2013
WELLNESS
| BELIZE | CANCER |
DIABETES
| STROKE | C.A.R.E.S.
TABLE OF CONTENTS Stroke
Stroke Stroke Signs Telemedicine Saves Precious Moments Telestroke
Diabetes
6 7 8 9
Living with Diabetes 10 Diabetes Services 11
Cancer Screening Breast Cancer Encyclopedia of Breast Cancer Prevention CT Scanner: Technology Improves Cancer Treatment Colorectal Cancer
12 12 13
Benefits of Breastfeeding are Multiple Pregnant? Eat Well. Exercising While Pregnant Mom Support
16 17 17 18
C.A.R.E.S. Purple Crying How to Keep Kids Well Sanford Clinic Wins Over Children
20 21 21 22
Cancer
Prenatal Health
Kids
From Klamath Falls to Belize: Touching Lives, Saving Lives Medical Records Wellness
Medication Safety Men: See a Doc Klamath Wrestles with Thorny Health Issues Joint Health Walking for Fitness CrossFit: Sweat Your Way to a Healthy Lifestyle
14 15
24 28 30 30 31 33 33 35
Advertising: Herald and News Design: Saffron Owen, Herald and News
Exercise Excuses What's Zapping Your Energy? Klamath Falls Couple Competes on World Stage Exercise for Seniors Balance Tips
Easing the Pain: Palliative Care Benefits Patients and Families Hospice Provides Comfort at the End of Life Recipes
36 37 38 42 43 44 46
48 48 49 50 51 51 Cascades East 53
Whole Wheat Nut Bread Quick Chicken & Veggie Spaghetti Skillet Jicama Hash-Browns Fish Tacos with Avocado Salsa "Sweet" Potato Fries Grilled Salmon & Asparagus
The Benefits of Non-profits: Sky Lakes Focuses on Reinvesting in its Operations Useful Numbers
54 55
YOUR THOUGHTS? Please share your thoughts and comments about this publication, which is published by the Herald and News in partnership with Sky Lakes Medical Center, or related topics by e-mail; feedback@skylakes.org, or by calling 541-274-4778 weekdays during regular business hours.
DISCLAIMER
Live Healthy is published as a service by the Herald and News for Sky Lakes Medical Center, 2865 Daggett Ave., Klamath Falls, Ore., 97601. Material in Live Healthy is obtained from a wide range of sources and is not intended to replace examinations or consultations with a physician. If you have concerns about specific items in Live Healthy, consult your personal physician about their effects on your health.
Locally Owned, Nationally Known. Living healthy is a lifestyle and your home plays a big part. When your family is ready for a change, come and grow with the industry leader. Together we will keep your home healthy and find the right fit for your family.
Coldwell Banker Holman Premier Realty 3815 S. 6th St., Ste. 110 Klamath Falls, Oregon 97603 541.884.1343 • CBHolmanPremier.com Equal housing opportunity. Each office independently owned and operated. Bill Haskins, Principal Broker / President
We either do the job or we don’t, healing the patient is the only thing that matters. Every day when we come to work, we know there are no shortcuts or excuses. Good enough doesn’t work here, we do. We are healers.
6 | Live Healthy 2013
STROKE
Stroke is the third leading cause of death among Americans and the No. 1 cause of disability in adults. That’s the bad news. The good news is, 80 percent of strokes are preventable.
“It’s true,” says Dawn Kleindorfer, M.D., a neurologist and a spokeswoman for the National Stroke Association. “You can take steps to limit your risk.” As with anything, the first line of defense is knowledge. Take control by learning the facts. 1. What is stroke? Blood vessels that carry oxygen to the brain become blocked or burst. When the brain cannot get enough oxygen, cells begin to die, causing disability and sometimes death. Nearly 80 percent are caused by a blockage from a blood clot or plaque, Kleindorfer says. The other 20 percent result from bleeding. 2. Who’s at risk? Anyone, at any age, can have a stroke. Certain factors, including being 55 and older and being male, put you at greater risk. 3. How can it be prevented? Control high-risk factors: Manage your blood pressure and cholesterol. Don’t smoke. Maintain a healthy weight.
ARE YOU AT RISK FOR A STROKE? You may be at higher risk if:
• You have high blood pressure • You have heart disease • You smoke cigarettes • You have diabetes • You are overweight or physically inactive • You have atrial fibrillation (irregular heartbeats) • You have high blood cholesterol
4. What are the symptoms? Recognizing a stroke and seeking immediate treatment are keys to reducing the damaging effects. If you notice the following sudden symptoms, call 911 immediately; do not drive to the hospital. Numbness or weakness in the face, arm or leg, especially on one side of the body. Confusion, trouble speaking or -understanding. Trouble seeing. Trouble walking, dizziness, or loss of balance or -coordination. Severe headache with no known cause. 5. Is it treatable? Yes, but get to the hospital quickly. “Some people will qualify for clotbuster drugs, if they arrive early enough,” Kleindorfer says. Receiving these drugs early can reduce the stroke’s permanent effects and make a full recovery more likely. 6. What happens afterward? Patients should take part in a stroke rehabilitation program—which consists of physical, occupational and speech therapy—as soon as they’re strong enough.
Stroke Signs and
Greg Enos, L.Ac. Your Complimentary Care Headquarters
You can recognize stroke symptoms by remembering the word FAST.
We’re here to help you on your road to recovery after:
Injuries / Pain Motor Vehicle Accidents Orthopedic Surgeries Post-Cancer Treatments We work in conjuction with:
Medical Providers Physicians Physical Therapists Chiropractors We assist in:
Natural Pain Relief Stress Reduction Men’s and Women’s Health Issues Clay McCord, MD, is an accomplished rheumatologist, and is board certified in both rheumatology and internal medicine. He is currently accepting new patients.
Give us a call to schedule an appointment or visit our website:
Shastaacu.com
541-884-1952
2650 Washburn Way, #180
SkyLakes.org
2200 Bryant Williams Drive, Suite 2 Klamath Falls 541.880.2750
At the South End of Westwind Village
8 | Live Healthy 2013
Telemedicine Saves Precious Moments
Remote appointment: Dr. Konrad Eppel, a doctor at Sky Lakes Medical Center, shows off what they call the robot — a machine that allows stroke patients to be seen remotely by neurologists from Providence Portland Medical Center.
L
ong travel distances, transportation and financial barriers contribute to Klamath County continuing to be ranked “among the bottom in both health indicators and health outcomes,” the public health department states in its most recent annual report. It can also take weeks to get an appointment with local primary care physicians. Cascades East Family Medicine Clinic reported no openings for at least two or three weeks. Sky Lakes Family Medicine Clinic was booked until the third week of June when called on March 1. And with recent changes to health coverage under the new coordinated care organization system, some patients have complained about being switched away from health care providers they had been with for years. Along with challenges of recruiting and H&N photo retaining doctors, and by Devan Schwartz logistical hurdles, the overall health care landscape is a bit rocky — even as Sky Lakes Medical Center and other local providers continue seeking to improve and expand their coverage. Doctor shortages Access to physicians and a high continuity of care are hallmarks of quality health care, and providers in Klamath County are working to improve both. In its annual report, the Klamath County Department of Public Health argues “the medically underserved area and evident health care professional shortages have worsened in recent years.” The report specifies “a number of local physicians have announced retirements and relocations, largely attributable to the anticipated uncompetitive federal reimbursement rate.”
By Devan Schwartz H&N Staff Reporter
In May, the Herald and News ran an
article on the departure of Dr. Tzann Fang, a medical oncologist at Sky Lakes Medical Center. Fang took a position at Virginia Commonwealth University’s Massey Cancer Center in Richmond. He said Sky Lakes didn’t offer to extend his contract, though Paul Stewart, president and CEO of Sky Lakes Medical Center, said that was untrue. Running
counter
to
the
public
health department’s assessment is a study conducted by the University of Wisconsin and the Robert Wood Johnson Foundation that found Klamath County’s ratio of doctors to patients in Klamath County is 489:1, placing it ninth in Oregon, which has 36 counties. Recruiting efforts
Sky Lakes spokesman Tom Hottman said
the hospital is undergoing active physician recruitment efforts, including specialists from the most-needed fields.
In the last year, specialists in emergency
medicine,
medical
oncology,
internal
medicine, general surgery and pulmonology have been recruited by the hospital.
Hottman added Sky Lakes is currently
recruiting
family
medicine
physicians,
another gastroenterologist, a neurologist, a urologist, additional hospitalists, additional internists, an obstetrician/gynecologist and a vascular surgeon.
Additionally, Sky Lakes cites success
with retaining graduates from Cascades East Rural Family Medicine Residency Program. “Physician
recruiting
is
a
team
effort involving an assortment of medical center departments as well as community partners,” Hottman said. “It often requires several months to locate qualified candidates who are clinically excellent and good fits for the community.”
Live Healthy 2013 |
9
Sky Lakes Stroke Patients Benefit from Technology & Specialists A picture is worth a thousand words. You might not think about this in relation to strokes, but such is the case for neurologists who are able to remotely see stroke patients at Sky Lakes Medical Center. Using the Telestroke Network, a doctor at Providence Portland Medical Center digitally appears on a monitor in Klamath Falls in order to assess whether a stroke has occurred or how a stroke patient’s recovery is going. “A picture is worth a thousand words,” said Dr. Konrad Eppel, an emergency doctor at Sky Lakes. “Having the ultimate specialist eliminates the need to have a doctor here.” Eppel estimates they use the machine, which they call “the robot,” for one or two patients per week. He added that incorrectly prescribed medications can cause bleeding in the heads of stroke victims, so it’s especially nice to get the advice of specialists who have been sent digital copies of CT scans.
Telestroke The more quickly stroke patients can be diagnosed and treated, the better their outcomes. That’s the primary reason Sky Lakes Medical Center partners with the Providence Telestroke Network. Besides excellent emergency care, patients in Klamath Falls now have access to some of Oregon’s top stroke specialists, 24 hours a day. Through an advanced two-way video communication system in the Sky Lakes Emergency Department, Providence Telestroke Network allows stroke
“We like it because we have someone to collaborate with,” said Eppel.
neurologists from Providence Brain and Spine Institute
The usage of telemedicine is increasingly common in rural areas, said Sky Lakes spokesman Tom Hottman, where practitioners may not have the level of confidence they would like.
family members and Sky Lakes physicians.
“Just because we live in God’s country doesn’t mean we can’t have the best there is,” he said. The robot, called an InTouch Health ControlStation, has been used at the hospital for about a year.
in Portland to be in the room – virtually – with patients,
This means we are able to more quickly determine the best treatment for people who have suffered strokes, says Ron Woita, a registered nurse and director of the Sky Lakes Emergency Department. “With Providence Telestroke Network, I can consult with local physicians to provide expert stroke care and potentially lifesaving treatments to patients regardless of where they live,” says Nicholas Okon, D.O., medical leader for the Providence Telestroke Network. Partnering with Providence Stroke Center means local access to a program that consistently exceeds the American Stroke Association’s quality guidelines for care.
10 | Live Healthy 2013
DIABETES
Living with Diabetes
Diabetes is a health condition that can impact your entire body. But by taking care of yourself you can help delay or prevent the onset of diabetes-related complications.
Eyes People with diabetes are more likely to develop eye problems, including cataracts, glaucoma, diabetic retinopathy, and vision loss or blindness. Early detection and treatment of eye problems is essential.
Kidneys High blood glucose levels can damage the kidneys over time. Prevent kidney damage by managing blood pressure and blood glucose levels, and checking for protein in the urine once a year.
Mouth Diabetics have a higher risk for gum disease, which can lead to tooth loss and other mouthrelated problems, and even heart disease. Practice good oral hygiene and see your dentist regularly.
Skin Diabetics can be prone to skin conditions such as bacterial or fungal infections and itching. They may also develop skin spots and scaly patches. Most can be prevented or easily treated if caught early.
Heart Diabetes increases the risk of heart attack, stroke and complications related to poor circulation. Controlling your blood glucose levels—as well as your blood pressure and cholesterol levels—is critical.
Feet If you have diabetes, you’re most likely to develop foot problems if you have nerve damage or poor blood flow in your feet. Check your feet daily for cuts, sores or swelling, wear shoes that fit well and protect your feet from extreme heat or cold.
Diabetes Warning Signs
From Diabetes.org, the American Diabetes Association
Diabetes often goes undiagnosed because many of its symptoms seem so harmless. Recent studies indicate that the early detection of diabetes symptoms and treatment can decrease the chance of developing the complications of diabetes.
Type 2 Diabetes*
Type 1 Diabetes Frequent urination Unusual thirst Extreme hunger Unusual weight loss Extreme fatigue and Irritability
Any of the type 1 symptoms Frequent infections Blurred vision Cuts/bruises that are slow to heal Tingling/numbness in the hands/feet Recurring skin, gum, or bladder infections
*Often people with type 2 diabetes have no symptoms
Diabetes Services The Diabetes Services at Sky Lakes Medical Center is the only American Diabetes Association Recognized Diabetes Education Program in the Klamath Basin. Using a one-on-one or group education setting, educators provide patients with necessary information regarding management of diabetes. Education topics include: Meal planning Blood glucose monitoring Exercise Medications, including insulin Preventing and managing complications Foot care Dental care One-on-one education sessions are customized to help people who have been diagnosed with type 1 or type 2 diabetes, pre-diabetes or gestational diabetes gain the skills they need to manage the disease successfully.
Sky Lakes
Diabetes Services
American Diabetes Association Recognized diabetes education program
Using a one-on-one or group setting, we provide patients with information regarding management of diabetes through education about: • • • • •
• •
Meal Planning Blood Glucose Monitoring Exercise Medications, including insulin Preventing and managing complications Foot Care Dental Care
541.274.2633 SkyLakes.org
Additionally, education sessions can help to keep patients current on research and management strategies, or to help patients through the changes in treatment of the disease. For more information, call 541-274-2633.
Coming late summer 2013 Dr. Z. Iskra Mathura, MD
Critical Care Pulmonary Disease
Save the Date:
Vascular and Thoracic Surgeon
LIVING SMART WITH DIABETES HEALTH FAIR
Dr. Laneah Snyder, MD
Saturday, November 2 at the Community Health Education Center 2200 N. Eldorado Call 541-274-4778 for details
Dr. Simon Bachir, MD Dr. Jared Ogao, MD General Surgeon Family Medicine
SkyLakes.org
12 | Live Healthy 2013
CANCER
Cancer Screening While regular screening tests and self-exams may not prevent cancer, they are effective in helping to catch it in its early stages, when treatment is typically most effective.
According to the American Cancer Society, when cancers of the breast, prostate and skin—among the top cancer killers in the U.S.—are caught early, it can translate into five-year survival rate of at least 99 percent. Both men and women should have their mouths, skin, colons and rectums screened and examined for abnormalities. An annual fecal occult blood test finds hidden blood in the stool, which can indicate the presence of colon polyps that may develop into cancer. Skin cancer screenings involve careful examination of any moles, especially those that have irregular borders. Men should have their prostate and testes screened as well, while women need their cervixes and breasts examined. Nearly 1 in 5 cervical cancer cases occur in women over age 65, so it’s important to continue to get regular Pap smears on a schedule you determine with your doctor. Annual mammograms can catch any suspicious masses in the breasts.
Breast Cancer The American Cancer Society recommends yearly mammograms starting at age 40 and continuing for as long as a woman is in good health. The ACS also recommends a clinical breast exam about every 3 years for women in their 20s and 30s and every year for women 40 and over. Women should know how their breasts normally look and feel and report any breast change promptly to their physician, experts say. Breast selfexam is an option for women starting in their 20s. Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRI in addition to mammograms.
Talk with your doctor about your history and whether you should have additional tests at an earlier age. Sky Lakes Cancer Treatment Center shows its support for women with its free mammogram program. It began in 1994 with a start-up grant of $7,575 from the Susan G. Komen Foundation. Various community and individual donors, as well as local businesses, foundations, and members of the Sky Lakes Cancer Advisory Committee have continued to support the program by making financial contributions totaling more than $150,000. Over the past two decades, Sky Lakes Cancer Treatment Center has partnered with independent radiologists at the
former Klamath Radiology Associates, which is now Sky Lakes Outpatient Imaging, to provide more than 1,500 mammograms and nearly 500 ultrasound examinations to qualifying women in the community. In 2006, the Computer Automated Detection (CAD) system provided additional computerized readings that have been shown to detect up to 98 percent of all potential breast cancers. Almost 300 participants have elected to have the CAD readings. Call Sky Lakes Cancer Treatment Center, 541-274-4171, to learn if you qualify and how to apply for the mammogram program’s benefits.
Encyclopedia of Breast Cancer Prevention A:
APPLES And broccoli, and whole grains, and fish, and all the other things that make up a healthy, low-fat diet. A report from the World Cancer Research Fund and the American Institute for Cancer Research claims that following a proper diet, along with staying physically active and maintaining a normal body mass index (BMI), could reduce all cancer rates by 30 percent to 40 percent.
B: BUTT, CIGARETTE Evidence of a direct link between smoking and breast cancer is mixed. Active smoking and passive smoke inhalation, however, are known to cause at least 10 other types of cancer, not to mention heart disease, stroke, and bad teeth. So if you smoke, quit. Ask your doctor for help choosing a prescription or over-the-counter medicine to make quitting easier.
B:
BUTT, YOURS We don’t mean to be rude, but obesity is linked to increased breast cancer risk, especially in postmenopausal women. Work with your doctor to control your weight. (See also HIKE, TAKE A.)
C:
CHARDONNAY Or beer, or single malt scotch—whatever your alcoholic drink of choice, keep drinking moderate. Limit your alcohol consumption or don’t drink at all. Even one or two drinks a day appear to increase breast cancer risk.
D: DOCTOR
VISITS The American Cancer Society (ACS) says you should have a doctor examine your breasts every three years if you’re between ages 20 and 39, and annually if you’re 40 or older. The ACS guidelines advise you to discuss your personal risk factors, including the simple fact that you are
growing older. And if your doctor determines that you are at increased risk for the disease, take the preventive steps listed here even more seriously.
H: HIKE, TAKE A A brisk, half-hour daily walk significantly reduces the risk of developing breast cancer, reports the massive Women’s Health Initiative study of women ages 50 to 79. Of course, it doesn’t have to be a hike. Any exercise—done for 30 minutes a day most days of the week—can help reduce cancer risk. Running, especially when combined with fundraising, is highly effective. M:
MAMMOGRAM The ACS and other major health organizations continue to recommend regular screening mammograms. The U.S. Preventive Services Task Force found that mammography reduces mortality rates by perhaps 25 percent over 10 years. The American Cancer Society recommends yearly mammograms a starting at age 40 and continuing for as long as a woman is in good health. Clinical breast exams (CBE) should be repeated about every 3 years for women in their 20s and 30s and every year for women 40 and over.
S: SELF-EXAM Over the last four or five years, most major health organizations have taken a new look at the value of breast self-exams (BSEs). Major studies have found little or no connection between self-exams and reduced death rates. As a result, these health groups have put self-exams in the optional category. It’s OK for women to choose not to do BSEs or to do them occasionally. However, if you do find anything unusual, report it to your doctor immediately.
X: X-RAY That’s what a mammogram is. And like most X-rays, it can be uncomfortable. To make yours less so, schedule your mammogram for the week after your period. Your breasts will be less tender then. And don’t wear deodorant, powder, or lotion under your arms or on your breasts. These can show up as spots on the X-ray that might be confused for cancer.
Live Healthy 2013 |
13
14 | Live Healthy 2013
CT Scanner
T
Technology Improves Cancer Treatment
he Cancer Treatment Center at Sky Lakes Medical Center has made significant strides in technology over the past year to improve the overall health of the Klamath community. In addition to starting the transition to electronic medical records, the facility now has a new CT scanner with a new linear accelerator on the way. The CT scanner, which was installed in October 2012, has improved cancer treatment significantly, according to Dr. Bradley Kramer, radiation oncologist at Sky Lakes. The previous CT scanner was around 10 years old, and with its replacement, Kramer and his team are able to get faster, higher quality and more precise images of tumors. One of the features of the new CT scanner is its ability to capture motion on the 4D level, allowing for a better understanding of the tumor’s movement with respiration and other natural bodily movements. “I, as the physician, feel much more confident about where the tumor is,” said Kramer. “There’s no more guesswork now.” Kramer mentioned how physicians used to make incorrect assumptions about the location of the tumor and whether it was static or in motion.
“We’re talking about millimeter precision now,” said Kramer. “Years ago, we couldn’t do that.” Increased precision also allows Kramer to prescribe a higher dosage of radiation to hit the tumor, as it will minimize irradiation to healthy tissue. The CT scanner performs scans faster, which helps patients feel more comfortable while on the table. Another feature of the CT scanner is the larger bore through which the patient goes through to obtain the scan. Patients have more freedom to be in different positions for the most optimal scan, and also allows larger patients to fit through the scanner. “We’re really happy with the CT scanner,” said Kramer. “It’s a wonderful piece of equipment.” Kramer hopes the new linear accelerator, or Linac, will be installed in the late summer or early fall, but the process of installation is long and complicated. The current Linac, which is 12 years old, already does a great job at delivering radiation doses to tumors, but according to Mike Hurtado, dosimetrist at Sky Lakes, it is time for an upgrade. The new Linac also features better precision capabilities to target tumors with radiation, it has better resolution, and it performs faster. With the new Linac, Hurtado will be able to give a week’s worth of more concentrated radiation doses, instead of the typical five- to six-week treatment plans. Kramer said this treatment, referred to as Stereotactic Body Radiation Therapy, has become an effective way to treat a tumor. Kramer and his oncology team can deliver CT scans to patients every day before their treatment with a builtin CT scanner in the new Linac. This image-guided therapy is state-of-theart.
By Kate Tracy H&N Staff Reporter
“The accuracy will allow us to treat more patients than in the past,” said Kramer. The Cancer Treatment Center at Sky Lakes provides advantages of cancer care with these new machines. The facility itself houses the two machines in its own building, making scheduling and treatment efficient and convenient for patients and staff alike. The fact that the center has a CT scanner and Linac makes treatment convenient for many patients who would otherwise have to travel to a bigger city. “I think it’s important the people of Klamath Falls and Klamath County know that we have a cancer center,” said Hurtado. “The staff here treat patients with a lot of care; we really care about the outcome.” Although not unusual for small towns to have specialized equipment like the CT scanner and Linac, Hurtado explained how Sky Lakes has always made technology and equipment a priority. If they are going to offer cancer treatment, the cancer center wants to do it with the best technology available, he said. Since Klamath Falls is a small community with a low economy, Kramer added that it was unusual for a poor community to raise money for such expensive equipment. All told, the equipment cost is around $3 million. Since October 2012, the community raised $90,000 for the CT scanner through donations, with another $1.1 million donated for the cancer center for unspecified reasons. Fundraising is ongoing for the rest of the expenses. In addition to the new equipment, the oncology department will be implementing electronic medical records to improve physician communication and accuracy of patient history.
Sky Lakes
Colorectal Cancer
Outpatient Rehabilitation Services
No one likes to think about cancer. But especially when it comes to colorectal cancer, giving it some thought could be a lifesaver. According to the American Cancer Society (ACS), regular screenings and some lifestyle changes can help prevent colorectal cancer.
Physical Therapy Occupational Therapy Speech-Language Therapy Hand Therapy
There are some risk factors, like age and family history, which you can’t do anything about. Here are four things you can do to reduce your risk: Eat the right kind of diet. A diet high in red meat and processed meats can increase colorectal cancer risk. On the other hand, diets high in fruits and veggies have been linked with decreased risk. The ACS recommends eating five or more servings of fruits and vegetables daily, limiting consumption of red and processed meats, and choosing whole grains whenever possible.
Specialized treatment for all orthopedic and neurological conditions. Compassionate, skilled professionals using state-of-the-art technology to help you recover, quickly. 2621 Crosby Ave.
541.274.6406 SkyLakes .org
Get adequate exercise. Physical inactivity can increase your chance of developing colorectal cancer—but getting a move on can reverse that risk. Aim for at least 30 minutes of physical activity five days a week, says the ACS, and more activity is even better. Watch your weight. Obesity increases the risk of colorectal cancer, so try to maintain a healthy weight through diet and exercise. Control those vices. Long-term smokers are more likely to develop colorectal cancer, says the ACS, and the heavy use of alcohol has also been linked to colorectal cancer. Kick the smoking habit and limit alcohol to no more than two drinks a day for men and one drink a day for women.
Sky LakeS DermatoLogy 3000 Bryant Williams Dr.
These four steps can help prevent a host of other problems, too, so take control and get headed on a healthier path.
Jaymie Panuncialman, M.D. or The doct y r e is in ev ! y a d J. Eric Brunswick, M.D.
Licensed Physician On Duty On Site X-Ray, Lab, EKG Evaluation • Treatment • Physicals Occupational Health Services Insurance Billing
Certified by the American Board of Dermatology.
Thomas C. Koch, M.D.
Call 541-274-8900 Laura L. Moore, M.D.
Kathie J. Lang, M.D.
Open mOn-Fri 8-7, Sat 9-6, Sun & hOlidayS 9-3
3737 ShaSta Way, Suite a • Klamath FallS (541) 883-2337 • Fax: (541) 883-2504
DERMATOLOGY CLINIC
SkyLakes.org
16 | Live Healthy 2013
PRENATAL HEALTH Benefits of Breastfeeding are Multiple By Samantha Tipler H&N Staff Reporter
Why breastfeed? “The No. 1 health promotion that starts at the beginning of life is to breastfeed,” said Kay Easton, a registered nurse and certified lactation consultant at Sky Lakes’ Family Birth Center. “It’s the primary nutrition for an infant, the most optimal nutrition.” Easton said breast feeding helps a baby develop good health right from the start. It’s also good for the mother, she said. Right after birth it helps reduce the risk of postpartum hemorrhaging. Long-term breast feeding means a lower risk of breast and ovarian cancer later in life. Medical organizations, the Oregon Department of Health and Human Services and the World Health Organization all have recommendations for the length of time to breastfeed. Easton said mothers should breastfeed exclusively for the first six months. She advised no other food or drink for the baby during that time, just breast milk. After six months parents can introduce solid food. She recommended continuing to breast feed for the first year in addition to solid food. Many of the positive health benefits are tied to a full year of breast feeding, Easton said. Breastfeeding is so important Easton said the department of health and human services and the surgeon general put out 100-page long documents in support of the practice and its benefits to the U.S. population.
Kay Easton, Registered Nurse Certified lactation consultant Easton, 64, has worked at Sky Lakes Medical Center since 1987. She is one of two lactation consultants at the Family Birth Center. She has had specialized training on how to teach women about breast feeding and support breast feeding.
The Klamath area has put together a coalition – made up of physicians, public health, Women Infants and Children and La Leche League (a mom-to-mom breastfeeding support group) – to help address barriers to breast feeding in the community. Barriers include the need to educate parents and ensure health providers support breastfeeding. If an expecting mother wants to learn more about breastfeeding, Sky Lakes Medical Center offers free classes. Information can be found at the hospital’s learning resources and are listed on the website (http://www.skylakes.org/Classes-Events/default.aspx). Parents can also contact Easton and Angel Pyles, the lactation consultants at the Family Birth Center, at 541-274-6201. Women Infants and Children (known as WIC) also offers classes and information.
For more information please contact La Leche League 541-281-9570
Pregnant? Eat Well. You need to eat healthy foods when you are having a baby. This means no junk food, coffee or alcohol. You need foods with good vitamins, proteins and minerals. Proteins help your baby grow. Milk, chicken, cheese, beans and yogurt have lots of protein. Eat them at least three times a day.
Live Healthy 2013 |
17
Take a prenatal vitamin every day. Make sure the vitamin contains 600 to 800 micrograms of folic acid. Folic acid prevents birth defects. Also make sure you take iron and calcium. Eat small meals every four hours. Even if you aren’t hungry, your baby is. If you don’t feel well, smaller meals may help you feel better. Most women gain about 25 to 35 pounds while pregnant. Ask your doctor about the right amount for you. You will put on the most weight at the end. This is when the baby grows the fastest. Remember, now that you are pregnant, you are eating for your baby’s health too.
Exercising When Pregnant When you’re pregnant, fitness brings with it a fresh set of challenges. You may feel more fatigued, and it can be increasingly difficult to move around. But a smart, safe exercise program is one of the very best ways to prepare for labor—and to start your child’s life off right.
Before starting an exercise program, talk to your doctor about the best activities for your fitness and health level, and how to move safely. Use common sense and pick low-impact aerobic or strength-building exercises such as walking, swimming, yoga and hiking.
The American College of Obstetricians and Gynecologists (ACOG) says exercise has myriad benefits for both mother and child. For mom, regular physical activity improves circulation and boosts mood and energy.
If you were a runner before becoming pregnant, you can likely continue the sport with some modifications, such as shorter distances and a slower pace. Avoid exercises that require you to lie flat on your back during your third trimester, because excess pressure on the vein that supplies the uterus can restrict blood flow.
Exercise can also help fight side effects of pregnancy, such as constipation, bloating and swelling. Strengthening the back, butt and thigh muscles can relieve backaches brought on by the added weight at the front of your body. ACOG points out that physical activity can help prevent or treat gestational diabetes, which is when the mother’s blood-sugar levels spike during late pregnancy. And improving stamina and strength can facilitate easier labor and delivery and a faster recovery. When mom benefits, baby benefits too. The fetuses of women who exercised had lower heart rates, proof of cardiac health, according to a study by the American Physiological Society.
Keep in mind that as your belly grows, your center of gravity will shift. Your lung capacity will also be reduced as the uterus pushes upward. Pregnancy is not the time to push yourself or to set a personal record, but simply to get the body moving, so aim for 30 minutes of physical activity nearly daily. Sky Lakes Medical Center hosts a variety of childbirth and parenting classes all available at no charge. For class details, go to SkyLakes.org/Classes; call 541-274-6235 to register.
18 | Live Healthy 2013
FMOS
Mom Support First-time mothers often wonder why their babies don’t come with instruction manuals. With this in mind, Sky Lakes Medical Center’s Family Maternity Outpatient Services (FMOS) seeks to provide lactation instruction and support for all new moms.
What is it? A service of the hospital for first-time moms who give birth at Sky Lakes Medical Center. Why do they do it? Home visits and follow-up phone calls are instrumental in preventing weight-loss, dehydration, poor nutrition, jaundice or infection among newborns.
FMOS is entirely staff-developed. The program began in 1993 and recognizes that new moms are not accustomed to breastfeeding and would greatly benefit from one-on-one instruction and support. Not only do lactation nurses visit moms while they are in the hospital, but they also follow-up with new moms by phone and offer a home visit to answer questions. In 2012, FMOS nurses talked to 398 new mothers by phone and visited 191 in their homes. Today, 85 percent of Sky Lakes Family Birth Center patients receive a followup assessment. Families living outside this area are invited to return to the hospital for a follow-up consultation.
Routine, urgent and consultative gynecologic care Specialty obstetrical care including management of high-risk pregnancies, cesarean sections Minimally-invasive surgery and hysterectomy alternatives Management of abnormal bleeding No-incision female sterilization
During a home visit that is scheduled 1-3 days from the time of discharge, the nurse will conduct a complete head-to-toe physical assessment (including being weighed) for baby. Mom will receive an assessment on her physical and emotional recovery. Considerable time is spent discussing postpartum depression. Referrals are made to local agencies such as Healthy Start and Public Health whenever ongoing parenting needs are identified.
Urgent and same-day appointments available five days a week Our physicians are board-certified and participate in annual maintenance of certification
Please Join Us in Welcoming Dr. Melissa Brunner to Heartfelt Now accepting new patients! Call 541.205.6890 2640 Biehn Street, Suite 1, Klamath Falls
www.heartfeltobgyn.com
For those visits to Spanish-speaking moms, the hospital interpreter or a Spanishspeaking staff member is taken along to translate. The breastfeeding instructional classes prior to childbirth, breastfeeding education and assistance during the hospital stay, home visits for first-time moms, follow-up phone calls for moms are free-of-charge.
• • • • Drug & Gifts
Prescriptions • Gift Boutique Over the Counter • Balin’s Fudgery Health • Postal Substation Cards • UPS Shipping • Cosmetics by Lady G Your Good Neighbor Pharmacy
1791 Washburn Way • Klamath Falls, OR 97603 • (541) 884-1347
THE
BEST
way to
lose
YOUR
health is
TO IGNORE IT. When it comes to diagnosing and successfully treating a health condition, we have only one ironclad rule: Earlier is better. That’s why we offer an ongoing series of seminars, support groups, and educational and community events to help educate and empower the people in our community to take control of their own health.
To find out more go to SkyLakes.org and click on the Classes & Events button.
20 | Live Healthy 2013
KIDS “C
C.A.R.E.S.
hild Abuse Prevention Is Everybody’s Business” is at once the slogan and the guiding principal of
Klamath-Lake CARES (Child Abuse Response and Evaluation Services).
Child abuse is an uncomfortable topic and its prevention is vitally important to the livability of our community.
By Ken Morton Executive Director, Klamath-Lake CARES
by highly trained Forensic Interviewers. We do not presume abuse has occurred; we gather medical and forensic information, which may or may not lead to a diagnosis of abuse. CARES works with community partners including the District Attorney’s office, law enforcement departments, the Department
of
Human
Services,
Klamath Youth Development Center and literally dozens of local agencies to ensure these children are protected. Beyond
providing
objective
assessments, CARES is also committed to
child-abuse
education
and
prevention. We present information at
schools,
organizations
businesses, and
service
churches.
We
sponsor events to raise awareness regarding the issue of child abuse and its effects on the entire community. CARES has also been a leader in the CARES, a department of Sky Lakes Medical Center, provides medical assessments for children up to 18 years old who are suspected of having
national award winning “Stop the Hurt” multi-media campaign which is a child abuse prevention effort unique to Klamath County.
been victims of abuse. The categories
The Sky Lakes leadership was visionary
are physical, sexual, neglect and/or
in 1993 when it created CARES, They
emotional abuse.
recognized child abuse as the far-
Because we are interested in the child’s
as well as psychological and spiritual
total well-being and not just the area
implications that run deep within the
of suspected abuse, specialty Medical
soul of this community.
reaching issue it is, with economic
Examiners perform complete physical exams for suspected abuse victims.
CARES is an excellent example of the medical mission of Sky Lakes: Taking
Further, if there is a disclosure of abuse
What: Klamath-Lake CARES (Child Abuse Response and Evaluation Services). Specially trained staff will examine and/ or interview 260 children this year who are suspected victims of child abuse. The number has trended up annually for almost two decades, however dropped by 18 percent in 2012.
care of people, especially those who
indicated, the child is interviewed
are most vulnerable and least able to
using a series of non-leading questions
care for themselves.
How: The program, a department of Sky Lakes Medical Center, has a budget of more than $500,000 a year, but receives only about $90,400 in patient revenue. Community philanthropy and grants help the budget, which CARES as been fully responsible for balancing since 2008. Learn more: SkyLakes.org; klamathlakecares.org; klamathstopthehurt.org; or call 541-274-6289.
PURPLE Crying
Most people think they’d never harm their child. Yet there are hundreds of cases of child abuse annually in the Klamath Basin. The top trigger for child abuse: Crying. That’s why Klamath-Lake Child Abuse Response and Evaluation Services (CARES) and other Sky Lakes departments launched a comprehensive education effort: the Period of PURPLE Crying. It informs parents about the dangers of shaking an infant, and offers ways to reduce stress related to the crying.
Live Healthy 2013 |
21
Designed to stop child abuse by the stress of inconsolable crying, the message is simple: Stop, pause, reset. Healthy baby crying is normal. When the baby resists soothing and crying persists, despite being healthy and well cared for, caregivers can become frustrated. But it’s not their fault, nor the baby’s. The Period of PURPLE Crying” describes the characteristics of crying in healthy infants. It: • Peaks at 2 months of age and ends at 4 or 5 months; • is Unexpected; • Resists soothing; the child appears to be in Pain; • it is Long lasting (typically 20 minutes to five hours); and • occurs more in the Evening. This period of increased crying is temporary and eventually does end.
You know that your children need to see a doctor when they are sick. But they also need to see a doctor when they are sick. But they also need to see a doctor when they are feeling fine. These are called “well-child visits” and they are important for keeping your kids healthy.
How to Keep Kids Well
A well-child visit lets the doctor check your child for health problems before they get serious, says the American Academy of Pediatrics. Here are some things the doctor should do at a typical well-child visit: • Check your child’s growth. • Test your child’s vision and hearing. • Talk to you about health issues, such as nutrition, exercise, and safety. • Answer your questions about your child’s health, growth, or behavior. At this visit, the doctor should also give your child any needed shots. Babies and older children need a series of shots to protect them from serious diseases, Cherry said. Ask the doctor if your child’s shots are up-to-date.
Also remember to take care of your child’s teeth. Children need to have regular dental checkups and cleanings to keep their smiles bright and healthy.
22 | Live Healthy 2013
Sanford Clinic Wins Over Children Since the gate to the fortress opened in October, the Sanford Children’s Clinic in Klamath Falls has made itself a part of the community fabric. It has done so by not only providing much needed healthcare to the community, but by holding education and entertaining events that promote the well-being of children in the region. From luncheons to read-alongs, the pediatric-focused facility has opened the doors of its castle and brought in tours from Tulelake, Merrill, Malin and Dorris. The clinic has also hosted classes about preparing for parenthood, meet and greets with providers and a Klamath County Chamber of Commerce social.
“We’ve been very busy,” clinic director Sue Hayden said. “We were welcomed with open arms and we’re thrilled to be here.” It’s quite a different scenario than what could have played out if the Sanford Clinic didn’t come to Klamath Falls. With the pending retirement of several pediatricians, the number of healthcare providers focused on children and family could have been whittled to very little. Step in the Sanford Health Foundation, a few million dollars and some land donated by Sky Lakes Medical Center and the project was underway in mid-2011.
Now Offering
allergy service
By Dave Martinez H&N Staff Reporter
The clinic, which is modeled after the original Sanford Clinic in Sioux Falls, S.D., is built to look like a castle. The interior is filled with bright colors and shapes to appeal to children’s imagination and make a doctor visit not so scary. But beyond the interior decoration comes an advanced facility where a staff of registered nurses are capable of providing intravenous treatments or measuring lung capacities. For such a small castle atop a hill, it holds the heartbeat of the community’s children safe in its walls.
Rand Hale, MD Debra Hartley, MD Accepting new patients.
Dr. Richard DeVore has added nasal allergy testing and treatment to his recently opened practice in the new Sky Lakes Ear, Nose and Throat Clinic. He was board certified in otolaryngology in 1989, and has special interest in endoscopic sinus surgery, thyroid and parathyroid surgery, pediatric ENT, and inhalant allergies. He is accepting new patients.
Coming This Summer: Lanie Snyder, M.D. The Sky Lakes Ear, Nose and Throat Clinic 2617 Almond Street
541.850.7680 SkyLakes.org
Sky Lakes Family Medicine Clinic 3000 Bryant Williams Drive Suite 120
541.274.8980 SkyLakes.org
Providence Telestroke Network
276 miles away...
.
.. and by your side at Sky Lakes Medical Center Besides excellent emergency care, you now have access to some of Oregon’s top stroke specialists, 24 hours a day. Through an advanced video system, Providence Telestroke Network allows stroke neurologists from Providence Brain and Spine Institute in Portland to be “in the room” with you, your family and Sky Lakes Medical Center emergency physicians, helping to determine the best and fastest treatment for you. To learn more about Providence Telestroke Network at Sky Lakes Medical Center, visit www.skylakes.org.
Providence Stroke Center, part of Providence Brain and Spine Institute, is a nationally certified primary stroke center and a leader in comprehensive, state-of-the-art stroke care, education and research. Providence St. Vincent Medical Center in Portland and Providence Portland Medical Center are both Get With The Guidelines® gold award recipients for consistent excellence in stroke care.
From Klamath Falls
to Belize Touching Lives, Saving Lives
F
By Nora Avery-Page H&N Staff Reporter
or some people, a trip to Belize constitutes an exotic vacation. But for Klamath Falls medical doctors Richard DeVore, Rick Zwartverwer and Andrew Smith, the trip is about so much more than that. DeVore, an otolaryngologist at Sky Lakes Ear, Nose and Throat, has made a record seven trips to Belize as part of a medical mission trip to help impoverished Belizeans get the medical care they need. Zwartverwer, a pediatrician at Sanford Children’s Clinic, and Smith, a local dentist, have both gone with DeVore the last two years. “It’s a big group,” DeVore said, adding that between 40 and 60 people make the trip each year. DeVore helped organize the trips, which now occur every January or February, while still working in Cincinnati, before moving to Klamath Falls two years ago. Smith said that he had been on several medical mission trips before, and was contacted by DeVore after the doctor moved to Klamath asking him to be a part of the Belize trip. “It’s kind of a cool thing for our community to be involved in,” Smith said. Now, he plans to make the trip for years to come, Smith added. “It’s very fulfilling, I have to say,” DeVore said.
Typical trip The medical mission, called Partners for Belize, includes a surgical team, village medical team, pharmacy, dental, a construction crew that builds a house each year and missionaries. All services are offered to the Belizeans free of charge. The group travels to the northern end of Belize around the town of Corozal, an area under-serviced for medical needs. While the northern part of the country is full of sugar cane fields, flat cattle lands and papaya groves, the southern area is rainforested, where cruise ships port and tourists swarm, DeVore said. >>>
Live Healthy 2013 |
25
26 | Live Healthy 2013 “It’s flat and it’s hot and it’s just rank with poverty,” DeVore said of northern Belize. A typical seven-day trip includes two travel days, an organizational day screening patients and scheduling surgeries if necessary, followed by three days for surgery, house construction, children’s ministry and time for the general practitioners to visit small, outlying villages around Corozal. “This is a group that I helped organize to begin with, but it’s take on a life of its own,” DeVore said. “We’ve got it down to a system.” The group typically spends one day of the trip sight-seeing and taking in the local culture, relaxing at the beach or exploring the rainforest. “It’s a pretty well-established trip,” Smith said. The doctors usually see about 300 patients and perform about 45 operations. The pharmacy team gives out about 1,000 prescriptions, and the dental team has about 200 patients. All of this occurs over just four days. “We see patients year after year that come back,” DeVore said. The surgical team sets up in the local hospital, and DeVore said the reason his group is
able to be successful during their trip is because of the assistance they get from Belizeans willing to help. “They’re doing their best under difficult circumstances,” DeVore said. The dental team sets up in a mobile clinic outside the hospital, Smith explained, and offers a full-service dentistry, everything from cleanings to extractions and fillings. Zwartverwer appreciates the time he spend traveling to smaller villages, where he and the rest of the village medical team can see up to 100 patients a day, visiting with people in a local school, someone’s home or another meeting place. “It’s an interesting experience,” Zwartverwer said. Although he is a pediatrician in Klamath Falls, he acts as a family doctor while on these trips, Zwartverwer said, although the other doctors typically send the children his way. “I’ve seen the 80-year-olds and I’ve seen the 8-year-olds,” he said. Zwartverwer explained that he has diagnosed heart conditions and congenital problems in his patients where it is unlikely local doctors would have been able to identify.
Building a home The house that is built each year for one family usually costs about $5,700, DeVore said. This year, the house was built for a mother who couldn’t walk, living in a house with no indoor plumbing with two mentally disabled daughters, Zwartverwer said. The mother had to drag herself outside to go to the bathroom, he said. The family’s previous home also had no doors, and many of their possessions were stolen, Zwartverwer said. They now have a new, more secure home with an indoor bathroom. The physical therapists on the trip were also able to build the woman a combination wheelchair and walker, Zwartverwer added. “It’s really touching,” he said. “It’s really a fun experience.” The trip, for each member of the group, costs about $1,700, he said. “Everybody pays their own way,” DeVore said. “Nobody is getting paid to do this. It’s quite a sacrifice.”
Fulfilling journey For DeVore, who makes the trip a family affair and travels with his brother, who is also an ENT in Dayton, Ohio, and sometimes is wife and sons, the trip is rewarding for many reasons. He enjoys helping people in need “who really have nothing,” and it’s a tangible way of expressing Gods love to people, he said. It’s also a way for DeVore to practice medicine without the burden of paperwork, giving services for free to people who need it. The people of Belize also make the trip great, he added, and he has been able to build relationships with them over the years. “It’s part of me,” DeVore said. “Once you go, you feel like you’re home. It’s like a homecoming, it’s a reunion every year. You don’t leave your friends in a lurch, you go down and help.” One of the other benefits, DeVore said, is that Belize is a fairly safe country for medical groups like theirs, where they don’t have to worry about narcotics or terrorism, and the main language is English. DeVore said he is glad there are many medical and mission groups that travel to Belize, not only because the people need it, but it is also a representation of the American spirit, he said. “There’s a lot of people willing to help,” DeVore said. “It’s a big deal.”
Both Smith and Zwartverwer commented that the Belizean people have been very friendly and welcoming, which makes the trip even more worthwhile for them. “The patients were super appreciative and very open and welcoming to us,” Smith said. “It feels like a vacation working and serving the less fortunate.” For future trips, Smith hopes to recruit other Klamath Falls people to make the trek to Belize. “It’s been a really great experience,” Smith said. “It’s so nice down there.” For many people, their impression of Belize might only be the tourism side, which draws people to the blue beaches and dense rainforests, as well as the longest barrier reef in the Western Hemisphere, making the southern part of the country a hub for eco-tourism, scuba-diving, and fishing. While that might be what tourists see, it doesn’t represent the whole country, DeVore said. “The underbelly of it is just grinding poverty,” he said. “The Belize that we see is beautiful in a different way. And it’s the people that make the difference.” For more information, please visit partnersforbelize.com
Live Healthy 2013 |
27
28 | Live Healthy 2013
Medical Records Before the age of new digital media, medical patients had to jump through hoops and clear hurdles in order to obtain copies of their medical records. It required contacting each individual medical care provider where they wanted their medical records from, writing out a medical release, enduring a wait of up to 30 business days and paying a fee upwards of $30. With Sky Lakes Medical Center’s transition from paper to electronic medical records, this grueling process is now becoming a task of the past; patients will have the power to access their medical records through online databases, instantaneously, free of charge. “Not only will electronic medical records be available to physicians and other healthcare providers almost immediately, anywhere in the world where there is access to the Internet, patients will be able to view their records through online portals,” Director of Health Information Management Tara Irvine said. According to the United States Department of Health and Hu-
By Miles Sari H&N Staff Reporter
man Services, nearly 80 percent of hospitals providing Medicaid or Medicare and more than half of health clinics and doctor’s offices will have electronic health records by the end of 2013. The shift from paper to electronic medical records comes from a push from the federal government to modernize the country’s healthcare system. According to MedicalRecords.com, the federal mandate for the transition to electronic medical records requires physicians and healthcare providers to adopt a certified electronic medical records system by 2015. If a physician or a healthcare provider has not demonstrated an electronic medical record system by 2015, Medicare reimbursements will be reduced by one percent, and then increased by two percent in 2016, three percent in 2017, etc. However, physicians and healthcare providers who implement an electronic medical record system may receive up to $44,000 in Medicare incentive payments as part of the American Recovery and Reinvestment Act. While Sky Lakes Medical Center has had an electronic information system since the early 1990s, Irvine said the drive to fully transition from paper to electronic documents and records wasn’t made until 2008. “Currently, seven of our 13 clinics have completely converted to the electronic medical records system, and our other six clinics are in the process of integrating the system
into their practices,” Irvine said. The seven clinics that are now operating solely with electronic medical records have online portals available to patients who are interested in viewing their records on the Internet for free. While Sky Lakes Medical Center itself is currently looking for thirdparty vendors to set up online medical record access for patients, Irvine said patients can expect the six Sky Lakes clinics to have completed the electronic transition in the next 12 to 18 months. Though there is always a risk of losing privacy with making sensitive, private information available online, Irvine said the electronic system implemented by Sky Lakes is nothing less than secure. “Security is always a factor when information is online, but our systems have several barriers that protect patients’ information,” Irvine said. “We have the ability to encrypt all the information in the medical records database, which only allows verified patients to access their information. Security is an issue that is always on people’s radar, however, patients should not be worried about the safety and privacy of their information. There’s no reason for alarm.” In order to create an electronic medical record for patients, all documents from physicians and other medical professionals are scanned and immediately added to a patient’s online record. Once a document is scanned into a patient’s online record, it is kept
by Sky Lakes for 90 days, allowing a window of time to correct any problems or mistakes on the document or within the record. A health information records technician compares the scanned version with the physical document to ensure that all information is accurate and legible, and then the document is shredded after 90 days. “The benefit of collecting all of this information electronically is that the most current health record for patients is available instantaneously,” Irvine said. “An electronic medical record leads to a more concise, thorough, and up-to-date record.” Irvine said an electronic medical record also makes for a more informed patient. “With an electronic medical record, a patient will be more informed about their health care and more involved with the decisions made about their health,” Irvine said. “In the past, it seemed like patients were just recipients of healthcare – other people were making decisions for the patient. Now patients can interact with their physicians and their own records in a way that puts them in charge of their health.”
Tara Irvine Title: Director of Health Information Management Education: BA in software engineering, MA in business administration, and project management certification from the Project Management Institute. How did you become the Director of Health Information Management? The medical field has become more electronic, and the hospital was looking for a person with a strong background in project management, business administration, and software engineering. That combination has become useful as Sky Lakes brought in a lot of new technological systems and upgrades. How long have you been with Sky Lakes? I’ve been with Sky Lakes since 2001, and I’ve been HIM director since 2006. What’s your favorite part about the position? I really like problem solving. There are always new challenges and new opportunities with this position.
30 | Live Healthy 2013
WELLNESS
Medication Safety
Medication is supposed to help you feel better. But what if your medication is doing more harm than good? Make sure yours is doing what it’s supposed to by keeping medication safety top of mind. One survey of Medicare participants found that two out of five seniors take five or more prescription medications, according to the national Council on Patient Information and education. That’s a lot of potential for misuse and dangerous drug interactions, and that’s not even accounting for over-the-counter medications and supplements. To avoid potentially hazardous drug interactions, create a list of every medication you take—prescription and over the counter— as well as the dosage and how often you take it, and carry the list with you to every doctor appointment. Adverse drug interactions can be deadly. Or they can simply render a medication useless, which is ineffective and a waste of money. Drug interactions or taking medication improperly also can lead to balance problems and falls, depression, hallucinations, confusion and malnutrition.
Men: See a Doc Men are less likely than women to visit the doctor and use medical services, even if they’re experiencing symptoms of something as serious as a heart attack. In fact, a recent U.S. Census Bureau report showed that almost one-third of men said they had not seen a doctor in the previous 12 months. But men need to look after their health the same way women do— especially when you consider that one in five American men has heart disease and three in four are overweight, according to the Agency for Healthcare Research and Quality.
Medication safety means following dosage instructions exactly.
It’s important to see your doctor regularly. Be sure to give your doctor as much information as you can about your health history, the medicines you’re taking and any problems you might be having. It’s the best way for your doctor to determine how to help you stay healthy. Visiting the doctor isn’t a sign of weakness—it’s actually a show of strength. If you want to take care of your loved ones for years to come, start by taking the best possible care of yourself.
Thorny Health Issues
M
oving the dial on key health issues facing Klamath County is a difficult, but not insurmountable task. The city and county sits at or near the bottom when comparing unhealthy lifestyle habits to the rest of the state.
Reversing that trend is the goal of a diverse group of community members and health care providers who see economic as well as intrinsic value in a healthier population.
If you wish to read the Klamath County Community Health Assessment 2013, go to healthyklamath.org and click on the story under that name.
The participants include the local health department, Sky Lakes Medical Center, Cascade Comprehensive Care and Klamath Open Door Family Practice. Also in the mix is the Herald and News newspaper, county and city officials, business leaders and the local law enforcement. Key findings from the recently completed 2013 Community Health Survey have shown that: 1. Good jobs and a healthy economy are the most important factors for a health community; 2. The riskiest behaviors that need addressing are drug and alcohol abuse; 3. And child abuse and neglect is considered the most important health problem. The survey numbers were the result of 13 months of collaborative work among the players. Last year, the local nursing program sent its students out to all corners of the county to do on-the-ground surveys and Sky Lakes and The Herald and News also surveyed residents and readers. This year, the third-year nursing students focused on the core of Klamath Falls, surveying the residents of five political wards. Not surprisingly, the issues across the street are the same as across town and the county. Access to affordable health care; better transportation (such as the bus system that is available at odd hours and on Sundays); neighborhood grocery stores that supply healthy foods; curbing drug and alcohol abuse, all topped the list in the neighborhoods as necessities. The city ward residents want more safe routes to schools, sidewalks or sidewalk repairs, and a community center they can identify with. Many of sectors reported high unemployment and above average of single moms caring for children under age 5. The next step for the project is to narrow the set of topics to three to five main issues that the group can attack. That will provide a road map for action. That road map should be ready by summer’s end. “Now we need to do the hard work,” Paul Stewart, president and CEO of Sky Lakes, told a recent meeting at the Community Health Education Center. “Now is the time for action.” >>>
By Gerry O’Brien H&N Editor
Live Healthy 2013 |
Klamath Wrestles with
31
32 | Live Healthy 2013
Changing the Health Culture Will Take Dedication Sky Lakes Medical Center President and CEO Paul Stewart minces no words when it comes to resolving the nagging health care issues the plague the community. “The health care system is set up to fix something that has already broken,” Stewart said recently. “I sometimes call it the ‘sick care system’ because we are responding to people that are already sick, rather than focusing on prevention.” Consider these statistics: One in four Klamath County residents still smokes, despite of all of the evidence of the damage it can cause; Two-thirds of county residents are clinically overweight; And 70 percent of the residents regularly consume alcohol. “Those of the types of things that are causing the vast majority of health care costs,” Stewart said. He suggested a two-pronged approach to get at a change in attitudes. The first prong is to invest resources in changing the overall culture from one of inactivity and poor habits, to one of an active, vibrant community. The second is to focus on the frequent consumer most, the “frequent fliers,” as he calls them. “Five percent of our population consumes 50 percent of the health care resources. Ten percent of our population consumes two thirds of our health care resources,” he said. They are frequently in the emergency room, the hospital or the doctor’s office. “We have to find a way to help them manage their lives better to free up our health care system,” Stewart said. Most people spend their lives making lifestyle choices, be it whether to smoke, drink to excess, what foods to eat and how much, if any, exercise to get. All that can add up to a physical ailment that means a trip to the emergency room or a doctor, who may fix the problem temporarily, get us back on our feet, send us on our way and send us a bill…much like in auto repair.
By Gerry O’Brien H&N Editor
“There’s little if any incentives built into the system for you or I to take care of ourselves. We have a system designed to respond after somebody has already gotten sick,” Stewart said. “We continue to spend an inordinate amount of money trying to fix things after they break.” That is where Healthy Klamath comes in. The goal is to realign resources to focus on better health upstream, rather than on the result of poor choices downstream. “This is a significant challenge and a long term journey, almost generational in nature,” Stewart said. “It can’t be how we can provide more specialty care, more procedures, and more diagnostic tests. It should be how we can help people choose a healthier lifestyle, be more active, be more engaged. And we who are in the healthcare system need to change our focus from the individual episodic visit to the hospital, to what we can do to manage the overall health of an entire population. The transition will be hard and take a lot of time and involve difficult decisions, but it must be do This is not voluntary, what looks good on paper or feels good as a mission statement. It is where we have we go as a community.“
Live Healthy 2013 |
33
Walking for Fitness Walking: Humans are programmed to do it from birth. Few people may be able to run five miles at a stretch, but many can walk the same distance with ease. It’s not surprising then that as an exercise regimen, walking is among the most popular forms of physical recreation in the nation, with an estimated 77 million Americans walking for health every day. It’s easy, it’s painless, and it’s good for life. Why Walking? Anyone can start a walking program to improve health and fitness, no matter what his or her current fitness level. Seriously overweight people can begin to shed pounds and tone muscles almost immediately by walking for just half an hour every other day. Runners or other athletes can repair torn muscles and ligaments more quickly if they walk as part of their rehabilitation. And individuals with heart trouble or high blood pressure can improve their health dramatically by walking a little every day. Getting started is easy, since almost everyone already owns the necessary walking equipment: a comfortable pair of well-cushioned shoes. No special clothes, no gadgets, and no expensive accessories are required. Even the weather can’t stop walkers, since it can be just as easy to walk around the mall a few times as it is to take off on a regular neighborhood route. Whether it’s a stroll or a racewalk, any amount of walking at any intensity will build muscle, strengthen bones, relieve stress, improve cardiovascular function, and boost anyone’s outlook on life. The Health Benefits of Walking Gain without pain. The best news about walking is that it provides all the health benefits of other exercises without the risk of injury. So walkers can improve their cardiovascular capacity at the same rate as joggers, burn more calories than people who play tennis, and strengthen muscles at the same rate as basketball players. And they can do it day after day because their bodies don’t experience the jarring impact associated with other forms of exercise. Losing fat, building muscle. Most people find it hard to believe something as simple as walking can burn calories at a level that can sculpt a flabby body into a firm physique. But just by walking at a moderate pace, people can burn fat at a faster clip than those who jog >>> >>>
Joint Health A lot of jumping around isn’t exactly good for your joints—but you can take steps to protect your joints and improve their health. Be sure to: • Maintain a healthy weight. Every extra pound you gain puts four times the stress on your knees, but even a small amount of weight loss will give your knees relief, according to the Arthritis Foundation. • Get regular aerobic exercise, especially low-impact aerobic activities, such as bike riding, swimming or elliptical machines. Those types of exercise will protect the joints and the muscles around them, according to the American Academy of Orthopaedic Surgeons. Regular exercise can keep muscles, bones and joints in good shape for people well into their 80s and 90s. • Include stretching to stay limber. This helps prevent tight muscles, which exert extra force on joints and limit range of motion. • Add weight-bearing exercises, which keep bones strong. Weight-bearing exercises include weight lifting, as well as aerobic activities in which you must support your own weight. • Take care of your joints starting today; prevention starts at a young age.
34 | Live Healthy 2013
the same distance. The difference is that walking a certain distance takes longer, so more time is spent boosting metabolism and shedding fat. Generally, the longer the walk, the greater the benefit. Cardiovascular strength. Walkers don’t have to burn up the pavement at a six-minutes-a-mile pace to reach an aerobic level that strengthens the heart and improves lung capacity and endurance. Keeping a workout within the appropriate target heart range is enough. Anyone who’s starting an exercise program should always check with the doctor to get the go-ahead. Then be sure you have a good pair of walking shoes and appropriate clothing for the weather. Neither should be a problem, since almost everyone owns shoes they like to walk in and breathable clothes they can layer. Many people invest in a well-fitting pair of athletic shoes made especially for walking, but usually any pair of lightweight shoes with good heel support and a comfortable innersole will do. Walk This Way Starting slowly is best, especially for people who are seriously overweight, have a chronic medical condition, or are recovering from illness or surgery. Regardless of fitness level, everyone needs to perform some gentle stretching before working out, as well as slower warm-up and cool-down periods at the beginning and end of each workout session. All three components will guard against overexertion, shin splints, muscle aches, and the fatigue that can sabotage even the best of intentions. A good schedule for beginners is 30 minutes a day, every other day. After a week or two, they’re ready to extend workouts to 45 minutes. In subsequent weeks, walkers can try to increase the distance walked in 45 minutes, which will provide a better aerobic workout and increase muscle tone. In study after study, researchers are finding that the healthy benefits of walking depend not on the distance covered or the speed achieved, but on the consistency with which a fitness routine is followed. It’s not enough to start a walking program; the rewards come with sticking to it.
The Do’s and Don’ts of Walking Do increase walking’s aerobic benefits by swinging your arms. Bend your arm at the elbow, 90 degrees, and make a loose fist. Swing your arms as you stride, making sure your fist goes no farther back than your waist and no more than 12 inches forward on the upswing. Don’t walk at a pace that leaves you breathing heavily, especially if you’re just starting to exercise. You should be able to carry on a conversation or sing a song without becoming breathless as you walk. Do replace fluids during and after every walking workout. Don’t watch your feet as you walk. This can cause neck and shoulder strain. Instead, walk with your head up, back straight, and shoulders relaxed. Do use your entire foot. You should land on your heel with your toes and the ball of your foot raised at a 25-degree angle. Then rock forward and push off with your toes. Don’t use ankle weights during your walking workout. They place too much strain on your lower leg and interfere with your stride. Do use stretching exercises, as well as warm-up and cool-down periods, for maximum performance. Don’t forget to relax and take smooth, even strides, especially as you increase the speed of your workouts.
Your Target Heart Rate Whenever you work out, try to keep your heart beating at a rate that provides the most beneficial conditioning for your heart and lungs (see chart). To determine your heart rate at any point during your workout, stop and press your fingers to the large artery on the right side of your neck. Count for six seconds, then add a zero to the number to get your beats per minute. Too fast? Slow down for a while. Too slow? Pick up the pace.
Age
Target Heartbeats Per Minute
25
98-146
30
95-142
35
93-138
40
90-135
45
88-131
50
85-127
55
83-123
60
80-120
65
78-116
CrossFit:
Sweating Your Way to a Healthy Lifestyle
“No excuses.” That’s what the sign hanging in the abandoned warehouse-converted-gym says. Another sign reads, “The strong shall inherit the earth.” Gymnastics rings dangle from the ceiling and pull-up bars resemble a hard-core jungle gym. Kettle bells, medicine balls and free weights lie in orderly piles. No treadmills, ellipticals, stair-climbers or other typical workout machines. There are monster truck tires, however. God only knows what those are for. Welcome to CrossFit Klamath, 1311 Elm Ave., one of two CrossFit gyms in Klamath Falls. Owner Dean Limb began teaching CrossFit workouts in September 2011 with only three clients. Now, Limb has around 75 clients, ranging from ages 11 to 67, and three other trained and experienced coaches on staff, working together to improve the community’s health through fitness. “My goal here is just human improvement,” said Limb. “It’s really just competitive exercise.”
By Kate Tracy H&N Staff Reporter
“His quality of life was significantly improved,” said Limb. Not only does Limb train elite athletes, firefighters, policemen and military folks, but he finds great reward in seeing results from the everyday client. One Cross-fitter mom even texted Limb, thanking him because CrossFit made her strong enough to lift herself onto a tube while boating with her family. Sabrina Criswell, 26, is a police officer who has been doing CrossFit workouts for two and a half years. Criswell appreciates how CrossFit has increased both her endurance and explosive power. “A lot of cops do CrossFit,” Criswell said. “We need to be in better shape than the bad guys, and CrossFit is a very well-rounded workout.” That’s the advantage of CrossFit Klamath: it is challenging enough for the softball player competing in the Olympic trials, but scaleable for the mother who just had a baby. Women ages 28 to 36 make up
What’s a typical CrossFit workout? There isn’t one. The workouts of the day, or WODs, vary because the CrossFit philosophy is to specialize in not being specialized. One thing a person can expect is to have a hard workout, however. Kettle bell swings, burpees, squats, pull-ups, box jumps, and Olympic lifts are only some of the many intense exercises a WOD may include. CrossFit is a nation-wide fitness regimen developed by Greg Glassman in 2000. The workouts incorporate elements of gymnastics, cardio exercise and strength training to target all components of fitness. Athletes compete in a group setting to add a competitive edge to finish the workouts as quickly as possible. Most prescribed workouts are no more than 30 minutes, and some are as quick as five minutes. For Limb, the benefits of CrossFit Klamath have been multi-faceted. He began CrossFit when he was in the Navy. His father was a type II diabetic, 300 pounds and taking enormous amounts of medication for his disease. Within six months of beginning CrossFit, he was off almost all of his medications.
65 percent of Limb’s clientele. Limb enjoys helping his clients realize that CrossFit workouts are accessible and beneficial for everyone, not just athletes who are used to heavy weight lifting. “They don’t have to be a football player to get into the gym,” said Limb. “It’s really opening up for everyone.” >>>
Live Healthy 2013 |
35
36 | Live Healthy 2013
Take, for example, Rebecca Saxton, a sophomore track athlete at Klamath Union High School. Saxton trained all winter at CrossFit Klamath and did not do a running workout once, but still managed to set a personal record in the 400 meters as well as the long, triple and high jumps. Now, she can even powerclean close to her own body weight and placed second in the state Olympic lifting meet. “CrossFit has really helped my track and everything,” said Saxton. “It improved my jumping so much. My muscles got
Exercise Excuses Not all excuses are about food. We’re full of alibis when it comes to exercise too. Here are the top excuses for not working out-busted.
Excuse: I can’t afford to join a gym.
dangerous without proper technique, Limb makes sure to have
Busted! If you want to get fit on the cheap, get active at home. “There are a lot of fun cardio activities you can do outside, like walking, jogging, and cycling,” says Jason Karp, Ph.D., an exercise physiologist and an instructor with USA Track & Field.
an appropriate 10:1 client to trainer ratio so that no one gets
Excuse: I have no time to exercise.
stronger just because I worked hard every day.” One thing that sets Limb’s gym apart from other gyms is the high level of personal training that his clients receive. Each trainer has completed the Level 1 CrossFit certification and served an apprenticeship at the gym. Since many of the lifts are
injured. “No one ever works out here without a trainer on staff,” said Limb. Limb customizes the workouts at his gym to fit his clients, instead of always assigning the prescribed CrossFit WODs. Community is a priority at Limb’s gym as well; clients often get together for barbeques when doing a million pull-ups and tossing tires around the parking lot does not provide enough bonding time. “My No. 1 here at the gym is community management,” he said. “Our community here is very tight.” CrossFit Klamath usually offers six classes every weekday, with two on Saturdays, and the first class is free for anyone trying it out. Prices for unlimited monthly access to the gym are $95, with discounts for students, military, families, police and firefighters. For some, that price may seem steep, but for the personal training they receive, “that’s the cheapest gig in town,” said Limb. “Mentally they’re looking at a membership. They don’t understand everything they’re getting.” So what will CrossFit Klamath do for you? It will make you sweaty, very sweaty. And probably sore for a few days. Or weeks. Stairs might become your worst enemy. But it will all be worth it when you start seeing the incredible results CrossFit is sure to give. No excuses, remember?
Busted! “You don’t need a lot of time,” Karp says. “You can get health and fitness benefits from doing short, intense bursts of activity.” Try doing 15 minutes of an aerobics video twice a day or hoisting weights in between loads of laundry.
Excuse: I’m too tired. Busted! Just get going and you’ll be happy you did. “Exercise will actually give you more energy and make you feel better,” Karp says. If you can get yourself to lace up your shoes and head outside, chances are you’ll feel much more energetic after your workout.
SUGAR
Sugar provides quick energy, but after picking you up, it drops you hard and leaves you looking for more. One key to cutting back on sugar is having the right food with you so you don't head to the nearest vending machine for a candy bar. Make sure they contain at least 1 to 2 ounces of protein to keep your blood sugar stable for several hours, combined with a complex carbohydrate to give you a quick boost of energy. Examples include: whole-grain crackers and low-fat cheese, fresh fruit and low-fat cottage cheese, plain non-fat yogurt.
A sleepless night here and there, a stressful day at the office, or one too many pieces of chocolate cake can take their toll. But when you're constantly feeling drained, it might be time to look at what's bringing you down. Check out these energy zappers and see how many apply to you.
C A F F E I N E E X E RC I S E
Caffeine can also leave us tired and wired. If we need sleep and we choose caffeine instead, we continue to throw off our natural sleep cycle. If you find that too much caffeine – whether it comes in the form of coffee, tea, cola, or even chocolate – is keeping you from getting a good night's sleep, switch to decaffeinated varieties of your favorite beverage and cut back on the chocolate.
(too little or too much)
Without it, we're naturally more sluggish. Exercise also enhances our mood by increasing the release of endorphins, a "feel good" chemical that increases energy levels. On the other hand, too much exercise also presents a problem. Overtraining depletes our energy reserves, breaks down muscle, and eventually makes us weaker, not stronger. Overdoing the workouts also suppresses the immune system, which in turn reduces our resistance to bacterial and viral invasion.
Sky Lakes
Nutrition Services
Staffed by registered and licensed dietitians. Nutrition counseling is an essential component of comprehensive health care. People with a variety of conditions and illnesses can improve their health, their quality of life and their productivity with nutrition counseling. Medicare and many insurance plans cover Medical Nutrition Therapy for qualifying conditions.
541.274.3800 NUTRITION SERVICES
SkyLakes .org
Live Healthy 2013 |
What’s Zapping Your Energy?
37
38 | Live Healthy 2013
Klamath Falls Couple
Competes on World Stage
A
By Nora Avery-Page H&N Staff Reporter
nu Campbell’s background is as a runner. Sean Campbell’s background is as a cyclist. For the past few years, the couple has learned from each other to compete as part of Team USA in the ITU (International Triathlon Union) Short Course and Sprint Duathlon World Championships. “It’s a run, bike, run event,” Anu said. “I think it’s actually more challenging because it includes two runs.” Both Anu and Sean qualified for the world championships again this year, and will be competing in Ottawa, Canada in August. This will be Anu’s third time at worlds, while Sean has qualified eight times, and made the trip to the competition seven times starting in 2006. “He got into it first and I’ve been kind of following,” Anu said. Despite her other trips to the championships, Anu said she still considers herself a beginner, although she also competes in other races locally and nationally. Anu, 43, came in first in her age group in 2011 and claimed the bronze medal in 2012, when the championships were held in Nancy, France. Anu, a physical therapist at Sky Lakes Medical Center, is originally from Finland. She and Sean, who is from Washington, met while living in Saudi Arabia before they moved to the United States in 2001. Sean is a member of the Air Force and works at Kingsley Field as a member of the 173rd Fighter Wing Maintenance group. Getting started The couple started out racing together before both began competing in duathlons. “I was doing the cycling and she was doing the running,” Sean said. But that changed when Anu was injured before a race. When Sean asked how he would find someone to replace her, Anu told him that he could do the running part himself.
Live Healthy 2013 |
39
Anu said she appreciates that the competition requires you to be a good overall, not just in one area. “It’s kind of a nice multi-sport,” she said. She also appreciates that cycling gives her a break from running, which helps her avoid stress fractures, although the transitions between each sport can be difficult, Anu added. “After the first run, you just feel like you just don’t have the cycling legs and the breathing is different too,” Anu said. Racing together Both Sean and Anu said they enjoy visiting the different locales the races are held. The two have traveled to Spain, Italy, the United Kingdom, France, and other countries for the championships, whether they were both competing or just Sean. It’s nice to sight-see and meet new people, Anu said, but she also likes to see the familiar faces of people they have raced with before. But Anu and Sean do have to save up for the trips; as part of Team USA, they have no sponsors. “They’re kind of like vacation plan,” Anu said. But the couple is happy to compete for their country, she added. >>>
Anu & Sean Campbell
40 | Live Healthy 2013
“It’s kind of nice to represent,” Sean said. And, Sean said, while it’s not very unusual for a couple to be competing together, it is a little rare. “It’s kind of nice because it gives us something to do together,” Sean said. Training To Anu, the beauty of cycling and running as exercise is that you can walk out the front door to do it, and both require very little equipment beyond running shoes and a bicycle. Training for their competitions involves year-round training, she said, and while trail running, for example, might be more ideal, she usually runs around town or in her home gym to train because she doesn’t like the idea of having to drive somewhere for her workout. To Sean, training is “just getting the miles on the road,” he said, adding that weekends are great because it allows him more time to work out. For both husband and wife, training consists of mostly running and cycling, although Anu said working on core strength is also important. She also likes to swim. “When the racing season is over you can take a little bit of a breather,” Anu said, adding that some people like to do cross-training during the off-season. There are great opportunities to run or bike in the Klamath area, Anu said because there are many hills and varied terrain, which helps build endurance and strength as well as prepare the couple for the different locales of races. But Klamath also has long winters, Anu pointed out, making the home gym she and Sean use necessary. They are lucky to be able to have that set-up, she said. “As you get older, you have to train smarter,” Anu said. The races do not get easier as you moved up the age groups, she explained. “They’re pretty tough and fast age groups,” she said. A typical workout for the Campbells during the winter is to simulate a race by running on the treadmill, then hoping over to a stationary bike, before returning to running. They also do what is called a brick workout, completing a one mile run, followed by a short bike ride, then back to running, and so forth, Anu said. Such workouts build you up and help them prepare for the difficult transitions between each sport, she said. “Every workout should count and be a smart workout,” Anu said. Anu and Sean will also do distance runs or bike rides, that include hills, intervals and other challenges. Sean said that it can be difficult to find the motivation to train after a long day at work-- sometimes it’s the last thing he wants to do, but Anu will push him. “She’s kind of a good catalyst,” Sean said.
Diet Sean, in turn, encourages Anu to eat healthier, she said.
Sky Lakes
Adult Medicine Clinic
“He’s the role model in that,” she said. They try to follow a back to basics diet and eat smarter by avoiding processed foods, read labels or just eat foods that don’t require labels, Anu explained. But as athletes, they also need to eat a lot of carbohydrates because they burn a lot of energy, Anu said. It’s important to fuel your metabolism, she added, and although some people are afraid to eat, or eat more, because they don’t want to put on weight, the food is necessary. That’s something she has struggled with herself, she said, but she is experimenting with eating more.
Michele Rushton, MD
We’re Moving!
August 2013 to 3001 Daggett Ave.
Sky Lakes Adult Medicine Clinic 2200 Bryant Williams Drive Suite 3 Bassel Choufani, MD
Berta Garvey, PA-C
It’s also especially important to make sure to drink enough water, she said. “We all need to be drinking a lot more,” Anu said.
Mohamed Siyad, MD
ADU 541.274.8930
ADULT MEDICINE CLINIC
COME IN AND MEET OUR NEW PROVIDERS! Jennifer Boudreaux & Karen LeRoy
New Office Hours: Monday through Friday 8:00 a.m. - 6:00 p.m. Saturday Clinic & Same Day Appointments Available
Call us to schedule: 541-884-1224
New patients are always welcome! Dr. Cherry was raised in the Klamath Basin as were her grandparents and her great-grandparents. She founded Children’s Clinic of Klamath to serve the needs of area residents by providing excellent medical care for their children. The Children’s Clinic of Klamath is committed to making a difference in every child’s life and well-being. We strive to make a difference here, in our community. The Children’s Clinic of Klamath remains locally owned and managed.
2580 Daggett Ave. • Klamath Falls, OR 97601 We are a Tier 3 Patient Centered Primary Care Home. Find us at: www.cckonline.com
42 | Live Healthy 2013
Exercise for Seniors As we get older, our bodies naturally get less flexible, we lose some strength, and our endurance isn’t what it used to be. That could leave you thinking that exercise is no longer a good idea. But for most people, exercise is more than just a good idea: It’s crucial to good health at any age. It can even improve health conditions like diabetes, heart disease, and arthritis. The key is to tailor your program to your own abilities and limitations. Talk to your doctor about developing a fitness plan, or create one yourself using the following guidelines. Just be sure to get the OK from your doctor before getting started. Four Steps to Fitness Begin exercising slowly, especially if you’re not already active. Gradually increase the intensity or amount of time you spend. It’s important to exercise regularly, not strenuously. Your fitness plan should cover these four areas: 1. Endurance. These exercises build stamina and strengthen your heart and lungs. Walking, dancing, swimming, stair climbing, and tennis are good examples. Work up to at least 30 minutes of endurance activity most days of the week. Break it up into three 10-minute sessions through the day if you prefer. Always warm up first with a light activity like walking in place. Once an activity begins to feel easy, increase length of time you do it. Then, increase the intensity by putting more effort into it. 2. Strength. Build muscle strength through resistance exercises. Small weights, resistance bands, and weight machines build strength. Biking, rowing, or practicing Pilates are effective, too. Work both upper- and lower-body muscle groups. Build up to two to three sessions a week if you’re using weights. Activities like biking or rowing can be done three to five times per week. 3. Flexibility. Stretching exercises, including activities like yoga, keep your body flexible. Stretches should always be gentle and static (don’t bounce). Include flexibility exercises for 15 to 30 minutes a day for each muscle group. Stretching is best when you’re warmed up after endurance or strength exercise. 4. Balance. Exercises that improve your balance help prevent falls. They can be worked into your strength, endurance, and flexibility routines. Yoga and tai chi are helpful as well. Or practice standing on one foot or standing up and sitting down without holding onto anything.
Wise Move: If you experience chest pain, breathing problems, dizziness, or nausea while exercising, stop and call your doctor.
Live Healthy 2013 |
43
Balance Tips
Falling is not a normal part of aging and can be prevented. Being aware of fall risks, ways to prevent falls, and staying active may prevent you from falling. Here are a few ideas to make your home safer: • Begin a regular exercise program; • Have your healthcare provider review your medicines; • Have your vision checked; and • Make your home safer. • You can make your home safer by removing throw rugs, and increasing lighting especially in hallways and stairs.
Douglas Todd, MD
General Surgeon, Stanton T. Smith, M.D.
Coming This Summer: Jared Ogao, M.D.
Dr. Douglas Todd is a Board Certified
Otolaryngologist by the American Board of Otolaryngology. He is also a Board Certified Head and Neck Surgeon. Dr. Todd offers exceptional treatment and a strong commitment to state-of-the-art procedures with a friendly, down-to-earth nature. He is accepting new patients.
Are you at risk? Get a free balance screening, performed by a licensed physical therapist at Sky Lakes Outpatient Rehabilitation Services. You’ll get a personalized “balance report card” so you can discuss results with your physician. Call 541-274-6406 for a free appointment.
Cascade Ear, Nose, Throat & Facial Plastic Surgery 3000 Bryant Williams Drive Suite 200
541.274.3000 SkyLakes.org
A board-certified surgeon, and Stockton, California, native, Dr. Smith relocated to Klamath Falls from Connecticut where he completed a fellowship in minimally invasive surgery. He has extensive training in advanced laparoscopic surgery, complex hernia repair, and gastrointestinal surgery. Additional services provided include upper and lower endoscopy; endocrine, breast, vascular and weight-loss surgery. Like all of our doctors and medical staff, Dr. Smith is committed to the highest quality care for his patients. He is now accepting new patients.
To make an appointment call 541.274.2345
44 | Live Healthy 2013
Easing the Pain
Palliative Care Benefits Patients and Families
A
n elderly patient walks into Sky Lakes Medical Center with symptoms of shortness of breath and constant chest pains. After numerous tests, the physician diagnoses the patient with lung cancer. With the turmoil of emotional and physical distress surrounding the patient, what should the family and patient do next? According to Mary Anne Keane, Clinical Nurse Specialist and Palliative Care Coordinator at Sky Lakes, most patients are so overwhelmed after receiving a devastating diagnosis they hear only about 50 percent of a doctor’s information. And of that 50 percent, they hear only 50 percent accurately. Because of this, patients are sometimes confused and often do not consider their wide array of options with a serious illness. Palliative care assists patients in creating a plan to tackle the illness, and can also help with the symptoms and emotional stress accompanying it. “Palliative care is specialized medical care for anybody with a serious illness. It’s about providing an extra layer of support, and helping patients navigate the complexities of the healthcare system,” said Keane. Keane helps patients and their families communicate with physicians and their care team to achieve a clear goal for the patient, while reducing the symptoms and stress of the illness. She visits patients
By Kate Tracy H&N Staff Reporter
throughout the hospital at Sky Lakes, helping them decide between hospice or aggressive treatment. She said 250 patients received palliative care last year, and about 40 percent of those chose to receive hospice care. Not only does Keane care for the physical needs of the patient, but also for the emotional needs, as most experience anxiety and depression. “I feel privileged to be able to walk people through this difficult time of life. It’s an honor to help people navigate the challenges of serious illness,” said Keane. Kathy Chavez, 64, speaks highly of her experience with Palliative Care Services at Sky Lakes. Her husband, Manuel Chavez, was diagnosed with vascular dementia, resulting in a 31-day stay at Sky Lakes in June 2012. The doctor referred the Chavez family to Keane after he stopped responding to medicine. “I thank God ever day for Mary Anne for being there and telling us what to expect,” said Kathy. “With everything he had in order — his will, advanced directive and everything, she knew what he wanted.” Since Manuel had clarified in his advanced directive he did not want any sort of artificial life support, this ruled out feeding tubes. He was not getting better, so Keane suggested in-home hospice care or a nursing home. Kathy, along with hospice nurses from High Desert Hospice, cared for Manuel at their home until he passed away on Nov. 5, 2012.
Kathy says she highly recommends palliative care because of the extra communication and support. “It was comforting because it wasn’t a big shock. Every stage they go through, it was explained to us,” she said. “It was an amazing walk.” Keane notices how people are sometimes not aware of palliative care, and if they are, they equate it with hospice care. “The biggest challenge to overcome is to de-link palliative care with hospice care because hospice often evokes fear of dying, and so people will hold it off as long as possible,” she said. Since the most effective time for palliative care is right at the beginning of a diagnosis, Keane wishes more people were aware and considered palliative care at the beginning of a diagnosis. “Historically, palliative care is seen as only something you can do when you can’t do anything else,” she said. Keane hopes to change this misconception by helping people embrace the inherently valuable treatment of reducing suffering. Keane advises families caring for their family member with a serious illness to get additional support at the beginning of a diagnosis. Many families have an independent mentality of trying to care for their family member themselves until they become emotionally and physically exhausted. So, she suggests getting a medical support system immediately to help meet the patient’s needs and assist the family caregivers.
Klamath Radiology Associates
is now part of the
Sky Lakes Medical Center family
Diagnostic imaging services including mammography, ultrasound, X-ray, CT and MRI Bretton Breazeale, MD • Jeffrey Chudoba, MD Scott Allen, MD • William Tamplen, MD COMING SOON: Christopher Gabel, MD
2900 Daggett Avenue • Klamath Falls
541.884.1371 • SkyLakes.org
MICK INSURANCE AGENCY, INC.
PORCELEIN VENEERS • DENTAL IMPLANTS • DENTURES & PARTIALS
Need a Family Dentist?
Here to help you with your Individual, Group or Medicare Insurance needs
Carol Mick & Jodi Applegate Agents
Fred Daum, D.M.D.
—Financing Available—
NEW Patients Welcome 5232 South 6th St. Klamath Falls, OR 97603 (541) 884-9339 • Fax (541) 884-0454 www.klamathdentalcare.com
Klamath Dental Care, Inc.
4509 S. 6th St., Suite 110 Klamath Falls, OR 97603
541.882.6476 Fax: 541.273.2364
46 | Live Healthy 2013
Hospice Provides Comfort at the End of Life Jeri Icenbice, registered nurse and clinical manager at Klamath Hospice, recalls one patient visit where she approached the house of a patient only to have the family greet her on the lawn. “Don’t tell Mom she’s dying,” they told Icenbice. “Don’t let her know you’re from hospice—she won’t take it well.” As she made her way into the house, she greeted her terminally ill patient and told her she was there to help. “Don’t tell my family I’m dying,” said the woman. “They won’t take it well.” Stories like this demonstrate the reluctance in American culture to approach the end of life openly and fearlessly, on both the part of the dying and those who know the dying. Icenbice cannot stress enough the need for communication between families and a dying family member. “We go through life feeling like we’re totally invincible,” said Icenbice, adding that people’s taboo view of death is “not what it could be so that communication is there.” Perhaps this attitude of invincibility contributes to an unwillingness to accept hospice care at the end of life.
that bothers me the most is you go on hospice, you stop medication, and you die,” said Icenbice. In reality, hospice care provides what no other medical service can. Statistics show patients in hospice care live longer than those without it; Icenbice attributed this to hospice nurses’ ability to manage a patient’s pain levels. With registered nurses, aids, social workers, volunteers, spiritual counselors and medical doctors among the services hospice provides, hospice care’s goal is to provide comfort rather than a cure. “In today’s technology we can do many things to people, but what can we do for them?” said Icenbice, highlighting the hospice philosophy of providing quality care at the end of life, rather than a temporary cure through exhaustive and often dangerous treatments. Klamath Hospice currently serves 40 patients, and in 2012 they served 225 patients altogether. Since hospice serves only those diagnosed with a terminally ill disease and given less than six months to live, Icenbice said her organization has treated patients of all ages, from a newborn to a 105-year-old. Hospice is cost-effective, as most insurance companies and Medicare will pay for it. Klamath Hospice never rejects a patient based on an inability to pay. But the question still stands: is hospice the best option for end-of-life health care?
“One of the biggest common myths
For Lisé Palmer, resident of Klamath Falls, the answer is an emphatic “yes.” When her father, Tom Palmer, was diagnosed with stage 4 colon cancer in 2007, her family placed him under hospice care for the remaining month of his life before he passed away May 5, 2008. Palmer said the most touching aspect of her experience with Klamath
By Kate Tracy H&N Staff Reporter
Hospice was that their nurse arrived within 45 minutes of her father’s death, despite it being the middle of the night in Tulelake. “I can’t say enough great things about hospice,” said Palmer. “They are just dripping with compassion and love.” Palmer appreciated how the hospice team was equally compassionate and straightforward about what to expect with her father’s death. She said the nurses educated her family thoroughly about her father’s worsening symptoms. And in the middle of emotional turmoil, the nurses offered clarity of thinking for the family members too devastated to rationalize much of anything. “I loved the fact they were nurses,” said Palmer. “I trusted their judgment; I liked the experience they had.” Palmer’s experience with Klamath Hospice was so positive that she decided to become a volunteer for the organization in April. “It’s something I’ve been wanting to do ever since my dad passed away,” she said. “It’s awesome to be able to understand my own experience with my dad.” Klamath Hospice currently has 17 volunteers who work mostly alongside the families of patients in hospice care. Volunteers and other aid workers provide respite for the caregivers and a helping hand in the home of the patient. In addition to its volunteer and aid programs, Klamath Hospice also offers bereavement counseling for 13 months following a family member’s death. Camp Evergreen is also a camp for children, which offers grief counseling and help to children going through the loss of a family member.
What to Expect with Hospice Care • 24/7 response from skilled hospice nurses who will treat symptoms and manage pain • Assessment of a patient’s needs, including equipment, comfort and hygiene needs • Social care workers who will manage other care options, including additional aid workers • Volunteers who offer respite for the caregivers and an additional support system; they also record memories for a “life story” of the patient in written, audio or visual form • Medical supplies, including oxygen, hospital bed, briefs or anything else required for the best amount of care • Spiritual counselor who will address the spiritual or religious needs of the patient • Medical director who acts as a liaison between the patient and physician and will visit the patient if needed • 13-month bereavement services for families
We’ve moved!
OUR CARE SPEAKS FOR ITSELF
541.882.1636 www.HighDesertHospice.com Nurse Owned and Operated
Gastroenterologist Dr. Patrick Maveety Dr. Patrick Maveety offers diagnosis and treatment for many conditions, including:
OB/GYN Specialist
Linda Walker, MD, FACOG Now Practicing at Sky Lakes Women’s Health Clinic Obstetrics & Gynecology
• Inflammatory bowel diseases • Ulcerative colitis • Crohn’s disease • Liver and pancreatic diseases • Swallowing disorders • Acid reflux
Dr. Maveety also performs surgical procedures including: • Colonoscopy • Colon cancer screening • Upper endoscopy
Dr. Maveety is now accepting referrals from your primary care physician.
2850 Daggett Ave Klamath Falls, OR 97601
541.274.8610 2200 Bryant Williams Dr., Suite 6 Klamath Falls, OR 97601 541.274.8970
skylakes.org
48 | Live Healthy 2013
RECIPES
Whole Wheat Nut Bread
Makes 1 loaf (14 slices) | serving size: 1 slice Ingredients 1 cup whole wheat flour 1 cup all-purpose flour ½ cup Splenda 1 tbsp baking powder ½ tsp salt 1 egg, beaten 1 cup 1% milk ¼ cup cooking oil ¾ cup chopped almonds Preparation 1. Preheat oven to 350F. Grease the bottom and ½ inch up the sides of an 8x4x2-inch loaf pan; set aside. In a large bowl stir together flour, sugar, baking powder, and salt. Make a well in center of flour mixture; set aside. 2. In a medium bowl combine the egg, milk and oil. Add egg mixture all at once to flour mixture. Stir just until moistened (batter should be lumpy). Fold in nuts. Spoon batter into prepared pan. 3. Bake for 50-55 minutes or until wooden toothpick inserted near center comes out clean. Cool in pan on a wire rack for 10 minutes. Remove from pan. Cool completed on wire rack.
Nutritional Information Calories: 140 Total Fat: 7 g Saturated Fat: 1 g Cholesterol: 15 mg Sodium: 170 mg Total Carbohydrate: 14 gm Dietary Fiber: 2 g Sugars: 1 g Protein: 4 g
Quick Chicken & Veggie Spaghetti Skillet Preparation time: 15 minutes Cook time: 15 minutes Makes 4 servings
Nutritional Information Calories: 99 Total Fat: 4 g Saturated Fat: <1 g Trans: 0 g Sodium: 14 g Total Carbohydrates: 14 g Dietary Fiber: 7 g Sugars: 4 g Protein: 1 g
Live Healthy 2013 |
49
Jicama Hash-Browns Servings: 2 (without the eggs) Serving size 1 cup
Ingredients
Preparation 1. In a large skillet, heat the oil over medium high heat.
2 cups of jicama, peeled and grated 1/2 onion, chopped 1 cove garlic crushed 1 tsp sweet paprika (optional hot) 2 tsp oil Salt (optional) and pepper, to taste
Ingredients 1/2 box spaghetti 2 teaspoons olive or vegetable oil 2 teaspoons minced garlic 1 cup broccoli florets 3 medium tomatoes, coarsely chopped 1/2 cup reduced-sodium, fat free chicken broth or vegetable broth 2 cups cooked chicken pieces or strips** 1/4 cup sliced fresh basil 2 tablespoons shredded Parmesan cheeses
2. Add the onion and garlic and cook until translucent. Add the paprika, stir 30 sec, add the jicama, salt (optional) and pepper and cook until brown. 3. Top with your favorite egg dish and breakfast is served!
Preparation 1. Cook pasta according to package directions. 2. Meanwhile, heat oil in large nonstick skillet over medium heat until hot. Add garlic. Cook and stir 1 to 2 minutes, until garlic is softened. Add broccoli; cook and stir 1 minute. Add tomatoes and broth; cook 3 to 5 minutes until broccoli is crisp-tender, stirring frequently. Remove from heat. 3. Drain pasta. Add to skillet and toss. Add chicken; toss. Sprinkle with basil and Parmesan cheese. *If traditional pasta is used in this recipe there is a total of 40 g carbohydrate. **Use rotisserie chicken, packaged, precooked chicken strips or left over grilled or broiled chicken
Nutritional Information (1/4 of recipe) Calories: 351 Total Fat: 9 g Saturated Fat: 2 g Cholesterol: 64 mg Sodium: 191mg Total Carbohydrates: 10 g Dietary Fiber: 6 g Protein: 29 g
50 | Live Healthy 2013
Fish Tacos with Avocado Salsa Serves: 4 | Serving size: 2 tacos Since experts recommend eating seafood at least twice a week, take a break from the standby beef taco and go fish.
Ingredients 1/4 cup all-purpose flour, spooned into measuring cup and leveled 1/4 cup cornmeal 1/2 tsp onion powder 1/2 tsp chili powder 4 fish fillets (1 lb total) such as tilapia, rinsed, patted dry, and cut in 8 strips total 2 Tbsp canola oil, divided 1/4 tsp salt 8 corn tortillas, warmed 1/2 of a medium avocado, peeled, pitted, and diced 1/2 cup fresh pico de gallo, salsa verde, or picante sauce 1 medium lime, cut into 8 wedges
Nutritional Information Calories: 375 Total Fat: 14 g Saturated Fat: 2.2 g Trans Fat: 0 g Cholesterol: 75 mg Sodium: 335 mg Total Carbohydrates: 37 g Dietary Fiber: 5 g Sugars: 2 g Protein: 27 g
Preparation 1. Combine flour, cornmeal, onion powder, and chili powder in a shallow dish, such as a pie pan. Coat fish with mixture. 2. Heat canola oil in a large nonstick skillet over medium-high heat. Add fish; cook 3 minutes on each side or until browned and fish flakes with a fork. Place on serving platter and sprinkle evenly with salt. 3. Place fish in warmed tortillas and top with equal amounts of avocado and pico de gallo. Squeeze a lime wedges over each tortilla. Flavorful tip: Salsa doesn’t have to be limited to Mexican fare. It can be used as a spread for sandwiches and a topping for simple cuts of meat, poultry, and fish
Calories: 160 Total Fat: 4.5 g Saturated Fat: <1 g Cholesterol: 0 mg Sodium: 35 mg Total Carbohydrates: 28 g Dietary Fiber: 3 g Protein: 2 g
Preparation 1. Preheat oven to 400 degrees. Spray a baking sheet with cooking spray. 2. Place potatoes in a bowl and add oil; toss to coat. 3. Add remaining ingredients and mix well. 4. Place potatoes on a baking sheet and bake for 35 minutes or until potatoes are soft.
"Sweet" Potato Fries Serves: 6 | Serving Size: 10-12 Fries Dietitian Tip: Sweet potatoes are packed full of good nutrition providing a good source of vitamin
Grilled Salmon & Asparagus Serves 4 | Serving size: 1/4 recipe Lovely to look at and as fresh as summer itself, Grilled Salmon & Asparagus can be served hot or cold. Serve it with a baguette. Ingredients 2 Tbsp extra virgin olive oil 2 cloves garlic, chopped 1/4 cup fresh basil leaves, thinly sliced 2 lemons, juiced 1 lb thick salmon fillet, skinless, cut into 4 portions 2 tsp salt-free lemon-pepper seasoning 2 lb thin asparagus, ends broken off and placed in a bowl of water
Nutritional Information Calories: 300 Total Fat: 17 g Saturated Fat: 3 g Trans Fat: 0 g Cholesterol: 75 mg
Sodium: 80 mg Total Carbohydrates: 9 g Dietary Fiber: 3 g Sugars: 3 g Protein: 29 g
Preparation 1. To prepare the garlic bath, place olive oil in a small sauté pan. Add garlic and heat until garlic becomes fragrant, about 2 minutes. Add basil and turn heat off. Whisk in lemon juice. Set aside. 2. Sprinkle salmon with lemon-pepper seasoning. Set aside. 3. Preheat grill pan for a few minutes. Drain asparagus and place on grill pan. Cover and roast asparagus for 3 minutes, shaking occasionally. Remove cover. Brush salmon with lemon garlic bath. Place on the grill pan. Cook first side until a nice crust forms. Turn and cook second side. If you want your salmon well done, the lid can be placed on the grill pan. 4. Place asparagus on serving plate. Top with salmon. Drizzle with lemon garlic bath. Additional lemon garlic bath can be stored for future use.
51 Live Healthy 2013 |
Ingredients Cooking spray 2 large sweet potatoes (about 2 pounds total), peeled and cut into 1/2-inch wedges 2 tablespoons olive oil 1 teaspoon cinnamon ¼ cup Splenda® Brown Sugar Blend
Nutritional Information
Family. Community. Education.
Complete Physical Exams | Well Child Exams | Immunizations Womenâ&#x20AC;&#x2122;s Health | Family Planning, Prenatal, OB & Newborn Care Sports Medicine | Orthopedic Clinic Mental Health & Social Services | Lab, X-Ray, and EKGs Office Procedures (including biopsy, circumcision & vasectomy) Same Day Visits for Acute Illness | Se Habla EspaĂąol
Providing experienced family medicine health care to people of all ages
Clinic Hours: Mon., Tues., Wed., & Fri., 8:30 a.m. to 5 p.m. Thurs., 8:30 - 11:30 p.m. and 4:30-7:30 p.m. 2801 Daggett Avenue | Klamath Falls, Oregon, 97601 Ph 541-274-6733 | SkyLakes.org
Cascades East Cascades East Family Medicine is both a medical clinic and a threeyear rural family medicine training program on the Sky Lakes Medical Center campus. It is a decades-long partnership between the medical center and Oregon Health & Science University and remains OHSU’s only residency training program outside the Portland metro area. Cascades East is accredited by the American Council for Graduate Medical Education (ACGME). In 2010, Cascades East received from the council a full five-year reaccreditation with no citations – a very rare accomplishment. Cascades East has also become a certified Patient-Centered Primary Care Medical Home with the state of Oregon, receiving the highest designation of Tier 3. “The physicians and staff at Cascades East are dedicated to providing personal, comprehensive, and continuing health care for people of all ages, their families, and the community of Klamath Falls,” said Joyce Hollander-Rodriguez, M.D., a graduate of the Cascades East program and now the program director. “We specialize in ‘patientcentered’ primary care.” The patient-centered medical
home model is a “coordinated, team-based approach to care focused on engaging patients and families in a partnership for their health,” she added. The team of health professionals at Cascade East includes faculty and resident physicians, nurse practitioners, registered nurse-case managers, medical assistants and mental health professionals who collaborate to provide patients with coordinated physical, mental, and specialty care needs all in one medical home. Patient records are maintained electronically so that quality and preventive measures can be tracked and patients can have access to their results and care providers through an online portal. This approach allows the care team to focus on prevention and necessary care delivery, which can ultimately save time, money and lives. Cascades East receives approximately 1,000 applications annually – almost 20 percent of the total applicants to family medicine programs – from medical school graduates seeking their family medicine specialty in a rural setting. Every fall, some 85 qualified medical students interview for the residency
training the program. Some of the exceptional physicians who have recently graduated from the Cascades East program choose to stay and practice in Klamath Falls. Among them: Kristi Coleman, M.D., Cascades East Family Medicine Kanani Dilcher, M.D., Sky Lakes Medical Center Debra Hartley, M.D., Sky Lakes Family Practice Clinic Daniel Pederson, D.O., Cascades East Family Medicine Ed Trobaugh, M.D., Klamath Open Door Clinic Chris Zowtiak, M.D., Cascades East Family Medicine Members of the 2013 graduating class will also remain in Klamath Falls: Ann Kellogg, D.O., and Lindsey Burwell, M.D., will both be among the Sky Lakes Medical Center hospitalists, and Lanie Snyder, M.D., will join Sky Lakes Family Practice Clinic. We are fortunate that so many Cascades East program graduates have decided to remain in Klamath Falls and continue to serve our community.
Cascades East is delighted to announce the Class of 2016. These physicians will relocate to Klamath Falls this summer: Helen Carlson, D.O., from Des Moines University College of Osteopathic Medicine Makary Hofmann, D.O., from Philadelphia College of Osteopathic Medicine Anh Nguyen, D.O., from Philadelphia College of Osteopathic Medicine Andrew Owen, D.O., from Rocky Vista University College of Osteopathic Medicine Kasey Schmidtbauer, M.D., from Chicago Medical School at Rosalind Franklin University of Medicine and Science Janessa Sickler, D.O., from Des Moines University College of Osteopathic Medicine Brynn Smedra, M.D., from Stanford University School of Medicine Jason Yost, M.D., from University of Colorado Denver School of Medicine
The Oregon Health Authority recognizes Cascades East Family Medicine as a Tier 3 PatientCentered Primary Care Home. The award is the highest level available for demonstrated excellence in providing high-quality individual and family-centered care.
Live Healthy 2013 |
53
54 | Live Healthy 2013
The Benefits of Non-profits Sky Lakes Focuses on Reinvesting in its Operations
F
or profit, nonprofit and publicly supported hospitals are all different creatures with different sets of goals in mind. Sky Lakes Medical Center is only one of five private, not-for-profit hospitals in Oregon. “We are not in this business to make money,” said Paul Stewart, the CEO of Sky Lakes. “We’re in this business to fulfill our mission in our community. That’s a subtle difference, but a very important one,” he said. “It is what drives all of our operations.” Unlike a for profit facility that needs to be beholden to the stockholders, a nonprofit can take the majority of the money it makes and put it back into the hospital infrastructure, buy new equipment or help recruit new doctors. “Free enterprise at a for profit hospital doesn’t always work for a health care model,” Stewart said. “When you live in a community that has a small population, competition among hospitals can hurt the fabric of that community.” For Klamath Falls, the demographics of a lower income level, higher than the norm unemployment and many lacking basic health insurance, mean that a for-profit hospital would be a bad fit. “We enjoy the advantages of not paying income taxes. But in return for that, there is a benefit for the community; we’re expected to take care of everyone,” he said.
By Gerry O’Brien H&N Editor
Sky Lakes absorbs a healthy amount of coverage for lowincome, uninsured patients who show up at their doors. In 2012, the hospital wrote off $28.5 million in coverage. In contrast, a for-profit hospital would only pay about $3 to $5 million in taxes and not have to take every charity case. “If you make up to twice the federal poverty level and have a stay in the hospital, we write off 100 percent of that,” Stewart said. Some of that is recovered in higher hospital costs that the insured will pay. “However, our medical costs are comparable to just about any hospital in the region, they are not out of line,” Stewart said. Further, the hospital is able to plow money back into state-ofthe-art equipment. “We’ve invested in upgrading our equipment, remodeled and added on to our building, built the community center, and are adding a multi-million dollar linear accelerator to our cancer treatment center. Plus, we are able to recruit doctors by absorbing some of their startup costs so they are successful in their first year of practice.” Finally, the governing board for the nonprofit comprises local residents who live and work in the community. They have the community at heart when making decisions about Sky Lakes and are not dictated to by outside sources and a larger corporation. “We maintain local control and that is a valuable thing,” Stewart said.
Sky Lakes Mission: Sky Lakes Medical Center will continually strive to reduce the burden of illness, injury and disability, and to improve the health, self-reliance and well-being of the people we serve. We will demonstrate that we are competent and caring in all we do. We shall endeavor to be so successful in this effort that we will become a preeminent healthcare center. Vision We aspire to create healthier communities through our efforts and by engaging others in building new visions and models of care.
Family Klamath Medical Clinic is now part of the Sky Lakes Medical Center family Family medicine including obstetrics Carl Barbee, MD Jerri Britsch, MD David Dassoff, MD Glenn Gailis, MD
Dawn Jennings-Peterson, MD John Kleeman, MD Randal Machado, MD Sharon Cowie, FNP
Office hours: 8 a.m. to 5 p.m. Monday through Friday; 9 a.m. to noon Saturday Drop-in Clinic: 10 a.m. to 6 p.m. weekdays 1905 Main St. Klamath Falls, OR 97601
541.882.4691
KLAMATH MEDICAL CLINIC
Live Healthy 2013 |
55
USEFULâ&#x20AC;ŻNUMBERS Sky Lakes Medical Center, main
541-882-6311
Ambulatory Care Department
541-274-5101
Cancer Treatment Center
541-274-4171
Cascades East Family Medicine
541-274-6733
CARES
541-274-6289
Day Surgery
541-274-4700
Diagnostic Imaging
541-274-6269
Emergency Department
541-274-6176
Lab Services
541-274-6240
Medical Records
541-274-6287
Outpatient Rehabilitation
541-274-6406
Outpatient Scheduling
541-274-6740
Patient Accounts (Business Office)
541-274-6221
Patient Financial Aid Counselors
541-274-6699
Personnel (Human Resources)
541-274-6260
Pharmacy
541-274-3784
Resource Management
541-274-6282
(Complete listing in the telephone directory) COMMUNITY SERVICE NUMBERS Medical, Fire or Police Emergency
For all information regarding Community Health events, Childbirth and Sibling classes and Joint Center seminars please go to SkyLakes.org.
Klamath Crisis Center
541-884-0390
Oregon Road Conditions (toll free)
800-977-6368
Poison Control Center (toll free)
800-452-7165
Senior Citizens Council
541-883-7171
RECORD YOUR FREQUENTLY USED NUMBERS HERE Physician Physician Dentist Pharmacy Insurance Company (medical)
541.274.4778 SkyLakes .org
911
ID# Agent
Hero
Roni started Cuts for Cancer in 1998
Survivor
Lori - in remission from breast cancer - 2011
The people of Klamath who donated over the years to the Cancer Treatment Fund didnâ&#x20AC;&#x2122;t know whom they would help. Turns out, some people ended up helping their friends or family members or even themselves. Be a hero and donate to the Cancer Treatment Fund, you never know whom youâ&#x20AC;&#x2122;ll help. Donate at 541 274-4768. 2 8 6 5 D a g g e T T av e n u e , K l a m a T H F a l l S , O R 9 7 6 0 1
KFallsHero.org