SPRING 2016 | Volume 4, ISSue 2

Living at the height of wellness

Improve your outlook

Page 2

AvoId seAsonAl AllergIes

Page 12

6 questIons for your hIp surgeon

Page 8

lumpectomy vs. mAstectomy

Page 10

greAtBegInnIngsLearn how to reap the benefits of breastfeeding for you and your baby.Page 4

ELEVATE is published four times annually by Castle Rock Adventist Hospital — Portercare Adventist Health System. 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 elevate@centura.org. ELEVATE is produced by Clementine Health marketing. executive editor is Christine Alexander.

2350 Meadows BouLevard | CastLe roCk, Co 80109

Spring 2016eLevate 2

when it comes to your health — both emotional and physical — perception is as important as reality. Your outlook and how you approach life is just as critical as your actual circumstances. Outlook is also one of eight focus areas that helps guide the CREATION Health lifestyle, a scientifically proven approach that Castle Rock Adventist Hospital’s wellness programs are based on. David Martinez, the hospital’s chaplain, zeros in on three key practices that can help you keep a positive outlook.

1. Be grateful. “Gratitude gives you endorphins, the same kind of feel-good hormones you get when you run,” Martinez says. He suggests making a daily gratitude list that includes the events of the day and why you’re grateful.

2. have a vision. “My son wants to become a baseball player. It’s a one-in-a-million shot, but I don’t want to be a dream killer,” he says. “So I tell him he needs something he can see every day to remind and encourage him to do the things he needs to achieve his goals.” This is good advice for everyone, for both long- and short-term life goals.

3. find hope. A big part of Martinez’s job is helping to create a sense of hope, whether a patient has a serious illness or is nervous about surgery. “Zacchaeus had hoped to meet Jesus and when he did, his life was turned around. That’s what we want to give people,” he says. So, what’s a good way to find hope in tough times? Start by referring back to Nos. 1 and 2.

CoVe

R PH

oTo:

©IS

ToCk

PHoT

o.Co

m/m

ARTI

Nedo

uCeT

; THI

S PA

Ge, C

loCk

wIS

e: ©

ISTo

CkPH

oTo.

Com

/ANT

HIAC

umm

ING,

/PeS

kym

oNke

y, /P

AulP

AlAd

IN, /

kARA

NdAe

V; o

PPoS

ITe

PAGe

: ©IS

ToCk

PHoT

o.Co

m/C

eNTR

Al IT

All

IANC

e

ou

tlo

ok

lIve long And posItIveIt turns out, the “good guys” really

do win in the end: Not only do optimists live longer than their

pessimistic counterparts, research from Mayo Clinic shows they live better, with greater physical and

mental function and a higher quality of life.

Add up your grAtItudeCounting your blessings is more

than a reminder to be thankful for what you’ve got. One study found

it can help you:• Feel happier• Exercise more • Sleep better • Experience fewer physical

ailments

LIVE ON THE

bright sidethe perks of forgIveness trAInIng

During the Stanford Forgiveness Project, 260 adults who took a six-week forgiveness course

experienced meaningful results. • 70% felt less hurt• 13% felt less anger• 27% had a decline in physical

symptoms, including gastrointestinal issues

Better ZZZs, BrIghter outlook

A recent study links going to bed later and getting less shut-eye with

repeated negative thoughts — distress thoughts that can replay on a loop in your mind (and likely also keep you awake). So, to help

maintain your sunny disposition, set an early bedtime and stick to it.

Beyond A BAd moodSleep deprivation can negatively

affect our emotions. A bad night’s sleep can lead to a bad

mood for the day. But in the long term, it can cause (or worsen)

depression, Duntley says. “That’s why the treatment of depression

is made more effective by treating sleep disorders.”

stolen memorIesSleep deprivation has been linked

to a greater risk for dementia. The research is ongoing, but

some studies have found that brain plaques increased in

animals that were sleep deprived.

rIsky BusInessCan sleep loss make you

reckless? “It’s not an area that’s discussed much, but risk-taking behaviors increase tremendously

and you’re much more likely to make bad decisions if you’re sleep deprived,” Duntley says.

tIppIng the scAlesWhen you’re sleep deprived, it can affect the hormones that control your appetite, as well

as the types of food you crave. But there’s also a practical

component: Researchers are learning that more time awake —and thus more opportunities to

eat — makes weight gain an even bigger risk.

leArnIng strugglesWhen we aren’t sleeping

well, it affects not only our concentration but also our ability to learn and retain

new information. “Memory consolidation requires a full

night’s sleep — between seven and eight hours for adults and children need even more — to be effective, and many of us

aren’t getting it,” Duntley says.

CoVe

R PH

oTo:

©IS

ToCk

PHoT

o.Co

m/m

ARTI

Nedo

uCeT

; THI

S PA

Ge, C

loCk

wIS

e: ©

ISTo

CkPH

oTo.

Com

/ANT

HIAC

umm

ING,

/PeS

kym

oNke

y, /P

AulP

AlAd

IN, /

kARA

NdAe

V; o

PPoS

ITe

PAGe

: ©IS

ToCk

PHoT

o.Co

m/C

eNTR

Al IT

All

IANC

e

eLevate3Spring 2016castlerockhospital.org

Sleep is one of the three pillars of good health — along with diet and exercise — that we rely on to keep us physically and emotionally sound. It’s also one that we typically don’t pay enough attention to. Stephen Duntley, MD, Centura Health South Denver Group sleep medical director, shows us some surprising ways that sleep (and lack of it) can affect your health — both day to day and over the long term.

study up on your sLeepwhen it comes to getting your Zzzs, the news isn’t all bad. you can protect your sleep by practicing good sleep hygiene, with measures such as: • making sleep a priority by

allowing enough time for it• Not taking your worries (or

your tech gadgets) to bed• Reducing caffeine intake

overall and cutting if off earlier in the day

• Getting regular exercise

If you’re still not getting quality sleep, talk to your doctor and consider a sleep study. The newly expanded Castle Rock Sleep disorder Center offers a complete range of sleep services and testing for adults and children ages 5 and up. “we’re capable of managing the full spectrum of sleep disorders, with neurologists and pulmonologists to read the studies and consult, and a full range of specialists to address them,” duntley says.

sleepBetter heAlth

your WAy to

To learn more or schedule an appointment

for a sleep study, call 720-455-3740.ZZZ

Spring 2016eLevate 4

Like most moms-to-be, Krista Borrego had a picture in mind of what the experience of having her first child would be like — especially when it came to breastfeeding. But things didn’t go exactly as planned. When her son, Dominick, arrived at Castle Rock Adventist Hospital following a complicated delivery last March, he experienced some problems and was placed in the NICU (neonatal intensive care unit). Because of low blood sugar issues, he had to be bottle-fed at first — so Borrego wasn’t able to nurse him like she had planned. “I had this idea of how the breastfeeding experience would be, of this baby with a perfect latch,” she says. “It felt like a loss at first because it didn’t go as planned.” This is when the expertise and support of lactation consultants can come in handy. We’ll explore how they can help moms who struggle, like Borrego did, as well as the extensive health benefits of breastfeeding that make the extra effort worthwhile.

A Worthy GOALBreastfeeding isn’t aLways the easiest path. But with a LittLe support (and patienCe), new MoMs and their BaBies Can reap the Benefits.

Persistence paid off for new mom krista Borrego. After getting off to a slow start, krista got help from the lactation consultants at Castle Rock Adventist Hospital and found a way to breastfeed her baby, dominick.

Castle Rock Adventist Hospital offers a free breastfeeding class and support group for expecting and new moms.

Call 720-455-0355 for info.

castlerockhospital.org eLevate5Spring 2016

PHoT

oS: ©

elle

N JA

Skol

feed It forWArd What happens if you can’t breastfeed exclusively or your child has to be in the NICU as Borrego’s was at first? A milk depot like the one at Castle Rock Adventist Hospital can help. “We can do all of mom’s blood work, take in her milk, and give it to the milk bank if she wants to donate,” Northrup says. Often moms with a large milk supply choose to donate in conjunction with breastfeeding their own child, and some moms continue to pump after they’re done breastfeeding. While Dominick was in the NICU, he received breast milk from a donor as well as Borrego’s milk, which was just coming in and wasn’t enough to keep his blood sugar stable at first. During this time, Borrego decided to pump and save her milk, too. “Now that he’s starting on solid foods, he’s naturally not drinking as much breast milk, but there are premature babies out there who are in need,” says Borrego, who donated more than 360 ounces to the milk bank. To learn more about the Milk Depot at Castle Rock Adventist Hospital, go to castlerockhospital.org/milkdepot.

mArIjuAnA And mIlk The research on the effects of marijuana while

breastfeeding is limited, but it is known that traces of THC — the chemical in marijuana that causes you to feel high — can be found in urine of babies whose mothers use marijuana. The American Academy of

Pediatrics and the American College of obstetricians and Gynecologists currently advise breastfeeding moms

NoT to use marijuana. Also, they warn that “pumping and dumping” — a common practice when a woman imbibes in alcohol and then throws out her breast milk

for the next 12 to 24 hours — does not work with marijuana because the THC is stored in fat and stays in the system for a much longer time. Get more facts at

castlerockhospital.org/breastfeeding.

heAlthy perks

Right from the start, breastfeeding offers numerous benefits to mom and baby. The first milk that mothers produce is called colostrum, but it’s been nicknamed “liquid gold” — both for its yellow hue and the nutrients and antibodies it delivers. “We see fewer ear and respiratory infections and fewer stomach issues with exclusively breastfed babies because the antibodies (contained in breast milk) help fight off viruses and bacteria,” says Jacque Northrup, RN, CLC, ICCE, birth concierge and lactation consultant at Castle Rock Adventist Hospital. Other benefits include: Decreased risk of sudden infant death syndrome (SIDS) Decreased risk of obesity in teen years and adulthood Faster postdelivery healing for mom Reduced rates of breast and ovarian cancer in mom Reduced cost (formula cost runs $4-$10 per day) Convenience (no bottles to warm or formula to pack) “Oxytocin released during breastfeeding helps the uterus contract and return to normal more quickly, and there’s evidence that it may help moms lose postpartum weight as well,” says Danielle Wallach, DO, an OB-GYN at Castle Rock Adventist Hospital. The release of oxytocin, along with another hormone, serotonin, also helps babies and moms bond, and has been shown to result in better emotional development and stability for the child.

perseverAnce pAys off

Borrego found support to keep her going after the initial delay by attending the weekly breastfeeding clinic at Castle Rock Adventist Hospital, which provides new moms with a place to talk, share their stories — even vent — and get the breastfeeding support they need. Because Dominick had trouble latching on at first, Borrego ended up using a nipple shield, an artificial nipple worn over the mother’s natural nipple that can help infants who may not recognize their mother’s nipple after being given a bottle. “In my mind, the only option was to keep going and never give up,” Borrego says. “This was better than nothing at first because it at least allowed me to get him used to the closeness.” Eventually the lactation consultants were able to help Borrego taper off the nipple shield as Dominick began to latch on. “It took a lot of practice, but I didn’t give up,” she says. “I am so thankful to everyone who works there. All of the nurses told me to never quit.” Every so often, Borrego still stops by the lactation clinic to share that message with other new moms. “I give them a pep talk, and tell them they can do it,” she says. “And the lactation consultants are always so helpful and available for whatever you need. It’s a great resource to have to make sure your transition to being a new mom is a little bit easier.”

For your special deliveryexpectant moms in the Castle Rock area can

expect a special and unique birth experience at The BirthPlace, which was recently expanded to add

five new labor, delivery, recovery, and postpartum (ldRP) suites — each with a soaking tub for a more comfortable labor. with other amenities, including a birth concierge, a 24-hour visitation policy, gourmet food, breathtaking mountain views and, of course, round-the-clock expert care for mom and baby, it’s

just the place to add to your family.For a tour or to find out more about planning your delivery at The BirthPlace at Castle Rock Adventist

Hospital, please call our birth concierge, Jacque Northrup, at 720-455-0355.

The new labor, delivery, recovery, and postpartum (ldRP) suites at The BirthPlace offer high-tech equipment, stress-reducing

amenities, and beautiful views.

Spring 2016eLevate 6

LOOKING FOR lung cAncerLow-dose Ct scan catches cancer earlier when it’s more treatable

tAke A deep BreAth. hold It. exhAle. You have just pressed your lungs into active duty, expanding to accommodate the extra-big breath you just took in and acting as command central for oxygen delivery to the body.

Our lungs work without us directing them. You could even say our lungs work silently, behind the scenes. Here’s the scary thing: Lung cancer

progresses silently too, often not showing symptoms until it’s no longer curable.But there is promising news. There is now a low-dose CT scan that may catch cancer early

enough to treat it — and beat it. Here’s what you need to know.

no. 1 cAncer kIller“Lung cancer is the leading cause of cancer death in the U.S. among both men and

women. It claims more lives every year than colon, prostate, ovarian, and breast cancers combined,” says David Gilliland, MD, medical staff president and lead radiologist at Castle Rock Adventist Hospital.

Does that get your attention? It should — especially if you have a history of smoking.“Lung cancer is by far the most deadly cancer out there,” Gilliland says. “Patients who

develop metastatic disease — cancer that has spread beyond the lungs — have a five-year survival rate of 1 percent. However, when lung cancer is detected at its earliest, most treatable stage, survivorship soars to 50 percent.”

That’s where a low-dose CT scan comes into play.

Who Is elIgIBle?The screening is offered to those at highest risk of developing lung cancer. Based on

data from the Lung Cancer Screening Trial, a study involving more than 50,000 current or former smokers, the patients mostly likely to benefit from screening are:

Between the ages of 55 and 74 current smokers, or those who have quit within the past 15 years heavy smokers — a history of 30 pack years or more (a pack year is an average of one

pack per day per year; for example, one pack per day for 30 years or two packs per day for 15 years)

Gilliland says results are promising. “Trial participants who got the CT scan had a 20 percent overall less chance of dying of lung cancer than those who just got a chest X-ray,” he says.

schedule your screenIngThese South denver hospitals now offer low-dose

CT scans to screen for lung cancer for $199.*

Castle Rock Adventist Hospital1-855-456-LUNG(5864)

littleton Adventist Hospital303-738-7747

Parker Adventist Hospital303-269-4500

Porter Adventist Hospital303-778-2415

*Some insurance plans may cover the screening. Check with your plan.

symptoms not to Ignore

While lung cancer often has no early symptoms, if you experience any of these signs, talk with your doctor to evaluate the cause:

A new cough that doesn’t go away Coughing up blood Chest pain that worsens with coughing or deep breathing Shortness of breath and wheezing Recurrent infections, such as bronchitis or pneumonia Swelling of the face Losing weight without trying

7dr. david Gilliland

Castle Rock Adventist Hospital, Littleton Adventist Hospital, Parker Adventist Hospital, and Porter Adventist Hospital are part of the Centura Health Cancer Network, delivering integrated,

advanced cancer care across Colorado and western Kansas.

THIS

PAG

e: P

HoTo

:©do

llAR

PHoT

oClu

B.Co

m/C

HeRR

IeS,

Illu

STRA

TIoN

S: l

uNG

©do

llAR

PHoT

oClu

B.Co

m/A

NNex

S2; G

RouP

©do

llAR

PHoT

oClu

B.Co

m/J

ACAR

TooN

; oPP

oSTI

e PA

Ge: ©

ISTo

CkPH

oTo.

Com

/BAy

HAyA

leT

eLevate7castlerockhospital.org Spring 2016

SOLVING THE WeIght loss PUZZLE

curIng WeIght proBlems for good Is the key to success

When Marlow Perez, MD, and Drew Werner, MD, sought to develop more effective ways to help their patients lose weight, they knew it would take an out-of-the-box approach. “While no patient would accept a lifetime of crutches to manage a broken leg with no attempt to heal the bone, many patients accept a lifetime of medication to manage diabetes or to treat hypertension,” Perez says. “Our approach is about equipping our patients with tools to cure them.” The key, say these family medicine physicians who are also athletic trainers, is focusing on three key areas: adequate sleep, regular exercise, and a healthy diet. “All three of these are hard to do consistently all the time,” Werner says. “But it doesn’t have to be incredibly difficult or challenging. We work with you where you are.” For every patient, the plan looks different. While one person may exercise

daily, he may be sleeping only four hours a night and eating high-carb foods to make it through the day. Another may eat a healthy diet but sits at a desk all day. Perez and Werner give these tips to as guidelines:

get regulAr, AdequAte sleep

Not everyone needs eight hours nightly, but you should feel rested and be able to wake up without an alarm clock on most days.

stAy ActIve throughout the dAy, every dAy

New research is finding that it’s important to be moving for at least five to 10 minutes every hour you are awake plus working in a session of strength training, stretching, or aerobic exercise most days.

eAt close to the ground

Rather than worry about counting points or measuring percentages of fats versus protein, this one easy-to-remember guideline will help you maintain your ideal weight and health: Make vegetables and fruits at least half of every meal and reduce—or even eliminate—any food that requires a manufacturing plant. By following a simple yet customized approach, many of Perez and Werner’s patients are losing up to 8 to 10 pounds per month and seeing their diabetes resolved. “It’s remarkable what any human body can do with the right motivation, persistence, and education,” Werner says.

4 WAys those extrA pounds Are hurtIng you noWBeing overweight can not only put you at an increased risk for health concerns in the future, it may be harming your health today. Here are a few examples:

depression: Obese people are 25 times more likely to suffer from depression than people of a normal weight.

sleep apnea: Individuals who are overweight have extra tissue in the back of their throat that can obstruct the airway, preventing air from getting into the lungs while they’re sleeping.

osteoarthritis: Recent research shows fat cells may be working against our bodies in ways that can destroy our joints.

diabesity: Approximately 90 percent of people with type 2 diabetes are overweight or obese, leading to this new term.

dr. marlow Perez

dr. drew werner 12

3

4

THIS

PAG

e: P

HoTo

:©do

llAR

PHoT

oClu

B.Co

m/C

HeRR

IeS,

Illu

STRA

TIoN

S: l

uNG

©do

llAR

PHoT

oClu

B.Co

m/A

NNex

S2; G

RouP

©do

llAR

PHoT

oClu

B.Co

m/J

ACAR

TooN

; oPP

oSTI

e PA

Ge: ©

ISTo

CkPH

oTo.

Com

/BAy

HAyA

leT

Spring 2016eLevate 8

PHoT

oS: T

HIS

PAGe

: ©Ju

lIe

Bell

e; o

PPoS

ITe

PAGe

: ©el

leN

JASk

ol, ©

ISTo

CkPH

oTo.

Com

/PIx

Hook

hoW do I ActuAlly knoW thAt my hIp or hIp

ArthrItIs Is the proBlem? “Many people think they’re having hip pain and point to the outside of the hip, but the groin is where people usually feel the pain of hip arthritis,” says Scott Resig, MD, a board-certified orthopedic surgeon at Castle Rock Adventist Hospital. Besides groin pain, other symptoms may include limping, stiffness, and difficulty crossing your legs or tying your shoes.

WhAt surgIcAl ApproAch do you recommend?

There are three possible approaches for hip replacement surgery: posterior (back), lateral (side), and anterior (front). “In my experience, the anterior approach gives better results. Patients have less pain, and the technique allows for a more accurate restoration of leg lengths,” Resig says. “It also

typically requires a shorter hospital stay, and there’s less scar tissue, and a lower rate of postoperative dislocation.” If your surgeon recommends an anterior approach, be sure to ask how many he or she has performed, Resig says. “There’s a learning curve. It typically takes about 50 procedures to appreciate all of the nuances associated with this approach.”

WhAt Are potentIAl complIcAtIons

of thIs procedure? Complications can happen with any surgery, including infection, blood clots, fractures, dislocation, and loosening of the components.

WhAt kInd of recovery cAn I expect? “Recovery can vary, but people are generally in

the hospital one to three nights and using a walker or crutches for the

first few days,” Resig says. “At two weeks, patients are usually walking without any aids or possibly with a cane. And they’re generally happy at six weeks, and very happy by three months.”

WhAt cAn I do to Improve my outcome?

Improving your results starts with taking ownership of your recovery by doing any exercises your therapist prescribes after surgery. “A regular exercise program will help reduce the stress placed on your new hip,” he says.

When do I knoW I’m reAdy for surgery?

“I usually tell people when pain affects daily life and prevents them from doing things they love to do, it’s time to consider hip replacement,” he says.

If you’re living with hip pain and considering surgery but aren’t sure where to start, here are six

questions to ask your surgeon to help you make the most informed decision.

dr. Scott Resig

deCisionsjo

Int

6 questIons to Ask your

surgeon ABout hIp

replAcement

1

23

4

5

6

1

reApIng the reWArdswillie Burns lived with hip pain for several years before deciding to see a doctor. when she finally did, she discovered that her cartilage had worn down to the point that the bones in her hip socket were rubbing together. the 60-year-old flagler resident scheduled her surgery in June with scott resig, Md, a board-certified orthopedic surgeon who specializes in joint replacement at Castle rock adventist hospital. she opted for anterior hip replacement, which is performed through a tiny incision that allows for faster healing, because she wanted to be able to help with the harvest on her family’s farm. Burns was able to do just that, and used her harvest-time activity as physical therapy. today, she says she doesn’t even think about her hip, and is more active than ever. “people tell me i don’t limp anymore, and it used to be pretty bad,” she says. “My son climbs mountains, and i told him i want to try to climb my first 14er with him this summer.”

eLevate9castlerockhospital.org Spring 2016

PHoT

oS: T

HIS

PAGe

: ©Ju

lIe

Bell

e; o

PPoS

ITe

PAGe

: ©el

leN

JASk

ol, ©

ISTo

CkPH

oTo.

Com

/PIx

Hook

When tricia Lancaster went to Castle rock adventist hospital after experiencing a severe headache and neck pain for several days, she assumed it was related to a pulled muscle, because she’d had lower back and neck issues before. But the real problem was more serious. Lancaster had a vertebral artery dissection — a tear in the inner lining of the artery in the neck that pumps blood to the brain. when the inner lining tears, the blood can clot inside the artery wall. as the clot grows, the artery wall thickens and makes it hard for blood to continue flowing through to the brain. Lancaster’s tear was spotted during a Ct scan, which she didn’t think she needed at first. “i sat there thinking this was way overboard, but it turns out it most likely saved my life,” she says.

even serious syMptoMs Can soMetiMes Be easy to Miss. Learn how CastLe roCk adventist hospitaL’s quiCk-thinking eMergenCy teaM heLped one patient get the Care

she needed to prevent a stroke and save her Life.

lookIngdeeper

extrAordInAry cAre for kIds, too | It’s not just moms and dads who benefit from the emergency medicine experts at Castle Rock Adventist Hospital. Since opening in 2012, Castle Rock Adventist Hospital’s eR team has cared for more than 13,500 children with injuries from broken bones to life-threatening illnesses. At Castle Rock Adventist Hospital, your family benefits from specialists who average more than 30 years of experience. And we are located right here in Castle Rock, so there’s no need to fight I-25 traffic to get fast care for your family’s emergencies. Check castlerockhospital.org/crh/specialties/emergency-care for wait times.

AvertIng A stroke

Lancaster, 34, of Castle Rock, was admitted to the ICU that evening. While she was grateful the problem had been identified, she was also terrified. But an ICU nurse helped calm her down, and she was monitored for signs of stroke and put on blood thinners. The next morning, she saw a neurologist and learned that the tear was small — not large enough for surgery — and would likely heal on its own. She underwent an MRI to determine if she had already had a stroke (she hadn’t). But she would need to stay on blood thinners and be monitored until her next MRI in a couple of months to make sure the tear had healed. Vertebral artery dissection isn’t always easy to spot, as Lancaster learned when she researched the condition via an online support group for people with it. “A lot of people were saying they’d gone to the ER multiple

times, and their issues never got resolved,” she says. “They were surprised when I told them that I got a CT scan right away, because it likely prevented a stroke and probably saved my life.”

experIence pAys off

So, how was Castle Rock Adventist Hospital’s emergency team able make this catch? While the hospital is still new to the community, the team inside has decades of experience — experience that led the team to catching Lancaster’s potentially life-threatening condition. “We’re trained to ask specific questions on what the worst or most emergent items would be, and it’s our job to try to rule them out,” says Britney Anderson, MD, emergency medicine physician and physician director of informatics at Castle Rock Adventist Hospital. In Lancaster’s case, questions about her ongoing headaches and

neck pain led her to disclose that she’d recently seen her chiropractor, which threw up red flags. “We have seen vertebral artery dissections in the past due to chiropractic neck manipulations,” Anderson says. “It’s rare, but it’s something we think of because that’s how we’re trained.” And Lancaster is certainly grateful for this training, and the care she received in the hospital. “From when we walked in the door, the whole experience was awesome,” she says. “I knew I was in a good place and that they knew what they were doing.”

Castle Rock Adventist Hospital is part of the

Centura Health Trauma System, the region’s largest and most comprehensive

network of trauma care and emergency services.

dr. Britney Anderson

A lifesaving diagnosis in the eR at Castle Rock Adventist Hospital

helped Tricia lancaster get home to her family safe and healthy.

lookIng At lumpectomyWhile a lumpectomy conserves part of the breast and may help avoid reconstruction, one of the downsides with this choice is that “women who choose lumpectomy should also undergo radiation therapy to improve local control,” Rogness says. “Radiation therapy will decrease the risk of local recurrence from 40 percent to 7 to 10 percent.” And while lumpectomy does preserve breast appearance, it’s not appropriate for everyone. Size matters — both the size of the tumor and the size of the breast, Rogness says. “If the tumor is greater than 5 centimeters, you really shouldn’t be doing breast conservation [lumpectomy],” Rogness says. “If you have an extremely large breast that would allow for a good surgical margin, you could technically accomplish a lumpectomy, but at 5 centimeters, we typically don’t recommend breast conservation. Neoadjuvant chemotherapy may be used with tumors this large, as the tumors may shrink considerably and allow for lumpectomy.”

For a woman with smaller breasts, removal of a 2-centimeter tumor may cause significant breast deformity. In this situation, a woman may decide to pursue mastectomy with reconstruction. Women typically either have a lumpectomy to preserve sensation or to preserve the appearance of the breast. “So, if you can’t give someone a good cosmetic result with lumpectomy, they should probably undergo a mastectomy,” Rogness says.

mAkIng the cAse for mAstectomyIn addition to size, mastectomy has clear indications for women:3 Who have already had radiation therapy in the

affected breast3 Who have two or more areas of cancer in the

same breast 3 With diseases such as scleroderma or lupus,

who may not be able to handle the side effects of radiation therapy

3 With inflammatory breast cancer Rogness understands that emotion is also part

of the decision and may play a larger role for some women than others. “It can be such an emotional question, and some women cannot stomach the uncertainty and anxiety of follow-up imaging,” she says. “It can become so overwhelming that quite often mastectomy is a better option for them. We’re not improving their quality of life if they’re terrified every morning when they wake up that they’re going to get breast cancer again.”

Spring 2016eLevate 10

PHoT

oS: T

HIS

PAGe

: ©IS

ToCk

PHoT

o.Co

m/l

Ady-

PHoT

o; o

PPoS

ITe

PAGe

: ©IS

ToCk

PHoT

o.Co

m/S

ImAR

Ik

deCiding Between LuMpeCtoMy and MasteCtoMy to treat Breast CanCer Can Be diffiCuLt. arMing yourseLf with the faCts Can heLp you Make the Best ChoiCe for you.

an

Informed Decision

Many women with early stage or locally advanced breast cancer must choose between lumpectomy (conserving part of the breast) and mastectomy (removing all of the breast). While having options is a good thing in general, it’s not always easy to know the right one for you. Medically speaking, both treatments are relatively equally effective, but there are up- and downsides to both.

Some women, understandably, may approach their diagnosis from a position of trepidation. “They feel that if they are very aggressive surgically, and undergo a mastectomy for a tiny tumor, it will dramatically improve their survival — but there’s no science to support that,” says Christine

Rogness, MD, FACS, a breast surgeon at Castle Rock Adventist Hospital who sees patients in her clinic in the Alexander Building, adjoining the hospital. In fact, research shows that survival is not affected by whether you choose mastectomy or lumpectomy with early stage or locally advanced breast cancer. Local recurrence risk, the risk that the tumor will come back in the affected breast, is slightly higher with lumpectomy, Rogness says.

dr. Christine Rogness

Scheduling your annual screening mammogram at Castle Rock Adventist

Hospital is as easy as texting a friend! Just text your name to 720-644-0880 and

we’ll call you to make your appointment.

more mAstectomIesThe number of women choosing

double mastectomy is on the rise.

1998

2%2011

12.3%

If you’ve suffered with back pain, you know the toll it can take. Getting out of bed, walking, even sitting can hurt. Eager for relief, you might be open to surgery. But is it a good option for you?

If you’re considering spine surgery, keep in mind that some conditions are more successfully treated with surgery than others, says Christopher Gallus, DO, a spine surgeon at Castle Rock Adventist Hospital. Here’s a brief overview.

PHoT

oS: T

HIS

PAGe

: ©IS

ToCk

PHoT

o.Co

m/l

Ady-

PHoT

o; o

PPoS

ITe

PAGe

: ©IS

ToCk

PHoT

o.Co

m/S

ImAR

Ik

are you a Candidate for spine surgery?

BAck on trAck

hernIAted dIsc/nerve pAInWhat it is: The discs between the bones in the spine act as shock absorbers and aid in flexibility. An injury or regular wear and tear can lead to a disc herniating or “slipping.” When the herniated disc presses on nerve roots, you can experience pain, numbness, and/or weakness in the arms or legs, depending on which disc is herniated.

likelihood of surgery helping: high. Surgery to decompress the nerve involves removing the material that is pressing on the nerve root, and can be very effective at resolving this kind of pain, Gallus says.

spInAl stenosIsWhat it is: Commonly occurring in the lower back or the neck, spinal stenosis is the narrowing of the spaces within the spine. This puts pressure on the spinal cord and/or nerves.

likelihood of surgery helping: Moderate. Be mindful of your expectations. Decompression surgery aims to relieve the pressure on the nerve roots and should relieve pain and weakness in the legs that occurs as a result of the stenosis. Surgery may not improve pain in the back, however.

generAl loW BAck pAIn What it is: If you can’t point to a specific injury that’s causing your current pain, that could be a sign of muscular strains or a chronic degenerative condition in the spine such as arthritis, Gallus says.

likelihood of surgery helping: varies. “The hardest conversations I have are telling people they don’t need surgery,” Gallus says. “For these conditions, things like exercise, physical therapy, massage, manipulation, or injections for the pain might offer better relief.”

spInAl deformItIesWhat they are: Conditions like degenerative scoliosis (a curvature of the spine), kyphosis (extreme rounding of the spine), and cervical flexion deformity (chin on chest deformity) can cause a great deal of pain — in addition to self-esteem and social challenges. Some people are born with spinal conditions that evolve and worsen over time, while others develop them as adults.

likelihood of surgery helping: Moderate to high. “I’m very comfortable doing these big procedures,” says Gallus, who trained extensively with experts who commonly treat spinal deformities with surgery. But these are complex surgeries with a lot of variables, so it’s important to ask questions and have realistic expectations.

stArt hereif a spine condition is causing severe nerve damage, symptoms may include loss of bladder or bowel control, progressive leg weakness, and extreme pain. in these cases, emergency surgery is likely. But for chronic back pain, there are a few things experts advise trying before surgery. “when i’m working with patients who have low back pain, i opt for a pretty conservative approach,” gallus says. “By the time it gets to surgery, they’ve known me for quite some time.” Before surgery is an option, make sure you’ve tried other therapies and lifestyle changes, including:• Regularexercise• Weightloss• Smokingcessation• Physicaltherapy• Injectionsforpain• Massage• Chiropracticcare

If you are struggling with back pain, physical therapy may be the right place to start. And if you’re facing

surgery, therapy before and after can help improve your outcome. To learn how we can help, call our physical

therapy clinic at 720-455-3700. we are located in the Alexander

Building next to the hospital.

eLevate11castlerockhospital.org Spring 2016

dr. Christopher Gallus

NoN-Profit orgUS PoStAgE

PAiDDENvEr, Co

PErmit No. 4773EL

EVAT

E YO

UR

sprI

ng

2350 Meadows BoulevardCastle Rock, CO 80109

Portercare Adventist Health System

Castle Rock Adventist Hospital is part of Centura Health, the region’s 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 Health’s Office of the General Counsel at 303-804-8166. Copyright © Centura Health 2016

Pioneering health in Castle Rock.

entityhospital.org

entityhospital.orgCAstLe RoCK Ridgeline Family Medicine at the Meadows2352 meadows Boulevard, Suite 300Castle Rock, Co 80109720-455-3750  

Ridgeline Family Medicine — Castle Pines250 max drive, Suite 102 Castle Rock, Co 80108 303-649-3350  

AURoRA CHPG Cornerstar Primary Care15901 east Briarwood Circle, Suite 200Aurora, Co 80016303-269-2626

CHPG southlands Primary Care 6069 South Southlands ParkwayAurora, Co 80016 303-928-7555

CeNteNNiAL CHPG Grace Family Practice 6909 South Holly Circle Centennial, Co 80112720-528-3559

CHPG Care Holly Creek 5500 east Peakview Avenue Centennial, Co 80121303-649-3820

DeNveR CHPG Clermont Park 2479 South Clermont Street denver, Co 80222 303-649-3155

CHPG Primary Care Porter950 east Harvard Avenue denver, Co 80210 303-649-3200

CHPG Primary Care Cherry Creek 300 South Jackson Streetdenver, Co 80209303-316-0416

GReeNwooD viLLAGe CHPG at DtC 8200 east Belleview Avenue Greenwood Village, Co 80111303-770-6500

HiGHLANDs RANCH Highlands Ranch Medical Associates 9135 South Ridgeline Boulevard Highlands Ranch, Co 80129303-649-3140

LittLetoN Chatfield Family Medicine10789 Bradford Road littleton, Co 80127303-738-2714

Clement Park Family Medicine 6901 South Pierce Street littleton, Co 80128303-932-2121

south suburban internal Medicine 7750 South Broadway lIttleton, Co 80122303-347-9897

PARKeR Parker Primary Care 10371 Parkglenn way, Suite 220 Parker, Co 80138 303-649-3100

timberview Clinic at Parker9399 Crown Crest Boulevard Suite 200 Parker, Co 80138 303-269-4410

no need to Live with seAsonAl AllergIes Spring marks the return of runny noses and itchy eyes that leaves many people running to the drugstore for relief. Others, however, have become so accustomed to the symptoms that they accept them as a part of life, which could lead to health issues, says Manujendra Ray, MD, a board-certified specialist in allergy, immunology, and internal medicine at Castle Rock Adventist Hospital. “When it comes to severe nasal allergies, we have to worry about what the long-term effects may be on quality of sleep and disease processes like obstructive sleep apnea,” Ray says. Effective diagnosis and treatment can put an end to the suffering. For most people, skin and blood tests can help zero in on the culprit (or culprits). But sometimes it can be trickier. “We may have individuals with significant symptoms — sneezing, itching, watery eyes in the spring — but their skin and blood tests come back negative,” Ray says. A new test method could help solve the puzzle for these patients who are thought to have local allergy syndrome or entopy. “We take an allergen extract, such as tree pollen extract, and we spray it into the nose and look for reactions,” Ray says. For some patients, that reaction makes it clear what’s causing their symptoms, making a course of treatment clear as well.

BreAthe AgAIn PRiMARy CARe PRACtiCes by City

injections vs. DropsInjectable immunotherapy:

Injections that expose patients to extracts of allergens in a slow,

graded fashion over time. Can take three to five years, but

often results in years of benefit.

Sublingual version: delivers allergen exposure via oral drops

that can be taken at home after an initial clinic visit. only effective with some allergens and symptom relief may not last if treatment is stopped.

PHoT

o: ©

ISTo

CkPH

oTo.

Com

/STe

FANo

luNA

RdI