Training for Ski Season

By Dr. Sanjay Jatana

Even though ski season is still a few months away, proper training is important to prevent or minimize injuries from winter sports. Skiing and snowboarding require strengthening your leg muscles, improving your flexibility and getting your CORE stronger.

Training and exercise before ski season can help prevent injury

CORE muscles stabilize the spine. They help transition forces from the legs to the torso.  In the low back, these are the abdominal muscles, specifically the transverse abdominus muscle and the paraspinal muscles in the back. From a spine perspective, CORE strengthening is the key to protecting the back during sports activities, and preventing flare-ups of existing back problems as well as new injury.

CORE strengthening can be done at home, with a physical therapist, or at the gym.  Although most people can learn how to perform them well, it’s often difficult to know how strong is strong enough.  In other words, what level do you need to reach to minimize injury and get the most out of your sport?

Shirley Sahrmann’s grading system can help you determine how strong your CORE is. The system uses five levels to categorize CORE muscle strength. The higher the level achieved, the stronger the CORE.  The levels begin with simple abdominal muscle bracing and feedback. Level 5 is the most difficult. It requires that you can stabilize your spine while taking the legs through a large range of movement.

http://www.spechtpt.com/testing/index.php#1

The more you progress in your sport, the higher the level of CORE stability you need to avoid injury.  In addition to a strong low back, you will also need sport specific conditioning prior to heading to the slopes.  In my opinion, conditioning should start about 8 weeks prior to the winter sport season.

Source: Sahrmann, SA. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis, MO: Mosby. 2002.

Dr. Sanjay Jatana

Dr. Sanjay Jatana is a Board-certified, fellowship-trained spine surgeon at Denver Spine and Rose Medical Center. Dr. Jatana focuses on general spinal surgery and has special interest and training in the cervical spine (neck). He also specializes in treating patients who require repeat or revision surgery.

During surgery, Dr. Jatana employs spinal cord monitoring techniques and a microscope to facilitate safety and accuracy. His goal is to accurately identify the pain source so that surgery is successful in alleviating the symptoms. After surgery, Dr. Jatana prefers to follow his patients for at least two years to ensure long-term positive results.

What does quality patient care mean to you?

At Rose Medical Center, our top priority is the quality of patient care. To ensure that we are delivering the best care possible, we want to hear from YOU, the patient, about what quality care looks like. 

This September we will be conducting three focus groups for patients who recently had Spine, Orthopedic or Bariatric procedures here at Rose. 

Each of these groups will consist of about 10 people and last for an hour. We will ask questions about your stay at Rose and what you liked and didn’t like. As a thank you, coffee and pastries, free parking and a small nonmonetary token of appreciation will be available for participants.  

In June, we conducted a similar focus group for our new mothers of Rose babies, and the comments received were invaluable. From that feedback, we were able to concentrate on the areas that need improvement as well as identify our strengths.

With your valuable input, we will be able to make Rose a home away from home and provide the comfort that you want and expect. If you would like to RSVP to be a participant e-mail us at RoseMC.PDQ@HCAHealthcare.com.

Please include your name, contact information and choose the focus group that corresponds with the type of surgery you had while at Rose.

Spine procedures include : Cervical, Lumbar, Thoracic, Craniotomy,

Ortho procedures include: Joint Replacement, Shoulder surgery, Foot or Ankle surgery, Hand and Wrist, Fracture

Bariatric procedures include: Lap Band, Gastric Sleeve, Gastric Bypass

Thank you for all your help and support! 

Some Details: 

Your Stay at Rose:               Spine Patients*	Your Stay at Rose:                    Ortho Patients*	Your Stay at Rose:                                           Bariatric Patients*
September 13th6:00PM – 7:00PM	September 15th12:00PM – 1:00PM	SESSION #1:September 206:00PM – 7:00PM	SESSION #2:September 213:00PM – 4:00PM
Place: Rose Medical Center Auditorium
RSVP: RoseMC.PDQ@HCAHealthcare.com

Is Working at Rose Medical Center Right for You?

by Clarence G. McDavid, Vice President, Human Resources

Since opening its doors in 1949, Rose Medical Center has been a leader of health care in the Denver community.

Our hospital mission is about putting the care of the patient and the needs of the community first, and we are always looking for bright and honest individuals to add to our staff. 

We created the video below to highlight the values and commitment we look for in our employees, along with information about our hiring process. 

When hiring, we look for people who are honest and show integrity. We expect all of our employees to be courteous and respectful, and to utilize teamwork to do the job right.

Everyone has an important role at our hospital and can affect patient care. Thomson Reuters named us one of the nation’s Top 100 Hospitals, and everyday our employees exhibit the behaviors that won us that honor in 2007, 2008 and 2009. 

I hope this video helps explain the high standards we have for employees. If you think that you would be a good fit at Rose, please visit our careers web page, or go to http://www.healthonejobs.com/ to search for job openings.

 

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Welcome to the Rose Knows Health blog!

By Ken Feiler, Rose President and CEO

Ken Feiler, Rose CEO

When I found out that almost 80 percent of patients look online for information about health and medical conditions before even speaking to a doctor, I wasn’t surprised. More and more people are searching online for information on everything from restaurants to products to healthcare.

What does surprise me is how much of that medical information might be false or misleading. A recent study of tweets on Twitter about antibiotics showed that millions of those tweets contained false information. And I can just imagine that this trend continues across Facebook and blogs and websites. 

This got me thinking about where people are getting their health information, how accurate it is, and how we at Rose could help solve this problem for our community. 

For more than 60 years, Rose has been dedicated to offering high-quality medical care for our patients. Our mission statement says, “Foremost in our hearts and minds is the commitment to our patients. Therefore, we assume responsibility for everything that affects their care.”  

Rose Medical has been serving the Denver community since 1949

I believe that this responsibility now extends onto the web, which why we created this blog. Our goal is to provide you with trustworthy information from knowledgeable sources, like our Rose physicians, in the world of “Web 2.0”. 

In this blog we will be posting videos and articles on medical topics and health-related issues to keep our community informed of the latest developments in healthcare. We will also give you an inside look at Rose and share stories from our hospital, our staff and our community. 

Thank you for taking the time to visit our blog, and I hope that you keep coming back. Sign up for email updates and please post your comments below.  We do have some guidelines for posting comments, but we welcome an open dialogue, as long as it’s appropriate. 

Thanks for joining us, and enjoy Rose Knows Health! 

Ken Feiler

President & CEO Rose Medical Center

Ken Feiler is the CEO at Rose Medical Center and has been with HCA since 1994.  Ken holds a masters in Health Care Administration from The George Washington University as well as a graduate degree in Psychology from State University of New York. His professional associations include serving as a board member for ADL, Shalom Park Nursing Home, and Young Americans Bank. Ken is married and has two children, Melyssa and Jacob. He enjoys golf, tennis, running, photography, and gardening.

Is Playing Golf Really an Exercise?

Do you ever watch golf and wonder if it’s really that difficult? Have you ever golfed and wondered just how good of a workout it is? Or maybe you’ve discussed if golf is a sport or a game? 

At the Rose Center for Health & Sports Sciences, our Medical Director Neil Wolkodoff, Ph.D., recently finished a research study that will help answer these questions.  

Dr. Wolkodoff studied how many calories golfers burn while golfing, depending on if they walk with a caddy, walk and carry their own bag, walk with a pushcart for their bag, or ride in a golf cart. 

Each participant in the study played 9 holes of golf, while wearing metabolic measurement gear to monitor their oxygen levels, heart rate and calories burned. The final results had some surprises. 

You would probably expect to burn the least amount of calories riding around on a golf cart, because you’re not walking as much, and this is true. Playing golf with a motor cart only uses about 411calories per nine holes. 

On the other hand, playing golf with a caddy burns 613 calories per nine holes, and using a pushcart and carrying your bag both burn about 720 calories per nine holes. 

The study concluded that even though a pushcart adds more weight, putting your bag on wheels is a more efficient use of energy and movement. 

Carrying your golf bag burns calories, but wastes energy

A study like this hasn’t really been done before, according to the New York Times “On Par” golf blogger Bill Pennington. He was also  impressed with the study’s findings of a possible connection between being physically fit and a better golf score.

According to the study, the higher your anaerobic threshold levels (the point when lactic acid buildup generally begins to impair coordination and concentration) the easier walking the green and concentrating on your shot will be.  Wolkodoff suggests that golfers do weekly endurance training and also some type of total-body interval training during the off season to raise their anaerobic threshold and, in turn, lower their golf score. 

Walking doesn’t just burn calories, but it might also help you refocus after a bad shot.  “On Par” also looked into this idea with Wolkodoff.

Wolkodoff suggests that there might be a psychological benefit to walking after a bad shot because it gives you time to cool down and refocus before your next hit, as opposed to getting in a golf cart and zipping over to your next shot. 

“Even one minute walking down a fairway will probably do a lot to get rid of the adrenaline and stress hormones that get into your system when you’re upset,” Wolkodoff said. “The physical nature of walking flushes the system and has a calming effect. You can reclaim your rhythm. It’s a natural response as opposed to a rushed one.” (From the NY Times blog) 

To answer the title question, playing golf really IS an exercise. In fact, it uses almost every muscle in your body. And by walking the course and carrying or pushing your bag, you can make sure it counts (and maybe even lower your score).

Learn more about the Rose Center for Health & Sports Sciences, and how our docs can help you improve you customize a program for maximum athletic results at http://www.rosechss.com.

Neil Wolkodoff, Ph.D.

Neil Wolkodoff, Ph.D., has trained a variety of athletes including NFL, NHL, MLB, and Olympic athletes for more than 15 years. Wolkodoff has been a pioneer in applying gas exchange and energy system testing (VO2 Max/AT/Lactate Threshold), to assess and design individual levels of performance. 

In his role as exercise physiologist/director of education for the Pro-Rehab & Fitness Center, he trains the staff on medical and fitness modalities and their use. His clients include various professional and amateur athletes, as well as professionals from the LPGA, PGA and Senior PGA tours. He has contributed articles to Golf Tips, Golf Magazine, Golf Digest, Shape, Men’s Fitness, American Health and golf.com. He is the author of Core Powered Golf, Physical Golf and Body Logic published by KickPoint Press.

 

 

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The Importance of Vitamin D

By Dr. Asela Russell, at the Center for Women’s Health  

Dr. Asela Russell

Vitamin D is everywhere in the news. When I was in Health Class in high school, I learned that it was a minor nutrient that used to be associated with rickets but that wasn’t very important in the modern world of Vitamin D-fortified milk. I also learned that being outside guaranteed the skin’s natural production of Vitamin D. Now all of that thinking has been turned upside down.

Long hours working indoors, commuting behind UV-filtering glass and using high-SPF sunscreen- all measures that we’ve adopted to protect us against skin cancer- have led to more and more cases of Vitamin D deficiency. To compound the problem, lots of adults lose the enzymes needed to digest milk sugars (lactose) and are unable to tolerate large quantities of milk or milk-products without having major digestive problems.

In my practice, I’m often surprised by how many women, who are otherwise well-nourished, have Vitamin D deficiencies when we measure their blood Vitamin D levels. As medical studies link Vitamin D deficiency to osteoporosis, obesity, breast and colorectal cancer, depression, hypertension, diabetes, polycystic ovary disease and heart problems, Vitamin D deficiency has become a 21^st century health emergency.

You are at higher risk for Vitamin D deficiency if you have browner skin, wear clothing that blocks sun from most of your skin and if you live at our northern latitudes. Being vegetarian increases your risk as Vitamin D is found naturally in a few foods — including fish, fish liver oils and egg yolks. You’re also at risk if you are unable to absorb vitamin D due to intestinal problems such as Crohn’s or celiac disease and IBS (irritable bowel syndrome). Being overweight (BMI over 30) can lower your Vitamin D levels, due to the action of fat cells. Finally some adults’ kidneys lose the ability to convert Vitamin D to the active form Vitamin D3, causing a functional deficiency.

Symptoms of Vitamin D deficiency can include muscle aches and weakness, fractures, poor sleep, fatigue, inability to lose weight, depression and immune problems. Unfortunately, most women with low Vitamin D levels have no symptoms at all.

My advice to patients is to supplement with additional Vitamin D, either alone or combined with a calcium supplement. In fact, most calcium supplements packaged for use by adults contain Vitamin D. But is it enough? The RDA (recommended daily allowance) for Vitamin D is 50 IU but recent studies suggest that’s not enough. The AI (recommended dose) according to the Food and Nutrition Board at the Institute of Medicine of the National Academies is 200 IU (international units) for adults up to age 50, 400 IU for adults age 51 to 70 and 600 IU for adults over 70. Other studies suggest that even higher levels are ideal. We know that Vitamin D overdose can occur, but usually this requires levels that are 10 times higher than what is available in supplements.

Action Plan for Vitamin D:

• Determine if you have any risk factors for Vitamin D deficiency.
• Increase the amount of fish, eggs, dairy products and vitamin fortified grain in your diet.
• Consider supplementing with Vitamin D, especially Vitamin D3 (cholecalciferol), the activated form of Vitamin D.
• Ask your doctor if checking a Vitamin D level is appropriate for you.

Dr. Asela Russell, the founder of Center for Women’s Health, is a Board-certified OB/GYN. She has practiced in the Denver Metro area since 1987 and opened the Center for Women’s Health in 2003, after working with The OB/GYN Associates for more than 15 years. 

Dr. Russell attended Yale University and Duke Medical School and completed her OB-GYN Residency at the University of California-San Francisco. After completing her residency, she was a US Public Health Service provider working for the Navajo Nation in Arizona.

Fourth of July- have a safe and fun holiday!

The 4^th of July usually brings to mind one thing- fireworks (and lots of them).

You aren’t allowed to possess or use consumer fireworks at your home if you live in Denver, so leave the heavy lifting to the professionals and instead take a look at the list from the Denver Post of firework displays and 4th of July festivities in the Metro Area. Or, celebrate early and check out the Civic Center SOUNDS: Independence Eve Celebration on July 3rd in Civic Center Park.

However, if you do live in an area that allows consumer fireworks, be extremely careful, and make sure to follow these tips and rules from the National Council on Fireworks Safety.

• Find out what kind of fireworks are allowed in your area (check with your local fire department)
• Avoid unlabeled fireworks
• Don’t ever use homemade fireworks, or try to alter ones you buy
• Select a suitable area for lighting fireworks.(Follow the warning labels on the firework)
• Always light fireworks outdoors, preferably in large open area with no trees
• Make sure there are no gasoline cans, or other flammable materials nearby
• Light fireworks on a level and sturdy surface
• Keep a bucket of water and a garden hose handy
• Have one to two sober adults as the designated firework shooters
• If you are lighting fireworks, always wear glasses or safety goggles
• Use safety lighters or BBQ lighters to ignite the fireworks
• Make sure that none of your body parts are over the firework when lit
• Keep spectators at a safe distance (usually 20-40 feet away)
• Never relight a dud, and let it cool for 15 minutes before disposing it
• Always soak fireworks in water before putting them in trash
• Never carry fireworks in your pockets

 Have a safe and happy holiday this weekend!

Rose at the Denver Heart Walk, June 5 2010

On June 5, employees from Rose walked in the American Heart Association Denver Heart Walk. We are proud to have raised over $10,000 for such a good cause!

Rose employees gather at the 2010 Denver Heart Walk

 

Great Save Celebration honors emergency responders

April 24, 2009, started as a regular day for Wendy Wilbanks. She went to work and even took a walk at lunch. But that afternoon, Wendy almost lost her life to a heart attack.

Thanks to the quick response from her coworkers, Denver Health EMS staff and the doctors and staff at Rose Medical Center, Wilbanks is still here today, and her case was honored Tuesday during the Rose Medical Center Great Save Celebration, a part of EMS Appreciation Week.

Wendy Wilbansk and the people who contributed to saving her life

The Great Save Celebration is an annual event where the Rose Medical Emergency Department recognizes the teamwork and efforts of all of the people involved in an extraordinary emergency case.

It was about 2 p.m. on April 24, 2009 when Wilbanks got back from her lunch break. As she sat down at her desk, she went into sudden cardiac arrest, followed by a seizure.

Wilbanks’ two coworkers, who happened to be nurses, recognized the signs of cardiac arrest. One immediately started performing CPR while the other called 9-1-1.

“If it wasn’t for her two coworkers, Wendy wouldn’t be here today,” said Dr. Don Lefkowits, Medical Director of the Rose Emergency Department, during Tuesday’s ceremony. “Bystander CPR was effective and it was started immediately. Help was called immediately, and arrived almost immediately.”

Dr. Don Lefkowits presenting the case

The Denver Fire Department arrived on the scene about four minutes after receiving the 9-1-1 call, where they continued CPR and used a defibrillator to shock Wilbanks’ heart. When the Denver Health Paramedics arrived, they intubated Wilbanks and started IV lines, while the Fire Department continued CPR.

In less than 40 minutes after her heart attack, Wilbanks arrived at Rose Medical Center, where the emergency department staff continued resuscitation until Wilbanks was stabilized. She was then taken to the Rose Catheterization Lab, where they used a device to inflate a balloon in her blocked arteries to open them up.

“Thanks to the Rose Medical Cardiac Alert system, which alerts our Emergency Department team when a heart patient is on the way in, Wendy was up to the Catheterization Lab in under 60 minutes from the time we got her EKG and confirmed cardiac arrest,” said Lefkowits.

Wilbanks was then transferred to the Intensive Care Unit where she underwent a new treatment technique called Hypothermia After Cardiac Arrest (HACA), which is when the body is cooled down to help prevent brain damage in heart attack patients who were unresponsive for long periods of time.

“It is a new element to post-cardiac arrest care,” said Lefkowits. “But what we now know is that HACA makes a huge difference. It preserves brain function.”

Wilbanks spent two weeks in the ICU, and another several days at Spaulding Rehab Center before finally returning home. By August of 2009, she was back to work full-time, and now one year later, she is healthy and back to enjoying her life completely.

“‘Thank you’ is all I have to offer,” said Wilbanks told the care providers who had gathered for the Great Save Celebration. “You did the approximately 83 miracles that had to happen to allow me to still be here today. Getting a chance to see you all, and say thanks is a gift beyond measure for me. Thank you very much.”

Wendy and her husband, thanking the responders