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HORIZONS spring

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summer 2013

BACK TO SCHOOL

CHILDREN’S HEALTH FAIR P. 18

LOW B O N DENSITE Y

New Tes BeforetYCan Detect ou Break

P. 42

tV’s NCIS star

MARK

HARMON

Raises Money for Pediatric Clinic P. 8 Oklahoma City Indian Clinic

www.okcic.com

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HORIZONS

Summer/Spring 2013


U N I T E D W E T H RI V E

THE CHICKASAW NATION

B I L L A N OAT U B BY, G OVE R N O R

WWW. C H I C KA SAW. N ET

Oklahoma City Indian Clinic

www.okcic.com

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Oklahoma City

INDIAN

EXECUTIVE OFFICERS Robyn Sunday-Allen Chief executive Officer / president

CLINIC www.okcic.com

Mission Statement

Mission: Providing excellent health care to american Indians

David Toahty Chief Development Officer

Vision: to be the national model for american indian health care core Values: patients first, Quality, integrity, professionalism, and indian identity

lysa Ross Chief Operating Officer

Accredited by the

Chris van ess Chief finance Officer

ACCREDITATION ASSOCIATION for AMBULATORY HEALTH CARE

Board Of Directors front row: Cherokee ballard, Carolyn Maxwell, Mary Ann brittan, Meredith Rivas brockman, everett R. Rhoades back row: John Daugherty, Jr., brian gabbard, Christopher Anoatubby, David Thomas, William K. “bill” veazey, Sr., heather Shotton, David Wilson (not pictured Sean ludlow and Alvin Deer) 4

HORIZONS

Summer/Spring 2013


from the ceo

As you will read in these pages, Oklahoma City Indian Clinic (OKCIC) continues to work diligently to meet and exceed the health care needs of American Indians and to provide excellent health care. We are thrilled whenever we are able to expand services to better meet the needs of our consumers whether that is by introducing DEXA bone imaging services for our beautifully aging population, the Eagle’s Nest program for our youngest patients, or community events like the Walk for Wellness. With this in mind, it is my pleasure to announce our newest endeavor, expanding pharmacy services with Oklahoma City Indian Clinic’s CARES Capital Campaign– Healing Nations, Saving Lives. OKCIC’s CARES Capital Campaign is a $2 million project that will fund the construction of a new 7,000 squarefoot pharmacy. This new pharmacy will provide space for the clinic staff to hold educational seminars, confidential consultations, and most importantly, create the capacity to fill more than 400,000 prescriptions annually (double the pharmacy’s current capacity). Constructed directly west of the Corrine Halfmoon Medical Building, the new pharmacy will also include drive-through operations that will provide potentially lifesaving medicine and information conveniently to our patients. Funding to complete this campaign will come from community members like you.

There are multiple ways to support the CARES Capital Campaign. The Red Feather Gala offers high impact donors the opportunity to give generously at a black tie experience like no other. Attendees from across Oklahoma will enjoy an evening of dinner, live and silent auctions, dancing, participating in a cultural dance, and watching live painting by internationally known Native American artists. High impact donors will also have the chance to have their names permanently listed at the new pharmacy through the purchase of engraved bricks. For those unable to attend the Red Feather Gala but wish to assist in building the new pharmacy, there is an opportunity to lend your support as well. Consider having your name temporarily listed through our Brick by Brick campaign for a small $10 donation. On behalf of Oklahoma City Indian Clinic, I would like to say thank you to all patients and supporters. We are thankful for all contributions, large and small. It is your trust and continued patronage that enables us to strive for excellence each day. Health and blessing always,

R obyn Sunday-Allen Robyn Sunday-Allen Chief Executive Officer / President

Oklahoma City Indian Clinic

www.okcic.com

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HORIZONS is a free publication by:

501(c)(3) non-profit corporation • Equal Opportunity Employer

4913 West Reno Avenue Oklahoma City, OK 73127

CALL: (405)948-4900

Oklahoma City Indian Clinic SERVICES

facebook.com/dreamcatchermag dreamcatchermag.net issuu.com/dreamcatchermag

Comprehensive Medical Services Health Promotion Disease Prevention Diabetes Care and Prevention Harmon-y Pediatric Clinic Behavioral Health Public Health Pharmacy Dental Optometry Laboratory Radiology Wellness Center WIC

Horizons Staff: Publisher: David Toahty, Chief Development Officer Editor in Chief: Andrew Davis, Director of Marketing Contributing Writers: Hazel Lonewolf, Dewayne Tiger, Valene Bartmess, Carol Arnold, Belinda Rogers, Summer Welcher-Duke, Sarah Brown, Monica McKee, Nikki Moore, Timothy Kinnard, Rebecca Bundy, Michelle Dennison-Farris, Kayla Meeks, Christin Crosswhite, and Cynthia Caudillo OKCIC Community Development Office: 5208 W. Reno, Suite 310 Oklahoma City, Oklahoma 73127 Models photographed in HORIZONS are used for illustrative purposes only. Oklahoma City Indian Clinic does not suggest that models actually engage in the conduct discussed in stories they illustrate. Publisher, editor, and their associates are not responsible for errors and/or omissions.

GREAT AFFORDABLE AD RATES and WIDE DISTRIBUTION! For more information call David Toahty (405)948-4900 ext. 483 or david.t@okcic.com $100 per business card $250 per quarter page $500 per half page $1000 per full page

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Horizons Summer/Spring 2013


in this HORIZONS

spring| summer 2013

Cover Stories

12

WALK fOR WELLNESS

8

MARK HARMON raises Money for peDiatrics clinic

18 bacK to scHool CHILDREN'S HEALTH FAIR 42 HoW DExA SCANS Help pREVENT BROKEN BONES

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SpRIng AnD SuMMeR TuRTLE CAMpS

Dental DepartMent fiGHts EARLY CHILDHOOD CAVITIES

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vISIT OuR WebSITe:

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Mark Harmon and cbs sunday Morning visit oKcic

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Visit from ceo of australian indigenous Doctors association

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iHs awards oKcic staff

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online patient satisfaction surveys

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oKcic serves as tornado relief site

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blue cross blue shield awards oKcic $55K Grant

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surviving cancer: alma’s story

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pharmacy technician Dustin ivy Deploys to afghanistan

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friends and coworkers reflect on nikki Kirkendoll

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oKcic and seminole nation Host soccer clinic

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Kids in the Kitchen

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new program brings education and services to expectant and new Mothers

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conquering the baby blues

28

avoiding Disease by Vaccination

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improving Dental care access for american indians

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teaching Healthy relationship practices to youth

34

the Many benefits of Gardening

36

running breathing tips

38

avoiding or stopping unhealthy eating Habits

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What is reliable Heath advice

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new cooking class for star participants

41

the importance of checking your blood sugar

www.okcic.com Oklahoma City Indian Clinic

www.okcic.com

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OKCIC Receives Special Visitors Mark Harmon & CBS Sunday Morning CBS Sunday Morning recently profiled arguably television’s biggest star, Mark Harmon. Along with showing his work on hit TV show NCIS, Sunday Morning wanted to include something important from Harmon’s personal life. Harmon chose to highlight his work with Oklahoma City Indian Clinic's Harmon-y Pediatric Clinic

making lead by Albert Gray Eagle. Harmon enjoyed seeing the people he has helped and the walls he has helped raise. “You like the solid walls?” Smith asked.

For the past 13 years, Harmon and a small group of friends have come to Oklahoma to hold the Mark Harmon Celebrity Weekend. Money raised from the weekend’s events supports Oklahoma non-profits whose values reflect enriching the lives of children, scholastic leadership, academic excellence, and mentoring. Over the past several years, funds raised by Harmon and his friends have helped Oklahoma City Indian Clinic expand its pediatric facility, which now serves over 3,500 children annually. “If we can lend three days of our time and impact this place, like, you know, obviously we have,” said Harmon.

“Yeah, I like that it’s there. I like that it’ll remain there,” Harmon said, when referring to Harmon-y.

Tracy Smith, Sunday Morning correspondent, and crew accompanied Harmon to Oklahoma City to interview Harmon and film the clinic’s facilities. In honor of Harmon’s visit, a special Saturday TURTLE camp held. Thirty children participated in gardening, stick ball, and flute

The segment aired ahead of the fundraising weekend, drawing attention and money to the cause. In addition to raising money, Harmon’s visits bring OKCIC national exposure and recognition for the type of work it does and the people OKCIC serves.

Mark Harmon visiting with TURTLE Campers at Oklahoma City Indian Clinic.

Romlie Mokak

chief executive officer of australian indigenous Doctors association Australia's Romlie Mokak visited indigenous organizations across the United States, Canada and Norway. As he traveled, he investigated the organizations' governance and resource arrangements and compared them to findings from Aboriginal and Torres Strait Island organizations to make recommendations relevant to Australian Indigenous Doctors Association's future. He found Indigenous institutions are central to Indeginous identity, policy and development. 8

HORIZONS

Summer/Spring 2013


Indian Health Service awards oKcic staff by: andrew Davis

Deborah Doray, Wendy Gaines, Board of Directors Chairman Dr. Everett Rhoades, Chief Executive Officer Robyn Sunday-Allen, Bryan Fehr, and Monica McKee

Oklahoma City Indian Clinic (OKCIC) had several honored at the 10th Annual Oklahoma City Area Director’s Indian Health Service, Tribal, Urban Awards Ceremony. Wendy Gaines, Monica McKee, Deborah Doray, and Bryan Fehr were recognized for their service and effort to improve the health and well-being of American Indian and Alaska Native patients and communities. Wendy Gaines, a Patient Relations Representative, received a Peer Recognition Award. Wendy works at the OKCIC medical clinic front desk, where she registers patients for services and checks them in for their appointments. Wendy volunteered her help with Optometry registration, eyeglass selection, and ordering during a recent staffing shortage. Wendy has a great attitude and works well with patients and coworkers. Dental Hygienist Monica McKee received a Merit Award. Monica works in the OKCIC dental department, where she helps with dental policy updates, writes dental health articles for HORIZONS, and volunteers at clinic events. Monica improved sterilization procedures in the dental department and shared the process with the OKCIC Infection Control Committee, thereby helping to improve the sterilization process clinic-wide. She does whatever is necessary to keep the dental department running efficiently

and offers her help to others whenever possible. The Area Director’s Area Impact Award was awarded to Deborah Doray. Deborah has worked as an OKCIC Physician Assistant for thirteen years, providing excellent patient care services. Recently, she helped create the wound care program, a model clinic program that is receiving positive attention nationwide. Bryan Fehr received an Area Director’s Excellence in Customer Service Award. Bryan works in the OKCIC wellness center, where he creates personalized exercise programs for patients and staff of OKCIC. In addition, Bryan greets visitors to the wellness center and helps visitors with safe operation of the equipment. Whether working through a personal training session, teaching children rock-climbing, or setting up for an OKCIC event, Bryan always has a smile. Oklahoma City Area Indian Health Service Director, RADM Kevin D. Meeks, RS, MPH, was pleased to recognize all the recipients of awards. “Today we acknowledge the distinguished service and tireless efforts of our colleagues to improve the health and well-being of American Indian and Alaska Native patients and communities.” Meeks continues, “I am grateful for the opportunity to work alongside such dedicated individuals.” Oklahoma City Indian Clinic

www.okcic.com

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teleVision proDucer & star

Mark Harmon raises Money for oklahoma city indian clinic pediatrics by: andrew Davis

KWTV Reporter Adrianna Iwasinski, Television Producer and Star Mark Harmon, Chief Executive Officer Robyn Sunday-Allen, and Chief Development Officer David Toahty

Mark Harmon, star and executive producer of hit CBS TV series NCIS, and a team of famous friends did not allow severe whether to shortened their stay or lessen their impact during the 13th Annual Mark Harmon Celebrity Weekend charity event. 10

HORIZONS

Summer/Spring 2013

Festivities started with host-sponsored bowling teams matching up at the Citizen Potawatomi Nation Firelake Bowling Center in Shawnee. While teams bowled, celebrities mingled with the crowd and signed autographs. Two bowling sessions were followed by live and silent auctions, featuring many Hollywood related items, including Harmon’s annual donation of an exclusive walk-on part on NCIS, which includes travel expenses to Hollywood.


A celebrity baseball game was planned for the following day, with Harmon joined by his college roommate and agent Barry Axelrod, movie producer Frank Marshall, former Major League Baseball (MLB) player and coach Mickey Hatcher, and former MLB pitcher Rick Sutcliffe. Rounding out the team were Rob Hertel, Steve Klosterman, Jim Ryan, Rusty Van Dam, Mark Heydorff, Peter Dubrawski, Steve Klausen, Deacon Nauslar, Don Manning, and Scott Wedman. Unfortunately the game at Chickasaw Bricktown Ballpark was cancelled because eight inches of rain fell the night before. Instead the celebrities signed Hollywood and baseball memorabilia for the more than 300 gathered, in a fan appreciation autograph session. Funds from the 13th Annual Mark Harmon Celebrity Weekend bowling tournament, auction and celebrity baseball fan appreciation went to the OKCIC Harmon-y Pediatric Clinic. The pediatric clinic was named after Harmon in recognition of his support over several years. This state-of-the-art pediatric facility specializes in treating health issues particular to American Indian youth. The funds will allow the pediatric clinic to serve more children and provide preventative services, including behavioral health screenings which pinpoint issues like depression and domestic abuse. These issues can lead to suicide, the second leading cause of death for Native American youth.

Chief Development Officer David Toahty believes the clinic and its patients have been truly blessed with Harmon’s continued support. “This is the fifth consecutive year Oklahoma City Indian Clinic has benefited from Mark Harmon and his celebrity baseball team, 'The Bombers,” says Toahty. “His involvement has helped us continually expand the Harmon-y Pediatric Clinic. We now offer services to 4,000 children annually.” Oklahoma Sports Science and Orthopedics (OSSO) spine surgeon Michael Wright invites Harmon and the team to participate in the weekend of fun each year. Wright says “we’ve enjoyed having this event as much as Mark and his friends have enjoyed participating and hope to continue for many years to come.”

OKCIC would like to give special thanks to Oklahoma Sports Science and Orthopedics surgeon and Oklahoma Kidz Charities founder Michael Wright, the Chickasaw Nation, Absentee Shawnee Tribe, and Home Run Event Sponsor, the Choctaw Nation of Oklahoma. Oklahoma City Indian Clinic

www.okcic.com

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online SuRVEYS

patient Satisfaction

by: Hazel lonewolf, MpH

The mission of Oklahoma City Indian Clinic (OKCIC) is to provide excellent health care to American Indians. One of the tools OKCIC uses to gauge whether it is fulfilling its mission is patient satisfaction surveys. Prior to 2013, paper patient satisfaction surveys were distributed twice a year, in April and October, through Patient Registration. However, since improving the quality of healthcare is an ongoing process, the patient satisfaction surveys are now online and given to all patients with appointments via e-mail, after their appointment.

In order to receive a patient satisfaction survey, patients must have the following: 1.

An up-to-date email address

2. Given the Clinic permission to use the e-mail address for health information Surveys for the previous week’s appointments are typically sent out on Mondays. Survey responses are monitored and compiled on a monthly basis for the Quality Improvement (QI) Committee to review. Any specific comments or concerns that relate to safety or infection control are forwarded to specific committees to address. If patients would like to be contacted regarding their survey comments, they can include their chart number and someone will contact them regarding their concerns. For patients without access to the internet or e-mail, survey cards are placed throughout clinic departments with the same questions as the online survey. All survey comments are reviewed. Positive comments related to specific staff members are recognized at the quarterly all-staff meeting. Negative comments are also addressed accordingly. If you receive an OKCIC patient satisfaction survey, please take the time to complete it.

♦ Turquoise Jewelry ♦ Pendleton Blankets ♦ Pueblo Pottery ♦ Beadwork ♦ Music - Movies ♦ Moccasins ♦ Supplies ♦ Sage ♦ ♦ Sweetgrass ♦ Cedar - Osha Root ♦ ♦ Handmade Native American Gifts ♦

4716 N MacArthur Blvd., Oklahoma City, OK 73122 405-495-1800 ♦ indianartoklahoma.com Open: Wed. - Thurs.. - Fri. 10 am to 5 PM Saturday 10 am to 4 PM 12

HORIZONS

Summer/Spring 2013


OKCIC serves as tornado relief site for

Choctaw Nation In response to the severe weather from Sunday, May 19 and Monday, May 20, Oklahoma City Indian clinic served as a medical relief site for the Choctaw Nation and its tribal members. Members of the Choctaw Nation visited Oklahoma City Indian Clinic to receive health care services administered by the Choctaw Nation’s medical staff as well as personnel from OKCIC, including immunizations, behavioral health care and nursing care, as well as referrals to Choctaw tribal programs. “We are happy to partner with the Choctaw Nation in this time of need,” said Robyn Sunday-Allen, CEO of Oklahoma City Indian Clinic. “Whether they were directly or indirectly impacted by severe weather, it’s important to ensure their members living outside of the direct Choctaw Nation area have access to needed health care services.”

Blue Cross Blue Shield of Oklahoma

Awards OKCIC $55K Grant

Oklahoma City Indian Clinic recently received a $55,057 grant from Blue Cross Blue Shield of Oklahoma to help fund Project POWER: Fitness. This program provides opportunities for wellness, health education, exercise and recreation to American Indian families in central Oklahoma. “We are ecstatic and honored to receive this grant from Blue Cross Blue Shield of Oklahoma,” said Robyn Sunday-Allen, Oklahoma City Indian Clinic CEO. “We are always looking for ways to expand our Project POWER: Fitness program and I know this grant will go a long way to help us develop more fitness programs for the American Indian families we serve.” Currently, the Project POWER: Fitness program encompasses many activities including an after school program, rock climbing, garden club, sports clinics, family bike night and family fun night. “Programs like the Project POWER: Fitness are extremely important for families to get involved in to help encourage their children to partake in healthy habits,” said Lauren Jones, Communications Consultant of Blue Cross and Blue Shield of Oklahoma. “Blue Cross and Blue Shield of Oklahoma is proud to support diverse programs that will benefit the community and we look forward to what Oklahoma City Indian Clinic will accomplish with this grant.” To learn more about Project POWER: Fitness and other Oklahoma City Indian Clinic programs, please visit www.okcic.com.

Photo by by DVIDSHUB

Oklahoma City Indian Clinic

www.okcic.com

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2013

oKlaHoMa city inDian clinic

Walk for Wellness by: andrew Davis

The sky was overcast and rain threatened to fall, but drizzling rain could not dampen Oklahoma City Indian Clinic’s Walk for Wellness. Over 250 OKCIC patrons and friends attended the event to show their support for living a healthy lifestyle and learn about the services offered by the clinic and other central Oklahoma healthcare providers. 14

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Health and wellness booths promoting programs designed to educate, encourage healthy habits, and promote fitness and wellness lined the inside walls of Remington Park Racing & Casino. Participants learned about the programs available at OKCIC including comprehensive health services, pediatrics, women’s health, optometry, dentistry, an onsite pharmacy, behavioral health, WIC, public health, Pink Glory breast care, and BRAID and STAR diabetes education programs. Walkers browsed indoor booths for program information and promotional items before making their way outside and starting the one-mile fun walk. Free T-shirts and water bottles, donated by the OKCIC’s Behavioral Health Department, were given away at the finish line, congratulating participants on completing the fun walk. Bananas, provided by Crest Foods, and bottled water, donated by Oklahoma Inter-Tribal Diabetes Coalition (OIDC), were also available. After the walk, children played outside on an inflatable slide, sponsored by OIDC, families toured the Oklahoma Bureau of Narcotics (OBN) Mobile Command Center and OBN’s seized Humvee, and everyone had the opportunity to visit any booths they may have missed before the walk. The morning started with rain but ended with rainbows and smiles all around. Oklahoma City Indian Clinic would like to thank the Chickasaw Nation for providing use of Remington Park Racing & Casino. OKCIC would also like to thank the following booth exhibitors: • Metropolitian Library System • Community Nutrition Education Program (CNEP) • Lupus Foundation of America Oklahoma Chapter, Inc. • Safe Kids Oklahoma • Eagle Ridge Institute • American Heart Association • American Cancer Society • Big Brother Big Sisters of Oklahoma • Oklahoma Health Care Authority • OU Children’s Diabetes Center • OKC VAMC Suicide Prevention • Family Expectations • Chickasaw Nation Aalhakoffichi • Talking Leaves Job Corps • Dynasty Care Service • OBNDDC Oklahoma City Indian Clinic

www.okcic.com

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surviving cancer:

Alma’s Story Cancer is the second leading cause of death among American Indians. This dreaded disease continues to impact community families across the country and state. A reminder of cancer’s effect on the community and the importance routine medical care come in the form of Alma Hickman. A dental assistant at Oklahoma City Indian Clinic for the past 14 years, Alma Hickman is a two-time cancer survivor. The first cancer was discovered during a routine mammography. This cancer, Invasive Ductal Carcinoma, was treated with chemo and radiation therapy. A second trip to the doctor came when Alma discovered a spot on her neck. It was cancerous and required additional radiation therapy. Alma remembers the worst part of her experiences was the neuropathy, pain and numbness in the hands and feet. When Alma first learned of the diagnosis she thought of it as a death sentence. “What would happen to my family was my immediate concern” said Hickman. Her solace was her faith in God, the support of her loving family, friends and coworkers, and her love of life. Fortunately, Alma caught both cancers early. Survival rate for many cancers have a cliff-like curve. Find the disease early and odds of survival approach 90 percent. But find it late and chance of survival drop to 10 or 20 percent. “Keep strong. Have faith. Stay in a prayerful attitude,” says Alma. “Enjoy every day God gives you and whatever happens, remember that God is in control.”

Alma Hickman Dental Assistant at OKCIC for the past 14 years

Preventing Cancer

(from Centers for Disease Control)

The number of new cancer cases can be reduced, and many cancer deaths can be prevented. Research shows that screening for cervical and colorectal cancers as recommended helps prevent these diseases by finding precancerous lesions so they can be treated before they become cancerous. Screening for cervical, colorectal, and breast cancers also helps find these diseases at an early, often highly treatable stage. CDC offers free or low-cost mammograms and Pap tests nationwide, and free or low-cost colorectal cancer screening in 25 states and four tribes. CDC: A person's cancer risk can be reduced in other ways by receiving regular medical care, avoiding tobacco, limiting alcohol use, avoiding excessive exposure to ultraviolet rays from the sun and tanning beds, eating a diet rich in fruits and vegetables, maintaining a healthy weight, and being physically active.

For more information go to:

www.cdc.gov/cancer/dcpc/prevention or www.cancer.org or talk to your OKCIC Care Team 16

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Summer/Spring 2013


Being All That He Can Be pharmacy technician Dustin ivy Deploys to afghanistan by: andrew Davis

Over the past two and a half years, Dustin Ivy has served Oklahoma City Indian Clinic (OKCIC) as a pharmacy technician, developing his people skills and building lasting relationships with his coworkers. Starting this summer, Ivy is taking a leave of absence from OKCIC to serve in a different manner. Dustin Ivy is resuming active duty in the United States Army, where he holds the rank of Specialist E4. Ivy is a member of a crew that operates a Multiple Rocket Launching System (MRLS), an armored, self-propelled, multiple rocket launcher. He will spend the next two months training, polish up his skills operating the MRLS, before deploying to Afghanistan for nine months. The youngest of five children, Dustin Ivy grew up in Norman, Oklahoma, and plans to return to Oklahoma and OKCIC, when his Afghanistan tour is over. “I really enjoy the atmosphere and employees at the clinic. It is great being with fellow employees… getting to know each other on a different level,” said Ivy.

“Oklahoma City Indian Clinic is an amazing place to work. It’s the reason I’m coming back.” Dustin Ivy believes in OKCIC’s mission of providing excellent health care to American Indians. Belief in the mission is what originally drew Ivy to OKCIC. Ivy commented, “I am proud of my Native American heritage, and I like helping people that can’t afford the cost of healthcare.” Oklahoma City Indian Clinic’s staff held a potluck lunch to show their appreciation for Dustin’s hard work and friendship. OKCIC staff is sorry to see Dustin Ivy leave, but they wish him a safe journey and look forward to his safe return.

Oklahoma City Indian Clinic

www.okcic.com

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Remembering

Nikki Kirkendoll

Reflections by Friends and Coworkers Oklahoma City Indian Clinic (OKCIC) family lost one of our most vibrant and spirited members when Nikki Kirkendoll, Behavioral Health Director, lost her battle with lung cancer. Nikki, a proud member of the Delaware Tribe, had the type of personality that could brighten a room, and light up a life. Her passion for helping Indian people contributed to significant positive changes at the OKCIC, and her lively, genuine character landed her a permanent home in all of our hearts. It is our pleasure to celebrate and honor the life of this unforgettable woman with the following reflections from some of her closest coworkers and friends. “Nikki was absolutely one of a kind. She was a leader, a comedian, a ‘reality hammer’ (as we liked to call her) and a loyal friend. Knowing her has enhanced my life, and losing her has changed my life. Her friendship, knowledge, laughter and (brutally) honest advice will continue to be a part of my thought process for as long as I live. May her voice never be forgotten. May her jokes bring a smile when we need one. And may she be forever loved and remembered as the unique and beautiful woman who made an impact on every single person she encountered.” -Summer Welcher-Duke

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Horizons Summer/Spring 2013

“It’s an understatement to say Nikki had an open door policy. In our office, her door was always open and welcoming even after she had gone home. I knew that there was never an idea too big or small that would be turned away. She greeted ideas with encouragement and support. I also knew that no matter the personal matter, she would listen, help me laugh, and offer words of advice. Sometimes the open door was too welcoming, because it was hard to walk by that door and pass the opportunity to share with her. Her spirit was captivating to most who crossed her path. She carried this ‘open door policy’ in every part of her life.” -Rebecca Bundy


“I remember when I first heard about Nikki, through Summer Duke. Summer had recently started working at OKCIC in 2009. She spoke so highly of the clinic and her new, ‘awesome’ boss, Nikki Kirkendoll. From the moment I met Nikki, I could tell she captivated people. She was so easy to talk to. When I became a member of the Behavioral Health Department, I felt as though it was through her leadership that allowed our team to become so close knit. Like a family member, she provided guidance and encouragement. I will always remember Nikki as a woman who was tenacious, entertaining, and incredibly intelligent. Her passion for mental health and Native people was truly inspiring. She will be missed.” – Holly Forster-Nguyen “Upon her passing, my brother, Chief Grey Eagle, a visitor named Ti (a Maori from New Zealand), a friend Muriah and I held a sweat lodge ceremony. My request for prayers was for Nikki’s safe crossing over to the spirit world. When Ti and Muriah arrived, I said, ‘I may not be very good company tonight. I lost my friend and former Director of Behavioral Health to cancer this week.’ So when Ti started his prayer, he quietly said, ‘God, Creator please be with our sister, D. J. as she is hurting with the loss of her friend. Also, be with (Nikki’s) Mom, Dad and sister‘. I was so taken with his prayer when all of a sudden he says, ‘She’s dancing now!’. I felt Nikki was letting us know how well she is and loves being where she will be with all of us someday. When I worked with Nikki at the clinic, I knew we had a great team. We loved each other so much. When we girls went out, one thing we knew was Nikki was not going to dance. So, when I heard that ‘she’s dancing now’, it took my pain and tears away. This experience was just too good to keep to myself, dear friends. May Nikki rest in peace.” - D. J. Battiest

“I am honored to have known our good friend and co-worker, Nikki Kirkendoll. Even though there was an age difference, it was certain to me that she was loyal to her job and career. I admire someone who never quits until the job is done, and that of course, was Nikki Kirkendoll. I’ve known Nikki for 5 years. I first met her when she walked into the Behavioral Health office and introduced herself, so young and full of energy. I was impressed with Nikki; she was an Energizer Bunny. I knew that this was someone I wanted to know and we have been friends and coworkers ever since. I respected her advice and knowledge. She always asked me, ‘What do you think Jeanette?’ Also, Nikki always had the time to ask about my family. She always knew when something was bothering me, and always asked if I was all right. If I wanted to talk, she was available. She liked to hang out with friends, and she loved her family. Nikki gave our Behavioral Health Department great leadership. She will be missed dearly by friends and family”. – Jeanette Kemp “The Oklahoma City Indian Clinic owes a great deal of its recent success to Nikki. She spent her time as the Behavioral Health Director really putting the program on the map. She initiated and championed what is now called “integration of behavioral health into medical”. Patients never get lost in the system and now receive comprehensive care because of Nikki’s initiative. I remember when she sat on a panel of professionals discussing what they had done for their respective Clinics by way of improving patient care. Nikki talked about the model program she had developed and was immediately bombarded with people asking her how she did it and would she come to their facility to help them. During this same speech, the Director of Indian Health Service leaned over to me and said, ‘You’ve got a good one there. You better hang on to her!’ The Director was absolutely right. The Clinic had a good one in Nikki. She will never be replaced, and we are all better to have been her Clinic family’.” - Robyn Sunday-Allen

Oklahoma City Indian Clinic

www.okcic.com

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bacK to scHool

Children's Health Fair by: andrew Davis

Oklahoma City Indian Clinic (OKCIC) held the 2013 Children’s Health Fair. Things were bustling inside and out as over a day and a half OKCIC served over 340 children between the ages of 4 and 18. 20

HORIZONS

Summer/Spring 2013


School physicals, hearing exams, vision tests, dental exams, behavioral health screenings, and immunizations were available inside OKCIC. Outside, when they were not playing basketball or running through the physical education obstacle course, children visited booths offering information on healthy eating and gardening. “The Children's Health Fair is a way to detect if there are any problems or concerns with a child’s physical state,” says Valene Bartmess, Public Health Director. “Catching those things and getting shots up to date are very important before your child starts school.” Even mild impairments to vision or hearing can affect a child's ability to understand language, pay attention in class, and excel at school. In addition to check-ups and information, OKCIC offered children great free gifts, including mini basketballs, snacks, drinks, sport bottles, and bags of much needed school supplies. Community vendors were also available offering giveaways, like bicycle helmets from Safe Kids Oklahoma and children’s car seats from Oklahoma City Area Indian Health Service. OKCIC can always use more help. If you would like to help sponsor next year's Children’s Health Fair, e-mail: david.t@okcic.com. OKCIC wants to thank all of our community partners and volunteers who helped make this year's Children Health Fair huge success: • Arthritis Foundation • Big Brothers Big Sisters of Oklahoma Native American Division • Eagle Ridge Institute • Family Expectations • Infant Crisis Services, Inc. • Kickapoo Tribal Health Clinic • Metropolitan Library System • Nike • Nike N7 • Oklahoma City Area Indian Health Service • Oklahoma City Area Inter-Tribal Health Board • Oklahoma City Fire Department • Oklahoma City-County Health Department/Students Working Against Tobacco (SWAT) Tobacco Use Prevention Program • Oklahoma Health Care Authority • OU Health Science Center / Early Access Autism Project • OUHSC Children’s Diabetes Center/ TODAY Study • Reach Out and Read • Safe Kids Oklahoma • Seminole Nation of Oklahoma • Smart Start • YWCA Oklahoma City Indian Clinic

www.okcic.com

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oKcic's Project POWER: Fitness Joins forces with Seminole Nation Diabetes Program to Host

Soccer Clinic by Dewayne tiger | seminole nation

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Oklahoma City Indian Clinic's (OKCIC) Project POWER: Fitness recently partnered with the Seminole Nation Diabetes Program to host a one-day soccer clinic for 26 native youth. The clinic was coordinated with the Seminole Nation Diabetes Program Director Dewayne Tiger and OKCIC Activity Specialist Wes Wilson to enhance the youth’s experience with a new group activity. Emphasis was placed on fun in a structured setting.

Because there aren’t many people within the Native American communities with a soccer background, the sport doesn’t receive much support. Tiger predicts that will change. “I receive more requests each year to hold these free camps. I want to share my knowledge and teach people how to run their own soccer clinics,” states Tiger. Soccer is the number one sport in the world and has been growing in native communities over the last ten years.

At first most children aren’t enthusiastic, but by the time they are done, they don’t want to leave the field. They want to keep playing. “It’s a fun way to get multiple kids moving all at the same time, using energizing soccer drills and games to introduce kids to an exercise experience that has never crossed their mind,” says Tiger. "It was a prime example of what can be done over a short 3 hour period with a few volunteers."

The OIDC holds free training each year for multiple organizations. Working together to deal directly with diabetes prevention and cardiovascular education. This coordinated effort with OKCIC and the Seminole Nation is just that kind of collaboration. If you or your organization would like to receive information on a free soccer clinic, please contact Dewayne Tiger at tiger.d@sno-nsn.gov.

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EDITORS NOTE:

The soccer clinic is a part of Project POWER: Fitness which is funded by the Nike N7 Fund. The N7 Fund provides Native American and Aboriginal communities support to promote sports and physical activity programs for youth. Project POWER: Fitness offers monthly Saturday sports clinics. For more information contact Wes at (405)948-4900 ext. 656 or wes.w@okcic.com


Kids Kitchen In The

By: Cynthia Caudillo, HPDP Dietitian

Almost 30 children between 8 and 12 years old participated in a summer cooking workshop just for children. Kids in the Kitchen was held at the OSU Extension, there children learned to make nutritious snacks and a healthy “breakfast for lunch,� whole wheat pancakes with berries and omelets with vegetables. Children also learned the basics of cooking, measuring, and kitchen safety. Activities and games provided by Oklahoma Nutrition Information and Education (ONIE) and gardening activities from Master Gardeners were available for the participants. Each child got to take home a chef hat and apron that they got to paint and decorate; a child-friendly cookbook of recipes to make at home; their very own measuring cups and spoons; herb plants to grow and cook; and new lunch bags for the upcoming school year. Special thanks to Diana Romano, Ladonna Dunlop, and Danielle Curtis from the OSU Extension who helped make this event possible.

Oklahoma City Indian Clinic

www.okcic.com

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sprinG & suMMer

TuRTLE CAMpS

by: cynthia caudillo, HpDp Dietitian & staff

TURTLE Camps oer Oklahoma City Indian Clinic the opportunity to mentor American Indian children. Participants learn about healthy eating, being active, diabetes prevention, self-esteem, arts, and crafts. In the Spring, Glorieta Baptist Church opened up their gym and classrooms to TURTLE camp. Health assessments were provided to each child. Albert Greyeagle from ImagiNativz talked about Cultural Coping, honoring traditional values and ceremony, makes a strong and healthy person. Presentations were given by a dance troupe from the Riverside Indian School in Anadarko, Oklahoma and the Apache Fire Dancers, made up primarily of students from San Carlos, Arizona. Summer TURTLE Camp was located at Coolidge Elementary. Children were taught about proper nutrition, decreasing sugary beverages, increasing fruits and vegetables, dental health as well as diabetes, tobacco, and bullying prevention. The campers played many games while at camp, and even made their own hula hoops to take home. Raised bed gardens were built on the first day of camp. Children tended to the gardens each day, learning the skills to grow their own food. Summer TURTLE Camp had several special visitors. Grayeagle taught participants to make their own reed flute that each child got to decorate and take home at the end of camp. Other special visitors to camp included the Regional Food Bank of Oklahoma’s Urban Harvest Program, Chickasaw Nation, Oklahoma Nutrition Information and Education (ONIE), and Blue Cross Blue Shield of Oklahoma,who donated gift bags. OKCIC staff and community volunteers helped the children learn and have a great time, making these camps a great success. Special thanks to Behavioral Health-SKY program for donating camper t-shirts, Glorieta Baptist Church and Coolidge Elementary for hosting TURTLE Camp, and Coolidge Elementary for taking over future care of the garden beds.

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Oklahoma City Indian Clinic

www.okcic.com

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Working together to improve health and wellness in tribal communities. Blue Cross and Blue Shield of Oklahoma recently awarded a grant to the Oklahoma City Indian Clinic to fund Project:POWER. The program provides opportunities for wellness, health education, exercise and recreation to native families in central Oklahoma. BCBSOK is proud to be a part of Oklahoma’s American Indian culture and rich heritage through our commitment to diverse communities across the state.

bcbsok.com

okcic.com | 405-948-4900

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

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73504.0413_Powwow_Guide_AD.indd 1

73504.0413

4/18/13 11:24 AM


Models photographed are used for illustrative purposes only.

Coming of the

Blessing

NEW Eagle's Nest Program Brings Education and Services to Expectant and New Mothers By: Valene Bartmess, MS, RN, Director of Public Health Carol Arnold, PhD, RN, LCCE Belinda Rogers, State Director, Programs and Government Affairs, March of Dimes Oklahoma Chapter

One of the most important things a woman can do for her baby is ensure she and her baby are healthy. To help American Indian and Alaska Native families achieve this goal, The Coming of the Blessing® was designed and created by Native women along with the help of the March of Dimes. Although initially created as an educational booklet, The Coming of the Blessing® has become a National March of Dimes initiative for American Indian and Alaska Native families across the country. Oklahoma City Indian Clinic (OKCIC) along with the March of Dimes have worked together to build a new prenatal program for American Indian families called Eagle's Nest, that will use The Coming of the Blessing® as a basis for its prenatal education portion. Eagle's Nest comprises of two components: home visits and group care. In home visits, public health nurses will deliver high-quality, culturally-relevant, evidence-based care to Native Americans living in the Oklahoma City area. Visits made to expecting mothers will entail prenatal education, support, and referrals to other disciplines and services as needed. When the baby is born, postpartum visits will continue. Breast-feeding education and support, education and assessment on growth and development of the baby, immunizations, and home and sleep safety education are provided. Home visits will supplement pre- and postnatal care, not replace

recommended prenatal check-ups or Well-Baby exams done by a physician. Home visit funding comes from the Indian Health Service and their “Healthy Beginnings” grant. The group care component of Eagle's Nest is made possible by a partnership with the Oklahoma Health Care Authority’s new initiative “StrongStart.” Expectant mothers will meet at the clinic throughout their pregnancy to attend prenatal health education group classes along with individualized assessments from their provider. Groups will learn how to care for themselves and their unborn baby and develop a support network with the other group members who share a close gestational age, or due date. Groups will start and end on time and snacks will be provided. Participants will spend more quality time with their provider and be more active in their prenatal care. Through the Eagle's Nest program and collaborative partnerships, OKCIC continues its commitment to changing lives, strengthening families, and building healthy communities for Native Americans. Oklahoma City Indian Clinic

www.okcic.com

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conquering the

Baby Blues? by summer Welcher-Duke

Photo by U.S. ARMy CORPS OF ENGINEERS LOS ANGELES DISTRICT

Pregnant women often expect the period of fresh motherhood, right after birth, will be the happiest time of their lives. Many are shocked and frightened when they find themselves feeling overwhelmed, depressed, anxious, and lonely. Perhaps they cry often or have unpleasant thoughts about themselves or their new baby. These experiences are very common and related to the “baby blues”, which occur in up to 70% of women during the first 10 days postpartum (DSMIV). “Baby blues” can be caused by changes in social life, body changes, lack of sleep, lack of time for self, less support than expected, and worries about being a good parent. Symptoms may occur due to a simple realization: “I’m a mother now and my life is different.” Noticing these traits from time to

Assisting American Indians with Disabilities in Finding Employment

VOCATIONAL REHABILITATION PROGRAM Delaware Nation Service Area Counties: ~ Blaine ~ Kiowa ~ Caddo ~ Logan ~ Cleveland ~ Grady ~ Oklahoma ~ McClain

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Oklahoma City Office 7249 S. Western Ave, Ste. 204 Phone: 405-632-3749 Toll Free: 1-877-297-3139


time is normal, and they will improve in a short period of time. Parenthood presents many life changes. So it is understandable that it takes time for new mothers to adjust to their new role. Understanding the “baby blues” is likely to help new mothers through this phenomenon. If two weeks pass and a mother can’t seem to overcome the baby blues or if the depression becomes worse, then she may be experiencing postpartum depression. Unlike the baby blues, clinical postpartum depression impairs functioning, can limit mothering abilities, and can occur up to a year after a child is born. Symptoms include changes in appetite, loss of joy, loss of motivation, thoughts of death or suicide, thoughts of harming the baby, feelings of worthlessness, significant anxiety or panic attacks. In some very rare cases, women may even develop a postpartum psychosis, in which they develop thoughts that are not based in reality or start hallucinations (hearing or seeing things that do not exist).

Helpful tips for dealing with postpartum depression: • • • • •

Ask for more help with the baby Sleep when the baby sleeps Make time for yourself Talk with other mothers Don’t expect yourself to be a perfect parent!

If functioning or parenting becomes impaired in any way, or if you feel scared, uncertain or overwhelmed by any of your experiences, it is important that new mothers speak with their loved ones and health care providers right away. Postpartum depression can be treated with therapy and/or medication.

If you are experiencing these changes please contact your OKCIC Care Team.

1520 N. Portland Ave. Phone: 405.943.7935 Open Monday-Saturday 10:00 a.m. - 6:00 p.m www. okitd.com

Kachina Dolls ~ Sterling Silver Jewelry ~ Pottery Beadwork ~ CDs ~ Sculptures 29 Oklahoma City Indian Clinic

www.okcic.com

29


safeness, pureness and potency. Manufacturing facilities are inspected regularly to ensure quality and safety.

groups at a greater risk for flu complications:

Children

(under 2 Years Old)

Adults Over 65 pregnant Women American Indians – Center for Disease Control (2012).

immunization by

Vaccination by sarah brown, lpn

Not many years ago, immunity to chicken pox or measles came from catching the disease and often came with a price, such as foot lesions or eye sensitivity to sunlight. Today, there are many diseases we don’t have to suffer because there are now vaccines. Vaccines contain a killed (or inactive) disease causing virus. The inactive virus does not cause the disease but is similar enough your body develops memory cells to fight the ‘live’ virus when it comes around. Vaccines are put through various testing phases prior to Center for Disease Control (CDC) approval. The first testing phase uses a small sample of healthy volunteers. The second phase uses several hundred volunteers. 30

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In the third phase, thousands of volunteers are tested. Questions asked are: • Is the vaccine safe? • Does the vaccine work? • Are there any serious side effects? • What are the most common side effects? • How is the size of dose related to the side effects? • How is the immune system responding to the vaccine? • How do people who receive the vaccine compare to the people who do not? Only if the vaccine is safe, effective, and benefits outweigh the risks, will the Food and Drug Administration (FDA) license the vaccine. Vaccines are tested for

Once the FDA puts their stamp of approval on the vaccine it is reviewed by the Advisory Committee on Immunization Practices (ACIP), American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP). These groups carefully review information from the clinical trials and other studies to develop recommendations for vaccine use. Their findings are presented to the CDC Director who makes it official. As with any medication you take, vaccine information should be reviewed prior to receiving the vaccine. A Vaccine Information Statement (VIS) gives information on the purpose of the vaccine, potential side effects, and contacting the CDC if you experience side effects. CDC vaccine reports are monitored and if a dangerous trend is seen the vaccine is pulled from use. There are many reputable sites to refer to regarding vaccines: www.immunize.org, www.chop.org.edu.org, or call the OKCIC Public Health Department at 948.4900 ext. 468.


OKLAHOMA CITY

INDIAN CLINIC www.okcic.com ®

5208 W. Reno, Suite 185, Oklahoma City, OK 73127 on the corner of Reno and Ann Arbor

 Pink Glory Breast Care Program

2013 Mammogram Schedule September: 3, 9, 23, 30 October: 15, 17, 28, 29 November: 4, 7, 18, 26 December: 9, 16, 17, 23 Please schedule your appointment today! Contact Public Health at (405)948-4900 ext. 467 Must be a patient of the Oklahoma City Indian Clinic. Oklahoma City Indian Clinic

www.okcic.com

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Combating Cavities oKcic attains first early childhood caries initiative by: Monica McKee and nikki Moore

In order to reduce the risk of tooth decay for school aged children it has been recommended that dental sealants are applied to all permanent, non-decayed, teeth as soon as permanent molars erupt. A dental sealant is a clear, plastic-like material that is placed on the chewing surfaces and grooves of teeth. The sealants fill in the deep grooves of teeth, especially molars. They are pain free, require no anesthesia and are approximately one-third of the cost of filling a cavity. However, a drastic number of pediatric patients with early childhood caries (also known as baby bottle tooth decay) have been seen. So, it is equally as important to initiate prevention on primary baby teeth, which begin erupting around six months of age. OKCIC Dental Department has partnered with the Indian Health Service Early Childhood Caries Collaborative Virtual Learning Community Program II (IHS ECC Collaborative, VLCP-II) to help increase awareness and knowledge of early childhood caries throughout IHS, Tribal, and Urban dental programs. Of the 15 dental programs nationwide that were 32

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chosen, OKCIC is the only urban clinic selected and is the first urban clinic to participate in such a study. The overall goal of the collaborative is to reduce the prevalence of early childhood caries in 0-5 year old American Indian/Alaskan Native children by 25% by the end of the Fiscal Year 2015, but OKCIC is dedicated to going above and beyond those standards. OKCIC plans to take the state’s recommendation on prevention a step further by applying fluoride varnish to children in the 0-5 age group, as well as applying dental sealants to primary (baby) teeth. The Indian Health Service ECC Collaborative is promoting this effort, and has generously donated the dental materials needed to apply fluoride varnish and sealants for our native youth. By 2015, the goal is to increase dental access, the number of fluoride varnish applications, dental sealants, and interim therapeutic restorations (fluoride-releasing glass ionomer placed on teeth to prevent the progression of caries), for American Indian and Alaskan Native children to 25%. This is all in hopes of decreasing early childhood tooth decay and earning a better grade when it comes to dentistry in the Native American community.


Caring is Strong Medicine. The vision of IHCRC is to eliminate health disparities, expand innovative family-focused practices and promote an embracing approach to care that strengthens physical, mental, emotional and spiritual wellness within the Indian community.

Improving Dental Care Access for American Indians by: timothy Kinnard, DDs, MpH, rDH nikki Moore, rDH and Monica McKee, rDH The Academy of General Dentistry Foundation has awarded Oklahoma City Indian Clinic (OKCIC) a grant to help fund the “Dental Care Access for American Indians” project. This funding has allowed the dental department to attain sealants, topical fluoride and other dental hygiene supplies.

Health Services Medical Care • Well Child Care Health Education and Wellness Optometry • Dental Care Lab • X-ray • Mammography In-house Pharmacy • WIC Behavioral Health Care

550 S. Peoria Ave., Tulsa, OK 74120 | 918-588-1900 | ihcrc.org

These supplies are necessary to achieve the “Dental Care Access for American Indians” project’s goal, increase dental access and decrease the prevalence of dental disease for American Indians. To provide better access, the dental department is working in conjunction with other departments such as the medical department, pediatrics, health promotion and disease prevention, WIC and public health to provide services events outside the conventional OKCIC setting, including the Children’s Health Fair and the Walk for Wellness. The project has been a success, increasing the number of unduplicated patients in OKCIC’s dental program from 2,103 patients in the year 2011 to over 2,900 patients in 2012. The dental department exceeded their goal of 25% by increasing access to 29.9%. This is a considerable jump from 2011’s dental access increase of 11.6%. In the current year, the dental department is projected to exceed all dental access measurements monitored by OKCIC in the Government Performance and Results Act (GPRA) and clinical performance measures for accreditation. “The Dental Department continues to look for new ways to expand and improve in order to better serve its patients,” states Timothy Kinnard, DDS. “We are pleased with the results of our “Dental Care Access for American Indians” project, and look forward to continual improvement of dental access in 2013.” Oklahoma City Indian Clinic

www.okcic.com

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Roller Skating and Relationships skate party offers opportunity to teach healthy relationship practices by: rebecca bundy

Unhealthy relationships can start early and last a lifetime.

Teen dating violence often begins with teasing and name calling. Among our youth, these behaviors are sometimes believed to be an acceptable part of a relationship. However, these behaviors can progress

example of a red flag might be controlling behavior or someone who demands all your time. "Green flags," healthy traits in relationships, may also be seen. An example may be having a positive outlook

1 10 in

HIGH SCHOOL STuDENTS experienced physical violence from a dating partner in the past year. – Center for Disease Control (2012).

into far more serious violence, including physical assault and rape. Because unhealthy relationships early in life can sometimes lead to a cycle of abuse, the clinic developed Skate Social to educate youth on the qualities of good, healthy relationships. Skate Social was sponsored by the Behavioral Health programs Domestic Violence Prevention Initiative, lead by Suzanne Johnson, MSPI Coordinator. Clinic staff talked with children about looking for healthy traits in new relationships and avoiding "red flags". Red flags, often seen early on in relationships, tell us a relationship could potentially be unhealthy. An 34

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on life or respecting your limits. It is important to teach traits to look for in relationships, whether they are friendship or romantic. This helps develop a sense of what is a healthy relationship. For more information on healthy relationships visit: www.cdc.gov/violenceprevention.

SKy will be sponsoring an Suicide Awareness Event at Andy Alligators on Sept. 14, 2013 Teens who participate in the Suicide Awareness education will receive a two-hour FREE Play Pass. For more Information call 948-4900 ext. 608


Amerrican IInndian dianss and Ame Naatives wh whoo ha havve Alaska N diabeetes ar aree aatt hi higgh rriisk ffoor diab artt aatttack an andd ssttroke. a hheear

Fight back. Live a long, healthy life. Ask your health care provider what your blood glucose (sugar), blood pressure and cholesterol numbers are and what they should be. Take steps to control your diabetes and reduce your risk of heart attack and stroke.

We can manage our diabetes and take care of our heart for ourselves and future generations. For more information about diabetes and heart disease, visit www.ndep.nih.gov or call 1-800-438-5383.

The National Diabetes Education Program is a joint program of the National Institutes of Health and the Centers for Disease Control and Prevention.

Oklahoma City Indian Clinic

www.okcic.com

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Sowing Healthy Seeds

by: Michelle Dennison, MS RD/lD, bC-ADM, CDe

Sprouting healthy habits can be as simple as planting a seed. Gardening can be a rewarding, inexpensive, and healthy activity for children, seniors or busy parents. Now is the perfect time to start.

Perhaps the most important benefit of gardening is exercise. Gardening burns calories and promotes better endurance, strength, flexibility and mobility. The simple act of digging in the dirt and feeling a soft or strong breeze can help reduce stress levels. Growing an edible garden has additional benefits. The fruits of your labor are a good source of fresh, non-processed, low sodium, low fat, high fiber, ready to eat, inexpensive food. If you are new to gardening, an herb garden may be a good start. These typically can be grown in containers in a sunny spot inside or out. They 36

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provide flavorings for your food that do not involve sodium and may reduce blood pressure. Examples of easy to grow herbs are rosemary, basil, chives, sage, mint, oregano, parsley and thyme. Any of these can be started from seeds or bought as small plants at your local home improvement store. A more seasoned grower may be interested in a vegetable/fruit garden or growing trees. Tomatoes, strawberries, green beans, onions and carrots are high in fiber and phytochemicals (which plays a role in cancer prevention) and low in carbohydrates, calories, and fat (which is good for your waistline, blood sugar, blood pressure and blood cholesterol).


Apple and apricot fruit trees or blueberry and blackberry bushes could be a great yard addition. These fruits provide important cancer prevention agents and are low sodium and low fat. Members of the squash family, like zucchini and pumpkin, can add variety, fiber and important vitamins and minerals to your diet, without adding fat or calories. Gardens do not have to be large. You can start a garden with a few small pots or containers, and with a little effort, you can reap good health for yourself and your family.

MAYA & MIGUEL and associated logo is a trademark of Scholastic Entertainment Inc. All rights reserved.

Contact “Master Gardener” Cynthia Caudillo, RD/LD, with the Health Promotion Disease Prevention Department to join Oklahoma City Indian Clinic’s garden club. The clinic has a garden onsite to practice gardening skills. For more information, call Cynthia at 405-948-4900 ext. 683.

A) Jumping Bean B) Jack’s Bounce C) Jumping Jacks D) None of the Above Even if you don’t know the answer, all you need to know is that any activity is a good activity. So play sports, run, dance, jump in place, ¡Lo que sea! whatever, just get up and play at least one hour a day! For fun activities and ways to stay healthy visit

www.letsmove.gov Oklahoma City Indian Clinic

www.okcic.com

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Tips for Running pART I

by: Kayla Meeks, pt, Dpt

Inhaling and exhaling air, getting oxygen in and carbon dioxide out of the lungs, breathing, is an essential part of life. Generally speaking, the harder your muscles work the more oxygen they need, causing you to breathe deeper and faster. Running and walking are considered aerobic exercises, which mean they require continuous oxygen, and continuous breathing. When you begin an exercise program, like walking or running, you may notice breathing is much harder than normal. As your body adapts to regular exercise, your heart and muscles will work more efficiently; your breathing will be more controlled and exercise will be more fun. People often ask what breathing style is best: through the nose, mouth, or a combination of both. Inhaling through your nose and exhaling through your mouth is a good way to start. As you pick up pace and/or distance, breathing through your nose becomes harder and inhaling and exhaling through your mouth is usually more effective. If you are walking or running on a colder day, inhaling through the nose will warm the air before it reaches the lungs and can make breathing easier. It is important to find the breathing style that is right for you. When figuring out your breathing style, slow your pace down to practice breathing technique. Gradually speed up as your breathing becomes more efficient. Avoid chest breathing and 38

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focus on diaphragm breathing (also known as “belly breathing�). Chest breathing can lead to cramps, side aches, fatigue, tension, stress, and dizziness, and wastes energy that could be used for running or walking. Diaphragm breathing allows more oxygen to enter your lungs, increasing the oxygen your blood sends to your muscles. More oxygen in your muscles gives your body more energy and endurance, making a run or walk more enjoyable. If you are congested, cleansing breaths (adapted from yoga) can help clear your system before you walk or run. Start by taking the two middle fingers of your left hand and close the right nostril. Breathe in to a count of four through the left nostril. Next, use your thumb to close the left nostril and hold your breath for a count of four. Lastly, release your right nostril and breathe out for a count of eight. Repeat on opposite side. Do this a few times until you are able to blow your nose. Next Issue: Tips For Running Part II


Come Visit the Newly Renovated

WellnessCenter

Group Exercise Activities, Cardio Equipment, Exercise Room, Strength Training Machines, Free Weights, And Personal Training

Group exercise activities* High Impact Circuit Training - Mon & Wed 10:30 am – 11:15 am Zumba Class - Tue & Thu 5:45 pm – 6:45 pm Yoga for Everyone - Mon 12 pm – 1 pm Get SET and Fight Diabetes – Call for appointment *Class Times Subject to Change

Criteria to be eligible for the Wellness Center: Wellness Center referral signed by an Oklahoma City Indian Clinic health provider Minimum age of 12 years old (children 12-16 must be accompanied by a parent or legal guardian)

For additional information contact (405)948.4900 ext. 618 Oklahoma City Indian Clinic

www.okcic.com

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Why We Eat Michelle Dennison Ms rD/lD bc-aDM, cDe, HpDp Director

Would a trip to the movies be complete without popcorn? Would Thanksgiving be Thanksgiving without turkey? Would you feel deprived without a big meal at Christmas? When you can’t control a stressor, do you control food? We can eat for a number of reasons. Food provides a social connection, comfort, and enjoyment and is a physical necessity. However, eating because of emotions teaches us to ignore hunger queues, which can lead to eating more, less, or nothing at all. Using food to react to emotions can lead to poor diabetes management and prevention. When foods do not meet our physical needs, only our emotional, it is necessary to change the way we eat.

What You Can Do! Discover your stressor Understand the events or problems that stress you then lead to changes in your eating habits. You can accomplish this by maintaining a food diary with an additional column for your feelings when you eat. Simply, include how you are feeling whenever you eat then evaluate what it was that made you feel that way. Listen to music This is simple and generally does not require you to buy something new. Pick a music type that is soothing to you, sit down, and just listen. If you can’t sit down, play it in the background. Physical Activity Physical activity has been shown to relieve stress, so be active instead of focusing on your stressor or food. A walk can be a good time to talk and catch up with your family. If you like something a little more intense, be careful to avoid letting your blood sugar levels get dangerously low. Deep Breathing Yoga, martial arts, and other traditional medicines focus upon this as part of the life process. Breathing exercises are practiced by many cultures and usually involve sitting in a calm, personal area. Research! Many practices will be similar but not necessarily the same.

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Think Positive Take time to forget what is troubling you. Sit in a quiet place and focus on what brings you joy. If you can’t think of anything, have a small picture of a happy calming place and imagine yourself there. Reinvent your Tradition Think outside the box. Christmas will still be Christmas without all of the pies, candies and cookies. Incorporate more physical activity into your family events and go easy on less healthy foods. Starting a new family tradition of good health is a great way to honor the season. Healthy Snacking If you decide to snack, create healthy snacks with higher protein and lower carbohydrates to help control your blood sugar and calm you down. Always have some of these snacks ready to grab in an easy place.

These are only a few things that you can do. Remember that you are an individual; everything may not work for you. It’s important to find what works best for you and your family. Don’t be afraid to be the champion for your family’s health. It is worth it.


Who Do you trust for

Health Advice? Michelle Dennison Ms rD/lD bc-aDM, cDe, HpDp Director

It can be confusing, determining what is truth and what is fiction when it comes to healthy living. There are thousands of websites, articles and products set up by companies who are very interested in making a profit. However, it is the wise consumer that makes healthy lifestyle decisions based on proven scientific basis. Think over a number of things when considering health advice: What is the source? All prescription medications in the USA must meet testing guidelines put forth and monitored by the Federal Drug Administration (FDA). Choices for healthier living can be easily found in your neighborhood supermarket. Look for messages that are supported by organizations like the American Medical Association, the American Heart Association, the American Diabetes Association or the American Dietetic Association. Then follow up on the information, especially important side effects. Does it seem too good to be true? If it sounds too good to be true, it probably is. Don’t believe that eating 3 pounds of bacon a day will help you live a long life. While it may control your blood sugar in the short term, it will certainly increase your weight, cholesterol and blood pressure, and in the long-term, your blood sugar. Being healthy

comes back to truly being healthy: eating healthy and being physically active. Eat less, burn more. Be your own health advocate. Take a good honest look at your situation. Figure out the problem, and deal with it. Take a look at where your money is truly spent. How much is spent on tobacco? Alcohol? Fast food? Soda? Convenience food? Fresh veggies, fruit and grains all have a lower per ounce cost and are much better for you. Typically, the problem is not enough forethought in planning meals. Often old habits or not really wanting to choose healthier options get in the way. What does your healthcare provider think? Always run new treatment ideas past your healthcare provider. They may be able to determine what a new treatment will do when mixed with current medications. Always tell your doctor or pharmacist if you are taking herbal remedies. Herbal remedies, taken with other medications, can cause some very serious complications.

Weigh your options and consider what is being promised. If you have any questions call your OKCIC care team at (405)948-4900. Blue Ext. 278, Red Ext. 261, Sage Ext. 212, Purple Ext. 259, and Harmon-y Turquoise Ext. 172. Oklahoma City Indian Clinic

www.okcic.com

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star program initiates

Cooking Class “The number one request of patients in the diabetes prevention program is more information on what they can eat and how to prepare it,” reports Cathy Waller, Diabetes Education Coordinator for Oklahoma City Indian Clinic (OKCIC). Taking that cue, Steps To Achieve Results (STAR) developed a cooking class and brought on board Chef Brian Valdez, Registered Dietician. Valdez, Kiowa and Apache, attended Sheridan Technical Center’s Culinary Arts program, earning his Culinarian Certification in 2004. Since then he has worked in multiple resorts, and served as livein personal chef for an elderly Seminole woman suffering from diabetes and heart problems. “As a chef, I hope to spark interest in healthier cooking that benefits our patients,” states Valdez. The first thing he looks for in a recipe is the fat content. He then checks the amount sodium and carbohydrates. Valdez explains, he selects recipes that are simple enough for anyone to make, do not include expensive ingredients and do not use unique kitchen equipment. “I ask myself, ‘would I have to spend a lot of money if I were to make this at home?” Valdez wants people to have fun making healthy dishes and enjoy eating them. “I never want a cooking student to think ‘oh this is that boring healthy food I have to eat today.” Currently the cooking class is only available to patients enrolled in Special Diabetes Programs for Indians (SDPI). The SDPI program utilizes funds from the grant to targets patients with diabetes and pre-diabetes. Check for Facebook for recipes from Chef Brian

www.facebook.com/OKCIndianClinic 42

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Everyone with diabetes should test their blood sugar at least 2 times per day. Testing is highly individualized. However, some general rules apply. Fast, do not eat or drink anything for greater than 8 hours, prior to the first test. Then, test again at bedtime. These tests will show how well you are able to control the sugar that your liver produces overnight (fasting) and how well you have adjusted your diet and exercise to control your diabetes (bedtime). The information from these tests will enable your medical team to make the right treatment changes for you. NOTE: Patients who are on insulin should test their blood sugar about 4 times per day, before each meal (breakfast, lunch and dinner) and at bedtime.

Photo by RICHARD ELZEy

the importance of checking your

Blood Sugar

It may take time to solidify a new testing routine. Providing cues can help. For example, if you need to check your blood sugar when you wake up and when you go to bed, keeping the meter at your bedside may visually remind you. Setting a cell phone alarm has also proven helpful to many people with diabetes. Some patients, who check before meals, keep their meter at the dinner table. Only you know what will work best for you. The important thing to remember is that every test takes you a step closer to better health. Testing can be done quickly. The meters provided by the clinic provide results in about 5 seconds and record your readings, so keeping a blood sugar log is not required. Just bring in your meter to every clinic visit, and the clinic staff will download and printout the results. Contact your OKCIC care team if you have any questions.

by Michelle Dennison Ms rD/lD bc-aDM, cDe

If you have diabetes, checking your blood sugar is one of the most important things that you can do to maintain good health. Testing your blood sugar helps you decide what immediate treatment actions need to take place, such as stretching, going for a walk or adjusting food intake, to reduce high blood sugar. Test results help your health care team make long term treatment decisions, like reducing or increasing medications. When your medical team does not have accurate and consistent blood sugar readings, it is very difficult and sometimes impossible to treat your diabetes effectively. Still, many people don’t test their blood sugar as needed.

Does It Hurt?

Checking your blood sugar can hurt, however when done properly the pain is minimal. If you poke your finger on the side of the finger and not on the tip, there is a lot less pain. Rotate fingers and rotate sides to minimize soreness. The meters that Oklahoma City Indian Clinic provides require very little blood, so you can dial down the lancet depth on your lancing device. you are poking too deep if there is a lot of blood leftover when the test is done. If you have severe neuropathy (nerve damage) in your fingers, checking blood sugar in the palm of the hand is a good alternative. While testing blood from the palm is not as accurate, it is better than not testing at all. For questions regarding palm (alternative site) testing, contact your OKCIC care team.

Oklahoma City Indian Clinic

www.okcic.com

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Radiology Department's

New Tool to

Prevent

Broken Bones By: Christin Crosswhite BSRT (R) & Shannon Schwartz RMA Oklahoma City Indian Clinic (OKCIC) Radiology Department has added Bone Density Test (also known as DEXA) services. DEXA stands for Dual Energy X-Ray Absorptiometry. During DEXA scans, two x-ray beams are aimed at the patient's bones. Bone density is determined from the absorption of each beam by the bone. The results of an exam are compared to results from patients of similar age, sex and ethnic background. DEXA scans are commonly performed on the lower spine and hips. They can also be performed on the wrist of non-dominant hand, if unable to use spine or hips. These areas are most likely to break because of low bone density. A DEXA scan of the hips and spine also predict the likelihood of future fractures in other bones. DEXA scans are quick, noninvasive and use less than 1/10th the dose of a standard chest x-ray. The results of a DEXA scan, will determine if you have normal bone density, low bone density (osteopenia), or osteoporosis. Osteoporosis is a gradual loss of calcium, thinning, and weakening of bone structure. You have a greater risk for future fractures, if your results show osteopenia or osteoporosis. With osteoporosis, broken bones cause serious problems, including longer recovery times, increased pain, and even disability. Identifying decreases in bone density can help you avoid a broken bone, before it happens. A DEXA scan will also confirm a prior diagnosis of osteoporosis or osteopenia. This is a great tool, to get knowledge that will help you keep your bones strong and healthy. Talk with you provider about whether this exam is right for you. Scans must be ordered by an OKCIC provider to be scheduled. 44

Horizons Summer/Spring 2013

Osteoporosis Risk Factors • • • • • • • • • • • •

Women age 65 or older Men age 70 or older Late Bone fracture (after age of 50) Early menopause (before age 45) Height loss of ½ inch or more within one year Total height loss of 1 ½ inches from original height Family history of osteoporosis Thin or small build Smoking Certain Medications (Chronic Steroids or thyroid hormones) Inadequate calcium intake Vitamin D deficiency

How often do you need a Bone Density Test? 1. Get first test done at age 50 to determine good baseline 2. Standard test every 2 years (depends on risk factors)


Diabetes HealthSense Resources for living well

Diabetes HealthSense provides easy access to more than 140 resources to help you live well and meet your goals— whether you have diabetes or are at risk for the disease.

Find resources for: coping with stress & emotions eating healthy being active managing your weight

www.YourDiabetesInfo.org/HealthSense The National Diabetes Education Program is a partnership of the National Institutes of Health, the Centers for Disease Control and Prevention, and more than 200 public and private organizations. June 2011

Oklahoma City Indian Clinic

www.okcic.com

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(800) 349-7026 www.cnhsa.com

Excellence In Rural Health Care

Choctaw Nation Health Care Center One Choctaw Way Talihina, OK 74571 (918) 567-7000

Emergent & Urgent Care Open 24 hours, 7 days per week.

Atoka Clinic

Broken Bow Clinic

1201 W Liberty Atoka, OK 74525 (580) 889-1981

Hugo Clinic

410 North M Hugo, OK 74743 (580) 326-7561

Poteau Clinic

109 Kerr Ave. Poteau, OK 74953 (918) 649-1100

1300 Martin Luther King Dr. Broken Bow, OK 74728 (580) 584-2740

Idabel Clinic

902 Lincoln Rd. Idabel, OK 74745 (580) 286-2600

McAlester Clinic

1127 S. George Nigh Expy McAlester, OK 74501 (918) 423-8440

Stigler Clinic

2204 E. Main Stigler, OK 74462 (918) 967-9200

Lois White Burton Refill Center (866) 367-4084 Services vary by location. Must have CDIB to be eligible for services.

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HORIZONS

Summer/Spring 2013


help me fight a silent killer.

Rock legend Bret Michaels foR moRe of bRet’s stoRy, go to bRetmichaels.com/stopdiabetes

I’ve had diabetes since I was six. It’s a constant battle. Testing. Treating. Fighting to live a normal life. Every year, diabetes kills more Americans than breast cancer and AIDS combined. It’s been called a silent epidemic, and unless we stop it, it will only get worse. Please join me in the movement to Stop Diabetes®. And give what you can to help spread the word, improve lives and fund research for a cure.

SHARE. ACT. LEARN. GIVE.

Join the movement at stopdiabetes.com. Together, we can Stop Diabetes.

stopdiabetes.com

1-800-diabetes

TExT* T JoiN To 69866

Oklahoma City Indian Clinic

*Standard data and message rates apply.

www.okcic.com

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COAIHC, Inc. 4913 West Reno Oklahoma City, Oklahoma 73127

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Horizons Summer/Spring 2013

Non Profit Organization U.S. Postage Paid Permit No. 2234 Oklahoma City, OK


HORIZONS