5280 HEALTH 2022

from left to right:

Alysa Paul (President)
Pamela Hill, RN, CANS (Founder)

Emily Prete (COO)

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I DO WHAT I DO...

Jared Foran, MD
Orthopedic Surgeon
Outdoor Enthusiast

Brenda Marie Mizek,
Lee-Amato, RN

RN

Jude Torchia, Jared Foran, Mavourneen
CEO MD Miller, RN

BECAUSE I LOVE
WHAT YOU DO

Jill
Knee Surgery 2020
Outdoor Enthusiast

I’m an orthopedic surgeon at OrthoColorado Hospital, and I take every
opportunity I can to get outside. I think there’s so much joy to be found in the

simple things — like walking my dog Grisby. It gives me an understanding
of how important my patients’ hobbies and activities are to them, too. And

that’s exactly why I love what I do.
I do what I do, so my patients, like Jill, can get back to doing the things
they love most. It’s the reason we’re all here — to deliver the very best in

orthopedic and spine care.
OrthoColorado: Colorado’s Only Orthopedic Hospital.

www.orthocolorado.org



E

CONTENTS

34 44

FEATURES DEPARTMENTS

34 HOW TO RAISE A 10 BEHIND 20 TIME FOR Cover: Getty Images. This page, clockwise from top left: Taylor Callery; Getty Images; Jeff Nelson; Courtesy of Float & Flow; Jeff Nelson

MORE RESILIENT KID THE STORIES A CHANGE
Children and teens in the
Centennial State are facing 13 GIFT HORSE Designed in Boulder, the
an unprecedented mental OneClock provides a
health crisis. Even so, they Inside CSU’s new equine healthier way to wake up.
can still learn to endure therapy center.
difficulties and rebound
from failure. 14 SEEING THE LIGHT 22 RISE WITH

44 THE BEST MEDICINE Will protecting yourself THE MACHINES
from the sun actually short-
Preventive health care en your lifespan, as recent Three Front Range gyms 26 13
saves time, money, and headlines have suggested? offering the latest body- 112
lives. So why aren’t boosting advancements.
Coloradans seeing their
doctors? The pandemic A local doc separates fact 24 INTERNAL ERROR
may have provided an
excuse for skipping ap- from pseudoscience. Strive Health aims to fix
pointments, but it’s time
to return to your regular 16 FOR THE kidney care by combining
medical schedule. data and old-fashioned
LONG HAUL personal attention.
52 TOP DOCTORS
How an innovative clinic
Our must-have annual list
of Denver’s best physicians. at UCHealth helps 26 DIGGING DEEP

62 TOP DENTISTS COVID-19 patients with Ietef Vita is advancing

5280’s yearly directory lingering symptoms. access to nutritious food
of Colorado’s top-rated
dental professionals. 18 PARENTAL in Denver and beyond
through urban gardening,
ADVISORY youth-oriented nonprofit
work, and rap music.
A rare, previously untreat-
able disease is every

mom’s and dad’s nightmare 112 ADVANCED
diagnosis. But thanks to a RETREATS

cadre of local parents, such Colorado fitness workshops

prognoses might no longer and wellness getaways are

be hopeless. back and better than ever.

5280 (ISSN 10826815) is published monthly by 5280 Publishing, Inc.,1675 Larimer St., Suite 675, Denver, CO 80202. Subscriptions are $16 for one year (12 issues). Back issues are available for $5.99 plus tax and shipping by visiting shop.5280.com. Periodical postage
paid at Denver, CO, and additional mailing offices. POSTMASTER: Send all UAA to CFS (see DMM 707.4.12.5). NONPOSTAL AND MILITARY FACILITIES: Send address corrections to 5280 Publishing, Inc., P.O. Box 37270, Boone, IA 50037-4270. Canadian Post Publica-
tions Mail Agreement No. #40065056 Canadian Return Address: DP Global Mail, 4960-2 Walker Road, Windsor, ON N9A 6J3. 5280® is a federally registered trademark owned by 5280 Publishing, Inc. 5280 also owns trademark registrations for TOP OF THE TOWN,
DENVER’S TOP DOCTORS, DENVER MAGAZINE, COLORADO PARENT, and COUTURE COLORADO. © 2022 5280 Publishing, Inc. All rights reserved.



Q WHAT CHILDHOOD EXPERIENCE TAUGHT YOU RESILIENCE?

EDITORS Spencer Campbell, Jessica LaRusso Living abroad. SUBSCRIPTIONS
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rejected by my high CONTRIBUTING WRITERS Julie Dugdale, Nicholas Hunt, 5280 from 7 a.m. to 11 p.m. Monday
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CONTRIBUTING ARTISTS Caleb Santiago Alvarado, Taylor Callery, to [email protected].
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BEHIND THE STORIES

CONTRIBUTORS

ETHAN PAN FROM THE EDITORS

A food writing and cognitive science Taking Care
major at Brown University, Pan
During the past year, we both welcomed mental and behavioral health problems are pre- Clockwise from top left: Courtesy of Ethan Pan; Sarah Banks; Courtesy of Jessica LaRusso; Courtesy of Taylor Callery; Sarah Banks
got a literal taste of his subject’s work our firstborns into the world—and im- ventable, parents can prepare children for bullies,
while reporting “Digging Deep” mediately joined the ranks of perpetually broken hearts, and missed shots by helping them
(page 26), a profile of Denver petrified parents. We had read all the books develop a deep well of resilience they can draw
and bought all the bottles, but we were still ill- upon—starting the day you bring them home
hip-hop artist, gardener, and vegan prepared for everything there is to fear. Why aren’t from the hospital.
chef Ietef Vita (aka DJ Cavem). they sleeping? Have they gained enough weight?
Aren’t they supposed to be rolling over by now? Who’s That news arrived just in time for this pair
“While showing me his herbs, he was going to watch them when we return to work? Should of new parents. Because, as we’re quickly learn-
adamant I try them,” Pan says. “It they be sucking on that? ing, there’s only so much we can control (hello,
showed not only his generosity, but Evidently, this terror doesn’t go away. If our projectile vomit!), which is why it’s important
also his understanding that sharing relatives and co-workers are to be believed, it to get ahead of the things you can. In “The Best
flavor makes a special moment.” will only become more intense as our boys grow Medicine” (page 44), an exhaustive guide to the
older and begin to confront adversities on their preventive care you may have skipped during the
MADI SKAHILL own, out of our soothing reach. And, according pandemic, you’ll discover how to do just that.
to a growing body of research, being a kid today At the same time, we’re thrilled to cut through a
Skahill, a digital assistant editor is even tougher than it used to be. Instagram and seemingly never-ending period of doubt and un-
for 5280, says that researching “Rise TikTok have made the ups and downs of teenage certainty with stories of hope—from horse-based
angst a 24/7 affair. Athletics are more cutthroat, therapy that’s helping children with disabilities
With The Machines” (page 22) thanks to the rise of club teams. Climate change. (“Gift Horse,” page 13) to a Denver startup us-
was a wake-up call: “Apparently, Partisan politics. School shootings. A 2018 study ing artificial intelligence to detect and treat the
in the Journal of Developmental and Behavioral early stages of kidney disease (“Internal Error,”
I’m losing bone strength by the Pediatrics found that the number of anxiety diag- page 24). We hope this issue inspires you to take
minute.” Luckily, she found three noses for those ages six to 17 increased 20 percent proactive care of yourself and those you love—
local gyms with state-of-the-art between 2007 and 2012—and that was before because even when the little ones are covered in
equipment that garners results COVID-19 upended children’s lives. puke, they’re still pretty cute.
almost as quickly. “I love that these Enough with the scare tactics. The question
exercise machines help me work isn’t, “What should you be afraid of?” but rather,
my body smarter,” Skahill says, “How do we make sure our kids are ready to
confront, endure, and rebound from life’s chal-
“not harder.” lenges?” The experts we spoke with for this issue’s
cover story (page 34) say that although not all
TAYLOR CALLERY
SPENCER CAMPBELL & JESSICA LARUSSO
As Callery created the bold,
graphic illustrations for “How To Tommy Campbell (left)
Raise A More Resilient Kid” (page & Ozzie LaRusso
34), the Detroit-based artist found

inspiration in his seven-year-
old niece. “Her world is so complex

in comparison to my own era of
being a child,” Callery says. “I take

this issue to heart with passion
because of her.” Callery’s work has
appeared in Rolling Stone, the New
York Times, and Sports Illustrated.

10 5 2 8 0 H E A L T H 2 0 2 2

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SKINCARE „ COVID-19 „ ADVOCACY „ TECHNOLOGY „ FITNESS „ INNOVATION PULSE

A 14-year-old patient
works with a steed named
Concho at Denver’s
interim Temple Grandin
Equine Center this past fall.

Gift Born with Down syndrome and weakened muscles, Izzy S. couldn’t sit up atop her mount when she began visiting the Temple Grandin
Horse Equine Center (TGEC) interim facility in Elyria-Swansea a year and a half ago. By this past July, however, the four-and-a-half-year-old
was able to stand in the saddle for 10 seconds. Her progress can be attributed to equine-assisted services (EAS), a form of therapy
Inside CSU’s designed to treat a range of physical, cognitive, and emotional disabilities, from autism to spina bifida. (For Izzy, a horse’s gait helps
new equine her understand what walking feels like.) Determined to become the world’s foremost EAS provider, in February 2021 Colorado State
therapy center. University debuted an approximately 14,000-square-foot TGEC facility—named for the school’s famed animal sciences professor
and autism advocate—near its Fort Collins campus; a permanent TGEC outpost at Denver’s National Western Center will open in Janu-
ary. The Denver venue, located in the new CSU Spur campus at the complex, will feature enough space for 13 horses and 250 therapy
sessions per week, meaning that, come the new year, Izzy won’t be the only person riding high. LISA KENNEDY

PHOTOGRAPH BY JEFF NELSON 2 0 2 2 | 5 2 8 0 H E A L T H 13

SKINCARE

Seeing The Light with less sun exposure. Such
research has launched plenty
Will guarding yourself against the sun shorten your lifespan, as recent headlines of click-bait headlines, in-
have suggested? One local doc separates fact from pseudoscience. cluding “Soak Up The Sun
This Vacation, It Can Really
Y ou may have heard the news: Protecting yourself from the sun is actually detrimen- Lower Heart Disease Risk.”
tal to your health—at least, according to a 2016 study in the Journal of Internal
Medicine that’s part of a growing body of research re-examining the role sunlight Such conclusions, how-
plays in our well-being. But while there’s mounting evidence that not getting ever, are reductive—and
enough sun could be a serious risk, there’s a lot to unpack before you decide to leave dangerous—interpretations
your parasol behind on a trip to Dillon Reservoir. of the science, says Dr. Neil
Box, a cancer researcher at
At the heart of the controversy is vitamin D, the nutrient we get from food, the University of Colorado
supplements, and ultraviolet radiation (aka sunshine). Higher levels of vitamin D Anschutz Medical Campus:
“People who are getting out
have long been correlated with everything from reduced inflammation to lower rates in the sun are people who are
often exercising and getting a
of skin cancer and heart disease. But researchers haven’t been able to verify causation load of other health benefits
from that.” Besides, Denver’s
between oral vitamin D supplements and many of those health benefits. This has led some experts strong outdoors and fitness
cultures mean it’s likely most
to suspect it’s actually sunlight, not vitamin D, that’s responsible for healthier bodies. The Journal locals enjoy enough sun dur-
ing their daily activities, Box
of Internal Medicine study seems to bolster that hypothesis: In a review of nearly 30,000 Swedish says. The World Health Or-
ganization recommends five
women, it found that those who spent more time in the sun lived up to two years longer than those to 15 minutes of sun on your
hands, arms, and face two
to three times a week during
summer to stay healthy. And
because of our high elevation,
the city receives about 26 per-
cent more UV radiation than
areas at sea level.

That number likely plays
into another alarming statis-
tic: Colorado ranks seventh
in the nation for skin cancer
deaths per capita, according
to the Centers for Disease
Control and Prevention. So,
it’s extremely important for
Coloradans to avoid the sun
when ultraviolet rays are
strongest, around 10 a.m. to
4 p.m. You should also wear
protective clothing such as
broad-brimmed hats or long-
sleeved shirts when you can
and use shade and sunscreen
when you can’t.

“We’re not saying you have
got to be a troglodyte, that
you’ve got to be a cave dwell-
er and stay inside and avoid
the sun,” Box says. “We just
need to be careful with how
we balance these kinds of
health messages.”

NICHOLAS HUNT

14 5 2 8 0 H E A L T H 2 0 2 2 ILLUSTRATION BY DAN BEJAR



COVID-19

FOR THE LONG HAUL

How an innovative clinic at UCHealth helps COVID-19 patients with lingering
symptoms return to life.

People suffering long-term effects of COVID-19 have a new co-pilot: the Post-COVID
ICU Clinic at the University of Colorado Anschutz Medical Campus in Aurora. There,
UCHealth specialists in cardiology, pulmonology, physical rehabilitation, and behavioral
health come together to see those who struggle with symptoms a month or more after
recovering from the coronavirus. “There are patients in their twenties, thirties, and forties
who were highly productive and are now unable to walk across the room without feeling
exhausted,” says Dr. Natasha Altman, an advanced heart failure and transplant cardiolo-
gist. The clinic is the brainchild of Dr. Sarah Jolley, a pulmonary and critical care medicine
specialist at the CU School of Medicine who was developing a post-ICU clinic to aid
long-term recovery when COVID-19 hit in spring 2020. The project quickly evolved to
include pandemic patients with protracted, mostly unexplained issues: Symptoms some-
times resemble those caused by autoimmune disorders or POTS syndrome (a condition
that affects blood flow and causes light-headedness and fainting). Thankfully, early studies
show that vaccines cut the odds of developing long COVID approximately in half. But
for Coloradans with the mysterious ailment, the UCHealth clinic offers a focused, inter-
disciplinary approach that looks something like this. HILARY MASELL OSWALD

Å START

A month or more after having COVID-19, you continue to experience mysterious symptoms such as extreme fatigue,
shortness of breath, ongoing cough, brain fog or trouble concentrating, loss of taste or smell, and elevated heart rate.

During your first appointment at the Post-COVID ICU Clinic, you’ll undergo testing tailored to your particular ail-
ments. If you’re having heart-related issues, for example, specialists might check your blood pressure, order

an electrocardiogram, and request blood tests or do a stress test to evaluate circulation through your
ticker—all while making sure you don’t actually have an unrelated disease.

Depending on your symptoms, Altman and Jolley consult with other doctors from physical and rehabilitative
medicine, integrative medicine, and/or behavioral health to develop an often two-pronged, tailored treatment

plan that addresses specific physical and mental needs.

PHYSICAL MENTAL

“For the most part, we try to get people Psychiatrists trained in managing depression, anxi-
back into activity and exercise slowly,” Altman ety, insomnia, and cognitive issues—all of which
says. “Recumbent exercise—on a bike or rowing may accompany long COVID—screen patients to
machine or swimming—is generally proving to be identify problems and prescribe medications. The
helpful.” Other treatments might include inhalers
for pulmonary symptoms and physical therapy to clinic also uses both individual and virtual group
therapy to help treat the emotional burdens
build stamina and regain strength. associated with the virus.

You may need to go into the clinic every few months for as long as a year, but Jolley says the results so far indicate
that symptoms will resolve over time: “We’ve embraced this holistic model, and we realize the importance of
[supporting] mental health and physical health for long-haulers. Overall, I’m hopeful.”

Getty Images (16)

16 5 2 8 0 H E A L T H 2 0 2 2

Over 200,000 Denver-area children go to school hungry.
Fill the Void is an Amp the Cause program created
to alleviate hunger through grocery gift cards.

With your help we can Fill the Void created by overrun
food banks, supplement SNAP benefit programs,
and ensure children have reliable access to food.

Your $250 donation will feed a family of four
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new year,
same

hunger.

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Amp the Cause is a nonprofit that works with over 55 beneficiary
organizations to improve the lives of Colorado’s children and families.

ADVOCACY

Lauren and Hosea Rosenberg $1 millon through virtual
with their daughter, Sophie auctions and partnerships
with local chefs (Spuntino,
Parental Advisory the Edible Beats group, and
others, for example, sold a
Learning your child has a rare disease is every mom’s and dad’s nightmare diagnosis. special ice cream flavor to
But thanks to a cadre of local parents, such prognoses might no longer be hopeless. benefit the nonprofit). The
money funds research aimed
I n March 2020, as COVID-19 spread across the country, Hosea and Lauren Rosenberg’s at discovering an effective
world had already come to a halt. Days before the pandemic forced the couple to shut down treatment for MCTO.
their Boulder restaurants, Blackbelly and Santo, they learned that their then two-year-old
daughter, Sophie, had multicentric carpotarsal osteolysis (MCTO), a painful, progressively Some of that research is
crippling genetic disorder that can be life-threatening due to its accompanying kidney failure. being performed by biotech
Sophie shares the disease with approximately 30 to 50 other people on the planet. companies Artisan Bio-
technologies of Aurora and
In the past, the heartrending prognosis might have been the final word. Today, however, Boulder’s SomaLogic, whose
parents like the Rosenbergs are leading searches for treatments and cures—and in the process, founder the Rosenbergs
know through the restaurant
they’re changing how the medical community thinks about these under-researched diseases. industry. But Lauren says it’s
because parental advocacy
“[Sophie’s doctors] basically printed out a stack of papers and said, ‘Here’s the literature that has raised the profile of rare
genetic conditions that biotech
exists about this disease, but there’s nothing you can do to treat this,’” Lauren says. “We were and pharmaceutical compa-
nies are now devoting more
just stunned…. I could tell right away that we needed to do way more. We had to take it upon ourselves.” time and resources to these
types of diseases. “It’s on us,”
That’s not to say the Rosenbergs were without a model to follow. Julia Vitarello, also from Boulder, Lauren says. “There’s no one
else who’s going to do it.”
established a nonprofit dedicated to fighting her child’s disorder in 2016, when her then six-year-old
Hopefully, that won’t be
daughter, Mila, was diagnosed with the rare, fatal, cureless Batten disease. Vitarello leveraged the the case much longer. Chil-
dren’s Hospital Colorado
internet—a game-changing resource for this generation of parents—to access obscure studies, connect in Aurora has launched a
precision medicine initiative
with other patients, and solicit donations. Mila’s Miracle Foundation eventually raised nearly $5 million focused, in part, on tailoring
treatments to patients of rare
to pay for gene-therapy treatments specifically tailored to Mila. That personalized care helped stabilize diseases. This sort of targeted
care is now possible thanks to
Mila’s seizures and improve her quality of life before she died from her disease in February 2021. technological developments,
such as using viruses to deliv-
Vitarello’s example—as well as that of Amber Freed, another local mom whose nonprofit, Milestones er healthy genes that replace
malfunctioning ones, driven
for Maxwell, has brought in about $2 million to treat her son’s genetic disease—inspired the Rosen- by rare-disease advocates—
i.e., parents. “The parents I’ve
bergs to start Sophie’s Neighborhood. As of early December, Sophie’s Neighborhood had raised nearly interacted with, they’re a force
to be reckoned with,” says Dr.
Scott Demarest, a pediatric
neurologist at Children’s who
has worked with both Vita-
rello and Freed and will help
lead the unit.

“Some researchers are re-
alizing they can really make
a difference,” Lauren says.
“Even if it’s not specifically
benefiting millions of peo-
ple, you can make a greater
impact on people who had
no hope at all.”

ALLYSON REEDY

18 5 2 8 0 H E A L T H 2 0 2 2 PHOTOGRAPH BY GAELLE GLASS

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TECHNOLOGY

Time For A Change

While traditional alarm clocks—or your iPhone—may be great at rousing you from your slumber, they’re
also full of features that can compromise sleep. Those problems led Boulderites Jamie Kripke and Howie Rubin

to tap into the latest sound science to design OneClock, a new take on helping us wake. ANGELA UFHEIL

• The Problem: Hitting The Fix: OneClock simply • The Problem: Your alarm rhythms, and using your
the snooze button once does not offer a snooze clock keeps you awake cell phone’s alarm isn’t a
or twice—or, OK, seven with its luminous digits. loophole. “Your cell phone
times—may feel good, button. The design decision Myriad studies blame is addictive, and if it’s in
but it ultimately leads to a might scare some customers
sluggish morning. It takes artificial light for disrupting your bedroom, you’re
about 90 minutes to get away, but Rubin and our circadian going to be looking at its
into the rapid eye move- Kripke know it’s simply too glowing screen before
ment (REM) stage of sleep, going to bed,” Josiane
the restorative state of tempting to exist. Broussard, director of the
slumber, meaning micro- Sleep and Metabolism Lab
naps between alarms only at Colorado State Univer-
sity and OneClock’s sleep
make you foggy.
expert, says.

The Fix: Other than a small
bulb you can switch on,
OneClock lacks lumens.

• The Problem: When that subtly rearranges the • The Problem: Blaring One Clock • The Problem: Many alarm
an alert’s sound never composition you hear each alarms stir you, sure, but acks umens clocks harm the Earth’s
morning. “It may lead with their shrieks also make you ²ut comes
changes, it becomes inef- tense. When you wake n ree colors health too. “I’ve purchased
fective. Scientists study this a different frequency or up, levels of the stress alarm clocks made so
phenomenon (called alarm pitch,” Eli Mishkin, a One- hormone cortisol naturally cheaply that the factory
fatigue) in hospitals, where Clock sonic strategist, says. spike—and people report
workers tune out repetitive You can even buy albums even higher levels of stress glued the plastic together,”
floods of beeps over time. on its website composed Kripke says. “There’s no
by musicians—such as Jon and anxiety if they’re
The Fix: Some hospitals woken by a loud sound, way to fix it if it breaks, so it
now use an ever-shifting Natchez of the War on according to Broussard. just winds up in a landfill.”
variety of sounds to ensure Drugs—exclusively
doctors and nurses don’t for OneClock. The Fix: OneClock’s The Fix: OneClock is
ignore them. The OneClock alarm begins with quiet made of aluminum and
team took that lesson and tones designed to nudge— white oak panels. The
designed an audio filter not drop-kick—your brain materials contribute to the
into consciousness. The product’s hefty price tag
initial hums gradually give ($299), but the former can
way to simple melodies be recycled and the latter
that grow in complexity
and volume, gently lifting can be composted.
you into consciousness.

Courtesy of OneClock

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INTERNAL ERROR

Strive Health aims to fix kidney care by combining data and good
old-fashioned personal attention.

In 2015, Chris Riopelle’s best friend called him with a question about his kidneys. The subject wasn’t as weird as it might sound,
because Riopelle was an executive at Denver-based DaVita, the nation’s largest dialysis company, at the time. The friend’s doctor
had recommended he see a nephrologist about some lab numbers, and Riopelle asked to look at the test results. Within hours,
on Riopelle’s advice, his BFF was headed to the emergency room in a race against kidney failure. The friend eventually received
a transplant, but the experience reinforced to Riopelle the warped manner in which health care handles kidney disease: Mostly
eschewing early detection, the industry focuses on end-stage care (i.e., dialysis). “Of all people, I’m the one who said, ‘Hey, buddy,

your kidneys aren’t working,’” Riopelle says. In 2018, Riopelle co-founded Strive Health to balance the system. The Denver-
based startup uses data-backed analytics to help its customers (insurers and hospital systems) identify kidney disease early and

predict the best courses of treatment. We ran our own numbers to find out exactly how it works. SPENCER CAMPBELL

THIRTY-FIVE 90%bcb cb cb cbc

Percentage of the estimated 37 million Americans with chronic kidney disease who have not
yet been diagnosed. (Sixty percent of that population will only discover their kidneys are failing
when they wake up in a hospital, Riopelle says.) Although end-stage renal disease (ESRD) pa-
tients often show early warning signs, such as high blood pressure and diabetes, prior to their

diagnoses—and while it sure seems like your general practitioner would connect the two—
health care professionals who aren’t kidney specialists can fail to make the link, Riopelle says.

Different data models Strive’s analytic Members of Strive’s care-delivery team, ~$410
technology uses to identify patients a collection of nurse practitioners, nurses, BILLION

who might have kidney disease. Once case managers, and dieticians. These Amount that Americans spend annually on
insurance companies or health care health care professionals are in charge unmanaged health care related to kidney
providers hire Strive, the startup combs of implementing the interventions the disease. Most of that money goes toward
through medical records, lab results, and computer comes up with by personally treating ESRD—when patients’ kidneys stop
other health-related data to predict the calling or meeting with patients. Strive functioning and they are directed to dialysis
best medical interventions—such as find- centers for treatment—as opposed to early
ing a nephrologist, examining existing employed only 30 in 2020.
medications to ensure they aren’t further detection and care.
damaging the kidneys, or lining up >100
at-home dialysis—for each person.

$140 11 Geographic Getty Images (15)
MILLION markets
(mostly in
Amount Strive raised during its Series B round of funding, which closed in March 2021 the Mid-
and included an investment from a growth fund managed by Google’s parent company, west; there
Alphabet. Combined, Strive has raised $223.5 million since its inception. Early detection are none in Colo-
and treatment of kidney disease have become hot investment targets, with Strive competitor rado) Strive currently
operates in, serving
Cricket Health announcing an $83.5 million funding round in August 2021.
45,000 patients of
insurers and health

care providers.

24 5280 HEALTH 2022

Trusted care.
Right where you need us.

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2
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ATTENTION: If you do not speak English, language assistance services, free of charge, are available to you. Please call 303.763.4900 Ext. 61500.

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NUTRITION BY ETHAN PAN

Digging
Deep

Ietef Vita is advancing access
to nutritious food in Denver and
beyond through urban garden-
ing, youth-oriented nonprofit
work, and rap music.

A blazing midsummer
sun shines overhead as
35-year-old Ietef Vita rat-
tles off the fruits growing
in his backyard—apricots,
plums, peaches, apples.
On one tree hangs wine-
colored globes, tapered
like teardrops. “The red
pears are just coming

in,” he says.This urban

orchard is only half of

Vita’s idyllic Westminster home garden. In

the front yard, a veggie lover’s paradise, bees

dart between onion and echinacea flowers.

It’s not easy tending to such diverse

flora, but Vita has years of experience coax-

ing plants to edible maturity: From 2008 to

2016, he was a gardener for Elyria-Swansea-

based GrowHaus, a nonprofit education

center and farm co-founded by his mother,

artist and cultural activist Ashara Ekundayo,

to improve the neighborhood’s access to

nutritious fare. Even before gardening

became his profession, Vita’s family taught

him how to adjust for Denver’s intense sun,

low rainfall, and relatively poor soil with

tricks like dropping banana peels into the

dirt to increase potassium content.

Vita, who grew up in Five Points, credits

gardening for helping him keep his life straight—“pushing seeds, not the father of eco hip-hop, a small but enthusiastic genre that

drugs,” he says. And while he’s aware of the intergenerational trauma layers hard-hitting beats with lyrics about food justice. His

many Black people experience toward agriculture because of slavery, Vita tunes and mission caught the attention of former First Lady

believes urban gardening can mend the rift while bringing better eating Michelle Obama, who invited Vita to perform at the White

habits to communities plagued by poor health. “The most important part House in 2015 to help publicize her Let’s Move initiative.

is people having access [to good food] and, at the same time, really healing Other high-profile gigs have

that post-traumatic stress that is deep in the cellular memory,”Vita says. Home Grown included a stint as a personal vegan
Ietef Vita in his garden chef for ex-Denver Nugget Wilson
Since 2007, Vita has been spreading that word through his other in Westminster Chandler from 2017 to 2018 and

passion—rap music—under the moniker DJ Cavem. He’s considered

26 5280 HEALTH | 2022 PHOTOGRAPHY BY JEFF NELSON

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NUTRITION

making food for a private party hosted A vegan since the age of 14, Vita
by Will and Jada Smith (their son, Jaden remembers having to walk 2.3 miles to LoDo’s
Smith, is a friend of Vita’s). Despite living
a life increasingly filled with high-profile Sakura Square to find tofu.
names, however, Vita’s greatest influence
might be through his more intimate, grass- and a glut of fast-food options. This leads “Who here knows someone with
roots work with the next generation. to an increased risk for food insecurity (the diabetes?” Vita asks. Most of the kids’
sustained inability to access healthy food), hands shoot up. African Americans are 60
INSIDE A KITCHEN in a Curtis Park com- a blight that disproportionately impacts percent more likely than non-Hispanic
munity center, Vita fills a food processor low-income communities and people of white adults to have the disease, which is
with cashews, maple syrup, coconut oil, and color: 22.5 percent of urban Black Colora- also linked to food insecurity, and twice
whole vanilla pods. He’s leading a youth dans and 13.6 percent of urban Hispanic as likely to die from the chronic illness.
workshop through Denver Urban Gardens, Coloradans suffer from food insecurity, Vita’s grandmother was one of its victims.
which oversees 190 community gardens, compared to a statewide average of 9.6
the largest such network in the nation.The percent, according to a 2020 Colorado A vegan since the age of 14, Vita
20-some teenagers in attendance watch Health Institute report. Lacking nutritious remembers having to walk 2.3 miles to
attentively as he demonstrates how to make food is associated with a slew of physical LoDo’s Sakura Square to find tofu. In
a vegan cheesecake, lining two pans with a and mental health problems, including an attempt to ensure future generations
walnut-date crust, pouring in the cashew high blood pressure, poor oral health, and wouldn’t have to follow his footsteps,
filling, and sticking them in the freezer. maternal depression. These effects trickle Vita co-founded a GrowHaus initiative
“When I was a kid, french fries were my down to food-insecure children, too, who called Seed2Seed in 2010.The eight-week
vegetable,” he says. are at least twice as likely to report “fair summer leadership program teaches high
or poor” health and a third more likely to schoolers from north Denver about urban
Today, many neighborhoods in have been hospitalized than their peers agriculture, healthy eating, and communi-
northeast Denver—such as Five Points, with plenty of healthy food to eat. ty-based social justice. More than half of
Globeville, and Elyria-Swansea—remain the students at the Denver Urban Gardens
food deserts with few full-service grocers

28 5280 HEALTH | 2022



NUTRITION

MENTAL + PHYSICAL + HEALTH + WELLBEING

WE REDEFINE INTEGRATED HEALTHCARE

Seeding Change workshop are in
Vita mailed more than its 2021 cohort.
20,000 seed packets

to urban gardeners Vita pulls the
across the nation. cheesecake out of

CONNECT WITH OUR HEALTHCARE TEAM the freezer and

starts doling out portions in paper bowls.

The teens are quiet at first, seemingly un-

sure about how the motley combination of

fruits and nuts will taste. As they sample

the dessert, though, chatter slowly bubbles

up. Hesitance turns into interest, then

outright excitement. One student calls out

to another across the room: “You want to

make cheesecake?”

These moments motivate Vita to keep

preaching the benefits of plant-based eat-

Daniela Stamatoiu, MD Margeaux King, PMHNP-BC Lynn Mason, FNP-C ing—which studies show helps decrease

CHILD, ADOLESCENT PSYCHIATRIC NURSE PRACTITIONER, FAMILY cardiovascular morbidity and manage
& ADULT PSYCHIATRIST NURSE PRACTITIONER MEDICINE & ENDOCRINOLOGY
insulin resistance—particularly to youth.

He also wants to impart that food and

agriculture can be viable careers. “It takes

someone relatable,” says Rob Payo, Denver

Urban Gardens’ director of K–12 educa-

tion and the organizer of Vita’s workshop,

“to make more of an impact.”

Maureen Davis, PMHNP Cindy Souser, LMFT Maeson Temple, RDN, CNSC ILLUMINATED BY the pink glow of a salt
lamp, Vita’s home studio resounds with
PSYCHIATRIC LICENSED MARRIAGE REGISTERED beats from his upcoming album, Kon-
NURSE PRACTITIONER & FAMILY THERAPIST DIETITIAN NUTRITIONIST crete Garden, set to be released this spring.
One of its singles, “Pull up on the Gate,”
CONTACT US TO LEARN MORE came out this past April and highlights
his experiences with racism when tending
(303) 393-1726 • paramounthealthdirections.com/5280 gardens in affluent Denver neighbor-
52 Monroe Street, Denver, CO 80206 hoods. References to people calling the
police on his landscaping crew flow
30 5280 HEALTH | 2022 alongside messages about composting,
permaculture, and forgoing pesticides.

MENTAL
WELLNESS

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HTS‫ܪ‬IJSHJ FSI are functioning.
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FRONTAL LOBE Processes Temperature, Taste, Arts
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Exercise Therapies
Important Involuntary Movement, Balance,
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NUTRITION

Specialized medical care for food and drug allergies, hay fever, asthma, The music glamorizes a life of growing
eczema and allergic skin conditions, and immune-related illnesses. and eating plants (“I like my food vegan,
avocado toast”), but Vita doesn’t want to
NOW WITH 12 CONVENIENT stop at giving his listeners a gardening
FRONT RANGE LOCATIONS! soundtrack; he aims to give them the
tools they need to dig in. While pre-
Brighton paring to go on tour to promote his 2019
%URRPȴHOG album, Biomimicz, he partnered with
Castle Rock Broomfield-based seed company Botan-
Centennial ical Interests to produce packets of kale,
Denver - Lowry arugula, and beet seeds. Although the
Denver - Highlands COVID-19 pandemic foiled his plan to
Fort Collins distribute them at shows, he still mailed
Greeley out more than 20,000 of the packets to
Greenwood Village urban gardening organizations around the
Highlands Ranch country. For Koncrete Garden, he intends
Lakewood to give away even more elaborate promo-
Littleton tional materials at his concerts: full kits
with sprouting trays, seeding instructions,
DOCT Named Top Doctor, and recipes for the final products.
ORS Allergy & Immunology,
D by 5280 Magazine Still, Vita’s dreams keep growing.
TOP He opened for Wu-Tang Clan this past
R fall and is already working on his next
E 2019 E album. Walking through his front yard
garden, however, he takes the time to
NV pause and pluck basil and mint leaves.
During the workshop, he talked about
how gardening showed him a new side to
the foods he ate growing up. “I didn’t
know potatoes make the most beautiful
white flowers,” Vita said. Those particular
plants are not in bloom right now, but
they will be soon enough.

Ethan Pan is a former 5280 intern and senior
at Brown University, where he is majoring in food
writing and cognitive science. Email feedback

to [email protected].

Book your appointment now! www.coloradoallergy.com

32 5280 HEALTH | 2022

L-R: Alison Collier, ARNP, Jim Schleve, MD, Meg Lemon, MD, Ann Leibold, MD, Elizabeth Robinson, MD, Daniel Callaghan, MD

In 2020, two extraordinary practices became one when Whole-Patient Care for
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For the past 20 years, Dr. Lemon has been named a “5280 What’s Your Skin Hiding?
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HOW TO
RAISE
A MORE
RESILIENT
KID
EDITED BY JESSICA LARUSSO
ILLUSTRATIONS BY TAYLOR CALLERY

Cyberbullying, cutthroat club sports, and, oh yeah, a pandemic that isolated them
from their peers: Perhaps it’s no wonder children and teens in Colorado are facing
an unprecedented mental health crisis. But young people don’t have to be powerless
against adversity. We spoke with local experts to find out how to prepare your
kids—no matter their age—to endure difficulty and rebound from failure.

2022 | 5280 HEALTH 35

TRUE GRIT AGES 02

Why Colorado medical professionals think fostering resilience in children Babies are com-
pletely dependent
is vital to treating the state’s youth mental health crisis. on their caregivers,
which makes
B etween January and April 2021, big factor, they also believe this crisis has been the mental and
Children’s Hospital Colorado’s brewing for some time. More resources for emotional health
pediatric emergency department treating the symptoms (adding psychiatric beds, of those adults
saw a 72 percent increase in be- increasing inpatient hospital staff ) would help, especially critical to
havioral health visits compared to but even those measures are not a cure. their development
through the first
the same period in 2019. Mean- What is? No one knows for sure, and not all couple of years
mental and behavioral health problems can be of life. The other
while, twice as many patients at prevented, of course. But helping kids develop unique thing about
resilience is a key part of the strategy, accord- this stage, says Dr.
Children’s Pediatric Mental Health Institute ing to experts. The good news is that teaching Anna Zimmermann,
children to persevere—that “adversity is some- a neonatologist at
reported increased anxiety, depression, and thing to learn from and even celebrate, not Rocky Mountain
avoid,” as Denver child psychiatrist Dr. Chris Hospital for
feelings of isolation and social disconnected- Rogers puts it—doesn’t require an advanced Children, is that
degree. Instead, caregivers can use everyday “every single thing
ness. Eighty-seven Colorado kids ages 10 to 18 interactions to show children and teens how to that they do is new,
gradually build the skills that will allow them and every single
died by suicide in 2020. to better navigate life’s challenges—from spills thing that they do,
on the bunny slope to teenage breakups. they’re going to fail
Those are scary numbers—and they led at, again and again
and again.” Those
Children’s CEO Jena Hausmann to declare a struggles—to walk
or bring a spoon
“pediatric mental health state of emergency” in to their mouths or
stack blocks—are
May 2021 and Children’s chief medical officer, opportunities for
adults to offer
Dr. David Brumbaugh, to say “our kids have run encouragement,
praise the effort,
out of resilience.”While health officials contend and “normalize the
fact that you’re not
the pandemic and related stressors have been a supposed to get
it on the first try,”
Zimmermann says. JL

re•sil•ience noun — the ability to cope with difficulties, have
the confidence to take calculated risks, and bounce back from failure

36 5280 HEALTH | 2022

S SUSTAINABLE
SUPPORT
¯
Try T his!__ Virtual care and
connection for new moms
Local experts’ top resil- might be here to stay.
ience-building strategies.
Research shows that poor care-
The Theory: Caring relation- The Theory: Trying anything The Theory: Knowing when giver mental health negatively
ships with parents, in which unfamiliar can be scary at first, to ask for help—and feel- affects children’s mental and
babies become confident so it’s important for kids to ing like it is acceptable to do physical wellness, so giving birth in
they have consistent love learn that they can grow to so—is a crucial skill children the middle of an anxiety-inducing
and support, serve as an like new things. need to develop to success- pandemic was not ideal—for
external source of resilience fully navigate challenging moms or babies. “It was espe-
that will be the foundation The Practice: When you feed tasks and emotions. cially hard for women who didn’t
for developing internal your six-month-old avocado have family nearby or who need-
sources as they get older. and he spits it out, don’t as- The Practice: Instead of ed to isolate from grandparents
sume he’s destined to hate telling your toddler she can’t for health risks,” says Dr. Celeste
The Practice: Showering guacamole. Instead, praise him carry her water bottle to the St. John-Larkin, a child psychiatrist
babies with attention and for sampling it and continue park because it’s too heavy, and medical director of Children’s
affection, comforting them to offer it every few days. let her attempt it and experi- Hospital Colorado’s Healthy
when they are sad, and Odds are he’ll learn to enjoy it ence a little frustration before Expectations Perinatal Mental
actively listening to them once he becomes more com- kindly (read: no need for
is easier when caregivers are fortable and confident with an “I told you so”) offering Health Program, which has of-
tending to their own needs. tShe flavor and texture. to help. fered psychiatric services and
Thus, prioritizing self-care group therapy to local moms
like exercise, socializing with struggling with mood and anxiety
friends, or simply watching disorders for more than 15 years.
a little TV isn’t selfish; With in-person meetups unavail-
what’s good for the parent able, Healthy Expectations took
is good for the baby. most of its programming to Zoom.
“We’ve had really great atten-
dance,” St. John-Larkin says—so
good they’ve extended virtual
options for the foreseeable future.
“It’s easier for moms to get to their
[one-on-one] appointments via
telehealth, without having to pack
up baby and everything else.”
Healthy Expectations also moved
its free support groups online and
began offering a new meetup for
Black mothers led by Dr. Shaleah
Dardar, a Black psychiatrist and
mother herself.

WARNING SIGNS • Developmental regressions. • Lack of eye contact or
If your child has been, for interaction. Around or after six
There’s a fine line between example, talking consistently months, this can be an early sign
normative childhood behaviors and suddenly stops for a of an autism spectrum disorder,
(like tantrums) and cause for significant period of time, even if your baby is meeting
concern, but our experts suggest she may be experiencing an gross motor skill milestones like
considering a behavioral health underlying issue. sitting or crawling.
consult if you spot these red flags.

AGES 27 HOT
TOPIC
The preschool and
early elementary POWER STRUGGLES
years are a period of
widespread external As kids begin to explore their independence, everyday tasks can become epic
exploration, char- battles—and lay the foundation for how they think about conflict resolution.
acterized by rapid
language develop- S neakers or snow boots? Holding and medical director of Child and Adolescent
ment, make-believe hands or crossing the street alone? Services at HealthOne Behavioral Health and
play and emulation, Sharing the truck or hitting a Wellness Center. Try empowering her by giving
and egocentrism. playmate? These are all choices pre- her a decision to make: I trust you to hold the
“Language becomes schoolers increasingly know they leash by yourself and walk Rufus in the park, or you
more complex as kids can walk Rufus down our street if I hold his leash
learn to speak in full can make, although complicating with you. Says Rogers: “We can create these
sentences, and that easy wins for them by providing safe choices
comes with additional factors—weather, heavy traffic, the that we’re fine with.”
milestones in the way
they interact with feelings of others—are still beyond their grasp. Parents also need to understand that failure
others,” says Jessica is an opportunity for long-term learning, even
Hawks, child and ad- Which, of course, necessitates intervention. “The if there’s some minor, short-term discomfort
olescent psychologist involved. Amie Lofton, a child psychologist
and clinical director of hallmark parent-child conflict here is centered and behavioral medicine specialist with Kaiser
ambulatory services Permanente, encourages natural consequences
at the Pediatric Men- around children wanting to assert independence (safety permitting) when possible, such as letting
tal Health Institute at your raincoat-refusing daughter get wet. In the
Children’s Hospital versus not really having the skills to do it safely,” case above, you might say, “Rufus is really strong;
Colorado. Yet, she if you walk him by yourself, he may pull his leash
adds, “they can only Hawks says. “They’re becoming cognitively aware out of your hands.”Then (once you’re in a cushy
understand why things patch of grass), let her experience the yank and
are happening in their that they have the ability to influence the world turn to you to wrangle the dog. “Learning to ask
world based on their for help,” Lofton says, “is building resilience.”
own point of view.” around them, but allowing a parent to scaffold for
Figuring out how to
keep their cool after them can sometimes be difficult.”
they’re told they can’t
do exactly what they So how do you avoid a full-scale meltdown—
want to—often by a
caregiver and for their and crushing your child’s well-intentioned
own protection—is
crucial to developing initiative—when, for example, your four-year-
resilience at this age.
old sets her mind on walking your 90-pound
JULIE DUGDALE
German shepherd down a busy road? “Kids
38 5280 HEALTH | 2022
need to have a great amount of perceived con-

trol,” says Dr. Chris Rogers, a child psychiatrist

¯ significant reward for risk at The Theory: It’s natural ALL TOGETHER
any level. While a fall can be to compliment a win or an NOW
Try T his! frustrating, harnesses and ropes achievement, but if young
put climbers right back where children feel important or Increasingly, behavioral
Local experts’ top resil- they started to build on what proud only after earning an health care access is
ience-building strategies. they learned. award or scoring points, it as easy as going to your
can make them feel like their well-child visit.
The Theory: Healthy risk- The Theory: Parental reac- worth is tied to success.
taking during playtime allows tions to stress (shouting, Since its launch in 2005, a Chil-
kids to experiment with prob- slamming a door, storming The Practice: Team sports, dren’s Hospital Colorado initiative
lem-solving.The key is finding away) are often kids’ earliest such as soccer, provide plenty has been implementing integrated
an activity that feels high-stakes guideposts for how to deal of opportunities to offer behavioral health services in the
but isn’t actually dangerous. with adversity. affirmation when you see be- Denver area. Though the name
haviors you’d like to encourage, sounds complicated, it simply
The Practice: Rock climb- The Practice: “It’s important like helping a teammate up, means Project CLIMB (Consulta-
ing at a gym like ABC Kids for parents to pause, wait, and Srather than an outcome. tion Liaison in Mental Health and
Climbing in Boulder requires decide how they want to react Behavior) embeds mental health
sSelf-direction and offers when their first instinct is to professionals inside pediatricians’
get frustrated,” says Dr. Edward offices. That way, if a parent
Taylor Buckingham, a child expresses concern during a well-
and adolescent psychiatrist with child visit about a kid’s sudden
Kaiser Permanente in Denver. refusal to participate at school,
Calm your mind and body to therapists are already there to
set a positive example of how assess the child’s state and any
to manage big feelings and ap- contributing familial or environ-
proach conflict resolution. mental stressors before offering
insights, strategies, and potential-
ly referrals. And because patients
are likely to come back again
soon (flu season!), a continued
dialogue is built in. Project CLIMB
operates out of Children’s three
on-site primary care settings,
but its impact has been much
broader: It has provided train-
ing and education to a range of
metro-area private practices and
hospital systems, including Denver
Health Medical Center, that have
started similar programs. “Prima-
ry care is the front line, the front
door,” says Ayelet Talmi, director
of Project CLIMB and professor of
psychiatry and pediatrics at the
University of Colorado School of
Medicine and Children’s. “Hav-
ing the social-emotional services,
support, and resources they need
in a setting where they already
are is key.”

WARNING for example, or to a friend’s house • Inability to follow basic direc-
SIGNS due to the near certainty of an tions…ever. Noncompliance is a
excessive meltdown? hallmark of this age group as kids
• Outbursts that consistently explore boundaries and push for
disrupt everyday tasks. Do you • Overly aggressive behaviors autonomy, but failing to demon-
avoid going to the grocery store, with peers, such as constant and strate an increasing ability to listen
prolonged hitting or kicking. as they grow older is problematic.

AGES 711 HOT
TOPIC
Kids in this age group
are developing the ORGANIZED SPORTS
language and cog-
nition to express Tween athletics come with opportunities for parents and kids to win
their thoughts and the game of fostering resilience.
feelings—e.g., say-
ing “I’m mad at you A s you pull your car into the what he could have done better and help him
for riding my Razor” rec center roundabout, your choose one or two specific things to focus on
instead of just decking nine-year-old silently slides in practice—like flip turns, for instance—that
their sibling—in ways into the back seat with wet might help him improve his time.
that foster healthy hair and dampened spirits.
coping methods, says Giving kids those kinds of concrete objec-
Scott Nebel, director He got outtouched in the 50- tives can help with motivation and increase
of clinical services for their ability to bounce back from challenges,
child and family at the yard backstroke. Again. Your says Dunn, who specializes in sports psychol-
Mental Health Center ogy. Emphasizing learning and mastering new
of Denver. They’re caregiver instinct tells you to soothe his disap- skills doesn’t mean you have to completely
also establishing more dismiss your child’s inner will to win, though.
social and emotional pointment: “That was so unlucky!” “You just “That competitive nature is really what moti-
independence from vates us,” Dunn says. “It’s part of what makes it
their parents and have to think positive.” “Who wants ice cream?” fun.” Just be sure to balance it with reminders
honing the ability to to focus on what is controllable. If you do that,
think for themselves. A better approach, says Dr. Brooke Pengel, athletics can teach kids to see adversity as a
Even so, many still path to becoming stronger—a crucial skill that
see the world in black pediatric sports medicine physician with Rocky will help them navigate everyday disappoint-
and white, says Ken- ments such as getting a bad grade on a test or
dra Dunn, a licensed Mountain Hospital for Children, is to encour- learning that their BFF no longer wants to sit
psychologist in Little- with them at lunch. “Sports,” Dunn says, “are a
ton. Caregivers can age your child to adopt a growth mindset: the beautiful way to help build resilience.”
help progress their
children’s thinking perspective that failure is not an inherent part
beyond regarding
situations as either of who they are but rather an opportunity to
successes or total, ir-
redeemable failures learn what to do differently next time. In this
by emphasizing nu-
ance and framing scenario, step one is to help your swimmer
difficulties as growth
opportunities. move on from focusing on the result—“I’m a

JENNY MCCOY loser”—to identifying something that did go

well: “OK, I didn’t win, but I got a good start

off the block.” From there, ask him to discuss

40 5280 HEALTH | 2022

¯ LIFE LESSONS

Try T his! At four Colorado Springs
area schools, resilience is
Local experts’ top resil- part of the curriculum.
ience-building strategies.
Somewhere between learning
The Theory: Helping your ficult situations in a healthy, S the scientific method and discuss-
kids put words to the difficult constructive manner and build petence and decision-making ing chapter 10 of Holes, some
emotions they’re experienc- interpersonal skills. abilities, and it also gives them 2,000 students in Colorado
ing—and then asking them ownership over choices that Springs and Manitou Springs
what they think they need to The Practice: Your child feels impact their lives. have received resilience lessons
cope—encourages them to hurt that Pieper didn’t invite over the past two years, thanks
learn how to effectively man- him to her birthday party at The Practice: Instead of to Children’s Hospital Colorado’s
age challenging moments. Water World. Validate his signing your child up for a Building Resilience for Healthy
feelings, but also ask him to weeklong baseball or mountain Kids initiative. The six-week pro-
The Practice: The next time consider Pieper’s point of view: biking camp without consulting gram pairs sixth graders from
your child is clearly upset, say, Maybe her mom could only af- him—which can undermine his four different schools with trained
“It looks like you may be feeling ford to pay for a certain number sense of autonomy and develop hospital employees who serve as
frustrated—is that right?” From of kids, or perhaps she decided a reliance on caregivers—give coaches. During weekly sessions,
there, ask how you can support she wanted an all-girls group. him several options for how he
her, whether that’s by talking can spend spring break.Then, these professionals lead students
about what’s bothering her; The Theory: Allowing your honor his choice, whether that through mindfulness activities—
doing something active, like kids to make their own choices be hiking in Rocky Mountain breathing exercises, visualization,
going for a walk; or giving her helps build their sense of com- National Park, taking a class progressive muscle relaxation—
some alone time. about dinosaurs, or simply and help them set goals across a
recharging at home. range of topics, from academics
The Theory: Highlighting to building relationships to healthy
to your kid that other people lifestyle habits to self-esteem.
have different points of view Students report back on their
than they do can help them experiences working toward,
Slearn how to reframe dif- say, consistently attending soccer
practice or managing distractions
during homework time; coaches
then help them identify lessons
learned, celebrate achieve-
ments, and strategize next steps.
Researchers at the University of
Colorado Colorado Springs and
CU Anschutz Medical Campus,
who studied the effectiveness of
the program, concluded that such
efforts may improve resilience
and self-efficacy among all kids
and also ease anxiety specifically
among those struggling with
mental health.

WARNING characteristic sadness or irritability • Aggression. Younger kids, • Physical symptoms. Kids
SIGNS that lasts a week or longer in your compared to adolescents, are can and do experience soma-
normally cheerful—or stoic—child. more likely to express their tization (when psychological
• Dramatic shifts in mood. Not to emotional angst with their fists. conflicts manifest as bodily pain),
be confused with mere temporary • Social withdrawal. Pulling away Be on the lookout for an uptick in so take note if they frequently
crankiness, this might present as un- from family and friends can be asso- physical fights with siblings complain about ailments like
ciated with anxiety and depression. or friends. stomachaches or headaches.

2 0 2 1 | 5 2 8 0 H E A L T H 41

AGES 1217 HOT
TOPIC
As if puberty weren’t
tough enough, kids SOCIAL MEDIA
ages 12 and up are,
relatedly, in the midst How to teach your child to survive—and even thrive—
of major cognitive and in today’s digital landscape.
social transitions. Their
emotions are raging, K ids these days are as well-versed about when and how they use social media. Set a
and they haven’t yet in feeds and likes as Millen- household digital bedtime and establish digital-
fully developed ex- nials were in Game Boys and free zones, like the dinner table and bedrooms.
ecutive function (the Beanie Babies. But parents’ Encourage active screen time (during which you
ability to regulate concerns about time and and/or your kids are creating content, such as
feelings and inhibit TikTok dance videos) over mindlessly consum-
impulsive responses). allowance dollars wasted on ing whatever YouTube throws their way. Monitor
Having more free- their activity and talk to them about cyberbully-
dom to explore their Donkey Kong can seem quaint ing and sexting: Ask open-ended questions, such
identities and take on as “Would you treat a friend this way?” or “Do
responsibilities means compared to cyberbullying, sexting, and unhealthy you think this is appropriate?”
more distance from
parents and increased comparison as teens hold their lives up to the Social media shouldn’t replace live interaction,
dependence on peers so make sure they’re spending time with friends
as they get older. airbrushed highlight reels of peers and influencers. IRL. And if your phone is glued to your hand,
Those relationships consider giving yourself a digital timeout—and
outside the home are So, should parents cut off social media entirely? ask your kids to hold you accountable. Chang-
a practice ground for ing your own behavior is a powerful way to show
future adulthood, but Not according to Dr. Diane Straub, department teens that they also have the agency to decide
parents and guard- how much what’s happening online affects them.
ians still have crucial chair of adolescent medicine, and Jenna Glover, “If your kid is eating appropriately, sleeping ap-
roles to play by vali- propriately, socializing, getting homework done,
dating their kids’ director of psychology training, both at Children’s and getting some outside time,” Glover says, “his
concerns and helping screen time doesn’t matter.”
them think about the Hospital Colorado. Instagram and WhatsApp are
bigger picture when
challenges arise. normal parts of kids’social lives now, and during
Caregiver support
helps kids trust them- the pandemic, they provided important avenues
selves during a time
when they’re enduring for interaction with friends. Plus, very high social
a lot of change and
builds confidence for media use and very low social media use are as-
facing adversity.
sociated with depression.“In the middle is where
MEREDITH SELL
the most well-adapted kids are,”Straub says.
42 5280 HEALTH | 2022
To get there, Straub and Glover recom-

mend encouraging children to be intentional

¯ TALKING POINTS
Try T his!
Kaiser Permanente’s
Local experts’ top resil- Ghosted program sparks
ience-building strategies. conversations about men-
tal health in local schools.
The Theory: Destigmatizing S The Theory: Trusting your
mental health removes teen with an increasing level If a friend told you they had anxi-
shame from emotional and The Theory: Focusing on of responsibility encourages ety, how would you respond?
behavioral struggles and the learning process, instead independence and helps them Since fall 2018, staff from Kaiser
makes asking for help— of outcomes, shows kids how develop self-confidence. Permanente Colorado’s Arts
whether from peers, family, incremental steps can help them Integrated Resources team have
or professionals—easier. eventually conquer what seem The Practice: Give your son a posed questions like this to eighth
like insurmountable obstacles. corner of your garden to plant grade and high school students
The Practice: Seasonal de- and tend. Don’t correct him in the Centennial State as part of
pression can hit hard during The Practice: Shift your focus if he picks a shade-lover for Ghosted, a nationwide program
the winter. Use the weather from achievement to progress, the sunniest spot, and when it designed to reduce mental health
to start a conversation with whether you’re on the ski slopes wilts, allow him to diagnose stigma. The assembly-style ses-
your kid and ask if she’s ever or checking your kids’ report and address the problem on sions begin with a 30-minute film
felt extra gloomy at this time cards. Ask about how they’re his own. about four students who learn
of year. Be honest about your honing their carving technique about the others’ mental and
own experiences, and give her (instead of how many black S emotional struggles and promise
space to share what she thinks diamonds they skied) or what not to, in the parlance of our
could be helpful for someone strategies they’re using to master times, ghost one another. The
facing depression. linear equations in Algebra 2. video is followed by an interac-
tive discussion, during which
students talk through questions—
How do you understand depres-
sion? What are some ways you
cope with difficulty?—and are
told about available resources.
The film breaks the ice. “They
can see a character and identify
with them,” says Brian Harper,
program lead for Ghosted. His
favorite moments, though, are
when students take over the
conversation. In 2021, Kaiser
debuted a follow-up program,
Own It, which is exclusively avail-
able in Colorado and focuses on
practical next steps for students
who find out a friend is struggling
with thoughts of suicide.

GET HELP

If your child is engaging
in self-harm or has ex-
pressed suicidal thoughts,
call the Colorado Crisis &
Support Line at 844-493-
8255 or the National
Suicide Prevention Lifeline

at 800-273-8255.

WARNING bed, though, isn’t. Snoozing too • Self-medication (vaping, support. Any level of substance
SIGNS much or experiencing insomnia alcohol, drugs). While some use warrants a conversation.
can be signs of emotional stress, experimentation can be expect-
• Significant changes in eating and under- or overeating can ed among teens, substance use • Self-harm. Cutting and other
and sleeping habits. Sleeping indicate a range of mental and is strongly correlated with avoid- forms of self-harm are serious red
in? Normal. Never getting out of behavioral health concerns, from ance of emotions and can be a flags and require intervention as
eating disorders to anxiety. sign that your kid needs extra soon as possible.



THE BEST
MEDICINE

Preventive health care saves time, money, and lives. So why aren’t Coloradans
seeing their doctors? The pandemic may have provided an excuse

for skipping appointments, but it’s time to return to your regularly scheduled
medical routine. EDITED BY SPENCER CAMPBELL

2022 | 5280 HEALTH 45

MISSED
CONNECTIONS
Understandably, COVID-19
deterred or discouraged thousands
of Coloradans from accessing rou-
tine medical care—but the longer
we’re all overdue, the bigger the
problem could become.

W hen the most devastating health
care crisis in generations hit,
Coloradans responded by steer-
ing clear of the doctor.That
might sound ironic, but shortly
after COVID-19 first appeared
in the Centennial State, Gover-

nor Jared Polis signed executive

orders that, from March 23

to April 26, 2020, prohibited providers from

performing many routine medical services.

Some doctors who would have been allowed

to treat patients during that time voluntarily

closed to preserve personal protective equip-

ment for essential workers. And even after

all medical offices were allowed to reopen,

many patients demurred on seeking treatment

out of fear of contracting COVID-19 while,

say, getting their teeth cleaned.The aggre-

gate result of these actions was that visits to

health care providers along the Front Range

in 2020 plummeted 25 percent compared to “Preventive medicine is extremely impor- 35 and older received all the high-priority
tant,” says Dr. Scott Joy, chief medical officer preventive treatment providers recommend.
2019 totals, according to a September 2021 of HealthOne Physician Services Group in
Denver. “If we detect problems before they Why do so many people pass on routine
report from the Colorado Health Institute, a become catastrophic, you’ve obviously saved care? For many, such as the uninsured, it’s
a lot of money from emergency room costs, not so much a choice as a financial necessity.
Denver-based nonprofit. extensive procedures, and length of stay.” Others simply don’t know the doctors and
tests—all of which change based on age,
As understandable as missing treat- Not to mention saved lives: Preventive care family history, and behavioral factors—they
has routinely been shown to decrease morbid- should regularly access. Read on to make
ment was under those circumstances, the ity and mortality. (Recommended vaccines sure you have all the information and tools
alone prevent more than 42,000 deaths in the you need to keep the most important New
long-term impact of this so-called “foregone United States each year.) Yet even before CO- Year’s resolution of all: taking (preventive)
VID-19, only eight percent of U.S. adults ages care of yourself.
care” could be devastating. That’s because

preventive visits, the easiest appointments

to skip or reschedule, were the most likely

to be missed. And without regular physicals,

cancer screenings, and other evaluations,

doctors lost many of their frontline defenses.

47% Mind The Medicine Gap 27% Previous spread and this page: Getty Images (5)

Decrease in wellness 44% Fewer HBA1C tests, which mea-
exam visits sure blood sugar and are used
Drop in blood-pressure to check for diabetes in adults
exams, which help screen for

cardiovascular disease

Source: Colorado Health Institute; data based on Coloradans, from March 15, 2020, through January 2, 2021, compared to the same period in 2019

46 5280 HEALTH | 2022

REGULAR MAINTENANCE

So what exactly is preventive medicine? It’s health care designed to promote
wellness and stave off the three D’s: disease, disability, and death. Below, a basic
outline of what that looks like—and how it changes—as you grow older. BARBARA URZUA

AGE WHOM TO SEE WHAT TO EXPECT QUESTION TO ASK
(AND HOW OFTEN)
Babies, The American Academy of Pediatrics recommends Could these behaviors be
birth to 36 months Pediatrician checkups at two to four days, two weeks, and one, a sign of autism?
(multiple times
two, four, six, nine, 12, 15, 18, and 24 months. According to the Centers for Disease
per year) That may seem like a lot, but your baby’s physical Control and Prevention, some causes

growth needs to be meticulously monitored to of concern include avoiding eye
ensure she’s eating enough and not suffering from contact, using few or no hand gestures
intestinal issues. You can also anticipate hearing by 12 months, and a lack of empathy

screenings and immunizations. by 24 months.

Children, Pediatrician or Ensuring your child is growing and developing as Which kinds of snacks
ages 3 to 12 family physician he should be continues to be the most important are healthiest?

(yearly) issue during well-child visits. You don’t need to hire a nutritionist
to find out; it’s your pediatrician’s
1 Dentist If your child is sexually active, a yearly screening job to recommend alternatives to
(every six months for sexually transmitted infections is a must. “Teens sugar bombs (looking at you, Fruit By
Teens and
young adults, to a year) can be hesitant to talk to their providers about The Foot).
ages 13 to 20 these issues, but it is so crucial that they do,” says
Optometrist Dr. Corey Lyon, family physician and associate What are signs of drug
(every two years) professor at the University of Colorado School of and alcohol abuse?
Medicine. This may necessitate letting your teenag-
1 Primary care ers enter the exam room by themselves so they can If you’ve seen your kids’ grades plum-
provider (yearly) met or friend groups suddenly change,
have some privacy with the doc. these may be signs of substance abuse.
Dentist (yearly) The doctor or school counselor should

Optometrist (yearly) have ideas on how to talk to them
about it and, if needed, seek treatment.

Adults, Primary care Age-appropriate blood test screenings are How can I keep my cholesterol
ages 21 to 64 provider (yearly) crucial to catch maladies that haven’t presented levels in check?

Dentist (yearly) symptoms yet. If reducing saturated fats and
exercising regularly aren’t working,
1 Optometrist (every
one to two years) prescription medication might.
Late adulthood,
ages 65 and older Primary care An often-overlooked issue among older adults Should I think about moving to an
provider (yearly) is mental health, ranging from difficulty making assisted living facility?
decisions to plain isolation (which can affect
Dentist (yearly) If you’re struggling with daily activities
1 mental acuity). “The pandemic has brought like bathing, cleaning, cooking, or even
Optometrist (every loneliness and inactivity for many older adults,” socializing, your physician is an unbi-
one to two years) says Samantha Farro, geriatric psychologist at the ased resource for some hard truths—and
CU Anschutz Multidisciplinary Center on Aging, they’ll have informed recommendations

“which is why mental health awareness is so for appropriate living situations.
important right now.”



2 0 2 2 | 528 0 H E A LT H 47

With Colonoscopies, SAFETY NETS
Everything’s
Looking Up!* Colorado’s new plan to get everyone to the doctor.

Colorado Public Radio host Ryan Warner F or some Coloradans, the journey to insurance through their employers but earn From left: Courtesy of Ryan Warner; Getty Images
recently took to social media to document the physician’s office is easy.They too much to qualify for Medicaid. More-
his colon cancer screening. His reason for schedule an appointment, drive to over, the law mandates that each insurer’s
going public? It’s personal. the building, and, thanks to their physician network include providers who
health insurance plan, hand over are working to reduce racial health dispari-
In 2000, Katie Couric famously got a colo- a copay that doesn’t destroy their ties, such as doctors who employ transla-
noscopy live on the Today Show after her budget. Others face more compli- tors in their offices for Spanish-speaking
husband died from colon cancer. So I guess cations.They might have to take an patients. “It could potentially provide better
you could say I rode her coattails (or is it unpaid day off work, work around outcomes for these communities who have
entrails?) by posting a photo of my procedure the bus schedule, and cover the full bill. faced historical health barriers,” Healthier
to Twitter in August 2021. Anyway, 12 years Colorado spokesperson Kyle Piccola says.
ago, I nearly lost my mother to the disease. According to nonpartisan research
organization the Colorado Health Institute, Even after the Colorado option
She’d been exhausted and, we later 82 percent of Coloradans went to a doctor in launches, providers need to do a better
learned, was on the verge of cardiac arrest 2021, but only 67 percent went to a preven- job of considering patients’ entire lives
when the doctor ordered a colonoscopy. tive care appointment. Of those who didn’t, when treating communities of color, says
She was bleeding internally, which is com- 20 percent blamed cost and 10.5 percent said Dr. Cleveland Piggott, the vice chair for
mon with colon cancer. In her words, she they couldn’t get time off work. Insurance diversity, health equity, and inclusion for
“basically had no blood left.” The latest access represented the biggest decider: Of all the Department of Family Medicine at the
recommendation from the Centers for uninsured Coloradans, about 43 percent said University of Colorado Anschutz Medical
Disease Control and Prevention is regular they’d foregone care. Communities of color, Campus, where he is also a professor. CU’s
colonoscopies for men and women starting whose members face lower rates of insurance A.F. Williams Family Medicine Clinic
at the age of 45. My mom was 64 and had than white Coloradans, were slightly more in the Central Park neighborhood began
never been screened. likely to say they’d skipped a doctor’s appoint- screening patients in 2017 for social factors
ment because their lack of insurance made such as job loss or food insecurity as well as
Mom endured multiple surgeries and the visit too expensive. other things that can impact health, such as
started chemo, but it made her so sick that she race or chronic conditions.
stopped. My fears for her future metastasized, Signed into law in June 2021, the
but the cancer did not: She’s been free of it Standardized Health Benefit Plan Colorado During the pandemic, CU nursing
for more than a decade. And today, I am free Option aims to erase cost as a hurdle by students used that information to proac-
from any hesitation around prevention. At 43, requiring insurance companies operating in tively contact at-risk patients—people with
I’ve already had three colonoscopies that the state to create insurance plans with pre- diabetes, for example—to nudge them to
have blessedly detected no cancer. They have, mium rates that, by 2025, will be 15 percent attend preventive appointments. “We want
however, revealed diverticulitis with a splash of lower than their cheapest plans in 2021.The patients to come to us,” Piggott says, “but to
colitis, or what a friend calls my “fussy Jewish plans, which will become available in 2023, make sure our communities are healthy, we
tummy.” Both are relatively manageable. are designed for residents who don’t have need to go to them.” ANGELA UFHEIL

*The author would like to thank Twitter user
@neonnurse for inspiring this headline.

Ryan Warner is the senior host of Colorado
Matters, the flagship daily show from
CPR News.

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