Flourish Fall 2011

flourishBrain remodeling | HPV SHot in men | Fit to driVe

Fall 2011

Penrose-St. Francis Health Services

SeedS OF HOPeBreast cancer surgery

made more precise

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Fruits and Veg-etables provide vitamins, minerals, fiber and anti-aging phyto-chemicals. Dark green and brightly colored fruits and vegetables are best.

Tea is high in anti-oxidants, which help prevent damage to cells. Green tea is particularly high in polyphenols—a free-radical fighter—and can reduce heart disease risk by 31 percent.

Whole Grains provide fiber, B vitamins, antioxidants and miner-als such as iron, zinc and copper.

Dairy is often over-looked in adulthood but provides necessary nutrients, including calcium, vitamin D and potassium, that are necessary for longevity.

Although the Fountain of Youth has yet to be found, there are many natural foods that can help keep you young, inside and out. Sharon Jacob, a registered dietitian with St. Francis Medical Center, shares five essential “youthful” foods.

Safe DrivingDrivers impaired by injury, illness or age can now get help to stay on the road safely through a new program being offered by Penrose Hospital rehabilitation services. The program, called Fitness to Drive, assesses drivers and then makes recommendations for physical training or adaptive equipment that can help them continue to drive safely.

Fitness to Drive is recommended for:• People who have stopped driving due to a stroke, brain injury, multiple sclerosis or other condition.• Older adults who are experiencing vision changes, arthritis, diabetic neuropathy, or dementia or are unsure of their driving skills.• Students and new drivers with learning disabilities, attention deficit disorder or physical disabilities.

The program includes a driving test to assess vehicle control, judgment and problem-solving skills as well as a clinical evaluation of vision, cognitive skills (memory, judgment, speed of response) and motor function. After the assess-ment, drivers meet with a driving specialist to go over the results and receive recommendations.

Go to penrosestfrancis.org/drive to learn more, or call 719-776-5200.

MagicElixirs5 foods that can turn the tides of time

No More Mouth-to-MouthA new CPR method that doesn’t require mouth-to-mouth breathing can

double a person’s chance of surviving cardiac arrest. “Hands-only” CPR only requires a bystander to make rapid, firm pushes on the chest. “When a person collapses, they have as much as 10

minutes’ worth of oxygen left in their blood,” says David Ross, DO, an emergency medicine physician with Penrose-St. Francis

Health Services. “By pushing on the chest, the bystander is actually pumping the heart and circulating that blood.”

healthystart

Flourish is published four times annually by Penrose-St. Francis health Services. As part of Centura health, our mission is to nurture the health of the people in our community. the information herein is meant to complement and not replace advice provided by a licensed health care profes-sional. For comments or to unsubscribe to this pub-lication, please email us at [email protected]. Flourish is produced by Clementine llC of Denver, Colo. executive editor is Jill Woodford.

2222 n. nevada Ave., Colorado Springs, Co 80907

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penrosestfrancis.org 3Fall 2011 flourish

Omega 3 Fatty Acids reduce the risk of heart disease, diabetes, Alzheimer’s and age-related brain decline. overall reduced inflammation is the reason for such power-ful benefits.

For the Man in Your LifeVaccinate: HPV, or human papil-lomavirus, is the leading cause of cervical cancer in women and is now the top cause of oropha-ryngeal cancer in men, beating out smoking and drinking, according to recent studies. “We’ve seen an alarming increase in tonsil and throat cancer in non-smoking men in their late 30s through their early 50s that is a result of exposure to HPV earlier in their lives,” says Joel Ernster, MD, a head and neck surgeon with the Penrose Cancer Center. The HPV vaccine, once recommended just for girls, is now recommended for boys as well. In addition to reducing the risk of oropha-ryngeal cancer, the vaccine prevents 90 percent of genital warts in males.

Condition needs an eR When aCCompanied By: needs URgent CaRe When aCCompanied By:

Chest Pain Pressure or squeezing feeling; shortness of breath; numb-ness; sweating; nausea; high fever; or sharp pain in chest

Cough with or without mucus production, chest muscle soreness

headache Described as “worst” headache of your life; severe pain; stiff neck; vomiting; injury to head; numbness, tingling or weak-ness in arms or legs; or slurred speech

Dull pain; accompanied by cold or flu symptoms; history of migraine; or sinus infection

Abdominal Pain Abdomen tender to touch; bloody or black, tarry stool; vomiting blood; fever; or pregnant

Watery diarrhea; fever and muscle aches; chills; burning when urinating

Tough CallChoosing between an ER and urgent careSure, it’s easy to know you need an emergency room if bones are protruding or someone’s unconscious. And a 100-degree fever typically can wait until your doctor’s office opens. But what about the “in-betweens” — conditions that can’t wait, but you also don’t want to spend money or time going to an ER unnecessarily. Carey Pelto, MD, medical director of Penrose Community Urgent Care, offers this guide to knowing the difference when it comes to the three most common visits to an ER. “If you’re unsure, call ahead and ask the nurse for the most appropriate venue for your symptoms,” he recommends.

Should current or former smokers get CT scans to screen for lung cancer?A study released a year ago showed that screening cur-rent and former smokers with CT scans can reduce lung cancer deaths by 20 percent, compared to chest X-rays. This was the first evidence of a viable screening to help us find lung cancer earlier. However, we do not recommend CT screening for all people in the same way we recom-mend colonoscopies or mammograms. Currently we believe CT screening is most useful in patients who match the criteria used in the study:

• 55-74 years old• Smoked the equivalent of at least 1 pack of cigarettes daily for 30 years or more• Access to follow-up with a multidisciplinary team specializing in lung nodules

Matthew Blum, MDThoracic Surgeon specializing in lung cancer with the Penrose Cancer Center

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For a more in-depth look at signs and symptoms that require emergency care, please go online to penrosestfrancis.org/urgentcare.

Hear more ways to slow down the

aging process at a free program.

See back cover

for details.

To learn more about using CT screenings to detect lung cancer, call the Penrose Cancer Center Lung Nodule Clinic at 719-776-6997.

Fall 2011flourish Penrose-St. Francis Health Services4

Women with breast cancer in Colorado Springs are the first in the state to be offered a new high-tech tool to more easily and accurately find and remove breast tumors.

The procedure, called radioactive seed localization, offers “more precise detection (of the tumor), reduces the amount of breast tissue that needs to be removed and is more convenient for the patient,” says Toni Green, DO, medical director of breast oncology at Penrose-St. Francis Health Services.

Penrose is the only hospital system in the state permitted to offer the procedure and Green is the only surgeon in the state autho-rized to perform it.

With seed localization, a radiologist inserts a small radioactive metal capsule the size of

half a grain of rice into the breast at the location of the tumor, which is detected via a mammogram. The procedure takes about 15 to 20 minutes and can be performed up to five days before surgery. The seed contains very low doses of radiation, far lower than X-rays or CT scans, Green says. During surgery, the surgeon locates the seed using a handheld device similar to a Geiger counter and then removes the tumor and the seed.

New-School ProcedureHistorically, tumors have been located through a wire-localiza-tion procedure, which requires patients to arrive at the hospital hours before surgery. The radiologist conducts a mammogram and inserts a needle threaded with wire into the breast near

the area of the tumor. The wire is taped into place and covered with what Green calls a “coffee cup” so the wire doesn’t move.

“Wires are bulky, old-school technology,” says Green, who was trained to perform seed localization at the Mayo Clinic in Minnesota before joining Penrose last summer. “The wire can move around a little bit or become dislodged, so it has the potential to be not as accurate. And it can be painful depending on where it’s located.”

Fewer Follow-uP SurgerieSSeed localization also requires fewer follow-up surgeries to remove cancerous cells that were missed in the first surgery, according to studies.

Margins were negative in 73 percent of radioactive seed patients versus 54 percent of wire localization patients, according to a study published in the Breast Journal in 2008. Positive margins are cancer cells that extend beyond the tumor to the edge of the surround-ing tissue.

A 2001 study published in the Annals of Surgical Oncology was one of the first studies published about radioactive seed localization. This study demonstrated that 26 percent of radio-active seed localization patients required second operations to remove additional positive margins compared with 57 percent of wire localization patients who required additional surgery.

Patients recommend seed localization

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Patients who have had radioactive seed localiza-tions to pinpoint breast tumors before lumpecto-mies say they’re pleasantly surprised at the ease and convenience of the new procedure.

Seed localization, available in Colorado only at Penrose Hospital, offers these benefits to patients:• Convenience: Patients can schedule the proce-

dure up to five days before surgery rather than

having to arrive hours earlier on the day of surgery to have a radiologist insert a needle and wire at the site.• Speed: The procedure takes about 15 minutes.• Results: Seed localization removes less healthy breast tissue and requires fewer follow-up surgeries than traditional wire localization. Jennifer Kronebusch, 51, says her decision was easy after her surgeon, Toni Green, DO, medical director of

Dr. Toni Green, breast surgeon

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Radioactive seeds smaller than a grain of rice help surgeons locate and remove breast tumors more precisely.

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“So a full quarter of surgeries were avoided,” Green says.

The procedure is appropriate for any patient who needs a localization, Green says. “It’s been very well received.”To reaCH dr. Toni green, CaLL 719-571-8840

Personal assessmentTo understand your personal risk for breast cancer, sign up for a Breast Cancer Risk Assessment with the experts at the Penrose Cancer Center. You will meet with a genetic counselor for 60 to 90 minutes and then receive customized rec-ommendations on genetic testing along with the type and frequency of breast cancer screenings you should obtain. The assessment costs $25 and a report will be sent to your physician.

For more inFormaTion oR To MAkE AN APPoiNTMENT, PLEASE CALL 719-776-5279.

breast oncology at Penrose-St. Francis Health Services, compared seed and wire localizations with her.

“It seems to be less invasive and it was amazing how quickly it went,” she says. “It took more time for them to set up than it did to put the seed in. When it was over, I walked out and said to my husband, ‘OK, let’s go get lunch.’ ”

Family TreeYour risk of breast cancer goes up if you have a family history of the disease or you inherited a cancer-causing gene. Kate Crow, genetic counselor at Penrose Cancer Center, helps sort out fact from fiction regarding inherited breast cancer.

Equal OppOrTuniTyAlthough the incidence of breast cancer in men is very low, you have just as much chance of inheriting a breast cancer gene from your father as from your mother.

FaMily lOOkSGenes that create external appear-ance are different from those that cause breast cancer. You don’t have to look like your mother to inherit a cancer-causing gene.

Six GEnESAlthough BRCA is the most commonly known, there are now six known genes that cause breast cancer.

OunCE OF prEvEnTiOnIf you are carrying a breast cancer gene, you can take preventive mea-sures to reduce your risk of getting breast cancer, such as taking tamoxi-fen or removing your ovaries.

yearly breast screenings still bestBy Laura Pomerenke, MDBreast Surgeon with Penrose-St. Francis Health Services

Two years ago, the U.S. Preventive Services Task Force recommended that women wait to begin annual screening mammograms until age 50 and then get them only every other year, versus the previous recommendation for annual mam-mograms beginning at age 40. Re-sults of this new recom-mendation are still being analyzed, but one study estimates that if all American women now in their 30s follow the new guide-lines, 65,000 more women will die than under the previous recommendation.

The USPSTF recommendation was based on studies in Europe and Canada, where digital mam-mography is not readily available as it is in the U.S., including at Penrose-St. Francis Health Ser-vices. Digital technology is more effective at finding breast cancer early, which provides more treat-ment options and the best chance for a cure. The American Cancer Society and the American College of Radiology continue to recom-mend that women at normal risk of breast cancer get:

• Monthly breast self-exams• Annual physical exams by a

trained professional• Annual screening mammograms

starting at age 40

To SCHEduLE A digiTaL mammogram, CALL 719-776-8010, oPTioN 3.

Penrose-St. Francis Health ServicesFall 2011flourish 6

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In just a matter of minutes, a stroke can wipe out your ability to tie your shoes, remember your name or climb stairs. But doctors are learning that thanks to your brain’s amazing ability to remold itself, those functions don’t have to be lost forever.

“In the last 10 years, we’ve really begun to understand the capability of the brain to accomplish neuroplasticity, literally the ability to change or mold itself like plastic,” says Glen House, MD, medical director of rehabilitation services at Penrose-St. Francis Health Services.

Eighty percent of strokes are caused by a clogged artery that stops oxygen-laden blood from getting to the brain. Within 12 minutes, a

pea-sized portion of the brain dies from the lack of oxygen. And with it goes those functions that were controlled by that particular region.

The surround-ing area, called the penumbra, also has been damaged by the lack of oxygen but is not quite dead. “It’s teetering on ‘Do I die or do I live?’ ” House

says. If blood flow can be restored to bring it oxygen, that portion often can be saved and further damage averted.

Once the initial crisis has been controlled, that’s not the end of the story. With rehabilita-tion, the neurons (or brain cells) that remain can form new connections and take over the lost functions — even if they are in completely different parts of the brain.

“There are many ways for neuro recovery to occur,” House says. “Existing neurons can sprout new dendrites and take over functions

they didn’t previously do. Partially damaged neurons can wake up. Other parts of the brain can take over. There’s this incredible interconnection throughout our brains.”

Studies have found that the faster rehabilitation starts, the bigger the potential gains. Penrose starts rehabilitation in acute care within 24 hours if the patient is medically stable. Patients are moved to the rehabilitation unit as soon as possible, resulting in one of the earliest intervention programs regionally and nationally.

“By doing this, we’ve been able to achieve outstanding outcomes,” House says.

Rehabilitation acts like exercise for the brain muscle, helping the brain cells grow and take over new functions. For instance, a stroke patient may start out not being able to stand, let alone walk. So rehabilitation therapists will hold up the patient using a suspension system and help move the patient’s body through the motion. As the motion is repeated over and over and over, small electrical impulses are flashing in the brain that help form the new connections to relearn the function, House says.

“We see miracles every week ” he says. “We’re shocked by what people end up being able to do. But we’re also shocked at how well people can adapt despite their disabilities.”

Making New ConnectionsRehabilitation helps brains recover after stroke

stroke Centers improve oddsPenrose-St. Francis Health Services is the only Joint Commission-certified Primary Stroke Center in Colorado Springs.

Patients who receive care at a certified stroke center have a 20 percent lower chance of dying than patients treated at other hospitals, according to a study published in the Feb. 26, 2011, issue of the Journal of the American Medical Association.

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FITNESS CLASSESWinter Sports ConditioningGet ready to shred the slopes. Cardiovascular conditioning, plyometrics, stability, full body and core strength will be the foundation of this functional and athletic workout. By first snowfall, you will be ready to take your training and fitness to the slopes.

Date: Six-week session on Mondays: Oct. 17 – Nov. 21Time: 5:15 – 6:15 p.m.Location: Penrose Hospital Wellness Center, 2222 N. Nevada Ave.Cost: PSF employees: $35 PSF volunteers: $40 Community members: $45 Registration required: 719-776-7393

PilatesA fun and energizing mat workout designed to improve posture, create long and lean muscles, and build strength and flexibility. Focus is on breathing patterns, spinal alignment and engaging the deep core muscles. Students of all levels are encouraged to participate, as exercises are presented at multiple fitness levels.

Date: Four-week session on Tuesdays: Nov. 22 – Dec. 13Time: 6:10 – 7:00 a.m.Location: Penrose Hospital Wellness Center, 2222 N. Nevada Ave.Cost: PSF employees: $25 PSF volunteers: $30 Community members: $35Registration required: 719-776-7393

Women’s Healthy Back ClubDo you have back issues like muscle tightness, aches and spasms, or do you just want to learn how to keep your back healthy? let our experts help you incorporate fitness into your busy lifestyle, motivate you to stick to an exercise plan, and improve your overall back health. each session will include a half-hour discussion with a back expert followed by a half-hour of supervised stretches and exercises.

Date: 4-week program runs every Tuesday, Oct. 25 – Nov. 15Time: 5:15 – 6:30 p.m.Location: Penrose Health Learning Center Gym, 1644 Medical Center PointCost: $20/personRegistration required: 719-776-4852 (Class is limited to 20 participants)*Note: If you have sharp back or leg pain, this class may not be right for you. Please consult your physician.

Tai Chi this form of ancient Chinese martial arts works to improve body awareness, strength and coordination.

Date: Four-class session on Nov. 15, 17, 22 and 29Time: 9 – 10 a.m.Location: Penrose Health Learning Center Gym, 1644 Medical Center PointCost: $20/personRegistration required: 719-776-4780

SUPPORT GROUPSIntegrative Therapies for Cancer PatientsA weekly support group offering a wide range of complementary therapies for cancer patients and caregivers including reiki, easy Chair Yoga, Progres-sive relaxation, Guided imagery, managing insom-nia, Cognitive Behavior therapy, nutrition, humor, and Aromatherapy. Classes are open to all cancer survivors in the community regardless of where they have received cancer treatment.

Date: ThursdaysTime: 2 – 3 p.m.Location: Penrose Cancer Center, 2222 N. Nevada Ave.Information: 719-776-5311

WomenHeart Support Grouphave you been diagnosed with heart disease or suffered a heart attack? Are you at risk for heart problems? emPoWer your personal journey toward heart health by joining the Womenheart Support Group. Shared experiences can help you regain a sense of control, feel less alone, develop a positive life outlook and find the strength to commit to lifestyle changes. All ages are welcome!

Date: Third Friday every month – Oct. 21, Nov. 18 and Dec. 16Time: 11:30 a.m. – 1 p.m.Location: Penrose Hospital Volunteer Conference Room, 2222 N. Nevada Ave.Cost: FREE!Information: 719-200-2645

bIRThING CLASSESPreventing Premature BabiesBabies born before the 37th week or weighing less than 5 ½ pounds encounter serious health problems and may require intensive hospital care. recognize the signs of premature labor and take precautions to prevent premature birth. the ideal time to attend this class is from 18 to 35 weeks pregnant. this class is a must for all expectant couples!

Date: Single class offered Monday: Oct. 17, Nov. 21 or Dec. 12Time: 6:30 – 8 p.m.Location: St. Francis Medical Center, 6001 E. Woodmen RoadCost: FREE! (Fathers are encouraged to attend)Registration required: 719-571-3101, option 1

Additional classes in parenting, childbirth, breast-feeding, infant CPR and many others are offered through The Birth Center at St. Francis Medical Center. For a full list and calendar, please go to penrosestfrancis.org/birth.

Visit penrosestfrancis.org/wellness for a list of additional health and fitness classes.

calendar Fall

Back to Your Future: Survivorship Workshop for Women with Breast or GYN Cancersif you’re a survivor of breast or GYn cancer, join us for this four-week support group to rebuild a life of energy, excitement and enthusiasm—all in the company of other women sharing your journey. each session will feature a cancer expert along with fel-lowship and sharing. learn to:

• Plan your post-cancer care • Boost your self-esteem and sexuality • heighten your health with nutrition and supplements • Fight fatigue and escalate energy through exercise.

Date: 4-week program runs every Tuesday, Oct. 18 – Nov. 8Time: 6 – 7:30 p.m.Location: Julie Penrose Health Education and Resource Center (Northcare Building on the St. Francis Medical Center campus) 6071 E. Woodmen RoadCost: FREE!Registration required: 719-776-4541

FEATURED PROGRAM

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Date: Tuesday, November 15, 2011Time: 6-8 p.m. Refreshments will be served.Location: Julie Penrose Health Education and Research Center (Northcare Building on the St. Francis Medical Center campus) 6071 E. Woodmen RoadCost: FREEFor more information and to register, call 719-776-5052. A drawing for a free facial will be held at event—must be present to win.

Chelsea and Sherwood don’t have last names and they don’t get paychecks, but they are integral members of the rehabilita-tion team at Penrose Hospital. The two dogs, part of the hos-pital’s “rehab buddy” program, help retrain patients who have suffered from strokes, spinal cord injuries or brain injuries.

“It’s amazing to watch what patients can do when they are with the dogs and not thinking about what they can’t do,” says Lynette Olson, a physical therapy assistant. “You can have a stroke pa-tient who can’t speak suddenly say ‘sit’ to the dog.”

The dogs are used to help patients retrain their bodies. For example, a patient having a difficult time sitting may be placed on a mat and play tug-of-war with the dog. At other times, the dogs are used simply to lift the spirits of a patient.

“If we have a patient who is depressed, we’ll bring in the dog and we can get the patient to do things they wouldn’t do before,” Olson says.

HEART CARE at Penrose-St. Francis Health Services has received more quality awards and recognition than any other cardiac program in Colorado, including the Consumer Reports Top 50 Heart Bypass Surgery Program for 2010 and 2011. Penrose Cardiothoracic Surgery was one of only two groups of cardiothoracic surgeons in Colorado to receive the highest three-star grade by the rating agency.

Catholic Health Initiatives Colorado

You’re not getting older, you’re getting better. Join us for the latest program in our Conversations with Women series to hear why this statement is true in so many ways. Did you know, for instance, that healthy mitochondria can keep your muscles as lean as when you were in your 20s? (And if you don’t know what mitochondria are, we’ll tell you that, too.) Or the 10 things that your brain can do better as you age? Or how phytochemicals in pomegranates prevent wrinkles? Learn these secrets and more to staying young as you age!

Centura Health complies with the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973, and no person shall be excluded from participation in, be denied benefits of, or otherwise be subjected to discrimination in the provision of any care or service on the grounds of race, religion, color, sex, national origin, sexual preference, ancestry, age, familial status, disability or handicap.

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Pet Therapy

Pets bring a bounty of health benefits. According to the U.S. Centers for Disease Control, pets can help increase opportu-nities for exercise and socializa-tion while also decreasing:✓ Blood Pressure✓ Cholesterol Levels✓ Triglyceride Levels✓ Feelings of LonelinessSherwood, rehab buddy

at Penrose Hospital

health ConneCted

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