SAH NEWCOMERS GUIDE

1

General Surgery Residency Program Sponsored by

NEWCOMERS GUIDE 2015-2016

FOR RESIDENTS AND THEIR FAMILIES LAKEWOOD COLORADO

2

The information contained in this guide was obtained from numerous sources and is meant to provide helpful information Residents and their families may use this guide at their own discretion None of the information should be considered mandatory or required

3

Red Rocks Amphitheater

ndash west of Denver

ldquoThe best vacations are close to home luckily your home is Coloradordquo ndash wwwcoloradocom

Welcome to Colorado It is true that Colorado is thought of by most

outsiders only as a vacation destination However it is a great state to live in Whether you are into winter sports summer sports or just watching sports Colorado has it all With 7 resorts within 2 hours of Denver you can ski snowboard snowshoe dog sled and anything else you can think to do during the winter But they arenrsquot just winter-time resorts Open year-long you can also hike fish bike ride ATVs shop or relax and enjoy the beautiful seasons While the eastern plains are better known for farming and agriculture Denver IS the gateway to the Rockies If you love the outdoors you will love living in Denver Colorado isnrsquot just for outdoorsman though Denver hosts over 40 museums from the world-renowned Denver Art Museum to the Molly Brown House to the Butterfly Pavilion and Insect Center ndash there is at least one museum for every interest You can tour the great houses on Capital Hill (therersquos even a haunted house tour in the fall) You can have high tea in a quaint restaurant in Golden or tour the Coors Brewery if that is more to your taste Speaking of breweries according to local legend Denversrsquo first permanent structure was a saloon Colorado is currently home to over 161 brewpubs and breweries (3 of these are wholesalers) In 2012 Colorado ranked 3

rd in the nation for the number of

craft breweries according to the Brewers Association Denver has been nicknamed ldquothe Napa Valley of beerrdquo But perhaps wine is more to your taste Colorado is also home to over 100 wineries According to ColoradoWinecom our majestic Rocky Mountain valleys are blessed with warm days cool nights and low humidity ndash perfect conditions for the cultivation of wine grapes with the complex character and chemistry required to produce award-winning wines Denver is disputably the entertainment capital of Colorado The Denver Center for the Performing Arts hosts award-winning Broadway plays the Colorado Ballet the Colorado Symphony Orchestra Opera Colorado comedians and other entertainers as well as local productions Denver has a wide variety of venues for musical artists and performers from the Pepsi Center and Red Rocks Amphitheater to smaller venues such as the Filmore and Paramount theaters For movie buffs there is the Denver Movie Festival and the highly regarded Telluride Film Festival

Pikes Peak near Colorado Springs

Capital Building ndash downtown Denver

Cache la Poudre Pass ndash Rocky Mountain

National Park

Copper Mountain Resort ndash view from the top

Coors Field ndash downtown Denver

4

Contents GENERAL INFORMATION 5

WHERE TO LIVE 6

UTILITIES 7

DRIVERrsquoS LICENSE 8

VEHICLE REGISTRATION (Colorado platestags) 8

VOTER REGISTRATION 8

COLORADO LAWS 9

MARIJUANA 10

ALTITUDE SICKNESS 10

ACRONYMS NICKNAMEamp ABBREVIATIONS 14

5

GENERAL INFORMATION Government wwwcoloradogov ndash Official website for the Colorado state government Includes information on occupational licensing driversrsquo license services state agencies taxes etc wwwdenvergovorg ndash Government information and news for the city and county of Denver Includes elected officials safety emergency preparedness neighborhoods employment etc wwwlakewoodorg ndash official community and government information for the city of Lakewood CO (where St Anthony Hospital is located) ndash a suburb of Denver With information on licenses amp permits parks and recreation and events and performances wwwjeffcous ndash official site for Jefferson County (the county which Lakewood resides in) The fourth most populated county in Colorado Jefferson County is located along the lsquofront rangersquo (the leading edge of the Rocky Mountains) of the Denver Metro area County services include Sheriffs offices motor vehicle tagsregistration property taxes voting and registration parks and recreation Jefferson County has 28 parks without entry fees with nearly 230 miles of trails ndash some of the most beautiful parks and trails you will find in Colorado within minutes of your home

wwwcoloradocom ndash Colorado Live Work amp Play Includes things to do festivals and events descriptions of Colorado regions and cities hotels and lodging trip ideas and special offers

6

WHERE TO LIVE The Denver Metro area is over 155 square miles with a population of over 630000 Besides Denver there are at least 14 suburban cities You can live on the plains on a ranch in a high-rise loft in the middle of the city in the mountains or anywhere in between However given the fact that you will be working in Lakewood for at least one year (hopefully longer) on the west side of Denver we highly recommend that you give careful consideration to how much of a commute you are willing to undertake While on the map it appears that there are easy roadways to every area this is not always the case The Denver metropolitan area has grown considerably over the past 25 years and our infrastructure struggles to keep up Your drive time to the hospital relies on much more than just the mileage in between the two destinations Weather will play a large part in your daily commute lsquoSnow daysrsquo can turn a 15 minute commute into an hour More routinely though it is the traffic itself which will determine whether you will have to get up two hours before a shift or just 30 minutes In general it is best to avoid having to rely on I-25 or I-70 for your rush hour commutes Choosing to live west of I-25 and south of I-70 should provide you with the shortest commute times

Statistics

City Avg Home Price (2 bdrm1 bath)

Avg Rental Price (2 bdrm1 bath)

Average Utilities (incl energy water

amp garbage) 900 sq ft

Average cableinternetphone

costs

Denver $262000 $1567 $114 $99

Lakewood $257000 $1366 $114 $99

Arvada $280800 $1350 $114 $99

Littleton $313700 $1340 $114 $99

httpwwwtruliacomfor_saleDenverCO wwwzillowcom httpwwwnumbeocomcost-of-livingcity_resultjspcountry=United+Statesampcity=Denver2C+CO

7

UTILITIES Before moving into your new home you should make arrangements with the following utility companies for services Electricity amp Gas Xcel Energy (electricity amp natural gas) httpwwwxcelenergycomStart_Stop_Transfer 1-800-895-4999 Water Water is provided by multiple agencies throughout the area and is typically included in your rent If you are purchasing a home your realtor will help you determine which company services your new home Garbage Collection amp Recycling This is also provided by private companies (not state county or city agencies) There are a number of companies to choose from Once again apartment communities typically include this in your monthly payment or your realtor can help you if you are purchasing a home Household hazardous waste some counties and municipalities conduct annual collections of household hazardous wastes while others have permanent collection facilities or sponsor curbside pickup programs Check out this website for further information httpswwwcoloradogovpacificcdphehousehold-hazardous-waste-collection-programs-0 The following items should NOT be disposed of in the trash

Electronics computers and computer monitors televisions printers fax machines DVD amp VCR planers preipherals such as keyboards and mice radios and sterios video game consoles laptops notebooks ultrabooks netbooks and tablets Paint Latex and oil based paint Cleaners and pesticides Motor Oil and Antifreeze Batteries Fluorescent light bulbs

Cable Internet and Telephone Service Providers There are three major internet and television providers in the Denver Metro area

Comcastreg ndash wwwComcastcom (also provide home telephone service) DISHreg Network ndash wwwDISHcom (they use CenturyLink as their internet provider) DirectTVreg - wwwdirectvdealscom (they offer a choice between CenturyLink Verizon FiOS or

ATampT for internet)

8

DRIVERrsquoS LICENSE After becoming a Colorado resident you have 30 days to transfer your driverrsquos license and 90 days to register your vehicle If you have a valid driverrsquos license in your possession which was issued by another US state territory or possession you will normally not be required to take the written exam or drive skills test Driverrsquos license employees have the responsibility to require a drive test if there is a problem with your physical aptitude analysis or vision screening Your valid out-of-state driverrsquos license will be used for identification purposes and to waive testing requirements When visiting the driverrsquos license office please bring the following

1 Valid out of state driverrsquos license If it does not display your full legal name (ie middle name spelled out) bring your certified original state or county issued birth certificate US passport or military ID to confirm your identity

2 Payment $2100 (cash or check ndash they do not take creditdebit cards) 3 Proof of address Anything that shows your name and current residential address (bank

statement utility bill check book vehicle registration rent agreement etc) Please visit httpswwwcoloradogovpacificdmvnode44456 for more detailed information

VEHICLE REGISTRATION (Colorado platestags) Vehicles must be registered within 90 days after becoming a Colorado resident You will need

If the vehicle was titled in another state a VIN verification must be completed Title assigned in ownerrsquos name or current out of state registration Colorado drivers license out-of-state issued photo driver license or US passport (see

httpswwwcoloradogovpacificsitesdefaultfilesDR2841pdf for entire list of ldquoSecure and Verifiable IDrdquo

Proof of Colorado Vehicle Emissions Proof of Insurance Payment (all counties accept cashcheck some accept credit cards ndash see

httpswwwcoloradogovpacificdmvregistration-requirements for further details

VOTER REGISTRATION All Colorado drivers license offices provide voter registration services Once your voter

registration information is completed at the drivers license office it is then forwarded to the specific county where you live

Please note however that all Drivers License employees are prohibited from giving personal opinions regarding voting information or party affiliation

9

COLORADO LAWS DRIVING - GENERAL

Right turn on Red ndash LEGAL unless posted otherwise U-Turns ndash ILLEGAL unless posted otherwise Seatbelts must be worn by all passengers at all times children

under 8 years of age or 40 pounds must be in a child safety seat Colorado point system (driver license) you start out with a clean

record (0) and accumulate points each time you receive a traffic violation Adult driver license may be revoked if you accumulate

o 12 points in any 12 consecutive months o 18 points in any 24 consecutive months

No cell phone (includes texting) use while driving unless it is to contact 911 ldquoMove Over Lawrdquo - When passing a stopped emergency or law-enforcement vehicle with its

flashing lights on you must either vacate the closest lane or significantly reduce your speed (20 mph lower than posted limit)

MOUNTAIN DRIVING Mountain driving can be very different from normal driving conditions Some hazards you should be aware of are steep hills changing weather wildlife and rocks in the roadway If your vehicle experiences difficulty traveling up steep roadways pull off the road at the first place you may do so safely or stay in the right lane to allow other vehicles to pass Helpful tips bull Pay special attention to speed limit signs and warning signs such as those warning of curves

steep hills or other hazards bull Watch for bicyclists near the right side of the road bull Use a lower gear to control speeds while going up or down long steep hills bull You must yield to vehicles going uphill if you are traveling downhill on a narrow road bull Do not coast downhill by shifting into neutral or disengaging the clutch

BICYCLES AND MOTORCYCLES Motorists must be on the lookout for cyclists and anticipate sudden and unexpected moves from them A ldquoShare the Roadrdquo attitude is the best policy to promote safe highways in Colorado The most common motorist caused car-bicycle or car-motorcycle collision is a motorist turning left in front of an oncoming bicycle or motorcycle Drivers may fail to see cyclists or a driver may fail to judge the speed of oncoming cyclists As a driver remember to look for cyclists at the right side of the lane or on the shoulder and then look again Make sure you see the cyclist and know their speed before you make your left turn Bicycles travel in the same direction as motor vehicles and are entitled to the full lane when traveling at the normal speed of traffic However they are generally moving more slowly and will usually travel to the right of the right lane or on the shoulder or bike lane Exceptions include making left turns or when a right turn lane is present and the cyclist is traveling straight through Motorcycles are entitled to the same full lane width as other vehicles Bicycles and motorcycles are smaller harder to see and can move faster and stop faster than expected Their control is more easily hampered by road defects and debris Use extra caution when sharing the road with bicycles and motorcycles and increase your following distance

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PUBLIC TRANSIT ldquoRTDrdquo is the company that provides most of the public transit in the Denver Metro area Schedules fares and other services can be found on their website wwwrtd-denvercom

MARIJUANA The Law Colorado residents 21 and older can purchase and possess up to 1

ounce of retail marijuana at a time non-residents are limited to 12 an ounce The biggest difference between medical and recreational is that medical CAN be sold to those under 21 with a medical marijuana license

It is illegal to consume marijuana in public regardless of the form

Centura Policy bull Amendment 64 legalized medical and recreational marijuana in the

State of Colorado The supreme court of Colorado has upheld an employerrsquos right to view a drug screen that is positive for marijuana as incompatible with employment even if the candidate has a medical marijuana card Centura Health takes this issue seriously and will not employ anyone with a drug screen that is positive for marijuana or any other non-prescriptive medications that could possibly affect a personrsquos ability to care for patients If you wish more information on this subject please ask for the formal policy

ALTITUDE SICKNESS It isnrsquot called lsquothe Mile Highrsquo city for nothing Denver is at 5280 feet above sea level and has 17 less oxygen than cities at sea level (Lakewood sits just above at 5445 feet above sea level) If you are moving here from just about anywhere you will notice the altitude for a few days or a few weeks Here are a few tips to help you adjust Symptoms include Headache that is not relieved by over-the-counter pain medicine Nausea or vomiting Dizziness or lightheadedness Weakness or fatigue Difficulty sleeping Loss of appetite

A Take it slow ndash a slow ascent is one way to prevent altitude sickness but this may not be

practical if yoursquore flying direct Try to give your body a break and take it easy once you are on solid ground

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B Drink MORE water ndash Doctors seem to agree that acclimatization is often accompanied by fluid loss so you need to drink lots of water to remain properly hydrated (at least 3-4 quarts per day)

C EAT MORE pasta ndash Melissa Gallagher founder of Healthy Being LLC says ldquoA carb-rich diet is key because carbohydrates naturally replace muscle glycogen levels and prevent protein from being burned as energyrdquo Additionally high-carb diets also require less oxygen for metabolism and digestion

D Iron-man ndash some doctors recommend increasing iron consumption prior to ascent though the medical explanation is unclear

E BREATHE ndash try to take a few deep breathes every hour You might also try the yogic breath exercise called pranayama to increase the amount of oxygen in your blood One method explained by online resource yogasitecom involves involves 3 steps 1) Sit with dignity and take long slow deep breaths through the nostrils 2) Allow the breath to be gentle and relaxed as you slightly contract the back of your throat creating a hissing sound as you breathe in and out 3) Lengthen the inhalation and exhalation as much as possible without creating tension anywhere in the body Repeat

F Get up your Go with Gingko ndash Gingko enhances circulation which is why some researchers think it helps alleviate the effects of thinner air Mark Rosenberg MD says ldquoThe best way to protect yourself from altitude sickness is to begin taking 60 mg of gingko each day at least five days before your ascent Studies show its effective just one day before but five days provides even better results I recommend using a gingko extract rather than a capsule-generally liquids absorb into your body betterrdquo

G Sherpa Soup ndash The famous sherpa guides of Nepal reportedly serve garlic soup to patients with altitude sickness Medical research in this area is lacking but if yoursquore game to experiment try this recipe from cookscom 2 c chicken broth 4 med potatoes cut in quarters 1 whole elephant garlic 14 c chopped basil 14 c good olive oil 1 Cover potatoes with water and bring to boil Cook until fork tender with whole elephant garlic that has been cleaned and chopped 2 When potatoes and garlic are fork tender transfer water potatoes and garlic to blender Add chicken broth and blend all until smooth Transfer all to pan and heat to boil 3 Put into individual soup bowls Top with a swirl of olive oil and sprinkle with basil Serves 4

H Listen to your body ndash rest and sleep will help you adjust to the elevation That sluggish exhausted feeling is your bodyrsquos way of telling you to get some rest If you experience a headache that does not go away chest tightness or fullness inability to catch your breath fever walking with a staggering gait confusion visual changes or changes in your ability to think you should consult a physician as these can signify a much more serious high altitude sickness

12

WEBSITES AND OTHER SOURCES OF INFORMATION httpwwwdenverorgthings-to-do Heart of Art Denvers Golden Triangle neighborhood brims with more than 30 innovative art galleries and artists studios showcasing the innovative wares of nationally renowned talent and regional up-and-comers First Friday Art Walk a shuttled gallery tour that takes place the first Friday of each month is a terrific way to tour art marts like Walker Fine Art (300 W 11th St) The Golden Triangle art galleries are bordered by Speer Boulevard Colfax Avenue and Lincoln Street Shuttle tours begin at the Osage Street Light Rail Station Colorado State Capitol Tour The Colorado State Capitol modeled after the Capitol Building in Washington DC is a stunning spectacle embellished with stained glass depicting events and people inherent to Colorado coupled with gorgeous Colorado white granite rose onyx and yule marble To see if youve got what it takes to adjust to the altitude climb the 99-step spiral staircase to an open-air deck affording jaw-dropping views of the city skyline and Rocky Mountains The Corinthian-styled building famed for its gold-plated dome rising 272 feet above the ground offers temporary exhibits visitor galleries and complimentary tours by reservation Note The Capitol Dome will be undergoing major structural renovations for 2-3 years and not offering tours during that time-frame Tattered Cover Bookstore No visit to Denver would be complete without a journey through the Tattered Cover Bookstore one of the top independent booksellers in the country This astounding literary marvel boasts several Metro Denver locations but the newest store in the renovated Lowenstein Theater on a burgeoning stretch of East Colfax is the talk of the town Grab a latte from the in-house java joint plop down in one of the overstuffed chairs or sofas to wrap your hands around the latest best seller or attend a free book signing or author lecture from big-names like John Gray Al Gore Annie Leibovitz and Garrison Keillor United State Mint Tour To see where your currency is conceived (sorry no free handouts) follow the money trail to the one of only two mints in the United States Hour-long weekday tours led by knowledgeable guides provide a fascinating look into the history of coinage and both kids and adults love getting up close and personal with the shiny pocket change that streams off the production lines Admission is complimentary but reservations must be booked in advance

Jeffcous - httpjeffcousopen-spaceparks Running North to South along the front range Jefferson County parks and open spaces are some of the nicest you will find in Colorado This web site features a list of all Jeffco open space parks with descriptions and maps Most are open year round and all are free While fishing is allowed when available you must have a Colorado fishing license Why not make a goal to hike through all 30

13

Hunting amp Fishing Licenses Colorado Parks amp Wildlife Total Licensing System ndash httpswww2cowildlifelicensecomstartphp All Colorado hunt andor fishing licenses may be purchased online or at over 300 licensed retailers (see website for list) If you are 16 and older a Colorado Annual resident fishing license is $26 $56 for non-residents Individuals aged 18 through 64 must also purchase a $10 habitat stamp with the first purchase of the year Residency qualifications must live in Colorado at least six consecutive months immediately before applying for or buying a license possess a valid Colorado Driverrsquos license and provide the same address as listed on your Colorado income tax return

14

ACRONYMS NICKNAMEamp ABBREVIATIONS To help you acclimate and hopefully better understand your new home here are some common acronyms nicknames and abbreviations

Acronym Nickname or Abbreviation

Explanation or Meaning

5280 The elevation of Denver ndash if you want to stand exactly a mile high go to the 13th step of the Capital building

Breck Breckenridge CO

Colorado Carwash Using a fresh clump of snow to wipe down your car windshields etc

Colorado Casual (aka as John Denver formal) ndash a long sleeve button up shirt tucked into jean (Wranglers of course) accompanied by a brown belt and Nike trainers or cowboy boots

Colorado drag race

Interstate 25 in Colorado especially the section between Colorado Springs and Denver that is mostly only 2 lanes on each side is notorious for drivers who block the left lane doing 60 mph because they feel the need to pass the guy in the right lane doing 597 mph (The speed limit is 75) This is called Colorado drag racing

Cowtown Greeley CO

FAC Friday Afternoon Club ndash (happy hour happy hour bbq)

Five Points One of Denverrsquos oldest neighborhoods

Flatlander Anyone who ISNrsquoT from Colorado

Green Mountain

The first mountain to mark the transition between the plains and the foothills of the Rockies A popular destination for hikers it offers a lovely view of Denver and the mountains It is located between 6th Avenue amp Alameda Parkway (N to S) and C-470 and Union (E to W)

LODO Denverrsquos lower downtown area

Poudre The Cache La Poudre River (pronounced lsquopooderrsquo ndash runs through Greeley amp Fort Collins and floods occasionally) ndash beautiful camping and hiking

Satanrsquos Steed One of the nicknames for the blue horse sculpture just outside of Denver International Airport (DIA)

Summit or Summit County

The area just over the continental divide (I-70 west and through the Eisenhower tunnels) including the towns of Dillon Breckenridge and Frisco and the following ski areas Keystone Breckenridge Loveland and Copper Mountain

the lsquointerstatersquo I-25

the lsquomousetraprsquo The intersection of I-25 ampI-70

the Foothills Denver is actually located 15 miles east of here-a gentle series of peaks ranging from 7000 to 11000 feet-and not in the actual mountains (contrary to popular belief)

The Fort FOCO FTC Fort Collins CO

the Front Range A series of mountain peaks (some as high as 14000 feet) just beyond the

continental divide the Springs Colorado Springs CO

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You know yoursquore from COLORADO if -Youll eat ice cream in the winter -It snows 5 inches and you dont expect school to be cancelled -Youll wear flip flops every day of the year regardless of temperature -You have no accent at all but can hear other peoplersquos And then you make fun of them -Humid is over 25 -Your sense of direction is Toward the mountains and Away from the mountains -You say the interstate and everybody knows which one -You think that May is a totally normal month for a blizzard -You grew up planning your Halloween costumes around your coat -You know what the Continental Divide is -You dont think Coors beer is that big of a deal -You went to Casa Bonita as a kid -Youve gone off-roading in a vehicle that was never intended for such activities -You always know the elevation of where you are -You wake up to a beautiful 80 degree day and you wonder if its going to snow tomorrow -You dont care that some company renamed it the Broncos still play at Mile High -Every movie theater has military and student discounts -Everybody wears jeans to church ndashYou actually know that South Park is a real place not just a show on TV -You know what a trust fund hippy is and you know its natural habitat is Boulder -You know youre talking to a fellow Coloradoan when they call it Elitches not Six

Flags -A bear on your front porch doesnt bother you -Your two favorite teams are the Broncos and whoever is beating the crap out of the Raiders -Youve been to the original Chipotle near the DU campus on Evans -When people out East tell you they have

mountains in their state too you just laugh -You go anywhere else on the planet and the air feels sticky and you notice the sky is no longer blue