Winter 2013 | Volume 5, Issue 1

Weight-loss surgery improves fertility.

page 6

When is back pain not back pain?

page 7

Express mammograms for busy women.

page 2pLUS...

SUrgery Robotic surgery arrives at Parker Hospital Michael Gavigan, MD,

medical director of Parker Hospital’s robotics program

evoLUtion

Photo by EllEn Jaskol

Cancel out colon cancerIf you coulD PrEvEnt a deadly type of cancer with a half-day procedure once every five to 10 years after age 50, would you?

Apparently, only two in three Americans are willing to do so. That’s the number of Americans ages 50-75 who are current with their colon screenings, according

to a recent study by the Centers for Disease

Control and Prevention.

“It’s really an eye-opener to know that despite everything we’re doing, we’re not doing

enough to get Americans to take action,” says Jehad Barakat, MD, a gastroenterologist at Parker Adventist Hospital. “Colon cancer

is unique in that it’s preventable, and we can save lives by doing colonoscopies.”

The majority of colon cancers develop from polyps, abnormal growth of tissue out of the colon wall. About 15 to 20 percent of people have polyps, which can be removed easily during a colonoscopy and tested for cancer. About 75 percent of people survive five years or longer if colon cancer is detected and treated at its earliest stage, compared to just 6 percent if found at its most advanced stage, according to the American Cancer Society.

The National Polyp Study tracked 1,400 people who had colonoscopies and all existing polyps removed. After an average

of six years, only five people had developed colorectal cancer, all at an early stage, and none died. That compares to 50 cases in patients who did not have polyps removed. Overall, colonoscopies and removal of polyps lower the risk of colon cancer by 76 to 90 percent, according to the study.

“It’s really a tragedy if someone dies from colon cancer because they missed the opportunity of being screened appropriately,” Barakat says.

Phot

o: C

ouPl

e ©

iSto

CkPh

oto.

Com

/NaS

tCo;

Pho

Ne ©

iSto

CkPh

oto.

Com

/keN

ex

“Colon cancer is unique

in that it’s preventable, and

we can save lives by

doing colonoscopies.”

preventionParker Adventist Hospital offers a $1,000 colonoscopy to people who do not have any health insurance. to find out more, please call 303-269-4185, or go to parkerhospital.org/colonoscopy.

Express Mammograms The Trio Breast Center is offering “express” screening mammograms with early morning and lunchtime hours. Make

an appointment, pull into valet parking, and head straight to your test. You’ll be out in 30 minutes, and your car will be waiting. All mammograms are performed with the latest digital technology and interpreted by a board-certified breast radiologist. Trio is accredited by the National Accreditation Program for Breast Centers. NEW extended hours: Monday-Friday, 7:15 a.m.-4:30 p.m., INCLUDING lunch appointments from noon-1 p.m.Location: The Trio Breast Center, located just off the main lobby of Parker Hospital

Parking: Pull into the FREE valet service at the main entrance to the hospital and tell them you are scheduled for an express mammogram, and they’ll hold your car close by

Schedule your screening mammogram by calling 303-269-4150.

Under the Affordable Care Act, colonoscopies are now paid for completely by insurance

with no out-of-pocket charges to the patient.

FREE Cholesterol ScreeningGet a complete cholesterol

profile, including HDL, LDL, and

triglyceride levels. Screenings

are limited to the first 500.

Fasting is required.

Date: Feb. 22Time: 7-10 a.m.Location: Parker

Adventist Hospital

Conference Center

Registration: Required; call 303-

777-6877, option 1

2 ■ Winter 2013

health screeningsText us to scheduleyour mammogram! text your name to 303-816-8648, and we’ll call you within two business days to schedule your mammogram.

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 grow@centura.org. grow is produced by Clementine LLC.

Executive Editor: Rachel Robinson

Cancel out colon cancer

grow ■ parkerhospital.org ■ 3

Phot

o: h

eaRt

©iS

toCk

Phot

o.Co

m/l

aflo

R; S

uRGi

Cal—

CouR

teSY

of

maz

oR R

obot

iCS

ltd.

FeBrUary FREE health seminars

BUrning QUeStionStopping heartburn before it leads to bigger problems

occAsIonAl HEArtburn is no reason to panic. But when symptoms are frequent, it’s time to talk to your doctor.

“The chronic exposure of the lower part of the lining of the esophagus to acid or alkaline fluid can cause inflammation,” explains Christine Rogness, MD, a general surgeon at Parker Adventist Hospital. Over the long term, that inflammation can lead to Barrett’s esophagus, a possible precursor to esophageal cancer.

“The other problem with chronic inflammation,” she explains, “is that it can cause such severe scarring that it actually narrows the esophagus, and you can’t swallow.”

Surgery for gastroesophageal reflux disease (GERD) should be considered if medication and lifestyle modifications have failed.

Fundoplication is a surgical procedure that wraps the upper part of the stomach (the fundus) around the base of the esophagus to strengthen the sphincter. The procedure is done laparoscopically, using small wandlike surgical instruments inserted through tiny incisions.

“If your symptoms can’t be controlled, then surgery is a great option,” says Rogness, who is now performing these surgeries using the da Vinci® robotic system that results in less pain and faster recovery for patients.

Weight-Loss SurgeryWed, Feb 6 | 6:30-8 p.m.Join bariatric surgeon Dr. Josh Long for a better understanding of what works and what doesn’t when it comes to weight loss and why you may want to consider surgery sooner rather than later if you have diabetes.

is it really Back pain?Thu, Feb 14 | 6:30-8 p.m.Thirty percent of back pain sufferers actually have SI joint problems. Once correctly diagnosed, it’s very treatable. Join SI joint specialist Dr. Brad Duhon, neurosurgeon, to learn more.

robotic Spine SurgeryTue, Feb 19 | noon-1:30 p.m.Spine surgery with laserlike precision can lead to better outcomes. Join orthopedic spine surgeon Dr. Scott Stanley to learn the benefits of spine surgery with the new Mazor robotic system.

Joint replacement Surgery Thu, Feb 21 | 6:30-8 p.m.Are you considering joint replacement? Learn how new procedures being used at Parker Hospital result in faster recovery with less pain, with orthopedic surgeon Dr. Derek Johnson.

See back cover for March seminars!

Join Parker Adventist Hospital for a series of FREE health seminars. All seminars are held in the Parker 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. Guests are encouraged to park on the west

side of the hospital.

Huh? hearing loss hits teens

AltHouGH Most PEoPlE AssocIAtE HEArInG loss with old age, one in five adults has some degree of hearing loss by age 35.

“A recent study found that hearing loss is occurring at earlier ages. The use of earbuds has

been implicated as a possible cause,” says Mark Willis, MD, an otolaryngologist (ENT) at Parker Adventist Hospital.

Prolonged exposure to loud noises damages the hearing over time, Willis says, and it can happen as early as the teen years. To prevent hearing loss, Willis recommends using over-the-ear headphones rather than earbuds. Limit regular sound to below 85 decibels (a hand drill is about 95 decibels); use apps on devices to limit volume; and use ear protection when exposed to loud noises.

If you do have hearing loss, there are many treatment options, including hearing aids that fit entirely inside the ear canal. A variety of surgeries also are available, including reconstruction of the middle ears with prostheses.

Hearing Screeningcolorado Ent specialists is hosting two FREE hearing screenings for adults and children. Adult screening (18 and over): Jan. 25, 1-4 p.m.Pediatric screening (ages 2-17): feb. 1, 1-4 p.m.Location: sierra Medical office building at Parker Adventist Hospital, suite 401Registration: required; space is limited; call 720-274-2544

Stop the BurnJoin Dr. christine rogness at a FREE community seminar on March 5 to learn more. see back cover for details.

SURGERY

Firefly Fluorescence imaginga special dye lights up in “firefly green” when using a specialized camera, revealing the difference between cancerous and healthy tissue. this allows surgeons to remove the cancer while leaving more healthy tissue intact.

enhanced visualizationthe da Vinci 3-D camera provides images that are magnified 10 times. surgeons view the anatomy through both eyes instead of a single lens that is used in traditional laparoscopic surgery.

SurgeonHand Controlas the surgeon views the anatomy, he or she uses highly sensitive hand controls to perform the surgery. the surgeon’s movements are instantly translated into precise movements by the robotic instruments inside the patient.

tiny instrumentsFour instruments — one to hold the camera and three to perform the surgery — are inserted through half-inch incisions. Parker hospital’s da Vinci robot also allows gallbladder removal through just one incision through the naval. the small size of the incisions along with the precise movements of these instruments result in less trauma to the patient.

360-Degree Wrist rotationthe robotic endowrists rotate in a complete circle. this allows more precise incisions and sutures than possible with freehand surgery or traditional laparoscopic tools, which rotate only 180 degrees.

potentiaLpatientBeneFitS� less blood loss� less pain� less recovery time� less scarring

4 ■ Winter 2013 ■ grow

Phot

o by

Ell

En J

asko

l

evolution

Steady HandsNew robot helps spine surgeons deliver precise results

onE of tHE nEWEst robots at Parker Adventist Hospital is providing laserlike precision to very delicate back surgeries.

the renaissance™ surgical robot provides surgeons with an instant “blueprint” of each patient’s spine. once the spine is mapped out, the robot positions a cannula, or tube, that guides the surgeon’s hand to the precise position for the surgery.

“It’s like having a helping hand or a second surgeon beside me stabilizing my hand,” says scott stanley, MD, medical director of the spine program at Parker Hospital. “It takes away more potential for error. We’re talking about less than a millimeter, but even that one millimeter will result in better outcomes for our patients.”

In a study published in the European Spine Journal, robotic-assisted spine surgery achieved the following results compared with freehand surgery:

� Improved accuracy � reduced X-ray doses� reduced complications � reduced number of revision surgeries

orthopedic spine surgeons and neurosurgeons at Parker Hospital are using the renaissance to navigate spinal surgery for patients suffering from debilitating back pain or limited range of motion caused by spinal deformities, degenerative conditions, slipped vertebrae, scoliosis, and pinched nerves. some of the procedures performed include spinal implants, spinal fusion, and bone cement injections.

When Michael Gavigan, MD, enters the operating room at Parker Adventist Hospital, he has a new robot helping him perform surgeries with more precision than ever.

“The No. 1 benefit to me of having the robot is what it does for my patients,” says Gavigan, a gynecologist and medical director of the Parker Hospital robotics program. “There is less blood loss because the visualization is optimal, and it allows us to operate in small spaces with very little impact to the surrounding tissue.”

Parker Hospital opened its advanced robotics center last fall, featuring two robotic surgery systems — the da Vinci Si Surgical System and the Mazor Robotics Renaissance™ Guidance System. The hospital is the first in the region to offer the Renaissance, which is used for spinal surgery. Parker’s da Vinci system features Single-Site™ robotic technology, which allows gallbladder surgery to be performed virtually scarless through one small incision through the navel.

Less pain for patientsGeoff Ledgerwood, MD, a urologist at Parker Hospital, has performed several hundred robotic-assisted surgeries. The robot’s “wrists” that rotate in a complete circle allow him to suture more easily.

“One of the goals is to spare as much normal tissue as possible,” he explains. “That leads to less blood loss and less pain for the patient.”

Using the robot is particularly beneficial in surgery to remove part of the kidney due to cancer.

“To do this surgery, we have to clamp off blood supply to the kidney,” Ledgerwood explains. “The robot allows me to move very quickly yet very precisely. And the faster we can restore blood flow, the faster the patient’s recovery.”

parker Hospital’s advanced robotic surgery program is supported by centura centers for clinical Innovation, extending advanced health technologies across colorado.

robotic surgery helps patients heal faster with less pain

Parker Hospital surgeons are using the da Vinci robotic system to perform surgical procedures in:✓ Gynecology✓ urology✓ General surgery✓ colorectal surgery✓ single-incision

gallbladder surgery

Learn more and find a robotic surgeon at parkerhospital.org/robotics.

potentiaLpatientBeneFitS� less blood loss� less pain� less recovery time� less scarring

grow ■ parkerhospital.org ■ 5

Dr. Scott Stanley

Phot

o co

urtE

sy o

F 36

0 m

EDia

evolution

6 ■ Winter 2013 ■ grow

onE out of EvEry fIvE ADults In colorADo Is obEsE — and that includes women who are pregnant

and trying to get pregnant. And along with the increase in obesity has come an increase in diabetes. “Both pregestational and gestational diabetes are on the rise,

mirroring increasing obesity rates,” says Sharmini Long, MD, an endocrinologist at Parker Adventist Hospital. “About 18 percent of women will be diagnosed with diabetes during pregnancy.”

Just being overweight puts a woman at risk for high blood pressure and preeclampsia, and the complications significantly increase with uncontrolled diabetes. The three major complications are miscarriage, birth defects, and low birth weight babies. High blood sugar during pregnancy also

may lead to metabolic changes in the baby that promote obesity and diabetes later in life.

“If blood sugar is well-controlled during pregnancy, those risks come close to the typical rate for nondiabetic

women,” Long says. “This emphasizes the importance of tight blood sugar control before and during pregnancy.”

Q&A With Josh Long, MD, Bariatric Surgeon

Should obese women have weight-loss surgery before getting pregnant?

A Growing ProblemExtra weight puts moms and babies at risk

If you are overweight, prediabetic, or diabetic, Long recommends:

Before pregnancy: Get a diabetes screening if you are overweight. If you’re diagnosed with prediabetes or diabetes, make sure your blood sugar is under control before getting pregnant.

During pregnancy: Maintain an A1c level below 6 percent throughout your pregnancy. Do this with diet and exercise and medications if necessary.

After pregnancy: Be diligent about increasing physical activity and losing weight. Women with gestational diabetes have a 50-70 percent chance of developing type 2 diabetes after pregnancy, but that risk can be reduced by maintaining a healthy weight and regular exercise.

Dr. Josh Long

A: Women with a body mass index over 35 with diabetes or over 40 without any health problems should consider weight-loss surgery if they have tried diet and exercise to no avail. And because diet and exercise are effective in only 1 percent of the morbidly obese, chances are that most obese

women will qualify for surgery. Bariatric surgery can help you — and your future baby — in many ways.

Bariatric surgery is highly effective at curing or improving type 2 diabetes, especially when patients have been diabetic for less than eight years or are not yet on insulin. Getting rid of your diabetes before getting pregnant significantly increases your chances of having a healthy pregnancy, delivery, and baby. Reversing the obesity trend in your family culture also may prevent your children from becoming obese and acquiring diabetes and other related health problems later in life.

Bariatric surgery can even help you get pregnant. Many obese women have polycystic ovarian syndrome (PCOS), causing irregular menstrual cycles that prevent women from getting pregnant. Bariatric surgery is so effective at reversing infertility problems that discussion about birth control is part of our preoperative counseling.

to learn more about weight-loss

surgery, attend our FREE seminar on feb. 6 or March 13. see Page 3

and back cover for details.

Phot

o: W

omaN

©iS

toCk

Phot

o.Co

m/a

NGie

Phot

oS

grow ■ parkerhospital.org ■ 7

PEoPlE WHo suffEr froM sAcroIlIAc (sI) joint dysfunction are finding relief from a new surgery at Parker Adventist Hospital.

SI joint dysfunction causes pain in the upper buttocks and upper legs. It often occurs during pregnancy when hormones loosen the joint, causing

increased stress, abnormal wear, and back pain. Fusion of the lower back, uneven leg lengths, and abnormal gaits also are common culprits.

“As many as 30 percent of patients with low back pain actually have SI joint problems,” says Brad Duhon, MD, a neurosurgeon at Parker Hospital who performs the procedure and also teaches it to other surgeons across the country. Parker Hospital is one of just a few hospitals

in Colorado to offer this procedure.Once diagnosed, the majority of SI patients are

treated successfully with nonsurgical therapies. For the remaining patients, the new SI fusion surgery is highly effective. “Ninety percent of patients are pleased with the results,” Duhon says.

A two-inch incision is made on the hip while the patient is asleep. Using X-ray guidance, the surgeon implants three triangular devices across the SI joint. Made of the same material as artificial joints, the implants allow bone to grow into and around them to stabilize the joint. Surgery typically requires a one-night hospital stay and a six-week recovery.

Join Dr. Brad Duhon on feb. 14 to learn more about sI joint dysfunction, nonsurgical treatments, and the new fusion surgery. see Page 3 for details.

Joint replacement patients going home quickerA nEW ProGrAM that combines better pain control and earlier rehabilitation is helping joint replacement patients at Parker Adventist Hospital have a speedy recovery.

“Since putting these protocols in place, we are discharging nearly half of our patients less than 24 hours after surgery,” says Derek Johnson, MD, an orthopedic surgeon and medical director of Parker Hospital’s joint replacement program.

The reduced length of stay—twice as fast as the average time for most joint replacements—is leading to better outcomes and decreased complications.

“The longer the patient is in bed, the higher the risk of blood clots, pneumonia, and other medical complications,” Johnson says.

Patients also reported lower pain levels and greater overall satisfaction.

Parker Hospital’s program includes comprehensive pain control and an early mobilization protocol. Most patients at Parker Hospital receive one or more rehab sessions the same day as surgery, with many walking 50-100 feet within hours of surgery.

Join Dr. Derek Johnson feb. 21 to learn tips for a faster, easier recovery from joint replacement surgery. see Page 3 for details.

BaCk reLieF

Dr. Brad Duhon

new surgery relieves sI joint pain

The Joint Commission recently awarded its highest level of accreditation to the joint replacement and spine programs at Parker Hospital. The level of engagement and passion of the physicians and staff were “unprecedented,” noted the inspector. Parker Hospital performed more than 300 hip and knee replacements and 800 spine surgeries in 2012.

iS it yoUr BaCk or yoUr Si Joint?lie on your back and cross your legs. If it’s sI joint dysfunction, you won’t be able to do this without pain.

Phot

oS: b

aCk

©iS

toCk

Phot

o.Co

m/P

eePo

; Ski

©iS

toCk

Phot

o.Co

m/u

ltRa

maR

iNfo

to

non-Profitorganizationu.s. Postage

PAIDDenver, co

Permit no. 47739395 Crown Crest Blvd.

Parker, CO 80138

Portercare Adventist Health System

Thumbs UpEarly arthritis appears in hands first

DID you knoW your tHuMb is responsible for up to 70 percent of your hand function?

Then it’s no surprise that the thumb is one of the first areas to feel the pain of arthritis. And women are three times more likely than men to be affected, says Kelly Martin, a certified hand therapist with the Parker Adventist Center for Rehabilitation & Sports Medicine. That’s because the basal joint that supports the thumb is smaller and flatter in women, which puts more wear on the joint.

“It’s not unusual to see women in their 40s already feeling pain and stiffness,” Martin says.

Most people put too much pressure on the thumb joint, which deteriorates the cartilage and leads to pain. We turn the key in the ignition with force, hold our pencils too tight, squeeze our cellphones, and just generally put too much strain on the thumb.

To stave off arthritis or help relieve pain if you already have it, Martin recommends: Give your hands a break every 15 minutes when performing repetitive

work, such as knitting or typing Use everyday tools with larger grips, such as cushioned pens Replace “squeeze” bottles, such as shampoo and toothpaste, with pumps

For More tipS on relieving pain in your thumbs, go to parkerhospital.org/thumb. or call the Parker Adventist center for rehabilitation & sports Medicine at 303-269-4590.

MarCH FREE health seminars

Become 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 Hospital Conference Center at the west entrance. A light lunch is served during noon seminars, and light snacks are served during evening programs.

gerDTue, Mar 5 | 6:30-8 p.m.Join general surgeon Dr. Christine Rogness to learn more about gastroesophageal reflux disease, the dangers of leaving it untreated, and the new robotic surgery to treat chronic heartburn.

Colon CancerThu, Mar 7 | noon-1:30 p.m.Colon cancer screenings save lives, but which one is right for you? Join gastroenterologist Dr. Jehad Barakat as he discusses the different options and when screenings should begin.

Weight-Loss SurgeryWed, Mar 13 | 6:30-8 p.m.Join bariatric surgeon Dr. Josh Long for a better understanding of what works and what doesn’t when it comes to weight loss and why you may want to consider surgery sooner rather than later if you have diabetes.

prostate HealthTue, Mar 19 | noon-1:30 p.m.Join urologist Dr. Geoff Ledgerwood for a discussion on prostate health and robotic surgery as a treatment option with better results for men needing surgery.

an easier HysterectomyThu, Mar 21 | 6:30-8 p.m.The second most common surgery for women can now be done with less pain and faster recovery time. Join gynecologist Dr. Michael Gavigan to learn about minimally invasive hysterectomies using robotic surgery.

See Page 2!

CHoLeSteroL SCreening

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.

Free

Phot

o: h

aNdS

©iS

toCk

Phot

o.Co

m/d

kaRt