finding peace in the now

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Lydia’s STYLE Magazine
M
Ti
Michael P. Curiel, MD
Adult Neurology
Pediatric Neurology
Electroencephalography
Neurorehabilitation
Evoked Potentials
Multiple Sclerosis
Alzheimer’s Disease
Electromyography
Pain Management
Head Injury
Headache
Seizure
Vagus Nerve Stimulators
Parkinson’s Disease
Neck and Back Pain
Botox Injections
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Stroke
Now Doing Infusions in Office
F O R T C O L L I N S N E U R O L O G Y, P. C .
D I P L O M AT E S , A M E R I C A N B O A R D O F P S Y C H I AT RY A N D N E U R O L O G Y
2 1 2 1 E a s t H a r m o n y, S u i t e 2 7 0 | F o r t C o l l ins, CO 80528
Timothy J. Allen, MD
11
[ 9 7 0 ] 2 2 1 - 1 9 9 3 | FA X : [ 9 70] 221-9170
CONTENTS
northern colorado medical & wellness
VOLUME III 2009
14
16
20
26
32
33
37
38
42
46
50
52
54
58
Publisher’s Letter
Technology Advances in Healthcare
Faces of MS: Finding Peace in the Now
Two community members share their
experiences living with multiple sclerosis.
Trauma Care Team Stands Ready
Follow the process from ambulance to recovery
in Northern Colorado.
Comfort, Convenience at the New Medical
Clinic at Centerra
One-stop location for healthcare in Northern Colorado.
Brain Integration for Learning Disabilities
Dr. Charles Krebs’ own struggles lead him to create a
new modality for treating learning disabilities.
16
Faces of ms: finding
peace in the now
20
26
Comfort, Convenience at
the New Medical Clinic at
Centerra
32
46
Perfect Vision With iLASIK
50
Paul Joncas prevails over his MS with the
help of Fort Collins Neurology, P.C.
trauma care team
stands ready
Follow the process from ambulance to
recovery in Northern Colorado.
Maximizing Communication A Multi-Pronged Approach
Speech & Language Stimulation Center, Inc.
New Approaches to Treat
Learning Disabilities
LearningRx
Chronic Kidney Disease On the Rise
The Nephrology Clinic, P.C., shares important
information on CKD.
Practice Directory
A cross-section of healthcare providers in
Northern Colorado.
Perfect Vision With iLASIK
State-of-the-art eye surgery at Eye Center
of Northern Colorado.
Orthodontic Team Uses Cutting-Edge
i-CAT Imaging
Orthodontic Associates of Greeley, P.C.
Non-Invasive Treatment for Scoliosis
One-stop location for healthcare in
Northern Colorado.
Brain Integration for
Learning Disabilities
Charles Krebs, Ph.D., is founder of the
Learning Enhancement Acupressure
Program designed to treat learning
disabilities.
Spine Correction Center of the Rockies
24-Hour Pet Emergency Care
Signs to look for in an emergency and where to
take your pet after hours.
Physician Profile; A Father’s Influence
Donn Turner, M.D., Front Range Center for Brain &
Spine Surgery, P.C.
State-of-the-art eye surgery at Eye
Center of Northern Colorado.
on the cover:
Neurologists Michael Curiel, M.D., and Timothy
Allen, M.D., of Fort Collins Neurology, P.C.,
outside their office in Fort Collins.
12
Orthodontic Team
Uses Cutting-Edge i-CAT
Imaging
Orthodontic Associates of Greeley, P.C.
The articles in this issue of Northern Colorado Medical & Wellness
are presented for your general knowledge and are not a substitute for medical advice or treatment. If you have any questions or concerns about your
health, please contact your doctor of healthcare provider.
Lydia’s STYLE Magazine
The earlier a health problem is detected, the
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This high level of expertise ensures that our
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Northern Colorado Medical & Wellness 2009
Publisher’s Letter
Technology Advances
in Healthcare
H
ealthcare in our region is expanding at
such a phenomenal rate I am always
intrigued and amazed at the breadth
and depth of the professionals our region seems to attract. But, why not?
We are living in one of the most desirable areas in
the country.
Enjoy reading this issue focusing on a few of the
region’s exciting new advances in healthcare.
14
Recently, Nancy and Robert Evans contacted me
to let me know Charles Krebs, Ph.D., was coming
to town and they wanted me to meet him. After
learning a little about him and browsing his book, I
was convinced we needed to interview him for our
Northern Colorado Medical & Wellness issue. This
brilliant yet affable man, through his education and
his own traumatic personal experience, had developed an important treatment modality for learning
disorders. Best of all, he is establishing the Learning
Enhancement Acupressure Program (LEAP) certification in Fort Collins and working with Nancy and
Robert to develop the Fort Collins office as a hub of
brain integration education. Not only is this good
news for many children and adults afflicted with
weaknesses in learning and attention deficit disorder, it is another important addition to the overall
healthcare in our area. In fact, I am going through
the program to improve my left and right brain integration!
More state-of-the-art developments in healthcare are featured in this issue. The Eye Center of
Northern Colorado has teamed up with Poudre
Valley Health System to form the Eye Laser Center
of Northern Colorado, which now offers the newest technology in its iLasik procedure. This bladeless
technology is safer, completely custom fit, and offers the surgeons exceptional accuracy for their
procedure. I find it amazing that vision can be improved to 20/20 almost immediately!
After raising two daughters, both of whom were
patients of Dr. Burdett Edgren for their orthodontia,
I was interested in the newest developments in their
diagnostics and treatment. Orthodontic Associates
of Greeley recently added new advancements with
their i-CAT scanning equipment to provide three-di-
mensional images to help them diagnose facial and
jaw problems, pinpoint issues with wisdom teeth,
and offer soft and hard tissue images to make earlier
treatment plans that are more effective.
The summer is a time when we all are a little
more relaxed as we enjoy outdoor activities and
sports. It is also a time when we are more vulnerable
to accidents and injuries. We felt it was important
to bring mindful awareness to what can really happen when we are careless. We decided to look at
trauma care in our region and were impressed with
the exceptional care our area offers. Trauma is the
leading cause of death for ages one to 44, so we are
fortunate to have the Trauma Center of the Rockies as a Level II trauma center in Northern Colorado.
The exceptional team, led by Chris Cribari, M.D.,
Medical Director of Trauma for MCR, and Timothy
Wirt, M.D., Neurosurgeon with Front Range Center
for Brain & Spine Surgery, P.C., have their hands full
in the warm summer months.
Emergency care also extends to pets. Pets often
become ill at night or on the weekends. My Lhaso
Apso, Daisy, gave me a scare this past year when she
punctured her eye and I found myself in a vet’s office
at midnight and Daisy in surgery at 3:00 a.m. to save
her eye. After much anguish and lots of recovery
time, she is fine and just as curious and mischievous
as ever! Read up on pet emergency care and clip
out our ER list of vets for your refrigerator in case
you might need a quick reference in a time of need.
Enjoy the sun as it peaks out between the summer showers.
[email protected]
Lydia’s STYLE Magazine
27 POINT INSPECTION • OIL CHANGES • CLUTCHES
BRAKES • TIMING BELTS • SHOCKS • TUNE UP
15
awareness
Multiple Sclerosis
“Multiple sclerosis is
not a death sentence
or a disability
sentence like it used
to be. With access
to knowledge, better
diagnostics, and
better meds, it is
very manageable.”
Timothy Allen, M.D.,
Fort Collins Neurology, P.C.
Michael Curiel, M.D., and Timothy Allen, M.D.,
Fort Collins Neurology, P.C.
Faces of MS:
Finding Peace in the Now
by Corey radman
photos by warren diggles
Multiple sclerosis (MS) is a disease that affects the central nervous system by disrupting the flow of information
from the brain to the body. According to the National MS Society, “it is an elusive disease with no known cause
and no known cure. Symptoms vary from person to person depending on where the central nervous system is
affected, making it hard to diagnose.” MS generally strikes people in the prime of life between ages 20 to 50
years old. Of those diagnosed, 73 percent are women.
T
ori Case is mean as spit and crazy
too – at least that’s how she describes
herself. However, anyone who meets
her isn’t fooled. Case lights up the
room with her fiery spirit, warm and
ready laugh, and twinkling blue eyes that seem to
say, “I know.”
She knows she defies the wheelchair-bound
stereotype of someone with MS. “And I’m not
going to use a cane, like some old lady,” she says.
Case knows it is her unrepentant obstinacy that
has kept her mobile through 31 years living with
MS. Asked about the limitations that MS imposes
on her lifestyle she says, “I don’t give a damn
what I’m supposed to do! I’m going to do what
I want.”
16
Case’s nervous system began to show signs
of the disease at age 16, before she was really
aware of it. Her mother, a healthcare professional,
noticed her daughter’s eyes had stopped tracking
from left to right and she was turning her head
to see her periphery. Walking had also become
difficult; Case says, “I looked like I was always going up stairs because my feet were numb and I
couldn’t feel where the floor was.” After a spinal
tap diagnosed probable MS, Case’s mother chose
not to tell her daughter, fearing her flighty, rebellious teenager wouldn’t handle it well.
“She was probably right,” muses Case, “but
I kept saying to myself, ‘Why is this happening?’”
It took two years, and Case’s future husband,
Terry, to finally break the news to her that she had
MS. “My mother told Terry about it when she
could see we were getting serious so he would
know what he was getting into,” she remembers.
The young couple had moved to Vail to begin
their life together when Case’s symptoms became
debilitating. “It was horrible. My legs and hands
didn’t work, I couldn’t hold things or walk the
way I wanted to, and I still didn’t know why. I was
really depressed.”
They returned to Greeley to see her doctor
and be closer to family. After yet another vague
medical appointment with more questions than
answers, Terry finally told Case that she had MS.
“I remember screaming ‘No! They’re wrong!’
I thought the doctor was a liar,” says Case.
It took her and her husband a long time to
Lydia’s STYLE Magazine
adjust to the diagnosis and its relapsing-remitting
pattern. It hasn’t been easy, but 29 years and four
children later, Terry and Tori Case are still working
through it together. “We just celebrated our 27th
anniversary,” she smiles.
In Her Case
Case says, “MS has been like a roller coaster
for me. Things will be really great for a while and
then…” she pauses, sifting through the myriad
examples, “one eye goes blind.” She cites the
symptom with a shrugged shoulder. “Then I wear
a patch for a while until it goes away.”
“Tori has one of the most severe types of MS
(Secondary-Progressive),” says her neurologist,
Timothy Allen, M.D., of Fort Collins Neurology,
P.C. “She has done extraordinarily well with the
newest medications. They make a huge difference
for prevention of disability.” Case injects herself
with the medicines weekly. “Twenty-five years
ago, most people diagnosed with MS would have
been in a wheelchair within three or four years,”
he says. “Attitude makes all the difference.”
“I love Dr. Allen,” says Case. “We connect.
He says my MRIs show so many brain lesions that
I should be in a wheelchair, but I just refuse. I still
don’t feel like I have MS. The symptoms come and
go, but my frame of mind keeps me well. I just
refuse to be told what I can do, even by my own
body.”
Prognosis and treatment
“Common symptoms of MS include numbness, tingling, and sensory problems like weakness, vertigo, or poor balance,” explains Dr. Allen. “However,” he cautions, “you can’t jump
to conclusions with these symptoms. There are
more common causes for numbness or tingling. But if they happen over a number of days
or occur through half of the entire body, it may
be MS,” he says.
Dr. Allen, who did his undergraduate work
at Colorado State University and medical education at University of Colorado, is certified by
the American Board of Psychiatry and Neurology. He has been a partner at Fort Collins Neurology since 1997.
Dr. Allen’s partner, Michael Curiel, M.D.,
elaborates further: “There are different levels
of MS: possible, probable, and definite.” With
a definite or probable diagnosis, treatment can
begin. “It’s better to be proactive [with probable MS] and start treating to suppress,” he
explains. Cases of possible MS are usually observed over time.
Dr. Curiel is one of the founders of Fort
Collins Neurology, which originated in 1984.
He completed his graduate studies at the University of Arizona and is a Diplomate of The
American Board of Psychiatry and Neurology.
Drs. Curiel and Allen typically recommend
one of five major disease suppression medications for MS treatment. Some of the medications can be injected by the patients; others are
administered by IV infusion at their office. Diet,
exercise, and stress control are also important
to disease management.
Dr. Allen says, “MS is not a death sentence
or a disability sentence like it used to be. With
access to knowledge, better diagnostics, and
better meds, it’s very manageable.”
Northern Colorado Medical & Wellness 2009
Colorado Ranks High
A Patient With Patience
The local chapter of the National MS Society
reports that Colorado has one of the highest incidences of MS in the nation; there are 9,000, or
one in every 540, Coloradans living with MS. Allison Hines, Regional Development Manager for
the Colorado Chapter of the National MS Society,
explains why the numbers for Colorado may be
so high: “Colorado has a very mild climate and
people living with MS are adversely affected by
the heat. Many people find the climate in Colorado more suitable.”
Paul Joncas, who has Relapsing-Remitting
MS, thinks Colorado’s high incidence rate is primarily due to non-natives like him who moved
here for the climate and excellent resources. “I
can’t ask for a better place to have this disease,” he jokes, but continues seriously, “I’m
utterly grateful to be in Fort Collins and to have
had the good fortune to connect with Dr. Curiel.”
Dr. Curiel notes 85 percent of people diagnosed with the disease have Relapsing-Remitting MS. Joncas has tried many medications in
the five years since his diagnosis, but is currently holding most of his symptoms at bay with a
monthly IV infusion of an immune-modulating
drug.
Joncas is like many people with MS. He
spent much of his adulthood with symptoms
that would come and go, but never last long
enough to get a diagnosis until all of the niggling annoyances like blurred vision, fatigue,
and numbness on his right side occurred at
the same time and refused to disappear. At 52
years old, Joncas finally understood what had
been going on all those years.
“My wife, Debbie, and I felt very confident
in our course of action because of Dr. Curiel’s
patience and concern.” On the day he was di-
Tori Case was diagnosed with multiple sclerosis
31 years ago, when she was only 16.
Paul Joncas was diagnosed with multiple sclerosis in 2004.
17
agnosed, Joncas and his wife stood asking questions of Dr. Curiel for 45 minutes. “He never
once looked at his watch,” says Joncas.
Joncas tried to continue to work for another
year as pastor at Shepherd of the Hills Lutheran
Church in Fort Collins, but his relapses were too
frequent. Eventually he retired from the pastorship, but has continued to serve others through
the MS Society. His recumbent tricycle has become a familiar site in the Bike MS event that
covers 150 miles each summer.
This year, Joncas was honored by the Fort
Collins MS Society office as the 2009 MS Champion. “Paul has demonstrated exemplary volunteer service by helping the newly diagnosed
adjust. He maintains an extremely positive atti-
tude,” says Hines.
Joncas, perhaps because his diagnosis came
later in life, more easily accepts the changes that
have transformed his world, like the two crutches he uses to walk. His jokes are quick and often
self-deprecating. “Of all the things I lost because
of MS, I miss my mind the most,” he quips about
the difficulty in concentrating for long periods.
MS Misperceptions
Dr. Michael Curiel works with MS patient
Paul Joncas.
Joncas often speaks to groups and mentors
others with the disease. Asked to help others understand more about MS, he says, “We all have
symptoms in common but no one’s MS is exactly
the same as another person’s.”
Joncas answers blunt questions honestly for
those who come to him through the MS Society.
“Doctors can sometimes be evasive about the
hard questions,” he says. “New patients want to
know: ‘Will this shorten my life? Am I going to
end up in a wheelchair?’”
“While it’s true no one can ever know for
sure, the vast majority of people never end up in
a wheelchair. The fact that I use crutches is unusual. Most people with MS are able to continue
their careers with some adjustments.”
“I think of myself as lucky,” he says. “Twenty
years ago the prognosis would have been different. Today, with new drugs, MS doesn’t necessarily shorten life expectancy. I see the changing
symptoms as something I adjust to. I have good
days and less good days. There is no point in having bad days. If all I get done in a day is reading
a few pages in something [due to fatigue], I still
got something done,” he says smiling.
Joncas is hopeful about the future of MS:
“The current research is remarkable. There are
oral drugs coming. Lab tests have had good luck
in getting myelin to grow back on mice, which
may be the road to a cure. That course of treatment may not be able to repair damage for people like me, but those who come after me may
benefit.”
Life Lessons
Though their journeys with MS have been
drastically different, Case and Joncas have arrived at many of the same conclusions: life is
what it is. “There is no promise that life is going to be perfect,” says Joncas.
Case agrees. “I figure life’s too short.
There’s nothing I can do about this, so why
wallow?”
“My outlook has changed,” says Joncas.
“MS keeps me in the present. I can only deal
with what’s right now. I can’t worry about the
past or the things I can no longer do. I can’t
look too far ahead, because I don’t know what
I will be able to do tomorrow.”
Planning for the future with MS is tricky,
however a few things are certain. Case and
Joncas will continue to use their challenges to
make the most of life, often through laughter.
Both will keep trying to reach out to make others’ days brighter. Both plan to continue stepping forward each day with grace, strength,
and dignity. +
Dr. Timothy Allen performs an exercise with patient Tori Case.
Corey Radman is a freelance writer and mother of
two living in Fort Collins.
18
Lydia’s STYLE Magazine
Want to Help?
Bike MS is one of the MS Society’s
signature events that raises money
for research and support for those
living with MS.
Paul Joncas rides his recumbent tricycle in last
year’s Bike MS event.
Saturday, June 27
&
Sunday, June 28
TWO days, 150-mile cycling ride
Start/Finish at Front Range
Community College in Westminster,
with an overnight event at Colorado
State University.
Register, donate, or find
more information online at:
www.bikeMScolorado.org
Volunteers can call:
Jaclyn Wilmot at 303-698-5444 or
[email protected]
The National MS Society is the largest
private MS research funder in the nation,
providing support for 440 research projects
worldwide. The Colorado Chapter contributes research funds each year to the National MS Society’s nearly $50 million annual
research budget. There are eight nationallyfunded research projects in Colorado.
Northern Colorado Medical & Wellness 2009
19
regional care
Trauma Response
“Before, we would all
come in and parcel
out our care. There
was no coordinated
effort. I don’t think
there is any question
that with this system
in place there are
improved outcomes.”
Timothy Wirt, M.D.,
Neurosurgeon,
Front Range Center for
Brain & Spine Surgery, P.C.
Trauma Care Team
Stands Ready
by Lynn M. Dean
It is summer at last. In Colorado that means outdoor fun. It also means traumatic injuries. “We see an increase in the number
and severity of injuries in the summer,” says Chris Cribari, M.D., Trauma Medical Director at the Trauma Center of the
Rockies at Medical Center of the Rockies. “More people are out in the warm weather participating in recreational activities.”
T
rauma is the leading cause of death
for ages one to 44 in Larimer County
and in the United States. Trauma Center of the Rockies is a Level II trauma
center that provides comprehensive
care for critically injured patients in Northern
Colorado, southern Wyoming, and western Nebraska.
Motorcycle and automobile accidents accounted for 43 percent of the traumatic injuries
treated at the Trauma Center at Medical Center
of the Rockies (MCR) last year. Injuries from falls
comprised another 32 percent.
Most of these injuries are fairly innocuous, according to Rob Baer, M.D., orthopaedic trauma
surgeon with the Orthopaedic Center of the
Rockies. “The most common injury we see at the
Orthopaedic Center is a wrist fracture caused by
20
falling on an outstretched hand. Ankle and leg injuries are a close second. Unless, of course, you
are talking about motorcycles; I think they are
dangerous and anybody who decides to ride one
has to understand, sooner or later, they’ll probably crash.”
“During the summer months we see a life- or
limb-threatening injury daily,” adds Dr. Baer. He
notes that it is important to remember not all of
these injuries occur in the immediate area. “We
have a large catchment area. We get patients, by
ambulance or helicopter, from northern Denver,
Wyoming, Nebraska, and even South Dakota.
Sometimes, life-threatening injuries are not
caused by something as dramatic as a motor vehicle accident or a fall while rock climbing. Sometimes they are just due to an unlucky circumstance
or a lapse in judgment. That is what happened to
Carlos Toca, a teenager from Loveland, in August
2008.
“Carlos did what the majority of under-21year-olds with cervical spine injuries have done,”
explains Dr. Timothy Wirt, M.D., a neurosurgeon
with the Front Range Center for Brain & Spine
Surgery, P.C. “He wasn’t drinking. He wasn’t doing anything any other normal 15-year-old boy
wouldn’t do.”
It all happened last summer on a sweltering
hot day up the Big Thompson Canyon. Dripping
with sweat, Carlos and his friends decided to take
a dip in the river. One by one, they jumped into
the cool mountain water. And one by one they
surfaced, refreshed. All except Carlos.
A local emergency medical services (EMS)
team was called to the scene. The paramedics
quickly assessed the situation and determined,
Lydia’s STYLE Magazine
Chris Cribari, M.D., Medical Director of Trauma
for MCR’s Trauma Center of the Rockies
Rob Baer, M.D., and Orthopaedic Trauma Surgeon with the Orthopaedic Center of the Rockies
Timothy Wirt, M.D., Neurosurgeon with Front
Range Center for Brain & Spine Surgery, P.C.
based on his injuries and lack of sensation in his
legs, that Carlos needed to be transported to a
Level II Trauma Center. He was airlifted to MCR.
“He came within millimeters of being a quadriplegic,” says Dr. Wirt, the neurosurgeon on Carlos’
trauma team. “He got very lucky.”
Luckier still, Carlos had his near-fatal mishap
in an area with a regional, Level II trauma center.
A hospital that was in constant communication
with the ambulance crew and had already begun
assembling a team of specialists and sub-specialists. A hospital that was already developing an action plan while Carlos was still en route.
As the Trauma Surgeon, Dr. Cribari leads a
team of specialists like Dr. Wirt and Dr. Baer that
are all part of a coordinated on-call system. “We
have to be available to be at the hospital within
a half an hour,” adds Dr. Wirt. It is a system that
works.
“I think (Poudre Valley Health System’s Trauma Program) has unified what used to be a very
fragmented approach to treating multiple-injury
patients,” says Dr. Wirt. “Before, we would all
come in and parcel out our care. There was no
coordinated effort. I don’t think there is any question that with this system in place there are improved outcomes.”
Poudre Valley Health System (PVHS) began
its trauma program at Poudre Valley Hospital in
the early 1990s, building the PVH program into a
Level II trauma center.
“When we were considering building a new
hospital, one of the driving decisions was being
able to offer these top-level trauma services regionally,” explains Lori McDonald, a registered
nurse and PVHS’s trauma program director. “We
also realized that we couldn’t take trauma resources out of the city – we needed to make sure
that PVH would still be capable of handling some
trauma.”
Ultimately, PVHS decided to move the Level II
services to MCR, while maintaining basic essential
services at PVH at a Level III designation.
Dr. Cribari describes the process: “Upon arriv-
al, the patient is met by a team of specialists who
work in concert to quickly identify and treat all of
the injuries.” Trauma patients are whisked into a
state-of-the-art emergency department (ED) with
dedicated trauma rooms where the team’s first
task is to stabilize the patient, getting blood pressure and bleeding under control, and resuscitating them if necessary. Once stabilized, the patient
is evaluated from head to toe.
“The trauma patient undergoes a rapid assessment and diagnostic workup while undergoing resuscitation,” says Dr. Cribari. “This begins in
the ED trauma bay and continues in the adjacent
CT scanner, the OR (operating room), or the surgical intensive care unit. When you have someone
with multiple injuries, there may be injuries that
are not as obvious as others, but equally important to identify immediately.”
MCR’s trauma team works closely together,
says McDonald, who describes the intricate dance
that takes place in the trauma room.
“Besides the trauma surgeon, anesthesiologist, and ED physician, there are two ED nurses,
Daniel Asadi, D.O., Medical Director of the Northern Colorado Long Term Acute Hospital
Joseph Jacob, M.D., Medical Director of the
Northern Colorado Rehabilitation Hospital
Sam Laney, M.D., Associate Medical Director of
the Northern Colorado Rehabilitation Hospital
The Process
Northern Colorado Medical & Wellness 2009
21
Medical Center of the Rockies’ Trauma Center of the Rockies team works to stabilize a patient.
a critical care nurse, and an OR nurse. There’s also
a phlebotomist from the lab, a radiology tech,
and a respiratory therapist. We have a couple of
other people who may respond, including a nursing supervisor, security, and a social worker who
will notify and assist the family. So it’s a pretty big
group of people in the room. Sometimes it may
look like chaos, but it is organized chaos because
everybody has a specific job to do.”
Recent advances in technology have also
enhanced the diagnostic and treatment process.
“What is now a critical link is remote digital imaging,” explains Dr. Wirt. “I can read CT scans
and X-rays from the office, home, or any of the
hospitals. Within 60 seconds, I can tell the trauma
surgeon at the other end of the phone whether
the patient needs to go to the OR right away
or whether it is something that can wait. We
couldn’t do the coordination we do without the
current technology and system in place.”
22
According to McDonald, many people misconstrue trauma as ER care. “They don’t understand it is an entire continuum that includes prehospital care, in-hospital care, and post-hospital
care.”
After the trauma patient is stabilized and evaluated at MCR, he or she will either go to the operating room or to the surgical intensive care unit
(SICU). In Carlos Toca’s case, the trauma team determined that he had broken his neck and bruised
his spinal cord. He was taken into surgery where
Dr. Wirt inserted a plate and fused his spine.
Once patients get to the SICU, whether they
come directly from the ED or from the OR, they
are carefully followed by their trauma team.
“Trauma patients have a potential for fragmented
care,” says McDonald. This can happen, she explains, because of the different specialists who
may be involved in their care.
The trauma center employs trauma case man-
agers - nurses specially trained in the care of the
injured patient - who work closely with the trauma surgeon. Case managers serve as a liaison for
the patient, family, trauma team, and specialists,
says McDonald.
“We do multi-disciplinary rounds every morning where the trauma surgeons and care providers come to the patient room to review the plan of
care with each other and the patient,” she says.
Besides the trauma surgeons and case managers,
the team includes primary care nurses, a physical
therapist, pharmacist, and discharge planner.
Once patients are ready to leave the SICU,
they are moved to the post-trauma unit. “One
of the scariest times for families is when the patient is ready to leave the ICU,” says McDonald.
“Again, the case manager is available to the patient and family. Because they see the same person throughout, it reassures the patient and their
family and provides continuity of care.”
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Northern Colorado Medical & Wellness
23
MCR’s Trauma Center of the Rockies 2008 Trauma Accidents
20%
Falls
Motor Vehicle Crash
Motorcycle Crash
Bicycle Crash
Other Various
32%
5%
15%
28%
Figures courtesy of Poudre Valley Health System
Friday, June 12, 2009
Dr. Timothy Wirt with Carlos Toca minutes before
he removed the hardware from Carlos’ neck.
Thanks to Dr. Wirt and the Trauma Center of the
Rockies team, Carlos has recovered significantly
from his accident in August 2008, where he
broke his neck and bruised his spine.
Simultaneously, the team is getting the patient ready to leave the hospital. “Our rehabilitation therapists are integrated from the get-go,”
says McDonald. “They’re already doing things
while the patient is still in bed and do a lot of
therapy with the patient in the room.”
What Happens After the Hospital
Trauma care doesn’t end when patients are
ready to be discharged. The continuum of care
includes making sure the patient gets the posthospital care they need. The trauma team works
with the patient and family to find the best fit for
their rehab needs, which may include the PVH
Life Skills Rehab facility or one of the other local
or regional rehabilitation facilities.
Two other local options include The Northern
Colorado Rehabilitation Hospital (NCRH) and the
Northern Colorado Long Term Acute Hospital
(NCLTAH), both of which share a campus not far
from MCR.
Decisions regarding post-hospital care are
made based on the individual needs of the patient. For example, Carlos went to Craig Hospital in Englewood where he would meet and be
treated with other young patients with spinal
cord injuries.
“If a patient has enough injuries that they
can’t go home safely and they need a doctor to
manage their medical issues, then such a patient
is more appropriate for an acute rehabilitation
hospital like NCRH,” says Sam Laney, M.D., Associate Medical Director of NCRH. “We actively
look at patients who have multiple injuries and
require multiple avenues of care to recover. The
24
Lydia’s STYLE Magazine
goal, which is accomplished as a team, is to
medically optimize them, make them stronger,
and enable them to do more for themselves. We
call that maximizing independence. We train
them safely how to use devices like walkers,
power wheelchairs, and even train the family to
take care of their loved one in the home environment.”
NCRH was recently rated in the 10 percent
of inpatient rehabilitation facilities in the United
States. “This hospital is the only freestanding
rehabilitation hospital north of Denver and into
Wyoming,” adds Joseph Jacob, M.D., NCRH’s
Medical Director. “We provide physical rehabilitation for individuals with arthroscopic, neurologic, or musculoskeletal disease or trauma. In
this hospital, we can admit patients over the age
of 14 from a variety of settings.”
For patients who are very sick, have a great
preponderance of medical issues, and require
constant monitoring, NCLTAH might be a more
appropriate choice. “If a patient is too sick to
actively participate in rehabilitation, the NCLTAH
would be an option,” says Daniel Asadi, D.O.,
NCLTAH’s Medical Director. “At our facility, we
have pulmonologists, nephrologists, and infectious disease doctors. It is a level of care that is
more intense. All the rooms are able to have a
cardiac monitor.”
“NCLTAH is for patients who need an ICU
level of care,” adds Dr. Laney, who often consults with Dr. Asadi on an as-needed basis.
Such collaboration is one of the many positive aspects of a joint campus. “It’s just a wonderful situation because, even though we are
two separate entities, the doctors at NCRH and
NCLTAH can help each other,” explains Dr. Asadi.
“The medical and therapy related strengths of
each facility complements the other,” adds Dr.
Laney, “It makes the medical campus better able
to meet the needs of the complex patient.”
Once NCLTAH patients are more stable, it
also provides a continuity of care when they
transfer to NCRH. “A good portion of our patients go to the rehabilitation facility,” agrees Dr.
Asadi.
Once patients are released from whatever rehabilitation setting deemed appropriate and go
home or into a skilled nursing facility, the continuum of care goes on and the circle closes. Patients continue to meet, on an outpatient basis,
with specialists like Dr. Wirt and Dr. Baer, who
manage their care as long as such oversight is
necessary.
“It is a trauma system that works,” says Dr.
Wirt, who thinks more communities need to
adopt a similar model. “Nationally we need to
have highly efficient, good trauma centers that
work with trauma patients. If we don’t promote
(our success) other systems will never evolve to
where they need to be.” And in the end it will
be the patients and their communities who are
short-changed.
For Carols Toca, the outcome is a happy one.
This month, Dr. Wirt removed the hardware in
Carlos’ neck. Besides some limitations in his
hands, he is almost back to normal and, with a
few restrictions, Carlos is able to participate in
most activities with other teens his age. +
the five levels of trauma care: What they mean
There are five levels of trauma care a hospital
or other facility can choose to provide, according to Lori McDonald, Poudre Valley Health
System’s Trauma Program Director. They are as
follows:
Level V - Indicates a minimum level of care and is
generally assigned to ski clinics.
Level IV - Indicates a small community hospital
where physicians are available, but general surgeons
may not be available 24/7. In a trauma situation, their
role is to stabilize the patient and get him or her ready
for transfer to a trauma center.
Level III - Indicates the hospital has a trauma center.
In addition to the anesthesiologists, there are general,
trauma, and orthopedic surgeons at the ready. Other
sub-specialists, like neurosurgeons and facial-trauma
surgical specialists, may not be available. Poudre Valley Hospital is a Level III trauma center.
Level II & Level I - Indicates a hospital that offers
what is considered upper-level care. This hospital can
take care of the full spectrum of clinical needs. Subspecialists are on-call, ready to respond as needed.
The only difference between a Level II and a Level I is
that Level I is affiliated with post-graduate Residency
programs and has a trauma research program. Medical Center of the Rockies is a Level II trauma center.
Lynn M. Dean is a Colorado writer and mother
of three. She has written more than 500 articles
which have appeared in over 100 different publications in 35 states.
Northern Colorado Medical & Wellness 2009
25
regional care
Medical Clinic at Centerra, P.C.
“It is a one-stop
shop for world-class
medical treatment.
These are the
only true medical
office buildings on
the campus of a
hospital facility in
this region. Patients
don’t have to run all
over town for tests
or specialists, it’s all
right here and they
appreciate that.”
Ron Kuehl,
McWhinney Vice President
of Real Estate.
Steven Dubs, M.D., surgeon with Greeley Medical Clinic,
P.C.
Comfort, Convenience at the
New Medical Clinic at Centerra
BY Julie Estlick
When Steven Dubs, M.D., is called to perform an emergency appendectomy on a day when he is seeing patients in
the office, it’s no sweat. Dubs, a general surgeon with the Greeley Medical Clinic, P.C., (GMC) practices next door to
Medical Center of the Rockies in the new Medical Clinic at Centerra.
C
onvenience for doctors and patients
was the key factor in construction
of the Centerra North and South
medical office buildings adjacent to
the Medical Center of the Rockies
(MCR) in Loveland. Both buildings have covered
walkways directly into the hospital and were developed by Loveland-based McWhinney.
With the opening of the North building earlier this year, patients are now able to have labs
or X-rays done minutes before seeing their family
physician and meet with any number of specialists at GMC’s Medical Clinic at Centerra, P.C. The
South building opened with MCR in 2007 and includes Heart Center of the Rockies, a pharmacy,
and durable medical goods store, among others.
“It’s a one-stop shop for world-class medi-
26
cal treatment,” says Ron Kuehl, McWhinney
Vice President of Real Estate. “It’s very common
throughout the country to have on-campus medical offices, but unique to Northern Colorado.
These are the only true medical office buildings
on the campus of a hospital facility in this region.
Patients don’t have to run all over town for tests
or specialists, it’s all right here and they appreciate that.”
The MCR campus master plan included two
medical office buildings flanking the hospital as
part of the 91-acre campus. Although no one expected the North building to go up so quickly,
Greeley Medical Clinic was eager to move its
doctors and services closer to MCR, Kuehl says.
The Colorado Contemporary style of both
buildings blends well with the look of MCR. Na-
tive buff sandstone quarried in Masonville was
used on the exterior and continued in the interior common lobbies for a mountain feel. Brick
and Centria, a sleek pre-finished metal panel system with concealed fasteners, were selected for
the exterior to reflect the stature of the providers
and level of care offered within, says Tim Stern,
Project Manager for Delta Construction, Inc.,
who served as general contractor for the project.
The little details like a covered patient dropoff area and clear signage take into account the
patient experience as soon as you exit Interstate-25 and drive into the lot. Stepping inside
the North building, patients are greeted by a
warm, inviting color palette of muted tones and
cheerful geometric rugs. Paintings by local Front
Range artists dot the walls and modern yet com-
Lydia’s STYLE Magazine
fortable couches and chairs in the waiting areas
create a sense of calm worlds away from the
cold, clinical feel of most doctors’ offices.
The Medical Clinic houses 27 physicians
with specialties in family practice, internal medicine, gastroenterology, oncology, rheumatology,
dermatology, and general surgeons. Blood and
imaging labs that include ultrasound, X-ray, CT
scans, and MRI bays are located on the first
floor. The imaging department has comfortable
changing rooms, each with its own small waiting
area for privacy.
Upstairs are minor surgical procedure rooms
and infusion suites for cancer and arthritis patients with panoramic mountain views. Additional services are provided by Hanger Prosthetics
and Orthotics, the Urology Center of the Rockies, and Caring Hearts Home Health Care, who
all lease space from GMC.
The layout is open rather than separate,
walled-off offices filling the space. Everyone checks in at a central desk and finds their
“storefront” within the long waiting room that
is closest to their doctor’s door. The storefronts
are divided by hanging glass panels stenciled
with trees that were created so everyone is not
bunched into one place. Phone calls and scheduling actually happen in the back of the building
for both confidentiality and to keep the waiting
area as calm and quiet as possible.
“It feels like a good, soothing environment
when you come here – truly a place to get better,” says Donna Lankford, Director of Operations for Greeley Medical Clinic. “We designed
this building for medical purposes and we’ve had
rave reviews. Many of our patients say they prefer to come here rather than other physician’s
offices because there’s generally no wait and it’s
not as chaotic.”
GMC has an ownership share in the North
building and also has sites near the North Colorado Medical Center in Greeley and Loveland’s
McKee Medical Center.
The Medical Clinic doctors have “work patterns” which are small offices 5 ½ feet by 6 ½
feet set behind a nurse’s station of the same dimensions. A door separates them for doctor-patient confidentiality during phone calls. The offices are shared with no one owning a particular
area, allowing for maximum flexibility and use.
“The physicians indicated the work pattern
allows them to hand their nurses something
rather than calling them or walking down the
hall,” Lankford says. “Physicians can see patients
more quickly and on time. There is more effective communication with nurses and assistants. If
a physician is not working, another one can hold
clinic utilizing the same work space.”
Stern, a veteran of medical office building construction, was certainly impressed with
GMC’s design concepts. “The Medical Clinic
at Centerra space is really innovative. It’s the
first time I’ve seen an office combine the doctors’ and nurses’ spaces in one little room,” says
Stern. “It was also unusual to combine a bunch
of different specialties in one space on each floor
rather than their own distinct offices.”
Denise Swingle, RN, and owner of Caring
Hearts Home Health Care, was thrilled when
GMC invited her agency to expand to the North
Northern Colorado Medical & Wellness 2009
The North Medical Office building opened in early 2009 and is home to the Medical Clinic at Centerra and
Caring Hearts Home Health Care.
The South Medical Office building houses Heart Center of the Rockies and was completed in 2007.
27
building.
“Servicing the aging population is very important to us and this location is ideal,” Swingle
said. “We can talk directly to the physicians,
make eye contact, and discuss a patient’s problems. Then we speak to a patient before they are
discharged about the care they need at home.
Elderly folks feel more comfortable if they get to
meet us beforehand.”
Caring Hearts Home Health Care, ranked in
the top 100 of Home Health Care agencies in the
country, is working to raise awareness among
doctors and the public about the range of services available for at-home care. Their office at
the Medical Clinic is like an endorsement from a
doctor and a platform to educate patients, medical assistants, and physicians about medical care
in the home, Swingle added.
If business in the South building is any indication, patients are certainly benefiting from
the cost savings and convenience of having their
health care needs taken care of in one location.
As the region’s premier cardiac care center, many
patients travel hundreds of miles to be treated at
Heart Center of the Rockies.
The Heart Center shares special diagnostic
equipment for heart patients with the hospital
and pulmonologists and cardiac rehabilitation
specialists in the South building. The machines
are housed in a first floor hospital room that adjoins the Heart Center’s offices for easy access.
“We didn’t want to waste space or resources,” says Dr. Gary Luckasen, President of
Gary Luckasen, M.D., President of the Heart Center of the Rockies
Christopher Bee, MD
Joseph Chaffin, MD
Wentzell Hamner, MD
LOCALLY OWNED AND OPERATED,
we serve the communities of Loveland,
Greeley, and Ft. Collins and provide services
to physicians and medical facilities in
communities across Colorado and Wyoming.
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28
James Christian, MD
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Center of the Rockies in Loveland.
Lydia’s STYLE Magazine
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McWinney’s Ron Kuehl, Vice President of Real Estate, and Dean Barber, Vice President of Development for the Medical Group
the Heart Center of the Rockies. “This saves on
costs and staff can flex between inpatient and
outpatient services. It is great to have everything
right here.”
Those patients undergoing cardiac rehabilitation are clearly safer because specialists are
right on site if they should collapse on the treadmill or anything goes wrong, Luckasen adds. “It’s
also convenient if a patient gets a test done and
has abnormal results, we can put them in the
hospital right away.”
Heart Center doctors share work pods when
they are in the office and have access to studies
in the hospital as well as electronic records and
testing results, a common move among hospitals
and physicians to use less paper files to ensure
accuracy and cut down on errors.
The casual observer may not notice, but
several green design features were included in
the North and South buildings to save energy
and electricity, says Dean Barber, McWhinney
Vice President of Development for the Medical
Group. A special building management system
controls the HVAC unit and electrical can be
fine-tuned for efficiency so lights shut off when
rooms are unoccupied, motors can be phased up
or down, and adjustments made to let in more
fresh air.
The silver sunscreens above the windows are
adjusted in the winter months to provide passive
solar heat for the building and deflect heat in the
scorching summertime, Barber notes. A tan reflective roof was installed so heat is not absorbed
into the building, and a whopping 75 percent
of what left the site during construction – like
cardboard, wood, and concrete – was reused or
recycled and kept out of the landfill.
The building is a success on many fronts, but
efficiency in patient care stands at the forefront.
“I’ve been developing medical buildings for over
15 years and you really see an improvement in
the quality and efficiency of the patient care system when physicians, imaging, outpatient, and
specialty physicians are represented in one location rather than in 40 clinics spread out all over
the place,” Barber says. “It helps the patient and
it’s a better solution than stand-alone medical offices, in my opinion.” +
Julie Estlick is a freelance writer and editor living
in Fort Collins with her husband and young son.
30
Lydia’s STYLE Magazine
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Northern Colorado Medical & Wellness 2009
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31
learning disorders
new facility
Brain
Integration
in greeley
“Any loss of integrated
brain function results
in the loss of a specific
mental capacity and
can result in learning
disabilities.”
Charles T. Krebs, Ph.D.,
co-author of A Revolutionary
Way Of Thinking
Brain Integration for
learning disabilities
By kay rios
photos by warren diggles
“Since the brain is unlike any other structure in the known universe, it seems reasonable to expect that our
understanding of its functioning - if it can ever be achieved – will require approaches that are drastically different
from the way we understand other physical systems.” – Richard M. Restak, The Brain, The Last Frontier, 1979
T
o meet Charles T. Krebs, Ph.D., is to
know you have met a brain science
virtuoso. He has a unique gift for explaining complex brain functions, how
learning disorders occur, and cuttingedge treatment strategies in a vernacular that
regularly surprises lay people with how much they
are able to learn from him. It is a gift Dr. Krebs has
honed in 25 years as a teacher, research scientist,
clinician, and inventor of acclaimed treatment techniques. So it is not entirely surprising it was standing
room only when Dr. Krebs recently held a lecture at
32
Fort Collins’ Bas Bleu Theater.
“Brain integration,” he explains, “involves
maintaining precise synchrony and timing of all
brain functions to effectively process information
and make timely decisions.” That is the basis for
the Learning Enhancement Acupressure Program
(LEAP), which Dr. Krebs co-created with Susan
McCrossin, a health practitioner in Boulder. LEAP,
which Dr. Krebs has taught in ten countries around
the world, is aimed at correcting learning problems
such as attention deficit disorder (ADD), attention
deficit/hyperactivity disorder (ADHD), and dyslexia.
The LEAP model involves an understanding of
the latest scientific discoveries of how the brain
functions. Popular models divide the brain into left
and right brain, a concept that has been around
since the 1960s when American psychobiologist
Roger W. Sperry discovered the human brain has
two very different ways of thinking. The right brain,
he determined, is visual and processes information
in an intuitive and simultaneous way, looking first
at the whole picture then at the details. The left
brain is verbal, processing information in an analytical and sequential way. This side first looks at the
Lydia’s STYLE Magazine
pieces and then puts them together to create the
whole picture. Recent findings have shown that
things aren’t quite that simple and the brain is not
as split as the explanation would have it.
Research has proven the human “bio-computer” is more complex than initially thought.
Although specific areas of each hemisphere are
responsible for initiating individual brain activities,
such as math or reading, the reality is multiple areas
of both hemispheres must be able to freely share
information throughout the brain. That, says Dr.
Krebs, is the definition of an integrated brain.
This explains, according to Dr. Krebs, why many
people have learning and behavior disorders. “Any
loss of integrated brain function results in the loss
of a specific mental capacity and can result in learning disabilities.” He likens it to how a car’s spark
plugs will misfire or sputter if the electrical timing
is off. Similarly, if brain processing is not properly
synchronized and free flowing, its ability to take in,
process, and carry out critical information is compromised.
Symptoms of learning difficulties include inability to concentrate, demonstrated hyperactivity, poor impulse control, limited understanding of
cause and effect, displays of inappropriate social
behaviors, problems with reading and reading comprehension, with abstraction and math, and with
short term memory. Behavior problems also appear
when the brain is not integrated. “Children who
are integrated control their behavior,” Dr. Krebs
says.
Stress is a large contributor to the loss of brain
integration, Dr. Krebs maintains. “Brain integration
is a continuum.” He describes a spectrum running
from “distressed” and zero percent integration at
one end, where learning and mental tasks are difficult. The other end, at 100 percent integration, Dr.
Krebs designates as “in the zone.”
When people become stressed, loss of brain
integration can be indicated by Dr. Krebs’ long list
of symptoms: a sense of being overwhelmed, inappropriate anger, inability to focus, muddled thinking, feeling fearful, difficulty sleeping, difficulty or
inability to listen to or understand what you are
told, Freudian slips or inappropriate social responses, extreme fatigue, and the inability to make decisions. “These symptoms let you know you have lost
brain integration,” Dr. Krebs says.
Dr. Krebs’ Story
Dr. Krebs knows firsthand what it is not to function well. His personal history took him through a
time when there was no integration of brain or
body. Dr. Krebs completed his Ph.D. at the Marine
Biological Laboratory in Massachusetts and ended
up in Australia in the 1980s. He was 35, physically
fit, and the picture of health. He ran daily, played
volleyball and basketball, was a strong downhill skier, and practiced karate two to three times a week.
An invitation to spend a week diving off a national
park called Wilson’s Promontory seemed perfect.
Dr. Krebs, a professional diver, and his friends
began working to build up to a dive searching for
the wreck of an old ship about 60 meters deep,
the limit for scuba divers using compressed air. He
had been that deep on several dives before, but this
time something happened. He became anxious on
the dive and, back on the boat, he began to lose
control of his motor coordination. He realized he
Northern Colorado Medical & Wellness 2009
Dr. Ann Pendley shows a patient how the brain processes information.
Maximizing Communication
A Multi-Pronged Approach
W
ith the goal of maximizing communication, the Speech and Language
Stimulation Center, Inc., offers a variety of services. “We focus on pretty
much everything in the communication field,” says
Ann Pendley, Ph.D., and owner/director. It is a large
menu for a small operation, but “one that works
well.”
The Center helps patients who may have difficulty with articulation, voice-vocal fold problems
(literacy), pediatric feeding and swallowing, cleft palate, cognitive-language difficulties, brain injury, autism, stuttering, and more. In July 2009, they will begin seeing stroke patients and accepting Medicare.
“It’s pretty eclectic. There are four therapists and
we each bring our own brand of training and, by
cross training, we’ve created a system that comes
together.”
One common influence is the Lindamood approach. “Most of us came from her perspective in
literacy and we base our process on that.” She refers
to the Lindamood Phoneme Sequencing (LiPS®) Program, which stimulates phonemic awareness: making individuals aware of mouth actions that produce
speech sounds. The awareness becomes the means
for verifying sounds within words, enabling individuals to become self-correcting in reading, spelling, and
speech. The technique is catered to the client’s needs
with Pendley’s unique approaches incorporated.
“We determine the learning style of our client
and then incorporate the parts of their brain that
they may not have used before. For example, when
you first look at the print on a piece of paper, the
information goes to the occipital lobe (back of the
brain), where you see the letters. Then it goes to the
temporal lobe, where you interpret language. Then,
if you read out loud, you bring it up front to the parietal lobe. The frontal lobe helps you monitor yourself, make corrections, and get the bigger picture.
That is also part of the right hemisphere of the brain.
So while most functions may happen on the left side
of the brain, you also need the right side to grasp the
bigger picture of what’s occurring.”
There are many methods of incorporating other
areas of the brain. “The motor component is not
By kay rios | photos by warren diggles
typically used in reading. But, by crossing your legs
at the ankle or sitting on an exercise ball, or even
walking when you read, you might stimulate something that will help with learning. When we work
with sensory-based colleagues, occupational therapists for example, they might suggest using exercise
before a particular client sits down to read or write or
concentrate on something. We take those suggestions and we integrate them into what we need to
do and that’s the nice tie in between the disciplines.”
It is within this area that brain integration might
be useful, says Pendley. “If I’m working with a client and something just isn’t clicking – maybe they’re
very distracted or frustrated or there’s a whole history we don’t know about – we may not be able
to get through to the patient. That’s where I see
something like Dr. Charles Krebs’ idea of opening
pathways might work. It might be appropriate for
some people to take a break from what we do, work
with someone who does brain integration, and then
come back. They may then be in a better place to
add on this next layer.”
Pendley says there is, of course, a full spectrum
of approaches in the speech and language field as
in any health-related area. “When you go to one
end of the spectrum, it’s all evidence-based, and
then at the other end of the spectrum are those
non-scientifically demonstrated techniques. I put us
in the middle. We like to base our work on what
has been shown to be good and then we integrate
some things that are a little less traditional. We need
to be flexible and let it depend on the needs of the
individual clients. If they need more evidence-based
therapies, we can do that. If they come from a more
non-traditional, holistic approach, we also try to incorporate that as much as we can.”
It’s all about outcome, she says. “The point is to
get them to learn to their full potential and it may
take several different styles to do that.”
For additional information on the Speech and
Language Stimulation Center, check their Website at
www.speech-language-voice.com
Kay Rios, Ph.D., is a freelance writer based in Fort Collins.
33
Certified brain integration technique professional and founder of Open Pathways to Learning, Nancy Evans works on reading skills with a child at her office.
Evans has been invited to join Dr. Krebs in incorporating and leading his USA brain integration
certification program.
34
was experiencing type two bends. One after another, portions of his body became paralyzed. After
ten days of treatment in a decompression chamber
he made some progress, but doctors thought he
would never walk again since the nerves in his legs
had been badly damaged.
A month after his accident, he began to
work out for seven hours a day, trying to build up
strength and muscle tone. He made slow progress,
finally moving from a wheelchair to a walker. He
had to practice balancing and had to remember
how to walk. By the sixth month of rehabilitation,
Dr. Krebs had moved to two walking canes. However, even getting dressed was a major effort and he
had to catheterize himself four and five times a day.
Despite this, he returned to work at the Victorian
Marine Science Laboratory where he transferred to
a desk job.
He soon realized something was wrong with
the way his brain functioned. Work became increasingly difficult and he was required to have a
neuropsychological assessment. The test showed
that as well as spinal damage, he had suffered brain
damage. He spent the next few years searching for
a means to heal himself, to make progress back
into a body and brain in which he felt comfortable.
Through a series of events, he came in contact with
a kinesiologist. What he heard made sense and he
became convinced about the effectiveness of kinesiology. After two hours of acupressure and applied
physiology techniques, 80 percent of the chronic
back pain he had been suffering for several years
was eliminated and he experienced dramatic improvement.
As he continued to work with the kinesiologist, he began to believe his muscles didn’t work
Lydia’s STYLE Magazine
I
ADD/ADHD • Dyslexia • Reading Problems • Math Difficulties • Poor Handwriting
Attention & Focusing Issues • Extreme Anger • Depression • Poor Self-Esteem
Memory Problems • Hyperactivity • Muddled Thinking • Poor Social Skills
Traumatic Brain Injury • Mood Swings • Eye Strain • Test & Stress Anxiety
Brain Integrati on Treatment can successfully resolve these and many other
symptoms of improper neuro- pathway functi oning.
Non-invasively and without drugs, this gentle therapeutic process restores the
brain 's ability to successfully process and integrate inform ati on.
Call today or visit our website to discover why Brain Integrati on Treatment is
popul ar in many count ries around the world.
FREE PHONE CONSULTATIONS AVAILABLE
OPEN PATHWAYS TO LEARNING uc
LEARNING &: BRAIN DISORDERS SOLUTIONS
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Northern Colorado Medical & Wellness 2009
35
Dr. Krebs (center) pictured with Robert Evans and
Nancy Evans of Open Pathways to Learning, LLC.
because a “circuit breaker” had switched off in his
nervous system. Those observations led to more
work and more investigation into the reaction of his
neurons in response to the stress of hypoxia. They
didn’t die, says Dr. Krebs, but went on standby until the energetic system could be reactivated. After
more work, he was able to regain full brain function
and, though he still walks with difficulty, he is far
from incapacitated.
Open Pathways to Learning
That experience brought him to the concepts
he incorporated into the LEAP approach. In the
LEAP model, clients are assessed using two tools.
The first is a means of accessing memory of past
experience, traumas, or stress. “You can actually activate much of the same neurology that was
activated by the original experience. For example,
when you remember an argument, you often become angry again.”
The second tool is direct muscle biofeedback
with muscle monitoring or muscle testing. “Most of
the muscle function is subconscious and it provides
reliable subconscious feedback that can be consciously observed and felt,” he says. “Using muscle
monitoring, we can assess brain integration and its
functional consequences.”
Once the assessment is done, acupressure techniques can be applied to re-synchronize brain functions, defuse the stressful emotional issues causing
the dysfunction, and reopen neuro-pathways so
learning can occur and mental tasks can be more
easily performed, he says.
Nancy Evans is one success story. Her daughter was diagnosed with ADHD. After trying medication, doctor visits, support therapy, and tutors,
she came across brain integration treatment. Since
treatment, according to Evans, her daughter is no
longer on medication and has developed into a
talented writer, where previously she had difficulty
writing a single paragraph. A registered nurse, Evans became so convinced of the potential of brain
integration, she became certified as a brain integration technique professional and, with her husband
Robert, co-founded Open Pathways to Learning in
Fort Collins.
Christie Hoffer’s family is reflective of the kind
of parent who seeks out Evans’ help. When Hoffer’s
son was just five years old, he was diagnosed with
ADHD and experienced trouble staying focused and
being able to “just go with the flow” while in the
classroom. A friend of Hoffer’s, whose son was also
diagnosed with ADHD and had found help at Open
Pathways, invited her to attend one of Dr. Krebs’
36
Lydia’s STYLE Magazine
lectures. Hoffer was intrigued by what she learned
and immediately had Open Pathways evaluate her
son.
“What convinced me to try Open Pathways
more than anything was Nancy’s honesty. She said,
‘I don’t know if I can help your son, but I can try.’
We decided to do three to four sessions to see.”
Two sessions later, Hoffer and her husband saw a
dramatic change in their son. “Especially with his
reading. He went from reading at a normal kindergarten level to reading complete sentences.” A year
later, she reports, “This has been life-changing. He
has calmed down, has more focus, more interests,
and is more able to just go with the flow, a 180-degree change.”
His teachers have since recommended him
for gifted and talented programs and Hoffer says
she cannot thank Open Pathways enough. “This
has been a bigger help than just medication and
it is permanent,” she says. “The biggest thing I tell
people [who ask about Open Pathways] is to be
open-minded. We tend to have a fear of Eastern
medicine, thinking it is mumbo jumbo. This is much
more than that.”
The Future of Brain Integration
Therapy
Dr. Krebs recently invited Nancy and Robert
Evans to join him in incorporating and leading his
USA brain integration certification program. “We
were honored that Dr. Krebs invited us to join
with him,” says Evans. She will take on the role
of Admissions Coordinator and Robert as Business
Director. “He has been impressed with our practice
and leadership in creating the Learning Solutions
Network of Northern Colorado. The good news for
Northern Colorado is that we’re now positioned to
become the national hub of brain integration. National and international learning disorder experts
and teachers will be heading our way and families
and health professionals in our area will definitely
benefit!”
Dr. Krebs says his plans for the future involve
getting his work to people in the mainstream. He
does, however, caution that this is not a fix-all. “If
it is organic damage, like extreme autism, this may
not be able to correct it. Brain integration is like a
software fix, but it can’t fix a hardware program.”
He also says it is not a stand-alone approach.
“I’ve worked with speech pathologists and other
health professionals for years. My technique prepares people for learning and for functioning. After their brain is integrated and they’re not working
with faulty pathways, then other professionals can
work with them more effectively.”
Scientific research of why and how brain integration achieves its results hinges on future
funding. Currently, complementary and alternative medicine modalities are largely overlooked in
research. However, Dr. Krebs has succeeded in attracting the attention of learning disorder medical
specialists in several areas of the world. A recent
Haifa University control group study of learning
disabled children in Israel produced impressive data
on the success of brain integration. The study can
be reviewed on Open Pathways’ Website, www.
openpathways.org. +
Kay Rios, Ph.D., is a freelance writer based in Fort
Collins.
Northern Colorado Medical & Wellness 2009
Mike Winchell, co-owner of LearningRx Fort Collins, working with a student.
New Approaches to
Treat Learning Disabilities
A
brain that performs slowly and inefficiently can be the underlying cause of
learning disabilities. But that can often
be remedied, say Mike Winchell and
Don Cassidy, co-owners and co-directors of the
LearningRx Fort Collins brain training center.
“It is widely assumed you are born with a fixed
amount of intelligence you carry with you the rest
of your life,” Winchell says. “However, the things
we do every day modify and improve the factors
that make up IQ: how fast you think; your processing speed; how well your memory works, including
short and long term memory; your attention skills,
including the ability to focus for sustained periods
and block out distractions; the ability to multitask;
auditory processing, including key reading skills; visual processing; and logic and reasoning, which are
important for math and arithmetic.”
Cassidy equates LearningRx techniques to the
approach a physical trainer might use, pushing
the client to go faster and become stronger. “We
don’t accommodate weaknesses; we fix them and
turn them into strengths. For example, we have a
student who was diagnosed with ADD and learning disabilities. His mother used to have to sit at
the table with him to get homework done. After
brain training, she now enjoys an hour and a half
of ‘me’ time while he completes homework on his
own without distraction. Where accommodation
of his weaknesses and modification of his learning
environment were previously necessary, we have
turned his attention weakness into a strength.”
LearningRx students work five days a week at
the center and their skills translate into academic
achievement and life skills, Winchell says. “Brain
training is synergistic with what schools do; we
work on strengthening cognitive skills and they
work on teaching academic content. It makes a
great partnership.”
“The LearningRx approach takes the struggle
out of learning,” Winchell continues. “We work at
a more fundamental level than schools and tutoring to fix the underlying problems. Most people
don’t realize you can change basic cognitive skills,
By kay rios
photos by warren diggles
so when others talk about ‘underlying problems’
they don’t know what that truly means. Study
skills, for example, are a second level skill, not an
underlying problem.”
Discussion around gains differs as well. “When
we talk about years of gain, we talk about cognitive gain and the ability to think faster and remember better. When others talk about years of gain,
it’s typically about current academic gain and not if
the brain can function better or if there is the ability
to retain content after the test.”
The results of the LearningRx approach register cognitive gains, he adds. “We get between
two and six years of gain per cognitive skill. For
instance, if a 13-year-old is processing at the speed
of an 11-year-old when she starts the program, six
months later we can have her processing at the
level of a 15-year-old. We have a recent student
who gained even more than that.”
The training is not for everyone, Winchell admits. “We have turned people away, but,” he clarifies, “almost everyone can benefit from cognitive
skill training no matter their age. For seniors it can
mean getting their youthful feeling back with improved processing speed and better memory. For
working adults is can mean faster, better work and
more billable hours or more time with their family. For the unemployed it can mean a hiring edge.
And for the struggling student it means faster
homework and easier A’s.”
Winchell says LearningRx has improved the
brains of over 20,000 students of all ages in its 57
centers across the country. “These techniques were
developed over the last 30 years using the most
advanced brain research. For families who struggle,
this program can be an incredible gift. At the end
of the day, the most important thing is how we
have changed the lives of the families we touch.
That is why we brought this program to Northern
Colorado.”
Kay Rios, Ph.D., is a freelance writer based in Fort
Collins.
37
awareness
Chronic Kidney Disease
“Now there are
specific levels of
disease and also
a corresponding
action. In the first
two stages, we focus
on diagnosing the
cause and limiting its
progression. When it
gets to stage three,
we look at treating
complications.”
Jason Merritt, M.D.,
The Nephrology Clinic, P.C.
Chronic Kidney Disease
on the rise
By kay rios
Photos by warren diggles
More than 20 million Americans have chronic kidney disease (CKD) and 20 million more are at increased risk for
developing it, according to National Institutes of Health (NIH) estimates. Many of those people are not aware of the
risk. “Kidney disease is often asymptomatic until the organs are functioning at less than 30 percent,” says Jason
Merritt, M.D., at The Nephrology Clinic, P.C., in Fort Collins. “That’s why it can develop into a chronic disease before it’s
diagnosed and treated.”
K
idney disease, or the increased risk
of CKD, is not something to ignore,
says Dr. Merritt, since kidneys are
vital to good health. The kidneys
are hard working organs. They
balance body fluids, filtering excesses out of the
blood through urination. They regulate body water and minerals in the blood such as sodium, potassium, phosphorus, and calcium. They remove
waste products from the blood, help expel drugs
and toxins from the body, release hormones that
control blood pressure, make red blood cells, and
keep bones healthy.
The two most common causes of CKD are
38
diabetes and high blood pressure, and CKD is a
condition that increases the chance of premature
death. “People with CKD are more likely to develop heart disease,” Dr. Merritt says, “and this
is the number one cause of death among kidney
patients.”
The good news is that early detection and
treatment can keep kidney disease from worsening and can prevent life-threatening complications such as kidney failure and heart disease.
But, because symptoms may not show up until
late in the game, CKD often goes undiagnosed.
In the past, early diagnosis was inhibited by the
lack of a universal definition and classification sys-
tem for the stages of CKD. In 2002, the National
Kidney Foundation created definitions and guidelines that would help doctors make appropriate
diagnosis in its Kidney Disease Outcomes Quality
Initiative (KDOQI).
“Before the National Kidney Foundation
came out with its guidelines and stages of CKD, it
was just classified as renal insufficiency,” Dr. Merritt says. “Now there are specific levels of disease
and also a corresponding action. For example, in
the first two stages, we focus on diagnosing the
cause and limiting its progression. When it gets to
stage three, or less than 60% of normal function,
we look at treating the complications.”
Lydia’s STYLE Magazine
Early diagnosis is essential, he says. “The
sooner diagnosis is made, the less likely it will
progress to the need for dialysis.”
While most people don’t experience severe
symptoms until kidney disease is in the last stages,
there are some symptoms that might cause concern. Those include feeling more tired than usual,
having trouble concentrating or thinking clearly,
or poor appetite. Other indicators can be nighttime muscle cramps, swollen feet and legs, or a
foamy quality to the urine.
Even without symptoms, it is wise to get a
check-up. “Get your annual physical and blood
work,” Dr. Merritt says. “That will typically include
a creatinine level, which is a marker of kidney
function.”
Creatinine is a waste product created through
muscle activity and then eliminated through urination. The results of the blood creatinine test are
used to estimate the glomerular filtration rate, or
GFR, which indicates the level of kidney function.
A low GFR may mean that the kidneys are not
working as well as they should to remove wastes.
Analysis of the urine can also detect whether protein in being excreted, which if present can indicate compromised kidney function.
Using the GFR as a standard, the National Kidney Foundation established five stages of chronic
kidney disease. In stage one, there is some kidney
damage (for example, protein in the urine) but
GFR is normal (more than 90 mL/min). Stage two
indicates kidney damage with a mild decrease in
GFR (60 to 89). Stage three reflects a moderate
decrease in GFR (30 to 59). Stage four indicates a
severe decrease in GFR (15 to 29) and stage five
is considered kidney failure when dialysis or a kidney transplant is needed.
There is more to the interpretation of GFR results than just the number, however. “The problem is that the lab has to account for everyone
from a 25-year-old male bodybuilder to a 95-yearold female with no muscle mass. So the range of
creatinine values is large,” Dr. Merritt says. “Creatinine has to be interpreted based on age and
muscle mass. In other words, the interpretation
has to be individualized.”
That’s what nephrologists do, he explains.
That and education. “We do our best to educate
other physicians as to what chronic kidney disease
is and when patients should be referred to a nephrologist.”
Patients also have to be educated. “Initially, a
lot of patients do not see their diabetes and hypertension as systemic diseases capable of damaging other organs, such as the kidneys. However, after being diagnosed with chronic kidney
disease, these patients tend to pay more attention
to their blood sugar and blood pressure. Their primary care doctor may have already told them that
poor blood sugar or blood pressure control could
result in kidney damage. But until they hear the
CKD diagnosis, they are often not as vigilant or
compliant as they need to be.”
Diagnosis is half the battle. Action is the other
half. “You can slow the progression of chronic
kidney disease,” Dr. Merritt says. “This can be
done through tighter blood sugar and blood pressure control, use of specific medications to decrease the protein in the urine, and avoidance of
a few over-the-counter medications which can be
harmful to the kidneys.”
Northern Colorado Medical & Wellness 2009
39
The National Kidney Foundation lists several
ways to lower the chances of developing kidney disease. First, patients must carefully follow
prescribed treatments to control diabetes and/or
high blood pressure. Losing excess weight with a
healthy diet and regular exercise program is also a
must. Smoking is a major contributor. So, if you’re
a smoker, stop. Other ways to lower chances include avoiding use of large amounts of over-thecounter pain relievers and limiting the intake of
alcohol.
Even with a diagnosis of CKD, early detection
and treatment can often stop or slow the progression of the disease. Treatment depends on the
stage of CKD and other concurrent health problems, but some common efforts that doctors may
recommend include:
• Control of high blood pressure. That may
require medication such as an angiotensin
converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB). Limiting the
amount of salt in your diet also helps.
• Control of blood sugar if diabetic.
• Following a special diet that controls the
amount of protein and saturated fat consumed. Registered dietitians can help plan
meals that include appropriate quantities and
are aimed at weight control.
• Treatment of anemia with iron supplements
and erythropoietin (EPO). EPO stimulates red
blood cell production.
40
Lydia’s STYLE Magazine
Dr. Jason Merritt examines a patient. More than
20 million Americans have been diagnosed with
chronic kidney disease.
• Preventing bone disease with balanced phosphorus and calcium levels. The kidneys normally remove excess amounts of phosphorus,
but when they aren’t working well it can build
up, ultimately leading to a loss of calcium
from the bones. Doctors may recommend dietary restrictions or may prescribe medication.
• Following a doctor-recommended exercise
program.
• Taking steps to prevent heart problems, including treatment of diabetes, high blood
pressure, anemia, and high cholesterol levels.
• Smoking cessation.
How well the treatment achieves its goal depends on several things. The earlier treatment is
started, the better. Results also depend heavily on
how carefully the treatment plan is followed.
Dr. Merritt encourages anyone at risk or with
CKD to talk to his/her primary care doctor. “Primary care physicians in this area really do a good
job trying to get people more involved in their
own health care. And they can also tell you when
it’s time to see a nephrologist. The main thing is
to get educated and get active.” +
Kay Rios, Ph.D., is a freelance writer based in Fort
Collins. She writes for a variety of regional and
national publications and is currently at work on
a collection of creative non-fiction and a mystery
novel.
Northern Colorado Medical & Wellness 2009
41
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Directory
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P R A C T I C E D I R E C T O RY
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P R A C T I C E D I R E C T O RY
cardiology
Heart Center
of the Rockies
2121 East Harmony Road,
Suite 100 & 200
Fort Collins 80528
P: 970.221.1000
1.800.459.4241
Monday - Friday: 8:00 - 5:00
www.heartcenteroftherockies.com
A cross-section of the
finest healthcare providers in
Nor thern Colorado.
dentistry
Overton Center for
Dental Arts, P.C.
1220 Oak Park Drive
Fort Collins 80525
P: 970. 223.6677
Monday - Thursday: 7:00 - 5:00
www.overtoncenter.com
other Locations:
2500 Rocky Mountain Ave.,
Suite 100
Loveland, CO 80538
P: 970.624.1800
Estes Park Medical Center
555 Prospect Avenue
Estes Park 80517
P: 970.577.4478
Heart Center of the Rockies, in partnership with Poudre Valley Health System,
has 18 cardiologists, two cardiovascular
surgeons, and over 180 clinical support
specialists. They are considered a leader
in all medical matters of the heart.
Hematology/Oncology
In practice for 15 years, Dr. Tom
Overton is a general dentist with
a special focus on cosmetic and
neuro-muscular dentistry. He creates beautiful smiles by utilizing
his artistic talent and staying on
the cutting-edge of technology.
Cancer Center
of the Rockies
2121 E. Harmony Road, Suite 150
Fort Collins 80528
P: 970.493.6337 | F: 970.493.3528
Monday - Friday: 10:00 - 6:00
Saturday: 9:00 - 12:00
www.cancerhealth.com
Cancer Center of the Rockies is an independent group of physicians and professionals devoted to the diagnosis, care,
and treatment of patients with malignancies (oncology) and blood disorders (hematology).
other Locations:
2500 Rocky Mountain Avenue
Suite 350
Loveland 80538
P: 970.493.6337
F: 970.493.3528
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P RA C T I C E D I RE C T ORY
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P RA C T I C E D I RE C T ORY
Multi-Specialty
other Locations:
Medical Clinic
at Centerra, P.C.
2500 Rocky Mountain Avenue
North Medical Office Building
Loveland 80538
P: 970.203.7000
Monday - Friday: 8:00 - 5:00
www.greeleymedclinic.com
www.medicalclinicatcenterra.com
Greeley Medical Clinic, P.C.
1900 16th Street
Greeley 80631
P: 970.353.1551
Peakview Medical Center
5881 West 16th Street
Greeley 80634
P: 970.313.2700
Urgent Care West
2001 70th Avenue, Suite 100
Greeley 80634
P: 970.378.4155
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P RA C T I C E D I RE C T ORY
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P RA C T I C E D I RE C T ORY
Nephrology
The Nephrology
Clinic, P.C.
1600 Specht Point Rd., Suite 127
Fort Collins 80525
P: 970.493.7733 | F: 970.493.8745
Monday - Friday: 8:30 - 5:00
www.thenephrologyclinic.com
The Nephrology Clinic has been
providing the highest level of
care for patients with kidney
problems and hypertension in
Northern Colorado since 1980.
Their nephrologists have medical
staff privileges at five Northern
Colorado hospitals and can
provide hemodialysis, peritoneal
dialysis, and therapeutic plasmapheresis.
Greeley Medical Clinic has served Northern Colorado for over 75 years and is
one of the oldest continuously physicianowned multi-specialty medical practices
in Colorado.
neurology
Fort Collins
Neurology, P.C.
2121 East Harmony Road, Suite 270
Fort Collins 80528
P: 970.221.1993 | F: 970.221.9170
Monday - Thursday: 8:00 - 5:00
Friday: 8:00 - 2:00
Neurosurgery
Fort Collins Neurology’s physicians are Diplomates of the
American Board of Psychiatry
and Neurology. They specialize in
assessing and treating neurological disorders such as multiple
sclerosis, Alzheimer’s Disease,
pain management, head injury,
seizure, stroke, Parkinson’s
Disease, and more.
F O R T C O L L I N S N E U R O L O G Y, P. C .
D I P L O M AT E S , A M E R I C A N B O A R D O F P S Y C H I AT RY A N D N E U R O L O G Y
Northern Colorado Medical & Wellness 2009
Front Range Center for
Brain & Spine Surgery, P.C.
1313 Riverside Avenue
Fort Collins 80524
P: 970.493.1292 | F: 970.493.1210
Monday - Friday: 8:00 - 5:00
www.brain-spine.com
Front Range Center for Brain & Spine Surgery
is the regional expert in non-surgical and surgical treatments of spinal and intracranial pathology and treatment of problems concerning the
peripheral nerves. The addition of an orthopedic surgeon has further enhanced the scope of
spine procedures they offer.
other Locations:
2500 Rocky Mountain Avenue
Suite 360
Loveland 80538
P: 970.669.0470
2001 70th Avenue, Suite 300
Greeley, CO 80634
P: 970.356.4488
800 E. 20th Street, Suite 320
Cheyenne, WY 82001
P: 307.635.8388
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P RA C T I C E D I RE C T ORY
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P RA C T I C E D I RE C T ORY
Ophthalmology
Eye Center
of Northern Colorado, P.C.
1725 East Prospect Road
Fort Collins 80525
P: 970.221.2222 | F: 970.221.4286
Monday - Thursday: 7:00 - 6:00
Friday: 7:00 - 5:00
www.eyecenternoco.com
other Locations:
Skyline Center for Health
2555 13th Street, Suite 225
Loveland 80537
P: 970.679.0000
Windsor Medical Center
1455 West Main Street
Windsor 80550
P: 970.686.7171
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P RA C T I C E D I RE C T ORY
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P RA C T I C E D I RE C T ORY
Orthodontics
Orthodontic Associates
of Greeley, P.C.
3400 West 16th Street, Building 4-V
Greeley 80634
P: 970.356.5900 | F: 970.356.2418
Monday - Friday: 7:30 - 5:00
www.dredgren.com
Orthodontic Associates of Greeley are specialists in orthodontics
and dentofacial orthopedics for
adults and children. At their initial
visit, each patient receives a
detailed treatment consultation
with complete clinical diagnosis, written summary of their
findings, and detailed plan of
treatment.
The Eye Center of Northern Colorado has been
located in Fort Collins for over three decades.
They provide the most complete medical and
surgical eye care in the region. The Eye Center
is the only provider in Northern Colorado to offer
the most advanced LASIK technology, iLASIK.
Orthopedic
Orthopaedic Center
of the Rockies
2500 E. Prospect Road
Fort Collins 80525
P: 970.493.0112 | F: 970.493.0521
pathology
Loveland office:
2923 Ginnala Drive
Loveland 80538
P: 970.663.3975
F: 970.663.2235
Summit Pathology
(in Skyline Center for Health building)
2555 E. 13th Street, Suite 120
Loveland 80538
P: 970.353.5136 | F: 970.353.5614
Monday - Friday: 8:00 - 5:00
Call to check holiday hours.
www.orthohealth.com
Monday - Friday: 8:00 - 5:30
Orthopaedic Center of the Rockies provides expert care in orthopaedics, podiatry, and sports medicine. Their 23
physicians have board certification and/or
specialized fellowship training.
Summit Pathology is a locally physician-owned
and -operated clinical and anatomic pathology clinic with specialties that include breast
pathology, cytology, blood banking and transfusion medicine, gastrointestinal pathology,
genitourinary pathology, surgical pathology,
hematopathology, and dermatopathology.
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www.summitpathology.com
other Locations:
Cytology Laboratory
2918 West 10th Street
Greeley 80634
Summit Pathology has offices in
the Estes Park Medical Center,
McKee Medical Center, Medical
Center of the Rockies in Loveland, Northern Colorado Medical
Center in Greeley, and Poudre
Valley Hospital in Fort Collins.
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P R A C T I C E D I R E C T O RY
Pulmonary
Poudre Valley Hospital
Sleep Disorders Center
1107 South Lemay Avenue,
Suite 260
Fort Collins 80524
P: 970.495.8670
Monday - Friday: 8:00 - 5:00
www.sleepcenteroftherockies.com
Sleep Disorders Center of the Rockies is a
comprehensive sleep facility with Diplomats of
the American Board of Sleep Medicine physicians who diagnose and design treatment
plans for common sleep problems like snoring
and apnea. They have additional sleep testing
facilities in Loveland and Estes Park.
2127 East Harmony Road, Suite 130
Fort Collins 80528
P: 970.282.2900 | F: 970.282.9800
8:00 a.m. to 9:00 p.m. Sunday through Saturday for X-ray, 8:00 a.m. to 9:00 p.m. Monday
through Friday and 8:00 a.m. to 1:00 p.m. on
Saturdays for Ultrasound, CT and MRI.
P R A C T I C E D I R E C T O RY
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P R A C T I C E D I R E C T O RY
Radiology
office Locations:
Sleep Disorder
Centers of the Rockies
2121 East Harmony Road,
Suite 300
Fort Collins 80528
P: 970.663.3377 or 970.619.6105
2500 Rocky Mountain Avenue,
Suite 300
Loveland 80538
P: 970.663.3377 or 970.619.6105
Radiology
The Imaging Center
at Harmony
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Advanced Medical
Imaging Consultants, P.C.
Corporate Office:
2008 Caribou Drive
Fort Collins 80525
P: 970.484.4757 | F: 970.377.3386
other Locations:
All of Advanced Medical
Imaging Consultants’ doctors are
hospital-based and serve Western Nebraska, Northern Colorado
and Southern Wyoming.
www.AdvMedImaging.com
The AMIC team consists of over 20 board-certified, subspecialty-trained radiologists. They
use today’s most advanced technologies in the
areas of Women’s Imaging, Cardiac Imaging,
Interventional Radiology, Neuroradiology, Musculoskeletal Imaging, and Oncologic Imaging.
sports medicine
other Locations:
The Imaging Center
at Centerra
2500 Rocky Mountain Avenue,
Suite 150
Loveland 80538
P: 970.282.2900
www.the-imaging-centers.com
The Imaging Center offers convenient, easy
access to radiology services for the residents
of Northern Colorado, Southern Wyoming,
and Western Nebraska. The Imaging Centers
are staffed by board-certified radiologists and
equipped with state-of-the-art imaging technology.
Northern Colorado Medical & Wellness 2009
Colorado Spine, Pain &
Sports Medicine, P.C.
1301 Riverside Avenue, Suite 2
Fort Collins 80524
P: 970.692.5550 | F: 970.692.5561
Monday - Friday: 9:00 - 5:00
Website coming soon
Colorado Spine, Pain and Sports
Medicine provides non-surgical
treatment of low back, neck, and
other orthopaedic conditions.
They also specialize in sports
medicine, electrodiagnostic
medicine, and spine intervention
procedures under fluoroscopic
guidance by a fellowship-trained
and board-certified physician.
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vision
iLASIK
“The iLASIK procedure
is a marriage of the
accuracy of a custom
fit and the safety of
bladeless surgery.”
Gary Foster, M.D.,
Eye Center of Northern
Colorado
perfect vision with
ilasik
By Angeline Grenz
Photos by warren diggles
Our eyesight is one of our most cherished senses. A weakness in our sight can easily be improved with eyeglasses
or contact lenses, but they still hold many back from the active lifestyle they desire.
T
aking back their precious sight
through LASIK eye surgery, millions
today have been able to gain perfect
or near-perfect vision. The Eye Center
of Northern Colorado has teamed up
with Poudre Valley Health System to form the Eye
Laser Center of Northern Colorado. Together they
have taken LASIK surgery to the next level with
a new technology, iLASIK. This technology makes
LASIK bladeless, safer, and completely custom-fit
to your eyes’ specifications.
“The procedure is a marriage of the accuracy
of a custom fit and the safety of bladeless surgery,” according to Gary Foster, M.D. Foster is one
of the four doctors at The Eye Center of Northern
Colorado who perform the iLASIK procedure. He
is passionate about the advantages of the new
46
technology. “The iLASIK procedure offers a higher standard and level of care,” says Dr. Foster. In
fact, the iLASIK procedure is so effective that it
has been approved for NASA astronauts. According to clinical trials, 98 percent of patients who
undergo the procedure can see 20/20 or better
after the treatment. Doctors Matthew Robinson,
Randall Smith, and Karl Olsen also perform iLASIK
at the Eye Laser Center of Northern Colorado.
The iLASIK vision correction procedure specifically refers to a three-fold technology. The first
step is a machine that creates a custom map of
the eye, the next is the bladeless creation of a
treatment flap, and the final step is a laser that
reshapes the cornea to correct the imperfections
in the eye, fixing those defects that make you
nearsighted or farsighted.
The process begins with a complete diagnosis
of the eye. The Wavefront machine bounces light
through the eye, measuring the eye in a hundred
different ways. This technology creates a “blueprint” of the eye, determining what is wrong and
enabling the LASIK laser to make a custom focusing correction for the eye.
Traditional LASIK procedures use a general eye
glass machine to create the treatment. Though
great for glasses, the machine does not have the
precision of the Wavefront machine. “Sometimes
we will use this Wavefront machine to measure
patients that are hard to fit with glasses, who
aren’t even planning laser correction, because it
is so accurate. They end up with an amazingly refined glasses prescription,” says Dr. Foster.
This extensive examination is the first step
Lydia’s STYLE Magazine
in the iLASIK process. Next is the Intralase laser,
which creates a thin flap in the cornea that enables the doctor to make corrections to the vision.
To ensure accuracy, the room that houses the laser
is given very careful attention. The air is scrubbed
clean of any particles and the temperature and
humidity are monitored and kept steady. Both
actions ensure that nothing disturbs the laser
as it works. Two battery packs in the room and
another backup generator outside the building
ensure that if the power does go down for any
reason the delicate process with the laser is uninterrupted. “Everything is done for the greatest
laser precision,” says Dr. Foster.
What a laser can accomplish over bladed surgery, says Dr. Foster, is to create a better flap. “The
laser creates a thinner, smaller flap that is more
consistent and the procedure is overall safer.” Another benefit is that the flap fits more tightly over
the eye, creating greater security and strength
during the healing phase. “The flap is much more
secure to trauma and, because it is thinner, the
procedure leaves more of the natural strength and
resilience of the eye.” The final step, laser vision
correction, is driven by the blueprint made by the
Wavefront machine.
The iLASIK procedure is quick, as little as ten
minutes per eye. During the procedure patients
are awake, but are given medication to help them
relax and feel only a slight pressure during the surgery. After the procedure, it is not uncommon for
patients to have 20/20 vision almost immediately.
While there is a little sensitivity immediately
following the procedure, the discomfort generally
disappears within a few hours. Bladeless LASIK
takes longer than the standard LASIK procedure,
“but one of the beauties of the Intralase is that
if you don’t believe you have the ideal flap, you
Dr. Gary Foster takes a scan of patient Dr. Peter
Smith’s eyes.
Northern Colorado Medical & Wellness 2009
47
can recreate it with the laser. It is a very forgiving
process with a high safety profile.”
Both the bladeless and bladed procedures
have quick recovery times for patients. Dr. Foster
recommends a patient wear a protective eye covering while sleeping for the first week after surgery, but they can resume normal activities and
exercise. Almost immediately, most are free to
enjoy the benefits of better vision. Regular checkups are scheduled the first week after the procedure, a month after, three months after, then nine
months after to monitor the health of the eyes
with the patient’s preferred eye doctor.
One such patient who has been enjoying
greatly enhanced vision since his procedure is
Peter Smith, M.D., a doctor of internal medicine
with Big Thompson Internal Medicine in Loveland.
Dr. Smith’s eyesight before the procedure was not
good. “I couldn’t read my digital clock in the
mornings,” he says. Dr. Foster adds, “Smith’s preoperative vision was 20/400 without his glasses,
twice as bad as legally blind.”
As Smith’s children reached an age where
they could participate in sports activities and outdoor recreation, Smith made the decision to look
into LASIK vision correction. “The kids got old
enough to do beach vacations and we started to
spend a lot of time in the water. It was hard to be
in the water with my kids and not be able to see
well. For me, it was a lifestyle quality issue.”
Dr. Smith contacted The Eye Center of Northern Colorado and came into contact with Dr.
Foster, who recommended the iLASIK procedure.
Smith says the entire process was surprisingly
simple. “I had to do eye drops a couple weeks
before the procedure to prepare my eyes, but the
procedure itself seemed to take less than ten minutes per eye.” After the surgery, which occurred
in February, recovery was pleasantly hassle-free
for Smith. “I was a little uncomfortable for a
couple hours after the procedure. The feeling was
something like getting soap in the eye, but I went
home and went to sleep and was fine.” After a
week with an eye protector worn at night, Smith
was fully recovered.
“I was a little nervous before the procedure, but the doctor did a great job of talking
me through it. My vision now is spectacular. It is
slightly better than what I had with glasses. The
visual acuity is impressive.” Smith officially “tested” his new eyesight during spring break when
he took his two children, ages six and eight, to the
ocean. “I couldn’t be happier with the outcome.”
There are patients who do not qualify for
LASIK procedures. Generally, these are persons
who have a naturally weak cornea or who have
a prescription too big to allow for an elective procedure. However, some patients who could not
have the bladed LASIK do qualify for iLASIK because the Intralase laser can make a much thinner
flap.
“The Eye Center of Northern Colorado and
Poudre Valley Health System are pleased to be
able to work together to provide the latest, safest, and best technology available,” says Dr. Fos-
48
Lydia’s STYLE Magazine
Dr. Gary Foster works with the Interlase laser to
create a custom-fit flap over the cornea.
ter. “We are the only organization to offer the
iLASIK procedure, with the Wavefront blueprinting system and the Intralase laser, in Northern
Colorado.”
“If you love high tech toys, then you would
love being an eye doctor,” jokes Dr. Foster. One
very special machine used by Dr. Foster in a recent clinical study gives “CAT scan type” images
of the cornea. They also have two different types
of machines that can give topographical maps of
the cornea prior to iLASIK. “Patients often have
no idea how much effort we are putting into
their safety,” he adds. The next frontier in optical health, predicts Dr. Foster, will be using a laser
to correct the vision of those who need reading
glasses.
The Eye Center of Northern Colorado is home
to a large staff of eye experts and specialists. “The
collegial, teamwork approach that comes from
having specialists for each area of the eye under
one roof allows us to provide the best possible
service to the community. Our practice in Northern Colorado has roots that go back to 1935. We
have been here and will be here for our patients
throughout their lives. They are our neighbors.
We are the largest eye center in the region and
provide the best LASIK technology available. We
are proud of what we do here,” concludes Dr.
Foster. +
Angeline Grenz is Contributing Editor for Style
Magazine.
Northern Colorado Medical & Wellness 2009
49
Orthodontia
new technology
“People just want the
best care possible and
that is where we stand.
More and more today,
doctors are handing off
the treatment to other
staff with less and less
training. Those doctors
are taking an ancillary
approach to treating the
patient. That is not how
we operate.”
Burdett Edgren, DDS, MS,
Orthodontic Associates of
Greeley, P.C.
Orthodontic Team Uses
Cutting-Edge i-CAT Imaging
By Angeline Grenz
Photos by warren diggles
The doctors Edgren, patriarch Burdett and son Bradford, encapsulate the best of a successfully functioning team.
Dedicated to running the highest quality orthodontic office, the path has taken them to a new frontier of technology:
a scan that provides advanced imaging to facilitate a more accurate diagnosis and treatment for their patients. The
i-CAT scanner has even enabled the doctors to detect potential health problems that the patient was unaware of or
was not clearly visable on a routine dental radiograph.
T
he Edgren duo may be soft-spoken,
but underneath the quiet manner is
a firm commitment to their field. Dr.
Burdett Edgren, DDS, moved to Greeley in 1971 and began his first Colorado practice. He opened Orthodontic Associates
of Greeley, P.C., at its current location in 1986,
designing it with the expectation of his son joining him in the practice. Dr. Bradford Edgren, DDS,
joined him in 1993, after finishing school. Despite
familial ties, their 16-year partnership has been
much more than a matter of convenience.
Dr. Burdett describes their practice as “handson” with a focus on quality care. “People just want
the best care possible and that is where we stand,”
he says. “More and more today, doctors are handing off the treatment to other staff with less and
less training. Those doctors are taking an ancillary
approach to treating the patient. That is not how
we operate.”
“Some people just want us to straighten the
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Social Six,” says Dr. Burdett, referring to the six
front teeth that appear when we smile. At Orthodontic Associates of Greeley, Drs. Edgren refuse
to sacrifice function for the sake of looking good.
“We strive for function first, then work on the aesthetic result,” adds Dr. Bradford. “In general, if the
patient has good, proper function, then it will be
aesthetic.”
Their quest to provide the highest quality orthodontic care has led them to cutting-edge technology, the i-CAT imaging system. Dr. Bradford is a
proponent of the system, having done beta testing
on the imaging software and lecturing other orthodontists about the system. “These scans are more
diagnostic, convenient, and efficient,” he says.
The advantages of the i-CAT scanner over
other technology are impressive. The i-CAT needs
only seconds to take and download a scan. Digital files are downloaded quickly and easily shared
or transferred. There is significantly less exposure
to radiation for the patient than other computed
tomography. The scan captures three-dimensional
images that aid in implant planning, extractions,
impactions, airway assessment, panoramic images,
and much, much more.
“The images we make are far superior to traditional dental radiography,” says Dr. Bradford. “We
are finding all sorts of things that patients may not
have known about. We have been able to find previously undiagnosed facial and jaw problems.” The
scans are so clear and can be examined from so
many different angles that they have detected jaw
fractures in accident victims. The doctors have also
found enlarged adenoids and polyps in patients’
sinuses. These patients were then refered to the
appropriate physician for further diagnosis.
Traditional radiographic images are twodimensional, such as the panoramic X-ray taken
before a patient has their wisdom teeth removed.
With one i-CAT three-dimensional scan, the doctors can evaluate views from the front, axial, and
lateral sides of the head. The additional views al-
Lydia’s STYLE Magazine
Burdett R. Edgren, DDS, MS, is the founder of
Orthodontic Associates of Greeley, P.C.
Bradford N. Edgren, DDS, MS, joined his father
Dr. Burdett Edgren in the family practice in 1993.
low them to easily see the nerve canals that run
along the roots of the wisdom teeth before they
are removed or the anatomy surrounding an extra
tooth (a supernumerary) that was not visible on a
traditional X-ray.
“You can’t diagnose what you don’t know and
you can’t treat what you aren’t able to diagnose. If
we are unsure of something, there are several ways
to look at the patient’s scan,” explains Dr. Bradford.
The images can be adjusted to show soft tissue. Or
if the concern is about hard tissue, the image can
be changed to show only bone. “The machine enables us to evaluate what the problem is and treat
it accordingly, or when necessary, refer the patient
to a specialist,” says Dr. Bradford. Images can be
compared to visual norms based on age, sex, and
race to determine dental versus skeletal problems.
One special feature is the ability to diagnose
airway problems. Airway obstructions can be directly related to dental-facial development, according to Dr. Burdett. “This is useful for all our
orthodontic patients,” he adds. It is also useful in
helping other physicians assess health problems
such as sleep apnea, upper airway obstruction, and
mouth breathing. Drs. Edgren have had other dentists as well as other dental specialists refer patients
in to have scans made.
Adolescents, in particular, benefit from the
new technology. Because they are still developing,
potential airway and dental-facial problems can
lead to larger problems if they are not treated at a
young age. With the iCAT scanner, the doctors can
compare scans of a growing child through their
adolescence.
Even before the iCAT technology was available, Drs. Edgren made it their practice to provide
the most complete care possible. “We saw one
child with a cleft palate from six weeks to 18 years
old,” recalls Dr. Burdett.
By age seven, a child has completed 75 percent
of their total growth with regards to dental-facial
development, he continues. “Why wait until a
child is 15 or 16 years old, when they have finished
growing, to treat? We can find significant dentofacial problems, treat them, and prevent them from
getting any worse.”
“This is becoming the gold standard in care,”
says Dr. Bradford. “We feel it is the right thing to
do for our patients and it is important in the way
we want to run our practice,” adds Dr. Burdett.
Though the i-CAT images are more expensive to
create than traditional 2-D dental radiographs, the
doctors absorb some of that expense themselves
and patients win out in the long run with better
imaging, less time invested, and overall better
treatment.
“A wise consumer realizes that when it comes
to healthcare, your first shot is your best shot for
treatment,” says Dr. Burdett. “After that comes repair,” concludes Dr. Bradford, “and there are no
bargains in healthcare.” +
Angeline Grenz is Contributing Editor for Style
Magazine.
The i-CAT imaging system enables Drs. Edgren to
create more accurate scans for better diagnosis
and treatment at their practice, Orthodontic Associates of Greeley, P.C.
Northern Colorado Medical & Wellness 2009
51
Spine Correction Center of the Rockies
chiropractic
“In addition to keeping people out
of surgery, we are helping people
that have already had surgery and
are still suffering with chronic pain.
It is fulfilling as a doctor to see lives
changed and get them back to the
life they want to live.”
April Cardwell, D.C.,
Spine Correction Center
of the Rockies
Non-invasive treatment
for Scoliosis
By Laura lee carter
The Spine Correction Center of the Rockies represents the very best in
non-invasive, non-surgical treatment for scoliosis and disc disorders.
Michael Farrell, D.C., and April Cardwell, D.C., are among the less than two
percent of doctors who have received advanced training and certification
from the CLEAR Institute, a non-profit organization formed to empower the
chiropractic and medical community with the mission of implementing an
effective system of scoliosis treatment.
S
coliosis is a condition affecting 4.5 percent of the population that causes curvature of the spine greater than 10 degrees
when viewed from the front. It can cause
symptoms of back pain, headaches, fatigue, and in severe cases, digestive symptoms and
breathing difficulties. The condition affects women
more often than men and is generally diagnosed
during the teen years. The disease can be progressive, with curves continuing to advance even after
the patient has finished growing. There is a misconception that scoliosis will stop once a person has
finished puberty, yet the latest research has shown
curves can continue to progress at a rate of one to
three degrees per year after growth has ended. It
has been shown that scoliosis may decrease a person’s lifespan by up to 14 years if not treated.
Dr. Farrell and Dr. Cardwell have been able to
treat and successfully reduce the curvature of the
spine in patients ranging in age from preteen to
those in their 80s. “While catching scoliosis earlier
in life may allow for easier correction,” notes Dr. Farrell, “fantastic results can be obtained by patients
into their 70s and 80s. The effectiveness of this new
procedure is profound. To date, there has not been a
scoliosis patient that we have not been able to make
a positive impact on their ability to function.”
Linda Williams, a patient with adult onset scoliosis, first came to the Spine Correction Center of
the Rockies in July 2008. She began treatment when
52
she learned they offered non-invasive methods. Previously, Williams had been told by several doctors
there was no treatment for her painful condition.
She had reached a point where she could no longer
enjoy her day-to-day activities. “I feel great now,”
Williams says, “My spine curvature has been reduced by 60 percent. I could not have imagined I
would have these kinds of results. I love the atmosphere at the clinic and plan to keep coming here
because I’ve seen so much improvement.” She continues, “I even went for a walk a few weeks ago
without the use of my trekking poles for support.
I didn’t believe I would be able to do that again.
I walked for 20 minutes without pain, now that’s
improvement!” Williams can now get back to her
yard work and daily walks, thanks to Dr. Cardwell.
Statistics show that back pain accounts for almost 80 percent of doctors’ visits each year in the
United States. There are many causes for back pain,
including osteoporosis, spinal stenosis, scoliosis, disc
herniation, buldging discs, muscle spasms, and arthritis. Spine Correction Center of the Rockies has
been able to relieve and eliminate pain for patients
suffering from all of these conditions. Along with
their CLEAR certification training in scoliosis, they
also specialize in decompression treatment, which
allows them to help disc disorders.
Decompression therapy, discovered by NASA, is
FDA-approved for the treatment of disc disorders.
Decompression allows the spine to alleviate the
pressure on the discs, helping them regenerate and
heal during treatment. Patients usually see a significant decrease in pain levels within just two weeks of
treatments. Decompression is also extremely effective for other conditions such as carpal tunnel syndrome, migraine or severe headaches, and tingling
and numbness in limbs.
“Patients’ symptoms differ greatly,” Dr.
Cardwell explains, “but the most common we see
are electric shock pain that typically goes into the
arms when the disc issue is in the neck and into the
legs when the issue is in the lower back. Along with
pain, there can be muscle weakness from the lack
of nerve energy to that muscle or surrounding areas.
Most patients can avoid surgery, prolonged use of
medications, and a lifetime of pain with spinal decompression therapy.”
Medical journal research has placed the effectiveness of spinal disc decompression therapy at 75
to 92 percent with a relapse rate of two percent. “In
addition to keeping people out of surgery, we are
helping people that have already had surgery and
are still suffering with chronic pain. It is fulfilling as
a doctor to see lives changed and get them back
to the life they want to live. It makes me feel good
when I go home to know that what we do is helping
so many people.” says Dr. Cardwell.
Patient Lou Hall was treated at Spine Correction
Center of the Rockies for scoliosis and says, “When
I began treatment with Dr. Farrell I was hoping to
straighten and strengthen my spine and reduce the
chronic pain that comes with scoliosis. Along with
achieving these goals came an unexpected added
bonus - a new lease on life. I was unaware how
many aspects of my life were affected by the pain
of my scoliosis. My treatment not only helped my
scoliosis but it significantly improved the quality of
my life.”
“The ability to provide this new treatment for
scoliosis and disc disorders has a very significant
meaning to me as a physician. It is fantastic to see
patients able to resolve their conditions without the
invasiveness of surgery or bracing, which can sometimes result in severe disability. I love what we are
able to accomplish and hope to be able to continue
healing and restoring the quality of my patients’
lives,” Dr. Farrell says.
For more information on the innovative, noninvasive treatments provided at Spine Correction
Center of the Rockies visit their Website at: www.
spinecorrectioncenter.com.
Laura Lee Carter is a freelance writer and author of
the new book Midlife Magic: Becoming The Person
You Are Inside! Please check out her blog at www.
MidlifeCrisisQueen.com.
Lydia’s STYLE Magazine
Colorado’s Premier Clinic Specializing in Non-Invasive,
Non-Surgical, Non-Bracing Treatment of
Scoliosis & Disc Disorders
SPINE CORRECTION CENTER
OF THE ROCKIES
JUNE IS SCOLIOSIS MONTH
Complimentary Scoliosis Screening
Tuesday, June 30th, 2pm-7pm
Free refreshments and 1/2 hour presentation
given by doctors at 3pm and 6pm
Scoliosis
Bulging & Herniated Discs
Dr. Michael Farrell, DC
Dr. April Cardwell, DC
CLEAR Institute Certified
CLEAR Institute Certified
Carpal Tunnel
Dizziness
Headaches/Migraines
Chronic Back/Neck Pain
Call to schedule a FREE consultation
by phone, email or in person
970.226.1117
[email protected]
1101 Oakridge Dr. Ste. A | Fort Collins, CO 80525 | www.spinecorrectioncenter.com
Northern Colorado Medical & Wellness 2009
53
24-hour care
Emergency Veterinary Care
“Emergency clinics allow
vets to avoid being on
call 24/7, which makes
for more consistent
quality care for pets and
peace of mind for pet
owners. When there are
veterinarians dedicated
solely to emergency
care, there is always
someone rested, ready,
and available to help.”
Ted Mika, DVM,
Fort Collins Veterinary
Emergency Hospital and P.E.T.S.
of Northern Colorado
Jon Geller, DVM, co-owner of Fort Collins Veterinary
Emergency Hospital and P.E.T.S. of Northern Colorado, with technician Corina Herron holding a couple
of very cute patients.
24-Hour
Pet Emergency Care
By Allie Comeau
If you’ve ever had a pet get sick or hurt, you know it rarely happens during office hours. Call it Murphy’s Law or just
plain bad luck, but pets often become ill at night or on the weekends. So what is a pet owner to do with an ill or
injured pet if their usual veterinarian is unavailable?
T
hankfully, pet owners in Northern
Colorado have access to emergency
veterinary care. Emergency veterinarians are dedicated emergency professionals who treat acutely ill or injured
pets. They typically work in clinics that are either
open 24 hours a day or open on nights and weekends when traditional veterinary practices are not.
They are there when your pet gets sick or hurt –
no matter what time of day it happens.
Pet owners can visit Ted Mika, DVM, or his
partner Jon Geller, DVM, and their staff of emergency vets, assistants, and interns at the Fort Collins Veterinary Emergency Hospital (FCVEH) or at
Pet Emergency Treatment Services of Northern
Colorado (PETSNC), in Greeley. “There has been
a shift in veterinary medicine towards supple-
54
menting traditional veterinary practices with afterhours emergency clinics,” says Dr. Mika. “It gives
veterinarians their lives back. Emergency clinics
allow vets to avoid being on-call 24/7, which
makes for more consistent quality care for pets
and peace of mind for pet owners. When there
are veterinarians dedicated solely to emergency
care, there’s always someone rested, ready, and
available to help.”
Susan Wight, DVM, an emergency veterinarian with VCA Veterinary Specialists of Northern
Colorado, echoes these sentiments. “Vets can
refer their after-hours emergencies to us and rest
assured their patients will be taken care of,” she
says. “We try to communicate with our patients’
regular doctors, and keep them apprised of the
situation. We handle crises and keep them from
escalating further. We provide 24-hour care for
patients that need it, with access to specialists if
the situation requires it.”
Both FCVEH and VCA are open 24 hours a
day, seven days a week, 365 days a year. “As of
November of last year, we’re always open,” says
Dr. Mika. “Our referring veterinarians around
town were getting so busy they needed the option
of daytime emergency care as well. Now trauma
victims and severely ill pets can receive treatment
right away, rather than making an appointment
or waiting to see a doctor who’s booked up with
surgeries or vaccinations. We’re also able to provide long-term critical care at the clinic in addition
to emergency care.”
Emergency and Critical Care has been a specialty of veterinary medicine since 1989. Residen-
Lydia’s STYLE Magazine
DOES YOUR PET NEED
EMERGENCY CARE?
Dr. Susan Wight, DVM, with VCA Veterinary
Specialists of Northern Colorado recommends
pet owners seek medical attention when their
pets exhibit the following signs:
Difficulty breathing • Vomiting or diarrhea • Pain
Extreme lethargy • Pale gums • Lack of appetite
Difficulty walking • Snakebite in any pet
Bleeding • A pregnant pet in prolonged labor
Fort Collins Veterinary
Emergency Hospital
OPEN 24 HOURS • (970) 484-8080
816 S. Lemay Ave. • Fort Collins, CO 80524
www.veterinaryemergencyhospital.net
VCA Veterinary Specialists
of Northern Colorado
OPEN 24 HOURS • (970) 278-0668
201 W. 67th Ct. • Loveland, CO 80538
www.vcavsnc.com
P.E.T.S. of Northern Colorado
Emergency Hospital
OPEN NIGHTS & WEEKENDS • (970) 339-8700
3629 23rd Ave. • Evans, CO 80620
www.petsemergency.com
56
cies and board certification are available, but are
not prerequisites to the specialty. Many emergency vets are traditionally trained veterinarians
who were drawn to emergency care. Long-time
practicing veterinarians, Dr. Mika and Dr. Geller,
founded PNC in 2001 after noting the need for
such services in the Greeley area. FCVEH followed closely, along with a third clinic in Grand
Junction.
Dr. Wight has been practicing veterinary
medicine for 20 years but calls emergency care
“her niche in veterinary medicine.” Dr. Wight
was a traditional vet in Estes Park for eight years
before coming on board with VCA in 1996. Dr.
Wight works with one other full-time ER doctor,
a part-time ER doctor, and two rotating interns.
FCVEH works closely with the CSU Vet Hospital to offer internships and education and
remain up-to-date with the latest veterinary
medicine advances. “We have continuing education allowances for our technicians and staff
and we’re one of the only emergency clinics
that has a board-certified anesthesiologist,”
says Dr. Mika. “Dr. Bonnie Wright manages
protocols for anesthesiology and also runs a
pain-management clinic here. We have excellent pain-management protocols, including
acupuncture.”
Emergency veterinarians deal with everything from vomiting and diarrhea, to pet poisonings, trauma, snakebites, and more. “We see
about 4,000 to 5,000 cases a year, everything
from lacerations to gunshot wounds to car accidents to intoxication from anti-freeze, rat poison, and chocolate,” says Dr. Mika. “We’ve had
six snakebite cases so far this season.”
“There really isn’t a most common illness or
injury we see,” says Dr. Wight. “I’ve seen just
about everything in the past 20 years; it’s about
equal between illness and injury. This time of
year, we see an increase in snakebites (five so
far), lacerations, animal bite trauma, and automobile trauma.”
What can pet owners do to prevent accidents from happening? Dr. Wight warns
pet owners not to let dogs ride in the back of
trucks, to remove metal lawn edging due to risk
of laceration, to use mouse traps instead of rat
poison, to keep current on all vaccinations, to
keep all medication, foreign objects, and people
food away from animals, and never to selfprescribe medication (even aspirin) to your pet.
“Most of it is common sense,” says Dr. Wight.
“But seemingly harmless things, like chocolate,
candy, gum (Xylitol can be fatal to dogs), string,
small kids’ toys, and bones can cause major
problems.”
Dr. Wight stresses the need to bring your pet
to an emergency clinic if they are displaying any
of the following symptoms: difficulty breathing,
vomiting or diarrhea, pale gums, bleeding, pain,
lack of appetite (which often indicates pain),
difficulty walking, or extreme lethargy (which
indicates pain or illness). A bloated abdomen in
a dog, or a snakebite in any pet, warrants an
immediate trip to the ER because both can be
fatal if not treated immediately. A pregnant pet
in labor but progressing slowly should also see
an emergency veterinarian.
“The best way to avoid snakebites is to keep
Lydia’s STYLE Magazine
pets leashed when walking or hiking, although
dogs have been bitten on leashes and in backyards,” says Dr. Wight. “It was a mild winter
and their food supply is abundant, so snakes will
probably thrive this year.” If your dog is bitten,
it will most likely need antivenin from an emergency veterinarian, who should have it on hand
at the clinic. “Snakebites are treatable and we
have a supply of antivenin, but fatalities do happen – we saw several last year unfortunately.”
In the summer, heat stroke is also a real
threat for many pets, especially dogs. Never
leave a dog in a parked car in the summer and
limit exercise in the afternoon. “Avoid any kind
of over-exertion (hiking or running; walking is
okay with ample water) if the outside temperature is more than 75 degrees; keep bull dogs and
other ‘short nosed, smashed face type’ dogs in
air conditioning when it’s warm outside,” says
Dr. Wight. “Dogs don’t sweat. They cool themselves by panting. That only goes so far before
their compensatory mechanism is overwhelmed
and their body temperature increases rapidly.”
“You should always call and ask if you
have a question about a symptom or if you’re
unsure whether or not a trip to the vet is warranted,” says Dr. Mika. “Something that may
seem minor, like vomiting, could turn out to be
a poisoning but we won’t know that unless you
bring the pet in. Better safe than sorry – that’s
what we’re here for.”
Allie Comeau is a freelance writer, copywriter, and
blogger living in Fort Collins, CO. Email her at [email protected]
Northern Colorado Medical & Wellness 2009
Pet ER:
Cooperative Veterinary Care
T
he Fort Collins Veterinary Emergency
Hospital (FCVEH) supplements traditional veterinary service by providing
after-hours emergency care for pets.
Inspired by a spirit of cooperation and a need to
relieve veterinarians of around-the-clock duty,
FCVEH “gives vets their lives back” by caring
for pets who become ill or injured during nights
and over weekends.
FCVEH, a cooperative emergency clinic,
works closely with local veterinarians who refer
patients for emergency care. The 21 veterinary
members/owners of FCVEH treat the emergency clinic as an extension of their own practices.
“These partnerships allow for a higher level of
consistent care and let local veterinarians enjoy
their time off without having to take emergency calls,” according to owner Ted Mika, DVM.
Now that FCVEH is open 24 hours a day,
seven days a week, and is able to provide critical care in addition to emergency care, these
partnerships are evolving even further. FCVEH
is now able to see emergency cases during the
day, which makes it easier on both the patient
and the referring veterinarian. (Because FCVEH
is dedicated solely to emergency and critical
care, they’re ready to treat an ill or injured pet
at a moment’s notice.) The other benefit to the
clinic being open 24 hours is that sick pets no
by Allie Comeau
longer have to leave the clinic in the morning.
“This way, a critically ill or injured pet doesn’t
have to be transported back and forth between
the emergency clinic and the veterinarian’s office. We keep the vet apprised of the patient’s
condition at all times,” says Dr. Mika.
FCVEH is a fully staffed and equipped clinic, complete with a broad range of diagnostic
services, a well-stocked pharmacy, in-hospital
surgery suite, in-house digital X-ray capabilities,
and closely supervised hospitalization area.
The sister clinic of FCVEH, P.E.T.S. of Northern Colorado, was the first cooperative emergency clinic in Northern Colorado. Founded by
Dr. Mika’s partner, Jon Geller, DVM, in 2001,
PETS operates in the Greeley area and is similar
to FCVEH. The only difference is that P.E.T.S. is
only open on nights and weekends. P.E.T.S. of
Northern Colorado has 12 veterinary owners.
Both FCVEH and P.E.T.S. provide an invaluable service to pet owners and veterinarians
alike. “Before we had the emergency clinic,
vets would be on call nights and weekends,”
says Dr. Mika. “Having trusted emergency veterinarians to take those calls and see patients
during the night has not only enhanced the
quality of life for local vets but also the quality
of care for local pets. It’s a win-win situation for
everyone.”
57
physician profile
donn turner, M.D.
“There is something
fantastic about being
able to fix a patient’s
health problem with one’s
hands.”
Donn Turner, M.D.,
Front Range Center for
Brain & Spine Surgery, P.C.
A Father’s
Influence
By Connie Hein
Donn Turner, M.D., was sure he would grow up to be an airplane pilot, until a discussion with his father changed his plans and his life. “My father was a World War
II Navy carrier fighter pilot and, throughout my life, a United Airlines pilot. I admire
him more than anyone.”
W
hile growing up, “my intention
and desire was to be a professional pilot, just like my father
was,” Turner relates. Dr. Turner,
neurosurgeon with Front Range
Center for Brain and Spine Surgery, P.C., is a secondgeneration Colorado native born in Denver. He and
his twin brother, Bruce, both applied and were accepted to the Air Force Academy with the intention
to fly. “My brother was the first to change his mind
and accepted admittance to Colorado College in
Colorado Springs. I also turned down the Air Force
Academy after a last minute talk with my dad. He
said he thought I would be bored with flying. He felt
I could do something more important with my life
and encouraged me to go to Colorado College with
my brother.”
Dr. Turner’s father had much to do with what
he became and the career he chose, but his brother
was also a great influence on him. “We were always
very competitive and there’s no doubt he influenced
58
me greatly to work hard and excel.” It is interesting,
he adds, that both brothers changed careers and
did not grow up to become what they thought they
would. “My brother always wanted to be a doctor,
but turned down medical school to eventually become a diplomat for the U.S. State Department. I
always wanted to be a pilot, but turned down pilot
training to become a doctor.”
Dr. Turner received his doctorate of medicine in
1978 from Washington University School of Medicine in St. Louis. During medical school, Dr. Turner
started thinking about a specialty in neurology but
realized he enjoyed surgery even more. “I had two
surgical procedures done on my neck during medical
school by neurosurgeons and admired them. I decided I wanted to be like them and do that kind of
work.” He completed his neurosurgical residency at
the University of Iowa in 1984, then moved to Fort
Collins and joined Front Range Center for Brain and
Spine Surgery later that year. Dr. Turner was certified
by the American Board of Neurological Surgery in
1986 and became a Fellow of the American College
of Surgeons in 1988.
What he loves most about his career is “figuring
out each patient’s individual puzzle, looking at lots
of cool images, and then planning the best way to
get them back to their life,” he says. Dr. Turner enjoys the act of performing surgery because it requires
knowledge, discipline, exactness, and artistic talent,
blending these qualities together to obtain an excellent result.
“There is real beauty in an operating room,” he
adds, with the efficiencies and camaraderie among
the entire crew of nurses, orderlies, technicians, and
partners all working together to get the best outcome for the patient. “There is something fantastic
about being able to fix a patient’s health problem
with one’s hands.”
Even though he loves his career, Dr. Turner says
his great passion is his family. “My first passion is
truly my wife and children. Though I love neurosurgery and it has shaped me, I try to spend every spare
second I have with my family. Skiing has been a great
family pastime as was camping and fishing when
the kids were younger. As my kids leave the nest, my
wife and I are trying golf and a little tennis.”
Dr. Turner met his wife, Mary Kay, while she was
a manager for Poudre Valley Health System. Because
they were both in their mid-thirties, Dr. Turner says
they decided to start a family right away and feels
very fortunate to have had kids without difficulty
before it was too late. “I truly made the best decision ever with my wife, and I absolutely adore my
kids and am extremely proud of each of them. I don’t
have many outside interests unless it somehow involves them.”
Dr. Turner and his wife have been married for
22 years and have three children: Kyle, age 20, attending Colorado College in Colorado Springs; Leah,
18, attending University of Denver; and Kara, 16, a
Junior at Fossil Ridge High School. “My wife became
a stay-at-home mom after our third child was born
and is very involved in their schools, the National
Charity League, and several other charities. She
helps me get involved in the community outside of
medicine.” Dr. Turner says he and his family love Fort
Collins and are passionate about giving back to the
wonderful community that has given them so much.
Connie Hein is a freelance writer living in Windsor
and the author of the Toliver in Time series of children’s books.
Lydia’s STYLE Magazine
LITY
~ARE
Your locally owned leader
in health care is a national
role model for excellence.
Poudre Valley Health System has
received the 2008 Malcolm Baldrige
National Quality Award- the highest
Presidential honor given to United
States businesses and organizations
that demonstrate performance
excellence.
Thank you to our treasured patients
and families, incredible volunteers,
staff and physicians, and the many
regional organizations who support
us in achieving our vision to provide
world-class health care .
Were herefor you.
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