Medical Voyce | Your Health Care. Your Way.

By Colorado HealthStory

Theresia, previously gainfully employed, shares her story about losing her job and the affect it had on managing her chronic health issues. She describes needing assistance and the impact of a safety net clinic.

“I’ve just kind of learned to be honest, say that there was a need and hold my head up high because I didn’t do anything to cause this to happen and it’s been a very humbling experience. I’m used to giving, not receiving.”

Lung Transplant| They were a mere 13 steps up an ordinary staircase. But they symbolized, ironically, how steeply a man’s life can decline because of illness.

Less than a month ago, it took Mark Tomes five minutes to ascend those steps in his home. He suffered from severe emphysema, the result of a nearly four-decade, two-pack-a-day smoking habit. He routinely required six liters of oxygen to breathe. Physical exertion that most of us think nothing about – like climbing a short flight of stairs, washing pots and pans or even taking a shower – forced him to increase the flow to nine or 10 liters.

Improve Public Health | The Colorado Department of Public Health and Environment identified 10 Winnable Battles that are key public health and environmental issues where progress can be made to improve public health in the next three-five years.

Chris Urbina, executive director and chief medical officer for the department, said, “We selected these 10 Winnable Battles because they provide Colorado’s greatest opportunities for ensuring the health of our citizens and visitors and the improvement and protection of our environment. All partners and stakeholders are needed and welcomed in helping address these Winnable Battles. With collective efforts, we can make a difference.”

The identified 10 Winnable Battles for public health and the environment are:

Hip and knee replacements are improving.

Better surgical techniques and new materials are speeding patients’ recovery.

Ten years ago, patients seeking total hip and knee replacement faced lengthy hospital stays, painful recoveries, and the possibility that the joint would wear out in 10 to 15 years.

Improvements in surgical technique, better pain management at the time of surgery, and new technology enable faster recoveries with less pain and the promise that the new joint will last, says Dr. Eric Jepson, a total joint specialist with Colorado Springs Orthopaedic Group.

“We are able to mobilize patients earlier than we did even five years ago. The plastics, metals, and ceramics we are using make the biggest difference in long-term outcomes,” Dr. Jepson says.

Better surgical techniques

Few patients enter our health care system prepared for the unexpected and embarrassing circumstances that can routinely happen.

Most can accept it when we’re treated with modesty and respect. But not many are prepared for those times when you might be unnecessarily exposed or treated rudely. The possibilities for embarrassment are endless and it is usually unexpected. When avoidable incidents do happen, most patients are not prepared to speak up. Many regret their inability to speak at the time of the incident.

Military Traumatic Brain Injury - James Kelly, MD, has gone from the clinics of University of Colorado Hospital to the front lines in the fight against the signature injuries of modern American warfare.

Kelly is director of the National Intrepid Center of Excellence (NICoE) at the National Naval Medical Center in Bethesda, Md. The center brings some $65 million in infrastructure and a $30 million annual budget to help diagnose and treat soldiers returning from Iraq and Afghanistan with military traumatic brain injury and associated disorders, including post-traumatic stress disorder (PTSD).

“There’s essentially nothing equivalent to it in the country at any of the academic centers,” Kelly said.

According to the American Diabetes Association, one in four people with diabetes will develop a foot ulcer during their lifetime. Because people with diabetes lose many of their defensive mechanisms and may develop numbness in their feet, unnoticed or neglected foot sores can become infected. The consequences can be drastic: About 66,000 Americans with diabetes will have a lower extremity amputation this year; others will be disabled, and some will die.

“Foot care for people with diabetes is the single most important step toward preventing infection, deformity, and amputation,” says Dr. Nicholas Sol, Podiatrist-Pedorthist at The Walking Clinic, P.C. of Colorado Springs. “In the majority of patients who suffer amputations, their problems began with a sore on the foot caused by ill-fitting shoes or an area subjected to repetitive pressure and rubbing.”

When Dr. Rick Meinig, a surgeon with Front Range Orthopaedics, first heard news reports about the disastrous earthquake in Haiti on Jan. 12, 2010, he knew immediately that he had to do something.

“I put in an application for volunteering with the Orthopaedic Trauma Association, Partners in Health, and some other associations,” Dr. Meinig says. “I thought I would get a quick response, because they were saying there was a critical need for orthopaedic surgeons.”

Through Facebook posts, he learned that Dr. Jim Smith, a Pueblo surgeon, was already in the devastated country, helping to organize the medical personnel streaming in. He also found that a small, private hospital in Port-au-Prince was desperate for help.

Cancer Center Research has been funded for two diabetes drugs taken by millions of Americans and believed to prevent lung cancer in some patients but could speed up cancer metastases in others, according to researchers at the University of Colorado Cancer Center.

The National Institutes of Health has just awarded these researchers a $1.4 million, five-year RO1 grant to learn why the same drug could have seemingly opposite effects.

Bunions aren’t just unattractive lumps on your big toe. They’re a common, progressive foot deformity that can become quite painful. But many people don’t take them seriously and delay treatment for years. Conservative treatment may help to relieve the symptoms, but bunions get worse over time, and surgery is the only way to fix the deformity.

“It’s not uncommon for patients to wait until they absolutely can’t stand it anymore,” says Dr. Fred Hainge of Hainge & Groth Foot and Ankle Clinic of Colorado Springs. Not only that, but waiting can mean that arthritis sets in. It’s much harder to fix them if arthritis is present.

Thanks to technological advances, the procedures that Drs. Hainge and his partner Bryan Groth perform are highly successful and have a low risk of complications.

What are bunions?

Pulmonary Hypertension: David Badesch has spent more than 25 years chasing a disease, one so elusive that many physicians have trouble even recognizing it, much less knowing how to treat it.

It’s pulmonary arterial hypertension (PAH), a relatively rare, but extremely debilitating and even deadly disease that increases pressure in the blood vessels in the lungs, making the right side of the heart work harder. Patients suffer from shortness of breath, fatigue, heart palpitations, and limb swelling. Left untreated, it leads to right-side heart failure.

Physician Performance| Physician Recognition Program Linked to Improved Health and Spending Savings

Physician Performance| In 2006, a number of Colorado health plans and employers joined together in a national program called Bridges to Excellence (BTE). Under the leadership of the Colorado Business Group on Health (CBGH), these groups agreed to recognize physicians who voluntarily applied to this national organization and who could demonstrate that most of their patients could meet rigorous standards for metrics on blood pressure, cholesterol, blood sugar, and other vital statistics. BTE recognizes and rewards physician performance to those who deliver superior patient care. With a special emphasis on chronic conditions, the BTE collaboration among employers, health plans and physicians is designed to spur continuous improvements in the quality of health care.

The pain was off the charts. Surgery was a last resort that helped get her back into action.

A month before her 28th birthday, Angela Crews was carrying a heavy piece of equipment at the photography studio where she worked. When she twisted to keep from dropping it, pain shot through her lower back.

Angela had x-rays and began physical therapy, but her pain worsened over the next three years. After consulting several orthopedic physicians and a pain specialist, she was diagnosed with degenerative disc disease—a condition that is relatively rare in a young, slim and active person like Angela. She was treated with further physical therapy, therapeutic exercise, electric stimulation, medication, steroid injections, and spinal manipulation by an osteopathic physician. But the pain remained.

Aortic Valve Replacement | Replacing a heart valve – one of the trickiest, most difficult and most dangerous things a human can do to strengthen the structure of a heart – is about to become a minimally invasive procedure. The procedure, transcatheter aortic valve replacement surgery, or TAVR (pronounced TAY-ver), is coming to UCH as soon as March, and the hospital’s Valve Clinic will be the first – and for a time the only – hospital in the state to offer it.

Functional Electric stimulation can commonly help with the difficulty moving following a stroke or brain injury. Therapists help persons with weak muscles to move better is through functional electric stimulation.

A healthy muscle contracts when an electrical signal from the brain travels along a nerve to a muscle and stimulates that muscle to move. Therapists can also stimulate muscles to move by using functional electrical stimulation (FES). FES works by electrically stimulating the muscle through an electrode that is placed on the skin.

Gamma Knife | After months of discussion, planning and other heavy lifting – both literally and figuratively – the Rocky Mountain Gamma Knife Center opened its doors in the Anschutz Outpatient Pavilion on Monday, Jan. 9.

Those doors lead into a 4,700-square-foot addition built just for a center to house the 42,000-pound Leksell Gamma Knife Perfexion, which has spent the better part of a month in transit from its former St. Anthony Central Hospital home, and then in testing here at UCH. The Gamma Knife focuses cobalt-60 radioactive sources into 192 guided beams, which converge in precise patterns to destroy tumors and other malformations deep inside a patient’s brain noninvasively and with minimal collateral damage. Patients usually go home the same day.

Avoid Sugar - Things That Make Sugar Not So Sweet

Contributed by Tony Isaacs author of Cancer's Natural Enemy

Refined sugar is the number one cause of health problems in the world. The following list is taken from the Article126 Reasons Sugar Is Ruining Your Health by Nancy Appleton, Ph.D. If you have a thing for sugar, you might want to copy this list and put it on your refrigerator or underneath your sugar bowl.

1. Sugar suppresses the immune system.

2. Sugar upsets the minerals in the body.

3. Sugar can cause hyperactivity, anxiety, difficulty concentrating, and crankiness in children.

4. Sugar can produce a significant rise in triglycerides.

5. Sugar contributes to the reduction in defense against bacterial infection.

6. Sugar causes a loss of tissue elasticity and function, the more sugar you eat the more elasticity and function you lose.

Pain in the neck or down an arm, or numbness in the fingers is enough to send many people over 50 to the doctor. It’s obvious something is wrong, especially if the pain has been going on for a while.

But sometimes, more subtle symptoms can signal a condition called cervical myelopathy, which occurs when a degenerative condition or arthritis of the small joints in the neck are narrowing the spinal canal and pressing on the spinal cord.

“Myelopathy can cause generalized weakness, poor balance, difficulty walking, difficulty with tasks that require precise use of the fingers,” says Dr. Mark Santman, an orthopaedic surgeon with Front Range Orthopaedics of Colorado Springs. “The patient just starts to feel clumsier. It’s so gradually progressive that often it gets chalked up to just getting older.”

Patients typically don’t associate some of these symptoms with a cervical spine problem.

For Cindy Fowler, life at age 48 was nearly perfect. She loved her job in business development and marketing and was involved in community activities. Her daughter, a college student, was spending her junior year abroad, and Cindy planned a trip overseas.

But after she returned from Europe, Cindy felt something strange in her left breast.

Her previous mammograms were normal, but this time, there was a new ridge of tissue. A biopsy showed abnormal cells.

Her primary care physician, Dr. Kimberly Tibbs, referred her to Dr. Ingrid Sharon, a surgeon at Memorial Health System’s Breast Surgery Specialists.

“I was lucky enough to have a primary care physician who said, ‘I am not an expert in breast cancer, and I want you to see somebody who is.’ I credit her for saving my life.”

Cindy was diagnosed on Feb. 11, 2008 with multifocal cancer of the left breast.

“It was well hidden,” Cindy says. “The typical diagnostic tools did not indicate it.”

“Bariatric surgery is much safer and much more regimented than it used to be,” says Dr. Michael A. Snyder of Denver Bariatrics. “The results are phenomenal in treating weight problems and the conditions that accompany them. Not treating weight issues aggressively if a patient has high blood pressure really means not fully treating the high blood pressure.”

Patients often feel frustrated because their doctors want them to try yet another diet. Some primary care doctors may not be giving bariatric surgery proper recognition and recommending it to their patients for consideration, Dr. Snyder says. That may be because they are basing their decision on out-of-date information.

When should student athletes return to the playing field after a concussion?

It’s a question that has concerned Dr. Mitchell Seemann of Panorama Orthopedics & Spine Center for several years.

Traditionally, Dr. Seemann says, coaches looked at symptoms like headache and disorientation to determine how severe a concussion might be and when a player was capable of returning. In many cases, players have been allowed back onto the field if they seemed relatively normal.

But when they return to sports after a concussion, young athletes are particularly vulnerable to what’s known as Second Impact Syndrome, when an individual has a second injury before the first one has healed. The second injury may seem relatively mild at first, and the athlete might just appear to be dazed. But in fact, the athlete’s brain can quickly swell, and the consequences can range from cognitive impairment to death.

New survey reveals patients and doctors need to talk about asthma management.

If you have asthma, ask your doctor to talk with you about how to properly manage and control your condition.

That was one of the most important messages from the Asthma Insight and Management (AIM), the largest, most comprehensive survey of asthma patients and physicians in the United States in a decade. Results of the survey of 2,500 current asthma patients 12 and older, 1,004 adults without asthma, and 309 physicians in the United States, were released in November 2009.

The study showcases the burden of this chronic disease, says Dr. Robert Nathan, an allergist at Asthma & Allergy Associates and Research Center in Colorado Springs and Pueblo, and a principal adviser on the survey.

What the survey found

Stroke Rehabilitation | HealthSouth Rehabilitation Hospital of Colorado Springs has earned certification for Disease-Specific Care in stroke rehabilitation. The Joint Commission’s Gold Seal of Approval™ was awarded to the hospital for its compliance with the organization’s national standards for healthcare quality and safety for stroke rehabilitation.

Occlusion and TMJ…do you have them?

If you have natural or replacement teeth (most of us), the answer is yes! The term “occlusion” refers to the relationship between upper and lower teeth when they are held together. More commonly it could also be called a person’s “bite.”

Public Health Colorado| The El Paso County Board of Health unanimously appointed Jill Law to the position of El Paso County Public Health Director, and welcomed Dr. Bill Letson as the agency’s Medical Director.

Both Law and Letson come to their new roles with decades of public health experience.

For the past five or so years of my life, I have dedicated my time to understanding health. My reference to health is not simply the absence of pain or a diagnosable disease. Health is something more. Over these five years, I have noticed the word wellness thrown around with different ideas of what it means. This pushed me to explore within myself to find my definition of wellness.

So, after attending hundreds of hours of classes and lectures and spending more time than I would like to admit reading various articles, books and papers, this is what I have come up with.

Wellness cannot be offered in a single service or purchased at a store. Wellness is much more than that. The best definition that I have found is written by The National Wellness Association and they define wellness as “an active process of becoming aware of and making choices toward a more successful existence.”

Even though he was only 56 years old, Dennis knew that the heavy pressure he was feeling in his chest was probably a heart attack. A call to 911 was all it took to put the lifesaving process in motion. Paramedics arrived at his home in just a few minutes. An EKG confirmed he was having a heart attack and the results were faxed to the hospital. By the time he arrived at Penrose Hospital, the heart team was waiting for him. Only 30 minutes later, doctors had opened the blockage in his heart. Dennis did the right thing by calling 911 right away. Cardiologists will tell you that “time is muscle” and the longer treatment is delayed, the more damage is done to your heart. Now, Dennis was faced with the reality that he had to bounce back from this event and make some changes in his life to prevent another heart attack.

Ytttrium - 90 | Interventional radiologists at Memorial Hospital are treating liver cancer patients with yttrium-90 (Y-90) radioembolization, an outpatient procedure that targets tumors with a high dose of radiation while sparing healthy liver tissue.

For patients with Hepatocellular Carcinoma (HCC) or liver tumors from metastatic colorectal carcinoma, Y-90 radioembolization is “an exciting form of therapy that’s very well tolerated by the patient and can prolong the time to progression and survival,” says Dr. Steven Wegert, one of two radiologists at Radiology & Imaging Consultants, P.C., trained to do the procedure at Memorial.

Health Insurance Premiums got some protection from the Department of Health and Human Services (HHS) when they issued a final regulation to ensure that large health insurance premium increases will be thoroughly reviewed, and consumers will have access to clear information about those increases. Combined with other important protections from the Affordable Care Act, these new rules will help lower insurance costs by moderating premium hikes and provide consumers with greater value for their premium dollar. In 2011, this will mean rate increases for health insurance premiums of 10-percent or more must be reviewed by state or federal officials.