2010-10 Northern Colorado Medical & Wellness

A STYLE MEDIA AND DESIGN, INC. PUBLICATION : : EST. 1984

N O R T H E R N C O L O R A D ON O R T H E R N C O L O R A D O

MEDICAL WELLNESSMEDICAL WELLNESSOCTOBER 2010

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A STYLE MEDIA AND DESIGN, INC. PUBLICATION : : EST. 1984

ADVANCES INALZHEIMER’S RESEARCH

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Lydia’s STYLE Magazine2

With digital mammography, you can benefit from less radiation exposure, shorter exam times and

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~

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VISIONARY HEALTHCARE Feeds: t)! Posts t)! comments

Taking healthcare from good to great

YISIONARY HEALTHCARE A BLOG BY RULON STACEY

PVHS and our Rocky Mountain Robotics Institute by rstacey

Over the past few months there have been interesting

advertisements in Northern Colorado about expertise and robotic surgery. To be honest, some of the claims amuse me

because organizations which have done relatively few robotic surgeries have proclaimed themselves expert in the specialty.

So, what should you know about robotic surgery in Northern Colorado? The fact is that PVHS was the first - by many

YEARS -to provide this service (in fact, in 2004, we were second in the state to launch robotic surgery) . We use the

robot in gynecology, urology, thoracic and general surgery. No organization in northern Colorado can claim that kind of

diversity - our thoracic (lung procedures) robotic program is the only one in Colorado .

Our OR teams are so experienced that they've helped set the

standards and define processes that are taught to new robotic programs across the country. PVHS has done nearly 2,000

robotic procedures since 2004. No one in northern Colorado can

come close to that .

That's why we encourage you to know that experience matters

when it comes to robotic surgery.

So, where would you go for robotic surgery? Easy choice!

Rulon

Follow Rulon's blog at visionary.pvhs.org

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Board Certified Former Faculty of John's Hopkins Hospital

listed in "Best Doctors in America" and "America's Best Doctors".

Patients Choice Recipient 2008

Nationally Recognized Expert in Sinus & Nasal Disease.

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Assistant Program, University of Colorado Health Sciences Center of Denver

Focus on General Ear, Nose & Throat

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Board Certified Doctor of Audiology

Focus on Hearing & Balance Disorders and Tinnitus Treatment

1-----~i;,._

ine Care of To111orrow-... Today!

"Almost thirty years of chronic back pain. You are the only doctor who explained my numerous problems and did various treatments that finally brought me some pain relief and most of the time pain free. You always told me that you were not going to give up on me, and you didn't."

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Northern Colorado Medical & Wellness 2010 7

Just found out she needs spine surgery

When you got the news, it was overwhelming. So many decisions to make. But after a little crying and a lot of

soul searching, you began your research . That's when you understood, experience matters. That's where

Banner Health shines. For decades, we've provided doctors with the advanced technology and support they

need to make the care you need possible. Like being able to perform spine surgery to replace damaged

discs with new ones made of innovative materials. Whatever your health issue, you know that it matters what

hospital you choose. And what matters now is that you go to the place where experts work best.

McKee Medical Center Banner Health North Colorado Medical Center

www. BannerHealth.com/COexperts Banner Health has been named as a Top 10 Health System in the U.S. for patient care according to Thomson Reuters.

Connect with us: You ,.


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office Manager/about town editor Ina Szwec

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office assistants Ronda Huser, Trisha Milton

contributing writersConnie Hein, Jon Geller, DVM, Kimberly Lock,

Erica Pauly, Corey Radman, Kay Rios, Laura Sebastian, Tracee Sioux

PhotograPhers Warren Diggles, Marcus Edwards

contributing PhotograPhers Mari Wolf

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Lydia’s STYLE Magazine10 The articles in this issue of Northern Colorado Medical & Wellness are presented for your general knowledge and are not a substitute for medical advice or treatment. If you have any questions or concerns about your health, please contact your doctor or healthcare provider.

Clarence and Thelma Ehlbert, in front of the Fort Collins Senior Center, are active seniors who take advantage of Colorado’s beautiful weather and bountiful local bike trails as part of their fitness regimen.

on the cover:

12 Publisher’s Letter

14 Health News

16 The Dimming of the Light

17 A Cure in Sight?

20 Lifestyle Medicine: Taking Aimat Modern Day Diseases

22 Embody Change Focuseson Lifestyle Choices

24 Advancements inRobotic Surgery

26 Protecting Your Skin

30 Easing the End-of-Life Transition

36 Seniors Staying Independent

40 Long-term CareInsurance Game Plan

42 Seniors Living Luxuriously

35 Keeping Active inYour Senior Years

53 Aids to Hearing Again

56 A Fungus Among Us

62 Exercise to Change Your Life/Reduce Red and Processed Meats in Your Diet

63 Get Fit, Give Back Calendar

67 Search and Rescue Dogs

octoBer 2010

Northern Colorado Medical & Wellness

53

HYPNOSISTHAT HEALS

SAFE PETTRANSPORTATION

60

64

24ADVANCEMENTS INROBOTIC SURGERY

contentS

A CURE IN SIGHT?

EASING THE END-OF-LIFE TRANSITION

30

17

AIDS TOHEARING AGAIN

60 Hypnosis That Heals

64 Safe Pet Transportation

70There for Your Pets

74 Physician Profile:Dr. Kevin Keefe

72Top 10 Medications thatPoison Pets


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Publisher’s Letter

Healthy Living Today

Our Northern Colorado region continues to be recognized in national publications as a favorite settling place among retirees because

of quality of life, mild weather, and many cultural and outdoor amenities. And that is precisely why our senior cover models, Clarence and Thelma Ehlbert, chose Fort Collins for retirement. Read “Keeping Active in Your Senior Years” to be inspired by these two very active, healthy and young-looking seniors. They are truly exceptional role models for all of us.

The Ehlbert’s healthy lifestyle is testimony to recent research pointing to lifestyle as a key determiner of health. You will find “Lifestyle Medicine: Taking Aim at Modern Day Diseases” interesting and informative. Learn about how lifestyle medicine is an emerging specialty and is included in the Fort Collins Family Medicine Residency Program at Poudre Valley Hospital, and how Kathleen Jones, independent certified intrinsic coach, can consult with you to make healthy choices.

As our parents age, the decision whether to continue living at home or moving into senior housing needs to be addressed. In “Seniors Staying Independent,” Linda Gabel speaks about providing services for seniors by seniors as a good solution to those who want to continue living at home. This is win-win partnership for both the giver and recipient of services!

For those of you finding that your hearing might need assistance, read “Aids to Hearing Again” for an overview of some of the state-of-the-art appliances now available. The options are many and our area offers many audiology professionals to guide you.

If you are interested in learning about senior living communities, browse “Seniors Living Luxuriously,” where Good Samaritan Water Valley Senior Living Resort and The Hillcrest Senior Residences are commit-ted to safety, independence, quality of life and social connection for their residents.

Whether you are a senior or not, pets are impor-tant family members and contribute to our quality of life. Recently I met Lorry Schmitz, who started a new business called Safely There Animal Transportation. I was intrigued with her passion for critters and her commitment to providing safety and comfort to animals that need to be transported. Read about her in “Safe Pet Transportation.”

We hope you enjoy reading the many interesting articles in this issue, along with the special section devoted to seniors, which will be continued as an annual focus. We enjoyed exploring the many important topics that relate to keeping a high quality of life as we age.

Enjoy our beautiful fall,

Experience matters

When it comes to robotic surgery, experience is the name of the game.

• PVHS was first in Northern Colorado to offer robotic

assisted surgery. Since 2004, we've completed nearly

2,000 procedures.

• Our Rocky Mountain Robotics

Institute offers one of the longest-running and most

experienced programs in the

Rocky Mountain region .

• We offer unmatched expertise

in gynecology, urology,

thoracic and general robotic

surgeries. Patients typically

have less pain, shorter hospital

stays and faster recoveries.

ail

www.robotics.pvhs.org (970) 495-8180

Rocky Mountain Robotics Institute POUDRE VALLEY HEALTH SYSTEM


Congratulations to IBMC On Expansion PlansThe Institute of Business and Medical Careers (IBMC)

has expanded into a 4th college campus with the acquisition of the former New Frontier Bank building at 2315 North Main Street in Longmont. They held their open house on September 9 and first class on September 20 at the 9,000 square foot building.

IBMC has also purchased the Circuit City building in Cheyenne, with plans to remodel the building to offer a more convenient, state-of-the-art facility for their students. The Cheyenne campus is expected to open in late November.

Best Place to Work for the Third YearPoudre Valley Health System

has been named by Modern Healthcare as one of Ameri-ca’s 100 best places to work in healthcare for the third straight year. Modern Health-care is a leading publication for the healthcare industry and will release their list for the top 100 on Octo-ber 18.

New Pre-operative Clinic at NCMCA new pre-operative clinic at North Colorado Medical

Center will prepare patients for their surgery, easing anxi-ety and improving processes for surgeons and staff.

“We’re doing more complex surgeries on patients with more and more medical problems,” says anesthesiologist Jim Birgenheier, M.D. The clinic allows doctors and staff to assess patients’ multiple conditions and prepare for those conditions prior to the day of surgery.

The clinic is offered at no extra cost to the patient and is open to all surgical patients who have questions about their care.

North Colorado Med Evac Offers Flights for High-risk Obstetrics

In July 2010, North Colorado Med Evac expanded their service to include emergency air transport for expectant mothers who are facing a health crisis. The air transport team, based at North Colorado Medical Center in Greeley, added eight specially trained Labor and Delivery nurses and Medical Director Shane Reeves, M.D., to create their specialized High-Risk Obstetrics crew.

health news

Our July cover featured tiny infant Nevaeh, born 3 pounds 3 ounces at Poudre Valley Hospital on May 24. Nevaeh’s mother, Lindsay Bryant, was undergoing chemo-therapy to treat stage III Hodgkin’s lymphoma when she gave birth to Nevaeh.

In late September, Style visited with Lindsay to see how she and her precious child were faring. “Nevaeh is doing wonderful – she is alert, so funny and sleeping through the night,” Lindsay reports. Her daughter is now four months old and weighs a healthy 10 pounds 4.5 ounces.

Lindsay wrapped up her chemotherapy in August, but a September PET scan revealed a little cancer left. She will begin radiation soon, but is in good spirits as she watches her little daughter continue to thrive. “My prognosis is good, and my hair is growing back,” she says.

UPDate ON BABY neVAeH AnD MOM LInDsAY

Longmont Campus


Alzheimer’s DiseaseMeDIcAL


T H E D I M M I N G

OF THE L IGHT

One out of every eight people over 65 is diagnosed with

Alzheimer’s disease. By age 85, that number rises to one

out of every two.

By Corey radman

Bob and Tammy Calhoon (pictured left) call themselves recycled teenag-ers; their whirlwind of dating lasted just four months before the retirees were married. Tammy smiles as she

explains, “When you are older you have already figured out what you want. We believed God arranged our being together, and we wanted to spend as much time together as possible.”

Both have survived the death of a beloved spouse, and had been alone for some time. So, they were tickled to find in one another that companion, that special someone who would be with them for the rest of their years. Bob was 61and Tammy 62 when they married in August 2002.

By the following summer, Bob started getting lost on the way to the store. This was unthinkable. They lived in Greeley, where he spent 20 years with The Group, Inc., as a residential Realtor. Bob helped to build the community, but now couldn’t find his way home from King Soopers.

Tammy remembers: “As a Realtor, I expected him to tell me how to get places. He just couldn’t remember. When he would come to a green light and stop, or go through a red light, I just thought he was preoccupied with me.”

Shortly after those early clues, Tammy began to suspect that their journey together wasn’t going to be quite like she anticipated. “There is a poem I love about getting on a plane to Italy and landing, instead, in Belgium. It’s like that for us. Belgium is nice, and there are interesting things to see there, but it’s not Italy,” she says. But this is not self-pity on Tammy’s part.

Bob has Alzheimer’s disease. He has spent a lifetime communicating with people, first as a broadcaster and then a Realtor. But slowly, that ability is waning.

Still, when asked what sparks their love, the twinkle in this couple’s eyes speaks volumes. “She’s the world’s nicest person,” utters Bob, in a moment of verbal clarity – a gift for his sweetheart. Tammy’s eyes well as she shakes her head modestly.

what is Alzheimer’s?Alzheimer’s disease is a brain disorder that slowly

destroys or impairs brain cells. “The protein beta-amyloid creeps into nerve cells and keeps them from functioning in a normal way,” explains Gerald McIntosh, M.D. He clarifies: “It clogs up the brain’s nerve cells so they can’t function… Under a micro-scope, this looks like scarring or plaque.”

Dr. McIntosh, a board certified neurologist since 1981, practices medicine at Neurology Associates of Northern Colorado and is medical director at four different neurology or neuro-rehab centers in the region.

At first, Alzheimer’s attacks the hippocampus, “the memory file clerk of the brain,” explains Dr. McIntosh. “But amyloids are seen throughout the entire brain. Damage to the hippocampus affects short term memory.” This is why individuals with Alzheimer’s can remember what they learned a lifetime ago, but not 10 minutes ago. “Most people with Alzheimer’s can still drive a car, but they don’t go to the right place.”

SymptomsJeff Siegel, M.D., neurologist with North Colo-

rado Medical Center’s Neurology Clinic in Greeley,


Signs of Alzheimer’s/

Dementia

Typical Age-Related

Changes

Poor judgment and decision making

Inability to manage a budget

Losing track of the date or the season

Difficulty having a conversation

Misplacing things and being unable to retrace steps to

find them

Making a bad decision once in a while

Missing a monthly payment

Forgetting which day it is and

remembering later

Sometimes forgetting which word to use

Losing things from time to time

PrognosisIt generally takes the amyloids 10 to 20 years to

completely spread through the affected person’s brain. Very often the first 10 years of the disease are only noticeable to the individual or their family, who might notice changes in perception or memory.

The professor of biochemistry, molecular biology and biomedical sciences at Colorado State University is pursuing a line of study that has shown the potential of insulin to preserve learning and memory in the brain.

In previous studies, IGF, an insulin-related protein, has been shown to cross the blood-brain barrier when it is injected under the skin, and to prevent impaired learning and memory in rats. Ishii’s team has also shown that low levels of insulin and IGF may accel-erate brain shrinkage in Alzheimer’s and diabetes patients. (The two diseases are both marked by a reduction of insulin in the brain.)

Combining these two factors, Ishii’s hypothesis is that infusion of insulin in early stages of dementia should stop the progression of the disease.

At present, the team has applied for international patents on the use of insulin to treat Alzheimer’s disease. “This may give rapid entry towards eventual product devel-opment,” says Ishii. “We are getting closer to substantial hope that new treatment is not far off on the horizon.”

A cure would be a staggering relief, both for families and individuals with Alzheimer’s, but also for public healthcare budgets. The current annual cost of treating dementia patients is $172 billion per year. That number is expected to triple by 2050 with the oncom-ing wave of aging Boomers.

The next step in this process is clinical

trials. First, the team needs to prove that the drug does no harm in humans. Then, stage II will study the drug’s efficacy in treating dementia.

“Bringing a new drug to market takes a village,” says Dr. Ishii. “By that, I mean no one person or group can do it themselves. Early phases of lab research use government grants. But from there you are expected to raise funds from private sources.”

Thus, Dr. Ishii is raising funds locally through the help of commercial investors and philanthropists. Without this type of fundraising, it’s very difficult for scientists to take promising research and convert it to an actual treatment. “Without help, we may never get a drug,” Ishii says.

Local artist Dawn Weimer, who has Alzheimer’s disease, has created an art sale called Friends of Hope. She and her husband Tom have committed to donating half of all proceeds from the sale of the “Friends of Hope” pewter sculpture to Professor Ishii’s research fund. More information can be found at www.dawnweimer.com.

If you are interested in supporting this research, contact Douglas Ishii at: [email protected].

Corey Radman is a Fort Collins-based writer and mother of two.

A Cure In Sight?Douglas Ishii, Ph.D., is the principal investigator on a promising study that may yield a cure for Alzheimer’s and diabetic dementia.

explains the difference between regular age-related memory troubles and Alzheimers. “Everyone experi-ences some memory loss as a part of aging. But the difference with Alzheimer’s is that people will experience difficulty in remembering new things they have just learned or will repeatedly ask the same questions.”

Dr. Siegel, a board certified neurologist since 1993, treats many patients who present with memory problems. To diagnose probable Alzheimer’s (certain diagnosis requires a brain tissue sample), Dr. Siegel looks for the memory issues plus dif-ficulty in one of the other cognitive domains like language, judgment, attention or reasoning. He says: “As the disease spreads, thinking slows down. Multi-tasking becomes very hard. The individual’s judgment degrades.”

The percentage of the population with dementia increases with age, and one’s risk doubles every five years after age 60. After 85, the chance of getting Alzheimer’s reaches nearly 50 percent.

Seventy to 80 percent of all elderly patients seen for dementia have Alzheimer’s disease. However, not all age-related memory loss is dementia. Emmalie Conner, regional director of the Colorado Chapter of the Alzheimer’s Association, wants the public to understand: “Alzheimer’s is not a normal part of aging. It is a disease.”

Family history does matter. Those with a parent, sibling or child with Alzheimer’s are more likely to get it.

18 Lydia’s STYLE Magazine

“The decline is slow. I liken it to a room lit by 1,000 candles being blown out one by one,” says Dr. Siegel.

Eventually, the amyloids spread to the brain stem, which controls basic life functions like swallowing and breathing. At present, there is no cure for this fatal disease.

Drug therapies usually include a cocktail of medi-cines like Aricept and Namenda that are thought to slow the symptoms of Alzheimer’s. “The best we have is not good enough,” says Dr. Siegel. “It basically pushes the clock back a year or two.”

Both neurologists recommend to patients a heart-healthy lifestyle that includes a sensible diet and moderate exercise. “Presence of heart disease, diabetes and obesity are all risk factors for having Alzheimer’s,” says Dr. Siegel, who wants his patients to remain as active as possible. “Keep those wheels spinning. Challenge your brain, try new things, learn a language or sign up for a class.”

The body of evidence about the benefit of puzzles like Sudoku and other brain games’ ability to ward off Alzheimer’s is mixed. Dr. Siegel says it probably can’t hurt. Dr. McIntosh’s best advice for preventing the disease is to avoid traumatic brain injury: “Try not to get concussed,” he says. “There is a link between people who have played aggressive contact sports and a higher incidence of Alzheimer’s.”

Jeff Siegel, M.D., Neurologist,North Colorado Medical Center

More philosophically, Dr. McIntosh sums up his best advice: “Live well now, and be happy.”

CopingAs the disease progresses, concern for the indi-

vidual’s safety at home becomes paramount. Emmalie Conner and the Alzheimer’s Association provide guid-ance for families through all the stages of Alzheimer’s.

“We can help people determine when it is time to consider a change in living environment,” Conner says. “We’re also very concerned for the well-being of the caregivers.” Caregiver burnout is common; they are at risk for isolation, depression and heart attack. Alzheimer’s Association provides support networks to help caregivers lend a hand to one another.

The non-profit organization also provides Alzheim-er’s education for the community, especially healthcare organizations. But most importantly, the association offers a kind ear and voice of experience to those still reeling from the shock of a new diagnosis.

Asked about advice she most often provides fami-lies, Conner urges people to seek a physician’s opinion as soon as they suspect something is wrong. Early diagnosis is important: for medicines’ effectiveness, for the time it takes to plan estates and finances, and for the opportunity to participate in clinical trials, she says.

Both Tammy and Bob Calhoon attest to the

enormous relief they feel because of the Alzheimer’s Association and the support groups they attend. “I just don’t know what our lives would be like without Emmalie,” says Tammy.

Faith and LoveThe Calhoons’ future is bleak, no matter how you

slice it. But neither feels sorry for themselves. “It is what it is,” says Bob, with the characteristic stoicism of a plainsman who spends most sunsets gazing at the mountains to the west of his kitchen window.

The reality of the situation dictates that Bob will likely forget Tammy’s name at some point, but what can’t really be measured, only felt, is how he will continue to recognize the spark of love in her eyes long after words have failed him.

Tammy says: “We really feel like God has brought us together for a reason – His word is true; He is faithful. He will get us through this. Trusting in the Lord, we’ll survive and we will have more good days.”

Resources:

Alzheimer’s Association – www.alz.org

Corey Radman is a Fort Collins-based writer and mother of two.

One frustration for many families who experience Alzheimer’s disease is the disap-pearance of their friends and family, who out of fear, may begin to shy away.

• Don’tbeafraidtocontinuetherelation-ship.Bybeingopenandunderstanding,youcaneasetheburdenofthecaregiverandtheindividual.

• Listenandinvitethemtotalktoyou.

• Haveaplanwhenyouoffersupport.Don’tjustsay,‘WhatcanIdotohelpyou?’Say:‘ThisiswhatIwouldliketodotohelpyou:bringamealortakeBobgolfing.’

• RemembertheindividualwithAlzheimer’sisstillathinkingperson.Theymaynotrememberyourname,butmightstillappreciateseeingandhearingfromyou.

Emmalie Conner, Regional Director,Colorado Chapter, Alzheimer’s Association

Gerald McIntosh, M.D., Neurologist,Neurology Associates of Northern Colorado

What to say when someone is dealing with Alzheimer’s disease


BEGINNING A

t!zew't~;u OF

PATIENT CARE SPECIALIZING lN

ROOT CANAL THERAPY

GENUINELY CARING FOR EACH INDIVIDUAL


Lifestyle MedicineMeDIcAL

T A K I N G A I M A T

MODERN DAY DISEASES“As we saw chronic diseases

grow, it became apparent it

was related to what we eat,

if we smoke, if we exercise.

we wanted people to look

at lifestyle choices and

understand the connections

between the lifestyle and the

disease.”

– Austin Bailey, M.D., program director for Fort Collins Family Medical Residency Program

By kay rios

As everyday life has changed over the past decades, so have the diseases that end life. With those changes and a growing body of evidence, a new approach in

disease treatment is gaining favor: lifestyle medicine.

Lifestyle medicine is an emerging specialty that uses interventions such as nutrition, physical activity, stress reduction, smoking cessation and avoidance of alcohol abuse as primary tools in preventing and treating disease.

“It’s a maturation of a concept that began in the ‘70s when the chronic disease burden was becoming apparent in the U.S.,” says Austin

Bailey, M.D., who oversees Poudre Valley Hos-pital’s Family Medicine Center (FMC) and is program director of the FMC-based Fort Col-lins Family Medicine Residency Program (FMRP), which provides intensive on-the-job continuing education for new medical school graduates.

“Previously, the prevailing acute diseases were infectious ones. But by introducing clean water and sewer systems, and with the advent of vac-cines and antibiotics, infectious diseases came under control for the most part.”

In the early 1900s, pneumonia, influenza, tuberculosis and diarrhea – all communicable diseases – were the leading causes of death in the U.S., and heart disease and cancer were farther down on the list of killers. Around mid-century,

Kathleen Jones (right), owner of Embody Change, consults with a patient about lifestyle choices.


heart disease, cancer and other degenerative diseases (lifestyle diseases) moved up the chart and, by the late ‘90s, accounted for more than 60 percent of deaths, according to the National Center for Health Statistics. In 2007, lifestyle diseases including heart disease, cancer, stroke, chronic lower respiratory diseases, Alzheimer’s disease and diabetes topped the chart of leading causes of death in the U.S.

“As we saw chronic diseases grow, it became apparent it was related to what we eat, if we smoke, if we exercise,” Dr. Bailey says. That inspired the concept of health promotion and disease prevention. “We wanted people to look at lifestyle choices and understand the connec-tions between the lifestyle and the disease. But, as physicians, that was the last thing we did. It was a tag-on to traditional treatment.”

That’s beginning to change, he continues. “What we are finding now is that lifestyle medi-cine should be an active approach rather than an add-on.” It then becomes prescriptive and is used as an intervention as opposed to a sug-gestion, Dr. Bailey says.

The lifestyle medicine approach is evidence-based, says Kathleen Jones, a certified intrinsic coach with Embody Change Lifestyle Coaching.

“Even though it’s a relatively new field, there’s too much evidence to ignore. People have the idea that good health is the result of advances in medicine with better drugs, better tests and surgeries – and those do play a role – but study after study has shown that lifestyle choices are especially powerful in both preventing and treat-ing disease. Given the right conditions, the body has a remarkable ability to heal itself.”

She refers to cardiologist Dean Ornish’s studies in the mid-1980s that used low fat diets, exer-cise, stress management and yoga. The studies documented how those actions reversed heart disease in the participants. “He showed how comprehensive lifestyle changes could be more effective than a bypass,” Jones says.

Based on the mounting evidence, interest in lifestyle medicine is also growing nationwide – and the FMRP training efforts reflect that. FMRP was one of the first programs in the nation to move into lifestyle medicine as a continuing education topic for residents and FMC physicians.

FMRP provides experience for 18 residents; each resident receives valuable hands-on training for three years at FMC, PVH and other Poudre Valley Health System-owned medical services.

As part of their training, residents learn infor-mation in an intensive class that focuses on areas such as dietary changes and exercise programs.

“The class helps residents work on motivational interviewing, talking to patients and helping them set goals,” says Tasha Ballard, who oversees FMRP lifestyle medicine rotation. “The current model with chronic disease management is for the doctor to give a directive: ‘I want you to do this.’ This is stepping away from that because we know when an idea for change originates from the patients, they will be more likely to follow through. The doctor will lead them down the path, but it will be their own path.

“We try to make it appropriate for primary care and go through what’s possible and what can be expected,” continues Ballard. “We look at related medical areas they can incorporate into their clinical practices.”


“The bulk of the physician’s work is in diagnosis and treatment, and they can use lifestyle changes as part of that treatment plan,” Dr. Bailey adds.

“The physician can do the initial interview and help set up the plan that will direct the patient to the proper professional. The patient is at the center and the physician helps collect a team of people around the patient. The doctor is no longer the hub of the wheel. The patient is the hub.”

The primary goal, Dr. Bailey says, is to help the residents understand that lifestyle is at the core of the chronic condition.

“It’s not meds first and then – as a patient walks out the door – throw in a comment about exercise,” he says. “It’s more specific with actual strategies, and it’s more about how the patient can do it. It makes a big difference if you, as a physician, give them a prescription to go see someone else. People actually have some internal motivation to change but if the doctor says it’s important to do this, it increases that motivation.”

“I think our residents sometimes feel the current way medicine is often practiced in America can be frustrating as our lifestyle-related diseases continue to increase. Obesity, for example, has become an epidemic,” Ballard says. “It’s hard to get people to change. Our residents don’t want to just be dispensing pharmaceuticals. They want to help people get healthy again. They also come to see motivational interviewing as a key piece to working with patients, and they see how it can help behavior changes occur.”

Physicians and medical organizations across the country are beginning to accept the impor-tance of lifestyle medicine as an integral approach to treatment.

In 2007, the American College of Preventive Medicine’s (ACPM) Board of Regents voted to actively pursue involvement in evidence-based lifestyle medicine. ACPM convened a blue ribbon panel of experts from leading primary care and

Austin Bailey, M.D., Program Director,Fort Collins Family Medical Residency Program

Lifestyle medicine is one of the first discourses to recommend that life-style is the treatment for a chronic disease,” says Kathleen Jones, cer-tified intrinsic coach with Embody

Change Lifestyle Coaching. “The evidence linking lifestyle choices to chronic disease is compelling and we can’t ignore that.”

Jones says that most everyone has an idea of what a healthy lifestyle looks like, but that doesn’t mean the ideals are followed. “We know it’s about being active, eating fruits and vegetables, learn-ing to manage stress. But we live in a time where inactivity, overeating, and cutting back on sleep hours are the easier choice to make. These passive choices undermine health and lead to lifestyle-related illnesses.”

In her work at Embody Change, Jones works with clients to help them make changes in their lifestyle. “It requires effort and some degree of active engagement so that the actions they choose support, rather than undermine, their health. Our bodies are incredibly responsive to lifestyle choices.”

Jones, who is a member of the American College of Lifestyle Medicine, completed her certification with the Harvard Institute of Lifestyle Medicine and has advanced training in motivational interview-ing. She works with other healthcare providers who want to offer their patients the option of a lifestyle approach. Her areas of expertise include behavior change theory, spirituality in medicine, stress resiliency and life balance.

The challenge in achieving life balance and making positive lifestyle choices is really about working with the mind, developing self-awareness and strengthening self-mastery, she says. “When we make wise lifestyle choices, our bodies respond with improved health.”

Given that, the first question she asks a new client is, ‘What would be different in your life if you could make one change?’ The benefits on the other side of that question make the answer more compelling. For example, someone might say, ‘I would be more athletic’ or ‘I would be more energetic.’ It makes it more personal.”

That’s how she approaches coaching, she says. “I try to work from within the language of our lives, and there’s often an emotional depth to that.”

Clients often come in with stated intentions such as managing stress, chronic illness or weight. However, says Jones, the intentions can be vague, so the first thing is to translate that into a goal.

“We move on from there into practices. People feel like they have to unlearn old habits, but that’s not necessarily true. For instance, someone might say,

‘I drink too many coffee drinks.’ But when people try not to do something, it’s like saying, ‘Try not to think of elephants.’ That’s the first thing you think of. So instead, we ask, ‘What could you choose instead?’ Perhaps it’s buying a pretty water bottle and drinking water and tea. It’s really about help-ing new habits form, and it can be a simple thing. We plant some positive habits that will pull them forward, and we create a plan they can commit to.”

The choices are very individualized, with ideas that come from the clients themselves. “A client may choose belly dancing, meditation, strength training, or just a simple walk after dinner. Others may want more structured fitness with weight loss programs or working with personal trainers,” Jones explains. “The key is that the client becomes empowered to choose lifestyle practices that sup-port his or her well-being.”

Sometimes it’s as simple as recognizing patterns, Jones says. “Many lifestyle choices are automatic, so when [clients] become self-aware, they can move away from choices that are automatic and into new habits that are very conscious.”

That’s what lifestyle coaching is about, Jones explains. “It’s built on an understanding of what activates change.”

With that understanding, Jones then helps clients align goals with personal health recommendations.

“Most people want to be at their best. We can either support that or undermine it. Lifestyle medicine supports that.”

Kay Rios, Ph.D., is a freelance writer in Fort Collins.

E M B O D Y C H A N G E

FOCUSES ONL I F ESTYLEC H O I C E S

By kay rios

“


other medical associations to develop competen-cies for practicing physicians in lifestyle medicine, says an article published in the Journal of the American Medical Association.

The article states that the leading causes of death for adults in the U.S. are related to lifestyle, and also maintains there is plenty of room for improvement for those who are asymptomatic or those living with chronic disease. “Health behaviors could greatly influence future health and well-being, especially among patients with chronic disease,” the article says.

As lifestyle medicine becomes more wide-spread, other considerations will have to be made, Dr. Bailey says. “We don’t have good infrastruc-tures for this yet. We are not just thinking about individuals, but that the team and the average family physician would not be able to afford it or have the resources within their practice.”

Setting up a team effort will require coopera-tion and networking, he says. “When our resi-dents go to communities like Yuma or Julesburg, we teach them to look at who is in the community that can work in the capacity of pharmacist or counselor or social worker. In the residency week, we identify those issues and offer resources.”

Dr. Bailey believes those issues can be worked out, and he feels the insurance industry will eventually step up to the plate. “It will be cheaper in the long run for the insurance company. Ethi-cally, it’s the right thing to do; economically, it’s the right thing to do. But politically, it’s a very complex matter.”

Kay Rios, Ph.D., is a freelance writer in Fort Col-lins. She writes for a variety of publications and is at work on a collection of creative non-fiction and a mystery novel.

Tasha Ballard, Lifestyle Medicine Coordinator, Fort Collins Family Medical Residency Program

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Robotic SurgeryMeDIcAL

A D V A N C E M E N T S I N

ROBOTIC SURGERY“I am so excited by this

technology; it is truly

revolutionizing medicine

today. we are able to

provide a much better

surgical experience with

less operating time, less

distress for the patients,

less bleeding and a lower

morbidity rate.”

– Sarjvit Gill, M.D., Alpine Ear, Nose & Throat

By kimBerly loCk

when Loveland resident Keith Poore discovered he had a growth at the base of his tongue, he had no idea how his

life would change. And when the doctors diagnosed it as cancer, he had no idea how he would help change medicine.

Poore was sent to Sarjvit Gill, M.D., with Alpine Ear, Nose & Throat in Loveland. Dr. Gill had recently performed a robotic-assisted surgery on a patient with throat cancer, and Poore made an excellent candidate for the same procedure.

“They discovered a squamous-cell tumor on the base of my tongue, and I was told that normally

they would not treat me with surgery because of the invasiveness of it,” Poore says. “Instead I would receive chemo and radiation for the tumor.”

Traditionally, the open approach for surgery to treat throat cancer requires the surgeon to make a long incision through the throat and jaw. The surgeon generally needs to break the jawbone to perform a tracheotomy and insert a breathing tube. The breath-ing tube is left in for up to 10 days after the surgery.

This surgical approach can cause disfigurement and result in difficulty eating, speaking and swallowing. Reconstructive or plastic surgery may be needed to rebuild the bones or tissues removed during treatment.

“Because of the tremendous visual access the robot provides to remove tumors, we do not have to split the jaw leaving a lot of vital functions and


capabilities of the head and neck intact,” Dr. Gill says. “I usually don’t get too excited about new technology, but this is revolutionary and provides us with a much better surgical experience.”

This allowed Poore to drink water three days after the surgery and begin eating foods within two weeks of the surgery. “I had to be intubated, but once they removed the tube I could speak again,” says Poore. “It was hard to swallow for a few weeks because it felt weird, but I know I feel a lot better than I would have.”

Doctors need to have a full line of sight to operate, and the daVinci Surgical System robot allows doctors to have a three-dimen-sional view inside the body that is unrivaled

– even by laparoscopic technology. “I am so excited by this technology; it is truly

revolutionizing medicine today,” Dr. Gill says. “We are able to provide a much better surgical experience with less operating time, less distress for the patients, less bleeding and a lower morbidity rate.”

Dr. Gill is one of a handful of surgeons in the nation and the only one in Colorado and surrounding states who has performed this transoral robotic surgery using the daVinci Surgical System. All four hospitals in Northern Colorado – Poudre Valley Hospital in Fort Collins, McKee Medical Center in Loveland, North Colorado Medical Center (NCMC) in Greeley and Medical Center of the Rockies in Loveland – offer surgeries assisted by the daVinci Suite. There are now approximately 900 hospitals in the nation offering this technology, double the number found in 2007.

In July 2010, the makers of the daVinci robotic system named McKee Medical Center an epicenter for gynecological surgery. The designation means surgeons from around the country can come and observe gynecological procedures completed in the robotic suite at McKee.

The flexibility and dexterity of the robot is truly remarkable. The robotic arms are inserted into a patient through incisions that range from 5 mm to 8 mm in length. These robotic arms have “wrists” at the ends which allow the surgeons to operate anywhere within 360 degrees – more dexterity than a human wrist. And the surgeon is responsible for moving the camera, allowing them to get the precise image they need.

The surgeon is seated at a console a few feet from the patient, and they control the four robotic arms with joysticks located under the console. They slide their hands into the controls so they become an exten-sion of the surgeon. They can see the operating field by viewing a three-dimensional image in the console.

“Your view of the operational field is magnified 10-times,” says John Crane M.D., obstetrician and

gynecologist for Banner Health OB/GYN Associates. “The dexterity of the instruments is greater than that of my own wrists. Once you get in there you can move the tools around 360 degrees.”

Patients who have a robotic-assisted surgery are released from the hospital sooner and experience less blood loss and pain than those who have a traditional “open” or even laparoscopic surgery. Dr. Crane says a robotic surgery is more comfortable for the surgeon as well. Instead of standing and looking up and away at a monitor, the surgeon is in a more ergonomic seated position.

At NCMC, the daVinci robot has cut patient stays from five to ten days for a urologic procedure to an average three to four days. In Colorado, insurance companies do not pass on any additional costs associ-ated with robotic surgery because the benefits and savings outweigh additional fees.

The first hospital in Northern Colorado to use the daVinci was Poudre Valley Hospital, who installed its system in 2004. The suite was originally intended to be used in gynecologic procedures, including hysterectomies, and for removal of prostate cancer. But now the system is used in a wide variety of operations, and the future appears endless.

“I know for radical prostatectomies, doctors prefer to use it because they make a smaller incision and they get a more precise look around,” says Mary Johnson, urology RN coordinator for NCMC. “It is like a virtual reality environment; it is really amazing to see these surgeries performed.”

Great surgeons are still integral to the process. “I want to make one thing clear, the robot does not teach you how to perform surgery,” Dr. Crane says.

“It can take a B-surgeon to an A by improving the environment. But it can expose a poor surgeon as well… good open surgeons will make good robotic surgeons.”

Dr. Crane says surgeons have to go through a clinical pathway to learn how to use the robot

before they operate on a real person. The tech-nology involved with the surgery has to be learned, but for people who have spent hours playing video games, it seems a little more intuitive.

Kids and young adults who play video games have an easier time adapting to the vir-tual reality element of the system. They seem to be able to sit right down at the console and do a majority of the primary tests offered.

For gynecological procedures, the daVinci suite was originally used for hysterectomies, but is now used for more delicate surgeries within the uterus, like remov-ing cysts and clearing blocked fallopian tubes.

Doctors agree the robotic surgery suite is revolutionizing medi-cine. It is not a reinven-

tion of an existing technology – it is a whole new frontier.

Regional Robotic Surgery Programs at a Glance:

Name: Robotic Surgery

Health System: Banner Health

Hospitals: McKee Medical Center and North Colorado Medical Center

Program Inception: NCMC began in 2006; McKee in September 2009.

Areas of Expertise: Gynecology, Urology, Headand Neck, Bariatric Surgery

Number of robotic surgeons: 17

Program Volume: 435

Number of Robots: 1 at McKee, 1 at NCMC

Name: Rocky Mountain Robotics Institute

Health System:Poudre Valley Health System

Hospitals: Poudre Valley Hospital and Medical Center of the Rockies

Program Inception: 2004

Areas of Expertise: Urology, Gynecology, Thoracic, General Surgery

Number of robotic surgeons: 18

Program Volume: 1,800+

Number of Robots: 2 at PVH, 1 at MCR

Kimberly Lock is a freelance writer who enjoys living in Colorado and spending time with her husband, kids and huskies in the outdoors.

Dr. Gill uses the daVinci Surgical System to remove the squamous-cell tumor from the base of Keith Poore’s tongue. Dr. Gill is only one of a handful of surgeons in

the nation that has performed this kind of transoral robotic surgery.


P R O T E C T I N G

Y O U R S K I N with 300 sunny days a

year, Colorado is one of the

sunniest states in the U.S.

But, while we love all that

sun, the sun doesn’t love our

skin back.

By TraCee sioux

Skin CancerMeDIcAL

Ingerlisa W. Mattoch, M.D., is a dermatopa-thologist at Summit Pathology, a specialist who analyzes biopsied tissue.

“Since I have been working in Colorado, I’ve seen the most significant pathology in

regards to melanoma – meaning I’ve seen the most melanomas and the worst melanomas of my career,” says Dr. Mattoch.

According to the Colorado Deparment of Public Health and Environment, the incidence of melanoma in Colorado is nearly 30 percent higher than U.S. rates and continues to rise.

“According to the U.S. Center for Disease Control, Colorado has one of the highest inci-dence rates of skin cancer in the U.S., with 21 per 100,000 people developing melanoma per year,” says Dr. Mattoch. “The death rates from skin cancer also fall into the highest subset, with three per 100,000 people dying from skin cancer melanoma per year.”

One of the reasons for these high numbers is Colorado’s special place close to the sun. “An increase in elevation is an increased exposure to ultraviolet (UV) radiation, which is thought to be the causative factor in development of skin cancer,” says Dr. Mattoch.

“UV radiation increases 10 to 12 percent for every 3,000 feet in elevation,” she continues. “If you combine the increased intensity of UV radia-tion due to Colorado’s elevation with the three hundred sunny days per year, there is a lot of opportunity to spend time outdoors and accrue UV eposure. It’s a wonderful lifestyle, but puts you at risk for the development of skin cancer if you don’t take the necessary precautions when you’re outdoors.”

Mary Blattner, M.D., a dermatologist at Gree-ley Medical Clinic, also cites outdoor work, like farming, and a large population of people with Northern European ancestry (fairer skin) as con-tributors to the high skin cancer risks.

That’s A Funny MoleDr. Blattner encourages people to do self-

screenings and have a physician do an annual full-body skin check.

“If something’s growing on you, have it checked,” recommends Dr. Blattner. “Any change in an existing mole or a new growth on the skin should be checked. Generally, a melanoma is black or brown and multi-colored as opposed to evenly colored. Usually there is a change. Not always, but it can be fairly dramatic, within a few months or year there can be a discernible change in size or color. It doesn’t mean they’re all cancer but you should have it checked.”

Melanoma is the most dangerous type of skin


Ingerlisa Mattoch, M.D., dermatopathologist at Summit Pathology, analyzes a biopsied tissue sample.

“If the melanoma is not detected early, it can become an invasive melanoma. At this stage, it gets into the supportive structure of the skin, the dermis,” Dr. Mattoch continues. “This is the stage where melanoma gets its reputation for being so fatal. When in the dermis, it has a very strong potential to metastasize due to its access to dermal lymphatics and blood vessels.”

If detected early enough, pre-squamous cell carcinomas can be treated with a simple cryo-surgery, an in-office procedure where the growth is burned off with liquid nitrogen. In situ melano-mas can often be removed with a surgical incision in the office.

Once a melanoma has developed into an invasive cancer, things get more complicated.

“We do a surgical removal in the office and sometimes we will refer patients for radiation therapy,” explains Dr. Blattner. “If they are beyond a certain degree we will do a sentinel node biopsy that helps stage the tumor. Then, depending on the results, we will also refer to an oncologist to determine if chemotherapy is necessary. We send biopsies in to a pathologist to determine if the margins are clear and we got it all.”

One form of treatment is a Mohs surgery,

cancer and is the leading cause of death from skin disease. Other types include basal cell and squamous cell carcinoma.

“A basal cell carcinoma appears as a red nodule and they generally will grow, sometimes quickly, sometimes not. A new red growth or nodule on skin needs to be checked,” says Dr. Blattner.

Squamous cell carcinoma can also appear as a red bump and become sore and tender. As with most cancers, “usually you’re at higher risk if you are fair and you’ve been sunburned a lot,” says Dr. Blattner.

Don’t forget to check your scalp. “I see so many cancers on the scalp, particularly on bald-ing men or women with thinning hair,” says Dr. Blattner.

As with any other cancers, both doctors say early detection is key.

“From a pathologist’s perspective, and I know this is also a dermatologist’s perspective, early detection is your best friend,” says Dr. Mattoch.

“Melanoma goes through a series of stages. When detected early, melanoma is in its ‘in situ’ phase – this means that the melanoma is in the first layer of skin, the epidermis. At this stage it has not acquired the potential to metastasize.


Epidermis

Derm

is

Melanoma (examples above) is the most dangerous form of skin

cancer. Melanomas are most often black or brown and unevenly

colored. Often, melanomas will change their appearance, so it is important to have any such spot

checked by a doctor.

Basal cell and squamous cell carcinomas

(examples below) are both generally red in appearance and form a nodule on the skin.

These carcinomas can sometimes grow quickly.

Epidermis

Dermis

Squamous Cells

Basal Cells

Melanocyte

generally used for basal cell cancers in vulnerable areas where cutting may cause damage to the structure, such as the nose or mouth. The surgeon removes the tumor and marks the borders, then checks the tissue while the patient is in the office. If they didn’t get it all, they will go back and excise further. The patient waits in the office until all of the margins are clear. The Mohs surgery allows doctors to know


with a high degree of certainty whether they got the cancer. Not all dermatologists are certified in this procedure.

No Such Thing as a Good SuntanThere are many ways to enjoy the weather and

outdoor lifestyle while protecting yourself from the poisonous UV rays: sunscreen or sunblock; protective clothing, including hats, sunglasses, and shade; and avoiding the sun between 10 a.m. and 4 p.m. People should protect themselves not only when playing outdoors, but during daily activities like running errands, gardening or walking outside.

There are two different types of cream or spray sun protection. A sunscreen scatters and filters the UV rays as they hit the skin. Sunblock stops the UV rays completely.

Dr. Blattner recommends at least a sun protec-tion factor (SPF) of 50 in a sunscreen or sunblock. She uses an equation when looking at an SPF protection. Sunburn time multiplied by SPF equals reapplication time. So, if you’re a person who burns after five minutes of sun exposure and you use an SPF 30, then you need to reapply every 150 minutes.

A simpler rule is to use a high SPF and reapply liberally every hour.

“There are no all-day protection sunscreens or sunblocks,” reminds Dr. Blattner.

“Skin cancer is a cumulative event,” explains Dr. Mattoch. “It develops over time with exposure to radiation. In a person’s life, the highest expo-sure is when you’re a kid. People think that by virtue of having a tan, it affords them some sun

Mary Blattner, M.D., dermatologist, Greeley Medical Clinic

protection. This is sometimes true, as a suntain equates to an SPF of approximately 3. However, it does not afford you any protection against accruing UV radiation points over time.”

“There is no such thing as a healthy tan. Every bit of ultraviolet radiation you’ve gotten has done something to damage your skin,” says Dr. Blattner.

Children should be applying sunscreen every hour when playing outdoors, including recess and getting to and from school, not just on a summer day at the pool. They should also be wearing hats, sunglasses and protective clothing. Dr. Blattner loves to see UV protective swim shirts.

“People think they are protected completely if they have a hat on and they aren’t,” cautions Dr. Blattner. “Sun reflects off pavement, snow and water.”

For a sun-kissed look it’s all about the sunless tanner, as tanning beds also have UV rays. “I love spray tans,” says Dr. Blattner. “Spray tans have gotten so good that when [patients] come in I can’t even tell and I start to lecture. They have to stop me to explain it’s a sunless tan.”

For more information about how to protect your family against dangerous sun exposure visit www.SunSafeColorado.org.

Tracee Sioux is a Fort Collins writer. She can be found at TheGirlRevolution.com and www.linkedin.com/in/traceesioux.


HospiceMeDIcAL

E A S I N G T H E

END-OF-LIFE TRANSITION By TraCee sioux

The pain of death touches

everyone. Often, emotional

and spiritual needs are as

important and complex

as physical needs. As the

end-of-life transition nears,

there is assistance available

to ease that pain for both

the dying and their family.

Local hospice fills this need.

Hospice programs serve a person through their end-of-life transition. Hospice makes no attempt to cure a patient and every attempt to make their

last days, and their passing, as compas-sionate and dignified as humanly possible.

“I look upon death as simply a passage of life; it needs to be done with dignity and it needs to be done with a humanistic approach and kind care,” says Mary Ann Abrams, a hospice volunteer at Hospice of Northern Colorado (HNC) in Greeley.

To be accepted in a hospice program, a patient must have six months or less to live. Hospice provides end-of-life medical and nurs-ing care, comfort care, pain management, grievance counseling for patient and family, respite care to give caregivers a break, non-denominational spiritual guidance, ancillary

therapies such as music therapy, pet therapy and massage therapy, and 13 months of coun-seling for grieving survivors.

“Hospice focuses on what is important to that individual if he or she should become very ill,” says Kim Mueller, marketing and outreach executive for Pathways Hospice in Fort Collins. “Maybe it’s repairing a relationship or a final accomplishment; maybe it is dying at home. We’re there to allow conversations to come up and sometimes even facilitate the conversation.”

Don Erickson, HNC board member, says his father chose to enter hospice and maintain his quality of life during his last days, rather than pursue painful and costly cancer treatment.

“The end stages of life are not served well traditionally,” says Erickson. “Doctors are uncomfortable because they want to cure people. Hospice educates the community [about death] and makes the patient feel


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comfortable and relieves their pain. It’s about making the last stage of your life comfortable and productive.”

“Once the patient accepts hospice for themselves, there is relief,” says Rose Rossi, Mountain Valley Home Health (MVHH) hospice community representative. “It’s a relief if they were going through a lot of treatments or a two-page list of medication regiments. It feels like a whole weight on their shoulders is lifted. They focus on spending time with their families. They can go out more and not have to go to the hospital so often. There is a sense of acceptance about what’s going on with them.”

People generally want to die comfortably in their own homes, and hospice allows many of them their wish.

“There was a study done by CBS called The Cost of Dying,” says Mueller. “The vast majority of Americans say they want to die at home, but 75 percent die in a hospital or nursing home. Hospice is one way that many people are granted their wish to die at home, because of all the services we provide.”

Spiritual guidance is also offered. Non-denominational hospice chaplains usually have higher degrees in theology or philosophy. Their goal is to assist the patient in achieving peace with and through their own spiritual belief systems.

Mary Peery, Pathways Hospice board member, first experienced hospice care when her father-in-law was dying. Her mother was also a recipient of hospice care when she died.

“What was most touching to me, when my father-in-law was in in-patient care, was when they asked, ‘Did he want to see one of our chaplains?’” says Peery. “He didn’t necessarily believe in an afterlife. Within 15 minutes she pulled his belief structure out of him, and she became his most favorite hospice resource. It wasn’t about her belief structure, but what she could do to support him in a spiritual way so he could experience relief. That was profoundly impactful. I give you that example because what I was most impressed with is their capacity to get in-tune with absolutely what the patient needs and what the most impactful way is.”

Many board members and volunteers of hos-pice programs had such wonderful experiences with hospice when a loved one transitioned out of this life that this motivates them to pass the gift onto others.

“I’ve always had this thing that it was very necessary to do something for your fellow man and have something constructive to do,” says Abrams. “I am widowed, I live by myself, my family is very, very small, so I need this to connect with people. I really get much more from the people that I come in contact with than I feel I ever give them.”

Ralph Murphy, whose wife received hospice care, experienced great comfort from the work-ers and volunteers prior to her death. Now, as a Pathways Hospice volunteer grievance counselor, he comforts others going through similar experiences.

“I go to the patient’s home and sit with the patient and offer comfort and companion-ship,” says Murphy. “Also, it’s for the spouse


or caregiver, to give them some relief. They can go out and go shopping and go get a massage while I stay with the patient and look after his needs. The patient is comforted and it takes them away from their illness to have someone other than their family to talk to. A lot of times they will confide their inner feelings and things they won’t tell their family that they are worried or concerned or happy about. They look forward to our visits.”

A serious stressor in the lives of seniors today is financial issues related to healthcare.

“On a practical level, there are deeper con-cerns now with healthcare, insurance, Medi-care, reimbursement and the unknown that generally creates a lot of stress for our elderly community – ‘What is going to be there for me?’ It has a huge impact on them. It’s not like they can go back out there and get a job,” Peery notes.

Hospice is fully covered by Medicare, Med-icaid and private insurance. Pathways Hospice and HNC are non-profits, so no patient is turned away for inability to pay. MVHH also has a foundation to assist patients with end-of-life services.

Every hospice program needs volunteers. Duties range from clerical help, technology expertise, grievance counseling, or simply sitting with patients.

Pathways Hospice and Hospice of Northern Colorado both depend on community dona-tions to provide this humane, compassionate end-of-life experience for people.

In addition to helping patients, hospice offers services and relief to family members and familial caregivers. As a patient’s health deteriorates, hospice helps families accept the inevitable and deal with the enormous responsibility of caring for a terminally ill family member.

Grief counseling, group or individual, is something every hospice program provides to the entire community, whether their loved one has been in a hospice program or not.

“Nobody likes to talk about death and dying,” says Erickson. “Hospice helps them get edu-cated and understand the stages and what to expect. It makes the passing a lot easier for patients and family and friends. When you know what’s going to happen, it’s not totally foreign to you. Hospice provides 13 months of counseling services that you can go through, tying the event up, making sure you can get your life back on track.”

“One of the things that we take a lot of pride in is the grief and loss support that we offer to anyone in the community, whether or not they are connected with hospice,” says Mueller.

“We have a wide variety of services. We offer one-on-one grief counseling, cooking-for-one classes, play therapy for young children, expressive art for teens. We offer considerable options for support to grieving individuals in the community.”

Tracee Sioux is a Fort Collins writer. She can be found at TheGirlRevolution.com and www.linkedin.com/in/traceesioux/

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By Angeline grenz And Audrey Springer

k e e p i n g a c t i v e

in your senior yearsAfter 55 years of marriage, Clarence and

Thelma Ehlbert still embrace the active lifestyle more common to adults half their age, and it shows. Clarence and Thelma are lithe, slender and attractive 70-somethings, who, it would seem, do not have “couch potato” in their vocabulary.

They are energetic, sprightly and dedicated to their healthy lifestyle. It has benefitted them well – neither has had any serious health issues. Clarence proudly boasts, “After 55 years, if we had the clothing from our wedding, I think we would still fit in them.”

Theirs is truly a match made in heaven. They both enjoy exercise together and separately. Clarence, 76, used to “live for tennis.” Since his shoulder won’t let him serve anymore, he has devoted himself to table tennis and pickle

InsIde: keeping active in your senior years page-35

seniors staying independent page-36

Long-term care insurance game pLan page-40

seniors Living LuxuriousLy page-42

ball (a combination of badminton and tennis, where you serve underhanded).

Clarence plays both sports three times a week at the Fort Collins Senior Center, often for hours at a time, stopping long enough between one sport for dinner, then returning for the other. He even teaches a beginners pickle ball class at the Senior Center on Thursdays, for anyone interested in the sport.

Clarence, retired from the Federal Aviation Agency, decided to run his first marathon at age 50 – coming in at just under four hours. Today, he may no longer run as much, but he touts the value of stretching and keeps that part of his daily routine. “I enjoy exercise. It feels good and keeps me healthy and fit,” he says with a twinkle in his eyes.

Thelma, 73, is no slouch, either. Her schedule is packed full – she swims one mile two times a week; plays pool volleyball once a week; walks four miles once a week with a friend; lifts weights twice a week; and practices yoga five times a week. She and Clarence also bike 25 miles together at least once a week. They have already broken in the new 40-mile bike trail connecting Windsor and Greeley.

“We have always been that active. It is a lifestyle that works for us,” Thelma says.

And while Clarence might not always enjoy it when Thelma makes him eat his broccoli, they both enjoy good health and are rarely sick. In fact, for the Ehlberts, an active style seems to be more instinct than effort.

When Clarence retired from his job based

Special Seniors Section

CONTINUED ON PAGE 48


Senior ServicesSenIorS SectIon

S E N I O R S

STAY ING INDEPENDENT

It is the idea behind virtually every support group: a person experiencing what you’re experiencing is best at understanding your needs and how to meet them.

After all, a relationship with a peer brings

about a comfortable, non-judgmental bond that can not only heal but also bring joy. This idea is the driving force behind Seniors Helping Seniors, a Fort Collins-based agency that pairs senior citizens who need assistance with other senior citizens who are able to provide it.

Linda Gabel, owner and operator of Seniors Helping Seniors, is the matchmaker, pairing seniors up with caregivers to help them stay independent by providing non-medical assis-tance in such areas as personal grooming, light housekeeping, meal preparation, yard work, small repairs, pet care, and transportation to run errands and or go to doctors’ appointments. But, most importantly, these senior caregivers

provide friendship and companionship. “The goal is to help seniors stay in their home

as long as they’re physically able and, while doing that, to offer them a friend, not just a paid worker coming in to do chores,” Gabel says.

“The mission statement of Seniors Helping Seniors focuses on dignity and respect, and I’m kind of famous for saying that just because we lose our memory doesn’t mean we lose our intelligence. We still want to relate on a mature level with people, we don’t want people talking down to us, and we want to live as independently as we can for as long as we can.”

The agency also provides what is called “respite care” for people who have a family member living in their home who needs a break from caring for them. Not only do the family caregivers get this respite, the elderly person gets to visit with someone his or her own age. It’s a welcome option for those who don’t want to put their parents or other loved ones into

By laura seBasTian

“Just because we [seniors]

lose our memory doesn’t

mean we lose our

intelligence. we still want to

relate on a mature level with

people … and we want to

live as independently as we

can for as long as we can.”

– Linda Gabel, Seniors Helping Seniors


By laura seBasTian

assisted living, yet still need some help and time for themselves.

Though this help does come at a cost, prices are reasonable and vary depending on needs and services. For instance, companion care, home-maker services, light housekeeping, personal care and local transportation are $20 per hour, while such things as yard work range from $22 to $25 per hour, and handyman services range from $27 to $35 per hour (which is still cheaper than calling a professional). Though Gabel does not accept Medicare or Medicaid, there are options she can guide those on a budget to, such as grants to pay for services from the Office on Aging or from Volunteers of America.

Gabel’s agency is a part of what has become a hugely successful operation. Seniors Help-ing Seniors was founded in 1998 by a woman named Kiran Yocom and her husband Philip, who began the endeavor in Pennsylvania as a non-profit organization. Yocom, a native of India, had worked for 14 years alongside Mother Teresa before coming to America. According to the Senior’s main website, she began Seniors Helping Seniors “as a personal mission to help those who can’t help themselves…[based on the] simple concept that seniors can help each other age better and that those who give and those who receive benefit equally.” Though Yocom still runs the flagship agency as a non-profit, its tremendous success led her to decide to offer franchises, which now number approximately 100 and can be found across the country. Gabel’s franchise is one of only two in Colorado; the other is located in Denver.

It all began with Gabel’s quest to find a business to run, something that would utilize her skills and provide a way for her to bring something positive and necessary to the com-munity. When she stumbled on an article praising Seniors Helping Seniors, she knew at once that it was a perfect fit.

“Kiran Yocom doesn’t accept everyone who applies for a franchise,” she says, “but we hit it off when we spoke on the phone and she invited me for an open house at her home in Pennsylvania and, in September of 2009, offered me a franchise.”

An additional part of what drew Gabel to Seniors Helping Seniors was her experience with her own parents. Her mother still lives in Illinois, where Gabel grew up, and Gabel worries about her not just because her mother is elderly but because she tends to isolate. Before her father’s death, Gabel saw in him too the hardships of aging, especially for those without help and stimulation.

“He suffered physically from rheumatoid arthritis for 25 years, but his mind was intact,” she says.

When it came to launching Seniors Helping Seniors, Gabel’s professional background came into good use as well. She holds a Bachelor of Science degree in psychology and communica-tion from the University of Illinois in Urbana-Champaign, Illinois, and an MBA in business administration and finance from the University of Tennessee in Chattanooga, Tennessee. For the past 25 years, she has held such titles as executive director of auxiliary services, chief financial officer and vice president of business services for various universities and companies,


most recently serving as the director of Busi-ness Services, Housing and Dining Services for Colorado State University.

“When people ask about my qualifications for choosing caregivers I tell them I’ve had as many as 100 people reporting to me at dif-ferent times in my management career, and that experience means I know how to match the right people with the right job,” Gabel says. “I’m a good judge of who’s going to be a good provider and who isn’t and it’s my main priority to find that right person for your loved one. We do nationwide background checks on prospective providers and require personal references, and we also require initial and on-going monthly training for them. Though we do pay our providers, I don’t use people who just need or want to make money, I use people who truly want to do this, truly want to help.”

At this time, Gabel has 35 providers to match with her growing list of clients, and the result has been positive for everyone involved. Mar-garet Williams is one of those clients. A retired English professor, Williams suffers from both COPD and congestive heart failure.

“I needed help,” Williams says. “I’d feel embarrassed having a young person take care of me, but someone my age is dealing with some of the same issues. The woman who

Linda Gabel, owner and operator, Seniors Helping Seniors


helps me is in her 60s and we share a lot of interests, like cooking. She helps with groceries, picks raspberries for me from my garden, helps me bathe and takes me to doctors’ appoint-ments. She is a true friend. Other options, like assisted living, would mean I’d have to leave my home, and I’m not ready to do that. The Seniors program is a great idea and I’m just delighted with it.”

Seniors Helping Seniors is a member of the Eldercare Network, and is tied in with and receives referrals from other agencies, individual practitioners and case workers. Geriatric manag-ers and occupational therapists refer clients to Gabel, and she’s also included in the resources listed for the elderly at Poudre Valley Hospital, the Medical Center of the Rockies, and the Office for Aging’s on-line resource center.

Nancy Driskill, founder of and certified care manager at Fort Collins’ Consultants for Aging Families, is another fan of Seniors Helping Seniors.

“In my experience, I’ve learned that elders overwhelmingly prefer helpers who are mature, seasoned and competent with the tasks required,” Driskill says. “They also want consistency, individualized service and respect, and Seniors Helping Seniors delivers that to my clients with grace and efficiency. They provide individuals who know how difficult it can be to ask for help, who are thankful that they are in a position to be of help, and who share many of their clients’ values. This makes for excel-lence and is exactly what I want for my clients.”

With her agency taking off, Gabel has learned much about how best to care for the elderly. One of the most important bits of advice she has for children of elderly parents is this: Know what is going on with your parent both mentally and physically. To do this, she suggests not relying on a parent saying they’re fine, but instead literally observing your parent so you know first-hand the obstacles he or she faces.

“A lot of the problems we see with people who are aging badly have to do with their being isolated,” she says. “They stop going out, and they may say they’re fine, but I’d like to see us stepping in before they get to the point of isolation.

“And for the elderly themselves, I tell them we shouldn’t be ashamed of asking for help when we lose some of our independence,” she continues. “As we get older, I think we deserve it. We deserve to get care when we need it. People need meaning and purpose in their lives at any age. I’ve read, and I know from what I see, that spiritual community, family community and community in general are things that people need in order to thrive. Seniors Helping Seniors is all about creating community and creating those connections.”

For more information about the program, visit the website: www.seniorshelpingseniors.com/LarimerCountyCO.

Laura Sebastian, who lives in Fort Collins, has worked as a freelance writer for 11 years.


LONG-TERM CARE INSURANCE

GAME PLAN

At age 90, Maggie lived indepen-dently, until a few months ago, when a severe fall affected her ability to fend for herself.

Following a hospital stay and weeks in a rehab center, she needed to make a decision. She was moved to a local nursing home for several weeks while she looked for another option. Friends packed up her apartment and stored her belongings, and she reviewed her financial situation.

“I was really concerned because my retirement income and my IRA weren’t going to be enough to put me in a decent assisted living facility,” she says. “Then I remembered that I had taken out a long-term care policy. I did it in 1988, a year after my son died.”

Her only offspring died in a tragic accident and, as she began to heal from her grief, she

realized that, as a divorcee and with no other living relatives close by, she would one day have to face the inevitable aging question: “Who’s going to take care of me?”

Twenty-two years later, Maggie’s investment paid off and, with the daily allowance, she’ll be able to find a comfortable setting where some-one can take good care of her. Although her name has been changed to protect her privacy, Maggie is an actual person living in Fort Collins, and her story is true. And there are many other people like Maggie, who are either glad they bought long-term care insurance years ago or wish they had.

“Everyone should think about long-term care,” says Chip Beake, a State Farm agent. “You should start talking about it when you are 40 and make a decision by the time you’re 45 or 50. Buying younger is better but you can actu-ally get long-term care insurance at most any age. I talk about it with everybody whether

they’re a Colorado State University student or a 70-year-old senior.”

According to the American Society on Aging, after age 65, Americans have more than a 70 percent chance of needing some form of long-term care. And long-term care may be required by anyone, not just seniors. While the need for care is usually a result of aging, it may also be needed because of chronic disease or while recuperating from an accident.

Long-term care includes a wide range of medical and support services and is not neces-sarily medical care but rather “custodial care” that involves assistance with activities of daily living. This type of care is chronic (full-time) and can become very expensive. Long-term care can be provided in a number of different settings including nursing homes, your own home, assisted living facilities and adult day care.

Long-term care insurance can provide for this type of care. It has been around in one form or another since the early days of Medi-care, although policies have changed over the years. Where early policies were similar to a basic Medicare supplement plan, today’s plans typically cover a broad range of services. Like any insurance product, long-term care insur-ance allows the insured to pay an affordable premium to protect them from an unaffordable catastrophic event.

The consideration of long-term care insur-ance should be part of any retirement plan, and Beake, who was an NFL coach for several teams (including the Broncos and the Saints), likes to have a game plan.

“When I’m coaching people about the financial futures, I tell them that retirement is book-ended between long-term care and life insurance,” he says. “Long-term care insurance is the final piece to retirement planning to protect assets and retirement dollars. If you don’t have a long-term care plan, everything you have saved can go flying out of the door if a catastrophe happens.”

There are many plans that can fit any budget, from simple and low-cost to a more complex

“Cadillac” version, Beake says. “There are three main variables: one, your choice of a daily ben-efit; two, the elimination period (how long you want to wait before it’s available) – you can pick 30 days up to 180 days; three, do you want an inflationary factor included.”

The cost also decides the timeframe for which the benefit would be available, for example, two years, three years, five years or even a lifetime.

“There are different options,” Beake says, adding that age also affects the premium rates, as does asking for a spousal discount.

Many companies are now offering long-term care insurance, and it’s crucial to look at several factors before deciding on one. First, “make sure the company will be around,” says Beake.

“There are several really good ones. You want a company that will be there 40 years from now. State Farm has been around since 1922, and we are a mutual company so we can’t be bought, sold, or leveraged because we are owned by our policy holders.” That’s a good sign, he says.

Next, make sure there’s an adequate daily benefit. “In Fort Collins, the current cost [of a private nursing home room] is $175 a day,” he says.

Look at inflation protection, Beake suggests.

By kay rios

InsuranceSenIorS SectIon


“The cost of services increase over time so you’ll want to consider that.”

Also look at the claims process: “You want it to be as hassle-free as possible.”

It’s a complicated topic because there are many factors involved, he says. He suggests working with an agent because she/he will get to know you and your specific needs. Other ben-efits of working with an agent include building a trusting relationship with a local professional.

“This is someone who has the experience to help protect you, and your family, and help you plan for the future.”

Get started looking now, he says. “It’s never too late to apply for a long-term care policy, and it is very important to get some coverage for you and your family. Any policy is subject to medical underwriting for approval, so the bottom line is to get long-term care insurance while you are healthy.”

For more questions about this topic or other senior planning concerns, contact the Larimer County Office on Aging, (970) 498-7755.

The following is a partial list of possible long-term care insurance providers.

State FarmCHIP BEAKE

106 East Olive StreetFort Collins, CO 80524

(970) [email protected]

www.statefarm.com/insurance/ltc/ltc.asp

Genworth Financialwww.ltcinsurance-il.com/gen/index.asp

Phone: (800) 416-3624

John hancock life Insurancewww.johnhancockltc.com/individual/

New York lifeFoRT CoLLInS SALES oFFICE

MARK C BIREn, MAnAGInG PARTnER3003 East Harmony Road, Suite 110

Fort Collins, Co 80528Phone: (303) 403-5600www.newyorklife.com

Mutual of OmahaRonALD WIESE CLU, CHFC

GEnERAL MAnAGERPhone: (720) 875-0102

www.mutualofomaha.com/

Kay Rios, Ph.D., is a freelance writer in Fort Col-lins. She writes for a variety of publications and is at work on a collection of creative non-fiction and a mystery


SENIORS LIVING

LUxUR IOUSLY

Lured by 300+ days of sun, relatively easy winters and all the ameni-ties in a carefree Western lifestyle, northern Colorado has long been known as a great place to retire,

recently recognized as such by U.S. News & World Report. now, retirement options have expanded to include resort living at its finest and most convenient.

Senior living communities today answer not only the desire of many seniors to stay active while enjoying an enhanced quality of life, they also look toward the future with aging-in-place models that help seniors with needed services as they enjoy their golden years – safely and independently.

An unfortunate effect of the recent economy has been to keep seniors in their homes longer than they intended, according to Lyndsey Bur-meister, marketing director for Hillcrest Senior Residences in Loveland. “Many are holding on to everything, staying in their homes longer

than they should, skipping the independent living step before they realize it,” she says. The result: by the time they move from their homes it is often to go directly into an assisted living facility, missing out on the retirement time they always dreamed of, she says.

She encourages seniors to make the transition sooner and choose a living environment that suits their needs.

“The number one concern for seniors is to have a secure living environment,” according to Paul Rainbolt, executive manager of Good Samaritan Water Valley Senior Living Resort in Windsor. The next concerns for many: independence and living an active lifestyle. All three needs are answered at communities like Water Valley and Hillcrest.

Good Samaritan water Valley Senior Living Resort

Understanding that seniors are looking for luxury, safety and convenience, Water Valley Senior Living Resort was designed to deliver

– and then some. The stunning setting for Water Valley is unparalleled. A choice of views

includes Lake Water Valley or the waterfalls on the Pelican Falls Golf course, where residents receive a free golf membership to the course.

Outside aesthetics are just the beginning. The interior features handsome dark wood, light soothing colors, natural rock and plenty of cozy seating in common areas and tucked in nooks for visiting with friends. On-site amenities include underground parking, fine dining, a salon and spa, a bistro for coffees, a convenience store, fitness classes, and Sunday church services. Any other needs can be addressed by transportation provided to residents who no longer keep a car.

By angeline grenz

An aerial view of Good Samaritan water Valley Senior Living Resort (top) and one of their full-kitchen independent living apartments.

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The Hillcrest senior residences in Loveland features 44 independent living, 14 supported living, 14 assisted living, and 10 secure memory care apartments.

The 114 residences also reflect an understanding for seniors who want a home-like setting without the maintenance. The one- and two-bedroom apartments feature full kitchens, private laundry, walk-in closets and large private patios or balconies. They range in size from 762 to 1,357 square feet.

“It is important to our residents to have the ability to cook for themselves – though almost none of them actually cook,” says Kim McCloud, marketing coordinator for Water Valley.

In part, residents enjoy showcasing their attractive kitchen with gleaming appliances and the option to entertain if they choose. Most, however, are thoroughly spoiled by gourmet meals provided in the dining room.

The aging-in-place model is embraced at Water Valley. Independent living residents can access home care services as they need and as they age. Health-care, personal care and supportive care needs can be arranged and adjusted so that family members can also provide a portion of the care. In addition to the security the model provides, “aging-in-place also keeps spouses together longer,” says McCloud.

The resort also provides an endless list of unique activities to their residents, including boat rides and a 4th of July party this summer on the island in the center of the lake. Recently, a group traveled to Estes Park for dinner and to see the bugling of the elk and aspens change colors. The newly formed book club,

with a local book mobile arriving twice a month, is another popular activity.

Beyond the physical amenities provided, Water Valley provides residents a spiritual home as well, says Rainbolt. “This is a Christian community based on our motto that ‘everyone is someone,’” he adds.

“We build the environment around them.” “Prayer is something that happens here openly,”

adds Colleen Garton, director of lifestyle enrichment at Water Valley. McCloud concurs: “You can walk into the dining room and join in on any number of group prayers.”

“The difference here is the Good Samaritan phi-losophy of compassion and understanding that has been the mission of Good Samaritan for the last 88 years,” continues McCloud. “Here you will feel that philosophy, all wrapped up in the comfort and convenience that made you look forward to retire-ment in the first place.”

These are the ideals that drew Harold and Marian Steinhoff to Water Valley. Both Steinhoffs are deeply religious and found a perfect fit at the resort. “I want to leave a legacy that I was faithful to God,” says Harold, adding that the Christian fellowship and compassionate, Christian staff members are their favorite parts of living at Water Valley.

Good Samaritan Water Valley, who opened their doors in 2008, currently has 42 occupied apartments and 55 people living at the resort. With the rebound

of the economy, they have seen a spike in interest and are maintaining a waiting list of seniors who plan to sell their homes and move into the resort in coming months. Their youngest resident is 70 and their oldest is 95. Water Valley accepts residents age 55 and up.

Good Samaritan Society Water Valley Senior Living Resort, 805 Compassion Drive, Windsor, (970) 686-2743, www.good-sam.com

The Hillcrest Exceptional Senior Residences

Where Water Valley is sprawling, Hillcrest is small and intimate. The luxury senior residence is tucked in a charming tree-lined Loveland neighborhood, conveniently located near downtown, with views of the Rocky Mountains and plenty of wildlife that comes to visit regularly.

Hillcrest has 44 one- and two-bedroom inde-pendent living apartments, and is wrapping up construction of 14 supported living, 14 assisted living and 10 secure memory care apartments, in the second phase of construction. Supported living units are a new offering, a hybrid of independent and assisted living, with extra services available, such as wake-up calls, night checks and laundry service, says Burmeister.

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Hillcrest’s independent living apartments are luxuriously appointed and feature ample

space and full kitchens.

notice first is our comfortable, home-like setting,” according to Mimi Wahlfeldt, with Hillcrest’s market-ing department. “We are small enough that team members know every resident personally, but large enough to offer the amenities seniors are looking for, namely, high-quality apartments, exceptional customer service, and a full array of social, fitness and education activities.”

Because “Hillcrest is small and quaint, it really draws a different senior population,” says Burmeister. While Hillcrest offers a variety of organized events and transportation for residents who no longer keep a car, they also allow residents to take the lead in activities – like the recent wine tasting hosted by a resident, and a new discussion group called News & Views, created and led by a resident who saw the need for such an activity.

The luxury apartments at Hillcrest’s independent community feature full kitchens, private laundry, balconies with views in many apartments, ample closet space, and even a fireplace in most units. Granite countertops and stainless steel appliances are among the many sumptuous standard features, and each fireplace has a unique, hand carved mantle. The independent living apartments are soundproof for privacy and range in size from 805 to 1,445 square feet.

Common area amenities include gourmet dining in the dining room, fitness center, library, wellness activities, an activity room for cards, games and crafts, and more. Secure, covered parking is also available, as is storage for residents’ bicycles. Residents also have access to on-site physical and occupational therapists as needed.

“Every resident can enjoy the spectacular view of Long’s Peak and the Front Range from either their west-facing apartment or from the common areas


(dining and family rooms), where generous windows and cozy chairs invite people to relax and take in the peaceful setting,” says Wahlfeldt.

The grounds include a gazebo, raised garden for the garden club, walking paths throughout and bike paths nearby. Additionally, residents receive a free membership to nearby Chilson Senior Center.

Eighty-two years old is the average age in the independent living residences at Hillcrest, with the youngest resident being 64 and the oldest 95 years old. They accept seniors starting at 55 years old.

Local ownership also sets Hillcrest apart. “The owners of The Hillcrest are local and available,” says Wahlfeldt. “They are actively involved in the designing and building of this luxury senior living community, first as the independent living com-munity was established (open since 2007) and now with the expansion that will include supported and assisted living, as well as secure memory care.”

This presence, says Burmeister, adds to Hillcrest’s family atmosphere and gives residents direct access to those who make the decisions affecting their community.

Burmeister encourages those interested in Hill-crest to come and spend two nights free of charge in their guest suite. “We will treat you like one of our residents, and you can try out the experience before you move in,” she says.

The Hillcrest, 535 North Douglas Avenue, Love-land, (970) 593-9800, www.hillcrestofloveland.com

Angeline Grenz is editor for Style Magazine.


in Longmont, the pair travelled extensively before deciding to settle in Fort Collins. They chose their central Fort Collins neighborhood in anticipation of the Senior Center, which was built a year later. They wanted to be close to the Center and to the bike paths that wind throughout Fort Collins.

Clarence and Thelma estimate they visit their local Senior Center approximately five times a week, taking advantage of the activities, both physical and social, offered there.

“We are just the kind of people who wake up in the morning, drink a pot of coffee and say, ‘What do we want to do today?’” says Clarence.

The Ehlberts stay healthy and motivated by accessing programs available to them at their local senior center. A wealth of activities exist for seniors in the community at little or no cost. Here are a few resources that are available:

FORT COLLINS SENIOR CENTERFeatures include a two-lane lap pool, 10-person spa, gym, indoor track, billiards, library, kitchen and lounge. Clubs and classes range from the Adventure Travel Club to bridge mentoring.www.fcgov.com/recreation/senior-center.php 1200 Raintree Drive, Fort Collins(970) 221-6644Membership: For adults 55+: $3.25 daily pass. Annual pass $300, must be 55 and older. Pass includes unlimited membership to Senior Center, Mulberry Pool, Epic, The Farm and Northside Aztlan Center. Hours: Monday - Friday: 6am - 9pm, Saturday 8am-5pm, Sunday noon-5pm Pool Hours: Monday - Friday: 6am-8pm, Saturday 9am-3pm, Sunday-closed

CHILSON SENIOR CENTER - LOVELANDLocated at the Loveland Civic Center with access to the full-service Recreation Center, features include billiards, shuffleboard and lounge areas. Classes range from aqua fitness to healthy cooking.www.ci.loveland.co.us/parksrec/seniorcenter.htm 700 East Fourth Street, Loveland(970) 962-2783Membership: For seniors 62+: $3 for a day pass. Within city limits: $145 for a 6-month membership and $240/year. Outside city limits: $154/6 months and $264/yearHours: Monday-Friday: 8am-5pm, Saturday: 9am-12pm

GREELEY SENIOR ACTIVITY CENTERFeatures include travel programs, sports and tournaments, classes, games and nutritional lunches.www.greeleygov.com/recreation/SeniorCenter.aspx 1010 6th Street, Greeley(970) 350-9440Membership: 50 years+: $2 daily drop-in fee, $20 annual fee for residents, $22/year fee for non-residentsHours: Monday-Friday: 8am-5pm, Saturday: noon-3pm, closed on Sundays

CONTINUED FROM PAGE 35

CONTINUED TO PAGE 50


EstEs Park sEnior CEntErFeatures include outdoor adventures and trips, weekday lunches, fitness programs and facility rentals. www.estesnet.com/seniorcenter 220 Fourth Street, Estes Park(970) 586-2996Membership: $15/yearHours: Monday-Friday: 9am-4pm

Windsor Community rECrEation CEntErActivities range from a weekly drop-in senior basketball game in the open gym, tap dancing lessons, and day trips to historical sites and Rocky Mountain National Park.www.windsorgov.com/index.aspx?nid=189 250 N. 11th Street, Windsor(970) 674-3500Membership: pay by activityHours: Monday - Friday: 7am - 10pm, Saturday: 8am-6pm, Sunday: 1pm-6pm

asPEn Club A service provided through Poudre Valley Health Service that includes health education, screenings, hospital discounts and social opportunities. https://vic.pvhs.org/portal/page?_pageid=333,429686&_dad=portal&_schema=PORTAL&pagid=136 1224 Doctors Lane, Fort Collins2500 Rocky Mountain Avenue, Loveland (Inside Medical Center of the Rockies)Membership: Age 50+, freeFort Collins Hours: Monday – Friday: 8am-4:30pm, third Saturday of every month: 9am – noonLoveland Hours: Monday-Friday: 8am-4:30 pm

thE sEasons ClubA service provided through McKee Medical Center with service discounts, classes, screenings and recreational trips.http://www.bannerhealth.com/Locations/Colorado/McKee+Medical+Center/Programs+and+Services/The+Seasons+Club.htm At McKee Medical Center200 Boise Avenue, Loveland(970) 635-4097Membership: Age 50+, freeHours: see website for class details

CONTINUED FROM PAGE 48

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Hearing AidsweLLneSS


By angeline grenz

Eh, what’d you say?” “Speak up; you’re mumbling.” Married couples may joke about the selective hearing of their partners. But the truth of the matter is, when hearing loss becomes noticeable,

it is likely to be your mate who takes notice first.

“Hearing loss happens with age. But it is not always the person with the loss to notice it first,” says James Skordas, Au.D., with Front Range Ear, Nose & Throat and Audiology in Greeley. “Often, you think others are mumbling. Family members are the ones who notice you aren’t hearing the way you used to.”

The typical wear and tear to your hearing as you age can first be noticed in the higher frequencies, according to Natalie Phillips, Au.D., with Advanced Otolaryngology in Fort Collins. “They usually tend to go first, which applies to the softer consonants, typically then ends of words, and is especially notice-able in noisier environments.”

If hearing loss is suspected, a hearing evaluation should be scheduled. The evaluation should include two parts. First is a test, often done in a soundproof booth, where the doctor examines how well different

tones are heard to check for hearing loss and clarity. The second part of the evaluation includes word

recognition and discrimination: the doctor says a word and has the patient repeat it. The middle ear status is also checked for any signs of infection or fluids.

Natural, age-related hearing loss is called pres-bycusis. The cumulative effects of aging and noise exposure throughout your life can have a large impact on presbycusis. Heredity can also play a factor. Statistics find that 30 to 35 percent of adults between the ages of 65 and 75 have hearing loss; after age 75, the number rises to nearly 50 percent.

In most cases, presbycusis affects both ears equally. “The natural progression of hearing loss will be sym-metrical; the same in both ears,” says Rachel White, Au.D., with All About Hearing in Fort Collins. “There is concern if there is a difference between the two ears – unless the cause can be determined to be noise related or medically related.”

If the hearing loss is caused by age, a hearing aid is most likely the next step. Hearing aids are small electronic devises worn in or behind the ear to help make some sounds louder. In the past, a hearing

aid would only be fitted in one ear, but over time doctors have established that individuals are better served with a device placed in each ear. “You get better speech recognition – there is a reason we have two ears,” says Dr. White.

Hearing aids come in a variety of styles and price ranges, generally broken down into entry level, mid-range and high-end devices. Lifestyle is generally one of the most significant deciding factors for the type of hearing aid a patient might need, and the difference between the price points is generally in the bells and whistles.

“First you must consider your lifestyle; how active are you?” says Dr. Skordas. “Then consider what your budget allows. Almost always, we can find you a hearing aid that strikes that balance.”

Older patients who are mainly limited to home or a senior housing situation may do fine with a simpler, less expensive model. Someone who is still working and leads an active lifestyle will want a hearing aid with a higher level of technology. Today’s hearing aids offer connectivity and wireless technology that includes Bluetooth, and can hook into your telephone, cell phone, television and more.

Higher-end devices also include additional chan-nels for better resolution of sound, which means better clarity for the wearer and a more realistic sound quality. They are also better equipped for wind and noise suppression.

Hearing aids can range in price from around $2,800 to $7,000 for both ears. Medicare does not cover the cost of hearing aids. Medicaid will only cover a hearing aid if the senior is in an assisted living facility or the patient is between the ages of 0 and 18 years old. Other insurance providers will cover a portion of the hearing aid, but coverage varies widely.

All hearing aids come with a minimum 30-day trial period, though many offices extend that to 45 days. This is because hearing aid selection is not a one-size-fits-all approach.

“Finding a hearing aid is not an exact formula,” explains Dr. Phillips, “There will be adjustments. It is the responsibility of the user and the audiologist to work towards satisfaction. Always return to the audiologist if you are having any problems. I recom-mend, during the trial of your hearing aid, to write down the things you like and don’t like.” A final piece of advice from Dr. Phillips: “Fitting a hearing aid is like an art. Make sure you seek out an audiologist and be very wary of Internet sales.”

Early detection is key when dealing with hearing loss, says Dr. Phillips. “We are finding that the earlier that we get you into a hearing aid, the longer we can prolong clarity,” she says. “Your hearing is like a muscle; you must exercise it to keep it intact for a longer period of time.”

Dr. Skordas recommends coming in for a baseline hearing test between ages 60 and 65. After the baseline is established, he says patients should come in annually after that for a check-up.

Dr. Phillips does emphasize, however, that once hearing is lost, it cannot be restored. Dr. White adds, “You can never get your natural hearing back. You need to have realistic expectations of what a hearing aid can do. However, we have many more advancements today over when I started even eight years ago. Today they are advanced enough to give you very good hearing.”

Angie Grenz is the editor at Style Magazine.

AIDS TO

HEARING AGAIN

“

Dr. Rachel White, with All About Hearing, performs a hearing exam on a patient.


InSound Medical Lyric – Lyric Hearing is the first 100 percent invisible extended wear hearing solution. Unlike a traditional daily wear hearing aid, Lyric is worn 24 hours a day, seven days a week, for months at a time. With no surgery or anesthesia needed, Lyric is placed in the “Acoustic Sweet Spot” of your ear canal, where it uses the ear’s natural anatomy to minimize background noise and provide clear, natural sound quality. You can wear Lyric during your daily activities – sleep-ing, showering, exercising, using headphones and talking on the phone. There are no batteries to charge and no maintenance is needed; simply visit your Lyric trained professional as needed to replace your devices and receive the latest Lyric technology. From $1,795 (per ear).

Available from: Hearing Rehab Centerwww.hearingrehabcenter.comFort Collins: 1217 E. Elizabeth St., Unit 9 (970) 482-5700Loveland: 2980 Ginnala Drive, Suite 102 (970) 593-9700

Widex Passion440 – The Passion440 is an ultra-small, high-performance hearing aid. It is a tribute to the senses, integrating visual appeal and exceptional sound performance in a remarkably discreet casing. Despite its size, Passion440 adds to the ultimate hearing experience with additional innovative features. It is the world’s only Receiver-In-Canal model to offer the revolutionary Zen harmonic sound program, providing a choice of tones and chimes to help you relax. It also features our intelligent SmartSpeak information system, which actually talks to you and informs you of various hearing aid functions, such as low battery power and program mode. Available in 12 colors. From $2,800 (for the pair).

Available from: Advanced Otolaryngology, www.advancedotolaryngology.com, 2001 South Shields St., Building E, Suite 101, Fort Collins, (970) 493-5334

The Latest in Hearing Aid TechnologyHere is a small sampling of some of the latest technology in hearing aids. Contact these local hearing centers to discuss the hearing aids men-tioned here or ask them about the variety of manufacturers they carry.

Please note: Many of these hearing aids and devices are available at multiple locations in Northern Colorado. Please ask your center of choice what products they may have available.


Audibel Anthem – Introducing Anthem with IntelliFlex Technol-ogy, where industry-leading technology and design meet real

life to create an unparalleled listening experience. IntelliFlex Technology delivers what you want most from a hearing instru-

ment: best-in-class feedback cancellation for virtually no whistling; instantaneous transitions in different listening environments for smoother, clearer sound; and

compact design that is virtually invisible when worn. Anthem Receiver-In-Canal and Behind-The-Ear products are available in a variety of color options to match skin and hair tones. From $1,450 (per ear).

Available from: Hearing HealthCare Centers of Larimer County www.larimercountyhearing.com Fort Collins: 3726 Timberline Rd., #103(970) 221-5011 Loveland: 2902 Ginnala Dr. #3(970) 593-1509

Oticon Agil – The technology behind the Oticon Agil hearing device is designed to provide better speech understanding with less energy by pro-tecting the natural spatial and speech cues that are embedded in any sound source. Three unique features work together to make Agil one of the most advanced hearing devices on the market today: Spatial Sound 2.0, which supports the brain’s natural process of understanding speech, so you will never be bombarded with a “wall of sound;” Speech Guard, which works in harmony with your brain to recognized natural speech cues and keep competing noises or voices from distracting you; and Connect Plus, which allows you to stream music through any Bluetooth device. From $5,600 (for the pair).

Available from: Advanced Hearing Services www.bakerhearing.net2001 S. Shields St., Building J2, Fort Collins(970) 221-5249

Phonak SoundRecover – Phonak hearing instruments with SoundRecover provide a hearing solution for everyone, regardless of degree of sound loss, lifestyle, personal preference, age or budget. SoundRecover makes high-pitched sounds easier to hear and recognize, which makes speech in all listening environments easier to hear and understand. The technology is available in the tiniest of in-the-ear models and uniquely shaped behind-the-ear hearing instrument for the style-conscious. Wireless connectivity from Phonak gives you easy and unlimited access to the world of communication and entertainment. From $1,600 (per ear).

Available from: All About Hearing www.alpineent.comFort Collins: 1124 E. Elizabeth St., #E-101(970) 221-3372Loveland: 3820 North Grant Ave.(970) 461-0225

Siemens Pure with Tek Connect – At last, for people who love technology, the wireless enhancement that streams audio from MP3 players, Bluetooth wireless technology enabled phones, TVs, and stereos directly to select Siemens hearing instruments. Tek Connect, the remote control for Siemens Tek, was specifically designed to meet the needs of today’s interactive hearing instrument wearer. Answer calls, stream stereo sound wirelessly, and enjoy audio from your TV with no disturbance or feedback. Paired with the Siemens Pure, a nearly invisible hearing instrument that features Siemens BestSound Technology for unrivaled speech clarity, sound comfort and personalized hearing. From $3,200 for hearing aids and Tek package.

Available from: Frontier Audiology, www.frontieraudiology.net, 419 Canyon Ave., Suite 310, Fort Collins, (970) 449-4110


PodiatryweLLneSS

Toenail fungus can yellow

your toenails, or cause them

to appear crusty and flaky.

Nearly 25 million Americans

have it. Do you?

By Corey radman

A F U N G U S

AMONG US

970.330.5555 • www.frontrangeent.com

Comprehensive, Compassionate Care

for the Whole Family Sanjay K. Gupta, MD, FACSBoard Certified in Otorhinolaryngology

Recipient of the American Academy of OtorhinolaryngologyBoard of Governors

2010 National Practitioner of Excellence

Sarmad Sabour, MDOtorhinolaryngology Training at the

University of Cincinnati

Doctor of Medicine, University of Texas Health Science Center at San Antonio

Bachelor of Science, University of Texas

Sunny Park, PA-CBoard Certified Physicians Assistant

Training at Midwestern Health Sciences, Glen Dale, Arizona

Bachelor of Science, ColoradoUniverisity- Colorado Springs Campus

James D. Skordas, AuD, FAAA, CCC-A


• Coordinated medical care with Ear, Nose and Throat physicians • Comprehensive hearing exams for all ages

• Full line of 100% digital hearing instruments in all sizes and styles

• Custom ear pieces for swimming, hearing protection and hearing aids • Tinnitus (ringing in the ear) assessment

• Electronic evaluations of the auditory nerve

• Intra operative nerve monitoring for surgical patients for head & neck surgery.

Dr. Sanjay K. Gupta Welcomes Dr. Sarmad Sabour to Front Range ENT

and Northern Colorado

Nose and Sinus • Balloon Sinuplasty • Allergy • Ear ProblemsHead and Neck Surgery • Thyroid Surgery • Snoring and Sleep Apnea

Balance Problems • Hoarseness • Speech and Voice ProblemsAudiology and Hearing Aids

Adult and Pediatric

6500 29th Street, Suite 106 Greeley, CO 80631

It goes without saying that your feet are fabulous – as are (of course) my feet. There is neither a bunion nor a blister to be found on any of our little piggies. We’re all walk-ing around on Cinderella-like perfection.

But on the off chance that you have a friend whose feet have gotten perhaps a little… well, funky… let me tell you about a recent conversation I had with a podiatrist. “Toenail fungus can happen to anyone, and when it does people usually get creeped out by it,” says Robert Schulte, DPM, with an under-standing smile-grimace. The patients he sees at A Step Ahead Foot & Ankle Center generally arrive feeling embarrassed or frustrated that their toenails have become so ungainly.

The American Podiatric Medical Association (APMA) reports that onychomycosis (fungal nail infection) is often caused by the spread of athlete’s foot, and can go months or years without much notice because it causes no pain.

At the beginning, the fungus changes your nail color from pink to yellow or white. It can impact fingernails, but generally attacks the toenails. While the initial color change or even thickening of the nail seems like just a cosmetic issue, if left alone the fungus invades the whole nail and can conquer the other toes as well.

“This type of infection makes nails flake apart or start to disintegrate and sometimes marked thickening can occur,” Dr. Schulte says. Ultimately, this nasty little bug can cause you to lose your nail.

If you’ve got feet like this, there is no need to hide them in steel-toed boots. You’re not alone. The New England Journal of Medicine reports that two to three percent of all Americans carry this critter, and the incidence increases with age. Twenty-five percent of the entire elderly population has it.

Heel Me, DocDr. Schulte and his colleagues at A Step Ahead

recommend that patients seek treatment for foot

problems from a podiatrist “to ensure that what you are treating really is a fungal infection,” he says. “After we debride the nail [grind or file off the dried bits], we typically prescribe either an oral anti-fungal medicine or a topical ointment.” However, Dr. Schulte says, success rates are 55 percent at best for the oral meds and 20 percent for the topical applications. There is also some risk of liver damage with oral meds.

New laser treatments seem to improve your chances of vanquishing fungus. A Step Ahead has added a laser to its arsenal. With a self-reported success rate at 88 percent over 180 days of treatment, the early results indicate that laser therapy far surpasses other forms of treatment.

57

970.330.5555 • www.frontrangeent.com

Comprehensive, Compassionate Care

for the Whole Family Sanjay K. Gupta, MD, FACSBoard Certified in Otorhinolaryngology

Recipient of the American Academy of OtorhinolaryngologyBoard of Governors

2010 National Practitioner of Excellence

Sarmad Sabour, MDOtorhinolaryngology Training at the

University of Cincinnati

Doctor of Medicine, University of Texas Health Science Center at San Antonio

Bachelor of Science, University of Texas

Sunny Park, PA-CBoard Certified Physicians Assistant

Training at Midwestern Health Sciences, Glen Dale, Arizona

Bachelor of Science, ColoradoUniverisity- Colorado Springs Campus

James D. Skordas, AuD, FAAA, CCC-A


• Coordinated medical care with Ear, Nose and Throat physicians • Comprehensive hearing exams for all ages

• Full line of 100% digital hearing instruments in all sizes and styles

• Custom ear pieces for swimming, hearing protection and hearing aids • Tinnitus (ringing in the ear) assessment

• Electronic evaluations of the auditory nerve

• Intra operative nerve monitoring for surgical patients for head & neck surgery.

Dr. Sanjay K. Gupta Welcomes Dr. Sarmad Sabour to Front Range ENT

and Northern Colorado

Nose and Sinus • Balloon Sinuplasty • Allergy • Ear ProblemsHead and Neck Surgery • Thyroid Surgery • Snoring and Sleep Apnea

Balance Problems • Hoarseness • Speech and Voice ProblemsAudiology and Hearing Aids

Adult and Pediatric

6500 29th Street, Suite 106 Greeley, CO 80631


New laser treatments for toenail fungus are showing success rates that surpass topical

or oral medications.

Lethal weapon The near infrared light emitted by the laser has

photolethal effects on onychomycosis. In Eng-lish, this means the laser fries those parasitic crit-ters hitching a ride on your tootsies. The specific wavelength used passes through the nail without damaging your tissues, but kills the fungus beneath.

The laser is not yet FDA approved for treatment of toe fungus; however, podiatrists are anecdot-ally reporting great success in the majority of the cases they work with. Treatments usually span three sessions, the first of which are two weeks apart, and the last 120 days later. Your infected toe is exposed to light in pulses that cycle on then off every few seconds for 16 minutes. Up to four toes can simultaneously be treated.

Dr. Schulte’s first patients to try the laser have reported little discomfort during their treatments, but just to be safe, they have a patient-controlled pause button if they need to take a break.

The early clinical trials of the laser have shown no negative side effects or tissue damage.

Laser therapy is not now and may never be covered by insurance, but for more than twice the rate of success, it may be worth the out-of-pocket expense.

While the laser treatments are helpful, it’s much harder to treat this varmint than to avoid it in the first place. Add to that the consideration that recurrence is very common, and you can see why Dr. Schulte sings the praises of prevention.

Stamp Out Fungus!By devoting the same amount of attention to

your toes that most of us give our nose hairs, you can easily avoid an infection.

1. Keep your feet dry. Fungus loves a warm, moist home, so discourage it from settling in.

2. Dry your feet well after a shower.

3. Wear moisture wicking socks during a workout (or even all day if they tend to be sweaty).


The photos above show a marked increase in the toenail after just 180 days when

treated with an infrared laser.

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4. Change socks mid-day if you have moist feet.

5. Don’t wear the same shoes two days in a row – they really need to dry out between wearing. (I was overjoyed by this prescription, until Dr. Schulte said I still only needed two pairs of shoes. I think his math is off.)

6. A word about your gym locker room floor: it’s probably teeming with fungus. Dr. Schulte says, “Even with daily cleaning, the floors in the locker room never really get a chance to dry out.” He suggests that shower shoes are a good idea. “Or at least, dry your toes really well with a clean towel.”

7. Verify that home or salon pedicure instruments have been sterilized. Dr. Schulte advises: “Ask salons, ‘What is your procedure for sanitiz-ing the instruments?’ If they can’t tell you specific steps, they probably don’t have one.” Additionally, don’t paint nails that you suspect have fungus – it encourages more growth.

Foot NoteIn all seriousness, toenail fungus can be a real

threat to people who are immunocompromised or who have diabetes. “Diabetics are susceptible to bacterial infections that use the open path created by the fungus to attack the foot. That type of infec-tion could ultimately cost them a toe or even a leg.”

Dr. Schulte advises anyone with health problems who notices a toe abnormality to seek medical treatment.

Corey Radman is a Fort Collins-based writer who is buying flip-flops as you read this.

Baseline

Baseline

Day 180

Day 180


Medical Hypnosiswellness

H y p n o s i s

tHat Heals

Hypnosis is an artificially-induced altered state of consciousnes, characterized by heightened suggestibility and receptivity to direction.

You may be picturing a wacky doctor swinging his pocket-watch in front of his submissive patient while methodically chanting, “You’re getting very sleepy…” Instead, picture yourself listening to music on your headset. Take yourself back to a time when you were very relaxed and almost asleep, but you could still hear all your favorite lyrics. As Stanford Hospital says, “It’s comparable to being so absorbed in a movie or a novel that one loses awareness of his or her surroundings.” Stay in that place as we uncover one of the oldest forms of healing with some of the biggest misconceptions.

The new craze of medical hypnosis is every-where. It is in the papers; the nightly news features those bright-eyed patients who claim to be healed from 30 years of smoking through hypnosis. And

automatically our minds set down the path of doubt. What if you learned that Stanford Hospital has three doctors practicing this treatment on patients right now? What if we looked into our own community for results like those discussed nationwide?

Let’s begin by taking a look at the three-foot-tall glass vase overflowing with cigarettes and lighters in the office of Sandi Squicquero, M.Ed., LPC, at The Medical Hypnosis and Counseling Center, in Wind-sor. The lighters and cigarettes are the remaining remnants of the past lives of her patients. Medical hypnosis does have the power to heal, right here in Northern Colorado.

Medical hypnosis treats the daily irritating nuance issues like stress and phobias (like the fear of flying). But it can also work deeper within a patient to cure illnesses like depression, encourage weight loss or smoking cessation, and alleviate anxiety. So what’s the trick behind the swinging pocket-watch?

“How our minds work is a mystery,” says Squic-quero. “You can give textbook answers to how the conscious and subconscious create a balance (to

By erica pauly

achieve a hypnotic state), but the bottom line is that our mind does work and there are no limits to what you can accomplish with the power of the mind.”

Squicquero’s knowledge and education on the brain, and the power of the human mind, comes from years of schooling, months of studying under nationally recognized doctor Dan Zelling, M.D., and more than 20 years of firsthand experience on the subject.

Who is a good candidate?Some patients may have tried every method

under the sun to quit smoking; others may have had a fear of flying since they were young and never realized they could do something about it. Medical hypnosis is for anyone who is ready to dig deep into his or her mind. Children can even receive immense help from hypnotherapy, especially if they are suffering from traumatic events. In Squicquero’s case, the Windsor Tornado from 2008 brought in children as young as five who couldn’t seem to get the image of the tornado out of their minds.

The tornado brought her adult patients as well. Cindy Miller, teacher at Windsor High School and former patient of Squicquero, says, “I received three treatments from Sandi after the Windsor tornado. My house was condemned and had over $100,000 of damage. I felt like a walking zombie and did not feel like myself. I was just going through the motions and was numb. After my three treatments I felt like myself again. I remember how awesome it was to feel like me. I felt a huge load off my back and truly was able to get back into life and started to enjoy it again.”

How does it work?There are two variations of hypnosis. The first is

“straight hypnosis.” The patient is generally being seen for issues like smoking addiction, weight loss, nail-biting habits, sports success (i.e. visualizing your goals and plans) or pre-surgical/dental distress. All of these are issues that do not require intense analysis of a patients’ life history. These are solely problems that require straight hypnosis and a definite decision to walk away from the issue at hand.

The second hypnosis variation is “hypno-analytic.” This requires a thorough consultation between therapist and patient on the patient’s life history. According to Squicquero, “After we go through the questionnaire I probably know them better than anyone in their life,” due to the intense and personal nature of the questionnaire. “If someone requires hypno-analytic treatment it is usually for depression, pain management, panic or severe phobias.” When patients are receiving hypno-analytic treatments, Squicquero is sure to speak with the patient’s other doctors and psychologists to make sure everyone is working together to help the patient in the best way possible.

In most practices, self-hypnosis is taught along-side the therapy sessions. “This is something my patients can take with them, and when they find themselves in an uncomfortable place, they have the tools to know what to do,” says Squicquero.

How long until i’m healed?Complete healing is never a 100 percent guaran-

tee; every program and every person is a different case. There is no ‘one size fits all’ when it comes to medical hypnosis, but there are statistics. Squicquero has an 85 percent success rate when working with smoking cessation patients, and most of them only


require five sessions. “I didn’t need more than three treatments from

Sandi,” recalls Miller. “I felt better and I felt like our sessions met our objective and I was able to move on with my life. Medical hypnosis worked for me and I would encourage others to try it.”

A few lingering misconceptions: 1. Hypnosis is about mind control. Hypnosis is

about strengthening one’s mind, not having someone else control it. It is about using a relaxed state to come to new realizations without all of the normal daily chaos that tends to scream inside our minds at all times.

2. We have no control over our bodies while under hypnosis. While in the hypnotic state, a patient has full control of their body and they hear everything going on around them. It is their choice to participate in any activity directed by their hypotherapist. If the room catches on fire, the patient will be 100 per-cent aware of their surroundings, able to wake up and take action just like everyone else.

3. Anyone can be hypnotized. Entering into a hypnotic state requires focus and willingness on the patient’s part. If a patient is not enter-ing into the session wanting to be hypnotized, they won’t be. And vice-versa, if a patient is ready and willing, while it may take a few sessions to be completely relaxed, a patient can and will enter into a hypnotic state.

So the next time you hear of a success story on ABC or CNN, take a moment to consider this age-old medical treatment. Top physicians in the country are practicing hypnosis. And if it’s worked for someone else, it very well could work for you. All it takes is a willingness to enter into a new world of relaxation, and a very real desire to be healed.

Erica Pauly is a freelance writer and marketing direc-tor for GrowSecure Insurance and Financial Services who recently experienced her first hypo-therapy session and is a true believer in its healing power.

Sandi Squicquero, M.Ed., LPC, at The Medical Hypnosis and Counseling Center, debunks the mystery surrounding medical hypnosis and boasts an 85 percent success rate working

with smoking cessation patients.


ExERCISE TO CHANGE YOUR LIFE

Hamburgers and hot dogs are quintessential American foods, but they could be killing us. Multiple studies, including a study published in August by the American Heart Association, link red meats – defined as any meat that comes from mammals – and processed meats to a higher risk of cardiovascular disease. Red meat has also been linked to arthritis and hypertension, and both red meat and processed meats are linked to various forms of cancer, including breast and colon cancers.

ReDUce ReD aND PROceSSeD MeatS IN YOUR DIet

Perhaps the single best lifestyle change you can make for better health is to exercise regularly. Ex-ercise is linked to a variety of benefits: better heart health, an increase in brain cell production and learning, a decreased risk of breast cancer, better bone density, a reduction of anxiety and stress, a decreased risk of stroke, and added years of life.

But exercise is a broad term, and you may be robbing yourself of its full benefits if you do not include a little strength training and stretching into your cardiovascular routine.

“I am not nixing cardio exercises, but you need a total workout,” says JoEllen Amundson, owner of

Curves in Loveland. “Cardio gets your heart rate up, but strength training builds muscle and helps you burn fat. Stretching when you are done helps lengthen muscles and reduces your injury poten-tial.”

Strength training also helps you burn calories efficiently, control weight, develop strong bones, manage chronic conditions such as diabetes and osteoporosis, and sharpen mental focus as you age, according to an article published by the Mayo Clinic. And most people don’t need exten-sive weight training routines to benefit: two to three sessions lasting 20 to 30 minutes per week

are sufficient. Stretching also helps promote proper balance,

increases flexibility and improves your range of mo-tion. It can even promote better posture and relieve stress, states another report by the Mayo Clinic.

Those benefits provide good incentive to pay attention to your fitness routine. But not every-one feels comfortable working out in a full-service health club, and many need guidance to build a good workout routine.

Specialty gyms, like Curves, may be what some need to make the leap to a regular, structured ex-ercise program. Curves’ program for women is de-signed to make exercising easy, enjoyable and effi-cient. The program does this by combining strength training with aerobic exercise and ending the pro-gram with a few minutes of stretching.

“This is a personal training program,” says Amundson. The Curves workout is a circuit made up of 13 resistance machines that work the major muscle groups in as little as 30 minutes. The ma-chines are designed with a woman’s build in mind.

With their CurvesSmart technology, the equip-ment tailors the workout to your personal range of motion and endurance level, giving you feedback and gradually increasing the intensity. Four different workout levels are available: a cardio level; fit and trim, the most popular level; an endurance level for intense training; and a muscle-building level.

At Amundson’s location, she offers regular nutri-tion classes and encourages an atmosphere of sup-port. “We are like a real community here,” she says.

The Curves system works well for many busy women in the community, but the most important goal is to find a program that works for you and stick with it.

“Put it on your calendar,” advises Amundson. “Schedule your exercise just like you would sched-ule a doctor’s appointment or a trip to the grocery story. It is a deposit into your health account.”

Other tips to make exercise a part of your weekly routine:

Fortunately, there are many foods that have the nutrients we get from these meats without the health risks. The pro-

tein, vitamin B12, iron and zinc found in red and

processed meats are found in many other foods. The most obvious source of

protein is from animals. Non-processed fish and poultry contain the complete amino acids our bodies require. Proteins are also found in veg-etables, beans, nuts and whole grains, although none of them alone have all the amino acids our bodies need. Mix and match these foods throughout the day to ensure you get all the proteins your body needs.

Vitamin B12 is naturally found only in animal products. Fish and poultry are great sources, as well as eggs, milk and milk products. Vegans

will need to get B12 from vitamin supplements or certain fortified breakfast cereals and other foods.

Egg yolks are a rich source of iron, but they are also high in cholesterol. Dried beans, spinach and dried fruits also have iron, but the body may not absorb it as well, and you may need supplements to ward off iron deficiency.

Shellfish is rich in zinc, as well as grains, nuts and legumes. If you take zinc supplements, be careful not to take too much. According to the American Heart Association, “Supplements containing 50 mg or more may lower HDL (‘good’) cholesterol in some people.”

It may be hard to kick the red meat habit, espe-cially at dinnertime. Try this delicious recipe from Nancy Stilson-Herzog, Certified Wellness Coach at The Other Club, to make the transition easier:

Nancy says: “Don’t be daunted by all the fresh herbs on the ingredients list; most supermarkets stock a fresh herb mix that contains just enough sage, thyme and rosemary for this recipe.”

• Choose an activity you enjoy. You are more likely to stick with it if you find something you like.

• Make exercising a commitment and write down your fitness goals. Put it in your calendar. Tell other about your plans; look for support.

• Start out slowly. Begin with a program of moderate, not vigorous, activity. Walking can be a great way to start. A good rule of thumb is 30 minutes of moderate activity a day.

• Add variety into your fitness routine. Vary the time of day and location of your exercise session, as well as the types of workouts you are doing.

• Begin with a proper warm up session and stretching. Include several minutes of walking or stretching as a cool down at the end of your routine.

•Experts recommend incorporating muscle strengthening into your routine at least twice a week. Target all the main muscle groups.

•Make sure you have the proper equipment and clothing for your routine and drink plenty of water.

• Most of all – have fun!

A word of caution: if you have a medical condi-tion, consult your physician before you begin any fitness routine. Let them help you set moderate, reasonable goals.


Many of these great events donate a portion of their

proceeds to local and national non-profits. So

get off the couch, strap on your tennis shoes and get out there for a

worthy cause.

OctObeR30 – CSU Triathlon Halloween 5k, 9 a.m., CSU campus, Fort Collins, benefitting the CSU Tri-athlon team, www.csuhalloween5k.weebly.com

31 – Spooktacular Race 5k Run/Walk, 9 a.m., Spring Canyon Community Park, Fort Collins, benefitting the Children’s Speech & Reading Center, www.csrckids.org

NOveMbeR6 - Heart Center of the Rockies Half Marathon, 8:30 AM, Boyd Lake State Park, www.run-nersroostftcollins.com

13 – Turkey Ball, 9 a.m., Chimney Community Park, Windsor, benefitting the Windsor Reduced Fee Program, www.ci.windsor.co.us

13 & 14 – New Belgium Cup bike race, 6 a.m., Fort Collins, www.usgpcyclocross.com

25 – Pelican Lakes Turkey Trot, 8 a.m., Pelican Lakes Golf Course, Windsor, benefitting the Windsor Food Bank, www.rmpeakfoundation.org

25 – Fort Collins Club T-Day Run/Walk, TBA, Old Town, Fort Collins, www.fortcollinsclub.net

25 – Loveland Turkey Trot, 8:30 a.m., McKee Med-ical Center, Loveland, benefitting the Stepping

Stones Adult Day Care Program at McKee, www.bannerhealth.com

25 – Northern Colorado Medical Center Turkey Trot, TBA, Greeley, www.bannerhealth.com

DeceMbeR4 – Fantasy Ball, 6 p.m., Stanley Hotel, Estes Park, benefitting the Estes Park Music Festival, www.estesparkmusicfestival.org

GET FIT, GIVE BACK CALENDAR

4 – Jingle Bell Run/Walk 5K, 10 a.m., Colorado State University Oval, www.runnersroostftcollins.com

12 – Christmas Classic 4 Mile, 9 a.m., Foot of the Rockies, Fort Collins, www.footoftherockies.com

31 – KRFC Resolution Run 5k, 7 a.m., CSU Clark Building, Fort Collins, www.krfcfm.org

AuTuMN WILd RICE RISSOLESServes 6

1 cup cooked wild rice

1 cup cooked brown or basmati rice

½ cup small red onion, finely chopped

½ cup dried cranberries

½ cup of jarred, marinated artichoke hearts, drained and coarsely chopped

¼ cup chopped toasted pecans

2 tbsp. olive oil, plus more for cooking patties

2 tbsp. chopped fresh sage

1 tsp. fresh thyme leaves

1 tsp. chopped fresh rosemary

4 egg whites

1 cup saltine cracker crumbs or crushedrice crackers

¾ cup chunky cranberry sauce

Stir together wild rice, brown rice, onions, dried cranberries, artichoke hearts, pecans, oil, sage, thyme and rosemary in large bowl. Fold in eggs, then cracker crumbs. Season with salt and pepper, if desired. Shape mixture into 12 ¼ cup patties. (At this point, rissoles can be chilled up to 24 hours.)

Heat 1 tsp. olive oil in a nonstick skillet over medium heat. Add 4 patties to hot skillet, and cook 3 to 4 minutes, or until browned and crispy on 1 side. Flip patties, and cook 3 to 4 minutes more, or until browned and crispy on second side. Repeat with remaining patty mixture until you have 12 patties. Serve each patty topped with 1 tbsp. cranberry sauce.


s a f e p e t

transportat ion “to me pets are a non-

negotiable part of our lives.

We want to keep them

no matter if we move, no

matter if we can’t drive

anymore.” to many of us, our pets are part of our family, and it’s not uncommon for them to be cared for so well that they have their own medical insurance and even a mention in

our wills. Adding to the services already avail-able to them is the new Fort Collins-based Safely There Animal Transportation (S.T.A.T.), poised to ferry your four-footers across town or across country.

The motto is, “Anytime, Anywhere…We’ll get them there!” says founder and CEO Lorry Schmitz. Getting them there can mean anything from trans-porting them to the vet or groomer for a routine visit, to the emergency vet in a crisis, or, if you’re moving, to anywhere from Paris, Texas to Paris, France.

S.T.A.T., which opened for business May 1, caters not only to cats and dogs, but also to exotic pets and farm animals as well. Schmitz has already transported quite a few woolly, scaly and feathered creatures, including alpacas and llamas, a pet hedgehog, and

an exotic Alexandrian parakeet. She’ll even transport your aquarium.

“The idea for S.T.A.T. grew from many things,” Schmitz says. “Among them was seeing elderly people, sick people, people who travel, just people who had trouble transporting their pets when they needed care. It also sprang from experience with my own pets. Years ago, I had a Great Dane named Snapdragon, and late one night he got sick, couldn’t walk or stand, and I couldn’t lift him. I remember wishing for a pet ambulance then, and again through the years as I’ve had dogs going through cancer treatments. During those times it would have been incredibly helpful to have someone to transport them to the clinic while I was at work.”

Schmitz’s devotion to animals has been lifelong. Growing up in Foxpoint, Milwaukee, her first animal companion, Thunder (another Great Dane), came along when she was only 9 months old.

“Oh, I would bounce on him and kiss him and he was so kind and patient,” she says. “But I’m sure he thought, ‘God I hope this kid grows up soon.’”

By Laura SeBaStian

When Schmitz did grow up it was almost seren-dipitous that the jobs she held provided experience in business, transportation and animal care, the ideal trifecta for later beginning S.T.A.T.

After earning a Bachelor of Arts degree in cultural anthropology from the University of Colorado at Boulder, she was hired as the university’s assistant manager of mailing services, which put her in charge of finances, inventory and the supervising of admin-istrative staff. Next, her driving skills were honed when she moved to a position at the university’s transportation center, where she learned to drive a

Transportationveterinary

– Lorry schmitz, owner, safely there animal transportation


bus while also supervising 25 drivers and teaching defensive driving.

After moving to Fort Collins in 1996, she worked at Colorado State University in various administrative capacities over a 15-year period, her final position being Departmental Administrative Assistant for the Department of Forest, Rangeland and Watershed Stewardship.

Her background for starting S.T.A.T. seemed complete when, in 2000, she began volunteering at the Larimer Animal-People Partnership, which promotes the human- animal bond by taking animals for animal-assisted therapy to schools, hospitals and homes for the elderly. In her six years there, Schmitz went from volunteer to president, eventually teach-ing classes to volunteers on such topics as how to recognize stress in the animals, and how best to interact with the people they’d be bringing therapy animals to meet.

It was in early 2010 that Schmitz left her job at CSU, ready to embark on her dream of making S.T.A.T. a reality.

“It was just time,” she says. “I had the resources to start it and I could see a growing need for it, what with such things as the increasing elderly population, and the rise in people from here and around the country bringing their animals to CSU vet school for things like cancer treatment, and often needing help transporting them.”

To calm the anxious pet parent, S.T.A.T. has an array of qualifications and certifications. Bonded and insured, S.T.A.T. is certified to legally transport animals, affiliated with the Independent Pet and Animal Transporters Association International, regu-lated and inspected by the USDA, and is a member of the Red Carpet Committee of the Fort Collins Chamber of Commerce. Schmitz herself has been trained by both the Red Cross and CSU vet school in first aid for animals.

Focused on safety, Schmitz worked with the Larimer Humane Society, which helped her design and equip the S.T.A.T. vehicle to provide the ultimate in animal comfort and welfare, including multiple, secured crates, climate control, ramps for easy walk-in and a rolling stretcher that holds up to 200 pounds. Schmitz added additional safety features for stability control, flashing yellow lights on the vehicle’s top for added visibility, and a back up camera so the driver can see well from behind. If the pet parent is still anxious, they’re welcome to ride along too. Animal transport prices start at $25.

In the future, Schmitz would like to use S.T.A.T. to aid animals in natural disasters and, eventually, she’d like to franchise it.

“I haven’t been able to find anything that offers the comprehensive services S.T.A.T. does,” she says.

“And I think it’s something important to have avail-able for our pets.”

Her own brood includes cats Sammy, Delila, Carmen Luigi and Jamie, and dogs Baby, a lab mix, and Boo, (aka “Boo-Boo-Licious”), a golden retriever mix.

“To me, and to a lot of other people, pets are a non-negotiable part of our lives,” Schmitz says. “We want to keep them, no matter if we move, no matter if we can’t drive anymore. They give us so much; they improve our mental health, even our physical health. I’ve seen the amazing benefits having pets has for disabled and senior people and I’ve seen how devastating it is for them, and for their animals, if they’re forced to give them up. Having the option of help from S.T.A.T. means they don’t have to give

Express Flu ClinicsSpend less time in line and more time with your family this year by schedulling your familys flu vaccines at one of our upcoming Express Flu Clinics. Parents of Youth Clinic patients can log on to our website at www.youthclinic.com and select a date and time that meets your families busy schedule. Our automated reminder system will automatically send an email reminder 2 days prior to your families appointment. Avoid the lines this year and schedule your families appointment at an Express Flu Clinic.

Flu MistProtect your children all year long without a shot. Flu-mist is a live nasal flu vaccine that takes the “ouch” out of the annual flu shot. Certain chronic conditions may not qualify for Flu Mist. Ask your Doctor if Flu Mist is right for your child. The Youth Clinic also carries preserva-tive free flu shots as an alternative to Flu Mist.

North Fort Collins1200 E. Elizabeth St.

South Fort Collins1214 Oak Park Dr.

Loveland 2695 Rocky Mountain Ave. Suite 260

The Advisory Commit-tee on Immunization Practices (ACIP) and the Center For Disease Control (CDC) recom-mend the vaccination of all children 6 months through 59 months of age as well as household members.

Main Number (970) 267-9510 Fax (970) 207-9967

Register Now at www.youthclinic.com

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them up, it means they can still care for them. I’m just happy I have the ability to provide this service. It’s a win-win situation for the humans and for the animals.”

ContaCt InformatIon:

Lorry Schmitz, ownerWebsite: www.safely-there.comEmail: [email protected] Telephone: (970) 556-8661

Local rates:Daytime: 7am-7pm $1.00 per mile,

$25.00 minimum

Nighttime: 7pm-7am $1.00 per mile, $50.00 minimum

Emergencies: Anytime, $1.00 per mile, $150.00 minimum

Laura Sebastian, who lives in Fort Collins, has worked as a freelance writer for 11 years.

Lorry Schmitz, owner of Safely There Animal Transportation, helps an injured canine up the loading ramp of her van.


Rescue DogsveterInArY

SEARCH AND RESCUE DOGS By angeline grenz

Meet Bear, a chocolate lab

and former search and rescue

dog. The old guy is 13 now; he

retired from the Larimer County

Search and Rescue two years

ago. During his professional

career, Bear and his handler

Dan Fanning served on more

than 100 missions together,

responding to emergency calls

from hikers, campers and

others who became lost or in

need of rescue in our Northern

Colorado wilderness.

Bear’s passion for search and rescue was evident early on, says Fanning. “Bear just had a fire in his belly. He was always so excited over search work, jump-

ing up off the ground when it was time to go.”

Often, Bear’s missions involved a middle of

the night call to action. Friends or family of the missing person, deciding that they had been gone too long, called in the notification to local law enforcement. The Emergency Services depart-ment of the Larimer County Sheriff’s Department is responsible for dispatching the all-volunteer Larimer County Search and Rescue (LCSAR) team, of which Fanning is a 28-year member.

Bear and Fanning were trained and certified under Search and Rescue Dogs of Colorado, the governing body for local search and rescue (SAR) dog teams. Currently, Larimer County has eight

dog/handler teams. SAR Dogs of Colorado requires members to be part of their local search and rescue team.

After receiving a call, Bear and Fanning assem-bled their gear and headed out to the trailhead or designated meeting area for the LCSAR team, law enforcement and other emergency response crew. Within as little as an hour’s time, the teams would be broken into 2-3 person groups and sent on their search assignments. Because Larimer County has one of the largest SAR dog groups in the state, a dog like Bear is almost always present on missions.

Searches generally last for about six hours as the teams comb the area for the missing person. For most missions, the entire process takes around nine hours. If they make contact, the person is retrieved and they return home with another success under their belts.

If the missing person is not contacted during the first eight to twelve hours or operational period, a second group of searchers is assembled for the next operational period. The seriousness

of the search and rescue is heightened at that point, and teams enter into a much more intense planning process.

During each mission, whether it is a search for a missing person, a rescue of a person who has been injured or is in a precarious situation, or a combination of the two, LCSAR teams and SAR dogs teams have their own special skills. For Bear, he was specially trained in trailing. Trailing dogs can follow the scent of where a person walked.

SAR dogs can also be trained in air scent, water scent, avalanche work, to search for evidence, and to search for trapped victims in disaster situations. An air scent dog can detect scent particles that were shed by the missing person and carried in the wind from the subject’s location. A water scent dog can search a body of water for drowning victims.

Bear’s skill was impressive even during his training, says Fanning. Once while training, Bear was able to work a trail that was four days old (the expectation is 24 to 48 hours old during training). He also worked the same location twice and picked up a scent from the week before – a life-saving skill set for a missing person that is gone for longer than the average 12 hours.

To obtain certification, the dogs and their owners go through a rigorous training schedule.

“Our dogs train around 10 hours for every one hour spent on a mission,” says Fanning. SAR dogs differ from law enforcement canines and must be well socialized and good around people in order to do their work.

SAR dogs train every weekend with their han-dlers, and most dogs begin their training as pup-pies. The training process takes two to four years before a dog can become certified. They are the property and pet of their handler, so the dedication to training must belong to both pet and master. The most common breeds for search and rescue work are the hunting and herding breeds: Lab-radors, Golden Retrievers, shepherds and collies.

“The team relationship between the pair is so important,” says Sergeant Kevin Johnston, the man in charge of emergency services for the Lar-imer County Sheriff’s Department. “The handler has to be able to read what the dog is telling them. Even if they don’t find the person, the team can at least clear an area for us.”

SAR dogs go through a lengthy testing protocol before they are certified. Trailing testing includes following and resolving a 1.5 to 2 mile trail that is 12 hours old within two hours. Air scent dogs must search an area that is .5 miles by 1 mile and resolve it within two hours. Because it takes at least five people and many man-hours to pull off a test, SAR dog handlers perform mock tests to make sure their dog is ready.

Even after certification, dogs continue to train, and handlers help train new dogs at weekly train-ing sessions. Because Larimer County’s SAR dog program is so large, they are often called to help with search and rescues throughout the state and even into neighboring states, again dispatched through the sheriff’s department.

Beyond the time commitment, handlers are also responsible for all their equipment, any vet-erinarian fees, and any other costs they may incur. LCSAR training is just as rigorous for humans as it is for dogs. New applicants must agree to an intense schedule of training on weekends and Wednesday evenings from March through May. The application and interview process begins in late fall, so anyone interested in joining this elite group should visit their website now for details, www.larimercountysar.com.

LCSAR members are responsible for buying their personal gear, valued at approximately $2,000, training fees and yearly membership dues. LCSAR trainees are taught navigation skills, search theory, man tracking, knots and rope systems, commu-nication skills, stress management and more. At the end of the training period, they participate in search and rescue scenarios and are evaluated to determine if they should be brought on to the team.

There is a link between the successes, and those instances of tragedy, that are felt by both humans and canines. “Dogs sense when it is the real thing,” says Fanning. “When we work a really long time, it is stressful to us. It affects dogs the same way.” SAR dog handlers work hard to make the missions a pleasant experience for their charges by including lots of playtime after a mission is complete.

But missions where fatalities occur or the sub-ject is never found are always the hardest. Such was the case in 1999, when LCSAR and SAR dogs responded to the search for young Jaryd Atadero, the 3-year-old who went missing in Poudre Canyon. Despite an extensive search, the boy was not found. In 2003, remains believed to be Atadero’s were discovered, and it is suspected that he was the victim of a mountain lion attack.

“This was a really tough search ‘cause we didn’t find Jaryd. LCSAR searched for at least a week,” recalls Fanning.

After countless missions over several years, Bear finally retired from active duty when he began to exhibit signs of arthritis. Today, he stays comfort-ably at home leading the good life, though it was not an easy transition to retirement.

When it became apparent that Bear’s health would pull him from search and rescue work, Fanning decided to train another dog. His newest partner is Trace, a yellow lab now certified for two and a half years. “When I first started to leave the house with Trace, it was really hard on Bear,” says Fanning. Trace has been on about 15 missions with Fanning to-date.

The 90+ LCSAR members respond to approxi-mately 80 missions in Larimer County each year. Each mission requires a team of 12 to 15 people. The missions are split roughly between search and rescues. LCSAR members come from all walks of life: electricians, doctors, law enforcement personnel, and a retired school principal (Fanning).

The all-volunteer staff does not charge for their services, unlike other emergency services such as ambulances and helicopters.

“We have never charged for our services, and hopefully never will,” says Fanning. “We don’t want people to check their wallets before they call us.”

However, their efforts carry a large price tag, including trucks that can run up to $150,000 fully equipped, additional training, and ever-increasing


Larimer County Search and Rescue dogs, and their owners, go through extensive weekly training to assist local law enforcement in search and rescue missions in the

Colorado mountains.

insurance costs. “They provide a valuable service to the com-

munity,” says Sgt. Johnston. “All the time and effort they put in is something that we couldn’t afford to provide.”

The reward LCSAR members get from each mission is the camaraderie of a tight-knit group of people making an important contribution to their community, says Fanning.

“There is a great energy in what we do,” says Fanning. “We work with really cool people, get good training and see parts of Colorado we would have never seen otherwise, even if it is only by headlamp at night.”

Support LCSR!Larimer County Search and Rescue

Annual Fundraiser

Lost Luck Costume & Casino NightSaturday, October 30

Agave Room at The Rio$30 per ticket

Additional information:www.larimercountysar.org/LostLuck

or call (970) 488-1134

Enjoy professional casino tables and dealers, live music, dancing, a costume contest, raffle for a scooter, Bahamas

getaway and more, and a catered buffet. All proceeds benefit the Larimer County

Search and Rescue team.

Angeline Grenz is editor for Style Magazine.

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Dan Fanning and fellow LCSR volunteer Jayne Zmijewski and her dog Lakota met on a

beautiful fall day to run tracking exercises with the search and rescue dogs.

70

Poison ControlveterInArY

tOP 10MEDICATIONS THAT POISON PETS

By Jon geller, dVm

Below is a list of the top 10 human medi-cations most frequently ingested by pets, along with some tips from the veterinarians at Pet Poison Helpline on how to prevent pet poisoning from human medications. This list comes from calls received at the Pet Poison Helpline.

At our emergency hospital, we have seen patients who have ingested all of these products. now that medical marijuana is available, it would move to the top spot on the list, at least in Fort Collins.

Signs of marijuana ingestion in dogs can include increased or decreased heart rate, coma-like stupor, stumbling, incoordina-tion, decreased body temperature and loss of bladder control.

OTHER MEdICATIONS TO BE AWARE OF:

1. nSAIDs (e.g. Advil, Aleve and Motrin)Topping our list are common household medica-

tions called non-steroidal anti-inflammatories (NSAIDs), which include common names such as ibuprofen and naproxen. While these medications are safe for

people, even one or two pills can cause serious harm to a pet. Dogs, cats, birds and other small mammals (ferrets, gerbils and hamsters) may develop serious stomach and intestinal ulcers, as well as kidney failure.

2. Acetaminophen (e.g. Tylenol)When it comes to pain medications, acetamino-

phen is certainly popular. Though this drug is very safe for humans, even for children, this is not true for pets – especially cats. One regular strength tablet of acetaminophen may cause damage to a cat’s red blood cells, limiting their ability to carry oxygen. In dogs, acetaminophen leads to liver failure and, in large doses, red blood cell damage.

3. Antidepressants (e.g. Effexor, Cymbalta, Prozac, Lexapro)

While these antidepressant drugs are occasionally used in pets, overdoses can lead to serious neuro-logical problems such as sedation, incoordination, tremors and seizures. Some antidepressants also have a stimulant effect leading to a dangerously elevated heart rate, blood pressure and body temperature. Pets, especially cats, seem to enjoy the taste of Effexor and often eat the entire pill. Unfortunately, just one pill can cause serious poisoning.

4. ADD/ADHD medications (e.g. Concerta, Adder-all, Ritalin)

Medications used to treat Attention Deficit Dis-order/Attention Deficit Hyperactivity Disorder con-tain potent stimulants such as amphetamines and methylphenidate. Even minimal ingestions of these medications by pets can cause life-threatening trem-ors, seizures, elevated body temperatures and heart problems.

5. Benzodiazepines and sleep aids (e.g. Xanax, Klonopin, Ambien, Lunesta)

These medications are designed to reduce anxiety and help people sleep better. However, in pets, they may have the opposite effect. About half of the dogs that ingest sleep aids become agitated instead of sedate. In addition, these drugs may cause severe lethargy, incoordination (including walking “drunk”), and slowed breathing in pets. In cats, some forms of benzodiazepines can cause liver failure when ingested.

6. Birth control (e.g. estrogen, estradiol, progesterone)

Birth control pills often come in packages that dogs find irresistible. Thankfully, small ingestions of these medications typically do not cause trouble. However, large ingestions of estrogen and estradiol can cause bone marrow suppression, particularly in birds. Additionally, female pets that are intact (not spayed) are at an increased risk of side effects from estrogen poisoning.

7. ACE Inhibitors (e.g. Zestril, Altace)Angiotensin-converting enzyme (or “ACE”) inhibi-

tors are commonly used to treat high blood pressure in people and, occasionally, pets. Though overdoses can cause low blood pressure, dizziness and weak-ness, this category of medication is typically quite safe. Pets ingesting small amounts of this medication can potentially be monitored at home, unless they have kidney failure or heart disease. All heart medications should be kept out of reach of pets.

8. Beta-blockers (e.g. Tenormin, Toprol, Coreg)Beta-blockers are also used to treat high blood

pressure but, unlike the ACE inhibitor, small ingestions

Lydia’s STYLE Magazine

71Northern Colorado Medical & Wellness 2010

of these drugs may cause serious poisoning in pets. Overdoses can cause life-threatening decreases in blood pressure and a very slow heart rate.

9. Thyroid hormones (e.g. Armour desiccated thyroid, Synthroid)

Pets – especially dogs – get underactive thyroids too. Interestingly, the dose of thyroid hormone needed to treat dogs is much higher than a person’s dose. Therefore, if dogs accidentally get into thyroid hor-mones at home, it rarely results in problems. However, large acute overdoses in cats and dogs can cause muscle tremors, nervousness, panting, a rapid heart rate and aggression.

10. Cholesterol lowering agents (e.g. Lipitor, Zocor, Crestor)

These popular medications, often called “statins,” are commonly used in the United States. While pets do not typically get high cholesterol, they may still get into the pill bottle. Thankfully, most “statin” ingestions only cause mild vomiting or diarrhea.

STEPS TO REMEMBER TO kEEP YOuR PETS SAFE:

– Always keep medications safely out of reach and never administer a medication to a pet without first consulting your veterinarian.

– Never leave loose pills in a plastic Ziploc bag – the bags are too easy to chew into. Make sure visiting houseguests do the same, keeping their medications high up or out of reach.

– If you place your medication in a weekly pill con-tainer, make sure to store the container in a cabinet out of reach of your pets. Unfortunately, if they get a hold of it, some pets might consider the pill container a plastic chew toy.

– Never store your medications near your pet’s medications. Veterinarians frequently receive calls from concerned pet owners who inadvertently give their own medication to their pet.

– Hang your purse up. Inquisitive pets will explore the contents of your handbag, so simply placing your purse up and out of reach can help to avoid exposure to any potentially dangerous medication(s).

It is also important to note that while a medication may be safe for children, it may not be safe for animals. Pets metabolize medications very differently from people. Even seemingly benign over-the-counter or herbal medications may cause serious poisoning in pets.

If your pet has ingested a human over-the-counter or prescription medication, please call your veterinar-ian or Pet Poison Helpline’s 24-hour animal poison control center at (800) 213-6680 immediately. You should also plan on going to your local veterinarian or an after-hours emergency veterinary hospital for additional evaluation and treatment.

Dr. Geller is an emergency veterinarian at Fort Collins Veterinary Emergency Hospital and Pets Emergency in Greeley, as well as a freelance writer. His work has appeared in Dog Fancy Magazine, Bottom Line Personal, and Mother Earth News. In addition, he has a current blog at thebark.com and medhelp.org, and answers dog owners’ questions online at Dogchannel.com.


Pet CareveterInArY

By TraCee sioux

THERE FOR YOUR PETS

Sydni Brown is fourth on the kidney transplant list. She will have one hour to get from Fort Collins to Denver when a kidney becomes available. She will then be away

from home for two months. Pets Forever will be caring for Palleigh Sue, her West Highland White Terrier, and KaiKai, her Siamese cat, while she recovers.

Pets Forever is a non-profit program assisting seniors and disabled Larimer County residents. Pets Forever volunteers provide dog walking, administer medications to animals, and transport animals to clin-ics and groomers. Pets Forever also has collaborative relationships with veterinarians and the Colorado State University Veterinary Teaching Hospital to provide medical services like spaying, neutering and immunization shots.

Their services are vital to residents like Brown who want to care for their pets but have limited abilities. “I’m disabled and on a waiting list for a kidney. I also have fibromialgia, so I lead a sedentary life; I can’t get out and do anything,” says Brown. “My dog wasn’t used to it and she was becoming a couch potato. Pets Forever has been wonderful about taking her out and building her up again. She’s bouncing around like you wouldn’t believe at 17 years old. For two months I’ll be out of the house and the volunteers aren’t complete strangers. This has been a huge blessing in my life.”

Lori Kogan, Ph.D., founder and director of Pets Forever and associate professor in the clinical sciences department at Colorado State University, believes

in the importance of human-animal relationships.“My research interest is the human, animal bond,”

she says. “The relationship people have with their animals is really important. It’s often the only relation-ship they have. I wanted to provide some type of support system in the community for the population, so they could maintain those relationships longer.”

“One man recently went into assisted living; his family said that basically his cats are the reason he’s still alive,” Kogan continues. “The only way he can keep his cats is because we’re going in and cleaning the litter box

and bringing food.” Kogan began the program in the summer of

2009 and participation is steadily growing. To date, there have been around 70 recipients assisted by 35 volunteers.

“I loved the idea of helping low income elderly and disabled individuals take care of their animals,” says Lauren Gould, volunteer coordinator of Pets Forever and pre-veterinary biology student.

“Every time I go out and I see a client, no matter what is going on in my day, I’m always able to leave feeling happier than ever,” Gould continues. “It has a great impact in people’s lives. I’ve learned so much from their lives and the great experiences they’ve had throughout their lives. I’m really thankful that I’ve been able to experience that.”

Because Pets Forever is a service-learning course at CSU, in collaboration with the social sciences departments and the School of Veterinary Medicine, Kogan gets to see the impact on the volunteers.

“Whether its a pre-vet student who wants more animal experience or those in the human camp from psychology, social work or occupational therapy departments, many of them talk about the oppor-tunity to work with a population they just wouldn’t get to normally,” Kogan says. “They get a better understanding of some of the difficulties faced by this population. They experience more compassion. It gives them a larger picture of what other people in the community are facing. There’s also the low income piece – they get to see what it means when you’re really struggling to have enough money to have medication or food.”

Many of the animals’ health has improved thanks to regular exercise that their owners had been unable to provide, notes Kogan.

Despite the program’s good work, they still face hurdles in providing all the desired services to their targeted segment of the Northern Colorado com-munity. “Honestly the biggest struggle that we have is money,” Kogan says. “We have an agreement with the veterinary teaching hospital for vaccinations and wellness exams, but when the animals get sick or have an accident we need money for those things.”

To donate, sign up for Pets Forever services or volunteer, contact Lori Kogan at (970) 297-5000 or [email protected]. Visit their website at www.csuvets.colostate.edu/petsforever.html.

Tracee Sioux is a Fort Collins writer. She can be found at TheGirlRevolution.com and www.linkedin.com/in/traceesioux.

Lauren Gould, Pets Forever volunteer and pre-veterinary biology student, sits with Sydni

Brown and her terrier Palleigh Sue. Gould helps Brown with the weekly care of her pets.

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Dr. Kevin KeefephYSIcIAn SpotLIght


DR . KEV IN KEEFE

A PASSION FOR PATIENT CAREBy Connie hein

Ralph Waldo Emerson said, “The years teach much which the days never knew.”

Kevin Keefe, D.O., internal medicine specialist at Aspen Medical Center in Loveland, believes the years do indeed teach much. And every person has their own story and life experiences as they age. This is one of the many reasons he says his passion in his medical career is treating seniors. Over the years, he has gained much knowledge and wisdom from this wonderful generation of people.

Dr. Keefe always knew he wanted to work in a science-based field, and he started out as a pharmacist. But soon he found he wanted more patient contact and responsibility for patient care, so Dr. Keefe decided to become an internal

medicine specialist. His career slowly evolved and now the majority of his patients belong to the senior population.

The elderly have a wealth of experience that they are delighted to share and can teach us so much if we will just take the time to listen, says Dr. Keefe. He believes he gains as much from his patients as they do from him.

“It may take a bit of extra time and patience to guide my older patients through their health concerns because of the realities of old age, such as hearing and vision loss, confusion and memory lapses, but it’s time well spent,” he says.

Dr. Keefe maintains his focus on patients, despite the distractions of a busy office, to ensure they receive his undivided attention and care.

“As physicians it is easy to become so over-whelmed and busy with filling out forms and other business that we don’t take time to really get to know our patients and form relationships

with them as people. I feel like my job is getting to know the patient as a person and educating them so they can help themselves to have a great quality of life as they age.”

He believes it is very important for seniors to understand the reasons for his advice and treat-ment. “Patients will be more motivated to take my advice and cooperate with medical treatment if they understand and see the advantages.”

Dr. Keefe has built up the reputation as one of the leading internal medical specialists in Northern Colorado, largely through his outstanding care of seniors. He says one reason for his success is the team of specialists he has the privilege to work with.

“When I am away from the office, I have com-plete confidence that the other doctors in the practice will treat my patients with the same care and respect as I do.”

That kind of medical team makes his life much less stressful, and makes it possible to concentrate on patients when he is in the office, and then on his family and activities when he is not.

Dr. Keefe and his wife Deb have only been in Colorado for three years, but he says they quickly learned to love the area and the people. As native Iowans, Dr. Keefe says they had planned to retire in this area, but decided to move out before retirement to enjoy the milder climate and all the great outdoor activities Northern Colorado has to offer.

Dr. Keefe is an avid biker and believes that helps him to be a better, healthier doctor and a good example for his patients. He rides his bike to work and back daily throughout most of all four seasons.

“It starts my day out in a positive way, being able to ride to work enjoying the view of the mountains,” he says. “And is a great stress reliever after long hours at work.”

Dr. Keefe is very dedicated to his patients, and spends long hours treating and caring for them, but he also takes time to be with his family. He has two children and one grandchild. He says there is nothing like enjoying modern jazz and a mountain view to relax with his family.

And even though he has a great family life and successful career with many loyal patients, he never wants to become complacent.

“It is a wonderful feeling to be good at some-thing you love, but I will never get to the point that I have no room to learn or grow and improve.”

Connie Hein is a freelance writer and the author of several books including the Toliver in Time series of children’s books.

Name: Kevin Keefe, D.O.

Occupation: Internal Medicine Specialist at aspen Medical center

In His Downtime: avid biker, jazz enthusiast, father of two and grandfather of one.

Northern Colorado Medical & Wellness 2010 7575Northern Colorado Medical & Wellness 2010

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