SCOPE Magazine February 2009

Where caring counts. Feel the difference.

February 2009

TM

Vol. 25 No. 1

Surgery doesn’t have to be a “pain.”

Have it close to home at Mason General.

When you have surgery – the last thing you want to do is drive on “I especially

“Dr. Ogle is exceptional in my view point. He is always willing to answer questions and give explanations in an unhurried friendly way.”

Obese Kids have MiddleAged Arteries A study of the carotid arteries of obese children and adolescents found increased thickness similar to that of an average 45-year old adult, according to a study presented at the meeting of the American Heart Association [November, 2008]. Artery wall thickness is considered a reliable indicator of heart disease risk. {SOURCE: Geetha

Raghuveer, University of Kansas City School of Medicine, American Heart Association meeting, November, 2008; Pam Belluck, New York Times, November 12, 2008}

icy roads, or worse yet, drive an extra 30 minutes when you don’t feel well. Mason General Hospital’s surgery department is so close and convenient – you’ll be back in your own bed in no time.

Thyroid, colon, gall bladder, hernia and cancer surgeries are among the many surgeries done at Mason General Hospital, as well as men’s and women’s breast issues and laparoscopic procedures.

Above and left: “Senior” surgeon, S. Garrett Ogle, M.D., board-certified in general S. Garrett Ogle, M.D. surgery, at MGH since 1999, also performs colonoscopy and esophagogastroduodenoscopy (EGD). Prior to MGH he served 25 years as a Captain in the U.S. Navy, where he traveled the world. He has many fond memories; once serving on the largest aircraft carrier in the world – the U.S.S. Nimitz.

When it was time to retire from the Navy, Dr. Ogle knew he would live in the Pacific Northwest. “I wanted to be in the central part of the area so I could practice in Olympia and Shelton. Mason General was a great fit,” Dr. Ogle added, with a smile. “It is small enough that we are a real team, and we are well equipped with state-of-the-art technology. That was all I needed.” In addition, he pointed out, MGH has “the nicest patients in the world. They are very personable.”

Rounding out the general surgery team is Vanni C. Manthiram, M.D., also boardcertified in general surgery. Other surgeries at MGH are performed by Ophthalmologist, Monica Vuong, M.D., board-certified; Gynecologists/Obstetricians, Jonathan A. Gold, M.D., board-certified; Lystra B. Wilson-Celestine, M.D., board-eligible; and Nkem Nwosa, M.D., board-certified; Podiatrists, John Rice, D.P.M., board-certified, and James A. Wright, D.P.M.; and Lap-Band ® specialist, William D. Neal, M.D., board-certified.

Hypoglycemia: Heed Warning Signs Most Americans recognize the warning signs of hypoglycemia, or low blood sugar: sweating, nervousness, hunger, weakness, and maybe numbness in the fingers or around the mouth. Actually, these signs are associated with the release of adrenalin into the blood in an effort to help return blood glucose to normal. At the same time, the pancreas releases the hormone, glucagon.

These symptoms warn us to eat or drink something to increase blood sugar. Unfortunately, these signs may go unnoticed by a person who has had diabetes for several years.

Later, more serious symptoms such as a headache, lack of coordination, and confusion are likely to hinder the patient’s efforts to seek help. {SOURCE: Johns Hopkins White Papers, Diabetes, 2008}

appreciated Dr. Ogle taking time after the procedure to meet with me and discuss my grandson’s recovery and the procedure.

Everyone was very helpful.”

Above and below: Vanni C. Manthiram, M.D.

SCOPE Christmas Baby Richie

Wesley Ora Howe was Mason General Hospital’s 2008 Christmas Baby.

Pictured here with his mother, Nicole Johnson, and father, Christopher Allen Howe, Richie was delivered by Dr. Lystra B. Wilson-Celestine, obstetrician/gynecologist, on December 25 at 2:17 a.m., weighed 6 lbs, 15 ounces and was 20 inches long. His special gifts for being the Christmas Baby included a Christmas stocking and knitted hat – both hand-made by MGH’s Women’s Auxiliary. A local quilting club also made the Christmas quilt he was wrapped in.

New Year’s Baby

Dr. Jonathan A. Gold, obstetrician and gynecologist

at Mtn. View Women’s Health Center, holds Mason General Hospital’s 2009 New Year’s Baby, Joshua James Petrinovich. Dr. Gold delivered Joshua on January 1, 2009, at 2:05 a.m. Joshua weighed 9 pounds, 6 ounces and was 22.5 inches long.

Expecting a visit from the Stork?

˜

The Birth Center @ MGH can make it happen!

For all of us, the beginning of a new year is often a time for reflection on accomplish-

ments of the past year, and focus on worthy goals for the coming year. At Mason General Hospital, we are involved in that process all year long – in an effort to improve all aspects of care to patients, service to the community, and support of our employees and partners.

In 2008 many changes occurred in the MGH Quality Improvement process. MGH participated in and remained committed throughout the year to several quality improvement activities: ◗ Maintaining full accreditation with the Joint Commission, the primary (and premier) accrediting body for hospitals of all sizes in the United States. This accreditation requires maintaining the highest standards in all aspects of patient care and preparedness for supporting the community’s healthcare needs. ◗ Institute for Healthcare Improvement’s 5 Million Lives Campaign focuses quality improvement efforts on twelve important areas to improve care to patients, including treatment of heart failure, pressure sores, complications of surgery, infection control inside and outside the hospital, medication safety, and rapid response to emergencies. This is a voluntary effort that involves all hospital departments. Much was accomplished. ◗ A new and far-reaching Mason General initiative to build enthusiasm and satisfaction of all hospital employees, especially those who provide hands-on care to patients. The Hospital board, administration, and management are personally reaching out to individual staff members and patients, asking to hear their opinions and concerns.

These are lofty goals, but are absolutely necessary if we are to meet our commitment to you – our patients, community, and employees – to continually provide “Where Caring Counts. Feel the Difference.” We look forward to 2009!

Diet Affects Colon Cancer Outcome

Jonathan A. Gold, M.D. Board Certified, OB/GYN Lystra B.Wilson-Celestine, M.D. Board Eligible, OB/GYN

(360) 426-1611

Quality Improvement Always on the Radar Screen at MGH and Clinics

Nkem Nwosa, M.D. Board Certified, OB/GYN

The Birth Center @ TM

Among 1,009 patients with metastatic colon cancer followed for about five years, those following an unhealthy diet – with a relatively high intake of red meat, saturated fats, sugary desserts, and refined grains, were three times more likely than other subjects to have a recurrence of cancer or die.

Conversely, the researchers found no correlation between prudent eating and a better survival. {SOURCE: Allison Gandey and Charles Vega, “Diet appears to influence colon cancer outcomes.” Medscape Medical News CME, August 17, 2007}

SCOPE Join the Fun... Walk or Run...

Goldsborough Creek Run Saturday, May 30, 2009 in Shelton, Washington

Fantasy Forest

Thank You!

Many thanks to all of the Fantasy Forest

event chairs, steering committee members, volunteers, and sponsors for their support of Fantasy Forest 2008 – “Where the Treetops Glisten.” Without their involvement, this event’s success would not have been possible.

Also, a big thank you to Treasures Thrift Store, who contributed $115,000 to Mason General Hospital’s endeavor to bring fullfield digital mammography services to the residents of Mason County and Public Hospital District No. 1.

Mason General Hospital Foundation 2009 Foundation Officers President Sara Watkins Vice President Janis Byrd Secretary/Treasurer Joan Hayes Past-President Marian Greenberg Directors Karen Anderson Peggy Cleveland Adele DuPont Sallie Faughender Fred Finn Merlyn Flakus Marian Greenberg Beth Gregg Karen Hilburn Gary Koch Mark Mager James McElroy Jeff McHargue Mary Anne Munson Tim Sayan Bill Smith Donna Wolden

Sign up for:

Registration Fees:

7 mile Walk – 7:00 a.m.

7 mile Run – 8:00 a.m.

2 mile Walk – 8:00 a.m.

2 mile Run – 8:00 a.m.

1/4 mile Junior Jog – 10:00 a.m.

•$20 without t-shirt •$30 with t-shirt (cut-off date for shirt orders is May 15th) •$10 fee for Junior Jog

For more information and Run application go to: MasonGeneral.com/creekrun.htm Sponsored by Centennial Hospital Guild. All proceeds benefit Mason General Hospital.

An affiliate of Mason General Hospital Foundation

Friday June 26, 2009 At L

a

kelan

age G d Vill

olf Cours

e, E 200 Old Ranch Rd., Allyn,

WA

If you are interested in participating

Please reserve your spot now!

Individual Player Fee – $140 • Golf Cart for 2 – $30 • Extra Dinner Ticket – $25

Registration materials are available at the MGH Development Office. You can:

Drop in: Office is at 2505 Olympic Hwy N, Ste. 460, Shelton, WA 98584 Phone: Call Meghan Lucas at (360) 427-3623 Email: mlucas@MasonGeneral.com

Tournament Includes 18 Holes of Golf • Outdoor Dinner • Entertainment Special Prizes • Tee Prizes for Each Player • 4-Person Scramble Format Great Tee Packs for All Players

Schedule of Events 10:00 a.m. – Registration • 11:00 a.m. – Shotgun Start 4:00 – 6:00 p.m. – Entertainment • 4:00 – 6:00 p.m. – Buffet Dinner & Awards

SCOPE Staphylococcus Aureus: Is this New?

by Gary Preston, Ph.D. — Infection Control Humans and Their Organisms Many microorganisms live in and on us without causing disease ...bowel, skin, mouth, nose, etc. This is called “colonization”.

These same organisms can cause disease if they reach body sites they do not normally inhabit. For example, organisms in the nose and mouth can cause pneumonia if they reach the lungs or meningitis if they reach the brain; bowel organisms may cause peritonitis if they find their way into the abdominal cavity such as via a burst appendix or, urinary tract infection if they reach the bladder or kidneys; skin organisms may cause cellulitis or abscess (“boils”) if they find their way into a wound or break in the skin. Fortunately, our immune response (antibodies and blood cells that fight microorganisms) is on duty to assist with disposing of microorganisms that stray from their usual locations.

Staphylococcus aureus Staphylococcus aureus (Sa) is one of the many species of staphylococcus that can inhabit (colonize) the skin and other body sites. It is present in or on approximately 30% (1/3) of normal people. This makes it available to enter wounds or the lower respiratory tract and then possibly the blood where it can cause infection (disease). It is also available to be transmitted by contact from one person to another directly or indirectly on surfaces and objects. The more of the organism available, such as during an infection, the more available for transmission. Some people are not colonized, some are intermittently colonized and some are persistently colonized. Who has what today?

Antibiotic Resistance and Virulence Most antibiotics originated from substances produced by microorganisms to kill other competing microorganisms. When microorganisms (or any group of organisms) are exposed to stressful conditions, those individuals which are genetically most capable of surviving become predominant. This happened when penicillin (PCN) was introduced in the late 1940’s and ‘50’s. At first, Sa infections could be treated with PCN. Now almost all Sa are resistant to PCN. Semi-synthetic PCN’s (methicillin, oxacillin, nafcillin, etc.) replaced PCN for treating Sa infections and soon (~1968) genes coding for resistance to these began to spread among Sa. (Methicillin

Resistant Staphylococcus aureus). Vancomycin replaced penicillins for treating MRSA infections and, as you might anticipate, given enough time and Vancomycin use, resistance to Vancomycin emerged in some Sa (VRSA) in ~2002. Newer antibiotics can be used if/when VRSA (now rare) is present and it will be important to monitor Sa resistance to these. It is obvious by now that preserving the effectiveness of antibiotics requires that their use be limited to circumstances where they are really needed if the selective pressure for resistance emergence is to be kept low.

The ability to cause disease (virulence) is also determined by the organism’s genetic code — which can vary from one organism to another even among Sa.

In healthcare, elevating the head of the bed of the intubated patient helps prevent the patient’s own upper respiratory organisms from reaching the lower respiratory tract. Not shaving and thereby preventing micro-nicks of the skin in which bacteria can grow and administering antibiotics just before incision helps prevent surgical site infection due to normal skin organisms. In and out of healthcare, transmission of Sa and other organisms transmitted by contact and not the airborne route is prevented by sanitation: cleaning of objects, surfaces and hands after each person contact. Transmission prevention may be accomplished by insuring that prevention steps are reliably and consistently used all the time after every contact.

Tracking Infections for Healthcare and Public Health

Transmission Prevention

Mason General’s infection control program has for years routinely monitored patterns of infection due to all organisms in all patients... including but not limited to MRSA. While our analysis guides intervention, since prevention depends on appropriate patient care practices, we also monitor the consistency of our prevention procedures: equipment cleaning, hand hygiene, preoperative care, pneumonia prevention, IV line care, etc. The more intensive the effort to improve practices, the lower the risk of infection.

Public health tracking of infections is particularly important when transmission of the infectious organism is not by predictable contact from one person to the next but by the difficult-to-control airborne route (e.g., measles, tuberculosis), when many people may be infected by a single source such as food or water (e.g., Salmonella, E. coli O157: H7, Shigella) or when each infection comes with a high risk of serious outcome (e.g., HIV, Rabies, Tetanus). Staphylococcus aureus infections are very common, the organism is transmitted by contact and serious outcomes can occur but are infrequent relative to the number of total infections.

Infection Prevention at Mason General Hospital Infections may be caused by organisms already present in or on the body (endogenous) or organisms newly acquired (exogenous).

Prevention of infection requires attention to both potential sources of organisms.

The debate regarding the most effective transmission prevention strategy is on.

One strategy assumes: 1. infected and colonized patients who have no signs of infection are equally potential sources of organisms for t r a n s m i s s i o n to other patients (not supported by the evidence); 2. routine cleaning and hygiene are insufficiently practiced to reliably prevent transmission (unacceptable condition); 3. culture screening of patients can reliably identify who has Sa at any given time and that culture results are necessary to insure that hygiene and cleaning around culture positive patients is adequate to prevent transmission (untrue and unacceptable [see #2]); but that 4. culture of healthcare workers need not be done because, unless signs of infection and/or evidence of transmission are present, healthcare workers are not likely to be significant sources for transmission (inconsistent with #1).

This is similar to the HIV transmission strategy that called for HIV testing of all persons so that appropriate disinfection and sterilization steps could be followed selectively following use with HIV positive patients as if only transmission of HIV (and not HBV, HCV, HDV, HGV, HTLV-I&II etc.) was to be prevented. Clearly it is not and appropriate disinfection and sterilization steps were adopted to prevented transmission of all of these.

A second strategy calls for increased and sustained attention to reliable hand hygiene

SCOPE and routine equipment cleaning so as to prevent transmission of not just MRSA but all Sa (from the 30% who have it to the 60% who do not) and other potential pathogens such as Enterococcus (which can be resistant to Vancomycin (VRE)), Clostridium difficile, E. coli, Pseudomonas, etc. Reliable performance of these steps will minimize transmission of microorganisms from patient to patient, patient to healthcare worker and healthcare worker to patient no matter who has what. This is similar to the strategy adopted to prevent HIV transmission that does not depend on HIV testing of potential sources but, rather, insures appropriate disinfection and sterilization steps whether the individual potential source patient is known have a particular blood-borne pathogen organism or not.

Help Support Digital Mammography at MGH MGH Foundation is reaching out to supporters to complete the funding of a new, state-of-the-art digital mammography unit for Mason General Hospital. The goal is $470,000 and thanks to our community we have raised $165,000 towards the purchase of this equipment. We now need your support.

Digital mammography can significantly reduce the overall radiation dose to breast tissue, in part because images may be manipulated on-screen in such a way that additional exposures aren’t necessary.

To make your tax-deductible contribution, please call Jennifer Capps, chief development officer, Mason General Hospital Foundation at (360) 427-3623; or send an e-mail to jcapps@MasonGeneral.com. Gifts of appreciated stock, pledges, multi-year commitments, and major credit card payments are accepted. Contributions may also be made in honor or in memory of loved ones.

Conclusion MRSA is just one sub-type of just one of the organisms that is commonly around us that can cause disease. Antibiotic resistance has increased dramatically in all of potentially disease-causing microorganisms over the years that antibiotics have been used in medicine and agriculture. Resistance will continue to be a problem that can be minimized by appropriate antibiotic use. Infections and transmission of microorganisms that can cause infection will be prevented when we accept the challenge to reliably and appropriately use the steps we know can reduce infection due to microorganisms already present and prevent transmission of microorganisms from where we expect they might be to where we do not want them.

Aiming for Good Health?

Pick Oakland Bay Pediatrics for your team:

©2007 Healthcare Management Alternatives, Inc.

(3 6 0)

Are Talking About Us e l p o Ambulatory Pe Fre

Surgery Patient Comments

r al Li n e

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“Two days after I got home the nurse called meewith a follow-up e to see if I was okay. Thank you.”P h y s i c i a n R “It was so easy that I woke from the anesthetic and it was as if it had never happened.”

Emergency Department Patient Comments

“The registration staff is wonderful. When I walked in they welcomed me with a big smile and open arms. You just walk in with your illness and they make you feel better from that moment on. The doctors and nurses are heroes. They do a wonderful job of saving lives and helping others.”

“My dad received excellent and timely care while in the emergency area and also while he was an inpatient. Mason General has an excellent staff. The nurses are very efficient and caring (doctors too).”

ICU Inpatient Comment

“Everyone was helpful and interested in helping at all times.

Fun people.”

Saad Al Alou, M.D. Board Certified Meltem Karatepe, M.D. Board Eligible Therese Pizanti ARNP

l.com enera

G www.Mason Flu shots Physicals: school & sports Well-baby checkups Immunizations (including HPV & Rotavirus) Free prenatal consultations Now offering “Electronic” medical records

Call (360) 426-3102 for an appointment.

Accepting new patients — birth thru 18 years of age.

Mon. – Fri., 8 a.m. – 5 p.m.

247 Professional Way Shelton, WA 98584

SCOPE Medical Staff Officers Elected – Chiefs Of Service Appointed

Saad Al Alou, M.D. Chief-of-Staff

Roy G. Belville, M.D. Asst. Chief-of-Staff

County Blanketed with Snow

Timothy J. Weber, M.D. Secretary

MGH’s more than 100 physicians recently elected its medical officers and

appointed its Chiefs of Service for 2009. There are more than 100 physicians in 21 specialties – active, courtesy, and consulting – with privileges at MGH. Elected as Chief-of-Staff – Saad Al Alou, M.D., board-certified in pediatrics; Assistant Chief of Staff – Roy G. Belville, M.D., board-certified in emergency medicine; Secretary – Timothy J. Weber, M.D., board-certified in family practice; and Past Chief-of-Staff – Dean E. Gushee, M.D., boardcertified in emergency medicine.

The 2009 Clinical Chiefs of Service department heads are: Anesthesia – Robert F. Goad, M.D.; Intensive Care Unit – Mark L. Schlauderaff, M.D.; Emergency Services – Dean E. Gushee, M.D.; Infant and Children’s Services – Saad Al Alou, M.D.; Laboratory Services – Terrence A. Schulte, M.D.; Medical/Surgical – Christopher W. Penoyar, D.O.; Obstetrics – Jonathan A. Gold, M.D.; Respiratory Therapy – Douglas F. Lindahl, D.O.; Surgery – Vanni C. Manthiram, M.D.; and Radiology – Thomas J. Luetkehans, M.D.

Hospital\District Strategic Goals Every well-run organization has a plan – and Mason General Hospital and District No. 1 are no exception. Here is a brief summary of the Strategic Goals for MGH and the District for the next three years.

Goal #1: Create and sustain a base of providers (primary care and specialists) that supports local healthcare delivery and meets identified needs for access while maintaining/maximizing eligibility in provider/community federal enhanced rural reimbursement programs.

Goal #2: Continue to improve patient care and outcomes by implementing the Information Technology Plan and ensuring that the right information is provided to the right person at the right time.

Goal #3: Be a top performer in all relevant national patient safety goals and quality initiatives.

Goal #4: Develop and begin implementation of a facility master plan that ensures that District facilities and infrastructure: 1) are adequately sized to meet resident needs, 2) are accessible, 3) are able to accommodate current and future technology, and 4) support the delivery of quality, patient-centered care.

Goal #5: Ensure that residents of all communities comprising the District perceive value and benefit from the District’s core services.

Goal #6: Maintain operating margins and financial ratios consistent with those necessary to support future growth and development.

Goal #7: Develop and offer programs that maximize health and independence for those with chronic healthcare needs.

Goal #8: Create and sustain a work environment that attracts and retains superior quality employees and providers.

Goal #9: Foster a care environment that supports patient-centered care, patient empowerment, and family involvement.

More than a foot of snow stopped holiday activities and work flow for many people in Mason County in December. However, Mason General Hospital remained opened 24/7 with a full staff, despite the record-breaking weather conditions and blocked roads.

Employee Focus – Live, Learn, Work at MGH Arlene Hutchins, Monitor Tech and Unit Secretary Arlene has been an employee at MGH for 38 years, and attests, “The ‘family feelArlene Hutchins ing’ is what has kept me here so long. I just I.C.U. love everything about this place.

“I can’t say enough good about MGH – it’s such an awesome place to work. I have spent as many holidays with my co-workers as I have with my family. We have helped each other through crises, loss of loved ones, surgeries, financial difficulties, having babies and watching the children grow to have babies of their own. We have celebrated many milestones together – sometimes laughing and sometimes crying.

That is why there is such a family feeling at MGH.”

SCOPE News Briefs… …Congratulations to MGH “Employee of the Month” for January – Mona Mecham, laboratory; and February – Robin Montoya, environmental services. …Treasures Thrift Store recognized “Volunteer of the Month” for November – Lois Hunter; and December – Teresa Wright. Congratulations! …MGH’s next Adult, Child, and Infant CPR Class, is set for Thursday, February 26, 2009 from 6 to 9 p.m. in the Washington Room. It is free, but pre-registration is required. “We will cover the proper technique for infant, child, and adult CPR as well as a review of the symptoms of heart attack and stroke,” said Tom DiDonna, R.N., education coordinator at Mason General Hospital. Everyone attending the class is asked to wear comfortable clothes. There will also be a Spanish interpreter on site. Advanced registration is recommended, as class size is limited. Reservations must be made by Thursday, February 19 by calling (360) 427-3609. …Public Hospital District No.1, the governing body of Mason General Hospital, Oakland Bay Pediatrics, Mason County Eye Clinic, Mountain View Surgical Services, Shelton Family Medicine, and Shelton Orthopedics recently announced the officers for the 2009 Board of Hospital Nancy Trucksess, Commissioners. Nancy Trucksess, Shelton, was elected by her peers President to be president of the three-person board. Scott Hilburn, Shelton, will be secretary; and Don Wilson, Potlatch, will be a trustee. The Commissioners meet every second and fourth Tuesday of the month (except holidays) at 8 a.m. in the Washington Room at Mason General Hospital. …Dona Kravis, B.S.N., R.N. is the new emergency department director at Mason General Hospital. Dona came from Capital Medical Center, Olympia, where she served as director of quality/risk management and director of the emergency department. Prior to that she worked as the director of critical care services. Dona received her Bachelor of Science degree from the University of Washington, Tacoma, and her Registered Nurse degree Dona Kravis, B.S.N., from South Puget Sound Community College, Olympia.

R.N. “I am pleased to have Dona as a part of our team at MGH, and the experience and skills she brings to this organization,” said Eric Moll, CAO at MGH. MGH’s emergency department sees nearly 21,000 patients a year and has more than ten physicians on staff that are board-certified. While at Capital Medical Center, Dona was presented with the “Frist Humanitarian Award” in 2001, for taking care of a seven year-old girl whose mother was admitted to CMC, and later died. Dona cared for the girl in her home until a relative was found. In addition, during a span of 17 years at CMC, Dona was selected by her peers four different times as “Employee of the Month.” …Allyn’s monthly Diabetes Support Group, sponsored by Mason General Hospital and affiliated with the American Diabetes Association, meets on the fourth Thursday of every month from September to June, from 1 to 2 p.m. in the downstairs meeting room of the Port of Allyn building. It is free and open to people with type 1 and 2 diabetes, their friends, and family. For more information call Sue Barwick, R.N., C.D.E., at (360) 427-7332 (from Allyn (360) 275-8614, and ask for the Diabetes Wellness Department). …Mason General Hospital has a hospital diabetes nurse educator at the Skokomish Tribe Health Clinic on the second Wednesday afternoon of each month. There are many skills and tools available to patients with diabetes that can help them manage and slow down the advancement of the disease. With proper application of self-management skills and professional support, someone with diabetes can lead a normal, active life. “Mason General Hospital hopes this new service will aid the community by allowing close access to important educational visits, which are needed to help support diabetes patients in achieving excellent diabetes management,” said Sue Barwick, R.N., certified diabetes educator at MGH. …Detecting diabetes before it shows symptoms has caused many people to be surprised when their test results indicate diabetes. However, today, there are many factors that go into controlling diabetes that can slow down the advancement of the condition. With proper application of self-management skills and professional support, someone with diabetes can lead a normal, active life. If diabetes is a part of your life, plan to attend Mason General Hospital’s two-day session entitled, “Living Well With Diabetes.” The two consecutive days are Tuesday, May 5 and Wednesday, May 6 in the Ellinor Room at MGH, starting at 12:30 in the afternoon. Due to space limitations, advanced pre-registration is required.

Appel in the Morning on KMAS

Bob Appel, CEO of MGH and Public Hospital District No. 1; and Jeff Slackey, morning DJ at KMAS Radio 1030 AM get ready to answer questions submitted by area residents about MGH and the Hospital District. Residents will receive a total of five letters during the first half of 2009, which were written by the Hospital Commissioners.

The intent of the letters is to share District and Hospital facts and “news” and invite questions. The questions and answers will be aired every Monday morning at 7:15 on KMAS. To submit a question, send it to news@masongeneral.com.

Do a Physician Search at www.MasonGeneral.com

Do Fruits, Veggies Reduce Cancer Risk?

Fruits and vegetables are rich in fiber and are believed to offer many health benefits, including, according to early studies, a reduced risk of colon cancer. Recent studies have not shown such favorable results in this regard, however.

In a recent pooled analysis involving 756,217 men and women followed for 6 to 20 years, researchers found a smaller than expected correlation between fruit and vegetable intake and colon cancer risk, although subjects with the lowest intake of fruits and vegetables had an elevated risk. {SOURCE: Anita Koushik, et al, “Fruits, vegetables, and colon cancer in a pooled analysis of 14 cohort studies,” Journal of the National Cancer Institute, November, 2007}

SCOPE Nuts Better than Grains for Diabetics

Defibrillators Donated Cheryl Dunning (holding framed certificate), a local, licensed practical nurse and CPR instructor, recently donated two Automated External Defibrillators, plus accessories, to Mason General Hospital, in memory of her mother, Elizabeth W. Bailey. Accepting the donation were hospital staff members (l to r), Bob Appel, CEO; Sherry Curtis, education assistant; Eric Moll, CAO; and Tom DiDonna, R.N., education coordinator. According to Tom DiDonna, the AEDs will be placed in areas of the hospital and clinics that have the greatest need. “Cheryl, your generosity will potentially save lives,” said Tom, during the presentation. Tom and MGH presented Cheryl with a certificate of appreciation and recognition.

Persons with type 2 diabetes are often advised to adopt a highfiber diet to keep their blood sugar under control. In terms of high fiber, most Americans think first of “brown foods” such as whole grain bread and breakfast cereal, brown rice, and potatoes with the skins on. A recent six-month study, published in the Journal of the American Medical Association [December 16, 2008] found that low glycemic index foods such as nuts, beans, peas, and lentils were even better for controlling blood sugar in diabetics. Pumpernickel and rye bread, and oatmeal and oat bran cereals were also part of the low glycemic diet.

Subjects following the low glycemic diet also showed improvements in HDL, the “good” cholesterol. {SOURCE: David J. A. Jenkins, et al, JAMA, December 16, 2008; Roni Caryn Rabin, “Recommended diet for diabetics may need changing, study suggests,” New York Times, December 18, 2008}

MGH Foundation Contributors Memorialized

The Mason General Hospital Foundation would like to acknowledge

former contributors. Listed below are supporters the Foundation would like to recognize for their past support of our mission and work in the community. Please join us in acknowledging their support of the Foundation during their lifetimes.

John Aumend* Nora P. Jost* Ray B. Stevens* Joann Tate* (*deceased)

Memorial Contributions Mason General Hospital Foundation has generously received donations in memory of the individuals listed below. Memorialized individuals and donors listed in this report reflect contributions made to the Foundation beginning December 1, 2008 and ending January 5, 2009.

Francis Lukey Chris Rapacz – Anonymous – Adele DuPont Dean Biggs– Ray Stevens – Alice Biggs – Anthony & Rhonda Belfield Charles Gregg – Larry & Toni Stevens – Patricia Gregg – David & Agnes White Douglas Larson – William & Betty Woodruff – Edee Larson Gwen Stidd Ruth Olander – Gene Stidd – Michael & Virginia Leonard Williams, Sr. McCarty – Michael & Virginia McCarty Please be advised that every effort has been made to ensure the integrity of this listing. If we have inadvertently omitted any names, please accept our apologies and most sincere thanks for your generosity and continued support of Mason General Hospital Foundation.

T hey can’t wait to have you back. So, have your surgery close to home.

Thyroid, colon, hernia, and cancer surgeries… laparoscopic procedures… men’s and women’s breast issues…

At Mountain View Surgical Services, General Surgeon Vanni Manthiram, M.D. wants to put your mind at ease. Choose Mtn. View, and the comfort and convenience of surgery at MGH. Call (360) 426-4142 to make an appointment.

Vanni C. Manthiram, M.D. Board Certified General Surgery

American College of Surgeons The American Society of Breast Surgeons Society of Laparoendoscopic Surgeons

(360) 426-4142

1710 N. 13th Loop Rd., Shelton, WA 98584 www.MasonGeneral.com

SCOPE Formas de controlar el Estrés Duerma bien. El no dormir lo suficiente disminuye la capacidad que uno tiene de controlar el estrés. Objetivo: Trate de dormir de 7 a 8 horas cada noche. Si tiene problemas para dormir consulte con un medico sobre como mejorar su situación.

Haga ejercicio. Realizar ejercicio regularmente relaja los músculos tensos y también relaja la mente. Pruebe una caminata vigorosa, una clase de ejercicios o un paseo en bicicleta.

Coma de forma saludable. Realice comidas pequeñas y ligeras durante el transcurso del día esto le ayuda a tener mas energía y a mantener estable el azúcar en la sangre y esto podría facilitarle el hacer frente a situaciones estresantes.

Planifique con anticipación. Cuando sepa que un evento estresante se esta aproximando prepárese de antemano. Planifique estrategias para controlar la situación, haga una lista de personas que puedan brindarle apoyo, prepárese y practique.

Reduzca la cantidad de cafeína que consume. El efecto de la cafeína en el cuerpo es muy similar al del estrés, aumenta la frecuencia cardiaca y la presión sanguínea y acelerando el cuerpo y la mente. Beba mas agua en vez de bebidas con cafeína en situaciones estresantes.

Relaje su cuerpo. Una vez al día, tense y luego lentamente relaje cada grupo de músculos de la cabeza a los dedos de los pies.

Relaje su mente. Haga una pausa mental de 15 a 20 minutos todos los días.

Medite, suene despierto o escuche música, lo que sea mejor para usted.

Tómese unas vacaciones imaginarias. Cierre los ojos e imagínese una escena agradable...en una montana...en una pradera...junto al mar. Imagínese relajándose en el lugar ideal para usted.

Maximice su energía. Programe su trabajo mas difícil para las horas del día en las que se encuentre mas descansado y alerta. Emprenda las tareas mas fáciles cuando su energía este en el nivel mas bajo.

Realice algún trabajo social. Ayudar a otras personas evita que usted exagere demasiado sus propios problemas.

Evite apresurarse. Salga más temprano para llegar a tiempo a sus reuniones y otras obligaciones.

Niños Obesos tienen arterias de personas de la mediana edad.

En un estudio de las arterias carótidas en niños y adolescentes obesos se encontró un aumento en el grosor similar al promedio de una persona adulta de 45 años, según el estudio presentado en la reunión dela Asociación Americana del Corazón (Noviembre 2008). El engrosamiento de las paredes de la arteria se considera como un indicador de personas con riesgo de enfermedades del corazón. {SOURCE: Geetha Raghuveer, University of Kansas City School of Medicine, American Heart Association meeting, November, 2008; Pam Belluck, New York Times, November 12, 2008}

Beber mucho alcohol no es sano para los diabéticos.

Los pacientes que son diabéticos deben beber alcohol en moderación y siempre con alguna comida o aperitivos. En especial los pacientes que utilizan insulina o alguna medicina que aumenta la producción de insulina. El beber mucho alcohol, beber alcohol para estar embriagado o tomar alcohol con el estomago vacio puede ocasionar un ataque de hipoglucemia (azúcar baja en la sangre) hasta dos días mas tarde. {SOURCE: National Institute of Diabetes and Digestive and Kidney Diseases Clearinghouse, “Hypoglycemia.”

NIH Publication No. 09-3926, October, 2008} {SOURCE: National Institute of Diabetes and Digestive and Kidney Diseases Clearinghouse, “Hypoglycemia.” NIH Publication No. 09-3926, October, 2008}

Deje de procrastinar. Haga una lista todos los días de las cinco tareas principales que necesita completar y concéntrese en ellas mientras su energía esta en su nivel mas alto.

Hipoglucemia: Señales de Advertencia.

Hable sobre sus problemas y situaciones. Utilice como apoyo a sus familiares, amigos o compañeros de trabajo para que le ayuden a encontrar soluciones.

La mayoría de las personas reconocen las señales de advertencia de la hipoglucemia o del azúcar baja: sudores, nerviosismo, hambre, debilidad y posiblemente dedos dormidos o el área alrededor de la boca adormecida. En realidad estos síntomas se deben a que el cuerpo libera adrenalina en la sangre para ayudar a que la glucosa en la sangre tenga un nivel normal. Al mismo tiempo el páncreas libera la hormona llamada glucagon.

Estos síntomas nos advierten de que debemos comer o beber algo para aumentar el azúcar en la sangre. Desafortunadamente una persona que ha tenido diabetes por varios años puede ser que no se de cuenta de estas señales. Y mas adelante otros síntomas más serios como dolor de cabeza, perdida de la coordinación y confusión pueden impedir que el paciente busque ayuda medica.

Desahogue las tensiones. Libere el enojo y la tensión de maneras saludables.

Salga a correr, anote sus preocupaciones e inquietudes o pruebe un nuevo pasatiempo.

Exhale el estrés. Si se siente tenso. Deténgase, respire profundamente y exhale el estrés.

Ríase. Es una gran manera de dejar escapar el estrés y le brinda al corazón y pulmones una mini sesión de ejercicio aeróbico.

Siéntase agradecido. Al final de cada día agradezca las cosas buenas que han ocurrido. Le sorprenderá darse cuenta de todo lo que resulto bueno.

Obtenga ayuda si necesita. Hable con un profesional de la salud o con un consejero si le es imposible controlar el estrés.

Acepte el cambio. oportunidades

Considérelo como un estado natural que ofrece

{SOURCE: Johns Hopkins White Papers, Diabetes, 2008}

SCOPE Sr News 2 col (4-7/8”) x 7”

Welcome Our New Optometrist

Whole Grains/ Fruit Diet Gets Nod A dietary pattern emphasizing whole grains, nuts, seeds, green leafy vegetables, and low-fat dairy products was associated with a 15 percent lower risk of type 2 diabetes than a pattern stressing red and processed meats, refined grains, tomatoes, beans, and regular soda, according to data from the Multi-Ethnic Study of Atherosclerosis (MESA).

“Although both beans and tomatoes have positive nutrient attributes,” the authors wrote, they were, in this study, combined “with less favorable food groups.” Subjects included white, black, Hispanic and Chinese adults, from 45 to 84 years of age. {SOURCE: Lyn M. Steffen, et al, “Dietary patterns and risk of incident type 2 diabetes in the multi-ethnic study of atherosclerosis (MESA).” Diabetes Care, June 10, 2008}

Dr. Yang Joins Eye Clinic K

eren Yang, O.D., optometrist, recently joined the staff at Mason County Eye Clinic, headed up by Monica Vuong, M.D., ophthalmologist and eye surgeon. The Eye Clinic is located at 2300 Kati Court, Suite C, Shelton, and may be reached at (360) 426-8717. Dr. Yang received her Doctor of Optometry from Illinois College of Optometry, Chicago, in 2004. Prior to that she received a Bachelor of Science degree in mathematics and biological sciences from the University of Washington, Seattle, in 1999. Dr. Yang is a member of the American Optometric Association and she also has her Washington State Diagnostic/Therapeutic/Oral license certification. Dr. Yang is bilingually fluent in English and Korean.

Our Mission: We take every possible action to protect and promote the health of the people in Mason County while extending respect and compassion as we serve each individual.

Published by: Public Hospital District No. 1 for Mason General Hospital, Mason County Eye Clinic, Mountain View Surgical Services, Oakland Bay Pediatrics, and Shelton Orthopedics.

Published six times per year. Editor: McCarty & Associates, Inc. “a marketing firm”.

Business Office: Office hours: 8 a.m. – 6:30 p.m., Monday – Friday. Spanish Translator Available. Located at Gateway Center, 2505 Olympic Hwy N., Suite 460, (360) 427-9547 Mason General Hospital: Visiting hours: 8 a.m. – 8:30 p.m., daily. Intensive Care Unit (I.C.U.) visiting hours: special hours on a patient-by-patient basis, call for Unit hours. Located at: 901 Mtn. View Drive, Building 1, PO Box 1668, Shelton, WA 98584-5001, (360) 426-1611, from Allyn (360) 275-8614. Serving the medical needs of the county since 1968.

Accredited by the Joint Commission. TTY/TTD: (360) 427-9593.

Translation Services Provided. Se habla español. Equal Opportunity Provider.

Mason County Eye Clinic: 2300 Kati Court, Suite C, Shelton, WA 98584, (360) 426-8717 Mountain View Surgical Services: 1710 N. 13th Loop Rd., Shelton, WA 98584, (360) 426-4142 Oakland Bay Pediatrics: 247 Professional Way, Shelton, WA 98584, (360) 426-3102 Shelton Orthopedics: 939 Mtn. View Dr., Ste. 130, Shelton, WA 98584, (360) 427-0663 Administration: Bob Appel, chief executive officer; Eric Moll, chief administrative officer; Saad Al Alou, M.D., chief of staff; Nancy Trucksess, commissioner/president; Scott Hilburn and Don Wilson, commissioners.

Approved by the Joint Commission Mason General Hospital POB 1668 Shelton, WA 98584

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