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Taking the leap Fairbanks physician opts for double knee replacement
Chugiak school nurse honored for excellence
Health Sense • Alaska health officials urge residents to wear masks in public • Veterans Administration: Enjoy the sun, but stay safe • Prince of Wales youth advocate against stigma of addiction • Dr. Brück Clift: Exercise beneficial during pregnancy • Dr. Lee Ann Gee: Effective mental health treatment a necessity
July 2020 Vol. 1, No. 7
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July 2020 Vol. 1, No. 7
Alaska People
About Alaska Pulse Alaska Pulse is a monthly magazine focusing on health in the Far North and distributed around Fairbanks and Anchorage. We’ll share stories from around the state about how people stay healthy. Learn from experts in different medical fields on ways to improve, or maybe just maintain, your health. We’ll hear personal stories about people’s triumphs over different health adversities. Alaska Pulse is a community publication, so every issue is sure to hold a variety of perspectives.
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After years of knee problems, Fairbanks physician Dr. Corrine Leistikow opted for a double knee replacement.
Chugiak school nurse Catherine “Cat” Haese honored with statewide award for excellence.
By David James Page 4
By Aliza Sherman Page 18
FEATURES Most total knee replacements are successful..................................................................................... 8 Fairbanks Native Association, agencies help combat impact of COVID-19............................ 10
health sense Alaska health officials ask residents to continue wearing masks. 9
Prince of Wales youth advocate against stigma of addiction. 15
Veterans Administration: Enjoy the sun, but stay safe. 14
Clift: Exercise beneficial during pregnancy. 17
Gee: Effective mental health treatment such as TMS necessary in today’s stressful world. 22
AlaskaPulse.com — July 2020
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Two of a kind Dr. Corrine Leistikow uses a walker at Rocky Mountain National Park near Sprague Lake shortly after her double knee replacement. Opposite page, navigating a steep trail post-recovery. Eric Troyer photos
Leistikow’s knees pre-surgery, above, compared with an X-ray of them post-surgery.
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July 2020 — AlaskaPulse.com
New knees mean new adventures for Fairbanks physician By David James
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s the American population ages and baby boomers look to remain active into their retirement years, joint replacement surgeries have become an increasingly common elective medical procedure. According to the American Academy of Orthopaedic Surgeons, more than 600,000 total knee replacements are performed each year, and over 300,000 total hip replacements. When other joint replacements are factored in, over 1 million Americans seek such treatment annually, a number that is expected to quadruple over the coming decade. Results vary, with most patients enjoying substantially reduced pain and an improved quality
of life following the surgery. Corrine Leistikow, a family medicine physician and the medical director of Tanana Valley Clinic’s Family Medicine department in Fairbanks, is one such person. A lifelong athlete, Leistikow has experienced knee troubles since her teens, and, after two previous procedures, underwent double-knee replacement in 2015. Having both knees replaced at once is something that many orthopedists advise against, Leistikow said. “It’s a harder recovery when you have no good knee to use,” she explained, and for some patients there is an elevated risk of cardiac complications. But for Leistikow, who is highly active and generally quite healthy, the option of
only enduring one recovery period outweighed the added difficulties of undergoing a double replacement. “I didn’t want to have to rehab twice. Most doctors don’t recommend doing both at the same time. Recovery is slower. You have to be motivated,” she said, adding, “I was a good candidate and very motivated!”
A history of knee pain
Leistikow’s knee troubles first surfaced in her teens. She suspects she had anterior cruciate ligament (ACL) injuries at the time, although these went undiagnosed and untreated. Over the course of her 20s, however, she experienced increasing debilitation in her right knee caused by the AlaskaPulse.com — July 2020
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m l Pre-surgery marks on Corrine Leistikow’s knees.
early onset of arthritis. At age 30, Leistikow underwent an experimental procedure that was then being used. “I had my (right) ACL repaired with GORE-TEX, which we now know is terrible. And they did something called a high tibial.” A high tibial involves taking a wedge out of the knee itself to realign it in hopes that altering the directional forces in the joint would relieve the arthritis. For Leistikow, the problems remained, and a decade later she underwent an allograft surgery in hopes of forestalling a knee replacement. This is essentially a knee transplant from a cadaver. Leistikow located a doctor in California who performs the procedure. Then, she said, “You’re on a waiting list for someone to die who has the same knee size as you, then you have to fly down immediately.” “After the allograft surgery I don’t think I was ever pain-free,” Leistikow said. “I think I had less pain and was 6
July 2020 — AlaskaPulse.com
able to do more and had less swelling.” Leistikow had to depend on anti-inflammatory drugs like Feldene and ibuprofen to keep pain at bay but was able to maintain her lifestyle. “I expected to have surgery in my mid40s but was able to wait until my mid-50s by having the allograft surgery,” she said. “I feel that I did buy myself a little bit of time. Because artificial knees generally only last about 20 years, Leistikow didn’t want to have the procedure done until her 50s, as she wanted to avoid having to undergo it a second time while still in her active years. In the interim, her left knee began to degenerate from years of using it to compensate for the weakness in her right. In her late 40s she was diagnosed with an autoimmune disorder, ankylosing spondylitis, which is an uncommon type of inflammatory arthritis that likely was a contributing factor to her troubles. In October 2015, at the age of 56, Leistikow and her husband, Eric
Troyer, flew to Greeley, Colorado, to have both of her knees replaced. An unexpected complication arose when doctors opened up her right knee and bumped and ruptured her patellar tendon, which she said was “paper thin” from all her years of knee problems. This meant that instead of getting that knee moving as soon as possible, it had to be immobilized for eight weeks.
A determined recovery
Leistikow knew that the rehabilitation period was the most important part of the recuperation, and because of the delay with her right knee while the patellar tendon healed, her recovery was lengthened. But she said she went straight to work on the left leg while waiting for the right to come out of its brace. “Basically I had a peg leg,” she said. The couple remained in Greeley for a week, but Troyer said they quickly discovered a mistake they had made in
reserving their accommodations. “We had reserved a place through Air BnB or one of those services. The place had stairs. Not many, but after a doubleknee replacement, you don’t want any! We quickly realized that wasn’t going to work, so I got a handicapped accessible room in a nearby motel. That worked much better. Corrine was very happy about that, especially the handicapped accessible shower.” Troyer said he helped Leistikow in the days following the surgery but that she bounced back fairly quickly. “I drove her places until she could drive on her own. Helped her carry things. Stuff like that,” he said. “I was there for moral support. She needed a little bit of that, but not much.” He added, “She knew what she was in for, though she had complications that made her recovery take quite a bit longer than planned. Still, she was pretty upbeat about it. She was really glad the surgeon knew his stuff.” Leistikow said getting her range of motion back took determination. “It’s like trying to force something that
doesn’t want to go and it hurts when you make it go more. So you have to be willing to make yourself be in pain. You know, no pain no gain. I’m pretty good at that, though.” Leistikow used a stationary bike at home as part of her physical therapy, and though under doctor’s orders to avoid falling was able to get outdoors to ski and fat bike by midwinter, provided she stuck to level surfaces. In March 2016, less than six months after her surgery, she participated in the annual 20K Sonot Kkaazoot cross-country ski race in Fairbanks. “It wasn’t my fastest time or anything, but I was able to do it no problem,” she said. Possessing a lot of personal drive helped her stick with her physical therapy. She said it took about a year to get back to nearly full capacity. “Before the surgery,” she said, “even squatting 90 degrees was hard, but I have really good range of motion for someone who’s had full knee replacement. They try to get 130, and I definitely have more like 165, 170. As
long as I can still pee and poop in the woods, I’m happy.” Looking back, Leistikow said the decision was the right one for her. In 2018 she took part in the Tour Divide, a bicycle race from Jasper, in Alberta, Canada, to Antelope Wells, New Mexico, and had no serious knee concerns. She can’t run, as this is not advised with knee replacements, but she hadn’t been a runner since her 20s. She was able to resume backpacking, something her knees had forced her to quit doing prior to her surgery. She no longer reaches for the ibuprofen and is able to continue her active lifestyle. “It’s allowing me to do the things I love for longer. I was getting to the point where even skiing a 10K I’d be sore and hobbling around the next day. I have a lot less stiffness, I have a lot less pain, and I am able to continue to do those activities that are super important to me. Which is getting outside and recreating.” David James is a freelance writer in Fairbanks. Comments about this story? Email editor@AlaskaPulse. com.
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A biking enthusiast, Dr. Corrine Leistikow has tackled some challenging trails since her double knee replacement. Eric Troyer photo
Study: Most total knee replacements are successful By David James
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ccording to the University of Washington’s Orthopaedics and Sports Medicine clinic, more than 90% of patients who undergo total knee replacements have successful results over a 10-year period. This is defined as the complete or substantial reduction of pain and the ability to walk without a limp or the need for a cane. Arthritis, which is a leading cause for those seeking replacements, does not generally heal on its own, although its severity can fluctuate significantly over time. Other injuries can also prompt individuals to consider treatment as well. But everyone thinking about getting one needs to make a fully informed decision. Corrine Leistikow, a family medicine physician in Fairbanks who has undergone a double-knee replacement, often sees patients who are looking for referrals. She said that when contemplating such an invasive procedure, a person needs to consider three factors. “It depends on quality of life versus pain 8
July 2020 — AlaskaPulse.com
versus timing,” she said. “It’s different for everybody.” Leistikow advises that people who are looking at possible knee replacements first consider other options. Weight loss can often make a big difference. Physical therapy can ease pain. She added, “A lot of people aren’t doing the stuff they need to do. You need to move. Even though you have arthritis and it hurts to move, the more you move the more you kind of, quote, ‘lubricate’ the joint and it does better. But it’s really hard to get people to move when it hurts.” She added that when choosing an orthopedic surgeon to perform the procedure, “You want to have it done by a doctor who does a lot of them. The more they do, the better they’re going to be at it.” She said a hundred a year is a good number to indicate the physician knows what they’re doing, but this isn’t an absolute. Leistikow cautioned that knee replacements are not a panacea. Some people don’t get good results, and some don’t get the range of motion they hoped for. She said that recovery is key.
It’s important to take off adequate time from work after surgery so that you have time and energy for rehab and to remain committed to the physical therapy regimen. She also said there is a growing belief among some in the medical community that too many total knee and hip replacement surgeries are being performed. As with any serious medical procedure, it never hurts to get a second opinion before committing to a course of action. And if getting a joint replacement proves to be the best option, recognize that the surgery itself is just the first step. Recovery and a return to one’s accustomed activity level is a process that requires the full participation of the patient. The University of Washington School of Medicine’s Orthopaedics and Sports Medicine clinic has an extensive patient’s guide to knee replacement and hip replacement. David James is a freelance writer in Fairbanks. Comments about this story? Email editor@AlaskaPulse. com.
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HEALTH SENSE
One small ask: Please wear a mask By Susan Morgan
T
o mask or not to mask? It’s a question on the minds of many Alaskans who want to stay healthy amid the COVID-19 global pandemic. While Alaska’s case numbers have remained low, the risk for infection is expected to continue until an effective vaccine or treatment is found. Most people recover from the illness. But for some, COVID-19 can be devastating or even deadly. So it makes sense to try to mitigate our risk as much as possible. That means doing all the things we’ve learned about in recent months: frequent hand-washing; keeping at least 6 feet from others whenever possible; disinfecting frequently touched surfaces; staying home when ill. Many health officials add wearing a cloth face covering or mask to that list. In early April of this year, the Centers for Disease Control and Prevention (CDC) issued a recommendation advising people to wear cloth face coverings while in public to help prevent the spread of COVID-19. Public opinion about the effectiveness of masks and whether people should wear them is divided — to put it mildly! Some say masks should be worn whenever you leave your home. Others say it’s pointless and we should never wear masks. Still others point out that it all depends on what kind of mask you’re wearing. What are the facts about masks? First, it depends on what kind of mask you’re talking about. There are basically three types: N95 masks (properly called respirators); surgical masks; and cloth face coverings. All are effective if used properly and in certain conditions. N95 respirators: These are the masks we’ve all heard from the beginning of
this pandemic that should be reserved for health care providers caring for sick patients. That’s still true. When fitted to the face and properly handled, they are highly effective at protecting the person wearing them from even tiny respiratory droplets. Surgical masks: These, like the N95 respirators, are generally made from special materials good at filtering out respiratory droplets but aren’t fitted to the wearer’s face like an N95. This means they aren’t as effective but still keep out the larger droplets. Most importantly, they help keep the wearer’s droplets from spreading to others. Cloth face coverings: Often handmade, these masks vary in quality and effectiveness, depending on materials used, thickness, etc., and aren’t generally considered adequate for medical personnel dealing with contagious or ill patients. Still, it’s believed they reduce the spread of COVID-19 from infected people by blocking large respiratory droplets before they can travel from the
wearer and infect others, especially in situations when social distancing is difficult. This makes them suitable for the general public and important, especially as we’ve learned that a large percentage of COVID-19 transmission comes from people who don’t know they’re sick – either being asymptomatic throughout the course of the disease or simply not yet showing symptoms while still contagious. Masks don’t protect the wearer so much as they protect others. Wearing one shows respect for others, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN. “You wear a mask, they wear a mask, you protect each other.” While not everyone can wear a mask or face covering comfortably for long periods of time because of medical or other conditions, many health care officials believe that, for most of us, wearing a cloth face covering when we’re in public could help cut down on the spread of COVID-19. And if it turns out we are asymptomatic carriers, it means we’re less likely to be unwittingly infecting our friends and loved ones, especially those at higher risk for complications from the disease. Please note, however, that cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing or who is unconscious, incapacitated, or otherwise unable to remove the mask without assistance. Cloth face coverings are easy to make, they can be fashionable, and they’re a sign that you care about not infecting others. Alaskans are famous for their ability to pull together and overcome any obstacle. In this case, wearing a little mask could go a long way. Susan Morgan is a public information officer for the Alaska Department of Health and Social Services.
AlaskaPulse.com — July 2020
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Rebecca Buckles, program director for Street Outreach and Advocacy Program, shows off her collection of food for homeless/ at risk youth.
Seeking solutions
Agencies work together to lessen strain of pandemic on Interior’s at-risk youth
By Diana Campbell
W
hen the free food samples disappeared at the Fairbanks Costco because of COVID-19, so did the jobs for at-risk young people. As did restaurant, fast food and other entry level work some teens depend upon to work their way out of homelessness and poverty. It didn’t go unnoticed at Fairbanks Native Association Youth and Young Adult Services. “In one month’s time, 68 youth lost their jobs,” said Rebecca Buckles, pro10
July 2020 — AlaskaPulse.com
gram director for Street Advocacy and Outreach Program, part of YYAS and who works with homeless youth in Fairbanks. “I see how the youth have tried so hard to build a better life and in one crisis, due to no fault of their own, all their hard work was taken from them. Many have been trying for months to stay off assistance but had to go back on.” COVID-19 has been a challenge for the teens for whom the six programs under FNA Youth and Young Adult Services provides mental health and other support. For SOAP, that means providing extra food boxes and emo-
tional support. Other staff are using the internet and phone calls to keep up with their clients, who range in age 0-25 years old, during the pandemic, said Caroline Ramos, YYAS program director. SOAP focuses on homeless teens and young adults, while other programs provide family support, suicide prevention, alcohol use/abuse prevention, methamphetamine addiction, and case management services. YYAS is a part of FNA’s Behavioral Health Services. “We are here. We love. We care,” Ramos said. “We’re just a phone call away. We don’t judge. Reach out to us.”
Above, Sean Williams, Visions project manager, speaks with students at Effie Kokrine Charter School. At left, a food box for YYAS kids.
Fairbanks youth face so many challenges, said Steve Ginnis, FNA executive director. FNA was formed in 1963 to help those young people and today FNA has grown to a huge organization with over 250 employees that provide mental health, educational and community support services. “We have a dedicated staff who care about youth,” Ginnis said. “I’m proud that FNA has grown enough over the years to reach our most vulnerable population, our youth.” Buckles, at SOAP, has been cooking meals for her “kiddos.” “The youth have gotten stronger because of the support of FNA’s SOAP and have made better choices,” Buckles said. “However, food insecurities have started to show.” She has seven teens living in tents, and is helping them and others to find ways to pay rent and navigate welfare applications. She provides mental health counseling, as well. SOAP sees to the immediate needs. Other YYAS programs offer sober and emotionally healthy activities for their young people. Gabrielle Johnson is using the internet and phone calls to reach out to her young consumers, knowing that COVID-19 has caused extra anxiety and depression. Johnson is the program coordinator for YYAS’s Methamphetamine Suicide Prevention Initiative. She has partnered with Linda Thai, a local health and wellness expert, to teach a Zoom series on boundaries, communication and relationships, an understanding that traumaimpacted teens need. Johnson also started a Storytime Hour for 2-10 year olds and their parents and caregivers via Zoom. She gave out cookie-making kits to go along with the activity. “We have Mason jars with all the dry ingredients needed for
From left, Caroline Ramos, FNA Youth and Young Adult Services director; Jackie Sunnyboy, with Family Wellness; and Amanda Fontana, infrastructure specialist with Synergy.
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AlaskaPulse.com — July 2020
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Caroline Ramos, FNA Youth and Young Adult Services director, leaves boxes of food and supplies for SOAP 12 July 2020 — AlaskaPulse.com youth.
the cookie recipe,” Johnson said. “Families will be able to pick up cookie jars, bake the cookies at home and enjoy them while listening to a short Alaskan story with a guest reader via Zoom.” Amanda Fontana is also using Zoom and Linda Thai to reach people. Fontana is the infrastructure specialist with YYAS’s Synergy, and she is part of a local 17-member group of local Interagency Transition Council that work with youth and young adults in the Fairbanks North Star Borough. Thai will teach a series on traumainformed care. The course goes over how childhood trauma affects the brain and adult health. She offers a rethinking of how to understand trauma. “’What’s wrong with you?’ becomes ‘What’s happened to you,’” Thai said. “’Why don’t you get it?’ becomes ‘Let’s figure out how you learn.’” The workshop is one way Fontana is keeping in touch with her peers. Working with other mental health care providers is necessary because it ensures Fairbanks youth are getting the same levels of care, no matter where they go, Fontana said. “We as a community can collaborate together as a team, and we’re all here for our youth and young adults,” she said. YYAS has two new programs. The Fairbanks Alaska Native Strategic Prevention Framework is meant to prevent the onset of alcohol use and reduce the progression of alcohol abuse among 9-20 year olds. The program is seeking a manager. The other new program is Family Wellness, managed by Jackie Sunnyboy. The program is a collaboration with Thrive Alaska and the Alaska Center for Children and Adults. The group will address the mental health issues parents face after coming out of substance abuse treatment or incarceration with their children. The program is currently discussing the framework and strategy of making the program work. FNA will work with parents or caregivers, while Thrive and ACCA will work with children ages 0-8. Many of the children aren’t with their parents, and have attachment issues. This provides a challenge to newly sober parents, who are also trying to maintain sobriety, look for work and housing. Yet learning to build
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Kentucky Fried Chicken donated food for YYAS youth.
a relationship with their children is important, because the trauma-impacted child is more likely grow up to abuse alcohol or drugs. They may end up continuing the cycle of behavior. “It’s very scary and a lot of hard work for parents,” Sunnyboy said. “It is my hope that we can provide that additional support and healthy sober activities. I want them to know they have someone to talk to and they are not alone.” Sean Williams wants his youth to know they are not alone, too. Williams is the project manager for YYAS Visions program, which is a suicide prevention program. He works with kids who are thinking about suicide. Usually he prefers to speak in person with the youth, but has had to use Zoom and telephone calls. It’s harder to read the body lan-
“The youth have gotten stronger because of the support of FNA’s SOAP and have made better choices. However, food insecurities have started to show.”
Rebecca Buckles, program director Street Advocacy and Outreach Program
guage of a teen using impersonal means, but he manages. “I’m up front with them,” Williams said. “I would ask them straight up if they are thinking of suicide. Kids who are going through a lot will say, ‘Yes, I am.’” He’ll help them find ways to cope with stress, get a counselor, or in some cases, take them to the emergency room. He’ll encourage them to remember their good relationships with friends, or even their pets.
Kids often aren’t willing to ask for help if they are hurting emotionally, and will put on a front that they are OK, he said. It’s can be tough to knock through that barrier and Williams has learned from his training the best way to deal with a suicidal child. “Flat out ask him or her if they are suicidal is the best,” he said. Diana Campbell is the director of communication for Fairbanks Native Association. She can be reached at dcampbell@fairbanksnative.org
AlaskaPulse.com — July 2020
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HEALTH SENSE
Play safe, play smart: UV safety By Katie Yearley
I
t feels so good to be in the swing of summer, what with the constant sunshine, greenery, and of course, mosquitoes. Many people are taking trips around Alaska while practicing social distancing to enjoy this beautiful weather and the many outdoor activities available. While I have thought a lot about safety precautions since moving here (bear spray, medical kits, emergency lighting), I still have one thing that I always forget before going out the door: sun protection. It is the height of summer, and protection from ultraviolet (UV) radiation should be on everyone’s radar. Bryanna Kerbuski, Army veteran, spends a great deal of time outdoors. In winter she plays hockey, goes snowshoeing, does tubing, and even camps in the snow. In summer, she hikes, plays tennis, gardens and bikes. She reckons she spends most of the weekend outdoors when she can. Despite some of the risks of UV, Kerbuski has mixed feelings about sun protection. She says, “I understand that sunscreen and UV are bad, but I really hate the feeling of sunscreen on my skin … When I go somewhere super sunny and warm, I tend to suck it up at least a little bit and put on more sunscreen.” To balance out her sun protection, Kerbuski wears a hat and long-sleeved clothes, but 14
July 2020 — AlaskaPulse.com
Eldridge if the longer hours in summer put Alaskans at higher risk for UV damage, she said we are actually at a lower risk because of the angle of the sun. She says the states closer to the equator have higher rates of melanoma and nonmelanoma than Alaska. Though things are safer here than in the Lower 48, Dr. Eldridge says the risk continues to get higher with the reduction of ozone and that long-term sun damage can easily happen with just a few sunburns. People in Alaska do a lot of recreation in the snow and on water, and she says the UV rays can be more Bryanna Kerbuski, right, and her partner Emily Kerbuski, damaging because left, at the summit of Flattop mountain in Anchorage. of it. I asked her what she admits she likes to have a bit of a tan. she recommends for current Alaska I also do not like the way sunscreen residents, and she said, “If you’re going feels, but I try to remember to put it on to wander out for more than 15 minutes, if I am outdoors longer than an hour. then you want to put on clothes … sunI grew up in Arizona, so I have always glasses and a wide-brimmed hat. If you been aware of the dangers of sunburn. are fair skinned, you may want to use at Now that I am in Alaska, I cannot help least SPF 15 for that kind of exposure.” but wonder how cautious I need to be. I sat down with Sandra Eldridge, clinical pharmacy specialist, to get some insight on the issue. When I asked Dr.
Katie Yearley is a public affairs specialist at the Anchorage office of VA Healthcare System in the Department of Veterans Affairs.
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HEALTH SENSE
The Youth Leaders of Prince of Wales gather on the rocks of the Southeast Alaska island.
Young leaders
Youths spark change, advocate against stigma surrounding addiction in Southeast Alaska By Dakota Eller, age 16, Alayna Parsley, age 15, Kyleigh McCoy, age 12 and Shianne Eller, age 11
W
e are the Youth Leaders of Prince of Wales, a group of people ages 12 to 17 who are part of a Youth Leadership Program run by the Prince of Wales Health Network in Southeast Alaska. We are a combined group from the nine communities across the length of the island and are empowered to be “change
agents” and help with the alcohol and substance misuse that ravages our island and destroys our families. We are an extremely active group that takes pride in our actions and activities in our communities, such as youth led and organized dinners, and community youth-led projects, including creating street signs, cleaning up communities, honoring elders with assistance, and volunteering time and aid for families in need and nonprofit organizations. We also hosted a 150-mile bike ride across the island to raise money for a
family in need who had lost their parent to cancer. But our focus is creating a safe future and environment with bringing awareness to the problematic issue of drug and alcohol misuse that surrounds us. We have dedicated a large quantity of time, effort, and funding into events and activities that we feel have made an impact on the island. We have helped organize marches against opioid addictions, attended conferences, and assisted in dinner and events that promoted recovery from AlaskaPulse.com — July 2020
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The group hosted a 150-mile bike ride to raise money for a family in need.
addictions. We have created space for people in long-term recovery to tell their stories, promoted awareness as peers in the schools, and acted as mentors.
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laska Pulse is a monthly magazine focusing on health in the Far North and distributed around Fairbanks and Anchorage. We’ll share stories from around the state about how people stay healthy. Learn from experts in different medical fields on ways to improve, or maybe just maintain your health. We’ll hear personal stories about people’s triumphs over different health adversities. Alaska Pulse is a community publication, so every issue is sure to hold a variety of different perspectives.
Contact editor Rod Boyce at editor@AlaskaPulse.com or 907-459-7585 to talk about it. Alaska Pulse is a publication of the Fairbanks Daily News-Miner. 200 North Cushman Street • Fairbanks AK, 99701
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Our group was organized to give us a voice and the recognition that we aren’t prepared to stand on the sidelines and watch as our homes and futures are dictated by drugs and our families are destroyed. We are young, but we are fierce. We feel we can help, and have helped, to bring awareness to the upcoming generation that we have an issue that shouldn’t be hidden and that there is no shame but only support for those who have had addictions and are wanting to stop. There is more support and are more resources than one knows in our communities, through your neighbors and with your friends and families. We demonstrated that in our Recovery Festival. It was an event that we devised as a group that would incorporate an inclusive family atmosphere and interests that we felt would allow entire families to attend. We released memorial lanterns at the end as a powerful message for those lost to addiction. Our next large event that we are planning is a three-day island recovery and awareness walk that we hope to have drug and alcohol-related statistics marked along the roadside, aid stations, and open for people to walk and join in showing their support. We continue on our journey to bring focus and awareness to the island’s devastation while bringing a hopeful vision of what we know our communities can be by giving our youth and others a voice and recognition to overcome and assist. We feel like we make a difference. We feel we have a voice. We feel empowered to move forward. We stand as role models for others. We stand as “change agents” for the future of our island, communities and families. We are prepared to act as advocates and help teach the younger generations how to do the same.
HEALTH SENSE
Exercise during pregnancy is beneficial By Dr. Brück Clift
Exercise is a major modifiable risk factor that has one of the greatest effects on our health and longevity. Aerobic exercise and strength training both play roles in overall fitness. There is no upper limit to the duration of daily aerobic exercise that positively affects cardiovascular fitness. Men who can do a minimum of 40 push-ups exhibit a significantly decreased risk of heart attack. Resistance training has been found to decrease risk of developing osteoporosis, it is the method of choice to prevent bone loss in astronauts. Aerobic and resistance training decreases dementia risk and progression in old age and reduces depression and anxiety. Sedentary lifestyle is associated with obesity, metabolic syndrome, type 2 diabetes, chronic inflammation, cardiovascular disease and many cancers. During pregnancy, however, the benefits of exercise have not always been emphasized. In addition to the benefits noted for non-pregnant adults, exercise in pregnancy decreases risk of excessive weight gain (and subsequent postpartum weight retention) and may reduce the risk of gestational hypertension, gestational diabetes, preeclampsia, largefor-gestational age newborn, pelvic pain, and associated urinary incontinence. There are pre-existing conditions that require reduced or limited exercise in pregnancy and if you have reason to believe your pregnancy may be of above average risk, you should definitely consult your doctor, but in general women
with uncomplicated pregnancies and no pre-existing reason to preclude participation are encouraged to perform both strengthening and aerobic exercises. The same minimum standard of 30 minutes of aerobic exercise most days of the week is recommended in pregnancy as in the pre-conception and post-partum period (also recommended to men!). The anatomy and physiology of the body changes in pregnancy, so modifications to your normal routine may need to occur. Reasons to stop exercising and contact a health care provider may include amniotic fluid leakage, abdominal pain, fainting or dizziness/lightheadedness, difficulty breathing prior to exercise, vaginal bleeding, headache, calf pain or swelling, chest pain, and fatigue or muscle weakness. Exercise should be discontinued if regular painful contractions are occurring (especially if preterm) until evaluation by a health care provider. Pregnancy increases risk for thromboembolic events due to it being a hypercoagulative state. Being sedentary further increases this
risk. Bed rest is not routinely recommended for pregnant women with intact membranes. However, women with known increased risk for miscarriage or preterm labor may be asked to reduce their physical activity by their health care provider. Movement during active labor is likely beneficial, though may be limited due to use of epidural anesthesia. Being upright during labor may shorten duration and may reduce risk for cesarean. Being more cardiovascularly fit, with fewer health problems before and during pregnancy generally foreshadows a smoother labor and delivery. This should be no surprise. Yoga, stretch and incorporation of Kegel exercises can be beneficial before and after delivery in reducing long-term effects of pregnancy and vaginal delivery on the pelvic floor (prolapse and incontinence). Women who undergo cesarean are less likely to have postoperative postpartum complications if they started with normal prepartum weight and didn’t gain excessively or develop metabolic or cardiovascular disorders. Morbid obesity alone makes a cesarean more high risk. “Even when all is known, the care of a man is not yet complete, because eating alone will not keep a man well; he must also take exercise. For food and exercise, while possessing opposite qualities, yet work together to produce health.” — Hippocrates Dr. Brück Clift is a family medicine doctor whose practice is in Palmer.
Statistics on some of our newest Alaskans • In 2018, Alaska resident mothers gave birth to 10,092 babies. • August had the largest number of births by month (934). • The most popular girl’s name was Olivia. • The most popular boy’s name was Oliver. • The mean age of mothers was 28.6 years old,
• The mean age of fathers was 31.3 years. • Teenage mothers (aged 15-19) gave birth to 422 babies. • The youngest mother was 14 years old, while the oldest was 49. • The youngest father was 15 years old, while the oldest was 71. — DHSS 2018 Vital Statistics annual report AlaskaPulse.com — July 2020
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Lifelong caregiver
Chugiak school nurse Catherine ‘Cat’ Haese honored with 2020 Award of Excellence By Aliza Sherman
R
eceiving the Alaska School Nurse Association’s 2020 School Nurse Excellence Award and handling the emergency response to a historic natural disaster are only two of Catherine “Cat” Haese’s 18
July 2020 — AlaskaPulse.com
career accomplishments. The Alaska earthquake of 2018 put her skills to the test. The school nurse at Gruening Middle School in Eagle River at the time, Haese was working with a student when the building began to shake. “I put them under my desk and we
rode the earthquake out together. There was a lot of glass shattering, things falling over, a bunch of ceiling tiles were coming apart,” Haese recalls. She and her colleagues at the school were able to evacuate the building pretty quickly, making sure that all of the kids were safe outside. They took roll call to
“I’m very thankful that we didn’t have any major injuries and that I have such great staff to work with who really take charge. They know their kids, they knew who were feeling unsettled and provided some extra support, so I really rely on my staff to relay that kind of stuff to me.” – Catherine “Cat” Haese
Left, Catherine “Cat” Haese participates in a local radio show promoting school nurses in the community. Above, family photo with husband Fred and sons Hudson and Carson. Photos courtesy of Catherine Haese
make sure every student was present. As parents began showing up to take their kids home, they devised a system, without computers, to document each child and who picked them up to make sure they were leaving with the right person. “A lot of what I did was calming kids down — I had a lot of kids who were very shaken — and checking in on my medically fragile kids to make sure they were doing OK. We were outside in the cold, so we were getting people emergency blankets and water until they were able to get picked up by their parent or guardian.” Parents working on military bases were unable to leave, and parents from Anchorage were unable to easily get through to Eagle River, so school staff
watched over a number of kids for at least another four hours. “It was definitely memorable,” she says. “I’m very thankful that we didn’t have any major injuries and that I have such great staff to work with who really take charge. They know their kids, they knew who were feeling unsettled and provided some extra support, so I really rely on my staff to relay that kind of stuff to me.” Being prepared for a disaster was part of Haese’s training as a school nurse as well as being the designated disaster safety team leader. Haese explains that each school has an emergency preparedness team with a team leader, usually the nurse, to review and implement Anchorage School District protocols
during emergency situations, such as an earthquake. Preparedness includes obtaining the proper equipment, filling emergency backpacks with essential supplies, making sure there are ways to communicate during an emergency, playing out scenarios, even thinking through how to best care for medically fragile students with special needs such as a blind student or one in a wheelchair. Navigating the aftermath of an earthquake wasn’t Haese’s only encounter with a potentially life-threatening situation. Earlier in her nursing career, she administered a life-saving epinephrine injection to a student experiencing anaphylaxis shock to an unknown allergen. “I was able to give that student an epi AlaskaPulse.com — July 2020
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Left, Catherine Haese at registration for the Alaska School Nurse Conference with Kathy Easley. Above, Haese at her graduation from the University of Alaska Anchorage in 2008.
pen and get an ambulance there for that student to take that student to be evaluated,” recounts Haese, adding, “I’m very grateful for the Anchorage School District for having standing orders for us to have epi pens if someone needs them in a time crisis. It was definitely much needed. It can happen very quickly, and it’s very dangerous. I was lucky I was there, and I’d been trained and knew what to do and we were able to save that child’s life. The child and mom are super grateful.” As a school nurse, Haese is especially attentive to students who are unable to advocate for themselves. An example of this is her dedication to students in transition, according to Megan Hatswell, principal at Chugiak High School, pointing out that Haese would make sure a homeless child had the eyeglasses they needed as well as food, a safe place to sleep, and would even bring them clothes out of her own closet for them. “I couldn’t think of a nurse more deserving of the award,” Hatswell adds. Haese is more modest about her caring and generous acts. “Most school nurses are the Child in Transition site coordinators, and that’s for children who maybe are homeless, maybe living in their car, maybe liv20
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ing in motel, their home situation has changed, and they need some kind of assistance to go to their home school,” she says. “It’s kind of like a point of contact person for the school to create some stability for that child. And that’s a pretty common thing for school nurses.”
‘A caregiver my whole life’
Haese grew up in Minnesota and moved to Alaska in 1999. She graduated from Chugiak High School in 2003 then went on to the University of Alaska Anchorage where she received a bachelor of science in nursing. Out of college, she worked as a children’s psychiatric nurse for a few years at Northstar Behavioral Health before working for the state of Alaska. In 2012 she started with the Anchorage School District. Nursing is something Haese says she wanted to pursue from a young age. Says Haese, “I have been a caregiver my whole life, it’s just kind of a natural thing. I knew all through high school that I wanted to be a nurse. Being a nurse is one of those things when you say, ‘Oh, I want to be a nurse when I grow up’ everyone says ‘Oh, that’s so
great and you’ll be so good.’ You get a lot of positive feedback. I always knew that was what I wanted to do. Finding the right fit for me, such as school nursing — I definitely think I’m where I’m supposed to be.” Immediately after the 2018 earthquake, Gruening Middle School students and staff moved into Chugiak High School because the middle school’s building was unsafe. Haese and her colleagues made the transition into the new building, merging with the high school staff and sharing facilities. She partnered with the Chugiak nurse to jointly provide nursing support to both the middle school and high school students. When the high school nurse retired in 2019, Haese became the nurse for both schools, taking care of two staffs, principals and over 1,500 students with the help of a licensed practical nurse. Eventually Gruening Middle School hired its own registered nurse for the 2020/2021 fall semester; however, the two RNs will function as one office, able to take care of any student. Haese’s new title is now Chugiak High School school nurse. In addition to her nursing job, Haese is also the National Board Certification School Nurse Liaison for the state of
Alaska, helping school nurses who are working toward their nursing tests. She belongs to several of her profession’s membership organizations including the National Association of School Nurses and the Alaska School Nurses Association and serves on a number of committees including conferences for school nurses in Anchorage and around the state. In the past, she sat on the School Nurse of Excellence board helping choose awardees and was the vice president of the Alaska School Nurses Association before moving into the role of liaison.
Dangers of vaping
Haese also works on initiatives to increase awareness of the dangers of vaping. “Now that I work at a high school, it is a concern with kids — even middle school kids — exposure to vaping. They can be pretty slick with it. The devices
are very small, odorless, it’s pretty easy for kids to be sneaky … (We’re) trying to teach kids about the dangers of vaping.” Haese has invited Alaska Tobacco Prevention to come into the schools and talk to classes. They’re younger and can really talk to that peer group, she explains, which can be more effective than a lecture from a teacher. One of the things Haese says she finds most meaningful about her job is conducting suicide risk assessments and self-harm risk assessments. She works as part of a team with the school administrator, school psychiatrist and school counselors to support the students and form relationships with them to help them in times of crisis. “It’s very rewarding to me because it helps when you know that kid and you can talk to them, you know a little bit about their home life or who their friends are, or what is triggering these feelings and these thoughts. Being able
to give you’re your time and full attention…is super important.” Hatswell, Chugiak High School’s principal, gives Haese high marks. “Cat does a really great job with high stress, anxiety or emotionally disturbed students, suicide populations,” she says. ” She has a knack for reaching out to kids when they need it most and they trust her. She takes care of them in a way that a lot of students don’t see.” While Haese loves her job and her work, she says her “lofty, big time goal for the next 10 years” is to get her master’s degree as a psychiatric mental health nurse practitioner. With two young children of her own, finding the right time to go back to school is challenging. Knowing Haese and her vision, mission and accomplishments, she’ll meet her goal and then some. Aliza Sherman is a freelance writer in Anchorage. Comments about this story? Email editor@AlaskaPulse. com.
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AlaskaPulse.com — July 2020
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HEALTH SENSE
Why effective mental health treatment is needed now, more than ever By Dr. Lee Ann Gee
TMS Center of Alaska
T
he ramifications of the coronavirus pandemic extend far beyond the familial, financial, and social effects on people’s lives. The crisis is significantly impacting the mental health of people locally and globally.
Your mental health needs have never been more important.
Mental health is an “emerging potential crisis” during the coronavirus pandemic, according to Dr. Karestan Koenen, a professor of psychiatric epidemiology at the Harvard T.H. Chan School of Public Health. Many people are dealing with severe mental health issues that can cause a wide range of emotional and physical problems. Trouble eating and/or sleeping, headaches, and other health issues have emerged as people cope with the stress of COVID-19 and its aftermath. To try to forget about these issues, people may use alcohol and/or drugs, but doing so won’t resolve their mental health issues and may actually make them worse. Alternatively, some people may try to ignore their mental health issues and the associated symptoms — despite the fact that doing so can be damaging to themselves and others. An inability or unwillingness to identify, accept, and manage mental health issues can cause severe isolation, particularly since people are strongly encouraged to socially distance themselves from others to help slow the spread of the coronavirus. Combined with health and financial concerns, the stress caused by trying to stay a minimum of 6 feet away from others while shopping for groceries, walking, or doing any other activities can be overwhelming. If people are 22
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coping with too much stress, they may choose to isolate themselves from others altogether. When this happens, loneliness, helplessness, and other symptoms of depression may become too much to handle, especially if people feel like no help is available.
I need mental health help: What should I do?
Mental health treatment is crucial. When people undergo a medical evaluation for their mental health issues, they can get the help they need to manage the associated symptoms both now and in the future. At the first sign of mental health issues, explore medical treatment. Doctors are available, and many of them are offering telemedicine appointments. These appointments enable patients to discuss their mental health issues with a doctor via video chat, and all information shared over video chat is secure and confidential. In addition to telemedicine appointments, immediate medical help is available to those who are struggling. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255, and they have counselors available over the phone 24 hours a day, seven days a week. Lifeline counselors understand the importance of mental well-being, and they can help people manage men-
tal health challenges. For those who experience thoughts of self-harm and/ or harming others, call 911 for urgent medical care.
I’m struggling with my mental health and need someone to talk to: What should I do?
Everyone has mental health needs. Having someone to talk to about them can truly help. Setting up regular video chats with friends and loved ones during the pandemic and afterward can be beneficial. These chats allow people to see family members and friends and share their thoughts and feelings. They can also help people feel supported at a time when they may need additional support. The pandemic has separated many people from their offices, normal social functions and day-to-day activities, too. Casual conversations at the water cooler, meeting for coffee, lunches or dinners may have seemed minor before the crisis. Now, some of these activities may not be possible in the same way as before and that sense of loss may create a sense of distance along with sadness, loneliness and other depression symptoms. In the event that people believe loved ones or co-workers are coping with mental health issues, it is important to address these problems directly. Mental health issues can linger, and the longer they persist, the worse they may become. However just by checking in, you can help loved ones, friends, neighbors and co-worker find safe, effective ways to manage mental health issues.
I want to help others address their mental health needs: What should I do? The first step to help others address
their mental health needs involves a discussion. Share how you feel with your loved one, friend or co-worker and explain why you are concerned about their mental health. You can also explain that this situation is putting a strain on everyone right now and that mental health treatment options are available. If possible, offer to help your loved one find a mental health care provider, and set up a doctor’s appointment for them if they are too overwhelmed to do so independently. This allows you to show that you care about their health and want to do whatever you can to help them get through this challenging period. You need to accept that someone who is dealing with mental health issues may refuse your assistance as well. In this instance, you can offer to stay available and ready to chat at any time. Even if your loved one does not reach out to talk, it’s important that they know you’re there to provide support if they need it. It can also be helpful to provide resources to help someone you know
manage their mental health issues. You can provide information about resources such as the National Suicide Prevention Lifeline and explain that many doctors are offering telemedicine appointments during this time. Should your loved one’s mental health issues lead to recurring thoughts of death and/or suicide, it is critical to call 911. To treat mental health issues caused by the pandemic, one or more therapy options may be considered. Antidepressant medication and/or psychotherapy may be used to help people manage their mental health issues. There are also alternative therapy options, including transcranial magnetic stimulation (TMS) therapy.
Is TMS an effective treatment for mental health issues during the coronavirus pandemic?
TMS involves the use of magnetic pulses, which stimulate underactive regions of the brain to help reduce or eliminate depression symptoms. The therapy is noninvasive, and it does not require medication, electrical shocks, or
anesthesia. TMS may also be used in combination with or in lieu of medication, psychotherapy, and other depression treatment options. TMS Center of Alaska is the leading provider of TMS therapy in Alaska. We understand that effective mental health treatment is needed now more than ever, and our providers are here to assist patients and their families dealing with the symptoms of depression and anxiety. As part of our efforts, we are offering HIPAA-compliant telemedicine appointments for those seeking consultations, evaluations, and follow-ups. We are also providing daily treatment that follows all CDC guidelines. Since insurance companies may experience delays associated with the pandemic, we encourage you to begin the insurance approval process immediately. To learn more about TMS therapy, please contact us online, or call us today at 877-257-3193. Dr. Lee Ann Gee is a licensed and board certified general practice psychiatrist based at Achieve Medical/ TMS Center of Alaska in Anchorage. She also practices in Fairbanks. For more information please visit info@ tmscenterofalaska.com or call 833-872-5867.
AlaskaPulse.com — July 2020
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TVC 1st Care Respiratory Center
TVC 1st Care Downtown
The downtown 1st Care building is now the Respiratory Center, dedicated to caring for patients that have concerning symptoms for COVID-19.
In our ongoing efforts to keep you and our staff safe, 1st Care urgent care center is now located on the first floor of the main TVC building.
“At Tanana Valley Clinic, we believe that protecting you is part of caring for you. It’s time to get the care you and your family need, and we are here for you.” -Dr. Pete Dillon, Medical Director, TVC 1st Care
8am - 8pm, 7 days/week for all your urgent health care needs 24
1001 Noble Street
July 2020 — AlaskaPulse.com
907-459-3500
www.foundationhealth.org