Fall 2016 | Volume 8, Issue 4
making
THE RIGHT CHOICE
New Combined ER and urgent care open 24/7 eliminates the guesswork of deciding where to go.
PLUS...
Winning Weight Loss
Nixing Neck Pain
Healing Hearing Loss
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Bariatric BENEFITS Weight loss surgery gives patients back their lives, literally BARIATRIC SURGERY can bring about significant and sustained weight loss. But its benefits don’t end there. Weight loss surgery also improves and even cures many diseases. “It is really life-changing,” says Joshua Long, MD, Parker Adventist Hospital’s medical director of bariatric surgery. “Patients tell me: ‘You’ve given me my life back.’ One important stat: In the first five years after bariatric surgery, the chance of dying prematurely drops by 89 percent. It is incredible.”
Number of bariatric surgeries in the U.S. in 2013:
42.1%
Dr. Joshua Long
MULTIPLE BENEFITS Patients who undergo bariatric surgery and successfully maintain a healthy body weight can experience a bundle of benefits. Here are the most significant research findings: + 86% of patients with Type 2 diabetes see a significant improvement or complete reversal + 30-50% of patients’ blood pressure returns to normal + 60% of patients experience lower total cholesterol and/or triglycerides, as well as an increase in high-density lipoproteins (the good cholesterol) + 50% reduction in heart attack risk + 50% reduction in stroke risk + 77-86% of patients saw resolution or improvement in obstructive sleep apnea + 80% of patients saw resolution to buildup of fat in the liver + 48% of women experienced improved fertility and more regular menstrual cycles
Roux-en-Y 34.2% Gastric Bypass Revisional Surgery
14% 6%
Other
Don’t let an accident ruin Halloween fun
Set up a contest to see who can bring home the most treats — it’s your best chance to limit sugar intake and inspect the goods. Remind kids not to walk and chew candy at the same time — it’s a choking hazard for distracted kids to gobble on the go. Children under 12 should be accompanied by an adult. Discuss safely crossing streets. Set route and boundaries ahead of time. Children and parents should have a predesignated time and place to meet up if separated. Paint children’s faces instead of masking them. Masks impair vision. Add reflective tape to costumes, or give kids glow sticks. Bulky costumes can be a tripping hazard. Tell kids to trick-or-treat now, text later — no social media distractions during travels. Warn small children ahead of time they might see gruesome decorations and costumes, and assure them those scary things are just make-believe.
grow
3.7%
Gastric Banding
To learn more about the various types of weight loss surgery and whether you are a candidate, join us for a FREE seminar on Oct. 26 or Dec. 14. See back cover for details.
HALLOWEEN IS A TIME OF MAKE-BELIEVE MONSTERS, but there can be some real-life frights for trick-ortreaters. In fact, more child pedestrians are killed on Halloween than any other day, according to the National Center for Statistics and Analysis. To keep the spookiness “pretend,” follow the advice of Primary Care Meridian pediatrician Olukemi Akinrinola, MD. “You can encourage kids to be safe without scaring them,” she says. Her top tips:
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Gastric Sleeve
Dr. Akinrinola is a pediatrician with Centura Health Physician Group Primary Care Meridian (formerly Parker Primary Care). Dr. Akinrinola is accepting new patients. To make an appointment, call 303-649-3100.
Centura Learn more about Page 5. Health Meridian on
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SC RE SAFELY
179,000
Sticking Your NECK OUT Everyday neck pain, or something more serious?
PRUNE SOME HIGH BRANCHES, paint your ceiling, or take in a weekend air show and your neck muscles might punish you with soreness and stiffness, and maybe even a headache, the next day. Neck pain is a common complaint — at any given time, 13 percent of American adults suffer from it. Most neck pain is muscular, says Scott Stanley, MD, an orthopedic surgeon at Parker Adventist Hospital who specializes in spine issues. “About 80 percent of the people I’m seeing don’t require surgery, but they do require a diagnosis,” says Stanley, explaining that treatment recommendations depend on an accurate understanding of what is causing the pain. Necks are built more for bending forward and down than for bending back to look overhead, Stanley says. So be careful doing chores where you look and reach overhead for a prolonged period. Even “healthy” activities that require repeatedly turning your head, such as dancing or swimming, if overdone, can strain neck muscles, To learn more about Dr. Scott Stanley tendons, and ligaments. Often neck strain can be eased by over-the spine and low back pain, counter medications, such as nonsteroidal anti-inflammatory drugs like ibuprofen. But join Dr. Stanley for a pain that lasts or is severe may require epidural injections or physical therapy. FREE seminar on Nov. 1. Always see your doctor if neck pain lasts several days without relief, or is Details on back cover. accompanied by severe headache, numbness, or loss of strength in your arms or hands or if you have shooting pain into your shoulder or down your arm, Stanley says.
The THREE MOST COMMON medical conditions that cause neck pain are: OSTEOARTHRITIS, or neck pain caused by deterioration of joint cartilage, is something most people develop to some degree during their lifetimes, Stanley says. Beyond reducing risk by exercising and maintaining a healthy weight, which can help head off osteoarthritis, severe pain caused by arthritis often can be helped with physical therapy or corticosteroid injections.
A HERNIATED DISC is when the soft inner core of a disc leaks out and presses on a nerve, which can cause severe pain. While trauma or injury can cause a herniated disc, the symptoms more often start spontaneously, most commonly in adults ages 30 to 50. If more conservative treatments don’t help, Stanley says, surgery can relieve the pressure.
AGING causes degenerative changes that narrow the neck or tighten the spinal canal, a condition called cervical stenosis. Over time, this can pinch the spinal cord and cause shooting pains in arms and legs, and even some loss of motor skills. The only effective treatment is surgery to remove the bone spurs.
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Parker Adventist Hospital offers a Joint Commission-certified spine program providing today's most innovative treatments, including pain management solutions. To learn more about ways to control your pain, contact Dr. Stephen Campbell at 303-649-3870 or go to parkerpainspecialists.org.
9395 Crown Crest Boulevard, Parker, CO 80138 grow is published quarterly by Parker Adventist Hospital—Portercare Adventist Health System—as part of our mission to nurture the health of the people in our community. To comment or unsubscribe, please email grow2@centura.org. grow is produced by Clementine Healthcare Marketing. Executive Editor: Lisa Gates
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GAME
Your husband wakes up in the middle of the night with burning chest pain. Is it a heart attack or just indigestion? You’re suddenly struck by the worst headache of your life. Is it dehydration, or is it a stroke? While precious seconds tick by, you’re playing the guessing game. People are increasingly avoiding emergency rooms, often because they don’t want to make a fuss if it’s nothing serious — or they want to avoid a big medical bill. But that choice could be putting their life at risk, says Nathaniel Hibbs, DO, an emergency medicine physician at Centura Health Emergency & Urgent Care at Meridian. “We see it every day,” Hibbs says. “A sore throat can be strep throat or a serious abscess that could close off your airway. If it’s strep, you can be treated with antibiotics and go home and get on with your life.” But if it’s something more than that? Well, that’s when you need the experts.
Little or
BIG?
Trying to decide when a medical problem is or isn’t an emergency can put you in harm’s way
“Everybody with chest pain and risk factors potentially has a life-threatening emergency,” he says. “And stomach pain can mean anything from virus to a rupturing aneurysm.” Stories of patients showing up at grocery store health clinics in the midst of a heart attack are all too common. A new concept developed by Centura Health aims to change that. The concept combines an urgent care center and a hospital-backed emergency room into one 24hour location. You will be evaluated, treated, and pay only for the level of care received. Non-emergency cases are billed at urgent care levels. The Meridian facility, which opened in September as part of Centura Health Meridian, is the first in the south metro area, with another opening in December in Highlands Ranch. These facilities are designed to alleviate the guesswork of choosing whether you need urgent or emergency care. But a person still must decide to get care in the first place. In general, any symptom that strikes suddenly or severely needs medical attention, Hibbs says. If a condition is causing anxiety, don’t talk yourself out of getting care. “Let the experts determine how serious it is.”
Common symptoms can all too commonly be confused. Here are a few you should know:
SYMPTOM
IT COULD BE:
OR IT COULD BE:
Chest pain Trouble breathing Lower abdominal pain Severe vomiting, diarrhea Severe cough Pain from a fall or injury Back pain
Indigestion or heartburn Mild asthma Stomach flu Flu virus or bacterial infection A cold or the flu Sprain or strain Strain or spasms
Heart attack Severe asthma attack or respiratory infection Appendicitis Bowel obstruction or severe GI infection Pneumonia or airway obstruction Fracture or even internal bleeding Herniated disk or ruptured aneurysm
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GUESSING
CENTURA HEALTH MERIDIAN Centura Health Meridian offers families a onestop location for everything from preventive to emergency care. The building includes: › Emergency and urgent care services open 24/7 › Diagnostic imaging and lab services › 3-D mammography › Primary care › Pediatrics › OB/GYN › Urogynecology
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WINTER Is Coming Flu, colds, and decisions Flu and colds can make you miserable, but most of the time you’ll recover in a week or two without serious complications. Still, each year in the U.S. more than 200,000 people end up in hospitals because of the flu; and it kills between 3,000 and 49,000 people, according to the Centers for Disease Control and Prevention. It can be hard to distinguish the flu from a cold. But the flu usually comes on faster and is more severe, and you are more likely to have a high fever with the flu. So how do you know when you should tough it out at home with plenty of rest, fluids, tissues, and your favorite symptom-relieving medications, or when you should seek help?
9949 South Oswego Street • Parker, CO 80134 Learn more at parkerhospital.org/meridian or call 303-925-4630.
Call 911 for: › Extreme difficulty breathing › Unconsciousness › Blue lips › Grunting noises with each breath Centura Health Meridian ACC
Get urgent or emergency care for:
May 11, 2015
1426 Pearl Street, Suite 300 | Boulder, Colorado 80302 | 303.499.7795 | boulderassociates.com
› Difficulty breathing › Pain in the chest or abdomen › Sudden dizziness or confusion ›A stiff neck, a severe headache, severe ear
BOULDER
▪ SACRAMENTO ▪ ORANGE COUNTY ▪ SAN FRANCISCO ▪ DALLAS
pain, or a very sore throat
› F lu-like symptoms improve but soon return with a fever and worsening cough (possible secondary infection)
› F ever with a rash › S evere vomiting ›A child who has one or more of these symptoms: -N ewborn-3 months: temperature of 100 degrees Fahrenheit or above
-A ny age: temperature of 104 degrees Fahrenheit or above - B reathing fast or has labored breathing - C oughing up blood or is wheezing -D ehydrated (cries without tears, not urinating) -N ot waking up; appears very lethargic or is too restless or upset to be held
Call your doctor when: ›A child under 2 years has a fever that lasts for more than 24 hours
›A child over 2 has a fever that persists more than three days ›A child’s chest hurts even when not coughing, or the ribs pull in with each breath
Parker Adventist Hospital is part of the Centura Health Trauma System, the region’s largest and most comprehensive network of trauma care and emergency services.
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MOVING
TARGET
Breast screening guidelines keep changing, but women don’t need to be confused
It happened again. Another agency, in this case the American
as soon as possible.
A New View
The latest technology in breast screenings is tomosynthesis, or three-dimensional mammography. Rather than creating just two images of each breast, tomosynthesis uses multiple low-dose X-ray pictures to create a series of 3-D views. “Having so many images means greater accuracy and fewer callbacks due to false positives,” Fox says. “Centers like ours, using 3-D mammography, are detecting 40 percent more cancers.”
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To schedule a mammogram, call the Centura Health Breast Care Center of your choice. Or text your name to the number shown, and a scheduler will call you to set up your appointment. Parker Adventist Hospital 9397 Crown Crest Boulevard, Parker Call: 303-269-4150 Text: 303-816-8648 Castle Rock Adventist Hospital 2350 Meadows Boulevard, Castle Rock Call: 720-455-1111 Text: 720-644-0880 Centura Health Meridian 9949 South Oswego Street, Parker Call: 303-269-4150 Text: 303-816-8648 Centura Health Southlands 6069 South Southlands Parkway, Aurora Call: 303-269-4150 Text: 303-816-8648 Littleton Adventist Hospital 7700 South Broadway, Littleton Call: 303-738-2767 Text: 720-358-5412 Porter Adventist Hospital 2555 South Downing Street, First Floor, Denver Call: 303-765-6500 Text: 303-872-7469
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Cancer Society, changed its recommendations on when a woman should get screening mammograms. No one would blame women if they just threw their hands up and ignored the whole issue, but that’s not an option, says Monique Fox, MD, a breast radiologist at the Breast Care Center at Parker Adventist Hospital. “Our goal is to detect cancer as small as possible, as soon as possible. That’s the direct correlation to survival,” Fox says. “You want to catch it before you can feel it.” Fox keeps a close eye on the various recommendations and the research Dr. Monique Fox guiding these decisions so she can help women navigate the waters. The bottom line, in her mind, is that women in good health and at average risk should start annual mammograms at age 40. This is the recommendation of the American Congress of Obstetricians and Gynecologists as well as the American College of Radiology. Women with a family history of breast cancer should discuss with their doctors how early and how often to undergo screening. In general, a woman with a family history of the disease should have her first mammogram 10 years earlier than the age of the family member when she was diagnosed with breast cancer, Fox says. About 10 percent of breast cancers are caused by a genetic mutation, so women with a family history also should discuss Our goal is to possible genetic counseling with their physicians. Women should continue to have annual mammograms detect cancer as as long as they are in good health and expect to live 10 small as possible, years or longer, according to the American Cancer Society.
Sound SOLUTION For those with profound hearing loss, cochlear implants can break the silence FOR PEOPLE WHO have moderate hearing loss, hearing aids may be enough to turn up the volume. But if you’ve experienced severe hearing loss or deafness, hearing aids — which only make sounds louder — can’t restore hearing. For that kind of severe hearing loss, cochlear implants may be the answer. The cochlea, a tiny, snail-shaped structure in the inner ear, is the main hearing organ. When it suffers significant damage and can no longer send sound signals to the brain, a tiny electronic device called a cochlear implant can take over the function of the damaged cochlea.
processor and transmitter/coil, which is worn on the outside. Each piece has a magnet. The two magnets attract across the skin, and communicate through radio signals. Next, the cochlear implant is activated by an audiologist (a health care professional who specializes in hearing). The audiologist works with the patient to adjust the speech processor and improve hearing. Those adjustments, called mapping, are an essential part of cochlear implants, Sdrulla says. Cochlear implant devices available now come close to re-creating what happens when the human ear picks up sounds and how those sounds are processed, Sdrulla says. “The sound is close to normal. But it takes a little while for the brain to relearn what the electrical impulses mean.”
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WHO IS A CANDIDATE? At Parker Adventist Hospital, a team of surgeons and hearing specialists is using cochlear implants to restore hearing and speech in adults whose world had gone silent, or nearly silent. “It is really a great honor to possess the training needed to be able to offer people another option once hearing aids become useless,” says Dan Sdrulla, MD, PhD, an ear, nose, and throat surgeon at Parker Adventist Dr. Dan Sdrulla Hospital. “It’s extremely rewarding to be able to help these folks.” The cochlear implant has two main pieces. The internal piece is implanted during surgery, which takes about two hours, Sdrulla says. After the implanted area has healed — in about six weeks — patients are fitted with the second piece, the speech
To be considered for a cochlear implant at the Parker Adventist Hospital cochlear implant clinic, you will first be evaluated by Sdrulla and an audiologist at Colorado ENT Specialists. “You must have severe hearing loss and be motivated to hear again,” Sdrulla says. Regaining hearing and speech takes hard work but “with good family support, patients do fantastic,” he says. “The patients who do best are the folks who have the devices implanted shortly after the onset of deafness.”
Can you hear me now? Inside the cochlea, nerve cells, called “hair cells,” pick up sounds, code those sounds, and send them to the brain. When those hair cells get bent or broken, they can’t do their job, and permanent hearing loss results. Damage can result from: Very loud noise or extended exposure to noise Certain powerful antibiotics Diseases, such as meningitis, Meniere’s disease, and tumors Advanced age
TO LEARN MORE about cochlear implants, join Dr. Sdrulla for a FREE seminar on Tuesday, Nov. 8, at 5 p.m. For details, see back cover.
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POWER UP
Portercare Adventist Health System
Non-Profit Organization U.S. Postage
your access
Centura Health Virtual Care, powered by MDLIVE, provides virtual access to Centura Health physicians, anytime, from any place. Now, there’s an easy way to get care from a board-certified physician, whether it’s in the middle of the night, during the week, or over the weekend.
PAID
Denver, CO Permit No. 4773
9395 Crown Crest Boulevard Parker, CO 80138
free FALL Seminars Join Parker Adventist Hospital for a series of FREE events and seminars. All seminars are held in the Parker Adventist Hospital Conference Center, located on the Garden Level at the west entrance. A light lunch is served during daytime programs, and light snacks are served during evening programs. Registration is required for all seminars. Register online at parkerhospital.org/seminars.
Go online and visit centura.org/virtual-care to download the MDLIVE app, or call 1-888-905-7502.
Breast Cancer Update
Thu, Oct 13 | Noon-1 p.m. From 3-D mammograms to one-time radiation treatments, breast cancer care is rapidly advancing. Learn the new guidelines around screenings and the latest news with Dr. Monique Fox, breast radiologist.
What You Need to Know About Supplements
Thu, Oct 20 | 11:30 a.m.-1 p.m. Meet Dr. Vandna Jerath, OB/GYN, and learn what supplements are key for maintaining a healthy lifestyle.
Weight Loss Surgery Presented by Dr. Katie Irani Wed, Oct 26 | 6-7:30 p.m.
Presented by Dr. Joshua Long Wed, Dec 14 | 6:30-8 p.m. Join our bariatric surgeons as they discuss the latest advancements in weight loss surgery and the requirements to become a candidate.
Treatment Options for Chronic Neck and/or Back Pain
Tue, Nov 1 | Noon-1 p.m. Join Dr. Scott Stanley, orthopedic surgeon, to learn more about common causes of neck and back pain, treatment options, and when it’s time for surgery.
Cochlear Implants Can Correct Hearing Loss
Tue, Nov 8 | 5-8 p.m. Join Dr. Dan Sdrulla, ear, nose, and throat surgeon, to learn about the latest advancements with cochlear implants, and how they can restore hearing to those with severe hearing loss or deafness.
Part of Centura Health, the region’s leading health care network. Centura Health does not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, and marital status in admission, treatment, or participation in its programs, services and activities, or in employment. For further information about this policy, contact Centura Health’s Office of the General Counsel at 303-804-8166. Copyright © Centura Health, 2016.
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MDLIVE will connect you with a physician via phone or secure video to access care for common health ailments. Physicians are available 24/7 to diagnose, recommend treatment, and prescribe medication when appropriate. There’s no need to wait days for an appointment or to struggle with finding the nearest urgent care – just sign in and talk to a doctor via secure video or phone from your home, office, or on the go. If you have a primary care provider, you may ask MDLIVE to forward a summary of your visit to this provider to keep your provider informed and your medical records together.