Feeds:
Posts
Comments

Patients diagnosed with cancer in northern Colorado can receive the best care possible without leaving the region. While many may think they would go to a national center if faced with cancer, the reality is that more than 80 percent of cancer patients in the U.S. receive treatment in their own community. In fact, very few have the resources to travel far for the approximately 100 appointments that occur in the first year after diagnosis.

UCHealth conducts hundreds of research trials. Participation in a trial may provide those who qualify with access to treatment options years before they are widely available.

UCHealth conducts hundreds of research trials. Participation in a trial may provide those who qualify with access to treatment options years before they are widely available.

For decades, Poudre Valley Hospital has built a cancer program to provide comprehensive cancer services in northern Colorado. Access to clinical trials is a key component.

Patients have access to approximately 100 open studies at any given time. The study portfolio is continually reviewed in order to ensure that it matches the needs of the communities of northern Colorado. Today, the program’s enrollment rate is 8 percent of eligible patients— well over the national average of 3 percent. Advances in cancer treatment are based on the data from clinical trials. 

A key role of research staff is to inform patients and support their decision making about clinical trials. Oncology Research Manager, Valerie Cummings, says, “Clinical trials are not for everyone, but it’s always in the best interest of patients to understand all their options.”

Dr. Steven Schuster, medical oncologist and lead research physician.

Asked about what is particularly exciting in the world of clinical research, Dr. Steven Schuster, medical oncologist and lead research physician comments on program initiatives that are in the works. The creation of University of Colorado Health and expanded partnership with University of Colorado Cancer Center has expanded local access to clinical trials. The new cancer center on Harmony Road, further integrates research staff with the patients’ care team by providing on site space for research. PVH’s new electronic health record system called EPIC, makes it easy for patients to communicate with their research nurse or research coordinator about clinical trials options. “Who doesn’t want to be home when they’re sick? We work every day so that our patients have access to the highest levels of care and research right here where they live, where their family and friends are,” said Dr. Schuster.

Learn more.

So you want to have a baby

pregtestjpgBY KARLA OCEANAK
There may not be a more exciting time in a woman’s life than thinking about or trying to have a baby.

If you’re in one of these modes, you’ve got time to prepare for a healthy pregnancy. Dr. Natalie Rochester, an OB/GYN at University of Colorado Health OB/GYN who delivers babies at Medical Center of the Rockies in Loveland, offers these suggestions.

“We want mom to be as healthy as possible before she conceives,” said Rochester. “That means eating a healthy diet and exercising at least 30 minutes a day, and having all of your medical problems under excellent control before trying to conceive.”

“Prenatal vitamins are also super-duper important. A couple of months before trying to get pregnant, start taking prenatal vitamins with folic acid. The vitamins lower the risk of birth defects.” Rochester said. You can buy prenatal vitamins over-the counter or get a prescription from your doctor. It’s important to know what to expect when you start trying to get pregnant.

“Many women think they’ll get pregnant quickly and are surprised when they don’t,” said Rochester. “It often takes a number of months. In fact, only 85 percent of women with no infertility issues will be pregnant within a year, even if they’ve been having timed and frequent sex.”

If you’ve been trying to conceive for a while without success, Rochester suggests keeping an ovulation calendar. “Many women don’t understand their menstrual cycles and when they can get pregnant,” said Rochester. “Keep track of your periods and have sex at the most opportune times.”

Your ovaries release an egg about 12 to 14 days before your period starts. If you have a 28-day cycle, you’ll usually ovulate sometime between day 12 and day 16 of your cycle (with day one of your cycle being the day your period starts). To conceive, your egg needs to be fertilized within 12 to 24 hours of ovulation. Sperm live for two or three days, so if you want to get pregnant, you need to have sex a few days before you ovulate through the day of ovulation.

After six months of regular and timed sex without a pregnancy and if you’re frustrated about your results, talk to your doctor. There are simple tests and treatments your doctor can use without going the full-blown infertility route. But remember, you’re still well within the one-year, 85-percent window.

“People don’t always seek care when they’ve been trying unsuccessfully because they’re afraid of the costs and protocols of infertility treatment,” said Rochester. “But the truth is, there are a number of simple next steps we can take.”

A blood test can reveal whether or not you’re ovulating each month. Medications that stimulate egg production are also relatively easy to take and manage. The prospective mom’s age is also a fertility factor. Women ages 20 to 35 have the highest chances of conceiving quickly and delivering a healthy baby without complications.

“But I have many patients who are in their late thirties and early forties,” said Rochester. Finally, remember that each pregnancy is different. If you conceived quickly with your first baby but are having trouble conceiving your second, you’re not alone. It’s not uncommon for conception to take many months. And during those months, it’s essential that moms don’t neglect their own health.

“After they have one child, women tend to be so busy that they don’t take care of themselves,” said Rochester. “But it’s important for them to be in good health before they get pregnant again.”

Pre-pregnancy checklist
• I’m eating a healthy diet.
• I’m exercising at least 30 minutes a day, most days.
• I’m taking prenatal vitamins.
• I’m abstaining from alcohol, drugs and marijuana.
• I’m up-to-date on routine doctor’s check-ups, including my annual pelvic exam and pap smear.
• I’ve talked to my doctor about any pregnancy risk factors I might have.
• I’m managing well any chronic health conditions (such as diabetes or high blood pressure).

To make an appointment with an OB/GYN or one of the certified nurse midwives at UCHealth, call 970.336.1500.

Anxious Love

Last week we premiered Anxious Love, a video short, at the Lyric in Old Town Fort Collins.

Anxious Love features one family’s story about premature birth. It gives us insight into what it’s like to have babies born too soon. Corry and Emily Petersen and big sister Ella, welcomed twin girls, Lily and Nora at 29 weeks gestation. Full term birth is 40 weeks.

Having babies born too soon is very scary and can those babies can have many long term health issues. However, thanks to modern medicine and the high level care available in our neonatal intensive care unit (NICU), most babies grow to run, jump and play with little sign they arrived far earlier than nature intended.

We invite you to walk in the Peterson’s footsteps and see the role our NICU embraces in caring for our smallest, most fragile patients.

Please watch and share their story with friends and family. If premature birth has touched your life, please share your story with us.

 

Local artist Armando Silva's Corry and Emily Petersen Family portrait.

Local artist Armando Silva’s portrait of Corry and Emily Petersen’s family.

 

 

 

 

 

 

 

 

 

 

Armando Silva paints Nora and Lily in motion.

Armando Silva paints Nora and Lily in motion. Nora and Lily were born too soon at 29 weeks gestation but are now healthy, vibrant little girls.

 

 

 

 

 

 

 

 

 

 

 

Armando Silva paints Baby Hope with the desire to bring hope to families with premature and sick babies.

Armando Silva paints Baby Hope with the desire to bring hope to families with premature and sick babies.

Jeff Eagan, oncology PT program supervisor, instructs Jean.

Jeff Eagan, oncology PT program supervisor, instructs Jean.

By Dave Rizzotto, UCHealth

Rapidly pumping her violet and lime green Skechers on the elliptical pedals, Jean Lehmann did not appear out of breath.

You’d be hard-pressed to know that Lehmann recently completed breast cancer treatment.

Stepping on a treadmill might be the last thing to cross your mind during the whirlwind of a cancer journey. But studies show it should be near the top.

Fatigue can affect a patient’s ability to adhere to a treatment schedule. To counter this, exercise helps maintain energy to keep up with treatments and maintain strength.

That’s why University of Colorado Health offers the cancer rehabilitation program at Poudre Valley Hospital. The program provides a physical therapist who creates an exercise plan for each patient, during or after treatment.

Five Benefits of Exercise for Cancer Patients

  1. Decreased fatigue.
  2. Improved mood.
  3. Improved appetite.
  4. Increased cardiovascular efficiency.
  5. Improved chemotherapy completion rates (adherence to treatment plan)
Jean, a survivor and rehab participant, shares her experience.

 

“Even when I didn’t feel well, it got me out of the house, improved my appetite and helped me sleep,” said Lehmann, who used the rehab service. “When you do that your mood gets better.”

Exercise helps patients stick to their treatment schedules more closely allowing them to get the right amount of medicine, on time and on schedule which helps achieve treatment goals. Staying on schedule allows for optimal drug delivery to destroy the cancer cells in the body.

Jeff Eagan, the oncology trained physical therapist, who runs the program, explained that many patients are pleased to discover they can still build strength during cancer treatment. It’s an area of the treatment plan that they can have some control over.

“The big thing for patients in this program is getting your life back where you want it,” said Eagan, who designed Lehmann’s workout plan. “We have great providers that help save your life from cancer and give that life back to you. I look at rehab as helping answering the question ‘what is that life going to look like? What do you get to do with it now?’”

Learn more.

Dave Rizzotto is a marketing strategist for University of Colorado Health in northern Colorado.

 

Beats and the brain

Music therapy enhances physical rehabilitation.

By Andrew Kensley

Sarah Johnson assisting a patient at the CSU facility.

Sarah Johnson assisting a patient at the CSU facility.

Under the close watch of his physical therapist, a stoic man marches up and down a four-inch step with admirable consistency. His left hand holds a walker for support, but his feet endure in their instructed endeavor; forward and backward, up and down, left and right.

The therapist says barely a word, but she doesn’t have to. This man — a victim of Parkinson’s disease and a stroke — heeds another master, a primal part of his brain that craves rhythm and symmetry.

The therapist, Sarah Johnson, is one of many University of Colorado Health rehabilitation professionals working to help patients get their groove back. Like most rehab therapists, she sports a sunny demeanor while touting the benefits of exercise and task-specific, functional training. But her patients march to a different tune — music.

Seeing potential in music

Since 1987, Johnson has expertly used a variety of musical-based techniques in conjunction with physical, occupational and speech therapists to improve stimulation of sensory and motor systems for patients injured by accidents or strokes, or suffer from diseases such as multiple sclerosis or Parkinson’s.

While Johnson and the music therapy program she helped build in northern Colorado are primarily based in the Rehabilitation Unit at Medical Center of the Rockies, she also sees patients at the region’s outpatient adult and children’s therapy services clinic.

Regaining function, say the experts, is the main goal of rehabilitation. And, as Johnson and her colleagues will attest, it often occurs faster — and better — when it’s set to music.

“We may do some singing, but I’m not trying to teach patients how to sing,” Johnson said. “We may be working on speech skills. I’m helping them use their air, develop their lung capacity. Using music can help our bodies move better, help our muscles work together in a more coordinated fashion, help us strengthen muscles that are weak, and help us retrain our neurologic pathways.

“The rhythm of the music helps support the movement to be more fluid and more natural. Then when you add the instruments into it, you get that visual, auditory and tactile feedback.”

Another major benefit is the natural opportunity for repetition. When you add a beat to a certain movement — reaching, stepping, lifting — patients become part of the creative process, Johnson explained.

“They have multiple opportunities to do what you’re asking them to do,” she said, adding that it leads to better performance, carryover into normal activities, and, quite often, a level of enjoyment rarely seen in the challenging process of recovery from debilitating injuries.

IMG_4254 music therapy story photo 2Leading the way

In 1987, Dr. Gerald McIntosh, a Colorado Health Medical Group neurologist and the then-director of Poudre Valley Hospital’s LifeSkills Rehabilitation unit, was curious about the use of complementary therapies in rehabilitation and hired Johnson to create a music therapy program from scratch.

Since then, the program has echoed outward from its origins in patient care to the research world — and beyond. Poudre Valley Hospital’s pioneer program in music therapy, in collaboration with Colorado State University, led to the creation of CSU’s Center for Biomedical Research in Music and Robert F. Unkefer Academy of Neurologic Music Therapy, both of which continue to promote the worldwide development of the field of NMT.

With a small grant from the Poudre Valley Hospital Foundation, McIntosh and Dr. Michael Thaut, a music therapist and CSU professor of music and neuroscience, initiated a research partnership between the two organizations. In 1990, physical therapist Ruth Rice joined the PVH rehab staff, bringing with her a neurologic rehabilitation background that allowed her to play an active role on the clinical side of the groundbreaking studies.

During the past 20 years, McIntosh has collaborated with Rice and Thaut in the publication of more than 40 articles illustrating the rehabilitative benefits of neurologic music therapy.

“I was naïve about music therapy; I had no idea it would be a physical enhancer,” Dr. McIntosh admitted. “But I observed that during treatment sessions, motor performance was improved with its addition. Dr. Thaut and I began research to demonstrate the effectiveness for music therapy to augment motor performance.”

They began with studies that demonstrated that walking performance improved with music therapy. They progressed to studies on stroke victims with one weak side, Parkinson’s patients, and children with cerebral palsy in collaboration with Children’s Hospital in Denver. And much of the newer research, some done by Rice, has confirmed their findings and shown a significant reduction in falls for patients involved in music therapy rehab programs at the hospital or at home.

Johnson, who in 2009 was awarded the American Music Therapy Association’s Professional Practice Award for her significant contribution to the profession, has hosted students and therapists from Europe, Asia, South America and Australia to observe UCHealth’s innovative program. Ruth Rice, along with McIntosh, Thaut and the CBRM staff have served as ambassadors of their brainchild by presenting research findings in various locations throughout the world.

Spreading the word

“I remember watching Sarah work, strumming down the hallway with her autoharp and a big smile on her face, watching her do amazing things with people’s walking,” Rice recalled. “I don’t think people realize that a lot of the research happened here in Fort Collins and CSU.”

In addition to devoting themselves to improving lives one chord at a time, Rice and Johnson continue to do their part in the world of academia. In 2013, they published “A Collaborative Approach to Music Therapy Practice in Sensorimotor Rehabilitation,” in the journal, Music Therapy Perspectives.

In the article, they stated that a collaborative approach among physical, occupational, speech and music therapies, with “each contributing unique research and clinical-based knowledge to the treatment team,” was unquestionably the best way to help patients achieve “functional real-world outcomes.”

Sarah Wild, a physical therapist in MCR’s Rehabilitation Unit with almost 20 years of rehab experience, said she was skeptical at first.

“I thought, ‘How could having someone sing and play an instrument during physical therapy really help, and, can I accomplish what I need to do in the same time frame?’” Wild said. “After working with neurologic music therapy for a number of years now, I am fully on board. I have found I can actually achieve more activities during sessions, especially with patients who have cognitive impairments. I also believe I have better outcomes, and the patients seem to leave the hospital sooner. I wish all therapists had the benefit of working with neurologic music therapy.”

This article was written by Andrew Kensley, a local freelance writer, published author and physical therapist for Poudre Valley Hospital. Photos were taken by Mary Pridgen of Bare Bones Photography in Fort Collins.

 

Beating cancer

Early detection helps woman conquer lung cancer.

By Susan Skog and Kim Vecchio

A busy lady beats cancer. Dona Ammons sits with her dogs, Mr. Beau Jangles and Bambi. (Photo by Dave Rizzotto)

A busy lady beats cancer. Dona Ammons sits with her dogs, Mr. Beau Jangles and Bambi. (Photo by Dave Rizzotto)

When Loveland resident Dona Am­mons developed a pain near her ribs she figured it was a result of her osteo­porosis. Assuming she had a bruised or broken rib, she went to her doctor to get it checked out.

“On April 1, I went to see an orthopedic doctor, who took an X-ray,” said Ammons. “He confirmed I didn’t have anything wrong with my ribs, but he said, ‘I see something in the X-ray that bothers me.’”

After a chest X-ray and CT scan, Am­mons visited with University of Colo­rado Health pulmonologist, Dr. Richard Milchak. He showed Ammons the mass on her lung. He ordered a biopsy and three days later, took Ammons’ case to UCHealth’s newly created Lung Nodule Clinic in northern Colorado. That’s when the cogs were set in motion for Ammons’ treatment plan with her team.

On April 26, after meeting with a team consisting of radiologists and pathologists, as well as pulmonologists, medical and ra­diation oncologists, surgeons and patient navigators, Milchak called Ammons to tell her she needed additional testing.

“With the advent of the Lung Nodule Clinic, we may see a patient on Wednes­day and hopefully get him into a diag­nostic procedure within a few days to a week,” Milchak said. “Then, a diagno­sis can be more quickly reached and a treatment plan in place within weeks, not months. That time is valuable when you’re treating lung cancer.”

Early detection an important piece

UCHealth is on the frontlines of one of the most urgent, cancer-fighting pursuits in the country: the drive for early detec­tion and better treatment of lung cancer.

Though rates are dropping, lung cancer is still the leading cancer killer in both men and women in the United States, according to the American Lung Associa­tion. It causes more deaths than the next three most common cancers combined: colon, breast and pancreatic. About 159,260 Americans will die from lung cancer this year, the association estimates.

Part of the problem is that the majority of lung cancer diagnoses are made too late, said Dr. Matthew Sorensen, medical director of UCHealth’s oncology service line in northern Colorado.

But Sorensen’s team is working hard to reverse that trend and boost survival rates through the Lung Nodule Clinic. For the first time in northern Colorado, patients benefit from a more efficient approach to detecting and treating lung cancer.

“The lack of communication among providers is one of the biggest com­plaints patients and their families have,” Sorensen said. “There is nothing more frustrating than having two contradictory opinions given to patients at two succes­sive appointments. Now, after I sit down with a patient and their family, and shake their hands as I leave the room to put their treatment plan into place, they don’t need to ask, ‘Are you sure you’ve talked to my surgeon or my radiation oncologist?’ They know we’re all on board, and we’re all aware of the treatment plan.”

A new tattoo

Ammons, who was diagnosed with Stage 1B lung cancer in April, said the clinic was key to her beating cancer. The day after she spoke with Milchak, the Lung Nodule Clinic’s patient navigator, Ladelle West, called Ammons to help schedule her appointments in the right order, coordinate communication among all providers and stay on top of each step of her treatment plan.

West is like the conductor of a sophisti­cated symphony, weaving together all the medical notes. Milchak calls West “the most important person in this process.” And Dr. Kirk DePriest, UCHealth pulmo­nologist added, “like the quarterback to our entire team.”

“Ladelle was very helpful. She handled everything for me,” Ammons said. “She set up all of my appointments and kept me informed. I never had to worry if the physicians were talking to each other be­cause they were constantly communicat­ing and everyone was on the same page. It moved along smoothly.”

Ammons added, “I am a busy lady caring for my dogs, Mr. Beau Jangles and Bambi. I’m also the choir director at my church, I belong to a train club and I play in a uku­lele band. Ladelle and my team handled everything so I could go on living.”

By May 7, Ammons had completed her tests and was scheduled to see Dr. Ann Stroh, UCHealth medical oncologist, who coordinated radiation treatments with UCHealth radiation oncologist Dr. Gwen Lisella. On May 20, Ammons was mapped for her five radiation treatments and on May 29, she had a trial run be­fore beginning her treatments.

“I didn’t know what mapping meant except that I’d get a tattoo,” said a smil­ing Ammons. “At 76 years, I was going to get my first tattoo. Turns out, they were outlining the treatment area, and the tat­toos were small dots to line me up with the machine to make sure I was receiv­ing radiation where I needed it.”

As of June 11, Ammons is cancer-free, two and half months after being diag­nosed with lung cancer.

On Ammons’ last day of treatment, the radiation staff gave her a little white cake with a candle that said “happy day.” However, her last day of treatment won’t be the last day she sees her team. Ammons has multiple follow-up visits scheduled with Milchak, Stroh and her primary care doctor. She will also have a PET scan every three months to make sure the cancer does not return.

“Nobody is letting loose of me,” she said. “Makes me feel so secure that they are following up and taking care of me. They weren’t going to drop off at the end when I finished my treatments.”

It’s that kind of over-the-top support, collaboration and excellence that fires Sorensen up to strive to make the Lung Nodule Clinic at the new Cancer Center one of the best in the nation.

“It’s been so rewarding for me to see the most talented cancer care providers I’ve ever seen come together for the com­plete care of patients,” he said.

Ammons’ team consisted of doctors who bring their expertise to the table to develop the best treatment plan for each patient after discussing everything from the patient’s risk factors to the top drug, clinical trial, surgical and radiation options. In addition to radiologists and pathologists, the team includes pulmon­ologists, medical and radiation oncolo­gists, surgeons and patient navigators.

 

By Nicole Caputo

Think about your most memorable conversation. Does it bring back fond memories? Leave you with a certain feeling?

Me, my dog Brady and my dad on a wooded trail in rural Minnesota. Have you had a life-changing meaningful conversation?

Me, my dog Brady and my dad on a wooded trail in rural Minnesota. Have you had a life-changing conversation?

My dad and I are strolling along a forest path, the morning fog is clearing over the treetops and, with a prideful tone, he tells me his secrets to living a meaningful life. It is a conversation I’ll never forget and, more importantly, one I won’t need to wish we had when he’s gone.

Many conversations define our lives. But one topic we shy away from is talking about what happens when a loved one dies. It’s not a comfortable topic to think about let alone discuss. But important? Hugely. And when the time comes, what may have been hard decisions will come more easily.

Like learning secrets to a meaningful life, it is one conversation we don’t want to wish we had after our loved ones pass away.

Why have the conversation?

Statistics show that most of us don’t want to burden our family with tough decisions after we die. The best way to ease that burden is to sit down and talk. Whether you’re a parent or the child, don’t wait to have the conversation. Sit down over a cup of coffee and talk.

The unanswered questions that arise after a loved one dies can lead to stress, and even anger among family members. When a loved one passes, family members want to carry out last wishes, not fight amongst themselves on what those wishes may have been.

According to The Conversation Project, an organization that is dedicated to helping people talk about their wishes for end-of-life care, each conversation will empower you and your loved ones to live and die the way that you choose.

The conversation should include all your desires, from the contents of your will and the affairs you still need to get in order, to where you want to receive care and what kinds of aggressive treatment you may want (or not want).

Before you have the conversation with your kids about your end-of-life wishes think about these questions. Write down your answers and have them by your side during the conversation(or send these questions to your parent(s) so they can think about them before you talk):

 

Click to view full size
  • What do I value the most?
  • Do I have any particular concerns about my health?
  • Are there any disagreements or family tensions I’m concerned about?
  • What matters to me at the end of life?
  • How long do I want to receive medical care?
  • What role do I want your loved ones to play?

Here are some useful tips for everyone to think about during the conversation:

  • Be patient. Some people may need more time to process information.
  • Let the conversation happen naturally. Don’t steer it with specific talking points.
  • Don’t judge. A “good” death means different things to different people.
  • Nothing is set in stone. You and your loved ones can always change your minds as circumstances shift.
  • Every attempt at the conversation is valuable.
  • This is the first of many conversations; you don’t have to cover everyone or everything right now.

The hardest part of starting the conversation is making time. Pick the next family birthday party or major holiday to sit down and chat. One conversation won’t solve everything, but it will allow you to share what matters most to you. It will be a conversation that helps define your life.

The University of Colorado Health Aspen Club has adopted principles from The Conversation Project and is hosting a series of classes and events (The Conversation Project and Death Cafe’s) to help you start the conversation.

To learn more, go to UCHealth’s Aspen Club or The Conversation Project.

 This blog was written by Nicole Caputo, marketing strategist for University of Colorado Health.

Follow

Get every new post delivered to your Inbox.

Join 152 other followers