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Experts agree that insurance policies should be kept in a safe, secure place in the event of an emergency. Jeremiah Timmons has taken that advice to heart.

Dr. Tim Johnson, UCHealth electrophysiologist, northern Colorado

Dr. Tim Johnson, UCHealth electrophysiologist, northern Colorado

On April 4 at Medical Center of the Rockies, University of Colorado Health cardiologist and board-certified electrophysiologist Dr. Tim Johnson inserted a different kind of insurance policy, a device called a Subcutaneous Implantable Defibrillator (S-ICD), under Timmons’ left armpit. The potentially life-saving piece of equipment protects Timmons against deadly heart rhythms by providing a shock when those rhythms are detected, rapidly resetting the heartbeat to normal.

“The left side of my heart only pumps at 30-percent capacity, and I have an enlarged heart due to high blood pressure for most of my life,” Timmons said. “They wanted to put in the device in case I had a heart attack, because my heart muscle is so weak.”

After suffering from debilitating dizzy spells, weakness and chronic malaise, the 33-year-old Johnstown resident was diagnosed in 2013 with cardiomyopathy, a condition in which the heart muscle becomes enlarged from being overworked, and is at some risk for developing life-threatening arrhythmias, or irregular heartbeats.

Because Timmons has already had one minor heart attack, his regular cardiologist referred him to Johnson, one of only four physicians in the state currently trained in S-ICD procedures. In Colorado, only electrophysiology-certified cardiologists are allowed to perform the procedures.

University of Colorado Health cardiologist and board-certified electrophysiologist Dr. Tim Johnson, pictured here, is one of only four physicians in the state currently trained in S-ICD procedures.

University of Colorado Health cardiologist and board-certified electrophysiologist Dr. Tim Johnson, pictured here, is one of only four physicians in the state currently trained in S-ICD procedures.

Automatic vs. Subcutaneous

The implantable defibrillator is not new. Cardiologists have been successfully using the Automatic Implantable Cardioverter Defibrillator (AICD) since the 1980s. But the S-ICD, approved by the U.S Food and Drug Administration in September 2012, has the advantage of being a considerably less invasive and thus potentially safer option.

The concept is the same for both defibrillators. A small generator with a battery pack detects potentially lethal arrhythmias that originate in the lower portion of the heart. Then, like a small-scale model of the paddles you see on television, the defibrillator sends a shock to the heart muscle within 15 to 20 seconds, resetting it to a normal rhythm. And that’s where the two devices diverge.

With the AICD, the wire is tunneled upward to the left subclavian vein en route to its ultimate destination, the right ventricle. A tiny extendable corkscrew anchors it to the inside of the heart muscle. This approach carries a high risk of bleeding and damage to the blood vessels, heart and lungs.

“The wire,” Johnson said, “is the weak link in the system.”

Additionally, if bacteria clamp onto the wire inside the heart or blood vessels or onto the generator under the skin, antibiotics can’t be used to eradicate the infection. The only option would be to remove the wire entirely, which is, according to Johnson, “not a low-risk procedure.”

With the S-ICD, all components remain safely outside the chest wall. The generator, which is about the size of an iPhone 4, is implanted under the skin in the left side of the chest below the armpit. The wire that performs the defibrillation is tunneled under the skin, from the generator around the front of the chest wall toward the lowest point of the sternum, avoiding the need for incisions to the chest cavity or vital blood vessels. The physician makes three small incisions: one on the side of the chest to implant the generator; another at the base of the sternum where the wire is anchored with a stitch; and a third to anchor the wire’s tip as close as possible to the heart tissue. The procedure takes 60 to 90 minutes, and the device also is easier to remove than the AICD, Johnson said.

Dr. Duy Nguyen, UCHealth electrophysiologist, Denver.

Dr. Duy Nguyen, UCHealth electrophysiologist, Denver.

“There’s not a lot of anatomic variability when you’re just placing it (S-ICD) outside the chest,” said Dr. Duy Nguyen, UCHealth cardiologist at the University of Colorado Hospital in Denver who has implanted seven S-ICDs since December 2013. “You are fairly certain how long it will take. The AICD placement depends on anatomy, and could take as long as a few hours.”

Generally, any patient who is at high risk or already has irregular heartbeats may be an appropriate candidate for the S-ICD, Nguyen said. The most common candidates are those with a high likelihood of sudden death because of a prior heart attack or a history of cardiomyopathy. Other likely candidates are people with vascular access problems and those who are at significant risk of infection. Nguyen suggests that patients who benefit the most are ones who can’t tolerate having a foreign substance in their bloodstream or inside their heart. His youngest patient was 17 and suffered from a congenital defect that precluded him from having an AICD placed.

“It was perfect timing,” Nguyen recalled. “We saved him from open-heart surgery.”

One drawback of the S-ICD, Nguyen said, is that unlike the traditional ICD, it doesn’t have the dual capability of functioning as a pacemaker. For patients with certain arrhythmias that could cause the heart to beat either too slow or too fast on a regular basis, Nguyen said that the standard ICD is the better option.

For young patients like Timmons with severe cardiomyopathy, treatment options are typically limited to medications and lifestyle modifications such as losing weight and lowering blood pressure. Still, there’s no guarantee of reversing cardiac muscle damage, and the risk of a death remains high.

“I didn’t want it because of how young I am, but I guess with my heart condition it’s necessary,” Timmons said. “You hope it doesn’t have to work.”

Recovery

Other than basic discomfort, Timmons’ recovery was smooth.

“The first week, I felt where he fished the wires through my body, and when I was lying down and moving around, I felt the wires tugging on the tissues around it,” he said. “Otherwise, I don’t really notice it too much. I’m not too worried about it, especially knowing it’s not wired through my heart.”

Johnson said he feels that the S-ICD has a promising future. “This will probably be performed by every electrophysiologist in Colorado within a short period of time. It really does open up the technology to patients who in the past may not have had any other alternative.”

And even though the S-ICD lies just below the skin, for Timmons, its benefits reach far deeper.

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

by Kevin Unger, PhD, FACHE

I get asked this question a lot. I’ve been told that our community doesn’t understand who or what UCHealth is and what we stand for; that they think we’re based out of Boulder; that we are part of the University of Colorado. I want to take some time today to explain who we are and what we do. Here is the short answer:

Image

Here is the longer story of our courtship with the University of Colorado Hospital and our evolution into UCHealth.

The courtship begins

It all began in 2011, through many conversations about the future, the state of health care and health care reform, we decided an engagement with another hospital was in order. Poudre Valley Health System, anchored by Poudre Valley Hospital in Fort Collins and Medical Center of the Rockies in Loveland with many clinics throughout northern Colorado and southern Wyoming, declared our intent to partner with University of Colorado Hospital, an academic teaching hospital in Aurora. This hospital has ties to the University of Colorado through the medical school but the hospital is not based in Boulder nor is it a part of University of Colorado.

It’s official

In early 2012, we took the next step. We married UCH and chose to change our health system name to University of Colorado Health. I must tell you, digesting this name was hard for me at first. We hired a company to conduct research about brand recognition and the research told us this was the name for us.

But, as many of you know, I was born at PVH. I grew up in Fort Collins. I was a Lambkin at Fort Collins High School and I still bleed green and gold for CSU. I am proud to be a CSU Ram. Watching the PVHS name fade away and embracing a name that sounds like CU was a hard pill for me to swallow.

Patients benefit

Name change aside, I knew that this would benefit our patients in the long run. I strongly believe in putting patients first and keeping our patients at the center of our decision making processes. I knew in the years ahead that our community would greatly benefit from an integrated health system, direct access to cutting edge research, a universal medical record and access to great care throughout Colorado.

Partnering with UCH would help us create a unique system where patients would have access to their community-based providers but, when life delivered the unexpected, they would also have access to UCH’s academic medicine including cutting-edge research and additional clinical trials.

Our family grows

In October of 2012, Memorial Health System joined the UCHealth family. We have welcomed them with open arms, excited to see the health system reach from southern Wyoming to southern Colorado.

Since then, we have continued to grow by adding additional clinics to our medical group. We have changed many processes which improve patient care and make us more efficient and effective. We’re starting to see the patient benefits. The list of changes is long and substantial, all with the goal of making us more efficient, more effective while exceeding our patients’ expectations.

Embracing change

Change is hard. It’s been hard on our employees. It’s been hard for me. I know every UCHealth team member has been affected in some way. On the days that are long, when the change feels overwhelming, I keep my focus on the countless letters I get from patients and patients’ families, telling us how great our team and our care are, and how happy they are that we are part of this community.

Our roots run deep

I’m rooted in our community. My family and I love living in Fort Collins and enjoy taking in all that northern Colorado has to offer. I can’t imagine another place I’d rather be or another organization where I would feel so at home. I’m happy to watch our hospitals and clinics thrive in northern Colorado. I’m happy to be rooted here with an incredible team of physicians, employees and volunteers.

If you work for UCHealth, thank you for your commitment to this growing organization and our patients. If you’re a current or former patient, thank you for trusting us to care for you and your family. If you’re a community member, know that we’ll continue to be here if you need us.

by Dan WeaverElizabeth (Liz) Concordia

On Tuesday, April 29,  University of Colorado Health (UCHealth) named Elizabeth (Liz)
B. Concordia
as President and CEO beginning September 2, 2014.

Concordia comes to UCHealth from UPMC (University of Pittsburgh Medical Center) where she served as the Executive Vice President and the President of UPMC’s Hospital and Community Services Division. In her roles there, Concordia has been instrumental in developing strategies that benefited patients by increasing the quality, value and safety of healthcare. Concordia was also crucial for growth and the integration of multiple hospitals within the UPMC system.

“I am honored to be named President and CEO of University of Colorado Health,” said Concordia. “UCHealth is a successful, fast growing, quality-focused academic and community system that’s improving the lives of patients throughout the Rocky Mountain region. I am truly excited about this new opportunity.”

Over the past eight months, a broad search team made up of physicians and leaders from UCHealth, Colorado Health Medical Group and the University of Colorado School of Medicine has spent countless hours examining an impressive list of candidates from across the nation. The search committee also used scores of interviews with UCHealth physicians and employees to develop the values used to screen candidates.

“We are thrilled about this selection. Liz is more than just a talented and experienced leader, she is someone who truly embodies the values and the vision of UCHealth,” said UCHealth Chairman Dick Monfort.

“Liz will build on the nationally-recognized quality of UCHealth while ensuring our physicians, nurses and staff have the tools they need to deliver the very best experience for our patients,” said Tom Downes, MD, chief medical officer, UCHealth in northern Colorado.

Concordia already has vast experience leading a large health care system that combines academic medicine with community hospitals and clinics. The UPMC hospital division includes 20 hospitals with 5,100 licensed beds, 17 senior community facilities and 36,800 employees.

“I believe the physicians within UCHealth and the CU School of Medicine will be very excited to work with Liz,” said Rich Schulick, MD, chair of surgery, CU School of Medicine. “She has a track record of integrating large groups of physicians and their staffs across a complex health care system with a focus on quality and safety, and I am very confident in our future with such talented leadership.”

“The individual hospitals and clinics within UCHealth have already seen important improvements in quality and safety while adding innovative new treatments,” said George Hayes, Memorial Hospital CEO. “Liz’s experience will enable her to continue integrating UCHealth’s academic medicine with our community hospitals, allowing the very best of both to positively impact all of our patients throughout the Rocky Mountain Region.”

The University of Colorado Health Board of Directors thanks Dr. Bill Neff for his service as Interim President and CEO during this search process. Dr. Neff will help ensure a smooth transition before returning to his role of UCHealth Chief Medical Officer in September.

By Dave Rizzotto, UCHealth

cancerhotline3

Cancer care is complicated. Treatment can take months, sometimes years. Patients often have more than 100 appointments with dozens of specialists in their first year of diagnosis alone. Often, people find it difficult to know where to start.

University of Colorado Health launched a phone hotline and website this month to provide immediate relief to the emotional crisis often associated with a cancer diagnosis.

Dr. Miho Scott, a UCHealth medical oncologist.

“There are so many paths cancer can take you on, and it varies for each person,” said Dr. Miho Scott, a UCHealth medical oncologist. “Some start with surgery, others with radiation, and others with chemotherapy. Not only is the diagnosis overwhelming, but figuring out your options can be overwhelming.”

The hotline, 970.237.7700, is answered by staff members experienced with all types of cancers, treatment and customer service, from 8 a.m. to 5 p.m. They also respond to inquiries on the website, uchealthcancercare.org.

Callers will often be connected with patient navigators, who are specially-trained oncology nurses. They provide free guidance to patients and their loved ones to understand treatment options and find resources such as transportation, financial assistance and emotional support.

“We know that while cancer is a disease of the body, it affects every area of your life, including your mind and spirit,” said Patti Frelund, supervisor of UCHealth’s patient navigator program. “It was clear that our community needed a resource to help get past the  barriers to cancer care.”

The free hotline was based on community need as was UCHealth’s new cancer center, which will open in June in Fort Collins. Reducing travel, visit frequency and treatment coordination were the main reason to building the center.

Dr. Anne Kanard, a UCHealth medical oncologist.

“The day our new cancer center opens, patients will be able to see multiple physicians during the same visit,” said Dr. Anne Kanard, a UCHealth medical oncologist. “We wanted to complement the physical single-entry point of the cancer center with the single hotline and website so our patients and their families can spend more time healing and less time going from appointment to appointment.”

UCHealth also has cancer care clinics in Greeley and Loveland. Residents in these communities and throughout northern Colorado have full access to the support available through the hotline and website.

To learn more about UCHealth’s cancer care program and the new cancer center, visit uchealthcancercare.org.

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

Sterling Kaczanowski in PVH's ICU

Sterling Kaczanowski in PVH’s ICU

The baby’s story is compelling—birth and near-death played out at Poudre Valley Hospital in Fort Collins, Colo.

And it is a major inspiration, an underscoring reason, for why local people will don their walking shoes April 26 and join walkers across the nation in the annual March of Dimes March for Babies.

Local walks start in Edora Park in Fort Collins and Bittersweet Park in Greeley. As usual, teams from PVH and Medical Center of the Rockies are signed up and ready to walk in the family-friendly event to raise awareness about premature birth and support March of Dimes research that benefits full-term and premature babies.

{Learn more about the walks and how to join in}

For Fort Collins residents Shari and Robert Kaczanowski the walk has great meaning. They have been designated the Larimer County Ambassador Family. They will speak at the Edora Park walk and talk about how March of Dimes research benefitted their family.

Here’s their story:

They were cautiously excited to add to their family when they learned that Shari was pregnant with their second child. Big brother Zeke was three years old when Shari found out she was expecting again. Zeke was born healthy at 38 weeks even though Shari developed preeclampsia during her first pregnancy.

Although Shari was considered high-risk during her second pregnancy—due to her previous experience with preeclampsia—the doctors said there was less than a 70 percent chance she would have the same outcome. Even with such good odds, the couple was nervous and still thrilled that they would soon add to their family.

At 30 weeks and three days, Shari was admitted to the hospital for bed rest because of elevated blood pressure. Unfortunately, Shari was one of the 30 percent and not only did preeclampsia strike a second time, it had progressed to HELLP Syndrome, a life-threatening pregnancy complication usually considered to be a variant of preeclampsia. Shari was immediately given a shot to help develop the baby’s lungs. Three days later Sterling was delivered via emergency Caesarian section.

Born at 30 weeks and six days, Sterling weighed two pounds and 14 ounces and was 15 inches long.  In comparison, a Barbie doll is 11.5 inches tall; Ken, 12 inches. The average length of a newborn male baby is 20 inches; weight, 8.12 pounds.

A long stay in PVH’s NICU

Sterling’s lungs were underdeveloped and he was put on a ventilator and CPAP machine in PVH’s Neonatal Intensive Care Unit. Due to her HELLP Syndrome, Shari remained hospitalized for the first two weeks of Sterling’s life while the doctors worked to get her blood pressure under control. Finally, after 10 days Shari was able to hold Sterling.

Sterling now.

Sterling now

During that special moment, Shari was nervous and barely breathing while thinking that Sterling was all hands and feet. His tiny head was smaller than an orange, but it was covered with the blondest hair.

After 68 days in the NICU, Sterling was finally able to join his family at home. More than two months of spending time at work, with Zeke at home and then rushing to the NICU to be with Sterling culminated in a joyful end when Robert and Shari were able to have both boys under their own roof.

Even though those first days home alone, without the monitors, hospital staff and support, were terrifying for Shari and Robert, the couple overcame the transitional time and enjoyed watching their growing family.

Today: Healthy, happy

Today, at three-and-half years, Sterling is a healthy, happy boy. The only lasting issue he has from his prematurity is minor asthma. Although the first year of his life was spent on oxygen and the second overcoming significant early delays with the help of multiple therapies, today Sterling is a blossoming preschooler who is working with his teacher to compose and practice his March of Dimes Ambassador speech.

Shari and Robert say they are thankful that their family’s story has such a happy ending. They realize this is not the case for many families. They credit the March of Dimes with helping Sterling survive by funding research and other programs for premature babies and sick babies.

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.

By Nicole Caputo

A movement grows through participation, passion and energy. This movement – the Healthy Kids Club Schools on the Move 5210 Challenge–started with one northern Colorado school district. Ten years later, it has Schools on the Move Challengegrown to seven school districts from Brighton to Walden encompassing 84 elementary schools and thousands of students, staff and family members.

Each February, northern Colorado elementary schools make a pledge to be active and eat healthy by adopting 5210 to their daily routine. The Schools on the Move 5210 Challenge, a University of Colorado Health program, asks all participants to track healthy habits through 5210.

What is 5210?

Each day participants need to:

  • Eat five servings of fruits and veggies.
  • Limit recreational screen time to less than two hours.
  • Be active for at least one hour.
  • Drink zero sugary drinks.

Up to $1,500 in prize money is awarded to schools with the highest percentage of participants and 23 winners are announced in three different categories, large school, small school and Weld-area schools. All prize money is used toward P.E. equipment or wellness initiatives.

Last year, Healthy Kids Club added a video challenge. Each school had the opportunity to create a video that showcases active, healthy learning. The top three videos were chosen by the community with over 3,500 votes. Video challenge winners are also awarded prize money.

The videos showcase the dedication and excitement these schools have for wellness and many of the videos are produced by the kids, said Laurie Zenner, manager, University of Colorado Health Healthy Kids Club. “It [the video challenge] is a creative way for participants to highlight ‘wellness in action’ at their schools and we hope the videos will inspire others to 5210,” said Zenner.

Schools on the Move logoAll participating schools have innovative ways to get kids and staff motivated throughout the month, such as individual challenges and classroom games.

At B.F. Kitchen in Loveland, the school secretary keeps everyone on their toes by tracking down staff and teachers to make sure logs are being filled out. They also had a daily challenge announced each morning to keep the students excited.

“The Schools on the Move 5210 Challenge has provided conversations and connections about healthy habits with families. The 5210 language becomes common during the month; it’s a new energy that is building positive momentum for this generation,” said Kristin Quere, B.F. Kitchen physical education teacher.

UCHealth’s Healthy Kids Club has been teaching kids healthy habits for 16 years. “Healthy kids learn better. It’s that simple. Each year, we see more participants and more creative approaches to teaching 5210,” said Zenner.

The Schools on the Move 5210 Challenge is a movement powered by pure energy and passion. Everyone can adopt 5210 to their daily routine. Join the movement.

Nicole Caputo is a marketing strategist for University of Colorado Health in northern Colorado.

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