November 2014 Thrive

FIGHTING THE FLU

There are many options available — with more on the way — for getting vaccinated this season. Page 8.

THRiVEnc» NORTHERN COLORADO WELLNESS

November 2014

» INSIDE: MAKE SMART MEDICARE DECISIONS • TEENS FACE STRESSES DAILY • HEALTH EVENTS

THRIVENC n October 29, 20142 n HEALTH

Radiation treatment for early prostate cancer can take 8-9 weeks of appointments. With high-dose rate brachytherapy, our experts can treat your cancer with pinpoint accuracy, reducing the treatment period to as little as 24 hours. It’s just another way we take care of our own. Talk to your radiation oncologist to find out if this treatment is right for you. For more information or to schedule your appointment, call (970) 350-6680 or visit BannerHealth.com/COCancer.

October 29, 2014 n THRIVENC 3HEALTH n

«Yoga basics classes, 4:30-5:30 p.m. Nov. 3-Dec. 15. Yoga Basics is an introduction to the foundational poses in a beginning yoga practice. This class will focus on careful physical alignment for the creation of a safe practice. This class is best suited for those with no physical limitations. NCMC offers yoga classes with Yoga Alliance Certified Teachers. Payment is due at time of registration. Refunds will not be processed once classes have begun. The cost is $48 for six weeks.

«Gentle Yoga, 4:30-5:30 p.m. Wednesdays, Nov. 5-Dec. 17, there will be no class Dec. 26. In Gentle Yoga, the postures are presented in an easy to follow, accessible manner with plenty of time for modifications and focus on breath work. An excellent class for seniors, those with chronic illness or injuries, those newer to yoga or students wanting a gentle practice. The cost is $48 for six weeks.

«Cooking classes, “Healthy Holiday Gifts,” 6-7:30 p.m., Nov. 4 at NCMC in the Cardiac Rehab Kitchen. Treat your family, friends, teachers and neighbors to healthy, homemade gifts this holiday season. We’ll make both sweet and savory gifts so you’ll find something for everyone on your list. Taught by Julie Gormley, R.D. Come and learn a variety of fun and healthy cooking options. These courses are taught by a registered dietitian and are a great way to modify your cooking habits and learn about heart healthy cooking. Recipes and samples are included! All classes are held at North Colorado Medical Center in the Cardiac Rehab Kitchen. The class is $10 per class. Payment due at the time of registration. If you are absent from the class, you will be charged the full amount. Please call (970) 350-6633 to register.

«Body Check... What you need to know: Head to Toe, Nov. 4 and Nov. 18 at Summit View Medical Commons, 2001 70th Ave. This head-to-toe health assessment gives you the tools to put your health first by receiving a comprehensive set of preventive health screenings. Invest in your health today! This screening includes: health fair panel (fasting blood work, please fast 10-12 hours), sleep questionnaire, lung function test, body composition, weight and body mass index, hip and waist measurements, health education with a Wellness Specialist, EKG with results read by a board-certified cardiologist, peripheral arterial disease screening includes: education about peripheral vascular disease, stroke, stroke

prevention and osteoporosis prevention, ankle brachial index, ultrasound of the carotid vessels, ultrasound of the aorta (above four screenings are read by a board–certified radiologist). Upon request: colorectal take-home kit costs, $10 and prostate specific blood antigen screening cost $30, body check with colorectal take-home kit costs $185, body check with PSA costs $205, body check with a colorectal take-home kit and PSA costs $210. All results are sent to your personal physician and to you. The cost is $175 and payment is due at time of service. Please call (970) 350-6070 to schedule an appointment. Wellness services is not able to bill insurance.

«PAD Screening (Peripheral Vascular Disease), 1-3 p.m. Nov. 4 and Nov. 18, at Summit View Medical Commons. NCMC’s Peripheral Vascular Disease Screening program offers the education and prevention proven to be the best tools for fighting vascular disease and stroke. Patients receive: ankle brachial index: evaluation of leg circulation, carotid artery disease screening: ul-trasound of the carotid vessels, abdominal aortic aneurysm screening: ultrasound of the aorta, lipid panel voucher, health education with a wellness specialist, health information packet. The cost is $100 for all four screenings and the payment is due at the time of service. NCMC Wellness Services is not able to bill insurance. Please call (970) 350-6070 to schedule an appointment.

«STAR, 5:30-7:30 p.m. Nov. 6, NCMC Cancer Institute Conference Room. Come support, touch and reach breast cancer survivors (Breast Cancer Support Group). For further information, please contact Betty Parsons at (970) 339-7137.

«CPR for Health Care Providers (Recertifica-tion), 3-5:30 p.m. Nov. 10 at NCMC in the Union Colony Room. This class is designed for licensed and non-licensed health care providers who need to re-certify through the American Heart Association. The certification is valid for two years. Please notify us one week in advance if you are unable to attend the class. Your registration will be refunded and there will be a $10 service charge. The cost for the class is $50. If you are absent from the class, you will be charged the full amount. Refunds will not be processed once classes have begun. To register, please call (970) 350-6633.

«Cardiac Education Classes, 3:45-5:30 p.m. Nov. 10 and 8:45-10:30 a.m. Nov. 12, Cardiac

Rehab Classroom. All classes are free. This class, “give your meals a makeover” will feature the teachings of R.D. Mary Branom. Please call (970) 350-6204 to confirm class times and dates.

«Passport to Health: SPAIN, “Your Adventure Against Diabetes: What You Can Do NOW,” 6:30 p.m. Nov. 11 in the NCMC auditorium. When it comes to diabetes, you have power! By making some simple changes, you can help prevent diabetes — or if you already have it, you can cut your risk of complications. Our clinical experts will present current information on the many steps you can take to manage your weight, lower diabetes risk and boost your overall health. For complete details visit www.bannerhealth.com/NCMCspirit or call (970) 392-2222.

«Flu, Pneumonia, Whooping Cough and Tetanus Clinics in Weld County, 7-8:45 a.m. Nov. 12 at NCMC via east entrance. The flu can be costly to you and your family because it causes you to feel poorly, miss work or school and be at risk for further complications. Don’t get caught unprepared, make sure you and your family get vaccinated. There are a wide variety of options and locations in Weld County for your conve-nience. Costs: injectable flu vaccine for $25, nasal mist flu vaccine for $35, pneumonia vaccine for $90, Tdap — tetanus and pertussis (whooping cough) for $55. It’s important to note that Medi-care billing is available for flu and pneumonia vaccines. Please bring your Medicare Part B card. Supplemental insurance such as Humana are not accepted.

«CPR for Health Care Providers Skills Check, by appointment, in the Wellness Conference Room. This class is designed for licensed and non-licensed health care providers who need to re-certify through the American Heart Asso-ciation. The certification is valid for two years. Renew your CPR certification by completing an online CPR module which includes watching a video, reviewing content and an exam. When the online module is complete and a Course Comple-tion Certificate is printed, call Wellness Services to schedule a skills check. Please bring a copy of the Course Completion Certificate with you. The cost is $50 for CPR for health care providers includes skills check with a certified American Heart As-sociation instructor. There is a separate $50 fee for online course, payable online. Payment due at the time of registration. If you are absent from the class, you will be charged the full amount. To

register, please call (970) 350-6633.

«Blood tests, 7-8:45 a.m. Nov. 12 and Nov. 26 at NCMC via entrance No. 6 or Nov. 19 at John-stown Family Physicians, 222 Johnstown Center Drive. Wellness Services offers low-cost blood screenings open to community members; some immunizations are also available upon request and availability. To schedule an appointment, call (970) 350-6633. Appointments preferred; please fast 12 hours prior to blood draw. The cost varies and payment is due at time of service. NCMC Wellness Services will not bill insurance.

«CT heart score, 1-2 p.m., Monday-Friday, NCMC. CT Heart Score provides a non-invasive test that accurately measures the amount of calcified plaque in the arteries. The procedure begins with a fast, painless computed tomography CT exam. CT, more commonly known as CAT scanning, uses X-rays and multiple detectors to create interior images of the heart. The Heart Score program includes a 10-minute consultation with a Wellness Specialist, focusing on cardiac risk factor education, identification of non-modifi-able and modifiable risks and lifestyle behavior change options. The cost is $199 and payment is due at time of service. NCMC Wellness Services is not able to bill insurance. To schedule an appointment call (970) 350-6070 to schedule an appointment.

«NCMC adult fitness, available to people in the community who are interested in starting an exercise program in a health care setting. The cost per month for an individual $45 or couple, living in the same household, $80. Please call (970) 350-6204 for information.

«Walk with a Doc, Nov. 15 on the west side of San-born Park, 2031 28th Ave. This is an international program where interested people meet at a park or public location (usually Saturday mornings) for an informal five-minute health talk and a 30-minute walk (at your own pace). Families are encouraged to attend. There are healthy snacks at the completion of the walk. Free blood pressure checks are available for those interested. Upcoming walks are posted on the Walk with a Doc website at www.WalkwithaDoc.org.

«Pulmonary Rehabilitation, lung disease management, education and exercise. Please contact (970) 350-6924 for information and opportunities.

NOVEMBER HEALTH EVENTS



It’s typical to worry when raising a teenager — but it’s important to remem-ber that it’s more stressful being a teenager. Not making the cut for the football team, breaking up with a girlfriend, fighting with friends, bombing a test, moving to a new town, feeling one doesn’t belong or switching schools is stressful for many teenagers.

Because of this, it’s sometimes hard to know when resulting behaviors are typical and when you should seek help. How do you know if your teen’s behavior is “normal?”

First, it is important to note that “normal” is a misleading word. So much of what someone does depends on his or her environment, experiences, family history and beliefs. What is familiar for one teen and family may not be familiar for the next; it is important to keep that in mind when evaluat-ing how your teenager is responding to stress.

Consider what’s normal for your teen — and then determine whether and how much of a change you see in his or her behavior. As a caregiver, you may notice that something has changed or seems drasti-cally different: like a once talkative, outgoing teen who suddenly has nothing to say and is hiding out in her room — or a straight-A student who is caught

skipping school and fight-ing with his teachers.

Here are some behav-iors or events that could be cause for concern:

» Change in eating or sleeping habits

» Change in friends or activities

» Change in mood or behavior like irritability, aggression with others

» Change in grades, school performance, or attendance

» Missing curfew, running away, or leaving without permission

» Isolation from family or friends

» Suspected substance use

» Suicidal thoughts or mention of suicide

» Self-harming behav-iors such as cutting

» History of any trauma or abuse

» Recent family conflict» Recent loss of loved

one close to teenIt is never easy being a

teen, and it can be hard to watch one you care about struggle with challenges. When your teenager’s behavior has changed in ways that cause you concern, it can be helpful to seek support for your family. Many counselors or therapists are well versed in helping parents and caregivers discuss teens’ behaviors and what’s “normal.” If your teen is unwilling to go to a counselor, sometimes it is a good idea to seek help for yourself, to learn positive and practical coping and communication strategies. A good therapist will help you identify your family’s and teen’s strengths and build on those while ad-dressing any concerns. A family who is armed with the right emotional and communication tools is a stronger and happier one.

Rebecca Wyperd is the program director for Youth

and Family Services at North Range Behavioral

Health.

Expert: Teens face stresses every dayBy Rebecca WyperdFor THRIVEnc

» For moreTo contact North Range Behavioral Health Child, Youth, and Family Services, call (970) 347-2120.

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S tatistics from the National Kidney Foundation

show that more than half a million Americans visit the emergency depart-ment each year because of problems associated with kidney stones. One Banner Health urologist says simple changes in diet can help reduce the risk.

Dr. Jay Paddack, from the Banner Health Clinic

specializing in urology, 5890 13th St. in Greeley, specializes in general uro-logic conditions and more complex issues men and women may face. Kidney stones are among the conditions he treats.

Paddack describes kidney stones as a solid piece of material formed by an excess of certain minerals in the urine, most commonly calcium. Stones vary in size and composition and can form anywhere throughout the urinary tract.

“Certain factors can increase the likelihood of forming kidney stones,” Paddack said. “Those include low fluid intake, diet, obesity, age, gender, a personal or family history of stones.”

Additionally, Paddack said certain medications, including acetazolamide and indinavir, and certain medical problems, such as diabetes, Crohn’s disease and others, can increase the risk of kidney stones. Anyone who has had pre-vious intestinal surgery,

like gastric bypass, is more susceptible, and any blockage of the urinary tract can lead to stone formation.

While kidney stones have typically affect-

ed men more than 30 years old, the incidence of women and younger people having stones is on the rise, Paddack said. Diets high in salt, fat and protein and elevated obesity rates has raised the frequency of women and young people developing kidney stones, according to Paddack.

Diet change and an in-crease in fluid intake can help reduce the risk of de-veloping stones. Paddack recommends people drink two to three liters of water every day, or enough to keep the urine light yellow to a clear shade.

“Testing for kidney stones is typically only done after one goes to the doctor’s office or emer-gency room with severe, fluctuating pain in the back that radiates to the abdomen and groin,” Paddack said. Additional symptoms may include bloody urine, nausea and vomiting, frequent urina-tion that may be difficult and fever that may also be

accompanied by chills.To test for kidney

stones, doctors may request a urine sample to analyze and look for an infection. Tests might include a urinalysis and/

or urine culture to look for infection. Blood tests can also identify serious infec-tion and show how well the kidneys are working.

Doctors likely will order some form of imaging study to deter-mine if and where kidney stones are present. The most effective option is a non-contrast computer-ized tomography scan, or CT scan, which can show the size and location of almost all stones. Oth-er alternative imaging studies include X-rays and ultrasounds which may be less precise.

“Kidney stones can become problematic when they begin to pass through the urinary tract, causing severe pain, urine ob-struction and sometimes infection,” Paddack said. “Although most stones will pass through the urinary tract on their own, some-times surgical procedures are necessary to remove them.”

Doctors have three primary surgical options

to treat kidney stones. The first is called shockwave lithotripsy, which uses sound waves focused on the stone to break it into small, easily passable fragments.

A second option, called ureteroscopy, uses a small scope inserted into the ureter through the urethra and bladder to visualize the stone. It can then be broken into pieces with a laser and grasped with small instruments.

For large stones in the kidney, doctors may use the third option, percuta-neous nephrolithotomy. With this procedure, the doctor makes a small incision in the back and inserts a scope directly into the kidney. The stone can then be broken up and removed with special instruments.

Additionally, urologists may prescribe medica-tions to minimize stone formation. “These med-ications alter the levels of certain substances commonly associated with stones that are present in the urine,” Paddack said.

Fortunately, Paddack said not all stones need to be treated. Stones which remain stable in size can just be observed. This can delay the use of surgical procedures until they become large enough to cause problems.

Jason Webb is a public relations specialist for

Banner Health.

GREELEY DOCTOR DISCUSSES TREATMENT OF KIDNEY STONESBy Jason WebbFor THRIVEnc

“Testing for kidney stones is typically only done after one goes to the doc-

tor’s office or emergency room with severe, fluctuating pain in the back that radiates to the abdomen and groin.— DR. JAY PADDACK, Banner Health Clinic

Join Columbine Commons for Important Educational Sessions

• Tuesday, November 11 – Trusts/Wills/Powers of Attorney

• Tuesday, January 13 – Health Fair6:30 to 7:30 p.m.

2:00 to 4:00 p.m.

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A friend of mine, a diabet-ic, stumbled on to another booby trap in the pricing of generic drugs. Insur-ers are pushing a two-tiered pricing system on patients. You can choose a non-preferred generic and pay more, maybe a lot more, or a preferred generic and get a price break. That’s the same pricing scheme insurers use for the expensive brand-name drugs.

Consumer groups, doctors, and insurance carriers have encouraged patients to choose gener-ics over the name brands as a way to help lower the nation’s healthcare tab. So for many years my friend has been using a generic drug called gemfibrozil that diabetics often take to lower triglycerides and cholesterol.

It has worked for him. No nasty drug inter-actions. No nasty side effects. And the price has been low — $2.71 for 60 pills. In August the price more than doubled to $6.14. He was still OK

with that.He was not OK when

he got a bill in September from Express Scripts, the pharmacy benefit manag-er for his Medigap carrier whose plan is offered by his former employer, the City of New York. (PBMs, as they’re called, manage the drug benefits for em-ployers and insurers and supposedly help hold the line on prices.)

Express Scripts wrote his doctor without consulting my friend, the patient, suggesting that for reasons of “safety and efficacy,” he should switch his patient to a different drug, a generic called fenofibric acid. His share of the cost would now be $156.70 for 90 pills. Fenofibric acid costs $1.74 per pill compared to gemfibrozil’s 10 cents a pill resulting in an out-of-pocket cost increase of 1,640 percent.

Why the switch? my

friend asked his doctor. The doctor pointed to the reasons given in the letter about an increased risk of skeletal muscle effects and said maybe it was advisable to try the new drug. He was, however, astounded by the price, but my friend said it was clear the doctor wasn’t going to fight the PBM.

My friend spoke to an official at New York City’s employee benefits office who said her office has never heard of a PBM rec-ommending that a more expensive generic drug replace a cheaper one.

I rang up John Rother, former chief lobbyist for AARP and now head of a group called the National Coalition on Health Care. The Coalition is waging a campaign to educate the public about the exor-bitant prices of drugs, particularly the Hepatitis C drug Sovaldi and other specialty drugs in the

pipeline that will carry super high price tags.

“Generic drug prices have been rising steeply, and there doesn’t seem to be an explanation for it,” Rother told me. He said he could only guess that some generic drug makers are leaving the market and the ones remaining will have less competition and the power to increase market share and raise prices.

Maybe there are med-ical reasons my friend should make the switch, but so far his doctor hasn’t been persuasive. Has the PBM discovered new side effects for the drug he’s been taking? Who’s treating the patient — the doctor or the PBM? And how does this big price jump fit in with the PBM’s purported mission: to save money for insurers and employers? Was my friend caught in a tussle between the clinician and the bean counters? How does he know who’s right without doing extensive research himself?

Since individuals can’t negotiate prices with drug companies, and Congress

has prohibited Medicare from negotiating prices when it passed the pre-scription drug benefit law in 2003, my friend says, “companies have carte blanche to rip people off. In situations like this no one ever talks straight, but someone is making a lot more money.” He’s trying to get back on gemfibrozil or a similar generic that’s cheaper than the one the PBM suggested.

Rother looks at the big picture now coming into focus from the sharply rising prices of gener-

ics. “Four years after we passed what we thought was universal health coverage, you can’t get the medicines you need because of the prices. It’s tragic,” he says.

The Rural Health News Service is funded by a

grant from The Common-wealth Fund and distrib-

uted through the Ne-braska Press Association

Foundation, the Colorado Press Association, the

South Dakota Newspaper Association and the Hoo-sier (Indiana) State Press

Association.

GENERIC DRUG FIELD IS FULL OF PRICING TRAPSBy Trudy LiebermanRural Health News Service » Speak out

Rural Health News Service wants to hear your questions and comments about your health care experiences. Tell us about your experiences with generic drugs. Write to Trudy at [email protected].

THINKING ABOUT HEALTH

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If someone doesn’t get vaccinated before the holidays, she said, it’s still a good idea to be vaccinated at any point during the flu season because it can reduce the likelihood of catching the flu or, reduce its severity if it is contracted.

People can choose between a trivalent vac-cine, which covers three flu viruses, or a quadri-valent vac-cine, which covers four. For those who don’t like nee-dles, many hospitals and clinics also offer a nasal spray, a trivalent higher-dose vaccine, that Sykes-John-son said is recommended for people over age 65 who may need the extra coverage provided by the higher dose.

“The flu shot is very safe,” she said. “It’s not giving you the flu but it is commanding a response from

your immune system.”She said its side effects depend on

the vaccinated person’s health, but generally aren’t more severe than slight soreness or inflammation at the site of the vaccination.

North Colorado Medical Cen-ter spokesman Gene Haffner said

FIGHTING THE FLUBy CASEY KELLY

[email protected]

REGISTERED NURSE LINDA MILLER gives a flu shot to patient during a visit to the Evans Recreation Center last month.

JOSHUA POLSON/[email protected]

» How to tell If you have the flu» You will have a sudden headache and dry cough.» You might have a runny nose and a sore throat.» Your muscles will ache.» You will be extremely tired.» You can have a fever of up to 104 degrees.» You most likely will feel better in a couple of days, but the fatigue and cough can last for two weeks or longer.

Source: Centers for Disease Control and Prevention

» Good health habits to help prevent the flu» Avoid close contact.» Avoid close contact with people who are sick. When you are sick, keep your dis-tance from others to protect them from getting sick, too. » Stay home when you are sick.» If possible, stay home from work, school and errands when you are sick. You will help prevent others from catch-ing your illness. » Cover your mouth and nose.» Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. » Clean your hands.» Washing your hands with soap and hot water or alcohol hand gel (containing at least 60-percent alcohol) often will help protect you from germs. » Avoid touching your eyes, nose or mouth.» Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose or mouth.


» Want to get vaccinated?North Colorado Medi-cal Center, 1801 16th St., will host a clinic from 7-8:45 a.m. Nov. 12 at the east entrance of the building.Cost:» Injectible Flu vaccine: $25» Nasal mist flu vac-cine: $35 » Pneumonia vaccine: $90» Tdap: Tetanus and pertussis (whooping cough): $55

If you haven’t received your flu shot yet this season, there are myriad options for getting vaccinated against the contagious disease, with even more options on the way soon.

Flu season generally begins in the fall and carries through to March or April, and the best time to receive your flu shot is early in the fall, ac-cording to Marilyn Sykes-Johnson, Banner Health’s coordinator for its flu shot program.

“Early November is a good time to get the flu shot,” she said. “During the holidays, many people travel and are seeing family from other areas, so it’s a good idea to get vaccinated before then.”


in addition to the flu shot, people should also consider getting vacci-nated against pertussis, also known as whooping cough, because of how many cases have been seen recently in northern Colorado. He said older people should also consider getting a pneumonia vaccine, as they can be more prone to upper-respiratory infections.

FIGHTING THE FLU There are many options available — with more on the way — for getting vaccinated this season

REGISTERED NURSE LINDA MILLER gives a flu shot to patient during a visit to the Evans Recreation Center last month.

JOSHUA POLSON/[email protected]

» How to tell If you have the flu» You will have a sudden headache and dry cough.» You might have a runny nose and a sore throat.» Your muscles will ache.» You will be extremely tired.» You can have a fever of up to 104 degrees.» You most likely will feel better in a couple of days, but the fatigue and cough can last for two weeks or longer.


» Who should get vaccinated?» Anyone 65 years and older.» People who live in nursing homes and other long-term care facilities.» Women who will be pregnant during the influenza season.» All children 6 to 23 months of age.» Adults and children 6 months and older with chronic heart or lung condi-tions, including asthma.» Adults and children 6 months and older who needed regular medical care or were in a hospital during the previous year because of: • a metabolic disease (like diabetes). • chronic kidney disease. • weakened immune system (including immune system problems caused by medicines or by infection with human immunodeficiency virus (HIV/AIDS).» Children 6 months to 18 years of age who are on long-term aspirin therapy.» People with respiratory problems.» People 50 to 64 years of age. Nearly one-third of people in this age group have medical conditions that place them at increased risk for serious flu complications.» Anyone in close contact with some-one in a high-risk group, including all health-care workers, adult and child caregivers.

» Who should not be vaccinatedThere are some people who should not be vaccinated without first consulting a physician. These include:» People who have a severe allergy to chicken eggs.» People who have had a severe reac-tion to an influenza vaccination in the past.» People who developed syndrome within six weeks of getting a previous influenza vaccine.» Influenza vaccine is not approved for use in children less than 6 months of age.» People who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms lessen.


» New vaccination option on the horizonGolden-based company PharmaJet has developed a new delivery system for the flu vaccine that should sound appealing to those who want the pro-tection without the prick.

The new needleless device to de-liver the flu vaccine gained Food and Drug Administration approval in late August this year and should be widely available for use in next year’s flu sea-son, according to Adam Jaskowiak, director of the research department at Medical Center of the Rockies.

“Due to the timing of the flu season it isn’t widely available this year, but pro-duction is ramp-ing up for next year,” Jaskowiak said.

The device shoots a precise stream of the vaccine straight through the skin without the use of a needle, which Jaskowiak said is useful be-cause there aren’t any sharp objects to dispose of and people with aver-sions to needles might find the idea of a needle-free vaccine more appealing.

“It’s a round cylinder, about six inch-es long and an inch-and-a-half in di-ameter. On the end of it is a disposable syringe that holds the vaccine,” Jasko-wiak said. “There aren’t any sharps, just small holes. It makes a fine jet of

the vaccine that is able to pierce the skin and get to the depth it needs to. The syringe is ejected and a new tip is put on there for the next vaccine.”

Jaskowiak led a 1,250-person study on the efficacy of the new device be-tween October 2012 and January 2013 at University of Colorado Health’s northern Colorado locations. The study found the new device is at least as effective as traditional vaccines and found local site reactions, like inflam-

mation, to be comparable between the two methods.

“I think this kind of highlights that we’re trying to give patients access to the latest technological advancements to provide better care in the region,” Jaskowiak said. “This is one example of that.”

THE U.S. FOOD AND Drug Administration recently approved the first needle-free flu vaccine delivery system, the PharmaJet Stratis 0.5 mL Needle-Free Jet Injector, which delivers the vac-cine by means of a narrow fluid stream that pene-trates the skin in about one-tenth of a second.

FOR THRIVENC/PharmaJet


The state of our health care sys-tem depends, in part, on the state of our health care providers. But research over the last few years has shown that physician burn-out is on the rise.

Mark Linzer, director of the division of general internal med-icine at Hennepin County Med-ical Center in Minneapolis, has been studying physician burnout since 1996. Burnout, he says, is a long-term stress reaction that includes emotional exhaustion, a sense of depersonalization, and a lack of a sense of personal accom-plishment.

Linzer says burnout occurs in all medical specialties but is high-est in physicians who practice on the front lines of medicine. That includes those in emergen-cy medicine and primary care. “Burned-out doctors,” he says, “are more likely than other doc-tors to leave medicine.”

“When doctors become dis-couraged and leave medicine,” says Doris Gundersen, medical director of the Colorado Physi-cian Health Program, “the prob-lem of the current shortage of physicians is exacerbated.”

With 10,000 baby boomers turning 65 and becoming eligible for Medicare every day, and mil-lions of new patients becoming insured through the Affordable Care Act, access to doctors is be-coming increasingly difficult.

Every time a doctor leaves medicine, says Linzer, an inter-ruption in continuity of care is created, and a cost of $250,000 is incurred to replace that physi-cian.

Surveys by the AMA and the RAND Corp., the Mayo Clinic,

the University of Rochester Med-ical Center, and Stanford Uni-versity School of Medicine show that the hours and demands of the work, the requirements to interact regularly with insur-ance companies, the increase in clerical duties, inefficient elec-tronic medical records, a loss of a sense of autonomy, and difficulty maintaining a work-life balance all contribute to the problem. “Burnout,” says Linzer, “results primarily from challenges within the system.”

When asked in separate stud-ies by the Mayo Clinic and a RAND Corp./AMA collabora-tion what makes them satisfied in their work, physicians stressed the importance of a sense of autonomy that allows them to

make the best decisions for their patients. As pressure mounts to treat patients quickly, and over-sight by the government and insurance companies increases, these decisions can become com-promised.

Physician surveys show that doctors report frustration with the pressures of daily practice that make it difficult to estab-lish relationships with patients. Gundersen says doctors regular-ly spend hours dealing with in-surance companies trying to get treatment approval and dealing with insurance denials and ap-peals of claims.

The amount of documenta-tion required by insurers and government agencies takes up more staff time and requires too

much physician involvement to resolve complicated billing and recordkeeping issues. Meeting required rules and regulations interferes with the time physi-cians can spend with patients.

While doctors overwhelmingly say in these ongoing surveys that they appreciate the theoretical usefulness of electronic records, those in use haven’t been proper-ly streamlined. Current systems, says Russell Phillips, director of the Center for Primary Care at Harvard Medical School, are not well-designed for the field and interfere with the face-to-face doctor-patient experience. “Elec-tronic records are burdensome and have made physicians into data entry clerks,” Phillips says.

Surveys also find that physi-

cians cite respect by colleagues, patients and payers as being im-portant to them. But as practic-es get bigger and workloads get heavier, many are feeling isolated and report a lack of support by the doctors and administrators they work with.

Colin West, a general internist and a lead researcher of physi-cian well-being at the Mayo Clin-ic, says physician burnout is com-mon and growing. “It’s not the exception,” he says, “but the rule, and the stigma of being burned out has to be eliminated so that we can move forward and create strategies to deal with it.”

On the cutting edge of research into physician burnout, the Mayo Clinic has done surveys and stud-ies and is expected to come out with programs designed to pro-mote physician satisfaction and well-being.

“We need to focus on the entire health care system, because we are all in this together,” says West, adding that first and foremost physicians need to be reminded about the importance and value of what they do.

At the University of Roches-ter Medical Center, Drs. Michael Krasner and Ronald Epstein have been researching burnout for years. They believe the cure lies in healthy encounters and relationships between health care workers, colleagues and pa-tients. To engage effectively with patients, says Epstein, one has to be present and attentive, and with that in mind, workshops to promote mindfulness meditation and interpersonal communica-tion are offered and have been found to reduce stress, burnout and enhance physician resilience

RX FOR EXIT: RESEARCH SHOWS PHYSICIAN BURNOUT IS ON THE RISEBy Barbara SadickChicago Tribune

RESEARCH OVER THE LAST few years has shown that physician burnout is on the rise.

TRIBUNE NEWS SERVICE

Turn to Burnout on P.11


As we head into autumn, people with Medicare once again need to consider their options for next year. Even if you like the coverage you have now, you should spend at least a few minutes making sure it will still meet your needs next year. Here are some key questions that people with Medicare should ask.

WHEN IS THE ENROLLMENT PERIOD?Medicare’s open enrollment period runs, as

usual until Dec. 7. During this time, you can make changes in your Part D prescription drug plan or Medicare Advantage plan, or, if you don’t have one, you can select one for the first time.

HOW IS THIS DIFFERENT FROM THE OPEN ENROLLMENT PERIOD FOR THE HEALTH INSURANCE MARKETPLACES?

If you have Medicare, the health insurance marketplace is not for you. Medicare coverage and its open enrollment period are completely different from those of the health insurance marketplaces (which are also known as exchanges).

The health insurance marketplace offers cover-age and financial assistance for people who do not qualify for Medicare — usually, people under age 65 who do not have permanent disabilities. The marketplace open enrollment period starts and ends later than Medicare’s. But if you have friends or loved ones who need coverage and do not qualify for Medicare, encourage them to check out www.healthcare.gov.

WHAT ARE MY OPTIONS?During Medicare open enrollment, if you have a

Part D prescription drug plan or Medicare Advan-tage plan, you can change it. You can also join a Part D or Medicare Advantage plan for the first time.

If you currently have original Medicare and a supplemental plan (either a private Medigap plan or a plan with a former employer), be very careful before dropping your supplemental plan. You may not be able to get that plan back later.

HOW SHOULD I PREPARE FOR OPEN ENROLLMENT?

If you have a Part D or Medicare Advantage plan, find out how your plan will be changing for 2015. Your current plan should have mailed you an Annu-

al Notice of Change (ANOC) and/or an Evidence of Coverage (EOC) notice in September. These notices highlight any changes in the plan’s costs, benefits and rules for the upcoming year. Use these resourc-es to find out whether your plan will cover the same services, drugs, doctors, hospitals, and pharmacies. Are premiums changing? What about copayments?

Once you know what your current plan will cover next year, you can start making comparisons. To compare your current plan to other plans, go to www.medicare.gov/find-a-plan.

IF I LIKE MY CURRENT PLAN, DO I NEED TO DO ANYTHING?

Even if you like your current Part D or Medicare Advantage plan, it could still be changing next year. You should always check to see what your plan will be covering next year and make sure it still fits your needs.

WHAT IF SOMEONE TELLS ME I MUST BUY A PARTICULAR PLAN?

You should never believe any high-pressure sales pitch for a Medicare plan.

Private plans do sometimes decide to drop out of Medicare or change their coverage significantly. If this happens to your plan, take your time to learn about your options and make an informed choice.

You will never be left without coverage — you will always have the option of taking original Medicare.

HOW CAN I GET MORE INFORMATION?You can get a lot of information about your op-

tions on the Medicare website, www.medicare.gov, or by calling 1-800-MEDICARE.

But the best way to get personalized help is to get individual counseling from your local State Health Insurance Assistance Program (SHIP). Every state has a program, and they offer free, unbiased advice. You can call 1-800-MEDICARE and ask for a refer-ral, or go to www.medicare.gov and click on “Find someone to talk to.”

WHAT IF I NEED FINANCIAL HELP?If you have limited income and resources, addi-

tional financial help is available. For more informa-tion, go to the Social Security website www.ssa.gov/prescriptionhelp , or call 1-800-MEDICARE and ask for a referral to your local SHIP.

Ron Pollack is the executive director of Families USA.

MAKE SMART MEDICARE DECISIONS FOR 2015

By Ron PollackFamilies USA

and are now being taught all over the world.

The Stanford Committee on Professional Satisfaction and Support, co-chaired by Bryan Bohman, an internist and anesthesiologist, says physicians must learn how to take care of themselves. “Medicine,” he says, “used to revolve around the doctor, but that has changed, and now patients are better educated, more knowledgeable, and unafraid to ask questions.” At the same time, he adds, phy-sicians are being constantly evaluated, scrutinized and pressured.

To take on the battle and explosion of complexity, Stan-ford is addressing wellness, work-life balance, satisfaction and support across its entire medical culture. Stanford’s satisfaction and wellness pro-

grams are geared to medical students, house staff (interns, residents and fellows), and medical staff (attending phy-sicians) and are working at building adequate networks of support not just to prevent their physicians from burn-ing out, but also to promote a high level of professional ful-fillment.

Programs at Stanford in-clude student counseling and mentoring. For residents, a 24-hour hotline is available for mental health consulta-tion, and several departments have implemented their own wellness programs to help build resiliency. A resident

peer support program has been set up to help the house staff when bad patient out-comes or other critical nega-tive incidents occur.

“In each department,” says Bohman, “the chief resident will be trained to conduct one-on-one conversations to listen and guide their colleagues through the coping process and make suggestions on how residents should take care of themselves during stressful times.”

Other initiatives are also in place at Stanford, and re-search continues. Bohman says the medical center is hoping to build a center de-voted to physician wellness. “We are completely aware,” he says, “that one of the greatest obstacles to improving patient care is burnout by doctors who practice on the front lines of medicine.”

At Harvard’s Center for Pri-mary Care, another model is

at work. About 20 percent of primary care physicians in the university’s hospitals and clin-ics are now working in teams that include nurses, commu-nity health workers, social workers, pharmacists and other professionals who can lend support. Primary care physicians have found that this prevents the burden from falling to just one person, and Phillips says morale has bene-fited enormously.

As programs to maximize physician well-being are im-plemented, patients will also be able to feel more confident that they, too, are getting the best care available.

Burnout from P.10

“In each department, the chief resident will be trained to conduct one-on-one con-

versations to listen and guide their colleagues through the coping process and make sug-gestions on how residents should take care of themselves during stressful times.— BRYAN BOHMAN, internist and anesthesiologist


TRiBUNE MEDiCAL DiRECTORY 2014ACUPUNCTURE

PHYLLIS HAMAR, L.A.C.Master of Science, Traditional Chinese MedicineNCCAOM Board Certified710 11th Ave., Ste. 106Greeley, CO 80631970-539-0324

WESTLAKE FAMILY PHYSICIANS, PC5623 W. 19th StreetGreeley, CO Phone: (970) 353-9011Fax: (970) 353-9135Professionals: Richard Budensiek, DO; Janis McCall, MD; Frank Morgan, MD; Jacqueline Bearden, MD; Angela Mill, MDWebsite: www.bannerhealth.com

ALLERGY AND ASTHMA

COLORADO ALERGY & ASTHMA CENTERS, P.C.7251 W. 20th Street, Bldg N, Ste 1Greeley, CO 80634Phone: (970) 356-3907

1136 E. Stuart St, Bldg 3, Ste 3200Ft. Collins, CO 80525Phone: (970) 221-1681

4700 E. Bromley Ln., Ste 207Brighton, CO 80601Phone: (303) 654-1234www.coloradoallergy.comProfessionals: Dr. Daniel LaszloDr. John James

NORTHERN COLORADOALLERGY & ASTHMAGreeley Phone: (970) 330-5391Loveland Phone: (970) 663-0144Ft. Collins Phone: (970) 221-2370www.NCAAC.comProfessionals: Dr. Vel Kailasam, MDKrishna C. Murthy, MDLoran Clement, MDMichael Martucci, MD

ALZHEIMER’S/SKILLED CARE

BONELL GOOD SAMARITAN708 22nd StreetGreeley, CO 80631Phone: (970)352-6082Fax: (970)356-7970Web Site: www.good-sam.com

GRACE POINTE1919 68th Avenue Greeley, CO 80634Phone: (970) 304-1919www.gracepointegreeley.com

MEADOWVIEW OF GREELEY5300 29th StreetGreeley, CO 80634Phone: (970)353-6800Web Site: www.meadowviewofgreeley.com

ASSISTED LIVING

BONELL GOOD SAMARITAN708 22nd Street Greeley, CO 80631Phone: (970) 352-6082Fax: (970) 356-7970www.good-sam.com

COLUMBINE COMMONS1475 Main StreetWindsor, CO 80550Phone: (970) 449-5540Web Site: www.columbinehealth.com

GRACE POINTE1919 68th Avenue Greeley, CO 80634Phone: (970) 304-1919www.gracepointegreeley.com

MEADOWVIEW OF GREELEY5300 29th StreetGreeley, CO 80634Phone: (970)353-6800Web Site: www.meadowviewofgreeley.com

THE BRIDGE ASSISTED LIVING4750 25th StreetGreeley, CO 80634Phone: (970)339-0022

AUDIOLOGYALPINE ALL ABOUT HEARING1124 E. Elizabeth Street, #E-101Fort Collins, CO 80524Phone: (970)221-3372Fax: (970)493-92373820 N. Grant AvenueLoveland, CO 80538Phone: (970)461-0225Fax: (970)593-0670Web Site: www.allabouthearing.comProfessionals: Renita Boesiger, M. A., CCC-A Rachel White, M. A., CCC-ACheryl Hadlock, M. S., CCC-A

AUDIOLOGY ASSOCIATES2528 16th Street Greeley, CO Phone: (970)352-2881Professionals: Robert M. Traynor, Ed. D. F-AAA; Karen Swope, M. A. CCC-A

MIRACLE-EAR2404 17th Street Greeley, CO 80634Phone: (970)351-6620

749 S. Lemay Avenue, Suite A1Fort Collins, CO 80524(970)221-5225

UNC AUDIOLOGY CLINICGunter Hall, Room 0330Greeley, CO 80639Phone: (970)351-2012/TTYFax: (970)351-1601Web Site: www.unco.edu/NHS/asls/clinic.htmProfessionals: Diane Erdbruegger, Au.D., CCC-A;Erinn Jimmerson, M.A., CCC-AJennifer Weber, Au.D., CCC-A

BALANCE

LIFE CARE CENTER OF GREELEY- ASCENT4800 25th StreetGreeley, CO 80634Phone: (970)330-6400Professionals: Cozette Seaver, PT;Leslie Vail, PT

CARDIAC VASCULAR SURGERY

CARDIAC, THORACIC & VASCULAR SURGERY (NCMC)1800 15th Street, Suite 340Greeley, CO 80631Phone: (970)378-4593Fax: (970)378-4391Professionals: Lyons, Maurice I. Jr. DORichards, Kenneth M. MDTullis, Gene E. MD

CARDIOLOGY

CARDIOVASCULAR INSTITUTE (NCMC)1800 15th Street, #310Greeley, CO 80631Phone: (970) 392-0900Professionals: James H. Beckmann, MD;Harold L. Chapel, MD;John Drury, MD;Lin-Wang Dong, MD;Cynthia L. Gryboski, MD;Cecilia Hirsch, MD;Paul G. Hurst, MD;Brian Lyle, MD;Randall C. Marsh, MD;Arnold Pfahnl, MD; James E. Quillen, MD;Gary A. Rath, MD;Shane Rowan, MD;Ahmad Shihabi, MD;Stephen Zumbrun, MD

HEART FAILURE CLINIC (NCMC)(970) 350-6953Missy Jensen, FNP-C

DENTISTRYASCENT FAMILY DENTALScott Williams, DMD3535 W. 12th Street, Suite BGreeley, CO 80634Phone: (970)351-6095www.dentalgreeley.com

JULIE KAVANAUGH, D.D.S.3400 W. 16th Street, Suite 8-EGreeley, CO 80634Phone: (970)351-0400www.drjuliekav.com

RALPH R. REYNOLDS, D.M.D., M.D.Oral Surgery7251 W. 20th St.Building H, Suite 2Greeley, CO 80634(970) 663-6878www.reynoldsoralfacial.com

ENDOCRINOLOGY

ENDOCRINOLOGY CLINIC (NCMC)1801 15th Street, Ste 200Greeley, CO 80631Phone: (970)378-4676Fax: (970)-378-4315www.bannerhealth.comProfessionals: Nirmala Kumar, MDKimberly Rieniets, MDCorinn Sadler, MD

FAMILY PRACTICE MEDICINEBANNER HEALTH CLINIC1300 Main StreetWindsor, CO 80550Phone: 970-686-5646Fax: 970-686-5118Providers:Jonathan Kary, M.D.Trina Kessinger, M.D.Anthony Doft, M.D.

BANNER HEALTH CLINIC100 S. Cherry Ave., Suite 1Eaton, CO 80615Phone: (970)454-3838Professionals: Marianne Lyons, DOLance Barker, DO, Internal Medicine

BANNER HEALTH CLINIC222 Johnstown Center DriveJohnstown, CO 80534Phone: (970)587-4974Professionals:Cara Brown, MDJ.Matthew Brown, MDJoseph Gregory, MDCourtney Isley, MDStephen Kalt, MD, Internal MedicineThomas Kenigsberg, MD

FAMILY PHYSICIANS OF GREELEY,LLP-CENTRAL2520 W. 16th StreetGreeley, CO 80634(970) 356-2520Fax: (970) 356-6928Professionals: Joanna H. Branum, M.D.Angela M. Eussen, PA-CJennifer D. Dawson , D.O.Douglas A. Magnuson, M.D.Paul D. Lobitz, M.D.Lori A. Ripley, M.D.D.Craig Wilson, M.D.

FAMILY PHYSICIANS OF GREELEY,LLP-COTTONWOOD2420 W 16th StreetGreeley, CO 80634(970) 353-7668Fax:970-353-2801Professionals: Stacey L. Garber, M.D.Amy E. Mattox, M.D.Christopher T. Kennedy, M.D.Daniel P. Pflieger, M.D.Mark D. Young, M.D.

FAMILY PHYSICIANS OF GREELEY,LLP-WEST6801 W. 20th St., Suite 101Greeley, CO 80634(970) 378-8000Fax: (970) 378-8088Professionals: Nathan E. Bedosky, PA-CAnn T. Colgan, M.D.Daniel R. Clang, D.O.Tamara S. Clang, D.O.R. Scott Haskins, M.D.Mathew L. Martinez, M.D.Chima C. Nwizu, M.DMichelle K. Paczosa, D.O.Andrew P. Stoddard, M.D.Kyle B. Waugh, M.D.Charles I. Zucker, M.D.

KENNETH M. OLDS6801 W. 20th Street, Suite 208Greeley ,CO 80634Phone: (970)330-9061

WESTLAKE FAMILY PHYSICIANS, PC5623 W. 19th Street, Greeley, CO Phone: (970) 353-9011Fax: (970) 353-9135Professionals: Richard Budensiek, D.O.; Jacqueline Bearden, MD;Tong Jing, MD;Janis McCall, MD;Frank Morgan, MD;David Puls, D.O. www.bannerhealth.com


TRiBUNE MEDiCAL DiRECTORY 2010TRiBUNE MEDiCAL DiRECTORY 2014FUNERAL SERVICES

ALLNUTT & RESTHAVEN FUNERALSERVICES702 13th Street, Greeley, CO Phone: (970) 352-3366650 W. Drake Road, Ft. Collins, CO Phone: (970) 482-3208 8426 S. College Avenue, Ft. Collins, CO Phone: (970) 667-02022100 N. Lincoln, Loveland, CO Phone: (970) 667-11211302 Graves Avenue, Estes Park, CO Phone: (970) 586-3101

GASTROENTEROLOGY

DOWGIN, THOMAS A., MD.CENTERS FOR GASTROENTEROLOGY7251 W. 20th St., Bldg J, Greeley, CO Phone: (970)207-97733702 Timberline, Ft. Collins, CO Phone: (970)207-97732555 E. 13th Street, Suite 220, Loveland, CO Phone: (970)669-5432Website: www.digestive-health.net

NORTH COLORADO GASTROENTEROLOGY (NCMC)2010 16th Street, Ste. AGreeley, CO 80631Phone: (970)378-4475Fax: (970)378-4429Professionals:Tong Jing, MDMark Rosenblatt, MDAhmed M. Sherif, MDYazan Abu Qwaider, MD

HEALTH AND FITNESS

WORK OUT WESTHealth & Recreation Campus5701 W. 20th Street, Greeley, CO 80634Phone: 970-330-9691www.workoutwest.com

HOME HEALTH CARECARING HEARTS HOME HEALTHCARE6801 W. 20th Street, Suite 207Greeley, CO 80634Phone: (970)378-1409

BLOOM AT HOME1455 Main StreetWindsor, CO 80550Phone: (970) 460-9200Web Site: www.columbinehealth.com/bloom

COLUMBINE POUDRE HOME CARE1455 Main StreetWindsor, CO 80550Phone: (970) 460-9200Web Site: www.columbinehealth.com

REHABILITATION AND VISITING NURSE ASSOCIATION2105 Clubhouse DriveGreeley, CO 80634Phone: (970) 330-5655Fax: (970) 330-7146Web Site: www.rvna.infoProfessionals: Crystal Day, CEO

HOSPICE

HOSPICE OF NORTHERN COLORADOAdministration Office2726 W. 11th Street RoadGreeley, CO 80634Phone: (970)352-8487Fax: (970)475-0037

PATHWAYS HOSPICE305 Carpenter RoadFt. Collins, CO 80550Phone: (970)663-3500Fax: (970)292-1085 Web Site: www.pathways-care.orgEmail: [email protected]

INDEPENDENT ASSISTED LIVINGGRACE POINTE1919 68th Avenue Greeley, CO 80634Phone: (970) 304-1919Website: www.gracepointegreeley.com

MEADOWVIEW OF GREELEY5300 29th StreetGreeley, CO 80634Phone: (970)353-6800Website: www.meadowviewofgreeley.com

INDEPENDENT ASSISTED LIVING W/SERVICES

BONELL GOOD SAMARITAN708 22nd StreetGreeley, CO 80631Phone: (970)352-6082Fax: (970)356-7970Web Site: www.good-sam.com

FOX RUN SENIOR LIVING1720 60th AvenueGreeley, CO 80634Phone: (970)353-7773Fax: (970)330-9708Web Site: www.good-sam.com

INFECTIOUS DISEASE

BREEN, JOHN F., MD (NCMC)1801 16th StreetGreeley, CO 80631Phone: (970)350-6071Fax: (970)350-6702

INTERNAL MEDICINEBANNER HEALTH CLINIC2010 16th StreetGreeley, CO 80631Phone: (970)350-5660www.bannerhealth.com Professionals:Danielle Doro, MD Giovanna Garcia, MD

MEDICAL EQUIPMENT & SUPPLIESBANNER HOME MEDICAL EQUIPMENT (NCMC)Phone: (970)506-6420

COLUMBINE MEDICAL EQUIPMENT1455 Main StreetWindsor, CO 80550(970) 460-9205Web Site: www.columbinehealth.com

MENTAL HEALTH SERVICES

NCMC - BEHAVIORAL HEALTHDr Patricia Al-Adsani, Child and Adolescent PsychiatryBanner Health Clinic-Internal Medicine2010 16th Street, Suite C, Greeley, CO 80631Banner Health Clinic- Windsor1300 Main Street, Windsor, CO 80550

Shawn Crawford, LPCBanner Health Clinic 222 Johnstown Center Dr., Johnstown, CO 80534Banner Health Clinic-Internal Medicine2010 16th Street, Suite CGreeley, CO 80631

Stephanie Carroll, LCSW, CACIIIBanner Health Clinic1300 Main Street, Windsor, CO 80550Banner Health Clinic Fossil Creek303 Colland DrFort Collins, CO 80525

Elise Pugh, LPCBanner Health Clinic Westlake 5623 W 19th St, Greeley CO 80631Banner Health Clinic1300 Main StreetWindsor, CO 80550

Susan Goodrich, LCSW Banner Health Clinic-Loveland PediatricsLoveland Pediatrics, Loveland COBanner Health Clinic- Windsor1300 Main Street Windsor CO, 80550

Renee Rogers, LMFTBanner Health Clinic1300 Main Street, Windsor, CO 80550Banner Health Clinic303 Colland Drive, Fossil CreekFort Collins, CO 80525

NEPHROLOGYGREELEY MEDICAL CLINIC1900 16th Street, Greeley, CO 80631Phone: (970) 350-2438Professionals: Donal Rademacher, MD

NEUROLOGY

CENTENNIAL NEUROLOGYDr. David Ewing7251 W. 20th Street, Unit CGreeley, CO 80634Phone: (970) 356-3876

NEUROLOGY CLINIC (NCMC)1800 15th Street, Suite 100BGreeley, CO 80631Phone: (970) 350-5612 Fax: (970) 350-5619Professionals: Barbara Hager, MDTodd Hayes, DOWilliam Shaffer, MDChristy Young, MD


TRiBUNE MEDiCAL DiRECTORY 2014NEURO-SURGERY BRAIN & SPINE

BANNER HEALTH NEUROSURGERY CLINIC1800 15th St., Suite 130Greeley, CO 80631Phone: (970)350-5996Professionals:David Blatt, MDBeth Gibbons, MD

NURSING HOME REHABILITATIONCENTENNIAL HEALTH CARE CENTER1637 29th Ave. PlaceGreeley, CO 80634Phone: (970) 356-8181Fax: (970) 356-3278

COLUMBINE COMMONS HEALTH & REHAB FACILITY1475 Main StreetWindsor, CO 80550Phone: (970) 449-5541Web Site: www.columbinehealth.com

OBSTETRICS & GYNECOLOGYBANNER HEALTH GYN CONSULTANTS1800 15th St., Suite 130Greeley, CO 80631Phone: (970)353-1335Professionals:Susan Carter, MD

BANNER HEALTH OB/GYN CLINIC2410 W. 16th StreetGreeley, CO 80634Phone: (970)352-6353Professionals:Neil Allen, MDLaurie Berdahl, MD

WESTLAKE FAMILY PHYSICIANS, PC5623 W. 19th StreetGreeley, CO Phone: (970) 353-9011Fax: (970) 353-9135Professionals: Jacqueline Bearden, MD; Richard Budensiek, D.O.; Janis McCall, MD;Frank Morgan, MD;David Pols, D.O. www.bannerhealth.com

ONCOLOGY & HEMATOLOGY

CANCER INSTITUTE (NCMC)1800 15th Street,Greeley, CO 80631 Phone: (970) 350-6680Toll Free (866) 357-9276Fax: (970)350-6610Professionals: Jeffrey Albert, MDElizabeth Ceilley, MDBrian Fuller, MDBenjamin George, MDSamuel Shelanski, MDKerry Williams-Wuch, MDAlice Wood, MDAriel Soriano, MD

ORTHODONTICS

ORTHODONTIC ASSOCIATES OF GREELEY, PCProfessionals: Bradford N. Edgren, DDS, MS3400 W. 16thSt., Bldg 4-VGreeley, CO 80634Phone: (970) 356-5900Website: www.drbradsmiles.com

ORTHOPEDICS

MOUNTAIN VISTA ORTHOPAEDICS 5890 W. 13th Street, Suite 101Greeley, COPhone: (970)348-0020Fax: (970)348-0044Web Site: www.bannerhealth.comProfessionals: Randy M. Bussey, MDRiley Hale, MDDaniel Heaston, MDThomas Pazik, MDKelly R. Sanderford, MDSteven Sides, MDLinda Young, MD

PEDIATRICSBANNER HEALTH CLINIC6801 W. 20th Street, Suite 201Greeley, CO 80634Phone: (970)350-5828www.bannerhealth.com Professionals: Amanda Harding, MDJames Sando, MD

PEDIATRIC REHABILITATIONBANNER REHABILITATION CENTER1801 16th Street, Greeley, COPhone: (970)350-6160Fax: (970)378-3858

PERSONAL RESPONSE SERVICE

BANNER LIFE LINE (NCMC)2010 16th Street, Suite C, Greeley, CO 80631Phone: 1-877-493-8109(970) 378-4743

PHYSICAL THERAPY

FRONT RANGE THERAPY1475 Main Street, Windsor, CO 80550Phone: (970) 492-6238Web Site: www.columbinehealth.com

HOPE THERAPY CENTER(Formerly North Colorado Therapy Center)2780 28th Avenue, Greeley, CO 80634Phone: (970)339-0011Website: www.GCIinc.orgProfessionals: Jeanne Rabe, PT;Jennifer Branson, PTKryste Haas, OT; Molly Wuethrich, PTAMoni Kohlhoff, PT

NORTHERN COLORADOREHABILITATION HOSPITAL 4401 Union Street, Johnstown, CO 80534Phone: (970) 619-3400Website: [email protected]

PULMONARY/CRITICAL CARENORTH COLORADOPULMONARY (NCMC)1801 16th Street, Greeley, CO 80631Phone: (970)392-2026Professionals: Kelli Janata, DORobert Janata, DODavid Fitzgerlad, DOMichael Shedd, MDDanielle Dial, NP

PROSTHETICS & ORTHOTICS

CERTIFIED PROSTHETICS &ORTHOTICS, LLC (GREELEY LOCATION)1620 25th Avenue, Suite A, Greeley, CO 80634Phone: 970-356-2123Fax: 970-352-4943

HANGER PROSTHETICS & ORTHOTICS7251 West 20th Street, Building M, Greeley, CO 80634 Phone: (970)330-9449 Fax: (970)330-42172500 Rocky Mountain Avenue, Suite 2100North Medical Office Building, Loveland CO 80538 Phone: (970) 619-6585 Fax (970) 619-6591Website: www.hanger.comProfessinal: Ben Struzenberg, CPOMichelle West, Mastectomy Fitter

REHABILITATION

ASCENT AT LIFE CARE CENTER 4800 25th Street, Greeley, CO 80634Phone: (970)330-6400Website: www.lcca.comProfessionals: Annie BennettLeslie Vail

BANNER REHABILITATIONPhone: (970)350-6160

COLUMBINE COMMONSHEALTH & REHAB FACILITY 1475 Main StreetWindsor, CO 80550Phone: (970) 449-5541Web Site: www.columbinehealth.com

FRONT RANGE THERAPY1475 Main Street, Windsor, CO 80550Phone: (970) 492-6238Web Site: www.columbinehealth.com


PEAKVIEW MEDICAL CENTER5881 W. 16th St., Greeley, CO 80634Phone: (970)313-2775Fax: (970)313-2777

RESPITE/ADULT DAY CARE

ELDERGARDEN ADULT DAY CARE 910 27th AvenueGreeley, CO 80634970-353-5003Website: www.eldergarden.orgSliding scale fee or no fee forMedicaid Enrollment process required

SKILLED CARE/REHAB

BONELL GOOD SAMARITAN708 22nd Street, Greeley, CO 80631Phone: (970)352- 6082Fax: (970)356-7970Website: www.good-sam.com

COLUMBINE COMMONS HEALTH & REHAB FACILITY1475 Main StreetWindsor, CO 80550Phone: (970) 449-5541Web Site: www.columbinehealth.com

GRACE POINTE1919 68th Avenue, Greeley, CO 80634Phone: (970) 304-1919Website: www.gracepointegreeley.com

SPORTS MEDICINE

MOUNTAIN VISTA ORTHOPAEDICS 5890 W. 13th Street, Suite 101, Greeley, COPhone: (970)348-0020Fax: (970)348-0044Web Site: www.bannerhealth.comProfessionals: Randy M. Bussey, MDRiley Hale, MDDaniel Heaston, MDThomas Pazik, MDKelly R. Sanderford, MDSteven Sides, MDLinda Young, MD

NORTH COLORADO SPORTS MEDICINE1801 16th Street, Greeley, COPhone: (970)392-2496

SPEECH LANGUAGE PATHOLOGY

BANNER REHABILITATION CENTER1801 16th Street, Greeley, COPhone: (970)350-6160Fax: (970)378-3858


UNC SPEECH LANGUAGE PATHOLOGY CLINICGunter Hall, Room 0330, Greeley, CO 80639Phone: (970)351-2012/TTYFax: (970)351-1601Web Site: www.unco.edu/NHS/asls/clinic.htmProfessionals: Lynne Jackowiak, M.S., CCC-SLPJulie Hanks, Ed.DPatty Walton, M.A., CCC-SLP


For obvious reasons, people around here think “oil and gas” when you say the word “pipe-line.” When we use that word at Centennial Area Health Education Center, on the other hand, we’re referring to a major strategy for recruiting a host of different health professionals so desperately needed to serve the citizens of so many of the towns in our northeast Colora-do service area.

There do not exist good detailed data documenting the exact extent of health professional shortages. We do know that all but one of the 10 counties in the CAHEC region are officially designated by the feds as medically underserved areas. I’ll bet you can’t guess which one isn’t. It’s Kit Carson County, way out there on the border with Kansas.

According to Kindra Mulch,

Kit Carson County director of health and human services and fellow member of the CAHEC board, the 8,000 residents of the county where she lives and works could use the services of three more laboratory technicians, three radiology technicians, one physical therapist, two physical therapy aids, an occupa-tional therapist and a speech therapist, as well as three more mental health workers, five nurses, a dietician and a pharmacist. I put a lot more faith in Mulch’s intimate knowledge of her community than I do in any statistics col-lected statewide or nationwide.

The best way to address the lack of health professionals,

especially in rural areas, is to grow your own. I grew up in Chicago. I’m the rare exception, an urbanite who has made the prairie and its small towns my home. In general, rural practices that are not located in a resort area are pretty unlikely to attract and hold the ur-ban-raised folks who make up most of the health workforce.

Small towns sometimes do pretty well at getting nurses. Everybody knows what nurses do and there are plenty of op-portunities to do some of nurse training from home, online. A lot more rural folk would probably choose other really cool professions, like speech therapist, laboratory techni-cian, or physical therapy aide, if they only knew about them.

That’s where CAHEC comes in. We have put on programs for primary school children.

“Body Shops,” which feature presentations to junior high school kids by various health professionals, have been quite popular. High school students have attended weeklong sum-mer heath career institutes at the Anschutz Health Sciences Campus in Aurora, hosted by the Area Health Education Pro-grams. We’ve held health career fairs at high schools, as well as at University of Northern Colorado and at Front Range Community College. Next sum-mer we’re hoping to expand the career fairs to include more health professions, presented at more sites. CAHEC has provid-ed one-on-one counseling and coaching to students, helping them to choose health career paths and then to complete their school applications.

Our goal is to get kids started along the health career path

as early as possible. It’s some-times a pretty long pipeline that needs filling. For example, it takes 11 years of post-high school education to become plain vanilla family doctor.

Once students do enroll in health professional school, CA-HEC shifts into a higher gear, coordinating training rotations in our service area, including providing housing. Tune in next month to hear more about what we’re doing to support and develop health professional training in northern Colorado one step closer to the end of the pipeline, where the refined “product” is finally delivered directly to the neighborhood service station.

Dr. Marc Rangel is a member of the Centennial Area Health

Education Center board of directors.

Education, opportunity help fill rural health ‘pipeline’

Marc RANGEL

CAHEC

TRiBUNE MEDiCAL DiRECTORY 2014SURGERY GENERAL & TRAUMA BARIATRIC SURGERY (NCMC)

1800 15th Street, Suite 200, Greeley, CO 80631Phone: (970)378-4433866-569-5926Fax: (970)378-4440Professionals: Michael W. Johnell, MD

SURGERY WESTERN STATES BURN CENTER (NCMC)1801 16th Street, Greeley, CO 80631Phone: (970)350-6607Fax: (970)350-6306Professionals: Gail Cockrell, MD Cleon W. Goodwin, MD BURN

SURGICAL ASSOCIATES OFGREELEY PC (NCMC)1800 15th St. Suite 210, Greeley, CO Phone: (970)352-8216Toll Free: 1-888-842-4141Professionals: Molly Decker, DO;Michael Harkabus, MD; Jason Ogren, MD;Samuel Saltz, DO; Robert Vickerman, MD

URGENT CARESUMMITVIEW URGENT CARE2001 70th Avenue, Greeley, CO 80634Phone: (970)378-4155Fax: (970)378-4151www.bannerhealth.comProfessionals: Susan Beck, MDThomas Harms, MDSusan Kelly, MDAmy E. Shenkenberg, MDLinda Young, MD

UROLOGY

MOUNTAIN VISTA UROLOGY5890 W. 13th Street, Suite 106, Greeley, CO 80634Phone: (970)378-1000Professionals:Curtis Crylen, MDDavid Ritsema, MDJames Wolach, MDwww.bannerhealth.com

VEINS

VEIN CLINIC (NCMC)1800 15th Street, Suite 340, Greeley, CO 80631Phone: (970)378-4593Fax: (970)378-4591Professionals:Maurice I. Lyons Jr., DOKenneth M. Richards, MDGene E. Tullis, MD


Did Meniere’s Disease Effect the Protestant Reformation?Martin Luther is best known as the Father of Protestantism, as he was the first to famously break away from the Catholic Church. A simple German monk of peasant background, Luther had as much influence in shaping our modern world as almost anyone who has ever lived. He was a puzzling, yet determined man of extraordinary conviction, determination, and boldness. Few people in history have produced as many interesting

stories, both positive and negative, as Martin Luther. He lived to see his teachings put in place by many and inspired Lutheranism, the first of the numerous Protestant faiths that exist today. He was, however, known to be volatile and, espe-cially later in life, a bit irrational. Could that erratic behavior have been the result of endolyphatic hy-drops or Meniere’s disease? Young MartinMartin Luther, born in 1483, was the eldest son of Hans and Marga-rethe Luder (later changed to Lu-ther) of Eisleben (now Germany). A difficult childhood left a perma-nent mark on young Martin. Hans was ambitious for himself and his family, determined to see Martin, his eldest son, become a lawyer. He sent young Martin to Latin schools in Mansfield, and then in 1497 to Magdeburg, a school op-erated by a lay group called the Brethren of the Common Life, and later in Eisenach in 1498. These were difficult years for him and he began to devote himself to reli-gious activities. After nearly dying in a frightening thunderstorm, he resolved to align his life more with God’s teachings. To that end, he

abandoned his college education and gave up his plans to study Law and at age 24 he entered the mon-astery of the Augustine friars, and was ordained into the priesthood in 1507.

The ReformationWhile profoundly Catholic, he strongly disagreed with several practices of the early Church, such as immoral behavior, poor educa-tion of clerics, and the absence of

Bishops from their assigned par-ishes. His anger at the Church of his time would lead eventually to the Protestant Reformation. Be-tween 1520 and 1530, Luther de-veloped the basic tenets of his new faith. His beliefs rested on four ma-jor articles, which differed greatly from the teachings of the Catholic Church. His major assertions were:• Man is saved by faith alone

(“sola fide”).• The Bible is the sole source of

authority in the church (“sola scriptura”).

• The church consists of the entire community of Christian leaders.

• All vocations have equal merit, and every person should serve God according to his individual calling.

Luther was responsible for bring-ing about both chaos and commu-nity to the masses, as he was the first to openly challenge the Cath-olic Church.

Luther’s Meniere’s DiseaseThroughout his life, Luther suffered from severe constipation, and it is a recorded fact that he received his greatest enlightenment--that it is man’s faith and not his achieve-ments that guarantee his salva-tion--while he was sitting on the toilet. His various diseases are well documented as he discussed them freely in his letters, and a

wealth of evidence exists through reports by his friends. Most of his diseases were common and well known to 16th century physicians, who interpreted them correctly as bladder stones, chronic constipa-tion, and hemorrhoids. The first of his Meniere’s attacks is documented to have occurred on July 6, 1527, when Luther was 43 years of age. It began with a roar-ing tinnitus in his left ear, which in-creased dramatically and seemed to occupy the left half of his head. A state of sickness and collapse fol-lowed, but he retained, conscious-ness throughout the whole period. After a night’s rest all his symp-toms subsided, except the tinnitus, which continued for the rest of his life with varying intensity. Similar attacks, with an increase of the

tinnitus and vertigo as the lead-ing symptoms, seized Luther at irregular intervals and distressed him extremely. According to one study his was a typical case of Menière’s disease of the left ear manifesting itself more than 330 years before Proper Menière’s classical observation. Luther felt that the devil would whistle and roar in his ears and squeeze his heart; sometimes the spin was so fast in his head that Luther would fall out of his chair. He regarded his severe tinnitus as a Satanic infliction and wrote: “When I try to work, my head becomes filled with all sorts of whizzing, buzzing, thundering noises.” The condition became so severe that he hired a body guard to prevent him from physically hurting anyone during very painful bouts of tinnitus.

Modern physicians have speculat-ed that Luther was suffering from Meniere’s disease, which attacks the inner ear, causing serious equi-librium problems. Some feel that his Meniere’s and hallucinations were a result of syphilis, which was rampant in Europe at the time. Whatever the source of the difficulties, Martin Luther in 1529 was not the same Martin Luther of 1519 and earlier. His diseases were taking a toll on his demeanor, writ-ings and speeches. In particular,

while earlier in his life, Martin Lu-ther defended the Jews as “God’s people whom the Lord will redeem in time”, by 1529, he wrote awful things about the Jews of his day. He might have been less volatile if there had been treatment for his tinnitus. In 1541, he became deaf, after experiencing bad ear aches and a discharge from his ears. It is difficult to believe that these dis-eases, particularly the Meniere’s disease did not affect his later writ-ings. He suffered from extremely high blood pressure, which led to angina pectoris, a heart disease causing spasms of pain in the chest. His diseased heart finally failed, and he lost consciousness and died with his friends shouting questions into his deaf ears. They wanted to know whether his faith in Christ remained steadfast as he approached the end. His last word, spoken to those questioning his faith, was yes. It was February 18, 1546 and the reformation was well on its way.

Miller, a co-researcher at Michigan, that the noise-induced hearing loss prevention concoction could be available within two years.

In another study funded by the Oklahoma Medical Research Foundation,researchers Dr. Robert Floyd and retired Army surgeon, Dr. Richard Kopke, M.D., discovered a combination of two compounds stopped damage to the inner ear caused by acute acoustic trauma – something like an IED exploding. Although they did not indicate what the compounds were they felt that,“This is a very exciting finding,” said Dr. Floyd, who holds the Merrick Foundation Chair in Aging Research at OMRF. “The research is still at a pre-clinical stage, but we’re hopeful that we soon can begin testing in humans.

More recently, Dr. Kathryn Campbell's work at Southern Illinois University involves the use of an antioxidant called D-methionine, a component of fermented protein

that is found in yogurt and cheese. The antioxidant, in concentrated doses, has been found to improve some forms of hearing loss and even prevent hearing loss before the exposure to noise. "We've been able to show in animal studies that if we give it before and after noise exposure, that we can get pretty full protection from noise-induced hearing loss," Campbell said. According to Campbell and her colleagues will continue their studies by looking at the effects of varying dosages of D-methionine on animal subjects exposed to different noises. They have already found that the drug can be given up to seven hours after the noise is experienced and still be effective. "It doesn't mean it's going to work for long-standing hearing loss, but it does mean that in the early stages, you could intervene and keep it from becoming permanent," she said. The research will then move into determining if even more time can elapse before the drug is given and the hearing loss becomes permanent. In a discussion in November 2012 Dr. Campbell stated that the human clinical trials with the U.S. Army are in the early planning stages, Campbell said.

So, with AuraQuell in field tests to defend against noise-induced hearing loss, the D-methionine possibilities also in clinical trial, and the ongoing stem cell research reported by Hearing International (www.hearinghealthmatters.org) last fall, a "morning after" pill for that tinnitus and noise induced hearing loss created the night before may soon be a simple swallow away.

Robert M. Traynor is the CEO and practicing audiologist at Audiology Associates, Inc., Greeley, Colorado with particular emphasis in amplification and operative monitoring. Dr. Traynor holds degrees from the University of Northern Colorado (BA, 1972, MA 1973, Ed.D., 1975), the University of Phoenix (MBA, 2006) as well as Post-Doctoral Study at Northwestern University (1984). He taught Audiology at the University of Northern Colorado (1973-1982), University of Arkansas for Medical Sciences (1976-77) and Colorado State University (1982-1993). Dr. Traynor is a retired Lt. Colonel from the US Army Reserve, Medical Service Corps and currently serves as an Adjunct Professor of Audiology at the University of Florida, the University of Colorado, and the University of Northern Colorado. For 17 years he was an Audiology Consultant to major hearing instrument and equipment manufacturers providing academic and product orientation for their domestic and international distributors. A clinician and practice manager for over 35 years, Dr. Traynor has lectured on most aspects of Audiology in over forty countries.

Author’s Bio:Robert M. Traynor,

Ed.D., MBA, FAAA

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They wanted to know whether his faith in Christ remained steadfast as he approached the end. His last word, spoken to those questioning his faith, was yes. It was February 18, 1546 and the reformation was well on its way.

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They wanted to know whether his faith in Christ remained steadfast as he approached the end. His last word, spoken to those questioning his faith, was yes. It was February 18, 1546 and the reformation was well on its way.

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November 2014 Thrive