Vibrant Winter 2013

porterhospitallorg :: Winter 2013 1

3 Reduce your odds of breast cancer recurrence

6 Banish belly fat for a healthier heart

7 Easier surgery to cure fibroids

InsIdE thIs IssuE

Your Connection to Healthy Living

Winter 2013 | Vol. 1, no. 1

Kidney donation at Porter hospital saves nine livesdr. Peter t. Kennealey (l), Porter hospital transplant surgeon, and Ken Woodbury, kidney donor.

Read their story on Page 4.

Chain Reaction

Photo by EllEn Jaskol

2 VIBRANT :: Porter Adventist Hospital

Heads UpMen 40-60 should be alert to symptoms of oral cancer

Porter Adventist Hospital is a regional medical center that provides care for complex health issues. We specialize in general and robotic surgery, cardiovascular care, spine care, joint replacement, liver and kidney transplants, and cancer care. We are part of Centura Health, the state’s largest health care network. The purpose of this publication is to support our mission to improve the health of the residents of our community. No information in this publication is meant as a recommendation or to substitute for your physician’s advice. If you would like to comment or unsubscribe to this magazine, please email us at [email protected].

2525 South Downing Street Denver, CO 80210303-778-1955

It’s fairly well-known that the human papillomavirus (HPV) can cause cervical cancer in women. But over the past decade, doctors have seen an alarming increase in HPV-associated oropharyngeal cancer in men. HPV now accounts for between 80 and

90 percent of all cancers of the oropharynx, which includes the tonsils and the back or base of the tongue.

“This is primarily affecting Caucasian men between the ages of 40 and 60 years,” says Andrew Gaines, MD, a surgeon at Colorado Head & Neck Specialists, a physician group specializing in head and neck cancers that is operated by Centura Health Physician Group and affiliated with Porter Adventist Hospital.

HPV is the most common sexually transmitted disease, according to the CDC. At least 50 percent of sexually active people will have HPV during their lives. While there is now an HPV vaccine, it was approved for boys only three years ago and has not yet been proven to protect against oral cancer, although it has been proven to protect against genital warts and anal cancer.

About 100 people in the U.S. are diagnosed every day with oral cancer. The Oral Cancer Foundation estimates that one person dies every hour from this cancer.

HPV-associated oropharyngeal cancer has an 80 to 90 percent cure rate if caught early. The most common symptoms are a lump or swelling in

the neck that doesn’t go away, Gaines says. Other symptoms can include a persistent sore throat or difficulty swallowing.

“Anything like this that persists for a few weeks without really improving is something to be concerned about, and you should see your primary care doctor,” Gaines says.

The Porter Heart and Vascular Institute recently became the only Colorado hospital recognized for outstanding care for patients with heart failure.

By following practices proven to be successful, the hospital has helped heart failure patients live longer, avoid hospitalizations,

and experience fewer complications, according to the Society of Cardiovascular Patient Care.

Join us for FREE heart health seminars in February! See back cover for details.

Leading Heart Care

Stop Cancer in Your KidsBoth boys and girls can be vaccinated to protect against the hPV virus, which causes cervical and oropharyngeal cancer. the CdC recommends the three-dose vaccination be given at ages 11 or 12. talk to your family doctor about the decision to vaccinate.

Get ScreenedColorado head & neck specialists and Porter Adventist hospital will be offering a FREE community oral cancer screening in April. Watch this newsletter for details or call Colorado head & neck specialists at 303-778-5868 for more information.

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Research seeks to improve joint replacement outcomes

Diet and exercise reduce the risk of breast cancer recurrenceUp to 20 percent of women who have beat breast cancer will have a recurrence within 10 years of their first diagnosis, according to the American Cancer Society.

But eating a low-fat, high-fiber diet and exercising 30 minutes at least four times a week reduces a woman’s chance of recurrent breast cancer by 40 percent, says Colleen Murphy, MD, medical director of the Porter Comprehensive Breast Cancer Care and Treatment Clinic.

“Women don’t have control over so many things, but this is actually one thing that they can do that makes a difference,” says Murphy, a breast surgical oncologist.

The risk of breast cancer recurrence depends on a variety of factors, including patient age, inherited susceptibility, stage of the original tumor, and type of treatment for the original tumor. Lifestyle factors also have been found to play a role.

Obese women are 40 percent more likely to have breast cancer recurrence and 69 percent more likely to die from breast cancer, according to a study in the journal Cancer. Even overweight, but not obese, women had a higher risk.

While excess weight increases the risk, a healthy diet and exercise reduce a woman’s risk, Murphy explains. The link between weight and recurrence is especially strong for women with estrogen-receptor positive cancer, which accounts for two-thirds of all breast cancer cases.

“Body fat produces estrogen and higher levels of estrogen elevate the risk of breast cancer recurrence,” Murphy says.

Mammos & MassagesAn after-hours mammogram and a massage are just what the busy woman ordered. Join us on Jan. 28 from 3-7 p.m. to get your annual screening mammogram and a FREE massage. See back cover for details and additional dates.

Orthopedic surgeons at the Porter Center for Joint Replacement, in conjunction with the University of Colorado School of Medicine, are conducting three research studies into ways to improve outcomes for joint replacement patients.

“Our research focuses on small changes that could potentially result in big improvements,” says Douglas Dennis, MD, an orthopedic surgeon at Colorado Joint Replacement (CJR) and co-medical director of the Porter program.

StRengtH tRAiningThis study focuses on introducing strength training sooner after knee replacement surgery. Preliminary findings showed more function at three months post-surgery than with traditional motion therapy. The NIH awarded $1 million to the University of Colorado Denver physical therapy department to expand this study with CjR.

BALAnCe tRAiningThis study looks at the effect of therapist-led balance training for hip replacement patients after returning home following surgery. early results show that these patients have more strength and function than even patients without hip arthritis.

SuRgiCAL PRACtiCe

Researchers are studying whether the tourniquet traditionally used in knee replacement surgery inhibits quadriceps rehab. This study compares use of a tourniquet in one leg to no tourniquet in the other in patients having both knees replaced.

Facing joint replacement surgery in the future? then you’ll want to stop smoking as soon as possible. nonsmokers heal faster after joint replacement surgery, while smokers suffer from higher infection rates. Come to a FREE class that will help you build a plan for quitting based on your addiction level and individual coping mechanisms. get more information and register by calling 303-778-5890 or emailing [email protected] is recruiting patients for these studies. If you are having hip or knee

replacement and would like more information, please call 720-524-1367.

3porterhospital.org :: Winter 2013

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Dr. Colleen Murphy

4 VIBRANT :: Porter Adventist Hospital

Three years ago, Ken Woodbury decided he wanted to donate one of his kidneys. He didn’t have a family member or friend in need of a kidney. He was never personally touched by someone who needed an organ

or someone who had kidney failure. He certainly wasn’t getting paid to do it.

He was just a man who believed he could do something good for someone else.

“A lot of people have asked me why I would take the risk for a stranger,” says the 59-year-old Vail Resorts restaurant manager. “I just didn’t see the difference between family and a stranger. How many times in life do you get a chance to make such a difference in someone’s life?”

But Woodbury didn’t just make a difference in one person’s life. Thanks to a unique program that uses sophisticated computer programming to match patients and donors across the country, Woodbury’s donation at Porter Adventist Hospital in Denver sparked a chain that resulted in nine kidney transplants across the country within 30 days.

A 3-year-old girl in New York and a 48-year-old woman who was considered an almost impossible match were part of Woodbury’s chain.

“We could have selected a recipient from our (patient) list, but we looked at how one donor could benefit the most patients,” says Peter T. Kennealey, MD, surgical director of Porter Hospital’s kidney transplant program.

Over the past 25 years, the Porter Transplant Center has performed more than 1,200 transplants and more than 420 living donor surgeries. It was one of the first programs nationally to begin removing donor kidneys through minimally invasive surgery. The Porter Transplant Center currently has 419 patients waiting for kidneys. Those patients, who require dialysis to live, will have to wait anywhere from 18 months to over three years to get a compatible kidney. That’s far better than the national average of four years but still not fast enough to save many patients years of debilitating health.

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Kidney donated at porter adventist Hospital sets off national chain of transplants

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Ken Woodbury is an altruistic kidney donor — a person who donates out of concern for the welfare of others.

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Watch His StoryMr. Woodbury was inspired to donate one of his kidneys after a woman in his church donated one of her own. hear more about his story by going to porterhospital.org/transplant and watching his video.

Kidney donated at porter adventist Hospital sets off national chain of transplants

Become a living donorPeter T. Kennealey, MD, surgical director of the kidney transplant program at Porter Adventist Hospital answers questions about becoming a living kidney donor.

What if I donate a kidney and my other kidney fails?

A: This is very unlikely due to the thorough screening donors undergo. However, in

the rare case you need a kidney transplant, you are given priority on the United Network for Organ Sharing deceased donor list.

Is the operation painful?

A: Porter Hospital performs this surgery laparoscopically through small incisions,

which helps reduce pain and speed recovery. Patients do experience mild discomfort, but they are up walking the same day as the surgery. Pain is easily managed with oral pain medications.

How long will it take me to recover?

A: Patients generally go home from the hospital within two days and are back to

normal activities within one to two weeks.

Will donating a kidney cost me anything?

A: No, the medical costs are covered by the kidney recipient’s insurance.

Is there anything I have to change after surgery?

A: You will be able to resume all your prior activities, including sports and

work, once you have healed. You will need to stay hydrated and avoid medications that may be toxic to your kidney, such as ibuprofen. We also recommend you see your doctor every year for a routine physical.

Learn Moreif you would like to learn more about becoming a living kidney donor, call Alan Qualls, director of the Porter transplant Center, at 303-765-6917.

5porterhospital.org :: Winter 2013

Dr. Peter T. Kennealey

“We can’t depend solely on deceased donors,” Kennealey says. “Living donors are essential, and altruistic donors? They’re wonderful.”

Last spring, shortly before Woodbury was able to donate his kidney, Porter became one of just 63 transplant centers nationwide and the only one in Colorado to join the National Kidney Registry (NKR). Started just five years ago, the NKR has created a database of patients who need kidneys and have a willing but incompatible living donor, typically a friend or relative.

Donation ChainsOnce a member center notifies NKR of a donor kidney, the NKR uses a computer program to begin matching kidneys from living donors and patients to create chains across the country. In the five years since being founded, NKR has facilitated more than 500 transplants. The longest chain yet resulted in 30 transplants.

After surgery on May 29, Woodbury’s kidney was sent to Weill Cornell Medical Center in New York and given to a 43-year-old man. When that man received Woodbury’s kidney, his living donor gave a kidney that went to a 47-year-old man in Boston, whose living donor gave a kidney to a 66-year-old man in Cleveland and so on down the line until nine people eventually received donated kidneys.

“Hospitals greatly extend a donor’s act of generosity by enrolling them in our registry,” says Joe Sinacore, NKR’s director of research and education. “Porter could have kept Mr. Woodbury’s kidney and transplanted it into one of their patients. But instead, they put it into

the registry and it ended up helping nine patients instead of one.”

Of the nine patients, three had blood types or other conditions that made it extremely hard to find a compatible kidney. One was considered nearly impossible, scoring a 99 PRA, a scale that measures the percentage of incompatible donors. A 99 PRA means that 99 percent of donors will be incompatible for this particular patient.

“The last patient helped was an 86 PRA,” Sinacore says. “That’s the beauty of this registry. A chain that started in Denver ended with someone on the waiting list who could have died. She is 31 years old.”

Pay It ForwardPorter Hospital soon saw the pay-it-forward concept come full circle when several months later, an Atlanta woman donated a kidney that was given to a patient at the hospital. That patient’s living donor then gave a kidney that was given to a second patient at Porter Hospital.

“With this project, we can get more people transplants quicker,” Kennealey says.

Two days after his surgery, Woodbury left the hospital. He was back to work a week later, managing eight mountain restaurants at Vail Ski Resort in time for the summer season.

“Once I decided to donate my kidney, it just seemed like things didn’t work out to allow that to happen for a few years,” Woodbury says. “But I just kept praying about it. I have a lot of faith, and I knew this was what God wanted me to do.”

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More than 7 million Americans have a heart rhythm problem known as atrial fibrillation that puts them at five times the normal risk for stroke.

But a procedure offered at just a few hospitals throughout the state, including Porter Adventist Hospital, can cure the condition and add years to a patient’s life, says Sri Sundaram, MD, an electrophysiologist (cardiologist who specializes in heart rhythm problems) at Porter Hospital.

The procedure, called an ablation, is performed in just a few hours. The electrophysiologist snakes tiny flexible tubes through a vein in the inner thigh to the area of the heart causing the irregular impulses. He then zaps that area with radiofrequency energy, forming scar tissue that disconnects the faulty rhythms.

“It takes about two to three hours, and the patient can usually go home the next day,” Sundaram says.

One Out of FourA-fib, as it is commonly known, affects one out of four American adults. The cause is not known, although risk factors include high blood pressure and problems with heart valves or lungs. “But about 50 percent of patients don’t have any of those,” Sundaram says.

Although a-fib is more common in the elderly, it’s not unheard of in younger people. Sundaram recently treated

a 22-year-old college basketball player who complained of running out of steam by the fourth quarter. Fatigue and weakness are usually the only symptoms of a-fib, and many patients don’t even experience those.

“The main symptom is no symptom,” Sundaram says.

Extending LifeAntiarrythmic drugs work in about 30 to 60 percent of patients, but they have significant

side effects. Patients who do not respond to at least one medication are candidates for ablation.

There are risks with the procedure, including a 2 percent risk of stroke and a 1 percent risk of poking a

hole in the heart. But the benefits are significant: Ablation completely cures the problem in 70 percent of patients; it

extends the patient’s life by as much as seven years; and it’s cheaper than medicine over time.

a-Fib ablationA cure for a common heart problem

6

$99 Heart ScanThe Porter Heart and Vascular Institute is offering $99 coronary artery calcium screenings. this noninvasive Ct scan measures the level of plaque buildup in your arteries, which is an indicator of heart disease. this special price will be offered Feb. 1-28. A physician’s referral is required, and results will be sent to your doctor. To schedule a scan, call 303-765-6500.

VIBRANT :: Porter Adventist Hospital

Learn more at a FREE class.

see back cover for details.

Porter Heart and Vascular Institute is part of the Centura Heart Network, Colorado’s leading

provider of cardiovascular care.

HearT CoNNeCTed

Want to banish your belly fat? Learn how at our FREE community seminar on Feb. 6. see back cover for details.

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Ban the belly fat

Are your pants fitting a bit snugger in the waist? If so, you could be on a deadly path. Abdominal fat is linked to high blood pressure, high triglycerides, and low HDL, which increase your risk of heart disease and death. “Fat doesn’t just sit there, it creates reactions that harm your heart,” says Richard Collins, MD, a cardiologist at Porter Adventist Hospital.Most people can get rid of belly fat through diet changes, says Collins, also known as the Cooking Cardiologist®. He recommends limiting sugar, alcohol, and carbohydrates while increasing lean or vegetarian protein to 20 grams per meal.

Dr. Beman loves to travel, and South America is a favorite destination. If you’re traveling south, Dr. Beman recommends Iguazu Falls in Argentina. “Think Niagara Falls times 200,” she says.

Small solution for BIG PROBLEMFibroids removed in same-day surgery through tiny incisions Many women begin experiencing abnormal menstrual bleeding after age 35 and chalk it up to midlife changes. But abnormal bleeding could be a symptom of fibroids, which occur in up to three-quarters of women.

“Fibroids are very, very common, but not every woman will have symptoms,” says Mandi Beman, MD, a gynecologist at Porter Adventist Hospital who specializes in surgeries performed through tiny incisions, a technique known as minimally invasive surgery.

Symptoms include heavy and possibly irregular periods, pelvic pain, pelvic pressure, urinary frequency, constipation and in some cases, infertility.

“The good news is that fibroids are highly treatable,” Beman says.

Heavy bleeding caused by small fibroids can sometimes be treated with hormonal medications, such as birth control. However, larger fibroids causing pain and other symptoms may need to be removed surgically or treated with a technique called uterine fibroid embolization. While embolization cuts off the blood supply to the fibroids, it does not remove them. And it may take up to 12 months to see an improvement in symptoms. Minimally invasive surgery, on the other hand, removes the fibroids completely and immediately relieves symptoms. Women usually are able to go home the same day as surgery and return to full activities within two weeks.

“Almost all fibroids can be removed through minimally invasive surgery,” Beman says. For larger or more complex fibroids, Beman uses the da Vinci® robotic system at Porter Hospital. The robot gives Beman increased dexterity and precision that is needed when removing large fibroids.

“If a woman has been told that she needs traditional surgery through a large incision to remove her fibroids, I encourage her to get a second opinion,” Beman says. “You seek second opinions for your car repairs, so why wouldn’t you for your body?”

Mandi Beman, MDgynecologist and minimally invasive surgeon

There’s one thing you should know about Mandi Beman, MD, a gynecologist at Aracea Women’s Care in the Cherry Creek district — she won’t hold anything back from you. “I’d say that patients who like information and like choices do really well with me,” says Beman, a Minnesota native.

Beman specializes in minimally invasive gynecological surgery. For many of her cases, she uses the da Vinci® robot at the Porter Robotics Institute, which allows her to perform complex surgeries, including hysterectomies, with minimally invasive techniques. Beman is one of only 100 physicians nationwide fellowship-trained in minimally invasive gynecological surgery.

Specialty: gynecology

Practice: Aracea Women’s Care, 300 S. Jackson Street, Suite 320, Denver (Aracea is operated by the Centura Health Physician group)

Family: Married with one son

Training: Medical school at the university of Minnesota; OB/gYn residency at the university of Michigan; one of only six physicians to have completed a fellowship in minimally invasive gynecological surgery at Harvard Medical School

porterhospital.org :: Winter 2013 7

to make an appointment with dr. Beman, call 303-316-6677.

Dr. Mandi Beman

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Portercare Adventist Health System

FEBRuARy

BaNIsH BeLLY FaTjoin the Cooking Cardiologist®, Dr. Richard e. Collins, to learn the biomechanics behind why you accumulate belly fat and the best ways to get rid of it. You’ll also learn to cook — and sample — the dishes that help you maintain a healthy weight and a healthy heart. Date: WeD, FeB 6 time: 6-7 p.m. Location: Porter Conference Center

sLeepLess IN deNVer? About 70 million people suffer from sleep disorders, such as sleep apnea, insomnia, narcolepsy, restless leg syndrome, and others. Dr. emily Roby, Porter Hospital’s sleep specialist, will discuss how a sleep problem not only compromises your quality of life, it can put you at risk for high blood pressure, heart attack, stroke, mental impairment, and accidents. Date: TUe, FeB 12 time: 6-7 p.m. Location: Porter Conference Center

a CUre For aTrIaL FIBrILLaTIoNone in four Americans will develop a-fib, a heart rhythm problem that is the leading cause of stroke. But a new procedure being performed at Porter Hospital can cure a-fib in just a few short hours. If you’ve got a-fib, you won’t want to miss this session with Porter Hospital electrophysiologist Dr. Sri Sundaram as he discusses a-fib ablation. (See Page 6 for more information.) Date: TUe, FeB 26 time: 6-7 p.m. Location: Porter Conference Center

MARCh

sLIps, TrIps, aNd HIps! Falls resulting in hip fractures or other injuries are the most common causes of hospitalization and long-term care for the elderly. join Porter Hospital physical therapist David LaValley to learn the common — and preventable — causes of falls. You’ll learn safety tips and some fun exercises that will help you reduce your risk of falling. Date: THU, MAR 7 time: 6-7 p.m. Location: Porter Conference Center

GrUMBLes, GUrGLes, aNd GroWLsYour digestive system is talking, but do you know what it is saying? join

gastroenterologist Dr. Wesley kasen to learn about some of the common gastrointestinal complaints, such

as irritable bowel syndrome, GeRD (acid reflux), diverticulitis, peptic ulcer, constipation, diarrhea, and more. Date: WeD, MAR 13 time: 6-7 p.m. Location: Porter Conference Center

aN oUNCe oF (CaNCer) preVeNTIoNone-third of the most common cancers could be prevented by diet and lifestyle changes. join Porter Hospital’s registered dietitian and board-certified oncology nutrition specialist Amber Thomas as she discusses the American Institute for Cancer Research’s recommendations for cancer risk reduction through nutrition and activity. Date: THU, MAR 21 time: 6-7 p.m. Location: Porter Conference Center

OngOIng

MoNdaY MaMMoGraMs aNd MassaGesThe Porter Breast Center is offering a special evening tailor-made for busy women. join us on the dates below from 3-7 p.m. to get a massage and a screening mammogram.

A physician’s referral is not necessary if you are over the age of 40, but please check with your insurance to be sure this service is covered at Porter Hospital. No appointment is necessary. Date: MoNDAYS: jAN 28,

FeB 25, MAR 25 time: 3-7 p.m. Location: Porter Breast Center

at The Cancer Care Center, 2555 South Downing Street, Suite 140 Cost: Massages are FREE and

mammograms will be billed to your insurance. Please bring your insurance information and photo ID. If you don’t have insurance, Porter Hospital offers discounts for self-pay patients. Registration: Walk-ins welcome;

however, if you’d like to schedule a time or if you have questions, please call 303-778-5815, option 2

Upcoming eventsJoin the health experts at Porter Adventist Hospital to learn about ways to stay healthy as well as new treatments for health problems. All programs are FREE but require registration by calling 303-777-6877, option 1.

Check-in for all programs begins at 5:30 p.m., with programs beginning promptly at 6 p.m. Arrive early for good seats and FREE light refreshments. FREE valet parking at the hospital’s main entrance or plentiful free parking in the Porter Hospital parking garage is available.

Centura health complies with the Civil Rights Act of 1964 and section 504 of the Rehabilitation Act of 1973, and no person shall be excluded from participation in, be denied benefits of, or otherwise be subjected to discrimination in the provision of any care or service on the grounds of race, religion, color, sex, national origin, sexual preference, ancestry, age, familial status, disability or handicap. Copyright © Centura health, 2013.

Register online at

porterhospital.org/events

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