Summer 2014 | Volume 6, Issue 3

Jeanette Castillo, a breast cancer survivor, expresses hope and gratitude through her crochet art.

PHOTO BY ELLEN JASKOL

Emotional and spiritual care all part of the treatment plan at Parker Adventist Hospitals

Cancer Center.Page 4

HOPE

New cartilage for aching ankles

PAGE 3

Faster fix for fibroids

PAGE 7

Nasal steroids for childhood allergies

PAGE 2PLUS...

The Power of

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Ah-choo!IF A STUFFY NOSE, sneezing, watery eyes, or other symptoms of allergies or a sinus infection are making your child miserable, nasal steroids can bring relief. Nasal steroids reduce the swelling that causes these symptoms.

In spring 2014, Nasacort AQ became the first nasal steroid to be available without a prescription. The safety profile of nasal steroids is very good, says James Jaskunas, MD, a pediatric ear, nose, and throat surgeon at Parker Adventist Hospital.

However, limit dosages to what is recommended in the directions and avoid long-term use in children under 12. Studies show that long-term steroid use can effect growth in children ages 2 to 12. If the child still needs treatment after a few weeks of nasal steroids, contact an allergist or an ear, nose, and throat doctor,

he says. Also, dont use nasal steroids for colds.Unlike antihistamines, which work fast, nasal steroids take time. Some children feel better within hours, but most need

to use a nasal steroid for at least a week to feel the full benefits. Many parents dont give nasal steroids long enough to determine if theyre going to help their child or not, Jaskunas says.

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New over-the-counter nasal steroids may bring allergy relief to kids

NAME THAT SNIFFLEIn order to choose the right treatment, youve got to first know whats making your child sick. Here are some quick telltale signs: Watery or itchy eyes Allergies Stuffy or runny nose Allergies, sinus infection, or cold Fever Sinus infection or cold Headache Sinus infection Sneezing Allergies or cold Body aches, sore throat, and cough Cold Pressure behind the eyes and the cheeks Sinus infection

Stop the SnifflesLearn more about controlling your childs allergies, sinus infections, ear infections, and other common childhood ENT problems at a FREE seminar with Dr. Jaskunas on Sept. 4. See facing page for details.

The doctor is waiting at the new Southlands ERTHE AVERAGE WAITING TIME for a patient in the emergency room to see a doctor in Colorado is 18 minutes, according to ProPublica. However, patients, on average, actually spend more than two hours in the ER talking to various nurses and physicians before being diagnosed, treated, and sent home or admitted.Parker Adventist Hospital is using a new door-to-doctor model in its ER to improve patient flow and reduce this time. Under this model, the check-in process is streamlined and patients are quickly assigned to rooms where they tell their stories just once to a doctor and nurse. If the patient has a minor illness or injury, the necessary tests are obtained and the patient is taken to a comfortable lounge with refreshments to wait. Once the tests are completed, a nurse takes the patient to a private room to complete treatment.

Emergency departments that have implemented similar models reduced the amount of wait time from hours to minutes, says Paul Davidson, MD, medical director of the new Centura Health Southlands ER, opening this fall at the Southlands shopping center at E470 and Smoky Hill Road. Centura Health Southlands ER is part of Centura Health Neighborhoods, an initiative by Centura to provide more local, convenient, and affordable services within our communities. Southlands ER will be open around the clock every day of the year and feature a helipad, full-service on-site imaging, and all the capabilities currently available at the Parker Adventist Hospital ER. It will be staffed by board-certified emergency medicine physicians.

The Neighborhood Health Center at Southlands also includes the Centura Health Physician Group Southlands, which provides primary care and womens services. Additional services include mammography, rehabilitation, and imaging.

Centura Health Southlands ER opens Nov. 3 at 6159 S. Southlands Parkway in Aurora.

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September FREE health seminars

When to Worry About a Runny NoseThu, Sep 4 | 6:30-8 p.m.Dr. James Jaskunas, pediatric ENT, will discuss common causes of nasal congestion and runny noses in children and how to treat them, including home treatment, over-the-counter medications, and when it may be time to see a doctor.

Aching AnklesTue, Sep 9 | 6:30-8 p.m.Join podiatric surgeon Dr. Alan Ng to learn the causes and treatments of ankle pain from sprains that dont seem to heal to chronic arthritis.

Weight Loss SurgeryWed, Sep 10 | 6:30-8 p.m.Trying to finish the year in a healthier spot? Now may be the perfect time to consider weight loss surgery. Join bariatric surgeon Dr. Josh Long for a look at the pros and cons of various types of bariatric surgery and which is right for you.

Hope and Healing in CancerThu, Sep 11 | Noon-1:30 p.m.Join Dr. Anuj Peddada, radiation oncologist, and Carol Jeanotillo, Parker Cancer Center Hope Ambassador trainer, to learn about the latest advancements in cancer treatment and the role hope plays in health and healing.

Advances in Joint ReplacementTue, Sep 16 | Noon-1:30 p.m.Join Dr. Derek Johnson, orthopedic surgeon, to learn about computer-navigated knee replacement, patient-specific knee replacement, and minimally invasive anterior hip surgery.

Join Parker Adventist Hospital for a series of FREE health seminars. All seminars are held in the Parker Adventist Hospital Conference Center, located on the Garden Level at the west entrance. A light lunch is served during daytime programs, and light snacks are served during evening programs. Registration is required for all seminars by calling 303-777-6877, option 1.

Stop the AcheLearn the causes behind ankle pain and the newest treatments from cartilage replacement to joint replacement at a FREE seminar with Dr. Ng on Sept. 9.

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RACING AHEADNew procedure regrows damaged ankle cartilage

WHEN KRISS DELLOTA MADE IT OUT OF THE ICU in 2004 after being hit by a car while cycling, he thought the coast was clear to go back to competing in Ironman triathlons.

But soon after, the 49-year-old Wellington emergency room doctor started having trouble with his ankle. At first, it started swelling but then began to lock up and wouldnt bear weight. The pain was so great that he was forced to retire from his intense training.

Dellota had suffered an osteochondral defect, most likely during his biking accident. This condition is created when a portion of the cartilage in the ankle joint is damaged, typically through trauma. It occurs in up to 10 percent of all ankle sprains and fractures.

Dellota wasnt ready to scrap his triathlon career, so he began researching treatments for the problem and discovered a new procedure that

replaces the damaged cartilage with juvenile cadaver cartilage. Turns out, a podiatric surgeon in Parker, Alan Ng, DPM, was not only performing the procedure but had helped pioneer it.

The new procedure is called arthroscopic cartilage implantation. Working arthroscopically through two small holes in the ankle, surgeons remove the damaged cartilage and insert the cadaver cartilage, which spurs the body to regrow new cartilage. The ideal candidate is under the age of 55 because the body still has the ability to regrow cartilage.

This is not a treatment for osteoarthritis where the cartilage gets worn down over time, says Ng, the podiatrist at Parker Adventist Hospital who performed Dellotas surgery. But it works very well in younger patients.

Patients can have the surgery and return home the same day, gradually regaining use of the ankle over four to eight months. Dellotas competitive nature had him back at full-intensity workouts within three months and competing in the Ironman Coeur dAlene in Idaho less than a year after his surgery. He even managed to shave 30 minutes off his best time.

I would have never been able to compete again without that surgery, he says.

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Raising Hope

HOPE doesnt cure cancer, but it can help support patients through treatment that can cure them. Hope can improve a patients quality of life, increase their coping skills, help them achieve goals, and bring them peace of mind.

While many people might believe hope is an intangible element that cant be measured, researchers have found otherwise. Beginning in the 1980s, researchers began measuring hope and its effect on outcomes in cancer patients. The results were not surprising to anyone who has gone through a cancer diagnosis or helped someone through cancer.

There is clear evidence that people who express hope do better, says Connie Wood,

director of oncology at the Cancer Center at Parker Adventist Hospital. Hope is a powerful tool, and I believe we can help create it for our patients.

The hospitals new radiation therapy center, part of a comprehensive cancer program, incorporates the concept of hope. A sculpture of a tree greets patients as they come through the front door. The tree, which is repeated in the hallway outside the linear accelerator room, is filled with more than 25 symbols that represent hope. Many of these symbols are repeated

throughout the center, along with quotes about hope and artwork either created by or inspired by cancer patients.

But the program is much deeper than inspirational artwork. Here, every caregiver from doctors and nurses to radiation technologists has completed specialized training in how to help foster and support hope in their patients. These Hope Ambassadors learn that hope can hinge on things even as small as a turn of a phrase.

We teach the staff how to reprogram their language, Wood says. Instead of saying if you get better, they learn to say when you get better.

Wood says this training is not meant to foster false hope. In fact, honesty is one factor shown to help support hope in cancer patients. Even if there is only a 12 percent chance of surviving, who are we to know whether this patient will be part of that 12 percent? Wood says. But Wood emphasizes that patients hope for many things, not just a cure for their cancer. They may hope to feel better that day or hope that their family will be OK.

Jeanette Castillo, of Parker, experienced the power of hope firsthand. Diagnosed last year at age 70 with breast cancer, Castillo at first refused to go through chemotherapy then later didnt want to face radiation therapy.

Caregivers at the Cancer Center at Parker Adventist

Hospital are trained in incorporating hope into cancer treatment. Jeanette Castillo, center, credits this hope for propelling her through treatment.

In gratitude, she crocheted hats and scarves for her team, including

(from left to right): Amy Horner, radiation oncology manager;

Katie Theiss, radiation therapist; Dr. Anuj Peddada, radiation oncologist;

and Deidre Hudson, radiation therapist

New program at Parker Adventist Hospitals Cancer Center incorporates hope into healing

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The radiation oncologist at Parker Adventist Hospitals Cancer Center talked with Castillo about her fears. He showed me research dating back to the 1950s on his computer, she says. He provided me with so much education that it gave me hope.

PROVIDING STRENGTH TO FACE TREATMENTAnuj Peddada, MD, a radiation oncologist at the Cancer Center at Parker Adventist Hospital, feels hope both on the part of the patient and the caregivers is essential to obtain the best outcomes possible.

Hope comes into play when our circumstances are dire, things are not going well, and there is considerable uncertainty about how things will turn out for the future, Peddada says. Having hope will remove the blinders of fear and despair and allow us to become more creative to find a solution. Patients who are more hopeful tend to be much more compliant with their treatment plans.

Parker Adventist Hospitals radiation oncology center opened in late 2013. It is equipped with a Varian TrueBeam linear accelerator, one of the most sophisticated radiation therapy machines available. The TrueBeam can deliver high-intensity radiation to cancer tumors while minimizing any radiation to healthy areas. Although newly opened, the center is staffed by nurses, physicians, and technologists who each have years of experience in the field of radiation oncology.

We can provide state-of-the-art radiation therapy and robust clinical trials. The level of care we provide is comparable with any care provided in our region, including that found in university settings, Peddada says.

INTEGRATING HOPE IMPROVES OUTCOMESBecause technology has improved so much, high-quality radiation therapy is widely available, Peddada says. What differentiates care at Parker Adventist Hospital is closeness to home, flexible scheduling, minimal wait time, patient navigators who guide patients through every step of care, and elements such as the Hope Program that allow the center to serve patients much better while reducing their stress and anxiety for both patients and their families.

Medical research studies have examined the role of hope in cancer treatment and outcomes. Some findings include: Hope provides adaptive power to help patients get through difficult

situations and achieve desired goals. (Oncology Nursing Forum, 2002) Hope is probably the single most important element in the lives of

cancer patients and their families. (Cancer Nursing, 1986) Nurses have great influence on patients and families concepts

of hope. (Cancer Nursing, 1986) Hope is one of a patients five greatest needs. (Oncology Nursing

Forum, 1982) Hope is important to a meaningful life and dignified death for patients

suffering from incurable cancer. (Palliative Medicine, 2001)

Building HopeFEELINGS THAT INCREASE HOPE:Knowledge :: Sense of control :: Listened to :: Connectedness :: Possibilities

FEELINGS THAT DECREASE HOPE:Uninformed :: Isolated :: Ignored :: Focus on cure :: Predictions

Source: Carol Jeanotilla, instructor of Parker Adventist Hospital Hope Ambassador Program

The program is cutting-edge, Peddada says. People have always thought that the effect of hope was not really proven, but there is evolving data that individuals who are hopeful have stronger immune systems and better overall health. There is more and more integration of these nontraditional treatments in cancer care, and Parker is at the forefront.

Castillo credits her family, her faith, and the support she got from her medical team for helping her choose to go forward with treatment.

Once I accepted (the cancer diagnosis), I had a lot of hope, she says. Hope is such a passionate feeling. You think everything is possible. I believe in hope and know that is what kept me going through the most difficult times.

Learn to build hopeJoin Dr. Anuj Peddada at a FREE community luncheon as he discusses the latest advancements in cancer treatments. Then Carol Jeanotillo, Parker Cancer Centers Hope Ambassador trainer, will discuss more about the role hope plays in health and healing. The luncheon will be held on Thursday, Sept. 11, at Parker Adventist Hospital. See full details on Page 3.

Having hope will remove the blin

ders of fear and despair and allow us to become more creative to f nd a solution.

vidence of Hope

The Cancer Center at Parker Adventist Hospital is accredited by the Commission on Cancer. It is part of the Centura Health Cancer Network, delivering integrated, advanced cancer care across Colorado and western Kansas.

...Th ere is evolving data that ind

ividuals who are hopeful have stronger immune systems and better overall health.

~Anuj Peddada, MD

6 Summer 2014 grow

From food to fitnessWomens Health & Wellness Expo offers the latest in health info

As women, our lives are so busy that we hardly have time to make a doctors appointment, much less learn everything we need to stay on top of our health.

Centura Health is here to offer some relief. Join us for four hours and find out the latest in skin care, memory loss, stress reduction, heart health, breast health, and much more. At the second annual Womens Health & Wellness Expo, women will get all the latest health news through keynote speakers, discussion groups, and an interactive vendor fair. Youll also be able to sneak in a workout, get free recipes from the nations top hospital chef, and much more.

This year, we have added more options so that there is something for everyone, says Marti Steger, community outreach coordinator at Porter Adventist Hospital. Porter Adventist Hospital, Castle Rock Adventist Hospital, Parker Adventist Hospital, and Littleton Adventist Hospital are presenters at the Womens Health & Wellness Expo.

Other hot topics to be covered at the expo include the role of inflammation in womens health and how to reduce your risk, as well as loads of nutrition information from the latest on gluten intolerance to the best new supplements. The half-day expo is free.

Centura Health is a network of care that is here to help women not just when they are ill but also in their efforts to stay healthy, Steger says. We want to partner with women through every stage of life.

Balance Your

HEALTH

Womens Health & Wellness ExpoDate: Friday, Oct. 3Time: 8 a.m.-noon

Location: Parker Arts, Culture and Events Center (PACE), 20000 Pikes Peak

Avenue, Parker, CO 80138 Cost: FREE

Info and Registration: southdenverhealth.org/womens-expo

Supplements are all the rage, but just because you can purchase most everything over the counter does not mean that you should. Theres no way to tell what supplements you may need without considering your age, diet, lifestyle, and how well you are absorbing minerals and vitamins, which can only be understood with a proper blood test and exam, says Susan Buckley, RDN, CDE, a member of the health and nutrition team at South Denver Cardiology. Buckley recommends considering these three things when it comes to supplements:

You should discuss all supplements with your doctor or pharmacist to avoid medication interactions.

Start with fruits and vegetables

Fruits and vegetables contain dozens of compounds, while

supplements may focus on only one or two. Aim for five to 10

servings of fruits and vegetables a day. Remember, serving sizes may be smaller than you think (1/2 cup of cooked broccoli or

carrots; 1 cup of lettuce).

Consider drug interactionsCertain medications interfere

with the absorption of vitamins and minerals. For instance, vitamin B12, which helps

prevent anemia and keeps nerve and blood cells healthy, is hindered by proton pump inhibitors. Coenzyme Q10,

which works as an antioxidant and produces energy for cell growth, is depleted with the use of cholesterol-lowering

medications (statins).

Embrace probioticsProbiotics are good bacteria

that promote a healthy digestive system. Found in foods like yogurt, miso soup, and kefir,

many people need a higher dose of probiotics than foods alone can provide. Antibiotics

kill natural probiotics. Roughly 70 percent of our immune

system is in the gut, so if we lack enough good bacteria, we are more susceptible to disease,

Buckley says.

BEFORE YOUpop pills Three things all women need to know about supplements

FRUITS AND VEGGIES TO GO! Put serving sizes of veggies and fruits in containers that you can grab for a snack, take to work, etc. Part of eating healthy is making it convenient, Buckley says.

LEARN MORE about supplements at the Womens Health & Wellness Expo presented by Centura Health

on Oct. 3!

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Freedom From FibroidsRobotic hysterectomy simplifies surgery and recovery

Lorelie Cajigas, a 43-year-old mother of five from Aurora, found out she had a uterine fibroid during a routine ultrasound while she was pregnant with her youngest child.

As many as three out of four women will have these noncancerous growths that develop from uterine muscle tissue, although many of these cases will cause no symptoms. Women who are affected may have:

> Painful, heavy periods> Abdominal pressure> Increased urinary frequency and urgency

Time to Treat?An IUD kept her periods light, but after a few years, Cajigas found the fibroid had continued to grow so that she could feel the bulge in her uterus.

I knew I was done having kids, and I figured a hysterectomy would be the best option for me for quality of life, she says.

Treatment options are available for women who want to preserve their fertility. However, fibroids can

grow back after taking medication to shrink them or having them surgically removed.

Hysterectomy is the ultimate option, because a woman wont have fibroids again, says Michael Gavigan, MD, obstetrician and gynecologist at Parker Adventist Hospital.

Shorter Surgical RecoveryNonetheless, as a busy mom who volunteers with her church and PTO, Cajigas had concerns about having surgery. Where do you squeeze that in? she says.

Women who watched their mothers take two or three months to recover from a hysterectomy may not realize how different minimally invasive surgery can be, Gavigan says.

After a robotic hysterectomy, most women go home from the hospital after one night or even the same day and are back to most normal activities with limited restrictions in two weeks.

Its a relief knowing that something is not continually growing inside me that I dont want there, Cajigas says.

Dr. Michael Gavigan

Lorelie Cajigas was back in the fast lane after having a robotic hysterectomy.

Dont wait for relief!

3.6 YEARSThe average time women wait to treat fibroids

Less invasive surgery for more womenWhen surgeons operate with a robotic surgical system, more women are candidates for minimally invasive hysterectomies. Robotic surgery offers a greater ability to operate in a limited environment, Gavigan explains.

Benefits to women include:> Less postoperative pain> Less blood loss> Smaller incisions> Shorter hospital stayIn patients with extremely large fibroids or who

have a high BMI, an open surgery may be more appropriate. But many women, even with large fibroids or abdominal scar tissue, can have laparoscopic surgery because of the excellent visualization and nimble instruments of the robotic platform.

Ruling out uterine cancerFibroids are almost always benign less than 1 percent are cancerous. And having fibroids doesnt increase your risk of uterine cancer.

But abnormal bleeding can be a red flag for uterine cancer, Gavigan says, and should always be evaluated. An endometrial biopsy can reveal uterine cancer instead of or in addition to fibroids.

The five-year survival rate for uterine cancer if its caught early is 95 percent.

Learn more at a FREE seminarIf you suffer from pelvic pain, heavy bleeding, or have been diagnosed with uterine fibroids, join Dr. Gavigan for a FREE seminar on Oct. 7. See back cover for details.

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PAIDDenver, CO

Permit No. 47739395 Crown Crest Blvd. Parker, CO 80138

Portercare Adventist Health System

October FREE health

seminarsBecome more body-wise with the experts at Parker Adventist Hospital. All seminars are FREE but require registration by calling 303-777-6877, option 1. Seminars are held in the Parker Adventist Hospital Conference Center at the west entrance. A light lunch is served during noon seminars, and light snacks are served during evening programs.

Pelvic PainTue, Oct 7 | Noon-1:30 p.m.Dont suffer in silence. Learn the latest news about causes and treatment for pelvic pain, abnormal bleeding, and fibroids with OB/GYN Dr. Michael Gavigan.

Weight Loss SurgeryWed, Oct 8 | 6:30-8 p.m.Tired of taking medicine for high blood pressure, diabetes, and joint pain? The solution could be weight loss surgery. Join bariatric surgeon Dr. Josh Long to hear the latest research on the positive impact of bariatric surgery on obesity-related health conditions.

Ending Back PainTue, Oct 14 | 6:30-8 p.m.Join Dr. Zak Ibrahim, orthopedic spine surgeon, to learn about treatment options for low back pain, including minimally invasive surgery, and how to know when its the right time for surgery.

Pain in the NeckTue, Oct 21 | Noon-1:30 p.m.Join orthopedic spine surgeon Dr. Scott Stanley to understand the most common problems causing neck pain and the best proven nonsurgical and surgical treatments.

Shoulder Repair and ReplacementThu, Oct 23 | 6:30-8 p.m.If youve been suffering from severe shoulder pain due to an injury or arthritis, join orthopedic surgeon Dr. Micah Worrell to learn the latest treatment options from rehab to minimally invasive surgery.

9395 Crown Crest Blvd., Parker, CO 80138grow is published quarterly by Parker Adventist Hospital as part of our mission to nurture the health of the people in our community. To comment or unsubscribe, please email grow2@centura.org. grow is produced by Clementine LLC. of Littleton, Colo.

Executive Editor: Rachel Robinson

New lung cancer screening availableSurvival rates soar with early detection

LUNG CANCER IS THE DEADLIEST OF ALL CANCERS, but a new screening has increased survival rates dramatically. Low-dose CTs increase five-year survival

rates to as much as 80 percent in high-risk candidates, as compared to just 15 percent when the cancer is detected later, says Lawrence Emmons, MD, a radiologist at Parker Adventist Hospital.

Patients who received low-dose CTs had 20 percent less risk of death than those screened with chest X-rays in the National Lung Screening Trial, which

tested CT vs. X-ray in 55,000 high-risk patients, Emmons says. Because of these results, low-dose CT is now being offered publicly to people at high risk of developing cancer.

To qualify for the low-dose CT, a person must be: Between the ages of 55 and 74 A current or past smoker

To see a full list of screening requirements, please go to parkerhospital.org/lungscreening. If you dont meet these qualifications, talk with your doctor about a referral for the screening.

$199 SCREENINGBecause many insurance plans do not yet cover this screening, Parker Adventist Hospital is offering it for $199 (normally $499). A physician referral is not required. For more information, call 303-269-4500.

Part of Centura Health, the regions leading health care network.Centura Health does not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, and marital status in admission, treatment, or participation in its programs, services and activities, or in employment. For further information about this policy contact Centura Healths Office of the General Counsel at 303-804-8166. Copyright Centura Health, 2014.

80%fve-year survival rate if lung cancer isdetected early

Dr. Lawrence Emmons