be sure and see your doctor. “One big concern is to figure out if your symptoms are from prostate enlargement or prostate cancer. Your doctor will review your medical history, and may want to have you complete a thorough physical exam. You may need to have a PSA (Prostate-Specific Antigen) test, and there are other options of tests and studies we can perform if they are indicated.” If you have an enlarged prostate, what are your treatment options? There are a few, says Dr. Ritsema, and his first approach is, of course, the conservative option. “I ask that patients void on a schedule, be certain they empty completely each time, and reduce fluid intake at night. We also look at a couple of classes of medications.” Alpha blockers help relax the muscle within the prostate to open the channel and allow lessrestricted flow. Drugs called 5 alpha reductase inhibitors shrink the prostate. In combination, or alone, these medicines help patients have a better stream and empty more completely. “There are several medicines in each of those classes, and we can try them individually and in combinations and monitor symptoms.” The next option is to consider minimally invasive procedures where the inside of the prostate is opened up. “For those experiencing urinary retention, bladder stones, urinary tract infections or blood in the urine, and where medications are not working, we may need to do an operation,” Ritsema notes. With microwave and thermal ablative therapy, which are in-office procedures, the physician places a catheter or moves a small camera through the urethra. Heat is administered through the catheter for microwave therapy and via needles for transurethral needle ablation. These treatments heat and kill prostate cells, causing the treated area of the prostate to shrink. Two different laser procedures are also available. Laser ablation vaporizes tissue from the urethra outward. Holmium laser enucleation works around the periphery of the prostate and separates overgrown tissue from the capsule of the prostate. Once it is separated, it is removed. Before multiple medications and other surgical options were available, the most common prostate operation on men in the U.S. was transurethral resection of the prostate (TURP). This is still considered the gold standard surgical treatment for an enlarged prostate. It also uses a camera inserted into the urethra, and the surgeon carves out the inner portion of the prostate using an electric loop that removes
Northern Colorado Medical & Wellness 2015
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small strips of tissue and cauterizes the wound simultaneously. In some cases the prostate is too large to remove through the urethra. If that is the case, the overgrown prostate tissue can be removed through an incision in the lower abdomen. During this procedure the prostate capsule is spared, in contrast to removal of the prostate for prostate cancer, where the entire prostate is removed. As with any medical procedure, each of these treatment options has its advantages and risks. “Meds can have side effects, and a common one with alpha blockers is light headedness. Otherwise, they are minimal. The main advantage with pharmaceuticals is you can stop taking them if there are side effects. Alpha blockers work within several days, and many patients notice a significant difference. Five-alpha reductase inhibitors are slower acting, and can take three to six months to have an effect. “Operations, of course, are not reversible,” he continues. “You can’t go back to where you were before. The main side effects include the chance of bleeding, infection and, while fairly rare, tissue can grow back or scar in a way that makes it more difficult to urinate.” Dr. Ritsema reports that minimally invasive office procedures take 30 to 60 minutes, require the patient to use a catheter for one or more days, and generally have minor discomfort. For the TURP procedure, most experience mild discomfort and have a catheter overnight. There is an immediate improvement in the urine stream, and mild discomfort during a few weeks of healing. “For those who have the TURP procedure, 85 to 90 percent do much better almost immediately. The effects last 10 to 15 years, so for younger patients, we may have to revisit things down the road if they start having trouble again.” “It’s gratifying to help any patient improve, but it is especially rewarding to see those who make the greatest turnaround. They go from retention—not being able to urinate at all, and having to wear a catheter—to a post-operative state free from the catheter. That is some of the most satisfying work we do.” Dr. David Ritsema offers services at McKee Medical Center and North Colorado Medical Center, as well as Loveland’s Skyline Medical Center. He’s been practicing in Colorado for just over two years, after completing medical school at Vanderbilt University and residency at the University of Arizona. He and his fellow physicians at Banner Health Clinic, specializing in urology, treat urologic cancer, including cancer of the kidney, bladder and prostate, along with penile and testicular cancer. They also treat kidney stones, perform vasectomies, address urinary issues including incontinence, and overall reproductive health issues, including testicular and fertility problems.
Brad Shannon is a freelance writer based in Loveland.
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Lydia’s STYLE Magazine
MEDICAL
VENOUS DISEASE
venous issues impact millions
banner health can help By Kyle Eustice
Look down at your leg. Notice the many miniscule blue veins connecting to one another throughout your entire body, delivering blood back to your heart and lungs.
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Now imagine if those same veins were causing extreme discomfort, swelling or even incapacitating pain. As many as 8 million people in the United States are diagnosed with venous disease every year, which is eight times more common than peripheral arterial disease—a condition that often gets much more attention in the media. And venous disease can be much more difficult to treat. People can experience venous disease problems at any age. Some venous diseases are hereditary and can even strike children. As a general surgeon, Thomas M. Blomquist, PhD, M.D., FACS of Banner Health Clinic, specializing in general surgery, sees plenty of venous issues in the vascular system. He recognizes the importance of early detection. “Most people experience venous disease in their 20s and 30s,” Dr. Blomquist explains. “It is very common for women to experience lower extremity venous problems with pregnancy. However, men can also experience these problems at a young age. Typically, people will not seek care for these venous problems until later in life. It is not uncommon for patients to put off care of their venous disease until his or her 60s or 70s. However, sometimes the disease has progressed to the point where the care becomes quite difficult. Had they sought care earlier, their treatment could have been less intense and potentially
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“Typically, people will not seek care for these venous problems until later in life. Had they sought care earlier, their treatment could have been less intense and potentially more effective.” - Thomas M. Blomquist, M.D., Banner Health Clinic Dr. Thomas M. Blomquist, General Surgeon, Banner Health Clinic
more effective.” Venous disease is primarily a malfunction of valves in the veins. These valves assist blood moving from the feet back up to the heart. Unfortunately, because of genetics, smoking, pregnancy and other factors, the valves can fail. Veins are very thin-walled and distend easily like a cheap water balloon. When the valves fail, the veins distend because of the higher pressure and the result is varicose veins. The biggest problem with varicose veins is not the diameter of the vein, but the sluggish flow in the veins, which does not allow oxygenation of the tissues and removal of waste products to occur. Untreated, this leads to further damage of the veins and surrounding tissue. The severity of venous disease can range from mild to limbthreatening. The worse case scenario for varicose vein disease of the lower extremities is a deep tissue wound that will not heal despite heroic efforts. “Infections in the veins can lead to loss of life or limb,” Dr. Blomquist explains. “Blood clots from veins can be fatal. However, deep venous thrombosis (DVT) is not common from superficial visible veins of the lower extremities. These devastating blood clots come from deeper veins, most commonly of the legs and pelvis.” “Poor vein flow can cause ulcers in the skin and soft tissues of the leg that can be extraordinarily difficult to heal,” he adds. “Oftentimes, the consequences of vein disease are simply discoloration and pain or prominent veins or spider veins. The most common complaint that we see in our vein practice is pain and the second most common complaint is unsightly veins. The least common complaint that we see is veins that have ruptured and bled.” Treatment of varicose veins and vein disease is tailored to the severity of the disease and the cause of the disease. For example, severe disease that
Northern Colorado Medical & Wellness 2015
Dr. Kenneth Richards, Cardiac Surgeon, CardioVascular Institute of North Colorado
has resulted in tissue loss will require advanced wound care techniques to treat. Additionally, treatment of the abnormal veins would be ideal, but oftentimes cannot be accomplished because of a patient’s compromised health and other issues. Milder forms of the disease can be treated with catheter-based therapies, injection therapy and, in some instances, external laser therapy. Moderate lower extremity varicose vein disease is often treated with endovascular ablation of the offending veins. This can be coupled with injection therapy for improved cosmetic results. Sometimes surgical excision of affected vein segments is required. Linda Secord, a patient of Dr. Blomquist, suffered from blood clots and varicose veins. Dr. Blomquist was able to treat her condition with a relatively pain-free procedure called Endovenous Ablation Therapy. “My varicose veins were getting worse,” Secord recalls. “My primary doctor recommended Dr. Blomquist. He went over everything very clearly. My father had varicose veins and his were treated much differently. He had them stripped, which they don’t do anymore because it’s very painful. I went to Skyline Center for Health and had vein mapping, then went in and had the surgery in May 2014. I didn’t have any problems, besides trying to get on the elastic hose afterwards! I wore them for a couple of weeks and I’m fine. I don’t have any pain anymore. I would have it done again. The procedure wasn’t painful, which surprised me. I had a really good experience. I was very lucky.” “For patients who are not candidates for advanced intervention, we offer alternative methods of noninvasive treatment that can manage the symptoms of varicose vein disease,” Dr. Blomquist says. “At Banner Health Clinic, we provide catheterbased therapy, advanced wound care therapy and surgical vein excision. We work in collaboration with aesthetic clinics to provide the best possible
functional and cosmetic outcomes.” Cardiac surgeon Kenneth Richards, M.D., of the Cardiac, Thoracic and Vascular Surgery Clinic at the CardioVascular Institute of North Colorado in Greeley, offers many treatment options for his patients, including ablation. “We often do a laser ablation of the greater saphenous vein [the major vein of the leg and thigh],” Dr. Richards explains. “The reason that works is because it takes the pressure off the varicosity [enlarged veins] so they don’t swell as much. It gets rid of the heaviness in a patient’s legs. In addition, some people have restless leg syndrome and the laser ablation helps take care of that. We also do some cosmetic stuff. Our physician assistant, Todd Bruce, does a lot of therapy for the tiny spider veins, which can be unsightly. We can inject them with a drug called Polidocanol so the veins don’t have a purple tint. They are more cosmetically pleasing.” While the treatment of venous issues can be a tedious process, a qualified doctor can provide several options to take care of the discomfort associated with them. However, early detection is crucial. And certain self-care steps, which include wearing compression stockings to decrease swelling, staying active and losing weight, can often help stave off medical procedures and years of pain.
Kyle Eustice relocated to Fort Collins from her hometown of Omaha, Nebraska. After spending four years living in Santa Fe, New Mexico, she was anxious to return to the mountain region. She is a regular contributor to Thrasher Skateboarding Magazine, Wax Poetics, Bandwagon Magazine, Ghettoblaster, and many others.
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MEDICAL
BEHAVIORAL HEALTH
Renee Rogers, Clinical Manager for Behavioral Health Service, Banner Health Northern Colorado
behavioral health:
a priority at banner health By Heidi Kerr-Schlaefer
What comes to mind when you hear the words behavioral health? It’s a frequently misunderstood discipline, but the team at Banner Health hopes to clarify the subject for their patients. 42
The field of behavioral health incorporates both mental health and substance abuse treatment, and encompasses a wide variety of issues—issues that vary on the scale of severity. A person seeking behavior health services because of work stress or parenting stress may be lower on the scale, while thought disorders, addictions and severe depression are more complicated and rate higher on the continuum of severity. All of these issues are covered by the behavioral health team at Banner Health. Established within Banner Medical Group in January 2013, the team consists of a child and adolescent psychiatrist,
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psychiatric nurse practitioner, two licensed clinical social workers, four licensed professional counselors and one licensed marriage and family therapist. “Of that group, two clinicians are also certified addiction counselors. In addition, we are bringing on one additional psychiatrist in 2015,” says Renee Rogers, clinical manager for behavior health service at Banner Health and the teams’ marriage and family therapist. The integration of behavioral health into primary care is not yet standard within the healthcare industry. “Medical and behavior health are absolutely coming together more in our practice, but I would currently say nationwide we are the exception, not the rule,” says Rogers. “Banner Health started with an innovative idea and, as we have grown, we continue to see the benefits of the integration and now we ask the question, ‘Why wouldn’t you integrate into the medical setting?’” Imagine that someone comes in to see his or her primary care physician with complaints of a chronic stomachache. Rogers notes that all kinds of issues may be contributing factors to stomach pain and frequently the pain is exacerbated by the patient’s mental and behavioral health. For example, intense mental stress at work may be aggravating the stomach and causing the discomfort. “It’s not the best patient care to treat these things separately,” says Rogers. The nine behavioral health team providers travel between six Banner Health clinics around Northern Colorado. Banner Health physicians now have the ability to offer behavioral health services to a patient when they see fit, and their patient can see the behavioral health provider in the clinic with which the patient is already familiar. This continuity of care adds an additional level of comfort for the patient and, according to Rogers, actually increases first appointment show rates, meaning patients are more likely to show up for their first appointment. “Plus the doctor and behavioral health provider can easily collaborate if needed. This is another benefit for the patients,” says Rogers. There are different levels of collaboration between the behavioral health team and the various clinics where they work. At the six participating clinics the physicians have face-to-face access to the behavioral health providers who are working there on a particular day. In one of the clinics there are scheduled monthly consultation times between the behavioral health team and the physicians. In addition, any of the Banner Health doctors can reach out to the behavioral health team via email or phone, even if they aren’t practicing out of one of the clinics where the team is assigned. Banner Health’s behavioral health team works at clinics in Windsor, Johnstown, Fort
Northern Colorado Medical & Wellness 2015
“Medical and behavior health are absolutely coming together more in our practice, but I would currently say nationwide we are the exception, not the rule. Banner Health started with an innovative idea and, as we have grown, we continue to see the benefits of the integration and now we ask the question, ‘Why wouldn’t you?’” - Renee Rogers, Clinical Manager for Behavioral Health Service, Banner Health Northern Colorado
Collins, Greeley and Loveland. Within pediatrics, according to Rogers, therapy with children involves a lot more cooperation and conversation with the child’s family. Parents are often brought into the room with the child by the child therapist and child psychiatrist, and discussions are held with the entire family. “With kids you do a lot more play than you do talk,” says Rogers. “Even with young teenagers, very few just want to sit on the couch and chat with you. So the work with kids is oriented more towards their ability to engage with what we’re doing and do it in a way so that we don’t lose their interest.” When it comes to psychiatry, Rogers says their team’s child and adolescent psychiatrist’s first line of defense is not to medicate a child. She will first analyze the family system, talk to the parents, look at the child’s school environment and see what types of behavioral changes can be made. Sometimes the answer is as simple as adding fitness to a child’s routine or even dietary
supplements. A behavioral health team member may be called in on a case by a pediatrician for a number of reasons. For instance, if a child is consistently complaining of stomachaches and the pediatrician doesn’t find anything medically significant causing the pain, and it continues, the physician may advise the patient to consult with someone on the behavioral health team. The pediatrician may believe the child is suffering from anxiety triggered by a number of things such as being bullied or a change in the home environment; a therapist may able to get to the root cause of the stomach pain. For instance, if there was a traumatic incident causing the anxiety, the therapist will help the child process the trauma. Together the pediatrician and therapist can help relieve the child’s pain both from a medical perspective and emotional perspective. When the behavioral health team works with adults the therapy is more focused, strategic and sophisticated. “There is a frequent perception that mental health/behavioral health is medication,” says Rogers. “The majority of people who benefit from behavioral health treatment don’t need meds. They can benefit from solution-focused therapies, they can benefit from learning new tools of communication and they can benefit from learning how to better manage their stress. We get a lot of people who just want a tune-up from time to time.” Behavioral health is typically covered by insurance. Some insurance plans have an “Employee Assistance Program” (EAP) that includes free therapy sessions for anyone in a family, not only the insured individual. The behavioral health team at Banner treats anyone from age 4 to 70. They do not specialize in geriatric behavioral health treatment at this time. Treating geriatric patients requires more case management because the elderly often have more complex medical issues requiring an additional layer of care. The full package of services offered by Banner Health’s behavioral health team include psychiatric evaluations, medication management, medication follow-ups, and psychotherapy for everything from mood disorders, anxiety disorders, thought disorders, behavior disorders and substance abuse. They see individuals, families and couples. “The integration of behavioral health into primary care here at Banner Health is a huge benefit for our patients,” says Rogers.
Heidi Kerr-Schlaefer is a freelance writer in Northern Colorado. She is also the founder of HeidiTown.com, the place for entertaining Colorado festival and travel stories.
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MEDICAL
SEXUALLY TRANSMITTED INFECTIONS
hpv
the silent infection By Malini Bartels
Millions of men and women are exposed to HPV every year. According to the CDC, chances are you have the virus at some point in your life and didn’t even know it. So, what should you know about the most common sexually transmitted infection in the United States?
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The human papillomavirus, commonly known at HPV, is a somewhat deceptive and silent sexually transmitted infection (STI). Most people who have HPV are completely asymptomatic and are unaware that they are carriers of the infection. A person can obtain HPV by having any kind of sexual contact with someone who has the virus. Human papillomavirus is most commonly spread through vaginal or anal sex; nonetheless, oral sex can also be a vehicle for the infection. Even condom use is not 100 percent effective in protecting someone from getting infected. However, condoms have been shown to decrease the rate of HPV transmission as well as the transmission of other sexually transmitted infections, and they are always recommended with every sex act from start to finish. Since HPV can be passed from person to person even when there are no signs or symptoms, it’s no wonder it has become such as widespread problem in our country. So, what are some of the symptoms associated with HPV? There are many different types, or strains, of HPV. Some of these strains cause genital warts in both men and women, while other strains have been associated with various cancers. HPV has been associated with cancers of the vulva, vagina, penis, anus, throat and, most common of all, cervical pre-cancer and cancer. One of the greatest challenges about cervical pre-cancer and cancer is that, unfortunately, they are usually asymptomatic for many years. If undetected and untreated over a number of years, highly treatable precancerous lesions on the cervix can progress to cervical cancer. According to Dr. Alison Cowan, an obstetrics/ gynecologist at McKee Medical Center, HPV is the most common way to get cervical cancer. “One of the challenges about HPV infection is that most sexually active young people have been exposed to it, and most of those who carry HPV are unaware they have it and may be spreading their infection to partners.” “It has been estimated that at least 80 percent of sexually active women have been infected with at least one type of HPV strain,” mentions Dr. Cowan. “Don’t judge your partner,” she adds. “The vast majority of men have no idea they even have it.” Currently, there is no way for males to get screened for HPV. For women, the Papanicolou test (or Pap smear) is the best way to check for pre-cancerous cells. The guidelines for the Pap have changed to every three to five years for low risk women. However, says Dr. Cowan, this has caused many women to think they do not need an annual pelvic exam, an unfortunate unintended consequence of this change. “Most gynecologists still recommend an annual pelvic examination because it is an opportunity to see abnormalities on the cervix,” says Dr. Cowan. In some cases, our immune systems will clear the virus on its own in a few years. But, there is no way to predict who will or won’t clear the virus. Symptoms can develop years after you have sex with someone who has the virus,
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making it very difficult to know when you first became infected. Exposure to the virus can happen with any kind of sexual contact with someone who has HPV—intercourse isn’t even necessary in order to acquire it. So, what are some was to protect yourself and your children from getting the virus? Currently, there is a vaccine available that helps protect males and females against strains 6, 11, 16 and 18 of the virus. Gardasil protects against the four high-risk types of HPV. Parents have the option of vaccinating their children in their teen years for protection against HPV in the future. It’s similar to protecting children with the right protective sports gear before they are involved in the sport. “There are strains of the virus not covered by the vaccine,” mentions Dr. Cowan. “But, the vaccine does lower your chance of getting it.” According to the Centers for Disease Control and Prevention (CDC), there are about 6 million reported new cases of genital HPV infections in the United States each year. Most of them occur in Americans between the ages of 15 to 24. “Ideally, we like to vaccinate before people have sex for the first time,” stresses Dr. Cowan. Pediatricians are doing a great job of recommending Gardasil to young adults. This should lower the rate of cervical cancer and infections for the upcoming generations.” It is also important to mention that antibiotics are not effective against HPV because it is a
The Four HPV Strains Everyone Should Know About:
Dr. Alison Cowen, Obstetrics/ Gynecologist, McKee Medical Center
virus. “One tool to lower the rate of HPV, and thus cervical cancers in the U.S., is to vaccinate your children,” mentions Dr. Cowan. “The other tool is safe sex practices.” Malini Bartels is a freelance writer, chef, mother, radio host and actress living the good life in Fort Collins.
Types 16 & 18: These strains cause about 75 percent of all cervical cancer cases. They are also responsible for roughly 70 percent of vaginal cancers and 50 percent of cancer of the vulva in females. Types 6 & 11: Responsible for 90 percent of genital warts cases found in males and females. Source: The Center for Disease Control and Prevention
Proud to work with Banner Health!
1109 8th Avenue Greeley, CO 80631 970.353.5031
1357 Water Valley Parkway Suite 500 Windsor, CO 80550 970.674.0933 Carpet | Tile | Granite | Hardwood & More | On-Site Interior Design
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What’s trending in the world of Medical & Wellness Stem Cell Therapy for Cats with Kidney Disease Colorado State University’s Veterinary Teaching Hospital has begun a clinical trial using stem cell therapy to treat feline kidney disease. Chronic kidney disease is common in older cats, but the disease has no cure other than a kidney transplant. CSU researchers are hopeful that stem cells will improve overall kidney function, even when the organs have already been damaged. CSU veterinarian Dr. Jessica Quimby is leading the trial. CSU is seeking cat patients with stage 4 chronic kidney (renal) disease. If the trials prove successful, a human application will be explored. “Kidney disease is indeed a huge and growing problem in human medicine,” Dr. Quimby says. “If we saw improvement with cats, we could relate it to curing humans.” For more information on participating in the trial, call (970) 297-5000.
Poor Sleep and Alzheimer’s A study by scientists from the University of Wisconsin-Madison may have found a link between poor sleep quality and Alzheimer’s disease. The study involves brain scans from a group of older people who had trouble sleeping but did not have mental health problems. The scans showed a build up of plaque from the amyloid protein in the brain—the same plaque that is found in high concentration in the brains of patients with Alzheimer’s disease. The study’s authors acknowledge that further research would need to be done to determine which came first: poor sleep from early stages of Alzheimer’s disease or a lack of sleep that contributed to the development of the disease. But the findings raise the possibility that treating sleep problems may help prevent dementia from progressing later in life.
More BPA Badness
Preeclampsia/Autism Link Found
A new study reports that cans and bottles lined with BPA (bisphenol A) can lead to increased blood pressure, according to Hypertension. The study’s author also contends that BPA exposure has been detected in more than 95 percent of the U.S. population. There are similar studies that show BPA can leach into food and drinks from the lining of containers, such as soda cans, soup containers and more. Patients with a history of hypertension or heart disease are most at risk.
New research shows that children with autism spectrum disorder were more than twice as likely to have mothers who suffered from preeclampsia during pregnancy, according to a University of California-Davis’ MIND Institute study, published in the journal JAMA Pediatrics. Preeclampsia, the condition of high blood pressure and protein in the urine during pregnancy, typically occurs during middle to late pregnancy and up to six weeks after delivery and affects 3 to 5 percent of pregnant women. Daughters of women who suffered from preeclampsia are 20 to 40 percent more like to have the disorder, according to the World Health Organization.
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Kathy Arents Mulberry | 222-1784
Georgena Arnett Loveland | 481-9801
Sheila Benshoof Harmony | 377-4957
Greg Bever Harmony | 377-4916
Cindy Blach Mulberry | 481-5821
Kathy Boeding Loveland | 231-9073
Brian Bogaard Harmony | 377-4954
Judy Bogaard Harmony | 377-4931
Jo Carney Mulberry | 310-1836
Kelli Couch Horsetooth | 310-8804
Joanne DĂŠLeon Harmony | 691-2501
Mary Doty Centerra | 396-3454
Brandi Garifi Harmony | 377-4917
Chris C. Hau Horsetooth | 377-6017
Jim Hauan Mulberry | 419-2303
Amy Hayden Centerra | 215-5950
Shelly Hill Mulberry | 419-2348
Chuck Hoburg Harmony | 377-4903
Michelle Hubbard Harmony | 377-6077
Keith Huntsman Harmony | 377-4941
Nicole Huntsman Harmony | 402-0221
Cindy Kurtz Centerra | 679-1545
Ali Lofquist Centerra | 744-8490
Bob Loner Horsetooth | 231-2222
Diana Luthi Centerra | 481-2692
Alycia Martinez Centerra | 679-1657
Deanna McCrery Harmony | 377-4971
Elaine C. Minor Horsetooth | 215-9236
Anna DiTorrice-Mull Horsetooth| 631-2649
Jim Murray Horsetooth| 377-4909
Dave Muth Harmony | 481-5963
Rob Mygatt Harmony | 229-5411
John Peden Centerra | 679-1574
Miki Roth Centerra | 679-1568
Karen Rowan Horsetooth | 310-5797
Andrea Schaefer Mulberry | 290-3758
Adrienne Scharli Harmony | 217-7350
Todd Sledge Harmony | 377-4901
Ryan Spencer Centerra | 214-0263
Linda Sioux Stenson Loveland | 215-9044
Faren Stroh Loveland | 222-6391
Jack Taylor Mulberry | 420-9302
Laura Thomas Loveland | 290-7544
Matt Thompson Harmony | 443-9910
Dave Trujillo Centerra | 679-1550
Cathy Vance Centerra | 679-1554
Karla VanDenBerg Centerra | 405-8530
Robert Walkowicz Harmony | 377-4945
Bill West Horsetooth | 690-0505
Becky Vasos Harmony | 377-4969
WELLNESS
COMMUNITY HEALTH
Loveland Community Health Center’s new location allows it room to grow as the community’s need increases.
loveland community health center
hits goals By Heidi Kerr-Schlaefer
The Loveland Community Health Center has served the community for 17 years, but for the past year, they’ve been able to provide services at their newly remodeled 27,000 square foot clinic just south of downtown Loveland.
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They’ve come a long way since their landlocked location on Cleveland Street where they had utilized every square inch of their 15,000 square foot building. “Over at the old location, we kept watching the practice grow. Every four years it expanded and we got to the point where there was no more room to grow,” said Melvina Romero, clinic manager and 17-year veteran of the Loveland Community Health Center. Romero and the rest of the staff at LCHC are thrilled with their new digs, but the move wouldn’t have been possible without the help of the McKee Medical Center Foundation, Banner Health and Sunrise Community Health. Other contributions for the project came from Caring for Colorado, Colorado Health Foundation and the City of Loveland. “This would not have happened if it wasn’t for the local community
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Dr. Sunny Park examines two young patients at Loveland Community Health Center.
and what they have given to LCHC,” said Mitzi Moran, CEO of Sunrise Community Health. The clinic has two identical “pods” with 12 exam rooms each. A total of 10 providers, doctors and physician assistants, work at LCHC. LCHC currently employees 72 employees, but that number will soon grow because there are several openings available. In addition to the medical staff, the clinic employs financial screeners, referral specialists, a case manager, a diabetic health educator, a medical social worker and an X-ray technician to operate the X-ray room. A procedure room allows LCHC to provide acute care, such as biopsies, in a family medicine setting. There’s also an in-house pharmacy. All of LCHC’s financial screeners have been trained in various health programs so that they can help patients identify if they are eligible for programs such as Medicaid. “Medicaid has expanded and a lot of people don’t know that,” says Moran. “They think they aren’t eligible until they come here and go through the financial screening process. It’s a wonderful thing to get connected to if you are eligible for it because you will then have a
Northern Colorado Medical & Wellness 2015
payer source for your healthcare.” Their financial specialists can also help people understand the health insurance exchange. Even if a patient isn’t eligible for any of the many available programs, LCHC can still help by using their sliding fee scale. “There’s something here that will be able to help you access affordable, quality healthcare,” says Moran. In addition to the two medical pods, LCHC provides dental services. Dental has a separate waiting area and separate check-in, and a total of nine operatories with three dentists on staff and openings for two more dentists. There’s also space to expand dental and build nine more operatories that will share the existing lab and X-ray area. In fact, the ability to expand was one of the reasons this building was so attractive to LCHC. An unfinished area will eventually be constructed into a third medical pod that will be identical to the first two. At that point the clinic will have 36 total exam rooms. LCHC had projected that they would serve approximately 7,000 patients in their first year at the new clinic and they hit that projection.
According to Moran, 27,000 individuals in Loveland struggle with accessing insurance and that number does not take into account the greater Loveland area. It seems inevitable that as more people learn about the clinic, and as Northern Colorado continues to grow, LCHC will need to build out their third pod and extra dental operatories. The staff at LCHC has received a lot of positive feedback from patients, but none as heartwarming as one woman who said, “When I come here I don’t feel poor anymore.” This was extremely moving for Moran and the LCHC staff to hear. “We want people to receive quality care in an environment where they feel valued,” she says. Loveland Community Health Center is part of Sunrise Community Health. It is located at 302 3rd Street SE in Loveland. You can find their telephone number and provider information at www.sunrisecommunityhealth.org. Heidi Kerr-Schlaefer is a freelance writer and founder of HeidiTown.com, the place for Colorado festival and travel stories.
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WELLNESS
DENTAL HEALTH
Dr. Brandon Owen, Owen Orthodontics
lingual braces
offer versatility By Michelle Venus
While braces for adolescents today are almost a right of passage, adults are very often selfconscious about having braces. Lingual braces change all that. Affixed to the inside or lingual (tongue) side of the teeth, lingual braces are invisible to everyone except the wearer. They can correct just about any bite issue without the cosmetic concerns of an unattractive smile. For Dr. Brandon Owen’s teenaged and adult patients, the option of lingual braces
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is often the tipping point of whether or not the patient goes ahead with orthodontia. “I’ve had patients tell me that if they had known about this option, they would have undergone treatment years ago,” says Dr. Owen. “The biggest barrier for most adults is not financial; it’s esthetic. A lot more people are willing to get braces if we can hide them.” First, the orthodontia low down. There are several different types of braces a patient can choose from. Traditional metal braces use brackets that are affixed to the front of the teeth and wires that are held on with rubber bands. These are the most common type of braces used. Clear braces, also affixed to the front of the teeth, employ a tooth-colored ceramic or plastic bracket instead of the metal one. They are less conspicuous than their full metal jacket cousins, but still visible.
Lingual braces, placed on the inside of the teeth, are virtually invisible.
Clear plastic aligners (Invisalign is a well known brand), are not extremely noticeable but not completely invisible, either. Some orthodontists prefer traditional braces over aligners because they feel the aligners don’t produce the best corrective results; they tilt or rotate the teeth and the roots rather than parallel shift the teeth, including the roots, the way traditional braces do. Then there are lingual braces. Their biggest advantage is cosmetic; they are completely hidden from view. They can correct bottom and top teeth, in full or limited (partial) systems. Limited systems correct the front teeth only—both bottom and top, whereas full systems correct all the teeth. Lingual braces are particularly suited to those patients engaged in contact sports or those who play wind instruments. They can correct nearly every bite problem—including “the worst of the
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worst,” says Dr. Owen, making them an ideal solution for those patients who are conscious of their appearance. Now for the downside. For patients under the age of 12, and for adults and teens with small teeth or excessive bite problems, lingual braces may not be the best choice. Full lingual braces are more costly because the brackets are custom made. Limited lingual systems tend to run in the same price range as clear or traditional braces. It can be a bit more difficult to adjust to lingual braces since the positioning of the brackets does affect the tongue, causing some speech issues and making swallowing somewhat tricky. Lingual braces wearers need to be more aware of plaque buildup and keeping their teeth clean; it can be more difficult to tell if food has been adequately removed after eating. After consulting with Dr. Owen and mulling over all the options, if a patient decides that lingual braces are the best route to a straight, white smile—what’s next? First the patient has an impression made of his or her teeth. This involves filling a tray that fits over the teeth with alginate, a goopy material that makes accurate and detailed negative impressions of the teeth and gums. The tray stays in the mouth until the alginate hardens. The impression is sent to a lab, where a dental technician uses that impression to make a cast of the teeth. A “set up” or mockup of the teeth arranged in perfect alignment is created and used
Northern Colorado Medical & Wellness 2015
to build custom brackets and robotically craft and cut wires. A computerized system actually determines the exact placement of the brackets in full lingual bracket systems. Placement is determined on the model for limited systems. Most of Dr. Owen’s patients use limited lingual systems. Typically, it takes four to six weeks to fabricate the custom hardware. The brackets for each arch, either upper or lower, are placed simultaneously after Dr. Owen has prepared the teeth for proper bonding. After the cement has been applied, an applicator tray holds the brackets in place to ensure precise alignment while the cement cures. Once the cement has hardened and the applicator tray has been removed, any excess bonding material is trimmed. The next step is to install the arch wires. Once they are in place, active treatment starts moving the teeth into their desired alignment. Treatment length is similar to that of traditional front-placed braces, though Dr. Owen has worked with patients whose treatment time is shorter. Dr. Owen is actively involved in developing new orthodontic equipment and techniques with DENTSPLY International, Inc., a global corporation based near Philadelphia that is renowned for its innovation in the dental industry. He is currently working with DENTSPLY to develop a 3-D printing system that will enable even more precise positioning of the brackets for next generation lingual and outside braces with the goal of reducing treatment time by nearly 40 percent. “That
means patients will be wearing braces for 12 to 14 months, rather than the usual 24 months,” explains Dr. Owen. “For the patient, there is less time in braces, less risk to the roots, and lower occurrences of cavities.” And for Dr. Owen, being involved in product development is immensely fulfilling. “It’s pretty cool being one of the guys creating this new and innovative technology. I’m having a blast.” Dr. Owen predicts that within the next two to five years, most orthodontists will be using digital systems to deliver superior results. In addition to product development, Dr. Owen enjoys a well-earned reputation as an educator in the field of orthodontics. He has traveled throughout the United States, Europe and Canada—and to Dubai this coming summer—training orthodontists all over the world in lingual and digital orthodontia. Closer to home, Dr. Owen is the only northern Front Range orthodontist working this extensively with digital technology. He recently hired Dr. Adam Timock and is opening a satellite office in Windsor (formerly the office of Dr. Jorgensen). “This new technology is revolutionary,” he says. “It’s changing everything. And that makes our patients very happy.”
Michelle Venus is a freelance writer based in Fort Collins.
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WELLNESS
SKINCARE
healthy
winter skin By Malini Bartels
Well, of course we all know that beauty originates from the inside. But during the winter in the Northern Front Range, most of us suffer from not-so-beautiful, rough, cracked and dry skin. What can we do to help alleviate some of the frustration and ensure we are also beautiful on the outside during the colder months?
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Skin conditions are quite individualized. The naturally arid climate of our community combined with central heating indoors can really dry out the air that surrounds us, thus leading to depleted skin. Fortunately, there are a few inexpensive things that we can do to prevent our epidermis from the painful side effects of winter, and there are also quite a number of nourishing products that can help soothe our skin once winter has taken over. Start with a good base of care. “Excessive dryness is a big problem where we live. It’s important to moisturize daily and within minutes of getting out of the shower or bath. Gentle, non-foaming
Lydia’s STYLE Magazine
A Different Kind of Pediatrician Medicine has changed drastically, especially over the last few years. The majority of physicians are employees of hospitals such as Banner Health system which includes North Colorado Medical Center and McKee. The independently practicing physician is almost a thing of the past.
A
n exception to this trend is Dr. Orest Dubynsky and The Children’s Health Place located in Greeley, Colorado. This is not surprising because Dr. Dubynsky has never been one to follow meekly along with the pack. He is the only physician in practice in Weld County to have received the distinction of “Medical Home” from the State of Colorado. This is a designation of quality and of setting high levels of patient care and practice standards. This was an exciting achievement, but has taken on a life of its own. It is like remodeling a house. Once you start improving and changing things, other areas of your home are affected. Soon after completing the criteria necessary for a medical home, Dr. Dubynsky began working with Project Launch. This is a grant program of the Federal Substance Abuse and Mental Health Services Administration who
Genesis Campos, Julie Dodson, Bertha Alvarez, Corina Medina, Nellie Sanchez
seeks to promote wellness of young children from birth to age eight. Project Launch focuses on improving the systems that serve young children with the goal of helping children reach physical, social, emotional, behavior and cognitive milestones. Practitioners working with Project Launch have screened over 8500 children resulting in hundreds of new referrals. This means that these children are getting the crucial help they need early in life. This brought automated screenings into the practice that integrated with the electronic medical health record being used to keep patient records. With this integration, other aspects of the practice were identified as ways to provide more comprehensive care to patients. In 2013, Sara Nohavec, a Speech Therapist specializing in pediatrics since 2001, joined The Children’s Health Place. So many children have speech and swallowing issues if not addressed early in life, are difficult to correct.
Holly May came on board in November 2014. Holly is a licensed Psychologist and has worked with children and their families for over two decades. 2015 will bring more additions which will increase services at The Children’s Health Place. A Tele-psychiatry program and a new assessment tool will be available. This will allow for a more standardized way to track the results of treatments of Attention Deficit Disorder, depression and other behavior challenges. This assessment also expands a patient’s access to care and consults with Psychologists located within the state of Colorado. A lactation specialist will be joining the team, hopefully, later this year. Medicine will change over the years. What you can count on never changing is Dr. Dubynsky and The Children’s Health Place’s dedication to the quality of care your children will receive.
Dr. Orest Dubynsky, Pediatrician
(970) 356-2600 S P E C I A L A D V E RT I S I N G S E C T I O N
cleansers are best; foamy and sudsy products strip the skin. Eucerin makes a nice oil-based calming body wash that is easy on the skin,” says Dr. B. Lynn West, a dermatologist and founding member of Dermatology of Northern Colorado in Fort Collins. Individuals who tend to be very dry will do better with a cream than a lotion. Most lotions are evaporative while creams are generally more substantive and thicker. Interestingly, women tend to prefer heaver moisturizers to those preferred by men. “Remember to soak, but not soap,” quips Dr. West. “The chemicals found in soap tend to dry out the skin and strip it of naturals oils and moisture. Of course, everyone should keep clean and soap the parts of the body that need it, but over soaping is all too common.” Most Americans tend to unnecessarily over-soap. When it’s cold outside and we don’t perspire as much, it’s not even necessary to bathe everyday. In fact, some physicians recommend skipping daily baths or showers and shifting to every-other-day to avoid parched skin. Also try a barrier cream to protect skin. “These new barrier creams are a step above moisturizing,” mentions Dr. West. “It’s not a medical treatment,
but it’s definitely a step above.” Barrier restoration/repair creams actually work differently than regular creams and lotions. By literally forming a barrier between the environment and your skin, these creams can help protect you from contaminants that can irritate and chafe our body’s largest organ and help keep moisture inside where it’s needed. Dr. West recommends Aveeno Active Naturals’ skin relief moisture repair cream that is fragrance-free and perfect for protecting and repairing extra dry skin. Some anti-aging creams can be beneficial for a youthful look, but they can also be very irritating. Dr. West points out, “All these anti-aging creams have some sort of acid in them that strips moisture. Sometimes people can only tolerate them in the summer months; that’s how harsh these anti-aging products are.” Dr. West reiterates that everyone should protect himself or herself from the sun at every age. Sunscreen is a must for the face. Diet is equally important. “Always drink plenty of water and eat antioxidant rich foods.” You are what you eat; eating well can help you obtain a wonderfully healthy glow from the inside out.
“Environmental factors play a huge role in conjunction with our genetics,” says Dr. West, “Even the propensity for eczema is genetic. We can’t change or control our genetics; all we can do is adjust to them and work with what we have been given.” Dermatologists often recommend that we all take dry-skin precautions during the months of October through April. “But if your skin is peeling with crusty patches and it won’t go away, then it’s probably time to see a dermatologist,” warns Dr. West. “Extremely itchy, red, cracking and peeling skin might be eczema, also known as dermatitis. Those are serious conditions and should be looked at by a physician to be treated with steroid creams and/or prescription medication.” Just like the other organs in your body, your skin needs to be nourished, pampered and even closely watched. It just happens to be what people first see when they meet you; the appearance of your derma says a lot about you and your overall health. Malini Bartels is a freelance writer, chef, mother, radio host and actress living the good life in Fort Collins.
simple ways everyone can prevent dry skin during cold weather months. 1. Moisturize: use daily moisturizers (the thicker the better), wear lip balm often to prevent chapping, apply lotion or cream immediately after showering to seal in moisture. 2. Humidify: consider adding a central humidifier to your house or at least a small room humidifier for bedrooms at night. 3. Antioxidants: eat antioxidant rich foods and plenty of Omega 3’s. 4. Clothing: wear non-irritating clothing, cover sensitive parts of the body (your face) exposed to harsh weather. 5. Shorter showers: take quick showers over long baths, use warm water instead of hot, close the door to keep moisture in and gently blot your skin dry. 6. Avoid: excessive central heating and sitting too close to a fireplace, harsh chemicals (exfoliates, chemical peels and anti-aging products), harsh and scented laundry detergent, foamy facial cleansers and soap. Avoid dull razors. 7.
Hydrate from the inside-out: drink plenty of water and avoid sugary drinks that can dehydrate your body.
8. Care for hands: wear gloves during dishwashing and when outdoors, avoid excessive hand washing and drying, don’t handle peppers with bare hands. 9. Block the sun: continue to use sunscreen; always wear sunscreen on your face, especially when skiing. You can even take the bold move of not showering every single day. Your friends may hate it, but your skin will thank you! 60
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2015
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WELLNESS
lighten
NUTRITION
up
By Mary Branom, RD Cardiac Rehab Dietitian North Colorado Medical Center
When I counsel my clients toward healthier eating I start by asking them about their typical eating patterns. It is helpful for me to know what some of their favorite meals are so we can start by modifying those recipes to make them fit into a more healthful meal plan. In essence, we give their meals a “makeover.” Many comfort food-type recipes are loaded with calories from fat, saturated fat, sugar and sodium. When visiting with my clients, we start by picking a recipe that they make often. We go down the ingredient list and chip away at ways to make it healthier. Often, I use a coined phrase I like to call “the dilution method.” For example, this may include using canned ingredients that have no added salt along with some ingredients that contain salt in order to achieve a lower sodium per serving result. Other times the modification process involves substituting one ingredient for another. • Try substituting ground turkey for ground beef (or very lean ground beef instead of a fattier version). Blot the meats before adding them to a recipe to remove excess fat. • Substitute a broth or stock that is much lower in sodium than the one you typically use to make sauces and gravies, or in a soup recipe. • Opt for crushed tomatoes in puree instead of tomato sauce for less sodium. The items that most typically make many entrees unhealthy include cheese, canned cream soup, mayonnaise, sour cream and fatty cuts of meats. Here is a few alterations that can make almost any recipe healthier. • Cut down on the amount of cheese you use by half. • Make a low-fat white sauce with 1% milk and a thickener like flour or cornstarch instead of canned soup in recipes.
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Whether you have a medical reason to change your eating habits or the scale is showing that the holiday goodies got the best of your waistline, sometimes the thought of giving up your favorite foods and dieting feels sort of—impossible. • Try using some plain Greek-style yogurt instead of the mayo or sour cream in a recipe. • Use leaner cuts of meats, trim visible fat and take skin off the poultry. • Use herbs and spices instead of the salt shaker. Most of us are lacking a sufficient intake of fruits and vegetables. These powerhouse foods are packed with vitamins, minerals, antioxidants and fiber. We need at least five servings a day. Here are a few guidelines: • Strive for one-half of your plate comprised of produce, one-quarter comprised of protein and one-quarter coming from whole grains. • Add extra vegetables to your recipes to amp up the nutritional content. • Set out a veggie/fruit platter while preparing the meal so your family can start to fill up on healthy options while waiting for the meal to be served. Remember that meal makeovers make the recipes healthier by using less saturated fats, and less high-calorie ingredients, however, you still need to practice portion control.
The Resources
Dietary Approaches to Stop Hypertension www.dash.bwh.harvard.edu National Cholesterol Education Program www.nhlbi.nih.gov/chd USDA Choose My Plate www.chosemyplate.gov Nutrition Data www.nutritiondata.com American Diabetes Association www.diabetes.org Mrs. Dash® salt free seasoning www.mrsdash.com Eating Well Magazine www.eatingwell.com
Cookbooks
The American Heart Association Low Fat, Low Cholesterol Cookbook: Time Life Books (various other cookbooks available at www.americanheart.org) The Best of Simply Colorado, Colorado Dietetic Association; (www.eartrightcolorado.org) The Road To A Healthy Heart Runs Through The Kitchen, Joseph C. Piscatella Every Day Cooking, Dean Ornish MD.
Branom recommends checking out these great resources for more important nutritional information:
Diabetes and Heart Healthy Cookbook, American Diabetes Association
Websites
The Cardiac Recovery Cookbook: Heart Healthy Recipes for Life After Heart Attack or Surgery, M. Laurel Cutlip, RD, LD
The Academy of Nutrition and Dietetics www.eatright.org American Heart Association www.americanheart.org
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2015
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Portobello Stroganoff Beef Stroganoff A lighter version by Mary Branom, RD
A lighter version by Mary Branom, RD
1 Tbsp. olive oil 4 portabella mushrooms, sliced ½ cup onion, chopped (1 medium) 1 clove garlic, minced 2 Tbsp. flour 1 Tbsp. tomato paste ½ cup white wine ½ cup cold water (if more liquid is needed) ½ tsp. Better Than Bouillon® vegetable base 1 tsp. Kitchen Bouquet® browning & seasoning sauce 1 cup plain Greek yogurt ½ tsp ground pepper 8 ounces wide egg noodles 1 Tbsp. fresh parsley, minced
12 ounces boneless beef sirloin steak, well trimmed, cut into ½-inch thick strips or chunks 1 8-ounce carton lower-fat sour cream or Greek yogurt 2 Tbsp. flour 1 Tbsp. tomato paste ½ cup white wine ½ cup cold water (if more liquid is needed) ½ tsp. Better Than Bouillon® base 1 tsp. Kitchen Bouquet® browning & seasoning sauce ½ tsp. ground pepper 8 ounces dry wide egg noodles Nonstick cooking spray 2 cups fresh mushrooms, sliced (5 ounces) ½ cup onion, chopped (1 medium) 1 clove garlic, minced 1 Tbsp. fresh parsley, minced
In a skillet, sauté the portabella mushrooms, garlic and onions in olive oil, cooking until tender and browned. Meanwhile, mix the Greek yogurt, flour and tomato paste in a small bowl. Mix the bouillon into the water until dissolved and add it to the yogurt mixture. Stir until mixed and set aside. Cook the noodles according to package directions, omitting any oil or salt. Drain well. Add the sour cream mixture to the veggies in the skillet. Cook until thick and bubbly. Serve over egg noodles. Sprinkle with parsley, if desired. Makes 4 servings (1 cup of meat mixture over ¾ cup noodles). Nutritional facts: Calories: 206, Total fat: 5g, Saturated fat: 1g, Trans fat: 0g, Cholesterol: 17mg, Sodium: 243mg, Total carbohydrate: 24g, Protein: 10.6g
Trim visible fat from the lean beef and cut into strips or chunks. Spray a skillet with cooking spray and stir fry the meat until browned. Meanwhile mix the sour cream or yogurt, flour and tomato paste in a small bowl. Mix the bouillon into the water until dissolved and add it to the sour cream mixture. Stir until mixed and set aside. Cook the noodles according to package directions, omitting any oil or salt. Drain well. Remove the meat from the skillet when browned. Add 1 Tbsp. water along with the mushrooms, garlic and onions to the same pan, cooking until tender. Add the sour cream mixture to the veggies in the skillet. Cook until thick and bubbly. Return the meat to the skillet and warm in the gravy mixture. Serve over wide egg noodles. Sprinkle with parsley, if desired. Makes 4 servings (1 cup of meat mixture over ¾ cup noodles). Nutritional facts: Calories: 281, Total fat: 5.7g, Saturated fat: 2.4g, Cholesterol: 60mg, Carbohydrate: 22.5g, Sodium: 334mg; Protein: 29g
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Lydia’s STYLE Magazine
Alfredo Sauce Made Lighter A lighter version by Mary Branom, RD 1 Tbsp. olive oil 2 garlic cloves, minced 3 Tbsp. flour 2 cups skim milk 2 Tbsp. light cream cheese 1/4 cup fresh grated parmesan cheese 1 Tbsp. fresh parsley, chopped
Chicken Salad A lighter version by Mary Branom, RD
In a saucepan add the olive oil and heat over medium heat. Add minced garlic; sauté one minute. Stir in flour. Gradually add skim milk, stirring with a whisk until blended. Cook until thickened and bubbly, stirring constantly. Remove the saucepan from the burner. Whisk in the cream cheese until melted and incorporated into the sauce. Add ¼ cup fresh parmesan cheese; stir until it melts. Garnish with parsley. Makes four ½-cup servings.
2 cups cooked, diced chicken 1/2 cup finely chopped celery 1/2 cup finely chopped onion 1/2 cup red grapes, quartered 1 Tbsp. Light mayonnaise or olive oil type mayonnaise 2 Tbsp. plain Greek yogurt Pepper to taste Lettuce leaf
Serving suggestions: • Pour over warm pasta and/or steamed veggies. Top with fresh parsley and fresh ground pepper to taste, and a pinch of Parmesan. • Use 1-2 Tbsp of pesto in the sauce for a great new taste. • This also tastes great over a grilled chicken breast or drizzled over grilled salmon.
Mix all ingredients together and serve on a lettuce leaf. Will keep for several days in a covered container in the fridge. Makes four 1-cup servings.
Here’s what makes a lightened up version of a regular Alfredo sauce: • Replaced heavy cream with skim milk. • Added light or fat free cream cheese to replace the dairy flavor lost when the heavy cream is omitted. It also thickens the sauce. • Add minced garlic, fresh parsley and ground pepper to enhance the flavor. • Used a small amount of fresh Parmesan cheese for best flavor.
Nutritional facts: 1 cup = Calories: 125, Total fat: 3.3g, Saturated fat: 0.8g, Trans fat: 0g, Cholesterol: 40mg, Sodium: 81mg, Total carbohydrate: 7g, Protein: 16.2g Regular chicken salad nutritional facts: 1 cup = Calories: 171, Total fat: 9.6g, Saturated fat: 1.7g, Trans fat: 0g, Cholesterol: 42mg, Sodium: 103mg, Total carbohydrate: 7g, Protein: 14.7g
Nutritional facts: ½ cup = Calories: 141, Total fat: 7.2 g, Saturated fat: 2.9g, Trans fat: 0g, Cholesterol: 15.5g, Sodium: 165.5mg, Total Carbohydrate: 11g, Protein: 7g. Regular Alfredo ½ cup = Calories: 532; Total fat: 53g; Saturated fat: 31g; Trans fat: 0g; Cholesterol: 179mg; Sodium: 271mg; Total Carbohydrate: 9g; Protein: 8g
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Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2015
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The number of Americans with hearing loss has doubled in the last 30 years, according to the American Speech-Language-Hearing Association (ASHA). Noise is a major risk factor and more than 30 million Americans are regularly exposed to hazardous sound levels, the ASHA adds. With those statistics in mind, it is likely that you or someone you know will be in need of a little hearing help. The fine local hearing centers featured here carry a wide variety of manufacturers and products. Here is a sampling of the latest in technology:
ReSound ReSound LiNX provides vivid, natural sound, making speech clear and easy to understand. The hearing aid provides direct sound streaming to your iPhone, iPad or iPod touch, and with the ReSound Smart app you can personalize your experience. Best of all, ReSound LiNX fits nearly every hearing loss. www.gnresound.com
Widex The new Widex Dream hearing aid allows more sound in than other hearing aids so you can hear the details of the world around you. If you are an experienced wearer, you will hear the difference on the spot. And if you’re new to hearing aids, get ready to enjoy hearing many of the sounds you have been missing. www.widexusa.com
Oticon The Oticon Nera Pro Mini seamlessly blends with the way our ears and brain work together, giving the wearer a clear sense of where sounds are coming from. The Nera features integrated directional microphones that give you the ability to focus on the sound most important to you while preventing whistling and feedback. www.oticon.com
Advanced Hearing Services Spring Creek Medical Park 2001 South Shields St., Bldg. J2 Fort Collins (970) 221-5249 www.bakerhearing.net
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Oticon The Alta Pro is Oticon’s finest hearing aid. Using Oticon’s most advanced technology, this devise combines enhanced sound quality while reducing the effort required to listen and understand the speech around you. The innovative new technology can be completely personalized. www.oticon.com
Phonak Enjoy all the benefits of better hearing without anyone knowing you are wearing a hearing aid with Lyric, the world’s first and only 100 percent invisible hearing aid, wearable 24/7—even in the shower. Lyric uses your outer ear to naturally direct sound into your ear canal; no need for multiple settings or complicated programs. www.phonak.com
All About Hearing 1124 E. Elizabeth St., Ste. E-101 Fort Collins (970) 221-3372
Audiology Associates 4675 West 20th St. Rd., Unit A, Greeley (970) 352-2881
Hearing Rehab Center 1030 Centre Ave., Ste. A Fort Collins (970) 482-5700
3820 North Grant Ave. Loveland (970) 461-0225 www.allabouthearing.us
4775 Larimer Pkwy., #100, Johnstown (877) 499-4327 www.hearingtime.com
2980 Ginnala Drive, #102, Loveland (970) 593-9700 www.hearingrehabcenter.com
Lydia’s STYLE Magazine
Northern Colorado Medical & Wellness 2015
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