Innholdsfortegnelse for 2017 i 5280 Health

BEFORE 5280 ASSISTANT EDITOR Mary Clare Fischer began reporting this issue’s “Addicted” (page 38), I had a vague notion of our national appetite for opioids. I might have been able to tell you that opioids—the class of drug that includes prescription painkillers such as codeine, morphine, Vicodin, and fentanyl and the illegal drug heroin—are highly addictive. I could have told you that in some cases, prescription opioids lead people to “graduate” to heroin because it’s often cheaper and, despite its illicit status, easier to get. I could have also told you that the recent deaths of celebrities Philip Seymour Hoffman and Prince involved opioid use. But the problem of addiction to opioids in Colorado is far more serious than I knew. Colorado is the only state the Substance Abuse and…

1) Use whole foods. You get a nearly perfect balance of macronutrients (protein, carbs, and fat) from nuts, seeds, and full-fat ground beef instead of lean and by keeping the skin on chicken. 2) Use homemade natural-oil dressings. Make your own olive-, peanut-, avocado-, or sesame-oil-based dressings to spruce up veggies. Plus, cooking with olive or coconut oil instead of vegetable oils (whose omega-6 fatty acids become inflammatory when processed for bottling) will help minimize inflammation and speed post-workout recovery. 3) Buy grass-fed animal products. Meat and dairy from pasture-fed animals are more expensive, but they have all the omega-3 fat most people need, so you don’t need fish oils (which go bad after 30 days). Grassfed animal fats also contain CLA, an essential fatty acid with anti-inflammatory and anti-cancer…

WHEN MY SON, QUINN, was three months old, my husband and I gave him a small bottle of milk-based formula. As soon as he polished off a few ounces, he threw it right back up. Within minutes he was covered in hives from head to toe. Thus began his violent allergy to dairy, which lasted well into his teens. While not insurmountable, the constraint was a constant source of frustration: Every home cooked meal, restaurant dinner out, and bake-sale craving was informed by the strict need for dairy free options. Then, when Quinn was 12, he inadvertently ate a muffin made with milk—and nothing happened. Not long after, he accidentally ate a cheddar bagel. Cheddar! The lack of reaction seemed inconceivable, considering he would still vomit and scratch at his…

5-3-6. THE NUMBERS flashed repeatedly in Esperanza’s* mind to the tempo of the blinking red brake lights shining before her on the highway. What she wanted to be thinking about was her birthday; she had turned 23 the day before, and her friends were planning a party south of town. But all she could focus on were those three numbers. Less than an hour earlier, the man who employed her as a nanny in the Cherry Creek area had forced her onto his bed and raped her, she had told the friend now driving her to a hospital in the south suburbs. Esperanza says she remembers glimpsing the bedside clock—it read 5:36 p.m.—as she prayed for him to stop. Now, as rush-hour traffic on I-25 slowed to a crawl, she…

It’s a familiar story to many Americans: On April 20, 1999, two students entered Littleton’s Columbine High School and killed 12 teenagers and one teacher. That day, Austin Eubanks, a junior, was in the library when he was shot in the right hand and left knee—an event that precipitated Eubanks’ long battle with prescription drugs. Over the weeks that followed, Eubanks’ physical discomfort and mental shock required serious medication; doctors gave him a month’s supply each of Percocet and Vicodin (for pain) and Klonopin (a benzodiazepine, for sleep) with the option for refills. “With the combination of those drugs, you can turn yourself into a robot,” he says. “You don’t have to feel anything.” After graduating from high school and foregoing college, Eubanks built a career in advertising and adopted…

Are doctors and dentists giving out too many painkillers? If you’ve had your wisdom teeth removed, you might have gone home from surgery with a prescription for 20 Vicodin or Percocet. Yes, your gums might have been sore, but did you really need so many opioids for minor surgery? Probably not, says Robert Valuck, a professor at the Skaggs School of Pharmacy at the University of Colorado Anschutz Medical Campus and the coordinator of the Colorado Consortium for Prescription Drug Abuse Prevention. In fact, a 2016 study at the Dartmouth-Hitchcock Medical Center in New Hampshire found that patients undergoing outpatient procedures needed, on average, only 43 percent of their prescribed opioids. The extra pills, he says, are part of the addiction problem: Most prescription drug addicts initially get hooked on…

1. TREK TO EVEREST BASE CAMP (9,300 to 17,598 feet) For Metcalfe and her team, this journey took about 10 days, which allowed them to acclimatize over ascending and descending terrain. Train Local: The trek is comparable (although much higher in elevation) to a two week trek on the Colorado Trail. Top off your CT hike with a few fourteeners—such as Mt. Elbert and Mt. Massive — for extra altitude training. 2. THE KHUMBU ICEFALL: EVEREST BASE CAMP TO CAMP I (17,598 to 19,685 feet) Completing the Khumbu Icefall means crossing crevasses on ladders. Train Local: Before the trip, Metcalfe tightened up her ice-climbing skills on frozen waterfalls like the Fang in East Vail and dialed in endurance with long days of ski mountaineering on peaks such as Bald Mountain.…

HELEN OLSSON Writer Helen Olsson is no stranger to chronicling her life with kids. The author of The Down & Dirty Guide to Camping with Kids and creator of the blog maddogmom.com tackled a sensitive topic in her essay “Got Milk?” (page 18), which details how her son overcame a dairy allergy. “Seeing him squirt whipped cream from the can into his mouth was a thrilling day for all of us,” Olsson says. Her work has appeared in Elevation Outdoors, Ski Magazine, and Women’s Sports & Fitness. NAFTALI BEDER An illustrator and developer, Naftali Beder created the opening illustration for this issue’s “Seeking Help” (page 22), an in-depth look at how Colorado hospitals serve—or fail to serve—victims of sexual assault. Beder’s illustrations have been published in the New York Times,…

Before moving into a new house, you’d likely spend months searching for digs suited to your specific needs. Finding an assisted living home for an aging parent tends to be less methodical: 90 percent of those making their first transitions to assisted living need to find housing within a week or two. Enter Mimi, a Denverbased startup that matches small assisted living facilities (which average 10 beds) with potential residents through a quick online assessment. Answer 15 questions about your loved one (Is your father diabetic? Does your mother need two or more people to help her out of bed?) via the HIPAA-compliant site, and it’ll return vetted results that fit your criteria and are within four miles of your chosen location. Then book your tours directly through Mimi—a no-hassle…

Rotator cuff tears can be career-ending for athletes, but they’re not exactly fun for the rest of us either. The painful problem involves the separation of tendons from the shoulder joint, and recovering from the intense surgery is almost as painful as the injury itself. Dr. Ted Schlegel, an orthopedic surgeon and former team physician for the Broncos and Rockies, searched for less-invasive techniques for more than 20 years. In 2014, he found his answer: a collagen-based implant that induces tendon growth. (Imagine patching fraying denim in your jeans and, over time, the patch growing to match the material around it.) Schlegel was the first doctor to perform the procedure in the United States, and he’s seen patients’ recovery times shrink from six months to about 12 weeks. He recommends…

FOR WOMEN PREGNANT WITH A breech (bottom-first) baby— that’s about 1 in 25 pregnancies— delivery typically means one thing: a cesarean section. That’s because these days, most obstetricians don’t allow moms to vaginally deliver babies who aren’t headfirst. “A lot of residents maybe have seen one or participated in one, but it’s not standard curriculum in med schools,” says Dr. Katie Rustici, an obstetrician/gynecologist at Stapleton OB-GYN. “It’s a training issue for sure.” As a result, she says, “C-sections are what attending physicians are comfortable with, and then it snowballs into the next generation of trainees, who often never get exposure to what was once a standard skill.” But Englewood’s Dr. Michael Hall says C-sections aren’t always necessary. Hall says he is one of the few Colorado obstetricians who routinely…

Trail running is better for your body than jogging on asphalt. Sometimes common sense is the best medicine— but we asked an MD just to be sure. “Generally speaking, softer surfaces cause less impact,” says Dr. Josh Metzl, a foot and ankle orthopedic surgeon at the Steadman-Hawkins Clinic in Denver who has also completed 13 marathons and five Ironmans. Concrete sidewalks are the most severe surfaces; repeatedly pounding the pavement could result in “overuse” injuries, including plantar fasciitis. While inside city limits, Metzl trains at Washington Park, where the crushed gravel path takes less of a toll on his joints. Once in the mountains, he suggests using skiresort service roads as a convenient—and cushy—entrée into trail running. “I really believe trail running helps the longevity of a runner’s career,” Metzl…

THIS IS YOUR BRAIN.* 1. Mesolimbic system: This network regulates your senses of pleasure and pain. Whenever you have an enjoyable experience, like eating your favorite food or having sex, neurons in the midbrain release a chemical neurotransmitter called dopamine. This chemical then binds to receptors (proteins found throughout the body, including in the brain and spine), signaling to other areas of the brain that you’re enjoying yourself—and telling them to file that detail away for future use. 2. Prefrontal cortex (PFC): The PFC deals with integral cognitive processes such as critical thinking and risk perception; the PFC also controls a part of the brain stem that responds to stress and panic. 3. Brain stem: This part of your brain is responsible for basic functions such as sleep, respiration, and…

Here’s a grim reality check: According to the Substance Abuse and Mental Health Services Administration, Colorado is the only state ranked as a top consumer of alcohol, marijuana, cocaine, and opioids for nonmedical purposes. Sure, genetics, age, and life experiences all influence who turns to drugs—and who becomes addicted—but what’s behind our propensity for mindaltering substances? THE MJ EFFECT Before the legalization of marijuana, recreational users might have smoked weed before they hit the bar. Now, the thinking goes, they tend to use harder substances for a pre-game high. “You don’t want to smoke weed [before going out] because you smoke weed every morning,” says Rob Archuleta, who battled meth addiction for 11 years and founded Addict2Athlete, a Pueblo-based organization that combines CrossFit workouts with 12-step programs to provide addicts…

How to use a drug to prevent death by overdose. One of the most effective tools to reverse an opioid overdose is naloxone, a medication that breaks the connection between the opioid and the receptor to which it attaches. (Note: You can’t get high off of naloxone, and it isn’t harmful if accidentally used.) Before 2013, only drug users could receive a naloxone prescription in Colorado—not the family and friends who’d be able to inject it in the case of an overdose. Now, thanks to expanded legislation, anyone can get the lifesaving drug. But naloxone isn’t useful unless you know when to administer it. With that in mind, the Colorado Naloxone for Life Initiative launched in late 2016 by sending naloxone to police officers and EMTs in the 17 counties…

Nearly 2,000 American service members have lost arms, legs, hands, and feet in our 16-year-long conflict in Iraq and Afghanistan. But unlike many of the 15,000 veterans who lost limbs in World War II or the 6,000 amputees from Vietnam, today’s veterans aren’t afraid to show off their prostheses. “In earlier times, veterans would hide them,” says Lea Lew, a certified prosthetist/orthotist who oversees the Veterans Affairs’ Jewell Clinic in Aurora, one of only seven regional amputation centers in the country. “Now it’s almost a point of pride.” Jewell Clinic’s prosthetics lab has a unique role in showcasing that pride: It customizes, on-site, the design of a prosthetic’s socket— the element most essential to stabilizing the prosthetic, ensuring comfort, and preventing infection and other injuries. Staffers make between 20 and…

At 79 years old, Bill Zinke started a second career by founding the Boulder-based Center for Productive Longevity in 2006 to help other people over the age of 50 maximize their second acts. “Many of these older people want to continue adding value and being productively engaged,” he says. Eleven years later, he’s still touting his seven guidelines for aging successfully, including social connection, physical fitness, adequate sleep, and sound financial management. The center hosts forums that give guests a chance to explore and implement these pillars in their own lives. And Zinke’s secret to living it up at 50-plus? “I’ve encountered very little ageism, and that’s not just because I live in Boulder and work out four times a week,” Zinke says. “I believe it’s because I project myself…

THE CLAIM A high-fat, low-to-no-carb approach enhances stamina, boosts performance, lowers body fat, and aids post-workout recovery. THE SCIENCE The process is called fat adaptation, championed by fitness experts such as Denver-based family physician Dr. Cate Shanahan, who helped transform the Los Angeles Lakers’ team diet to a menu of whole foods (including fats) in 2012. We’re all born fat-adapted, which means we can burn our body fat for energy, Shanahan says, but we’ve compromised this natural process by overdoing the carbs. The science works like this: When you eat carbs, your body breaks them down into glucose (blood sugar). In response, your pancreas releases insulin to shuttle the sugar to your needy cells. However, excessive carb intake creates a surplus of sugar, which is then stored in your body…

The way a baby is born can have health effects that reach far beyond delivery day. Recent research suggests that infants born via cesarean section have an elevated risk of some chronic diseases, including asthma, obesity, and type 1 diabetes, as compared to babies delivered vaginally. One explanation for the puzzling health disparity is the type of microbes (tiny, single-cell organisms, including bacteria) babies are exposed to at birth. A baby born through the birth canal ends up with a superior microbial community— including bacteria thought to help regulate immune systems and protect against disease—than babies born via C-section. In 2016, a team of scientists, including University of Colorado Boulder researcher Se Jin Song, tested a new technique that may help level the microbial playing field. Scientists swabbed babies born…

Turns out, the childhood rhyme is true: Dirt don’t hurt— and it might even help. A 2016 study led by neuroscientist Christopher Lowry at the University of Colorado Boulder suggests that exposure to Mycobacterium vaccae, a type of bacterium that lives in the soil, may have a positive effect on mental health. Why? Chronic inflammation is a risk factor for a host of psychiatric disorders, and some microbes found in rural environments are known to act as anti-inflammatories and immunoregulators. Indeed, scientists found that mice immunized with Mycobacterium vaccae are more resilient in the face of stress. Translation: Playing in the dirt— enough that you expose your immune system to soil bacterium—could lessen your anxiety. Dig in.…

No one ever thinks he’s going to become addicted to drugs: You know better, or you’ve got too much going for you. Especially in Colorado, celebrated as the land of the happy and healthy, it’s easy to assume we’re immune from problems with drug abuse, which seems more applicable to the lifestyles of international celebrities (such as Prince, who died of a fentanyl overdose last April) or unsavory happenings elsewhere. Thinking this way keeps the uncomfortable truth at a distance: Drug overdose is now the leading cause of injury death for Americans ages 25 to 64, and the primary culprit is a class of drugs called opioids. The category includes prescription painkillers (synthetics such as Vicodin, OxyContin, Percocet, and fentanyl) and illegal heroin (which is naturally derived from the opium…

As many as four in five addicts’ first habit-forming drug is a prescription opioid, thanks to easy initial access and the possibility of accidental dependency. About one-third of Coloradans have admitted to using pain medications prescribed for someone else, while 25 percent of us have used pills for something other than what our doctor instructed. But how do users get hooked on illegal heroin, which is often injected intravenously? >Heroin produces a similar high to prescription opioids at a much lower price—and the street drug tends to be easier to obtain long-term. >According to the Drug Enforcement Administration, dealers are starting to lace heroin with fentanyl—the fast-acting prescription opioid—to create a stronger, more euphoric high. >Following the legalization of marijuana in Colorado, Mexican drug cartels have pushed more heroin into…

When she was 11 years old, Kristy Rhodes was molested and raped by her mother’s boyfriend. A year later, she was raped a second time, by a classmate in the locker room after school. Before she was a teenager, Rhodes had turned to marijuana and booze as a way to cope with the trauma of her assaults. Each time she tried to get back on track, she faced new challenges. At 15, she quit weed and alcohol to focus on school. Then she got pregnant. By 22, she had divorced her abusive husband, whom she’d married in high school; a year later, her father—and biggest supporter— died. After each setback, Rhodes floundered; unaware of wellness and counseling resources in Pueblo, where she lived, she chose drugs as a coping mechanism.…

We visited the Foundry Treatment Center’s residential program for drug and alcohol addicts in Steamboat Springs to find out what starting a zero-tolerance (i.e., cold-turkey) longterm recovery plan is like. The following is a composite of patients’ experiences based on the author’s interviews and observations from her time embedded at the Foundry. Names are withheld to protect privacy. Individual experiences may differ. Friday, 9:03 a.m. En route. Hillsides and alpine lakes whip by, but you can’t focus on anything beyond your last high, which is fading into a painfully intense exhaustion. Your emotions bounce between resentment and anxiety about what’s to come over the next 90 days. 12:13 p.m. Detox. Buried in a strip-mall-like complex a few miles from the treatment center’s main residential ranch, the detox facility doesn’t scream…

My sons’ addictions started after they were prescribed Percocet for shoulder surgeries. They crushed up the pills and smoked them. Eventually, they could no longer afford pills on the street, so that’s when they got into heroin, which they bought from a dealer. They smoked it; they never injected. Even in their demented world, there were boundaries that scared them. They grew up in Westminster in a nice area; it’s not like we were living in poverty. My parents were co-parenting with me, always providing everything I wasn’t able to (their dad was in prison for 10.5 years for criminally negligent manslaughter). A year before their father was getting out, he began writing to me, telling me how sorry he was. He wanted to be in the boys’ lives. For…

NOTE: Each entry includes the physician’s name, the hospitals at which the physician has privileges, the doctor’s office or clinic address, and the best phone number to call for an appointment. Full listings, including information about how many years each physician has been on the Top Doctors list, are available at 5280.com/topdocslist. ADDICTION PSYCHIATRY Jonathan I. Ritvo UNIVERSITY 501 S. Cherry St., Suite 650 Denver 80246 303-333-3163 Christian Thurstone DENVER HEALTH, UNIVERSITY 723 Delaware St., MC-1910 Denver 80204 303-602-1893 ADOLESCENT MEDICINE Christine Gilroy CHILDREN’S 13100 E. Colfax Ave., Village Pavilion, Third Floor Aurora 80045 720-777-6131 David Kaplan CHILDREN’S 13100 E. Colfax Ave., Village Pavilion, Third Floor Aurora 80045 720-777-6131 Amy E. Sass CHILDREN’S 13100 E. Colfax Ave., Village Pavilion, Third Floor Aurora 80045 720-777-6131 Adult Congenital Heart Disease Joseph Kay…

THE PROCESS How we come up with the Top Dentists list. This list is pulled from the 2016 top Dentists database, which is created using peer evaluations and includes listings for more than 800 dentists and specialists in Colorado alone. To create its list, top Dentists asked dentists and specialists a personal question: “If you had a patient in need of a dentist, which dentist would you refer him or her to?” The nomination pool consisted of all active dentists listed online with the American Dental Association as well as with dental academies and societies. (Dentists could also nominate others who may not be on those lists.) Respondents were asked to consider experience, continuing education, manner with patients, use of new techniques and technologies, and physical results. After responses were…