HealthLine by Loveland Reporter Herald

Take me to MCR for world-class health care.

When you need medical care, the exceptional caregivers at Medical Center of the Rockies are here for you. Part of the Poudre Valley Health System family, Medical Center of the Rockies is a full-service hospital specializing in advanced cardiac and trauma care. We also offer general surgery, labor and delivery and emergency care 24 hours a day, 7 days a weekâ&#x20AC;&#x201D;all in a unique, healing environment.

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Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 3 On the cover: Ramona Perkins, RN and Clinical Educator with Medical Center of the Rockies in Loveland RH photo by Jade Cody

inside 14 A Day in the Life of a Nurse

Take a walk in the shoes of nurses in Northern Colorado

Allergies 17 Food Families learn to navigate severe food allergies

22 Health in a Handbasket Jade Cody relearns a back flip

23 Crandoodles Artist Steve Crandall honors nurses in his own special way

23 Rhema gears up for the Bolder-Boulder

24 Destination: Healthy Look internally for health indicators

24 Uncommon Sense Dr. Beth Firestein answers readers’ questions

25 Asthma or Vocal

Cord Disfunction? McKee Medical Center’s Anna Kujawska reveals information about breathing problems

5 Nurses of the Year Northern Colorado nurses are honored

Health Line of Northern Colorado is a monthly publication produced by the Loveland Daily Reporter-Herald. The information provided in this publication is intended for personal, non-commercial, informational and entertainment purposes only and does not constitute a recommendation or endorsement with respect to any company, product, procedure or activity. You should seek the advice of a professional regarding your particular situation.

For advertising information, contact: Linda Story — 635-3614

For editorial information, contact: Jade Cody: 635-3656 jcody@reporter-herald.com

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010

Skin cancer has become an epidemic in the U.S. Karen Kaplan Los Angeles Times

ThinkStock photo

Cindy Gregorian St. Louis Post-Dispatch

on-melanoma skin cancer is the most common type of cancer in the U.S. But just how common is it? According to a new estimate, more than 2.1 million Americans were treated for 3.5 million cases of the cancers in 2006. Since cases of non-melanoma skin cancer usually aren’t reported to cancer registries, experts must rely on estimates. Until this week, the most recent national estimate had been from 1994 — back then, researchers pegged the number of cancers at 900,000 to 1.2 million per year. To reach the new figure, researchers used two Medicare databases to tally the number of skin cancer procedures performed on patients covered by the government health plan. Then they used national survey data to extrapolate those figures to the entire U.S. population. The results indicate the incidence of skin cancer is “about double” what it was in 1994, the researchers wrote in Archives of Dermatology. Not only are more people getting

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non-melanoma skin cancer, but the number of procedures per patient is rising too. “There is an epidemic of (non-melanoma skin cancer) in the United States,” according to the report. This type of skin cancer usually isn’t deadly if found early, but the toll is still significant. The American Academy of Dermatology says that treatment of non-melanoma skin cancer cost $1.5 billion in 2004. The researchers didn’t say why they thought the rates were rising so fast — perhaps the rise of tanning salons is partly to blame. They did note that “educational programs emphasizing sun protection have mainly been disappointing in slowing skin cancer rates.” Of course, they conclude that more research is needed.

few months ago, MSNBC reported on a study which found that people who cycled in time to music required 7 percent less oxygen to do the same work when compared to music playing in the background. According to a British sports psychologist quoted in the story, there are four factors that contribute to a song’s motivational qualities: rhythm response, musicality, cultural impact and association. Among some recommended song choices: • “Bury Me With It” by Modest Mouse • “Cut Your Hair” by Pavement • “Mullet Head” by Beastie Boys • “Early Morning” by Old 97s • “The Underdog” by Spoon • “She Don’t Use Jelly” by The Flaming Lips • “Drunken Poet’s Dream” by Hayes Carll • “Four Leaf Clover” by Old 97s • “I Got A Gig” by Hayes Carll • “Rollerskate Skinny” by Old 97s • “Sleep to Dream” by Fiona Apple • “Comfort Eagle” by Cake • “Float On” by Modest Mouse • “Heavy Metal Drummer” by Wilco • “Born To Run” by Bruce Springsteen

Learn more about strokes, stroke prevention Poudre Valley Health System

special educational event will be held May 22 in Fort Collins to help community members learn more about strokes — the leading cause of adult disability in the U.S. Spotlight on Stroke, held during National Stroke Awareness Month, will feature presentations by healthcare professionals and a panel discussion focused on stroke information. Nurses will be available to provide free blood pressure screenings, stroke

risk assessments, and information on blood-pressure monitoring. Dr. Gerald McIntosh, medical director of the Poudre Valley Health System’s stroke program, will be the keynote speaker. He will discuss the most current methods of stroke prevention and treatment, as well as his reflections as a neurology physician who has treated many stroke patients. Laura Dvorak, a registered nurse and PVHS Healthy Hearts Program coordinator, said the event is designed to assist people in making healthy lifestyle choices that can help prevent a stroke.

“This is also a great opportunity for people who have had a stroke to reflect on their experience and gain positive coping skills,” she said. The free event will go from 8:30 a.m. to noon at Northside Aztlan Community Center, 112 E. Willow. Registration is required: call the PVHS Aspen Club at 495-8560. The event will be hosted by PVHS; the Aspen Club, an organization for older citizens; Health District of Northern Larimer County; and Center for Neurorehabilitation Services.

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 5

Honoring Northern Coloradoâ&#x20AC;&#x2122;s

Nurses The Reporter-Herald asked its readers to nominate the best nurses in Northern Colorado. In honor of National Nurses Week in May, here are some of the exceptional nurses in the area.

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Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010

Ramona Perkins started the Teddy Bear Hospital at MCR last year. It is a program in which children are able to bring in their “sick” pets to be cared for by the medical staff. Rh photo/ Jade Cody

Ramona Perkins RN and Clinical Educator, Medical Center of the Rockies

Jade Cody Special Sections Editor

s the clinical educator for MCR’s Emergency Department, Ramona Perkins finds joy in sharing her knowledge with the nursing staff. “I enjoy teaching and the one on one with people. I love seeing the light bulb go off,” she said. As an educator, Perkins ensures the nursing staff is properly educated and has the correct medical certifications. Nurses are required to be continually educated, with yearly courses and updates to their nursing practices. Perkins also enjoys educating the public, specifically the children. Last year she formed the Teddy Bear Hospital program to help children be more comfortable with the medical setting. In the program, children in the community are able to bring in their “sick” stuffed animals so that they can be treated by the nursing staff. “The goal is to ease their anxieties about coming to the Emergency Department,” Perkins said. This year’s Teddy Bear Hospital

will be from 10 a.m. to 2 p.m. on May 22 at MCR. Last year she said 173 children brought in their furry patients, including a teddy bear that fell off the roof and broke his leg and a manatee with critically severe injuries. When the children come in, their animals are promptly checked in, evaluated and then bandaged up. This year there will also be pet therapy dogs, the Loveland Fire Department, ambulances, North Colorado Med Evac with a helicopter and an obstacle course provided by the Healthy Kids Club. As a Loveland native, Perkins values her community. She graduated from Loveland High School in 1986 and the University of Northern Colorado in 1993. After working in Dallas and Michigan for a few years, she came to MCR when it opened in 2007. “My favorite thing is running into former patients in the grocery store,” she said. She performs clinical shifts along with her role in nurse education. “I enjoy nursing as a profession — it is very rewarding.”

PERKINS’ NOMINATION LETTER: Ramona is a night shift nurse at heart who instills strong patient and family centered values in everyone she works with and cares for. She has a great sense of humor and a natural camaraderie with providers, EMTs, housekeepers and nurses alike. She functions as the charge nurse in the ED as well as the ED educator. As a charge nurse, she demonstrates a calm, competent clinical presence that encourages ED staff to perform the best evidence-based practice, even in the most stressful trauma and medical emergency circumstances. She is an expert clinician and she shares her acquired knowledge. Ramona was the founder and continues to be the champion of the MCR Teddy Bear Hospital. She brought to the ED, the concept of a mini-hospital setting with hospital volunteers, where kids can bring their stuffed toys and animals for “care,” while demonstrating to the kids how the hospital can be a place where people get help and not be as scary for them or their loved ones. Ramona is always the first RN to volunteer in whatever capacity or shift that is needed to be sure that the department is always adequately staffed. She is a nurse, a leader, an educator and a humanitarian. Her support of her peers, her patients and her community make her the Best Nurse in Northern Colorado. Nominated by: Frances Culler

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 7

Rosanne Carroll

RN, Professional Home Health Care, Longmont

Carroll thrives on patient interaction and playing a meaningful role in people’s lives. As a home care nurse, Carroll goes to her t age 64, after serving with Red Cross Boulder patients’ homes to provide care. She sees up to eight or nine patients a day. for 40 years, Rosanne Carroll went back to school. She had unfinished “Our goal is to keep them in their homes business. and out of the hospital.” “I wanted to work more with people,” she Carroll sees herself as an advocate for her said. “When I graduated from high school in patients, helping them not only with medical 1960, I wanted to be a nurse.” care but also in regard to their families. She So she enrolled in school in Kentucky in a builds a trust with her patients and finds ways to provide them with successful care one-year accelerated program for nursing. plans. She graduated at age 65. “I know that I’m making a difference in “I’m doing what I wanted to do for 40 their lives,” she said. years,” she said. Jade Cody Special Sections Editor

NOMINATION LETTERS FOR ROSANNE CARROLL To whom it may concern: My staff nurse Rosanne Carroll is extraordinary in home care, especially with mental health clients who have challenges hospital nurses never see or learn to manage. Rosanne brings her years of experience with Red Cross as an executive director to Professional Home Health Care. Rosanne lets people keep their dignity and empowers them to manage their lives. She has learned the complex world of home care and done so with a sense of humor! She drives to Boulder while living and serving in Loveland. She is part of the human services commission for Loveland and helps with fundraisers. Thanks for your second profession! Nominated by: Janet Puglisi

raising two daughters and retiring from the Red Cross, she decided at the young age of 64 to return to school to earn her nursing degree. Like everything else she does, she put 100 percent into it and graduated with her bachelor’s degree in nursing. Rosanne is a home health care nurse, and she treats all of her patients with respect and compassion while giving them the best medical care possible. Her patients all love and respect her. She even brings them back little gifts from her travels! I believe Rosanne is the best nurse in Northern Colorado and you would too if you met her! By the way, this special lady is my Mother. She also serves on the Loveland Human Services Commission. Nominated by: Kirsten Konieczka

ond career. She got her nursing degree at the age of 65. Nominated by: Joann Passman

Dear ReporterHerald, Rosanne always makes me happy when she RH photo/ comes. She Jade Cody makes sure I take my medicine to keep me healthy, and has such a kind heart. God bless her. Rosanne regularly attends training and nursing seminars to improve skills. She serves on the Human Services Dear Reporter-Herald, Commission in Loveland and supports What I enjoy about Rosanne Carroll: many community fundraisers She arrives at a time that I can deDear Reporter-Herald, I believe After retiring as an executive director Rosanne Carroll should be recognized pend on each Monday. from the American Red Cross, took up She keeps complete records in her and acknowledged for her courage to nursing as a second career — graduatwork hard, to go back to school to train notebook on all of the details of my ing with a bachelor’s degree in nursing for such a hard, but rewarding, job. She health from week to week. at age 65. is much appreciated here as she cares Rosanne has also provided helpful Lives in Loveland and drives to Boulfor me, an 80-year-old person who ideas on how I can understand and im- der to take care of her clients. looks forward to her visit every Monprove my health. Nominated by: Juanita Najera day morning. She encourages me to Nominated by: Ivan Maiden Dear Reporter-Herald, Rosanne is a get better. Dear Reporter-Herald, Rosanne is just very extraordinary nurse. I could not Nominated by: Mildred Godsey a wonderful person. I see her every ask for anyone better. She has humor, Dear Reporter-Herald, Rosanne is week. I had two bleeding strokes 11 interest in the person who she gives truly a one of a kind nurse! As a young years ago. Rosanne serves on the Hucare to. I would miss her. woman she always knew she wanted man Services Commission in Loveland. Nominated by: Robert Holden to be a nurse, but like a lot of people She retired as an Executive Director Also nominated by: Howie Ehrlich life got in the way. After successfully from the Red Cross. Nursing is her sec-

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 RH photo/Jade Cody

Shauna Wall RN, Agent Care Coordinator, Medical Center of the Rockies

Jade Cody Special Sections Editor

s a charge nurse in the MCR Emergency Department, Shauna Wall knows how important family is in an emergency. She works to involve families with patients, even in critical care situations. It’s called a patient/family care model, which stresses a collaboration between the patient, family and physician. This means the family (defined by the patient) is involved in the care and allows them to be present and participate in care decisions. It also means that the number of family members aren’t restricted from being bedside in emergency situations. “I had a patient that came in terminally ill, and the family chose to be in the room when he arrested,” Wall said. One family member later told Wall that being able to help make decisions with the patient was a huge satisfier, she said. Wall’s position as a charge nurse makes her responsible for the flow of the department, as well as supervising the nurses on the floor. She has spent almost 31 years in emergency room care and enjoys the fast paced environment and the autonomy of her job. She has been an RN for 31 years, almost all in an emergency room setting. When asked what her favorite part of being a nurse was, Wall said “giving really good patient care and knowing that the things we do really matter.” She became interested in nursing because it combined her interest in science with her love of taking care of people. NOMINATION LETTER FOR SHAUNA WALL Shauna Wall is a natural leader who aspires to deliver the best possible care to patients in an emergency department or hospital setting. She takes the lead on new principles and theory, even when her ideas are unpopular or more difficult to perform. She challenges the staff to critically think, while giving them the education, skill and backup they need to feel confident with difficult situations. She runs a trauma team scenario with necessary military precision. Providers and peers rely on her for

guidance, leadership and clinical knowledge, whether during an end of life situation, a scared ill child or a devastating trauma. As an experienced ED practitioner, her hands-on skills set the standard for the entire department. She is well known hospital wide for her strong patient advocacy: less than optimum care is unacceptable. She believes that nurses are continuous learners and that they have a responsibility to be current on all modalities that affect positive patient outcomes, and she leads the way to

learning. She has been a champion for the Patient and Family Centered Care model at MCR. She leads a hospital committee made up of staff, managers and previous patients and their families from the community in a forum that promotes optimum care based on real experiences, evidencebased practice and tangible suggestions. Shauna is an inspirational nurse leader. Nominated by: Frances Culler, MCR Emergency Department Director

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 9

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Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010

Kathy Thomas

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RN, Case Manager, Mountain Valley Hospice and Health Care, Windsor

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fter meeting a hospice nurse who cared for her father-in-law, Kathy Thomas knew hospice care was her calling. “It’s become my life mission and desire to work in hospice,” Thomas said. Her father-in-law’s nurse made an immediate and definite impact. “She just took care of our whole family, and that’s what I’m learning and trying to do.” That sometimes means finding ways for the patient’s family to continue providing support and care for that person. She said she tries to help each of the family members find a way to help the patient and become more comfortable with the dying process. “All of my patients have the same prognosis,” she

RH photo/Jade Cody

said. “They all die. So how do we get this family together so that they can say goodbye without regrets? “Every dying person has a lot left to give, and I’m fortunate to be the recipient of that as a hospice nurse.”

NOMINATION LETTER FOR KATHY THOMAS It is my privilege to nominate Kathy Thomas as the Best Nurse in Northern Colorado. It is not just her job — she shows compassion and caring for the patient and his family. She took him snacks when he was losing a lot of weight because of no appetite and encouraged him to eat, even by sharing her lunchtime with him in the courtyard and by getting to know his needs and feelings. She volunteered to drive us to a restaurant so we could have lunch together. She worked with my husband in a hospice setting in a nursing home, but gave me her cell phone number so I could contact her any time about his condition and was never too busy to talk. She is a very caring person, above and beyond her “job.” It is her calling. Nominated by: Mrs. May Marie Irwin, widow of William G. Irwin (Bill)

Mary Johnson RN, Director of Nurses, Sierra Vista Healthcare Center, Loveland Jade Cody Special Sections Editor

n RN since 1980, Mary Johnson has found her niche with elderly care. For the past 18 years, she has served as the Director of Nursing for Sierra Vista Health Care Center. “I see myself as a facilitator working with the rest of the nurses here,” she said. Johnson and her nursing staff strive to give patients quality of life along with respect and dignity. “Our goal is to show them kindness and compassion,” she said. “For many residents, we are their family, and this is their home.” Sierra Vista serves as both a long- and shortterm care provider, offering residential care along with services such as rehabilitation and IV care. “Many residents who come to us do end up going home,” she said. “It’s a very rewarding experience working with our elders and staff.”

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 11 EXCERPT OF NOMINATION LETTER FOR MARY JOHNSON What would love look like if we gave it a face? It would look a lot like Mary Johnson. I had the pleasure of meeting Mary and working closely with her during my employment at Sierra Vista Healthcare Center in 2007. Immediately, I could tell she was an extraordinary nurse. She sets a high standard of care and leads by example. Very rarely will you find her in her office. She can easily be found, though, out on the floor, helping out at the nursing stations, engaged in conversations with the residents/family members, or offering help to anyone or anywhere she may be needed. RH photo/Jade Cody You will always find a beautiful smile on her face and an encouraging word for those in need. She truly brings joy and happiness to anyone who crosses her path. Mary is truly loved by all of the residents of Sierra Vista as well as the staff members. She provides an environment of love, family, home and a safe haven for all of the elderly residents entrusted in her care. She is an angel on earth. Nominated by: Karen Dembrun

Mark Clem

RN, Director, Pathways Hospice Care Center

Jade Cody Special Sections Editor

director with Pathways Hospice in Loveland. “I wanted to do something fter becoming an RN where I was able to help in 1976, Mark Clem people,” he said. “The posiserved as a chaplain tion I’m in now is a nice and then a minister, though his true calling turned out to combination of all of my be hospice care. He currently backgrounds. “Most people who work in serves as the care center hospice care feel called to it,” he said. “I’m fulfilling that original call to make a differNOMINATION LETTER FOR MARK CLEM career as a Hospice Nurse, a Surgical Care ence.” Chaplain, and a Hospice Chaplain. am nominating Mark Clem, RN and Clem said his duties as a currently Pathways Hospice Care CenHe embodies the holistic approach that director vary. One moment ter Director, for Reporter Herald Nurse Hospice offers our patients and families, he might be helping to fix a of the Year because of his outstanding combining skilled nursing knowledge contributions to the quality and success of with compassion, grace and wisdom. bed, the next giving annual Pathways Hospice’s in-patient unit at Mc- Mark leads the Pathways Hospice Care reviews to staff or meeting Kee Hospital. with a patient and his/her Center Team by his example. He has a family. It’s the one-on-one Mark is not only a Registered Nurse servant-heart and is mature and calm in care that he most enjoys, with over 15 years of hospice experience; his approach to management as well as though. he also trained as a Chaplain at Bethel patient care. Theological Seminary in Minnesota earn“I like being able to affect Nominated by: Kel Blackwell, Clinical ing a Master of Arts in Christian Education. people’s lives and make a Services Executive, Pathways Hospice Mark has worked at various times in his difference in a meaningful way,” he said.

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010

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Janelle Crawford RN, Surgical Oncology, McKee Medical Center

them or laughing with them — or whatever it is that day,” she said. “We or Janelle Crawford, become their support syspersonalized care is tem.” paramount. Crawford became inter“I’m huge on primary ested in healthcare when nursing,” she said, referher grandmother, who ring to a type of care in lived down the road from which nurses assign her, had a stroke. Crawthemselves to specific ford, who was 12 at the patients. time, helped take care of “That way I know what her grandma and essentially helped her stay at they have done and home. When she was 16 where they want to be.” This also allows the medi- she became a CNA, her cal staff to keep updated, first job, and later became close records of each pa- an RN for McKee. tient so that future care is Crawford provides that much more effective. nursing care in surgical settings as well as Crawford enjoys it bechemotherapy managecause she is able to offer ment and basic bedside stronger care to the panursing duties. tient. “I like crying with Jade Cody Special Sections Editor

RH photo/Jade Cody

NOMINATION LETTER FOR JANELLE CRAWFORD I nominate Janelle Crawford for this award because she is an amazing nurse who puts her heart and soul into the great care she gives her patients and their families. There was this patient who frequently was admitted to the surgical oncology floor, and Janelle would take care of her. This patient and Janelle had a good, positive and professional patient/nurse relationship. Janelle discovered this patient liked angels. The patient was admitted to another floor so Janelle bought her an angel from the gift shop and delivered it to her room to let her know that an angel would be watching over her. Janelle is a wonderful patient advocate — never afraid to phone the oncologist and assist with the plan of care. Janelle is always two or three patients’ primary nurse. Nominated by: a co-worker

Barb Schleiger Staff RN, McKee Medical Center Jade Cody Special Sections Editor

touch on the decor. She’s also turned in small quilts to the birthing departarb Schleiger knows the warmth ment for situations when they have a of a handmade fetal demise, she quilt can stretch thousands of miles. The McK- said. ee RN has made quilts For the past 18 and sent them as far as years, Schleiger has Africa, Israel and provided nursing Guatemala — to places care in the Banner such as orphanages and System. Her duties hospitals where the blan- include patient inkets are needed. terviewing, seda“That’s the gift that God tion and education. She said she feels has given me,” she said that God has about her quilting. placed her in this Once inside McKee, role. Schleiger’s quilts can be “I love being obedient seen hanging on the walls to God, and this is — a gesture she said helped warm up the hos- where he placed me,” she said. “He will show me pital and put her crafty

RH photo/Jade Cody

why I need to be here today. That’s exciting to me that I can be used that way.”

NOMINATION LETTER FOR BARB SCHLEIGER I nominate Barb Schleiger for her dedication to the profession of nursing. She has contributed to society by her involvement in assisting a physician prepare for missionary service to Africa. Barb helped organize and prepare supplies for use there. She continues to support this project by ongoing collection and organization of supplies, as communication liaison and equipment representatives to obtain needed supplies. Barb also utilizes her beautiful quilting skills by creating baby quilts for infants born into difficult circumstances. She donates hours of time to craft quilts and gives the quilts to Birthright of Loveland. They in turn give the quilts to moms with newborns. This is such a beautiful affirmation of each baby’s value and worth. This caring and loving heart is a hallmark of Barb. She also volunteers in church in any capacity needed. She is a fantastic nurse and a shining star in nursing. Nominated by: Mary Madrid, fellow nurse at McKee

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 15

A day in the life of a nurse All hours of the day, nurses care for patients

— Kathryn Kirkpatrick, Oncology Nurse Manager at PVH

Rhema Muncy Special Sections Reporter

very shift he is scheduled, McKee Medical Center Obstetrics night nurse Joe Bartell, RN, walks into the building with his backpack, lunch, iPod and three dozen little ghosts. “Every patient and situation I come across, there is that history and the perspective that sits there with me,” Bartell said. He described witnessing the moment of birth as watching life teetering on a razor’s edge. Until the first cry of a new born baby rings in the air, no one knows if the child and mother will live or die, even with the hum of technology filling the room. Bartell has helped deliver hundreds of healthy babies throughout his 16-year career, but it is the three dozen little angels he has taken to the morgue that drive him to keep focused on the care of the mothers and babies that cross his path each shift. “I figure the only way to pay that back is to know as much as I can about what I am doing, what I am involved in to make this life- changing crisis go through,” Bartell said. “I have had babies who lived with so many tubes that you can hardly find the baby. I figure that the best thing I can do is to protect families from the cold, sterile, stainless-steel and antiseptic part of the crisis. I never want my patients to see the horrible ugly side.”

“People who have cancer over a certain amount of time are thankful for this care.”

RH photos/Rhema Muncy

Above, Nurses Jenny Reinert and Kristen Cox administer medication to oncology patient Ashley Wood at PVH. Right, McKee Nurse Beth Higgs checks the emergency room equipment.

someone to talk to. We can reassure them and give them a plan. You have the time to just cially during Bartell’s night The night shift is not always signed to the nursery, a place sit down and talk for awhile.” watch. filled with intense moments. where he had no experience. Because the night shift is a “I usually say good morning Now he can’t stay away from Nurse Lea Rodningen walks different pace than the day the OB floor. when I get to work because her work nights on a specialnight is relative and it is mornHe keeps to the night shift for ized hall at Poudre Valley Hos- shift, the nurses can work without constant interruption and ing for me,” Bartell said. the atmosphere and the mone- pital. As a charge nurse for the tary advantages even though he oncology unit, she works three care for the cancer in-patients He gets a report from the dealing with the side-effects of said the World Health Organiza- 12-hour shifts each week and nurse who was taking care of their treatments. cares for a new baby. She said the patient before him. If it is a tion lists night shifts as a class “A lot of times their family one carcinogen. The night shift she does sleep well during the laboring patient, they discuss has left for the day and they day still, especially with the also isolates workers because how far along the process is, don’t have anyone,” Rodningen help of her husband and placfamily members and friends the health of the mother and said. “They are just thinking ing her baby in daycare three have different schedules. baby and how many weeks the about stuff. Sometimes they will days a week. Her passion repregnancy has progressed. “After working three night “They are either transitioning shifts in a row, I feel like I have mains on the oncology floor, a get worked up. Saying I have to the crisis moment or recover- been on a bender,” Bartell said. career she chose as a new grad- time and I can talk with them is important — cancer is a terrible uate eight years ago. ing from in it,” he said. “Every morning at 4 a.m. you On a typical night, she takes thing, and if you don’t have that He also helps newborns tran- get sick to your stomach, foggy care of four patients. If she is in support when you need it, that headed and pretty psychotic. sition from the womb to the can be hard.” charge, she will care for two. The light messes with your outside world, a four-to-six In the morning, the night sleep. Your body gets the most She spends the first couple of hour process that includes ascrew of the PVH oncology floor sessments, routine medications effective sleep between 2 and 5 hours doing assessments and getting the patients tucked into hands the care over to the day a.m.” and evaluations of how the shift. The daylight hour nurses newborn is doing. And yet Bartell has delivered bed. “Nights are special,” she said. begin with bedside reporting, a Bartell became a nurse after a three babies at 3 a.m. in the process that helps patients tranparking lots of hospitals. Appar- “A lot of stuff happens in the career of building houses in sition to a new care charge and days and patients don’t have ently newborns will make a California. He went to nursing time to process it. It hits them at helps nurses determine who grand entrance into the world school and then joined the needs immediate assistance. night, though, and they need whenever they want to, espeArmy nurse core. He was as-

change to do so.” Sometimes the patient/nurse relationship shifts to hard subjects, such as discussing the prospect of dying. There are also triumphs such as a positive chemotherapy result or a transition of the patient back to regular life that are celebrated by the entire floor. “It is not just about the patient,” Reinert said. “These people are faced with a life threatening illness. We like to get the family in there and give them the news or ask the patient who they want there. For a lot of people, it is not just cancer they are going through. They might be going through a divorce or losing a job. [The emo“We typically take three-totion] comes from our experifour patients on a day shift,” RN ence of bracing people with Jenny Reinert said. bad news. I like it because you “Our mornings tend to be really get to know the heart of a busy with physicians and person. You strip away all of the things that don’t essentially meals,” Kristin Cox, RN, said. matter in life.” “In oncology, we have the coolest patients. Most of our pa- AN EMERGENCY ROOM tients are motivated to get betPERSPECTIVE ter. There’s always family dyMcKee Medical Center emernamics in every area. They truly gency room RN Beth Higgs has want to learn about the disease worked nearly her entire 21and about their treatment. We year nursing career on this fastspend a ton of time educating, paced and unpredictable floor. and we also get to know our “We never know what is gopatients.” ing to happen at any time,” Oncology services nurse Higgs said. “You always have to manager Kathryn Kirkpatrick be prepared and staffed for finds oncology a fulfilling floor that. There can be people combecause treatment for patients ing in from the back or the front can span a couple of years and — it is never consistent.” patients often rotate in every The patients Higgs attends three-to-four weeks.. are from all generations, and “We see their family, children she works with all levels of and grandchildren,” Kirkpatrick sickness, from the acutely sick said. “People who have cancer to general check-ups. To preover a certain amount of time pare for the day, she automatiare thankful for this care. They cally keeps an open mind, have seen and learned a way to ready for whatever will come through the doors. experience life in a way that When the day shift comes in, neither you or I have had a

each nurse receives reports on the patients and is assigned to a station. “It is basically providing care for the patient the second they hit the door,” Higgs said. “ER nursing is about that excitement and being on your toes and being able to think quickly and get it done. It is very rewarding. A lot of nurses have gotten away from the bed side, but I still enjoy the patient care and contact.” One tough aspect of the ER is the high amount of horrific cases that the nurses work with. “You try to remember that your patients are there and they don’t want to be,” Higgs said. “I think everyone gets calloused at time. You have to put things in perspective — life is short. You have to respect people and help them get through situations. We have to relieve stress, and we do that by laughing.” A world away but only a few floors apart, the Transitional Care Unit is where McKee RN Catherine Webb focuses on long-term care and helping very sick patients gradually transition to home care. Everyday she administers medications and does physical assessments. She also coordinates discharges. They also do a lot of rehab and take care of patients who are difficult to place because they are homeless, drug addicts or alone with no family to care for them. Facing the finiteness of life is a common reality of Webb’s day. “Everyone is born and everyone passes away,” Webb said. “There can be a lot of family dynamic. Death is not a morbid subject. If you can get everyone I See Nurse Day/Page 16

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 15

A day in the life of a nurse All hours of the day, nurses care for patients

— Kathryn Kirkpatrick, Oncology Nurse Manager at PVH

Rhema Muncy Special Sections Reporter

“People who have cancer over a certain amount of time are thankful for this care.”

RH photos/Rhema Muncy

Above, Nurses Jenny Reinert and Kristen Cox administer medication to oncology patient Ashley Wood at PVH. Right, McKee Nurse Beth Higgs checks the emergency room equipment.

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010

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“Doctors care about the cure aspect of care, and nursing is about not just looking at a person’s physical diagnosis but also taking into account how the situation is affecting them emotionally and spiritually,” Webb said. Nurses have a capacity to recognize that each patient is a unique human being and to acknowledge the importance of their thoughts. “All patients wonder about their value, especially after having a surgery,” Webb said. “It is very therapeutic to get to know someone and talk about what is foremost on their mind. As a nurse, we often reflect with people by telling them stories of the other people we have met. We tell them stories of people who have been in similar situations and have found fulfilling lives.”

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McKee Medical Center nurse Beth Higgs works on a patient’s chart in the Emergency Department.

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 17

Put Your Feet in Our Hands

For some kids, allergies are life threatening

shock. According to the Mayo Clinic, this extreme potentially life-threatening allergic reaction can occur within minutes of exposure to something a person is allergic to. A flood of chemicals Rhema Muncy released by the immune sysSpecial Sections Reporter tem during anaphylaxis can ood allergies pose a se- cause the body to go into shock. Blood pressure will vere threat for many families, especially for plummet and airway passages will close up, requiring parents who live with the an immediate trip to the fear of their child being exposed to an allergen and ex- emergency room and an periencing an anaphylactic I

See Allergy/Page 18

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Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010

Meet Megahn Vasa of Loveland

Allergy From Page 17

injection of epinephrine. Many Northern Colorado families live with the fear that this reaction could happen to their child at any time. Dr. William G. Culver, an MD of Aspen Medical Center in Loveland, specializes in helping families solve the riddles of allergies. He sees cases ranging from mild rash break outs to anaphylactic responders. “We have seen children who it’s the first exposure to peanut,” Culver said of a child’s reaction to an allergen. “Sometimes it is the second, third or fourth exposure. There are genes that make you more susceptible to allergy in general. You’ve got an allergy tendency because of your parents or your grandparents. One parent is a 50 percent chance, two parents is 75 percent chance. At the first exposure, you make an allergic antibody. The antibody is then sitting in your system waiting for re-exposure.” Positive test results for an allergen do not mean a person will react. Culver said the only way to know if the allergen will manifest in a reaction is to experience an exposure. If the body does not react after exposure, it is probably safe to consume the allergen. However, people need to keep monitoring

the situation and watch for the effects of subsequent exposures. Because there are a range of reactions a child can experience with an allergy, the state legislature passed SB09226 that will go into effect on July 1, 2010. It mandates that all school districts have a consistent action plan for protecting kids with severe allergies and establishing allergy-free zones from pre-K to secondary schools. Health services coordinator for Thompson School District Barb Hartman is helping all of the schools implement these required policy changes. The district already follows several state guidelines concerning allergies. They offer an individual health plan for those with severe allergies and provide reasonable accommodations for kids with severe allergies such as allergy free classrooms and lunch tables. The district allows students to carry and administer medication for their allergies, including epi pens. Staff is also trained in emergency procedures, and the district will offer a broader education of staff about allergies and epi pens. For the 2009/2010 school year, 1050 kids were identified with allergies ranging from seasonal to severe and as of late April, Thompson School District served 15,197 students, Hartman said. The biggest change being I See Allergy/Page 19

fter grabbing a piece of her sister’s peanut butter sandwich at the age of 18 months, Megahn Vasa started screaming and within 20 minutes was covered in so many hives that she turned black. She was rushed to the emergency room, treated and then taken home with the instruction to avoid peanuts. Six months later Megahn landed in the hospital again when her grandmother Kathleen Vasa ate a spoonful of peanut butter and then kissed her on the cheek. A few years later, Megahn was at a family reunion and another kids gave her a peanut butter chip to eat. She came up to Vasa and said she had a tummy ache. Then she passed out. Vasa rushed her to the hospital again and ran screaming into the emergency room because Megahn wouldn’t wake up. As she was sitting watching Megahn in the hospital bed, Vasa vowed to learn everything she could about Megahn’s condition. When Megahn started school, Vasa utilized Section 504 of the American Disability Act to make reasonable accommodations for Meaghn’s severe aller-

gies. The teachers are all trained to use epi pens and Meaghn carries two with her at all times. A school nurse goes with her on field trips. While the school can’t tell parents not to feed their kids nuts, a letter goes home to all families to let them know of the situation. Restaurants are another allergy war zone. Megahn carries a card to let wait staff know what their allergies are. Sometimes a manager will let the Vasas know what Megahn can eat and then follow the food through the kitchen. Other times they will say they can’t guarantee the safety of their food and other times they will refuse to serve Megahn. “I would rather they tell us than to say they can feed us and then she has a problem,” Vasa said. “We like their honesty.” Megahn also had to overcome severe breakouts of atopic dermatitis on her face, a puzzle solved by doctors at National Jewish hospital in Denver. She also deals with Asthma. But Megahn doesn’t let anything slow her down. As the youngest member of the cycling group cy Club Hypoxia (see photo above left), Megahn has peddled up to 40 miles at one time.

Meet Jett Vasquez of Loveland

ne morning when the family was at breakfast, Jett’s father decided to give him some scrambled eggs. He had an allergic reaction and was later tested by Dr. Culver of Aspen Medical Center. Jett’s peanut allergies were astronomically high to the point where even airborne peanuts could send Jett into anaphylactic shock. Jett has never had to use an epi pen. Every year when Nicole Vasquez renews Jett’s epi pens, she is thankful they never had to use them and they practice using the old ones on oranges. Vasquez is concerned Jett does not understand the severity of the situation, especially as he enters kindergarten next year. “Jett thinks life is like a video game and that if he dies he will get another life,” Vasquez said. “He doesn’t understand what would happen if he was exposed to peanuts.”

Allergy

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 19

families with food allergies. When her son Andrew was diagnosed 10 years ago as From Page 19 anaphylactic to dairy, egg, made is the use of consistent tree nuts, sesame and sunflowers, very little resources forms statewide. Instead of just making a plan about al- were available. The support group turned their efforts to lergies with the nurse and parents and having a doctor support the state legislation sign off on the plan, doctors SB09-226 and work with the local school districts. will now provide a specific The Teck family completeplan for what they want to happen for every situation of ly changed their lifestyle 10 years ago and now they the school day. manage food allergies as one “It will be important to piece of the puzzle that links have that much input from to the rest of their lives. the doctor,” Hartman said. “Witnessing your child, Catherine Teck, the friend or loved one experifounder of the local the Inence a severe reaction spiring Children with Allerwhere their face swells, they gies Network group started I See Allergy/Page 20 the chapter to support other

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s a baby, Elizabeth Webb was very sick. At 18 months, her parents decided to take her to an allergist. She was tested and found to be allergic to 12 things. Now 9 years old, she has outgrown all but her allergy to milk proteins casein and whey — she is not lactose intolerant. Even a small bite with a trace of the proteins in it will cause her to vomit. So the Webbs don’t attend potlucks or eat at other people’s houses very often out of fear that a cross-contamination could happen to make Elizabeth sick. “When I go to the grocery store, if it takes you one hour, it takes me three,” Elizabeth’s mother Candace Webb said. “If [producers] don’t clean their lines very well, there will still be a milk residue on the products.” If Elizabeth accidently eats something with milk proteins, after one bite her mouth will swell so that she knows to stop. This has saved her from a possibly anaphylactic reaction, but even after one bite she is sick for a few hours. Since she outgrew a soy allergy, the Webbs are able to make baked goods with soy milk. “We remind her there are safe things she can have and that mom is here and reading labels for her,” Webb said. “She is very fearful. If someone is drinking a glass of milk or eating a bowl of ice cream, she backs away. In public situations, I stand next to her so that I am a barrier.” Webb hopes the public will learn to respect the severity of some cases of allergies. “We would never ask people to remove milk out of their diet as we have but just to recognize and acknowledge that we aren’t crazy parents,” Webb said. “We pray and hope that someday she will out grow it. Most kids outgrow it by the time they are 1, 3, 6 or school age. She is way beyond it — it is not impossible, but highly improbable once she carries it beyond that particular age.”

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Allergy From Page 19

I See Allergy/Page 21

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struggle to breathe, or they turn blue and pass out is a life changing event that you never forget,” Teck wrote in an e-mail. “We are thankful for everyday and live life to the fullest. We are blessed to have a child that demonstrates such strength and perseverence.” Parents of children with

extreme allergies hope that the public will grow to understand why their children need protection. Nine-year-old Loveland resident Megahn Vasa is anaphylactic to peanuts, tree nuts, sesame seeds, coconut and cats. After several traumatic exposures to her allergens, Megahn’s grandmother Kathleen Vasa is constantly learning about Megahn’s

Meet Elizabeth Webb of Loveland

t the age of 9 months, Cate Rankin was diagnosed with severe allergies. Her allergens include milk, peanut, egg, wheat, fish and shell fish, tree nuts, poultry and a few berries and vegetables such as blueberries, strawberries, lettuce and green beans. She is four and she still has a chance to grow out of a few of her allergies, but doctors think her major ones will stay around. Even the touch of dairy will cause Cate to have an anaphylactic reaction. The first time she had one she mistakenly drank her sister’s cows milk. The second time she merely touched a piece of cheese. After those reactions, the Rankin family voted to not have any dairy products in the house. They all usually eat the same dinner, and Cate has a stash of special snacks and bread. Cate seems to take her condition in stride and won’t let it slow down her enjoyment of life. One time her father forgot to bring her special cup cake to a birthday party she went to. Cate said “It’s Ok. I can have a stick of gum when we get to the car.” And she continued to enjoy the party. Her mother Wendy said she herself would not have been able to handle that situation as an adult. At the age of 18 months, Cate said “Me no have that” to someone who tried to offer her a gold fish cracker. The family is aware and protective of Cate. “We rally around her,” Rankin said. “We do get stressed. We wonder when this is going to stop. She has asthma and her allergies sometimes manifest so she can’t swallow. We are more protective of her.” Right and clockwise, Cate Rankin demonstrates how to use a test epi pen, Cate’s reaction after being touched by Cheetos dust (photo by Wendy Rankin), Cate shows off her allergy charm bracelet RH photos/Rhema Muncy

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Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 21 gen and then was used to mix a different homemade food is enough to trigger a From Page 20 reaction. “There are people who conditions. She understands would say that the child how hard it is to think of ev- couldn’t possibly have seery danger. vere allergies they are saying “If you don’t live it every- they have,” Culver said. Rhema Muncy Sweet Potato day, you don’t consider [a “Why should we have a Special Sections severe allergic reaction] as an peanut free zone so that Soup option,” Vasa said. “You Makes 4 servings someone doesn’t break out utting together an think there is a little kid who in a rash? That is the lower Ingredients: allergy-free kitchen needs a snack and you just end of the bell curve. Some involves fore1 tablespoon vegetable oil grab something. Mostly of these children could have 1 thought and research. /2 cup chopped onions adults don’t understand. anaphylactic symptoms and Some students in the mas1 cup chopped celery When I was raising my kids, die. There is at least one ter’s program at the nutri2 large sweet potatoes, I was that mom who thought child a year in the U.S. who tion department at CSU re- peeled and diced these parents were extreme.” is known to be peanut sensicently put on a cooking 3 cups chicken broth (or tive, has an exposure and show to help families But for many kids, even water with salt) dies. That is just the tip of learn to eat smarter. cross contamination of a 1 cup coconut milk spoon that touched the aller- the iceberg.” “When you have any 1 /3 cup maple syrup kind of allergy in your 1 /4 cup brown sugar family, make sure everyMeet the Kline Family of Johnstown 1 teaspoon nutmeg thing stays clean,” CSU Salt and Pepper he two youngest kids of the Klein family are nutrition center director severely allergic to peanuts and the youngest is alMelissa Wdowick said. Directions: Saute the so allergic to eggs. Deepa Balaraman made onions and celery in veg“We have to read labels like crazy,” mother Michelle gluten, dairy and egg free etable oil for 10 minutes. Klein said. “Pretty much anything with peanuts we got rid Add the diced sweet potaoatmeal raisin cookies of. We did a family vote and decided that their safety was toes and chicken broth. with fruit purees. Colin a priority. The eggs he is not so allergic to, so I can conBroderick made a pureed Bring to a boil, lower heat trol that better. So I am the lady at the super market readsweet potato soup. Karim to medium, cover and ing labels and taking forever, but I am making sure that Moukadd served up cook for 25 minutes until everything is safe.” chicken tacos and Kasey the potatoes are very tenThe family makes a lot of things from scratch, but they Brixius made smoothies der. Puree the potatoes in still have to watch everything such as where all of the elwith coconut milk, a blender (in small batchspinach, agave nector and es) or with a hand-held ements are processed at. The youngest, who is four, was mangos. diagnosed when he was 18 months old so he doesn’t immersion blender. Stir in quite understand everything yet. The second youngest is the coconut milk, brown “Contact the manufac8 and she was diagnosed when she was 6 so she rememsugar, nutmeg and maple turer if you have quesbers being sick and having reactions. syrup. Season to taste with tions,” Moukadd said. “They will get back to you salt and pepper. Reheat “If someone is having a birthday, I get the teacher and I right away.” and serve. try to match what the parent is bringing,” Klein said. When Klein first learned of her children’s severe allergies, her reaction was to want to put them in a bubble and never let them leave her side. “That is not realistic,” Klein said. “I have faith that God is watching over them. I communicate with the principal and the teacher. They understand the severity of the situation. If she goes to a friend’s house, I ask them not to feed her. She has become more vocal and lets everyone know she has a peanut allergy.” The older Klein siblings are very protective of their younger siblings. On a recent trip to their father’s work, they watched their 8-year-old sister to make sure she wasn’t exposed to peanuts. “There are kids with all sorts of allergies out there,” RH photo/Rhema Muncy Klein said. “If you are taking treats to someone’s classCSU Nutrition master’s students Kasey Brixius and Deepa room, give the teacher a call. That would help those of us Balaraman watch Colin Broderick make soup. who do have kids with allergies.”

Allergy

Healthy Plate

CSU students teach allergy free cooking

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010

Health in a Handbasket

Back flip: Check

above where people were watching. This was not helpful. Also, there were about 15 jumping acrobatic 10-yearolds who apparently had just mainAfter 23 years, it’s time lined pixie sticks and were doing douto bring the back flip back ble triple ninja spins and flips like they were extras in a Jackie Chan movie. At Jade Cody one point their ring leader climbed on Special Sections Editor a five-foot-tall platform and back flipped/spun downward onto the floor he following is a tutorial on how and landed right on his face. I cannot to perform a back flip without stress face plant enough. I don’t know so much as ninja footy-pants. if the face landing was more disturbing or the fact that he just shook it off and STEP ONE: FIND YOUR MIYAGI immediately went back to being a I summoned an old friend of mine crazy person. for help with flipping. I know her as Kress told me to ignore everyone Coyote Samm Kress (the nickname is and line up at the ball pit. I walked from her storied past — she spent slowly and begrudgingly over to the much of her childhood intimidating pit, lined up, and said my goodbyes. packs of coyotes with facial expressions alone). Kress is a cheerleading in- And I dived backward. This was not a success. I pretty much structor and knows her way around a just dived and twisted sideways. From good back tuck, which is what cheer what Kress told me, my eyes were dofolk call back flips. Kress gave me the ing their best full moon impressions, courage to propel backwards without wetting my pants. I wore three pairs of and I looked as if I was taking a cave exploration trip in Afghanistan. underwear just in case. It took Kress a good 10 minutes to STEP TWO: LISTEN TO YOUR MIYAGI stop laughing about the look on my Kress took me to a gymnastics gym face, which really helped with my conat a recreation center in Denver. fidence. Then it was time for tries two Positives: It was a perfect place to through 10. During this time I started learn — there was a foam pit, a bunch working on my form and saying more of spring boards and foam cushions for effective prayers. One of those two safe landings. things must have worked, because I fiNegatives: There were bleachers up nally started doing something similar to the back tuck Kress was trying to teach me. Health in a Handbasket We were soon overrun is a monthly feature in which by the flying teenage I try health-related adventures trapeze monkeys at the and write about them. If you foam pit, so it was time to have an idea for a new move to a more even suradventure, write to me at face. I was instructed to flip jcody@reporter-herald.com. off of a solid platform onto a padded one. was where I started Health in a Handbasket to This get the hang of it. My

This is basically my back flip. I tried to jump as high as possible then tuck my legs and propel them over my head. My end-of-life movie featured my childhood pet kitten (RIP), a beloved steak and my niece Hadley. In that order. Photos by Samm Kress

form was utterly awful throughout, but I was getting close to actually landing a flip. Kress stood next to me and helped throw my legs backward for the first couple, then after I accidentally elbowed her in the eye, she stood back and told me I was on my own. She cussed me out for a bit then encouraged me to focus on jumping as high as possible while tucking my legs and whipping them backward. I listened, and it helped. STEP THREE: VISUALIZE YOUR INNER CYMBAL MONKEY Do you remember those windup flipping monkeys with cymbals? Me too. That was pretty much the main thing I was thinking about throughout this ordeal. I tried to mentally see my monkey-self being wound up (that’s the most important part), then springing into the air to all the children’s glee. So basically I did this for the children. Honestly though it helped to see myself flipping mentally before I did it physically. And since I believe most anything that I imagine in my brain, it made me actually think I could flip. And I did. Kress was recording me with her camera, so after each jump I was able to pinpoint the precisely how much I resembled a newborn giraffe. As I tried flip after flip, I finally landed one. Mission back flip: Accomplished.

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 23

Pretty much ready to race Rhema Muncy Special Sections Reporter

eat me for dinner. With some major life events wrapping up, it is tornado hit my life. time to get out the running There I was, for the clothes again. When I first time since I talked to my trainer Jeff could remember, running Kline of PRS Fitness in for 45 minutes non-stop, Loveland, he told me I just minding my own busi- should still plan on particiness and making sure not to pating in the Bolder-Boulmow over any spring bun- der, but that I should modinies on the trail. But before fy my goals a bit. I even noticed, my running Instead of running the enshoes started to collect dust tire thing, I will be running in the closet — grad school, and walking the race. His buying a house, planning a encouragement helped me wedding and work finally remember why I got into caught up with me. this whole deal — to help me gain a healthy and conI have spent the past sistent approach to my fitmonth playing guilt tennis in my mind. When I finally ness without keeling over at the finish line. came clean with myself, I realized I had to set aside “Just the day is worth it,” running training for a bit Kline said. “Do whatever and focus on the tasks at you can do to get out there and do the race to have a hand, or else stress would

good time. Let that fuel your next race. If life bogged you down, figure out what your next goal is going to be.” A few weeks before the event, start to train with a bit more intensity, he said. Kline also pointed out the importance of minimizing sugar and keeping up with healthy eating. Hydration will also be a key element to my race success. “If it will be hot on race day, get out and practice drinking how you are going to drink on race day,” Kline said. “If you get to a race and start drinking something you aren’t used to drinking, you could get an upset stomach. And for a 10K, eat normally. There are enough glycogen stores in the

body that you will have plenty of energy to run the race.” No overloading on spaghetti the night before the race — check. Also no divulging in lots of sweets as a reward for my training (cough cough). Even though I didn’t reach my goal, I still made progress. So cheer me on or even come and join me in a few weeks as I take on the Bolder-Boulder. I have learned a lot and I can’t wait to train even better for the next race. To her surprise, Rhema Muncy is actually learning to like running. Send comments to rmuncy@ reporter-herald.com

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010

HL Destination: Healthy Look internally for health problems Amanda Wicker Destination: Healthy

ave you ever watched a duck just gliding across the water, so peaceful and without effort? What we don’t see is that ducks feet paddling franticly under the surface. Think about our body; it is the same really. On the outside things seem perfectly calm (most of the time). All the while, our organs are working hard to keep everything working smoothly. Taking in the big picture when it comes to our body and how it functions is vital to getting and staying healthy. One of the ways to get an inside look at what is going inside your

Amanda Wicker is a Loveland native and the founder of Destination: Healthy, a free weight loss support group held at Message of Life Ministries on the first and third Tuesdays of every month. Amanda has lost a total of 130 pounds using diet and exercise. She can be reached at destinationhealthy@gmail.com.

body is to have blood work Destination: Healthy done. Cholesterol levels can they function. Knowledge is power be an indicator that something is not on any life journey. right, but can also be reversed by changing your eating habits. Most TIPS people think that if you are a healthy • Local laboratories have year — weight your cholesterol must be at a round health fairs where you can healthy level as well. This is not true. have your blood work done (call Other tests that give helpful insight to ahead for details). the health of our bodies are blood • Have your body fat tested at a lopressure and body fat percentage. cal gym or sport nutrition store like These tests are a good thing to do at any stage in your journey. It can give Max Muscle. • Test your blood pressure monthly you the extra nudge to start or let you know you are on the right path. Using in your pharmacy. tests like these, we can gain more See your doctor for your annual exknowledge about our bodies and how am and review your results.

Uncommon Sense

Playing Internet games bothers girlfriend partners. In fact, it is quite natural, but crosses the line into being a problem if these start to replace in-person relafor someone. So how can you tell when the time you devote to gaming is tionships in your life to a large degree, uestion: I am in my late 20s normal and healthy and when it is too it may not be so healthy. Only you can much and potentially harmful? and I love playing interactive honestly answer these questions. games on the Internet. I When the amount of time you spend So what about your girlfriend and work full-time and pay my online hurts your work, your relation- her reactions to the time you spend bills. I think I’m a pretty healthy perships or taking care of your day-to-day gaming online? If you care about each life responsibilities, it is probably unson, but it drives my girlfriend crazy other and want the relationship to conthat I spend most of my free time play- healthy. Another sign of an activity that tinue or deepen, the two of you need is a problem is when you consistently ing games on the computer. I love it to communicate openly about this isfind yourself unable to break away and it is a big part of my social life. I sue. Are there specific ways she is feelfrom your online activities to eat, con- ing neglected because of your have lots of friends that play with me verse with your girlfriend, or go to bed on a regular basis. I don’t know if this I See FIRESTEIN/Page 25 is a problem or not. Can you help me? in time to get enough sleep to function well Answer: This is a question that comes up often in my counseling prac- the next day. Uncommon Sense There is nothing tice. Sometimes the question is raised with Beth Firestein wrong with playing by the person who plays the games. Often the question is raised by the per- games online or Dr. Beth Firestein is a licensed psychologist. even having it as a son’s spouse, girlfriend/boyfriend, or She has 24 years of therapy experience and family members. People in general and serious hobby. It can has practiced in Loveland for over 14 years. mental health professionals have lively also be healthy to She may be reached by calling her office at debates and widely differing opinions develop friendships 970-635-9116 or via e-mail at with online acquainabout whether gaming can be an adfirewom@webaccess.net. tances and gaming diction and when the fun of gaming

Dr. Beth Firestein Uncommon Sense

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010 25

Is this asthma or vocal cord dysfunction? Vocal cord dysfunction can occur at any age, though it predominates in lexis is an 18-year- women ages 20 to 40 old freshman and years. In National Jewish runner. She has ex- patients who were evaluercise-induced ated for poorly asthma, which controlled asthma, was well conVCD was found to trolled for coexist in 30 peryears. She was cent and was excited to join found to be the the college primary diagnosis cross country in 10 percent. team but soon The exact cause started having of VCD is not difficulty known, though Anna Kujawska breathing. there are many Within mintriggers including: utes of running, she expe- exercise, cold air, singing, rienced throat tightness as emotional upset and if having to “breathe stress, laughing, strong through a straw”. Her asth- odors, cigarette smoke, ma inhaler did not help post-nasal drip and heartwith these symptoms, and burn. Sometimes a trigger she had to stop running. is not known. The typical Vocal cord dysfunction symptoms of VCD are: (VCD), also called parashortness of breath, troudoxical vocal cord motion ble getting air in, hoarse(PVCM), is often confused ness, wheezing, cough with asthma, as both share and chest or throat tightsimilar symptoms. Vocal ness. Based on the sympcords are located at the toms and triggers, many top of the windpipe and people may be misdiagvibrate with exhaled air to nosed with asthma and produce voice. In normal treated — unsuccessfully breathing, vocal cords — with asthma medicaopen and close allowing tions. Though VCD can the air to flow. In VCD, the coexist with asthma, VCD cords close abnormally, can also present alone. leaving a small opening Some people experience for air to move and cause very dramatic shortness of asthma-like symptoms. breath and choking sensaAnna Kujawska, MMC RH paid advertorial

FIRESTEIN From Page 24

activities? If so, are you willing to change the amount of time you spend gaming in order to meet some of her needs? If it is primarily a matter of the amount of time you spend on it, can

tion with VCD necessitating multiple emergency room visits and, in rare cases, intubation (placing a tube into the windpipe for mechanical ventilation) before the correct diagnosis is established. The diagnosis of VCD is made with a careful history and physical exam. Pulmonary function tests can be helpful in excluding asthma, as in VCD they can show abnormality primarily on inhalation only. Laryngoscopy is a procedure where vocal cords can be visualized with a flexible scope passed through the nostrils by an otolaryngologist or an allergist. Laryngoscopy can observe abnormal vocal cord closure in VCD, though these findings are best seen during an acute episode. Once the diagnosis of VCD is made, the therapy can begin. If a person has no co-existing asthma, then asthma medications can be stopped. If postnasal drip or heartburn plays a role, those symptoms are addressed. One of the most important therapies to control VCD, however, is speech therapy. A speech and language pathologist teaches special breathing exercises

you reach a compromise? You may risk the relationship falling apart or ending if you can’t come to an agreement that is acceptable to both of you. Perhaps your girlfriend can work on becoming more accepting, especially if she is not feeling neglected in the relationship. In essence, it comes down to priorities and what you decide you can or are willing to do to change your level of

that increase person’s awareness of abdominal breathing and allows the throat muscles to relax. In addition, learning how to suppress cough and throat clearing can also be beneficial during an episode of VCD. All of these techniques enable a person to have more control over the vocal cords and overcome abnormal vocal cord movement. Another important part of treatment is counseling. VCD is often associated with stress and driven-type personalities who greatly benefit from supportive counseling. Counseling can help adjust to the new diagnosis and new treatment program. In young adults, such as Alexis, anxiety often precedes VCD symptoms especially when a situation becomes more competitive, such as joining a college crosscountry team. Stress reduction, therefore, can play an important role in treatment. The awareness of symptoms and an appropriate treatment regimen are usually very effective in controlling and combating vocal cord dysfunction. Anna Kujawska, M.D., is an allergist at Aspen Medical Center Allergy.

involvement for your own health and the happiness of your relationship. No one else can control you or make this decision for you and if you do change only for your girlfriend, you could end up resenting her. Think about whether you believe your level of involvement is healthy or unhealthy. If you still aren’t sure, you might want to talk to a counselor a few times to sort it out.

Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado May 20, 2010

Calendar

May and June health events TEDDY BEAR HOSPITAL Free, fun event for children that lets kids interact with doctors and nurses and get their favorite teddy bear or doll “treated” with mock procedures. When: 10 a.m.–2 p.m., Saturday, May 22 Where: Medical Center of the Rockies, 2500 Rocky Mountain Avenue, Loveland Contact: 624-1600 BREAST FEEDING SUPPORT GROUP When: 10-11 a.m. Mondays and Thursdays Where: McKee Cost: Free Contact: 669-9355 BLOOD PRESSURE SCREEN Have your blood pressure checked by a Wellness Specialist When: Monday through Thursday, 8 a.m.-4:30 p.m. and Friday 8 a.m.-noon. Where: McKee Wellness Services Cost: No charge Contact: 635-4056 COPD This seven-session multidisciplinary education series helps with the management of COPD. Anyone who has COPD, emphysema or bronchitis is encouraged to attend along with family and/or significant others. When: Classes meet Tuesday from 12:30-3 p.m. Sessions begin June 1. Location: McKee Conference and Wellness Center Cost: No charge Contact: 635-4138 DIABETES INFORMATION GROUP An informational/educational meeting for anyone touched by diabetes who wants to learn and share.

There will be a different subject matter for each meeting. Where: McKee Conference and Wellness Center Cost: No charge Contact: 203-6550 for more information and topics. HEART FAILURE EDUCATIONAL SERIES 2010 The goal of the Heart Failure Educational Series is to offer people with Heart Failure (and their family and friends) information, resources and support. We focus on management of Heart Failure. The series is open to members of the community who want to learn more about Heart Failure. There is no need to register. Topics are subject to change without notice. When: Second Tuesday of every month from 3:30 to 5 p.m. Where: McKee Medical Center in the Wellness and Conference Center. Cost: No charge. Contact: 635-4138. GENERAL CANCER SUPPORT GROUP When: 5:30-7 p.m. Tuesdays. Where: McKee Cancer Center lobby. Contact: 635-4129 CAREGIVER’S SUPPORT GROUP-FOR CAREGIVERS OF CANCER PATIENTS When: Call for times and locations: 635-4129. BREAST CANCER SUPPORT GROUP When: Second Thursday of each month from 5:30 to 7 p.m. Where: McKee Cancer Center lobby. Contact: 622-1961 SOULPLAY ART THERAPY People whose lives are

touched by cancer experience the benefits of expressing themselves through art. No art experience needed. When: Wednesdays, 9:4511:45 a.m. Where: McKee Cancer Center Conference Room Contact: 635-4129

Where: McKee Conference and Wellness Center

AARP MEDICARE COMPLETE FROM SECURE HORIZONS This Medicare informational sales meeting hosted by Secure Horizons is a chance to ask questions about Medicare and learn MAN TO MAN PROSTATE about the Medicare options CANCER SUPPORT GROUP available in the area. A local When: 5:30-7 p.m. the Secure Horizons sales reprefourth Thursday of the sentative will be available to month talk with you about choices. Where: McKee ConferWhen: 2p.m. on June 17 ence and Wellness Center Where: Perkins RestauContact: 622-1961 for rant in Loveland more information. Cost: no charge, pie and CAREGIVERS SUPPORT drinks provided For caregivers of elderly Contact: 303-638-0940 to adults. The group focuses on RSVP providing support and education about community re- BRIGHT BEGINNINGS Poudre Valley Health Syssources and behavior issues, tem offers free Bright Beginparticularly for people with Alzheimer's and memory im- nings materials for all families in Larimer County with pairment. children birth to 36 months Cost: No charge. Care of elderly adult family members of age. Materials cover growth and development, or friends is available health and safety, and inforthrough Stepping Stones mation on community reAdult Day Care program sources. These materials can during meeting times at no be obtained through a home charge. visit or by attending a class. When: 10 a.m.-noon on Registration is required. Call May 20 and June 17 495-7528 to register or to Where: First Christian Church, 2000 N. Lincoln Ave. learn more about the programs Contact: 669-7069 June classes: THE SEASONS CLUB Program A — for birth to The Seasons Club at McK12 months is offered at noon ee Medical Center strives to on June 15 at Medical Center enhance the quality of life of the Rockies and at 11:15 for mature adults through health promotion, education a.m. on June 21 at McKee Medical Center and recreation. To learn Program B — for 12-24 more about Seasons Club activities, call 635-4097 or visit months is offered at 9:15 a.m. on June 14 at Medical www.bannerhealth.com Center of the Rockies Keyword: McKee Seasons Program C — for 24-36 Club. What: Welcome to Medi- months is offered at 10:15 a.m. on June 14 at Medical care When: 5:30 p.m., June 28 Center of the Rockies

Just learned there may be complications with her pregnancy

But her choice isn’t complicated. She needs proven health care, not just a shiny, new hospital. It’s your first child and you wanted everything to be perfect. Now you need very special care. You never expected complications. But you did your homework and began to understand. Great health care is about a lot more than brand new hospitals. It’s about getting the best, most experienced care you can find. That’s where Banner Health shines. For decades, we’ve provided doctors with the advanced technology and support they need to make the care you need possible. Like being the first in the western United States to implement an innovative OB monitoring program that helps reduce complications before and during childbirth. It matters what hospital you choose. And what matters now is that you go where experts work best.

McKee Medical Center North Colorado Medical Center www.BannerHealth.com/COexperts Follow us on HL-310625

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