EvergreenHealth Monitor - Winter 2018

monitor

20 18

WINTER

Neuroscience, Spine & Orthopedics

Overcoming Obstacles with Optimism Defying the odds with a positive attitude and world-class care

Page 6 Shoulder to Shoulder

One surgeon provides specialized care for patients facing a range of injuries

Page 8 Deep Brain Stimulation Triggers New Hope for Parkinson’s Patients Page 12

Leading with the latest technology, treatment and innovations for musculoskeletal care.

Winter 2018

1

Message from the CEO

Dear neighbors, As we welcome a new year at EvergreenHealth, and our 46th year of serving the greater Eastside, we want to personally wish you good health in this New Year and hope that you have a wonderful start to 2018.

2017 was a year of significant growth in nearly every aspect of the services we offer the community—from primary care to the most complex of specialty care; from the start of life, to being there at the end of life; in services that are scheduled, to those that are needed at a moment’s notice and when you least expect it; and across the expanse of our community from Monroe down to Issaquah.

In this issue of Monitor, we showcase one of our health system’s most recent expansions: The Neuroscience, Spine & Orthopedic Institute. With the completion of two new floors in the DeYoung Pavilion, we now have a multidisciplinary, integrated care space offering advanced services in neurology, rehabilitation and physical therapy, spine and neurosurgical care, orthopedics, physical medicine and research—all under one roof, and connected to multiple other EvergreenHealth locations with the help of our digital health tools.

As proud as we are about this new space, the new Neuroscience, Spine & Orthopedic Institute is about so much more than its location. It is also a reflection of the incredibly talented physicians and staff who

2

call EvergreenHealth and our area home … and it’s about fulfilling the promise we made 46 years ago to enrich the health and well-being of our community.

I hope you enjoy reading about this new facility and the exceptional care made possible by the incredible collaboration between our multi-talented providers and staff. We’ll look forward to sharing more exciting news about how we expand these services in 2018 at our hospital in Snohomish county, EvergreenHealth Monroe, and in collaboration with our partners at Overlake Medical Center.

And, above all, we look forward to sharing all the ways we’ll continue to deliver on our commitment to thoughtfully growing alongside our community to be your best partner in health.

Happy New Year,

Robert H. Malte EvergreenHealth Chief Executive Officer

Contact Us

We invite your feedback and questions.

Contact us at patientrep@evergreenhealth.com

EvergreenHealth Monitor

Introducing EvergreenHealth’s Neuroscience, Spine & Orthopedic Institute David Likosky, MD, SFHM, FAAN, FAHA, FACP Vascular Neurologist and Executive Medical Director, EvergreenHealth Neuroscience Institute and Hospitalists

Features 4

More than 2,000 years ago, Socrates advised, “If you would seek health, look first to the spine.”

While medicine itself was in infancy, the Greek philosopher’s message speaks to the magic and power that early scholars recognized in our spines—and their interconnected neurological and musculoskeletal systems—and the vital roles they play in good health.

In this issue of Monitor, we share compelling stories from patients and providers who have worked together to overcome spine, neurological and orthopedic challenges— the disciplines connected in our new EvergreenHealth Neuroscience, Spine & Orthopedic Institute.

From a nearly fatal mountain bike accident to a decadeslong search for a pelvic floor diagnosis, their experiences demonstrate the power of seeking health and healing through integrated care.

I am pleased to have been part of EvergreenHealth’s journey to this integrated model of care for many years. We built the foundation for this program through our creation of one of the region’s most robust neurology programs, including our nationally recognized stroke program, which I’m honored to help oversee.

We invite you to learn more about our integrated approach and the people that make EvergreenHealth an amazing place to receive care as you enjoy these stories about your neighbors.

Table of Contents

Introducing EvergreenHealth’s Neuroscience, Spine & Orthopedic Institute

6

Overcoming Obstacles with Optimism

8

Getting Back to Peak Performance

9

Thriving at Home with Relief from Pain

10

Teamwork On and Off the Field

11

Grabbing Life by the Roots

12

Deep Brain Stimulation Triggers New Hope for Parkinson’s Patients

13

Regaining Control with Clinical Trials

In Every Issue 2 Message from the CEO 15

EvergreenHealth Monroe Updates

16

Health Classes

18

EvergreenHealth Foundation

20 EvergreenHealth Highlights

Christian Palacay with wife and sons, EvergreenHealth Orthopedic & Sports Care patient

Winter 2018

3

N EU ROSC I E N C E, SP I N E & ORTH OPE DIC I NSTITUTE

Introducing EvergreenHealth’s The new institute leads the way with the latest technology, treatment and innovations for musculoskeletal care.

Mark A. Freeborn, MD, Orthopedic Spine surgeon and Executive Medical Director and Chief, Surgical Specialties

Patients visiting the new EvergreenHealth Neuroscience, Spine & Orthopedic Institute find expert care from renowned specialists including neurologists, orthopedic and spine surgeons, neurosurgeons, physiatrists, podiatrists, interventional spine and pain physicians, neuropsychologists, and radiologists, along with a team of rehabilitation, physical and occupational therapists, speech-language pathologists, nutritionists, social workers and counselors—on the EvergreenHealth campus in Kirkland.

In July 2017, EvergreenHealth celebrated the grand opening of the new institute with two additional floors in the existing DeYoung Pavilion, which now combines the health system’s comprehensive musculoskeletal, orthopedic and neuroscience specialties and practices together under one roof. The result is an intentional space that not only offers continuity between services, but also provides ease of access for patients and families, and promotes collaboration between provider teams and their patients.

“There is an exceptional synergy of technology, design, services, and patient care reflected in the new EvergreenHealth Neuroscience, Spine & Orthopedic Institute,” explained Dr. Mark Freeborn. “The complementary services within the institute allow us to enhance the ways we innovate in the areas of patient care, treatment and experience.”

The development of the Neuroscience, Spine & Orthopedic Institute was made possible in part by the generous contributions of donors who share the same vision and commitment to the health system’s mission.

EvergreenHealth graciously thanks:

Mike & Mary Kay Hallman • The Schultz Family Foundation • Tom & Connie Walsh

4

EvergreenHealth Monitor

N EU ROSCI E NCE, SPI N E & O RTHO PE DIC I NSTITUTE

Neuroscience, Spine & Orthopedic Institute A Healing Environment As part of a thoughtful planning process for the new floors, architects teamed with patients, families, providers and staff to design an extraordinary, refreshing space of health and wellness to serve the needs of all patients. High ceilings, curved walls and splashes of natural light create a sense of spaciousness, while combination lighting and floor lamps emit a warm, homelike feeling.

The institute’s design features pockets of private cul-de-sacs to encourage candid, intimate conversations, with soothing music in common areas to enhance relaxation.

In clinical areas, exam rooms accommodate large family groups and for patients receiving procedures, the overall flow from admission to discharge moves in a forward direction, with no need for backtracking. Tablets allowing for electronic patient self check-in make the entire process more user-friendly for patients and efficient for staff members, as well.

The two new floors of the Institute feature:

51 exam rooms

6 pre- and post-procedure rooms

3 procedural rooms

2 imaging centers

DeYoung Pavilion The EvergreenHealth Neuroscience, Spine & Orthopedic Institute spans four levels of the DeYoung Pavilion, and includes two newly constructed floors to house the system’s musculoskeletal and orthopedics practices, providing patients with the convenience of complementary services in one location.

Second Floor

Rehabilitation Services

Third Floor

Neurological Care

Fourth Floor

Orthopedic & Sports Care Foot & Ankle Care Interventional Spine Care

Fifth Floor

Sport & Spine Care Spine & Neurosurgical Care

The EvergreenHealth Neuroscience, Spine & Orthopedic Institute is focused on offering an extraordinary level of care.

To learn more or schedule an appointment, visit www.evergreenhealth.com/spine or call 425.899.3000.

Photo above: Fourth floor lobby of the new Neuroscience, Spine & Orthopedic Institute located in the DeYoung Pavilion.

Winter 2018

5

N EU ROSCI E N C E, SP I N E & ORTH OPE DIC I NSTITUTE

Overcoming Obstacles with Optimism After a near-fatal mountain biking accident, Mike McHenry defied the odds with a positive attitude and world-class care.

It was a beautiful summer day, heading into the Fourth of July holiday weekend. Woodinville resident Mike McHenry decided to take advantage of the sunny weather with a ride at Duthie Hill Mountain Bike Park in Issaquah.

But what started as a day of recreation suddenly turned into the most harrowing experience of the 60-year-old Kirkland resident’s life.

After a quick warm-up, McHenry had split off from a friend to explore the park’s technical trails when he approached a series of five jumps; each one taking him higher before landing at the end of the ramps on the wooded trail. He gained the right momentum and set off on the first, then second, then third—then everything went wrong.

From about 8 feet in the air and still on his bike, McHenry came crashing down virtually headfirst onto the forest floor.

“Immediately, I knew I’d been hurt pretty bad,” McHeny recalled. “I rolled over, but was numb from head to toe, and just started screaming for help.”

With his friend out of earshot, a passer-by heard McHenry’s cries and called 911.

The first responders soon arrived and, knowing that a spinal injury was probable, expertly stabilized McHenry before transporting him to emergency care.

Mike McHenry, EvergreenHealth Spine & Neurosurgical Care patient

6

EvergreenHealth Monitor

N EU ROSCI E NCE, SPI N E & O RTHO PE DIC I NSTITUTE

After a diagnostic MRI, EvergreenHealth’s renowned orthopedic spine surgeon and neurosurgeons Dr. Mark Freeborn, Dr. Shiviendra Jeyamohan, and Dr. Peter Nora confirmed the extent of McHenry’s injuries: a shattered collar bone, several broken ribs, bleeding in his lungs, a fracture of his C2 vertebrae in his neck, and a thoracic spinal fracture.

“We began surgery very carefully because of the high degree of risk involved in Mike’s case,” Dr. Jeyamohan described. “Because of our close collaboration with his ICU doctors, we were aware of a major complication that could have put his life at risk in the OR. Any miscommunication could have had severe consequences.”

Shiviendra Jeyamohan, MD, EvergreenHealth Spine & Neurosurgical Care surgeon

McHenry was lucky to be alive, but he wasn’t out of the woods—cervical and thoracic spinal fractures are extremely severe traumas that require surgical treatment from a team of highly skilled spine surgeons. A minute misstep in the procedure could result in permanent paralysis, or worse.

During surgery, McHenry became critically ill as his lungs stopped expanding. Reacting quickly, Drs. Jeyamohan and Freeborn cut into his chest to relieve the pressure building in his lungs.

After five hours on the operating table, Drs. Jeyamohan, Freeborn and Nora, supported by a multidisciplinary team of specialists, completed a successful surgery, placing several titanium screws and rods to stabilize McHenry’s spine and protect his spinal cord from irreversible damage.

The road to recovery, however, was just beginning.

McHenry was prescribed four weeks of inpatient rehabilitation in EvergreenHealth’s Acute Rehabilitation Unit, a recently renovated department that brings state-of-the-art rehabilitative resources together in

a homelike setting, allowing patients to

regain practical skills they’ll need for independence.

McHenry became immersed in intensive therapy, spending at least three hours each day on rehab exercises throughout his stay.

Along with following his prescribed rehab plan, McHenry described routine, meaningful visits from his surgical team, EMTs, family members and friends as providing the motivation he needed to recover.

“I believe I’m alive today because of the phenomenal care from every single one of my providers,” McHenry explained. “They helped me keep my attitude up and took such a personal interest in my care. I am incredibly touched by their caring and kindness.”

Today, McHenry is on the path to a full recovery—a truly incredible feat given the extent of his injuries. In November, Dr. Jeyamohan cleared him for increased activity and he returned to Duthie Hill Park and took his first spin on two wheels since the accident. It was emotional and exhilarating all at once.

“I think I’ll avoid the jumps,” McHenry said from his bike with a smile.

Winter 2018

7

N EU ROSCI E N C E, SP I N E & ORTH OPE DIC I NSTITUTE

Shoulder to Shoulder Getting Back to Peak Performance

Michael Codsi, MD, EvergreenHealth Orthopedic & Sports Care surgeon

Chris Tarkir tackles a catastrophic injury— and the Seattle Fire Academy.

Making the cut to train in the Seattle Fire Academy is a distinction that thousands of men and women pursue every year, but very few achieve. It requires a nearimpossible combination of extraordinary aptitude and mental and physical toughness to secure one of the handful of spots in the department’s arduous 15-week intensive training program.

Chris Tarkir, however, stood out through the application process and was among the top recruits when training began last year.

But just weeks into the program, Tarkir was manning the nozzle-end of a hose line when he suffered a catastrophic injury—a pectoralis major tendon tear. The tendon connecting the muscles across his chest had essentially ripped from his bone.

He needed immediate medical attention and a friend referred Tarkir to Dr. Brandon Messerli at EvergreenHealth Sport and Spine Care. After an initial diagnostic exam and tests, Dr. Messerli consulted with Dr. Michael Codsi, an orthopedic surgeon specializing in shoulder repair at EvergreenHealth, to collaborate on the best treatment plan for Tarkir—one that would increase his chances of a full recovery and eventual return to the fire academy.

The path to recovery for Tarkir, though, would require surgery and nearly a full year of focused rehabilitation, including physical therapy, chiropractic care and therapeutic massage.

Chris Tarkir, EvergreenHealth Othopedic & Sports Care patient

8

EvergreenHealth Monitor

“With a significant injury like Chris faced, my role is to be upfront and honest about the recovery process, but I also try to encourage patients with a sense of hope and optimism. I’m with them every step of the way through treatment, rehab and recovery,” Dr. Codsi said.

“Hearing that news was like throwing a harness on a wild horse,” Tarkir described. “But Dr. Codsi’s straightforward and supportive approach helped me process my new reality and get in the head space that would be critical to achieving a full recovery.”

A full recuperation would require patience, allowing the body to heal through a natural progression while methodically adding rehab elements in small, incremental steps.

“It was like being tied to a hitch,” Tarkir explained.

“But as a firefighter, I knew I had to take every precaution so that I could get back to my highest level of strength for everyone’s safety—including my own, my fellow firefighters’ and the safety of all the people we serve.”

Following what he described as the longest year of his life, Tarkir completed his training with the Seattle Fire Academy in November 2017 and was assigned to a station in West Seattle. “Through the entire journey, I knew I had the best people on my team—and that’s what kept me going toward the finish line.”

“I’m so thankful I landed at EvergreenHealth, where I found the support I needed to return to complete health,” Tarkir said.

N EU ROSCI E NCE, SPI N E & O RTHO PE DIC I NSTITUTE

How one EvergreenHealth surgeon provides specialized care to patients facing a range of injuries.

Thriving at Home With Relief From Pain

Christian Palacay opts for surgery to return to doing things he loves.

New dad and Woodinville resident Christian Palacay has always led an active lifestyle. Though he logs hours at his desk as a financial analyst for Boeing, the 38-year-old thrives on getting outside.

Whether it’s for a long-distance run, competitive cycling race, hike in the woods, or workout at his local CrossFit gym, staying in shape has always been a big part of his life.

And as a father of two, being able to keep up with a fast pace has become even more important.

Together, the two concluded that arthroscopic surgery was Palacay’s best So when some nagging discomfort around his left rotator option for regaining the strength and level of activity he desired. cuff began to feel more pronounced over time, he took careful notice.

Though the procedure itself is minimally invasive, recovery can take Determined to find the best orthopedic specialist for his time—in Palacay’s case, about nine months. needs, he delved into researching accredited hospitals and providers until he found EvergreenHealth’s “Treatment isn’t always a quick fix, but my job is to take Dr. Michael Codsi. the stress of the procedure off my patients, so all they need to focus on is getting better,” Dr. Codsi said.

“I was really impressed by how active in the community he is. Everything I could learn about him online—from Palacay was diligent about his rehabilitation, but admits patient testimonials and his own videos on the the process can be daunting.

EvergreenHealth website—was enough to convince me that I needed to meet him in person,” Palacay described. “It can be frustrating when you’re not progressing as quickly as you’d hoped, or when you can’t do the things Palacay’s instincts were right. During their first meeting, you could before surgery. But through it all, Dr. Codsi was Dr. Codsi clearly understood Palacay’s concerns and my biggest supporter. His confidence in my recovery was mapped out recommendations that the reassurance I needed.” gave Palacay plenty of options for treating “He ‘s hands down the best surgeon I’ve ever a torn rotator cuff.

worked with,” Palacay said.

Christian Palacay with wife and sons, EvergreenHealth Orthopedic & Sports Care patient

Winter 2018

9

N EU ROSC I E N C E, SP I N E & ORTH OPE DIC I NSTITUTE

Teamwork On and Off the Field After a knee injury put him on the sidelines, Joe Chatterton makes a full recovery with help from Dr. Vincent Santoro.

Joe Chatterton, EvergreenHealth Orthopedic & Sports Care patient

At age 40, Bothell resident Joe Chatterton kept his athletic skills sharp and enjoyed the team camaraderie of regular matches with the Greater Seattle Soccer League.

Until he collided with another player and heard his knee pop.

The injury—a torn ACL and meniscus diagnosed through an MRI at EvergreenHealth—put Chatterton in collaboration with a very different teammate: Dr. Vincent Santoro, an orthopedic surgeon at EvergreenHealth Orthopedic & Sports Care.

“This type of injury and its limitations on physical activity are so frustrating, and in my case I just wanted to make smart decisons so I could get back on my feet and onto the field,” Chatterton said.

From the start, Dr. Santoro explained numerous treatment options for ACL tears.

10

“It’s not a guarantee that a patient will need surgery, but if someone wants to return to an active lifestyle, like Joe, often surgery is the best choice,” Dr. Santoro said.

After discussing his goals and reviewing his care options, Chatterton—with an assist from Dr. Santoro—decided that surgery would be the best route to recovery.

“Dr. Santoro was truthful in letting me know the extent of my injury and explaining the different treatments, without trying to sway me in any one direction,” Chatteron said. “Ultimately, it was my decision to move forward with surgery; Dr. Santoro was a great team player in setting me up with the resources I needed to get there.”

In June 2016, Chatterton underwent surgery to repair his ACL and meniscus, and began rehabilitative physical therapy soon afterwards. Dr. Santoro said recovery wouldn’t be easy, and would take about a year before Chatterton could return to his high level of physical activity.

Although Chatterton encountered a minor setback when his meniscus became inflamed a few months postsurgery, Dr. Santoro reassured him that he simply needed rest, not an additional operation.

“It’s very common for patients to face setbacks after this type of procedure,” said Dr. Santoro. “The key is to modify activities accordingly and keep a positive attitude.

Nothing hinders physical recovery like a negative outlook.”

Almost a year to the day since his injury, Chatterton was back playing in multiple soccer leagues, with one more member on his health care team.

“I’m a strong believer in sitting down with my patients and giving them all the information to help them make an informed decison that best suits their health care needs,” Dr. Santoro said.

Vincent Santoro, MD, EvergreenHealth Orthopedic & Sports Care surgeon

EvergreenHealth Monitor

N EU ROSCI E NCE, SPI N E & O RTHO PE DIC I NSTITUTE

Grabbing Life by the Roots Debbie Casteel uses painting, along with holistic medical care, as a therapeutic release from living with MS. When Debbie Casteel was just 26 years old she was diagnosed with Multiple Sclerosis (MS), an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body.

“My whole life changed,” she remembered.

The diagnosis uprooted Casteel’s life as day-to-day activities became increasingly more difficult due to the physical and cognitive symptoms of MS, such as fatigue, vision problems and loss of coordination. Over time, she stopped practicing her favorite hobby, painting, due to her unsteady movements and lack of energy.

Two years ago, however, she was referred to EvergreenHealth’s Dr. Ted Brown, a physician and MS rehabilitation specialist, who provided her with new treatments. Beyond supporting Casteel with medicine, he also encouraged her to join a self-help group for patients with MS. It was there she rekindled her passion for painting, and learned she could still find joy in the same activities she practiced before her diagnosis.

“When I first met Debbie, her enthusiasm for finding her healthiest best was clear,” Dr. Brown said.

“Beyond her passion, her vision for treatment perfectly aligned with our approach towards wellness. We believe in treating the whole patient, which means expanding the focus beyond just medication and incorporating overall health, such as diet, exercise, sleep and stress management. A holistic outlook is key to managing a chronic illness like MS.”

Ted Brown, MD, EvergreenHealth MS Center and Neurological Care physician

Now, Casteel uses art to communicate the small victories, as well as the frustrations, of living with MS. She even donated one of her paintings to Dr. Brown’s office as a gesture of appreciation, not only for the medical treatment he provides but also for his help in restoring her confidence.

“Dr. Brown and his team really opened a whole new pathway of opportunities for me,” said Casteel. “I’ve made so many new friends, and I’ve gotten out of my comfort zone in ways I never would have before.”

“Painting is my therapy now,” said Casteel.

Hare by the Roots represents the day-today struggles of MS, the times when she wants to “pull her hair out because nothing is cooperating.”

Hare by the Roots by Debbie Casteel

Casteel says it’s like a private joke that will put a smile on the faces of other MS patients, since they are the only ones who understand this unique feeling of frustration.

“It can be extremely difficult for patients to receive a diagnosis of a chronic illness like MS,” said Dr. Brown.

“But it’s very possible to continue living a meaningful life—living with purpose—if they embrace the changes that come with managing symptoms. Developing a trusting relationship with health care providers lays the foundation for a smooth transition process.”

For anyone with MS, Casteel advises patience and persistence. “Don’t give up. Keep going. But do it carefully.

Then do it again.”

Debbie Casteel, EvergreenHealth MS Center patient

Winter 2018

11

N EU ROSC I E N C E, SP I N E & ORTH OPE DIC I NSTITUTE

Deep Brain Stimulation Triggers New Hope for Parkinson’s Patients EvergreenHealth neurosurgeon Dr. Peter Nora leads the region in DBS procedures, giving patients like Ron C. freedom from movement disorder symptoms.

Peter Nora, MD, EvergreenHealth Spine & Neurosurgical Care surgeon

On a nice day, you’re likely to find 66-year-old Whatcom County resident Ron C. kayaking in Bellingham Bay, soaking up the Pacific Northwest sunshine and breathing in the salty sea air. He launches the kayak and reels it into shore himself, working steadily with the current.

But just a few years ago, it was impossible for Ron to get out on the water—or even leave the house. Severe tremors brought on by a 2011 Parkinson’s disease diagnosis were a constant reminder of his limitations, which made even the simplest tasks difficult to manage.

Like many people living with Parkinson’s disease, Ron was consumed by the balancing act of taking enough medication to relieve his symptoms, while tolerating the dosage’s severe side effects. He was managing several prescriptions just to cope with what he described as a dismal quality of life.

But that all started to change in 2015 when his neurologist referred him to a seminar led by EvergreenHealth neurosurgeon Dr. Peter Nora on deep brain stimulation (DBS), a procedure that surgically places tiny wires, or electrodes, within critical areas of a patient’s brain.

Although the treatment sounded daunting, Ron was optimistic DBS could bring him some degree of relief.

According to Dr. Nora, Ron proved to be an ideal candidate for DBS, and they began the process of preparing for the surgery.

“Before I found Dr. Nora, I was really struggling,” Ron added. “But I would do it all again—it was worth it to be where I am now, and I couldn’t be more grateful.”

Kristen Crosley, ARNP, EvergreenHealth Spine & Neurosurgical Care, Ron C., EvergreenHealth Spine & Neurosurgical Care patient, Peter Nora, MD, EvergreenHealth Spine & Neurosurgical Care surgeon

12

EvergreenHealth Monitor

“Deep brain stimulation works by blocking abnormal nerve signals that cause tremor and other Parkinson’s symptoms, offering patients living with neurological conditions significant relief when medications are no longer as effective,” Dr. Nora explained.

The electrodes are controlled by a battery-operated neurostimulator, a device similar to a heart pacemaker that is surgically placed under the skin in the patient’s chest.

The device sends electrical stimulation to the electrodes placed in areas in the brain that control movement, effectively reducing the signals causing tremors.

For Ron, the relief was almost immediate. He noticed positive results quickly after his first procedure on his right brain hemisphere, and soon returned for the same treatment on his left brain hemisphere.

“I can’t say enough good things about Dr. Nora and his team at EvergreenHealth,” Ron said. “Not only are they experts at what they do, but I could also tell they cared about every aspect of my health, not just my Parkinson’s disease. And now, I feel like life is worth living again.”

Today, Ron takes only a fraction of the medication dosage he once did, and has no trouble getting out of the house to do things he loves. Everything he once took for granted, from being able to walk to the grocery store to kayaking, he now appreciates more than ever before.

N EU ROSCI E NCE, SPI N E & O RTHO PE DIC I NSTITUTE

Regaining Control with Clinical Trials EvergreenHealth’s research team shares access to clinical trials that offer patients a new lease on life.

Cindy Jacobson (far right), son and friends on vacation in 2017

When Cindy Jacobson was diagnosed with Parkinson’s disease in 2010, she was relieved to have an explanation for the symptoms that had been bothering her for more than a year—mild tremors, an increasing loss of muscle control, and fatigue that depleted her energy to get even simple tasks done around the house.

When she received a referral to see Dr. Pinky Agarwal at EvergreenHealth’s Booth Gardner Parkinson’s Care Center, Jacobson was immediately drawn to Dr. Agarwal’s focus on exploring treatment options outside of surgery. After discussing her condition and goals for treatment, Dr. Agarwal recommended that Jacobson enroll in a new clinical trial for Parkinson’s disease patients at EvergreenHealth.

For people living with Parkinson’s, it’s not uncommon to experience “off” times—periods of time when medications have worn off, inviting the return of tremors and other symptoms, before patients can take their next dose. For Jacobson, her off times had been leaving her without the strength and motivation to move around the house.

The clinical trial Dr. Agarwal recommended would work to reduce the chance of off periods by administering a medication as a continuous subcutaneous (under the skin) infusion via a portable pump. An infusion line is attached to the abdomen subcutaneously and is digitally programmed to release the correct dosage of medication from the pump directly into the body throughout the day.

The infusion line can be attached and removed by patients themselves.

After just a few weeks, Jacobson noticed a dramatic difference in her ability to manage her symptoms.

“Before I felt very fatigued and depressed, but now I look forward to getting out and planning trips with my family. I never could have done that a few years ago!”

Jacobson said. get my life back,” explained Jacobson.

According to Dr. Agarwal, Jacobson is a good candidate for the trial because of the disease’s effects on her energy levels and emotional outlook.

“Parkinson’s disease not only presents itself in physical symptoms, such as shaking and muscle stiffness, but also in psychological symptoms, like depression and anxiety,” Dr. Agarwal said. “Many patients with Parkinson’s are deficient in dopamine, a chemical in the brain that helps regulate movement and emotional responses.”

Pinky Agarwal, MD, EvergreenHealth Booth Gardner Parkinson’s Care physician

“The drug used in Cindy’s trial has some of the same effects as dopamine, which helps to make the treatment very effective for her,” said Dr. Agarwal.

EvergreenHealth leads dozens of clinical trials for patients living with a range of neurological conditions and welcomes patient participation to help advance research into new treatments. If you are interested in discussing your eligibility to participate in a clinical trial, please visit www.evergreenhealth.com/research or call 425.899.5385.

“With the support of EvergreenHealth, along with my wonderful husband and our faith in God, I was able to Winter 2018

13

N EU ROSC I E N C E, SP I N E & ORTH OPE DIC I NSTITUTE

Understanding Pelvic Floor Muscle Physical Therapy

The unexpected intersection of urogynecology and orthopedic care.

Katie McGee, DPT, EvergreenHealth physical therapist

For patients suffering from back or joint pain, it’s common for treatment to include physical therapy (PT). But rehabilitation for certain orthopedic problems might not involve what you’d first expect. According to EvergreenHealth physical therapist Katie McGee, it’s often the case that back and hip problems emanate from muscles deep inside the pelvis.

That’s where her specialty comes in—she’s a pelvic floor muscle physical therapist.

“When patients are living with back or hip pain, the cause can often be attributed to pelvic floor dysfunction, and vice versa,” McGee explained.

Her role is to evaluate pelvic organ and orthopedic symptoms, followed by an internal vaginal exam to assess the pelvic muscles. From there, pelvic floor rehabilitation includes hands-on treatment of muscles and other soft tissue, while also addressing related body mechanics such as breathing and proper alignment.

“In conjunction with physical therapy, our goal is to help educate patients on exercises they can do at home and throughout physical activity to help them achieve their best quality of life,” McGee said.

Mia Swartz, MD, EvergreenHealth Urology & Urogynecology Care physician

14

“The strong relationship between urogynecology and orthopedics is largely unrecognized. Yet understanding it is necessary to prevent, recognize and treat chronic and painful conditions like Fariha’s.

Having open conversations between patients, primary care providers and specialists allows for treatment to begin earlier, and result in more effective outcomes and better quality of life for patients.”

EvergreenHealth Monitor

Fariha Bhatti, EvergreenHealth Urology & Urogynecology Care patient

Meet Fariha After a severe car accident, Fariha Bhatti pursued countless forms of medical treatment to address chronic pain in her hips and lower back, but nothing seemed to help ease her debilitating discomfort.

Then she met Dr. Mia Swartz, a female medicine pelvic and reconstructive surgery (FMPRS) urogynecologist at EvergreenHealth. A physical therapist suspected Bhatti’s pain was caused by pelvic floor dysfunction, and she referred Bhatti to Dr. Swartz to explore treatment.

“I needed a provider who listens and focuses on treating the whole self—and that’s exactly what I found in Dr. Swartz,” Bhatti recalled. “Not only is she extremely knowledgeable, but she is also compassionate. She cares about me as a person and she’s willing to have an open dialogue to help find the best treatments.”

Together, the two discussed various treatment plans, including Botox injections to the pelvic floor muscles, combined with internal (vaginal) pelvic muscle therapy.

For the first time, Bhatti is optimistic about her prognosis, and she’s passionate about sharing her experience to help others understand the importance of communication in achieving wellness.

Dr. Swartz shares the hope that Bhatti’s case will promote better awareness among providers and patients of the common relationship between urogynecology symptoms like pelvic or sexual pain, and bowel or bladder symptoms, and other seemingly unrelated orthopedic conditions, like spinal issues or joint problems.

Dr. Swartz is currently leading a study on the use of Botox injections for treating pelvic pain. To learn more, visit www.evergreenhealth.com/ pelvic-health-research.

N EU ROSCI E NCE, SPI N E & O RTHO PE DIC I NSTITUTE

Updates from EvergreenHealth Monroe Exceptional Care and Service Get Local Adventurer Back on His Feet As the owner of an outdoor adventure company in Index, Washington, Bill Corson was in peak physical condition when he painfully ruptured his Achilles tendon during a game of volleyball last year.

As soon as he arrived at EvergreenHealth Monroe’s emergency department, Corson says the quality of the care he received far surpassed his expectations.

Bill Corson, EvergreenHealth Monroe patient

“Everyone, from the intake staff to the imaging technicians, were incredibly caring, timely, informative, and most importantly, made me feel like I wasn’t just another patient on their schedules. I felt assured in their ability to treat me with the best care,” Corson described.

Corson worked with orthopedic surgeon Dr. James Swenson to determine that surgery offered the highest chance of a full recovery. After a successful procedure, Corson continued to remain involved in his company’s activities while he focused on rehabilitation.

“Attitude is everything,” Corson explained. “That is our motto at Outdoor Adventures, as much of what we do—guiding trips through mountains, rivers and coastlines—cannot be done without positivity and a good dose of determination. My providers at EvergreenHealth Monroe shared that outlook, which greatly supported me in my recovery.”

EvergreenHealth Monroe Renews Partnership with Aetna EvergreenHealth Monroe is pleased to announce that the hospital is again accepting Aetna insurance.

According to chief administrative officer Renée Jensen, the renewed partnership is a direct result of listening to valuable feedback from the community. If you have questions about EvergreenHealth Monroe’s partnership with Aetna, or specific questions about your plan, call 360.794.1446.

Pharmacy Interns Gain Global Experience in Ghana In 2017, University of Washington School of Pharmacy students and EvergreenHealth Monroe Pharmacy interns Justin Fernando and Marissa Norton, traveled to Ghana for the second time to provide hypertension education and treatment to underserved populations.

After providing educational resources during a trip in 2016, the students returned last summer to find that their patients’ average blood pressure had drastically lowered—a significant improvement.

“My advice to other pharmacy interns is to pursue opportunities to learn about patient populations that are different from what you’re used to. When we’re able to better understand where patients are coming from, we can provide better treatment,” Norton said.

“I gained irreplaceable knowledge that will help me in day-to-day exchanges at our hospital-based pharmacy in Monroe,” she added.

Marissa Norton, EvergreenHealth Monroe Pharmacy Intern with a colleague in Ghana

Winter 2018

15

Health Classes Register for classes online or by phone.

For your convenience, you may register and pay for classes 24/7 online at www.evergreenhealth.com/classes.

You may also call the EvergreenHealth Nurse Navigator & Healthline at 425.899.3000, Mon. – Fri., 7 a.m. – 7 p.m.

In addition to the classes offered at EvergreenHealth Medical Center, we offer classes and health screenings at other convenient community locations. Visit www.evergreenhealth.com/classes for class schedules and locations.

FREE SEMINARS Weight-Loss Surgery: Is It Right for You? Experts from the EvergreenHealth Bariatric Center will discuss surgical options, postoperative follow-up, lifestyle changes, financial information and nutrition support.

WELLNESS & HEALTHY LIVING Healthy Meals Made Easy!

Are you looking for something new to include in your weeknight meal rotation? If so, let us help you! Join us in our demonstration kitchen where you will learn how to master wonderful recipes, gather a few tips and tricks, and gain nutritional knowledge.

Samples included!

WELLNESS & HEALTHY LIVING, CONTINUED

NEUROLOGICAL & MOVEMENT DISORDERS

• Seasonal Affective Disorder: Are You Feeling Sad?

• Gut and Brain Connection

EvergreenHealth Neurological Care offers classes and support groups to aid patients living with a variety of neurological diseases and movement disorders.

• Dry Eye

• Fall Prevention: Take Action

EMERGENCY & SAFETY EDUCATION

• Parkinson’s Disease Carepartner Support Group

• Meditation and Wellness • Nutrition: Back to the Basics

• Babysitting Basics • Infant and Child CPR • Community CPR • Community First Aid • Community CPR and First Aid • CPR for Health Care Providers SENIOR HEALTH CLASSES

• Weekday Breakfasts • One Pot Anti-inflammatory Meals • Healthy Whole Foods Desserts • Immune Support • Spring Detox • Healthy Baking • Power Up with Plants • Fast and Fresh Stir-Fry

• AARP Smart Driver Program

• Cold, Flu, or Pneumonia?

• Fall Prevention and Balance

• What You Can Do About Winter Skin

• Tai Chi for Back Pain

• Make Your Life Easier • Mat Pilates • Eliminating Heartburn/Acid Reflux • Acupressure for Self-Care • Laugh Your Way to Better Health • Mediterranean Lifestyle Class

16

EvergreenHealth Monitor

• Stay Warm Indoors: Chair Exercises • Food Allergies • Medicare: Are You Covered?

• Manage Your Blood Pressure Through Nutrition • Cholesterol and Diabetes Screening • Summer Nutrition

CHILDBIRTH PREPARATION For class dates and times or to register for classes, go to www. evergreenhealth.com/childbirth or call the EvergreenHealth Nurse Navigator & Healthline at 425.899.3000. Register early during your pregnancy, as classes fill quickly.

• Pondering Parenthood

• Neurological Exercise Group

• Family Maternity Center Tour

• Neuro-Nutrition Class

•

• From-The-Ground-Up Strength and Flexibility • Living Well After Stroke • Evergreen Men’s Group Eastside MS Self-Help Group Come join the ‘no whiners’ group. The name of the group is exactly what we are all about —no whining! Find comfort and strength with your peers as you learn new information and tips to get more out of your life. Guest speakers from many disciplines and areas of interest provide education each month.

We welcome people of all ages with all different types of MS. This group meets the second Wednesday of every month, 9:30-11 a.m. Please call Jerry Weiser at 425.868.6810 for more information.

Kirkland MS Self-Help Group Find comfort and strength with your peers as you learn, cope, laugh and celebrate the challenges and successes of living with MS. Share your story and learn new ways to live with MS. This group meets the third Thursday of each month, 7-9 p.m.

Please call Susan at 425.822.0462 for more information.

Tour De La Sala De Maternidad En EvergreenHealth Para Parejas De Habla Hispana

• Meet a Midwife • Meet an Obstetrician • Understanding Your Prenatal Testing Options • Warm Welcomes Delivery Day­—Birth and Beyond This comprehensive course is designed for expectant parents and covers the full spectrum of delivery topics including the labor and birth process, labor coping skills, patterned breathing and positioning, pain medication options and interventions including epidural anesthesia, induction, and cesarean birth.

Also covered in this course is the miracle hour immediately following birth, breastfeeding in the first few days of life, an introduction to life with a newborn, and postpartum care and recovery for mom and baby.

Course includes a tour of the Family Maternity Center.

For your convenience, this course is offered: 12-hours (6 weeknights; 2 Saturdays; or 1 weekend) 6-hours—an abridged version for expectant parents with limited time available.

CHILDBIRTH PREPARATION, CONTINUED

BABY CARE

• Delivery Day for Teens and Young Adults

• Car Seat Checkup

• Delivery Day for Multiples • Labor Coping Skills Review • Prepare the Nest: Childbirth, Breastfeeding & Newborn Care Class • HypnoBirthing®—The Mongan Method • Siblings Class • Conscious Fathering • Fit4Baby Program • Yoga for Pregnancy • Pelvic Health Class

• Car Seat Safety • Infant Safety and Injury Prevention: Just for Parents • Infant Safety and Injury Prevention: Just for Grandparents • Day About Baby • Breastfeeding Basics and Beyond • Pumping Class • Parent-Baby Groups • Parenting Your Toddler Classes • This is Not What I Expected • Starting Solids • Breastfeeding Your Older Baby

Bringing Baby Home Workshop Bringing Baby Home is a nationally recognized program developed by Dr. John Gottman based on 30+ years of marriage and family research.

This two-day workshop prepares couples for life with baby and helps them be the best parenting team possible.

In a relaxed and supportive environment, expectant and new parents learn skills to strengthen their relationship, foster baby’s development, and reduce the incidence or severity of postpartum mood disorders.

• Practicing Mindfulness through Easy Drawing

SUPPORT GROUPS

• Conversations About Motherhood

ARTISTIC EXPRESSION • Ikebana Flower Arranging

Cancer Care Classes

• Paint by Numbers • Stamps & Stencils

• Living & Working with Cancer

COOKING DEMONSTRATIONS

• Dental Issues & Concerns

• Cooking with Sea Vegetables

Classes and support groups at Halvorson Cancer Center.

EvergreenHealth offers cancer care support and education for patients and families in partnership with Cancer Lifeline. To register, call 206.297.2500 or 1.800.255.5505, or visit online at www.cancerlifeline.org.

• Benefits of Legumes • Winter Salads • Gut Health • Food, Mood & You • Natural Sweeteners EXERCISE AND MOVEMENT • Gentle Yoga • Healthy Steps—Managing Lymphedema • Qigong PRESENTATIONS • Self-Discovery through the Cancer Experience • Reducing Stress with Mindfulness

STRENGTH. DIGNITY. HOPE.

• Talking with Your Doctor

• Healing the Whole Person: Mind, Body & Spirit

• Small Steps for Decluttering the Mind • Fighting Fatigue • Chair Yoga • Poetry 101 • Life in Survivorship • Healthy Skin Care & Makeup • Estrogen Inhibiting Diet • Meditation Strategies for Better Sleep • Support Resources for Colon Cancer • Understanding Your PSA Results • Meditation 101 • Naturopathic Approaches to Prostate Cancer Treatment • Medical Marijuana

• Bosom Buddies Breast Cancer Networking Group • Breast Friends Breast Cancer Support Group • Colon Cancer Support Group • Living with Cancer Support Group • Living with Metastatic Cancer Support Group • Oral, Head and Neck Cancer Support Group • Prostate Cancer Networking Group Climb—Free workshops to support children (age 6-12), whose parents or grandparents have cancer. Contact Cancer Support Services at EvergreenHealth for dates and information at 425.899.2265.

Look Good, Feel Better Workshops—Support for women dealing with hair-loss due to cancer treatment. Classes offered monthly; to register for the next class at EvergreenHealth, call ACS at 1.800.227.2345.

For more scheduling information: Visit www.evergreenhealth.com/classes for a full listing of classes, descriptions, dates and times.

Winter 2018

17

EV E RG R E E N H EALTH FOU N DATION

Cardiac and Pulmonary Rehabilitation Dedicated to Carter Family EvergreenHealth’s Cardiac & Pulmonary Rehabilitation Center was recently dedicated to the memory of Phil Carter, a founding father of EvergreenHealth and the EvergreenHealth Foundation. The Carter family’s generous endowment has supported EvergreenHealth’s Cardiac & Pulmonary Rehabilitation program for the past several decades, and the EvergreenHealth Foundation was grateful to have the Carter family join us in unveiling the naming of this esteemed facility this past fall.

Seasons of Hope Raises Record $155,000 for Hospice and Palliative Care Programs The ninth annual Seasons of Hope Fundraising Luncheon was held on November 9 at the Lynnwood Convention Center, where more than 350 guests raised a record $155,000 to benefit EvergreenHealth’s Hospice and Palliative Care programs.

A portion of the proceeds from this inspirational event will support funding continuing education resources for staff and volunteers of the bedside care team.

Additionally, donations will support EvergreenHealth’s charity care program, which helps to cover the cost of hospice services for patients who are financially disadvantaged or do not have insurance coverage for hospice care.

On behalf of the EvergreenHealth Foundation, our Board of Trustees, hospice staff, volunteers, patients and families— thank you to everyone who contributed to this event’s immense success.

18

EvergreenHealth Monitor

(Left to right) Robb Carter, Katie Carter, Ann Carter-Tillotson and Charlie Carter

We’d particularly like to thank our table captains, as well as those supporting remembrance and recognition tables.

We couldn’t have done it without you!

A highlight of the event was keynote speaker Trudy James’ inspiring message based on Listening to Our Losses, which offered strategies for resilience and confronting grief. We are also grateful to Tom Hull for sharing his family’s peaceful and special experience with EvergreenHealth Hospice in remembrance of his mother, Gretchen.

Last, a very special thank you to our friends Karl Snepp and Karen Snepp, who generously gave a lead gift of $30,000 in memory of their cherished son and brother, Dave Snepp, as well as their loving wife and mother, Sue Snepp.

If you were unable to join us and would still like to contribute, we invite you to visit www.SeasonsofHopeLuncheon.org.

EVE RGR E E N H EALTH MO N RO E FO U N DATION

BECU Grant Funds Volunteer Training Center

EvergreenHealth Monroe Foundation Funds New 3-D Mammography Unit

EvergreenHealth Hospice Center, through a grant submitted by the EvergreenHealth Foundation, has been selected to receive a $15,000 Community Benefit Award from the BECU People Helping People Awards. These funds will support renovating the volunteer resource training center with new tables and chairs.

Members of the EvergreenHealth Monroe Foundation Board of Trustees, Patricia Fountain and Dianne Forth, were recently pleased to present a $200,000 check to help fund the purchase of a state of the art 3-D Tomosynthesis mammography unit for the hospital. The funds were raised by hundreds of generous donors throughout the Skykomish Valley, along with the proceeds from the 2016 Blue Jeans & Boots Gala.

Save the Date Saturday, May 5, 2018 2018 Evergreen Gala Kentucky Derby—A Run for the Roses Please save the date for the 2018 Evergreen Gala, returning to King County’s Marymoor Park on May 5, 2018.

This year’s theme is Kentucky Derby­—A Run for the Roses, complete with refreshing mint julips, comforting southern fare, open bar, exciting one-of-a-kind auction items, and plenty of music and dancing. And of course, Kentucky Derby finery is encouraged.

Proceeds from the gala will benefit EvergreenHealth’s Stroke and Neuroscience programs, including the purchase of advanced biplane technology to treat patients with stroke or at risk for stroke in the new catheterization lab.

To register, please visit www.evergreengala.org.

(Left to right) Linda Hanseth, EvergreenHealth Monroe patient and hospital volunteer; Dr. Lloyd Stambaugh, Radia; Dianne Forth, Gala chairperson; Patricia Fountain, Foundation president; Renée Jensen, CAO, EvergreenHealth Monroe; Tim Bates, diagnostic imaging manager, EvergreenHealth Monroe

This is the most sophisticated technology available for breast cancer screening. The unit was installed in September 2017 and is available to local residents for screening appointments.

To schedule a 3-D mammogram at EvergreenHealth Monroe, please call 360.863.4654.

Winter 2018

19

12040 NE 128th Street Kirkland, WA 98034 www.evergreenhealth.com

EvergreenHealth Primary Care Expands in Kenmore

Named Among the Top 5% of Hospitals in the Nation for Quality Care

This past fall, EvergreenHealth opened a new enhanced primary care and urgent care clinic in the LINQ at Spencer Square in Kenmore.

The opening marked the relocation of EvergreenHealth Primary Care, Kenmore and expands the practice’s services to include urgent care, physical therapy, 3-D mammography screening, and X-ray and laboratory services.

For the ninth time, EvergreenHealth received the Distinguished Hospital Award for Clinical Excellence™ from Healthgrades, placing the health system among the top 5 percent of more than 4,500 hospitals evaluated nationwide based on outstanding clinical performance.

Providing Specialty Care from Monroe to Issaquah

The new practice is located at 18151 68th Ave. NE, Suite 100, in Kenmore.

Primary Care operates Monday through Friday from 8 a.m. to 5 p.m. and until 12 p.m. on Saturday.

Urgent Care is open Monday through Friday, 8 a.m. to 8 p.m., and 9 a.m. to 5 p.m. on weekends.

To schedule an appointment, call 425.485.6561.

Follow Us!

Did you know EvergreenHealth’s care reaches patients and families as far south as Issaquah? Along with offering Primary and Urgent Care in Sammamish, EvergreenHealth also serves both male and female patients from its Urology and Urogynecology Care practice location, just off I-90 in Issaquah.

To learn more, visit www. evergreenhealth.com/urologist.

FACEBOOK facebook.com/ evergreenhospital.org

YOUTUBE youtube.com/ evergreenhospital

INSTAGRAM @EvergreenHealth

TWITTER @EvergreenHosp

PINTEREST pinterest.com/ evergreenhosp

OUR APP @EvergreenHealth

Receive our free, monthly e-newsletter with helpful tips and news to help you be your healthiest best!

Sign up today at: evergreenhealth.com/newsletter Download our free app for iPhone or Android. Search “EvergreenHealth.”

EvergreenHealth complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Español (Spanish) EvergreenHealth cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo.

(Chinese) 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 425-899-1000（TTY：425-899-1000）。

20

2016 EvergreenHealth Community Annual Report

For more information Contact EvergreenHealth by email at patientrep@evergreenhealth.com, or call the 24/7 Nurse Navigator & Healthline at 425.899.3000.

EVERGREENHEALTH BOARD OF COMMISSIONERS AL DEYOUNG, CHAIR Bothell/Duvall/Woodinville JEANETTE GREENFIELD, SECRETARY At Large MINERVA BUTLER At Large REBECCA HIRT Kirkland/Kenmore TIM MCLAUGHLIN Redmond/Sammamish CHUCK PILCHER, M.D. At Large VIRGIL SNYDER At Large You may contact the Commissioners by email at commissioners@evergreenhealth.com.

EDITOR EvergreenHealth Marketing and Public Relations Group and Firmani + Associates Inc. PHOTOGRAPHY Keith Brofsky DESIGN Arscentia and Lot 22 Creative EvergreenHealth Monitor is published as a community service by EvergreenHealth. Its contents are not intended to replace professional health care. See your health care professional for information relevant to your medical history.

EvergreenHealth is an equal opportunity employer and service provider.

For career opportunities at EvergreenHealth, visit our website at https://jobs.evergreenhealth.com.