2015-10 Northern Colorado Medical & Wellness Magazine by Style Media & Design, Inc.

OCTOBER 2015

ALZHEIMER’S IMPACT MAINTAINING FUNCTIONAL FITNESS ARE THERE HYPOALLERGENIC DOGS? stylemagazinecolorado.com

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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 EDITOR Kelly K. Serrano kelly@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 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 WRITERS Malini Bartels, Kyle Eustice, Heidi Kerr-Schlaefer, Kay Rios, Brad Shannon, Elissa J. Tivona Michelle Venus AFFILIATIONS Fort Collins Area Chamber of Commerce Loveland Chamber of Commerce Greeley 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 more than 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.

Lydia’s STYLE Magazine

THANK YOUS

Debbie and I recently moved to Northern Colorado and are excited to have found Style Magazine. We thoroughly enjoyed the August issue, especially the article, “Where the Chefs Go.” Not only do we now know where the chefs dine out, but where we will go, as well. Thank you for your first-class magazine. Dave Johns, Loveland Using the cover of your July 2015 Northern Colorado Medical & Wellness magazine and a few great shots my daughter took last Monday, I went to the Donna Baldwin Agency in Denver and was signed on the spot as a commercial print model. Apparently for the age group of 38-50, there is a lot of work. Crazy. So, thank you for the beautiful cover which helped me land the opportunity to do this. I am very thankful for your influence in my life and in Northern Colorado. Ena Burrud, Treetop Yoga Therapy, Fort Collins I wanted to let you know that I have received an incredible number of emails from friends, colleagues, doctors, people who work for UCHealth and others who have read our stories in the September issue of Style and have been inspired. Thanks to all of the sisterhood for the candor, transparency and bravery you have all been part of. I don’t think I fully understood community impact until today and I hope all of you know we have made a difference in the fight against the ‘big C’ that every woman fears. Thank you for allowing me to be part of this amazing group. I am incredibly grateful to you, Hope Lives! and for this experience! Robyn King, Windsor

support system in place. I feel so lucky to be part of such an awesome and inspiring group of women who were this year’s models. Thank you! Suzanne Trautwein, Fort Collins Thank you so much for your wonderful, informative and complete coverage of breast cancer in the September 2015 edition. As you pointed out, October is Breast Cancer Awareness Month. My mother-in-law was a breast-cancer survivor. Your articles pointed out that years ago the only option was a mastectomy. This was the case with my mother-in-law. She was a part of the “Pink Ladies” in Greeley and supported the Walk for Life each year. She died this past April and your September edition brought back many memories of her courage. Thank you. Let me also remind you that November is Prostate Cancer Awareness month. New studies point out that one in six men will develop prostate cancer. November is usually “No Shave November” to show support for this cancer that is the second most common among men. Skin cancer is first. I am a prostate cancer survivor. I chose to have a prostatectomy. However, there are many options available for men diagnosed with prostate cancer. I, too, experienced a number of the same fears and issues of women who find out about their diagnosis. Men typically do not talk about these “issues.” I would love to see a Style Magazine issue devoted to prostate cancer and its effect on men and their families. We are so fortunate to have wonderful medical resources in Northern Colorado to assist anyone diagnosed with all types of cancer. Your issues have always pointed out these great facilities. Thank you for your devotion to keeping all of us informed. Dave Todd, Greeley

I remember seeing you (Lydia Dody) at King Soopers while you were going through treatment and you told me about wanting to start a foundation to provide auxiliary services for women going through breast cancer and I thought, “Hmm, that’s nice,” but didn’t quite grasp what you were trying to do. Fast forward to 2014 and I get it! I will never say that I was lucky to have had breast cancer, but I was lucky to have had it in Fort Collins where there is such an incredible

Our appearance in your July 2015 Northern Colorado Medical & Wellness issue was very wellreceived. We’ve since fielded many, many phone calls from people who literally say, “The woman in the article, THAT’S ME!” And our new clients couldn’t be more pleased, often commenting after treatment about improved range-of-motion, lessened pain throughout the day, and more

personal enjoyment in their daily lives and activities. Every person who called KineticWise through our appearance in your publication has rebooked. Many have purchased our money-savings packages and joined our membership program. Thank you, to you and your crew, for providing this wonderful platform for the Northern Colorado health and wellness community, and also being that vehicle that allows us to be of service to an even broader audience as a direct result. Kathleen Weiss, KineticWise™ Massage, Fort Collins I just wanted to thank you again for the wonderful opportunity to experience being a model for your magazine. The response from my friends, family and others has been so positive and beautiful. I received numerous phone calls and texts regarding the issue and how many of the women’s stories were so inspirational for others. I even received selfies of people reading the magazine, which I loved! I will always be a part of Hope Lives! and will be volunteering for anything I can for the years to come. So thankful to you for making this all happen and for all you do in the community! You are and will always be such an inspiration for me! Thank you again for all that you do and including me in this wonderful experience. I am forever grateful to you and all the women involved. Andrea Obester, Fort Collins

OOPS!

In the “Meet the Models” section of the September 2015 edition of Lydia’s Style Magazine, we mistakenly noted that Celia Buchanan has two grandchildren. We apologize for the error.

WE LOVE TO HEAR FROM READERS. SEND YOUR COMMENTS AND SUGGESTIONS TO:

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

Lydia’s STYLE Magazine

CONTENTS

Northern Colorado Medical & Wellness

October 2015

ALZHEIMER’S UPDATE

26 PLANTAR FASCIITIS

SURVIVING CO-RETIREMENT

40 FITNESS TO HELP YOU FUNCTION

CARING FOR BABY TEETH

THE TRUTH BEHIND ‘HYPOALLERGENIC DOGS’

ON THE COVER: Style Magazine Creative Director Scott Prosser takes a break from his hike in Rocky Mountain National Park to soak in nature’s beauty and tranquility. Cover photo by Marcus Edwards Photography.

8 12 14 18 22 26 32 34 36 38 40 45 46 48 56 60 64

From Our Readers

Publisher’s Letter

Alzheimer’s Update

Surviving Co-Retirement

Just a Snip: Vasectomies

Plantar Fasciitis

Senior Living Center Expands

Eating Out? Make Smart Choices

A Healthier Clean

Cannabis: An Escape From Pain (minus the High)

Fitness to Help You Function

Special Dental Section

Caring for Baby Teeth

The Wisdom Behind Removing Wisdom Teeth Take a Hike Dealing with Aggressive Tendencies in Dogs The Truth Behind ‘Hypoallergenic Dogs’

The articles in this issue of Northern Colorado Medical & Wellness are presented for your general knowledge and are not a substitute for medical advice or treatment. If you have any questions or concerns about your health, please contact your doctor or healthcare provider.

Lydia’s STYLE Magazine

PUBLISHER’S LETTER

Staying Healthy We are delighted to bring you this October Medical & Wellness issue with a special focus on wellness and good health. Dental health is a very important component of overall wellness and, therefore, we are featuring our second annual Special Dental Section in this issue. It is probably surprising to some to learn that dental care ought to begin at an early age. Read “Caring For Baby Teeth” to learn how to start your youngster on good dental hygiene habits. And as children reach their teen years, wisdom teeth can become

a problem. Read “The Wisdom Behind Wisdom Teeth” to learn why extraction of the third molars is recommended, at what age it is desirable and more about the process. I think back to having all four of mine extracted in my mid 30s; I had numerous complications, with dry socket being one of them. Yet when Dr. James Troxell, oral surgeon, removed both of my teen daughters’ wisdom teeth, the process was much easier and free of complications. In this section we also introduce you to several excellent dental professionals. Read their profiles to learn about their practice philosophies and specialties and meet the professionals in their offices. As we all age, I have seen a number of my friends facing the difficult diagnosis of Alzheimer’s disease. It is a devastating diagnosis not only for the individual, but especially for the family facing many caretaking challenges. Be sure to read the touching story of a well-known local couple, Mark Goldrich and Prue Kaley, whose future has been permanently altered with Prue’s Alzheimer’s diagnosis. Get an update on this disease and some of the research being done in “Unraveling the Mystery That is Alzheimer’s.” A few years ago I started feeling pain in both feet with every step I took. The pain got to the point that I found it difficult to walk. I finally went to see a podiatrist, and he diagnosed my condition as plantar fasciitis due to wearing flat shoes with no arch support. This was definitely a new awareness for me as I embarked on therapy to deal with this discomfort. It took several months, but finally the pain subsided and has never returned, thank goodness. Be sure to read “Plantar Fasciitis: Getting to the Bottom of Foot Pain” to learn about this

condition and how to manage it. As we age, maintaining functional fitness is key to remaining young and helps us continue normal, everyday activities. I incorporate that kind of focus into my weekly workouts: it keeps my core strong, allows me to continue to work, and stay active and injury-free. Read “Functional Fitness” for information about the importance of this kind of workout focus. As many of you know, I have a passion for helping women in Northern Colorado diagnosed with breast cancer through the not-for-profit Hope Lives! The Lydia Dody Breast Cancer Support Center. Founded in 2001, the organization has provided over 21,000 free services for women and their families. Once a year Hope Lives! has a Celebration of Life benefit gala to raise funds to provide its numerous services. This year the 15th annual event is at 5:30 p.m. Saturday, Oct. 17, at the Embassy Suites in Loveland. Tickets are still available for this magical night. Enjoy a gourmet dinner, live and silent auctions, entertainment and an inspiring fashion show of breast cancer survivors. Invite friends and join us that evening. It is inspiring, touching and a lot of fun! Tickets are $150 and available online at www. hopelives.org or call the office at (970) 225-6200. This issue is packed with lots of great information to help you stay informed about health and wellness topics. I hope you enjoy reading the many interesting articles that relate to staying healthy and keeping fit and injury free. Wishing you an active and healthy fall,

lydia@stylemedia.com

Lydia’s STYLE Magazine

MEDICAL

ALZHEIMER’S

Life has taken an unexpected turn for husband and wife and former business partners Mark Goldrich and Prue Kaley since she was diagnosed with Alzheimer’s disease.

Lydia’s STYLE Magazine

UNRAVELING THE MYSTERY THAT IS ALZHEIMER’S R E SE ARCHERS S TI LL S E E K A C U R E F OR PAT IENTS, FA M I LI E S BY MICHELLE VENUS

ark Goldrich remembers the day a little over three years ago when he realized that something was seriously wrong with his wife and business partner, Prue Kaley. “She was missing for hours; her car was gone,” he recalls. “We did not know where she was and she wasn’t answering her phone.” Fearing the worst, Mark drove around, searching for Prue. Eventually a friend called, telling him she had received a phone call from Prue, who was sitting in her car in a grocery store parking lot in Loveland. And she didn’t know how she had gotten there. Or when she had gotten there. Or why she was there. That episode was one of the impetuses that sent Mark and Prue to a neurologist. After a battery of tests—one lasting 4 hours—doctors determined Prue was suffering from cognitive impairment. An Alzheimer’s diagnosis came shortly after that.

What is Alzheimer’s disease?

Alzheimer’s disease is a debilitating, progressive disorder. It damages and eventually destroys brain tissue, which leads to memory loss, changes in thinking and behavior, and loss of other brain functions. Typically, the disease is slow to develop and often goes undiagnosed until the patient’s behavior is markedly different from “normal.” Gradually, Alzheimer’s gets

Northern Colorado Medical & Wellness 2015

worse as the synapses—the contact points that relay signals between the brain’s nerve cells— deteriorate. Brain function declines, the cells die and the brain actually shrinks in size. The disease is fatal. Alzheimer’s is the most common form of dementia, accounting for between 50 and 80 percent of all cases. Dementia refers to various diseases and conditions linked to neurodegeneration, leading to problems with cognition and memory. Research scientists have identified several brain abnormalities considered hallmarks of Alzheimer’s disease. Plaques are clumps of a protein—beta-amyloid—found to damage and destroy brain cells in several ways, including misfiring of the synapses, which interferes with cell-to-cell communication. While researchers have not determined the specific reason for braincell death, accumulation of beta-amyloid on the outside of brain cells is a common denominator among Alzheimer’s patients. The brain depends on its own complex system that transports nutrients, oxygen and blood throughout the vital organ. This system relies on a structure of parallel threads, much like railroad tracks, to carry materials necessary for a healthy functioning brain. A protein called tau (rhymes with wow) keeps these tracks straight. In Alzheimer’s patients, threads of tau protein twist to form tangles. No longer straight, these threads disintegrate and cannot move essential materials through the brain cells, which eventually die. Research over the past two decades has shown

that inflammation in some Alzheimer’s patients’ brains may play a central role in the course of the disease. Damaged neurons and beta-amyloid insoluble deposits, as well as tau tangles, are prime targets for inflammation, which is the biological response when the body’s tissues are subjected to harmful stimuli.

The not-so-easy diagnosis

But how do people know if they or a loved one is struggling with Alzheimer’s disease? It’s not as if they can unzip the head and poke around for excessive protein buildup. That’s a bit of a conundrum. “We can’t recognize the disorder early enough to interfere with the progression [of Alzheimer’s],” explains Dr. Gerald McIntosh, neurologist with Neurology Associates in Fort Collins. “We can’t make a diagnosis until people are impaired, and by the time they’re impaired the disease has already caused a lot of damage.” Case in point for Mark and Prue. Looking back to the years prior to her diagnosis, Mark says small clues hinted at a problem, but nothing pointed to such a devastating illness. In retrospect, Prue’s decline started some time before her disappearance. Never one to make herself the center of attention, she became less inclined to engage in conversation and seemingly was becoming more introspective. She was frequently tired and took more naps. She began to neglect her business responsibilities. Prue’s tumble down the Alzheimer’s rabbit hole had started. Diagnosing the disease isn’t as simple as

running a few tests, either. Dr. McIntosh simplifies Alzheimer’s disease exists. There is no cure. Doctors can prescribe different medications the process, stating, “You make the diagnosis clinically and then you rule out other things.” to treat some of the problems that occur with Take this example: a patient comes to Dr. McInan Alzheimer’s diagnosis: memory loss, deprestosh presenting with dementia affecting memory sion, irritability or anxiety, even confusion, and language over other areas of function. aggression, agitation or hallucinations. Some believe that vitamin One of the first courses E’s antioxidant properof testing includes brain imaging studies, includties may protect nerve ing magnetic resonance cells from damage, but imaging (MRI) or comlittle evidence exists that this is an effective puted tomography (CT). treatment. Some people They determine if other have tried alternative factors—tumors, eviremedies, including dence of small or large coenzyme Q10, coral strokes, damage from calcium, huperzine severe head trauma or A and omega-3 fatty a buildup of fluid in the acids to prevent or treat brain—are causing sympAlzheimer’s disease, but toms that mimic those of not enough research Alzheimer’s. exists to show if they “We generally recomwork. mend the imaging studAt one time, hories and lab work that can mone replacement detect treatable conditherapy was thought tions,” says Dr. McIntosh. to lower the risk for “For instance, a severe women who took HRT Vitamin B-12 deficiency after menopause, but can result in dementiamore recent research like symptoms. We look indicates it may actually at possible alcoholism increase the incidence to make sure it’s not an of Alzheimer’s. Some alcohol-related demenscience shows that art tia; [we] make sure the and music therapy may patient hasn’t had mulstimulate the senses, tiple strokes. In many and can improve mood, respects, it’s a process of behavior and day-to-day elimination to arrive at an function for people with Alzheimer’s diagnosis.” Gerald McIntosh, M.D., Alzheimer’s, triggering Neurologist, Neurology memories and helping Research provides Associates them reconnect with hope the world around them. A new study out of Despite all this Canada uses saliva to research, Alzheimer’s disease is a moving target identify certain metabolites, which are molecular and the brain remains the body’s final frontier. byproducts of metabolism, that are linked to Wrapped up in the heavy bones of the skull, it cellular-level changes in the brain and appear to is tricky to access and doctors are still trying to point to the onset of Alzheimer’s. According to unlock its secrets. They will continue to redraw an article in Medical Daily, the study’s authors the maps they do have as new evidence about discovered specific substances highly concenthis amazingly complex organ is uncovered. trated in the saliva of people with Alzheimer’s For Mark and Prue, the life maps they drew weren’t as concentrated in the saliva of those with mild cognitive decline or healthy brains. as a couple are being redrawn as well. Prue cannot be left alone. Her cognitive abilities Though the test shows promise, it is not yet have degenerated to the point that she must commercially available. have a home caregiver present whenever Mark Another study led by researchers at Stony cannot be there to ensure she eats, doesn’t Brook University indicates that sleeping on the side may significantly affect neurological health. injure herself or wander off alone. It is inevitable that one day, soon, she will have to live in a Sleeping in the lateral position (another term full-care facility. for side-sleeping) may help to remove waste “So now,” says Mark, “I am trying to figure products, such as beta-amyloid and tau proteins out what this map looks like. It used to shoot from the brain. The study, which researchers have conducted only on rats thus far, used straight to the moon. But honestly, I don’t know where it’s going anymore. And that’s MRI scans to observe how cerebrospinal fluid one challenge of this disease I didn’t expect.” moves through glymphatic pathways—the system that removes waste chemicals from the brain—and passes it to the interstitial fluid that flows between all cells in the body in order to Michelle Venus is a freelance writer based in clear waste products. Fort Collins. For now, though, no effective treatment for

We can’t make a diagnosis until people are impaired, and by the time they’re impaired the disease has already caused a lot of damage.

B SHARP: ENGAGING ALZHEIMER’S PATIENTS AND CAREGIVERS IN THE ART OF MUSIC Maury Dobbie, president of the board of directors for the Fort Collins Symphony, is direct about why she spearheaded the B Sharp Alzheimer’s disease study: “Because my father is going through this [Alzheimer’s disease] right now and I am starting to feel the pain of being the caregiver.” Dobbie is not alone in her situation, as one out of every 10 seniors in Colorado has Alzheimer’s disease. Her personal situation and position with the symphony brought her to the table with other community leaders: Banner Health Systems, Colorado State University, the Alzheimer’s Association and the Larimer County Office on Aging. Together, they are sponsoring B Sharp, an arts engagement program that studies the effects of music on patients and their caregivers. The B Sharp program provides 30 people with dementia and their primary caregivers the opportunity to attend all five of the Fort Collins Symphony Masterworks performances. Each pair will have season tickets, so they can count on having the same aisle seats for each performance. The seats offer consistency and easy access to the exit should the individual with dementia feel overwhelmed and need to leave. The goals of the program are to improve the quality of life for people with dementia and their caregivers as well as expand opportunities for social interaction. “Alzheimer’s is a very isolating disease,” states Dobbie. “People tend to ‘pull in’ when it starts impacting their ability to be social, and the caregiver becomes housebound, too. B Sharp provides opportunities to socialize as well as to enjoy music, which has been shown to stimulate brain activity.” Recently deceased neurologist Oliver Sacks stated that, “Music evokes emotion, and emotion can bring with it memory … it brings back the feeling of life when nothing else can.” CSU will lead the study to measure the impact of B Sharp on a variety of quality-of-life and socialsustainability issues including the quality of interactions between the individuals and their caregivers; changes in cognitive functions and social connections; and the feelings of support and community connection for the caregivers. “We live in a community that is very giving,” says Dobbie. “Working with so many different organizations coming together to give something meaningful to these often overlooked members of our community is very gratifying.” Currently the study is in a fundraising phase. Community members can support B Sharp through donations. Paul Matthews (paul.matthews@bannerhealth.com) is overseeing the efforts and can provide more information.

Lydia’s STYLE Magazine

Northern Colorado Medical & Wellness 2015

MEDICAL

Mental Health

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

SURVIVING CO-RETIREMENT MAKING THE RELATIONSHIP WORK WHEN TIME TOGETHER IS ABUNDANT

inally! You can roll over and go back

to sleep—every morning. You can read your way through the stack of best-sellers piled on the nightstand. You can take the grandkids to the zoo, feed them clouds of cotton candy, smile innocently and hand them back to your son or daughter. In fact, you can schedule that bicycle vacation you’ve been dreaming about. Retirement fantasies are common, especially as people draw within five years of the target date. For the well-prepared, few barriers prevent them from achieving those dreams. But almost everybody making the transition from a working lifestyle to retirement experiences a period of adjustment, especially if they now find themselves spending virtually every moment of every day with a spouse. Marilyn MacIntyre, LMFT, therapist to Northern Colorado families for more than 20 years, recommends couples start discussing retirement considerations a year in advance. “Spouses often have different assumptions and core values around retirement,” she explains. One person may be thinking about more quality time together, while the other looks forward to solo mountain-bike adventures. Expectations about daily chores may need adjustment, as well. “Have regular conversations about what the transition to retirement looks like—physically, emotionally and spiritually,” Marilyn counsels. Growing numbers of couples negotiate “mixed retirements.” Jeff Wright, 23-year veteran and founding pastor at Heart of the Rockies Christian Church, announced a 2015 target for retirement several years in advance. However, Janet Wright, a licensed clinical social worker, opted to continue working after Jeff retired. “I stepped down to half-time in the office, but I still love my practice

Northern Colorado Medical & Wellness 2015

and didn’t want to stop altogether,” Janet says. Likewise, longtime retired couple Cheryl and John Becket, both former owners and managers of their own businesses for 30-plus years, recognize the importance of respecting each other’s needs. Cheryl advises, “Don’t decide ahead of time how retirement is going to be, but talk about what you would like it to be and see how [you can] sort through visions.” Valuable insights from personal experiences and from professional practice highlight 10 guidelines to make the adjustment to retirement as brief and painless as possible. • Get reacquainted with inner longings. Create a bucket list and understand what these items require in terms of time and resources, then save for them. Financial experts estimate that retired folks manage on 75 to 80 percent of preretirement income, so plan accordingly. • Get reacquainted with your partner. Renew a common interest or take up a common activity. Go on a date on a weeknight, relaxing over an elegant dinner and giggling at the poor folks who have to work in the morning. According to research psychologist John Gottman, a weekly date is one hallmark of the “magic five hours per week” that strengthens relationships. “Strong evidence suggests when couples apply Gottman’s principles, they work,” MacIntyre says. • Guard your health. Schedule a complete physical and get an honest assessment. Then clean up your diet, get off the couch and get active, even if it’s just taking a daily walk around the block. • Learn about resources and opportunities

BY ELISSA J. TIVONA

for seniors available in the community and beyond, and take advantage of them. Northern Colorado is commonly voted one of the best places to retire for good reason. • Be social for enjoyment, not to network. Book groups, contra dances, community choirs, fly-fishing clubs, hiking adventures, “maker spaces,” craft circles—name just about any interest and you can find someone who shares it. Make friends with new people for the sheer joy of connecting. The Wrights faced a significant loss of social contact because their church requires retired pastors to refrain from involvement with the congregation for at least a year. “I agreed in theory, but we didn’t realize how difficult it would be,” Jeff reflects. “We have to be very intentional about building new relationships.” • Give back. Hundreds of organizations need your skills, experience and wisdom. Many wise retirees discover service work fulfills that deep need for interaction, which came automatically with a regular job. The Becketts choose to serve on various nonprofit boards, and John enjoys being a “handy helper” for others. The Wrights are still reflecting on new purpose for this next phase. “Whatever years I have left, I know I want them to be about stitching the world together,” Jeff says. • See a little more of the world. Visit someplace new, local or exotic, just because. • Some people need to work, whether for the money or the meaning. Try a part-time job free from the stresses in your former career. For a challenge, start a business. “I’ve been surprised, even in the step-down

process, how much my work is part of my identity. I wonder, ‘Who am I if I don’t have that position?’” Janet shares. Jeff adds, “…right down to something as seemingly insignificant as not having a business card anymore.” • Lighten your load. Recycle excessive stuff to Goodwill, the kids, the church rummage sale or the curb; many people discover they enjoy more by taking care of less. • Keep learning. Returning to the state of openness and awe of a 3-year-old keeps the mind nimble and the heart humble.

OPPORTUNITIES FOR RETIREES • The Fort Collins Senior Center, 1200 Raintree Dr., offers resources and learning opportunities for older adults including arts and crafts, dance and movement, education, fitness, outdoor recreation and travel. Visit http://www.fcgov.com/ recreation/seniorcenter.php. • The Recreator from the city of Fort Collins includes plenty of adult programming. Visit http:// www.fcgov.com/recreator/index.php# to see the catalog online or request home delivery. • The Aspen Club, a University of Colorado Health program, provides health education and screenings, hospital discounts and social opportunities to residents ages 50-plus throughout Northern Colorado. Visit https://www.uchealth.org/Pages/ Services/Community-Health/Aspen-Club.aspx. • Osher Lifelong Learning Institute is a memberbased learning community, with special attention to those age 50 and better. Visit http://www. online.colostate.edu/osher/.

Lydia’s STYLE Magazine

Janet and Jeff Wright are discovering activities they can do together now that Jeff, a veteran and former pastor, has retired and Janet is working fewer hours as a licensed clinical social worker. John and Cheryl offer these final thoughts: “Think about the fact that you may be retired for almost as long as you had your last job and be prepared with long-term goals. Always keep your sense of humor. There is no right or wrong, just differences.” Elissa J. Tivona is a freelance writer based in Colorado who teaches at Colorado State University in the department of Journalism and Media Communication and the Office of International Programs.

• The America the Beautiful Senior Pass is a lifetime ticket to more than 2,000 federal recreation sites and, for $10, is available to any U.S. permanent resident age 62 or over. Visit http:// www.nps.gov/findapark/passes.htm. • Silver Sneakers, administered by Healthways, is the nation’s leading fitness program designed exclusively for older adults. The program is free to eligible seniors as a benefit of many healthcare plans. Determine eligibility at https://www. silversneakers.com/about. • Discounts at local cinemas and other entertainment venues are available at every theater in town, but remember to ask and have identification handy. • Colorado Parks and Wildlife issues Colorado residents 64 years and older an annual fishing license for $1. See http://cpw.state.co.us/buyapply/Pages/Fishing.aspx.

Northern Colorado Medical & Wellness 2015

MEDICAL

M e n ’s H e a l t h

Lydia’s STYLE Magazine

JUST A S N I P ! VASECTOMIES OFFER SIMPLE, SAFE SOLUTION TO BIRTH CONTROL BY BRAD SHANNON

t’s generated classic jokes and myths. Its mention is enough to make some men squirm. And it’s an important reproductive health option for men and their partners.

A vasectomy is a surgical procedure aimed at preventing a man’s sperm from entering the seminal stream so that it will not fertilize an egg. It is the fourth most common birth control method behind oral contraceptives, condoms and tubal ligation, according to Dr. John Paddack, a urologist with Banner Health. Exactly why is unclear to Dr. Paddock, who notes that it is safer than and as effective as a tubal ligation, a quarter of the cost, uses only local numbing, and results in less pain and less time off work. And, no, a tubal ligation does not end a woman’s monthly cycle. If someone is considering a vasectomy, chances are he knows several men who have had one, though it doesn’t come up in casual conversation. But if he asks, most are happy to share their experiences. A conversation with his primary care physician and a consult with a urologist is also informative. Dr. Paddack reports that patients who are interested in a vasectomy “typically are older males who are married or have a long-term partner and have kids. Usually he’s experiencing dissatisfaction with their current form of birth control. His wife is tired of taking a daily pill, and they want a more permanent solution.”

Deciding

The female partner typically initiates conversation and research and a good bit of inquiry goes into the decision, including talking to friends and family, he says. “Many know someone who has had one, often on the recommendation of a

Northern Colorado Medical & Wellness 2015

physician, and speak favorably of the decision.” There’s no medical reason to have a vasectomy, Dr. Paddack says. But, in addition to avoiding the female partner’s long-term use of oral contraceptive, a common desire is that she doesn’t have to undergo the more complex, risky procedure of a tubal ligation. “Wives are welcome and encouraged to be involved in the pre procedure discussion,” Dr. Paddack says. “There is not a formal policy related to this, but it is important to have agreement between the couple about having the procedure done.” “Anne,” of Ohio, whose former husband had the procedure, recalls that while her signature was not requested, the doctor who did the procedure required her to come in and participate in the discussion and decision. “Suzi,” of Loveland, wishes that had been the case for her. “My husband got a vasectomy after our daughter was born, and didn’t even mention it to me. I was only 25 years old and he made a decision for me that I would never conceive another child (with him),” she says. “The rest of the story is clear: I did have another child when I was in my 30s. Don’t ever take my choices away from me.”

The Procedure

On the day of the procedure, patients strip from the waist down, and health-care workers prep and clean the scrotum with an antiseptic solution. Two common approaches use a single incision in the middle, or one on each side, according to Dr. Paddack. Health-care providers numb the area with a local anesthetic and, in some cases, the anesthesiologist will use a mild general anesthetic to relax the patient, he says. The surgeon makes a small opening in the skin, brings the vas deferens to the surface using forceps and clears off any surrounding tissue. The surgeon can use one of several methods to close or block off the vas deferens, including taking out a small segment and burning the two ends, or clipping or tying the ends closed. A third option is to insert a piece of tissue between the

Dr. John Paddack, a urologist with Banner Health, says vasectomies are a safer and simpler procedure for men than a tubal ligation is for a woman to prevent pregnancy.

two ends, Dr. Paddack says. The incision is usually small enough that a suture isn’t needed, and the surgeon applies a bandage. It’s all complete in 10 to 15 minutes on average, he says.

Recovery

Recovery time following a vasectomy varies, depending on the patient’s discomfort level. “Avoid strenuous activity for three to five days, and abstain from sex for about a week,” says Dr. Paddack. “Wear snug underwear for support, ice for 24-48 hours and take pain medication as needed. Many return to nonstrenuous jobs the next day.” Caution is the rule. A patient may feel fine post-procedure, local residents “Bill,” of Fort Collins, and “John,” of Denver, agree, and then do too much and regret it. Ice or a bag of frozen peas is “your friend,” recalls Denver resident “Jim.” “Rick,” of Fort Collins, had to stay off his bike for a month, “which was probably the biggest hardship for me.” Eight to 16 weeks later, health-care providers perform an analysis to ensure there is no sperm in the patient’s specimen, Dr. Paddack says.

Risky Business

As with any surgery, risks are involved, but they are minimal, Dr. Paddack says. The most common—in less than 2 percent of patients—is bleeding that leads to a hematoma in the area of the surgery. Infection risk is between 1 and 2 percent—low enough that a prophylactic antibiotic before the procedure is not typically prescribed. Patients also have a 1 to 2 percent risk of experiencing chronic testicular pain after the procedure, which is typically resolved with “conservative management,” he says. An obstructive or back-pressure issue from a buildup behind

Surgeons make a small incision in order to cut and block off the vas deferens, which allows the sperm to enter the seminal stream.

the area where the vas deferens is closed off may cause the pain, but it typically does not require another operation or other intervention. “There’s a mild discomfort with the procedure, and failure is rare—one in 2,000,” Dr. Paddack says. “When that happens, there is a spontaneous rejoining of the two ends of the vas. When there is a failure, it usually fails within the first two to four months.” Numerous medical studies show no connection or increased risk between vasectomy and prostate or testicular cancer exist, he adds.

No U-Turn?

Dr. Paddack counsels patients that a vasectomy is a permanent procedure, and recommends against it for those who may want children in the future. The rate of reversal success varies with the time since the procedure. Less than three years later, pregnancy rates are around 76 percent. After nine years, that drops to 40 percent. “It is not related to age. There is no decrease in sperm productivity as men age,” he says. The reversal is done through a small incision, as well, but sometimes under general anesthesia and typically by a fertility specialist. The surgeon finds the two of the vas deferens ends, cuts them to make fresh ends, inspects the fluid for healthy sperm, and reconnects the ends using a microscope, Dr. Paddack explains. Sometimes it’s necessary to bypass a portion of the vas deferens that is not viable, and that can involve connecting the vas directly to the epididymis. For those concerned about reversibility, an approach called reversible inhibition of sperm under guidance (RISUG) is currently under development in the U.S. Called Vasagel, the long-acting, nonhormonal implant is in trials in other countries to evaluate risks and benefits, he adds.

Looking Back

Many who have had the procedure have some hazy memories of discomfort, but are glad they did it. “Kim,” of Loveland, had a child, had a vasectomy, had it reversed 14 years later, had another child and then another vasectomy. “I barely had a flicker tail on the end of my sperm after all that time, but it got the job done,” he says. “Don,” of Loveland, had one in the 1970s in the Midwest, suffered an infection and calls the experience “a nightmare.” But he is glad he did it and notes that his experience was “way out of the ordinary. No one else I’ve talked to had any type of similar experience.”

Check Insurance Coverage

A ballpark cost, Dr. Paddack says, is tough to answer, as it depends on the patient’s insurance provider and coverage, but most do cover it. “Carter,” of Loveland, had an issue with his insurance company just after the Affordable Care Act was implemented that left him with some unexpected costs when he thought it covered the procedure 100 percent. “It wasn’t that big of a deal, but I was very frustrated that there can be unforeseen costs with medical procedures and that no one can actually give you a price for the things they are going to do,” he says. It is rumored more vasectomies are performed just before the NCAA basketball tournament in the spring, but Dr. Paddack dismisses that with a chuckle. “In my experience, they are more common in December, when men have met their insurance deductible for the year,” he says. Brad Shannon is a freelance writer based in Loveland and owner of public relations and communications firm Shannon Marketing Communications, LLC.

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MEDICAL

Foot Care

PLANTAR FASCIITIS:

BY KAY RIOS

GETTING TO THE BOTTOM OF FOOT PAIN

f your first few steps out of bed in the morning finds you in agony, you’re in pace with a growing number of people suffering from plantar fasciitis.

Possibly the most common cause of pain in the inferior heel, plantar fasciitis may account for up to 15 percent of all foot symptoms requiring medical care, according to the New England Journal of Medicine. With over 30 articles in peer-reviewed medical journals this year alone, plantar fasciitis is receiving its share of attention, says Dr. Nathan Hunt, doctor of podiatric medicine (DPM) at the Orthopaedic and Spine Center of the Rockies. “That shows it is of interest to a lot of people,” he says. “I see it at least once a day.” Dr. Chad Knutsen, DPM, of A Step Ahead Foot

and Ankle Center, agrees. “It’s the most common thing we see. It’s an overuse-type malady.” Plantar fasciitis occurs when the plantar fascia—a thick band of tissue that runs across the bottom of the foot and connects the heel bone to the toes—becomes swollen or inflamed, according to the Mayo Clinic. The result is commonly a stabbing pain that usually occurs with the very first steps in the morning. Once the foot limbers up, the pain usually decreases, but may return after long periods of standing or getting up from a seated position. “The causes are not entirely understood,” Dr. Hunt says. “It can be from a trauma such as a fall or even as simple as jumping off a curb. Another common cause is overuse, similar to tendinitis. It can also be generated from abnormal biomechanics or a flat foot or very high arches.”

Experts list other causes including: • Overuse of the feet without adequate periods of rest; • Tightness in the Achilles tendon at the back of the heel; • Working conditions that involve long hours spent standing or lifting heavy objects; • Worn or ill-fitting footwear; • The normal aging process, which can result in a loss of soft-tissue elasticity. “The basic thing is over pronation,” Dr. Knutsen says, describing pronation as the way the foot

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There could be a lot of different causes for the pain … Don’t just automatically write it off as plantar fasciitis. See a doctor and find out what it is so you don’t delay treatment. Nathan Hunt, DPM Orthopaedic and Spine Center of the Rockies

rolls during walking and running and naturally helps the lower leg deal with shock. “It is a motion-control problem. “When the foot over-pronates, your arch collapses farther than it should and, because it collapses, the ligament is pulled from away from the bone. During the night, the body tries to make that repair but, because it’s in a relaxed state, it heals too fast and then there’s pain in the morning when the person gets up.” The treatments vary from simple to invasive, Dr. Hunt says. “Often the first line of treatment would be noninvasive: some level of arch support, stretching exercises specifically for the plantar fascia, anti-inflammatory modalities, icing, nonsteroidal medicines.” Treatments can then move into the next level, he says: “Night splints, steroid injections. There

Northern Colorado Medical & Wellness 2015

Try the more conservative approach for six months before even considering surgery. So try exercises, stretches, icing, deep massage with a tennis ball, rolling the foot over a frozen water bottle. Chad Knutsen, DPM A Step Ahead Foot and Ankle Center

The most important thing is to treat the cause rather than just focusing on the symptoms. Orthotics prevent a collapse of the arch and that, in turn, prevents pressure on the fascia. Emily Webb, DPM (Left) Pictured with Evie Plummer, DPM (Right) Save Your Sole Foot and Ankle Specialists, P.C.

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are formal physical therapy options such as soft tissue manipulation, ultra sound, dry needling.” Another option physical therapists use is iontophoresis—a technique that introduces ionic medicinal compounds into the body through the skin by applying a local electric current. The more invasive treatments include a wellmolded weight-bearing cast that immobilizes the patient’s foot in a neutral position for two to four weeks, Dr. Hunt says. “There are also surgical options or extracorporeal shockwave therapy. That takes place in an operating room under anesthesia and it’s painful.” Dr. Knutsen says 99 percent of cases don’t require surgery. “Try the more conservative approach for six months before even considering surgery,” he advises, because that can help the body heal itself. “So try exercises, stretches, icing, deep massage with a tennis ball, rolling the foot over a frozen water bottle.” Arch supports—preferably a custom orthotic— and then a night splint, as well as calf and foot stretches, also help, Dr. Knutson says. “A tight calf muscle can cause you to collapse your arch muscle more than you should and can be the start of pronation. And if you stretch the ligament on the bottom of your foot, it will heal quicker. That’s why the night splint is so effective.” Dr. Evie Plummer, DPM, of Save Your Sole Foot and Ankle Specialists, P.C., suggests keeping a towel or a stretch band by the bed and using it every morning to stretch before getting up. “The most important thing is to treat the cause rather than just focusing on the symptoms,” adds Dr. Emily Webb, DPM, of Save Your Sole. “Orthotics prevent a collapse of the arch and that, in turn, prevents pressure on the fascia.” While some patients say they’ve tried inserts in their shoes and did not improve, custom orthotics can provide the support they need, Dr. Plummer says. Dr. Hunt stresses that foot pain is not a problem easily solved. “It’s not as simple or straight forward as a lot of people like to think it is,” he advises. “There could be a lot of different causes for the pain: differential stress factors, a bony abnormality that can cause a pathologic fracture or it could be a bruise. You could have tendinitis. Don’t just automatically write it off as plantar fasciitis. See a doctor and find out what it is so you don’t delay treatment.”

Kay Rios, Ph.D., is a freelance writer based in Fort Collins.

Northern Colorado Medical & Wellness 2015

Good shoes are key to happy feet Wear the right shoes to avoid foot pain and problems. Drs. Emily Webb and Evie Plummer, DPM, of Save Your Sole Foot and Ankle Specialists, P.C., and Dr. Chad Knutsen, DPM, of A Step Ahead Foot and Ankle Center, make these suggestions on finding the right shoes: • Avoid wearing traditional summer footwear: “Going barefoot is even better than flip flops or sandals,” Webb says. • When choosing tennis shoes, go with running shoes: “They are lighter and more cushioned, but you do have to replace them more often. Every 500 miles is about the point of replacement,” she says. • Dr. Knutsen adds tennis shoes without good arch support are as bad as flip flops. • When using orthotics, consider a shoe conducive to them, Dr. Plummer says. • Dr. Webb recommends looking for shoes with a raised arch and a cushioned sole, that don’t allow for too much flexibility but provide support. • “Consider how much you’ll be on your feet,” Dr. Webb says. “You can’t wear high heels all week and then run a marathon and not expect a problem. If you wear cutesy shoes at work and then pound them on the weekend, injuries and pain are more likely to happen. So look at how you use your feet all week and plan for that.” • “Find a shoe with good arch support and a solid sole,” Dr. Knutsen says. “The problem is trying to find a shoe that matches length, width and height of your arch. That’s a custom shoe.” • Custom orthotics, the doctors agree, can provide the support shoes may not.

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Northern Colorado Medical & Wellness 2015

MEDICAL

Seniors

SENIOR LIVING CENTER EXPANDS

EXTENDS ‘GRACE’ TO THE ELDERLY

very day he walks into work, Steve Briscoe asks himself, “Would I want my mother cared for here?”

And every day since the chief executive officer of Continuum Health Management opened Grace Pointe Continuing Senior Care Campus in west Greeley six years ago, the answer has been a resounding, “yes.” “Grace Pointe is what it is because of the people who work here,” he says. “They save human life and rehabilitate human life here everyday. They’re really special people.” Deb Majors, executive director of the facility, agrees. “I think we are very blessed here at Grace Pointe,” she says. “We have a very caring staff. Our management team, for the most part, has

been with us since we opened. They and our frontline staff feel a part of the Grace Pointe community; they get to know the residents very well. We all love what we do.” Briscoe believes that reputation for caring is as responsible for Grace Pointe’s need to expand as much as the area’s growing demand for senior assisted-living homes and services. Grace Pointe added 26 living units, expanded its dining room, and added a community room downstairs for residents’ as well as community events, all of which resulted in the center growing from 72,000 square feet to 99,000 square feet. “There is a tremendous need and, over the last six years, the team at Grace Pointe has produced tremendous service that is highly desired by the community,” Briscoe says. “The only thing to do was to expand to respond to the community.” Majors says with the expansion, completed in June, Grace Pointe has filled 70 percent of

BY KELLY K. SERRANO

the new units between meeting the demand of its waiting list and others who have placed deposits on units. The other units won’t remain empty for long. Connie Berman, director of admissions and marketing, says with 10 floor plans, Grace Pointe makes it easy for residents to transition from their current living spaces to much smaller ones. “It’s all about giving people choices,” she says. “They can adjust to whatever space because of the community.” The units—whether one bedroom, one-bedroom with a den or a studio apartment—each offers a kitchenette with a microwave, sink and refrigerator. But the center provides three meals a day, and the hope is residents come out of their units not only for the tasty, high-quality food, but to socialize with their fellow residents as well as the staff, Berman says. The center also offers plenty of activities,

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Grace Pointe Chef and Dietary Manager Steve Klady gets to know some of his diners.

bringing in speakers and performers, planning outings such as picnic lunches and trips to various attractions, and holiday meals for residents and their guests. “We have a very busy activity calendar; we try to get them out and engaged in the community,” Majors says. Even as Briscoe, Majors and Berman take a guest on a tour of the center, they’re saying hello and chatting with residents, calling them by name. And the residents know them by name, as well. “It’s those folks who have that strong connection,” Berman says of Grace Pointe’s employees. “It really feels like a family. People like to work here. It says a lot about how (residents) are treated when they like to work here.” Briscoe points to Majors—whose parents owned a nursing home, so she has been caring for the elderly all of her life—as an example of the experienced, compassionate people who

Northern Colorado Medical & Wellness 2015

Madeleine Jacobs, Grace Pointe’s activity director, takes a few minutes to visit with a resident.

work at Grace Pointe. “I think people here have learned from Deb to treat others as you would want to be treated,” he says. “It truly is a wonderful place.” Briscoe himself has 38 years of experience in the senior-care field, including 20 with Continuum. “Steve has a great vision,” Majors says. “It’s been great to be a part of executing that.” And part of that vision included choosing the right contractor to expand Grace Pointe—Adolfson & Peterson Construction (A&P). “We chose them on the basis of their experience and their professionalism,” Briscoe says. “We understood that many people at A&P have loved ones currently in facilities or have experienced senior services, so we knew they would take an extra level of care. They had to connect the building, so they had to interact with our residents.” The construction workers walked through the

dining room often and came to know residents on a first-name basis, talking to them like their own family members, he notes. Majors adds that the construction project became an activity in and of itself for residents, and they often commented on it or gave advice to A&P’s workers. “A&P has very high standards both personally and professionally and we were happy to have them,” Briscoe says. “We had a great experience with them.” Grace Pointe Continuing Senior Care Campus 1919 68th Ave Greeley, CO 80634 (970) 304-1919 www.gracepointegreeley.com Kelly K. Serrano is editor for Northern Colorado Medical & Wellness Magazine.

Healthy You

EATING OUT?

MAKE SMART CHOICES BY MALINI BARTELS

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et’s be clear: if you’re making a conscious decision to go out to eat, you understand a higher caloric intake is involved. It’s not a secret that restaurants love butter, cream and frying anything possible. It tastes good. While trying to navigate through a menu can be overwhelming, trimming calories when choosing to dine out is not as difficult as it once was. Nowadays, apps such as Calorie King and My Fitness Pal can help monitor portion-controlled caloric intake and record information. Some restaurants provide nutritional labeling on their menus, providing valuable information to make wise decisions when eating out. As founder and chief executive officer of MenuTrinfo, a locally based and nationally used company, Betsy Craig is quite familiar with how the system of nutrition labeling works. The name MenuTrinfo is a portmanteau of the words menu, nutrition and information. The company provides menu labeling to restaurants, nutritional services and food-allergy training. “We teach chefs how to alter recipes for nutritional benefit,” says Craig. Initially passed as part of the Affordable Care Act of 2010, any restaurant that is part of a chain with 20 or more establishments will have to provide nutritional information on their menus by the end of 2016. Some restaurant chains such as Panera, Starbucks and McDonalds are already leading the way with menu-labeling services. “People have a right to know what they are eating. Ultimately, all restaurants will be required to provide nutritional information of the food they serve,” Craig says. As a certified diabetes educator and clinical dietician, Cecilia Jamieson, M.S., has worked to assist people with healthy eating habits through the University of Colorado Health system for the past 11 years. “Before eating out, you can type the name of the establishment and the word nutrition in your search engine and find per-serving nutritional information before even leaving your home,” says Jamieson. “This information is more current than what is available on any app.” She mentions that local and national restaurants are making a concerted effort to supply customers with available information and help accommodate needs. It’s up to consumers to make smart choices. “It’s essential to avoid intake of calories you don’t need. It’s very easy to drink extra calories, and soda pop is a huge culprit,” Jamieson says. “Juice should also be avoided or diluted as much as possible: even though

Northern Colorado Medical & Wellness 2015

it’s natural sugar, it’s still calories.” The typically coveted buffets are where people can get into big trouble. “It’s easy to overeat and exceed calorie intake when there is so much food available and right in front of you,” she says. Through her businesses, Zen Functional Wellness and Zen Eats, LLC, Crystal Melanson, a Certified Functional Diagnostic Nutrition Practitioner and Certified Natural Chef, provides nutrition and functional health services focused on addressing the root cause of health issues and symptoms. “My overall goal is to raise awareness of the power of nutrition and promote whole body wellness through education, healthy foods and a functional holistic approach,” Melanson says. “Try to look for words such as baked, broiled, roasted or fresh. These can often be clues to healthier cooking techniques. Watch out for items labeled creamy, crispy or fried, which can often be descriptions for dishes high in oils and fats,” she advises. She also recommends choosing items consisting mostly of veggies and protein, or even creating a meal from available sides and accompanying it with a protein. “Remember to stop eating when you are full,” Melanson insists, offering a tip that not only helps your waistline, but stretches your dollar, as well. “Who doesn’t love leftovers? Ask for a box to take home the rest of your meal or even pack up half of it before you start eating to ensure a smaller portion.” Melanson feels that many restaurants try to offer variations on the menu or are willing to cater to requests to make a dish healthier and accommodate food allergies and restrictions. “Being transparent and clear with menu descriptions of dishes can help customers know exactly what they are receiving so that they can pick a dish that is right for their diet,” she says. “As a chef, I know that many chefs and restaurants strive to please their customers. “As a customer, I’m not afraid to speak up and ask questions about the dish or how it is prepared. Most servers are very willing to help you navigate the menu, suggest choices and speak with the cooks to have a dish prepared for you that will fit your individual needs,” Melanson adds. As with most good habits, when it boils down to healthy eating, choice and knowledge are the tools for success.

Malini Bartels is a freelance writer, chef, mother, radio host and actress living the good life in Fort Collins.

Healthy You

A HEALTHIER CLEAN

GO GREEN AND NEVER GO BACK BY KYLE EUSTICE

t sounds scary, but it’s true: conventional cleaning products can lead to serious health complications.

The Environmental Protection Agency reports that indoor air pollution levels are as much as 100 times worse than outdoor air pollution, due mainly to volatile organic compounds (VOCs) that evaporate from cleaning supplies. Research has linked many minor health issues to indoor air pollution and, after years of exposure, more serious problems can occur, including some respiratory diseases, heart disease and cancer. “Going green” is a simple solution to exposing people and pets to unnecessary pollutants. Green cleaning shies away from the use of products that contain toxic chemicals, some of which emit volatile organic compounds causing respiratory, dermatological and other conditions. Tom Legget started Green Clean Colorado, a locally owned and operated cleaning company, in 2010. Specializing in the “reduce, re-use and recycle” business practices, Green Clean Colorado, as the name suggests, revolves around eco-friendly products and methods. “We use proprietary products for the most part,” Legget explains. “It’s hydrogen

peroxide-based and mixed with orange oil, which is used for multi-surface cleaning.” Countless options are out there when it comes to green-cleaning products. Aside from the big brand names like Simple Green or CitraSolv, many inexpensive, easy-to-use natural alternatives consist of basic household ingredients. Baking soda, for example, cleans, deodorizes, softens water and scours. Combined with white vinegar and water, it removes water-deposit stains on shower-stall panels, bathroom chrome fixtures, bathroom mirrors or windows. A splash of juice from a lemon—one of the strongest food acids and extremely effective against most household bacteria—and baking soda absorbs natural odors, as well. According to EarthEasy.com, Borax powder, or sodium borate, also cleans, deodorizes, disinfects and softens water. Businesses such as Target, Kmart and most grocery stores carry it in bulk. It has the ability to clean wallpaper, painted walls and floors. Mix one-fourth cup of Borax with one-fourth cup of vinegar and one-fourth cup of salt for an ideal carpet cleaner. Other ingredients such as unscented liquid soap, washing soda (similar to baking soda), isopropyl alcohol (rubbing alcohol), cornstarch,

and citrus solvent are ideal for homemade greencleaning products including: •

Air fresheners

•

Coffee/tea stain removal

•

Deodorizers

•

Dishwasher soap

•

Drain cleaner

•

Fabric softener

•

Floor cleaner/polish

•

Laundry detergent

•

Metal cleaners

•

Mold/mildew removers

•

Oven cleaner

•

Window cleaner

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•

Paint-brush cleaner

•

Toilet-bowl cleaner and more.

If timing is a concern when it comes to making homemade green-cleaning products, shopping for them is a painless process. Whole Foods Market, Natural Grocers by Vitamin Cottage and Trader Joe’s are good places to start. However, when in doubt, read the label and, according to www.greencleaningproductsllc.com, look for key words such as: •

Nontoxic

•

Fragrance-free

•

Bio-based

•

Concentrated

•

Reduced/recyclable packaging

•

No VOCs (volatile organic compounds)

•

Biodegradable.

Eliminating conventional cleaning products reduces the harsh chemicals absorbed into the skin or inhaled by the person doing the cleaning. Additionally, green cleaning products are safer, posing less risk of chemical burns or skin irritation. “There are no poisons in green cleaning products, but there are in a lot of other products because they aren’t regulated in any way,” Legget explains. “They aren’t considered a consumable product. Nothing’s tested and they can put basically anything they want in there. That ignores the fact that you, your pets or kids can absorb it from surfaces you’ve just cleaned. “Going green can help you and your family live a healthier life.” At the very least, the simple switch from conventional-cleaning products to green-cleaning products saves money: ingredients such as vinegar, baking soda and lemon juice can do the trick for pennies on the dollar. Switching to green cleaning products is not only beneficial for a family’s health, but is also looking out for the planet. Using green-cleaning products keeps the environment purer by minimizing the impact on ozone depletion, global climate change and, because so many greencleaning companies use recyclable packaging, it also cuts down on waste. “They are also biodegradable so, if you’re putting it down the drain, it’s not getting into the water system or causing any problems that way,” Leggett says.

Savvy Social Security Planning Join us for this FREE Educational workshop and learn!

RSVP TODAY! • (970) 377-1705 Thursday, October 8 • 9:00 am

Fort Collins Senior Center • 1200 Raintree Dr.

Learn strategies to avoid common mistakes. • Timing is everything - filing too early or too late • Not coordinating with other income sources • Not planning for inflation (you’ll need twice as much income in 20 years) • How married couples miss out on substantial benefits

Robert M. McCulley, CFP®, MAFM

CERTIFIED FINANCIAL PLANNER™ Masters Degree Accounting & Financial Management www.mcculleyassociates.com Securities and investment advisory services offered through Cetera Advisors LLC, MEMBER FINRA/SIPC. Cetera is under separate ownership from any other entity.

Kyle Eustice relocated to Fort Collins from her hometown of Omaha, Nebraska. After spending four years living in Santa Fe, New Mexico, she was eager to return to the mountain region. She is a regular contributor to Thrasher Skateboarding Magazine, Wax Poetics, Boulder Weekly Bandwagon Magazine, Ghettoblaster, and many others.

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Healthy You

Maka Kala'i, Director of Sales and Marketing

Kirk Scramstad, Director of Operations

Steve Ackerman, Owner

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CANNABIS PRODUCTS OFFER AN ESCAPE FROM PAIN (WITHOUT THE HIGH)

hances are even those who know nothing about marijuana have heard about a strain called “Charlotte’s Web.”

Two local brothers created it specifically for Charlotte Figi, who was featured on CNN. Charlotte suffered countless seizures on a daily basis, stopped talking and existed in a fugue state as a 6-year-old. Her parents gave her medical marijuana as a last resort and saw an almost immediate reduction in the number of seizures. The strain named in her honor was intentionally bred with as little THC (tetrahydrocannabinol, the compound responsible for most of marijuana’s “high”) as possible. It is rich in the compound CBD, or cannabidiol, which is being used increasingly as medicine for a wide variety of ailments including chronic pain. Industry terminology divides the two types up as either Sativa strains (higher in THC) or Indica strains (higher in CBD for pain relief, sleep, etc.), or some blend of the two. Like THC, nonpsychoactive CBD is extracted as an oil from the cannabis plant, and that oil is used in a variety of products that patients can consume, apply topically or smoke. For Charlotte, relief came from simply ingesting the CBD oil. “Gene” (not his real name), a single dad and software developer in his mid-40s, is an advocate of medical marijuana though his profession keeps him from being public about it. “I had leukemia, and the chemotherapy and radiation caused peripheral neuropathy. One of the chemo drugs had a side effect of eating away the myelin sheath that wraps the nerves in my extremities.” After treatment he felt like his hands and feet were constantly on fire. “Some folks live on opiates to function,” Gene says. “My pain was not at that level, but it impacts my everyday life. I gritted my teeth and took a lot of opiates to sleep, but they make me not a very nice person.” Gene started smoking marijuana occasionally before bed instead, but he was concerned with smoking’s link to lung cancer. Then he learned that a medical-marijuana license got him access to edibles and other modes of cannabis delivery.

Northern Colorado Medical & Wellness 2015

“I wanted that wider range of products to manage pain without altering my consciousness. I found CBD-only or with low THC products good for controlling pain for sleep. It’s not cheap, but it’s well worth it for a good night’s sleep,” Gene says. He swears by a high-CBD, low-THC cream with arnica and peppermint he found at the MiNDFUL dispensary in Berthoud. “It mutes my symptoms when I put it on my feet, and gets me through the day,” he says. Michelle Ballinger, who handles community relations for MiNDFUL, says the dispensaries carry a variety of topicals, infused edible products, hash oil pills and pain patches, teas and more, along with flower and concentrates to smoke for more immediate pain relief. “We have patients that have arthritis, multiple sclerosis, cancer, post-chemo side effects, headaches and general pain that prefer to use only the CBD products that have no to little THC in them,” Ballinger says. “There is a huge need for the CBD-only pills, crèmes and pain patches. These products have minimal THC and generally will not show up in a drug screen.” For Gene, “bad days don’t happen anymore. I used to have a day every week or two where the pain was so bad I had to go lay down and could not focus on my job. Every morning waking up was an adventure: would I need my cane? Could I do my job? Now I walk my dog daily, play with my kids. I’ve lost 25 pounds.” Maka Kala’I, director of sales and marketing at Organic Alternatives in Old Town Fort Collins, carries a variety of oils, tinctures and capsules. Some, he notes, are legal outside Colorado, since they are hemp-derived and contain less than 0.3 percent THC. The store’s “apothecary” line of products includes pain creams, muscle rubs, and bath soaps. It also offers a gel transdermal pen, a patch and a salve. “A lot of our customers get great relief from pure CBD products, but many find even more relief with some THC added,” Kala’l says. “The compounds are symbiotic, and CBD is more active when used with THC. Some, though, have no interest in the high or are concerned about being able to pass a drug test for their job.”

BY BRAD SHANNON

For Robert Cohen, owner of Cohen Medical Centers, based in Denver, serving medical marijuana patients is unique. “We don’t see what they take,” he says. “We validate their conditions and may suggest a course of care, but we can’t say ‘do this, take this, get it from here.’” Physicians struggle with cannabis as medicine, Cohen notes, because it has not been wellresearched or regulated. And because every individual responds differently to using medicinal marijuana, the repeatable, consistent nature of any given product or dose on an individual can vary substantially. Those who sell medical marijuana advise patients to do their research and ask lots of questions, choosing a dispensary that educates them. In some cases, they may need to find a caregiver who can make a product specific to their needs. Abide by the “low and slow, until you know” guideline. Don’t rush and take more than needed and have a bad experience. “We always invite anyone hesitant to come in for a visit,” Ballinger says. “We take a good hour or so to educate them on the difference between a Sativa (higher in THC for the ‘high’) and Indica (higher in CBD and pain relief/sleep, etc.). We make sure that they understand how the different components drawn from the plants work in the topicals and ingestible products as well. “The products are not cheap, but neither are prescriptions and this is a much healthier, long-term option.” Cohen adds, “There is a big learning curve that is the patient’s responsibility. We can tell you what to expect, but until you use the product, you don’t know. Some folks are high metabolizers and need more medicine. Some are ultra sensitive and need to be particularly cautious. Every time you take a dose, you learn what your medicine needs to become, and each person is different.”

Brad Shannon is a freelance writer based in Loveland and owner of public relations and communications firm Shannon Marketing Communications, LLC.

Healthy You

FUNCT IONA L FIT NESS BY HEIDI KERR-SCHLAEFER

Sarah Wilhelms does a single-arm shoulder press, which works the shoulder muscles and trains one side of the body to work independently of the other.

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Trainer Mary Homan observes Sarah Wilhelms doing a box jump with hip flexion, an exercise meant to increase hip and core strength and maintain the hips’ full range of motion.

ith the popularity of workouts such as CrossFit that incorporate it, some may think functional fitness is the newest fad in exercise. But it’s been around since Jack LaLanne inspired his viewers to use basic home objects—such as a chair—to perform exercises along with him on television’s longest-running exercise program, “The Jack LaLanne Show,” from 1951-1985 (Wikipedia). The Mayo Clinic describes functional fitness as exercise that “trains your body to help you do everyday activities safely and efficiently.” Examples include tai chi and Pilates, along with exercises such as multidirectional lunges, standing bicep curls and step-ups with weights. Today, functional-fitness classes are popping up in gyms across America, including in Northern Colorado. “Functional fitness is a buzz word in today’s fitness industry,” says Mary Homan, a personal trainer for 17 years who trains at several area gyms and for the city of Fort Collins. “But it’s been around for a long time and, if you are a good personal trainer, you incorporate functional fitness into your training program.” At The Other Club, Homan teaches GroupFit, a functional-fitness class for anyone. “The reason it’s for anybody is because functional fitness is progressive,” says Homan. People who have never exercised before can participate in a GroupFit class, as they will start with lighter weights and perform movements that don’t require much balance or core stability. As they continue in the class they will progress to heavier weights and do movements requiring more balance. “Functional fitness is all about safe progression of exercises that mimic how we live our lives day to day,” Homan explains. Whether it’s a strain from shoveling snow or

Northern Colorado Medical & Wellness 2015

kneeling in the garden, injuries occur around the home on a regular basis; functional fitness is a way to prevent these sorts of common injuries. For instance, Homan says her functional-fitness training helped her lift and place flagstones properly so as not to injure herself when she and her husband installed a patio recently. “Everything I do in the gym—squatting, situps, Pilates—helped me to build that flagstone patio,” says Homan. Functional fitness incorporates the core, and the core is much more than just abdominal muscles. Core stabilizers are abdominal, hip and gluteal muscles, and the big muscles in the legs. These muscles are constantly working to help perform daily activities, and functional fitness ensures they are working optimally. The more a person practices a specific functional-fitness exercise, the more the brain and body learn to work together. And this is where it gets scientific. Proprioceptors are sensory receptors in muscles, joint capsules and surrounding tissues that signal information to the central nervous system about position and movement of body parts, such as the angle of a joint or length of a muscle. Proprioception is the process of receiving this information with or without conscious awareness (Dictionary of Sports & Exercise Medicine by Churchill Livingstone, 2008). In laymen’s terms, this is muscle memory. As someone repeats an action—squatting for instance—the muscles learn how to work together properly and retain that information when someone is, for example, building a flagstone patio. Functional-fitness classes are usually an hour of continuous movement. While they are not “cardio classes,” some people may get a bit of a cardio workout from functional fitness. These classes often incorporate medicine balls, barbells, kettlebells and other pieces of small equipment. People come to Homan’s classes with various goals. While one client may want to climb five

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As part of her cool-down, Sarah Wilhelms rolls the foam tube through her shoulders, stretching the connective tissues that surround the muscles.

“fourteeners” next summer, another may just want to make sure he can continue his current lifestyle without fear of injury. Mary Lou Theodore is an example of the latter. A decade ago, Theodore started taking Strong Women, Strong Bones with Mary Homan at The Aspen Club. At the time, the 59-year-old photographer had injured herself while shooting in Glacier National Park. “The pavement had broken away and I fell and broke my foot,” recalls Theodore. “As I was hobbling around in a boot, I decided that I needed to do something to improve my balance and core strength.” As she frequently travels, Theodore wanted to continue to pursue her passion without worrying about getting hurt by stumbling off a crumbling road, putting luggage in overhead bins on an airplane, or carrying her heavy and unwieldly camera gear. Strong Women, Strong Bones is designed to prevent/postpone the onset of osteoporosis and incorporates functional-fitness exercises. When Theodore first started the class, she wasn’t an exerciser, but it has helped her gain strength, balance and confidence. She started with the lightest weights and has worked her way up. “I have been so grateful for the program,” says Theodore. “I’m stronger now at 69 than I was 10 years ago, when I started.” Theodore points to the enormous psychological benefits of her functional-fitness exercise routine. Today she is confident when she travels because she knows her body is strong. “Functional fitness is about progression, safety and effectiveness,” says Homan. “And it’s about being strong enough to do what you do outside the classroom.” Heidi Kerr-Schlaefer is a freelance writer and founder of HeidiTown.com, the place for Colorado festival and travel stories.

Northern Colorado Medical & Wellness 2015

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Special Dental Section Enjoy our October Special Dental Section, which includes articles parents of young children and teens should read, as well as profiles of some of the area’s best dental professionals.

Topics in this issue include: 46 - Proper Care of Baby Teeth takes a look at when dental care begins—as early as infancy—and the proper care of baby teeth to ensure heathy adult teeth.

48 – Wisdom-Teeth Extraction Find out why most wisdom teeth need to come out, when it’s time and how it’s done.

Northern Colorado Medical & Wellness 2015

Healthy You

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CARING FOR TEETH STARTS YOUNG

ood dental health doesn’t start when a baby’s first tooth pops up through the gum; it starts well before that little chomper makes its debut.

Working to keep teeth heathy even before they make their appearance helps to ensure a lifetime of dental health. Teeth start forming in the second trimester of pregnancy and babies are born with 20 primary teeth already in place, some of which have developed in the jaw, making pre-tooth eruption the perfect time to start a baby on the right path, according to the Women’s and Children’s Health Network (www.cyh.com). Dr. Greg Evans, pediatric dentist with Big Grins in Fort Collins, recommends teaching babies good dental habits by: • Wiping a clean, damp, soft cloth across her gums after meals to remove harmful bacteria. • Starting to brush her teeth once the baby cuts her first tooth. Wait until sensitive and inflamed gums have healed so that the baby doesn’t associate pain with brushing. • Using a soft infant toothbrush and a daub of toothpaste, about the size of a grain of rice, to minimize the amount of swallowed toothpaste, as babies aren’t spitting yet (spitting up, yes, spitting out, no). Around age 2, a child should learn to spit while brushing. Avoid giving the child water to swish and spit because this might make swallowing toothpaste more likely. • Brushing with a fluoride toothpaste approved by the American Dental Association (ADA) which bears its seal of acceptance if parents choose to

use a fluoride toothpaste. Parents who forego the fluoride route have plenty of options available, too. “Fluoride receives a lot of bad press and scare tactics but, like any other medicine or nutrient, getting the right amount is critical for good health,” says Dr. Greg. Generally fluoride treatments begin in a dentist office at age 3 unless cavity risk factors are evident at a younger age. • Scheduling a visit with a pediatric dentist when the baby is celebrating his first birthday. • Flossing once enough teeth have grown in that they are touching. “Twice a day brushing and flossing are the bedrock, fundamental first steps in raising a cavity-free child,” says Dr. Greg. When possible, brush after snacks—especially the sugary ones that contribute to the rapid bacterial growth that leads to cavities. Keep track of carbohydrate intake as well. Dr. Greg points out that bacteria can even use “good old whole wheat bread” to produce plaque acids. • Limiting the bottle to meal times. “I tell my patients they should treat the bottle like a breast. In other words, kids don’t walk around all day with one, and comfort feedings or use of a bottle for a pacifier is discouraged,” explains Dr. Greg. When the sugars from juice or milk remain on a baby's teeth for hours, they can eat away at the enamel, creating a condition known as bottle mouth. Pocked, pitted or discolored front teeth are signs of bottle mouth. • Weaning a child from the bottle between 14 to 16 months of age, Dr. Greg recommends. At that time, it’s a good idea to switch to sippy cups with straws or hard spouts. Babies as young as 6 months old can start using sippy cups to get them used to the inevitable transition away from

BY MICHELLE VENUS

the bottle. Remember to monitor the contents of the cup, as constant drinking of sugary beverages leads to the same bacterial overgrowth as constant snacking. Provide a baby with beverages for a discrete amount of time and then separate the child from the cup to allow saliva to buffer the food and plaque acid between meals, he advises. If a baby develops cavities in his primary teeth, it’s not necessarily an indicator of poor dental health down the road, Dr. Greg says. However, the No. 1 predictor of cavities in permanent teeth are cavities in the baby teeth, especially in between the teeth or prior to age 5. If a child has those types of cavities, he has a 70 percent chance of having them in his permanent teeth. Education and diligent habits can reduce the possibility of future dental decay, he says. Sometimes, though, little mouths have bigger problems. Ask Dr. Greg about root canals and pulling teeth and he is quick to put the kibosh on the procedure. While root canals are necessary to treat adult teeth when the nerve is dead or dying, it’s not so with baby teeth, he says. Since baby teeth come out at prescribed times, creating an ongoing and viable industry for the Tooth Fairy, children can forego the procedure, unless preserving a baby tooth until a child is older is necessary for better function, appearances or growth issues. Sooner is better when it comes to dental care for pipsqueaks, Dr. Greg says. It’s never too early to instill the good habits that will keep cherished smiles sparkling for a long time.

Michelle Venus is a freelance writer based in Fort Collins.

I tell my patients they should treat the bottle like a breast. In other words, kids don’t walk around all day with one, and comfort feedings or use of a bottle for a pacifier is discouraged. Greg Evans, DDS, Big Grins Pediatric Dentistry

Northern Colorado Medical & Wellness 2015

Healthy You

WHEN IT’S TIME FOR REMOVAL THE WISDOM BEHIND WISDOM TEETH

BY KYLE EUSTICE

ort Collins native Dr. James Troxell did not become an oral surgeon in search of wealth or social status, nor to attain the title of “most successful graduate” at his high school or college reunion. Dr. James Troxell, D.D.S., M.S., PLLC, became an oral surgeon because of empathy. “When I was in dental school, I was in a car accident and suffered facial injuries,” Dr. Troxell explains. “My mother and aunt were killed, but my cousin and I survived. I felt I had found my calling and wanted to learn more about oral surgery. I have a lot of empathy for people and my patients.” Only 23 years old at the time, Dr. Troxell made it his life’s mission to help other people. For the last 34 years he’s been serving the Fort Collins community at his Oral and Maxillofacial Surgery practice on East Elizabeth Street.

One of the more common procedures he performs is the extraction of the third molars, better known as wisdom teeth. “Generally, there’s not enough space for the teeth to come in to a useful position,” he says. “As a result of that, they are difficult to clean and there may not be sufficient room to keep bacteria away from the tooth, which can often be a source of inflammation or infection.” Wisdom teeth are much like other permanent teeth but, if a mouth doesn’t have sufficient space, they can easily become problematic, Dr. Troxell explains. They most often erupt through the gums during the late teens or early 20s. Extracting wisdom teeth can help alleviate pain or infection and prevent future problems. The best and most common time for extraction is in the teenage years, although some adults still need to have them removed. “The ideal time for removal is before they’re a problem,” he says. “Ideally, it’s nice to do it

before the roots reach full development because the longer the roots, the closer they can get to the nerves in the jaw or sinus. If teeth are removed in the teenage years, the roots are shorter and the procedure is usually less invasive.” Many people have smaller jaws that don’t have enough space for wisdom teeth to fully erupt. Because the teeth are difficult to reach to clean, the surrounding tissue may harbor bacteria, which could lead to infection, decay of the wisdom and adjacent teeth, gum disease and discomfort, Dr. Troxell says. It’s important to take preemptive measures as soon as possible, he warns, noting that as the roots develop and become curved, they may increase injury to the nerve and the procedure becomes more difficult. And as people get older, it may not be convenient to have an elective surgery like getting their wisdom teeth removed. Dentists with the proper training can perform the extraction. But if the procedure calls for

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Northern Colorado Medical & Wellness 2014

Dr. James Troxell, D.D.S., M.S., PLLC

Generally, there’s not enough space for the teeth to come in to a useful position. As a result of that, they are difficult to clean and there may not be sufficient room to keep bacteria away from the tooth, which can often be a source of inflammation or infection. James Troxell, D.D.S., M.S., PLLC Oral and Maxillofacial Surgery

anesthesia, patients see an oral surgeon, who reviews their x-rays, health history, explains the procedure, answers questions, and goes over the risks and benefits of anesthesia, Dr. Troxell says. “It depends on difficulty of the impaction,” he explains. “Many patients have intravenous medications for sedation and comfort. As an oral surgeon, we’re trained to do that. It’s very important to see the patient and learn about their medical history before we proceed.” Considering many patients are young when they have their wisdom teeth removed, Dr. Troxell has a specific protocol when dealing with adolescents. “We meet with the patient and their parents,” he says. “We want them to understand exactly what needs to be done and how the teeth are positioned. We explain the procedure step-bystep and address any of their concerns.” In rare instances, a patient has enough room

for the wisdom teeth to come in, Dr. Troxell says. “If they have room for them, we let them come in like a normal tooth,” he states. “It’s only if we see changes to the adjacent teeth, alignment problems or signs of periodontal disease that they’re removed.” Methods of extraction vary. The surgeon may need to make an incision in the gum to reach the tooth, Dr. Troxell says, as well as remove some of the bone around the tooth. Details of the procedure depend on the position of the tooth, whether the tooth has erupted, how deeply the tooth is embedded in the bone, and how close the roots of the tooth are to the sinuses or certain nerves, he adds. Once surgery is complete, the surgeon provides aftercare instructions and recommends a follow-up appointment to make sure the patient’s mouth remains healthy. “Of course, the more you brush and floss,

the better,” Dr. Troxell says. “It’s important to learn how to take care of your teeth when you’re young to avoid bigger problems later on. Removal of the wisdom teeth after age 25 increases operative and postoperative difficulties, and the recovery time is longer. In this case, good things don’t happen to those who wait.”

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ORTHODONTICS

Brad Edgren, DDS, MS Dr. Brad Edgren is a board certified orthodontist and a member of the prestigious Edward H. Angle Society of Orthodontists. He prides himself in his philosophy of designing his orthodontic treatment around the total face; rather than the narrower objective of treating just the teeth and/or just the occlusion (bite). He focuses on customizing the orthodontic and dentofacial treatment plan to each individual that enters his office. This includes evaluating upper airway patency, impacting teeth, dental crowding, jaw constrictions and future facial growth when examining the young, growing orthodontic patient. A treated orthodontic result that appears to be balanced at age 12 may be a failed result as early as age 18 because future facial growth, especially excessive lower jaw growth and airway problems, were not taken into consideration during treatment. Dr. Edgren recommends seeing patients by age 7 to take full advantage of dentofacial growth, optimizing the orthodontic result. Appropriate early interceptive orthodontic treatment in the growing patient reduces tooth extractions, jaw surgeries, and improves upper airway patency; reducing potential sleep apnea problems as adults. Dr. Edgren not only attends required continuing education courses to better serve his patients but is actually teaching these courses internationally and authors continuing education articles in peer-reviewed journals. These lectures and articles are what other orthodontic practitioners and residents are attending and reading. He is well known in the national orthodontic community for his commitment to practicing appropriate, thorough orthodontic treatment and sharing his knowledge with his colleagues to benefit the community as a whole.

Orthodontic Associates of Greeley 3400 West 16th Street, Bldg 4-V Greeley, CO 80634-6898 (970) 356-5900 www.drbradsmiles.com

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ENDODONTICS

Center for Endodontic Care Kelly Taylor, DDS, MS | Amber Severin, DDS, MS Our endodontists, with many combined years of experience specializing in root canal therapy, share a common philosophy about patient care. Using state-of-the-art equipment in a relaxing environment, we take time to fully educate patients, listen to concerns, and answer questions. Patients from Colorado, Wyoming, and Nebraska have trusted us to provide exceptional care, treating each patient with respect and kindness. For our patients’ convenience, we have offices in Fort Collins, Loveland, and Greeley.

www.centerforendocare.com

ORAL AND MAXILLOFACIAL SURGERY

James B. Troxell, DDS, MS, PLLC Diplomate, American Board of Oral and Maxillofacial Surgery Fellow, American Association of Oral and Maxillofacial Surgery Dr. Troxell has been offering oral and maxillofacial services in Fort Collins, northern Colorado, southern Wyoming, and western Nebraska since 1981. He was born and raised in Fort Collins and is respected for his compassion and patient focused care. He is supported by an experienced and loyal staff. The office is conveniently located one block north of Poudre Valley Hospital. We would welcome the opportunity to provide oral surgical services for you and your family.

Oral surgical services include: Tooth extractions • Wisdom teeth extractions • Dental implants Bone/tissue grafting and site preservation • Oral pathology (biopsy)

ORAL AND

Tooth exposure • Stem Save Banking • 2-D imaging • 3-D imaging

1120 E. Elizabeth Street, G-3 Fort Collins, CO, 80524 970-482-6811 www.jamestroxelldds.com

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DENTISTRY

Front Range Dental Center “Our mission is to create healthy and beautiful smiles for your entire family in a trusting and relaxing environment.”

Our family, general, preventive and cosmetic dentistry team in Fort Collins consists of some of the nation’s best dentists. We are locally owned and operated. We’re dedicated to helping our patients achieve beautiful, dazzling smiles in a comfortable enviroment. We’ve spared no expense in providing our patients with the absolute state of the art in equipment and care. Not only is it convenient to have your dental procedures performed in our Fort Collins office, but a team approach to dentistry means better communication between the dentists who treat you, which ultimately achieves the best dental result. Dr. Kathryn Radtke, Dr. Brad Eckhardt, Dr. Sandra Hunter, Dr. Alex Spiuak and our team of caring professionals at Front Range Dental Center are dedicated to giving you the smile you have always wanted.

Our Service Guarantee to You: • Our dentists will treat you with the respect and compassion that you deserve. • Front Range Dental Center follows strict guidelines to keep our dental office as clean and safe as possible. • Our dental staff continues to participate in continuing education, to offer you only the highest quality dentistry. • We will always be honest about your treatment needs and cost.

Front Range Dental Center 2720 Council Tree Ave #260, Fort Collins, CO 80525 (970) 672-4128 www.frontrangedentalcenter.com

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ORTHODONTICS

Crane & Seager Orthodontics Craig Seager, DDS, MSD

Mark Crane, DDS, MS | Craig Seager, DDS, MSD Drs. Crane and Seager and their team specialize in helping kids, teens and adults achieve a straight, beautiful smile by providing orthodontic solutions tailored to suit each patient’s lifestyle and personal preferences. We continuously strive to stay on the cutting-edge of orthodontic treatments and offer a full range of treatment options including the latest innovative orthodontic advancements available. We offer top-quality braces, including lingual braces, ceramic braces, and Invisalign® clear aligners. Our office was selected in 2015 as an Invisalign Top 1% Provider. This designation, the highest tier for providers, recognizes only 125 Doctors across North America to be a Top 1% Provider of Invisalign. Our office has previously been selected as an Elite provider for four years in a row. Drs. Crane and Seager have treated nearly 1000 patients with Invisalign appliances.

4144 Timberline Rd. Fort Collins, CO 80525 (970) 226-6443

3520 E. 15th St., Ste. 101 Loveland, CO 80538 (970) 663-4871

Mark Crane, DDS, MS

www.craneseagerortho.com

COSMETIC DENTISTRY

Family and Cosmetic Dentistry of the Rockies Travis R. Willey, DDS | Brandon M. Murri, DMD

“Where you are more than just a smile.”

ORAL AND

Our family and cosmetic dentistry team in Fort Collins, enjoy all facets of general dentistry with an emphasis on implant and cosmetic dentistry. They have been designated by the makers of Invisalign as Preferred Providers based on the number of patients they’ve treated and ongoing clinical education. We’ve spared no expense in providing our patients with the absolute state-of-the-art equipment and care and are now offering same day crowns. Dr. Willey and Dr. Murri are committed to and passionate about continuing education to ensure a beautiful and healthy smile for a lifetime. You can depend on us to provide you with the smile you have always wanted!

4745 E Boardwalk Dr #102 Fort Collins, CO, 80525 970-223-6101 www.smilefortcollins.com

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Dr. Mark Auble

Dr. Ralph Reynolds

ORAL AND FACIAL SURGERY

Reynolds Oral & Facial Surgery Our mission is to provide state-of-the-art dental, medical, and surgical care in a compassionate manner to our patients. Since 2001, Dr. Reynolds has surrounded himself with highly qualified, professional, and caring staff. In order to accommodate our growing practice, Dr. Reynolds hand-selected Dr. Mark Auble to add to our combined expertise in dental, medical, and surgical procedures. At Reynolds Oral & Facial Surgery, our patients are the first priority. That’s why for over a decade, our practice has invested in the finest surgical, imaging, and sterilization equipment available to dental professionals. Our office is dedicated to using the most advanced technologies and procedures to facilitate treatment to all of our patients. Our in-office surgical suites not only provide a comfortable environment, but are fully equipped with all necessary medical equipment for safe and effective procedures. We pride ourselves on offering a wide range of surgical services including: Wisdom Tooth Extractions, Dental Implants, Corrective Jaw Surgery (Orthognathic), All-on-4 Dental Implants (“Teeth in a Day”), Oral Pathology Treatment, Facial Trauma Repair, Gingival Surgery, Cleft Lip & Palate Surgery, Temporomandibular Joint (TMJ) Disorder Evaluation and Treatment, Facial Cosmetic/Plastic Surgery, Obstructive Sleep Apnea Treatment, Bone Grafting, Intravenous (IV) Anesthesia, and General Anesthesia. Drs. Ralph Reynolds and Mark Auble are MD-trained Oral & Maxillofacial Surgeons with over 26 years of combined experience. They are thoroughly trained in full scope, complex, oral and facial surgery procedures. We strive to understand our patients’ needs, desires, and concerns. We look forward to serving you!

Northern Colorado Medical & Wellness 2015

Loveland Office 3520 E. 15th Street, Ste 102 80538 Loveland, CO Greeley Office 7251 W. 20th Street, Bldg P 80634 Greeley, CO 970.663.6878 www.reynoldsoralfacial.com

COUNTING STEPS WITH BREATH BY AUSTIN LAMB

With a simple mantra of “counting steps with breath,” Scott begins his hike into the mountains and a journey into his soul. For many, hiking is not only a means of exercise, it is a spiritual journey. It’s a way to connect with nature, one’s self, and a stranger here and there.

“In every walk with nature one receives far more than he seeks.” - John Muir -

John Muir was a Scottish-American naturalist, author, environmental philosopher and early advocate of preservation of wilderness in the United States.

Maximizing Care Through Accurate Diagnosis Serving patients across the Rocky Mountain region for more than 35 years Providing unrivaled comprehensive diagnostic services to our community

Ross Barner, MD

Christopher Bee, MD

Cory Dunn, MD

Jason Schocker, MD

Jakub Stefka, MD

Craig Nerby, MD

Phil Haberman, MD Richard Halbert, MD Wentzell Hamner, MD

Thomas Neuhauser, MD

Carrie Pizzi, MD

Arlene Libby, MD

Michael Walts, MD Heath Worcester, MD

www.summitpathology.com Northern Colorado Medical & Wellness 2015

The handsome gent pictured is Style Magazine’s Creative Director Scott Prosser.

Scott and Bigfoot have a lot in common. They are both hairy, are often found in the mountains and are very rarely photographed!

Four years ago, Style Magazine’s Creative Director and resident yogi Scott Prosser started hiking. It was his way of disconnecting from technology, social media, work, drama—the banes of our collective existence in today’s society. What he didn’t realize was with what he would be reconnecting. Scott is not your typical hiker. He doesn’t carry a GPS. He doesn’t concern himself with hike specifics like location, length, elevation, weather or difficulty. He hikes for therapy; to better understand himself. Scott found himself reconnecting with nature and, in turn, his spiritual side. He would empty his mind of self-destructive societal thoughts and start chanting a mantra with every step. Each step bringing him closer to nature and closer to himself. “It’s not about the destination, it’s about the journey. If I come to a fork in the trail and I know where the right leads, I will take the left every time. New paths lead to new adventures and new self-discoveries,” Scott explains. “The mountains bring me the most complete peace because nature doesn’t judge you. Nature doesn’t care who you are, what you do, how much money you do or don’t have. Everyone is equal, no more or less significant than anyone else, and that’s a gift,” Scott says.

Scott may not concern himself with GPS or tons of trail data, but he suggests that every hiker should always be prepared and equipped. Here are his tips to beginner hikers: Wear comfortable shoes, which can be just tennis shoes, sturdy sandals or a pair of hiking boots. Some people even choose to hike barefoot.

Wear a daypack of any sort to carry essentials. Depending on the distance of the hike, take a variety of snacks, preferably those high in fat such as nuts, seeds and protein bars as well as fruit.

As Colorado weather can change on a dime, wear appropriate clothing and bring extra layers for longer hikes.

“Know your limit. Use common sense. Don’t be afraid to turn around,” Prosser says. “Anticipate the level of difficulty.”

Communicate plans to family or friends, in case of an emergency.

Take plenty of water for the length of the hike. “Hydration is probably your biggest thing. I would recommend getting a hydration pack such as a Camelback—anything with a bladder,” he says.

Find a local hiking group online. Prosser is a member of MeetUp.com, which means he always has one or more hiking companions if he so chooses.

Bring a hat and sunscreen, as even when it’s cloudy, sunburns still occur.

MANDATORY: Follow Scott on his hiking journeys on Instagram @scottprosser.

Lydia’s STYLE Magazine

Northern Colorado Medical & Wellness 2015

VETERINARY

Behavior

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BY KELLY K. SERRANO

t’s a conundrum that has baffled dog owners for centuries: how can their sweet, affectionate, mildmannered pooch turn into “Cujo” when someone knocks on the door or it spots another canine walking around the block?

Without answering that question first, it may prove difficult to answer the next one: how can they correct the behavior? “The No. 1 reason, no doubt about it, no question, is fear,” says Julie Yamane, owner of the Canine Learning Center in Fort Collins. “To get the scary thing away, (the dog gives) a big show of aggression.” If a dog wasn’t physically abused, the owner may have neglected it, not socialized it properly, or not treated it fairly or consistently. “They’ve been through a lot of trauma,” she says. A dog adopted from a shelter or acquaintances may not demonstrate aggressive behavior at first, but anxiety from the change in life circumstances may eventually lead to it acting out, Yamane says. Jessica and Cullen Howell, co-owners and operators of Fort Collins Dog Wizard, agree dogs that fear something they are unfamiliar with, or something with which they already have a negative association, often respond with aggression. “Any kind of environmental change can cause behaviors to come up with a dog,” Jessica agrees. “If it’s not given the proper tools to deal with that stress, that’s when you see that nervous aggression come out.” Cullen notes obedience training equips a reactive dog with security and confidence for scary situations.

Northern Colorado Medical & Wellness 2015

“The dog doesn’t understand, ‘This situation is OK, don’t be nervous.’ But it understands, ‘Come, sit by me,’” he says. “That’s going to calm them down just by obeying those commands.” Jessica says owners can nip aggressive dog behavior in the bud by recognizing the stages that lead up to it: 1. Flighty behavior, when the dog tries to get away from the object or situation;

of aggressiveness in a dog, it’s not the only one, according to Dr. Mary Ann Archer, DVM, with Loveland Veterinary Housecall Practice. A dog that suddenly acts out aggressively after never having done so before may have a medical condition that falls into one of three categories—two of which affect the brain directly and may trigger unusual behavior, she says: •

Neurological diseases range from petit mal seizures, infectious diseases such as rabies, meningitis or distemper, to hydrocephalis (water on the brain) or injury to the brain.

•

Endocrine diseases are related to hormone-producing glands such as the thyroid and may cause liver problems, causing toxic buildup in the blood stream that travels to the brain.

2. Growling and barking; 3. Lunging and nipping; 4. And, finally, biting. “It will always follow that cycle,” Jessica explains. “It just depends on how long it takes them to go through that cycle—years or a couple of weeks.” Once a dog has made it to the final stage, the risk increases as the dog may skip all the other stages in future situations and go straight to biting, she adds. When a dog exhibits hostile behavior, “the worst thing you can do is hit the dog,” says Yamane. She adds it is not safe to grab a dog by the scruff of its neck and throw it to ground in a show of dominance, nor is that kind of treatment effective. Instead, Yamane encourages giving the dog “high-value” treats (the treats it loves the most)—and lots of them—or a favorite toy when something the dog interprets as scary happens and it is not responding negatively. “You can’t praise too much, you can’t feed too much when you have a reactive dog,” Yamane says. “The dog will begin to think something good will happen when something unpredictable happens.” Yamane recommends booklets on solving behavior problems by Patricia McConnell, Ph.D., a certified applied animal behaviorist, available at patriciamcconnell.com. While fear—whether offensive/dominant or defensive/scared—is the most common cause

•

Pain causing a dog to act out is most common among older dogs that are more likely to develop issues such as arthritis, stomachaches, and/or chronic tooth or ear pain.

Dr. Archer encourages dog owners to take their pets to a veterinarian first to determine whether a medical condition is to blame for aggressive behavior, and go to a behavioral specialist to correct the behavior, if necessary. “I don’t think the normal person is going to be able to tell” whether it’s a medical issue, she says. Fear-based aggression takes commitment from dog owners and understanding the dog’s point of view to manage the behavior, Dr. Archer says. And preventing that aggressive tendency starts with bringing the puppy home. “Socialization in a controlled environment around other puppies and people can go a long way” toward avoiding hostile behavior, Dr. Archer says. Yamane also notes that if one or both of a puppy’s parents acts nervous, the puppy may have already learned reactive tendencies.

Julie Yamane, owner of the Canine Learning Center, discourages hitting a dog or demonstrating dominance when it acts aggressively.

Socialization works best if the owner protects the puppy’s space, allowing people to give it a treat instead of petting it upon introduction, Jessica says. If the puppy is uncomfortable with all the attention and figures out that growling and barking will keep other dogs and people at bay, that’s what it will do when it’s older. “It’s very hard to break the pattern,” she says. Cullen adds, “The earlier you catch it, the more impact you can have on a dog’s life. You’ll have a higher success rate doing the training yourself (when the dog is a puppy). But if it’s an older dog that’s been having issues for several years, you’ll get better results by seeking professional help.”

Kelly K. Serrano is editor for Northern Colorado Medical & Wellness Magazine.

Lydia’s STYLE Magazine

Northern Colorado Medical & Wellness 2015

VETERINARY

Allergies

A MODERN-DAY MYTH

DON’T BELIEVE THE HYPE ABOUT ‘HYPOALLERGENIC DOGS,’ SCIENTISTS SAY

any people with an allergy to dogs go looking for breeds labeled as “hypoallergenic.” But, according to science, hypoallergenic dogs are a myth.

“There is no such thing as a hypoallergenic dog or cat breed,” says Jennifer Schissler, DVM, MS, DACVD. “The allergens associated with pet dander are produced by the skin and they are produced by all dogs and cats, so there is no one breed that has been proven to be less allergenic than another.” Dr. Schissler, an associate professor of dermatology in the College of Veterinary Medicine and Biomedical Science at Colorado State University, went on to say that studies have shown that socalled hypoallergenic dogs actually have a little more dander in hair and coat samples than other breeds. Statistically, she says, no difference exists between dog breeds in terms of the level of dander allergen on their bodies and in the environment. Richard F. Lockey, MD, of Tampa, Fla., states, “… it is important for physicians and other healthcare professionals to use this science to provide quality care for their patients and to teach families to better care for themselves, in this case to understand that there is no such animal as a hypoallergenic dog,” in his editorial, “The Myth of Hypoallergenic Dogs (and Cats).”

BY HEIDI KERR-SCHLAEFER

While some people with dog allergies claim to have found dog breeds that work for them, scientists advise caution. “Although a person may say their own dog doesn’t cause an allergic reaction but other people’s dogs do cause a reaction, it’s difficult to determine how much of this is real and how much is perceived,” according to an article published by National Jewish Health (NJH), the nation’s leading respiratory hospital. But hope remains for people with dog allergies: some dogs produce a smaller amount of allergens by virtue of their size, NJH reports. A Chihuahua, for instance, produces a lesser amount of allergens than a German shepherd, just because the Chihuahua is so small. Households with dogs that tend to shed less, such as poodles, have fewer allergens floating around on errant dog hairs, according to NJH. However, NJH advises that the best solution for people with dog allergies is to not own dogs at all. It also counsels anyone who has been diagnosed with any allergies to think twice before getting a pet. This is because animal allergies can develop with exposure even in previously nonallergenic individuals, taking up to two years to develop after introducing a pet to the home. If this is not an option, another NJH article, published after the Obama family made news by purchasing a “hypoallergenic” dog, may help.

Dr. Harold Nelson, professor of medicine, and Dr. Rohit Katial, associate professor of medicine, both of NJH, write that the most effective way to keep pet allergies at bay is to keep the pet outdoors. If the animal does come inside, it’s important to keep it away from any carpeted areas of the house, especially the bedroom. They also recommend washing an indoor dog weekly. Some people find that a HEPA (high-efficiency particulate air) filter will help reduce the circulating levels in the home and keep allergens at bay, according to Drs. Nelson and Katial. And while some believe air purifiers help reduce pet allergies, Dr. Nelson says, “an air cleaner is probably of little benefit unless the pet is limited to areas with wooden or tiled floors.” Allergy shots were at the end of the doctors’ list of ways to reduce pet allergies. While they will help, Dr. Nelson says that the above methods are “cheaper and more effective.” In a country where the average household owns 1.6 dogs, Americans with dog allergies are under constant threat. But by practicing these methods, many may find some relief. Heidi Kerr-Schlaefer is a freelance writer from Northern Colorado. She is also the founder of HeidiTown.com, the place for entertaining Colorado festival and travel stories.

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Northern Colorado Medical & Wellness 2015

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