cheers fall 2015

Fall 2015 Volume 5, Number 4

Healing Wounds FasterPAGE 6

3-D Spine SurgeryPAGE 2

Making Dialysis Easier PAGE 4

CELEBRATING YOUR HEALTH

St. Mary-Corwin Medical Center

PHOTO BY STEVE BIGLEY

James West is back to kicking soccer balls after a ruptured spleen, thanks to the fast and accurate work of St. Mary-Corwin’s emergency team.

Quick thinking and accurate diagnosis can make health emergencies into distant memories. Story on Page 3

RAPID RESPONSE

2 cheers | St. Mary-Corwin Medical Center

Health Briefs

�FOLLOW UP St. Mary-Corwin physicians offer a wide range of orthopedic treatments. To learn more, go online to stmarycorwin.org.

The painful side of pot Marijuana use may make the pain worse after surgery

One out of eight Colorado residents reports using marijuana regularly, a 22 percent

increase from Colorado’s pre-legalization days, according to the National Survey on Drug Use and Health. Anecdotal evidence at St. Mary-Corwin Medical Center shows that a spike in usage is also increasing pain control issues following surgery.

“In cases where patients are chronic marijuana users either for medical or recreational purposes, we are having a much harder time controlling their pain in the recovery room,” says John R. Sandoval, MD, chief anesthesiologist at St. Mary-Corwin

Medical Center. Sandoval recalls one patient who underwent

a simple procedure, but the minimal amounts of opioids and narcotics generally required after surgery were ineffective in controlling his pain.

“More research about marijuana’s impact on pain control post-surgery and its interactions with opioids and narcotics is needed, but for the cases I’ve consulted on, there appears to be a connection between consistent marijuana use and (more difficult) pain management post-surgery,” he says.

�SUPPORT SPOT If you suffer from chronic pain, join St. Mary-Corwin’s pain management support group. During this FREE 14-week program, experts will discuss alternate treatment options available in the community, including acupuncture, massage therapy, nutrition, biofeedback, and many others. For more information, or to reserve your spot, call 719-557-3658.

Dr. John Sandoval

3-D Spine Surgery

Spine patients at St. Mary-Corwin Medical Center now benefit from a new piece of technology known as

neurospine navigation. Using 3-D images, neurospine navigation gives surgeons a more precise view of the patient’s anatomy and the location of instruments and implants during surgery.

“I’ve used similar navigation on knee replacements and spinal surgeries and have been extremely happy with the outcomes,” says Ken Danylchuk, MD,

PhD, the only orthopedic surgeon at St. Mary-Corwin Medical Center to utilize neurospine navigation. “In addition to increased accuracy, it may increase the efficiency of spinal procedures.”

Neurospine navigation can enhance a variety of procedures, including spine fusions, spinal revision surgery, and kyphoplasty for spine fractures, Danylchuk says.

Dr. Ken Danylchuk

NEUROSPINE NAVIGATION BENEFITS:e Increased accuracy of screw

and device placemente Better visualization of

anatomy and surgical instruments

e May reduce surgery time

SMC steps up sepsis control

Each year, more than 1 million Americans develop sepsis, a life-threatening medical condition caused by the body’s overreaction to

infection. During sepsis, chemicals and bacteria are released into the blood, restricting blood flow that can lead to organ failure. While people with weakened immune systems are most vulnerable to sepsis, it can affect anyone with an infection.

“More attention has been given to sepsis in the past decade, helping reduce the mortality rate from 90 percent to about 60 percent in severe cases today,” says Ashley Cox, a registered nurse at St. Mary-Corwin Medical Center who recently completed a graduate program research project on sepsis.

The only way to prevent sepsis is to eliminate infection. But to do that, infection has to be identified. So, the key to reducing mortality rates is recognition, says Tana Trujillo, RN, clinical nurse specialist at St. Mary-Corwin Medical Center, who has helped spearhead a hospital initiative to lower the rate of sepsis. “Intervention is not possible without recognition.”

A sepsis team at St. Mary-Corwin Medical Center helps promote community education and refine internal processes for sepsis recognition and treatment.

If sepsis is suspected, immediate medical attention, including intravenous antibiotics, can increase survival rates.

SIGNS OF SEPSIS CAN INCLUDE:

Abnormally high heart rate

Fever

High white blood cell count

Low urinary output

Chills

Lethargy

ZZZ

stmarycorwin.org • Fall 2015 | cheers 3

St. Mary-Corwin Medical Center is part of the Centura Health Trauma System, the region’s largest and most comprehensive network of trauma care and emergency services.

�St. Mary-Corwin provides ongoing medical education to first responders in our community. If you are an EMS or EMT professional, go online to get a schedule of upcoming classes at stmarycorwin.org/stc/specialties/emergency-services/education-center.

ON THE BALLSPEEDY, thorough emergency evaluation at St. Mary-Corwin Medical Center’s Level III Trauma Center saves soccer player’s spleen

James West, a Pueblo high school soccer player, and his parents are grateful for the quick diagnosis that got West back on the pitch.

INJURY TIME-OUTHead to the ER if you experience one of these lesser-known soccer injuries:

INTERNAL/ORGAN LACERATIONS: Internal lacerations caused by trauma to the pancreas, liver, spleen, and other internal organs can be life-threatening. Any lingering pain, especially atypical pain for the type of injury suspected (e.g., bruise), should be evaluated in the ER.

FACIAL FRACTURES: A Brazilian study finds that facial bone fractures are relatively common soccer injuries and that the time between a facial fracture injury and treatment can range from seven to 33 days — a delay that can lead to significant deformities, as well as chewing and breathing issues. Any signs of pain, swelling, and/or deformity should be evaluated immediately.

A routine soccer match in May led to unexpected injuries for 15-year-old James West, who was struck in the left side while making a headed clearance. West sat

out the remainder of the game, but his shoulder and rib pain kept increasing. “Once I got home, my pain just kept getting worse, so I knew it had to be more

than a bruise,” West says. West’s father, David, took him to St. Mary-Corwin Medical Center’s ER, a Level III

Trauma Center. “We’ve counted on St. Mary-Corwin’s quality care for years,” he says.

GOAL — QUICK, ACCURATE DIAGNOSISOnce at the ER, West was quickly evaluated and sent for X-rays, which ruled out broken bones. Because of West’s symptoms, the ER physician and Teddi Adams, RN, West’s ER nurse, pressed for a CT scan.

“James’ blood pressure kept dropping, he was getting more pale, and he was guarding his left side,” Adams says. “I suspected a spleen injury.”

Thanks to St. Mary-Corwin’s Level III Trauma Center capabilities, West underwent a CT scan within minutes, which showed a fractured (ruptured) spleen.

“The quick action saved James’ life,” Adams says. West was given fluids, stabilized, and immediately prepped for transfer via Centura

Health Flight For Life to Children’s Hospital in Denver. While St. Mary-Corwin Medical Center could have managed his care, the trauma surgeon recommended transfer due to his young age.

“St. Mary-Corwin’s friendly doctors and nurses kept us informed every step of the way,” says West’s mother, Debbie.

BACK IN THE GAMESt. Mary-Corwin Medical Center’s trauma capabilities saved both West’s spleen and soccer career. The entire process from walking into the ER until when West was flown to Denver happened in under an hour, say his parents. West’s spleen clotted, eliminating the need for surgery, and he went home after three days of bed rest. He was cleared to play soccer at the end of July.

“This is one example of the timely trauma care we’re able to provide here at St. Mary-Corwin,” says Patrick Stanifer, director of emergency services. “We can handle most any type of trauma.”

As a Level III Trauma Center, St. Mary-Corwin Medical Center offers state-of-the-art technology; on-site imaging; 24-hour emergency coverage by trauma-trained nurses, physicians, surgeons, and anesthesiologists; and specialties, including neurosurgery. As part of the Centura Health System, St. Mary-Corwin has immediate access to Flight For Life and St. Anthony’s Level I Trauma Center for consultations and adult transfers. Gunshot wounds and select pediatric cases are typically transferred to Level II or Level I Trauma Centers.

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St. Mary-Corwin’s vascular surgery department provides fistula surgery as well as ongoing fistula monitoring and management. Talk to your doctor for more info.

CONNECTIONDiabetes starts in the pancreas, but its debilitating

process can affect many organs, especially the kidneys, if left unchecked. Over time, high blood

sugar can damage the tiny blood vessels in the kidneys that filter waste products from the blood.

People with kidney failure need dialysis to take over the job the kidneys are supposed to do, unless or until they get a kidney transplant. A dialysis machine filters extra fluid and waste products from the blood.

But regular blood vessels aren’t strong enough for blood to travel in and out during repeated dialysis. To create better access for dialysis, a vein and an artery can be surgically connected in a procedure called a fistula. This procedure is now available at St. Mary-Corwin Medical Center.

Access for dialysisWhen dialysis was invented, “the idea of getting blood out of somebody and running it through a filter to do the job of the kidneys was a major medical advance,” says Kenneth R. Madsen, MD, director of vascular surgery at St. Mary-Corwin Medical Center.

The first tool to create access for dialysis was lifesaving for people with kidney damage, but it was far from perfect. “An external tube was sewn into the skin, connecting an artery and a vein,” Madsen says. “But

the tubes got infected, they were easily damaged, and sometimes they got pulled out and people bled to death.”

Today’s dialysis machines are very efficient, Madsen says. But the body hasn’t kept up. “The problem remains, how do you get the blood out at a good enough rate to run it efficiently through a machine to filter, and get it back into the patient and keep that flow at a high rate?”

The three main ways to create access for dialysis are as follows:

1. Fistula, a connection between two parts of the body that aren’t usually connected — in this case, a vein and an artery (usually in the forearm)

2. Graft, a connection made with synthetic (man-made) material

3. Catheter, an external tube, usually into a large vein in the neck

Understanding the optionsA surgical connection between an artery and a vein, called a fistula, is the best way to create access for dialysis, Madsen says.

A catheter may be used for emergency dialysis or while people are waiting for a fistula or graft to heal, but it’s not a good long-term option for dialysis patients. “There’s a high rate of infection with catheters,” Madsen

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�LIVING WELL WITH DIABETES Learn how to prevent diabetes complications. For information about diabetes education and self-management, call 719-557-5955.

Blood sugar on the riseWhen blood sugar is starting to get high, but isn’t high enough to be called diabetes, it is considered prediabetes. By catching people when they have prediabetes, “we can hopefully keep it from going all the way to becoming diabetes,” says Jody Schroll, RN, BSN, diabetes educator at St. Mary-Corwin Medical Center.

Only one in eight people with prediabetes knows they have it, according to a recent study in the American Journal of Preventive Medicine. When people realize they are at risk for diabetes, they are more likely to make healthy lifestyle changes, the study showed.

A report card of riskA blood test called a hemoglobin A1C measures average blood sugar over the past two or three months. “An A1C is like a blood sugar report card — it shows how much sugar is attached to the outside of red blood cells instead of inside where it’s supposed to be,” Schroll explains. “My father died from complications of type 2 diabetes, so I get an A1C every year.”

People at risk for diabetes who should be tested for high blood sugar include:

People who do not exercise regularly People who are overweight African-Americans, Hispanics, Native Americans, Asian-

Americans, and Pacific Islanders People with a family history of diabetes Mothers of babies weighing more than 9 pounds at birth,

or a history of gestational diabetes People with polycystic ovarian syndrome People with high cholesterol, high triglycerides, or

high blood pressure

Moderate weight loss and increased exercise can help people with prediabetes control their blood sugar and delay or avoid getting diabetes.

�DIABETES IN OUR NEIGHBORHOOD Pueblo has a higher rate of diabetes than the state average: 7.4 percent of adults in Pueblo have been diagnosed with diabetes, compared to the 5.45 percent average in Colorado. �

BE SUGAR SMARTIf you’re at risk for diabetes, call your doctor today to set up a blood sugar test. Visit stmarycorwin.org to find a doctor near you.

Procedure to connect a vein and artery makes dialysis safer and easier for patients

says. “They can cause blood clots to form and can cause narrowing and scarring inside the vein.”

With a graft, an artificial tube connects an artery and a vein. It is an alternative for patients whose blood vessels aren’t healthy enough for a fistula procedure, but it has a higher rate of infection and other problems than a fistula.

Connecting an artery directly to a vein creates a fistula, a self-healing “supervein” of sorts that can handle the repeated needle sticks needed for dialysis. “It can actually heal itself because it’s made of tissue,” Madsen says. “Fistulas can be used for dialysis for years and years, and they keep healing themselves right back up.”

How a fistula worksA fistula combines the flexibility of a vein with the high blood flow capabilities of an artery. “Veins are very thin-walled, because they are a low-pressure system. They don’t have to be thick-walled and muscular to handle high pressure like arteries do,” Madsen explains.

The flexible vein can adapt and mature into a stronger blood vessel when it is connected to an artery. “It expands and gets full of blood,” Madsen says. “Once there’s high pressure in the vein, it enlarges and thickens up a little.”

It takes about six to eight weeks for an arteriovenous (artery to vein) fistula to heal and mature so it is ready to use for dialysis access.


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Most everyone will experience some type of wound — a scrape or scratch that breaks the skin or body tissue. Yet, estimates show that up to 8 million Americans

battle chronic wounds, which are wounds that don’t heal properly or in the expected time frame for the type of wound.

Often, chronic wounds do not receive enough oxygen to heal, like in the case of patients with circulatory problems. To better treat this type of wound, St. Mary-Corwin Medical Center recently expanded its treatment options to include hyperbaric oxygen therapy (HBOT), which uses pressure and pure oxygen to speed healing.

“Hyperbaric therapy provides vast benefits, including helping wounds heal faster by killing bacteria, promoting the growth of blood vessels, and improving the performance of antibiotics,” says Christopher Jeffries, program director at St. Mary-Corwin Wound and Hyperbaric Center.

Among those with chronic wounds, HBOT has been shown to decrease amputation rates while increasing healing rates.

At St. Mary-Corwin Wound and Hyperbaric Center, patients spend roughly 90 minutes a day, five days a week, in a hyperbaric chamber that is pressurized to two or two and a half times that of normal atmospheric pressure and filled with 100 percent oxygen. Some patients require a few weeks of treatment and others a few months, depending on the severity of their wounds, Jeffries says.

HBOT has minimal side effects, with rare occurrences of claustrophobia and/or barotrauma (injuries, typically in the ear, resulting from pressure).

Up to 10 percent of St. Mary-Corwin wound patients could benefit from HBOT, says Patricia Turner, RN, clinical nurse manager at St. Mary-Corwin Wound and Hyperbaric Center.

Who can it help?Patients who may benefit most from hyperbaric oxygen therapy (HBOT) include those with: Diabetic wounds

Skin flaps or grafts that don’t heal well

Post-radiation wounds

Problem wounds (wounds that don’t respond to antibiotics, standard wound care, and/or surgery)

Osteomyelitis (bone infection)

Getting healthy skin back is easier and quicker with hyperbaric wound treatment at St. Mary-Corwin.

HEALING Hyperbaric oxygen therapy at St. Mary-Corwin helps wounds heal faster

�If you have a wound that is not healing properly, you may be a candidate for hyperbaric therapy. To learn more, call 719-557-5455.

WARD OFF WOUNDS Wound prevention can help those most susceptible to chronic wounds reduce their risk. “Early treatment is always better than waiting, no matter what type of wound you have,” says Patricia Turner, RN, clinical nurse manager at St. Mary-Corwin Wound and Hyperbaric Center.

Who: Diabetic patientsWhy: Diabetes can slow wound healing, and up to 15 percent of diabetic patients develop foot ulcers. What to do: Check feet regularly, maintain optimal blood sugar control, exercise regularly, and follow your diabetes treatment plan.

Who: Paraplegics and people with limited mobility Why: Limited movement can lead to wounds and hinder oxygen flow, slowing the healing process. What to do: Move as much as possible and shift weight regularly.

Who: People with peripheral arterial disease (PAD) and ischemia Why: PAD can advance to ischemia, a condition that impedes blood flow to the legs, feet, and hands. This lack of circulation can result in chronic wounds. What to do: Exercise regularly, maintain a healthy weight and diet, and avoid tobacco use.

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Discovering you have a spot, or nodule, on your lung likely triggers all kinds of emotions. While more than half of all lung nodules are not cancer, the team of pulmonary experts at

St. Mary-Corwin Medical Center’s Lung Nodule Clinic can offer peace of mind by tracking nodules — and, if necessary — treating them.

Sam Widdowson, BSN, MSN, FNP-BC, a thoracic nurse navigator at the clinic, answers common questions.

Female smokers more likely to develop cancer Quitting earlier means more time later Women smokers are 20 percent more likely to develop lung cancer — the leading cause of cancer-related death for both women and men — than in the past, according to a study published in 2013 in the New England Journal of Medicine. Researchers believe that is due to earlier and heavier smoking. But quitting earlier also reaps large rewards, found a second study in the journal. Women who quit by age 34 gain 10 years of life, compared to four years for women who quit later between ages 55-64.

But quitting at any time reaps benefits. In less than one month after quitting, you’ll start to feel your lung function and circulation improving. After about nine months, shortness of breath and coughing will decrease. And after just one year, your risk of heart disease decreases to half that of someone who continues to smoke.

St. Mary-Corwin Medical Center is part of the Centura Health Cancer Network, delivering integrated, advanced cancer care across Colorado and western Kansas.

Making sense of the spotsSt. Mary-Corwin Medical Center provides expert monitoring and management of lung nodules

Q: What is the Lung Nodule Clinic, and who does it help?

A: Housed at Pueblo Pulmonary Associates, the Lung Nodule Clinic evaluates patients who have previously been screened for lung cancer and patients in whom lung nodules are found “incidentally” through a CT scan of the chest or abdomen or X-ray of the chest.

Q: What if cancer is suspected? A: Both the size of the nodule and the characteristics of the nodule — plus a patient’s risk factors such as family history or smoking — will determine if we move on to further imaging or procedures. If cancer is detected at its earliest, most treatable stages, we will have better treatment options. This is the basis of our entire program. Early detection is key.

Lung nodules — whether cancerous or benign — most often do not cause symptoms.

Q: If the lung nodule is not cancerous, what then?

A: Many causes exist for lung nodules, including scarring and past pneumonia. In most cases, we will do surveillance of the nodule through repeat CT scans. We take the side of caution, monitoring nodules over time. If the nodule remains stable over time, often nothing more needs to be done.

Q: As a thoracic nurse navigator, what do you do for patients and families?

A: Education is the key component I bring. I walk them through the whole process, whether the nodule is cancerous or not. I explain what pulmonary nodules are, why we follow them, and how to limit the risk factors — such as smoking or environmental exposures — that might put patients into a higher-risk category.

Half of all “spots” on lung images, called nodules, are noncancerous, explains Sam Widdowson (above) with St. Mary-Corwin Medical Center.

�TIME TO QUIT Ready to eliminate one of the major risk factors for lung cancer? Our evidence-based, seven-week Freedom From Smoking class can help! For information or to register, call 719-557-5280.

Non-Profit Org.U.S. Postage

PAIDColorado Springs, CO

Permit No. 14

Catholic Health Initiatives Colorado

Part of Centura Health, the region’s leading health care network.Centura Health does not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, and marital status in admission, treatment, or participation in its programs, services and activities, or in employment. For further information about this policy, contact Centura Health’s Office of the General Counsel at 303-804-8166. Copyright © Centura Health, 2015.

1008 Minnequa AvenuePueblo, CO 81004

St. Mary-Corwin Medical Center brings specialized care in the complex areas of cancer care,

robotic surgery, joint replacement surgery, sports medicine,

pediatrics, women’s services, cardiology, and more. 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 in our community. No information

in this publication is meant as a recommendation or as a

substitution for your physician’s advice. If you would like to

comment on this magazine, please email [email protected]. Cheers is produced by Clementine Health

Marketing of Denver, Colo.

Total Joint SeminarMon, Oct 12 | 5-7 p.m.Dorcy Cancer Center Call 719-557-5622 to let us know you are coming. You can also visit us online at stmarycorwin.org/jointreplacementcenter.

Freedom From SmokingStarts Wed, Oct 14 | 2-3:30 p.m. Dorcy Cancer Center LibraryAn effective, evidence-based cessation program with eight classes spanning over seven weeks. Includes a FREE, basic membership to access the Web-based program and is available 24/7 for class participants. To register, call 719-557-5989.

Walk With a DocSaturdays, Oct 17, Nov 14, Dec 12 | 9 a.m.Lake MinnequaThis is the perfect way to stay active. The walk is FREE and goes around Lake Minnequa with physicians from Southern Colorado Family Medicine. Meet by the Lake Avenue fire station across from St. Mary-Corwin. Participants receive a free T-shirt and pedometer.

Blood DriveFri, Dec 11 | 10 a.m.-3 p.m. St. Mary-Corwin, West tower entranceSave up to three lives with just one donation of blood. To make an appointment, call 719-776-5822. Walk-ins are also welcome.

Looking for some inspiration or motivation to improve your health? Join the health experts at St. Mary-Corwin Medical Center at a variety of health classes and programs around the community. Here are just a few of the programs we offer. To see more classes, go online to stmarycorwin.org/calendar. Cheers to your health!

FREE

FREE

FREE

Events Calendar

STEPPING ON!Tuesdays, Nov 3-Dec 15 | 9:30-11:30 a.m. Dorcy Cancer Center, Healing Arts Room Stepping On! empowers older adults to carry out healthy behaviors that reduce the risk of falls. It is a community-based workshop offered once a week for seven weeks, using adult education and self-efficacy principles. In a small group setting, older adults learn balance exercises and develop specific knowledge and skills to prevent falls. Older adults who should attend are those who are at risk for falling, have a fear of falling, or who have fallen one or more times. The workshop is co-led by a health care professional and a lay leader. Local guest experts assist by providing information on exercise, vision, safety, and medications. Limited to 14 participants. Call 719-557-3631 to register.

FREE

FREE

Lung Cancer Support Group Meets the first Wednesday of every month from 5:30-6:30 p.m. Call 719-557-5989 for location and to register.

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cheers fall 2015

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