healthline november 2009

Take a Tour!

Come take a tour of

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Call for a schedule of

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M E D I C A L C E N T E R O F T H E R O C K I E SP O U D R E V A L L E Y H E A L T H S Y S T E M

If you’re having a baby, we’re here for you.

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Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado N ove m b e r 19, 2009 3

Researchers work on a nicotine vaccine................................................ pg. 4The Healthy Plate .................................................................................... pg. 6How Lovelanders are aging well ............................................................. pg. 8Seniors realize the importance of socialization................................... pg. 11Hospitals react to swine flu threat ....................................................... pg. 13Uncommon Sense with Loveland’s Dr. Beth Firestein ........................ pg. 17Gluten awareness increases................................................................ pg. 18COPD deaths to increase ..................................................................... pg. 20Crandoodles by Steve Crandall ............................................................ pg. 21Destination: Healthy with Amanda Wicker ........................................... pg. 22Loveland health calendar ..................................................................... pg. 23Loveland health briefs .......................................................................... pg. 24The Healthy Plate .................................................................................. pg. 26

Health in aHandbasket

also inside

Health Line of Northern Colorado is a monthly publicationproduced by the Loveland Daily Reporter-Herald. The informationprovided in this publication is intended for personal, non-commer-cial, informational and entertainment purposes only and does notconstitute a recommendation or endorsement with respect to any

company, product, procedure or activity. You should seek theadvice of a professional regarding your particular situation.

For advertisinginformation, contact:

Linda Story — 635-3614

For editorialinformation, contact:

Jade Cody: 635-3656jcody@repor ter-herald.com

InsideH E A LT HLLiinnee

November, 2009

Senior SalsaPage 5

Roboticsurgery inNorthernColorado

Page 14

Jade goes rockclimbing

Page 25

On the cover: The seniorsalsa dancing class at theChilson Chilson RecreationCenter in Loveland (RHphoto by Rhema Muncy).

4 Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado N ove m b e r 19, 2009

HL Health in the News

A Vaccine for Nicotine?Federal stimulus

grant supportscrucial study of

anti-nicotine vaccine

The Associated Press

Efforts to develop a vaccine capa-ble of preventing tobacco addic-tion got a $10-million shot in the

arm in the form of an American Recov-ery and Reinvestment Act grant. Theaward to Nabi Biopharmaceuticals ofRockville, Md., was funded by the Na-tional Institute on Drug Abuse (NIDA).

The Recovery Act funds will help payfor the first pivotal phase III trial of Nic-VAX, an injectable vaccine intended tohelp people quit smoking and preventthem from relapsing.

Successful completion of the studywill bring the vaccine closer to final ap-proval. Already given fast track designa-tion by the U.S. Food and Drug Admin-istration, NicVAX passed initial regulato-ry hurdles showing the basic idea issound. Patients in the trial get sixmonthly shots in the arm.

Earlier results show that smokers us-ing the vaccine had higher rates of quit-ting and longer term cigarette absti-nence than those given a placebo.

“Nicotine addiction causes nearly ahalf million deaths annually in the Unit-ed States alone. Finding effective treat-ments that can help people stay offcigarettes has been a real challenge,”said NIH Director Dr. Francis Collins.“This Phase III trial of a nicotine vaccineoffers tremendous hope towards solv-ing this immense public health prob-lem.”

Annually in the U.S., cigarette smok-ing costs more than $193 billion ($97billion in lost productivity and $96 bil-lion in health care expenditures).

Like other vaccines, NicVAX worksby boosting the immune system. In thiscase, the goal is to generate antibodiesthat bind to nicotine. Normally, nicotineis a small molecule that travels quickly

through the lungs, then the blood-stream and into the brain. However,when nicotine is trapped by an anti-body, it’s too large to get into the brain,subverting the rewarding effects of thedrug.

“We know that once inside the brain,nicotine triggers the release ofdopamine, a chemical linked to plea-sure and to addiction. Once a personbecomes addicted, it is extremely diffi-cult to achieve and sustain abstinence.Withdrawal symptoms, environ-mental cues and stresscan all trigger re-lapse,” said NIDADirector Dr. NoraVolkow. “A vaccinethat limits the abilityof nicotine to enterthe brain, and that is effec-tive for six to 12 months following vac-cination will give smokers a fightingchance to end the addiction/relapse cy-cle that plagues the great majority ofsmokers trying to quit.”

“In the future, the anti-nicotine vac-cine could also prove to be a powerfultool in smoking prevention,” Vo l k o wsaid.

The award continues a public-privatepartnership between NIDA and NABIthat started in 2001 with a grant to sup-port the basic science that led to Nic-VAX. The effort continued in 2005 witha grant to help support early clinical tri-als to test the safety and efficacy of thevaccine.

“The Recovery Act grant enablesNABI to take the next step in the devel-opment of NicVAX. We’re delighted thatNIDA has chosen to support the Nic-VAX program, since we think it couldultimately benefit millions of smokersworldwide,” said Dr. Raafat Fahim,president and chief executive officer ofNabi Biopharmaceuticals.

The National Institute on Drug Abuseis a component of the National Insti-tutes of Health, U.S. Department ofHealth and Human Services. NIDA sup-ports most of the world’s research onthe health aspects of drug abuse andaddiction. The Institute carries out a

large variety of programs to inform pol-icy and improve practice. Fact sheets onthe health effects of drugs of abuse andinformation on NIDA research and oth-er activities can be found on the NIDAhome page at www.drugabuse.gov. Toorder publications in English or Span-ish, call NIDA’s new DrugPubs researchdissemination center at 1-877-NIDA-NIH or 240-645-0228 (TDD) or fax orrequests to 240-645-0227 or [email protected]. Order onlineat www.drugpubs.drugabuse.gov.

NIDA’s National Drug Abuse Treat-ment Clinical Trials Network (CTN) is amulti-site research project of behavioral,pharmacological and integrated treat-ment interventions to determine effec-tiveness across a broad range of com-munity-based treatment settings and di-versified patient populations. For moreinformation about NIH and its pro-grams, visit www.nih.gov.

“In the future, the anti-nicotine vaccine could

also prove to be apowerful tool in

smoking prevention.”— Dr. Nora Volkow


Jennifer LehmanStaff Writer

Aroom full of seniorwomen move fromshimmying shoulder

action to a low, hard, wiggleof the behind. “Shimmy!”shouts Instructor Lisa Fan-cannon to the participants inher Senior Salsa class, guid-ing them to the next move,“Shake it all!”

Shimmies, shakes, mam-bo, salsa, merengue, squarestep, air guitar and the cha-cha intermingle with aero-bics during the Senior Salsaclass at the Chilson SeniorCenter in Loveland.

“It’s upbeat, it’s fun, weget to be silly,” said Instruc-tor Lisa Fancannon.

The class started inSeptember 2008 and hasbeen going strong eversince. Certified in Zumbaand a range of senior pro-grams, Fancannon sought

out a local certification forZumba Gold, the Zumbacourse geared for seniors.When she couldn’t find onearound she designed herown senior friendly danceaerobics class.

“The participants seem toenjoy the challenge of get-ting the steps and enjoy do-ing the steps versus just get-ting on a cardio machine, “said Fancannon.

Nancy Jones, 64, teachesclasses in the Silver Sneakersprogram Monday andWednesday at the ChilsonSenior Center but comesdown on Tuesdays just totake the Senior Salsa class.

“She keeps us moving,”said Jones. “It’s not boringyet it’s familiar enough thatwe don’t get confused.”

Jones said that traditionaldance aerobics classes orsalsa classes don’t take intoaccount the joint issues withseniors when it comes toturns and hip work.

“The class is geared to-ward this age group, towardthe health issues of seniors,”Jones said.

“I have been coming to

Chilson Center for 16 yearsdoing strength trainingwhich includes a little bit ofaer obics,” said BarbaraLewallen, age 70. “I neededmore aerobic type work andthis sounded like fun.Yo u ’re exercising and youdon’t realize it ... until youstart perspiring.”

Joann Grazier, 66, has

been participating in theclass it started.

“It gets my heart rate up. Ilike the music, I like todance,” said Grazier. “It’sfun to be with other peo-ple.”

“Who’s you’re hero?”shouts Fancannon to theclass, “We are!” they re-spond, flexing their biceps.

SStteepp,, sshhiimmmmyy,,rreeppeeaatt

Senior salsakeeps thosehips moving

RH Photos/ Rhema Muncy


HL The Healthy Plate

AP photoParmesan-Crusted Chicken Fingers

Start to finish: 35 minutes (15minutes active)

Servings: 4

Ingredients:Olive or vegetable oil cooking

s p r ay2/3 cup panko (Japanese-style)

breadcrumbs1/4 cup grated Parmesan cheese2 tablespoons chopped fresh

parsley (optional)1/4 teaspoon ground black pepper1 tablespoon Dijon mustard2 egg whites1 pound chicken tenders

D i re c t i o n s : Place a rack inthe top third of the oven.Heat the oven to 425 degrees.Set a wire rack on a bakingsheet and coat the rack light-ly with cooking spray.

In a shallow bowl, stir to-gether the breadcrumbs,Parmesan cheese, parsley (ifusing) and pepper. In anothershallow bowl, whisk together

the mustard and egg whitesuntil frothy and opaque.

Dip each chicken tender inthe egg white mixture, thenin the bread crumb mixtureto coat all sides. Place on theprepared rack.

Spritz the top of each ten-der lightly and evenly withcooking spray, then turn andrepeat on the other side. Bakeuntil the crumb coating isgolden brown and crisp andthe chicken is no longer pinkat the center, about 15 to 20minutes. Serve immediately.

Nutrition information perser ving (values are roundedto the nearest whole num-ber): 204 calories; 24 caloriesfrom fat; 3 g fat (1 g saturat-ed; 0 g trans fats); 72 mgcholesterol; 13 g carbohy-drate; 32 g protein; 0 g fiber;339 mg sodium.

Parmesan-Crusted Chicken Fingers

All faiths or beliefs are welcome. 09-G0452

45 miles of nerves. 630 muscles. 206 bones. 60 billion brain cells.

Recovery in body, mind and spirit. To learn more about our Gardner Therapy Center,

call us at (970) 624-5458.

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Age without limits

Rhema MuncySpecial Sections

Awell worn pathtraces the feet ofFrances Whitney as

she takes her regular walk.Next month she celebratesher 100th birthday and shehas hardly slowed down tocount the decades. For Whit-ney, physical activity hasbeen a life-long journey.Walking was her family’s on-ly means of transportationduring the depression but inlater years she never stoppedto take her athletic shoes off.

“It is important to stay ac-tive for your health morethan anything,” she said. “Iwent in for a check-up and[the doctor] said walking isthe best. It wasn’t anythingnew to me.”

On nice weather days,Whitney walks with herhelper around the churchparking lot near her house orwhen running errands theywill park as far from thebuilding as possible.

To keep her mind sharp,Whitney devours readingmaterials. She receives booksthrough the Loveland LibraryHomebound delivery pro-gram.

“I read all kinds of novelsand histories, and I travelwhile sitting in my chair,” shesaid.

Frances Whitney’s familyhas been celebrating her bigbirthday all year. She isthankful for her upstandinghealth and she hasn’t fol-lowed any gimmicks toachieve so many happyyears.

“I haven’t done anythingspecial,” Whitney said. “Justwatch your diet and usecommon sense. That is theonly thing I do.”

Loveland resident Carroll,a retired classical guitarist,takes weekly walks with theBody, Mind and Spirit walk-ing group at the SeasonsClub. With three other ladies,she takes a few laps aroundMcKee Medical Center’swellness track. Other days ofthe week she participates ina heart wellness programand a Tai Chi class.

“Activities make me feelgood,” Carroll said. “You useit or you lose it. Exercisemakes me feel better physi-cally, mentally and emotion-ally.”

On one weekly walk, Car-roll chatted with her close-

knit walking group girls andexpressed a grateful heart forlife.

“It is such a blessing. Thebeauty around us is over-whelming,” she said.

The Seasons Club exists topromote such supportgroups, social connectionsMcKee senior services man-ager Phoebe Hawley worksto cultivate in the seniorpopulation.

“I would love to reachthousands of people, but Iam happy if I just make animpact with one,” Hawleysaid.

The Seasons Club offers arange of programs, from bal-ance education to drivingability checkups. Seniors canalso participate in the heartwatchers program and re-ceive blood pressure checks.They also do monthly brownbag medication checks tomake sure senior’s medica-tions are balanced. The clubalso sponsors leisure activi-ties, such as regular cardgames and outings to frontrange activities, such as a re-cent trip to see the musicalWicked in Denver.

Hawley works hard topromote graceful and com-

petent aging.“The most important thing

is that we are going to ageno matter what but the quali-ty of the aging is what’s inquestion,” she said. “ A clublike this is designed to en-hance this quality.”

Because falls are a majorproblem among seniors, pro-active medication interactionchecks, limitation trainingand hearing screenings allhelp keep seniors indepen-dent.

“You only have to worryabout moving on to an ad-vanced level of care if youcan’t take care of yourself,”Hawley said. “By enhancinglife and doing the best wecan with the health we have,then folks aren’t visiting facil-ities as often and they are notchanging their location.Moving is very stressful andhaving health problems isstressful. Even if you helpsomeone in a tiny little way,you are enhancing theirquality of life.”

AGING AND FITNESSEnhancing fitness and so-

cial interaction is at the heartof the senior program atLifestyle Center Health Clubin Fort Collins, a Columbine

Jupiter Images


Health System facility. Man-ager Dana Rogers’ experi -ence with the senior pro-gram extends for severalyears. Many of her membersare over 90 years old andhave built an active commu-nity.

She notices that enjoymentof life effects the quality oflife day-to-day for many se-niors, and that enjoyment isenhanced by interacting withothers, creating a more posi-

tive outlook both mentallyand emotionally. Rogers en-courages group fitness class-es, social moving programsthat help also help seniorsachieve fitness goals.

“The ability to get up froma chair with out assistanceand walk without a cane or awalker is a thrill,” she said.

During exercise programs,Rogers sees a gradualchange in posture too.

“So many seniors need a

cane or walker and so theyhave a hump over fromleaning forward,” she said.“Exercise strengthens someof those muscles. Functionalfitness helps in continuingday-to-day activities, helpingthem to be more indepen-dent in their living.”

This independence is im-portant because seniorswant to continue taking careof themselves and living asthey please.

“Sometimes we take thatfor granted and don’t realizethose things could change ifwe don’t take care of our-selves,” Rogers said. “To beable to continue activitieswithout nursing care is whyit is important to be fit, tocontinue enjoying quality oflife.”

AGING AND NUTRITION

Chilson Recreation Centerdietician Denise Mooreteaches nutrition classes forseniors, coaching them inways to eat better and save

money.

“You have grand-kids andfamilies who care about youand this will make yourquality of life better,” Moor esaid. “Don’t be in a hurry. Ifyou lose even a smallamount of weight you canget off of some medicationsand save money.”

And when people give theexcuse of not wanting to eathealthy because of the price,Moore refutes their argu-ments with price compar-isons.

“Often people think thatthey can’t afford betterfood,” she said. “But com-paring a serving of buyingpotatoes to the French frieson sale or whole grain noo-dles as comparted to maca-roni and cheese, the healthyfoods are cheaper (per serv-ing). At the end of the day,with processed food thereare nine grams of fiber.Healthy choices can be up to31 grams of fiber per day.”

Jupiter Images

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www.BannerHealth.com, keyword: McKee Cancer

2000 N. Boise Ave. • Loveland • (970) 669-4640

Job opportunities: 866-377-5627 (EOE/AA) or www.BannerHealth.com

Banner Health is the leading nonprofit health care provider in northern Colorado.

Jerry’s cancer team gave him his life back. And that’s music to everyone’s ears.

Even after he was diagnosed with non-

Hodgkin’s lymphoma, Jerry found comfort

in playing the piano. And thanks to McKee

Medical Center’s carefully coordinated

cancer team, he soon found the strength to

go on to a healthy life. The pathology and

imaging departments quickly gave Jerry’s

doctors his test results, which helped get

his treatment started right away. Yet, Jerry

said his considerate doctors and nurses

took the time to explain his condition and

give him the best care possible. Because of

this highly specialized, personal approach,

Jerry’s life is in tune. Now he not only plays

for comfort, he gives back by using his

piano to lift the spirits of those in cancer

support groups. McKee Medical Center.

Remarkable health care inspired by you.

47-293320


OldFriends

Loveland retirees stick togetherafter decades of friendship


Bob and Gin Link,Bruce and JoyceGrauberger and Paul

and Marcia Wiener havebeen great friends for thepast 50 years or so.

The group is now in theirmid to late 70s and have metfor dinner just about everyweek for nearly fifteen years.

Bob, Bruce, Paul, Marciaand Joyce all attended thesame tiny college of 300hundred students in Lemars,Iowa and Bob met Ginwhen they were fifteen.

The men all went on toseminary together wheretwo became Methodist pas-tors and one a Presbyterianp a s t o r.

The group has been jok-ingly (but truthfully) referredto as the Six E’s or the SixEvangelicals.

“They were ministers wewere teachers, all of us areinterested in education,” Ginsaid.

With the names Grauberg-er, Wiener and Link thefriends have joked aboutstarting a sausage and ham-burger joint.

The group rotates housesand dinner starts promptly at5 p.m. when an evening ofsharing news, memories andjokes ensues.

Then it’s game time.“One of our favorites is

marbles which is anothername for divorce. Quite fre-quently the fellows playagainst the gals which gives

us extra incentive to win,”Gin said.

The group has sharedgood times and bad timest o g e t h e r.

“There were situations thatkind of cemented our rela-tionships,” Bruce said.

When the Link’s were onone of many annual visits tothe Grauberger’s home yearsago, the Grauberger’s son,who was three-and-a-half atthe time, came in to use therestroom while Bob wasshaving. Bob saw rust col-ored urine in the toilet andalerted the Graubergers.

Eric was admitted to thehospital for ten days fornephritis, a disease that cancause the kidneys to stopfunctioning if not caught intime.

“So in some respects wefeel that Eric is alive becauseof Bob. So you know, itsthese kind of relationshipsthat kind of help seal yourfriendships,” Bruce said.

The Links found solace intheir friends after they lost ason.

“When Dan died, ouryoungest son, why you wereall so supportive, wecouldn’t have made it with-out them, their help andsupport. There’s just nothingthat will take the place offriends when life is tough, “Gin said.

The Grauberger’s namedtheir youngest son BrianWayne after Bob WayneLink.

Paul Wiener was BruceG r a u b e rg e r ’s best man and

Marcia Wiener was JoyceG r a u b e rg e r ’s maid of honor.

When Bob and Gin Linkcelebrated their 25th an-niversary, Bruce renewedtheir vows.

An important factor in thestrength of their friendship,Bob said, is that this groupisn’t all that they have.

“We all have other friends.We get together once a weekand have a real good time,but we’re not clinging toeach other, we all have ourown friends and families.”

“We all have our ownspace,” Bruce said.

Between them some oftheir activities include a bar-bershop group in Loveland,the founding of and partici-pation in the Loveland PoliceChaplains, Rotary, Golden K.Kiwanis club of Loveland,theological study groups,men’s ministry groups, PEO,book club, women’s missionorganizations and calling onthe sick members of their re-spective churches.

“And being retired pastorswe still do funerals and wed-dings,” Bob said.

“Lots of our friends saidwe wish you had the sup-port that you all have had,”Gin said. “We all have ourkids and they are all fairlyclose around but we don’ttotally rely on them. We’veall had each other.”

“I saw a sign not too longago (that said), ‘It takes along time to grow an oldfriend,’ ... “I thought, thatsums it up pretty well,”Bruce said.

“We don’t all think alike.we don’t all agree,” Gin said,... “but we do enjoy eachother’s friendship and we’revery supportive to each oth-er. Whenever we’re needed,we’ll be there,” she said.

STAYING SOCIALFeelings of isolation and

loneliness in the elderly is aserious problem contributingto disproportionately highsuicide rates, alcoholism, de-

pression and a decline inmind and body health.

In 2004, people 65 andolder made up 12 percent ofthe United States populationbut accounted for 16 percentof suicide deaths, accordingto the National Institute ofMental Health.

“Our experience has beenthat isolation is very detri-mental to the overall wellbeing of elderly people. Itmakes them vulnerable forself-neglect, abuse, financialexploitation,” said GaryThurman, manager of theAdult Protection Program forLarimer County.

As we get older, the desirefor meaningful friendshipsdoes not change but formingnew friendships and main-taining the old can get moredifficult with the loss of aspouse or the onset of healthproblems that leaves some-one homebound.

“The older you get theharder it is to make friendsand it seems like less or few-er opportunities to makefriends,” said Dianne Stob-nicke, Director of Volunteersof America in Larimer Coun-ty that runs multiple pro-grams for seniors includingdaily congregate meals and afrozen meals on wheels pro-gram.

Stobnicke said that basedon a survey of the congre-gate meal attendants, social-ization is the No. 1 reasonthat they come.

For some “the biggest so-cialization they have duringthe week is that club meet-ing, it really is a life saver,”Paul Wiener said about theGolden K. Kiwanis club he’sinvolved in.

Meeting new people re-quires a willingness to workat it and sometimes it’s just amatter of luck said psycholo-gist Dr. Beth Firestein ofLoveland.

“I have clients who go andplay cards at the senior cen-ter and they’ve made some


great friends playing cards,participating in classes, play-ing bingo … through activi-ties basically,” Firestein said.“Some people are just plainoutgoing.”

“I think one of the thingsthat’s helpful to people is todo volunteer work,” saidPaul. “It will help you getbeyond yourself and reallyfeel that your life is neededby somebody else or someother institution, whatever itis.”

Even if someone has agroup of friends it can beisolating if those relation-ships are superficial.

According to a 2005 studyon elderly relationshipsfrom the University of Michi-gan, it is not the number ofpeople in the social networkof an elderly person it is thequality of those relation-ships.

To deepen existing rela-tionships, Firestein recom-mends taking the risk of

self-disclosure with anotherperson that seems like theywould be a good fit for adeeper friendship.

“A lot of times yourfriends may also be seekinga deeper connection,”Firestein said. “That invitesthem to share more andthey know it’s safe to go to amore personal level.”

“You can usually tell ifsomeone welcomes thatpersonal disclosure. It’s bet-ter to do it gradually and seehow the other person re-acts,” she said.

Sharing common intellec-tual and spiritual interests orgoals can enhance friend-ships.

“When people share par-ticipation in civil rights,helping the poor … they de-velop deeper relationshipswith others that are in-volved,” Firestein said. “It isa very fertile ground fordeepening a relationship.”

“Some people grow close

through bible study or at-tending same inspirationaltalk because in depth sub-jects leads to more meaning-ful conversations,” Fir esteinsaid.

Illness or an inability tocontinue driving can limitopportunities to get out andsocialize or volunteer.

Firestein recommends thepossibility of telecommuni-cation.

“Not every older person iscomfortable with technolo-gy but it is a way to stayconnected with families andfind people with similar in-ter ests,” she said.

“I’ve known people thatwere chronically ill thatfound an online communitythat they could speak veryopenly and honestly with,”Firestein said.

For those in their lateryears, Firestein offers this:

“Ther e’s no right way tobe an older person. There’sno one idea of psychologi-

cal health. My hope is thatthey would find the freedomto do whatever they want todo.”

RESOURCES

Larimer County Officeon Aging

• w w w . c o . l a r i m e r. c o . u s /seniors/lcoa.htm

970-498-7750

The Suicide ResourceCenter of Larimer County

• www.suicider esourcec e n t e r. o rg

Toll-free hotline 1-800-273-TA L K ( 8 2 5 5 )

Colorado Volunteers ofAmerica

w w w . v o a c o l o r a d o . o rg970-472-9630

Loveland Meals onWheels

970-667-0311

Chilson Senior Center970)-962-2783

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Current hospital safety measures

Rhema MuncySpecial Sections Reporter

The additional healthconcerns of the sea-son prompted both

McKee Medical Center andPoudre Valley Hospital to en-hance visitor rules and insti-tute several health precau-tions through out both hos-pital buildings. Paul Podus-ka, who works in the PVHSinfection control unit, ad-vised the hospital to adoptetiquette guidelines from theCenter of Disease Control forthe current flu and H1N1season when they set thetemporary rule of not allow-ing children as visitors.

“We try and work withpeople to make an arrange-ment so someone watchesthe kids while a parent is inthe hospital,” he said. “Wedon’t want them to be ex-posed to the flu or our pa-tients.”

Although the CDC doesnot recommend a specificage cut off, both McKee andPoudre Valley determined 12years as the youngest agepermitted to visit.

McKee’s infection preven-tionist Janet Conner seesH1N1 mainly in children be-cause they don’t hold thesame hygiene standards asadults.

“You need to assess yourpatient population and whatis best for your facility,” shesaid.

Both hospitals anticipateenforcing these and other fluprevention rules until the fluseason ends, about March orApril, Conner said. She alsoexpects November and De-

cember to be hard hitting flumonths.

According to Conner,younger adults and pregnantwomen see a lot more com-plications with H1N1. Peoplewho are older are at a lowerrisk because they have beenexposed over the decades toa similar virus. For otherswhose immune systems havenever seen a virus, the com-plications are harsher.

Every week, the staff atPVHS reviews the epidemicstatus of the area to assesshow to proceed with patientand staff hygiene regulations.The staff at PVHS also is nowusing a different type ofmask for the nose andmouth.

“They are a much higherdensity mask that filter out amuch smaller particle, suchas a virus, that could be gen-erated from a proceduresuch as suctioning, or if a pa-tient coughs with largeamounts of drops and virus-es,” Poduska said.

To amp up protection,both hospitals now have hy-giene stations with holderswith hand sanitizers, tissuesand masks. There are also in-structions posted throughoutthe buildings on cough eti-quette from the CDC.

“Basic respiratory andhand hygiene is the most ef-fective way of stopping thespread of infection any timeof the year,” Conner said.“Your eyes nose and mouthare huge gateways for virus-es. People shouldn’t touchthe mucus areas. If you havebeen in a public place, don’ttouch the eyes nose ormouth until you havewashed your hands.”

“Cough etiquette is using atissue or coughing into yoursleeve and washing yourhands. I can’t say enoughabout just washing yourhands,” Poduska said.

McKee has also removedall shared reading materialsfrom reception areas, asthese materials can host astore-house of germs from allpeople who have contactwith them. The restrooms arealso cleaned more frequent-ly.

To prevent the spread ofdisease in the work world,Poduska advises that all peo-ple to stay home, even ifthey are die-hard workers,and that they understandwhen symptoms are seriousenough to go to the hospital.

“Most flus come and goand you can do just fine withsomething to treat the feverand fluids. It is a virus and itwill last basically a week.”

GERMS AT HOME

For keeping the familyhealthy, clean frequentlyused surfaces. Poduska said

that most products on themarket will kill flu andH1N1. For am inexpensivealternative, Conner recom-mended a 10 percent bleachdisinfectant.

For hand washing, latherhands for 20 seconds. Thenuse the paper towel to turnoff the faucet and open thedoor, Conner said. Wash af-ter preparing food, cleaningkids rooms, changing diapersand using the bathroom.Conner also advocates usinga tissue only once becausetheir single use prevents thespread of infection.

Poduska also recommend-ed making sure the dish-washer booster is workingef fectively.

“When you go to dry thedishes, don’t dry them ontheir own,” he said. “Drythem in the washer. Thathelps disinfect the dishes.”

Harsh flu seasonrequires extra

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Robots

Left: Dr. Crane demonstratesthe pivoting ability of therobotic instruments. Below:The robotic tools are able toopen and close a safety pin.

SurgeonsLocal hospitals embrace thelatest in robotic technology


Three small, metal birdbeaks shaped likescissors and clamps

are working inside your bel-ly or in your heart, removingcancerous masses, perform-ing bypasses. Imagine thesebird beaks have the ability torotate 360 degrees, andmatch your surgeon’s wristsmove for move from acrossthe room, making delicatesnippets and slices.

This is robotic surgery.“I can do anything I want,

just as if I was operatingwith my normal hands,” saidDr. John Crane, gynocologist

with Banner Health Sys-tems at McKee Medical Cen-t e r.

Crane sits at a console, hisforehead set in a viewer, hisforearms resting at 90 degreeangles with the thumb andforefinger of each hand insmall slings that open andclose. From the console iswhere the surgeon’s handsare virtually downsized into

tiny instruments that are at-tached to a robot that lookslike a cross between anoversized R2D2 and a metalspider. During surgery thesurgeon sits at the console inthe corner and this robot isdocked next to the patient.

Surgeons at McKee Medi-cal Center, Poudre ValleyHospital and Medical Centerof the Rockies, and at agrowing number of hospitalsacross the country, are usingthis latest technology. Therobot called daVinci and de-signed by Intuitive Surgical,performs robotic laparo-scopic surgeries and thora-coscopic surgeries, minimal-ly invasive surgery of the ab-domen and chest area in-cluding lungs and heart bygynecologists, urologists andcardiac surgeons.

The wristed capability ofthe robotic instruments mim-ics all forms of motion ofyour own wrist and thumbsand forefinger said Dr.Michael Stanton, cardiac sur-geon for Poudre ValleyHealth Systems.

Traditional mini-mally invasivesurgery used fixedinstruments thatwere anywhere from30-50 cm long, saidCrane. “The scissorson the end orgraspers on the endwere just there, theydidn’t have the abili-ty to move and artic-ulate. This has whatare called wristed in-struments,” Cranesaid.

Demonstratingwith the robot,Crane grasps a safetypin with one clamp-ing tool and uses acurved clamp toopen the saftey pinand close it againwhile seated at theconsole several feetaway.

“There is absolute-ly no way you coulddo that with tradi-tional laparoscopy,”Crane said.

From the consolthe surgeon controlsthe instruments andviews them and theinnards from a highdefinition, three di-mensional screenthat magnifies thescope’s focus tentimes.

“It’s like when yousee this sheet right here,”said Crane, pointing to theblue sheet wrapping the sur-gical table. “When I’m in theconsole I can see every fiberof that blue sheet. That’s thedif ference.”

“I can get a lot closer andsee itty bitty arterials that Icouldn’t see with traditionallaparoscopy or even withopen surgery,” Crane said.

The difference betweentwo dimensional and threedimensional capabilities ishuge, said Stanton. Havingonly a two dimensional viewis like driving down the

street with one eye coveredas opposed to both eyes un-covered; three dimensionsoffers greater depth percep-tion, he said.

“Once you get used to itit’s like driving a stick shift,”Crane said, “you go aroundthe corner without eventhinking about it.”

In traditional laparoscopicand thoracoscopic surgeriesthe surgeon has to manipu-late the scope in one handand an instrument in theother hand inside the patientwhile viewing his or her ac-tions on a video screen. Just

the act of manipulating bothinstruments in the patientmakes the proceduremessier and less precise,Crane said.

“(Traditional laparoscopy)is ranking on that patient,where as this, the way it'sbuilt, it pivots. It allows meto get over, around and un-der neath,” said Crane.

The instruments used withrobotic surgery are nevermoving more than they haveto and tearing the muscle,something that is more likelywith traditional laparo-scopies, Crane said.

The typical recovery timefor a traditional laparoscopicsurgery for say, a hystorec-tome, is six weeks, withrobotic surgery, it’s twoweeks. Previous hospitalstays would have been twoto three days and withrobotic surgery the sameprocedure allows most pa-tients to go home after one.

The decrease in recoverytime is owed to the greatervisibility and articulation thatthe console and wristed in-struments offer with robotics u rg e r y .

“There is less cutting (inrobotic surgery) but evencompared to traditional la-paroscopy where the inci-sions are about the samesize and there is the sameamount, three, four or five,”said Crane, “there is still lessblood loss and that’s be-cause you have such a clos-er, more magnified, distinctview of your anatomy.

“In traditional laparoscopyyou may not see the littleblood vessels that are twomillimeters in diameter thatcan bleed 10-15 ccs here, 10-15 ccs over here. But (withrobotic surgery), you can seethem all and avoid that,” hesaid.

The amount of bleedingduring surgery directly im-pacts the pain factor becauseblood is an irritant, Craneexplained.

“You get blood in the bel-ly or the pelvis and it createsinflammation in all of the tis-sues and without that youdon’t hurt as much. Themore blood you lose themore your heart has to adaptto that blood loss, the bonemorrow cranks up and startsproducing more red bloodcells. It’s a systemic eventwhen you lose enoughblood,” said Crane.

Robotic surgery makes itso that cardiothoracic sur-geons don’t have to spreadthe ribs to access the chestcavity which is very painful,

said Stanton, contributing tofaster recovery times forheart and lung patients.

“It can hurt anywherefrom four weeks to severalmonths when you spreadthe chest,” Stanton said.

The robot has centralizedmajor surgical procedures.

The surgeon depends on-ly on the touch of a buttonto switch between the threeinstruments and scopewhereas open surgery andtraditional minimally inva-sive methods requires com-munication between assis-tants and the surgeon tochange out each instrumentCrane said.

“There is a lot of timewasted in traditional la-par oscopy”.

The surgeon is accompa-nied by an assistant, typicallyanother surgeon, who staysnext to the patient. A teamof surgical technicians is alsoin the room.

The surgeon makes theinitial incisions and closesthe surgical area by handonce the procedure is com-pleted.

Similar to traditional mini-

mally invasive surgery, theincisions for robotic surgeryare few and small at eight toten millimeters each.

The scope and instru-ments are guided into thepatient by little tubes calledtr ocars.

The trocar with the scope,or camera, is the first thing togo in so that the surgeon candetermine where to placethe other trocars.

In some cases, roboticsurgery is not the best op-tion.

“Ther e’s things where it’sabsolutely ideal and thingswhere it just isn’t,” Stantonsaid.

Combination heart proce-dures like a valve replace-ment and a coronary bypasscan take so long that it’sdetrimental to the patient,Stanton said.

In general, robotic surgerytakes 30-40 percent longer.

Ther e’s a longer surgerybut a shorter hospital stay,Stanton said.

If the patient has had a

RH Photos/Paul LitmanCrane sits at the surgical console manipulating the robotic instruments

&

“I can do anything I want,just as if I was operatingwith my normal hands,”

— Dr. John Crane, gynocologist with BannerHealth Systems at Mckee Medical Center.

� See ROBOTIC/Page 16

14 Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado N ove m b e r 19, 2009 Thursday LOVELAND REPORTER-HERALD/Health Line of Northern Colorado N ove m b e r 19, 2009 15

Robots

Left: Dr. Crane demonstratesthe pivoting ability of therobotic instruments. Below:The robotic tools are able toopen and close a safety pin.

SurgeonsLocal hospitals embrace thelatest in robotic technology


Three small, metal birdbeaks shaped likescissors and clamps

are working inside your bel-ly or in your heart, removingcancerous masses, perform-ing bypasses. Imagine thesebird beaks have the ability torotate 360 degrees, andmatch your surgeon’s wristsmove for move from acrossthe room, making delicatesnippets and slices.

This is robotic surgery.“I can do anything I want,

just as if I was operatingwith my normal hands,” saidDr. John Crane, gynocologist

with Banner Health Sys-tems at McKee Medical Cen-t e r.

Crane sits at a console, hisforehead set in a viewer, hisforearms resting at 90 degreeangles with the thumb andforefinger of each hand insmall slings that open andclose. From the console iswhere the surgeon’s handsare virtually downsized into

tiny instruments that are at-tached to a robot that lookslike a cross between anoversized R2D2 and a metalspider. During surgery thesurgeon sits at the console inthe corner and this robot isdocked next to the patient.

Surgeons at McKee Medi-cal Center, Poudre ValleyHospital and Medical Centerof the Rockies, and at agrowing number of hospitalsacross the country, are usingthis latest technology. Therobot called daVinci and de-signed by Intuitive Surgical,performs robotic laparo-scopic surgeries and thora-coscopic surgeries, minimal-ly invasive surgery of the ab-domen and chest area in-cluding lungs and heart bygynecologists, urologists andcardiac surgeons.

The wristed capability ofthe robotic instruments mim-ics all forms of motion ofyour own wrist and thumbsand forefinger said Dr.Michael Stanton, cardiac sur-geon for Poudre ValleyHealth Systems.

Traditional mini-mally invasivesurgery used fixedinstruments thatwere anywhere from30-50 cm long, saidCrane. “The scissorson the end orgraspers on the endwere just there, theydidn’t have the abili-ty to move and artic-ulate. This has whatare called wristed in-struments,” Cranesaid.

Demonstratingwith the robot,Crane grasps a safetypin with one clamp-ing tool and uses acurved clamp toopen the saftey pinand close it againwhile seated at theconsole several feetaway.

“There is absolute-ly no way you coulddo that with tradi-tional laparoscopy,”Crane said.

From the consolthe surgeon controlsthe instruments andviews them and theinnards from a highdefinition, three di-mensional screenthat magnifies thescope’s focus tentimes.

“It’s like when yousee this sheet right here,”said Crane, pointing to theblue sheet wrapping the sur-gical table. “When I’m in theconsole I can see every fiberof that blue sheet. That’s thedif ference.”

“I can get a lot closer andsee itty bitty arterials that Icouldn’t see with traditionallaparoscopy or even withopen surgery,” Crane said.

The difference betweentwo dimensional and threedimensional capabilities ishuge, said Stanton. Havingonly a two dimensional viewis like driving down the

street with one eye coveredas opposed to both eyes un-covered; three dimensionsoffers greater depth percep-tion, he said.

“Once you get used to itit’s like driving a stick shift,”Crane said, “you go aroundthe corner without eventhinking about it.”

In traditional laparoscopicand thoracoscopic surgeriesthe surgeon has to manipu-late the scope in one handand an instrument in theother hand inside the patientwhile viewing his or her ac-tions on a video screen. Just

the act of manipulating bothinstruments in the patientmakes the proceduremessier and less precise,Crane said.

“(Traditional laparoscopy)is ranking on that patient,where as this, the way it'sbuilt, it pivots. It allows meto get over, around and un-der neath,” said Crane.

The instruments used withrobotic surgery are nevermoving more than they haveto and tearing the muscle,something that is more likelywith traditional laparo-scopies, Crane said.

The typical recovery timefor a traditional laparoscopicsurgery for say, a hystorec-tome, is six weeks, withrobotic surgery, it’s twoweeks. Previous hospitalstays would have been twoto three days and withrobotic surgery the sameprocedure allows most pa-tients to go home after one.

The decrease in recoverytime is owed to the greatervisibility and articulation thatthe console and wristed in-struments offer with robotics u rg e r y .

“There is less cutting (inrobotic surgery) but evencompared to traditional la-paroscopy where the inci-sions are about the samesize and there is the sameamount, three, four or five,”said Crane, “there is still lessblood loss and that’s be-cause you have such a clos-er, more magnified, distinctview of your anatomy.

“In traditional laparoscopyyou may not see the littleblood vessels that are twomillimeters in diameter thatcan bleed 10-15 ccs here, 10-15 ccs over here. But (withrobotic surgery), you can seethem all and avoid that,” hesaid.

The amount of bleedingduring surgery directly im-pacts the pain factor becauseblood is an irritant, Craneexplained.

“You get blood in the bel-ly or the pelvis and it createsinflammation in all of the tis-sues and without that youdon’t hurt as much. Themore blood you lose themore your heart has to adaptto that blood loss, the bonemorrow cranks up and startsproducing more red bloodcells. It’s a systemic eventwhen you lose enoughblood,” said Crane.

Robotic surgery makes itso that cardiothoracic sur-geons don’t have to spreadthe ribs to access the chestcavity which is very painful,

said Stanton, contributing tofaster recovery times forheart and lung patients.

“It can hurt anywherefrom four weeks to severalmonths when you spreadthe chest,” Stanton said.

The robot has centralizedmajor surgical procedures.

The surgeon depends on-ly on the touch of a buttonto switch between the threeinstruments and scopewhereas open surgery andtraditional minimally inva-sive methods requires com-munication between assis-tants and the surgeon tochange out each instrumentCrane said.

“There is a lot of timewasted in traditional la-par oscopy”.

The surgeon is accompa-nied by an assistant, typicallyanother surgeon, who staysnext to the patient. A teamof surgical technicians is alsoin the room.

The surgeon makes theinitial incisions and closesthe surgical area by handonce the procedure is com-pleted.

Similar to traditional mini-

mally invasive surgery, theincisions for robotic surgeryare few and small at eight toten millimeters each.

The scope and instru-ments are guided into thepatient by little tubes calledtr ocars.

The trocar with the scope,or camera, is the first thing togo in so that the surgeon candetermine where to placethe other trocars.

In some cases, roboticsurgery is not the best op-tion.

“Ther e’s things where it’sabsolutely ideal and thingswhere it just isn’t,” Stantonsaid.

Combination heart proce-dures like a valve replace-ment and a coronary bypasscan take so long that it’sdetrimental to the patient,Stanton said.

In general, robotic surgerytakes 30-40 percent longer.

Ther e’s a longer surgerybut a shorter hospital stay,Stanton said.

If the patient has had a

RH Photos/Paul LitmanCrane sits at the surgical console manipulating the robotic instruments

&

“I can do anything I want,just as if I was operatingwith my normal hands,”

— Dr. John Crane, gynocologist with BannerHealth Systems at Mckee Medical Center.

� See ROBOTIC/


cardiothoracic surgery in that same areabefore, scar tissue from the previous re-covery may distort the anatomy makingthings difficult without the tactile senseof human hands, said Stanton.

“You can’t feel what you are doing.Sometimes in surgery, not always, tac-tile sense is very important.” Stantonsaid.

In gynecological surgeries, most ev-eryone is a candidate for roboticsurgery, Crane said.

“The people who are not candidateswould be large mass ovarian cancercases, or people in whom you alreadyknow have such bad bowel adhesionsthat just putting in a trocar would placethem at a high risk of getting a bowelinjury,” Crane said in an e-mail.

Some patients are expecting miracu-lous results.

“Everyone wants to get fixed withoutany pain,” said Stanton.

“The media blitz for this nationwide,

actually worldwide, is getting huge,”Crane said. “They’re still having majorsurgery. They just don’t realize it. Theyare looking and seeing four or five littleincisions, and from what they’ve heardon Opera and Redbook and Grey’sAnatomy, they think they are going tobe able to jump out of bed and go to

work.“You gotta realize you’re going to

have major surgery as if this was open(surgery). Still, two weeks is a heck of alot better than six weeks and leavingthe hospital after one day is better thanleaving the hospital after three days,”Crane said.

ROBOTICFrom Page 15

BannerHealth’s Dr.Crane withthe roboticsurger yequipment.

RH photo/Paul Litman

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HL Uncommon Sense

Reclaim personal life when kids grow

Beth FiresteinUncommon Sense

Question: My youngest sonstarted full time in school forthe first year. I thought I wouldbe thankful for some free time

after staying home with my three kidsfor the last seven years, but instead Ifeel deep emptiness. How can I claimmy own life back again?

Answer: I am probably stating theobvious when I say how powerful thefirst 5 or 6 years of parental attentionand bonding are to a child’s healthyemotional, psychological and physicaldevelopment. We often focus on the in-tensity of the bonding of the child tohis or her mother, but we sometimesforget how powerful the bonding is forthe at-home parent as well.

What you are feeling is probably ablend of things that can occur anytimethere is a marked change from the situ-ation we have been in for several years.Feeling of loss and feelings of happi-ness and relief are both natural emo-tional reactions to these changes, butyou may feel them at different times inthe transition.

In addition, the challenges are differ-ent for full-time mothers who care fortheir children at home and full-timemothers who work outside the home.(There is no such thing as a part-timemother, is there?) For awoman (or man) whohas taken on the all-con-suming responsibility ofdaily child-rearing, it isalmost impossible not tolose sight of whom youare as an individual.

Reconnecting withyour sense of self apartfrom your identity as

mother doesn’t happen overnight. Thespace and free time you are regainingare, in fact, empty at first. How could itbe otherwise? Refilling that inner andouter emptiness — which I prefer tocall free space and free time — usuallydoesn’t happen all at once. Rediscover-ing yourself, old interests and renewingfriendships is a process you can trustwill definitely happen if you allowyourself permission to be in that spa-ciousness. Slowly replant the free spacewith people and activities that are funand meaningful to you.

Replant freerelationship space

Dr. Beth Firestein is a licensedpsychologist. She has 23years of therapy experienceand has practiced in Lovelandfor over 12 years. She may bereached by calling her office at970-635-9116 or via e-mail atf i re w o m @ w e b a c c e s s . n e t .

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Awareness surroundingceliac disease, a ge-netic, autoimmune

disease that damages thesmall intestinal lining, has in-creased in the past few yearsbringing attention to themandatory gluten-free dietthat accompanies it.

Prolamins and glutenins,the proteins in wheat, barleyand rye are what cause theimmune system to gobonkers in patients with celi-ac, Dr. Crystal North, a gas-

troenterologist in Loveland,said in an e-mail.

Particularly in the last twoto three years there’s been ahuge mushrooming of avail-able foods and resources,said Judy Bushnell, secretaryof the Northern ColoradoChapter of the Celiac SprueAssociation, a national sup-port group for people withceliac disease.

“Restaurants are gettingmuch more knowledgeable.Any time I go into a restau-rant I ask if they have agluten-free menu and mostof the them do and if theydon’t, the chefs are at leastsomewhat knowledgeableabout gluten so you can getsteered in the right direc-tion.”

Bushnell was diagnosedwith celiac disease twentyyears ago when there was lit-

tle knowledge and supportsurrounding the disease andfew gluten-free options inthe stores, Bushnell said.

“It’s very exciting now,Bushnell said, “When newbakeries or gluten free prod-ucts would start up I wouldbuy them to encourage thembut there is too many now. Ican’t buy all of them andthat’s a wonderful choice tohave to make,” she said.

“It’s almost become a faddiet. People say, oh I’m notfeeling well I want to gogluten-free or wheat-free. Ithink that’s all feeding on the(gluten-free) market,” Bush -nell said.

Bushnell had what wereconsidered classic symptomsof celiac disease at the time,diarrhea and malabsorption.

“I was essentially starvingto death, even though I was

eating like an absolute pig,”said Bushnell.

“The only reason I thinkthat the doctor was able todiagnose it is because I start-ed to keep a food diary ofeverything I put in mymouth,” said Bushnell, whomade the connection thatshe felt better on one of thedays that she hadn’t eatenany wheat.

The wide variety of symp-toms, or lack thereof, canmake the disease difficult todiagnose.

Gina Mohr-Callahan, in-coming chairperson of theNorthern Colorado CeliacSprue Association, sufferedfrom fiber mayalgia andchronic headaches beforeshe was diagnosed.

“I had really unrelated

• See Gluten/

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symptoms and I was proba-bly sick my whole adult lifewith celiac related symptomsand no one put them all to-g e t h e r, ” Mohr-Callahan said.

“I was losing my hair, I hadenormous, thick, Diana Rosshair, and it just evaporated,”she said.

Mohr-Callahan, who wasdiagnosed about elevenyears ago, experienced se-vere weight loss, losing 40pounds in a year, leaving herat 89 pounds.

“No one could figure itout, it wasn’t like I was diet-ing in any way, I was eatinga normal diet,” Mohr-Calla -han said.

Through research shelearned that 50 percent ofpeople with the disease don’thave the classic symptoms.

“I begged my doctor to testme,” said Mohr-Callahanwho was diagnosed as hav-ing a wheat allergy andtipped off to celiac diseaseby a reader of her food col-umn. “She said, Oh youdon’t have that, its reallyrar e,” said Mohr-Callahan.

It is now known that celiacdisease is a common geneticdisorder affecting 1 in 133people, according to the Na-tional Institute of Health.

“Patients can have nosymptoms at all, have mildblood test abnormalities orcan have gastrointestinalpr oblems,” said North. Mal-absorption leads to vitamindeficiencies effecting every-thing from the brain to thebones. There are lists of re-lated symptoms and illness-es.

Celiacs are diagnosedthrough a blood test thatscreens for high levels of an-tibodies. If that number ishigh, celiac disease is likelyand a biopsy of the smallbowel is done to confirm thediagnoses and assess the

Potato StarchMuffins

From the Celiac Sprue Associ-ation web site

Ingredients:4 eggs, separated1 tablespoon sugar2 tablespoons cold water3/4 cup potato starch1/2 teaspoon saltgrated rind of 1/2 lemon

Directions: Beat the yolksuntil light. Gradually addthe sugar. Beat until lightand creamy. Add the waterand grated rind. Slowly siftin the potato starch. Blendwell.

In another bowl, beat theegg whites with the salt atlow speed until frothy; in-crease the speed to highand beat until peaks form.Carefully fold the stifflybeaten egg whites into theyolk batter. Fill greasedmuffin cups half full. Pre-heat oven to 350 degrees.Bake for 12 to 15 minutes.Yields 12 muffins.

damage, said North.Since gluten-free diets can

begin to repair the systemimmediately, people whobelieve they have celiacsshould get tested beforestarting the diet.

“It’s very difficult to test apatient once they have start-ed a gluten-free diet, saidNorth, “They feel good anddon’t want to “r e-challenge”themselves with gluten justfor a blood test. So thatleaves us with performing anendoscopy or getting the ge-netic testing done, whichisn’t 100 percent accurate,”said North.

M o h r- C a l l a h a n ’s diagnosesinspired her consulting busi-ness, A Fork in the Road, thatcounsels celiacs on diet andlifestyle.

“We ’re getting smarter andpatients are becoming morewell educated and becomingtheir own health care advo-cates, said Mohr-Callahan, “and health care practitionersare becoming more aware.”

Gluten-free options can befound everywhere fromhealth food stores to thedrive-in menu at Carl’s Jr.

“It can be a fad diet forsome people and then somepeople just fall somewherein between,” said DonnaHuckaby, owner of Granny’sGluten-Free Zone in Love-land and a diagnosed celiac.“A lot of people have takenthe test but it just doesn’tshow up, but they do feelbetter when they stop eatinggluten,” she said.

“I would say that it is un-wise to choose the gluten-free path if it is not certain ifyou have celiac disease or agluten intolerance,” saidMohr-Callahan, “It’s a verydifficult path. However,some people just feel bettergluten free. We need tomake good proactive choicesabout our health. Its impor-tant to heed your body’ssigns,” said Mohr-Callahan.

“It’s in medicine, it’s infood, it’s in cosmetics, it’s in

personal care items. Youneed to be educated aboutwhere it is if you are going tobe gluten free. And that’s notso simple when you thinkabout it. It’s a challenge toeat out in a restaurant. It’s achallenge to cook for your-self and make sure you’renot accidentally contaminat-ing your food with gluten.

“I don’t know if I see it as atrend or not,” said North, “Alot of people read about thesymptoms of celiac andplace themselves on agluten-free diet. They feelbetter. Whether this is repre-sentative of a gluten sensitivi-ty or allergy, I am not sure,”she said, “But one can’t ar-gue if the patient feels better.

RESOURCES

• Celiac Sprue Assocation:(877) CSA-4-CSAw w w . c s a c e l i a c s . o rg

• Northern ColoradoChapter of Celiac Sprue As-sociation:

www.norther ncoloradoc e l i a c s . o rg

RH photo/Jade Cody

GlutenFrom Page 18


COPD is fourth leading cause of death in U.S.Theresa Lindahl, McKee Medical CenterRH paid advertorial

COPD stands for Chronic Obstruc-tive Pulmonary Disease. Chronicmeans it won’t go away, Obstruc-

tive means partly blocked, Pulmonarymeans in the lungs and Disease meanssickness. This is a common lung diseasethat blocks the airways, making breathingdifficult. COPD is a group of lung diseaseswhich include emphysema and chronicbr onchitis.

COPD is a major cause of disability andis the fourth leading cause of death in theUnited States. While the death rate for oth-er major diseases such as Coronary HeartDisease and Stroke are declining, thedeaths related to COPD are increasing. It ispredicted that COPD will become the thirdleading cause of death in the year 2020.One of the reasons for the increased mor-tality is due to the expanding epidemic ofsmoking and the population living longer.

While smoking is the No. 1 cause fordeveloping COPD, it can also be causedby occupational dust and chemicals, envi-ronmental tobacco smoke and indoor andoutdoor air pollution. Genetics can also be

a risk factor in the development of COPD.In rare cases, a genetic condition calledAlpha -1 antitrypsin deficiency can causeCOPD. People who have this conditionhave low levels of this protein. Havinglow levels of this protein can lead toCOPD if you smoke, are exposed tosmoke or to other lung irritants.

You may have COPD if you have beenexposed to any of these risk factors andhave symptoms such as shortness ofbreath, a chronic cough and you bring upphlegm or mucus when you cough. Ifyou are over the age of 40 and have anyof these key indicators a COPD diagnosisshould be considered. Because it is a dis-ease that develops slowly, many peoplemay have it but don’t know it. More than12 million people are currently diagnosedwith COPD, an additional 12 million peo-ple have it but have not been diagnosed.

A medical evaluation and tests areneeded to diagnose COPD. The mostcommon test is a breathing test calledspirometry. This measures the amount ofair a person can breathe out, and theamount of time taken to do so. This test isquick and painless and can often be per-formed in your doctor’s office.

Although there is no cure, COPD canbe treated. The earlier a diagnosis is madethe more effective the treatment can be.Smoking cessation is the single most ef-fective and cost effective intervention toreduce the risk of developing COPD andstop its progression. Ask your doctor whatcan be done to help you quit smoking.Counseling, support groups or certainmedications may help you quit.

Part of a treatment plan may also in-clude medications for COPD that are usedto decrease symptoms and/or complica-tions. Oxygen therapy may be prescribedif tests show that your blood contains toolittle oxygen. If your doctor prescribesoxygen, use it. The long term administra-tion of oxygen has been shown to in-crease survival. Another part of your treat-ment plan may include pulmonary reha-bilitation. This program includes exerciseand education, and will help to reducesymptoms, improve quality of life, and in-crease physical and emotional participa-tion in everyday activities.

Remember that the No. 1 cause forCOPD is smoking and help us celebratethe Great American Smokeout on Nov.19. It’s never too late to quit.

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HL Destination: Healthy

Holiday Temptations

Amanda WickerDestination: Healthy

It’s the most wonderful time of the year. Yes, theholidays are here again and it does not seem totake long for the festivities to begin. This time of

the year is full of shopping, parties, family, friends andin the midst of it all food. The food of the season in-vokes comfort and good memories. Because this timeof year is so special it also seems to make a great ex-cuse to break healthy habits with hopes of startingfresh at the New Year.

Going into the holiday season with the goal of keep-ing the healthy habits you have started may seem like adaunting task, however it is not impossible. Over thelast year I have shared many tips and tricks that can

help you navigate the season with your health in mind.It would seem a waste to start over just because of thenew year approaching. My challenge to you is to takethe focus off the special food of the moment and lookaround at the many blessings and loved ones that sur-round you. Celebrate with love, and I think you willfind something incredible that even your favorite holi-day treat could never satisfy.

Navigate a healthfulholiday season

Destination: Healthy

Amanda Wicker is a Loveland nativeand the founder of Destination:Healthy, a free weight losssupport group held at Messageof Life Ministries on the first andthird Tuesdays of every month.Amanda has lost a total of 130 poundsusing diet and exercise.She can be reached [email protected].

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HL Health Line Calendar

ON OUR OWNPathways Hospice is pre-

senting a discussion groupfor people adjusting to life af-ter the death of a spouse.When: Second Wed. of ev-ery month at 6:30 p.m.Wher e: 305 Carpenter Road, Fort CollinsCost: No fee/registrationContact: 970-292-1080

SURVIVING HOLIDAYS AFTERDEATH OF A LOVED ONE

Pathways Hospice is host-ing a presentation for be-reaved persons help navigat-ing the holiday season.When: November 23 from 1-2:30 p.m. and 7-8:30 p.m.Wher e: 305 Carpenter Road,Fort CollinsCost: No fee/registrationContact: 970-292-1080

BRIGHT BEGINNINGSPoudre Valley Health Sys-

tem offers free Bright Begin-nings materials for families inLarimer County with children0-3 years of age. Materialscover growth, development,health, safety and info oncommunity resources. Mate-rials can be obtained througha home visit or by attendinga class. Registration required.December classes:• Program A for infants:When: Dec. 14 at MMC,Dec. 15 at MCR• Program B for toddlers:When: Dec. 7 at the Love-land Library• Program C for 2-3 yearolds:When: Dec. 15 at MCR

Contact: 970-495-7528

BREAST FEEDING SUPPORTGROUPWhen: 10-11 a.m. Mondaysand ThursdaysCost: Fr eeCall: 970-669-WELL (9355)

BLOOD PRESSURESCREENING

Have your blood pressurechecked by a Wellness Spe-cialistWhen: Monday-Thursday, 8a.m.-4:30 p.m. and Friday 8a.m.-noon.Cost: No chargeCall: 970-635-4056Wher e: McKee Wellness Ser-vices, 1805 E. 18th St. Suite 6,Loveland

DIABETES INFORMATIONGROUP

An informational/educa-tional meeting for anyonetouched by diabetes whowants to learn and share.Cost: No fee/registrationCall: 970-203-6550 for moreinformation and topics.Location: McKee Confer-ence and Wellness Center

JOINT PAIN SEMINARFor any type of joint pain.

When: 5:30 p.m., Nov. 19Wher e: Coors Room, McKeeConference/Wellness CenterContact: 970-635-4031

TOTAL JOINT EDUCATIONPhysical and occupational

therapists prepare patientsfor surgery. Program is coor-dinated through your physi-cian's office.When: Thursdays at 3 p.m.Call: 970-635-4172Location: McKee Confer-ence & Wellness Center

CANCER CAREGIVER’SSUPPORT GROUP

For caregivers of cancerpatients. Call for times/loca-tions.Contact: 970-635-4129.

BREAST CANCER SUPPORTGROUPWhen: Second Thursday ofeach month from 5:30-7 p.m.Wher e: McKee Cancer Cen-ter lobby.Contact: 970-622-1961

SOULPLAY ART THERAPYPeople whose lives are

touched by cancer expressthemselves through art. Noart experience needed.When: Wednesdays, 9:45-11:45 a.m.Wher e: McKee Cancer Cen-ter Conference RoomContact: 970-635-4129

MAN TO MAN PROSTATECANCER SUPPORT GROUPWhen: 5:30-7 p.m. the fourthThursday of the monthWher e: McKee Conferenceand Wellness CenterContact: 970-622-1961

CAREGIVERS SUPPORTFor caregivers of elderly

adults. Group provides sup-port/education, particularlyfor memory impairment.Cost: No charge. Care of el-derly family or friends avail-able through Stepping StonesAdult Day Care program dur-ing class times at no charge.When: Nov. 19, Dec. 17, 10a.m.-noonWher e: First Christian

Church, 2000 N. Lincoln Ave.Contact: 970-669-7069

LOVELAND TURKEY TROT 5KR U N / WA L KWhen: Nov. 26, 8:30 a.m.,Gobbler Trek starts at 8 a.m.Wher e: McKee Med. CenterContact: Active.com orwww.mckeefoundation.com

WORLDWIDE CANDLELIGHTING VIGIL

This ceremony takes placearound the world to recog-nize and honor children whohave died.When: 6:30 p.m. Dec. 13Wher e: McKee Med. Center

THE SEASONS CLUBGain insight to Medicare

basics with a counselor fromthe State Health InsurancePr ogram.When: 11 a.m., Nov. 23Wher e: McKee Conferenceand Wellness CenterContact: 970-635-4097Cost: No cost.

KNEE PAIN, JOINT REPLACE-MENT PRESENTATION

Find answers to questionsyou have about knee painand treatment options at anupcoming presentation atMcKee Medical Center.

Orthopedic surgeon MarkMcFerran, M.D., will servesas a guest speakerWhen: 5:30 p.m., Nov. 19Wher e: McKee Conferenceand Wellness Center, 2000Boise Ave., Loveland.Cost: Fr eeContact: 970-635-4031.


HL Health BriefsLOVELAND AUTHOR TO BEFEATURED IN PARENTSM AG A Z I N E

After publishing “The Oth-er Side of Pregnancy” in thespring of 2008, Loveland chi-ropractor and author Dr.Trenton Scott will be fea-tured in an article by Mau-reen Heaney with ParentsMagazine. Heaney’s articlefocuses on back pain andpregnancy and will publishin the Dec. issue of Parentsmagazine. The article will bein the “As They Grow” sec -tion of the magazine.

MCKEE FACILITIES DIRECTORRECOGNIZED BY NATIONALA S S O C I AT I O N

Jim Revis, McKee MedicalCenter’s director of facilitiesservices, has earned the des-ignation of Certified Health-care FacilityManager bythe Ameri-can Hospi-tal Associa-tion. Thecertificationis a nationalcr edentialthat distin-guishes Re-vis as beingamong the elite in the criticalfield of health care facilitymanagement. Revis joinedMcKee Medical Center inDecember 2008.

MCKEE MEDICAL CENTERTURKEY TROT MIDDLESCHOOL CHALLENGE

The Loveland or Berthoudmiddle school that has themost participants in the 2009Turkey Trot at McKee Medi-cal Center is in for an earlyChristmas present: a $250grant courtesy of the McKeeMedical Center Foundationto be used for a health orwellness-related purpose

The foundation, which or-ganizes the annual 5KThanksgiving Day race, has

challenged six middleschools to compete and seewhich school can send themost runners to this year’srace. The schools are BillReed, Conrad Ball, Lucille Er-win, New Vision Charter,Turner and Walt Clark mid-dle schools.

The 5K race begins at 8:30a.m. on Nov. 26 with theFree Kids Gobbler Trek start-ing at 8 a.m. The GobblerTrek is a short fun runaround the wellness walk ofthe hospital.

Register online atwww.Active.com or print aregistration form atwww.McKeeFoundation.com.

PVHS TO RECEIVE NATION’STOP QUALITY AWARD

PVHS will receive the 2008Malcolm Baldrige Nation-al Quality award fromPresident Obama at aDec. 2 ceremony inWashington, D.C.

The award is given bythe U.S. Department ofCommerce to recognizesustainable performanceexcellence. PVHS is theonly healthcare organiza-tion to receive the 2008

Baldrige award.

PVHS WINS MAGNETPRIZETM AWARD

The American Nurses Cre-dentialing Center (ANCC)and Cerner Corporation, aglobal supplier of healthcaresolutions, announcedPoudre Valley Hospital ofFort Collins as the winner ofthe 2009 Magnet Prize at theOct. 1-3 National MagnetConference in Louisville, KY.This award recognizes inno-vative nursing programs andpractices in ANCC Magnet-recognized organizations.

The Magnet RecognitionProgram was developed to

Jim Revis

� See BRIEFS/

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Dr. Bradley Schnee and Dr. Anne Siple look forward to caring for you and your family.

Call today for an appointment:(970) 619-6900

Foxtrail Family Medicine1625 Foxtrail Drive(Just south of Medical Center of the Rockies in Centerra)

pvhs.org

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We’re herefor your

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HL Health in aHa n d b a s k e t

HangMan

Jade takesrock climbing

lessons

Jade CodySpecial Sections Editor

As I clung to the top ofa ledge giving way toa 30 foot drop off,

my lip curled. You see, that’swhat happens with qualityaction heroes — their lipscurl, teeth grit and a growl-ing sound can be hearddeep within their chest.What is that sound, you ask?It’s courage, reader. Courageof a mountain cat.

I didn’t have an elbowspider web tattoo beforemounting this feat of danger,but as I shifted over theledge to repel down, onejust appeared there, muchlike permanent mental scarsappear on women who datemagicians.

A moment later I lookeddown. Then my arms did an

embarrassing shaking mo-tion — like a five-year-oldnervously gripping handle-bars on his first unassistedride. My elbow tattoo fadedas quickly as it appeared,and my lip descended sadlyback to a normal position.

Will I make it down? Willthe ropes violently slipthrough my hands slammingme into the ledge ear first?Yo u ’ll have to read on tofind out, reader. You didn’tthink I’d write a columnabout climbing walls with-out attempting an intense lit-erary cliffhanger, did you?

The reason I’m jauntingup and down walls is be-cause this month for Healthin a Handbasket, I took rockclimbing lessons from TracySowder of Airborne Gym-nastics in Longmont. Sow-der is a seasoned climberwho teaches in a fun,hands- and feet-on manner.From the moment I got intoclass we were climbing,tieing ropes and sayingwords like “har ness” and“wedgie” — real boy-type

activities I tell you.I learned right away that

rock climbing is less aboutmonkeying yourself up awall and more about usingyour legs, strategic footholdsand shifting your weight toreach the top. It’s more con-trolled than you might imag-ine, and safety is paramount.

The first thing Sowdertaught me was a properknot, which is essential ifyou’re interested in suchthings as not dying. Theknot I learned is called a fig-ure eight follow through. Toput it lightly, I struggled.When Sowder showed me

how to tie the knot for the53rd time, I did start to catchon (in a slow, not reallycatching on but still noddinglike I understood kind ofway).

When climbing a moun-tain, or in my case, a wallwith handy little notches,you need to have a belay. Abelay is not, in fact, an affec-tionate term for a person’sbelly. This disappointed me,as I’m sure it did you. Sodon’t go offering belay rubsto rock climbers, cause thatwould be awkward.

Belay is actually a termthat climbers use to identify

the anchor to theground below. A belayis usually accom-plished by anchoringto a person (or insome cases an object),

RH photos/Paul LitmanHere I am doing my best impression of a spider. TracySowder of Airborne Gymnastics, is providing me with abelay, which helps me not die when I fall. Below: a figureeight follow through knot.

Health in a Handbasket

Health in a Handbasketis a monthly feature in whichI try a health-related adven-ture and write about it. If youhave an idea for a newadventure, write to me atjcody@r eporter-herald.com.

� See C O DY:CLIMB/Page 26


HL Health Briefs cont’drecognize healthcare organi-zations that provide the bestin nursing care and upholdthe tradition of professionalnursing practice. The Mag-net Prize is awarded only toMagnet-recognized organi-zations. Winning organiza-tions must meet specific cri-teria such as extraordinarynursing activities that havebeen sustained over an ex-tended period of time, inno-vations that are beyond thecharacteristics of Magnet or-ganizations, and positiveoutcomes that have beendemonstrated and empirical-ly linked to the innovation.

The winning entry fromPoudre Valley Hospital high-lighted their CommunityCase Management Programwhich was selected as a pio-neer in the area of commu-nity outreach for its track

record of reducing costs andimproving outcomes inmanaging complex patientswith chronic conditions.

This unique program pro-vides a continuum of care,focuses on preventativecare, and improves the abili-ty of patients, families, andproviders to work togetherto manage chronic disease.Nurses and social workers atthis facility have worked to-gether for 14 years to devel-op and sustain the Commu-nity Case Management Pro-gram. The program targetspatients with inadequatesupport systems and finan-cial resources, and providesthem with a safety net todeal with complex issuesthat may otherwise result inavoidable visits to the Emer-gency Room or healthcarepr ovider.

the belayer, who creates friction on the ground (see photo atright). Belaying keeps climbers from falling very far.

Sowder started by letting me meander my way up thewall, picking and choosing which notches I wanted to use toratchet upward. Then he began challenging me to use spe-cific notches, such as the ones with blue tape below them,and I had to climb without raising my hands above my head,which made me use just my legs.

Sowder taught me how to shift my weight to create lever-age and balance, which proved effective on the more diffi-cult climbs. And at the end of the class, he taught me how torepel off of a ledge — with or without a lip curl.

THE HEALTHFULLY DEPARTED

High on the ledge, with my lip decidedly downward, Ishifted one leg over the wall and paused. Sure, I might fall, Ithought, but Sowder had me anchored in just in case I didslip. And with all climbing safety knowledge he had taughtme, I swung the other leg over and repelled all the waydown, safe and sound.

And although I had to disobey my mom (she gave mespecific instructions to NOT climb any rocks or walls), I feellike I was never in any real danger and I’m glad I took theclass. If you would like more information about rock climb-ing with Sowder, visit www.airbornegym.com or call303-651-1456.

CODY: CLIMBFrom Page 25

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