Grow Summer 2017 by Parker Adventist Hospital

Summer 2017 | Volume 9, Issue 3

Weight Loss

WINNERS Robotic bariatric surgery at Parker Adventist Hospital helped one couple lose weight and gain quality of life. See Page 4.

ROBOTIC REVOLUTION

reduces patient pain and speeds recovery for many surgeries. Page 5

PLUS...

Ankle replacement helps maintain mobility

Customize your mammography schedule

Warning signs for gynecologic cancers

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PAGE 7 PHOTO BY ELLEN JASKOL

health briefs

Be a Good Sport

COLORADO SUMMERS offer a great mix of activities to enjoy. But they all bring a chance of injury. To make the most of your summer fun, David Clampitt, MD, a family physician with Centura Health Physician Group Primary Care Meridian, offers these suggestions:

Activity

Potential Pain Point

Prevention Tip

Running

“For lots of people, when they start running things just start hurting — their knees, heels, ankles,” Clampitt says.

Gradually increase mileage. “Start over each season, even if you maintained your cardio over the winter,” he says. Change your shoes regularly and run on a good surface. Trails and treadmills are softer than asphalt.

Trail running

Ankle sprains

Build lower-body and ankle strength and stability. Clampitt recommends single leg dips: Stand on one foot, look at your toes, and do a squat until your knee covers your toes. Try 3 sets of 10 on each side.

Mountain biking

Concussions and broken clavicles (collarbones)

If you’re not ready for higher speeds, start slow and low and take your time to build up your comfort level.

Baseball

Overuse of the shoulder and elbow — especially in kids with open growth plates

Gradually increase your activity and work with coaches on good mechanics. If your technique is good, you will use your legs and lower body — not your shoulder — to generate power, he says.

Around-the-Clock Care

Not sure if that ankle pain needs urgent or emergency care? No worries. Centura Health Emergency & Urgent Care — Meridian offers both with emergency care 24/7 and urgent care from 7 a.m.-9 p.m. Call 303-925-4700 for information. And for nonurgent care, Dr. Clampitt is located right next door at CHPG Primary Care Meridian. For an appointment, call 303-649-3100.

Afternoon thunderstorms are routine in the Rockies — and they can come on suddenly. When you’re hiking, protect yourself from lightning strikes with these tips: Try to get below tree line or find the lowest point in an open area Avoid solitary trees and other objects that are taller than the rest of terrain Get rid of any metal objects you’re carrying (trekking poles, backpacks with a metal frame, even jewelry) Stay out of caves and buildings with exposed openings like picnic pavilions Avoid any water and stay out of low spots that might accumulate any rain

15-27% Spike in summer ER visits

THE TOP CULPRITS: heat-related conditions, sunburns, foodborne illnesses, trampoline injuries, lawn mower accidents, and animal bites

Dr. David Clampitt

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: Rebecca McLuskey

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PHOTOS: DOG ©ISTOCKPHOTO.COM/BILEVICHOLGA; LIGHTNING ©TOPVECTORS — STOCK.ADOBE.COM

Summer

SUMMER STORM SAFETY

Ready to Ride

Total ankle replacement helped Lynne Schroeder get back in the saddle WHEN LYNNE SCHROEDER WAS IN HIGH SCHOOL, she shattered her right ankle. That was 1975. But it wasn’t until last fall — when she strained her other ankle — that she decided she was finally ready to replace it. Forty-one years of wear and tear working as a nurse had left Schroeder with virtually no ankle joint, and she was beginning to wear off the inside of her tibia by overcompensating. But there was also another reason she was ready for surgery. “It was starting to interfere with my horseback riding,” the 58-year-old says. “I didn’t want to be missing out on the fun things!”

The case for replacement While it’s not a fit for everyone, there are common indications for total ankle replacement. “The typical candidate would be someone who’s relatively active with end-stage arthritis, and no neuropathy (nerve pain),” says Keith Jacobson, DPM, a foot and ankle surgeon at Parker Adventist Hospital. The surgery replaces the arthritic surfaces of the ankle joint with an implant. Jacobson performs the surgery as an outpatient procedure that offers big advantages over ankle fusion. “With replacement, you maintain mobility. Your ankle joint isn’t locked at 90 degrees forever,” he Dr. Keith Jacobson says. And for those who have already had ankle fusion, it can be revised to be an implant, Jacobson says.

PREHAB HELPS YOU BOUNCE BACK Rehab following surgery can help speed recovery, but a little “prehab” also has been shown to improve outcomes. Justin Newman, MD, an orthopedic surgeon at Parker Adventist Hospital, suggests these steps:  Add extra protein. Protein helps your body repair cells and create new ones, so focus on a diet with slightly higher levels of protein.  Stay active. “If you’re having joint surgery, you don’t want to do anything to exacerbate the pain. But gentle exercise can help you heal,” he says.  Mentally prepare. “I want patients to be educated, and understand the risks as well as their reasons for having the procedure,” he says. “This helps them rest better prior to surgery and not feel nervous.” Parker Adventist Hospital offers a pre-surgery class for all joint replacement patients. To learn more, call 303-269-4062.

The work of recovery Schroeder’s 12-week recovery was typical: four weeks bearing no weight, followed by four weeks weight-bearing in a boot, and then back to her own shoe, which she wore during physical therapy to restore her flexibility and range of motion. And Schroeder says it was all worth it. She’s back in the saddle, this time without the pain.

90 PHOTO BY ELLEN JASKOL

ankle replacement boasts success rates of up % Total to 90 percent at 10 years.

Lynne Schroeder is back in the saddle on her horse, LaBelle, after ankle replacement surgery at Parker Adventist Hospital.

Join Dr. Jacobson on Aug. 24 to learn more about surgical options for foot and ankle pain and injuries. See back cover for details.

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Weight Loss For a Parker couple, robotic gastric bypass surgery not only trimmed pounds, it restored health as well

PARTNE

etween them, Matthew and Amber Smith have lost nearly 300 pounds in just over a year. After years of struggling with their weight, the couple didn’t discover a magic diet. Instead, they found a skilled surgeon, Tom Brown, MD, who set them on the path to weight loss success, and restored health, through robotic Roux-en-Y gastric bypass surgery at Parker Adventist Hospital. For Matthew, who says he has always been “a big guy,” the surgery in February 2016 reversed a course that had him facing serious complications from diabetes. “When I turned 32, my health took a drastic turn,” he says. At 474 pounds, walking was painful, and he was starting to lose vision in his right eye. A year later, Amber, whose struggle with weight was complicated by removal of her thyroid, was frustrated. She had successfully trimmed 100 pounds from her peak weight of 300. But when the weight stopped coming off, her endocrinologist suggested a “jump start” through bariatric surgery. Amber says she hesitated a bit. “It’s not the easy way out. It’s actually difficult to say, ‘I can’t do this on my own.’” And from her husband’s experience, she knew success would mean a lifelong commitment to changing eating habits. But when she decided to go ahead, she knew immediately who her surgeon would be: Tom Brown. Brown has been performing bariatric surgery for more than 15 years. About two years ago, he began doing the procedure robotically, and after nearly 400 robotic procedures, he is a believer in that method. “Patients have less pain, and there are fewer complications,” he says. In addition, there is less blood loss, Dr. Tom Brown probably “because the procedure provides a three-dimensional picture,” which affords the surgeon a clearer view of the stomach, spleen, 4 ■ Summer 2017 ■

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PHOTO BY ELLEN JASKOL ILLUSTRATION: ©BEARSKY23–ADOBESTOCK.COM

GETTING RESULTS ROBOTICALLY

GASTRIC BYPASS BASICS

The Roux-en-Y gastric bypass procedure creates a pouch out of a small portion of the stomach. The pouch, which is too small to hold large amounts of food, attaches directly to the small intestine, bypassing a large part of the stomach.

ERS Matthew and Amber Smith now have more energy to keep up with their kids, and their chickens.

and blood vessels, Brown says. All that adds up to shorter hospital stays. People often go home just 24 hours after surgery, as Amber did, Brown says. That’s compared with two days or more in the hospital with other methods. In Matthew’s case, he was back working for an oil services company and walking in the field much of the day — after just a week. Within a month, he was back to normal activities.

BEATING BAD GENETICS

Now weighing in at 210 pounds, Matthew is glad he had the procedure. “The staff was fun, they kept it light, and did everything they could to encourage me,” he says. “Nobody in the office ever made me feel like I was a strange person who had failed in life and had to have this procedure.” Everyone in his office knows what causes significant obesity, Brown says. “Most of the time with our patients, the body is working against them. Everybody in the office understands that this isn’t a behavior problem; it isn’t that people can’t push themselves away from the table. This is a genetic problem.” In Matthew’s case, there is plenty of evidence of a genetic link. “My father was over 500 pounds. Everyone in my family suffers from diabetes — aunts, uncles, grandparents.” Brown estimates that about 80 percent of patients with type 2 diabetes “go into remission, meaning they are off medications and have normal blood sugars” after gastric bypass surgery.

LIGHTER — AND BETTER — THAN EVER

Matthew had also seen his father lose weight, and keep if off, with bariatric surgery. So he knew the dramatic difference the procedure could make — and the dedication it takes to make it stick. Matthew and Amber both knew the major lifestyle changes the surgery would require. They can’t physically tolerate sweets and soda, and are committed to focusing on proteins, veggies, and smaller portions. Amber even bought a set of smaller dinner plates. And they are pleased to be setting a healthy example for their four children, the Smiths say. At just two weeks post-surgery, “I feel great,” Amber says. “My energy is through the roof.” It’s that sort of result that makes Brown a proponent of robotic bariatric surgery. “Most operations are trying to restore people back to where they were,” he says. “This is actually taking someone from one place and putting them in a better place. It’s very rewarding.”

BEFORE

√

AFTER

Half of patients who have gastric bypass maintain about 60 percent of their weight loss five years after surgery.

60%

ROBOTIC SURGERY

EASES RECOVERY At Parker Adventist Hospital, the precise, versatile movement made possible by robotic surgery using the da Vinci® Xi HD, da Vinci Si HD, or Mazor Renaissance® systems means less blood loss, less pain, fewer complications, and shorter recovery times. Parker Adventist Hospital also offers minimally invasive spine surgery using the Renaissance guided spine surgery system. With nearly 30 surgeons skilled in robotic surgery, Parker Adventist Hospital offers robotic surgery in the following areas: + Bariatric surgery + General surgery + Gynecologic oncology + Gynecology + Spine surgery + Urogynecology + Urology Parker Adventist Hospital’s advanced robotic surgery program is supported by Centura Centers for Clinical Innovation, extending advanced health technologies across Colorado and western Kansas.

LEARN MORE

about robotic bariatric surgery options at a FREE community seminar on Aug. 17. See back cover for details. grow

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In April, Colorado lawmakers joined 29 other states in requiring that a woman be notified when a mammogram reveals she has dense breasts.

— Monique Fox, MD

SCREENING OUT

CONFUSION Knowing your breast cancer risk helps guide screening decisions

With prominent medical organizations disagreeing about when women should begin getting mammograms and how often they should have them, it’s no wonder women are confused. Monique Fox, MD, radiologist and breast imaging specialist at Parker Adventist Hospital’s Breast Care Center, says there should be no doubt about when to have that first mammogram. “We recommend every woman have a baseline mammogram at 40,” Fox says. “One of the most important risk factors is breast density. And you don’t know if you have dense breasts until you get a baseline mammogram.” Dense breasts are not synonymous with large breasts. Density measures the ratio of glandular and fibrous tissue to fatty tissue. The more glandular and fibrous tissue, the greater the breast density. As breast density increases, so does cancer risk, Fox says. She recommends ultrasound with mammograms for women with dense breasts. Knowing your breast density is important to help you and your doctor calculate your overall breast cancer risk. Other factors that can impact risk include: • Family history • Childbirth history • Age at first period • Menopause after 55 • Body mass index “If your lifetime risk is over 20 percent, we recommend screening each year, with MRI,” she says. 6 ■ Summer 2017 ■

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TAKING BREAST CANCER RISK PERSONALLY We’ve heard the numbers: One in eight women develops breast cancer in her lifetime. But all breast cancer risk is not equal. If your mother had it, your risk may be higher. If you had a child before age 30, it may be lower. Parker Adventist Hospital’s genetic counselor, Melissa Gilstrap, MS, CGC, can help you measure your risk, and discuss steps you can take to address it. Before seeing the genetic counselor, each woman fills out a family history questionnaire, Gilstrap says. “So, I have their risk determined when they come in. From there we can discuss what the guidelines say is right for them.” Then, a woman can pursue additional breast cancer screenings, like whole breast ultrasound or breast MRI, she says. The clinic also offers testing for genetic mutations that have been linked to breast cancer risk. To make an appointment to assess your risk, call 303-269-4975.

SAME-DAY MAMMOGRAMS

available at the following Centura Breast Cancer Center locations. To schedule your mammogram, call: • Parker Adventist Hospital: 303-269-4150 • Castle Rock Adventist Hospital: 720-961-2033 • Centura Health Meridian: 303-269-4150 • Centura Health Southlands: 303-269-4150 • Littleton Adventist Hospital: 1-844-325-5579 • Porter Adventist Hospital: 303-765-6500

WE RECOMMEND EVERY WOMAN HAVE A BASELINE MAMMOGRAM AT 40.”

LIFESAVING Surgery

Expertise and persistence team up to fight a rare cancer WHEN PAMELA SAMSON began experiencing bleeding after menopause, she knew better than to ignore it. But it took the experience and skill of Parker Adventist Hospital gynecologic oncologist Jeff James, DO, to recognize and diagnose the cause of her symptoms: an extremely rare cancer called uterine carcinosarcoma.

DIAGNOSING A RARE CANCER

By last New Year’s Eve, the bleeding had worsened, and Samson was in severe pain. She went to Parker Adventist Hospital’s emergency room and after numerous tests, “They told me, ‘We don’t know what it is, but you need to see Dr. James,’ and set up an appointment for me after the holidays,” she says. She went home, but within days was back in the ER. “I really thought I was going to bleed to death,” she says. James happened to be on call that day, and he correctly diagnosed Samson’s cancer, and quickly performed a robotic hysterectomy. James has been performing robotic surgery for gynecologic cancers for nearly a decade, and Dr. Jeff James says it was the best option for Samson. “She has a history of high blood pressure, hypothyroidism, and sleep apnea.” In addition, robotic surgery typically involves minimal blood loss, an important factor for Samson, whose religious beliefs forbid blood transfusions.

THE RIGHT TREATMENT BRINGS HOPE

Robotic surgery patients, like Samson, often go home the day after the procedure, James says, compared to five to seven days with conventional surgery. For Samson, a brief recovery meant she could quickly start chemotherapy to fight her cancer. Carcinosarcoma — also known as malignant mixed Müllerian tumors, or MMMT — is a rare and aggressive cancer that involves three types of cancer cells. Typically, only about two women out of 100,000 are diagnosed with carcinosarcoma in the United States each year. In Samson’s case, just three months after surgery she was halfway through chemotherapy, and blood tests indicated the treatments have been effective. She credits James and his ability to recognize her rare cancer and treat it quickly. “I feel like I’ve got the right doctor, the right treatment, the right everything,” she says.

Pamela Samson is back to sharing hope with fans of her artistic note cards.

Parker Adventist Hospital is part of the Centura Health Cancer Network, delivering integrated, advanced cancer care across Colorado and western Kansas.

Be wary of bleeding after menopause Bleeding after menopause can indicate a serious condition, such as gynecological cancer, says Parker Adventist Hospital gynecologic oncologist Jeff James, DO. Nearly 100,000 women in the United States will be diagnosed with a gynecological cancer this year, according to the American Society of Clinical Oncology. Like all cancers, these cancers are highly treatable if caught early, James says. James and colleagues at Parker Adventist Hospital offer comprehensive care for a range of gynecologic cancers, including:

To learn more about gynecologic oncology, and treatment options for different gynecologic cancers, attend a FREE seminar taught by Dr. Jeff James on Sept. 18. See back cover for details.

› Uterine cancer › Endometrial cancer › Cervical cancer › Ovarian cancer

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Portercare Adventist Health System

Mental Health

Non-Profit Organization U.S. Postage

FIRST AID

PAID

WE MAY NOT REALIZE IT, but most of us know someone who struggles with mental illness. Colorado is home to nearly 500,000 people living with a diagnosed mental illness, and the state consistently has one of the nation’s highest suicide rates. Yet few of us would know how to respond if a friend, colleague, student, or loved one experienced a mental health emergency. That’s why Castle Rock Adventist Hospital, Littleton Adventist Hospital, Parker Adventist Hospital, and Porter Adventist Hospital are offering Mental Health First Aid classes. The FREE, eight-hour classes don’t attempt to teach participants to diagnose, or treat, mental illness. Instead, participants learn to recognize symptoms and develop strategies to support someone experiencing mental illness or emotional crisis. A separate youth class is offered for teachers, social workers, coaches, and others who work with children and teens. Youth and adult classes offer a five-step action plan to:

To learn more about Centura’s FREE Mental Health First Aid classes, or to register for a class, visit mhfaco.org, or call 303-832-7594.

9395 Crown Crest Boulevard Parker, CO 80138

free SUMMER Seminars & Events Join Parker Adventist Hospital for a series of FREE events and seminars. All seminars are held in the Inspiration A and B conference rooms in the Parker Adventist Hospital Conference Center, located on the Garden Level at the west entrance, unless otherwise noted. 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.

Robotic Weight Loss Surgery

Cancer Care and Treatments

Thu, Aug 17 | 5:30-6:30 p.m. Join Dr. Tom Brown, weight loss surgeon, to find out about the latest innovations in robotic bariatric surgery.

• Assess risk of suicide or harm • Listen nonjudgmentally • Give reassurance and information • Encourage appropriate professional help • Encourage self-help and other support

Denver, CO Permit No. 4773

Tue, Aug 29 | 5:30-6:30 p.m. Join Dr. Brita Mutti, naturopathic oncologist, for an informational seminar on comprehensive cancer care, which is an approach that cares for the whole patient and all of an individual’s needs, not just the medical and physical needs.

Gynecologic Oncology What You Should Know

Mon, Sep 18 | 6-7 p.m. Join Dr. Jeff James, gynecologic oncologist, to learn more about signs, symptoms, and treatment for women's cancers.

Specialized Wound Care and Hyperbaric Medicine Advances in Foot and Ankle Surgery

Thu, Aug 24 | 5:30-6:30 p.m. Join Dr. Keith Jacobson, foot and ankle surgeon, to learn more about surgical options for foot and ankle pain and injuries.

Tue, Sep 19 | 5:30-6:30 p.m. Join Dr. Michael Bertocchi, general surgeon, for an informational seminar on the Wound Care and Hyperbaric Medicine Center at Parker Adventist Hospital. Find out who is a good candidate for specialized wound care and how it can improve the quality of life for our patients.

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 1-303-673-8166 (TTY: 711). Copyright © Centura Health, 2017. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-303-269-4053 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-303-269-4053 (TTY: 711).