Your Connection to Healthy Living
Volume 6, Issue 1 | Winter 2018
Girl Talk Half of all women will develop fibroids by age 50. Learn about this condition and how to get treatment. Page 4
After surgery to remove fibroids, Christie Weil got her wish come true—a healthy baby boy.
3 A pacemaker the size of a vitamin 6 Surgical solutions for back pain 7 Expanding care for the community
porterhospital.org :: Spring 2013
1 PHOTO BY ELLEN JASKOL
CENTURA
Winter
health briefs
s You
Centura Health Heart & Vascular Network is the region’s leading provider of comprehensive heart care, offering advanced heart diagnostics and state-of-the-art treatments to: Open blocked arteries R epair or replace heart valves Fix abnormal heart rhythms H elp patients recover after heart attacks R educe heart disease risk factors To find a heart program or expert in your neighborhood, go to centura.org/heart.
Heart rate apps may be missing a beat or two, according to a study last spring in the European Journal of Preventive Cardiology. “They tested four heart rate applications, and results were all over the place,” says Ajay Yadlapati, MD, interventional cardiologist with South Denver Cardiology, A Centura Health Clinic. This is partly due to the lack of regulation, he says. Better to stick to apps that motivate like “nutrition apps that track actual calories, or exercise apps that record steps or distance.”
Silent
I
TREATMENT Yes, heart attacks can happen without symptoms. The good news, Yadlapati says, is that there are some signs that signal silent heart attacks. If you’ve been experiencing even mild reflux or heartburn or a general sense of fatigue, especially if they persist despite diet changes and rest, talk to your doctor. Also, diabetes and kidney disease raise your risk for silent heart attack, so don’t shrug off signs.
ROBOTS
Robots in the operating room at Porter Heart & Vascular Institute are helping cardiovascular surgeons fix hearts through tiny incisions between the ribs vs. the more traditional open-chest methods. Patients needing mitral valve repair, tricuspid valve repair, removal of intracardiac tumors, correction of atrial fibrillation and, for very select cases, coronary bypass surgery, may all be candidates, says Sanjay Tripathi, MD, cardiovascular surgeon. Procedures performed by Tripathi using the assistance of the robot can help reduce pain and complications, and speed recovery.
HEART SCAN If you’re a man over age 40 or a woman over age 45, your risk for heart disease is on the rise. A heart calcium scoring exam, a noninvasive scan that checks for calcium buildup in the arteries, can help you assess your risk. To learn more or to schedule a heart calcium scoring exam for $149, call: Porter Adventist Hospital: 1-855-854-3278 Littleton Adventist Hospital: 303-744-1065 Parker Adventist Hospital: 303-269-4500
Porter Adventist Hospital is a regional medical center that provides care for complex health issues. We specialize in complex surgery, cardiovascular care, spine care, joint replacement, liver and kidney transplants, and cancer care. We are part of Centura Health, the region’s leading health care network. Vibrant is published quarterly by Porter Adventist Hospital — Portercare Adventist Health System. The purpose of this publication is to support our mission to improve the health of the residents in our community. No information in this publication is meant as a recommendation or to substitute for your physician’s advice. If you would like to comment or unsubscribe to this magazine, please email us at vibrant@centura.org. Vibrant is produced by Clementine Healthcare Marketing.
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VIBRANT :: Porter Adventist Hospital
PHOTOS: HANDS ©ISTOCKPHOTO.COM/NASTCO; HEART APP ©ADOBESTOCK.COM – SYDAPRODUCTIONS
APP FAILURE
KEEPING PACE In some ways, David Austin is the typical Colorado Springs outdoor enthusiast — an avid cyclist who’s in top physical condition. But when you consider he was born before World War II, his 70-mile-a-week cycling regimen is impressive. Austin had a long history of very low resting heart rates, which he believed to be a good thing. Protecting his heart from his low heart rate was not on his radar. But early last summer, when his newly acquired portable heart rhythm monitor began recording regularly abnormal heart rhythm patterns, he visited his cardiologist. The problem was not the rhythm readings but his ever decreasing low resting heart rate, or bradycardia, which put the 79-year-old Austin Actual size at high risk of fainting.
PHOTO BY MICHAEL RICHMOND; TRANSCATHETER COURTESY OF MEDTRONIC
To continue his amazing cycling routine, Austin needed an amazing solution. And in June 2017, his medical team at Porter Adventist Hospital provided just that when they implanted a new kind of pacemaker to regulate his heartbeat. Called the Micra™ Transcatheter Pacing System, this pacemaker has no leads, which are wires that deliver energy to the heart. “I had one week of rest, and then in July started riding my normal biking course again,” Austin says. According to William Choe, MD, an electrophysiologist with South Denver Cardiology, A Centura Health Clinic, the Micra offers several advantages. After getting a leadless pacemaker implanted, David Austin is back to biking.
Groundbreaking leadless pacemaker gets right to the heart of the issue
LOSING THE LEAD Traditional pacemakers are implanted into the chest with leads that extend into the heart. Leads both sense the heart’s electrical activity and deliver electrical impulses to the heart, causing it to beat faster if needed. “The Achilles heel — the weakest Dr. William Choe link in this whole system — is the lead itself,” Choe says, noting that they can wear out, dislodge, or lead to infection. By contrast, the Micra has no leads. Roughly the size of a large vitamin capsule, it’s implanted into the heart through the femoral vein in the leg.
WHO’S A CANDIDATE? Choe and colleagues at South Denver Cardiology, A Centura Health Clinic, participated in the research that led to the Micra gaining FDA approval in 2016. Still, Choe says it’s too early to say if the Micra will become the gold standard for pacemakers. However, the leadless pacemaker, which is intended only for patients who need a singlechamber pacemaker, may be a good option for the following: Active patients, who might be restricted by conventional pacemaker implantation Young patients in whom leads might wear out over a long period of time Dialysis patients or others who have catheter ports Learn more about the breakthrough tests and treatments for heart care at Porter Adventist Hospital. Visit porterhospital.org/heart or call 855-854-3278.
We are part of the Centura Health Heart & Vascular Network, the region’s leading provider of cardiovascular care. porterhospital.org :: Winter 2018
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THE FACTS on fibroids W
An
to yo a com
hen we hear the word tumor, our world starts to spin. But fibroid tumors — also commonly called uterine fibroids — are very rarely cancerous.
So, breathe a sigh of relief and read on. Mandi Beman, MD, director of robotics and gynecology at Porter Adventist Hospital, offers the facts on fibroids, including the major symptoms to look out for and when it’s time to seek treatment.
Q: What are uterine fibroids exactly?
A: What I tell patients is that fibroids are most often benign, or noncancerous, muscle cell tumors of the uterus. In other words, they originate from the smooth muscle layer in the uterus.
Q: What causes them, and why are they so common?
HALF
of all women have uterine fibroids by age 50.
A: Fibroids happen in about 80 to 85 percent of women. We don’t know why they are so common or why women get them. They seem to run in families, and they are much more common in African-American women.
Q: What are the main symptoms?
A: The good news is only about 20 to 25 percent of fibroids cause symptoms. When they do, the main symptoms are pain, pressure, and abnormal bleeding. Less commonly, fibroids can cause “fullness” in the lower abdomen, urge to urinate (if the fibroid is pressing against the bladder), and, in about 1 or 2 percent of cases, infertility.
Q: When do fibroids require treatment?
Dr. Mandi Beman
A: If you have fibroids but no symptoms, you generally don’t need treatment. But see your doctor regularly to make sure they are not growing rapidly, which (especially between ages 45 and 52) is when we get concerned with potential cancer. Fibroids generally shrink after menopause. If fibroids are causing painful symptoms or are affecting fertility, surgical removal, called a myomectomy, may be a viable treatment option. Depending on size, location, and age, other treatments can control symptoms or shrink the fibroids.
ONE-STOP PREVENTIVE CARE FOR WOMEN
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VIBRANT :: Porter Adventist Hospital
If you answered, “yes,” you’ll love the Care on CUE Clinic at Porter Adventist Hospital. A one-stop shop offering back-to-back-to-back medical and dental appointments, the Care on CUE Clinic is currently being piloted at Porter Adventist Hospital. “In a single morning or afternoon, a woman can get her mammogram, annual fasting labs, gynecological exam, and bone density screening. We are hoping to add primary care and dental care as well,” says Mandi Beman, MD. As women continue to take multitasking to new heights, we are too. Make your appointment at the Care on CUE Clinic today by calling 303-316-6677.
PHOTO BY MICHAEL RICHMOND
If you could just make one phone call to a nurse who would schedule your screenings and labs for the entire year in a single morning, would you do it?
nswers
our questions about this mmon female affliction
Christie and Sage Weil just celebrated their son's first birthday. Despite a high-risk pregnancy after fibroid surgery, delivery was drama-free for both mom and baby.
Unexpected Success For Christie Weil, all’s well that ends well. It’s the in-between that got a little dicey. Weil, 37, had surgery to remove problematic uterine fibroids in 2012, got married in 2013, and after a few years of infertility, decided to try in vitro fertilization when she and her husband moved to Highlands Ranch in 2015. “When I went in for egg implantation, my infertility doctor spotted another fibroid. I was devastated. All we wanted was a baby, and now we had to make a plan to take out the fibroid and wait nine months for implantation,” she says. Only — surprise — nine months later she would actually be giving birth to a healthy baby boy. Two weeks after the fibroid removal, the Weils conceived. It was shocking, given their history of infertility. And it was potentially dangerous, especially if the pregnancy implanted in the vulnerable area where the fibroid had just been removed. Weil’s surgeon, Mandi Beman, MD, director of robotics and gynecology at Porter Adventist Hospital, explains: “Surgery to remove uterine fibroids leaves a large defect in the muscle of the uterus. We repair that defect with multiple layers of sutures. Ideally we want three months for that to heal to decrease the risks that the incision will open or weaken as the uterus grows with pregnancy.” PHOTO BY ELLEN JASKOL
Weil let the reality set in. “Part of me was so excited to be pregnant. Part of me was really nervous,” she says.
Women who have had several children are less likely to have uterine fibroids.
After months of waiting, the Weils’ baby boy arrived in November 2016. “Every doctor who meets me says my child is truly a miracle,” Weil says. “Dr. Beman did such a good job in the surgery. I had more complications prior to my pregnancy than I did during my pregnancy.”
porterhospital.org :: Winter 2018
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PUSHING BACK PAIN An estimated eight in 10 people will experience back pain in their lifetime. “Back pain is one of the leading causes of not being able to work or enjoy recreational activities,” says Michael Gallizzi, MD, MS, minimally invasive spine surgeon with Centura Orthopedics & Spine — Porter.
Most back pain resolves with anti-inflammatory medications (such as Motrin), rest, and physical therapy. When symptoms persist, however, surgery may relieve pain. And today’s Dr. Michael Gallizzi spine surgery is not like that of even five years ago. “Hardware is better now, and newer techniques performed through small incisions spare muscles,” Gallizzi says. Here he helps take a look at conditions that often require spine surgery.
To make an appointment with Dr. Gallizzi or another surgeon at Colorado Orthopedics & Spine — Porter, call 303-925-4540.
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SURGICAL TREATMENT:
Spondylolysis/ Spondylolisthesis
Spondylolysis is a fancy name for a crack or stress fracture in a lower back vertebra. Its more serious cousin, spondylolisthesis, occurs when that fractured vertebra slips out of place.
Children and adolescents active in sports such as gymnastics, football, and weight lifting are at greatest risk, as are active adults in their 20s-40s.
Rarely responds to nonsurgical treatment. Spinal fusion “welds” vertebrae together to stabilize the spine.
Spinal Stenosis
Stenosis is a narrowing of the “tunnel” around your spinal cord. This can place pressure on nerves, leading to numbness, tingling, pain, and leg weakness.
It occurs mainly in adults over 60. Arthritis is the most common cause.
Decompression surgery removes bone and bone spurs that are causing pressure on nerves.
Herniated Disc
A disc is a soft, rubbery pad that serves as a “shock absorber” between vertebrae. When it herniates, or ruptures, its soft center pushes through the outer edge of the disc, sort of like the jelly seeping out of a doughnut.
Older adults are at risk, as are smokers, those who are overweight, and those who improperly lift or engage in repetitive strenuous activities.
Microdiscectomy, which removes only the protruding portion of the disc, is common for lower back pain. At all levels, disc removal and fusion of the two vertebrae also may be an option. Artificial disc implantation is an alternative to fusion in some neck pain patients.
BACK PAIN NOW RANKS AS THE THIRD MOST BURDENSOME CONDITION ON HEALTH IN 2010, UP FROM SIXTH IN 1990.
VIBRANT :: Porter Adventist Hospital
WHOM IT AFFECTS:
Porter Adventist Hospital — along with Littleton Adventist Hospital, Parker Adventist Hospital, and Castle Rock Adventist Hospital — are part of Centura Health, the region’s leading health care provider. The Porter Spine Institute has been recognized for outstanding clinical quality for spine surgery by Anthem Blue Cross and Blue Shield as well as UnitedHealthcare. To learn more, go to porterhospital.org/spine.
PHOTOS: ©ISTOCKPHOTO.COM/ADVENTTR, /VIOLETKAIPA, /CYNOCLUB, /CAPDESIGN
WHAT IT IS:
Quite a BUILDUP They’re raising dust at Porter Adventist Hospital, and it’s all to better serve patients, physicians, nurses, and staff. “Construction has started on the first phase of a 10-year, $47 million plan to update and expand the hospital,” says Vice President of Operations Rebecca Israel. The first phase is expected to be complete by fall, Israel says. While some projects will be quite visible, others — such as updated electrical and plumbing — will make operations smoother.
Construction and renovation at Porter Adventist Hospital will enhance the experiences of patients and staff
SECOND FLOOR New construction and renovation will add two orthopedic ORs, specially equipped for Porter Adventist Hospital’s award-winning joint replacement and spine programs, and two specially equipped ORs for head and neck surgery. Porter Adventist Hospital provides comprehensive inpatient and outpatient behavioral health, and a new waiting area will provide a soothing, healing environment for patients and families.
FIRST FLOOR A new oncology nursing station will be designed so that nurses can better monitor patients recovering from head and neck cancer surgery. Porter Adventist Hospital specializes in treating head and neck cancer. The new physician lounge will be modern and bright, with highspeed internet connections and delectable dining. Happy physicians make happy patients! Porter Adventist Hospital is one of the last hospitals in the Denver area to have a full medical library staffed by professional librarians who provide daily assistance to physicians and clinical staff researching the latest discoveries and state-of-the-art care. A new medical library will complement Porter Adventist Hospital’s growing research programs.
A new cadaver lab will serve as an education and teaching hub, attracting practitioners who want to advance their skills and practice new treatment techniques. A new, updated diagnostic laboratory will provide greater efficiencies and better workflow.
PHOTO BY ELLEN JASKOL
The hospital’s existing cafeteria will be completely rebuilt to offer patients and visitors an exciting new dining space, plus an expanded menu of delicious, healthy foods.
GROUND FLOOR
porterhospital.org :: Winter 2018
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THE ROUTE to good health We all want to be healthy. For some, that means overcoming, or preventing, chronic illnesses like diabetes, high cholesterol, or heart disease. For others, it means maintaining a healthy weight. And for still others, it means just feeling great, in body, mind, and spirit.
Portercare Adventist Health System
Non-Profit Organization U.S. Postage
PAID
Denver, CO Permit No. 4033
2525 South Downing Street Denver, CO 80210
Whatever your health destination, Centura Health’s 18-session holistic program, Pathways to Health & Wellness, can help you get there.
• Reverse chronic disease • Lose weight • Gain energy • Spend less on food and medications • Enjoy life again
TO LEARN MORE about Pathways to Health & Wellness, attend one of these FREE information sessions at Porter Place, 1001 East Yale Avenue in Denver: Sunday, Jan. 28, 12:30-1:30 p.m. Monday, Jan. 29, 6:30-7:30 p.m. Wednesday, Jan. 31, 6:30-7:30 p.m. Register for an information session at coloradocreationhealth.com.
Your closest Centura Emergency Department is at Porter Adventist Hospital — 2525 South Downing Street. Visit porterhospital.org for wait times.
FREE CLASSES & EVENTS Around the Community
R por egiste terh r osp online ital. org/ at eve nts
RSVP is required. Locations and times vary and are subject to change. Visit porterhospital.org/events or call 303-765-3825 for more information.
KEEP YOUR VEINS HEALTHY AND STRONG
PINK NIGHT Porter Adventist Hospital has an ongoing partnership with DU. As part of that partnership, we support several “Pink Night” events to encourage screening mammograms, raise awareness for breast cancer, and support survivors. Please join us for a fun family night. Wear pink and show your support for breast cancer awareness!
Have questions about your vein health? Learn more with Amanda Small, NP. Date: Thu, Feb 8 Time: 6-7 p.m. L ocation: Porter Adventist Hospital Conference Center
DU Women’s Gymnastics Pink Night Date: Sat, Jan 27 Time: 6 p.m. Location: Hamilton Gymnasium inside the Ritchie Center, 2240 East Buchtel Boulevard DU Women’s Basketball Pink Night Date: Sat, Feb 17 Time: 1 p.m. Location: Hamilton Gymnasium inside the Ritchie Center, 2240 East Buchtel Boulevard
porterhospital.org
GROCERY STORE WALK AND TALK
Join one of the registered dietitians from Porter Adventist Hospital and learn the best way to shop heart healthy. Date: Thu, Mar 1 Time: 1-2 p.m. L ocation: Sprouts Farmers Market, 2880 South Colorado Boulevard
MY ACHING BACK! BE HEART SMART
The heart is complex, but taking care of it doesn’t have to be. Learn the top tips on your heart health. Date: Thu, Feb 22 Time: 1-2 p.m. L ocation: Porter Place, 1001 East Yale Avenue
Understand common back disorders, treatments, recovery, self-care, and symptom management. Date: Thu, Mar 15 Time: 1-2 p.m. L ocation: Porter Place, 1001 East Yale Avenue
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, 2018. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-303-765-3826 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-303-765-3826 (TTY: 711).
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This three-month program is designed to provide priceless health benefits, including helping you: