April 2013 Thrive

Touchy subjectWhen it comes to their health, men aren’t keen on talking. But going to the doctor and early detection could be the difference between life and death. Page 6.

THRiVEnc» NORTHERN COLORADO WELLNESS

April 2013

PLUS...TAKE ACTION: Early detection techniques and facts

» INSIDE: STRETCH MARKS MORE THAN A SKIN-DEEP ISSUE • PROM SAFETY TIPS • APRIL EVENTS

THRIVENC n March 27, 20132 n HEALTH

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March 27, 2013 n THRIVENC 3HEALTH n

«Spirit of Women event, 6:30-8:30 p.m. April 16 at High Plains Library District Building, 2650 29th St. in Greeley. “Fortify Your Spine and Put Some Spring in Your Step!” Neurosurgeon David Blatt will present timely information on neurosur-gery, spine and neck issues, treatment options and other ingredients to fortify your spine. There will also be fun with spring shoes from Hearne’s and beautifying feet and legs for spring with Pink Papaya and Beauti-Con-trol. Free for members, $10 for nonmembers. To make a reservation, call (970) 392-2222.

«NCMC Family Life Class-room: “Grandparenting — Then and Now,” 6:30-8:30 p.m. April 15 and 22, 1801 16th St. in Greeley. A two-part series designed to delve into the “Cha-Cha-Cha-Changes” in parenting techniques and childcare that have occurred between “then” and “now.” Plus, learn valuable ways to develop great relationships with grandchildren whether they are near or far. Free for Spirit members, $10 for non-members. For more informa-tion, call (970) 392-2222.

«NCMC Family Life Class-room: “Couples Massage,” 6:30-8:30 p.m. April 24, 1801 16th St. in Greeley. Relax and reconnect as a couple and improve your sense of well-being by spending an evening learning massage techniques from a certified massage therapist in a relaxed atmo-sphere. Cost: $15 per couple. To make a reservation, call (970) 378-4044.

«Aging Well, 9-11 a.m. Thurs-days, through May 9 at North Colorado Medical Center, 1801 16th St. in Greeley. Weld County Area Agency on Aging will offer an aging well self-management on “A Matter of Balance.” The class is free. Donations will be accepted. To reserve a spot, call (970) 346-6950 ext. 6117.

«Blood Tests, 7-8:45 a.m. April 10 and 24, North Colorado Medical Center, Union Colony Room, Area C on the ground floor, 1801 16th St. in Greeley. Wellness Services offers low-cost blood screenings open to community members. Some immunizations also are available upon request and availability. Participants need to fast for 12 hours before the blood draw. To make an appointment, call (970) 350-6633.

«Body Check Head To Toe, April 2 and 16 at the Summit View Medical Commons, 2001 70th Ave. in Greeley. Head-to-toe health screenings include blood work, sleep question-naire, lung function test, body composition, hip and waist measurements, health education, EKG with results,

bone density, peripheral arterial disease screenings, ultrasound of carotid vessels and ultrasound of aorta, $175. To schedule an appointment, call (970) 350-6070.

«CPR for health care provid-ers recertification, 3-5:30 p.m. April 1 at North Colorado Medical Center, Longs Room, second floor, 1801 16th St. in Greeley. This class is designed for licensed and nonlicensed health care providers. Topics covered include cardiopul-monary resuscitation, airway obstruction and rescue breathing for adult, children and infants. The certification is valid for two years. Cost: $10. To register, call (970) 350-6633.

«CPR for health care provid-ers skills check, 3:30-4:30 p.m. April 8 at North Colorado Medical Center, Wellness Con-ference Room, second floor, 1801 16th St. in Greeley. This class is designed for licensed and nonlicensed health care providers. Topics covered include cardiopulmonary resuscitation, airway obstruc-tion and rescue breathing for adult, children and infants. The certification is valid for

two years. Cost: $50. To regis-ter, call (970) 350-6633.

«Cooking Class: More Veg-gies Please, 6-7:30 p.m. April 17 at North Colorado Medical Center, Cardiac Re-hab Kitchen, 1801 16th St. in Greeley. Learn creative ways to boost your vegetable intake, as well as nutritious tips, storage suggestions and tasty samples. Taught by Diane Braithwaite, R.D. Cost: $10. To register, call (970) 350-6633.

«Safe sitter, 9 a.m.-3 p.m. April 3 at the Greeley Family FunPlex, 1501 65th Ave. in Greeley. Safe Sitter is a one-day, six-hour curriculum designed for 11- to 13-year-olds. Participants learn care of the choking infant and child, babysitting as a business, success on the job, child care essentials, safety for the sitter, preventing injuries, injury and behavior management and preventing problem behavior. To register, call (970) 350-9400.

«Walk with a doc, 8 a.m. April 20 at the south entrance of the Greeley Mall. There will be an informal five-minute health talk and a 30-minute walk (at your own pace). Families are encouraged to attend. There will be healthy snacks at the completion of the walk. Free blood pressure checks are available for those interested. Details: Walkwith-aDoc.org.

« Living Well with Diabetes Program, individual appoint-ments and group classes in Greeley, Loveland, Windsor and Johnstown by calling

(970) 392-2344. Education offered for patients with diabetes, and their caregiv-ers or families, to provide knowledge, skills and tools to successfully manage their diabetes. Topics include nutrition, activity, monitoring, medications, problem solv-ing, healthy coping, reducing risks, weight loss, insulin, or considering insulin pump therapy.

«Diabetes and Pregnancy education, offered weekly at North Colorado Medical Center, 1801 16th St. in Gree-ley. For women with type 1, type 2 or gestational diabetes to teach skills needed to care for themselves during pregnancy. Topics include: healthy eating, being active, blood glucose monitor-ing, medications, problem solving, healthy coping and reducing risks. The goal is to help you and your baby stay

healthy. Cost: $10. Call (970) 392-2344 to schedule an ap-pointment.

«Diabetes Information Group, 7-8 p.m. April 9 at North Colorado Medical Center, Union Colony Room, 1801 16th St. in Greeley. For people with diabetes, their family, friends, caregivers or anyone with an interest in diabetes. To register, call (970) 392-2344. Free.

«Cancer Support Group, 5:30-7 p.m. Tuesdays at North Colorado Medical Center, 1801 16th St. in Greeley.

«Breast Cancer Support Group, 5:30-7 p.m. April 4 at North Colorado Medical Center, 1801 16th St. in Greeley.

«Man-to-Man Prostate Can-cer Support Group, 5:30-7 p.m. April 18 at North Colorado Medical Center, 1801 16th St. in Greeley.

APRIL HEALTH EVENTS

FOR THE TRIBUNE

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Pulmonary Rehab Week was celebrated March 10-16 and highlighted the impor-tance of programs around the country that help people improve their quality of life.

Pulmonary Rehab helps patients gain the confidence, the skills and treatments needed to take control of the disease and recognize warning signs early that could lead to complications and hospitaliza-tions. Pulmonary Rehab is the only place where the patient, family members, phy-sicians, re-spiratory therapists, nurses and exercise physiolo-gists come together regularly to meet the challenges of medications, equip-ment, and behavioral techniques that are required to deal with lung disease effectively.

According to the National Heart, Lung and Blood Institute, Chronic Obstructive Pulmonary Disease is the third leading cause of death in the United States. Lung disease generally develops slowly, and people often attribute the symptoms to being older, gaining weight, or being out of shape. Shortness of breath, increased work of breathing, and fatigue, even when wearing oxygen, become the norm.

Risk factors for COPD and other lung diseases can be smoking or smoking history. Exposure as an adult or child to secondhand smoke, indoor and outdoor pollutants, substances or chemicals from home, work, or recreational environ-ments and genetics can all play a role in the development of lung disease.

Beyond affecting the lungs, lung disease impacts the entire body. The brain, heart, muscles, and all organs are

affected by less oxygen. If left undiag-nosed and untreated, lung disease will worsen, and a person’s lifestyle, recre-ational interests and occupation can all be affected leading to early retirement, disability, depression, anxiety and a lot of unhappiness.

“Taking control of the disease, instead of letting the disease control you, is key,” according to Bonnie Piel, respiratory therapist for the program. Through educational and exercise opportunities participants learn:

» What activities can be done safely. » Whether oxygen is needed with

activity.» How much oxygen may be needed. » Which oxygen equipment or sys-

tems will be the most effective and easy to use.

Other issues that are important for the health of patients with lung disease and their families are:

» Traveling with a breathing prob-lem, oxygen, continuous positive airway pressure machines and other respiratory equipment.

» Breathing, pacing, and energy con-serving techniques.

» Practicing independence and self-care management.

North Colorado Medical Center’s Pul-monary Rehabilitation program has been helping patients with lung disease and their families for more than 35 years.

Sara Quale is a public relations spe-cialist for Banner Health, which man-

ages North Colorado Medical Center in Greeley.

Pulmonary Rehab helps patients gain confidence, recoverBy Sara QualeBanner Health

For information about Pulmonary Rehabilitation contact (970) 350-6924.

» For more

Taking control of the dis-ease, instead of letting the

disease control you, is key.— BONNIE PIEL, respiratory therapist for North Colorado Medical Center’s Pulmonary Rehabilitation program

“ATLANTA — Elizabeth Brockob’s eye was red and hurting, and so, like a lot of us, she went to the Internet for a diagnosis.

Within minutes the 13-year-old from Johns Creek, Ga., was convinced she was go-ing blind and that she could die.

“It scared me,” Brockob said.Although she had reason for concern, her

diagnosis was dead wrong.The teen had bacterial conjunctivitis, or

pinkeye, a common eye disease, especially in children, that may affect one or both eyes.

If recent numbers are any indication, the nasty little infection seems to be on the move, afflicting everyone from toddlers to school-age children, like Brockob, to adults.

The culprit? According to Dr. Glenda Brown, an optometrist with Caris Eye Cen-ters in Alpharetta, Ga., and incoming presi-dent of the Georgia Optometric Association, it is a brutal cold and flu season that is weak-ening immune systems.

“We’re all exposed to viruses and bacteria, and if our immunity is down, we can’t fight it off,” she said.

Since the flu season began, Brown said her practice has seen a 30 percent increase in pinkeye diagnoses — from 222 patients last year to 289 so far this year.

“That’s huge,” she said.Doctors in the Tasman Eye Group in Ken-

nesaw, Ga., have also seen a spike in pinkeye cases this year, said Dr. Stuart Tasman.

“There are many more cases of the flu this season, and that leads to more cases (of pink-eye), since this type is spread by people with upper respiratory tract infections,” he said.

Although Susan Brockob initially be-lieved her daughter might have been guilty of sleeping in her contact lenses again, she knew something was wrong because “Eliza-beth doesn’t complain very often.” Plus, the mother of four said, she has come to expect pinkeye to pay the family a visit. Each of her children has had it, and at least one of them more than once.

But be careful about trying to self-diag-nose, Brown said.

While conjunctivitis is usually a minor eye

infection, Brown said that some forms can be highly contagious and develop into a more serious problem, especially if misdiagnosed and treated inappropriately.

Conjunctivitis is the most common type and can be caused by viruses associated with the common cold and flu.

Bacterial conjunctivitis is an infection most often caused by staphylococcal or strep-tococcal bacteria from your own skin or re-spiratory system. And allergic conjunctivitis occurs more commonly among people who already have seasonal allergies but can be caused by other allergens.

“Many people think it goes away on its own, and often parents don’t understand the damage it can do,” said Brown.

For everyone, pinkeye is an inconvenience. But for some people, the condition is far worse.

“One of my patients recently diagnosed with EKC, epidemic keratoconjunctivitis, was home in bed for a whole week,” Brown said.

EKC is a highly contagious form of con-junctivitis often found in emergency rooms, nursing homes, schools, camps and child care centers.

Practicing good hygiene is the best way to control the spread of conjunctivitis. Once an infection has been diagnosed, follow these steps:

» Don’t touch your eyes with your hands.» Wash your hands thoroughly and fre-

quently.» Change your towel and washcloth daily,

and don’t share them with others.» Discard eye cosmetics, particularly mas-

cara.» Don’t use anyone else’s eye cosmetics or

personal eye-care items.» Follow your eye doctor’s instructions on

proper contact lens care.

Cold and flu season brings rash of pinkeyeMcClatchy Newspapers

For more tips visit the Georgia Opto-metric Association eye health resource center at www.GOAeyes.com or www.Facebook.com/ GeorgiaOptometricAssociation.

» For more


OAKLAND, CALIF. — For many women, they’re the red, white or sometimes brown badges of bearing children.

But while pregnant women are the group with whom we most frequently associate stretch marks, a larger percentage of the population is not immune. Weight gain can bring on stretch marks, too — men and women alike can end up with unsightly reminders of heavier days. Even people who went through sud-den extreme growth spurts during adolescence often have marks around their joints or on their backs. And bodybuilders sometimes get them on the up-per chest and shoulders.

Sometimes. That’s part of the frustration — and the mystery. Some people get them, and some people don’t, even under similar conditions. Whatever the cause, the main sticking point is they never really go away, and cer-tainly not on their own. The top-ic — especially for women — is a delicate one, akin to discussing personal finances or face-lifts. For some, the problem is more than skin deep.

Anne Nguyen, 32, a San Jose, Calif., accountant, says she felt like “damaged goods” when pro-nounced stretch marks appeared after she had her first two chil-dren.

“It has affected my confidence, and I never wear a bathing suit and avoid situations where I would have skin showing,” she said. “I hardly get in the pool with my kids, and they don’t un-derstand why.

What frustrated her is that she has always been physically fit. During pregnancy the weight

gain came rapidly and stretched her skin.

“It’s embarrassing, and it’s hardly ever discussed,” she said. “I know there are other problems that are more traumatic and life-threatening, but stretch marks do affect a person’s emotional state. Knowing it will never go away affected me.”

Many dermatologists say the cause is literally a stretching of the skin, hence the name, push-ing it to the point where con-nective tissue breaks down. Yet others assert it’s not entirely a matter of stretching but of hor-monal variations during extreme changes to one’s body. Almost all believe there’s a genetic compo-nent.

Various laser and even ra-dio frequency treatments can minimize the appearance, but if you’re prone to getting stretch marks, you’re pretty much stuck with some permanent road maps to your skin’s past.

Nguyen has undergone several

laser treatments with Dr. John Tang at the Rejuve nonsurgical cosmetic care clinic in Saratoga, Calif., and there has been a soft-ening of the marks.

“We can reduce the appear-ance, but you can’t ever really eliminate them,” Tang said.

He adds that hormones can be a factor.

“On a young healthy per-son, stretch marks are normally caused by rapid increase or de-crease in weight,” he said. “When we get older, the stretch marks we have often look worse due to hormonal loss, especially for women because of loss of estro-gen and growth hormone, which controls elasticity and collagen production.”

Dr. Richard Nolan of Laser Skin Source in Alameda, Calif., specializing in aesthetic medi-cine, likens human skin to a deli-cate fabric.

“If you push your finger through the fabric, you stretch out the fibers, and it never will

go back,” he said. “But it’s not the same for everyone. You’ll have a woman with five kids and no stretch marks and then a guy who was fat at age 14 and a mus-cle builder at 28 who gets them.”

The marks occur in the der-mis, the resilient middle layer of the skin that helps it keep its shape. They most often show up in areas of your body where fat is stored — the stomach area, breasts, upper arms and thighs.

Many dermatologists say hor-monal changes and genetics influence the skin’s capacity to withstand stretching. And some researchers have artificially cre-ated stretch marks on normal skin by applying strong topical steroid creams, suggesting a hor-monal cause. Also, sun exposure, smoking and diet can affect con-nective tissue, Tang said.

“And there’s obviously a ge-netic predisposition,” said Dr. Min-Wei Christine Lee, a der-matologic surgeon and the direc-tor of the East Bay Laser & Skin Care Center in Walnut Creek. “It tends to be if your mom and grandmother had them, you’ll get them, too. It’s so variable. For some people, even a slight bit of weight gain will do it.”

Not all stretch marks are equal. Some appear reddish, while some are purple or whitish. Some start out pink then change over time to a silvery appearance, which indicates the most dam-age. And they vary with different skin tones and types. Nolan says Asian skin seems to be particu-larly prone to the development of the marks, and dark skin must be treated more gently, or the pigment can darken even more in those areas, making the marks more pronounced.

“There’s an art to it,” Nolan

said. “With light skin, there’s less melanin, and it can take more aggressive treatments. With darker skin, too aggressive treat-ments can increase brown lines.”

Currently, the most popular procedures are various laser ther-apies to stimulate new growth of collagen and elastin. Tang uses a radio frequency device in con-junction with lasers. A study in the journal Dermatologic Sur-gery showed that radio frequen-cy combined with pulsed-dye laser treatment provided “good and very good” improvement of the appearance of stretch marks in 33 of 37 patients, but more re-search is needed, doctors say.

A relatively new treatment is fractional laser resurfacing, us-ing scattered pulses of light on one “fraction” of the mark at a time over the course of several visits. This creates thousands of microscopic wounds, and the skin responds by producing new collagen and tissue at the body’s outer surface.

As to over-the-counter creams, Lee has not found them to be very effective on their own. “An-ti-stretch-mark creams sound magical, and they may be help-ful combined with other treat-ments,” she said. “But they’re only really good moisturizers. They may help keep skin from looking worse and improve skin texture, but they’re not a cure.”

And perhaps there doesn’t need to be. In this age of online exposure, some celebrities have gone public. Country singer LeAnn Rimes recently tweeted about hers. And according to StretchMarks.org, in a pre-air-brushed image from a recent photo shoot one of the sexiest women alive — Jennifer Lopez — showed off her bared marks.

Stretch marks: Frustrating, embarrassing, and for some an issue more than skin deepMcClatchy Newspapers

FOR THE TRIBUNE

We can reduce the appearance (of stretch marks), but you can’t ever really eliminate them.

— DR. JOHN TANG“


TOUCHY SUBJECT

“As I’m coming out of being sedated, trying to be helpful and take out my IV, they’re telling my wife I have cancer be-cause there was no question it was can-cer, there was no reason to wait for the biopsy.”

A 4-centimeter tumor was nearing the end of his colon. It required a year and a half of chemotherapy, radiation, surger-ies and a support group that calls itself “Team Stormin’ Norman.”

After surviving colon cancer, Clift recommends men evaluate their health years before doctors typically require tests.

Unless a man has a family history of the disease or is black, both of which make people more susceptible, age 50 is the threshold after which doctors urge cancer screenings.

While there are many cases like Nor-man Clift, which disprove that threshold, Chief Medical Officer at the Colorado Department of Public Health and En-vironment and former family physician Chris Urbina argues that the risks of far-advanced screenings, like colonoscopies, outweigh peace of mind.

In addition to discomfort, colonosco-pies run the risk of infection, puncture,

bleeding and anesthetic complications, Urbina said. Additionally, the extremely low likelihood of benefitting from early testing does not undo the high costs of the medical work.

“I see people who want to get every test in the world and I say, ‘No, you’re wasting your money,’ ” Urbina said.

Three men who had been experienc-ing problems similar to Clift’s symptoms approached him after he spoke at March Manness, a men’s health initiative held in three locations across northern Colorado in early March. Clift urged them to see a doctor if they have symptoms, no matter what their age.

More than 200 people participated during the three days of the March Man-ness events, which were designed to get men to take their health seriously and see a doctor if they think they need one. University of Colorado Health Marketing Strategist and event organizer Dave Riz-zotto called it a huge success.

“We definitely plan to make it an an-nual event just based on the response we got,” Rizzotto said. “We didn’t want to slap wrists or use guilt, we just wanted to present accurate information and make this topic accessible.”

Based on information from Weld and Larimer counties, Rizzotto found that close to 50 percent of men in northern Colorado do not go to the doctor on a regular basis. Common reasons, he said, are hassle, embarrassment, cost and feel-ing like they’re in good health.

Michael Lee, a urologist at Colorado Health Medical Group Urology in Fort Collins, said men’s apathy toward doctors visits is an ongoing issue.

“The biggest barrier to men seeking care is fear, fear that we’re going to per-form real painful procedures, and also embarrassment,” Lee said.

He was a panelist at the Fort Collins

event, where he saw skeptical attendees find relief, he said, after discussing their concerns and deciding to take the plunge.

“Talking to your provider is the best thing you can do because he or she can help you decide the best tests,” Urbina said the same week he visited his own primary care doctor.

Genital screening is a main part of a checkup at primary care, Lee said, and the family doctor is who men should voice initial concerns to.

“The real gatekeepers are the primary care doctors,” the urologist said. “When something is identified like having trou-ble with erection or urine, there is then

a referral that is made and that probably accounts for the vast majority of people I see.”

From there, the specialty doctors walk people through every step of the process.

Three weeks after his last surgery in February, Clift boasts getting to see his grandson be born, teaching his second of two daughters to drive, and the ability to work out at the Rocky Mountain Cancer Rehabilitation Institute in Greeley. He is 100 percent cancer free and owes it, in part, to venturing to the doctor on his own will.

“I wouldn’t be standing here if I hadn’t gone in,” he said.

By ALISON [email protected]

Apathy, fear big concerns for men avoiding doctors visits

FOR THE TRIBUNE

Norman Clift’s voice quivered when he told his story.

But when he told the brewery full of attentive men to get themselves checked, his voice was strong.

Just 17 months before he shared his story in public for the first time, the then-49-year-old attributed ongoing bleeding to hemorrhoids. Clift finally went to the doctor when the problem was consistent, and he was immediately referred to a urologist for a colonoscopy.

“I had an appointment scheduled for my 50th checkup, and I beat him to the punch,” Clift said.

He should have gone in sooner.


TOUCHY SUBJECT

a referral that is made and that probably accounts for the vast majority of people I see.”

From there, the specialty doctors walk people through every step of the process.

Three weeks after his last surgery in February, Clift boasts getting to see his grandson be born, teaching his second of two daughters to drive, and the ability to work out at the Rocky Mountain Cancer Rehabilitation Institute in Greeley. He is 100 percent cancer free and owes it, in part, to venturing to the doctor on his own will.

“I wouldn’t be standing here if I hadn’t gone in,” he said.

What men can do: Early detection techniques and facts from the Centers for Disease Control and Prevention

PROSTATE CANCER» Receive prostate-specific antigen (PSA) blood test if age 50 or older with life expectancy of at least 10 years» Subsequent testing every two years for those with PSA of less than 2.5 ng/ml» Subsequent annual testing for those with PSA level of 2.5 ng/ml or higher» Overall health, not age alone, is important when considering testing

COLORECTAL CANCERMany symptoms are effects of infection or hemorrhoids, but discuss with your doctor if you exhibit:» A change in bowel habits such as diarrhea, constipation, or narrowing of the stool that lasts for more than a few days

» A feeling that you need to have a bowel movement that is not relieved by doing so» Rectal bleeding, dark stools, or blood in the stool, though cancer often does not affect look of stool» Cramping or abdominal pain» Weakness and fatigue» Unintended weight loss» Receive regular colonoscopies over the age of 50 years» Chris Urbina, chief medical officer at the Colorado Department of Health, recommends fecal occult blood test for younger ages

TESTICULAR PROBLEMS» Feel testicles and scrotum for lumps and masses» Other problematic symptoms include testicular swelling and pain» Testicular cancer is rare and found most among men under 40 years of age

» Take action

JOSHUA POLSON/[email protected]

NORMAN CLIFT SITS IN home in Evans on Friday afternoon. Clift owes surviving colon cancer to screening, and professionals suggest getting checked by a primary care doctor before age 50.

Apathy, fear big concerns for men avoiding doctors visits

FOR THE TRIBUNE


During the months of April and May, many high school students are preparing for one of the most

anticipated nights of the year for teens: prom. Hundreds of dollars are spent to celebrate this magical evening from cor-sages to limousines.

Tragically, as the teens celebrate, some prom-goers get into car crashes as a result of drinking and driving or being distract-ed. According to the Governors Highway Safety Association in February 2012, dis-tracted driving is at an all-time high, and authorities are seeing more crashes from cell phone use among all age groups. For teen drivers, though, inex-perience and accessibility to smartphones has made for a deadly combination. The National Highway Traffic Safety Administra-tion reports “young driv-ers, age 15-20 years old, are especially vulnerable to death and injury on our roadways — traffic crashes are the leading cause of death for teenag-ers in America. Mile-for-mile, teenagers are involved in three times as many fatal crashes as all other drivers.”

With these statistics, what are some tips for prom safety?

PARENTS: SOME TIPS THAT MAY EASE PROM ANXIETIES AND KEEP YOUR TEEN SAFE

» Know who your teen is attending the prom with and discuss the events for pre- and post-prom parties with other parents. If the plans of your teen change, confirm the change with the parents of the teens.

» Discuss the dangers of drinking and driving plus drugs and how to identify warning signs for assistance.

» Pre-plan and role-play answers that your teen can use to get out of uncomfort-able situations. (e.g., offered alcohol or drugs, getting a ride from an intoxicated driver, unwanted sexual advances, etc.)

» Discuss guidelines and a curfew and

the consequences of violating these rules.» Discuss travel plans. Use a reputable

limousine service that will not allow a person to bring alcohol or drugs or drive the teens yourself.

» Remind your teen that you are there for them. If they need a ride home, or to an after-prom affair, you are available and will be awake when your teen gets home. This gives your teen a chance to talk about the party and prom.

TEENS: SAFE DRIVING TIPS FOR A MEMORABLE EVENING

» Buckle up and make sure everyone in your car does, as well. You might have a fabulous dress or tuxedo on, but your outfit isn’t complete until you click that seatbelt.

» Watch the road. There are more drunk drivers on the roads during the prom, and you need to keep a close eye on other drivers plus not use your cell phone while driving.

» Ban the alcohol. Don’t drink or let your friends drink alcohol in the car. You may not be allowed into prom if they can smell alcohol on your breath. If you are involved in an alcohol-related crash, you could face felony charges.

» Plan ahead. Know where you’re go-ing after prom and have a backup plan.

» Trust your instincts. If you feel a sense of danger or uncomfortable, leave immediately. Contact your parents.

As your teen prepares for the highlight of the high school year with all of its wonder and excitement, your role as the parent is key in helping the teen have a safe and memorable evening. Research consistently shows that parents remain a powerful influence in fostering healthy teen development and preventing nega-tive outcomes.

Lyn Tausan is a retired school admin-istrator and resides in Greeley with her

husband. She is the marketing/public relations specialist for DRIVE SMART

Weld County.

KEEP SAFETY IN MIND FOR PROM

Lyn TAUSAN

DRIVE SMART

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ALZHEIMER’S/SKILLED CARE

BONELL GOOD SAMARITAN708 22nd StreetGreeley, CO 80631Phone: (970)352-6082Fax: (970)356-7970Web Site: www.good-sam.com

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GRACE POINTE1919 68th Avenue Greeley, CO 80634Phone: (970) 304-1919www.gracepointegreeley.com

MEADOWVIEW OF GREELEY5300 29th StreetGreeley, CO 80634Phone: (970)353-6800Web Site: www.meadowviewofgreeley.com

THE BRIDGE ASSISTED LIVING4750 25th StreetGreeley, CO 80634Phone: (970)339-0022

AUDIOLOGYALPINE ALL ABOUT HEARING1124 E. Elizabeth Street, #E-101Fort Collins, CO 80524Phone: (970)221-3372Fax: (970)493-92373820 N. Grant AvenueLoveland, CO 80538Phone: (970)461-0225Fax: (970)593-0670Web Site: www.allabouthearing.comProfessionals: Renita Boesiger, M. A., CCC-A Rachel White, M. A., CCC-ACheryl Hadlock, M. S., CCC-A

AUDIOLOGY ASSOCIATES2528 16th Street Greeley, CO Phone: (970)352-2881Professionals: Robert M. Traynor, Ed. D. F-AAA; Karen Swope, M. A. CCC-A

MIRACLE-EAR2404 17th Street Greeley, CO 80634Phone: (970)351-6620

749 S. Lemay Avenue, Suite A1Fort Collins, CO 80524(970)221-5225

UNC AUDIOLOGY CLINICGunter Hall, Room 0330Greeley, CO 80639Phone: (970)351-2012/TTYFax: (970)351-1601Web Site: www.unco.edu/NHS/asls/clinic.htmProfessionals: Diane Erdbruegger, Au.D., CCC-A;Erinn Jimmerson, M.A., CCC-AJennifer Weber, Au.D., CCC-A

BALANCE

LIFE CARE CENTER OF GREELEY- ASCENT4800 25th StreetGreeley, CO 80634Phone: (970)330-6400Professionals: Cozette Seaver, PT;Leslie Vail, PTCARDIAC VASCULAR SURGERY

CARDIAC, THORACIC & VASCULAR SURGERY (NCMC)1800 15th Street, Suite 340Greeley, CO 80631Phone: (970)378-4593Fax: (970)378-4391Professionals: Lyons, Maurice I. Jr. DORichards, Kenneth M. MDTullis, Gene E. MD

CARDIOLOGY

CARDIOVASCULAR INSTITUTE (NCMC)1800 15th Street, #310Greeley, CO 80631Phone: (970) 392-0900Professionals: James H. Beckmann, MD;Harold L. Chapel, MD;John Drury, MD;Lin-Wang Dong, MD;Cynthia L. Gryboski, MD;Cecilia Hirsch, MD;Paul G. Hurst, MD;Brian Lyle, MD;Randall C. Marsh, MD;Arnold Pfahnl, MD; James E. Quillen, MD;Gary A. Rath, MD;Shane Rowan, MD;Ahmad Shihabi, MD;

HEART FAILURE CLINIC (NCMC)(970) 350-6953Missy Jensen, FNP-C

DENTISTRYASCENT FAMILY DENTALScott Williams, DMD3535 W. 12th Street, Suite BGreeley, CO 80634Phone: (970)351-6095www.dentalgreeley.com

GREELEY DENTAL HEALTH1600 23rd Avenue Greeley, CO 80634Phone: (970)353-4329www.greeleydentalhealth.comProfessionals:Randy C. Hatch, DDSCharles W. Johnson, DDS

JULIE KAVANAUGH, D.D.S.3400 W. 16th Street, Suite 8-EGreeley, CO 80634Phone: (970)351-0400www.drjuliekav.com

ENDOCRINOLOGY

ENDOCRINOLOGY CLINIC (NCMC)1801 15th Street, Ste 200Greeley, CO 80631Phone: (970)378-4676Fax: (970)-378-4315www.bannerhealth.comProfessionals: Nirmala Kumar, MD

FAMILY PRACTICE MEDICINEBANNER HEALTH CLINIC1300 Main StreetWindsor, CO 80550Phone: 970-686-5646Fax: 970-686-5118Providers:Jonathan Kary, M.D.Trina Kessinger, M.D.Anthony Doft, M.D.

FAMILY PHYSICIANS OF GREELEY,LLP-CENTRAL2520 W. 16th St.Greeley ,CO Phone: (970) 356-2520Professionals: Joanna H. Branum, M.D.;Ann T. Colgan, M.D.;Jennifer D. Dawson, D.O.; Douglas A. Magnuson, M.D.;Lori A. Ripley, M.D.;Andrew P. Stoddard, M.D.;D. Craig Wilson, M.D.

FAMILY PHYSICIANS OF GREELEY,LLP-COTTONWOOD2420 W. 16th StreetGreeley ,CO 80634 Phone: (970) 353-7668Professionals: Christopher T. Kennedy, M.D.; Daniel P. Pflieger, M.D.; Mark D. Young, M.D.; Stacey L. Garber, M.D.Amy E. Mattox, M.D.

FAMILY PHYSICIANS OF GREELEY,LLP-WEST6801 W. 20th Street, Suite 101Greeley ,CO Phone: (970) 378-8000Professionals: Daniel R. Clang, D.O.; Tamara S. Clang, D.O.;R. Scott Haskins, M.D.;Mathew L. Martinez, M.D.; Chima C. Nwizu, M.D.;Michelle K. Paczosa, D.O.; Jeffery E. Peterson, M.D.;Kyle B. Waugh, M.D.;Charles I. Zucker, M.D.

KENNETH M. OLDS6801 W. 20th Street, Suite 208Greeley ,CO 80634Phone: (970)330-9061

WESTLAKE FAMILY PHYSICIANS, PC5623 W. 19th StreetGreeley, CO Phone: (970) 353-9011Fax: (970) 353-9135Professionals: Richard Budensiek, D.O.; Jacqueline Bearden, MD; Janis McCall, MD;Angela Mills, MD Frank Morgan, MD;David Pols, D.O. www.bannerhealth.com

FUNERAL SERVICES

ALLNUTT & RESTHAVEN FUNERALSERVICES702 13th Street, Greeley, CO Phone: (970) 352-3366650 W. Drake Road, Ft. Collins, CO Phone: (970) 482-3208 8426 S. College Avenue, Ft. Collins, CO Phone: (970) 667-02022100 N. Lincoln, Loveland, CO Phone: (970) 667-11211302 Graves Avenue, Estes Park, CO Phone: (970) 586-3101


TRiBUNE MEDiCAL DiRECTORY 2010TRiBUNE MEDiCAL DiRECTORY 2013GASTROENTEROLOGY

DOWGIN, THOMAS A., MD.CENTERS FOR GASTROENTEROLOGY7251 W. 20th St., Bldg JGreeley, CO Phone: (970)207-97733702 TimberlineFt. Collins, CO Phone: (970)207-97732555 E. 13th Street, Suite 220Loveland, CO Phone: (970)669-5432Website: www.digestive-health.net

NORTH COLORADO GASTROENTEROLOGY (NCMC)2010 16th Street, Ste. AGreeley, CO 80631Phone: (970)378-4475Fax: (970)378-4429Professionals:Mark Rosenblatt, MDAhmed M. Sherif, MDYazan Abu Qwaider, MD

HEALTH AND FITNESS

STUDIO Z FITNESS700 11th Street, Greeley, CO313-6924 or 388-7956www.zumbalove.ning.com

WORK OUT WESTHealth & Recreation Campus5701 W. 20th StreetGreeley, CO 80634Phone: 970-330-9691www.workoutwest.com

HOME HEALTH CARECARING HEARTS HOME HEALTHCARE6801 W. 20th Street, Suite 207Greeley, CO 80634Phone: (970)378-1409

REHABILITATION AND VISITING NURSE ASSOCIATION2105 Clubhouse DriveGreeley, CO 80634Phone: (970) 330-5655Fax: (970) 330-7146Web Site: www.rvna.infoProfessionals: Crystal Day, CEO

HOSPICE

HOSPICE OF NORTHERN COLORADOAdministration Office2726 W. 11th Street RoadGreeley, CO 80634Phone: (970)352-8487Fax: (970)475-0037

PATHWAYS HOSPICE305 Carpenter RoadFt. Collins, CO 80550Phone: (970)663-3500Fax: (970)292-1085 Web Site: www.pathways-care.org

INDEPENDENT ASSISTED LIVINGGRACE POINTE1919 68th Avenue Greeley, CO 80634Phone: (970) 304-1919Website: www.gracepointegreeley.com

MEADOWVIEW OF GREELEY5300 29th StreetGreeley, CO 80634Phone: (970)353-6800Website: www.meadowviewofgreeley.com

INDEPENDENT ASSISTED LIVING W/SERVICES

BONELL GOOD SAMARITAN708 22nd StreetGreeley, CO 80631Phone: (970)352-6082Fax: (970)356-7970Web Site: www.good-sam.com

FOX RUN SENIOR LIVING1720 60th AvenueGreeley, CO 80634Phone: (970)353-7773Fax: (970)330-9708Web Site: www.good-sam.com

INFECTIOUS DISEASEBREEN, JOHN F., MD (NCMC)1801 16th StreetGreeley, CO 80631Phone: (970)350-6071Fax: (970)350-6702

INTERNAL MEDICINEBANNER HEALTH CLINIC2010 16th StreetGreeley, CO 80631Phone: (970)350-5660www.bannerhealth.com Professionals: Giovanna Garcia, MDSteven Kalt, MD

MEDICAL EQUIPMENT & SUPPLIESBANNER HOME MEDICAL EQUIPMENT (NCMC)Phone: (970)506-6420

MENTAL HEALTH SERVICES

NCMC - BEHAVIORAL HEALTHDr Patricia Al-Adsani, Child and Adolescent PsychiatryBanner Health Clinic-Internal Medicine2010 16th Street, Suite CGreeley, CO 80631Banner Health Clinic- Windsor1300 Main StreetWindsor, CO 80550

Shawn Crawford, LPCBanner Health Clinic 222 Johnstown Center DriveJohnstown, CO 80534Banner Health Clinic-Internal Medicine2010 16th Street, Suite CGreeley, CO 80631

Stephanie Carroll, LCSW, CACIIIBanner Health Clinic1300 Main StreetWindsor, CO 80550Banner Health Clinic Fossil Creek303 Colland DrFort Collins, CO 80525

Elise Pugh, LPCBanner Health Clinic Westlake 5623 W 19th StGreeley CO 80631Banner Health Clinic1300 Main StreetWindsor, CO 80550

Susan Goodrich, LCSW Banner Health Clinic-Loveland PediatricsLoveland PediatricsLoveland COBanner Health Clinic- Windsor1300 Main Street Windsor CO, 80550

Renee Rogers, LMFTBanner Health Clinic1300 Main StreetWindsor, CO 80550Banner Health Clinic303 Colland Drive, Fossil CreekFort Collins, CO 80525

MIDWIFERY CARECENTER FOR WOMEN’S HEALTH1715 61st AvenueGreeley, CO Phone: (970)336-1500Professionals: Marie Foose, CNM; Krista O’Leary, CNMBrenda Bridges, CNM

NEPHROLOGYGREELEY MEDICAL CLINIC1900 16th StreetGreeley, CO 80631Phone: (970) 350-2438Professionals: Donal Rademacher, MD

NEUROLOGY

CENTENNIAL NEUROLOGYDr. David Ewing7251 W. 20th Street, Unit CGreeley, CO 80634Phone: (970) 356-3876

NCMC NEUROLOGY CLINIC1800 15th Street, Suite 100BGreeley, CO 80631Phone: (970) 350-5612 Fax: (970) 350-5619Professionals: Jeffery Siegel, MDWilliam Shaffer, MD; Todd Hayes, DOChristy Young, MD

NURSING HOME REHABILITATIONCENTENNIAL HEALTH CARE CENTER1637 29th Ave. PlaceGreeley, CO 80634Phone: (970) 356-8181Fax: (970) 356-3278

OBSTETRICS & GYNECOLOGYCENTER FOR WOMEN’S HEALTH1715 61st Ave.Greeley, CO Phone: (970)336-1500Professionals: Stewart Abbot, MD; Michael Plotnick, MD;Marie Foose, CNM;Krista O’Leary, CNM;Karen Vorderberg, CNM;Bea Bachenberg, WHCNP;Kecia Doll, Licensed Esthetician;

WESTLAKE FAMILY PHYSICIANS, PC5623 W. 19th StreetGreeley, CO Phone: (970) 353-9011Fax: (970) 353-9135Professionals: Jacqueline Bearden, MD; Richard Budensiek, D.O.; Janis McCall, MD;Angela Mills, MD Frank Morgan, MD;David Pols, D.O. www.bannerhealth.com

ONCOLOGY & HEMATOLOGY

CANCER INSTITUTE (NCMC)1800 15th Street,Greeley, CO 80631 Phone: (970) 350-6680Toll Free: (866) 357-9276Fax: (970)350-6610Professionals: Elizabeth Ceilley, MDBrian Fuller, MDKerry Williams-Wuch, MDAriel Soriano, MD

ORTHODONTICS

GREELEY ORTHODONTIC CENTER2021 Clubhouse Dr., Suite 110Greeley, CO 80634Phone: (970) 330-2500Fax: (970) 330-2548E-Mail: [email protected]: www.doctork.comProfessionals: Dr. Gary J. Kloberdanz

ORTHODONTIC ASSOCIATES OF GREELEY, PC3400 W. 16thSt., Bldg 4-VGreeley, CO 80634Phone: (970) 356-5900Website: www.dredgren.comProfessionals: Bradford N. Edgren, DDS, MS


TRiBUNE MEDiCAL DiRECTORY 2013ORTHOPEDICS

MOUNTAIN VISTA ORTHOPAEDICS 5890 W. 13th Street, Suite 101Greeley, COPhone: (970)348-0020Fax: (970)348-0044Web Site: www.bannerhealth.comProfessionals: Randy M. Bussey, MDDaniel Heaston, MDThomas Pazik, MDShelly Remley, PA-CKelly R. Sanderford, MDSteven Sides, MDLinda Young, MD

PEDIATRICSBANNER HEALTH CLINIC6801 W. 20th Street, Suite 201Greeley, CO 80634Phone: (970)350-5828www.bannerhealth.com Professionals: Amanda Harding, MDJames Sando, MD

PEDIATRIC REHABILITATIONBANNER REHABILITATION CENTER1801 16th StreetGreeley, COPhone: (970)350-6160Fax: (970)378-3858

PERSONAL RESPONSE SERVICE

BANNER LIFE LINE (NCMC)2010 16th Street, Suite CGreeley, CO 80631Phone: 1-877-493-8109(970) 378-4743

PHYSICAL THERAPY

HOPE THERAPY CENTER(Formerly North Colorado Therapy Center)2780 28th AvenueGreeley, CO 80634Phone: (970)339-0011Website: www.GCIinc.orgProfessionals: Chris Denham, PT; Kryste Haas, OT;Kathie Hertzke, PTA;Moni Kohlhoff, PT;Alex Luksik, PTA;Jeanne Rabe, PT;Howard Belon, PhD, Clinical Psychologist

NORTHERN COLORADOREHABILITATION HOSPITAL 4401 Union StreetJohnstown, CO 80534Phone: (970) 619-3400Website: [email protected]

PODIATRYFOOT & ANKLE CENTER OF NORTHERN COLORADO P.C.1931 65th Ave., Suite AGreeley, CO 80634Phone: (970) 351-0900Fax: (970) 351-0940

4401 Union StreetJohnstown, CO 80534Phone: (970) 443-0925Web Site: www.footandanklecolorado.comProfessionals: Daniel J. Hatch, D.P.M. Mike D. Vaardahl, D.P.M.

PULMONARY/CRITICAL CARENORTH COLORADOPULMONARY (NCMC)1801 16th StreetGreeley, CO 80631Phone: (970)392-2026Professionals: Kelli Janata, DORobert Janata, DODavid Fitzgerlad, DOMichael Shedd, MDDanielle Dial, NP

PROSTHETICS & ORTHOTICS

CERTIFIED PROSTHETICS &ORTHOTICS, LLC (GREELEY LOCATION)1620 25th Avenue, Suite AGreeley, CO 80634Phone: 970-356-2123Fax: 970-352-4943

HANGER PROSTHETICS & ORTHOTICS7251 West 20th Street, Building MGreeley, CO 80634 Phone: (970)330-9449 Fax: (970)330-42172500 Rocky Mountain Avenue, Suite 2100North Medical Office Building Loveland CO 80538 Phone: (970) 619-6585 Fax (970) 619-6591Website: www.hanger.comProfessinal: Ben Struzenberg, CPOMichelle West, Mastectomy Fitter

REHABILITATION

ASCENT AT LIFE CARE CENTER 4800 25th StreetGreeley, CO 80634Phone: (970)330-6400Website: www.lcca.comProfessionals: Annie BennettLeslie Vail

BANNER REHABILITATIONPhone: (970)350-6160


PEAKVIEW MEDICAL CENTER5881 W. 16th St.Greeley, CO 80634Phone: (970)313-2775Fax: (970)313-2777

SKIN CAREKECIAS SKIN CARE @ CENTER FOR WOMEN’S HEALTH1715 61st AvenueGreeley, CO Phone: (970)336-1500 Professinal: Kecia Doll, Licensed Esthetician

SKIN TRANSFORMATIONS LLC1711 61ST Avenue, Unit 102Greeley, CO 80634Phone: (970) 353-3008Professionals: Lorrie Beamer, Licensed EstheticianMelissa Mclean, Licensed EstheticianTerri Crouch, Licensed EstheticianAlissa Siegfried, Licensed Esthetician

SKILLED CARE/REHAB

BONELL GOOD SAMARITAN708 22nd StreetGreeley, CO 80631Phone: (970)352- 6082Fax: (970)356-7970Website: www.good-sam.com

GRACE POINTE1919 68th Avenue Greeley, CO 80634Phone: (970) 304-1919Website: www.gracepointegreeley.com

SPORTS MEDICINE

MOUNTAIN VISTA ORTHOPAEDICS 5890 W. 13th Street, Suite 101Greeley, COPhone: (970)348-0020Fax: (970)348-0044Web Site: www.bannerhealth.comProfessionals: Randy M. Bussey, MDDaniel Heaston, MDThomas Pazik, MDShelly Remley, PA-CKelly R. Sanderford, MDSteven Sides, MDLinda Young, MDNORTH COLORADO SPORTS MEDICINE1801 16th StreetGreeley, COPhone: (970)392-2496

SPEECH LANGUAGE PATHOLOGY

BANNER REHABILITATION CENTER1801 16th StreetGreeley, COPhone: (970)350-6160Fax: (970)378-3858


UNC SPEECH LANGUAGE PATHOLOGY CLINICGunter Hall, Room 0330 Greeley, CO 80639Phone: (970)351-2012/TTYFax: (970)351-1601Web Site: www.unco.edu/NHS/asls/clinic.htmProfessionals: Lynne Jackowiak, M.S., CCC-SLPJulie Hanks, Ed.DPatty Walton, M.A., CCC-SLP

SURGERY GENERAL & TRAUMA

BARIATRIC SURGERY (NCMC)1800 15th Street, Suite 200Greeley, CO 80631Phone: (970)378-4433866-569-5926Fax: (970)378-4440Professionals: Michael W. Johnell, MD

SURGERY WESTERN STATES BURN CENTER (NCMC)1801 16th StreetGreeley, CO 80631Phone: (970)350-6607Fax: (970)350-6306Professionals: Gail Cockrell, MD Cleon W. Goodwin, MD BURN

SURGICAL ASSOCIATES OF GREELEY PC (NCMC)1800 15th St. Suite 210 Greeley, CO Phone: (970)352-8216Toll Free: 1-888-842-4141Professionals: Lisa Burton, M.D.;Michael Harkabus, M.D.; Jason Ogren, M.D.;Samuel Saltz, D.O.; Robert Vickerman, M.D.

URGENT CARE

SUMMITVIEW URGENT CARE2001 70th AvenueGreeley, CO 80634Phone: (970)378-4155Fax: (970)378-4151www.bannerhealth.comProfessionals:Thomas Harms, MDAmy E. Shenkenberg, MDLinda Young, MD

UROLOGY

MOUNTAIN VISTA UROLOGY5890 W. 13th Street, Suite 106Greeley, CO 80634Professionals:James Wolach, MDCurtis Crylen, MDwww.bannerhealth.com

VEINS

VEIN CLINIC (NCMC)1800 15th Street, Suite 340Greeley, CO 80631Phone: (970)378-4593Fax: (970)378-4591Professionals:Maurice I. Lyons Jr., DOKenneth M. Richards, MDGene E. Tullis, MD


Cost of Hearing InstrumentsAudiologists and their patients have

witnessed hearing instrument costs move from about $295.00-395.00 for a good device in 1973 to over $4,000.00 per devices for some types of instruments in 2013. While this 10 fold increase may seem excessive, consider the real facts involved these increases.

A Bit of Hearing Aid HistoryIn the early 1970s, hearing instruments were mere analog amplifiers with a volume control. These amplifiers were built according to the patient’s individual hearing impairment, but were still very crude devices by today’s standards. For example, if the loss was for high pitched sounds, the amplifier had minimal amplification of low pitches while if the impairment was profound, there was a lot of power but not much control over the sound. Feedback (squealing) was common, constant changing of the volume control was required and patients often complained “I cannot hear without my hearing aids, but I cannot hear much with them”. These more simple instruments were quite beneficial for patients with profound

losses, but not much help for those with milder problems, leading physicians to not recommend hearing instruments for patients with high frequency and mild hearing losses. It was true in this period that it did not really matter what brand of hearing aid was used, they were all about the same in benefit and technology. Most of these products were in-the-ear or behind-the-ear products that were fit to the patient’s ear and tuned by the use of unreliable, invalid assessment techniques. In the mid-1980s, a circuit called a K-Amplifier (K-Amp) was invented by Dr. Mead Killion, an audiologist and electrical engineer that revolutionized not only the hearing aid circuitry but audiological fitting concepts. The purpose of this new circuit was to adjust itself to the signal that was presented to the hearing device. Basically, if the signal was loud, then amplification presented to the ear was minimal, and when the signal into the device was minimal, there was more amplification presented to the ear. The circuit adjusted instantaneously

according to the level of the signal presented to the microphone of the device. Since the instrument now compensated for the intensity of sound within the environment, the devices became substantially more beneficial. Additionally, some versions of the K-Amp had two channels (two amplifiers), one that amplified low frequencies and another that amplified high frequencies. This facilitated the amplification of the low frequency background noise differently than the high frequency speech frequencies. The use of this circuit allowed for the device to amplify sounds comfortably for most patients that were, due to their hearing loss, abnormally sensitive to the loudness of sound. Further, the 1980s was a time of miniaturization and the devices were becoming smaller and more cosmetic creating less psychological difficulty for those that used hearing instruments. This trend continued until the about 1996 when digital hearing instruments appeared in the market place.It is disputed by some as to the first manufacturer with digital hearing instruments. The facts are that

Widex (www.widex.com) and Oticon (www.oticon.com) were the first in the marketplace with digital hearing instruments. Both Danish companies, Widex was first in the market with their Senso instrument in 1996 and about a month or so later Oticon introduced the Digifocus. Once hearing instruments became digital they could attack the frustrating performance difficulties that had plagued these products for decades. Use issues for patients such as feedback, background noise reduction, newspapers rattling, car noises, clarity, size, and other concerns have made these products more beneficial. The digital generation began the increase in the number of amplifiers (or channels) that were used to adjust the sound according to the patients hearing loss and changes in the environment occurred. Although the Digifocus used two channels, the Senso had 3 three which allowed for continuous adjustment in low, mid and high pitches. These were the most beneficial hearing instruments ever invented which led to the technology race among device

manufacturers. Due to the research and development process today’s hearing devices offer feedback control, control of background and wind noises, and clarity that is unparalleled.

Research and Development Costs – Hearing InstrumentsAs the digital instrument became readily available, I was of the opinion that that these products were becoming rather expensive. Concerns of patients that were purchasing these products were foremost as it was difficult for many to afford them. In 1998-99, I had the opportunity to be involved as a member of a research and development team for a major hearing instrument manufacturer. The job was to serve as the audiology scientist on the team working with engineers, project managers, and marketing professionals in Switzerland. The cultural and travel benefits of living in Europe for a time notwithstanding, the experience of working with this team of dedicated professionals was an education in how the science of Audiology contributes to the development of hearing instruments. When pondering the costs of the product portion of hearing instruments, consider that during the hearing aid research and development process the manufacturer employs a plethora of professionals from various disciplines working together to develop a hearing device. This process employs about 60 full time engineers, 45 full time software engineers, project managers to coordinated these individuals, production managers that insuring the availability of components and their assembly, and audiological scientists that working each day for 2-4 years. Since most hearing instruments are designed in Europe, the R/D costs can be as much as 80-90 Million Euros from start to finish on a new hearing device. If the world market for hearing instruments is about 10 Million devices, the costs for development and to make a profit are unreasonable. Due to this R/D process, today’s hearing instruments offer more benefit to the hearing impaired than ever before, but there are significant costs involved in bringing these products to market.

Professional Added Value – The AudiologistWhile the products themselves are expensive, the other portion of the total cost of amplification is the value offered by Audiologists and the clinic that provides the support. Without this support, even the most advanced devices are virtually useless. Patients should expect value added services from their audiologist:

Choosing the appropriate instruments. It is very easy to over or under purchase hearing instrument technology. For example, if a patient is elderly and has a limited lifestyle, usually they do not require the highest level, most expensive technology. Conversely, it is a disservice to the patient to not

discuss the highest level capabilities as the benefits of these features can be of great benefit to their occupation or lifestyle. Audiologists can assess the lifestyle, hearing loss and present the benefits of various technologies relative to the costs.

Style of Instruments. There are many different types and sizes of hearing instruments. The audiologist assists the patient in the determination of the style of instrument that would be the best for them as well as meet the needs of their hearing loss.

Programming the instruments. Hearing instrument must be programmed in the patient’s ears and not from some remote location. Patients should expect the audiologist be an expert in the programming of their hearing instruments. They should be proficient in the initial programming and the in the adjustment of the products according to the difficulties encountered in their use. These adjustments should be made easily and with good results or an alternative plan should be offered.

Warranty Service. Warranties on hearing instruments are usually for a period of 1-4 years, depending upon the clinic and the manufacturer of the device. In

the hands of a good audiologist and cooperative patient, hearing instruments are relatively trouble free devices. There are, however, still issues that arise in the adjustment, use and care, progression of hearing losses, counseling and other follow up needs from time to time. These adjustments and office visits are usually part of the warranty on the hearing instruments do not incur further expense.

When considering the use of amplification, patients are often quite surprised at the costs involved. Generally, the prices paid for hearing instruments are twofold. First, there is the instrumentation and the acquisition costs involved the products themselves. Secondly, there is the value added services of the audiologist and the support that the clinic provides. Considering the development costs of today’s sophisticated hearing instruments and the audiologist the clinic, the benefits of ownership, greatly outweigh the costs incurred. These two costs combine to become the overall cost of a set of hearing instruments which makes it essential to work with a clinic that has been in business for some time and has a reputation for providing quality hearing care.

Robert M. Traynor is the CEO and practicing audiologist at Audiology Associates, Inc., Greeley, Colorado with particular emphasis in amplification and operative monitoring. Dr. Traynor holds degrees from the University of Northern Colorado (BA, 1972, MA 1973, Ed.D., 1975), the University of Phoenix (MBA, 2006) as well as Post-Doctoral Study at Northwestern University (1984). He taught Audiology at the University of Northern Colorado (1973-1982), University of Arkansas for Medical Sciences (1976-77) and Colorado State University (1982-1993). Dr. Traynor is a retired Lt. Colonel from the US Army Reserve, Medical Service Corps and currently serves as an Adjunct Professor of Audiology at the University of Florida, the University of Colorado, and the University of Northern Colorado. For 17 years he was an Audiology Consultant to major hearing instrument and equipment manufacturers providing academic and product orientation for their domestic and international distributors. A clinician and practice manager for over 35 years, Dr. Traynor has lectured on most aspects of Audiology in over forty countries.

Author’s Bio:Robert M. Traynor,

Ed.D., MBA, FAAA

April 2013 Thrive

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