Bloom Spring 2014 by Penrose-St. Francis Health Services

The Third Age

ANTIAGING Supplements

His OverActive Bladder

Headed for

Recovery

The miraculous journey of a young skierâ&#x20AC;&#x2122;s way back after a traumatic brain injury

Know the symptoms of the

No. 1

GYN Cancer Page 6

Spring 2014 Volume 4, Issue 2

healthystart

Develop a healthy aging attitude If you’re between the ages of 50 and 75, welcome to your third age. The third age is a time often marked by a lot of should-have and could-have thinking, but it doesn’t have to be that way, says Tobi Steinberg, MS, LPC, a clinical psychotherapist with the Center for Behavioral Health at Penrose-St. Francis Health Services. “We often ask ourselves, ‘Is this all there is?’ in a negative way,” Steinberg says. But if you shift your attitude slightly and ask that question from a place of positive thought and curiosity, it might lead to the birth of a new stage of life that is enhanced rather than diminished by your experiences and age. “When we enter the third age, external success is no longer as important or motivating as our dreams. You now have the opportunity to be a little selfish and look at things that you may have neglected or perhaps never pursued but now have time for.”

Three questions for the third age: What have I dreamed of doing that I never had the time, energy, or money to do before?

What truly matters to me, just me?

What’s Next? Are you at a fork in your life’s journey? Come explore which path is right for you at a special one-day women’s retreat on Saturday, May 10, at the Penrose Pavilion. “What If? What Else? What Now?” will help you draw a road map to arrive safely and promptly at your dreams. See full details on Page 7.

What strengths and talents do I have that I can use in new or unexplored ways that interest me?

The steps you’re taken through allow you to expand your mind to the possibilities for your life. I left hopeful, happy, and excited about the future I can create for myself. And, now I have a plan to get there. — Jill W.

bloom is published four times annually by Penrose-St. Francis Health Services. As part of Centura Health, our mission is to nurture the health of the people in our community. The information herein is meant to complement and not replace advice provided by a licensed health care professional. For comments or to unsubscribe to this publication, please email us at bloom@centura.org. bloom is produced by Clementine Words LLC. Executive editor is Jill Woodford.

Gum disease and poor oral health are linked to a 56 percent increased risk in oral human papillomavirus (HPV), a sexually transmitted disease responsible for up to 80 percent of all throat cancers, according to a new study. “Further research is needed to determine if poor oral health actually causes HPV infection to progress to cancer,” says Alan Monroe, MD, a radiation oncologist at the Penrose Cancer Center. “Oral health may simply be a marker of poor general health.” The Penrose Cancer Center treats roughly 100 head and neck cancer patients annually. “It’s important to get regular dental checkups to diagnose people in the precancerous stage, as oral health is intimately linked to head and neck cancers,” Monroe says. People who smoke or use other forms of tobacco or drink excessively should obtain additional screenings from their physician. FREE screening Stay on top of your health with a FREE oral, head, and neck cancer screening on Wednesday, April 23, from 4-6 p.m., Penrose Cancer Center, Conference Rooms A-C, 2222 North Nevada Avenue. Registration is required: 719-776-2000 or penrosecancercenter. org/headneckscreening.

2222 North Nevada Avenue, Colorado Springs, CO 80907

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Penrose-St. Francis Health Services

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Matters of the mouth

For the man in your life:

Bigger isn’t always better As men age, their prostate typically expands — 80 percent of men over the age of 80 have an enlarged prostate, known as benign prostatic hyperplasia (BPH). BPH does not raise the risk of developing prostate cancer, but it can cause unpleasant side effects. “The larger the prostate, the more symptoms men typically experience,” says Scott Jennings, MD, a urologist at PenroseSt. Francis Health Services. BPH puts pressure on the urethra, causing symptoms including frequent urination, decreased force of the urine stream, urgency of urination, and inability to fully empty the bladder. Treatment for BPH starts with alpha-blocker medications, like Flomax, which work almost immediately to relax smooth muscle in the prostate, improving flow and emptying of the bladder. Other medications can shrink the prostate but take months to be effective. Endoscopic surgery, typically performed as an outpatient procedure, is usually recommended for men whose conditions don’t respond to medications. Check Your Symptoms BPH and overactive bladder both cause men to urinate frequently, but they are not the same condition. Go to penrosestfrancis.org/bph for a checklist on whether your man has BPH or overactive bladder, and steps he should take to get treated.

Q&A

SHARON JACOB, RD

Clinical Dietitian, St. Francis Medical Center

What vitamins or supplements can help me stay healthy as I age?

A: A colorful diet will help

you obtain most of the vitamins you need to age “healthfully.” In

penrosestfrancis.org

Tech support for training goals Technology at your fingertips may be exactly what you need to achieve your fitness goals, says Jenna Florea, supervisor of the STRIVE Gym at Penrose-St. Francis Health Services. “Online tools can mean the difference between you merely setting a goal and you achieving a goal,” Florea says. “Whether you are looking for a basic platform to track goals or something more complex to calculate energy, there’s an app or website to meet your needs.” With hundreds of websites and apps available, the offerings can be overwhelming. To help narrow your options, look for a program that offers: • A way to create and track a plan with specific, measurable, achievable, realistic, and timely goals (SMART) • Reminders to keep you accountable • Information, from nutrition to training tips, to keep you healthy and motivated • Social networks that connect you with others with similar goals. Centura Health’s new free online platform, CaféWell, provides all four elements plus incentives for added motivation.

addition to the standard calcium supplement and vitamin D, here are three more you should consider: • Astaxanthin: This supplement is what creates the red coloring in salmon and shrimp. It is an antioxidant that helps protect against Parkinson’s disease, stroke, Alzheimer’s, and macular degeneration. It may even help prevent skin wrinkles! • Fish oil: This supplement is good for your heart and good for your brain, helping to stave off dementia. Not to mention that it’s also good for your hair and skin. If you haven’t tried

fish oil recently, you probably remember the huge capsule that made you have “fish burps” all day. But new products make it easier to take fish oil. My personal favorite is Coromega — a gel that you tear open and squeeze in your mouth — sounds disgusting but it doesn’t taste fishy at all, I promise. • CoQ10: You lose the ability to naturally produce this hearthealthy enzyme as you age, so it’s helpful to supplement once you reach menopause. If you are on a blood thinner, however, check with your doctor first before adding this supplement.

Rev up your diet with an individual nutrition counseling session. Call 719-776-3600 to find out more.

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Hats off to a great

Dr. Gary Klein Penrose-St. Francis Primary Care

Head injuries in older adults While sports-related head traumas among

young people are common, older adults are also at risk. In fact, the average age for patients in the acute care unit of the Penrose-St. Francis Center for Neuro & Trauma Rehabilitation is 60, says Charmé Jonker, manager of the unit. The unit is certified by the Commission on Accreditation of Rehabilitation Facilities. “We see a lot of adults who slip on the ice and fall,” she says. “Your awareness decreases as you’re older, and you don’t realize you need to be cautious.” Falls in older adults can be very serious, says Gary Klein, MD, a family practice physician. For adults age 65 and older, falls are the No. 1 cause of fatal and nonfatal injury, according to the Centers for Disease Control and Prevention (CDC). Fractures are common, as are brain injuries, which can be fatal. Nearly 22,000 older adults die each year from falls, the CDC reports. Falls become more common as we age because we experience declines in hearing, sight, muscle strength, balance, and reflexes, Klein says. It’s important, he adds, for caregivers to watch for evidence of falls. For example, some behavioral changes you observe might not be just a sign of aging. If you notice sudden personality changes, vision changes, or a loss of function, take your loved one to the doctor right away. And think about prevention, he notes. Regular exercise and physical therapy for older adults can help keep muscles strong and preserve balance to help prevent falls. Removing dangers — like cords and rugs — from the home and adding handrails near steps also can help. If you’re concerned about your risk for a fall, evaluations are available, Klein says. “It’s OK. Don’t be ashamed,” he advises. “Be proactive.”

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Head

tart S

How rehab helped a young skier recover after a traumatic brain injury

kiing had always been a part of Sally Francklyn’s life. Winter weekends on the slopes. Traveling to experience new runs. Even her jobs had been tied to the sport. But on March 24, 2012, everything changed. While skiing in Jackson Hole, Wyo., an 800foot fall left the 24-year-old with severe injuries and in a coma. “She was barely hanging on to life at that point,” recalls her mother, Barbara Francklyn. “She was hooked up to machines and on drugs. There were so many unknowns — including whether she was going to survive.” Three weeks after the accident, Sally was transferred to Colorado Springs to be near her parents during her recovery. “It was a series of very, very small steps,” says her father, Reg Francklyn. “We didn’t know how slow and painful it was going to be to do the simplest things. But she had a good spirit and was trying.”

“

The brain has incredible capacity to mold and change, but it doesn’t just do it automatically.

”

— J. Glen House, MD Medical Director, Penrose-St. Francis Center for Neuro & Trauma Rehabilitation

Penrose-St. Francis Health Services

High Hopes

J. Glen House, MD, medical director of the PenroseSally’s physical therapy took her from laying down to St. Francis Center for Neuro & Trauma Rehabilitation, sitting up, to standing, to walking, and even to climbing regularly visited Sally at a long-term care facility to stairs. She also started to regain mental abilities that were determine if she was stable and strong enough for rehab. lost after the fall. Finally, on May 14, Sally was transferred to the eighth One significant contributor to her success, Graef floor at Penrose Hospital. And for 2 1/2 months, she adds, was her parents’ involvement. Sally’s mother was followed an intensive rehab regimen — a minimum of with her during the day, and her father came to the three hours a day five days a week. She worked with hospital in the evenings. Her brother, Chris, visited, too. House as well as occupational, speech, and physical “We do think it helped,” Reg says. “We were lucky therapists and others to begin to rebuild her brain. that we could do that. Not everyone has that choice.” Conventional wisdom, House says, used to be that Sally’s determined, positive attitude was also essential, after a traumatic brain injury, you had to work with the Graef says. uninjured part of your brain to pick up functions. The “I’d never say, ‘I can’t do that.’ I’d do what they new way of thinking is that you can would tell me to do,” says Sally. “The retrain the damaged part, too. people at Penrose know what they’re “The people at Penrose “The brain has incredible capacity doing and what will help you. So you know what they’re to mold and change, but it doesn’t just just have to do it even if you don’t want do it automatically,” he explains. “In to or if it’s hard for you.” doing and what will the recovery process, there are parts of That work paid off. Last year, Sally, help you. So you just the brain that can take over functions now 26, put skis on for the first time have to do it even if you that they never did before.” since her accident. don’t want to or if it’s According to the Centers for Disease “That was great,” she says. “I crosshard for you.” Control and Prevention, there are more country skied on a flat surface.” than 1.7 million traumatic brain injuries She continues to struggle with — Sally Francklyn (TBIs) annually in the U.S. They are balance issues, something she says she most common among children ages 0 learned is common in people after a to 4, teens ages 15 to 19, and adults 65 and older. Falls traumatic brain injury. and car accidents are the most common causes of TBI, Today, she lives with a friend in Boulder and the CDC reports. Regardless of the cause or severity, volunteers for a ski company — happy to again be setting goals with a rehabilitation team is an important involved in the sport she loves so much. step in the recovery process. “This year, my goal is to downhill ski,” she says. Sally Sally’s physical therapist, Kathy Graef, PT, had high hopes to be able to take ski lessons and work toward hopes for Sally. When the team set goals for Sally’s that goal. rehab, she knew Sally’s age was a benefit — younger “That’s the only thing I want to have happen because brains are typically easier to re-form after trauma. I grew up skiing — and having that disappear from my “All brains have some level of neuroplasticity, which life is very challenging.” means they can rewire themselves, depending on what After a skiing accident, you do,” Graef notes. “Therapy’s job is to tease that out. Sally Francklyn was We’re trying to get the body to reroute those neurowires put back on the road to and learn a skill through a pathway that’s different than recovery at Penrose-St. the original pathway.” Francis Health Services.

Learn To Stop Falls and Prevent Brain Injuries One out of every three Americans over the age of 65 will fall this year, with many of those falls leading to severe injury, including traumatic brain injury. But falls can be prevented. Penrose-St. Francis Health Services offers two programs to help: Stepping On: A seven-week program covering topics including making your home safer and exercises to increase balance and strength. For more information, call 719-776-5926. Balance Program: A new program to screen a person’s balance and provide recommendations to help prevent falls. For more information, call 719-776-2107.

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Retraining the Brain

Know Your Risk

Lighting the way to advancements in treating endometrial cancer Surgeons at Penrose-St. Francis Health Services are using new technology that may improve results and lower the risk of complications for patients with endometrial and cervical cancers. The technology, called Firefly™, uses fluorescent green dye to potentially help surgeons identify the spread of cancer and plan the most appropriate treatment, says Dirk Pikaart, DO, founder of Southern Colorado Gynecologic Oncology. Dr. Dirk Pikaart Uterine and cervical cancers Southern Colorado spread through small vessels Gynecologic Oncology called lymphatic channels that drain into lymph nodes. Currently, surgeons remove all pelvic lymph nodes during surgery to check whether the cancer has spread. In some cases, this can cause painful swelling in the legs and can put a woman at higher risk of injury during surgery. “Removing fewer lymph nodes would result in less risk of lymphedema and other surgical complications. Currently, we have no way of knowing which nodes have been affected, so we have to remove all of them to be sure that we do not miss cancer spread,” says Jeff James, DO, also a gynecologic oncology surgeon with Southern Colorado Gynecologic Oncology. Pikaart and James use Firefly during robotic surgery to remove gynecologic cancers. The surgeon injects the dye into both sides of the woman’s cervix

bloom 6 Spring 2014

where the lymph channels drain. A special infrared camera lights up the dye, allowing the surgeon to see the path of the drainage. It also lights up the lymph nodes, allowing the surgeon to identify the first — or sentinel — lymph node in the chain. Surgeons can then pinpoint the highest risk nodes and test them for microscopic cancer cells. “The idea is that the first node in the chain is the first location cancer cells will spread to as they float out of the uterus. So if you take that node out and it’s negative, then all the others behind it should be negative as well,” Pikaart says. The hope is that research will allow surgeons to safely use Firefly to remove and test only the sentinel node instead of having to remove all pelvic lymph nodes. This would lower surgical side effects and complication rates without compromising the cancer treatment. Removing only the sentinel node is still being studied and has not yet been proven to be equal to a complete lymph node dissection. “Until more research is done, the Firefly identification of sentinel lymph nodes is experimental and should not replace the standard lymph node dissection. For now, we are using the technology to help guide our lymphadenectomy so that we are less likely to miss key lymph nodes,” Pikaart says.

Endometrial cancer is the most common reproductive system cancer in women. A woman at normal risk has about a one in 37 chance of being diagnosed with endometrial cancer in her lifetime. Your risk goes up if you have any of these characteristics: o Over 55 o Late menopause o Never giving birth or infertile o Obese o Diabetes or high blood pressure o Use of estrogen or tamoxifen therapies o Lynch syndrome (hereditary nonpolyposis colon cancer) - This genetic condition puts women at very high risk. If a high rate of colon cancer or polyps runs in your family, you should seek genetic counseling to find out if you should be screened. Act Fast Symptoms of endometrial cancer include: • Abnormal vaginal bleeding or discharge • Menstruating after menopause • Sudden, unexplained weight loss • Pelvic pain If you are experiencing any of these, you should see your doctor right away. If caught early, the chances of survival are very high. To learn more or schedule an appointment with Dr. Pikaart or Dr. James, call Southern Colorado Gynecologic Oncology at 719-776-6222.

Penrose-St. Francis Health Services

“Women helping women – we are so much better learning together – powerful growth and bonding program for women!” — Lauren H.

What If? What Else? What Now?

Date | Sat, May 10 Time | 8 a.m.-5 p.m. Location | Penrose Pavilion, 2312 North Nevada Avenue, 2nd Floor Conference Room Cost | $125/person Registration | penrosestfrancis.org/whatif1 Are you exploring a career change, a recent empty nester, or just in need of guidance on the next chapter of your life? Experience a one-day interactive, life planning session facilitated by best-selling author Sara Boatz. You’ll identify your dreams, articulate your goals, and leave with a clear purpose, direction, and a written plan to live the life of your dreams. Seminar includes continental breakfast, boxed lunch, work binder, and book. Registration is required by May 6. Payment due at time of registration.

Bloom Spring Calendar

Penrose-St. Francis Health

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Services offers dozens of health classes each quarter. Here is just a sampling of our classes. For a complete list, go to penrosestfrancis.org/wellness.

Have you been stuck in a weight loss/regain cycle? It’s not your fault! You haven’t been given the right tools — until now. This interactive seven-week program based on the successful book The Beck Diet Solution* will change the way you think about food and end the crazy cycle for good. You will be given the tools and confidence to: • Avoid unplanned eating • Stop overeating • Resist tempting foods • Overcome cravings • Refrain from emotional eating * Each participant will receive a copy of The Beck Diet Solution.

Has back pain prevented you from your daily activities? Get educated about your back health. At this FREE seminar, Dr. Mike Brown, neurosurgeon, will review the importance of spine care and why you should always speak up about symptoms. He will explain back pain causes and share the latest treatments, innovative procedures, and advanced technology that can provide relief.

Back pain affects 80 percent of Americans at some point in their lives. As technology and techniques improve, more people are finding relief. Join Dr. Scott Ross, physical medicine, rehabilitation and pain specialist, as he discusses the latest diagnostic methods and nonsurgical options for back pain. Registration required.

Join us for a fun evening of mug painting for a cause. Your painted mug will be donated to patients undergoing treatment at Penrose Cancer Center as a token of support and encouragement. All supplies are included, along with helpful instructions to design a beautiful hand-painted mug. Space is limited to 40 people. Cash, credit, or debit card accepted.

Oral, Head, and Neck Cancer Screening Date | Wed, Apr 23 Time | 4-6 p.m. Location | Penrose Cancer Center, 2222 North Nevada Avenue, Conference Rooms A-C Cost | FREE Registration | penrosecancer center.org/headneckscreening Receive a FREE noninvasive and painless oral, head, and neck cancer screening. Appointment required.

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May Screening Mammogram Special Dates | May 1-31 Location | The Center for Women’s Imaging, 2312 North Nevada Avenue, Suite 220 Cost | $99 Registration | 719-776-8010 In May, in addition to our usual spalike atmosphere, comfy robes, and aromatic hand treatments, enjoy fruity mocktails and receive a FREE gift! Saturday appointments available. Most insurance plans cover screening mammograms at no charge to the patient — check with your insurance plan for details. Self-pay patients pay only $99 during the month of May. Payment required at time of service. Schedule yours today.

The Great Bicycle Carnival Date | Sat, May 31 Time | 8 a.m.-5 p.m. Location | Bear Creek Park, 2002 Creek Crossing Registration | kidsonbikes.net/ event/the-great-bicycle-carnival/ The Great Bicycle Carnival provides something for everyone, with a focus on serious mountain biking and zany family fun for kids and adults who just want to play on their bikes. Events include a bike endurance challenge, full-scale obstacle course, beer garden, local live music, bunny hop, pixie bike competition, and much more! Stop by the PenroseSt. Francis Trauma Tent for bike and helmet safety tips and a limited supply of FREE bike helmets.

WomenHeart Support Groups Date | 2nd Wed of month Time | 11:30 a.m.-1 p.m. Date |3rd Wed of month (men and women) Time | 6:30-8 p.m. Location | Penrose Hospital, 2222 North Nevada Avenue Cost | FREE Info | 719-200-2645 Join a group of women beating heart disease. Share encouragement while learning the latest in heart science and strategies for coping. There is also a support group open to both men and women. Call for more information.

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Catholic Health Initiatives Colorado

Non-Profit Org US POSTAGE

PAID

One of America’s Top 50 Hospitals

colorado springs, CO Permit NO. 14

2222 North Nevada Avenue Colorado Springs, CO 80907

Penrose-St. Francis Health Services is proud to be named one of “America’s 50 Best Hospitals” for seven years in a row (2008-2014) by Healthgrades. We are the only recipient in Colorado and in the top 1 percent of the nation.

Penrose-St. Francis Health Services is 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, 2014.

The skinny on skin cancer

With Frank Samarin, MD, dermatologist at Penrose-St. Francis Health Services ince 1970, the chances of getting the deadliest form of skin cancer have gone up 700 percent, from eight cases in every 100,000 people to 60. Half of all melanoma cases are in people 45-64, according to a study released in the January issue of Mayo Clinic Proceedings. “There are lots of potential reasons as to why this is. One of the leading theories is the use of tanning beds and increased exposure to ultraviolet light,” Samarin says. A landmark study by the International Agency for Research on Cancer found that across all age groups, males and females who have ever used tanning beds have a 15 percent higher risk of developing melanoma. The two most important things women can do to lower their risk of getting skin cancer are to protect and screen. When it comes to screenings, Samarin gives this advice:

# Screen your skin monthly and involve your partner. Studies show

home screenings are even more effective if done by your significant other.

There’s been a

increase in melanoma in women 40-60 in the past four decades.

# Know what you’re looking for. Follow your ABCDEs: asymmetry,

uneven border, change in color, diameter over a quarter inch, or general changes in shape, size, or color (evolution). Go online to penrosecancercenter.org/skin-cancer to see pictures of what to look for. # See a dermatologist for a professional skin check starting in your 20s if you are at risk for skin cancer. Risk factors include fair skin, childhood sunburns, moles, and a family history of skin cancer. Most skin cancers are the non-deadly types — basal cell and squamous cell. Even though they are rarely deadly, women should get any suspicious spots checked quickly by a doctor. “Early diagnosis leads to less invasive treatment, sometimes avoiding surgery,” Samarin says.

Come for a FREE skin cancer screening on Saturday, May 3, from 8-11:30 a.m. at Peak Vista Community Health Center, 225 South Union Boulevard Call 719-444-CARE (option 3) to register.

Sunscreen Tips • Wearing a foundation with SPF is not enough protection; women should wear a 30 SPF sunscreen as a base. • SPFs over 30 don’t give you significantly more protection. If worn correctly, a 30 SPF blocks 97 percent of harmful rays. • The biggest mistake women make with sunscreen is not applying enough. You should use at least one shot glass full for legs, arms, and face — more if you’re in a bathing suit. • Reapply sunscreen every two hours. If you are working out or swimming, reapply every hour. “The biggest problem I have with patients are my triathletes who either sweat it off or swim it off,” says Samarin.