2009-07 northern colorado medical & wellness magazine and pvhs physician directory

MEDICAL WELLNESS&F O R T C O L L I N S

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THE WAY IN CREATING A VIBRANT, WORLD-CLASS

COMMUNITY."

PVHS is at the heart of Fort Collins: taking care of us and inspiring us to engage in the great, healthy lifestyle opportunities at our doorstep.

Whenever I have the privilege to represent what's great about Fort Collins, I'm proud to tell the story of PVHS . The Baldrige Award just shows the nation what we've known all along .

Congratulations, friends.

POUDRE VALLEY HEALTH SYSTEM

pvhs.org

Darin Atteberry Fort Collins City Manager

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3Fort Collins Medical Magazine & Directories 2009 2010

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5Sabrina was treated to all-around great care when having her baby at McKee Medical Center. She received personal

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the experience of the new baby together in a spacious and relaxing labor, delivery, recovery and postpartum room.

McKee Medical Center provides a private, feel-good atmosphere where you can welcome your baby into the world.

McKee Medical Center. Remarkable health care inspired by you.

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accounting Manager Karla Vigiloffice assistant Ronda Huser

contributing WritersLaura Lee Carter, Allie Comeau, Lynn M. Dean,

Connie Hein, Erica Pauly, Corey Radman, Kay Rios

PhotograPher Warren Diggles

contributing PhotograPhersAbby Bloedorn, Lydia Dody

affiliationsFort Collins Area Chamber of Commerce

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2009 style MagazinesJanuary-Loveland/Greeley Medical & Wellness

Magazine and DirectoryFebruary-Building & Remodeling

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April/May Northern Colorado Business & BuildingMay/June-Northern Colorado Medical & Wellness

June/July-Business & Building July/August-Fort Collins Medical & Wellness

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It is with special pride and a great deal of en-thusiasm that we publish our 11th annual Fort Collins Medical & Wellness Magazine and Direc-tories in collaboration with Poudre Valley Health System (PVHS).

This issue gives us the opportunity to revisit the exceptional management of PVHS, and this year has truly been an outstanding one. Rulon Stacey, President and CEO, and his management team have always been committed to providing world-class healthcare to our region. Naturally, this cannot be accomplished without the com-mitment of engaged employees who share the values, vision, and mission of PVHS.

One goal set by the team has now been achieved. After a 10-year pursuit, the System has been awarded the Malcolm Baldrige National Quality Award, the highest Presidential honor given to United States businesses and organiza-tions for performance excellence. This award is bestowed by the National Institute of Standards and Technology to recognize manufacturing, small business, service, educational, and health-care organizations that meet rigorous criteria and demonstrate excellence.

The award examined leadership, strategic planning, customer service, workforce develop-ment, knowledge and process management, and clinical regulatory and financial results. President Obama will present the prestigious award to PVHS leaders and staff members in Washington, D.C., in 2009. Congratulations to all 4,000 em-ployees who made this award possible!

Publisher’s Letter

Providing WorLd- CLass HeaLtHCare

Stacey’s leadership and employee commit-ment has brought more accolades to the System: PVH was presented with the American Nurses As-sociation’s highest award for excellence in nurs-ing and, in 2009, it again received the Magnet Award for Nursing Excellence by the American Nurses Credentialing Center. In addition, PVHS was named as one of the 100 Best Places to Work in healthcare by Modern Healthcare and Thomson Reuters has voted PVHS one of the Top 100 Hos-pitals for five consecutive years.

These many awards again point to how for-tunate we are to have the exceptional healthcare provided by the physicians and healthcare profes-sionals in our area. One such service is the PVH Cleft Clinic, which provides world-class cleft lip and palate reconstruction. Read about plastic surgeons, Dr. Mark Boustred and Dr. Christopher Tsoi, and their team’s sensitive approach to early assistance in this important corrective intervention for young children.

Each year 700,000 people suffer a stroke and stroke is the leading cause of serious disability. Read “Stroke Prevention, Treatment, and Recov-ery” to learn from Dr. Gerald McIntosh, neu-rologist, and Dr. Chad Stoltz, cardiologist, about strokes and the award-winning care PVH provides to stroke victims.

Keeping families together is the goal of the Poudre Valley Hospital and Medical Center of the Rockies birthing centers. Enjoy reading about the exceptional “Teamwork in the Nursery” and how the PVH NICU Level IIIA nursery team works with families and partners with the newly-remodeled nursery at MCR on a case-by-case basis.

The goal of this publication is to inform you of new technologies, new methods of diagnosis, and the latest in treatment modalities. Our desire is to inform you about medical facilities, services, protocols, introduce you to exceptional physicians and healthcare providers, and emphasize the im-portance of prevention.

Enjoy reading about “The Surgery Centers of Northern Colorado” and how they ease the trau-ma of surgery. Learn about “The PVHS Network” of neighborhood clinics providing more options for your family’s healthcare. Be introduced to “Virtual Colonoscopy - A Screening Alternative,” a non-invasive diagnostic procedure.

In the Wellness section of this issue, become informed with “Alcohol’s Impact on Your Health,” be introduced to pain management through “The Rossiter Approach,” and learn the importance of good sunglasses to protect eyes in “Sunshine’s Dark Side.”

This Fort Collins Medical & Wellness issue is full of useful and interesting information. It also includes an easy-to-use Physician’s Directory di-vided by specialty and physician name. My hope is that this issue will support you in taking care of yourself and your loved ones. May you enjoy this issue and keep it as a resource guide to help manage and maintain your health throughout the year.

Wishing each of you good health,

[email protected]

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t a b l e o f c o n t e n t sV O L U M E X I

Wellness Magazine & Directory

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Style Magazine offers these editorials for your general knowledge and not as a subsititue for medical advice or treatment. If you have any questions or concerns about your health, please contact your doctor or healthcare provider.

Medical Magazine & Directory 8 Publisher’s Letter12 Introduction Letter

Rulon F. Stacey, Ph.D., President and CEO, Poudre Valley Health System

16 Bringing Home Baldrige24 PVHS Looks to the Future

28 Stroke Prevention, Treatment, and Recovery

13 Introduction LetterStu VanMeveren, Chairperson, Board of Directors, Poudre Valley Health System

30 Move with the Music:Neurologic Music Therapy

31 New Ways to Learn

39 Introduction LetterDr. William A. Neff, Chief Medical Officer, PoudreValley Health System

35 Physician Directory

55 The Surgery Centers of Northern Colorado

32 PVH Cleft Clinic - World-Class Cleft Lip and Palate Reconstruction

74 Kettlebells - Total Body Workout

76 Alcohol’s Impact on Your Health

80 The Rossiter Approach

84 Sunshine’s Dark Side

86 Accurate Medical Records Save Lives

66 Front Range Pain Medicine Expands62 Teamwork in the Nursery

91 The PVHS Network - More Options for Your Family’s Care

94 Virtual Colonoscopy - A Screening Alternative

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88 Wellness Directory

We take your health to heart.

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Paul G. Hurst, MD Maurice Lyons, Jr., DO Randy Marsh , MD Arnold Pfahnl , MD Gary A. Rath, MD

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North Colorado Medical Center Greeley Information: 970-350-6162 BannerHealth .com, keyword: CVI

Dear MeDical & Wellness Magazine reaDer:Poudre Valley Health System has continued to grow to meet the needs of the 900,000 people

we serve in northern Colorado, southern Wyoming and southwestern Nebraska, a geographic area similar in square mileage to the state of Florida.

During the last two years, our growth has included: purchasing Loveland Urgent Care, which offers urgent care, family medicine and occupational health; opening Foxtrail Family Medicine, Loveland, owned by PVHS and managed by the Associates in Family Medicine; purchasing a family practice clinic in Milliken, owned by PVHS and managed by the Greeley Medical Clinic; completing a second medical office building for physician groups that want to be located next to the Medical Center of the Rockies, Loveland; constructing the Redstone Building on the PVHS Harmony Campus, Fort Collins, now occupied by physician offices and the PVHS corporate offices; completing the Westbridge Medical Suites building on the Poudre Valley Hospital campus, Fort Collins, with occupants including the Women’s Clinic of Northern Colorado, Associates in Family Medicine, PVH’s administrative offices, and Twenty Three Trees, the region’s highest quality medical and wellness spa; opening a four-story employee parking garage at PVH so more ground-level parking is available for patients and visitors who want to park near the hospital’s entrance; and a significant upgrade of PVH to enhance patient care areas.

Our expansion activities have been carefully planned with the strategic goal of offering easily accessible world-class services to our patients. Establishing clinics throughout the region, for example, is an important step in providing this easy access.

In addition, PVHS has entered into joint ventures with a variety of physician groups over the last decade. This allows the health system and private physicians to work more closely together to meet patient needs.

Much of what we have accomplished over the last decade can be traced back to our quest to achieve world-class excellence by following management and operational principles recommended by the National Institute of Standards and Technology through its Malcolm Baldrige program. The Baldrige method encourages companies to improve work processes and efforts in customer service, financial performance, employee and vendor relations, and, in the case of healthcare providers, medical quality.

PVHS first applied for the prestigious annual Malcolm Baldrige National Quality Award in 1999. Established by Congress, the Baldrige Award is the nation’s highest honor that recognizes private businesses, governmental agencies and healthcare organizations for achieving sustainable performance excellence.

We continued to apply for the award annually, not with the sole goal of winning, but with the overriding mission of improving the way we take care of patients and conduct the business of health care. Our journey along the Baldrige path helped the health system evaluate, refine, reorganize, and enhance our work processes.

In late 2008, we were notified that PVHS was one of only three organizations and the only healthcare organization to win the coveted award for that year.

The award is a tremendous validation that PVHS provides high-quality services that rival the best healthcare organizations in the world. Of the more than 50 national awards and honors that PVHS has received since 2004 for clinical quality and business operations, the Baldrige award is at the very top of the list for its national prominence.

As you may already know, healthcare reform will have a huge impact on the nation’s medical industry. Thanks to our Baldrige journey, PVHS is in many ways better prepared for reform than most other healthcare organization. The self-evaluation and knowledge we gained through our Baldrige journey helped us improve work processes, establish a health records network for PVHS and local physicians, and, among other many benefits, focus our emphasis on maintaining world-class care.

I would like to suggest that you read the letter on healthcare reform written by Stu VanMeveren, chairperson of the PVHS board of directors, and published in this magazine. His letter will give you more insight into the way PVHS approaches healthcare reform.

Finally, as you make your journey through the next year and beyond, please remember that Poudre Valley Health System is here for you.

Rulon F. Stacey, Ph.D., FACHEPresident/Chief Executive OfficerPoudre Valley Health System

rulon F. stacey, Ph.D., FachePresident/Chief Executive OfficerPoudre Valley Health System

P O U D R E VA L L E Y H E A LT H S Y S T E M

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Dear MeDical & Wellness Magazine reaDer:You can’t turn on your television or radio today without hearing about healthcare reform. Although

we are the richest nation in the world, we are by far not the healthiest. A high percentage of our citizens are unhealthy because they are overweight or obese. Cancer, heart disease, diabetes, and other ailments plague our population at high rates.

More than 40 percent of our population is under insured or uninsured. At times our emergency rooms are jammed. Many go without healthcare, exacerbating their health problems. As a nation, we’ve talked for decades about healthcare reform. Now it is becoming quite evident that healthcare reform in one form or another is on its way. It remains to be seen what the cost will be and how it will be paid for. We are all concerned about the impact it will have on our economy, the national debt, and the overall availability and quality of our healthcare.

My volunteer work as a board member for Poudre Valley Health System has helped me understand what healthcare reform means. Once you get past all the political dialogue, the complexities and the jargon, it can simply boil down to this: We want to have healthcare coverage for all Americans and we want to provide it in the least expensive way, with the highest quality of patient care.

That’s a tall order. Here’s what we can likely expect as healthcare reform settles into place in the coming years: Government programs such as Medicare will offer less reimbursement to hospitals, physicians and other providers, who care for patients covered by the programs. This will have a major impact on the healthcare industry, where more than 50 percent of America’s hospitals already are losing money. Meanwhile, the number of persons needing healthcare, as the Baby Boomer Generation ages, will keep increasing. As a result, providers will have to offer care to more people but will unlikely receive a corresponding increase in revenue. The upshot? The healthcare industry will have less money, so it will need to work smarter and harder to still maintain quality. A larger effort will have to be directed to preventive care.

As a way to contain costs and enhance care, the healthcare industry will focus on integration. This will require an increase in the use of electronic health records so hospitals, physician offices and other appropriate providers will have secure and immediate electronic access to the medical records of their patients. Integration also means hospitals and health systems throughout a geographic region will need to form closer working relationships or partnerships. This will create an economy of scale scenario, where all must work together rather than all working separately.

The healthcare industry will become more transparent. This is an absolute necessity. Public access to a hospital’s patient care outcomes, quality measurements, compliance information, and other records will be necessary to maintain quality. Without the ability of the public to keep abreast of such measurements, it might be tempting for a healthcare organization to save on expenses by cutting staff and other services, resulting in a lower level of care.

Given what healthcare reform means nationally, what could be the local impact on the region’s major healthcare provider, Poudre Valley Health System? PVHS is well-prepared. Fortunately, the health system has already honed many work processes, established an electronic health records system and is committed to making patient care outcomes and other important measurements of quality available to the public.

Much of this preparation was the result of a decade-long journey undertaken by PVHS to weave principles and work methods of the National Malcolm Baldrige program into the basic fabric of the health system. (Be sure to read Rulon Stacey’s letter in this publication on the PVHS Baldrige journey.)

The road ahead will be challenging for all healthcare organizations, including PVHS. Nonetheless, PVHS is committed to continue to improve upon the world-class healthcare that it now offers.

We intend to continue developing our electronic health records system to keep pace with the need of patients and local physicians and other healthcare providers. Meanwhile, we look forward to forming more alliances with other healthcare providers in the region as a way to broaden our reach of services and numbers of patients.

As I mentioned earlier, we already are committed to transparency. You can find our quality data and other measurements on www.pvhs.org or, for that matter, on Websites operated by the Colorado Hospital Association and federal agencies. In the near future, even more data will be available on www.pvhs.org as we expand our transparency.

All in all, these are exciting and challenging times for the healthcare industry. Whatever the path healthcare reform will take, be assured that PVHS will meet the challenge in a way that will benefit our patients and our regional community.

Stu VanMeverenChairperson, Board of DirectorsPoudre Valley Health System

stu VanMeVeren

Chairperson, Board of DirectorsPoudre Valley Health System

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www.youtube.com/user/PoudreValleyHealth

15LITY

Your locally owned leader in health care is a national role model for

excellence.

Poudre Valley Health System has

received the 2008 Malcolm Baldrige

National Quality Award- the highest

Presidential honor given to United

States businesses and organizations that

demonstrate performance excellence.

Thank you to our treasured patients

and families, incredible volunteers,

staff and physicians, and the many

regional organizations who support us

in achieving our vision to provide world

class health care .

Were here for you.


BaldrigeBringing HomeIt is 6 a.m. just before Thanksgiving, 2008, and the Poudre Valley Hospital System senior staff is already in the office. They are waiting for a call, a call that has failed to come three times before. But this year, they hope, is going to be different.

MEDICAL PVHS

The System has spent 10 years in pursuit of the highest goal an American business can aim for, the Malcolm Baldrige National Qual-ity Award. Each year since they first applied in 1999, they have undergone intense external evaluation and received feedback for improve-ment in seven different focus areas: leadership; strategic planning; customer service; workforce development; knowledge and process manage-ment; and clinical, regulatory and financial re-

sults. This would be the fourth year they made it to the final evaluation process, where up to eight trained examiners conducted four-day-long site visits and interviewed more than 350 staff, physicians, and volunteers.

This was the day when they were scheduled to hear the results of all that effort by so many people. The protocol required the organiza-tion’s “highest ranking officer” (President and CEO, Rulon Stacey, Ph.D.) be available for a call

from the U.S. Secretary of Commerce by 6 a.m. Mountain Time. Three times before, Stacey and his staff had waited for this call, only to be no-tified mid-morning they were not a recipient of the award.

But not this year.

When the phone rang just after 7 a.m. that day in November, Stacey’s Executive Assistant,

by Corey Radman

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PVHS representatives attending the Malcolm Baldrige National Quality Award ceremony in Washington, D.C., where President Obama will present the award: Warren James, M.D., Priscilla Nuwash, MBA and Director of Process Improvement, Melisa Smith, R.N., volunteer Mary Carlson, D.V.M., Rulon Stacey, Ph.D., President and CEO, and Gerald McIntosh, M.D.

16

Christy Ricks, answered with hopeful antici-pation. “Hello, this is the Secretary of Com-merce’s office calling for Dr. Stacey please,” said the voice in Washington, D.C.

“Yes!” breathed Ricks, as she transferred the call.

As she and the rest of the team gathered in Stacey’s doorway, silently celebrating while he accepted congratulations on the phone, the autumn sun’s rays were just peeking up over the horizon. A new dawn had begun for PVHS.

The Baldrige Award is bestowed by the National Institute of Standards and Technol-ogy (NIST) to recognize manufacturing, small business, service, education, and healthcare organizations that demonstrate sustainable performance excellence. President Obama will present the award to PVHS leaders and selected staff in a 2009 ceremony yet to be scheduled.

In Pursuit of ExcellenceIn 1997, Rulon Stacey and the PVHS board

of directors made the collective decision to pur-sue The Baldrige Award, knowingly biting off a sizeable goal. In order to be successful, the organization would have to entirely change its approach to management and self-evaluation.

The Baldrige process itself requires setting, meeting, and sustaining measurable progress. The application is 50 pages long with 250-plus questions requiring solid proof of improvement in each of the seven categories. Few organi-zations receive the award the first year they apply; applicants understand that the Baldrige program is a long-term commitment dedicated to creating businesses that can demonstrate quality improvement and a commitment to ex-

cellence. The beautiful crystal award is a sec-ondary goal.

With such a daunting process in front of them, Stacey proposed his father’s workhorse philosophy. Learned as a teenager picking cherries in Provo, Utah’s river bottoms, Stacey’s father explained that one could put all their ef-fort into a huge push the first few hours of the first day and have a respectable harvest. Or they could keep a slower, steadier pace that would sustain for several weeks and earn many more bushels of cherries.

“For us, it’s the process of getting better that is important. We didn’t have a specific per-centage of improvement in mind each year; we just wanted the slope to be positive,” explains Stacey.

With the workhorse philosophy in mind, PVHS began working toward small milestones each year. Asked to point to specific exam-ples, Stacey says, “How about 5,000 different things? It was a lot of people all doing their part that made it work.”

World-class CommunicationThe vision of PVHS is to provide world-class

healthcare. To help employees and volunteers understand and support that vision, Stacey points to the leadership’s communication strat-egies that, in part, enabled their success.

“I attend all the new employee orientations and tell them what I tell everyone who works here, ‘This has got to be the very best place you have ever worked.’ If staff has suggestions for how to make it better, I give them my home phone number. Other senior staff also have open-door policies to hear suggestions and

problems so we can make sure this really is the very best place any of us have ever worked.”

Stacey continues: “When CEOs of other companies ask me about our Baldrige success, I talk about Servant Leadership,” (a philosophy written about by Robert Greenleaf). “If you look at companies with long-term success-ful models, the leaders view their workforce as customers and themselves as providers of a service. I tell my senior staff, ‘If you believe your employees don’t have to like you – they just have to get the job done – you have got to go elsewhere. Here we provide a service. We are going to treat employees like family. We’re going to be happy in their successes and sad in their failures. We’re going to make this place like coming home,” he says.

SuccessAll that effort has certainly produced re-

sults that have caught the eye of executives nationwide, according to senior staffers. PVHS started their journey with employee turnover rates at 25 percent annually. Rates in recent years have been around seven to eight percent (even before the recession). In 2008, Modern Healthcare voted PVHS one of the Top 100 Best Places to Work in Healthcare.

Additionally, the system ranks in the top 10 percent nationally for inpatient mortality, pa-tient satisfaction, and in the top three percent for employee satisfaction. Thomson Reuters has voted PVHS one of the Top 100 Hospitals for five consecutive years.

Stacey’s eyes sparkle with pride and emo-tion when he attributes the system’s successes to his staff. “I believe that what put us over

Priscilla Nuwash, MBA, Director of Process Improvement

Baldrige asks what are your approaches? How do you deploy them? How do you learn from them? How do you measure them

so you know you are accomplishing your goal?

Rulon Stacey, Ph.D.,President and CEO

The people who work here are like family; I love these people.

17


the top was when we really, truly believed that these are our patients. That’s everyone – from me, to the doctors and nurses, to our cooks and housekeepers – who all said, ‘These are my patients, and I provide world-class health-care.’”

Talking to staff throughout the organiza-tion, one finds a common thread of passion for this vocation and enthusiasm about the health system. These are people who are constantly in search of ways to improve, who take those thoughts with them, even when their workday is finished.

Thinking TimePriscilla Nuwash, MBA and Director of Pro-

cess Improvement, has changed out of the day’s business attire and into her Frisbee-throwing jeans. Her sheepdogs, Yoko and Blue, happily chase the well-chewed plastic discs across the field that is her backyard, but her mind is only partially there in the native grass. She is thinking about customer satisfaction.

In her five years as a Baldrige examiner and leader of process improvement at PVHS, she has led and witnessed innumerable changes that built the path to current success. She cites the patient discharge phone calls as one example that drastically improved patient loyalty to the system, a system that took a lot of Frisbee-throwing time (and the efforts of many people) to get just right.

PVHS policy now requires that a hospital rep-resentative call all recently discharged patients to check in, make sure they understood the doc-tors’ instructions, and ensure they are feeling well. That effort paid off: it created an opportu-

nity for patients to provide direct feedback about their experience in the hospital and fostered loy-alty to the system.

“Now when we track our patient satisfac-tion, we don’t just track satisfaction from a level of one to five,” says Nuwash, “we break down the top box into smaller percentages. Those in the ‘highly satisfied’ box should be tracked in-crementally.”

“Our top box scores (meaning those who rate us in the highest category possible) are at 80 to 90 percent. The industry says that 60 percent exceeds expectation,” Nuwash explains.

Of the many changes Nuwash is proud of, the top box scores are one of her favorites. “It means that Northern Colorado residents aren’t just happy with the care we give, they rave about us.”

Nuwash is quick to dispel the myth that the Baldrige approach has cost the system in dollars. “‘How much does it cost?’ is the first question we get in presentations to other corporations. We found that when we made this the way we do business, it wasn’t a cost at all. The return on investment has been proven.” She cites their enormous drop in staff turnover rates as a huge savings: “When you start multiplying the cost of losing employees, it really adds up. We figure the cost of replacing a nurse is $100,000.”

PerksSince being honored with the Baldrige

award, PVHS has been included in a top-notch group of nationally known corporations called the BAR group (Baldrige Award Recipient group). “Now we get to learn from other re-cipients and we can all push each other to that

higher level,” says Nuwash.Members of senior administration have been

invited to speak on their best practices at confer-ences across the country and around the world. Rulon Stacey and Pam Brock, Vice President of Marketing and Strategic Planning, addressed an audience in Abu Dhabi in March.

Nuwash reports that representatives of cor-porations beyond healthcare have approached PVHS with congratulations. “Here we are in Northern Colorado and we are honored with na-tional recognition, not just for quality or great technology, but for covering the whole spectrum of needs for our community.”

Nuwash and performance excellence man-ager, Sonja Wulff, are part of the team that has kept PVHS on track in their quest for greatness. Nuwash is a believer in the process, “Baldrige is unique because each feedback report we get tells us how to improve.” (As opposed to other awards that give no feedback whether you win or lose.) “Even our winning application had 32 suggested improvements that PVHS is working on this year,” she says. “No one is perfect, but with Baldrige, every single year there are ways to improve.”

Engaged in ExcellenceIn addition to suggesting improvements, Bal-

drige also notes an organization’s strengths; one core competency of PVHS is employee engage-ment.

Melisa Smith, R.N., would agree. Like many of her fellow employees, her passion for her job laps over into her personal time. Even as she drives home from her night shift in the post trauma de-partment at Medical Center of the Rockies, she

Gerald McIntosh, M.D.,Chief of Staff, PVH, physician with Neurology Associates of Northern Colorado

Our physician staff was much more involved than the industry average. Why? Because we have an outstanding group of physicians

who are willing to work on [process improvement] projects.

Warren James, M.D., FACOG,Chief of Staff, MCR, physician with The Women’s Clinic of Northern Colorado

The relationship [between administrators and physicians] has been the key thing that has allowed this medical community to be as good as it is.

18

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calls the day nurses to relay a forgotten detail or suggestion.

“I love taking care of patients and doing it for PVHS,” she states. “The system has been so sup-portive of me. I started as a housekeeper at PVH and worked my way up as I went to school.”

“The administrators here are always very helpful to nurses and doctors. Any time there is a concern they’re right there to assist.” That coop-eration makes it clear to medical staff that patient care is a top priority.

“I also love that they are so accessible. Rulon [Stacey] is fun to talk to. It’s nice not to fear the CEO, even though he’s so important,” she says.

Smith, along with 20 other lucky volunteers, employees, and physicians, won the lottery to be included in the award ceremony in Washington, D.C. They hope to travel there soon, but are await-ing a call from President Obama’s schedulers.

Smith represents the workforce when she beams with pride about the accomplishments of recent years. “People here have always provided great healthcare, but morale went way up when we started to be recognized for it. Finding out that we are the cream of the crop has made it fun to be at work.”

Physicians fill a special role in any health sys-tem, and finding ways to work with these inde-pendent partners is often a challenge for hospitals, which is why Chiefs of Staff exist: to act as liaisons between physicians and hospital administration.

Asked if they ponder work issues while on re-laxation time, both Chiefs for PVH and MCR give a slightly chagrined, “I’m afraid so.”

Warren James, M.D., FACOG, is Chief of Staff at Medical Center of the Rockies (MCR) and a phy-sician with The Women’s Clinic of Northern Colo-

rado. He thinks about work and how to make it better all the time, he says - even while deer hunt-ing along the Platte River. Sitting silently in a deer stand watching the morning mist rise, he’s mulling over the best way to implement site marking – a new system that requires surgeons to mark in in-delible ink the portion of the body being operated on (the right kidney, not the left, for example).

Dr. James reports that extra steps like these (and the extra paperwork) for physicians make a long day, but asked if it’s worth it he says emphati-cally, “Yes. Ultimately, processes like these result in better care for patients.”

Gerald McIntosh, M.D., spends long days car-ing for patients both at the hospital and in his medical practice, Neurology Associates of North-ern Colorado. He acts as his fellow physicians’ representative as Chief of Staff at PVH. When he gets a chance, he says, he unwinds by bicycling the big hills west of Fort Collins on an Orbea car-bon fiber road bike. With inclines of eight percent or more, it can be hard to think about anything except forward motion, but thoughts of process improvement dog him there like his MCR counter-part on the plains.

McIntosh refers to a recent example of im-provement: “Physicians and nurses began work-ing with staff to reduce the number of patient falls. On the neurology floor, we noticed that falls were common for patients with neurologic impair-ments. We now identify potential fall victims and have installed video monitoring systems in the rooms. We have a fall alert system to notify staff when a patient looks like they might get out of bed.” In the first two quarters of this year, there have been no falls.

Dr. James attributes PVHS’ success to a number

What is the Malcolm Baldrige Award?

In the 1980s, the United States was seeing more international business competition than ever before. So much so that the Federal gov-ernment instituted a program to foster better business practices.

In 1987, the Malcolm Baldrige National Quality Improvement Act was passed (Pub-lic Law 100-107). Named for the Secretary of Commerce under President Reagan, the law forged a public-private partnership that fosters strategic planning for quality improvement pro-grams through a commitment to excellence. Initially targeting manufacturing and services, the government recognized that these sectors were essential to the well-being of the national economy and its ability to compete effectively in the global marketplace, according to the Na-tional Institute of Standards and Technology.

Since those early years, NIST has also added categories in manufacturing and healthcare.

In 2008, PVHS was one of 43 healthcare organizations that applied for the MBNQA. It was the only one honored in that category.

20

Mary Carlson, D.V.M.,Volunteer at PVH

You’ve got to give back to your community. Sometimes it’s better to give your time than to write a check.

Melisa Smith, R.N.,MCR Post Trauma Unit

Staff at the hospital keeps a positive attitude and constantly strives to make things better for themselves and the patients.

In that way, we keep making care better.

of changes. “It’s multi-factorial; not just one per-son or segment made the difference. The Chiefs of Staff’s relationship between administrators and physician groups has helped. And the culture com-ing from the administration is open. They want to work with us, which engenders the reverse. When physicians feel administrators want to collaborate, it makes it easier to trust and partner.”

Previous Baldrige feedback reports noted room for system-wide improvement in physician engagement. Dr. McIntosh observes that through collaborative problem-solving with the Chiefs, lis-tening and responding to doctor concerns, and investing in better systems (like the digital medical records system that enables doctors to view pa-tient charts and imaging scans from their offices or even their homes), the physician engagement is drastically improved.

A 2008 survey conducted by Gallup showed that physicians working with PVHS ranked 91st in the nation for engagement and 99th for loyalty to the system, which places PVHS in the top one percent nationally.

Dr. James sums up the admirable accomplish-ments of the system with regard to its physician partners: “I am most proud of the relationship be-tween administrators and physicians. I have seen in other systems that executives and doctors are like they are on two teams – competitive. Things don’t work effectively that way. We just don’t seem to have that here. That one relationship has been the key thing that has allowed this medical community to be as good as it is.”

Working TogetherAs important as direct patient care is, a huge

asset to the hospital system is its volunteer corp. So admired and valued are they that even former phy-sicians join the ranks and together log thousands of hours each year.

Mary Carlson, D.V.M., whacks the golf ball

Rulon Stacey, PVHS President and CEO, addresses a group of professionals. He and Pam Brock, PVHS Vice President of Marketing and Strategic Planning, were invited to speak in Abu Dhabi in March 2009.

Pam Brock, PVHS Vice President of Marketing and Strategic Planning, explains to professionals in Abu Dhabi the efforts that led to their achieving the Malcolm Baldrige National Quality Award in 2008. 22

22

with the force and determination that drives every-thing she does, even her volunteering at PVH’s in-formation desk. She thinks with satisfaction about the people she made smile today.

“On someone’s worst day, I can make it a little better.” Just a smile, a kind word, or a funny wheel-chair ride makes a difference for her patients.

As a volunteer with PVH for four years and long-time community volunteer and activist, Carl-son has a good vantage point on the system’s track record. She has been a patient herself and had sev-eral close family members admitted to the hospital. She believes the care provided by the system has been exceptional.

“Everybody is so proud of the job they do there,” she says. “We are all made to be as impor-tant as everybody else. We are all equally impor-tant to the vision. I think we do provide world-class healthcare.”

It took over 4,000 employees all working to-ward the same vision to achieve the Malcolm Bald-rige National Quality Award. And, at the day’s end, everyone involved in PVHS’ success is still thinking about how to make it better. They exercise, they spend time with their families, they throw Frisbees, and they provide world-class healthcare – every day.

EpilogueA new day has come. Rulon Stacey is again

up with the sun, running along Horsetooth Road, limping from his gimpy knee, but persevering like the work horse his father taught him to be. He’s distracted by the pain, but he can’t stop now. He is working out a plan... a plan that will help PVHS maintain its impressive trajectory toward the fu-ture of healthcare.

Corey Radman is a writer and mother of two who lives in Fort Collins.

23


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PVHS has also received numerous, high profile awards, not the least of which is the top Presiden-tial honor for business in the country, the 2008 Malcolm Baldrige National Quality Award.

With all that accomplished, one might ask, “What else is there to do?”

“We’re going to continue to provide world-class healthcare every day,” says PVHS President and CEO, Rulon Stacey, Ph.D.

And that’s no small thing. PVHS’ hospitals are consistently recognzied for being among the best in the nation for quality of care.

“We’re thrilled to have been honored with the Malcolm Baldrige award, but for us, it was re-ally about the process of getting better,” says Sta-

cey. “Going through the Baldrige process helped us develop into an organization focused on per-formance excellence.”

Stacey explains that even though PVHS is not eligible to apply for Baldrige again for five years, they will continue to seek out external reviewers to help provide the kind of feedback that ensures ongoing improvement.

Growing CautiouslyIn addition to providing excellent healthcare,

PVHS has plans to continue expanding – though plans are long range at this point.

“We’re going to grow into what we have just completed,” says Vice President of Marketing and

Strategic Planning, Pam Brock, with a smile and a well-earned sigh of relief.

But resting on current success is not in the PVHS culture. Brock is already hard at work on future plans: “We will continue to improve outpa-tient services and ambulatory services in this area. We are also just beginning relationships with rural clinics that will provide specialties to outlying ar-eas on an a regular basis.”

Brock explains that rural communities like these don’t have the demand for specialists to live there full-time, but still have occasional needs that aren’t currently being met. “So, for example, an orthopedist might travel there once a week, or once a month,” she says. Brock expects to have

Poudre Valley Health System has just completed an amazing run of success. In the last two years, the organization has opened Medical Center of the Rockies in Loveland and completed construction on a $35 million improvement at the Poudre Valley Hospital campus in Fort Collins, including a recently opened four-story parking garage and medical office building west of the hospital.

by Corey Radman

MEDICAL PVHS

PVHSLooksto theFuture

Westbridge Medical Suites, the $35 million improvement project at the Poudre Valley Hospital campus, included a four-story parking garage, a medical office building, and sky bridge to PVH’s main building.

2424

solidified many of those relationships within the next year.

A Third PVHS Campus?According to Brock, the system is also plan-

ning to announce a request for proposals that seeks offerings from architectural planning groups who specialize in healthcare. PVHS is interested in putting together a master plan that might some-day include a third campus.

“We have no definite plans for any building just now,” she says, “but if the right opportunity presents itself there might someday be an eastern plains or mountain campus.”

Like many health systems, PVHS is exploring the concept of a healthcare campus. “The health-care campus of the future will be different than just a hospital,” says Brock. “There will be doc-tors’ offices, wellness services, and medical fit-ness facilities for rehab and outpatient therapy. But there will also be family events.” Brock points to Robert Wood Johnson and the Mayo Clinic as examples. “These are places where families come to recreate and enjoy a healthy life together,” she says.

How Big Will PVHS Get?Asked if there is a danger of PVHS becoming

one of the “big guys” that swallows up smaller healthcare providers, Brock says no.

“Our mission is to remain independent and locally-owned. We don’t have a corporate headquarters far away in another state, and no stockholder base counting on a profit margin. The profits are reinvested into providing quality healthcare.”

However, she notes, they have no maximum cap on growth. “Because there are so many op-portunities to partner with others, we don’t want to set an artificial number.”

Stacey is optimistic that a larger system will be more advantageous in the coming years with the potential change to the nation’s healthcare system. “We think that to be successful in the fu-ture, the payer systems are going to favor larger systems and organizations that can integrate bet-ter with their physicians.”

Streamlining will be key to survival, he thinks. “We’ve had the lowest costs over the last few years and yet still maintain the highest quality.”

Continued ExcellenceStacey points to goals that will continue to

improve the system as it exists now. “We have worked very hard to increase integration with our physician partners, but we need to do more. We will continue to upgrade information systems that can be shared. That will keep costs low and qual-ity high,” he says.

“We’ll also continue to look for ways to part-ner with local employers. The ones we work with now, by providing preventative care, save signifi-cant amounts of money. We hope to extend those types of services to other businesses in the area.”

Baldrige BounceOne other perk in the near future is the op-

portunity for members of senior management to share their best practices. Because of the Baldrige award, PVHS is now frequently invited to speak across the nation and around the world about what makes large organizations run well. The in-vitations run the gamut from healthcare systems

to universities to governments.“Rulon [Stacey] and I were invited to speak

in Abu Dhabi last March and met several govern-ment and healthcare officials there,” says Brock. “It was the trip of a lifetime!”

PVHS is also hosting a series of workshops to share their best performance excellence practices. The workshops are already filling up. Two-day sharing workshops are scheduled through the end of 2009 and into April of 2010. They will fo-cus on leadership, strategic planning, customer focus, measurement, workforce, and process management. For those who can’t travel to Colo-rado, webinars will cover the same concepts in a condensed format, and are planned into next year. More information can be found at www.pvhs.org.

With so many recent honors it might seem like time for PVHS to ease up, but all signs from leadership point to continued perseverance to their mission to provide quality, innovative, and comprehensive world-class healthcare that ex-ceeds expectations every time.

Corey Radman is a writer and mother of two who lives in Fort Collins.

- Rulon Stacey, Ph.D., President and CEO of

Poudre Valley Health System

We’re thrilled to have been honored with the Malcolm

Baldrige award, but for us it was really about the process of getting better.

Going through the Baldrige process helped us develop

into an organization focused on performance

excellence.


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MEDICAL STROKES

Treatment, and Recovery By Allie Comeau

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Winfield Craven, M.D., Medical Director,

Department of Radiology, Medical Center of the

Rockies, stands in front of angiographic equipment,

which uses imaging to diagnose and treat medical

conditions.

Chad Stoltz, M.D., cardiologist with the Heart Center of the Rockies

When someone suffers a stroke, the onset is usually sudden and without warning. What happens next may mean the difference between life and death. That is why it is critical to know as much as possible about the prevention, symptoms, and treatment of strokes before they occur – because time is of the essence.

Stroke Prevention,To begin any discussion about stroke preven-

tion and treatment, we first need to understand what happens when you have a stroke. “A stroke is essentially the loss of brain function due to a disturbance in the blood supply to the brain,” says Chad Stoltz, M.D., cardiologist with the Heart Center of the Rockies (MCR).

Dr. Stoltz stresses how prevalent strokes are in our society. “Each year an average of 700,000 people suffer a new or recurrent stroke. Over 150,000 of these people will die. On average, someone has a stroke every 45 seconds and someone dies of a stroke every three minutes. Stroke is the leading cause of serious long-term disability, causing functional limitation in more than 1.1 million Americans.” Strokes seem to be gender blind, though six in 10 stroke deaths are women.

Causes of StrokeThere are two basic types of strokes. An isch-

emic stroke is the most common type, occurring in between 80 to 85 percent of stroke patients. “An ischemic stroke occurs when a blood ves-sel that carries oxygen and nutrients to the brain is blocked by a blood clot. If the blood vessel is blocked for an extended period of time it can cause irreversible damage or even death,” says Dr.

2828

Stoltz. “The second type is a hemorrhagic stroke. This occurs when a weakened blood vessel within the brain bursts or ruptures. This too can cause irreversible brain damage or death.”

While the type of stroke can vary, the risk factors generally don’t. “Both types of strokes have similar risk factors, although hypertension or high blood pressure is more strongly associated with hemorrhagic stroke,” says Gerald McIntosh, M.D., neurologist with Neurologic Associates of Northern Colorado. Diabetes, elevated cholester-ol levels, cigarette smoking, lack of physical activ-ity, a previous stroke, heavy alcohol consumption, obesity, and an unhealthy diet are the other major risk factors for both types of strokes.

Certain heart conditions can also predispose one to having a stroke. “If you’ve had a history of heart disease, then you have a risk for stroke,” says Dr. McIntosh. “There’s also what we call a cardiogenic stroke which can occur in patients who have certain heart conditions, like atrial fibril-lation.” That’s what happened in Dr. McIntosh’s case – his atrial fibrillation, undiagnosed until five years ago, eventually caused a stroke.

The risk with atrial fibrillation, a rhythm dis-turbance in the heart, is that small clots can form in the heart and travel to the brain. Because atrial fibrillation often goes unnoticed until something goes wrong, Dr. Stoltz recommends keeping up-to-date with doctor visits. “Evaluations by your primary care doctor should be performed on a routine basis for ongoing risk assessment and modification,” he says.

In some cases, stroke victims will get advance warning of an impending stroke. A Transient Ischemic Attack (TIA), also known as a “warning stroke” or a “mini-stroke,” has the same symp-toms of a stroke but only lasts less than 24 hours. Not all strokes are preceded by a TIA, but one-third of TIA’s are followed by a stroke. Therefore, a TIA should be considered a predictor of an im-pending stroke.

“If you have risk factors and/or you’ve had a stroke or a TIA, there are measures you can take to prevent having a stroke or a recurrent stroke,”

says. Dr. McIntosh. “With a combination of life-style modifications such as maintaining an exer-cise program, a weight-control program, and a diet program, and with certain medications, like blood thinners, anti-platelet agents, statins to control cholesterol, and ACE-inhibitors to lower blood pressure, we can effectively reduce the stroke risk by 50 percent.”

Time is CriticalBecause time is precious during a stroke, it’s

important to be aware of the symptoms. “Pa-tient and public awareness is very important for early recognition of a stroke. Time is critical and every second counts to prevent progression of a stroke,” says Dr. Stoltz. “Symptoms often occur suddenly and may involve numbness or weakness of the face, arm, or leg on one side of the body. There may be confusion or trouble speaking. A person may have trouble walking and have loss of balance or dizziness. There may also be trouble seeing in one or both eyes. Finally, a sudden se-vere headache may accompany any one of these symptoms.”

If you notice any of these symptoms in your-self or someone you love, call 911 immediately. “When you have any symptoms where your neu-rologic function is suddenly disrupted on one side, you need to see a doctor right away,” says Dr. McIntosh.

Acute treatment at the hospital will depend on the type of stroke. “If a CT scan shows a hemorrhagic stroke, steps will be taken to control blood pressure,” says Dr. McIntosh. “If there’s no hemorrhage, we know it’s either an ischemic stroke or a TIA. An MRI would then be ordered that would show whether there was an ischemic stroke or risk of an impending one.”

In the case of an ischemic stroke, treat-ment varies depending on the cause of the stroke. “There are medications which may be useful, including blood thinners such as aspi-rin or Coumadin,” says Dr. Stoltz. “There’s also a clot-busting drug that can be given within a few hours of the onset of a stroke caused

by a clot that can reduce long-term disability significantly. There are medications to control cholesterol, blood pressure, and diabetes. Fi-nally, there are many endovascular/catheter based procedures or surgeries that can prevent recurrences.”

It’s important to note and tell the attending physician the exact time stroke symptoms be-gan in order to facilitate successful treatment. There’s only a small window of opportunity doctors can use certain drugs, the clot-busting drug in particular. “Tissue Plasminogen Activa-tor (TPA) breaks apart blood clots and, if we give enough of it within the first three hours of an ischemic stroke, we can restore circulation to the area of the brain that’s blocked,” says Dr. McIntosh. “But there’s a risk of turning an ischemic stroke into a hemorrhage if the dam-age to the brain is too extensive.”

Dr. McIntosh recommends calling 911 for an ambulance as soon as you notice symptoms. “If you’re within the city/county area you are better off calling 911 and riding to the hospital in an ambulance (rather than driving yourself) so we can begin treatment.” PVH notes in a newsletter that patient care outcomes are of-ten improved if a stroke victim is transported in an ambulance, where medical care can be given on the way to the hospital.

RecoveryAfter suffering his own stroke three years

ago, Dr. McIntosh now has firsthand knowledge of stroke treatment from a patient’s perspective. “It has definitely been useful to me,” he says. “My own stroke recovery has helped me to bet-ter understand the process of rehabilitation.” He looks fully recovered to the untrained eye, but Dr. McIntosh says the left side of his body is forever changed. “I have to pay special attention to my left side. If you walk too close to me, I may bump into you,” he says with a smile.

After acute treatment, recovery begins in the hospital after three to five days of initial stabiliza-tion. “We begin rehabilitation early to get people

Hemorrhagic Stroke Ischemic Stroke TIA Stroke

A hemorrhagic stroke is caused by a bursting blood vessel in the brain that

spills the blood into the brain.

An ischemic stroke is the most common type and occurs when a blood vessel

carrying oxygen to the brain is blocked by a blood clot.

A Transient Ischemic Attack (TIA), known as a “warning stroke,” has the same symptoms of a stroke but only lasts 24 hours. A TIA is

considered a predictor of a stroke.

©2009 National Stroke Association ©2009 National Stroke Association ©2009 National Stroke Association

Images reprinted by permission of National Stroke Association, www.stroke.org.


It has been said that music has the transforma-tive power to heal. All it takes is a visit to Sarah Johnson’s neurologic music therapy exercise class to confirm that statement beyond a shadow of a doubt.

Johnson, a neurologic music therapist at Pou-dre Valley Hospital and adjunct faculty at CSU, helps stroke victims and others with neurological problems regain and maintain their motor skills. One of the first graduates of CSU’s Master of Mu-sic Therapy program, Johnson has been working as a PVH therapist since 1987. She and Ruth Rice, a PVH physical therapist and CSU research associate, have been assisting stroke patients in their music therapy classes for over 10 years. Johnson invited Style to sit in on one of her group exercise sessions at the CSU University Center for the Arts. It was evident from her wide smile and contagious enthu-siasm that she loves what she does.

“Most of these folks have finished outpatient therapy but want to stay strong and maintain their independence,” says Johnson. “The music helps them be active and remain physically fit. For many of them, it’s also the one time a week they get out and about.”

“We’re not here to do rhythm band,” she says, jokingly referring to the instruments they use in class. “It’s not about whacking instruments. We’re using the instruments and the music as a rhythmic structure and a tool to organize move-ment.” In other words, patients move to the music. And people love music. Music therapy uses that re-sponse to create movement and help patients re-gain motor patterns they may have lost due to a stroke or disease. “Music is a compelling force. We listen to it. Music therapy is all about using music to achieve non-musical goals. At its core, music therapy is about functionality.”

All of the exercises in the class – bicep curls, leg lifts, swaying side to side, and arm punches – serve a purpose. They mimic motions patients use in real life. When stroke patients who have lost partial movement repeat these motions in time with music, the movements become more fluid, succinct, and effective.

Before long, patients are able to more easily tie their own shoes, sit up straight, and steady them-selves.

“We’ve done a lot of research here [at the Center for Biomedical Research in Music at CSU] about how our brains and bodies process music, specifically rhythm, and how music helps us to re-train our brains and bodies,” says Johnson. “We use the properties of the music to organize, ac-cess, and pattern their neuromuscular responses.” Research conducted at the Center for Biomedical Research in Music is a collaborative effort between CSU and PVH.

Neurologic music therapy also enables patients to more easily relearn basic skills such as walking. The rhythmic structure of music provides a beat for the patients to move to, helping to regulate gait and lengthen stride, normalizing their gait pat-terns.

“We use music to structure and reorganize walking,” says Johnson. “Walking is intrinsically rhythmic. Stroke victims who have been walking all their lives already have that motor pattern, so what we’re trying to do is reactivate or rebuild neuromuscular pathways to generate that walking pattern again.”

Patients with neurologic diseases like Parkin-son’s and multiple sclerosis, people with traumatic brain injuries, children with developmental delays or autism, and orthopedic patients also benefit from improved balance, strength, flexibility, inde-pendence, muscle tone, and mobility that music therapy facilitates. At PVH, Johnson works with all of these types of patients.

“Most of the work I do is cooperative. I work with OT’s (occupational therapists), PT’s (physical therapists), and speech therapists in a multidisci-plinary group at the hospital every day and we get as many of our patients together as possible.”

The patients in the exercise class mingle hap-pily with Johnson, Rice, and their assistants after class. The patients maintain varying levels of inde-

pendence. Sally, paralyzed on her left side from a stroke she suffered in 2000, walks a mile and a quarter everyday now and was a torchbearer for the last Olympic Games. “I wouldn’t have been able to do either of those things without the help of this class,” she says. Another patient, Bob, suffered a

stroke in 1998 and has been coming to the music therapy class ever since. “Music has helped me walk better,” he says. “There’s just something about music that makes you

want to walk on.”Gerald McIntosh, M.D., a neurologist

with Neurology Associates of Northern Colorado, works extensively with stroke patients and suffered through his own stroke three years ago. Dr. McIntosh has seen the benefits of the exercise classes and has similar sentiments with regards to music’s power to heal. “Music therapy is

relatively magical,” he concludes.

Neurologic Music Therapy

by Allie Comeau

at a functional status as rapidly as possible,” says Dr. McIntosh. “Being active soon after a stroke is good for your mood and prevents complications. The first phase of rehabilitation lasts two to four weeks and can be done in a home-care program or outpatient program depending on the severity of the stroke.”

Dr. McIntosh and the rehabilitation and recov-ery team at PVH, made up of occupational thera-pists, physical therapists, speech therapists, music therapists, counselors, pharmacists, and nutrition-ists, work as a team during the recovery process. “Rehabilitation is a team effort. We discharge pa-tients only when they are able to perform basic life skills,” he adds. “Most people do better at home as long as there isn’t a risk for complications or falls.”

Recovery is dependent on many factors, the largest being the extent of damage caused by the stroke. “The size of the area in the brain that’s permanently damaged determines the fixed neu-rologic deficit and that, to a large part, determines the amount of recovery,” says Dr. McIntosh.

Recovery for one patient may be drastically dif-ferent from the next. “A stroke can produce pa-ralysis, visual disturbances, memory loss, and even affect behavior,” says Dr. Stoltz. “These disturbanc-es can be minor and isolated problems or major problems that produce long-term disability. Prompt recognition and treatment of a stroke is critical to

- Gerald McIntosh, M.D., Neurologic Associates of

Northern Colorado

Rehabilitation is a team effort. We discharge patients only when they are

able to perform basic life skills.

30

Move with the Music

By Connie Hein

Miracles seem to be occurring at the corner of Harmony and Lemay in Fort Collins. But while the word “miracle” comes to mind, the word “science” also applies.

What is actually happening is that the trainers at the one-year-old business, LearningRx, are help-ing stroke and traumatic brain injury (TBI) victims make astonishing changes in their lives by applying ground-breaking testing and training techniques.

Nate Jorgenson, of Fort Collins, is one of those individuals. On October 1, 2004, Nate was involved in a near-fatal car accident that resulted in a frac-tured cervical vertebrae and extensive brain hemor-rhaging.

His mother, Debbie Jorgenson, says, “One day he was a handsome, sociable 26-year-old young man pursuing a career in computer network engi-neering and in a moment, our lives changed for-ever.”

After two weeks in a semi-coma at Poudre Valley Hospital’s Neuro-Intensive Care Unit, three months in Denver at Craig Hospital, which special-izes in TBI, and almost two years at the Center for Neurorehabilitation Services in Fort Collins, Debbie says Nate had made great progress in his healing, but was still not able to live independently. “Nate’s learning problems made him feel stupid and gave him little hope of achieving his goal of becoming a personal fitness trainer. He was not able to retain the information necessary to become certified.” She says they were facing a new reality and wondering, “Where do we go from here and what do we do now?”

A friend who had helped Debbie raise funds for her newly-formed Shared Journeys Brain Injury Foundation helped answer that question when she told Mike Winchell, co-owner of LearningRx, about Nate’s struggles. Winchell contacted Debbie and told her they had many testimonials from TBI victims who experienced life-changing progress through their program and said he was confident they could help Nate.

“After talking with Mike and co-owner, Don Cassidy, I was convinced that the program could help and I enrolled Nate at the end of May,” says Debbie.

Cassidy says after assessing Nate, they found he had virtually no long-term or short-term memory, and therefore could not retain information because certain parts of his brain were damaged.

When starting with a new patient, Winchell says, they do an assessment to determine the results of the brain damage. Nate scored very low on audi-tory and visual processing tests along with his lack of memory. When processing and retention is that low, it takes intensive brain training for patients to get back to where they were before the injury or stroke, says Winchell.

With visual processing in a healthy brain, a person can imagine descriptions that are in books by reading them and creating visual images of the scene in their mind. A person with brain damage from stroke or injury may not be able to do that. The patient must be retrained, as they are doing with Nate, using pictures that correlate with names or words.

In trauma or stroke cases, Winchell says, certain areas of the brain are dead or impaired. With brain training, though, other areas can start picking up the slack for the damaged portions. He adds, “With this training the brain will actually create new path-ways and will figure out a way to do what you ask it to do.”

Debbie says she has been amazed by the pro-gram. “Nate actually notices the improvements he is making instead of just being told that he is improving. It has only been two months and Nate is like his old self again. He has confidence in his ability to move forward to pursue goals for his life with passion and pride.” Debbie says his progress has been an inspiration to her and everyone around Nate. “Many people say they have watched him be-come stronger and happier and are inspired to make changes in their own lives.”

Winchell and Cassidy agree that Nate is an in-spiration. “We all love seeing him, getting a hug, and visiting with him whenever he comes in,” says Cassidy. “He inspires me every day. If someone like Nate can overcome a traumatic injury and move for-ward to pursue his goals in life with such a positive attitude, I can do the same as I move through this time in my life starting a new business.”

For more information about LearningRx call 970-672-2020 or visit

www.LearningRx.com/Fort-Collins.

For more information about the Jorgenson’s foundation to help brain injured individuals, visit

www.sharedjourneysfoundation.org.

New Ways to LEARN reduce permanent disability and even death.”

Stroke Care in Northern Colorado In Northern Colorado, we are fortunate to

have some of the finest stroke treatment and re-covery specialists in the state. Dr. McIntosh has been practicing in Fort Collins since 1979. His subspecialty is neurologic rehabilitation, which concentrates on stroke and stroke rehabilitation. In addition to his practice and being Chief of Staff at Poudre Valley Hospital (PVH), he’s the medical director for LifeSkills Rehabilitation Center at PVH. “I’ve been interested and involved in strokes and stroke rehabilitation for the last twenty years,” he says.

Dr. McIntosh and the stroke team at PVH re-ceived an American Stroke Association award in February of this year for their new rapid-response stroke alert program. The award recognizes that PVH has a comprehensive system in place for rapid diagnosis and treatment of stroke patients admit-ted through the emergency room. “We do our best to ensure everybody gets the best treatment possible as soon as possible when they come in,” says Dr. McIntosh. Kathi Patterson, PVH’s stroke program coordinator, says this also includes pro-viding patient education in managing risk factors. “Studies have shown that patients who are taught how to manage their risk factors while still in the hospital reduce their risk of a second stroke,” she says.

Dr. Stoltz has been practicing cardiovascular medicine since 2005, after graduating from the University of Nebraska and completing his Inter-ventional Cardiology fellowship at the University of Wisconsin, Madison. He is board certified in in-ternal medicine, cardiovascular medicine, interven-tional cardiology, echocardiography and nuclear cardiology. He has also recently implemented a ca-rotid artery stenting program in Northern Colorado and is a chosen investigator for the CHOICE carotid artery stenting study.

For stroke prevention, treatment, and recov-ery, awareness is paramount to the best possible outcome. By spreading the word about stroke recognition to family and friends, you just might save the life of someone you love.

Allie Comeau is a freelance writer, copywriter, and blogger living in Fort Collins, CO. Email her at [email protected].

Illustrative diagram of the brain’s motor and sensory function. Sudden changes to these functions can indicate a stroke.

©2009 National Stroke Association

31Fort Collins Medical Magazine & Directories

World-Class Cleft Lip and Palate Reconstruction

by Allie Comeau


Winfield Craven, M.D., Medical Director,

Department of Radiology, Medical Center of the

Rockies, stands in front of angiographic equipment,

which uses imaging to diagnose and treat medical

conditions.

As the most common birth defect in the world, cleft lip and palate affects one in 700 live births. Fortunately, cleft lip and palate is also highly treatable with reconstructive surgery that can significantly improve facial appearance and function. Thanks to the caring practitioners at the Poudre Valley Hospital (PVH) Cleft Clinic, children born with this all-too-common oral-facial defect have access to a superior team of surgeons and therapists to ensure success of treatment.

MEDICAL CLEFT LIP AND PALATE

PVH Cleft Clinic

3232

When a baby is born with cleft lip and/or palate it basically means that the mouth and lips did not fuse together properly during early fetal development. Deb Brohard, speech pathologist with PVH’s Children’s Therapy Services, is the coordinator of the PVH Cleft Clinic and works with Christopher Tsoi, M.D., and Mark Boust-red, M.D., both plastic surgeons with Northern Colorado Plastic Surgery, to provide children and families affected by cleft lip and palate the best treatment available, right here in Fort Collins.

Having a child born with cleft lip and palate is a challenge but the team at PVH ensures the reconstructive process goes as smoothly as pos-sible. “The team approach is so important,” says Dr. Tsoi, a board-certified plastic surgeon who has been practicing in Fort Collins since 1992 and has done overseas cleft missionary work. “There are many aspects. We have access to genetic counseling and social work in addition to surgical support. In Fort Collins, we have a complete team and are registered members of the Cleft Palate Society.” The team is made up of plastic surgeons, a speech therapist, feeding specialists, an occupational therapist, a pediatric dentist, an audiologist, an orthodontist, an oto-laryngologist, a registered nurse, a social worker, a pediatrician, and a nutritionist.

Helping Children and ParentsThe Cleft Clinic team becomes involved as

soon as a family finds out they have a child with a cleft lip and palate, either in utero or after birth. (Ultrasound can diagnose cleft lip so there is a chance parents may know before birth.) “If a cleft lip has been diagnosed by ultra-sound, my practice is to see the parents before birth to counsel them and show them pictures of other children who have had cleft lip repairs. This helps the parents tremendously, relieves anxiety, and gives the family a game plan,” says Dr. Boustred, an internationally known plastic surgeon from South Africa who has performed cleft lip and palate surgery all over the world. “It makes a big difference.”

Genetics play a role in cleft lip and palate, and avoiding certain medications and drugs dur-ing early pregnancy may lower the risk. “There are two factors that contribute to the formation of cleft lip and palate: environment and genet-ics,” says Dr. Tsoi. “We now know certain things like retinoid acne medications, anti-convulsant drugs, cigarette smoke, and alcohol can contrib-ute to the formation of cleft lip and palate.”

“There are certain genes that cause cleft lip and palate but in the majority of cases we just don’t know what has caused it,” continues Dr. Boustred. “There’s even been recent research linking maternal diabetes, stress, and obesity to facial defects.”

When a baby with cleft lip and palate is born at PVH, Brohard is the first to meet with the in-fant and parents. “I’ll visit the parents in the hospital with a packet of information and make sure feeding is going well,” she says. “Then I’ll alert the plastic surgeon, otolaryngologist, and pediatric dentist so they can get in touch with the family within 24 hours to introduce them-selves and alleviate any concerns the parents might have.”

“The first thing we do is to make sure the baby can eat and drink properly,” says Dr. Tsoi. “Many times a baby with cleft lip and palate

won’t be able to generate adequate suction pressure to feed. So our first priority is to make sure the baby is getting nutrition and the moth-er feels comfortable doing the feeding.”

After the initial newborn period, the family will meet with the entire team at the same time to formulate a plan. The initial surgery takes place sometime after the baby is three months old. “The first surgery is so important because it sets the whole stage for the final result,” says Dr. Boustred. “Parents need to be sure that they have the first surgery done by a team that really knows what they’re doing and consistently gets good results.”

Continuing CareDepending on the size and severity of the

cleft, the first surgery will usually be followed by several more until the child is fully grown, in-cluding possible revision surgery before the child enters school at five to six years of age. “It’s a sensitive time. We want to make sure the child is accepted well by his or her peers,” says Dr. Tsoi. “We don’t want the cleft lip and palate to become a point of contention that takes away from other development.”

Dr. Boustred notes that the expectations of surgery are much higher than they were even 10 years ago. “We’re doing a lot less surgeries now because we have better techniques and are getting better results right off the bat,” says Dr. Boustred. “For example, performing nose repair at the same time as lip repair can produce bet-ter results. We also have new techniques that focus more on the muscles of the palate and restoring anatomy and function. We are getting away from surgeries that cause excessive scar-ring. There are also growth impact studies that give us a good idea of which types of surgery negatively impacted the child’s growth.”

After surgery there is other work to be done, most often with speech. “Sometimes there are problems with speech, even though the palate cleft is closed, and a small number of children may need additional surgery,” says Dr. Boustred. Ongoing speech evaluation is very important and that’s where Brohard comes in. “When the baby starts talking between the age of 10 and 12 months, it’s my job to look at language de-velopment, appropriate speech sound produc-tion, intelligibility, and resonance,” she says. “The ultimate goal is good speech.”

Children with cleft lip and palate may be in speech therapy for years, as they grow and go through additional surgeries. “I feel like we do a really good job here in optimizing their speech and intelligibility,” she says. “There may be a structural limit to speech development, but our goal is that someone who doesn’t know these kids will be able to understand 85 to 90 percent of what they’re saying.”

World-class Reconstruction in Northern Colorado

“The goal of the Cleft Clinic is to offer world-class cleft lip and palate reconstruction in Northern Colorado,” says Dr. Boustred, who came to Fort Collins in August 2008, from Penn-sylvania State University, where he was profes-sor and director of the craniofacial unit. He’s considered an expert in the field. “I’m confident we can offer patients here the same services they can get anywhere else, only we can offer

The PVH Cleft Clinic has done amazing work repairing cleft lip and

palate. Here are a few of the children they have been

able to help.

CONTINUED ON PAGE 68

33


P H Y S I C I A N ’ S S U R G E O N ’ S

If you're having a baby, were here for you.

If you're expecting a baby, the team of physicians

and birthing center professionals at Medical

Center of the Rockies are here to ensure that you

and your baby have a safe, comfortable delivery.

We look forward to being part of your specia l day.

TAKE A TOUR

Come take a tour of our state-of-the-art

birth ing center.

Call for a schedule of upcoming tour dates-

970-495-7500.

PVHS was one of only

three organizations in

the entire United States

to earn this honor and

was the only 2008 health

care recipient.

D I R E C T O R YD I R E C T O R Y

P H Y S I C I A N ’ S S U R G E O N ’ S

Donn M. Turner, M.D. • Timothy C. Wirt, M.D.Hans C. Coester, M.D. • Douglas W. Beard, M.D.

PRECISIONWHEN

PRECISIONCOUNTS

MOST

New patients and referrals are welcome.Ft. Collins:

1313 Riverside Ave. • (970) 493-1292Greeley:

2001 70th Ave. • (970) 356-4488Loveland:

2500 Rocky Mountain Ave. Ste. 360 • (970) 669-0470(800) 458-0306 • www.brain-spine.com

• We use the same precision and respect for nervous tissue required for brain surgery in your spine surgery.

• We use the latest technological advances in spine care, such as cervical and lumbar disc replacement, minimally invasive surgery, and kyphoplasty.

• We regularly review each other’s surgical recommendations providing a second opinion for free, without charge to you.

• We routinely work together assisting each other in the surgical procedure.

• Together we now have over 95 years of neurosurgical and orthopaedic spine experience and more combined continuing education than any other spine practice in our region.

• Our practice has a spine and brain surgeon on call for emergencies 24 hours, 7 days a week, at all local hospitals, and provide the brain and spine surgery trauma coverage for regional trauma centers at NCMC and MCR.

• We work in all of the hospitals and surgery centers in the tri-city region thereby allowing you to choose the facility most convenient for you and your family.

We are in network with all the major insurance carriers in our region, ensuring that you will be able to maximize your insurance benefits.

Specialists in Spine and Brain Surgery Since 1978

NEUROSURGERY & ORTHOPAEDIC SPINE SERVICES

ALL IN ONE PRACTICEThe blend of both neurosurgery and orthopaedics in one practice is unique to the region! This allows our surgeons to offer patients the best and most comprehensive care from both disciplines.36

Donn M. Turner, M.D. • Timothy C. Wirt, M.D.Hans C. Coester, M.D. • Douglas W. Beard, M.D.

PRECISIONWHEN

PRECISIONCOUNTS

MOST

New patients and referrals are welcome.Ft. Collins:

1313 Riverside Ave. • (970) 493-1292Greeley:

2001 70th Ave. • (970) 356-4488Loveland:

2500 Rocky Mountain Ave. Ste. 360 • (970) 669-0470(800) 458-0306 • www.brain-spine.com

• We use the same precision and respect for nervous tissue required for brain surgery in your spine surgery.

• We use the latest technological advances in spine care, such as cervical and lumbar disc replacement, minimally invasive surgery, and kyphoplasty.

• We regularly review each other’s surgical recommendations providing a second opinion for free, without charge to you.

• We routinely work together assisting each other in the surgical procedure.

• Together we now have over 95 years of neurosurgical and orthopaedic spine experience and more combined continuing education than any other spine practice in our region.

• Our practice has a spine and brain surgeon on call for emergencies 24 hours, 7 days a week, at all local hospitals, and provide the brain and spine surgery trauma coverage for regional trauma centers at NCMC and MCR.

• We work in all of the hospitals and surgery centers in the tri-city region thereby allowing you to choose the facility most convenient for you and your family.

We are in network with all the major insurance carriers in our region, ensuring that you will be able to maximize your insurance benefits.

Specialists in Spine and Brain Surgery Since 1978

NEUROSURGERY & ORTHOPAEDIC SPINE SERVICES

ALL IN ONE PRACTICEThe blend of both neurosurgery and orthopaedics in one practice is unique to the region! This allows our surgeons to offer patients the best and most comprehensive care from both disciplines.

970.493.53341.866.493.5334toll free:

2001 S. Shields, Building E, Suite 101Fort Collins, CO

Pediatrics & Adult

Sinus & Nasal Disease

Endoscopic Sinus Surgery

Meniere’s Disease & Balance Disorders

Hearing & Diseases of the Ears

Head & Neck Surgery

Voice Disorders

Snoring & Sleep Apnea

Coblation Tonsillectomy

Injection Snoreplasty

ADVANCED OTOLARYNGOLOGY, PC.

EAR, NOSE THROATDISORDER SPECIALISTS

&

Mark Loury, MD, F.A.C.S.Board CertifiedFormer Faculty of John’s Hopkins Hospital

Listed in “Best Doctors in America”and “America’s Best Doctors”.Patients Choice Recipient 2008Nationally Recognized Expert in Sinus & Nasal Disease.

Brooke Benton, PA-CChild Health Association/PhysicianAssistant Program, University of Colorado HealthSciences Center of Denver

Focus on General Ear, Nose & Throat

37


38 -..... _ . ....... .:;,.

When it's a face you love, were here for you. Serious injuries to the face require highly specialized trauma care_

And the fact is, the facial surgeons with the most experience

create the best possible outcomes_

Our physician specialists provide the expertise you need for

serious facial injuries_ Uniquely skilled to restore both delicate

aesthetics and function, the expert team at Trauma Center of the

Rockies gives extraordinary care, 24/7_

Specia lized response at a moment's notice and the best care in

the region for trauma patients_ Trauma Center of the Rockies is

part of Medical Center of the Rockies in Loveland_


Dear MeDical & Wellness Magazine reaDer:

The vision of Poudre Valley Health System is to “provide world-class healthcare.”That’s a huge statement. What does it mean? How do we determine that we provide world-class care?PVHS defines “world-class” as providing healthcare equal to or better than medical services offered

by the nation’s top 10 percent of best healthcare providers. Most of those best providers are perennially recognized in the healthcare industry as world-class organizations: Mayo Clinic, Johns Hopkins Hospital, Cleveland Clinic, and Massachusetts General Hospital, to name four.

We measure our health system against those providers by comparing patient satisfaction, length of patient stays, patient safety goals, mortality rates, hospital-acquired infection rates, cancer detection rates for mammography screenings, the number of patient falls, outcomes of sick babies in the neonatal intensive care unit, complications for such orthopedic procedures as joint replacements, and many other patient-care indicators. We also make comparisons in non-clinical areas, such as employee turnover, compliance and legal measures, staff and physician satisfaction, recycling efforts, earnings versus expenses, and a multitude of other measurements.

Some of the categories listed above may sound scary to persons unacquainted with the workings of healthcare. Mortality rates, fall rates, infections — yes, those bad things can happen in any hospital. The challenge is to keep the rates at a minimum, most preferably zero.

This is a challenge in which PVHS has been exceedingly successful. Here’s a brief look at some of our measurements and rankings, as tracked by organizations that are highly respected in the healthcare industry: PVHS patient satisfaction ranks in the top one percent of U.S. hospitals (there are approximately 5,000 hospitals in the nation), according to the U.S. Centers for Medicare and Medicaid Services (CMS). PVHS care of heart attack patients ranks in the national top 10 percent, again according to CMS. In 2008 and 2009, Poudre Valley Hospital was the nation’s No. 1 hospital for nursing quality, according to the American Nurses Association. PVHS ranks among the top three percent of U.S. hospitals for employee satisfaction and engagement, according to a national database of more than 1,000 hospital organizations. (A side note: Modern Healthcare named PVHS in its 2008 list of the best 100 places to work in healthcare.) PVHS ranks in the top one percent of U.S. hospitals for physician satisfaction and loyalty, according to Gallup, which conducts physician satisfaction surveys for the healthcare industry. PVHS was named one of only three U.S. organizations and the only healthcare organization to receive the 2008 Malcolm Baldrige National Quality Award, an honor established by Congress to recognize organizations with the best performance excellence. Finally, and this honor was announced in July 2009, PVH was named one of the 50 best hospitals that offer orthopedic care. The ranking came through U.S. News & World Report’s annual list of the nation’s best hospitals.

I could continue on with a long list of national awards and honors — more than 50 since 2004 — but I think you understand what I’m saying: PVHS is a world-class organization, providing world-class care.

With that thought in mind, this question begs to be heard: How did we get this way?It was a 10-year journey. We used management and operational principles recommended through

the national Malcolm Baldrige program. We conducted self-evaluations, underwent well-planned enhancements in our work processes, and developed the important mindset that we will be the very best.

That, simply put, was our journey. The critical energy that fueled the journey came from the dedication of local medical professionals and PVHS staff members. Unlike many of the nation’s healthcare organizations, PVHS employs only a very tiny handful of physicians. In the meantime, there are more than 650 private physicians and 200 allied healthcare professionals who have privileges at our two hospitals. These providers own their practices or work for private practices.

The providers work in close collaboration with the PVHS staff of 4,300 employees to offer world-class patient care. Unfortunately, this type of collaboration is lacking in some hospitals elsewhere in the U.S. The result in those hospitals: poor quality patient care.

In our case, the needs of the patient are the driving forces. All of us in the regions of northern Colorado, southern Wyoming and southwestern Nebraska served by PVHS are very fortunate to have top-quality, highly skilled, compassionate physicians and allied healthcare professionals ready to treat us. The same quality, skills and compassion can be found in PVHS staff members — like the physicians and allied professional, they are among the best in the world.

On behalf of PVHS and local physicians and allied healthcare professionals, I want to promise that our commitment to provide you world-class care will continue. It’s what we do.

Dr. William A. NeffChief Medical OfficerPoudre Valley Health System

WilliaM a. neFF, M.D.Chief Medical OfficerPoudre Valley Health System

39


WHAT WE KNOW ABOUT AND DIET- THE LATEST IN

MEET THE EXPERTS M IHO SCOIT, M .D .

PAOLA ROMERO , M .D .

ANNE KANARD, M .D .

REGINA BROWN, M .D .

MAITHEW SORENSEN , M .D .

T RICIA SMIKAHL, PA--C

Free to the general public.

Please reserve early as space is limited. Light refreshments, coffee and tea service.

Paolo Romero, MD Anne Kanard, MD Matthew Sorensen, MD Regina Brown, MD Miho Toi Scott, MA, MD

at the POUDRE VALLEY HOSPITAL HARMONY CAMPUS 2121 E. Harmony Rd. Suite 150, Fort Collins

www.cancerhealth.com 970.493.6337

2009PHYSICIAN’SFORT COLLINSdirectory*SURGEON’S&


ALLERGY/IMMUNOLOGY

Culver, William G., MD2001 S. Shields St., Bldg. H ............. 498.9226See ad on page 92

Gondalia, Lakhman L., MD Cheyenne, WY ................................... 307.778.2015

James, John M., MD1136 E. Stuart St., Bldg. 3-200 ......... 221.1681See ad on page 69

Kailasam, Velusamy, MD2121 E. Harmony Rd., Ste. 350 ........ 221.2370See ad on page 97

Kujawska, Anna, MD2001 S. Shields St., Bldg. H ............. 498.9226See ad on page 92

Lanting, William A., MD2121 E. Harmony Rd., Ste. 310 .............. 227-4611

Laszlo, Daniel J., MD2001 S. Shields St., Bldg. H ............. 498.9226See ad on page 92

Murthy, Krishna C., MD2121 E. Harmony Rd., Ste. 350 ........ 221.2370See ad on page 97

Seeley, Janet K., MD2001 S. Shields St., Bldg. H .....................498.9226

Vedanthan, P. K., MDLakewood, CO .......................................... 303.238.0471

ANESTHESIOLOGY

Alessi, Richard D., Jr. MD1236 E. Elizabeth St., Ste. 1 ............. 224.2985See ad on back cover

Bobo, Russell W., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Carline, Marylida, MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Cochran, Thomas S., Jr. MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Deringer, Michael A., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Derrisaw, James, MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Dunn, Duane L., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Eisenmenger, Michael J., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Fife, Jason D., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Ford, Troy A., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Harrison, William L., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Hodges, Kathleen A., MD1236 E. Elizabeth St., Ste.1 .....................224.2985

Horne, Stephen G., MD1236 E. Elizabeth St., Ste.1 .....................224.2985

Keate, Tyler L., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Koepp, Jeffrey, MD 1236 E. Elizabeth St. Ste. 1......................224.2985

Krohn, Douglas, MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Lichon, Amy, DO1236 E. Elizabeth St., Ste.1 .....................224.2985

Marks, Sandy C., III MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Markus, Jennifer L., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Martinez, Alice, MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Miller, Justin D., MD1236 E. Elizabeth St., Ste.1 .....................224.2985

Moss, William E., DO1236 E. Elizabeth St., Ste. 1 ....................224.2985

Neff, William A., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Olsen, Kimberlee J. MD1236 E. Elizabeth St., Ste. 1.....................224.2985

Perschau, Erik R., DO1236 E. Elizabeth St., Ste. 1 ....................224.2985

Raymond, Jeffrey MD1236 E. Elizabeth St., Ste. 1.....................224.2985

Reed, Jay A., MD3800 N. Grant Ave (Loveland) ...................622.0608

Richardson, Emily C., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Ryan, Kathleen D. MD1236 E. Elizabeth St., Ste. 1.....................224.2985

Salimbeni, Julio C., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Serell, Sean M., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Stenbakken, Gelerie D., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Velasco, Stephen E., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Vizena, Annette D., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Wagner, Jan Gillespie, MD1175 58th Avenue, Ste. 202 (Greeley) ......495.0300

Watrous, Dwain D., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Weiner, Kelli L., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Williams, Daniel K., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

Williams, Wendy M.H., MD1236 E. Elizabeth St., Ste. 1 ....................224.2985

CARDIOLOGY

Ashmore, Roger C., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Austin, Wendy J., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Baker, William B., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Doing, Anthony H., MD 2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Dow, Tristan J., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Downes, Thomas R., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Green, C. Patrick, MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Johnson, C. Timothy, MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Larson, Dennis G., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Luckasen, Gary J., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Miller, William E., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Myers, Gerald I., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Oldemeyer, John Bradley, MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Purvis, Matthew T., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000 See ad on page 43

Stoltz, Chad Lynn, MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000 See ad on page 43

Strote, Justin A., MD2121 E. Harmony Rd., Ste. 100 ....... 221.1000See ad on page 43

Tate, Charles, MD2121 E. Harmony Rd., Ste. 100 ....... 221.1000See ad on page 43

Treat, Stephen A., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Voyles, Wyatt F., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

Whitsitt, Todd B., MD2121 E. Harmony Rd., Ste. 100 ........ 221.1000See ad on page 43

DERMATOLOGY

Baack, Brad, MD1120 E. Elizabeth St., Bldg. G2 ................484.6303

Hultsch, Anne-Lise, MD 3726 S. Timberline Rd., Ste. 101 .............221.5795

Kornfeld, Bruce W., MD1006 Centre Ave. .....................................482.9001

Sayers, Clinton P., MD1120 E. Elizabeth St., Bldg. G2 ................484.6303

42

West, B. Lynn, MD 3726 S. Timberline Rd., Ste. 101 ...............221.579

EAR, NOSE & THROAT(OTOLARYNGOLOGY)

Chand, Maria S., MD1006 Centre Ave. .....................................482.9001

Conlon, William Sean, MD1032 Luke St. ...........................................484.8686

Eriksen, Christopher M., MD, FACS1120 E. Elizabeth St., F-101 .............. 221.1177See ad on back cover

Gill, Sarvjit “Sarge,” MD3820 N. Grant Ave. (Loveland) ...................593.1177

Gupta, Sanjay K., MD6500 29th Street, Ste.105 (Greeley) .........330.5555

Loury, Mark C., MD, FACS2001 S. Shields St., Bldg. E-101 ...... 493.5334See ad on 37 & back cover

Robertson, Matthew L., MD1120 E. Elizabeth F-101 ..........................221.1177

Runyan, Brad, MD2121 E. Harmony Rd., Ste. 350 ........ 212.0169See ad on back cover

Smith, Bruce M., MD2121 E. Harmony Rd., Ste. 350 ........ 484.6373See ad on back cover

Young, Dayton L., MD ............................. Fort Collins

Zacheis, David H., MD3820 N. Grant Ave. (Loveland) ...................593.1177

EMERGENCY MEDICINE

Apostle, Michael J., MD1024 S. Lemay Ave...................................495.7000

Dellota, Kriss, MD1024 S. Lemay Ave...................................495.7000

Farstad, David J., MD 1024 S. Lemay Ave...................................495.7000

Garth, Alisha P., MD1024 S. Lemay Ave....................................495.7000

Green, Gabriel E., DO1024 S. Lemay Ave....................................495.7000

Green, Jason T., DO1024 S. Lemay Ave....................................495.7000

Hallahan, Tara A. DO1024 S. Lemay Ave...................................495.7000

Johar, Jasjot S., MD1024 S. Lemay Ave...................................495.7000

Johnston, P. Scott, MD1024 S. Lemay Ave...................................495.7000

Litel, Alexa L., MD1024 S. Lemay Ave...................................495.7000

Luttrell, Matthew, MD1024 S. Lemay Ave...................................495.7000

Olsen, Eric B., MD1024 S. Lemay Ave...................................495.7000

Patrick, Kenneth M., DO1024 S. Lemay Ave...................................495.7000

Repert, William B., MD1024 S. Lemay Ave...................................495.7000

Solley, Matthew C., MD1024 S. Lemay Ave...................................495.7000

Springfield, Tracy J., MD1024 S. Lemay Ave...................................495.7000

Teumer, James K., DO1024 S. Lemay Ave...................................495.7000

Tremblay, Darren E., DO1024 S. Lemay Ave....................................495.7000

Turner, Daniel T., MD1024 S. Lemay Ave...................................495.7000

Updegraff, Jeffrey G., MD1024 S. Lemay Ave...................................495.7000

Weil, Lawrence J., MD1024 S. Lemay Ave...................................495.7000

Wideman, Eric DO1024 S. Lemay Ave...................................495.7000

Wood, Ian O., DO1024 S. Lemay Ave...................................495.7000

ENDOCRINOLOGY

Izon, Meriam P., MD2121 E. Harmony Rd., Ste. 300 ...............295.0010

Widom, Barbara, MD1040 E. Elizabeth St., Ste. 101 ............... 224-3636

FAMILY MEDICINE

Abrahamson, Bradley S., MD1107 S. Lemay Ave. Ste. 200 ............ 484.1757See ad on page 44

Abrahamson, Lara, MD1635 Blue Spruce Dr. ...............................494.4040

Adamson, Theran B., MD2021-D Battlecreek Dr..............................206.0851

Ahern, Caitlin M., MDAkron, CO .......................................... 970.345.6336

Anderson, Robert Scott, MD3519 Richmond Dr. .......................... 204.0300See ad on page 44

Andreen, Kristin, MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Askew, Crystal D., MD1918 S. Lemay Ave., Ste. A ......................494.4531

Bailey, Austin G., Jr MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Bakanauskas, Egle A., MD1300 Main St., (Windsor)......................... 686.5646

Basow, William M., MD2500 Rocky Mountain Ave. (Loveland) ............495.8450

Beck, Susan M., MD3850 Grant St., Ste 100 (Loveland) .. 669.5717See ad on page 90

Bender, Edward L., MD1212 E. Elizabeth St. ................................482.2791

Bender, John Lumir, MD4674 Snow Mesa Dr., Ste. 140.................482.0213

Bermingham, Roger P., MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Bethards, Kelby F., MD ............................ Fort Collins

Birnbaum, Bernard J., MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Bresowar, Kristin, MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Brewington, Flora Ho, MD1124 E. Elizabeth, Bldg. C ......................484.0798

Brickl, Ian D., MD1635 Blue Spruce Dr. ...............................494.4040

Broman, Steven D., MD1107 S. Lemay Ave. Ste. 200 ............ 484.1757See ad on page 44

Burnham, Linda A., MD1918 S. Lemay Ave., Ste. A ......................494.4531

Butler, Lisa R., DO1212 E. Elizabeth St. ................................482.2791

Cawley, John, MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Choate, Miriam, MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Coburn, Thomas C., MD1455 Main St., Ste.150, (Windsor) ... 686.0124See ad on page 44

Cranor, J. David, MD1124 E. Elizabeth St., Bldg. C ..................484.0798

de la Torre, Rebecca A., MD2032 Lowe St., Ste. 103 ..........................223.0193

DeYoung, Douglas B., DO1024 Centre Ave., Bldg. E-100A ..............484.0774

Duran, Christine B., MD1212 E. Elizabeth St. ................................482.2791

Duran, Matthew G., MD1212 E. Elizabeth St. ................................482.2791

Ferguson, David R., MD3000 S. College Ave. Ste. 210 .................266.8822

Fields, Jacqueline C., MD315 Canyon Ave., Ste. 1 ...........................472.6789

Fritzler, Stace A., MD2121 E. Harmony Rd., Ste. 370 ...............221.2290

Geppert, Margo J., MD2818 McKeag Dr.. .....................................225.2811

Glazner, Cherie, MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Goacher, Cynthia, MD2121 E. Harmony Rd.. ..............................297.6250

Gray, April K., MD1918 S. Lemay Ave., Ste. A ......................494.4531

Grossman, Daniel R., MD2121 E. Harmony Rd., Ste. 370 ...............221.2290

Haldy, Megan, DO1025 Pennock Pl. .............................. 495.8800See ad on page 90

Haskins, R. Scott, MD6801 W. 20th Street, Ste. 101 (Greeley) ....378.8000

Henderson, Sandra E., MD2025 Bighorn Dr. ............................... 229.9800See ad on page 44

Hiam, Sarah E., DO1635 Blue Spruce Dr. .............................. 494-4040

Hill, Brian, MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Hoenig, Mark W., MD2362 E. Prospect Rd., Ste. A ...................495.0999

Hopkins, Jan H., MD1120 E. Elizabeth St., Bldg. G-1...............493.2776

Jackson, Rebecca, DO1025 Pennock Pl. .............................. 495.8800See ad on page 90

Janasek, Mitchell J., MD2121 E. Harmony Rd., Ste. 310 .............. 221.3855

42

43For the lifesaving story of

retired Poudre High School

counselor Ray Gefroh, visit

heartcenteroftherockies.com.

MEDICAL CENTER OF THE ROCKIES POU D R E VALL E Y H EA LTH SYS TEM

pvhs.org

At Medical Center of the Rockies, cardiologist Brad

Oldemeyer and his team want to open the blocked

arteries of heart attack patients as quickly as possible .

Why? Because faster response times save lives.

They are part of a national initiative focused on reducing

the time it takes from a heart attack patient's arrival at

the hospital doors to the moment a balloon catheter

clears the blockage. The shorter this "door-to-balloon"

time, the more likely the patient will survive and recover.

In 2008, MCR's average door-to-balloon time for

qualifying patients was 48 minutes - well below

the national goal of 90 minutes, as set by the Center

for Medicare and Medicaid Services and the Joint

Commission .

It's comforting to know that doctors like Dr. Oldemeyer

have your future at heart.

~ Heart Center OF THE ROCKIES

PO UD RE VAL LEY HEALT H SYSTEM

For more information or to

make an appointment,

please call (970) 221-1000

or (800) 459-4521.

heartcenteroftherockies.com

44

Jinich, Daniel B., MD2001 S. Shields St., Bldg. E-201 ..............221.9991

Johns, Stacie L., MD1635 Blue Spruce Dr. ...............................494.4040

Kaleta, Andrea D., MD2025 Bighorn Dr. ............................... 229.9800See ad this page

Kauffman, Jeffrey N., MD1124 E. Elizabeth St., Bldg. C ..................484.0798

Kesler, James M., MD3519 Richmond Dr. ........................... 204.0300See ad this page Klinger, Susan K., MD2025 Bighorn Dr. ............................... 229.9800See ad this page

Kuroiwa, Christina L., MD8031 Campus Delivery .............................491.7121

Latter, Macy, DO1025 Pennock Pl. .............................. 495.8800See ad on page 90

Lembitz, Deanne D., MD4630 Royal Vista Dr., Ste.7 (Windsor) ..................530.0575

Lesage, Margaret R., MD1455 Main St,Ste. 150 (Windsor) ..... 686.0124See ad this page

Lockwood, Stephanie R., MD3519 Richmond Dr. ........................... 204.0300See ad this page

Loeb, Mark H., MD2121 E. Harmony Rd., Ste. 310 ...............221.3855

Lopez, Joseph M., MD1136 E. Stuart St., Bldg. 4, Ste. 202 .......221.5925

Lowther, Kelly H, MD4674 Snow Mesa Dr., Ste. 140.................482.0213

Lupica, Michelle, DO1025 Pennock Pl. .............................. 495.8800See ad on page 90

MacDonald, Nola A., DO315 Canyon Ave., Ste. 3 ...........................472.8008

Mallory, Patrick, DO1548 N. Boise Ave. (Loveland) ...................669.9245

Marchant, David R., MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Mason, R. Anthony, MD4630 Royal Vista Dr., Ste. 7 (Windsor) .................530.0575

Mayer, Paul T., MD1635 Blue Spruce Dr. ...............................494.4040

McCarthy, Victoria A., MD2001 S. Shields St., Bldg. I ............... 221.5255See ad this page

McCreery, Colleen R., DO3519 Richmond Dr. ........................... 204.0300See ad this page

McIntosh, Deric, DO1025 Pennock Pl. .............................. 495.8800See ad on page 90

Mercer, Jeannette Y., MD2555 E. 13th Street, Ste.110 (Loveland) .. 461.6140

Merkel, Lawrence A., MD2121 E. Harmony Rd., Ste. 370 ...............221.2290

Miller, Laurie A., MD1635 Blue Spruce Dr. ...............................494.4040

Monaco, Julie A., MD1635 Blue Spruce Dr. ...............................494.4040

Murphy, Lawrence E., MD1113 Oakridge Dr. .............................. 225.0040See ad this page

Naqvi H. Faraz, MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Nevrivy, Thomas E., MD3519 Richmond Dr. ........................... 204.0300See ad this page

Orozco-Peterson, Marilu, MD811 E. Elizabeth St. .................................224.1596

Ottolenghi, David R., MD2121 E. Harmony Rd., Ste. 310 ...............221.3855

Palagi, Patricia C., MD3000 S. College Ave., Ste. 210 ................266.8822

Podhajsky, Tim P., MD2025 Bighorn Dr. ............................... 229.9800See ad this page

Robinson, Anne L., MD1107 S. Lemay Ave. Ste. 200 ............ 484.1757See ad this page

Rodriguez, Juan B., DO4674 Snow Mesa Dr., Ste. 140.................482.0213

Rotman, Mark F., MD2001 S. Shields St., Bldg. I ............... 221.5255See ad this page

Rubright, Jon S., MD3519 Richmond Dr. ........................... 204.0300See ad this page

Sachtleben, Thomas R., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Samelson, Scott G., MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Samuelson, Scott J., MD1124 E. Elizabeth St., Bldg. C ..................484.0798

Sands, Arthur C., MD1021 Robertson St. ..................................482.0666

Schmidt, David S., MD2001 S. Shields St., Bldg. I ............... 221.5255See ad this page

Schnee, Bradley K., MD1625 Foxtrail Dr. ................................ 619.6900See ad on page 90

Seeton, James F., MD2121 E. Harmony Rd., Ste. 310 ...............221.3855

Serrano-Toy, Monica T., MD2121 E. Harmony Rd. Ste. 370 ............... 221.2290

Shamis, Mason, MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Siple, Anne I., MD1625 Foxtrail Dr. ................................ 619.6900See ad on page 90

Smith, Jerome I., MD2025 Bighorn Dr. ............................... 229.9800See ad this page

Stephens, Floyd V., MD1113 Oakridge Dr. .............................. 225.0040See ad this page

Stoddard, Andrew P., MD2520 W. 16th Street (Greeley) .....................356.2520

Sullivan, Donna L., MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Sunthankar, Shivalini M., MD1014 Centre Ave. .....................................482.8881

Taylor, Grant, DO608 E. Harmony Rd., Ste. 101 .......... 204.9669See ad on page 61

Thieman, William J., MDPO Box 272369........................................297.6250

Thompson, Breanna, DO1025 Pennock Pl. .............................. 495.8800See ad on page 90

Thorson, Steven J., MD1212 E. Elizabeth St. ................................482.2791

Tippin, Steven B., MD2025 Bighorn Dr. ............................... 229.9800See ad on page

Toth, Tiffany, DO1025 Pennock Pl. .............................. 495.8800See ad on page 90

Towbin, Michael M., MD1217 Riverside Ave.................................. 482.7800

Unger, Mark S., MD1113 Oakridge Dr. .............................. 225.0040See ad this page

Valley, George E., MD3000 S. College Ave., Ste. 210 ................266.8822

Van Farowe, Cynthia K., MD3519 Richmond Dr. ........................... 204.0300See ad on page 44

Weaver, Derek, DO1025 Pennock Pl. .............................. 495.8800See ad on page 90

Webber, Pamela, S., MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Weiskittel, Deborah A., MD1113 Oakridge Dr. .............................. 225.0040See ad on page 44

Weixelman, Janice M., DO8017 First Street #C (Wellington) ...........568.4800

Wetherbee, Katharine, DO1025 Pennock Pl. .............................. 495.8800See ad on page 90

Wideman, JD, DO2001 S. Shields St., Bldg. I ............... 221.5255See ad on page 44

Wilson, Fiona A., MD1107 S. Lemay Ave. Ste. 200 ............ 484.1757See ad on page 44

Winefrey, Ivory, MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Wozniak, Janell R., MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Ziegler, David, MD1025 Pennock Pl. .............................. 495.8800See ad on page 90

Zucker, Charles I., MD6801 W. 20th Street, Ste. 101(Greeley) .....378.8000

FAMILY PRACTICE/SPORTS MEDICINE

Servi, Jane T., MD2121 E. Harmony Rd., Ste. 290 ...............224.9890

Yemm, Stephen J., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

GASTROENTEROLOGY

Burgert, Stephen L., MD2555 E.13th Street, Ste. 220 (Loveland) .. 669.5432

Compton, Rand F., MD3702 Timberline Dr., Bldg. A ................... 207.9773

Dowgin, Thomas A., MD3702 Timberline Dr., Bldg. A ....................207.9773

Dunphy, Rebecca C., MD3702 Timberline Dr., Bldg. A ....................207.9773

Durkan, Mark N., MD3702 Timberline Dr., Bldg. A ....................207.9773

Holland, Rod R., MD3702 Timberline Dr., Bldg. A ....................207.9773

Jenkins, Joseph X., MD3702 Timberline Dr., Bldg. A ....................207.9773

Langer, Daniel, MD3702 Timberline Dr., Bldg. A ....................207.9773

McElwee, Hugh P., MD3702 Timberline Dr., Bldg. A ....................207.9773

Nosler, Michael J., MD3702 Timberline Dr., Bldg. A ....................207.9773

Sears, Stephen, MD2555 E.13th Street, Ste. 220 (Loveland) .. 669.5432

Simmons, Robert A., MD3702 Timberline Dr., Bldg. A ....................207.9773

Strong, Lewis R., MD2555 E.13th Street, Ste. 220 (Loveland) .. 669.5432

Witt, Peter C., MD2500 Rocky Mnt Ave.NMOB (Loveland) .. 350.2440See ad on page 99

GYNECOLOGY

Lepine, Lisa, MDBoulder, CO ....................................... 720.382.2621

Thayer, David O., MDBoulder, CO ....................................... 303.443.2010

HEMATOLOGY/ONCOLOGY

Brown, Regina, MD2121 E. Harmony Rd., Ste. 150 ........ 493.6337See ad on page 40

Fangman, Michael P., MDP.O. Box 271040 .......................................217.5160

Kanard, Anne Margaret, MD2121 E. Harmony Rd., Ste. 150 ........ 493.6337See ad on page 40

Kemme, Douglas J., MD2500 Rocky Mnt Ave.NMOB (Loveland) ....203.7080See ad on page 99

Lininger, Thomas R., MD1800 15th Street, Ste.C (Greeley) ................ 378.4170

Marschke, Robert F. Jr., MD2315 E. Harmony Rd., Ste. 110. ..............212.7600

45Fort Collins Medical Magazine & Directories 2009 2010 45


46

McFarland, Ross W., MD2315 E. Harmony Rd., Ste. 110. ..............212.7600

Medgyesy, Diana C., MD2315 E. Harmony Rd., Ste. 110. ..............212.7600

Moore, James C., MD2315 E. Harmony Rd., Ste. 110. ..............212.7600

Romero, Paolo, MD2121 E. Harmony Rd., Ste. 150 ........ 493.6337See ad on page 40

Scott, Miho Toi, MD2121 E. Harmony Rd., Ste. 150 ........ 493.6337See ad on page 40

Shelanski, Samuel A., MD2500 Rocky Mnt Ave.NMOB (Loveland)....203.7080See ad on page 99

Sorensen, Matthew D., MD2121 E. Harmony Rd., Ste. 150 ........ 493.6337See ad on page 40

Stone, Michael D., MD1800 15th Street, Ste.C (Greeley) ................ 378.4170

HOSPICE & PALLIATIVE CARE

Allen, David K., MD305 Carpenter Rd. ............................ 292.0179See ad on page 61

INFECTIOUS DISEASES

Cobb, David K., MD, FACP2121 E. Harmony Rd., Ste. 380 ...............224.0429

LiaoOng, Jacob C., MD2121 E. Harmony Rd., Ste. 380 ...............224.0429

Peskind, Robert L., MD2121 E. Harmony Rd., Ste. 380 ...............224.0429

INTERNAL MEDICINE

Abbey, David M., MD1100 Poudre River Dr. ..............................224.9508

Alessi, Grace, MD2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050See ad on page 99

Asadi, S. Daniel, DO4401 Union St. (Johnstown) ............ 219.2423See ad on page 68

Berntsen, Mark F., MD2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050See ad on page 99

Cash, Robert L, MD1900 16th Street (Greeley) ........................350.2438

Christiansen, Dana L., MD2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050See ad on page 99

Ebens, John B, MD2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050See ad on page 99

Ellis, Robert H., MD................................. Fort Collins

Hendrick, James D., MD4674 Snow Mesa Dr., Ste. 100.................482.3712

Hendrick, Jennifer M., MD4674 Snow Mesa Dr., Ste. 100.................482.3712

Herrera, Xavier, MD1100 Poudre River Dr. ..............................224.9508

Homburg, Robert C., MD1100 Poudre River Dr. ..............................224.9508

Juhala, Robert J., MD4674 Snow Mesa Dr., Ste. 100.................482.3712

Knepper, Katherine L., MD4674 Snow Mesa Dr., Ste. 100.................482.3712

Lopez, William, Jr MD2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050See ad on page 99

Lynch, Michael J., DO1101 Oakridge Dr., Ste. B.........................223.1199

Orton, Lambert C., MDSteamboat, CO .................................. 970.879.3327

Ow, Cathy L., MD4674 Snow Mesa Dr., Ste. 100.................482.3712

Randle, Michael T., MD2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050See ad on page 99

Reimer, Christina, MD4674 Snow Mesa Dr., Ste.100 ..................482.3712

Reinhardt, Marcus R., MD2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050See ad on page 99

Stafford, Neil K., MD1100 Poudre River Dr. ..............................224.9508

Sunderman, Steve R., MD607 Castle Ridge Ct. .................................223.8922

Thompson, Keith S., MD2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050See ad on page 99

Tryggestad, David I., MD1900 16th Street. (Greeley)............................350.2438

Zenk, Daniel R., MD2500 Rocky Mnt Ave.NMOB (Loveland)....203.7050See ad on page 99

INTERNAL MEDICINE/HOSPITALIST

Austin, William Bennett., MD2121 E. Harmony Rd., Ste 300 ................207.9958

Clipsham, Victoria A., MD2121 E. Harmony Rd., Ste 300 ................207.9958

Filipowski, Piotr J., MD2121 E. Harmony Rd., Ste 300 ................207.9958

Gaines, Jennifer L, MD2121 E. Harmony Rd., Ste 300 ................207.9958

Johnston, Christine G., MD2121 E. Harmony Rd., Ste 300 ................207.9958

Kopel, Charles S., MD2121 E. Harmony Rd., Ste 300 ................207.9958

LumLung, Christine M., MD2121 E. Harmony Rd., Ste 300 ................207.9958

Reghitto, Charmaine, MD2121 E. Harmony Rd., Ste 300 ................207.9958

Spannring, Mary M., MD2121 E. Harmony Rd., Ste 300 ................207.9958

Thieszen, John M., MD2121 E. Harmony Rd., Ste 300 ................207.9958

Yoder, Elizabeth Anne, MD2121 E. Harmony Rd., Ste 300 ................207.9958

INTERNAL MEDICINE/PEDIATRICS

Drysdale, Christopher R., MD4674 Snow Mesa Dr., Ste. 120.................266.3650

Lang, Christina, MD4674 Snow Mesa Dr., Ste. 120.................266.3650

Simmons, Mark S., MD4674 Snow Mesa Dr., Ste. 120.................266.3650

MATERNAL & FETAL MEDICINE

Heyborne, Kent D., MDDenver, CO ........................................ 303.860.9990

Porreco, Richard P., MDDenver, CO ........................................ 303.860.9990

Stettler, R. William, MDDenver, CO ........................................ 303.860.9990

NEONATOLOGY

Hall, Daniel M., MDAurora, CO ........................................ 303.724.2840

MacRitchie, Amy N., MDPVH, 1024 S. Lemay Ave. .........................495.8280

Paisley, Jan E., MDPVH, 1024 S. Lemay Ave. .........................495.8282

Satterwhite, Daniel J., MDPVH, 1024 S. Lemay Ave. .........................495.8280

Thilo, Elizabeth H., MDAurora, CO ........................................ 303.724.2840

Wilkening, Randall B., MDAurora, CO ........................................ 303.724.2840

NEPHROLOGY

Merritt, Jason L., MD1600 Specht Point Rd., Ste.127 ....... 493.7733See ad this page

Muelken, Kevin D., MD1600 Specht Point Rd., Ste.127 ....... 493.7733See ad this page

Rademacher, Donald R., MD1900 16th Street (Greeley) ......................350.2438

46


Simmons, Richard E., MD1600 Specht Point Rd., Ste127 ........ 493.7733See ad on page 46

Singer, James R., MD1600 Specht Point Rd., Ste.127 ....... 493.7733See ad on page 46

Teruel, Mark A., MD1600 Specht Point Rd., Ste.127 ....... 493.7733See ad on page 46

NEUROLOGY

Allen, Timothy J., MD2121 E. Harmony Rd., Ste. 270 ........ 221.1993See ad on page 21 & 46

Curiel, Michael P., MD2121 E. Harmony Rd., Ste. 270 ........ 221.1993See ad on page 21 & 46

Friedman, Sheri J., MD1221 E. Elizabeth St., Ste.3 .....................482.4373

Himes,Terry M., DO2500 Rocky Mnt Ave., Ste.310 (Loveland) ...619.6000

McIntosh, Gerald C., MD1221 E. Elizabeth St., Ste. 3 ....................482.4373

Meredith, Lawrence A., MD310 E. 5th Street (Loveland).........................667.7664

Miller, Tamara A., MD2121 E. Harmony Rd., Ste. 180 ...............226.6111

Nash, Jerry D., MD2121 E. Harmony Rd., Ste. 180 ...............226.6111

Schumann, Richard R. Jr., MD2500 Rocky Mnt Ave., Ste.310 (Loveland) ..619.6000

Tolge, Celina F., MD5890 W. 13th Street, Ste. 112 (Greeley).....353.2255

OBSTETRICS/GYNECOLOGY

Beresford, Kaea, MD1107 S. Lemay Ave. Ste. 300 ...................493.7442

Carter, Susan D., MD1800 15th Street, Ste. 220 (Greeley) ........353.1335

Cloyd, David G., MD1136 E. Stuart St., Bldg. 2, Ste. 100 .......493.5904

Donnelley, Beverly E., MD1107 S. Lemay Ave. Ste. 300 ............ 493.7442See ad on back cover

Hayes, Karen E., DO1224 E. Elizabeth St. ................................221.4977

Hayes, Kimberly W., MD1136 E. Stuart St., Bldg. 2, Ste. 100 .......493.5904

Hoffman, Mark F., MD1136 E. Stuart St., Bldg. 2, Ste. 100 .......493.5904

James, Warren K., MD1107 S. Lemay Ave. Ste. 300 ............ 493.7442See ad on back cover

Jeffrey, Ransy L., MD1107 S. Lemay Ave. Ste. 300 ...................493.7442

Kieft, Larry D., MD1136 E. Stuart St., Bldg. 2, Ste. 100 .......493.5904

King, Angela, MD 1107 S. Lemay Ave. Ste. 300 ...................493.7442

Kozak, Susan H., MD1107 S. Lemay Ave. Ste. 300 ............ 493.7442See ad on back cover

Micetich, Kara L., MD1107 S. Lemay Ave. Ste. 300 ............ 493.7442See ad on back cover

Priebe Philip N., MD1107 S. Lemay Ave. Ste. 300 ............ 493.7442See ad on back cover

Serniak, Elizabeth K., MD1107 S. Lemay Ave. Ste. 300 ............ 493.7442See ad on back cover

Skorberg, Christine F., MD1006 Luke St. ...........................................419.1111

Stern, J. Bradley, MD1107 S. Lemay Ave. Ste. 300 ...................493.7442

Tool, Audrey L., MD 1107 S. Lemay Ave. Ste. 300 ............ 493.7442See ad on back cover

Tool, Kevin J., MD1107 S. Lemay Ave. Ste. 300 ............ 493.7442See ad on back cover

Vance, Maude M., MD1107 S. Lemay Ave. Ste. 300 ...................493.7442

Yeh, Eric M., MD1107 S. Lemay Ave. Ste. 300 ...................493.7442

OBSTETRICS/GYNECOLOGY/INFERTILITY

Bachus, Kevin E., MD1080 E. Elizabeth St. ......................... 493.6353See ad on page 45, page 63 and back cover

OCCUPATIONAL MEDICINE

Holthouser, Michael G., MD4674 Snow Mesa Dr., Ste. 200.................495.8450

Milliken, William J., MD 8010 S. CR 5, Ste. 101 (Windsor) ..................377.1300 47

48

O’ Toole, Kevin J., MD4674 Snow Mesa Dr., Ste. 200.................495.8450

Scherr, Frederick P., MD 1025 Pennock Pl., Ste. 121 .....................495.8450

Yanagi, Ann K., MD4674 Snow Mesa Dr., Ste. 200.................495.8450

OPHTHALMOLOGY

Arnold, Patrick D., MD1725 E. Prospect Rd. ........................ 221.2222See ad on page 47

Bashford, Kent P., DO1725 E. Prospect Rd ......................... 221.2222See ad on page 47

Crews, Kent R., MD1725 E. Prospect Rd. ........................ 221.2222See ad on page 47

Foster, Gary J., MD1725 E. Prospect Rd ......................... 221.2222See ad on page 47

Norris, Andrew M., MD2121 E. Harmony Rd., Ste. 190 ...............224.2020

Olsen, Karl E., MD1725 E. Prospect Rd ......................... 221.2222See ad on page 47

Reistad, Chet Erik, MD1725 E. Prospect Rd. ........................ 221.2222See ad on page 47

Robinson, Matthew J., MD1725 E. Prospect Rd. ........................ 221.2222See ad on page 47

Shachtman, William A., MD1725 E. Prospect Rd. ........................ 221.2222See ad on page 47

Smith, Randall W., MD1725 E. Prospect Rd. ........................ 484.5322See ad on page 47

Stevens, William W., MD1725 E. Prospect Rd. ........................ 221.2222See ad on page 47

ORAL/MAXILLOFACIAL

Felton, Rickey E., DDS1008 Centre Ave., Ste. B ..........................221.4633

Orr, Mark F., MD2014 Caribou Dr., Ste. 100 ..................... 225.9555

Reynolds, Ralph R., DMD2992 Ginnala Dr. (Loveland) .......................663.6878

Thurgood, David B., DDS2001 S. Shields St. Bldg. J-3 ................... 498.0196

Troxell, James B., DDS1120 E. Elizabeth St., Bldg. B, Ste.3........482.6811

ORTHOPEDICS

Baer, Robert M., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Beard, David A., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Beard, Douglas W., MD1313 Riverside Ave.. ......................... 493.1292See ad on page 36

Benz, Robert J., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Biggs, William D., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Brackett, Bess E., MDPO Box 336694 (Greeley) ..........................330.5400

Bussey, Randy M., MD5890 W. 13th Street (Greeley) ....................348.0020

Chamberlain, Satoru T., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Clark, C. Dana, MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Dhupar, Scott K., MD1624 17th Avenue (Greeley) ...........................353.5959

Donner, E. Jeffrey, MD3810 N. Grant Ave. (Loveland) ...................669.8881

Duncan, Kenneth H., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Durbin, Mark B., MD2500 E. Prospect Rd. ....................... 493.0112See ad on page 23

Grant, Michael P., MD3810 N. Grant Ave. (Loveland) ...................669.8881

Grey, Sean G., MD2500 E. Prospect Rd. ....................... 493.0112See ad on page 23

Grossnickle, Mark D., MD2500 Rocky Mnt Ave.Ste.MOB (Loveland) 203.7100See ad on page 99

Houghton, Michael J., MD2500 E. Prospect Rd. ....................... 493.0112See ad on page 23

Hunter, Brett P., MD2500 Rocky Mnt Ave.Ste.MOB (Loveland) 203.7100See ad on page 99

Jackson, Wesley P., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Kindsfater, Kirk A., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Knauer, Sally A., MD2121 E. Harmony Rd., Ste. 290 ...............224.9890

48

Mahon, John H., MD2121 E. Harmony Rd., Ste. 260 ...............221.2827

Martin, Dale R., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

McFerran, Mark A., MD2923 Ginnala Dr. (Loveland) ............ 663.3975See ad on page 23

Nelson, Garth C., MD1020 Luke St. ...........................................493.2102

Pazik, Thomas J., MD6801 W. 20th Street, Ste. 201 (Greeley)...........330.1090

Pettine, Kenneth A., MD3810 N. Grant Ave. (Loveland) ..................669.8881

Reckling, W. Carlton, MDCheyenne, WY ........................................ 307.632.6637

Rusnak, Michael P., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Seiler, Steven J., MD2500 Rocky Mnt Ave.Ste.MOB (Loveland) 203.7100

Sides, Steven D., MD2500 Rocky Mnt Ave.Ste.MOB (Loveland) 203.7100See ad on page 99

Sobel, Roger M., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Young, Eric E., MD2121 E. Harmony Rd.,Ste. 260 ................221.2827

ORTHOPEDICS /SPORTS MEDICINE

Trumper, Rocci V., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

PAIN MANAGEMENT

Girardi, George E., MD3744 S. Timberline Rd., Ste. 102 ...... 495.0506See ad on page 48

Sisson, Charles B., MD2809 E. Harmony Rd., Ste. 100 ...............221.9451

PATHOLOGY

Barksdale, Sarah Kay., MD2555 E.13th Street,Ste.120(Loveland) ..461.6091See ad on page 23

Bee, Christopher S., MD2555 E.13th Street,Ste.120(Loveland) ..461.6091See ad on page 23

Chaffin, D. Joe, MD2555 E.13th Street,Ste.120(Loveland) ..461.6091See ad on page 23

Christian, James D., MD2555 E.13th Street,Ste.120(Loveland) ..461.6091See ad on page 23

Dunn, Cory D., MD2555 E.13th Street,Ste.120(Loveland) ..461.6091See ad on page 23

Halbert, Richard E., MD2555 E.13th Street,Ste.120(Loveland) ..461.6091See ad on page 23

Hamner, H. Wentzell., MD2555 E.13th Street,Ste.120(Loveland) ..461.6091See ad on page 23

Libby, Arlene L., MD2555 E.13th Street,Ste.120(Loveland) ..461.6091See ad on page 23

Neuhauser, Thomas S., MD2555 E.13th Street,Ste.120(Loveland) ..461.6091See ad on page 23

Walts, Michael J., MD2555 E.13th Street,Ste.120(Loveland) ..461.6091See ad on page 23

PEDIATRICS

Anderson, Carole M., DO1200 E. Elizabeth St .......................... 267.9510See ad on page 65

Archer, Deborah, MD1635 Blue Spruce Dr. ...............................494.4040

Bailey, Amy C., MD1200 E. Elizabeth St .......................... 267.9510See ad on page 65

Ballard, Elizabeth A., MD1200 E. Elizabeth St. ......................... 267.9510See ad on page 65

Booth, Richard R., MD2001 S. Shields St., Bldg. G ......................484.4871

Brockway, Julie M., MD1200 E. Elizabeth St. ......................... 267.9510See ad on page 65

Crawford, Deborah D., MD ...................... Fort Collins

Elliott, Max A., MD1200 E. Elizabeth St. ......................... 267.9510 See ad on page 65

Guenther, John P., MD1200 E. Elizabeth St. ......................... 267.9510See ad on page 65

Hanson, Vaughn W., MD1200 E. Elizabeth St. ......................... 267.9510See ad on page 65

Hull, Lori J., MD2001 S. Shields St., Bldg. G ......................484.4871

Markley, Jennifer L., MD2001 S. Shields St., Bldg. G ......................484.4871

49Fort Collins Medical Magazine & Directories 2009 2010 49


McGinnis, James G., MD1200 E. Elizabeth St. ......................... 267.9510See ad on page 65

McManigal, Jason, DO1200 E. Elizabeth St. ......................... 267.9510See ad on page 65

O’Brien, Barry G., MD1200 E. Elizabeth St. ......................... 267.9510See ad on page 65

Sampera, Kirsten M., MD1200 E. Elizabeth St. ......................... 267.9510See ad on page 65

Schaffer, Michael S., MDAurora, CO ........................................ 720.777.2942

Seidman, Marc H., MD1635 Blue Spruce Dr. ...............................494.4040

Whitman, Douglas W., MD1635 Blue Spruce Dr. ...............................494.4040

Wright, Jason T., MD2555 E. 13th Street, Ste. 130 (Loveland) ..663.5437

PEDIATRIC/DENTISTRY

Evans, Gregory D., DDS3221 Eastbrook Dr. ........................... 407.1020See ad on page 49

Hargleroad, Jennifer K., DDS2105 Bighorn Rd., Ste. 202 .....................493.2254

Van Tassell, Keith A., DDS2001 S. Shields, Bldg. A .......................... 484.4104

PHYSICAL MEDICINE & REHABILITIATION

Adamson, Carrie L., MD2021 Battlecreek Dr. ................................206.0851

Bender, John D., DO1330 Oakridge Dr., Ste. 130 ....................377.9555

Jacob, Joseph P., MD4401 Union St. (Johnstown) .......................619.3400

Lockwood, Bruce A., MD1300 Oakridge Dr., Ste. 130 ....................377.9555

Nieves, Ricardo A., MD1301 Riverside Ave., Ste.2 ............... 692.5550See ad on page 3

Wunder, Jeffrey A., MDWheat Ridge ...................................... 303.423.8334

PODIATRY

Anderson, James C., DPM1355 Riverside Ave., Ste. C .............. 484.4620See ad on page 97

Burns, Michael J., DPM2001 S. Shields St., Bldg. F ......................493.4660

Hatch, Daniel J., DPM1931 65th Ave., Ste. A (Greeley) ................351.0900

Hecker, Thomas M., DPM2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Knutsen, Chad M., DPM2001 S. Shields St., Bldg. F ......................493.4660

O’Halloran, William D., DPM1301 Riverside Ave. .................................482.3668

Schulte, Robert C., DPM2001 S. Shields St., Bldg. F ......................493.4660

Schultz, Peter D., MD1440 N. Boise Ave. (Loveland)........................278.1440

Thomas, Michael I., DPM1355 Riverside Ave., Ste. C .............. 484.4620See ad on page 97

Vaardahl, Michael D., DPM1931 65th Ave., Ste. A (Greeley) ................351.0900

Webb, Emily Huang, DPM1927 Wilmington Dr., #102 .....................416.9009

PSYCHIATRY

Gottfried, Joseph M., MD4601 Corbett Dr. ................................ 207.4800See ad on page 90

Heacock, Craig R., MD4601 Corbett Dr. ................................ 207.4800See ad on page 90

Moreno, Hermann A., MD4601 Corbett Dr. ................................ 207.4800See ad on page 90

Nagel, John K., MD4601 Corbett Dr. ................................ 207.4800See ad on page 90

Oddy, Richard A., MD120 Bristlecone Dr. ...................................224.5209

Pearson, Glenn E., MD4601 Corbett Dr. ................................ 207.4800See ad on page 90

Straumanis, Eric J., MD1762 Hoffman Dr. (Loveland) ...........................663.3030

Udupa, Usha R., MD4601 Corbett Dr. ................................ 207.4800See ad on page 90

Watanabe, Kenneth S., MD4601 Corbett Dr. ................................ 207.4800See ad on page 90

Woodard, Timothy W., MD4601 Corbett Dr. ................................ 207.4800See ad on page 90

PULMONOLOGY

Breyer, Diana M., MD2121 E. Harmony Rd., Ste. 300 ......................... 224.9102

DePriest, KIirk L., DO2121 E. Harmony Rd., Ste. 300 ......................... 224.9102

Gunstream, Stanley R., MD2121 E. Harmony Rd., Ste. 300 ......................... 224.9102

Hoyt, James D., MD2121 E. Harmony Rd., Ste. 300 ......................... 224.9102

Kukafka, David S., MD2500 Rocky Mnt Ave.Ste. 300 (Loveland)..619.6100See ad on page 95

Milchak, Richard J., MD2500 Rocky Mnt Ave.Ste. 300 (Loveland) ............619.6100

Neagle, Mark B., MD2121 E. Harmony Rd., Ste. 300 ........ 224.9102See ad on page 95

Peters, Brent T., MD2500 Rocky Mnt Ave.Ste. 300 (Loveland) ............619.6100

Petrun, Mark D., MD, FCCP2121 E. Harmony Rd., Ste. 300 ........ 224.9102See ad on page 95

Stevens, Eric E., MD2500 Rocky Mnt Ave.Ste. 300 (Loveland) ............619.6100

Vassaux, Carlos R., MD2121 E. Harmony Rd., Ste. 300 ......................... 224.9102

Wallick, Kristin A., MD2121 E. Harmony Rd., Ste. 300 ......................... 224.9102

RADIATION ONCOLOGY

Bryant, Michael H., MD2121 E. Harmony Rd., Ste. 160 ......................... 482.3328

Casey, William B., MD2121 E. Harmony Rd., Ste. 160 ........ 482.3328See ad on page 51

Lim, Meng Lai, MD2121 E. Harmony Rd., Ste. 160 ......................... 482.3328

Lisella, Gwen H., MD2121 E. Harmony Rd., Ste. 160 ........ 482.3328See ad on page 51

Petit, Joshua Henry, MD2121 E. Harmony Rd., Ste. 160 ........ 482.3328See ad on page 51

Simpson, C. Kelley, MD2121 E. Harmony Rd., Ste. 160 ........ 482.3328See ad on page 51

RADIOLOGY

Berkowitz, Bruce Andrew, MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Bodenhamer, John R., MD2008 Caribou Dr. .............................. 484.4757See ad on page 7 & 19

Contreras, Jaime H., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7

Cox, Patrick R., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7

Craven, Winfield M., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Dunphy, Thomas R., MD2008 Caribou Dr. .............................. 484.4757See ad on page 7 & 19

Esola, Christine C., MD2008 Caribou Dr. .............................. 484.4757See ad on page 7

Fleener, Christopher M., MD2008 Caribou Dr. .............................. 484.4757See ad on page 7 & 19

Florant, Tracy H., MD2127 E. Harmony Rd., Ste. 130 ........ 207.4700See ad on page 7 & 19

Fuller, Samuel E., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Geis J. Raymond, MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Geraghty, Micahel J., MD2008 Caribou Dr ................................ 484.4757See ad on page 7 & 19

Gunderson, Deborah Z., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Hayes, Amy S., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Howshar, Mark Edward, MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Jess, Sarah J., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Koplyay, Peter D., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Luttenegger, Thomas J., MD, FACR2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Markel, Curtis L., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Mills, Andrew D., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7

Pacini, Richard J., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Paquelet, Jean R., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7

Peck, Steven H., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Peet, Gary J., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7

Reese, Mark F., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

50

5050


Singer, Charles J., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Weinstein, Stanley W., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

Weissmann, Jeffrey R., MD2008 Caribou Dr. ............................... 484.4757See ad on page 7 & 19

RHEUMATOLOGY

Levine, James W., DO2500 Rocky Mnt Ave. NMOB (Loveland) . 461.1880See ad on page 99

Mayer, Patricia A., MD2121 E. Harmony Rd., Ste. 361 .............. 267.9799

Murray, Garvin C., MD2500 Rocky Mnt Ave. NMOB (Loveland) . 461.1880See ad on page 99

Thakor, Michael S., MD2121 E. Harmony Rd., Ste. 361 .............. 267.9799

Thompson, John Stephen, MD2500 Rocky Mnt Ave. NMOB (Loveland) . 461.1880See ad on page 99

SURGERY CENTERS

Harmony Surgery Center2127 E. Harmony Rd., Ste. 200. ....... 297.6300See ad this page

Loveland Surgery Center3800 N. Grant Ave. ............................ 622.0608See ad on page 79

MCR Surgery Center2500 Rocky Mnt Ave., Ste. 200 (Loveland) ..624.2250

Surgery Center of Fort Collins1100 E. Prospect Rd. ........................ 494.4800See ad on back cover

SURGERY/ASSIST

Johnson, Robert V., MD2500 E. Prospect Rd. ........................ 493.0112See ad on page 23

Kaiser, Dale C., MD2500 E. Prospect Rd. ....................... 493.0112See ad on page 23

Kesler, Kelvin F., MD 1107 S. Lemay Ave. Ste. 300 ...................493.7442

Ludwin, Gary A., MD 1107 S. Lemay Ave. Ste. 300 ...................493.7442

Ross, Vincent J., MD2500 E. Prospect Rd.. ....................... 493.0112See ad on page 23

Tutt, George O., Jr MD ............................. Fort Collins

SURGERY/CARDIOVASCULAR

Guadagnoli, Mark, MD2500 Rocky Mnt Ave.Ste.100 (Loveland) . 624.1800See ad on page 43

Lamounier, Fernando N., MD2500 Rocky Mnt Ave.Ste.100 (Loveland) . 624.1800See ad on page 43

Stanton, Michael, MD2500 Rocky Mnt Ave., Ste.360 (Loveland) ..... 619.6176

SURGERY/GENERAL

Bauling, Paulus C., MD1029 Robertson St. ..................................482.2866

Chiavetta, Thomas G., MD2121 E. Harmony Rd., Ste. 250 ........ 482.6456See ad on page 37

Clear, Craig R., MD2121 E. Harmony Rd., Ste. 250 ........ 482.6456See ad on page 37

Collins, John A., MD2315 E. Harmony Rd., Ste. 130 ...............221.5878

Cribari, Chris MD2315 E. Harmony Rd., Ste. 130 ...............221.5878

Davis, Lawrence G. MD2315 E. Harmony Rd., Ste. 130 ...............221.5878

Dickinson, James M., MD2121 E. Harmony Rd., Ste. 250 ........ 482.6456See ad on page 37

Dubs, Steven, MD2500 Rocky Mnt Ave.NMOB (Loveland) .. 203.7250See ad on page 99

Fraser, Lesley A., MD2500 Rocky Mnt Ave.NMOB (Loveland) .. 203.7250See ad on page 99

Kaufman, Steven L., MD1136 E. Stuart St., Bldg. 4-#102 ............498.8346

Lee, James S., MD6801 W. 20th Street, Ste. 202 (Greeley) ....350.0948

Livengood, Joseph C., MD2500 Rocky Mnt Ave.NMOB (Loveland) .. 203.7250See ad on page 99

Marty, Terri. MD2315 E. Harmony Rd., Ste. 130 ...............221.5878

Ogren, Jason W., MD1800 15th Street, Ste. 210 (Greeley) .......352.8216

Parsons, Sally A., MD2315 E. Harmony Rd., Ste. 130 ...............221.5878 51

CongratulatesPOUDRE VALLEY HEALTH SYSTEM

management, board of directors, physicians & staffon receiving the pinnacle of excellence, the

Malcolm Baldrige National Quality Award

Peetz, Michael E., MD2500 Rocky Mnt Ave.Ste.MOB(Loveland) 203.7250See ad on page 99

Pettine, Stefan, MD2121 E. Harmony Rd., Ste. 250 ........ 482.6456See ad on page 37

Quaid, Robert R., MD2121 E. Harmony Rd., Ste. 250 ........ 482.6456See ad on page 37

Roller, Michael D., MD2121 E. Harmony Rd., Ste. 250 ........ 482.6456See ad on page 37

Rubinson, Samuel M., MD2315 E. Harmony Rd., Ste. 130 ...............221.5878

Schiefen, James., DO1900 16th Street (Greeley). ......................350.2426

Turcios, Rosa E., MD2315 E. Harmony Rd., Ste. 130 ...............221.5878

Woodard, Scott, MD555 Prospect Ave. (Estes Park) ..............586.2200

SURGERY/OPHTHALMIC/PLASTIC/RECONSTRUCTIVE

Reistad. Chet, MD 1725 E. Prospect Rd. ........................ 221.2222See ad on page 47 and on page 87

Brewster, Amy Hill., MD2121 E. Harmony Rd., Ste. 360 ........ 266.0456See ad on page 6

Chapman, Jeffrey K., MD2315 E. Harmony Rd., Ste. 160 ........ 493.8800See ad on back cover

Duncan, Diane, MD1701 E. Prospect Rd. ...............................493.7445

Gonyon , Denis L., Jr. MD4450 Union St., Ste. 100 (Johnstown) ........... 624.7979

Tsoi, Christopher M., MD2315 E. Harmony Rd., Ste. 160 ........ 493.8800See ad on back cover

SURGERY/NEURO

Coester, Hans C., MD1313 Riverside Ave. ......................... 493.1292See ad on page 36 and back cover

Sheinberg, Michael A., MD1313 Riverside Ave. .................................493.1292

Turner, Donn M., MD1313 Riverside Ave. .......................... 493.1292See ad on page 36 and back cover

Wirt, Timothy C., MD1313 Riverside Ave. .............493.1292See ad on page 36 and back cover

UROLOGY

Brutscher, Stephen P., DO2315 E. Harmony Rd., Ste.140 ................484.6700

Eddy, Michael J., MD1647 E. 18th Street (Loveland) ..................669.9100

Everett, Randy W., MD2315 E. Harmony Rd., Ste.140 ................484.6700

Girdler, Benjamin J., MD2315 E. Harmony Rd., Ste.140 ................484.6700

Goodman, Gary R., MD1900 16th Street (Greeley) ........................350.2491

Lee, Michael R., DO2315 E. Harmony Rd., Ste.140 ................484.6700

Malcom, Troy J., DO1925 W. Mountain View Ave.(Longmont) ...303.776.1234

Manion, Sean P., MD1925 W. Mountain View Ave.(Longmont) ...303.776.1234

Nasseri, Kevin K., MD2315 E. Harmony Rd., Ste.140 ................484.6700

Phillips, George H., MD1647 E. 18th Street (Loveland) ..................669.9100

Soper, Timothy H., MD2315 E. Harmony Rd., Ste.140 ................484.6700

* Physician list provided by PVHS. Current as of 8.15.2009

BE A PART OF THE2010 | 2011

211 W. Myrtle St. STE 200Fort Collins, CO 80521

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IAN~~io~:i Quality

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POUDRE VALLEY HOSPITAL POUDRE VA LLEY HE A LTH SY STEM

pvhs.org

For excellent nursing care, were here for you. Poudre Valley Hospital was recently re-designated a Magnet

Hospital by the American Nurses Credentialing Center.

We've been honored with this

recognition since 2000, when we were the 18th Magnet Hospital in the entire country. Today, there are only 324 Magnet Hospitals in the U.S.,

Australia, and New Zealand .

Magnet status means PVH delivers exceptional nursing care . For your

family, it means peace of mind.

pvhs.org

PVHS also received the prestig ious

Malcolm Baldrige award for quality

in 2008.

Poudre Valley Health System (PVHS) physicians perform thousands of surgeries each year, 60 per-cent at Poudre Valley Hospital and the Medical Center of the Rockies, and the rest as less invasive outpatient procedures performed at local surgery centers. With the latest advances in technology and years of experience, these surgery facilities of-fer an array of surgical procedures in a caring en-vironment outside of the normal hospital setting.

Northern Colorado boasts a number of top-rated ambulatory surgery centers (ASCs), also known as outpatient surgery facilities, in the area. An ASC is a healthcare facility that specializes in providing surgery, including certain pain manage-ment and diagnostic (e.g., colonoscopy) services, in an outpatient setting.

In simple terms, ASC-qualified procedures include any procedure that does not require the immediate availability of blood bank, diagnostic laboratory, or advanced radiology services. With proper licensing, a number of our local ambula-tory surgery centers also offer extended recovery care which may include a night or two following surgery. The staffing requirements for ASCs are the same as for hospitals, so patients receive the

same level of care. Procedures performed in ASCs are broad and,

with technological advances, ever-expanding in scope. In an effort to cut costs in the 1980s and 1990s, many procedures that used to be per-formed exclusively in hospitals began taking place in ambulatory surgery centers. Knee, hip, shoul-der, eye, spine, and other surgeries are currently performed in ASCs, with recent expansion into hysterectomies, gastric bypass procedures, and to-tal joint replacements. In the United States today, more than 50 percent of colonoscopies are also performed in ambulatory surgery centers.

ASCs rarely have a single owner. Physicians who perform surgeries in the center will often have an ownership interest in the facility and be involved in the management and development of center protocols, policies, and procedures. Oc-casionally, an ASC is entirely physician-owned. However, it is more common for health systems or local hospitals to partner with physicians and create joint venture relationships to better benefit the community.

In the U.S. today, more than 22 million surger-ies a year are performed in more than 5,000 ASCs.

Most ASCs are licensed, certified by Medicare, and accredited by one of the major healthcare accred-iting organizations. All of our local surgery centers have contracts with the major health insurance companies.

Accreditation organizations for ASCs provide standards of medical care, record keeping, and auditing of individual ASCs and require members to receive periodic surveys or audits every one to three years. In a survey/audit, a team of auditors examines standards of performance such as medi-cal records, written policies and procedures, and compliance with industry standards. The three main accrediting agencies of ASCs are: the Ameri-can Association for Accreditation of Ambulatory Surgery Facilities, the Accreditation Association for Ambulatory Health Care, and the Joint Com-mission for Accreditation of Healthcare Organiza-tions.

At the State level, the Colorado Ambulatory Surgery Center Association is committed to en-suring that surgery centers continue to thrive as a distinct model for the delivery of safe, afford-able, and advanced surgical services to Colorado’s healthcare consumers.

Have you ever wondered where the word “surgery” came from? It comes from Greek words meaning “hand work.” Surgery is a medical specialty that uses manual and instrumental techniques to investigate and/or treat a pathological condition in order to help improve body function or appearance.

by Laura Lee Carter

MEDICAL AMBULATORY SURGERY CENTERS

The Surgery Centers ofNorthernColorado


HArMoNy Surgery CeNter2127 East Harmony Road, Suite 200

Fort Collins | (970) 297-6300www.harmonyasc.com

Separate admission and recovery areas have been designated to accommodate the patients’ privacy. The Center is conveniently located with labs, radiolo-gy (including MRI and CT scan services), a pharmacy, and a cafeteria within the same building.

Harmony Surgery Center procedures range from epidural steroid injections and colonoscopies to sur-gical procedures such as laparoscopic cholecystec-tomies and laparoscopic gastric bypass, or banding surgery. According to Rebecca Craig, CEO and nurse administrator, the procedures presently performed at the Center break down into approximately 50 percent gastroenterology, 20 percent pain manage-

The Harmony Surgery Center is a state-of-the-art, multi-specialty facility that provides high-quality medical care, confidentiality, comfort, and efficiency for patients from Fort Collins and the surrounding area.

The facility consists of four operating rooms, two gastroenterology rooms, a pain management room, and six private overnight extended recovery suites.

ment, and 30 percent surgical including general surgery, ENT (ear, nose, and throat), orthopedics, plastic surgery, urology, podiatry, maxillofacial, and ophthalmology.

“We offer a quiet, confidential setting with an extremely low risk of infection and an excellent nurse-to-patient ratio. Our patients rave about com-ing to our facility because of our high quality care and customer focus,” says Craig. “We encourage patients to obtain an estimate ahead of time and be good healthcare consumers. We are confident we are a cost-effective alternative to the hospital setting. Our streamlined processes also work more efficiently with our customers’ time.”

The Center is accredited by the Joint Commission and a member of the Colorado Ambulatory Surgery Center Association. They also hold a Convalescent Care license, allowing them to provide extended re-covery care for patients with extensive surgical proce-dures or that require a longer recovery stay.

MCr Surgery CeNterMedical Center of the Rockies Campus

South Medical Office Building2500 Rocky Mountain Avenue, Suite 200

Loveland | (970) 624-2250

rently: orthopedics, ENT, plastic surgery, podiatry, gynecology, general surgery, urology, maxillofacial, dental, and pain management as well as gastro-enterology. Craig, who administers both the Har-mony Surgery Center and the new MCR surgery facility notes, “Our highly experienced team shines and really makes an effort to go above and be-yond for all of our customers. At both facilities, all of our registered nurses are Advanced Cardiac Life Support and Pediatric Advanced Life Support certified and many of our team members have achieved other specialty certifications in their area of expertise.”

MCR Surgery Center is the newest PVHS sur-gery center, conveniently located on The Medical Center of the Rockies campus. Opened in April 2008, this facility is a joint venture partnership with Poudre Valley Health System and area physicians.

With four operating rooms and state-of-the-art equipment, their surgical specialties are cur-

“Customer service is our focus at both Har-mony Surgery and MCR Surgery Center. We want our patients to feel that they have received the best, most personalized quality care at our Cen-ters,” says Craig. “We try to efficiently discharge patients to allow them to return to their homes because research has shown that patients recover faster in the comfort of their own homes. Howev-er, if extended recovery care is needed, MCR Sur-gery Center has five private overnight stay suites which allow for a quiet, safe, and confidential recovery.” MCR Surgery Center is also Joint Com-mission accredited.

Rebecca Craig, CEO, Harmony Surgery Center and MCR Surgery Center

One of MCR’s state-of-the-art operating rooms.

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ortHopAediC CeNter of tHe roCkieSOUTPATIENT SURGERY AND RECOVERY CENTER

2500 East Prospect Road Fort Collins | (970) 419-7050

Website: www.orthohealth.com

Center. More and more of their patients are tak-ing advantage of this outpatient facility, as tech-nology and surgery techniques have advanced. Their physicians have done thousands of surger-ies in their Fort Collins Surgery Center. Many pa-tients go home the same day, while others spend one or more nights in recovery.

Their Recovery Center provides 10 private rooms and 24-hour nursing care for patients who need one or more nights of supervised re-covery after surgery. Unlike large hospitals, the Recovery Center provides quiet comfort for pa-tients and families. It also offers catered meals,

The Orthopaedic Center of the Rockies opened in 1990 and added a third operating room and a 10-room Recovery Center in 1999. Surgical services range from arthroscopic surgery for outpatients to more involved joint replace-ment and spine surgeries that require an over-night stay in a private room in their Recovery

a TV in each room, and a spacious family lounge for relaxation.

Mike Bergerson, the CEO of the Orthopaedic Center of the Rockies, states that their surgery center is “pretty unique nationwide. When you look at the total number of procedures we per-form each year, ranging from arthroscopic cases to total joint replacements, we are outstanding nationally. I think this is because we provide a comprehensive continuum of care from initial di-agnosis to surgery to a stay in the Recovery Cen-ter, where physical therapy can begin soon after the procedure is completed.” Approximately one third of their cases include an overnight stay.

The Orthopaedic Center of the Rockies is Medicare certified and maintains an extremely minimal infection rate. They are happy to pro-vide estimates to those who call ahead to com-pare prices.

stay. The ASC provides services for spine, orthopedic, ENT, and pain management patients. They average over 3,100 cases annually, while achieving excellent patient satisfaction and low infection rates. Loveland Surgery Center participates with all major insurance plans.

“We are excited that the high quality, compas-sionate care provided by the surgery center staff and affiliated physicians has earned us the designation of a Surgery Center of Excellence by Blue Cross Blue Shield,” says Sue Sumpter, Loveland Surgery Center Administrator.

The physicians at this ASC are involved in clinical

The Loveland Surgery Center is staffed with friendly, experienced, caring professionals who pro-vide the highest standard of care in a comfortable and professional atmosphere. It is a state-of-the art facility with three operating rooms, a room for mi-nor procedures, and extended recovery suites for those who have surgery that requires an overnight

research while helping local patients with their sur-gical needs. The Loveland Surgery Center is also a unique spine research surgery facility. The Loveland Surgery Center has the designation of being a site for new non-fusion spine device studies seeking FDA approval. The physicians are presently involved in 10 different FDA studies of experimental treatments, such as artificial disks.

Kenneth Pettine, M.D., takes great pride in the Center’s involvement in groundbreaking spine re-search. “More spine research comes out of this facil-ity than all Colorado hospitals combined. We are on the cutting-edge of evaluating new and innovative non-fusion spine implants.”

The centers’ ownership is shared equally be-tween physicians and National Surgical Care as their corporate partner. Loveland Surgery Center is ac-credited by Joint Commission and is a member of the Colorado Ambulatory Surgery Center Association.

LoveLANd Surgery CeNter3800 North Grant AvenueLoveland | (970) 622-0608

www.lovelandasc.com

Mike Bergerson, CEO, Orthopeadic Center of the Rockies

Sue Sumpter, Administrator, Loveland Surgery Center

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The facility was designed to provide conve-nient, compassionate care to patients, with four operating rooms and one treatment room. There are four pre-operative beds, eight recovery beds, and two recently-remodeled convalescent rooms for patients requiring multi-night stays.

Patient satisfaction surveys continually note the friendliness of the staff and the professional care they provide. The SCFC’s staff takes pride in providing excellent care in all aspects of a patient’s contact with the facility, whether it be provid-ing information on estimate of charges, what to expect during their stay at the facility, and after discharge, or follow-up with insurance companies.

The Surgery Center of Fort Collins (SCFC) is located at Lemay and Prospect Streets, blocks from the main campus of Poudre Valley Hospital. The Surgery Center was one of the first ASCs to open in Northern Colorado and was the first multi-spe-cialty ASC in our region. SCFC also has a Conva-lescent Care license, which allows them to provide extended overnight care for patients needing a longer recovery stay.

Ross Alexander, CEO, explains, “The physi-cians of the Surgery Center of Fort Collins are inti-mately involved in developing the protocols, poli-cies, and procedures of the center. They are very familiar with the facility, the nursing staff, and the instrumentation, which results in a very beneficial working relationship for surgeons and staff to pro-vide high quality, cost effective care.”

Procedures performed at the facility include, but are not limited to: general surgery, ENT, pain management, plastic surgery, neurosurgery/spine, gynecological, and podiatric procedures.

The Surgery Center is jointly owned by Cen-tennial Surgery Center, Surgical Care Affiliates, and Poudre Valley Health System. The Center is a member of the Colorado Ambulatory Surgery Center Association and is accredited by the Ac-creditation Association for Ambulatory Health Care (AAAHC).

Surgery CeNter of fort CoLLiNS 1100 East Prospect

Fort Collins | (970) 494-4800

SkyLiNe Surgery CeNter 2555 East 13th Street

Loveland | (970) 461-6200

Banner Health’s McKee Medical Center, the Big Thompson Medical Group, Loveland Surgical Associates, the Orthopaedic Center of the Rock-ies, and several other independent physicians formed a partnership to build Skyline Surgery Center.

The Skyline Surgery Center offers convenient,

high-quality, and cost-effective surgical services at its location in east Loveland. The Surgery Center provides orthopedic surgery, plastic surgery, gen-eral surgery, urologic, pain, and ophthalmic pro-cedures. They also provide more extensive spine and total joint replacement procedures with con-valescent care available in four overnight beds.

Skyline Surgery Center provides patients with a restful, healing environment. “We offer a quiet,

comfortable setting,” explains Dale Bergstrom, Clinical Director. “We have a great nurse-to-patient ratio, and most of our patients say that they would prefer to return here for future pro-cedures.”

The Skyline Surgery Center is presently cer-tified by Medicare and is seeking accreditation from the Accreditation Association for Ambula-tory Health Care.

Ross Alexander, CEO, Surgery Center of Fort Collins

Dale Bergstrom, Clinical Director, Skyline Surgery Center

6060


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in the NURSERY by Erica Pauly

We all know that Northern Colorado is a top pick for most to retire, but with new renovations and top-notch nurseries, Northern Colorado is also the perfect place to give birth.

medical Nurseries

Teamwork

Recently, Style sat down with the team from Poudre Valley Health System who makes giving birth - and the care thereafter - a comfortable and smooth transition for the roughly 3,000 infants born at Poudre Valley Hospital and Medical Cen-ter of the Rockies each year. The team consists of Barbara Newell, RN, MHS, Director of Mother and Family Care at Medical Center of the Rockies; Pat Bohling-Smith, MS, RN, Director of Women and Family Care at Poudre Valley Hospital; Barb Peters, RN, Nurse Manager of the Neonatal Inten-sive Care Unit at Poudre Valley Hospital; and Dan Satterwhite, M.D., Neonatologist for Poudre Val-ley Health System.

Top Nursery from Denver to MontanaHealthy newborns delivered at PVH and MCR

are kept with mom throughout their stay at either facility. “Rooming-in” is part of PVHS’ philosophy, which is dedicated to delivering every possible ounce of care to the bedside of mom and baby; even baths are given to the infant within the room. Dads and siblings can visit the new baby at any time and post-partum rooms at both facili-ties are equipped with high definition televisions that can function as computer screens, allowing mothers to check email and access the GetWell network, which provides interactive entertain-ment and educational programs.

While healthy newborns and mothers are moved into the Women’s Care Unit at Poudre Val-ley Hospital (PVH) just hours after birth, any new-born requiring further attention is sent to PVH’s Neonatal Intensive Care Unit (NICU), where the highly trained staff and well-equipped nursery shines. The NICU is a Level IIIA facility, which allows them to provide care to critically ill infants. Infants requiring surgical interventions, such as cardiac surgery, are transferred to The Children’s Hospital in Denver. PVH is the only facility with a Level IIIA NICU from Denver to Billings, Montana.

A Level IIIA NICU is able to treat babies deliv-ered up to three months early and weighing as little

PVH’s team in charge of the nursery and Neonatal Intensive Care Unit: Dan Satterwhite, M.D., Neonatologist for PVHS, Barb Peters, Nurse Manager of PVH’s NICU, and Pat Bohling-Smith, Director of Women and Family Care at PVH.62

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as two pounds and three ounces. Term babies with serious illness or organ failure are also cared for in the NICU. Sick and premature babies are treated in the NICU until they are well enough to go home or are transferred to the Newborn Nursery. The healthcare team is highly skilled and ready to treat any emergency, using state-of-the-art equipment and therapies.

“There is a strong sense of teamwork and co-hesion here, because you can have many people working with the infant at one time – the respira-tory therapist, the physician, the Neonatal Nurse Practitioner (NNP), and the pharmacist,” says Boh-ling-Smith. Not to mention others on standby to work with the infant and parents: developmental specialists, lactation nurses, counselors, and occu-pational and physical therapists.

“The key focus here is to keep the child with their family,” says Dr. Satterwhite. The nursery at PVH does just that. The NICU provides 19 beds, each with privacy curtains and chairs for parents to observe their little ones. Each child has a colorful nametag and usually photos of the family posted nearby. To promote family-centered care, PVH pro-vides several family sleep rooms where parents can stay so they are close by. PVH also owns a home in Fort Collins, referred to as ‘The Pitkin House,’ where families from out-of-town are able to stay while their infant recovers at the hospital. The nurs-ery is open 24-hours a day, seven days a week. Par-ents are encouraged to visit, spend time with their infants, and participate in their care. Bohling-Smith echoes Dr. Satterwhite’s sentiment, “Our motto: Keep mom and baby together.”

For subspecialty care prior to delivery, a perina-tologist conducts an on-site clinic one day a week and is available by phone 24 hours a day to con-sult with the obstetrician, family practice physician,

Dr. Satterwhite and Carol Wallman, NNP, look over their young patient, Matthew, in Poudre Valley Hospital’s Neonatal Intensive Care Unit.

63


or midwife, if necessary. Subspecialty care is also available after birth. Though PVH does not have a pediatric cardiologist on-site, with their close team-work with Children’s Hospital in Denver, it seems as though they do. “We can do an echocardiogram to look at the structure and function of the heart and a pediatric cardiologist from Children’s Hospi-tal will call us back with the diagnosis right then and there. This is another way we are able to keep moms and babies in their own community,” says Dr. Satterwhite, ensuring a tired mom doesn’t have to fight traffic to Denver to receive highly special-ized care for herself or her baby.

In order to keep mom and baby together, ev-eryone must be on the same page from day one. Dr. Satterwhite says, “We work hard to make sure that parents are partners in the process. We start caring for the family even before the baby is born.” Even in the labor room, PVH is ready for anything. Dr. Satterwhite continues, “We try to replicate the NICU in the operating room.” The equipment from the NICU, as well as the staff, is on-hand the mo-ment baby arrives and a NICU nurse is present at all PVH births.

A WeeStep FurtherOnce the new mother and her infant are re-

leased from PVH, the support and guidance contin-ues across the new walkway over Lemay Avenue. On the first floor of Westbridge Medical Suites, WeeSteps awaits new mothers. WeeSteps is a free program provided by PVHS and available to new mothers beginning five days after their dis-charge from the hospital. The program includes breastfeeding support groups, lactation support, and weighing rooms, where a mother can bring in her infant to make sure proper weight gain is occurring. “This way, they don’t have to make a separate appointment at the doctor just to weigh their infant,” says Bohling-Smith. Eventually, yoga classes for new mothers will be offered at the same location.

Across the hall from WeeSteps, mothers who need products and breastfeeding supplies can visit Twig Mom and Baby Care boutique with Twenty Three Trees Medical and Wellness Spa. Twig has all the amenities a new mom may need for a little ex-tra help with breastfeeding, along with baby out-fits, toys, and other goodies. Bohling-Smith says, “We think about everything from A to Z. What’s mom going to need? We’re here for the mothers and we take that to heart.” If extra pampering is

needed, Twenty Three Trees has many spa services to help mom relax. They will soon offer in-room massages for the new mother.

Continuing Ahead in LovelandKeeping mom and baby together is also pri-

ority at Medical Center of the Rockies (MCR) in Loveland. A recent renovation to their nursery was completed in January of this year, overseen by Newell. In May 2008, a committee was formed to discuss what would be a part of the transition. Dr. Satterwhite, an educator, a nurse manager, two staff nurses, a respiratory therapist, two NNP’s, and Newell met to discuss everything from space requirements to colors schemes and lighting.

A team of NNPs came from Children’s Hos-pital in Denver to train MCR staff on care and equipment transitions. “They did hands-on drills and helped reorganize everything to work more efficiently,” says Newell. Staff training was com-pleted in January 2009. The MCR nursery will have NNPs on-site covering the nursery 24 hours a day beginning in September 2009.

At MCR, any infant requiring further attention is sent to the Level I Special Care Nursery (SCN), which can care for newborns as early as 35 weeks (five weeks early). The Mother and Family Center at MCR includes four labor and delivery rooms, 10 post-partum rooms, a SCN with seven beds, including two beds in a separate room designated for patients requiring intensive observation and monitoring, or routine procedures like circumci-sions. The post-partum rooms mirror hotel rooms. Pullout couches are available in rooms so families can stay together. A jet-tub is one of the few extra amenities provided in every room.

The nursery’s new appearance and welcom-ing ambiance make it the perfect place for an in-fant to stay. Hues of yellow, blue, and green line the walls with monkeys, elephants, and giraffes dancing along the wallpaper. A rocking chair, new supply carts, privacy curtains, and dimmed lights add to the peacefulness. “We wanted it to be soft, comfortable, and cheerful,” says Newell.

MCR also offers the WeeSteps program, lo-cated in the hospital’s lower level, with the same invaluable breastfeeding and lactation services as the PVH program. It is so popular, the weekly attendance at their support group has doubled in size in the past year. MCR also offers the Breastfeeding Support Group for moms whose babies are three months and older.

6464

Working TogetherTeamwork is another similar trait between

MCR and PVH. The service line from MCR to PVH is where strong communication and steadfast team-work between both facilities is critical. Because the NICU is a higher-level nursery at the Fort Collins facility, MCR transfers infants to PVH when there is a need for further attention. “The cohesiveness of nursery care at both facilities is strongly supported by our neonatology group, which covers both PVH and MCR and cares for the sickest babies at each facility,” notes Dr. Satterwhite.

“We have the same policies and the same practice expectations here [at MCR] as PVH. I also have regular meetings with Pat Bohling-Smith to make sure we are in unison,” says Newell, on how they make the transition go smoothly between each facility. Bohling-Smith adds, “And when we are able to finish helping the patient here [at PVH], we can send them back to MCR so the family can be helped in their own community.”

It may not be too much longer before MCR is able to maintain more patients at their facility. The new nursery renovation is just the beginning of higher level of care for their infants. MCR is in the process of achieving IIA Special Care Nursery sta-tus, which would allow them to treat more infants in their nursery.

All About The FamilyWhether mom chooses to deliver her newborn

at PVH or MCR, it is no doubt the high quality care provided by the PVHS staff is what keeps mothers safe and comfortable during and after their labor. The teamwork coordinated between both facili-ties speaks volumes about the dedication and true heart of the staff. “We operate as a system togeth-er [MCR and PVH]. We work hard to keep families in their own communities. The key focus is to help each family as a whole,” concludes Dr. Satterwhite.

Erica Pauly is a freelance writer who lives in Love-land with her husband, Brent.

Barbara Newell, Director of Mother and Family Care at Medical Center of the Rockies 65


George E. Girardi, M.D., Front Range Pain Medicine, LLC

Our goal here is to treat, if possible, the

source of the pain, offer interventional treatment

options, promote healthy activities, and preventative care. We

strive to return patients to the most functional

and productive lifestyle possible and to coordinate multi-

disciplinary approaches, if indicated.

What purpose does pain serve in your life?

by Lynn M. Dean

MEDICAL ACUTE PAIN MANAGEMENT

Front Range Pain Medicine Expands

It’s a question Bruce Belleville, M.D., who just joined Front Range Pain Medicine, LLC, often poses to his patients on their first visit. Many times they look back at him quizzically. They don’t quite know how to answer. So he clarifies his question with this explanation: When you sprain your ankle, the pain is telling you not to walk on it. The same is true with injury-related back pain. It is not true of acute pain.

“Acute pain is pain that no longer serves a useful purpose,” Dr. Belleville explains. “It is a common ail-ment that runs the gamut. It doesn’t leave anybody untouched. It is not a disease that afflicts just one segment of society. It can be injury related, illness related, or aging related.” Then he asks the patient again, “What purpose does pain serve in your life?”

According to Kathryn Weiner, M.D., of the American Academy of Pain Management (AAPM), “Pain is a silent epidemic in the United States. An estimated 50 million Americans live with chronic pain caused by disease, disorder, or accident. An ad-ditional 25 million people suffer acute pain resulting from surgery or accident.”

Just as there are different sources of pain, there are different components to it, says Dr. Belleville. “It’s a bio-pscyho-social model. There’s a biological com-ponent, a psychological component, and a social component.” He says that each component must be addressed.

Dr. Weiner agrees. “Pain is complex and defies our ability to establish a clear definition. Pain is far more than neural transmission and sensory trans-duction. Pain is a complex mélange of emotions, culture, experience, spirit, and sensation. It is reason-

able to believe that unique characteristics of each individual impact their experience of pain.”

“It offers a lot of challenges in diagnosis, treat-ment, and coordination of care,” adds Dr. Belleville. Those challenges are one of the reasons he and his family moved back to Colorado after spending several years in Montana. “We had lived here in the 1990s,” he says. “We felt it was time to come home.” In Montana, Dr. Belleville has a busy occu-pational health practice that morphed into a chronic pain practice. “When we wanted to come home it seemed logical to transfer those chronic pain skills into the practice here.”

Dr. Belleville is one of only a few physicians in the country to be Board Certified in both Occupa-tional Health and Pain Management. “One of my goals is to utilize my expertise in occupational health issues and my additional training in pain manage-ment. I think Fort Collins is a growing community and pain is a prevalent condition.”

George E. Girardi, M.D., of Front Range Pain Medicine agrees. “I think Dr. Belleville’s joining the practice adds accessibility for patients because there will be another physician in town who is very ex-perienced with chronic pain conditions and occupa-tional health issues.”

Finding a physician who can treat pain is a chal-lenge not only in Fort Collins but also in commu-nities across the United States. A study conducted by the AAPM and other partners, “Chronic Pain in America: Roadblocks to Relief,” found that people with chronic pain have trouble locating doctors who can effectively relieve their suffering. The study

Bruce Belleville, M.D., (left) and George E. Girardi, M.D., of Front Range Pain Medicine, LLC66

66

found that one out of four patients surveyed had changed doctors at least three times because they were still in pain. Some patients reported that their pain was often not taken seriously, many doctors were reluctant to treat their pain aggressively, and doctors lacked knowledge about how to treat pain.

Front Range Pain Medicine has worked to fill this void in Fort Collins and the addition of Dr. Bel-leville will allow the practice to double its efforts. “Our goal here is to treat, if possible, the source of the pain, offer interventional treatment options, promote healthy activities, and preventative care,” says Dr. Girardi. “We strive to return patients to the most functional and productive lifestyle possible and to coordinate multi-disciplinary approaches, if indicated.”

“Our office offers everything that you can find in any pain clinic in the world,” continues Dr. Girardi. “My goal is to try to help patients avoid chronic nar-cotic therapy. Most of the interventional techniques are mainly for spinal issues and cancer patients in pain.” In addition to being a Diplomat of the Ameri-can Board of Pain Management, Dr. Girardi is also a Diplomat of the American Board of Anesthesia, allowing him to do many procedures that are not available elsewhere, including intrathecal drug de-livery which gives patients pain relief through medi-cine administered directly into the bloodstream or spinal canal. “We’re the only office that can put in pumps to diminish cancer pain and spasticity and pumps for spinal cord stimulation.”

Other procedures performed by Dr. Girardi in-clude nerve root blocks, epidural steroid injections, facet injections, sacroiliac blocks, discograms, trig-ger point injections, and radiofrequency ablation.

Up until this point, Dr. Girardi’s practice has been a procedural-based practice, but with the ad-dition of Dr. Belleville, Front Range Pain Medicine will be able to broaden its base. “The practice cur-rently focuses on interventional techniques to relieve pain without using medications, mainly narcotics, to treat it. But, there are a lot of problems I can’t help with interventional techniques,” he says. “And pa-tients wait a long time to be seen.” He adds that Dr. Belleville will be a qualified gatekeeper who can assess patients and recommend interventional tech-niques, where appropriate.

Dr. Belleville says his goal is to get the patient the treatment he or she needs. “I think we’re a growing community and pain is a prevalent condition. There is a need for someone who can treat pain with other options besides surgery or invasive procedures.”

The practice will still focus on helping people avoid becoming overly dependent on narcotic drugs. “On a yearly basis we hear of some ce-lebrity who dies and the question of drug abuse comes up,” says Dr. Belleville. He explains that celebrities aren’t the only ones experiencing these problems. “One of the goals of chronic pain management is to carefully monitor pain medications, and progress in management of pain, all the while attempting to do no harm.”

Luckily, with the addition of Dr. Belleville, Front Range Pain Medicine will be a more well-rounded practice able to address not only the pain associated with work-related injuries and illness, but chronic pain as well. Together they can help patients overcome their pain and thrive.

Lynn M. Dean is a Colorado writer and mother of three. Her work has won numerous first place awards from the Colorado Press Women.

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The goal of the Cleft Clinic is to offer world-

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and Hand Surgery, P.C., and a member of the Poudre Valley

Hospital Cleft Clinic

it in a more personable environment because we’re not a big clinic where you’re just another number,” he says. “We have all the expertise we need right here.”

The expertise and experience Dr. Boustred brings to the PVH Cleft Clinic is undeniable. He’s published research in scientific journals and written entire chapters on techniques in cleft lip and palate reconstruction. “People think they have to go to Denver to find a surgeon if they have a child with a cleft lip and palate,” he says. “But that’s not the case. We can provide top-notch care here in Northern Colorado.”

CONTINUED FROM PAGE 33

6868

The team approach is so important.

We have access to genetic counseling and social work in addition to surgical

support.

- Christopher Tsoi, M.D., Northern Colorado Plastic

and Hand Surgery, P.C., and a member of the Poudre Valley

Hospital Cleft Clinic

For Brohard and the rest of the team, the reward lies in helping families deal with some-thing that may have seemed insurmountable at first. “The best part for me is when parents take a deep breath and realize this is something they can handle,” she says. “That we’re all here to help them through it.” Right here in Fort Col-lins.

Allie Comeau is a freelance writer, copywriter, and blogger living in Fort Collins, CO. Email her at [email protected].

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If your baby is early, were here for you.

If your baby is born prematurely, the neonatal

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Total BodyWorkout

by Kay Rios

Ricardo Nieves, M.D., helps Kristina Stefka, M.D., improve her technique using kettlebells.

Kettlebells

“In only ten to thirty minutes with the kettle-bell, you can accomplish what you would do in a one to two hour session in a gym,” says Ricardo Nieves, M.D., of Colorado Spine, Pain, and Sports Medicine, P.C., explaining the growing interest in the kettlebell workout.

Made of cast-iron, a kettlebell resembles a can-nonball with a handle. A Russian creation, the orig-inal kettlebells weighed one pood, the equivalent of 35 pounds, one and a half poods, 54 pounds, and two poods or 72 pounds, says Chris Brown, owner and head trainer at Emergent Fitness. “You can now get them in smaller increments in the American versions.”

Kettlebells, so the story goes, were first used as counterweights in Russian farmers’ markets over 300 years ago. The farmers began swinging their weights and a new workout regimen was born. Pavel Tsatsouline, a former physical training instruc-tor for the Soviet Special Forces, brought the work-out to the U.S. He was contracted to work with the U.S. Marine Corps and the Secret Service and the word spread. In 2001, Dragon Door published Tsatsouline’s The Russian Kettlebell Challenge, and manufactured the first U.S.-made, Russian-style cast iron kettlebell.

The swinging routine of the kettlebells is for anyone, says Brown. Different body types and fit-ness levels can be accommodated. “We teach a kids class for six to 12 year olds and they do kettle-bell swings with light weights and focus on form. Age doesn’t matter because it’s easily scalable and these are functional movements.”

“Kettlebells train the body for real life,” Nieves maintains. “For example, a young mother carrying

a baby in one hand and groceries in the other – not many exercises in the gym prepare you for that. With kettlebells, you’re activating the whole body.”

The workout can be done every day, Brown adds. “This is a multi-joint, full body workout that includes cardio and flexibility.”

While both Nieves and Brown share an un-derstanding of the value of the kettlebell workout and both have received certification as kettlebell instructors, their approaches are different. Brown comes from a fitness world approach and Nieves from the medical arena.

Brown uses kettlebells in his CrossFit workouts. CrossFit is a strength and conditioning program that combines timed intervals of weightlifting, squats, push-ups, and cardiovascular exercise.

After Brown received his degree in computer sciences from New Mexico State, he relocated to Colorado and took a desk job where he gained 50 pounds. “I was 23 years old, my blood pressure was 180 over 90, and I was diagnosed as hyper-tensive.”

As a teenager, he had met Tsatsouline in New Mexico at a kettlebell demonstration. “I remem-bered the kettlebells and I decided to give it a try. In nine months, I lost the weight and got my blood pressure, cholesterol, and resting heart rate back to a good point.”

Nieves’ interest also stemmed from personal need. After receiving his medical degree, he com-pleted his internship at the Mayo Clinic, and his residency in physical medicine and rehabilitation at Temple University Hospital in Philadelphia. He opened his practice and served as medical staff for the Olympic trials. But while he was helping others,

he found that his own workouts were lacking. “In 2006, I was bored working out in gyms. I

was looking for something different and I found it on the Web. I bought some DVDs and kettlebells and imitated everything I saw. But then I received training with a certified instructor and realized what I was doing wrong.”

Nieves, a Certified Strength and Condition-ing Specialist with basic and advanced level Rus-sian Kettlebell Certification, was invited to be an instructor at the main certification program in Denmark in 2008. He currently incorporates his extensive medical training, knowledge of strength conditioning, and kettlebell knowledge to provide specialized workouts to his patients. He is planning to open a facility where he will provide kettlebell instruction to the general public.

While it’s easy to get started with kettlebells, with the equipment now readily available in stores and on the Internet, both Brown and Nieves stress using common sense.

Proper instruction is required. “A kettlebell is like a dumbbell. But, you start swinging and it comes alive. It can hurt you. You need to be taught by a certified instructor to learn about attention to detail, positions, spine mechanics, proper breath-ing, and proper technique,” Nieves says.

As with any workout, the moves need to be coupled with a healthy lifestyle, Brown adds. “Eat-ing well is an important part of the training.”

Kay Rios, Ph.D., is a freelance writer who spends many hours in front of a computer and is ever in search of the perfect workout.

WELLNESS KETTLEBELLS

If time constraints are your excuse for not exercising, kettlebells might just be the answer to the workout dilemma.

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Impact on Your Health by Angeline Grenz

Wading through the complex subject of alcohol intake is a difficult chore. The discussion ranges from alcohol’s health implications, to social behaviors that contribute to drinking, to the frightening, and often incomprehensible, alcohol addiction.

Alcohol’s

Can moderate alcohol intake improve your health? Should you only drink red wine? Or does the teetotaler have it right: no alcohol is good al-cohol?

What trends do we see in an economic cli-mate that has added significant pressure to the average family? How do college-age students fare as they fly the coop and enter a new phase of in-dependence? What are the signs that alcohol has crossed the line from leisure time companion to addiction?

These questions are not easily answered in a few words, but local experts from the medical and mental health communities give us their insight on how drinking behaviors are changing in our Northern Colorado community.

The Physical PersonAlcohol and our health: where do we draw

the line? It is a tricky question, according to Chris-tie Reimer, M.D., with Poudre Valley Internists.

Before the discussion begins, Dr. Reimer warns, “It is important to understand there have been no long-term ‘randomized controlled trials’ (what the medical community considers the gold-standard for determining benefits and risks) of alcohol consumption.” Furthermore, Dr. Reimer says the suggestive data collected creates only a definition of moderate drinking; a reference point for physicians, not an absolute standard.

Moderate use, says Dr. Reimer, is defined as an average of 14 drinks per week for men young-er than 65, and an average of seven drinks per week for women and men over the age of 65. Men should have no more than four to five drinks in one setting and women should have no more than three to four drinks in one setting. It is also important to know what a “drink” is: one drink is approximately 12 ounces of beer, five ounces of wine, or 1.5 ounces of hard liquor. Often, what makes up a single drink can be greatly overesti-mated.

“We have learned that there are some ben-efits of light to moderate amounts of alcohol intake,” she says. Among those benefits are the decreased risk of coronary heart disease, stroke, diabetes, gallstones, and overall mortality. “Those at the highest risk for heart disease probably ben-efit the most; there is a suggestion that the sub-group that may receive the greatest benefit from moderate alcohol intake is older men.”

Although red wine does have a few health benefits thought to be associated with grape skins, the benefits touted above do not hinge on a certain type of alcohol. Beer, wine, or hard liquor – it does not make a difference, according to Dr. Reimer.

Dr. Reimer warns that suggestive data for the benefits of moderate drinking may apply pri-marily to men, who have a higher risk of heart disease. “It is hard to know how to apply much of the information we have to women, especially since they are at increased risk of breast cancer,”

WELLNESS ALCOHOL

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Brain and Central Nervous System• Alcohol can act as a stimulant at low levels, but is generally a central nervous system depressant that causes impairment in judgment, loss of inhibition, balance, and motor coordination. At higher dosages, alcohol can cause blackouts and memory loss. Abnormal sleep patterns and an increase in snoring and sleep apnea can result.

• Long-term exposure to alcohol can lead to depression and anxiety, permanent brain damage, stroke, delirium, and dementia, as well as peripheral neuropathy (numbness and tingling) and addiction.

Heart• Prolonged alcohol intake can cause atrial fibrillation (a rhythm problem), hypertension (high blood pressure), acute myocardial infarction (heart attack), and cardiomyopathy (heart failure/weakened heart muscle).

Bones• Prolonged exposure to alcohol leads to an in-

creased fracture risk due to osteoporosis and an increased risk of falls.

Blood• Prolonged exposure to alcohol can lead to abnormalities in the production of all cell lines (red blood cells, white blood cells, and platelets).

Breasts• Alcohol intake can increase the chances of breast cancer.* Women with a family history of breast cancer should consider avoiding alcohol. The risk may be partially offset with folate supplementation.

Liver• Alcohol can inhibit the creation of glucose, causing low blood sugars.

• Long-term alcohol exposure can lead to alcoholic hepatitis (inflammation)*, cirrhosis of the liver, end-stage liver disease, and hepatoma (liver cancer).

Intestines• Prolonged exposure to alcohol is associated with colon cancer.

Reproductive Organs/Genitals• Alcohol can lead to an increased sex drive at low levels in both genders via disinhibition, primarily.

• Higher levels or long-term use can lead to decreased sex drive, erectile dysfunction, and difficulty reaching orgasm in both genders.

• Drinking alcohol during pregnancy can lead to fetal alcohol syndrome* and prolonged exposure can lead to male and female infertility.

Pancreas• Long-term exposure to alcohol can lead to pancreatitis (inflammation) and pancreatic cancer.

Stomach/Esophagus• Alcohol intake can cause nausea and vomiting.

• Long-term effects include gastritis (inflammation), bleeding, ulcers, and cancer.

Muscles• Prolonged exposure can lead to weakness and loss of muscle tissue.

Lungs• Exposure to high volumes of alcohol may

lower resistance to infection, cause breathing to stop, and even death.

Immediate & Long-Term Effects of Alcohol on the BodyAlcohol is absorbed through the entire GI tract, but mostly in the stomach and small intestine. While a small amount of alcohol is excreted in urine, sweat, and the lungs, most is metabolized by the liver.

* most concerning

Contributions to medical text by Christie Reimer, M.D., Poudre Valley Internists

77

says Dr. Reimer.The studies done on mortality rates seem to

be the most compelling. Data suggests that a moderate drinker (who has one or two drinks a day) lives longer on average than those who ab-stain completely or who drink in greater quantity, relates Dr. Reimer. Again, she warns that these studies are anecdotal.

There is a segment of the population that should abstain from alcohol completely, says Dr. Reimer: “Women who are pregnant, or consid-ering pregnancy; recovering alcoholics; those with chronic pancreas or liver disease, especially hepatitis C; those with a strong family history of alcohol dependence or abuse; those with a strong family history of breast cancer; and those whose occupation requires driving or operating machin-ery.” Further, she says, there are studies that sug-gest male and female fertility can be impacted by alcohol. “And, there is a definite link between alcohol and an increased risk of breast cancer.”

In the end, advises Dr. Reimer, “a decision to abstain from alcohol or drink moderately should be individualized. One must take into account the risks associated with his or her medical problems, other medications, and social and occupational environments.” In our diagram on page 77, Dr. Reimer provides a short synopsis of how alcohol can impact the body, both in an immediate sense and from a long-term perspective. The possible physical impacts from alcohol intake refer only to prolonged exposure to the body and are not specific to persons suffering from an alcohol ad-diction.

The Social DrinkerCollege drinking is one of the most concern-

ing segments of the drinking population. The tragic fatalities that have resulted from binge drinking by partying college students, both lo-cally and nationwide, has fueled public concern. Colorado State University has taken an aggressive route to help students understand the dangers and consequences of abusing alcohol.

“We are always asked, ‘why is the college population so difficult?’” says Lisa Miller, Direc-tor of CSU’s Research and Health Promotion. “But our population turns over every four years.” And every year, a new group of freshmen must be educated about CSU and the community’s ex-pectations, the risks associated with drinking, and smart strategies surrounding alcohol.

“We try to take a thoughtful, multi-pronged approach to educating students,” says Miller, add-ing that a “hardcore, zero tolerance” tactic rarely works at the college level. Greater success comes from “educating students on a cognitive level: teaching decision-making strategies, messages of accountability, and encouraging early planning,” explains Miller. “We teach them things, like how to quantify a drink.”

“We encourage students who plan to drink to have less than four or five drinks in one setting, to eat food before drinking, to alternate drinks with water.” One popular drinking ritual is “pre-funk-ing,” the practice of doing several shots of hard alcohol before going out for the night. Students are educated about the dangers of such behavior and encouraged to make smart decisions, such as

who will be designated driver for the evening, be-fore drinking begins. “Planning at the beginning of the evening always results in better outcomes.”

Another key is to “spread messages around social norms. We have a growing population of non-users. Between 30 to 40 percent of students do not participate in drinking. But the perception is that everyone drinks.” Miller says students are choosing not to drink for a variety of reasons. A healthy lifestyle is one. Another, surprisingly, is the poor economy. Parents, says Miller, are telling their children that if they pay for the child’s col-lege education, they expect them to stay focused and successful.

The drinking behavior of CSU’s student popu-lation has remained relatively static in current years, says Miller. However, there is an increase in students’ use of stimulants and opiates on a na-tionwide level, says Miller, in part, due to greater availability.

Do the drinking behaviors adopted during college years shape drinking patterns later in life? Possibly, says Miller. There is some data that sug-gests students considered high-risk drinkers at the college age continue to struggle with substance abuse into their 40s. And strong data supports the idea that students who learned decision-making at a young age were able “learn from mistakes and transfer that knowledge from one application to another” throughout their lives, says Miller.

Ken Ash, M.D., a psychiatrist practicing in Windsor, says the age at which a person begins drinking may have a great impact on drinking be-haviors later in life. Dr. Ash cites a recent Center for Disease Control study that found among chil-dren who started drinking at a young age, around 12 years old, more than half ended up with an al-cohol addiction at some point in their adult lives. Addiction appeared less often in those who did not begin drinking until later in life, around age 20 or 21 years old.

The Alcohol Addiction“There is a significant difference in alcohol

abuse and addiction,” says Dr. Ash. “Think of the college students who drink too much. After enough negative consequences, they can cut back and drink socially. Others may try to cut back and cannot.” However, addiction can develop in a variety of ways, Dr. Ash adds. One can begin drinking socially “and after a period of time, the brain changes and drinking can no longer be con-trolled.” For others, addiction comes from strong genetic factors and the very first drink can be the one and only trigger.

Abuse verses dependence, says Chris Meeker, Chemical Dependency Outpatient Program Coor-dinator at Mountain Crest Behavioral Healthcare Center, hinges on the answer to a variety of ques-tions: Can you stop drinking at one or a couple drinks or do you always need more? Have you attempted to quit drinking but have never been successful? Do you think about drinking or ac-quiring alcohol all the time? Does alcohol get in the way of other relationships?

“A person with an alcohol problem needs al-cohol to feel normal and sees alcohol as the an-swer to their problems, rather than as something that creates more problems,” says Meeker.

Meeker manages Mountain Crest’s outpatient programs. The Chemical Dependency Intensive Outpatient (CDIO) program is designed to provide

CONTINUED ON PAGE 98

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Approachby Angeline Grenz

Founder Richard Rossiter demonstrates the Rossiter techniques’ abil-ity to relieve pain on David Henre, Rossiter Instructor.

Connective tissue runs throughout the body, providing structure and support to our body’s composition. When we fall, work in a repetitive motion, or are in the unfortunate fender bender, often it is these connective tissues that take the brunt of the trauma. Though painful, connective tissue injuries can be relatively easy to correct and heal. All that is involved? A few good stretches, according to the creator of The Rossiter System.

The Rossiter

Call it a workout, not a therapy, says founder Richard Rossiter. This is because the Rossiter ap-proach involves two-person connective tissue stretching. But while the therapist may provide the proper weight to the tissue, the patient does all the work. It is a system that allows you to stretch to your maximum capability and puts the proper spac-ing back into your damaged connective tissue.

Rossiter says his approach can fix knee pain, carpal tunnel syndrome, elbow tendonitis, hand or foot problems, shoulder pain, sciatica, low back pain, knees, sprains, and strains. Even migraines and jaw problems can be alleviated. The pain relief offered by Rossiter’s approach comes without the invasive, and potentially harmful, side effects of sur-gery or injections. The exercises “provide a whole body stretch while doing a single technique” with the patient in full control, says Rossiter.

Rossiter created his technique in the late 1980s, a product of his own search to find pain relief. While still in his 20s, Rossiter was employed as a bush pilot in Alaska. A mixture of childhood sports injuries, wartime injuries, and occupational stresses had left Rossiter with constant pain in his shoulders. Searching for something to alleviate the pain, he stumbled upon Rolfing, a technique that focuses on lengthening and restoring the body’s connective tissues.

Rolfing enabled Rossiter to find relief from his pain and he applied to the Rolf Institute in Boulder,

Colorado. In 1987, he became a certified advanced Rolfer and established his own practice in Little Rock, Arkansas.

Shortly after setting up his practice, Rossiter was able to help a local neurosurgeon with a pain-ful back condition. Soon, Rossiter began to regular-ly receive referrals from the neurosurgeon. “He be-gan to inundate me with his worst clients.” Clients who were in chronic pain but did not want risky surgeries, or who had already undergone a surgery but were still experiencing pain.

“I was learning so much from working with his patients. I went to him and asked for carte blanche to find better, faster ways to fix people.” At the same time, Rossiter realized that he had an obliga-tion to help these people before they went through invasive surgeries in search of pain relief.

The Rossiter revelation came when he was teaching the Rolfing method to a married couple. The wife was diminutive in stature while her hus-band was very tall. Rossiter told her she would have to stand on him to get the leverage she needed to perform the stretch. And then it happened.

“We got tremendous results.” He realized the stretch achieved by placing the weight of the foot on the patient’s body enabled them to stretch deep-er. His modality was born. Rossiter stretches involve two people: the coach (or therapist) and the person in charge (patient). The way Rossiter works is the person in charge does the grinding and the pushing

and the coach leads the movement while applying weight. Thus, Rossiter’s technique lengthens the connective tissue, allowing pain-free movement by returning the proper space required for the body’s tissue to move and function properly.

“I found in my practice, when a patient just laid there they didn’t get well. But when I asked them to participate and work with me, they experienced better, quicker, and longer-lasting results. And they started to take responsibility for their own recov-ery,” says Rossiter. He continues: “Patients in pain know how far to stretch. They even know when they are cheating.” By the end of a Rossiter session, “patients are also smarter about their own bodies.”

While most of his more than 200 stretches in-volve weight from the coach’s foot, a handful of them do use weight from the elbow. The access point under the coach’s foot acts as the midpoint to the stretch, and the patient’s stretching move-ments engage connective tissue in multiple direc-tions. “Think of connective tissue as thin threads throughout the body. Add pure weight with slow, deliberate motion and you get an immediate reac-tion. Combine the right movement with the right amount of weight and you get the right stretch.”

Rossiter’s goal is to take his workout beyond gym rooms and therapists’ offices and move it right into the public arena. He offers courses in his stretching techniques to businesses that want to “take control of their healthcare costs.” By training

WELLNESS ROSSITER

8080

lay people, companies can help alleviate the aches and pains that send their employees to doctors, physical therapists, even surgeons. With Rossiter stretches, a person feels better, faster. This, in turn, cuts down on employee time lost to doctor’s visits or even permanent injury. “Companies can save up to 80 percent on their medical costs” by learning a few good stretches, says Rossiter.

David Henre is a local, Level 1 Rossiter Instruc-tor who teaches courses at The Other Club, Ltd., in Fort Collins. Henre is available for group train-ing or to teach Rossiter to companies who want to take a new approach to keeping their employees well. According to Henre, the technique is easy to learn and requires little in the way of equipment. “All you need is a mat to lay on and a block or two to elevate a person to apply their weight in a more even fashion.”

What is important, says Henre, are the benefits derived from Rossiter. “Structurally, when every-thing is out of balance, Rossiter can put the origi-nally designed space back into the tissue and pain goes away. It is gone that fast.”

Henre can be reached at (970) 376-7699 or [email protected]. Additional information about The Rossiter System can be found at the Website: www.therossitersystem.com.

Angeline Grenz is Editor for Style Magazine.

LeaAnn Haisch, City of Fort Collins crew chief for Parks and Recreation, has had 20 Rossiter workouts over the past two years to relieve her low back and hip pain. 81

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by Kay Rios


Most everyone would agree with John Denver’s musical assertion that sunshine makes people happy but, while those wonderful rays are certain to lift moods and encourage outdoor activities, there’s also a dark side to the sun.

WELLNESS EYE HEALTH

Take the effect on eyes as an example. The sun’s ultraviolet rays, in regular doses, can certainly con-tribute to the incidence of cataracts and conditions such as pingueculae and pterygia.

“Certain types of cataracts are more prevalent in parts of the world that have a great deal of sun,” confirms Randall Smith, M.D., ophthalmologist and cataract and refractive surgeon with Eye Center of Northern Colorado, P.C.

A cataract is a clouding of the eye’s lens that lies behind the iris and the pupil. The lens is primar-ily made up of water and protein and the protein is arranged so that it keeps the lens clear and al-lows light to pass through. With aging, the protein may bunch together and cloud part of the lens. Over time, as the cataract grows, more of the lens is clouded. While sunlight itself does not cause cata-racts, many studies have associated exposure to ul-traviolet light with cataract development.

Treatment for cataracts includes surgery with lens implants. “Surgery has become more straight forward,” Smith says. “Because of advanced equip-ment and improved techniques, along with foldable lens implants, a surgeon can perform the typical cataract surgery in a quick, painless manner. Surgery involves two tiny incisions, two millimeters or small-er, so that no stitches, or even shots, are required.”

The lens implants have also improved, he says. “All of the lens implants have UV protection at this point. We even have lens implants that have a very slight yellow tint that filters out high frequency blue light thought to be potentially damaging to the eye. If we look at the lens of a four-year-old, it’s crystal clear. As the eye ages, the lens slowly be-comes cloudier but it also filters out some UV light and the high frequency part of the light spectrum.

So a slightly yellow lens implant actually mimics a 20-year-old’s natural lens, giving the cataract pa-tient great vision and extra protection. Such lenses even come in a version that can give patient glasses-free vision for all distances.”

Two other conditions more directly related to damage by UV rays are pterygium and pinguecu-lum. A pingueculm is a wedge-shaped benign growth on the conjunctiva, a thin, clear layer over the white of the eye. As sun damage worsens, the growth extends over the cornea and is then called a pterygium.

“A pterygium can thicken and grow across the surface of the cornea, over the colored part of the eye, and become large enough to interfere with vi-sion,” Smith says. “It is particularly bad in people who work outside consistently and have direct dam-age to the cells by the sun. Most people with this come in complaining of red, irritated eyes and feel like something is in the eye. If it’s mild, a doctor can just measure the size of the growth and follow it once a year. If it’s growing toward the center of the cornea, then it must be removed.”

For this condition, removing the growth is fairly simple, Smith says, but “the recurrence rate can be as high as 40 percent if we simply excise it and do nothing else. So typically, we will take a graft from the patient’s own conjunctiva tissue under the lid and place it over the white of the eye where the pte-rygium was removed. This reduces the recurrence rate to less than five percent.”

Another eye condition that causes concern is macular degeneration. “It’s the number one cause of irreversible sight loss for people over 65.” And while Smith says that it is not caused solely by sun exposure, good sunglasses may play some role in

slowing down its progress.“If a person comes in to our office at age 70

with macular degeneration, we can’t say what role sun damage played throughout their life versus them being genetically predisposed to the disease. To err on the safe side, I’d suggest that people wear sunglasses throughout their lives.”

UV protection is essential for all eyes, Smith says. “Sunglasses should have 99 to 100 percent UV blocking. Darkness of the lens does not matter as much as the quality of UV coating.”

Check the label, he says. “Sunglasses usually have a sticker indicating UV protection. Generally, a prescription lens will automatically come with high-level UV protection and a reputable optician will check the UV rating of sunglasses prior to dis-pensing the lenses. You can also bring in your own glasses and have the UV rating checked.”

For those who like water sports, fishing, or ski-ing, he suggests polarization. “It blocks reflective light.”

Smith stresses the need to see an eye doctor. “Skin cancers ranging from basal cell carcinoma to melanoma can be found around the eyes. Melano-ma can also occur in the eye and can only be picked up during an eye exam, so it’s important to get a regular eye exam. We recommend every two years and then, beyond age 50, every year.”

And cover those eyes, he says. “Even in an age where we can make people glasses-free, they should still wear sunglasses for protection.”

Kay Rios, Ph.D., is a Fort Collins-based freelance writer and is currently at work on a collection of creative non-fiction and a mystery novel.

Dark SideSunshine’s

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WELLNESS MEDICAL RECORDS

Save Livesby Laura Lee Carter

She was just going out for a short bike ride around her local neighborhood in south Fort Collins. It didn’t really seem necessary to carry an ID, or even wear a helmet. Ten minutes later she was found lying on the ground unconscious on a bike path not far from Horsetooth Road.

Accurate Medical Records

The bystander who found her called 911 and an ambulance arrived soon afterwards. She was quickly whisked off to the emergency room at Poudre Valley Hospital. Her mind was con-stantly weaving in and out of consciousness. Luckily, she did remember her name and the moment she answered that question posed by an emergency room nurse, Poudre Valley Health System’s (PVHS) electronic medical records sys-tem provided the staff with her complete medi-cal history. All the information they needed to contact her next of kin, and provide her with the best medical care necessary, was at their fingertips instantaneously.

This is a true story. It happened to this writer only last May. My own up-close and personal stumble into a bad bike accident, leading to fractured ribs and traumatic brain injury, taught me how crucial it is for our local healthcare or-ganization to have an excellent networked elec-tronic records system. In an emergency, seconds save lives and accurate medical information is critical.

Fortunately, PVHS rates in the top 100 for

Most Wired healthcare organizations nation-wide, consistently achieving that rating for the past six years. Hospitals & Health Networks magazine recently announced: “PVHS is among the top 100 hospitals and health systems for us-ing information technology to enhance patient care, improve quality, provide customer service, fulfill business processes, manage workforce is-sues, and assist with patient safety.”

PVHS President and CEO Rulon Stacey, Ph.D., reports, “Our health system is continu-ing to expand its information technology while many of the nation’s healthcare organizations are slowing down on such capital investments due to the ailing national economy.”

So, how can PVHS afford this type of capi-tal investment at a time like this? According to Gary Kimsey, PVHS Marketing Specialist, they began creating their own electronic medical records system back in October 2005. “While maintaining the highest level of security, PVHS doctors and staff can access complete electron-ic medical records for all of their patients from Poudre Valley Hospital, the PVHS Harmony cam-

pus, Medical Center of the Rockies, and PVHS clinics located throughout Northern Colorado. This kind of information technology also pro-vides seamless communication to doctors who choose to work from home and provides a huge time, money, and paper savings.”

Kimsey explains, “Unlike many other health systems nationwide, PVHS has a huge advan-tage because, as a private, non-profit system, we invest our profits back into the organiza-tion. This re-investment has helped us to cre-ate new technologies, like our own networked electronic medical records system, long before most other healthcare systems nationwide.”

PVHS’ advanced level of information tech-nology not only expedites the transmission of medical records system-wide, their state-of-the-art automation system enhances the accu-racy and speed of lab tests, and automatically reviews medicines in each record to determine if a patient might have an adverse reaction to a certain medication. Why is this important? Mixing medications can be dangerous, or even deadly.

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Reports from the Center for Disease Control (CDC) found that deaths from accidental drug interactions rose 68 percent between 1999 and 2004, continuing a steady climb since the early 1990s. According to the CDC, unintentional drug poisonings accounted for nearly 20,000 deaths in 2004, making this problem the sec-ond-leading cause of death in the United States after automobile accidents. The CDC reports, “Prescription drugs, especially prescription painkillers, are driving this prolonged increase.”

People are mixing supplements, herbs, and over-the-counter medications with prescription drugs, unaware these different chemical sub-stances will interact. For example, many started taking herbal medications like ginkgo biloba to improve their memory, unaware that it may also increase the risk of bleeding in the body. Some learned that St. John’s Wort might help with de-pression, but did not know that this supplement should not be taken with prescription strength antidepressants and anti-anxiety medications. Some take echinacea to enhance their immune system, only to discover that this herbal supple-ment can interact with Lipitor, Celebrex, and Aleve to increase the risk of liver damage.

That is why it is so important to inform your primary physician of all supplements, herbs, ho-meopathic medications, over-the-counter medi-cines, and prescription drugs you are presently taking. Once this information becomes a part of your PVHS electronic medical record, if an emergency should arise, your caretakers have instantaneous access to information concerning all medications you are taking.

In contrast with our local electronic medi-cal records system, you might wonder about a new trend of creating online personal health re-cords (PHR). For example, the American Health Information Management Association (AHIMA) recently launched the new myPHR.com Website where individuals may choose to input their own health information record for emergency access worldwide.

Kimsey cautions readers about these new online medical record services. Here are a few crucial questions to ask before you decide to input your own health information into these systems. Who maintains your records and en-sures they are accurate? How does this com-pany make money? Exactly how secure is your information in these online systems?

Fortunately, our medical records are safe and local with Poudre Valley Health System. They are networked throughout Northern Colorado and ready at a moment’s notice to increase patient safety and save lives. This ad-vanced medical information system allows the staff at PVHS to easily analyze massive amounts of patient information to identify areas where patient care might be improved.

That is one of the many reasons why PVHS was the only healthcare organization to receive the Malcolm Baldrige National Quality Award in 2008, an honor established by Congress to recognize the performance excellence of the nation’s top organizations.

Laura Lee Carter is a freelance writer, counselor, speaker, and author of the new book: Midlife Magic: Becoming The Person You Are Inside. www.LauraLeeCarter.com


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88

NOW OPEN

TWENTY THREE TREES MEDICAL & WELLNESS SPA

A MEDICAL SPA BROUGHT TO YOU BY PVHS

Twenty Three Trees is a new medical and wellness spa owned and operated by Poudre Valley Health System .

Staffed by a physician and a licensed esthetician, nail technician and massage therapists to ensure the highest

quality care and medical expertise, Twenty Three Trees will offer comprehensive services in a luxury spa setting .

esthetic procedures I facials massage therapy

natural nail services laser skin renewal photofacial skin rejuvenation

Twenty Three Trees is located across the bridge from PVH in the new Westbridge Medical Suites.

To be placed on our e-mail list to receive special introductory offers, e-mail

[email protected].

To schedule a complimentary consultation or to make an appointment, call (970) 495-8400.

WHY TWENTY THREE TREES?

During excavation for the Westbridge building, it was necessary for 23 trees to be removed, but all were

relocated to the home gardens of PVHS employees. Twenty Three Trees Medical and Well ness Spa is located

on the same grounds where the 23 trees once stood and carries on the same spirit of renewal. This summer,

23 new trees will be planted around the Westbridge building, bringing the story full circle .


90 - --l Family

Medicine Center

Foxtrail Family Medicine Medical Center of the Rockies

.... -~·~:_____ ____ $ Windsor Medical Clinic

Milliken Family Clinic

POUDRE VALLEY HOSPITAL 1 024 S. Lemay Avenue

Fort Collins, CO 80524 (970) 495-7000 Toll-Free: (800) 252-5784

MEDICAL CENTER OF THE ROCKIES

2500 Rocky Mountain Avenue

Loveland, CO 80538 (970) 624-2500

Toll-Free: (800) 252-5784

MOUNTAIN CREST

4601 Corbett Drive

Fort Collins, CO 80528 (970) 207-4800

Toll-Free: (800) 523-1213

HARMONY URGENT CARE

2127 E. Harmony Road

Fort Collins, CO 80528 (970) 297-6250

FAMILY MEDICINE CENTER 1025 Pennock Place

Fort Collins, CO 80524 (970) 495-8800

WINDSOR MEDICAL CENTER

1455 Main Street Windsor, CO 80550 (970) 674-4900

flN;~ro~i Quality

Award

~~008Awaro , ... R~cipient

LOVELAND URGENT CARE

3850 North Grant Avenue

Suite 100 Loveland, CO 80538 (970) 669-5717

FOXTRAIL FAMILY MEDICINE

1625 Foxtrail Drive

Loveland, CO 80538 (970) 61 9-6900

MILLIKEN FAMILY CLINIC 1 760 Broad Street, Suite J Milliken, CO 80543 (970) 587-7999

by Kay Rios

It is a family affair in the Poudre Valley Health System (PVHS). PVHS is, in fact, a regional network of healthcare services for people in northern Colorado, southern Wyoming, and western Nebraska.

More Options for Your Family’s Care

The PVHS Network

MEDICAL PVHS FAMILY CARE

While Poudre Valley Hospital (PVH) and Medi-cal Center of the Rockies (MCR) are well-known as part of the system, additional locations provide family care to a broader expanse of citizens. Op-erating under the PVHS umbrella are the Family Medicine Center, Foxtrail Family Medicine, Har-mony Urgent Care, Loveland Urgent Care, and the Milliken Family Clinic.

Bringing them into the system was a natural pattern of growth, says Barb Yosses, PVHS Vice President of Ambulatory Services. “PVHS has been growing steadily over the past 10 years in North-ern Colorado.”

As PVHS has grown, its reputation has also grown, Yosses says, pointing to the number of awards received in recent years. The list is impres-sive. In 2008, PVHS won the Malcolm Baldrige National Quality Award, the highest Presidential honor given to United States businesses and orga-nizations for performance excellence. In addition,

PVH was presented with the American Nurses As-sociation’s highest award for excellence that same year and, in 2009, it again received the Magnet Award for Nursing Excellence by the American Nurses Credentialing Center. PVHS was named as one of the 100 Best Places to Work in health-care by Modern Healthcare and, in 2008, Medical Center of the Rockies’ Surgical and Cardiac ICUs received the Beacon Award for Critical Care Ex-cellence by the American Association of Critical Care Nurses.

“All this has drawn national attention and attracted many physicians to this area,” Yosses explains. “Physicians are interested in working for a top-quality healthcare system. Patients, in turn, are interested in having their healthcare delivered by physicians associated with PVHS, so that if they become ill, they will be taken care of at a PVHS facility.”

The demand was spurred by sheer numbers,

says Yosses. “With the population growth in this area of the country comes the need for more healthcare facilities where patients can receive individual care. PVHS has been working to grow a medical network that gives patients a place to receive healthcare close to home.”

Currently, that care is provided at a number of locations in Fort Collins, Loveland, and Milliken.

The Family Medicine Center (FMC) is located two blocks north of Poudre Valley Hospi-tal at 1025 Pennock Place. FMC serves as a train-ing site for PVH’s Residency Program. Each year, six new graduates are chosen from top medical schools across the country and, as part of the resi-dency, they see patients at FMC, PVH, and in rural communities that may not have enough doctors. The oldest of the clinics, FMC opened in 1977.

“Our mission is to train family physicians,” says Marcia Snook, FMC clinical coordinator. “In


92

doing so, we offer primary care in the family medicine model and that includes OB care, many in-office procedures, hospital care, integrated be-havioral health, geriatrics, and lifestyle medicine.” FMC’s healthcare team provides medical care for community members who might otherwise go without healthcare, Snook adds.

Foxtrail Family Medicine is one of the newest additions to PVHS, opening on August 20, 2008. Located just south of MCR at 1625 Fox-trail Drive, it provides a full-spectrum of primary medical care, including obstetrics, pediatrics, and geriatrics.

“We see all ages and offer a variety of health-care services to our patients in the Loveland area,” says Heather Smith, Foxtrail’s office manager. The location is also convenient for patients living in the Berthoud, Johnstown, and Windsor areas.

Harmony Urgent Care’s service is de-signed to take care of minor injuries and illnesses, such as the flu, strep throat, strains, sprains, and minor fractures. Harmony Urgent Care is located at PVHS’ Harmony Campus on the southeast side of Harmony and Timberline Road in southeast Fort Collins.

“We opened in 2001, so we’re coming up on our eighth full year,” says Jan Huff, clinic manager and RN. “We offer everything a family practice would except for those things that require con-tinuity of care, such as diabetes and high blood pressure checks.”

Huff stresses that, although they get a num-ber of emergency cases (49 in July 2009 alone), Harmony Urgent Care is not an emergency room. “For accidents, broken bones, chest pain – those things – we transport them to one of our hospi-tals.” Harmony Urgent Care also works with oc-cupational health patients, she says. “If workers have been injured on the weekend or in the eve-ning, we can see them for the initial visit.”

All patients are seen on a walk-in basis and do not need to make an appointment.

Loveland Urgent Care and Loveland Family Practice combine urgent care, family practice, and occupational health services into one convenient location. “We’re a convenient walk-in medical clinic with doctors available seven days a week,” says Keith Miller, clinical supervisor. They treat non-life-threatening illnesses or injuries that need immediate attention. It is a full-service medical clinic providing care in all stages of life.

Also housed in the same facility at 3850 North Grant Avenue in Loveland, the Loveland Fam-ily Practice offers the full range of primary care needs for all ages including physicals, screenings, and wellness services. “Both practices are depart-ments of PVHS,” Miller says.

Loveland Urgent Care opened in 2007 and was purchased by PVHS in 2008.

The Milliken Family Clinic is committed to listening to and treating patients as individuals, answering questions regarding healthcare con-cerns, and ultimately helping patients to reach and maintain optimal health. The Clinic is located at 1760 Broad Street, Suite J, in Trader Junction at Centennial Crossing in Milliken.

“The staff is leased by PVHS although they are Greeley Medical Clinic staff,” says Julie Neth-erton, patient care manager for Greeley Medical


Clinic (GMC), P.C. The Milliken Family Clinic is a family practice, she says. “So we offer compre-hensive care, health maintenance, and preventive services for all ages.”

The facility was previously open under Ban-ner Health but was taken over by PVHS and GMC in May of 2008. It’s a small practice, she says, with one family nurse practitioner and a lab on-site.

There are a number of advantages to having this type of network, they all say.

“Location is a big advantage for patients,” Huff says. “The clinics are strategically placed so they are as convenient as possible. I think we’re really doing a nice job in offering medical care throughout our community.”

Snook says, “Being associated with PVHS al-lows our patients access to many services they may not otherwise be able to use. Having afford-able, high quality care available close to home is a benefit to the community we serve.”

“PVHS has such a great reputation and I think it’s a good thing for the people of Love-land who know about that reputation to have a contact here so they don’t have to drive to Fort Collins to get that care,” Miller adds.

There’s more ahead, Yosses says. “As the community in Northern Colorado continues to grow, additional sites will be needed and PVHS intends to respond to that need.”

Kay Rios, Ph.D. is a freelance writer based in Fort Collins. She can now officially be called Dr. Rios but, as the police informed her at the pharmacy, she still can’t write scripts.

As the community in Northern Colorado continues to grow,

additional sites will be needed and PVHS intends to

respond to that need.

- Barbara Yosses, Vice President of Ambulatory Services for

Poudre Valley Health System

A Screening Alternative by Kay Rios

Doctors’ appointments are not on Glenna Cook’s list of things to do. A healthy and active woman, Cook figured she took care of business with exercise and diet so she didn’t need routine check-ups. And a colonoscopy? She didn’t see the need.

MEDICAL DIAGNOSTICS

Virtual Colonoscopy

The American Cancer Society would, how-ever, disagree with Cook. Early detection is paramount and an optical colonoscopy can help prevent colorectal cancer by finding and removing polyps that could create a problem down the line.

But, even though her mother died from colon cancer, Cook resisted. “I’m not a very cooperative patient,” she says. “My doc had been nagging since I turned 50 to get a colo-noscopy.”

But her doctor had the last word. As part of the maturation process, her thyroid had ceased

to function and she was put on a synthetic thy-roid replacement. “When it came time to re-new my prescription, he put his foot down. He wouldn’t renew until I came in for the yearly physical and all the other tests.” Those tests included the colonoscopy.

It wasn’t just taking a day out of her life to get it done; there was the fear factor for Cook, who had heard several “horror stories.”

During an optical colonoscopy, the doctor uses a colonoscope, which is inserted through the rectum into the colon. The colonoscope in-cludes a video camera that connects to a dis-

play monitor to facilitate close examination of the inside of the colon. Special instruments can also be passed through the colonoscope to re-move polyps. That procedure didn’t appeal to Cook.

Then a friend told her about the virtual colonoscopy. This screening exam uses an ad-vanced type of computed tomography (CT or CAT), which scans the colon and rectum. It produces detailed cross-sectional images and reformats them into 2-D and 3-D images that appear similar in detail to an optical colonos-copy, hence the term “virtual.”

Technician Laura Schultz prepares patient Lisa Rigg to be scanned for her virtual colonoscopy.

94

by Kay Rios

Deborah Gunderson, M.D., and radiologist with Advanced Medical Imaging Consultants, P.C., (AMIC) at The Imaging Center, says there are a number of advantages to a virtual colo-noscopy. “It is minimally invasive, anesthesia is not used, and it is quick and accurate. A bowel prep is still necessary since the inside of the co-lon needs to be very clean.”

Cook met with her doctor, who agreed to the virtual route. At 8:30 a.m. on a Tuesday morning in July, she is at The Imaging Center on Harmony ready for the test. After filling out the requisite paperwork, she’s escorted back to the nurses’ station where a nurse asks how the prep went.

“It blasted me into the end of the movie I was watching,” Cook says. “I can assure you there’s nothing solid left.”

Cook confides that she is still nervous. “I still don’t know what to expect. They told me I’d be filled with carbon dioxide (CO2) like a balloon, and that’s just a little disconcerting. But they said there would be little discomfort and I’d just feel like I want to evacuate. And, at least, the machine is not invasive.”

Cook’s procedure is guided by CT scan technicians, Laura Schultz and Bobbie Elliott, who are both certified in radiology and in CT scans. Cook lies on the CT bed, and her co-lon is filled with carbon dioxide gas via a small tube placed in the rectum. The slight expansion of the colon allows good visualization of the colon wall.

Elliott explains that it will take about eight seconds with Cook lying on her back as she is scanned, and then she will turn over and will be scanned for another eight seconds.

“The colon doesn’t lie flat, and air rises above the fluid, so that’s why the patient lies on her front and then on her back,” Schultz says. The prone and supine CT imaging is done to differentiate residual debris in the colon

95

Scans of the colon taken while the patient lies on her back and stomach.

Fort Collins Medical Magazine & Directories 2009 2010

from a polyp and allow visualization of the entire colon wall, which could be obscured by residual fluids and solids.

The technicians have both been doing this for a while. Elliott says she started in 1981. “It’s amazing how it’s changed.” Schultz agrees, In the old days, “if we got called in for an ac-cident, we’d be there all night. It used to be a nightmare. We were using much older equip-ment then.” Newer technology not only al-lows a better look at the area scanned, it offers greater efficiency. “This is going to be a beauti-ful scan,” Elliott adds. “She is very clean,” she says, referring to the prep process Cook com-pleted before the scan.

The virtual colonoscopy is interpreted by a radiologist in both two-dimensional and three-dimensional versions. The 2-D images reveal the colon and all of the other anatomy in the abdomen and pelvis. The 3-D images appear as though the viewer is traveling through the colon. Each crevice and fold is inspected, much like an optical colonoscopy. “It gives the same view as an optical colonoscopy,” Elliott says.

It’s efficient, she adds. “I’ll have the first set to the radiologist before the patient gets out of the bathroom.”

Cook gets up from the scan bed and re-treats to the bathroom and, in fact, before she emerges, both sets have actually been sent to the radiologist. Cook is escorted back to the reception area where she is given a warm blan-ket, offered juice, coffee, or tea, and told to sit for a few minutes and relax.

While the prep the night before wasn’t a ball of laughs, Cook says, “I feel fine, good re-ally. I had some discomfort last night. And I got a little hungry yesterday. I had a hardboiled egg for breakfast yesterday and nothing else.”

Still concerned about the CO2, Cook asks a nurse, “How do I dispose of the gas? I have a party this afternoon.” She is assured that it’s easily absorbed into the blood stream and the body will dispose of it within half an hour. She can make her party without any concerns. The entire process has taken 45 minutes and Cook walks out and drives off unassisted.

“The beauty of this method of colon cancer screening is that it does not take a day out of a patient’s life, compared to optical colonos-copy,” Dr. Gunderson says. “Other benefits in-clude the ability to assess other anatomy in the abdomen and pelvis. We have incidentally de-tected aortic aneurysms, ovarian masses, and renal stones.”

The Imaging Center has been offering virtual CT scans since 2000, says Dr. Gunder-son, who was responsible for bringing in the technology. “It was a new technique and, as I learned more about it, I thought it was going to be very valuable.”

The Imaging Center is the only medical im-aging facility in Northern Colorado and the sur-rounding region that offers virtual colonosco-py. The facility uses a state-of-the-art, 64-slice CT scanner and follows protocols used by other leading imaging programs.

There are those patients for whom a vir-tual scoping is not appropriate. “Virtual colo-noscopy is endorsed by the American Cancer Society for a specific colon cancer screening population,” states Dr. Gunderson. “This is in-tended for patients over the age of 50, without

Deborah Gunderson, M.D.,Advanced Medical Imaging Consultants, P.C.

The beauty of this method of colon cancer screening is that it does not take a day out of a

patient’s life, compared to optical colonoscopy.

96

symptoms. It is hoped that more people will be screened for colon cancer now that this tech-nique is available, since 70% of patients above the age of 50 have not been screened by any other method.”

There are drawbacks, however, because if a polyp or other mass is detected, it will need to be removed and additional imaging, tests, or biopsies may be necessary if any abnormalities are detected in other organs.

Virtual colonoscopy coverage by Medicare is limited to specific conditions and private insurance coverage is variable. Prospective pa-tients are advised to check with their insurance regarding virtual colonoscopy coverage. It is available to all patients for a fee of $700. As quality standards for this technique are devel-oped, expansion of Medicare and private insur-ance coverage is expected.

A short time later, Cook has received her results. She says, “I am extremely pleased with the outcome. I have no polyps and no cysts on my ovaries and that is a comfort to know.” She reflects on how easy the entire process was: “I didn’t even think the cleansing part was dif-ficult and everything went so fast. I would ab-solutely encourage other people to get this test and I will certainly go again when it is time.”

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

97Reluctant patient Glenna Cook found the virtual colonoscopy scan procedure to be relatively quick, with little discomfort.


daily support to someone struggling with addic-tion. The program, which runs for 26 sessions (six to eight weeks), offers evening programs Mon-day through Friday, from 6:15 p.m. to 8:00 p.m., and is set up to allow patients the ability to con-tinue working throughout their treatment. The group dynamic, lead by a facilitator, is interactive. “There are no ‘war stories.’ Talk is about recovery and is designed so people do not feel so alone.”

Attendees are encouraged to utilize Alco-holics Anonymous (AA) programs offered in the community in conjunction with their treatment at Mountain Crest. “Any program worth their salt will refer patients to AA,” adds Meeker. “Those who combine CDIO and AA meetings are 50 per-cent more likely to stay clean.” CDIO alumni are invited back to attend Wednesday classes free of charge, as part of the continuum of care.

Unfortunately, the current economy is no friend to those struggling with addiction. In ad-dition to an increase in the number of substance abuse cases related to “people drowning their sorrows in a bottle of liquor or pills,” psychiat-ric admissions are up at Mountain Crest, says Meeker. “On the opposite end, some people are not following through with treatment because of cost.”

Sadly, these ones miss out on the bigger pic-ture created by their addiction. “They are not looking at the high financial cost (and intangible cost) of alcohol and drugs, especially when that is added up over a period of time.”

As part of CSU’s efforts to educate and pro-tect their student population, their CSU Health Network has published extensive information de-tailing alcohol’s effects on the body, self assess-ment tests to determine if alcohol consumption is a problem, and other important information that the entire community can benefit from. Please visit their Website at: www.health.colostate.edu and access Counseling Services.

Angeline Grenz is Editor for Style Magazine.


Christie Reimer, M.D., Poudre Valley Internists

98


Christie Reimer, M.D., Poudre Valley Internists

~ MEDICAL CLINIC AT CENTERRA, PC

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