Bloom Winter 2015 by Penrose-St. Francis Health Services

Thyroid Insights | Customized Cancer Care | Caring for the Caregiver

Penrose-St. Francis Health Services

Nurturing womenâ&#x20AC;&#x2122;s health in Colorado Springs

Relieving your stress could save your life

HANGING BY

A Thread

FREE

Stress Seminar Page 10

Winter 2015 Volume 5, Issue 1

HealthyStart

How bad is it … not to

Controlling your body’s energy supply If you’re tired for no reason and have gained or lost weight, you could have a thyroid problem. This butterfly-shaped gland in the neck helps control your body’s energy supply, including calories burned, heartbeat, and temperature. When your thyroid is underactive (hypothyroidism) or overactive (hyperthyroidism), “everything feels off balance,” says Deborah Rice, MSN, APN, an advanced practice nurse at Penrose-St. Francis Primary Care. “These conditions affect the whole system.” About 1 in 3 women age 40 and older will have a thyroid problem.

Women are up to 8 times more likely than men to have a thyroid problem. If your mother or sister had a thyroid problem, chances are you will too.

Easily Found While the symptoms of under- or overactive thyroid mimic many health problems, these conditions tend to run in families. Left untreated, they can cause heart problems, depression, and more. This is rare, though, because a routine blood test can detect thyroid problems before symptoms appear. Effectively Treated Thyroid hormone replacement pills return an underactive thyroid to normal, but weight gain and fatigue may continue even once thyroid hormone levels normalize. “The usual healthy diet and exercise are paramount,” Rice says. Anti-thyroid medication or radioactive iodine (available through a referral) usually cures overactive thyroid. Sometimes surgery to remove the thyroid is needed. Radioactive iodine (which shrinks the thyroid) and surgery both lead to underactive thyroid, requiring a daily thyroid hormone replacement pill. Underactive Thyroid Symptoms • Fatigue • Weight gain • Constipation • Dry skin and nails • Brittle nails

Overactive Thyroid Symptoms • Fatigue • Weight loss • Tremors • Palpitations • Loose stools

You won’t get sick again by not tossing your toothbrush after a cold or the flu. While germs can live on your toothbrush for up to a few days, the immune system protects you from getting the same cold or flu again, says Clinton Callahan, DMD, PC. People with weak immune systems, though, should change their toothbrush after a cold or the flu, he adds. Healthy Habits For everyone else, the American Dental Association recommends getting a new toothbrush every three months or when the bristles get frayed. Children usually need a new toothbrush sooner. A flu shot is the best way to prevent the flu. To avoid spreading a cold or the flu at home: • Don’t share toothbrushes or glasses (use disposable cups) • Keep toothbrushes separate so germs can’t jump from one toothbrush to another

If you suspect you might have a thyroid problem, talk to your doctor or make an appointment with Penrose-St. Francis Primary Care by calling 719-776-4646. 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 healthcare 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.

2222 North Nevada Avenue, Colorado Springs, CO 80907

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Winter 2015

Penrose-St. Francis Health Services

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change your toothbrush after a cold or the flu?

Screening for stroke:

Could you have a broken back? A type of broken bone in the spine (a compression fracture) might — or might not — hurt. Either way, “you’ve broken your back,” says neurosurgeon Ronald Hammers, MD. Dr. Ronald Hammers Commonly caused by osteoporosis, compression fractures can curve your spine and shorten your height — and your life. If there’s no pain, a curved spine and lost height are the first signs you have one. Most compression fractures are treated by modifying your activities or by wearing a brace. Some require a minimally invasive procedure called kyphoplasty to inject cement into the spine to restore the bone’s height and prevent future collapse. Get your bones checked “Preventing osteoporosis is best,” Hammers says. “If you have osteoporosis, get it treated. If you’ve already developed a compression fracture, take it seriously.” After menopause, see your doctor regularly to check for bone loss and address any problems as soon as spotted. Join Dr. Hammers at a FREE community seminar on Tuesday, Jan. 27, from 6-7:30 p.m. to learn more about treatments for spine problems, including compression fractures. See full details on Page 11.

FAST FACT

25%

About of postmenopausal women have compression fractures.

Helpful or harmful?

If you’ve been recommended for an ultrasound to check whether the

arteries supplying blood to your brain are clogged, you should give it careful consideration. Screening for this condition, called carotid artery stenosis, is successful when the right patients are tested but may lead to unnecessary procedures in the wrong patients, according to the Dr. Kathryn Davis U.S. Preventive Services Task Force. Less than 1 percent of the general population is believed to have carotid artery stenosis, but that number can reach 67 percent in older patients with multiple risk factors. “We don’t recommend screening the general population. You can have false-positive readings that cause unnecessary worry and lead to unnecessary follow-up testing,” says Kathryn Davis, MD, a vascular surgeon at Southern Colorado Vascular Surgery. When screening is helpful Screening is helpful for people who’ve had: • Stroke • TIA (transient ischemic attack, a quick warning stroke) • Amaurosis fugax (vision loss in one eye from a temporary lack of blood flow)

When screening might help It also may be recommended for people with these risk factors: • Smoking • High blood pressure • A close relative with carotid artery stenosis • Heart disease • High cholesterol

“Whether to screen is an individual decision made by the patient and doctor,” Davis says. “The more risk factors a patient has, the higher the likelihood of finding something.” To schedule an appointment with Dr. Davis, call Southern Colorado Vascular Surgery at 719-776-6700.

For the (young) man in your life

Extreme sports, extreme risks

As more teens do riskier stunts on snowboards and skis, the number of head and neck injuries — ranging from concussions to traumatic brain injuries — is jumping. “You hear about people dying several times each year. These injuries can also cause paralysis and other disabilities,” says Jack L. Sharon, MD, medical director of emergency services at Penrose-St. Francis Health Services. Get help fast after a severe head injury. “Go to an emergency department if the person loses consciousness, throws up, can’t remember what happened, or just isn’t acting the same as before the Dr. Jack Sharon injury,” Sharon says. People with head injuries may not be able to make good decisions, so if persuading the person to go to the hospital doesn’t work, call 911 or drive the person there. “Do what’s best for the person you’re concerned about. Hopefully, they’ll thank you in the morning,” he says. If you’re not sure whether to call 911 or drive to the hospital, call 911.

penrosestfrancis.org

97,527

The number of head and neck injuries sustained by snowboarders from 2000-2011 Visit penrosestfrancis.org/ moveon for a list of physicians, joint and spine events, and to take a virtual tour of the new Total Joint and Spine Center.

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Hanging by a

thread Feel like if one more thing gets added to your to-do list, you’ll snap?

You may have reached the point where stress is harming not just your lifestyle but your very life. Learn how stress actually works on your body and what you can do about it.

id you make a New Year’s resolution to lose weight? Exercise more? Stop smoking? What about taking time to read a good book, take a bubble bath, or just simply put your feet up? When it comes to building good health, there’s one area that most women overlook — reducing their stress. Day-to-day, soul-crushing, sleep-robbing stress not only steals your lifestyle, but it could be endangering your health. Stress revs up your blood pressure, triggers inflammation, shuts down your immune system, and even changes your cells — all of which open the doors to problems like heart disease, diabetes, and cancer. And if you’re too busy, worried, and anxious to care about those long-term problems, you should know that stress also is linked to weight gain, GI problems, depression, and fatigue. “In the short term, like a car accident, your body’s stress response is good and can save your life,” explains Di Thompson, MD, a psychiatrist at Penrose-St. Francis Health Services specializing in oncology and women’s health. “We run into problems when stressors become chronic.” < [From left to right] Dr. Kimberly Dulaney, cardiologist, Dr. Di Thompson, psychiatrist, and Dr. Iwona NimptschKossek, an internal medicine physician, work with women in Colorado Springs to help them understand the effects of stress and how to combat it.

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Penrose-St. Francis Health Services

Thompson, along with cardiologist Kimberly Dulaney, MD, and internal medicine physician Iwona Nimptsch-Kossek, MD, help us take a closer look at what happens inside of our bodies when we are exposed to chronic stress. But first, a few cautionary notes. Researchers are still trying to unravel to what extent stress itself vs. how we react to stress harms our health. Genetics play a huge role in your health, not just whether you will develop heart disease but even in how your body responds to stress. Although we know that the body’s response to chronic stress creates an environment fertile for disease, it’s not clear who will develop disease, who won’t, and why that is.

The hormone to blame What you can blame is cortisol. This hormone regulates our blood pressure, insulin, immune system, and inflammatory response. Typically higher in the morning (think of it as the get-up-and-go button), cortisol is released when the body needs to go into hyperdrive. Like when you’re running from a saber-toothed tiger, you get into a car crash or, unfortunately, when the kids are fighting, you’re late for work, and the checking account is overdrawn. “If you’re in a car accident, your cortisol increases and triggers the blood pressure to go up, which we need to counter bleeding,” Thompson says. “But once we get taken care of, cortisol and blood pressure go down.” Under chronic stress, however, cortisol doesn’t go down and that’s what causes the problems. Cellular damage At the deepest level, researchers are finding that stress actually changes your cells. A study involving hundreds of women found that stressful events were linked to shorter telomeres, which are the protective tips of chromosomes that affect how quickly we age. As telomeres become shorter and they weaken, cells age and die. It’s this cellular aging that is associated with age-related illnesses, such as heart disease, Alzheimer’s, and cancer. The good news is that this same study, published last year in the journal Molecular Psychiatry, found that women who maintained active lifestyles, ate healthy, and slept well showed no significant shortening of their telomeres even under increased stress. penrosestfrancis.org

Inflammation Inflammation is the body’s natural response to irritants or injury. When you have an abscessed tooth, for instance, your immune system sends out white blood cells to fix it. That leads to the puffiness you see. But when the immune system is out of whack from the excess cortisol, it can’t regulate the inflammatory response. And researchers now believe that inflammation can damage arteries (leading to heart attacks and strokes), damage brain cells (leading to dementia or Alzheimer’s), and promote resistance to insulin (leading to diabetes). Researchers at Carnegie Mellon University were the first to identify that people under stress were more likely to catch the common cold. And two years ago, they published a study showing that people with prolonged stress produced higher levels of inflammation. “Our bodies are hardwired to protect us,” says Nimptsch-Kossek, an internal medicine physician at Penrose-St. Francis Primary Care. “Under stress, the hypothalamus sets off an alarm … and the brain has to shut down functions of the body that are not essential, like the immune system, and that’s why inflammation progresses.” continued next page

Seminar Learn more at a FREE seminar where experts will discuss which foods affect your stress levels and teach you relaxation and exercise techniques to help reduce stress. Saturday, Feb. 28, from 8:30-11:30 a.m. For full details, see Page 10.

How much is too much? All women respond differently to stress, and new research shows that this differing response might be hardwired into our DNA. And since no one knows who is at the highest risk, experts advise every woman to watch for signs that stress is out of control like: • Drinking more alcohol than normal • Eating more than normal, particularly carbs • Disrupted sleep patterns • Always fatigued and lack of enthusiasm • Irritable • Can’t find time for anything you enjoy on a daily basis

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photos: Opposite page: ©Ellen Jaskol, ©istockphoto.com/Floortje; this page: ©istockphoto.com/KateLeigh, /Cat_Chat

“I often hear from cancer patients, ‘I know if I hadn’t been under stress, I wouldn’t have cancer or it wouldn’t have returned,’” Thompson says. “That’s just not true. A large European study last year looked at groups of stressed and non-stressed (people), and the rates of cancer recurrence were the same between the two groups. We need to be careful not to blame ourselves for particular disease processes.”

Being “on pins and needles” is a figurative expression that describes an uncomfortable anticipatory feeling. continued from Page 5

Heart disease One of the best understood consequences of stress is its link to heart disease. When you are injured, say in that car crash mentioned earlier, your body releases cortisol, which triggers your blood pressure to go up, which is needed to counter bleeding. In a healthy state, your blood pressure goes up during times like this but then goes back down. But when you are stressed, blood pressure stays high and that sets the stage for heart disease and possible heart attack, says Dulaney, a cardiologist at Colorado Springs Cardiology, a Centura Health Clinic. “Stress is really multifactorial,” she says. “When you’re stressed, you blood pressure is higher, which damages the arteries and causes plaque buildup.” If not treated, the damage grows worse over time and starts to cause symptoms such as fatigue. “Women ignore the symptoms because they’re stressed out about everything and put themselves last,” Dulaney says. Weight gain In a non-stressed state, your cortisol levels go up in the morning and come down at night. That makes sense since cortisol regulates blood pressure and the provision of energy. When that pattern is disrupted, it has several affects that may lead to weight gain. Excess cortisol increases the appetite, which leaves many women reaching into the cookie jar. And thanks

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to cortisol, those extra calories tend to be stored as fat in the belly, according to some studies. Abdominal fat has been strongly correlated with the development of cardiovascular diseases leading to heart attacks and strokes. And if that’s not bad enough, women who store fat in their abdomen (the so-called apple-shaped bodies) seem to react more intensely to stress, which causes them to release even more cortisol, and these women also tended to eat under stress. The study that discovered this phenomenon, published in 2000 in the journal Psychosocial Medicine, also found that women with high waist-hip ratios (apples) didn’t adjust to stressors over time as did the women with low waist-hip ratios (pears).

Cut the Stress Looking for some ways to manage your stress? Penrose-St. Francis offers a bevy of programs, from tai chi to support groups. Go online to penrosestfrancis.org/calendar for a list of activities and programs.

Not everyone is alike Women also differ in how they deal with stress and that may be just as important as the stress itself. Lack of exercise, eating an unhealthy diet, not getting enough sleep, and smoking create many of the same reactions in the body as chronic stress. It’s well-known, for example, that smoking, poor diet, and too little sleep cause shorter telomeres that cause cells to age quicker. Those same factors also weaken the immune system and increase inflammation. “It’s important to recognize that we have ways of managing stress that can delay or prevent consequences including diabetes and dementia,” says Nimptsch-Kossek.

Why Exercise Works

One of the best ways to reduce your stress is through exercise. That’s not just because it makes us feel better mentally. It’s because exercise burns cortisol (the stress hormone) and produces serotonin and endorphins, chemicals that counter cortisol and its effects.

Penrose-St. Francis Health Services

& QA with Michelle Reed, DO Family Medicine Physician Penrose-St. Francis Primary Care 3027 North Circle Drive Colorado Springs

Top reasons for

seeing a doctor What you need to know

Q: Which common skin

problems should be treated? Can I prevent them?

A: Rough, dry, scaly growths (keratosis);

acne; and rashes and other types of skin inflammation (dermatitis) may require a visit to your doctor. If you already have keratosis, see your doctor if the growths get larger, scab or crust, change color, or itch or burn. Keratosis can become skin cancer, which is most curable when found early. Your doctor can destroy the growths by freezing them or with medicine. Occasionally, surgery is needed. Prevent keratosis by wearing sunscreen and avoiding the midday sun. For acne, see a doctor about prescription medicines if over-the-counter treatments don’t help. Keeping skin clean and moist helps prevent acne. If inflamed skin hurts or isn’t getting better after a few days, your doctor can prescribe steroid ointment and an antihistamine. Keeping skin moist and avoiding irritants (e.g., poison ivy or latex rubber) helps prevent dermatitis.

Q: When should arthritis be

treated? How can I prevent it?

A: Most people see a doctor when joint

pain and stiffness from arthritis becomes unbearable. It’s best to seek help earlier, since different types of arthritis have different treatments.

For wear-and-tear arthritis (osteoarthritis, the most common type), exercise is the best treatment — and a great way to keep joints healthy. Over-the-counter pain medicines like Motrin® and Tylenol® and ice packs relieve pain. Physical therapy helps improve function. Joint replacement surgery is an option for severe arthritis. Staying at a healthy weight also helps prevent arthritis.

Q: When does back pain need to be treated? How can I prevent it?

A: For back pain from a car accident or

a bad fall or sports injury, and back pain with numbness or tingling, loss of bowel or bladder control, or fever, call 911 or go to the emergency department. Most other back pain gets better with time. Medicines like Motrin and Tylenol and ice packs or heating pads relieve pain. Resting for a day or two helps the back heal, but more than that makes it weaker. If back pain isn’t getting better after about six days, see your doctor. Treatments include stronger medicines, physical therapy, massage therapy, acupuncture, and adjusting the spine manually (osteopathic manipulation). Exercising and staying at a healthy weight are the best ways to prevent back pain or keep it from coming back.

Dr. Michelle Reed

Dr. Michelle Reed partners with patients to help them improve their health.

A Colorado native, Michelle Reed, DO, likes being on the “front line” of medical care. “I get to be like Sherlock Holmes, and put the pieces of the medical puzzle together to figure out the mysteries of illness and disease,” says Reed, who has been a family medicine doctor for more than 18 years. Outside of the office, Reed plays golf with friends and family, enjoys art and music, and cares for her sheepdog puppy, Skiilar.

To make an appointment with Dr. Reed, call 719-776-4646.

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photos: Opposite page: ©istockphoto.com/Floortje, /pixdeluxe/ matka_Wariatka; this page: ©istockphoto.com/©hleib, portrait ©Steve Bigley

Skin problems, arthritis, and back pain — all irritating but not usually serious problems — are the most common reasons for visits to the doctor. bloom recently sat down with Michelle Reed, DO, a family medicine physician in Colorado Springs, to get advice on these problems that affect nearly everyone.

technology

Customized Cancer Care Radiation treatment for breast cancer is tailor-made for each woman

experienced. And she may have more choices than ever, from single-dose radiation during surgery to one-week intensive courses. “The word ‘radiation’ can scare us,” says Anuj Peddada, MD, medical director of radiation oncology at Penrose Cancer Center. “I tell my patients to think of radiation as medicine. If you don’t need it, we don’t prescribe it. If you need it, it can be lifesaving.” Radiation oncologists design a treatment plan customized to each patient’s anatomy, using computerized planning based on CT scan images. “There’s no cookie-cutter approach,” Peddada says.

A second opinion made simple Cancer doctors understand the peace of mind that comes with being confident about your treatment decisions. That’s why the Penrose Cancer Center offers a Second Opinion Clinic. For $99, patients can submit their records to be reviewed by a multidisciplinary team of physicians. The patient receives a report either agreeing with the plan of action or recommending that other tests or treatments be considered. To learn more about the Penrose Cancer Center Second Opinion Clinic or to set up an evaluation, please call 719-776-5271.

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Doing more with less As breast-conserving lumpectomies have become more common, radiation is becoming a more standard part of treatment. “Radiation optimizes local control, keeping cancer from coming back in the breast,” Peddada explains. Emerging breast cancer research supports a shortened course of radiation in some cases, depending on factors such as the patient’s age and the tumor’s size, location, and grade. Historically, breast cancer radiation has been done as a “Monday through Friday” treatment spanning six weeks. However, “there’s more data evolving that a shorter course of radiation — three to four weeks — has equivalent outcomes,” Peddada says. Research on effective treatments over a shorter duration has been driven by women, Peddada says. “Many women have breast cancer in the working and child-rearing years of their lives, and it’s hard to put your life on hold for six weeks while you’re going through treatment.” Some women qualify for accelerated partial breast irradiation, which can be given twice a day for five days. Partial breast irradiation also can be delivered by brachytherapy, with radioactive pellets temporarily placed in the breast. Under very specific circumstances, women may receive intraoperative radiation — a single radiation treatment at the time of surgery. Advanced and precise Just as how to use radiation more effectively has evolved, so has the technology that delivers the treatment. Penrose Cancer Center uses a TrueBeam™ linear accelerator to deliver radiation therapy from outside the patient’s body. This multimillion dollar machine can “shape” the radiation to exactly match the shape of the cancer tumor, sparing nearby healthy tissue. “It’s the most advanced linear accelerator in the world,” Peddada says. With the precision of modern radiation techniques, side effects tend to be fewer and milder than in the past. For example, “in the early years of radiation, before we really understood the risk to cardiac tissue, the heart received a lot more radiation than it does today,” Peddada says. “Now we’re very careful to avoid this.” Penrose-St. Francis Health Services

photos: ©istockphoto.com/kevinjeon00; opposite page: ©istockphoto.com/FredFroese, /jfens

Dr. Anuj Peddada

Getting radiation for breast cancer today is more like going to a high-end tailor than shopping off the rack. A woman can’t compare her treatment to what her friends or family may have

Caregiver

Coping If you’re a caregiver, now is the time to take care of yourself

eing a caregiver to an ill loved one is a 24/7 job that can quickly leave you burned out and unable to care for yourself, much less anyone else. “Burnout is caused by the demands on the caregiver that continue daily, often with no end in sight,” says Tobi Steinberg, MA, LPC, a clinical psychotherapist at The Center for Behavioral Health at Penrose-St. Francis Health Services. Here, Steinberg offers a four-step plan for taking care of yourself so that you can continue to take care of your loved one.

Tobi Steinberg, MA, LPC Clinical Psychotherapist, The Center for Behavioral Health 961 East Colorado Avenue, Colorado Springs Specialty areas: Individual, couples, and family counseling; women’s issues; and stress reduction As a long-distance caregiver for an aunt on the East Coast, Steinberg understands firsthand the stress of caregiving. She also spends much of her professional life helping family and professional caregivers deal with stress and prevent burnout. Baking is one of Steinberg’s outlets to help reduce stress. “In another world I would open a cafe and bakery,” she says. Steinberg also enjoys riding her bike and hiking with her husband and their four dogs, and photographing Colorado’s landscape.

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“Burnout is caused by the demands on the caregiver that continue daily, often with no end in sight.” —Tobi Steinberg

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Recognize your role. Taking care of a loved one is the ultimate act of love. It’s what we wives, daughters, sisters, and best friends do. “A lot of times we don’t think of ourselves as caregivers because we’re doing something that we think we’re just supposed to do,” Steinberg says. But the danger of not recognizing your official role as a caregiver is that you don’t develop the support systems you need to function well for an extended time. Make a plan. Just as you plan for your loved one, you need to make plans on how to care for yourself. Support groups and therapists can help you see what you’re facing down the road, offer advice, and help you watch for warning signs that you’re close to burning out. “Once you’re burned out, the road back is a lot harder,” Steinberg says. Take care of yourself, every day. Self-care is absolutely essential. “It’s like the oxygen mask theory; if you’re on a plane, you have to put on your oxygen mask first or you can’t take care of anybody else,” Steinberg says. Make a daily checklist (and put it on your phone) of the things you need to stay physically and emotionally healthy. Include at least one thing in each of these areas: • Physical care: eating right, exercising, rest • Mental care: something you enjoy that keeps your mind active • Emotional care: ways to stay connected with friends and family, opportunities to share your feelings • Spiritual care: ways to stay connected to something larger, such as God or nature Watch for danger signs. Despite your best laid plans, you still may face burnout. Maybe you are already there. The key here is to recognize signs so that you can take immediate action. “The biggest thing you can do is to ask for help,” Steinberg says.

Are you close to burnout? Go to penrosestfrancis.org/burnout to take on online quiz to find out. If you need help, call 719-634-1825 to schedule an appointment with a counselor at The Center for Behavioral Health.

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Exercise With Us!

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Keep Calm and Stress Less

Stress is all around us. And, over time, its effects can be quite taxing. But don’t worry — we can help! Let us show you how certain foods, relaxation, and exercise can help you stress less. Our experts will address the effects of stress on the body, which foods have a positive/negative effect on stress, lead you through a relaxing sitting yoga exercise, and engage you in a mini Zumba and Hot Hula class that are sure to melt the stress away. A healthy breakfast will be provided. Wear comfortable clothing and shoes for the Zumba and Hot Hula activity.

Inspire Health Tip

Sweet treats for Valentine’s Day don’t have to be at the expense of your healthy eating plan. For a healthier alternative to boxed chocolates, give your loved one dark chocolate-covered strawberries or bananas.

WomenHeart Support Groups Date | 2nd Wed of month Time | 11:30 a.m.-1 p.m. Date | Last Tue 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.

Heart & Soul

Heart Calcium Scoring Test Cost | $149 (Insurance is not billed for this screening. A physician referral is not required.) Info | Call 719-776-8768 to schedule an appointment Think a heart attack could never happen to you? Think again. Heart disease is the No. 1 killer of men and women in the U.S. And, if you smoke, are overweight, or have a family history of heart disease, your risk goes up. Know more about your heart. Schedule a heart calcium scoring test to help determine your heart attack risk by detecting calcium buildup in your arteries. It’s convenient, painless, noninvasive, and only takes 30 minutes. Plus, you’ll know at your visit your results and will discuss your risk with a cardiac nurse.

Easy Chair Yoga for Heart Disease and Cancer Survivors Date | Weds Time | 2-3 p.m. Location | Penrose Pavilion, 2312 North Nevada Avenue, 2nd Floor Cost | FREE Info | Call Sandy Weatherly, Breast Care Center manager, at 719-776-8208 Reap the benefits of yoga in this hourlong class that takes place sitting down. The chair replaces the yoga mat and becomes an extension of your body, allowing you to take full advantage of yoga’s amazing fitness and health potential. No special clothing or equipment needed.

Penrose-St. Francis Health Services

calendar

Winter

The Penrose-St. Francis Wellness Center offers group fitness classes, including Zumba, Tai Chi, Boot Camp, Yoga, Body Toning, and Spinning throughout the week. Visit penrosestfrancis.org/ calendar for class dates, times, and locations.

Chapel Hills Mall Walk n Roll – Sponsored by Penrose-St. Francis Health Services Date | Mons-Sats • Time | 6:30-10 a.m. Date | Suns • Time | 6:30-11 a.m. Cost | FREE Move your way to fitness! In winter, the mall is especially ideal for fitness walking, as it is climatecontrolled; has miles of smooth, hazard-free walkways; and has 24/7 security in and around mall property. Attend our monthly health seminars and earn prizes throughout the year for meeting your goals. To learn more and view the various walking courses, visit chapelhillsmall.com/info/ mallwalkers. What If? What Else? What Now? Date | Sat, Jan 24 Time | 8 a.m.-4 p.m. Location | Penrose Pavilion, 2312 North Nevada Avenue, 2nd Floor Conference Room Cost | $125/person Registration | penrosestfrancis.org/whatif4 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 Jan. 20. Payment due at time of registration. Osteoporosis and the Effects on the Spine Date | Tue, Jan 27 • Time | 6-7:30 p.m. Location | Penrose Cancer Center, 2222 North Nevada Avenue, Conference Rooms A-C Cost | FREE Registration | penrosestfrancis.org/events Join spine surgeon Dr. Ronald Hammers to learn about maintenance of overall spine health, the effects of osteoporosis on the spine, and how to manage osteoporosis-related spine fractures and other conditions. Refreshments provided.

NOW OPEN! 17230 Jackson Creek Parkway, Monument, CO Centura Health and the Tri-Lakes YMCA bring you a one-of-a-kind health center that delivers a range of personalized, high-value health and wellness services all under one roof. Services include: Urgent Care • Primary Care • Pediatrics • Obstetrics Lab/Radiology • Physical Therapy • Behavioral Health • Occupational Health • Tri-Lakes YMCA Tri-Lakes Café & Bistro • Child Care Services. Learn more at myneighborhoodhealthcenter.org.

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Voluntarily Happy Did you know do-gooders are also feelgooders? Older adults who stay active by volunteering get more out of it than just an altruistic feeling — they receive a health boost too! Volunteering is associated with reductions in symptoms of depression, better overall health, fewer functional limitations, and greater longevity. If you’re looking for a way to give back and get healthier, learn more about Penrose-St. Francis adult and teen volunteer opportunities at penrosestfrancis.org/volunteer.

Foot and Ankle Pain Seminar Date | Thu, Jan 29 • Time | 6-7:30 p.m. Location | Penrose-St. Francis Primary Care, 3027 North Circle Drive (Circle and Union), Community Room Cost | FREE Registration | penrosestfrancis.org/events Do you have foot or ankle pain that just doesn’t seem to get better? Join sports medicine and family physician Dr. Nick Piantanida and Shad Schreiner, DPT, OCS, physical therapist, as they look at disorders of the foot and ankle and possible reasons why they aren’t fully healing. Light refreshments will be provided. Understanding Palliative Care Date | Sat, Jan 31 • Time | 11 a.m.-12:30 p.m. Location | Penrose Cancer Center, 2222 North Nevada Avenue, Conference Rooms A-C Cost | FREE Registration | Email carolynkalaskie@centura.org or call 719-776-4542 by Jan 23 Palliative care is specialized medical care for people with serious illnesses such as cancer, cardiac disease, chronic obstructive pulmonary disease (COPD), kidney failure, Alzheimer’s, Parkinson’s, amyotrophic lateral sclerosis (ALS), and many more. If you have questions about palliative care for a loved one, our experts will discuss the latest on palliative care-related issues and answer your questions. Therapeutic Drumming for Cancer Survivors and Their Caregivers Date | Tues, Feb 3, 10, 17, and 24 Time | 4:30-5:20 p.m. Location | Penrose Pavilion, 2312 North Nevada Avenue, 2nd Floor Cost | FREE Registration | Call Sherry Martin, LCSW, at 719-776-5311 A group empowerment drumming experience that provides stress relief and helps strengthen the immune system.

Shouldering the Pain: From Rotator Cuff to Arthritis Date | Tue, Feb 10 • Time | 6-7:30 p.m. Location | Penrose Cancer Center, 2222 North Nevada Avenue, Conference Rooms B and C Cost | FREE Registration | penrosestfrancis.org/events Do you have sore shoulders? Learn the causes and treatment options for both rotator cuff injuries and shoulder arthritis from orthopedic surgeon Dr. Ronald Hollis and Vicki Lieber, physical therapist at Penrose-St. Francis Rehabilitation Services. Dress comfortably, as you’ll get the chance to learn some exercises to maintain good shoulder health. Refreshments provided.

Shoulder/Arm Injuries in the Overhead Athlete Date | Thu, Feb 19 • Time | 6-7:30 p.m. Location | Penrose-St. Francis Primary Care, 3027 North Circle Drive, Community Room Cost | FREE Registration | penrosestfrancis.org/events “Overhead” athletes are those who participate in sports where common movements place overuse stress on the shoulder and/or elbow. These sports include: baseball, softball, tennis, lacrosse, volleyball, and swimming. There are other medical conditions such as diabetes that predispose patients to shoulder pain similar to athletes. Please join Dr. Nick Piantanida, family and sports medicine physician, and Shad Schreiner, DPT, OCS, physical therapist, who will lead a discussion on optimizing preventive injury strategies for our “overhead” athletes and streamline management steps along a series of therapy options. Stepping On! Date | Fris, Apr 10-May 29 • Time | 10 a.m.-Noon Location | St. Francis Medical Center, 6001 East Woodmen Road, Conference Room 5 Cost | FREE Registration | 719-571-8000 Stepping On! empowers older adults to carry out healthy behaviors that reduce the risks of falls. It is a community-based workshop offered once a week for seven weeks, using adult education and self-efficacy principles. Older adults who should attend are those who are at risk for falling, have a fear of falling, or who have fallen one or more times. The workshop is co-led by a healthcare professional and a lay leader. Local guest experts assist by providing information on exercise, vision, safety, and medications. Limited to 14 participants. Winter 2015

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Recipient of the Healthgrades Cardiac Care Excellence Award™ for two years in a row (2014, 2015)

Penrose-St. Francis Health Services is part of Centura Health, the region’s leading healthcare 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, 2015.

Crushing cravings:

How to take back control

Sharon Jacob, RD, clinical dietitian at St. Francis Medical Center

Nearly all of us get food

cravings — those intense desires to eat certain foods. Women usually want sweet, fatty foods, like chocolate. Men are most often drawn to salty, fatty foods like french fries, chips, and barbeque. All of the foods we crave have lots of fat and calories.

100% of young women and

70% of young men had a food craving last year.

Cravings are part of us Having food cravings isn’t bad. “We’re hardwired to crave sweet, fatty, and salty foods,” says Sharon Jacob, RD, a clinical dietitian at St. Francis Medical Center. Once upon a time, human beings needed extra fat and calories to survive. That’s no longer true, but those instinctive cravings are still part of us. The desire to feel good Beyond biology, food cravings also come from our minds. “The areas of the brain responsible for memory and sensing pleasure are partially to blame for food cravings,” Jacob says. People often crave foods they associate with good memories, like eating ice cream on a family vacation. “When we eat those foods, our body releases dopamine,” she says. This “feel-good” brain chemical makes us want to eat those foods again and again. Stress and other negative emotions also create cravings. Foods loaded with fat and sugar are calming. When you eat them and feel better, you’re training your brain to seek this calming effect in the future. Food manufacturers have tapped into the desire to feel good by precisely loading processed foods with the optimal combination of sugar, fat, and salt to cause cravings. Most people don’t know about this, but it makes us want to eat more of these foods. Ignoring cravings increases them Ignoring food cravings doesn’t work because your brain seeks the euphoria that satisfying them brings. “When you tell yourself that you’re not going to eat something, you crave it more,” Jacob says. “Instead of one chocolate bar, you devour a whole bag of candy.”

Ice cream is the most common food people crave (followed closely by potato chips).

Satisfying Your Cravings

Don’t feel guilty about food cravings. Give in to them, but do it wisely: Eat a small portion of whatever you crave and enjoy it. The first four bites are enough to satisfy you emotionally. Buy less of the foods you crave and keep them out of sight. Buy more types of fruits and vegetables to satisfy the urge for something new. If it’s chocolate you crave, try our Black Bean Brownie recipe for a healthy, easy-to-make brownie that adds fiber and protein to your diet while satisfying cravings with less guilt. You’ll find it at penrosestfrancis.org/ recipes.