Create Celebratingyour health

Solving

EpilEpsy MySterieS

FastEr FErtilityiS a few tipS away

relieving pain with GEntlE touch

Celebratingyour health

Your health. Your life. Spring 2013

volume 1 | issue 2

Life’s A BALLnew anterior hip Surgery

putS patientS back in the gaMe faSter

Lee Yeingst of Aurora recently had a new type of hip replacement surgery. Read more on Page 4.

Tai chi significantly improved exercise

capacity and quality of life in patients

with COPD, a lung disease common

in many smokers, according to a study

in the European Respiratory Journal.

in goodhealth

Spring into actionWith the weather growing warmer, it’s time to get moving. We’ve long known that exercise decreases the risk for cancer, heart disease, and other illnesses. But did you know that you don’t have to be breathless and sore to reap the rewards? Research has found that gentle activity, such as gardening and walking your dog, can offer just as much benefit as vigorous exercise if done regularly. exercise is the fourth guiding principle of the CReATiON Health Lifestyle, an Adventist wellness program that is supported by medical research. To learn more, go to creationhealth.com.

loVinG touch BaBy on Board

2 | Spring 2013 • create

Babies born at Littleton Adventist Hospital are welcomed into the world with a special gift — a

tiny cap hand-knit and blessed by a group of two dozen volunteers. These volunteers knit the supersoft caps in colors to match the season,

while putting their love into each one. Nearly

500 hats are knit each year, in addition to prayer shawls and handsewn dolls

and pillows that are given to children in the

emergency room. “Moms love the caps and keep them in memory boxes forever,” says Catherine Bartley, manager of volunteer services.

If you’re trying to get pregnant and getting frustrated, you may think it’s time to see a fertility specialist. Not so fast. Your obstetrician should be your first stop. “Many couples think that if they don’t get pregnant right away that they’ve got fertility problems,”

says Kelly Lennon, MD, an OB/GYN at Littleton Adventist Hospital. “sometimes it just takes a few little changes and some patience.” indeed, 80 percent of couples will conceive within one year. Your obstetrician can tell you how to increase your odds and what’s getting in the way. for instance, most commercially sold lubricants inhibit motility of sperm or kill the sperm. Natural lubricants, such as canola oil, don’t have the same effect, Lennon says. Here are a few common mistakes couples make:• Having sex every day. This can increase stress, and every other day is just as effective.• Putting off sex. Sperm lose their motility after five days.• Smoking. It doesn’t matter if it’s the woman or man, smoking decreases fertility.

National Volunteer MonthLittleton Hospital honors and thanks our 350

volunteers. If you are interested in volunteering, go online to mylittletonhospital.org/volunteer.

Littleton Adventist Hospital brings specialized care to the people of South Denver in the complex areas of trauma, cancer, neurology, cardiology, orthopedics, women’s services, and more. We are part of Centura Health, the state’s largest health care network. The purpose of this publication is to support our mission to improve the health of the residents of our community. No information in this publication is meant as a recommendation or as a substitution for your physician’s advice. If you would like to comment or unsubscribe to this magazine, please email create@centura.org.

7700 S. BroadwayLittleton, CO 80122

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kelly lennon, Md

dolls and hats shown above were handmade by littleton hospital volunteers.

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a storm in the brainFindinG nEw ways to calm EpilEpsy

Men’s health: prostate cancer

If you live with epilepsy, everyday activities like driving to work or grocery shopping can pose a hazard. fortunately antiseizure medications quell the brain’s sudden outbursts of electrical activity in about two-thirds of patients. But for the other third, a seizure can strike at any moment. Littleton Adventist Hospital is opening a new epilepsy Monitoring Unit (eMU) that can help these patients find answers to questions such as: Which medication or combination of medications is most effective in controlling my seizures? Would surgery help? Do i actually suffer from epilepsy, or from a condition whose symptoms look like seizures? The Littleton Hospital eMU will employ sophisticated technology, including electro-encephalograms to measure the brain’s electrical activity. it will be the state’s only unit with high-definition video capabilities. Patients admitted to the EMU are monitored around the clock as seizure medications are reduced. The eMU is located inside Littleton Hospital’s intensive care

unit to provide maximum patient safety. Care is provided by a team of nurses, epileptologists, and neurosurgeons with specialized training in epilepsy. Who’s a candidate?Patients 17 and older with seizures or spells that may be seizures are candidates for Littleton Hospital’s eMU, according to Richard Clemmons, MD, medical director of epilepsy and a board-certified epileptologist. Up to 88 percent of EMU visits result in a definitive diagnosis, resulting in the discovery of better treatment options for up to 80 percent of patients, Clemmons says.

create | mylittletonhospital.org | 3

Stats: sixteen percent of men will be diagnosed with prostate cancer, usually after age 60. it’s the second most common cause of cancer death in men.

PSA screening: The U.S. Preventive Services Task force recommends against testing because PSA levels can be elevated by other diseases and because not all prostate cancers need to be treated. However, the American Urological Association is in favor of testing as the most effective way to find prostate cancer at its earliest stage. All men should talk with their doctors about testing.

Treatment: Radiation or surgery to remove the prostate. eighty percent of surgeries are performed robotically, which can decrease the side effects of incontinence and erectile dysfunction. “Robotic surgery is ideally suited for the treatment of prostate cancer. Our patients spend less time in the hospital and are back to normal activity in a much shorter time than conventional open surgery,” says James fagelson, MD, a urologist who performs robotic surgery at Littleton Adventist Hospital using the da Vinci® surgical system.

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A neurologist or primary care physician can refer patients to the emU. For more information, call the Littleton Hospital neuroscience nurse practitioner

at 303-734-8737.

A normal prostate is about the size of a walnut. Age or disease causes the prostate to enlarge.

richard clemmons, Md

offerS faster recovery and less pain

New anterior hip replaceMent

lee yeingst and grandchildren Jimmy (l) and Maddy (r)

lee yeingst is an optimistic man. But he couldn’t believe the speed at which his pain was gone and he was back playing with his grandkids after undergoing a new type of hip replacement surgery.

“Two weeks after surgery, I had a cane, but I didn’t need it,” says Yeingst, 80, a retired Colorado Symphony viola player. “Before surgery, even standing more than 10 minutes was too much. Now I can stand with the best of them and keep up with my grandkids.”

4 | Spring 2013 • create

Kick Lifeoutof

get a

CLASS ACTJoiNT CLASS iMproVeS ouTCoMeS

A little information goes a long way when it comes to surgery. People who receive patient education prior to surgery have shorter hospital stays, take less pain medication, and have less anxiety along with better outcomes and satisfaction, according to numerous studies. “When people know what to expect, they can be more engaged in their care,” says Leisa Knotts, PTA, physical medicine coordinator for the preoperative joint replacement classes at Littleton Adventist Hospital.

Littleton Hospital’s joint replacement preparation classes cover:• Whattoexpectinthehospitalandthe rolesofthevariouscaregivers• Howyoucanhelpimproveyour outcomesthroughactivity,nutrition, hydration,andpainmanagement• Howtoprepareyourhomeand continueyourrecoveryafteryouleave thehospital

And classes are not just for patients. Caregivers learn how to play an important role in successful recovery as well. “family members serve as cheerleaders to help the patient eat and participate in rehabilitation,” Knotts says. Patients who are scheduled for surgery are encouraged to take this class at least two weeks prior to surgery.

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the New aNterior hip replacemeNt surgery at a glaNce:

aftersurgery

to walking with a walker or cane

to unrestrictedactivity

0restrictions

2weeks

6weeks

create | mylittletonhospital.org | 5

Learn MoreJoin Dr. Thomas at a FREE seminar on April 30 to learn more about hip replacement surgery

and the new anterior approach that will get you back on the road to a full life quicker than ever!

See Page 7 for details and registration.

Yeingst had his left hip replaced in early December at Littleton Adventist Hospital. His surgeon, Robert Thomas, MD, offered to perform the surgery using a new procedure called

anterior hip replacement. This new method allows surgeons to replace the joint through the front of the hip rather than through the buttocks. surgeons then are able to move muscles and tendons instead of cutting through them. The result is that patients do not have any restrictions following surgery and immediate recovery is faster, with long-term results equal to posterior hip replacement. “The first comment most patients make is, ‘Why did i wait so long?’ because the pain relief and the speed of recovery are really remarkable,” says Thomas, an orthopedic surgeon with Littleton-based Center for Orthopedics.

No restrictions On average, patients who have hip replacement surgery are able to resume normal activity within three months, whether they have the procedure done through the new anterior approach or the traditional posterior approach. The difference with the anterior approach is the immediate benefits. With the traditional approach, patients are restricted from bending over more than 90 degrees or crossing their legs. sitting also can be uncomfortable until the cut muscles and tendons heal. With the anterior approach, patients have

no restrictions. Most also experience less pain and a faster initial recovery than patients who have the posterior approach. “Patients are in the hospital for two or three days, and using a walker or cane for about two weeks,” Thomas says. “By six weeks after surgery, most are satisfied and don’t give it another thought.”

Good CandidatesThat was certainly the case for Yeingst. Over the past two years, pain in his back and knees had grown increasingly worse to the point where he could no longer walk very far. for most of that time, he thought the pain was due to trouble with his knees or back. in fact, hip arthritis often is misdiagnosed initially

because it can appear as pain in the back, groin, or knee. By the time

his family physician referred him to Thomas, his hip had lost all cartilage, leaving bone rubbing against bone. He quickly opted for the anterior approach. “i had spoken to a friend

of a friend who had anterior done two months before my surgery,

and he was planning to ski this season,” Yeingst says. “i also talked to a friend who knew someone younger than me who had the regular surgery, and he was still using a walker two months after his surgery. Common sense told me to choose this new surgery.” Most patients are candidates for the anterior approach. The only patients who may require the traditional posterior approach are patients who have hip deformities or have had previous hip surgery. People who are especially muscular or very overweight may also do better with the posterior approach, Thomas says.

“the first comment most patients make is, ‘why did i wait so

long?’ because the pain relief and the speed

of recovery are really remarkable.”

robert thomas, Md

6 | Spring 2013 • create

Learn MoreLearn about the benefits of DBS and the new “asleep” DBS at a

FREE seminar with Dr. vanSickle on may 30.

Details on Page 7.

A new approach for deep brain stimulation (DBs) available at Littleton Adventist Hospital reduces the number of surgeries and allows patients to now be asleep. Using a new type of portable CT machine called the CereTom®, surgeons obtain precise images of the brain during the surgery. Prior to this, the procedure required separate surgeries to place markers in the head, implant the generator, and connect the batteries. The new procedure eliminates the first surgery and the need for patient feedback, allowing patients to be asleep

during surgery. “Having to be awake was very stressful and uncomfortable for patients,” says David Vansickle, MD, PhD, the neurosurgeon performing this new procedure at Littleton Hospital. “The CereTom also enables us to improve the precision of lead placement. This reduces the risk of damage to nearby healthy areas and

cuts operating time in half.” DBS is used for patients with Parkinson’s disease, essential tremor, or dystonia. it involves implanting an electrode in the brain that short-circuits the electrical signals that cause symptoms. it is powered by a small battery pack implanted below the armpit.

Fine-tuned Adjustments DBs works much like a pacemaker for the heart, only it provides a mild shock to a very tiny part of the brain causing tremors. For DBS to work effectively, it must be finely tuned and coordinated with a patient’s medications. Typically, that work is done by a neurologist at outpatient appointments that can take weeks or even months to secure. DBs patients at Littleton Hospital, however, receive this treatment before going home through the Center for Rehabilitation at Porter Adventist Hospital. After the surgery, patients are transferred to this inpatient unit, staying an average of five to seven days while the generator is being adjusted by Mihaela Alexander, MD, an on-staff neurologist. Porter, Littleton, and Parker Adventist Hospitals are Centura Health hospitals serving DBs patients throughout Colorado and the Rocky Mountain region. “You might expect that everything becomes normal after the implant, but the reality is that you don’t just flip a switch,” says Gin-Ming Hsu, MD, a physiatrist and medical director of the unit. “Programming is typically done in stages. if this were done as an outpatient, it might take weeks, but we can usually complete it in days.”

Nearly Symptom-freeOne patient recently had 95 percent of her symptoms disappear immediately after the surgery. But within a few days, some of her symptoms had returned, so the generator was adjusted along with her medications and she was able to go home nearly symptom-free, Hsu says. “Had she not been here, it probably would have taken several months to get through the process that took us 10 days,” he says. Littleton Hospital will be opening a similar inpatient rehabilitation unit this summer.

New procedure makes deep brain stimulation easier for Parkinson’s patientsLiTTLeToN HoSpiTAL FirST iN STATe To oFFer “ASLeep” DBS

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david vanSickle,Md, phd

SPRING 2013 Freehealthtipsandseminars

childBirth Education Preparing for childbirth, managing postpartum depression, or trying to introduce your pet to the new family member? The BirthPlace at Littleton Adventist Hospital offers a variety of classes to help prepare you and your family for a new baby. for a complete list of classes, go to mylittletonhospital.org/birth-classes. Most classes are Free or have a nominal fee. To register, call 303-777-6877.

create | mylittletonhospital.org | 7

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Do you sometimes feel like you’re bound up by your own skin? That might actually be the case, says Kelli Glaser, DO, a family physician with Chatfield Family Medicine. Fascia is fibrous tissue that connects bones, muscles, and organs in the body. “it’s like a net or a spiderweb throughout the body and can become tight or twisted and cause problems,” Glaser explains. The fascia, for example, can get wound around the kidney and contribute to high blood pressure. Relieving that with light pressure can result in a 10-point drop in blood pressure, Glaser says.

Glaser is a doctor of osteopathy, or DO. DOs go through the same training as medical doctors (MDs) and are tested and certified often by the same professional medical boards. Doctors of osteopathy, however, receive extra training to learn a technique called osteopathic manipulative treatment, or OMT. “OMT utilizes the physicians’ sense of touch to alleviate structural issues that might be causing problems,” Glaser says. “it can be gentle and feel like the physician is barely touching an area to more active therapies that involve using the muscles to get a structure realigned or moving correctly.” Common ailments that occur due to structural problems include back pain caused by a twisted vertebrae or pelvis, and chest pain that might be caused by a dislocated rib. Other conditions traditionally treated with medications, like pneumonia, can benefit from adding OMT techniques that can loosen up mucus in the chest and help patients heal faster.

BoDy STruCTure AND HeALTH

Learn MoreAt a FREE community seminar

with Dr. glaser, who will be performing demonstrations.

Date | may 23 Time | 6-7 p.m.

Location | Littleton Hospital, Conference room 1

Register | 303-777-6877, option 1

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calminG thE trEmors oF parkinson’s Littleton Adventist Hospital is one of only five hospitals in the U.s. offering a new two-step procedure for deep brain stimulation that allows patients to remain asleep during the surgery. (See Page 6.) Join Dr. David Vansickle, neurosurgeon, at this Free seminar to understand this new surgery and why even young Parkinson’s patients should consider surgery sooner rather than later.

date | May 30time | 6-7 p.m.location | Littleton Hospital, Conference Room 3register | 303-777-6877, option 1

- coupon -

morninG spEcial For Early risErsSchedule your mammogram between 7 and 9 a.m. during the months of May, June, and July and receive a gift card good for a FrEE coffee beverage. Our experienced mammography team will have you in and out in 30 minutes. Our breast center is conveniently located at Littleton Hospital one mile north of C-470 on Broadway. Call 303-738-2767 today to schedule your appointment and don’t forget to say you saw the Early Riser coupon in Create.

*Needhelprequestingfilmsfromapreviousmedicaloffice?We’rehappytohelp.Justgiveusacall.

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FastEr rEcoVEry with nEw antErior hip rEplacEmEnt surGEryLearn about the new anterior approach to hip replacement surgery that results in less pain, no restrictions, and faster recovery. Dr. Robert Thomas, orthopedic surgeon, will talk about the new technique, pain control, and when it’s the right time for joint surgery.

date | Apr 30time | 6-7 p.m.location | Littleton Hospital, Conference Room 1register | 303-777-6877, option 1

NoN-PRofIT oRgUS PoSTAgE

PAIDDENvER, Co

PERmIT No. 4773

porterCare Adventist Health System

7700 S. BroadwayLittleton, Co 80122

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. Copyright © Centura Health, 2013.

National Cancer Survivor DayIf you are a cancer patient, cancer survivor, friend or family member, or cancer medical caregiver — regardless

of where you received your treatment or where you work — you are invited to a celebration in your honor.

“This day is a celebration of life,” says kelley kovar, rN, mSN, Littleton Adventist Hospital’s oncology services manager. “It’s for patients and their families, but also for caregivers. It is so cool for us to see someone who

you’ve treated. It really rejuvenates you as a caregiver.”

Date | Jun 2 Time | 10:30 a.m.-1 p.m. Location | Littleton Hospital Activities | Lunch, live music, art activities, keynote speaker

registration is not required. Attendance is open to anyone in the community who has survived cancer or supported someone with cancer.

For more information, go to mylittletonhospital.org/survivor.

celebrating SurvivorshipSupport helps cancer survivors adjust to the new normal

he cancer journey can be difficult, and it doesn’t stop when a person finishes treatment. Indeed, cancer patients can suffer from a variety of problems from fatigue to physical pain for years or even a lifetime. “Your life changes forever if you’ve had cancer,” says Kelley Kovar, RN, MsN, manager of

oncology services at Littleton Adventist Hospital. “it’s different for everyone, depending on what type of cancer they had and their treatment. some may have physical changes that last the rest of their lives, and everyone experiences emotional changes.” If you have trouble sleeping or fight fatigue, for example, it’s important to know that you’re not alone. One study found that two-thirds of cancer survivors had trouble sleeping even two years after treatment. Another study found that up to 30 percent of breast cancer survivors suffer from persistent fatigue. “it’s very individual,” Kovar says. “Whatever you’re feeling is normal.” To help cancer patients transition after treatment, Littleton Hospital offers support groups, counseling, and this year the hospital will hold its first annual National Cancer Survivor Day celebration (see box). “This is a day to celebrate their journey and what they’ve gone through and what they’re still going through, and it includes patients in active treatment to 30-year survivors and beyond,” Kovar says. “Gathering together provides huge support and hope.”

CoMMoN SiDe eFFeCTS oF SurViViNG

CANCer:

Fatigue

infections

memory loss and attention deficits

relationship problems

heart disease

infertility

sexual dysfunction

depression or anxiety

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