Happening at Forks Community Hospital

COVID 19 – Facts not Fear

Facts not Fear

Forks Community Hospital is following the CDC and Washington Department of Health recommendations regarding COVID 19. We are in frequent communication with our public health department to maintain up-to-date responses to this changing situation, and we will keep you informed.

We are prepared to evaluate patients for coronavirus disease following CDC guidelines for infection prevention and control. To prepare frontline staff we have been conducting drills, educating in Donning/Doffing PPE (Personal Protective Equipment) and Hand Hygiene. We have information on our website regarding COVID 19 symptoms, risk factors, and ways to diminish risk and protect our community, ourselves and our families. As with any infectious disease, we are committed to providing the best possible care to our patients, while protecting all our patients, our staff, our visitors and our community by minimizing the risk of spreading the disease. All of us can do this by effective, frequent handwashing; keeping our hands off of our faces; working to stay healthy and, of course, staying home when we are sick. Forks Community Hospital is here to care for our community and that means preparing, in collaboration with our County, State and National health officials to prepare a plan for the potential of COVID-19 being here on the Olympic Peninsula.

What can You do to protect yourself and your family? CDC recommendations:

• Avoid close contact with people who are sick.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Wash your hands often with soap and water for at least 20 seconds.
• Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are unavailable.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently-touched objects and surfaces.

If you were in China, Italy, South Korea, Japan or Iran within the past 14 days (or have spent time in close proximity with someone who is suspected of having COVID-19) AND feel sick with fever, cough, or difficulty breathing, you should seek medical care. Call the Department of Health COVID-19 hotline – 1.800.525.0127 OR CALL YOUR HEALTH CARE PROVIDER BEFORE YOU VISIT A HEALTH CLINIC, and tell them about your exposure and your symptoms. They will give you instructions on how to get care without exposing other people to your illness. While sick, avoid contact with people, don’t go out and delay any travel to reduce the possibility of spreading illness to others.

While COVID-19 is not currently in Clallam/Jefferson counties, Forks Community Hospital is actively involved in containment of this disease and will continue to update you with the latest responses and information.

March 3, 2020

Centering Pregnancy – Appointments and Privacy

Bogachiel Clinic and Dr. Rebecca Pfaff are happy to introduce an expansion of prenatal care offerings with an ADDITIONAL option and approach to prenatal care.

While we will continue to offer the traditional model of prenatal during which you meet individually with Dr. Pfaff throughout your pregnancy, CenteringPregnancy® allows you and a companion or companions of your choosing to attend prenatal visits that are in a comfortable group setting. These appointments provide the time to ask a provider all of your questions, learn more about your health, and share with others who are having similar experiences.

CenteringPregnancy appointments run between 90 minutes and 2 hours. Centering is your healthcare appointment. There is no waiting for your appointment time to start- when you arrive, you will go straight to the Centering room and get started. You will receive all your prenatal appointments as soon as you enroll, you can plan in advance and never have to check out, or schedule a follow-up. You will stay together as a group throughout your pregnancy.

Centering is based on three components; care, education, and support. Each session is designed around these principles. At the start of a CenteringPregnancy session, you will complete your self-care and have an individual assessment and time with your provider. You may complete a “Conversation Starter” in your Centering notebook about a topic you’ll discuss later, enjoy snacks, and chat with other group participants. At the same time, each patient meets with the provider individually. When the group “circles up” together, there is facilitated discussion and activities. There is time to practice skills, such as breathing and relaxing or holding and comforting a baby.

Centering does have facilitated discussions; however, each group is tailored to its participants. Rural parents have some different concerns than suburban and urban parents. Centering allows room for cultural and traditional influences to be a part of the group as women and their companions share what pregnancy, childbirth, and raising children means to them and their families and ancestors. This setting allows for new parents and experienced parents to interact and discuss honestly things that have worked for them with the support of Dr. Pfaff.

Everyone benefits from real discussions with your trusted healthcare team and group, instead of relying on advice found on the web. Participants are empowered to share and learn from others in group. We are learning more and more about the benefits of social support and community in protecting pregnant women and babies from unnecessary stress. A special community develops in Centering groups. Participants tell us the group feels like a circle of friends sharing common concerns and the experiences of pregnancy, birth and parenting. You may find that the relationships developed in your group extend long past the scheduled visits as you create lasting friendships and support systems.

Many patients are interested in Centering but have concerns regarding privacy. At the first group session, each person signs a confidentiality agreement, and it is emphasized that particular concerns should not be discussed outside the group setting. Ground rules are agreed upon and posted in the group space. Each participant makes the decision to share information with the group; no one ever is pressured to disclose personal concerns.
Individual time with your provider will be conducted in a private area of the Centering room.

Should you require an exam or have issues that require additional privacy, you will be seen in an exam room outside the Centering appointment.

Our goal is to offer more choices, you are in charge of deciding what is best for you and your family.
If you have questions regarding CenteringPregancy ask Dr. Pfaff at your next appointment or email information@forkshospital.org General questions only, please keep all personal health information private by discussing it directly with your provider.

This Article is Brought To You By

CenteringPregnancy®
Bogachiel Clinic
Dr. Rebecca Pfaff, FPOB

2020

Centering Pregnancy – Frequently Asked Questions

Bogachiel Clinic and Dr. Rebecca Pfaff are happy to introduce an expansion of prenatal care offerings with an ADDITIONAL option and approach to prenatal care. While we will continue to offer the traditional model of prenatal during which you meet individually with Dr. Pfaff throughout your pregnancy, CenteringPregnancy® allows you and a companion or companions of your choosing to attend prenatal visits that are in a comfortable group setting. These appointments provide the time to ask a provider all of your questions, learn more about your health, and share with others who are having similar experiences.

Here are some frequently asked questions and answers:

FAQs

How is my privacy protected in a group setting?

At the first group session, each person signs a confidentiality agreement and it is emphasized that particular concerns should not be discussed outside the group setting. Ground rules are agreed upon and posted in the group space. The decision to share information with the group is made by each participant; no one ever is pressured to disclose personal concerns.
Individual time with your provider will be conducted in a private area of the Centering room. Should you require an exam or have issues that require additional privacy, you will be seen in an exam room outside the Centering appointment.

What is the cost of this type of care?

Your charges and/or copays for CenteringPregnancy care are the same as traditional care and are determined by your insurance coverage. If you have questions about your coverage and estimated out-of-pocket expenses, talk with patient financial services at Forks Community Hospital.

I am not sure I can leave my job for a two-hour appointment.

Centering group care is your healthcare visit. And while two hours may seem like a long time for your prenatal or well-child visit, remember there is no waiting for your appointment to start – when you arrive you will go right to the Centering room to get started. There is no need to check out after either, or to spend valuable time scheduling your next visit. You will receive a schedule of all your appointments when you enroll in Centering so that you can make arrangements for time off in advance.
I have problems with childcare. May I bring my older children to my group visits?

Childcare will be offered at Centering appointments. Please contact Kami Clagget at Bogachiel Medical Clinic for more information.

I’m afraid that my provider won’t really get to know me in a group setting.

Most patients and providers find they get to know one another better through Centering groups. This is because you spend so much more time together! In Centering, you get both private time to ask questions and talk with your provider, as well as group time that is fun and informative.

Can my partner or other support person attend my groups with me?

We encourage you to bring your partner or support person – they will benefit from being a part of the group too! We ask that you bring the same person to each session for continuity and confidentiality. Support people sit in the circle and fully participate in the all of activities and discussions. You can bring more than one support person.

What if someone is sick?

If you or your child are not feeling well and are potentially contagious, we ask that don’t come to your group visit. Just call the practice and schedule an individual appointment. Your group will appreciate it and look forward to seeing you next time!
I won’t feel comfortable sharing information in a group setting.
That’s a common concern. Rest assured that there is no pressure to share anything with the group that you are not comfortable sharing. However, most participants find that the group quickly feels like a group of friends who are all going through similar things, and the benefits they receive from sharing their experiences are tremendous.

Two hours seems like a long time for a healthcare visit. What happens during the two hours?

At the start of a CenteringPregnancy session, you will complete your self-care and have an individual assessment and time with your provider. You may complete a “Conversation Starter” in your Centering notebook about a topic you’ll discuss later, enjoy snacks and chat with other group participants while each patient meets with the provider individually. When the group
“circles up” together, there is facilitated discussion and activities. There is time to practice skills, such as breathing and relaxing or holding and comforting a baby.
Groups are lively, interactive, focused on the topics that are most important to you and FUN!

Will I still get my ultrasounds and lab tests that I expect in prenatal care?

CenteringPregnancy is your prenatal care. Dr Pfaff will work diligently to continue insuring that your care meets all the standards for prenatal care. Labs, prescriptions and ultrasounds will be ordered for you, as appropriate. Results of the lab tests and ultrasounds will be shared privately with you.
The reason for and significance of testing and medications is often a topic for group discussion. Women in Centering tell us they better understand lab testing and medications prescribed during pregnancy after the group conversations.

Will I like this?

Numerous studies have shown that women who participate in Centering are more satisfied with their care, feel more prepared for birth and for parenting and have higher rates of breastfeeding when they leave the hospital. Other studies have shown a decrease in the risk of preterm birth and higher birth weights for babies who are born premature. But if you don’t like it, we will be happy to transition you to individual prenatal appointments with Dr. Pfaff.

Is Centering for everyone?

We believe anyone can enjoy and benefit from Centering. Talk with your provider if you have any further questions about whether Centering is right for you. Bogachiel Clinic and Dr. Pfaff will continue to offer routine, one-on-one prenatal care for those who are not interested in Centering. Our goal is to offer more choices, you are in charge of deciding what is best for you and your family.

If you have questions regarding CenteringPregancy ask Dr. Pfaff at your next appointment or email information@forkshospital.org. General questions only, please keep all personal health information private by discussing it directly with your provider.

CenteringPregnancy®
Bogachiel Clinic
Dr. Rebecca Pfaff, FPOB

2020

Practical Suggestions to Stay Safe in Winter

Some practical suggestions to stay safe in winter.

As winter approaches, outfit yourself for safe walking:

• Choose a good pair of winter boots. For warmth and stability look for these features: well-insulated, waterproof, thick non-slip tread sole made of natural rubber, wide low heels, light-weight.
• Ice grippers on footwear can help you walk on hard packed snow and ice. But be careful! Grippers become dangerously slippery and must be removed before walking on smooth surfaces such as stone, tile and ceramic. Before buying the grippers, be sure that you are able to attach and remove them from your boots, this is best done sitting down.
• Use a cane, or even a pair of ski poles or walking sticks to help with balance. Make sure they’re the right height for you. When your cane is held upside down, the end should be at wrist level. Speak to your doctor, pharmacist or local public health department about how to use a cane properly.
• If using a cane, attach a retractable ice pick to the end. Cane picks will be slippery on hard surfaces so be sure to flip it back as you get indoors. Picks are inexpensive and available at most drug stores.
• If you need further support, use a walker. The cost might be defrayed by government programs; talk with your doctor.
• Help other road users see you by wearing bright colors or adding reflective material to clothing.
• Prevent heat loss by wearing a warm hat, scarf, and mittens or gloves. Dressing in layers may also keep you warmer.

Once the snow and ice arrive, make sure your walking surfaces are safe:

• Keep entrance ways and sidewalks clear of ice and snow. Report hazards on sidewalks or pathways to your landlord or the City.
• Contact your local home support agency or other community services for help with snow removal, transportation and grocery bus services.
• Carry a small bag of grit, sand or non-clumping cat litter in your jacket pocket or handbag, to sprinkle when you are confronted with icy sidewalks, steps, bus stops, etc.

Walking on Ice:

• Facing an icy surface can be a paralyzing experience. Not everyone has grippers and other safety aids. So, what should you do if it’s impossible to avoid an icy patch? Believe it or not, body movements can increase your stability on an icy surface.
• Slow down and think about your next move. Keeping your body as loose as possible, spread your feet to more than a foot apart to provide a base of support. This will help stabilize you as you walk.
• Keep your knees loose — let them bend a bit. This will keep your center of gravity lower to the ground, which further stabilizes the body.
• Now you are ready to take a step. Make the step small, placing your whole foot down at once. Then shift your weight very slowly to this foot and bring your other foot to meet it the same way.
• Keep a wide base of support.
• Some people prefer to drag their feet or shuffle them. If this feels better to you, then do so. Just remember to place your whole foot on the ice at once and keep your base of support approximately one foot wide.

Of course, it’s always better to avoid tricky situations by being prepared and planning a safe route for your walk

Tim Wade – Forks Community Hospital Safety Officer, Ambulance Supervisor, REMVAC Liaison

January 21, 2020

Energy Drinks – Are they worth the risk?

Myth: Energy drinks are regulated by the U.S. Food and Drug Administration (FDA) so they must be safe.

The makers of energy drinks market them as dietary supplements, allowing them to side step the U.S. Food and Drug Administration (FDA) beverage regulations. Because they have many vitamins and supplements in them, energy drinks appear healthy. However, there are no studies showing the safety or benefits of energy drinks, and there is clear evidence that some of the adverse reactions  —sometimes causing people to go to the ER after drinking energy drinks are due to an overdose of B vitamins!

Myth: Energy drinks and gourmet coffee drinks are comparable in amounts of caffeine and sugar.

The common energy drinks have the equivalent of  5-10 times as much caffeine as a regular soda or cup of coffee. In addition to excessive caffeine, energy drinks are packed with sugar. The large amounts of sugar help the caffeine be absorbed into the blood stream extremely quickly, causing dangerous spikes of caffeine in the blood.

Myth: Energy drinks only cause a small response in my body.

Energy drinks stimulate the sympathetic nervous system which is commonly known as the “fight or flight” response. It is our body’s rapid involuntary response to dangerous or stressful situations. Each time it is triggered there a “flash flood” of hormones released that stimulate the body for action. The common symptoms of these hormones are restlessness, wakefulness, anxiety, and the jitters. When coupled with exercise or other substances, energy drinks can overstimulate the heart, leading to heart arrhythmias and even death.

Myth: Energy drinks are safe for my child to consume. 

Children often drink energy drinks while participating in athletics. Vigorous physical activity also activates the sympathetic nervous system. The double activation that results can dangerously over stimulate the heart. In addition to the risk of arrhythmia and sudden death, parents should have real concern about the long term health effects of chronic overstimulation of sympathetic nervous system and hypervitaminosis (vitamin overdose) that can result from energy drink consumption.

Myth: It is safe to mix energy drinks with alcohol, because their effects cancel each other out.

Alcohol certainly depresses part of the central nervous system, and energy drinks definitely activate the sympathetic nervous system. However, this combination is surprisingly deadly, especially in children and adolescents. Caffeine activates the part of the brain that makes people charged and ready for action, while alcohol depresses the judgment part of the brain that warns people of danger. Everyone knows that people do stupid stuff when they are intoxicated. Combine the effects of caffeine and intoxication in the adolescent brain, and you have a potentially deadly combination. Truly.

Myth: My energy drink is healthier, as it is “All Natural.”

Energy drinks sell because of they are stimulants. The adverse reactions of over stimulation are just as harmful regardless of the source of stimulation. Plant-derived stimulants can harm just as easily as artificially derived stimulants.

Myth: Sugar-free energy drinks are healthier.

There has never been any evidence to show that artificial sweeteners are healthier than regular sugar. Actually, there is growing evidence that people who drink low calorie or sugar free soda actually gain more weight and develop diabetes faster than people who drink normal soda.  Look for an upcoming article on artificial sweeteners.

In summary, energy drinks are at best unhealthy for you; at worst, they can be deadly.  If you care about your health and the health of your family, your New Year’s resolution should be to get energy drinks out of your home and never bring them back.  Your body has a tremendous ability to deliver the energy you need, if you give your body what it needs for health: sleep, good food, exercise, and community.

Dr. Jeffrey Wallhoff – Emergency Department; Forks Community Hospital

December 2019

Respiratory Care Week October 2019

Respiratory therapy is best described as the assessment and treatment of patients with both acute and chronic dysfunction of the cardiopulmonary system.

According to the Bureau of Labor Statistics, respiratory therapists care for patients who have trouble breathing, for example from a chronic respiratory disease such as asthma or emphysema. Their patients range from premature infants with underdeveloped lungs to elderly patients who have diseased lungs. They also help provide emergency care to patients suffering from heart attacks, drowning or shock.

Respiratory therapists also perform a wide array of diagnostic tests. Pulmonary function tests, as well as many other types of diagnostic tests, are performed at the Forks Community Hospital in the cardiopulmonary department. This is where a licensed respiratory therapist may test lung capacity by having a patient breathe into an instrument that measures volume and flow when they inhale and exhale. Respiratory therapists may also perform arterial blood gasses to determine oxygen and carbon dioxide levels.

Other diagnostic tests commonly performed by respiratory therapists are: Cardiac stress treadmill tests, EKG’s, cardiac patch and holter monitoring, spirometry and pulse oximetry testing.

Respiratory therapists are also trained to operate a ventilator and assist during intubations where a physician or a nurse anesthetist inserts a tube into the patient’s lungs.

Today’s respiratory therapists have demanding responsibilities related to patient care and serve as vital members of the healthcare team.

Doug Devine, Director of Cardiopulmonary at Forks Community Hospital and Licensed Respiratory Care Practitioner stated that, “The field of respiratory care is wide open right now with a lot of opportunity. Respiratory therapists can work for hospitals, home care companies, sleep labs, medical device companies and research facilities. The opportunities are endless.”

To find out more about respiratory therapists and licensing requirements please visit:

www.nbrc.org

www.aarc.org

Resources:

Bureau of Labor Statistics – Occupational Outlook Handbook

RespiratoryTherapistLicense.com

Doug Devine, Director of Cardiopulmonary

October 2019

The Flu and You

Influenza, the flu, is one of 25 diseases that can be prevented by a vaccine.

Too many people died from influenza last year in Washington State, a total of 241.  That number includes two children.  It is too late to help them but do you want to help a child this year?  Get your flu vaccine. That way our tiniest citizens take advantage of the community immunity created by everyone getting the flu vaccine.

How do you know if it is a cold or the flu?    There is no vaccine for the common cold but it is not as deadly as flu.  See the chart “Is it a Cold or Flu” for ways to tell what you are experiencing.  Note that flu viruses are generally not found here until December or January.

The flu vaccine not only reduces your risk of getting the flu, it also reduces the risk of hospitalization and death from flu related symptoms.

Who should get the flu vaccine?  Everyone over the age of 6 months should get flu vaccine as long as they have no health problems that would prevent the inoculation.

Concerned about safety?  You should be.  That being said, the flu vaccine is safe and effective.  No one died from getting a flu shot but a few from a rare but severe allergic reaction called anaphylaxis.  Now the vaccine formulas available are tolerated, even with an egg allergy.  However there is an egg-free formula available for those who need it.  While many interventions have risks, peanuts are actually more dangerous than flu vaccine.

There are anti-viral drugs that can treat either Influenza A or Influenza B if you need it.  One drug is even given as a one-time single dose.  These get the best results if they are started within 72 hours of the time when symptoms begin.

It takes about two weeks for the flu vaccine to improve your immunity.  Until it is most effective and even after that, follow these safety tips:

• Wash your hands with soap before eating, after using the restroom, doing pet care, and when coming in contact with others like shaking hands or praying together;
• Use cleaning wipes for contaminated surfaces including the phone, computer, ATM, auto steering wheels and door handles, door knobs and grocery carts to name a few;
• Avoid touching the “T-zone” of your face;
• And use a mask if you are sick or if you want to avoid germs from others who are sick.

Get your flu vaccine by the end of October but if you cannot, get it as soon as possible.

Janet Schade, MS, RPh, Director of Pharmacy.

October 10, 2019

The Behavioral Health Program at West End Outreach (WEOS) is currently taking on Clients in its Substance Use Disorder Treatment Program.

Treatment  at WEOS is designed to help people address the underlying causes that might contribute to the abuse of drugs or alcohol, while also helping people chart their own course for recovery and overcome the problems that their drug or alcohol abuse may have caused.

The main goal is to eliminate barriers and make recovery available to everyone.  WEOS is unique in its ability to close the gap for people who might have co-occurring substance use and mental health disorders and is taking the lead on this approach locally.

There are currently 7.7 million adults in the U.S. who have co-occurring mental and substance use disorders, according to the National Institute on Drug Abuse (NIDA).

One disorder doesn’t necessarily cause the other. Of the 20.3 million adults with substance use disorders, 37.9 percent also had mental illnesses. Of the 42.3 million adults with mental illness, 18.2 percent had substance use disorders, according to NIDA.

Not everyone is getting the treatment they need. Of those with co-occurring conditions, 52.5 percent received neither mental health care nor substance use treatment, 34.5 percent received mental health care only, 9.1 percent received both, and 3.9 percent received substance use treatment only, according to NIDA.

A client at WEOS has access to individual substance use counseling, substance use assessments, mental health therapy, case management, day treatment, substance use group counseling, activity groups, and mental health group therapy.  It’s all tailored for the person’s individual needs.

The first step in getting help for yourself or a family member is to call (360 374-5011) and schedule an appointment or simply stop by WEOS, located at 551 Bogachiel Way in Forks.

Disclaimer: This Column is not intended as a diagnosis or recommended treatment of a specific condition. Answers are not a replacement for an individual medical evaluation. Individual health concerns should be evaluated by a licensed clinician.

Use Penicillin If You Can

What if you are sick and you tell the doctor you have an allergy to penicillin? Very often, a type of penicillin is the “Drug of Choice” which is the best antibiotic for that infection.  Yes, there are usually alternatives to penicillins but only 1 out of 100 people actually have a “true” allergy and would not be able to get those types of drugs, in many cases the best drug for that infection.

How do you know if you have a true penicillin allergy?  The first and most important way to know is if you had penicillin at some time and had difficulty breathing, if your throat swelled, or if you had an extreme reaction called anaphylaxis.   One might think a rash qualifies as a penicillin allergy but that is not necessarily an allergic reaction and it should be discussed with your doctor.  Second, it is not a penicillin allergy if you have a stomach ache, nausea or vomiting when you took the drug and neither is it an allergy if a close relative claims a penicillin allergy of their own.

Sometimes people are told that they had an allergic reaction in the past but they do not know what drug or what happened.  There is a test available at Forks Community Hospital if your doctor believes it could clarify your allergy status.  It is not for people with a history of anaphylaxis or difficulty breathing so make sure your doctor knows about those severe reactions.

Why do we care so much about a penicillin allergy?  Are there drugs that are just as good as penicillin that can be used instead of penicillin?  Yes and no.  Of the top 53 infectious bacteria we studied from references, 21 named a type of penicillin as both the top drug and the top alternate for that bacteria; of those, 13 listed penicillin as the top drug only; and 8 listed penicillin as one alternate.   Fourteen bacteria were not treated by penicillin but over three-quarters of the bacteria were best treated by penicillins.

Here are some examples of infectious diseases that should be treated by a penicillin-like drug:  Diabetic foot, diverticulitis, endocarditis, pneumonia (some), strep throat, rheumatic fever, some skin infections, and bites (dog bite, rat bite, bear bite and human bite).

Using the Drug of Choice like these penicillins reduces development of bacterial resistance. Resistance occurs where that particular drug may not kill that bacteria any more.  Using an alternate drug may not end with the best outcome.  Finally, some alternate drugs other than penicillins have more ill effects and in general cost more.

Some people, about 1 in 100 in the US population, actually have that true penicillin allergy.  If other people need to clarify whether they do or not, it could make a difference in being treated for a future infection with the best drug that is a penicillin or even a penicillin alternate.

If we fail to control resistance, by the year 2050 when most of your children or grandchildren are grown, they could die from what we now consider relatively simple infections like strep throat or a dog bite because we will no longer have antibiotics that can save them.

Testing for a penicillin allergy can give valuable information and save future lives.

Check with your doctor who can determine if you are eligible and refer you to the Infection

Preventionist, Nikki Reed at Forks Community Hospital.

Disclaimer: This Column is not intended as a diagnosis or recommended treatment of a specific condition. Answers are not a replacement for an individual medical evaluation. Individual health concerns should be evaluated by a licensed clinician.

Vaccinations, Please

It was frightening for many and heartbreaking for others when the measles outbreak reached 85 people in Washington State and killed one person in the United States.

An even greater tragedy for our state is the 241 deaths from influenza during the 2018-2019 season, including two children.  This is so sad:  241 deaths from the flu.  These were confirmed by laboratory tests.  Not everyone was a senior citizen either: 74 deaths were in people under the age of 65.

These deaths do not have to happen:  There is a vaccine for influenza.  It is now close to the time of year when we all need to get vaccinated, starting with infants at age 6 months.  The Centers for Disease Control recommend getting the vaccine by the end of October but one can still get it through the end of this year and beyond.

Everyone needs to add to the effectiveness of the vaccine by carefully following some simple guidelines:  1) Wash your hands often, at least before eating, after using the restroom, and following contact with others like using someone else’s phone or computer, the ATM or a grocery cart; 2) Use cleaning wipes for things like keyboards (or wipe your hands after using it), your steering wheel, radio buttons, door knobs (even your own dirt can cause infections if you come back to it later with a cut or abrasion that lets those bacteria into your systems), and shopping carts to name a few; 3) Don’t touch your face, eyes, nose or mouth with your hands, the “T-Zone.”

If you are sick, cover your cough, wear a mask, and stay home while you are contagious.  You can also wear a mask if you are healthy but want to avoid germs.  Don’t forget to throw away your toothbrush and get a new one:  Those bad bugs stay in the bristles waiting for the next opportunity to harm you.  Avoid using anyone else’s toothbrush too.

For more information on available vaccines and recommendations for specific age groups check

www.cdc.gov

www.doh.wa.gov .

Janet Schade, MS, RPh – Director of Pharmacy

July 30, 2019

Disclaimer: This Column is not intended as a diagnosis or recommended treatment of a specific condition. Answers are not a replacement for an individual medical evaluation. Individual health concerns should be evaluated by a licensed clinician.

Asking for Help Takes Strength

When you break your foot, you see a doctor or surgeon. If you feel sick, you let your coworkers know and you get medicine. It is common practice to share concerns about physical health with your friends and family. However, when dealing with a mental illness, many people never ask for help. Why are we so afraid to take care of the most vital organ – the brain?

Many psychologists have researched the benefits of teaching how to treat mental illness no differently than a physical illness – to speak openly about it, to ask for help, and to not see it as taboo.

The practice of taking stock of your mental health should be taught and reinforced on a daily basis in homes and schools. Behavioral problems are subtle signs of children & adults trying to ask for help. Ignoring these signs can lead to further problem in life: self-harm, low self-esteem, and a lack of identity. Not addressing mental health can contribute to depression, anxiety, and other issues. We must let children or adults cry, feel, and express their feelings as normal behavior.

Adults should be aware of the message they convey and model to children: it is important to be strong and showing emotions and having feelings does not make someone weak! Normalizing asking for help is a positive tool for your mental health. This will not only teach resilience but also compassion, courage, and that we are never alone and must never judge anyone for asking for help! Mental health starts at home and it starts with you.

Mental health in adults needs to be destigmatized. Feelings towards mental illness vary from culture to culture, but many communities have the attitude that mental illness is not real; that simply ignoring symptoms is the only “strong” solution. Seeking help is the bravest act you can do for yourself if you are struggling with a mental illness such as depression or addiction. You would not ignore a broken bone so do not ignore your brain.

Call and reach out, Forks Community Mental Health, WEOS provides services for the whole family, we provide mental health & substance use disorder services, now with Spanish services available.

We are here to help!

Mabel Thackeray, LMHC, DMHP

Supervising Mental Health Specialist

Licensed Psychotherapist.

January 31, 2019

Disclaimer: This Column is not intended as a diagnosis or recommended treatment of a specific condition. Answers are not a replacement for an individual medical evaluation. Individual health concerns should be evaluated by a licensed clinician.

The Importance of Women’s Heart Health

According to the American Heart Association, “Every minute in the United States, someone’s wife, mother, daughter or sister dies from heart disease, stroke or another form of cardiovascular disease (CVD). More than one in three women is living with CVD. Although heart disease death rates among men have declined steadily over the last 25 years, rates among women have fallen at a slower rate.

These are very staggering numbers and it stresses the importance of women lowering their risk for CVD’s including Heart Attack and Stroke. Heart disease is the most common cause of death for both men and women in the United States. Death from heart illness is much more common than death from breast cancer.

Information from the National Heart, Blood and Lung Institute suggests that Coronary Heart Disease or Coronary Artery Disease may be caused by several contributing factors which can damage the heart which are:

• Smoking, including second hand smoke
• High amounts of certain fats and cholesterol in the blood
• High blood pressure
• High amounts of sugar in the blood due to insulin resistance or diabetes
• Blood vessel inflammation

Fortunately women can take measures to identify signs and symptoms of heart disease and lower their risk factors for heart disease. Being aware of signs and symptoms of a heart attack or stroke are also key to getting the immediate treatment needed in this emergency situation. In a recent article from the Mayo Clinic, Heart disease in women: Understanding symptoms and risk factors, they outlined several factor’s identifying symptoms which may include:

• Pain or pressure in the chest
• Neck, jaw, shoulder, upper back or abdominal discomfort
• Shortness of breath
• Pain in one or both arms, or inability to lift arms
• Nausea or vomiting
• Sweating
• Lightheadedness or dizziness
• Unusual fatigue
• Slurring of words
• Facial droop

They also identified risk factors for women including:

• Diabetes
• Hypertension
• Mental stress and depression
• Smoking
• Inactivity
• Menopause
• Broken heart syndrome
• Certain chemotherapy drugs and radiation therapy for cancer
• Pregnancy complications

There are, however, many things that women can do to reduce their risk for cardiovascular disease. These include:

• Stop smoking
• Exercise regularly
• Maintain a healthy weight
• Eat a healthy diet that includes whole grains, fruits and vegetables, low fat or fat free dairy products, and lean meats. Avoid saturated or trans-fat, added sugars and high amounts of salt.
• Take medications as prescribed by your physician such as blood pressure medications.

Guidelines from the American Heart Association urge women to be more aggressive about cutting their cardiovascular disease risk. For some women this includes daily aspirin. Talk to your physician about the risks and benefits of taking aspirin.

Treatments for heart disease vary, and if your doctor suspects you may have heart disease, they will discuss a plan with you on how to best manage the disease. Your physician may order tests such as an EKG or Cardiac Stress Test which can be performed at the hospital. They may order a Holter Monitor device that monitors your heart and that you wear home for 24-48 hours and return to the hospital. These tests are designed to detect the presence or absence of abnormalities of the electrical conduction of your heart.

There are also newer forms of testing available, such as the extended cardiac monitor. These devices are worn home for 7-10 days and record your heart rhythm. The patient is also allowed to shower with these devices. The devices are then returned to the hospital where they are downloaded and interpreted by a physician. Forks Community Hospital recently tested one of these devices and we are hoping to offer this service at the hospital very soon.

In February of 2004, the American Heart Association launched the “Go Red for Women” program to increase awareness efforts about the effect of heart disease in women.  There is an online risk assessment tool as well as women focused messages and events to inspire women to take action.

For more information, please visit: www.goredforwomen.org to show your support and get involved.

Doug Devine  – Director of Cardiopulmonary at Forks Community Hospital

January 30, 2020

Disclaimer: This Column is not intended as a diagnosis or recommended treatment of a specific condition. Answers are not a replacement for an individual medical evaluation. Individual health concerns should be evaluated by a licensed clinician.

November 12 – 18, 2018 is Antibiotic Awareness Week

Fall and winter have arrived and bring with them cozy indoor activities and holiday celebrations.  Regrettably, this season also brings many viral illnesses such as the common cold, RSV, and influenza. Winter illnesses can make people feel quite ill, and they often go see their doctor for help. If you have recently been to your doctor with cold or flu symptoms, you may have noticed that doctors are prescribing fewer antibiotics than in the past. There are my good reasons for this.

Many people are aware of the benefits of antibiotics but not as familiar with the risks of antibiotics. Antibiotics are powerful medicines for treating bacterial infections. Unfortunately, despite their benefits, they can cause serious, even life threatening reactions and side effects. Medical providers are attempting to be better stewards of antibiotic use as a result of these complications. The goal is to only prescribe antibiotics to patients who need them and not to patients that do not need them.

Most of the winter illnesses are caused by viruses and treatment with antibiotics will not help.  Occasionally, a viral illness can transition into a bacterial infection that needs to be treated with antibiotics.  Medical providers now have better guidelines and quicker tests to help them decide when antibiotics are needed.

You can help medical providers be good stewards of antibiotics in multiple ways!  Prevention is the best medicine. Stay healthy this season by getting the Flu Shot and washing your hands.  If you get sick, use good hygiene to prevent the spread of your illness. Stay at home if you can, cover your cough, and wash your hands. With time and rest, your immune system will fight off a viral illness the majority of the time. If you are not getting better and do need to see your doctor, do not ask for antibiotics. Your doctor will prescribe them if they are needed.  When you are prescribed antibiotics, always take them as directed.  Anytime you take antibiotics, it is a good idea to add a probiotic like yogurt or kefir. Probiotics replenish good bacteria in your system and help to prevent some of the common complications that accompany the use of antibiotics.  Probiotics can also be prescribed in pill form by your doctor.

Enjoy the season and stay healthy!

Doctor J. Wallhoff –  Forks Community Hospital

November 2018

Disclaimer: This Column is not intended as a diagnosis or recommended treatment of a specific condition. Answers are not a replacement for an individual medical evaluation. Individual health concerns should be evaluated by a licensed clinician.