NEW PSA GUIDELINES | HELP FOR VARICOSE VEINS | CHRONIC DISEASE RELIEF

FREECholesterolScreeningand HeartCoaching

Winter 2012

bloomPenrose-St. Francis Health Services

nurturing women’s health in Colorado Springs

Mending Broken HeartsLearn how to stop stress from wreaking

havoc on your heart

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Winter 2012bloom 2

FOR THE MAN IN YOUR LIFE

PSA TestingThe U.S. Preventive Services Task Force recently recommended that healthy men do not need to have regu-lar screenings for prostate cancer.

This controversial recommendation, says Gary Bong, MD, a urologist with Penrose-St. Francis Health Services, was based on a study that found PSA blood tests didn’t reduce the rate of death from prostate cancer.

But other longer studies have shown a significant benefit, Bong adds.

“Early detection has helped reduce the rate of metastatic prostate cancers discovered at the time of surgery from 35 percent to 2 percent,” Bong says. “It seems obvious we’re doing some-thing right.”

However, PSA testing can yield false positives, and prostate cancer is often overtreated, Bong says. So it’s important to discuss this screening with your doctor.

Opening ThoughtsBy Stephanie Hammar, heart patient advocate

A year ago Penrose-St. Francis Health Services featured the story of my struggle with heart disease as the cover story in this magazine. Just as you were reading about how I had lost half of my heart function to a heart attack at age 42, I was back in the hospital to repair a closed stent.

Although I’d been through the drill before, it was just as devastating as the first time. The difference was that I now knew much more about my illness, and I had the incredible support of the WomenHeart Sup-port group at Penrose-St. Francis, a group we started a year ago to help women with heart disease. These incredible women helped pull me through a time that could have overcome me.

While heart disease is the No. 1 killer of women, many women do not know their risk factors or their symptoms. February is National Heart Month. As 90 percent of us have at least one risk factor, I urge you to take two simple steps this month that could save your life. Get your heart health assessed and learn the warning signs of a heart attack – no matter what your age!

healthystart

bloom, formerly called 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 professional. For comments or to unsubscribe to this publication, please email us at bloom@centura.org. Bloom is produced by Clementine LLC of Denver, Colo. Executive Editor is Jill Woodford.

2222 North Nevada Avenue Colorado Springs, CO 80907

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GET TESTED FREE!FREE cholesterol test, one-on-one heart coaching and more—see Page 7 and back cover for details.

A Surprising Treatment for Chronic Pain:Exercıse

When you have chronic pain, the last thing you want to do is exer-cise, but oftentimes, that’s exactly what you should do.

“Exercise breaks up the cycle of pain,” says Roberta Breiden-bach, an aquatic physical therapist with the Colorado Sports & Spine Centers.

Staying active can prevent joints from getting stiff, and strengthen-ing muscles can stabilize the body. If you have pain from arthritis, fibromyalgia, or other chronic conditions, it’s important to find an ex-ercise you can do comfortably — and that you’ll want to keep doing.

A study recently published in the Annals of Internal Medicine found that yoga for adults with chronic low back pain led to im-provements in back function.

Breidenbach also recommends low-impact exercises that aren’t jarring to the joints, such as water exercises.

“With the buoyancy of water, you can walk without pain,” she says. “When the water is up to your armpits, that takes 75 percent of your weight off your joints.”

Other low-impact activities include walking and riding a station-ary bike. Whatever activity you choose, the important thing is to stay active.

“Give it a fair chance,” Breidenbach says. “If you stick with it, you’ll feel the difference.”

SHOULD YOUR MAN BE SCREENED?

There are both benefits and risks to PSA testing, but the decision is ultimately yours.

SCAN THIS CODE ON YOUR SMARTPHONE for a closer look or go to

penrosestfrancis.org/psa.

Penrose-St. Francis Health Services

penrosestfrancis.org 3 bloomWinter 2012

Help for Varicose VeinsSeeking treatment for varicose veins – those blue and red enlarged veins on the leg – isn’t just vanity.“There are serious health issues that go along with having varicose

veins,” says Laura Kissell, MD, a vascular surgeon with Penrose Cardiac, Thoracic and Vascular Surgery. Not only can they be painful, but they can lead to skin ulcers and blood clots, which can be fatal. Here she answers a few questions about treating varicose veins.

What is the goal of treatment?Veins take blood from the body back to the heart. If the valves in the veins of the legs are damaged or weak, blood can leak backward and pool in the veins – causing varicose veins. Treatment blocks off or re-moves the leaky veins so that blood can’t back up. Then the remaining healthy veins take over blood flow.

What are the treatment options?First, we try compression stockings for three to six months. If that doesn’t work, we may try sclerotherapy, where we inject a chemical that seals off the vein to stop the blood flow. We also can use lasers or radiofrequency ablation to treat larger veins. During this procedure, we put a tiny tube into the vein and, using a small probe with a heated tip, we close off the large vein that’s causing the varicose veins. Finally, we can remove the lumpy, bumpy veins with phlebectomy.

Q A&

SAY GOODBYETO VARICOSE VEINS

To schedule an appointment with Laura Kissell, MD, or her partner, Thomas Crepps, MD, CALL 719-776-7600 TODAY.

FEELING DIZZY? CALL USIf you feel dizzy often, call Penrose-St. Francis

Rehabilitation Services at 719-776-5200 or the Colorado Sports & Spine Centers at

719-593-1989 to learn how we can help.

EASE YOUR PAIN IN THE POOLJoin us for pool therapy sessions or aquatic exercise classes, or exercise independently in the water at the

Colorado Sports & Spine Centers. TO LEARN MORE VISIT penrosestfrancis.org/aquatics

OR CALL 719-776-4788.

Balancing ActIf you get dizzy or lose your balance from time to time, you’re not alone. More than 90 million adults 17 and older share your experiences.

“The big thing with dizziness is you have to figure out where it’s coming from,” says Krista Bohlen, MPT, a physical therapist with Penrose-St. Francis Health Services. “Once you know where it’s coming from, then you can treat it.”

If a lack of balance stems from vertigo – a conflict between the signals sent to the brain by various systems of the body – a physical therapist can use techniques to actually retrain your brain to decrease the dizziness and enhance your coordination. Therapy also helps you strengthen the senses you use to main-tain balance to compensate for the inner-ear disorder.

Laura Kissell, MD

Penrose-St. Francis Health ServicesWinter 2012bloom 4

EXTREME EMOTIONAL OR PHYSICAL STRESS CAN LEAD TO HEART ATTACK-LIKE SYMPTOMS

Broken Hearts Club

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In October, Laura Debenham had one of the scariest days of her life.“I was really sick all day,” she recalls. “And I just kept getting sicker and sicker. Then,

I had hot flashes.” She had pain on the side of her chest, and she was having trouble breathing. She also felt

nauseated and couldn’t keep food down.“I went to a website and looked up the symptoms of a heart attack in women, because I’d

heard they were different than in men,” she says.Debenham had all but one of the symptoms she read about, so she called 911.At the hospital, after an EKG and other tests, her doctors thought it was a heart attack. But once

in the cardiac catheterization lab at Penrose Hospital, they discovered she hadn’t had one after all.Rather, she had stress cardiomyopathy, which is often referred to as broken heart syndrome.

“Cardiomyopathy” refers to severe weakness in the heart muscle, which can be brought on by intense emotional or physical stress.

STRESS AND YOUR HEARTLeft uncontrolled, stress can affect the heart – raising blood pressure and increasing our risk for heart disease and condi-tions such as stress-induced cardiomyopathy, also known as Takotsubo syndrome.

When a patient has stress-induced cardiomyopathy, the initial symptoms appear the same as a heart attack, says Debo-

rah Jalowiec, MD, a cardiologist with Colorado Springs Cardiologists, A Centura Health Clinic.

What Laura Debenham of Colorado Springs thought was a heart attack turned out to be stress-induced heart cardiomyopathy, a syndrome experienced mostly by women.

penrosestfrancis.org 5Winter 2012 bloom

“You have EKG changes,” Jalowiec says. “You have elevated cardiac enzymes. It looks like a heart attack until you get to the cath lab, and there are no blocked arteries.”

Stress cardiomyopathy is most common in women – in fact, in a recent study, 89 percent of patients with the condition were women.

“Overwhelmingly stressful situations cause the release of adrenaline, and this quick release seems to be toxic to the heart muscle. The heart muscle is temporarily damaged,” Jalowiec explains. “It’s not a heart attack because the heart muscle will go back to normal.”

Stress cardiomyopathy is commonly brought on by a stressful event, like a death in the family, a divorce or separation, the loss of a job, a sudden burst of anger, or intense fear. But it doesn’t always have to be a negative cause, Jalowiec says. Hearing “surprise” yelled at a surprise party can trigger the adrenaline response as well.

“There can be physical stressors too, such as an asthma attack, a migraine headache, or going into surgery,” Jalowiec explains. “But one out of three people (who experience this condition) cannot identify a stress issue.”

Debenham, 51, is one of those. While she says she lives with day-to-day stress – she owns and manages a sports bar and is the mother of three children – she doesn’t know what specifically caused her attack that day.

FINDING RELIEF FOR STRESSDebenham spent four days in the hospital after her stress-induced car-diomyopathy. Afterward, her doctor put her on medication and gave her some advice.

“He told me to control my stress,” she recalls. “And I laughed.”It’s not always easy to get away from stressful situations like your job

or family. But, Jalowiec says, if you are frequently under stress, there are

steps you can take when you feel stress mounting.“This condition seems to be more common in high-strung, anxious

people,” she explains. “You can try biofeedback or relaxation techniques to control the adrenaline release.”

Of course, she says, recognizing rising stress levels during a stressful or unexpected situation, like attending a funeral or be-ing in a car accident, isn’t likely. But the more you can manage your stress, the better for your heart.

As for medications, beta-blockers can help block the effect of adrenaline on the heart and can be used long term. ACE inhibitors also may be used immediately after an attack to help the heart muscle return to normal.

RECOGNIZE THE SIGNSEven if you think you might have stress cardio-myopathy, don’t wait for the heart to heal itself – because it could be a heart attack.

“You can’t tell the difference without a heart catheterization, so if you think you have symptoms, you have to go to the ER,” Jalowiec says.

And if it is broken heart syndrome, you should be under the watch-ful eye of a cardiologist to manage the condition with medications and to make sure there are no serious consequences. Very rarely, people can develop congestive heart failure or an arrhythmia (abnormal heart rhythm) as a result of the cardiomyopathy, Jalowiec says.

“Make sure you get medical care, and try to manage stress in your life. If you’re a high-stress person or high-stress-response person, get that under control,” she adds.

Debenham says her daily stress might not be going anywhere, but she enjoys her Denver Broncos tickets and makes time (though she should do it more, she says) for the activities she loves.

“I golf,” she says. “And I love it.”

Like stress, depression can affect the heart. And for women, depression isn’t uncommon.

“Women often blame themselves. They wonder, ‘Why is it that every other woman has it together, and I don’t?’” says Nancy Bader, a licensed clinical social worker with Penrose-St. Francis Health Services. “With all the demands that are placed on us to be successful in so many areas, it’s not uncommon for women to experience a bout of depression.”

Signs of depression in women include:• Lossofinterest/pleasureinthingsthey

used to do• Feelingsofguiltandworthlessness• Sleepdisturbances–sleepingmoreor

less than they used to• Suddenchangesinappetiteandweight• Lackofenergyandchronicfatigue• Difficultyconcentrating“Usually, the best approach for women is psychotherapy and, depending on the severity of the depression, medications,”

Bader explains. “It also helps to define your support systems and be around those people who will encourage you and see you through the hard times.”

It’s common to feel down on occa-sion, but when your depression is severe enough to affect your daily life, it’s time to ask for help.

Recognizing Depression in Women

FREEHeart ScreeningPeople with stress cardiomyo- pathy may not have any other signs of heart disease. But the

first step toward a healthy heart is managing your risk factors – such

as high cholesterol. To learn more about a FREE choles-terol screening and individual heart

coaching, see the back cover of this publication.

FREE Phone Consultation

If you’re concerned you may be suffer-ing from depression, talk to a profes-sional and get the support you need.

Penrose-St. Francis Behavioral Health recently started a new women’s

depression program. For a FREE phone consultation,

call 719-634-1825.

Penrose-St. Francis Health ServicesWinter 2012bloom 6

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It’s no surprise that when you don’t feel great, you’re more likely to skip the gym and blow your diet.

But if you’re living with a chronic disease, you don’t get the option of taking time off until you feel better. In fact, take time off from good health habits and you’re likely to make your condition even worse.

“People with chronic diseases never get a va-cation,” says Michelle Somers, a wellness coach with the Penrose-St. Francis Health Services Lifestyle Management program.

Chronic diseases limit daily living for one in every 10 Americans, according to the Centers for Disease Control and Prevention. Chronic dis-eases are any type of long-term health condition that cannot be cured.

Along with managing their physical health, people who live with chronic diseases also have to manage their emotional well-being.

Downward spiral When depression and fatigue strike – a matter of

when, not if, say the experts – a person is in danger of entering a

negative symptom cycle. “If a person is down or

blue, those feelings might cause fatigue, which often

causes the person to skip exercise, which could cause

the disease to get worse,” Somers says. That doesn’t have to be the case. A

number of techniques can help patients recog-nize and break the symptom cycle. Somers, who teaches a class on how to live better with chronic diseases (see box), offers these tips:

• Set goals: Setting reasonable goals, writ-ing them down, and then holding yourself accountable to someone can provide just the right amount of motivation when you’re ready to throw in the towel. Remember, though, that your goals need to be achievable.

• Limit negative self-talk: When you’re

feeling tired or frustrated, it’s easy to start tearing yourself apart. Limit negative chatter by being specific in your thoughts. Instead of thinking, “I never want to exercise,” think “I don’t feel like exercising today, but I exercised three times last week.”

• Mindful distraction: It’s easy to get stuck in the spiral of “I’m sad; I’m tired; I don’t want to take care of myself.” Try distracting your thoughts by engaging in something that en-gages your brain. Try out a new food tracker on your smartphone. Learn a new hobby or sport that requires intense concentration. Call a buddy to lift your spirits or better yet, meet a friend for a walk.

Mind Over MatterA few tricks to keep you on the road to good health

Live a Better LifeAre you living with the challenges of an ongoing health condition? Healthier Living Colorado™ is a six-week program devel-oped by Stanford University that teaches people with chronic diseases how to man-age their health and maintain active and fulfilling lives. Participants have shown:•Increased exercise•Fewer social limitations•Improved mental well-being•Improved health•Enhanced communication and

partnering with physicians

The program is open to anyone who has a chronic disease, including but not lim-ited to diabetes, cancer, COPD, asthma, lung disease, heart disease, arthritis, fi-bromyalgia, or chronic fatigue syndrome. Dates: Tuesdays, Jan. 24-Feb. 28Time: 5:30-8 p.m. Location: Penrose Health Learning Center, 1644 Medical Center PointCost: $40 ($25 for Penrose employees)

For more information and to register visit penrosestfrancis.org/healthierliving

or call 719-776-7983.

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Penrose-St. Francis Health Services encourages you to experience the wide variety of health programs, screenings, and fitness classes that we offer throughout the Colorado Springs area. This calendar briefly highlights some of our beneficial programs and classes, many of which are ongoing throughout the year. See the key below for location information, and visit penrosestfrancis.org/wellness for a complete listing. Registration is required for all programs and can be made by calling the number listed.

calendarwinter

LOCATION KEY:

CSSCA – CSSC Aquatics Center, 1625 Medical Center Point, No.160

NCB – NorthCare Building, 6071 East Woodmen Road

PCC – Penrose Cancer Center, 2222 North Nevada Avenue

PH – Penrose Hospital, 2222 North Nevada Avenue

PHLCG – Penrose-St. Francis Health Learning Center Gym, 1644 Medical Center Point

PHWC – Penrose Hospital, Wellness Center, 2222 North Nevada Avenue

SFMC – St. Francis Medical Center, 6001 East Woodmen Road

FITNESS

Aquatics Classes | CSSCA Call for feeWarm water exercise classes that are good for cardiovascular conditioning.Call for dates and times. 719-776-4780

Bootcamp | PHWC | $60*An action-packed, non-choreographed workout.Thurs, Mar 5-Apr 30, 5:15-6:15 p.m., 719-776-7494

Individual Fitness Assessment PHLCG | $50Measure your fitness level and set goals. Call for appointment. 719-776-4761

My Healthy Valentine | PHLCG $60A fun weight loss challenge.Jan 16-Feb 14, 719-776-4761

Pilates A body-conditioning routine that helps build strength, flexibility, endurance, and coordination.PHWC | $60*Tues, Mar 6-Apr 24, 6:10-7 a.m., 719-776-7494PHLCG | $40/month Tues, 8:45-9:45 a.m.; Thurs, 5:30-6:30 p.m., 719-776-4780

Power Up | PHWC | $60*Feel great through cardiovascular conditioning, muscle toning, balance, agility training, and flexibility.Sats, Mar 3-Apr 28, 9-10:30 a.m., 719-776-7494

Strengthen and Tone | PHLCG $40/month A full-body workout.Tues, Feb 7-28 & Mar 6-27, 4:30-5:30 p.m., 719-776-4780

T’ai Chi | PHLCG | $40/month (for 8 classes)A gentle, relaxing workout that improves body awareness, strength, and coordination.Tues & Thurs, 9-10 a.m., 719-776-4780

Yoga Stretch | PHLCG | $30/month (for 4 classes)Move your body through a series of seated and standing yoga poses.Mons, 9-10 a.m., 719-776-4780

PRENATAL

Breast-Feeding Class | SFMC $40Learn how to breast-feed the right way in this two-part class taught by an International Board Certified Lactation Consultant (IBCLC). Tues, Feb 14 & 21, 6:30-9 p.m., 719-571-3101

Moms in Motion | CSSCA $46/monthWater exercise class for pregnant women. Must have prescription from obstetrician to participate.Tues & Thurs, 5-6 p.m., 719-776-4780

HEALTH

Bariatric Weight Loss Surgery PH | FREELearn if you are a candidate, your surgical options, and what to expect following surgery.Sat, Mar 3, 9-11 a.m., 719-776-5359

Healthy Back Club | PHLCG $20/person; $30/two people Improve back health through fitness, exercise planning, and motivation. Tues, Jan 24-Feb 21, 5:30- 6:30 p.m., 719-776-4852

Healthier Living Colorado™ PHLCG | $40*If you’re living with a chronic condition, learn techniques to live a more fulfilling life. Tues, Jan 24-Feb 28, 5:30- 8 p.m., 719-776-7983

Lung Cancer Workshop | PCC FREELearn the different types of lung cancer and how to manage symptoms and side effects of treatment.Thur, Feb 9, 5:30 p.m., 719-776-5311

SUPPORT

Beginning Again: Tools for the Journey Through Grief | PCC FREEGrief support group for adults who have experienced the death of a loved one.Tues, Apr 3-May 22, 5:30- 7:30 p.m., 719-776-5311

Older Drivers | PCC – Rooms A, B, & C | FREEInformative workshop covering the delicate topic of older drivers and driving safety.Wed. Feb 8, 2-3 p.m., 719-776-2107

Tuned In | NCB | FREEA dynamic, interactive music experience that spotlights the surprising role music plays in your life. For cancer survivors and a guest. Lunch is provided.Sat & Sun, Feb 4-5 9 a.m.- 5 p.m., Elly Peters 719-776-2510

WomenHeart Support Group PH | FREEProviding encouragement and strategies to cope with a heart condition.2nd Wed of month, 11:30 a.m.- 1 p.m., 719-200-2645

*Penrose-St. Francis Health Services employees are eligible for discounts on these classes.

penrosestfrancis.org 7 bloomWinter 2012

Pamper Your Heart | PCC FREEJoin our cardiology experts as they give you the scoop on the latest technology in diagnosing heart disease and identifying risks to your heart. Learn what these screening tools tell you and how you access them. Find out more about contributing factors such as Broken Heart Syndrome, emotional stress, and how they can affect your heart health. Participate in a raffle for a complete risk assessment and coaching session. Open to men and women.Thur, Feb 23, 6-8 p.m., 719-776-5052

FREE HEART TESTS!

PUMP UP YOUR HEART HEALTH!

Non-Profit Org.U.S. Postage

PAIDColorado Springs, CO

Permit No. 142222 North Nevada AvenueColorado Springs, CO 80907

Penrose-St. Francis Health Services is offering a FREE smartphone app that can help you manage your health better. iTriage provides you with instant access to medical informa-tion about more than 300 symptoms, 1,000 diseases, and 350 medical procedures through your cellphone.

Say you have a headache and want to know the possible causes. iTriage can give you a list of the potential causes with the following information about each disease:•Description•Commonsymptoms•Treatment(includingmedica- tions and procedures)

iTriage also lets you geo-locate the closest emergency department, urgent care clinic, phar-macy, physician’s office, and more.

Catholic Health Initiatives Colorado

One of the best ways to take care of your heart is to know your numbers and have a good game plan for staying heart healthy. Join our heart health team to learn your heart risk numbers and get personalized coaching on what you can do to beat heart disease. Screenings include a full choles-terolpanel(fastingrequired),bodymassindexandbloodpressure check, followed by individual heart health coun-seling with a wellness coach.

This exclusive program – worth $50 – will be offered FREE, but it is limited to the first 50 women

who make an appointment.Heart-healthy breakfast treats will be provided, and each participant will receive a Love Your Heart bag filled with re-sources and other fun items to help keep your heart healthy.

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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Health Care in Your Hand

HEARTS CONNECTED

Register today!

Date: Saturday, Jan. 28Time: Appointments start at 7:30 a.m. (12-hour fast is required)Location: Penrose Cancer Center, 2222 N. Nevada Ave., Conference Rooms A-C For more information and to register, call Rhonda at 719-776-7983.

*BE SURE TO CHECK OUT THE OTHER FREE HEART PROGRAMS ON PAGE 7!

WARNING SIGNS Call 911 if you are having any of these symptoms:

Scan this code with your smartphone to download iTriage FREE or go to penrosestfrancis.org/itriage.

✓ Chest pain or other symptoms of a heart attack

✓ Severe headache or dizziness✓ Loss of consciousness✓ Arm, leg, or facial weakness

✓ Slurring of words, confusion, or inability to talk

✓ Sudden, severe, or lasting abdominal pain

✓ Ongoing trouble breathing