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Family Of FourBY ANDREW KENSLEY, UCHEALTH

As of January, more than 15,000 Larimer County residents qualified for Medicaid and 34,000 were eligible for subsidies in the Colorado Health Benefits exchange, according to the Colorado Consumer Health Initiative. The Family Medicine Center of Fort Collins, part of the University of Colorado Health, is doing its part to meet the needs of those with limited access to affordable health care, from babies to retirees.

“We see any patient in any setting,” said Dr. Janell Wozniak, a physician at FMC and a member of the faculty for its family medicine resident program. “We provide great services to the community for patients who otherwise wouldn’t have access.”

Creating a safety net

According to Wozniak, FMC is considered a “safety net” clinic, meaning that it accepts patients who are underinsured or uninsured. She estimates that FMC serves 8,000 unique patients every year, with 70 percent of those having either no coverage or a very limited variety. The latter is defined as depending on Medicaid, Medicare with Medicaid as secondary coverage, or Colorado Indigent Care Program (CICP), the state-subsidized program for patients who don’t qualify for, or cannot obtain, medical insurance.

In addition to traditional medical care, which can include home and nursing home visits, FMC offers counseling for individuals, couples and families, as well as lifestyle coaching and biofeedback. Other services include an integrated mental health program, on-site psychiatric services and counselors, and through a partnership with the Health District of Larimer County, access to social workers and a prescription assistance program. Through its lifestyle medicine program, FMC also offers free counseling services for issues like tobacco or smoking cessation, weight loss, diet, exercise and chronic illness management.

“There’s an added level of complexity to some of these patients,” Wozniak said, citing examples such as a lack of transportation, and an inability to afford medications or the electric bill required to run a home oxygen machine. “We find resources to help subsidize those things, funded through donations. We have to make sure that patients have access.”

Specialized prenatal care

Through its Poudre Valley Prenatal program, FMC works hard to serve a high-risk subset of those with limited healthcare coverage: pregnant women. Staffed by FMC residents and OB-GYN’s from the Women’s Clinic of Fort Collins, PVP provides specialized prenatal
care, helping to deliver about 500 babies a year, and totals 6,000 inpatient and 15,000 outpatient visits a year. No matter how a woman seeks prenatal care — through an emergency room, Medicaid offices, facilities like FMC or Salud Family Health Center (another Fort Collins safety net clinic), or area clinics — if she has little or no health coverage, she can access the program.

Dr. Breanna Thompson is a family physician at Salud who facilitates a group prenatal class that targets the same demographic seen by Wozniak and her FMC colleagues. Thompson says there is considerable data to show that pregnant women in lower socioeconomic brackets are at higher risk for dangerous conditions. As such, they tend to benefit most from education and support.

“Visits for prenatal care tend to result in higher birth rates, less preterm labor
and better control of gestational diabetes and preeclampsia,” Thompson said. “The (group) participants receive significantly more education about pregnancy because
of the amount of time that we’re able to spend with them. Rather than seeing each
of them for ten minutes, we see all of them together for two hours and they are able to
have a more enriching experience.”

Groups typically consist of about eight, and are led by a physician (Thompson, mostly), a behavioral health provider, and a maternal and family health coordinator. The sessions can take up to two hours, partners are invited, and childcare is provided. For Thompson, one of the greatest benefits for the participants is in creating bonds with others going through similar situations.

“The amount of help that people get from each other in a group setting is really significant,” she said. “It takes a village.”

Expanded access

Since the implementation of the Affordable Care Act in January 2014, Wozniak says that FMC’s patient list has swelled, including approximately 500 new Medicaid patients in the past couple of months alone, many of whom had no prior coverage. The increase in volume will require some adjustment, and dealing with complex social issues can result in more stress for providers. But Wozniak looks at it as yet another chance to help people who need it.

“It’s so much more rewarding for most of us who work in this setting when you’re able to help someone meet needs that they otherwise would not meet,” she said. “Accommodating this influx of volume has been and will continue to be a challenge for us, and we’ll continue to work internally and with the health system to see if there are ways we can expand access to this population of people.”

Andrew Kensley, the author of this article, is a local freelance writer and a physical therapist for Poudre Valley Hospital.

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DSC_0511You might think you’ll never be impacted by a heart attack. But when seconds count – and every second does when your heart stops working properly – do you know what to do?

“The number of heart attack patients eligible for treatment is expected to grow over the next 10 years. Our population is getting older and heart disease is on the rise,” said Dr. J. Bradley Oldemeyer of University of Colorado Health Cardiology.

The American Heart Association projects that 720,000 Americans will have a heart attack this year, up from 715,000 in 2013. While some heart attacks may look like something out of a movie – a sudden, shocking pain causing someone to clutch their chest before passing out – usually, heart attack symptoms start slowly.

Heart attack symptoms have been described as:

  • Chest discomfort, like pressure, squeezing or pain.
  • Discomfort in one or both arms, the back, neck or jaw.
  • Shortness of breath, sweating, nausea or lightheadedness.

These symptoms may arise with activity or after meals, but can also occur at rest or when awakened from sleep, and should never be taken lightly.

What to do.

When you or someone around you is experiencing a heart attack, have someone call 9-1-1.

Data from Medical Center of the Rockies in Loveland, Colorado shows that patients who called 9-1-1 for signs and symptoms of a heart attack had blood flow restored to their heart 30 minutes sooner than those who drove themselves to the ER.

When you call for an ambulance, emergency medical services professionals can start treatment on the way to the hospital that not only saves time, but potentially saves a life. Additionally, EMS professionals help the cardiac team be prepared to receive heart attack patients immediately upon arrival at the hospital.

If you believe you are having a heart attack, do not drive. If your symptoms worsen you may cause an accident.

The faster the balloon, the better.

When a heart attack patient arrives at the hospital, the cardiac team works quickly to administer a percutaneous coronary intervention (PCI), such as angioplasty. This is often referred to as “door to balloon time.” Lower door-to-balloon times equate to less heart damage, fewer complications and a return to normal activities after a heart attack.

At Medical Center of the Rockies, the average door-to-balloon time is 43 minutes, which is less than half the national goal of 90 minutes. In fact, approximately 29 percent of patients had a door-to-balloon time of less than 30 minutes in 2013.

Prevention first.

Minimize your risk of heart disease and heart attacks by developing a plan with your physician. To learn your risk of heart disease and to start a discussion with your doctor, take a short quiz at care.uchealth.org/heart.

Randi Freeman works in the marketing department for University of Colorado Health in northern Colorado.

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By Susan Skog

Dr. David Columbus: ”Our new ability to narrow down precisely where the pain needs to be controlled is just mind-blowing.”.

Dr. David Columbus: ”Our new ability to narrow down precisely where the pain needs to be controlled is just mind-blowing.”.

Jessica Thomas loved teaching first graders, but chronic pain crushed her career and chance for a normal life until she underwent a revolutionary procedure at University of Colorado Health (UCHealth) Pain Management.

Thomas, 31, started having migraines when she was 16. Her headaches spiked after a 2005 car accident. By 2010, she lived an unending neurological nightmare that ended her classroom days.

“In 2010, I started to have more severe migraines and cluster headaches,” she recalled. “Sometimes, I had occipital neuralgia, which caused the back of my head to be so sensitive it even hurt to lie on a pillow. It was totally miserable.

“I also developed trigeminal neuralgia, which felt like electrical shocks going through the side of my head to the front of my face. I had nausea, extreme sensitivity to light and dizziness.”

Docs gave up

Other doctors gave up looking for a permanent solution and were prescribing powerful pain medication, Thomas said. It wasn’t until she met Dr. David Columbus at UCHealth’s Pain Management that she began to imagine her chronic misery might end.

“Dr. Columbus stepped out of the box and looked for ways that could help without just throwing medicines at me,” she said. “He is one of the first doctors who really tried to help me and my husband, who has had to struggle with watching and not being able to help me.”

The patient, Jessica Thomas, holds up a photograph on her cell that shows X-rays of her neck with the electrodes next to her spinal column.

The patient, Jessica Thomas, holds up a photograph on her cell that shows X-rays of her neck with the electrodes next to her spinal column.

Using a frontline technology gaining popularity around the country, Dr. Columbus implanted a half-dollar-sized, lightweight spinal cord stimulator in Thomas’ upper buttocks.

The stimulator delivers small electrical pulses to thin leads—coated wires containing electrodes—placed in her spinal cord in precise areas along Thomas’ vertebrae. The pulses block pain by interfering with the nerve impulses that make Thomas experience pain.

Blocking pain

Using gentle sedation and with Thomas awake and responding, Dr. Columbus was able to determine precisely where to place several leads in her upper cervical spine, which turned out to best block her body from experiencing pain.

“With this new technology, we are able to place up to 32 different leads along the spinal cord to provide as much pain management coverage as possible,” said Dr. Columbus.

For people with chronic, intractable pain, this once-futuristic treatment is life-changing, he added. “We’ve seen this give back people their lives, relationships and work.”

So far, only 4,000 procedures using the new Boston Scientific technology have been done in the United States, Dr. Columbus said. “We believe we are the only ones in Colorado using this particularly advanced spinal cord stimulator technology.”

Hope

In Thomas’ follow-up visits, Dr. Columbus programmed the device to further fine-tune the type and strength of electric stimulation and cover areas of pain where she needed them. Thomas said she noticed improvements in her pain relief as soon as the device was turned on.

“The longer it has been in, the more coverage I am receiving,” she said. “Now it gives me more hope that things really can get better. In the worst of it all, it was really hard to keep hope when going through that much pain.”

Thomas is regaining her life one step at a time. “I started to have less sensitivity to the sun,” she said. “Now, I am able to participate in life more, meaning I can go to the store or go shopping with family members. I can take my dogs on walks. I am still adjusting to having a life again after spending so many years in such horrible pain and not being able to do anything for so long.”

Thomas also said her depression is much better, and her anxiety level has also dropped. “Both changes have been quite a blessing.”

Dr. Columbus said he is thrilled to see Thomas regain her life. “Jessica’s been able to get off most pain medication,” he said. “Her goal now is to return to teaching again.

“I’ve been a pain specialist for 22 years, and this is unbelievable and extremely rewarding,” he noted. “While spinal cord stimulation has been used for more than 30 years in this country, our new ability to narrow down precisely where the pain needs to be controlled is just mind-blowing.”

For more information about Dr. Columbus and pain management, visit pvhs.org or call 970.203.7000.

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Understanding new cardiovascular treatment guidelinesscreening_results

By Randi Freeman

For years, patients have been told to watch their cholesterol and change their lifestyles when their numbers were too high. When target numbers weren’t reached, prescribed medications helped them reach their goal.

In late 2013, all that changed. New cholesterol treatment guidelines released by the American Heart Association (AHA) and American College of Cardiology (ACC) removed the focus on achieving target cholesterol numbers and instead aimed to reduce a person’s overall risk of heart disease and stroke – the leading causes of death in the world.

Studies have shown that treating with statin drugs to lower cholesterol may not be necessary in everyone unless they have other factors that raise their risk of heart attack and stroke. According to Dr. Roger Ashmore, University of Colorado Health cardiologist, the primary goal of the new guidelines is to define those patients who are at a higher risk for heart disease and identify people who would benefit from cholesterol-lowering statin drugs.

There are three things people can do to reduce their risk of cardiovascular disease.

Look beyond the numbers.

The new guidelines still indicate that high cholesterol is one factor of cardiovascular disease. There are, however, other risk factors to consider such as diabetes, smoking, high blood pressure and family history. In fact, drug therapy is no longer recommended for the sole purpose of achieving cholesterol numbers.

Dr. Ashmore cautions that people should not abandon their efforts to lower their cholesterol. In fact, exercise and healthy eating habits, which improve total cholesterol numbers, are proven to be key in fighting heart disease and stroke. “The new guidelines stress the importance of lifestyle in managing cholesterol and preventing heart disease,” said Dr. Ashmore.

So what should we monitor instead of cholesterol numbers?

Know your risk.

The new guidelines recommend that people who have no history of cardiovascular disease or diabetes learn their 10-year risk by getting an assessment and talking to a doctor to understand their overall health. Then, if needed, the person should work with their physician and develop a treatment plan tailored to their needs.

People can get a risk assessment for heart disease and stroke through their primary care provider or cardiologist. This assessment looks at race, gender, age, total cholesterol, good HDL cholesterol, blood pressure, use of blood pressure medication and smoking status. Also, the AHA offers free online assessments on their website at heart.org.

Reduce your risk.

“The new guidelines are a significant change on how physicians treat with statin drugs,” said Dr. Ashmore. “We no longer concentrate on the level of bad cholesterol called LDL, but on the overall risk of the patient.”

According to the new guidelines, statin drug treatment is still recommended for people who are considered high risk.

“Patients with a history of cardiovascular disease or diabetes are at the highest risk of heart attack and stroke and should be treated with statin drugs regardless of their cholesterol numbers,” said Dr. Ashmore. “Statin drugs provide the greatest benefit in terms of preventing heart attacks and strokes and most people use these medications without difficulty or serious side effects.”

Gone are the days of chasing cholesterol targets. Instead, Dr. Ashmore indicates that the new strategy in heart disease prevention will focus on diabetes and blood pressure management, smoking cessation and lifestyle adjustments. And when needed, cholesterol-lowering statin drugs.

Learn your risk of heart disease now by taking an online heart assessment.

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University of Colorado Health pulmonologist Dr. Kirk DePriest and Diane Gutierrez, manager of Poudre Valley Hospital’s respiratory care department, simulate the bronchial thermoplasty treatment on a volunteer. With the aid of a tiny medical camera, they are seeing the procedure on a monitor as it is performed.

University of Colorado Health pulmonologist Dr. Kirk DePriest and Diane Gutierrez, manager of Poudre Valley Hospital’s respiratory care department, simulate the bronchial thermoplasty treatment on a volunteer. With the aid of a tiny medical camera, they are seeing the procedure on a monitor as it is performed.

New asthma treatment available at PVH.

By Kelly K. Serrano

Shortness of breath, wheezing and coughing are daily symptoms of someone suffering from severe asthma.  PVH has a new treatment to help these patients.

Bronchial thermoplasty is a treatment so new that some pulmonologists and other asthma experts around the nation aren’t closely familiar with it yet. But the procedure could mean a deep breath of air for severe asthma sufferers—something some of them may never have known before.

The treatment became available this month in northern Colorado only at Poudre Valley Hospital through University of Colorado Health (UCHealth) Pulmonology. The necessary medical equipment is ready and two possible patients have expressed interest in having the procedure in the near future.

The procedure targets the smooth muscle located beneath the surface of lung tissue, using heat to shrink it, reduce inflammation and prohibit spasms that restrict airflow, said Dr. Kirk DePriest, a UCHealth pulmonologist.

Dr. DePriest said he learned of the treatment during his fellowship from 2006 to 2009 in pulmonary critical care and interventional pulmonology at Wake Forest Baptist Medical Center in Winston-Salem, N.C., and, after coming to Colorado, introduced it to the doctors at UCHealth Pulmonology. Two other UCHealth Pulmonology physicians—Drs. Kristin Wallick and Richard Milchak—will also perform the procedure.

“Controlled energy”

Using technology called the Alair System, developed by Boston Scientific Corporation, a pulmonologist inserts a small catheter through a patient’s nose or down the throat and into the lungs, where it delivers controlled energy to reduce excessive smooth muscle that lines the airways. The patient is under moderate sedation.

The “controlled energy” is heat about the temperature of a warm cup of coffee, said Diane Gutierrez, manager of PVH’s respiratory care department. The outpatient procedure takes three sessions three weeks apart. Each targets a different section of the lungs.

After the treatment, patients continue to take their regular asthma medications, but doctors may later decrease them as their patients show reduced symptoms, Gutierrez explained.

Dr. DePriest said some patients show an increase in asthma symptoms for several days following the procedure, but most show noticeable improvement within six months.

Since the procedure has yet to be performed locally, a check of the Internet turned up comments from patients around the country who underwent the procedure. Some said the roughest part was the increase in asthma symptoms for a brief period following the procedure—as Dr. DePriest mentioned above.

On WebMD, a respected Internet medical information site, one patient wrote: “Another week has gone by so I’m a month post-procedure. I’m doing well and coughing a lot less than before. I’m glad I did this.”

Another patient commented on WebMD: “I just completed my third procedure Friday, August 23rd. I am 38 years old, female and have had moderate/severe asthma since the age of 3. I am already seeing benefits. I am not waking up at night needing my rescue inhaler. I have had the same side effects, coughing, mucus etc., but I realize it will go away in a few months.”

Quality of life

Cindy Coopersmith, an asthma sufferer and PVH registered respiratory therapist and asthma educator said bronchial thermoplasty—more so than traditional treatments—is showing a dramatic improvement in patients who have undergone the procedure.

“There’s not much we can do for people as far as quality of life,” she said of traditional treatments. “If they’re interrupted in daily living by asthma symptoms, it’s very difficult.”

About 25 million Americans have asthma, with an estimated five to 10 percent of them suffering from severe asthma. Coopersmith said these patients have daily wheezing, coughing and shortness of breath. Sometimes the symptoms wake them up at night.

“They are fragile, so they’re going to have frequent physician visits and hospital or ER visits and take a fair amount of Prednisone (a medication),” she added. “There is a certain percentage of people with asthma that we find very hard to treat, meaning having a good quality of life even with medicine. We have them on all the best asthma-control medications available to us, and they still have frequent asthma exacerbation and symptoms.”

Deep breath

But with bronchial thermoplasty, which was approved in 2010 by the Federal Drug Administration, the patients may be able to take a deep breath for the first time and continue to do so for a prolonged period, if not the rest of their lives, Coopersmith said.

According to Boston Scientific, the trial that evaluated the safety and effectiveness of the treatment showed that, after one year, patients who underwent bronchial thermoplasty had:

  • 32 percent fewer asthma attacks.
  • 84 percent fewer ER visits for respiratory symptoms.
  • 66 percent fewer days lost from work, school and other activities due to asthma symptoms.

Also, 74 percent of bronchial thermoplasty patients saw an improvement in their asthma-related quality of life, according to the study.

“What excites me is the long-term evidence,” Coopersmith said. “These are people who have never been able to breathe easily.”

Asthmas is among the top five chronic diseases, ranking up there with heart disease, stroke, cancer and diabetes. “I think it (bronchial thermoplasty) is exciting because it’s something else to offer people with severe asthma other than high-dose steroids and having to visit the emergency room every so often,” Dr. DePriest said.

Improvements

He said patients who participated in bronchial thermoplasty trials eventually didn’t need such high steroid dosages, and they experienced reduced exacerbation of asthma and ER visits. “We’re still going to be looking at 10-year data along the road, but their quality of life was improved,” Dr. DePriest said.

The procedure is limited to patients 18 and older who have shown that, even with the best asthma medications, they continue to live with severe asthma symptoms and require frequent visits to their doctors and hospitals, he said. Asthma sufferers who smoke or drink alcohol or have certain diseases, such as leukemia or lung disease, are not candidates for bronchial thermoplasty.

For more information, please call 970.224.9102.

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Physical Therapist Looking at an InjuryBy Kim Vecchio

The Regional Orthopedic Center at Poudre Valley Hospital was recently recognized as one of the top 97 hospitals for outcomes following joint replacement surgery by the Centers for Medicare and Medicaid Services (CMS).  Of the 97 hospitals noted, PVH is one of only 25 hospitals in the nation and the only Colorado hospital listed who performed better than average in avoiding readmissions or complications.

The measured outcomes were based on Medicare data on how well patients fare after hip and knee replacement surgeries.  The two outcome categories are readmissions after surgery and complications following surgery, such as a blood clot, infection, problem with the artificial joint or death. In judging hospitals, Medicare evaluated cases between July 2009 and June 2012.

“We should all be very pleased with the results of these outcomes, but at the same time, we must continue to try and improve them,” said Dr. Dana Clark, a surgeon at Orthopaedic & Spine Center of the Rockies.

“This represents a strong, collaborative effort by the physicians, nurses, therapists, and staff at PVH, who have made patient outcomes their number one priority,” said Dr. Clark, who is also director of the orthopedic service line for the hospital’s medical staff.

It is important for patients to have access to programs such as the Regional Orthopedic Center at PVH that has a proven quality track record, both surgeons and PVH officials believe.

“We know joint replacement surgery can make a huge difference in the lives of our patients,” said Kevin Unger, PVH president and CEO. “Our nurses, staff and physician partners work hard to ensure our patients receive the best care possible.”

Pam Boehm, director of PVH Orthopedic and Rehabilitation Services, said Regional Orthopedic Center patients benefit from having an experienced, well-trained staff, the staff’s long tenure also helps provide consistency in information offered to patients.

“We have very little turnover,” Boehm said. “I have been in orthopedics for two decades. Many on our team have been practicing at PVH on the orthopedic unit even longer. They love it, so they stay working in this specialty for many years. We have worked hard to create a culture where employees encourage each other to maintain the highest quality standards. ”

But, at the end of the day, it really comes down to teamwork, Boehm said. “People often say that it takes a village to make things work. For us, it’s the team. It takes a great team.”

Orthopedics at PVH has a long tradition of providing excellence in patient care. In 2003, 2004, 2005 and 2009, U.S. News & World Report recognized the unit as one of America’s best for orthopedic care.

The Orthopedic team by the numbers:

  • Three orthopedic surgical groups with about 25 orthopedic surgeons.
  • 35 nurses and nursing assistants.
  • 35 physical and occupational therapists.
  • Dedicated orthopedic operating room team of 10.
  • An average of 2,625 patients a year.
  • 1,645 total hip and knee replacements performed in the past year.

For more information about Poudre Valley Hospital’s Regional Orthopedic Center, visit pvhs.org/orthopedics.

Kim Vecchio works in the marketing department for University of Colorado Health in northern Colorado.

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By Dr. Timothy W. Woodard

The cold, dark, winter months are often a difficult time for people who suffer from depression.

The characteristic symptoms of depression are unusually sad or depressed mood, loss of energy or enthusiasm for enjoyable activities, disturbance of sleep or appetite, hopelessness, uncontrollable crying, and in serious cases, thoughts of suicide.

For most moderate to severe forms of depression, the mainstay of medical treatment remains the use of prescription medications. Often, despite good outcomes and general safety of the latest antidepressant medications, some patients show a high degree of resistance to using them. This is, in large part, due to a misunderstanding about the nature of medical treatments for psychiatric illnesses.

One concern that I hear voiced often is, “I don’t want to become dependent on anything.” It is an incorrect perception held by many people that any chemical that has any effect on the brain is automatically and by its very nature, addictive. This is absolutely not the case.

Some medicines, such as amphetamines, can be addictive because they have a direct effect on the circuits of the brain that govern the perception of pleasure and reward. Others, such as Valium, have the potential to cause physical dependence which, like alcohol, can produce life-threatening complications if the drugs are abruptly stopped without medical supervision. Properly prescribed, even these medications are usually safe for those who need them.

Antidepressant medications, however, do not work in this way. Once the best medication is identified and adjusted to the most effective dose for an individual patient, antidepressants are often extremely beneficial. It can be a time-consuming process that requires patience and perseverance but the final result is usually well worth the effort.

Antidepressants change the way certain chemical signals in the brain work. Stopping an antidepressant medication too quickly can cause your initial symptoms to resurge.

This is why many people need to stay on antidepressants for a prolonged period in order to reap the benefits. Six months is the usual minimum recommended duration of treatment, and it often needs to be longer. The average length of time that people remain on antidepressants, according to some studies, is about 80 days.

To rely on a medication to help you stay healthy and functioning at your best is not the same thing as being “dependent,” in the sense of being addicted. It is imperative that we be clear about that. Depression associated with other illnesses, like bipolar disorder, often requires different kinds of medications to treat it but the principle remains relevant. It is not fundamentally different than people with hypertension who rely upon their blood pressure medicine to keep their blood pressure under control.

Untreated or ineffectively treated depression can lead to absence from work, loss of productivity and income, sedentary activity that can adversely affect physical health, strained social relationships and, in the worst cases, suicide.

I believe it is essential for patients to have a realistic understanding of the reasons why medications are used to help prevent these negative outcomes. Few things are more tragic to a psychiatrist than to see a patient forego life-saving treatment because the perceived risks of treatment are far greater than the actual risks and the perceived benefits are far lower than the actual benefits.

At Mountain Crest Behavioral Healthcare Center in Fort Collins, we have an acute inpatient unit for both adults and adolescents who require hospitalization for severe or life-threatening cases of depression, as well as other serious mental illnesses. We also have a fully staffed outpatient clinic that offers medication management under experienced prescribers coupled with psychotherapy for both patients and their families.

If you or someone you know is struggling with depression this winter, please do not let misunderstandings about the nature of medical treatment prevent you from seeking, or encouraging others to seek, help when it is needed.

Dr. Timothy W. Woodard is a staff psychiatrist at Mountain Crest Behavioral Healthcare Center, which is part of the University of Colorado Health, in Fort Collins. 

Mountain Crest Behavioral Health Care Center helps adults and adolescents with mental health issues and substance abuse issues achieve a balanced life and a high level of health and well-being.  Programs offered at Mountain Crest include:

Substance Dependency Intensive Outpatient
A group experience that helps individuals develop new coping skills to deal with addiction.
More info: 970.207.4843

Mountain Crest Psychotherapy Outpatient Clinic
Individual appointments with a psychiatrist and licensed therapist.
More info: 970.207.4857

Wraparound Program
An in-home therapy and case management service for adolescents and families.
More info: 970.207.4891

For more information or to learn more about Mountain Crest and programs offered, visit pvhs.org/mountain-crest-behavioral-healthcare-center.

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HFU

More than 5 million people in the United States have heart failure. Patients diagnosed with heart failure need ongoing monitoring and guidance to manage their condition.

University of Colorado Health offers Heart Failure University, a free patient education series that provides information to people living with heart failure. The four-part series, held in Loveland and Fort Collins, is taught by a number of heart experts including a heart failure patient navigator, a pharmacist, a cardiac exercise therapist, a registered dietitian, a cardiac rehabilitation nurse and a community case manager.

Topics include:

  • The basics of managing heart failure and monitoring symptoms.
  • Medications used to treat heart failure and slow its progression.
  • Exercise and activity: finding balance and building endurance without stressing your heart.
  • Eating heart healthy to slow the progression of heart failure and heart disease.
  • Finding community resources, support groups and financial assistance programs.
  • Self-management, coping and building support systems.

Patients have the opportunity to bring care providers with them for support. Additionally, the small class setting offers the opportunity for open dialogue.

Click here to find an upcoming Heart Failure University class.

This blog was written by Randi Freeman, marketing strategist for University of Colorado Health.

Source: National Heart, Lung and Blood Institute

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Healthy Kids Learn Better

If you were to ask Laurie Zenner how Healthy Kids Club got where it is today, the answer won’t shock you. The answer will inspire you to change your life and the lives of those around you.

“It’s not about me, the program or the health system. It’s about our kids. It’s about collaborating with others and working together to invest in their future,” said Zenner, Healthy Kids Club’s supervisor.

In 1998, University of Colorado Health, then Poudre Valley Health System, mainly focused community health efforts on education and health prevention through its Aspen Club/Senior Services program for adults over 50. It was becoming clear, through emerging childhood obesity trends, that a program focused on youth was needed. It would be a program designed to curb the development of lifelong chronic conditions through prevention and healthier living.

According to the CDC, childhood obesity in the United States has more than doubled in children and tripled in adolescents in the past 30 years. In fact, the percentage of children aged 6–11 years who were obese increased from 7 percent in 1980 to nearly 18 percent in 2010. Overweight and obese children are at a higher risk of developing life-threatening adult health problems, such as heart disease, diabetes and cancer.

Starting with schools

Before building what is now Healthy Kids Club, each Poudre School District principal was interviewed to find areas of improvement in our kids’ overall health. A few consistent trends were found to be influencing factors among kids’ health: reduced physical education and recess time, fast food, super-sized portions and increased screen time.

With that knowledge in hand and support from the school district, Healthy Kids Club was born. It started with after school and neighborhood programs focused on physical activity, the Healthy Kids Run Series and a monthly newsletter. And from there, it grew. 15 years later, Healthy Kids Club has expanded throughout Northern Colorado, serving communities from north Denver to Walden and everywhere inbetween.

Healthy Kids Club doesn’t simply offer programs to elementary schools, the goal is to partner with schools, youth-serving agencies and other community initiatives to work together to create change. As Zenner stated, “it’s not about us, it’s about collaboration.”

School wellness wasn’t on anyone’s radar 15 years ago, said Zenner. “We had to strategize and figure out ways to not only educate schools but build lasting principles and partnerships.” Healthy Kids Club started working on building wellness teams at each school. The wellness teams would take the principles learned and ingrain them into the school’s teaching philosophy.

Healthy Kids Club and UCHealth’s CanDo, the Coalition for Activity and Nutrition to Defeat Obesity, have been instrumental in partnering with schools to develop wellness policies and establish these school wellness teams. Currently, all Poudre School District, most of Thompson School District and, most recently, a school in Greeley, have teams that work to sustain wellness efforts.

Are wellness teams effective?

Ask Kristin Quere, PE Teacher at BF Kitchen Elementary in Loveland, “Our partnership with UCHealth and Healthy Kids Club has provided life-changing health and wellness opportunities for our students, staff and families.The knowledge and skills developed from Healthy Kids Club programs have enriched many lives and supported the steps needed to work towards lifelong well-being.”

hkc_btn_largeFive years ago, BF Kitchen Elementary and Healthy Kids Club partnered up to improve the health and wellness of its students, staff and families. BF Kitchen is now a health and wellness-focus school committed to academic excellence by promoting high academic standards, increased physical activity, better nutrition and positive life choices for each student.

In 2011, BF Kitchen Elementary School in Loveland and Healthy Kids Club were honored by First Lady Michelle Obama at a reception at the White House, honoring them with the Gold Award of Distinction as part of the HealthierUS Schools Challenge Program.

The health landscape for our kids can’t be changed by financial involvement alone. Healthy Kids Club has spent the last 15 years rooting itself into our community at every level. Its health educators sit on school, neighborhood and city committees to be a voice for kids’ health.

“We are a highly-valued partner,” said Zenner. Kids and families love our programs and see great value in UCHealth’s investment in the health of our kids. We pride ourselves on being involved and trusted in the communities we serve.

What’s one simple message Healthy Kids Club can offer to change my child’s health?

Zenner says to focus on 5210 everyday. Eat at least five servings of fruits and veggies, limit screen time to two hours, get one hour of activity and try to avoid sugary drinks (zero is best). This simple message works wonders in both kids and adults. “Living simply and treating each other with kindness may be the best advice I can give,” said Zenner.

Healthy Kids Club is more than a program. It’s a community partner dedicated to making sure our kids grow up to lead healthy, vibrant lives.

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

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FamilyWalkingDogInMountains_87661146Building family connections, one small effort at a time.

Connection is the glue that keeps families together, helping them stay intact when life doesn’t go as planned.

A lot goes into building a healthy family but certain characteristics stand out.

Here’s a list of five healthy habits of emotionally-fit families and ideas on how you can incorporate these habits into your family life to build connection and a strong emotional base for your kids.

1. Talk often, talk openly.

Openly sharing ideas, beliefs and thoughts is at the base of all healthy relationships. Healthy families talk a lot. Whether it’s mere chit-chatting or having a serious discussion, it’s valuable. The key is keeping it open and not passing judgment. This is especially true when talking with teens—a time when asking open-ended questions rules over giving advice. Also, when parents make room for ambivalent and less desirable feelings—like disappointment and sadness—and are able to sit with these feelings rather than try to fix them, they send the message that ‘we’re here for each other no matter what.’

“When your child tells you about a bad choice they made and you feel upset, don’t show it. Try to stay calm and ask guiding questions, instead,” said Dr. Usha Udupa, a child psychiatrist with Mountain Crest Behavioral Health Center in Fort Collins. It’s okay to say that you’d rather discuss it later if you need time to absorb the information. That way you can pose your answer or consequence thoughtfully rather than reactionary.

Just as important as open communication is good listening. “Stop what you are doing and look your child in the eyes. Let them know they have your full attention. If they like to chat constantly, invite them to help you do a task together so you can get something done while they talk and share,” said Udupa.

If your child wants to talk at a time you simply can’t, let them know what the situation is and say you can talk after you’re done. Just make sure you follow through.

2. Establish routines and rituals.

Daily routines are important, especially for young kids. Knowing that every day starts with a “Good morning, Sunshine” and ends with storytime helps kids feel safe and secure. “These daily rituals become a pattern and serve as a comfort for kids,” said Udupa. Having the same routines their whole lives also defines the word “family” for kids.

“Rituals help us feel secure and like we belong. That’s why we repeat comfort foods and holiday routines from our own childhoods,” said Udupa.

A prime example of this is eating family dinners together. Of course, life gets crazy—mom or dad has to work late, kids have sport practices—and sometimes this simply can’t happen. But making it a priority as often as possible is really important. There are even studies that show that kids who eat dinner with their families get better grades and are less likely to try risky behaviors.

“Nightly family dinners guarantee that you’ll get at least 20 to 30 minutes of uninterrupted time together every day, no matter how busy life gets,” said Udupa, who suggests establishing dinnertime ground rules of no phones, no television and no newspapers.

3. Engage in signature family activities.

Like rituals, find other ways to connect and define your family. Maybe your family mountain bikes, camps, skis or goes to the mountains every fall or the beach every summer. Maybe you have a family book club or you do puzzles together. Maybe you go to church together every Sunday. Whatever it is, it’s uniquely yours. “When families bond over certain activities, they build a sense of cohesiveness, a sense of ‘we’re all in this together.’ It also helps siblings of different ages and stages stay connected,” said Udupa.

A word to the wise: Don’t stop these activities when your kids become teenagers. “Even if you get flack that they don’t want to do it, make them do it anyway,” said Udupa. Most teenagers prefer to be with friends rather than with family, but forced family outings are important to keep the “glue” strong.

4. Teach cooperation, not competition.

In this dog-eat-dog world, it’s good to teach the alternative—how to give someone a boost rather than devise a plan to leap over them. “It’s engrained in our culture to compete, so it’s good to teach the opposite in our families and on the sports field,” said Udupa. She advises that parents be okay when kids don’t get the top grade or the winning point. Instead of saying what a child could have done better on the field, point out what they did to help a teammate or support the winning play.

There are lots of ways to build cooperation in a family. The skills kids learn will prove invaluable in life and friendships. Here are a few:

  • Build something together—put in a deck or assemble a go-cart together.
  • Have everyone pitch in to clean the house. Play the “10-minute pick-up game” every night where everyone runs around and picks up their own items, throws away trash and hangs up coats for 10 minutes.
  • Volunteer as a family to support a community project, nonprofit or elderly neighbor.
  • Catch your child getting along with others or helping, and give them praise.
  • Do turn-taking activities that focus on fun and cooperation, like playing Frisbee or building a Lego tower together.
  • Tell stories of times you cooperated and had good results as a child or currently at work.

5. Put family first.

Nothing says ‘you’re important’ and ‘I value you’ more than putting someone first—above work, phone calls, friends, chores, projects and more. “Kids need to know they matter to you more than anything else, sometimes. Giving kids your full attention teaches them they are important in a very basic way. It teaches them security from the inside out and gives them the capacity to handle what life throws at them as they move forward,” said Udupa.

When parents give kids 100 percent of their attention and put down work to listen to them or be with them, kids believe ‘I am good’ not just because mom bought me the latest toy, but because mom wants to spend time with me.

Send this message by being attentive, and doing things together as families. When possible, plan activities or time to connect with each of your kids individually. This can be hard, especially for single parents, but it’s worth it. Create separate rituals, like dad goes golfing with his oldest son once a month or mom takes yoga with her youngest daughter each week. It doesn’t matter what it is, just so you get one-on-one time together. If your schedule doesn’t always allow time for individual activities, don’t fret. It’s amazing the difference even 15 minutes of undivided attention can make to keep you connected.

“When we send the message to our kids that they are our priority, we help build their core—a core that says, ‘I am worthy,’ ” said Udupa.

Also, when your older child wants to talk, stop and give her your time. If you can only spare five minutes without distraction, give it and then make a plan to talk more later on.

When kids are raised with a strong sense of family, they are resilient and flexible, and they see options. “Having a solid base gives kids the capacity to stand strong and not be knocked over by the first wind that comes along,” said Udupa.

So get out some “glue” and start dabbing it wherever you can: chat after school, help with a school project, eat dinner together, go on a family outing, listen and make eye contact. This is how emotionally-fit families are built: One dab at a time.

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