At Rose, we want our employees to achieve excellence, which is why we are excited to announce our second year of Rose University, which provides education and development programs and opportunities for Rose employees, most of which are free of charge. Rose University is separated into three different schools, each with a different learning focus: the School of Workforce Development, the School of Leadership and Personal Development and the School of Professional Development.

The School of Workforce Development is designed mainly for non-clinical staff to help further develop their work-related skills. One of the programs within this school is the School at Work Program.

Participants in this eight month program receive career advice, help with goal setting, preparation for degree or certificate programs and more to help them advance in their careers. In 2011, six out of our seven participants successfully completed the program, and one employee credits their recent promotion to being a part of School at Work. Eligible employees include staff in dietary, environmental services, patient transport security and other entry-level office or nursing positions.

In 2012, The School of Workforce Development will be offering a School at Work session, as well as English as a Second Language classes and some college and graduate courses for employees who are working towards a bachelor or masters degree. There also will be a “Learning Buffet” series, which was developed specifically for Rose employees to further their knowledge and insight of clinical areas and patient diseases.

The School of Leadership and Personal Development is designed to help Rose employees increase their knowledge of people, teams, and leadership skills. This year there will be over 40 different courses offered for employee development, ranging from Time and Stress Management to Effective Communication to PC Skills: Microsoft PowerPoint.

This school is also home to several programs designed towards creating future leaders. 2011 marked the beginning of a new program called “Board-Certified Rose Leaders”. This year-long program is designed for employees who someday hope to be a director, vice-president or executive and includes seminars, hands-on projects and mentoring to help accelerate the growth of our future Rose leaders. As an HCA hospital, Rose employees are also invited to apply for the HCA Executive Development Program. This program is for all HCA employees who are interested in someday becoming a hospital Chief Nursing Officer (CNO) or Chief Operating Officer (COO). The program lasts for 2-4 years and prepares its participants to become executives after completion.

Finally, we have the School of Professional Development, which is mainly for our clinical staff. The classes offered include Spring and Fall Education Excursions as well as a variety of medical topics including chest pain, stroke care, women’s care and pediatric care. There are also nursing skills classes and development programs for the nursing staff.

In only one year, we had over 500 students attend 56 classes and programs and we ranked #14 in HCA for employee engagement. Rose Medical is proud of the achievements of each school at Rose University and each of the participants involved, and we are excited to see how the programs, and our employees, flourish in 2012.

Later that day, Louise had a mammogram, ultrasound, and biopsy with Dr. John Lewin at the Rose Breast Center. Within one week, she had surgery with breast surgeon Dr. Barbara Schwartzberg to remove the tumor and five lymph nodes. Louise was diagnosed with Stage 2 breast cancer.

Since surgery, she has undergone three rounds of chemotherapy and has three rounds left to complete. After chemo, she will begin her radiation therapy, which is another six-week treatment process.

Louise has a family history of cancer, including her grandmother who had breast cancer. So she knew that given her heredity, it was possible she would face a breast cancer diagnosis. She was always careful to have her annual mammogram, and even at her well-woman exam in April, her doctor did not find this lump. Fortunately, Louise knew that something didn’t feel right and followed her instinct to check out that “twinge” she felt. Louise now stresses the importance of monthly self-exams, even in the mix of an annual mammogram and check at a well-woman exam.

Louise found a strong support network with her coworkers at Rose Medical Center, including several women who also fought a battle with breast cancer. She continues to work while she undergoes her chemotherapy, and said “of course I work – this is where I feel good!” With her built-in support group at work and ongoing encouragement from her husband at home, Louise has a positive outlook and looks forward to being cancer-free.  

The Rose “Surviving Well” Calendar is a 12-month calendar highlighting our cancer services, physicians, and some inspirational stories from our patients. Louise is our survivor for February, which is also Cancer Prevention Month.

Birth defects are defined by the Center for Disease Control as “conditions that cause structural changes in one or more parts of the body; are present at birth; and have a serious, adverse effect on health, development, or functional ability.” Birth defects can range from something small, like an extra finger or toe, to more complicated conditions such as congenital heart defects, Down Syndrome, Cleft Lip/Cleft palate, Spina Bifida and more.

According to the CDC about 1 in every 33 babies has a birth defect. The rates in Colorado are comparable to the national averages, and have remained fairly constant over time.

Dr. Stephanie Ring, OB/GYN at Rose Women’s Care at West Highlands, says that birth defects can be caused by a number of reasons, but that many of those causes are still unidentified.

“A majority of the causes of birth defects is unknown,” she says. “However, we do know that some are caused by genetic traits, and the rest are due to exposure to outside components like drugs, alcohol, tobacco and certain medications. There are other risk factors as well, such as obesity, diabetes, age, or having a family history of birth defects.”

Dr. Ring added that there are steps that both women who are pregnant as well as women trying to get pregnant can take to increase her chances of having a healthy baby.

Here are 8 Way to Help Prevent Birth Defects

• Avoid alcohol, drugs and tobacco
• Eat a balanced diet and exercise regularly
• Avoid infections and foodborne illnesses
• Take 400 mcg folic acid daily
• Avoid workplace and environmental exposure to things that could harm your baby
• Have regularly scheduled visits with your OB
• If you are trying to get pregnant and have high blood pressure, are overweight, have diabetes or have another medical condition, talk to you physician about steps you can take to address those issues before conception
• Genetic counseling and testing is available for expectant parents, and some people find it helpful because it gives the parents a chance to prepare for a child with special needs ahead of time

Dr. Stephanie Ring recently sat down with Denver’s Channel 7 News to discuss birth defects. Click here to watch the video.

After making the decision that I wanted to pursue gastric bypass surgery, I started jumping through all kinds of hoops to get ready, which is just the first step in this life change.  

Here is what I had to do, and criteria that I had to meet to be considered for this surgery with Dr. Snyder as well as meet my insurance requirements:

1. Verify insurance or work out financing or pay upfront.  Gastric Bypass (or Roux-n-Y) surgery costs about $20K – 25K.   Mine is covered by my insurance, except for a co-pay. I started working with my insurance-assigned case worker to coordinate all benefits.  This is a fair amount of work almost daily.

2. Have a BMI of 40 OR a BMI of 35-39 with multiple co-morbidities  (like sleep apnea, depression, arthritis, cardiac or pulmonary issues, etc).

3. Blood work. They drew 14 vials of blood from me–yes, 14.  That is based on my medical history and surgical consult results.

4. Pulmonary study to make sure that I either stay in the hospital long enough or go home with the right equipment if I really have breathing issues while I sleep. Apparently I snore like a truck driver, which I doubt is a turn-on for my husband. (My Great Dane doesn’t seem to care, but he is only my husband when the real husband travels!)   

5. Two psychological consults, totaling 90 minutes.  I think that is a little light, but I had been seeing a counselor for over a year. My weight and depression were a big part of those sessions, so I feel like I have a handle on it.

6. The initial seminar and then the initial consult with Dr Snyder.  Those seminars are only once a month, so if you miss it, you have to wait for the next one.   There is a line afterwards for people to sign up for the consultations, and space is sometimes limited.   The consults are 30 minutes long, and I must say he makes those 30 minutes very valuable.

7. Research on which surgical option you feel is best for you.  I was clear all along after my research that I wanted and would get the gastric bypass.

8.  Patients 50 or older are required to have a full cardiac workup. Since I’m not quite 50, I didn’t have to do it. A lot of people also require a gastroenterology clearance.

9. Mandatory pre-surgical nutrition classes with a group of patients and my support person.  They really want to see you and your support person at everything.  The internet bariatric discussion boards are littered with people who “fail” post-surgically because nothing changes in their lifestyle. The classes and support system are there to help with that change. If you cannot commit to the lifestyle change, this surgery will not be successful.

10. Mandatory meeting with the staff nutritionist at Dr. Snyder’s office. This is to specifically review my nutritional needs and expectations immediately post-op, as well as  the following stages as we move into what will become my “new normal of eating”– five to six 4-6 oz meals daily, comprised mostly of protein (70%) and complex carbohydrates.  You also learn that you cannot drink with meals, and you must learn to sip, not chug liquids.

11. Meeting with my primary care physician (PCP) to get a recommendation letter and medical records. This letter outlines that I am good surgical candidate and five years worth of records detailing my weight and what we have done to address it.  

12. Most insurance requires a mandatory 3-6 month physician monitored diet prior to surgery. Sometimes you can get it waived, which I was able to. You don’t ask, you don’t get…

All of these hoops are necessary and worth it and I don’t think anyone who is having bariatric surgery should take it lightly. This surgery is life-altering. Forever.  No turning back. So while it can be demanding and take up time, this stuff is necessary.

This process is already changing my life, in some ways that I might not have expected. I have already unearthed a surprising number of people in my life that are very resistant to this choice I have made   I knew to expect it, yet it surprises me anyway.  Why would anyone want me to stay obese?   I did not arrive at this decision lightly, and I did my research.

In regards to the resisters, my daughter summed it up best. She said that there are people out there that like having me as their “fat friend”. Well, too bad for them. Life is literally too short to keep toxic people around, so I am going to consider this part a blessing.

The hardest part in all of this is making the conscious choice to focus on me and my health, and to step away from taking care of everything else.  I am a HUGE (there is not a caps lock button large enough to emphasize this) control freak and I HAVE to let that go.  All the other people in my life can take care of themselves, and my desire to immerse myself in controlling every little aspect of their lives is part of what got me here.  

The biggest upside to this experience is going to be getting back to good health.  Getting back decades on my life, and eliminating health issues.  I want to run again. To have energy.  To not be depressed. In fact, I am less depressed just getting ready for this!

I’ve also found that my new favorite websites to cruise are clothing sites.  I have never done that before, because I have been fat since the shopping websites became popular. I was also excited to I hear that I might drop a shoe size, so I get all new shoes!

Lots of things are starting to change. I cannot imagine what it will be like to be out and about and not have people give me that look that obese people get.  You cannot imagine how mortifying it is until you have been on the receiving end of it.  Being critical of fat people seems to be the last acceptable bias. No one is happy being fat.   And I am ready to get control of this and take back my life and my health.

Get ready world.  Here I come!

Marie

Marie had her gastric bypass surgery in January of 2012. You can read more of her story on her blog, My Gastric Bypass Journey  and she will be guest blogging for Rose Knows Health with updates of her progress.

My name is Marie.  I am 49 years old, 5’5”, and I have been overweight my entire life, or at least it feels that way.  

When I got pregnant 24 years ago, I lost whatever hold I had on a semi-normal weight.  I weighed 264 lbs the day I came home from the hospital after giving birth. Some of that came off quickly, but a lot of it stuck around.  I started smoking to get the weight off, joined Weight Watchers, and basically starved myself.  I lost 100 lbs and when my children were 2, I weighed about 165, which didn’t last.  

I continued a ridiculous cycle with food.  I could take weight off, but it became harder and harder over time, and it came roaring back as soon as I ate more than 1000 calories a day.  The smoking was taking its toll as well.  When my grandmother asked me to quit smoking before she died, I quit cold turkey and promptly gained 60 lbs in under five months. I can remember making meals for my family, and then eating plain popcorn and drinking water to fill myself up, but I would still wake up feeling ravenous.

When I married my husband in October of 1999, I starved myself into a size 14 dress.  I weighed 168.  I was 37.  I came back from the honeymoon at 180.  I have not seen 180 since.

I have been over 200 pounds for a decade. Right now, I weigh 240ish.  I should weigh 100 pounds less to be at my optimum weight for my height of 5’5″.  

I mentally and emotionally gave up the battle last year.  I was shocked to see myself in a photo where I had three chins from smiling.  It broke my heart, but I always put on a brave face, and I tried hard to not let anyone see me down. I cannot remember the last time I shopped anywhere but Lane Bryant.  It is incredibly sad and depressing to have your fashion universe boil down to one store, and to have to be satisfied with anything that fits reasonably well.

I knew from experience that even when I was careful and counted calories, walked, did all the things normal people do to lose weight, I still would not. When I turned 49 I had this vague thought, “Now should be when I dig in and go for 150 at 50.” I quickly pushed it aside.  I knew that while I could get down to 150 lbs, it would be for a minute. Dieting. Does. Not. Work. For. Me.  

I was really getting afraid for my health.  How long can I be this big and not have it take a gigantic bite out of my life expectancy?  I had stopped golfing and skiing ages ago, and I quit running decades ago.  I walk with my dogs, but it’s not very quick anymore.

So I started researching.  And then I wound up overhearing a very normal sized guy talk about his gastric bypass experience to someone when I was sitting nearby.  I literally stopped breathing while I listened to his story.  He was really happy.  He was back in charge of his life.  He said he was never hungry anymore.  He had energy.  He was doing things he had not done in decades.  I wrote down the surgeon’s name that he mentioned, grabbed my bag and raced home to look the guy up.

And that was how I discovered Dr. Michael Snyder at Rose Medical Center. He has done well over 3000 bariatric surgeries and has zero mortalities.  I researched the dickens out of him and kept being amazed by what I found.  Everyone loves his practice, and I mean everyone.  His program includes support groups and nutrition classes, most of which are free of charge. I knew this was it, and was going to be what changed my life.

I went to a mandatory seminar for Dr. Snyder with my husband and daughter coming along for support. Dr. Snyder holds monthly seminars for potential patients because he wants you to know what bariatric surgery involves, and you can’t schedule an initial consult without it. The room was PACKED and I learned a lot that night.  There are a lot of people like me out there.  I was not alone, and there was a solution for me.  And I knew I could do it.

After the seminar, I made my consult appointment, and did everything I needed to do ahead of time.  I verified my insurance, I did my psych consults, I did pulmonary tests and my blood work.  I met with my primary care physician, got my records and got a letter from her blessing me as a candidate.  She was very in favor of my decision, and loved Dr. Snyder as my choice for surgeon.

Then I met with Dr. Snyder.  He loved me as a candidate for the surgery and accepted me as a patient. He said even though I am morbidly obese, I am in good shape considering, and should fly through the surgery, even with my co-morbidities of lupus, asthma, hypertension, pre-diabetes and rheumatoid arthritis

I am very aware of what I need to do for this to be successful and I am willing to commit to changing my life forever for this to work.  I just want the same fighting chance to keep weight off that normal people have.  

Click here to read Part II of Marie’s Journey.

Marie had her gastric bypass surgery in January of 2012. You can read more of her story on her blog, My Gastric Bypass Journey  and she will be guest blogging for Rose Knows Health with updates of her progress.

Olga, Cervical Cancer Survivor

Just by looking at Olga, you might not guess that she had cancer. When she was diagnosed at age 29 with cervical cancer, she was shocked herself.

It was during Olga’s routine yearly gynecologic exam that her doctor first found the abnormal cells. He had her come back for further testing and a biopsy, which is when they found the cancer.

“When I got that phone call with the diagnosis, I couldn’t believe it,” Olga says. “I was barely 29, I felt like I still had my whole life ahead of me.”

Olga then sought out another physician, who gave the same diagnosis, and also told her that it was very likely she would have to have a full hysterectomy to eradicate the cancer, which would leave her unable to have children.

“That was the hardest part for me,” Olga recalls. “I’m so young and the thought of never being able to have children really scared me. I want to get married and have a family someday.”

With the support of her family, including her twin sister, Olga decided to continue her treatment with Dr. Daniel Donato, a gynecological oncologist at Rose, and asked him if there was any possibility of treatment that might not leave her sterile.

“Dr. Donato was very patient with me, and he came up with an alternative,” she says. “He said that I would have to have surgery, but that we could take out only the part of the cervix and the surrounding lymph nodes that were affected, and that they could wait and see how much the cancer had spread before taking any other drastic steps.”

Olga decided to have the surgery and was at home recovering when Dr. Donato’s office called to give her the results—the surgery had worked, her lymph nodes were okay and she wouldn’t need any further treatment at the moment.

“I started crying. I immediately called my dad and he started crying,” Olga says. “It was such a happy day. The best part is that my chance to be a mom is still there. All of my testing has been okay. I feel very lucky.”

Today, Olga is healthy and cancer-free for three years. She says that one thing she has learned from this experience is the importance of regular checkups, and being active in your health and well-being.

“With me, I had regularly been going to see my doctor, and I had never had any problems with abnormal pap smears,” she says. “Then, it just happened. I had no signs or symptoms. Don’t be afraid of going to the doctor, and don’t be afraid to make your voice heard about what is important to you.”

The Rose “Surviving Well” Calendar is a 12-month calendar highlighting our cancer services, physicians, and some inspirational stories from our patients. Olga is our survivor for January, which is also Cervical Cancer Awareness Month.

Everything that we do here, and the quality care we are able to provide our patients is because of our amazing staff, physicians and volunteers. We also wouldn’t be where we are without the support of such a wonderful community.

Enjoy this holiday card filled with pictures from 2011 and holiday wishes from our staff to you.

Each year, the Rose Employee Activities team chooses a Denver school that primarily serves low-income children. The children are asked to provide two descriptions of what their “dream shoes” would be, and Rose employees volunteer to purchase shoes to make that wish come true for every student.

This year, the chosen school was Columbine Elementary, in Denver. The school enrolls students from age 3 through 6^th grade and over 90% of the students are eligible for free or reduced lunch.

Rose volunteers went to the school on Dec. 16 to deliver the shoes to the children, and they a few special guests come with them–several servicemen in the military, and Rocky, the Denver Nuggets mascot. The kids were really excited to get their new shoes (and almost just as excited to meet Rocky).

Here are some pictures from the day. Go to the Rose Facebook page to see the whole album!

One of our Rose patients is highlighted each month of the calendar, sharing his or her story about dealing with cancer. Each story is a unique testimony to our patients, living each day with a joie de vive that brings hope and happiness to us all.

We hope that their stories inspire you throughout the year as much as they have inspired us!

Thanks to a new procedure called Intraoperative Radiation Therapy (IORT), breast cancer patients who meet the medical qualifications can possibly be done with their entire cancer treatment in less than two hours.

At Rose, we are very excited to offer this cutting-edge treatment, and we wanted to do something a little different to educate the public about the procedure, which is why we decided to live-tweet from one of Dr. Barbara Schwartzberg’s IORT procedures.

On Wednesday, Nov. 30, we used the Twitter hashtag #RoseIORT to send updates from the operating room as well as answer questions and offer information about the procedure.

Below is the Twitter transcript, for those who were unable to watch the live feed. To learn more about IORT, click here.

11:19

We will start tweeting in less than an hour! Submit your questions here.

11:30

PGangolly: Why did you decide to tweet from the OR?

11:38

@PGangolly It’s a great way to inform & educate the public about new procedures & technologies that they might not know about. #RoseIORT

12:27

They are getting the room prepped for the surgery and procedure. We should be starting soon. #RoseIORT

12:39

IORT stands for intraoperative radiation therapy. We are now using it to help treat early stage breast cancer. #RoseIORT

12:49

The patient has early stage breast cancer. She’s excited to be in the new trial & get her surgery/radiation treatment at once #RoseIORT

12:53

Limabo88: @RoseMedical What kind of doctor performs this type of surgery? #RoseIORT

12:55

@Limabo88 Our general surgeons, who specialize in breast cancer, perform the lumpectomy & place the balloon for the IORT treatment #RoseIORT

12:57

@limabo88 Then the radiation oncologist connects the radiation technology and administers the radiation treatment. #RoseIORT

12:58

Patient is in her 60s. She has a small 8 mm (3/8 in) cancer in her right breast. #RoseIORT

12:59

Patient has very early breast cancer. She’s a perfect candidate 4 breast conservation (lumpectomy) & radiation as one procedure #RoseIORT

1:03

Dr. Schwartzberg is going through usual preoperative checklists, which is a part of our routine quality assurance. #RoseIORT

1:05

The patient has met w/surgeon and radiologist to make sure she is an appropriate candidate. #RoseIORT

1:06

The procedure is done under general anesthesia. It takes about an hour and a half and is an outpatient procedure. #RoseIORT

1:07

Dr. S is using the sentinel lymph node technique, which allows her to selectively identify lymph nodes that need to be checked. #RoseIORT

1:10

They’re done checking the nodes, & will wait to hear what the pathologists say. #RoseIORT

1:10

In the meantime, they will start the lumpectomy and removal of the tumor. #RoseIORT

1:11

Dr. S made about a 1 ½ inch incision to start the lumpectomy. Doing the IORT makes their entry approach a little different. #RoseIORT

1:12

Dr. S looks at the patient’s mammograms to see exactly where the cancer is and where she needs to operate. #RoseIORT

1:15

Fantastic. Dr. Schwartzberg says they were able to successfully remove the cancer. #RoseIORT

1:16

They’re applying some local anesthesia to the area to make the patient more comfortable (she is already under general anesthesia) #RoseIORT

1:18

Dr. S is taking an x-ray of the breast tissue to make sure that they have identified all of the cancer. #RoseIORT

1:18

The cancer they removed is about the size of a quarter #RoseIORT

1:20

Dr. Schwartzberg performing the lumpectomy. #RoseIORT

1:23

@PGangolly To get the word out about today, we used our social media pages, as well as those of our community partners. We’ll also make transcripts available afterwards.

1:24

Dr. Schwartzberg wants to remind women to get their yearly mammograms. Early detection is key! #RoseIORT

1:26

Nodes look to be cancer free. #RoseIORT

1:26

Now Dr. S. is looking at the cavity to decide what size of radiation balloon to use. #RoseIORT

1:31

They are checking the tissue around the lumpectomy site, before they insert the balloon. #RoseIORT

1:35

They use a temporary balloon to help decide what size radiation balloon to use. #RoseIORT

1:36

Dr. Howell, our great radiation oncologist, is here. She will be the one who does the IORT procedure. #RoseIORT

1:38

The team, looking at the ultrasound to determine balloon size. #RoseIORT

1:39

Fun fact—several people are wearing their Christmas surgical caps today. #RoseIORT

1:42

They’ve calibrated the size and it’s a 30 cc cavity. #RoseIORT

1:43

Now they are putting in the stainless steel shield to help protect the patient’s heart and lungs, etc during radiation. #RoseIORT

1:45

They are putting in a 6 cm shield. She has a shield over her hips and thyroid to protect her as well. #Rose IORT

1:46

Pathology just called to say that we have good margins and can proceed with the IORT procedure! #RoseIORT

1:48

Dr. S is making sure that the shield is covering the right areas. It took only 48 minutes, to get to the radiation portion. #RoseIORT

1:49

They are closing the tissue around the balloon, so that they have good approximation with the radiation. #RoseIORT

1:49

Each patient has a different treatment amount that is precisely calculated. #RoseIORT

1:50

They are going to do 7 minutes of radiation treatment. #RoseIORT

1:51

They are draping the patient for the radiation, and putting up the shield that the radiologist will stand behind. #RoseIORT

1:57

Setting up the room for radiation. #RoseIORT

2:03

We are waiting outside of the OR as Dr. Howell does the radiation. Does anyone have any questions for Dr. Schwartzberg? #RoseIORT

2:05

Radiation is finished! #RoseIORT

2:05

In just 7 minutes, our patient has received her entire course of radiation treatment for her breast cancer! #RoseIORT

2:07

Now, Dr. Schwartzberg is going to close up, and we’re done! #RoseIORT

2:08

Here is the Xoft Accent electric brachytherapy machine they use for the radiation. #RoseIORT

2:12

Dr. Schwartzberg is closing up the area. #RoseIORT

2:13

@PGangolly Dr. Schwartzberg wanted to let you know she’s a GW grad and to say hi to Foggy Bottom for her!

2:18

The recovery from this is pretty quick- Dr. S wants the patient up and walking by tomorrow. #RoseIORT

2:31

The surgery is all done! Now, they’ll take the patient back to Recovery & Dr. Schwartzberg expects her to be walking tomorrow. #RoseIORT

2:46

@myoungnp @mylifelineorg The patient did great

2:47

One question someone asked in email was if all types of breast cancers can be treated with IORT. #RoseIORT

2:47

The answer to that is no, not all types can be. #IORT is primarily used to treat patients with very early breast cancer. #RoseIORT

2:50

Someone else asked, “What is the treatment time compared to regular radiation?” #RoseIORT

2:51

The answer is, regular radiation treatments can take days or weeks. W/ IORT, the patient is done in less than 10 minutes. #RoseIORT

2:55

A big thank you to everyone who followed the surgery! #RoseIORT