Located on the Olympic Peninsula Forks Community Hospital Pioneers in Rural Health Care Lake Crescent ...in the heart of the Olympic National Park Bogachiel Medical Clinic 390 Founders Way Nosotros permanecemos aqui para usted Permanezca en casa porfavor para nosotros

Happening at Forks Community Hospital

Forks Community Hospital is proactive in ensuring the safety of our Long Term Care residents, patients, staff, and community. For more information regarding COVID-19 please call Department of Health at 1-800-525-0127.

Do NOT delay your care!

There are misconceptions around the safety of visiting a clinic or hospital right now- but medical providers want you to know accessing health care is safe. Care is available across Washington by phone, video call, or in person. In-person care looks a little different now: There aren’t any more crowded waiting rooms, and you’ll likely see a lot of people in masks, be asked screening questions, and have your temperature taken. All of these precautions are to keep you safe. See below “Ways we are working to ensure patient safety!”

Are you hoping a medical issue will just get better? Not getting help could mean it will get worse. If you have a physical or emotional health concern, make the call to your care team and let them make the call about your medical needs. Do not put your healthcare on pause.

Don’t Delay. Get Care. We’re Here.

To decrease wait times at the Central Check-In Station, please complete the top portion of the COVID-19 Assessment Form and bring it with you to your appointment. If you are attending an appointment as a caretaker, please have a form completed both for yourself and the patient. We appreciate your partnership as we work to safely provide you with exceptional, personalized care throughout the COVID-19 pandemic.

  • 7/28/2020 Family, Friends, and Residents: The presence of the current COVID-19 pandemic in Washington has resulted in long periods of separation for us all, and the consequences are concerning to everyone. Thank you for your forbearance while we worked to create new procedures that lowered......

  • Wednesday, August 12, 2020 News and Information If you have concerns in regards to COVID-19, symptoms, social distancing, or general COVID-19 questions please contact Department of Health at 360.417.2274   General Health Question of the Day “I was exposed to someone who tested positive for......

  • Drugs for COVID-19 are changing almost daily. Some that started out strong for characteristics that would impact the virus itself are no longer recommended including hydroxychloroquine and zinc sulfate. Azithromycin, an antibiotic, is not used for the virus (antibiotics do not affect viruses) but it......

  • Friday, July 24, 2020   Over the last 24 hours, the West End has had two more positive cases with one diagnosed by the Forks Community Hospital.  In both cases, the individuals were undertaking their day to day activities.  As their symptoms worsened, they sought......

  • The July 26th testing supervised by Clallam County Health Department will take about 30 minutes and involves a nose swab that is not painful. Testing is free and no insurance or identification is required. Testing will be supervised by the Clallam County Department of Health. ......

  • To ensure the safety of our residents, patients, community and staff, every person entering Forks Community Hospital and its associated facilities must first visit the drive up Central Check-in Station to be cleared to enter campus facilities unless there is a life threatening emergency.  Staff during......

  • Forks Community Hospital continues to work hard to partner with our community. We strive to meet your expectations and function with transparency. Please see the flyer below for information on testing and billing related to COVID-19. Click Here for Printable PDF...

  • As many residents have already heard, last night, June 1, 2020 the Laboratory at Forks Community Hospital received confirmation of a positive case of COVID-19. Department of Health was notified and has already begun the process of contact tracing. Contact tracing is the process of......

  • Administration, managers, employees, and the Board of Commissioners have all been working hard to put procedures into place that keep all patients safe. We encourage everyone to seek treatment for chronic and new health care needs that are either COVID or non-COVID related.   Printable......

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Click on the title to watch videos composed of important information and answers to common questions regarding COVID-19. Check back for updates as the Center for Disease Control (CDC), World Health Organization (WHO), Washington State Medical Association (WSMA), and Department of Health (DOH) create more content.

Can COVID-19 last on surfaces and in the air?

Disclaimer: This video 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.

Can ibuprofen make COVID-19 worse?

Disclaimer: This video 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.

COVID-19: Are You at Higher Risk for Severe Illness?

Disclaimer: This video 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.

When to Seek Care for COVID-19

Disclaimer: This video 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.

Answering 20 Questions about COVID-19

Disclaimer: This video 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.

Cloth Face Covering Do’s & Don’ts
Cloth Face Covering Do’s & Don’ts

Wearing a cloth face covering CORRECTLY can help prevent the spread of COVID-19 to others. When you go out on essential trips, follow these “do’s”. If you have a child, remember those under age 2 should not wear a face covering. See: https://bit.ly/2R9av5m

Posted by CDC on Wednesday, April 15, 2020

Disclaimer: This video 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.

What can I do to protect myself from COVID-19?

Disclaimer: This video 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.

What your doctor wants you to know about your COVID-19 RISK

Disclaimer: This video 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.

COVID-19 Stop the Spread of Germs

Disclaimer: This video 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.

What You Need To Know About Handwashing

Disclaimer: This video 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.

Your doctor wants you to BLOCK THE DROPS

Disclaimer: This video 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.

What your doctor wants you to know about COVID-19 SYMPTOMS

Disclaimer: This video 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.

5 things your doctor wants you to know about Coronavirus

Disclaimer: This video 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.

6 Steps to Prevent COVID-19

Disclaimer: This video 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.

COVID-19: What Older Adults Need to Know

Disclaimer: This video 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.

10 Things You Can Do to Manage COVID-19 at Home

Disclaimer: This video 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.

What your doctor wants you to know: Is it a cold or COVID-19?

Disclaimer: This video 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.

Lo que necesitas saber acerca del lavado de manos
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Cuándo buscar atención médica por el COVID-19
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Ponga de su parte para desacelerar la propagación
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Padres que apoyan a sus hijos
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Distanciamiento social
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Cuidar a alguien con COVID-19
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Cómo manejar la ansiedad y el estrés
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
COVID-19 Detenga la propagación de los microbios
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Síntomas de la enfermedad del coronavirus 2019
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Protégete a Ti Mismo :60 | Coronavirus Response | Ad Council
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
6 medidas para prevenir el COVID-19
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
10 cosas que puede hacer para controlar el COVID-19 en casa
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
COVID-19: Lo que los adultos mayores necesitan saber
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
COVID-19: Quédese en casa si está enfermo
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Cómo se CONTAGIA EL CORONAVIRUS y Cómo EVITAR CONTAGIRARSE del COVID 19
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Preparación y apoyo durante el COVID-19
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Corona Virus: En Maya Mam Y Español
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Lava tus Manos
Descargo de responsabilidad: Esta video no tiene por objeto servir de diagnóstico ni ser un tratamiento recomendado respecto de una condición específica. Las respuestas no reemplazan una evaluación médica individual. Las inquietudes de salud individuales deberán ser evaluadas por un clínico con licencia
Nosotros perma necemos aqui para usted. Permanezca en casa porfavor para nosotros.
Nosotros perma necemos aqui para usted. Permanezca en casa porfavor para nosotros.

La seguridad de nuestros residentes, pacientes, comunidad y personal, cada persona que ingresa a Forks Community Hospital es importante.

  • 28/7/2020 Familia, amigos y residentes: La presencia de la actual pandemia de COVID-19 en Washington ha resultado en largos períodos de separación para todos nosotros y las consecuencias son preocupantes para todos. Gracias por su paciencia mientras trabajamos para evitar la propagación de COVID-19 en......

  • Viernes, 24 de Julio de 2020 En las últimas 24 horas, el West End ha tenido dos casos más positivos, uno diagnosticado por el Hospital Comunitario de Forks. En ambos casos, los individuos realizaban sus actividades cotidianas. A medida que sus síntomas empeoraron, buscaron pruebas......

  • Miércoles, 12 de Agosto de 2020 NOTICIAS Y INFORMACIÓN Si tiene inquietudes con respecto a COVID-19, síntomas, distanciamiento social o preguntas generales sobre COVID-19, comuníquese con el Departamento de Salud al 360.417.2274. Pregunta General de Salud del Día ¿Estuve expuesto a alguien que dio positivo......

  • No somos un Centro de Pruebas COVID-19 designado, somos un Hospital de Acceso Crítico con Clínicas de Salud Rural; Las pruebas COVID-19 deben ser ordenadas por un proveedor. Los proveedores ordenarán pruebas según lo consideren médicamente necesario.  ...

  • Como muchos residentes ya han escuchado, anoche, 1 de junio de 2020, el Laboratorio del Hospital Comunitario de Forks recibió la confirmación de un caso positivo de COVID-19. El Departamento de Salud fue notificado y ya ha comenzado el proceso de rastreo de contactos. El......

  • Para proteger a los pacientes y empleados debido al Coronavirus (Covid-19) debemos practicar el distanciamiento social la puerta de enfrente está cerrada.  Cómo recoger medicamentos y otros artículos de la Farmacia y Variedad de Chinook....

  • Si necesita servicios de emergencia, no dude en llamar al 9-1-1. Continuamos respondiendo a las llamadas de emergencia  Se le harán preguntas para determinar si ha estado expuesto a Covid-19  Al principio, solo puede haber una persona de EMS (servicio médico de emergencia), el resto del equipo esperará afuera. Le hará preguntas a distancia antes de hacer contacto físico.  El EMS usará equipo de protección como máscaras, batas y protección para los ojos. No se alarme, esto es para proteger al médico para que pueda continuar sirviendo a la comunidad....

  • La Comunidad del Hospital de Forks es proactiva para garantizar la seguridad de nuestros residentes, pacientes y personal de ancianos de atención a largo plazo. Como tal, se han implementado algunas medidas de precaución COVID-19.  Una medida de precaución de COVID-19, no se permitirá la entrada de visitantes que no sean el personal hospitalario necesario al centro de Atención a Largo Plazo a partir del Jueves 12 de Marzo de 2020. Skype está disponible para que los residentes se mantengan en contacto con sus familias. Llame a (360)374-6271 extensión 110 para programar sesiones de Skype.  No se permiten visitantes en los edificios del Hospital de Forks. Esto incluye la Clínica Bogachiel, la Clínica Médica de Familia de Forks, la Clínica de Clallam Bay, Fisioterapia, Edificio Administrativo, Servicios Financieros para pacientes, la Clínica de Servicios Conductuales de West End Outreach. Se alienta a las personas......

  • Para garantizar la seguridad de nuestros residentes, pacientes, comunidad y personal, cada persona que ingrese a Forks Community Hospital y a sus instalaciones asociadas deberá primero concurrir a la Estación de Admisión Central con acceso para automóviles para ser autorizado a ingresar a las instalaciones......

haga clic para pdf
haga clic para pdf
haga clic para pdf
haga clic para pdf
  • The Employee of the Month can be any employee of Forks Community Hospital, Bogachiel Clinic, Clallam Bay Medical Clinic, Forks Family Medical Clinic, and West End Outreach Services who is nominated. Anyone can nominate an employee. Was your stay made more pleasant by a kind......

  • An instructor will guide you through the topics on pregnancy, childbirth, the newborn, and address your individual questions and concerns. Click the image for full details. To register: Call: (360) 327-8436 Email: cassieh@forkshospital.org Go to the Forks Community Hospital Admitting Desk        ......

  • Bogachiel Clinic and Dr. Rebecca Pfaff are happy to introduce an ADDITIONAL option and approach to prenatal care. CenteringPregnancy® allows you and a companion or companions of your choosing to attend prenatal visits that are in a comfortable setting. These appointments provide the time to......

  • The Certified Nursing Assistant Class is now accepting applications. This course is a first step in starting an exciting career in healthcare. The course cost is $300 and reimbursement opportunities are available. Applications must be turned in no later than Monday, January 27th. The course......

Did you know we have many experts that work at Forks Community Hospital? Do you have a medical topic you would like explained by an expert from Forks Community Hospital? Please submit your medical topic to information@forkshospital.org and we will do our best to answer them here and in the Forks Forum.

Click on a title below to view the answer:

COVID-19 Facts not Fear

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

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.

STROKE - Learn the Symptoms

Stroke – Learn the Symptoms

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.

Centering Pregnancy - A New Approach to Prenatal Care

Centering Pregnancy – A new approach to prenatal care.

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 was developed by providers who felt they were unable to spend quality time with their patients in prenatal appointments. Traditional care normally allows for 2 to 4 hours total of face to face time with your provider over the course of a your entire pregnancy The 90 minute to 2-hour time block of each Centering appointment helps to address this issue. Despite the group setting, patients find they get to know their provider better as Centering allows them to spend so much more time together when compared to the traditional prenatal care appointments.

In Centering, you are provided with both private times to talk with your provider and ask personal questions, as well as group times that are fun and informative. Over the course of your pregnancy you will spend 20 hours face-to-face with your provider, allowing for relaxed conversation and an opportunity to really feel heard and understood.

CenteringPregnancy is prenatal care. It has no additional cost to the patient or insurance, despite the extra time with the provider. Your individual care needs are addressed in private; orders and results of ultrasounds, labs, personal needs, belly checks, and prescriptions are part of your appointment time built into the Centering group block. However, the reason for general testing and medications is often a topic for group discussions. Participants have reported that Centering group discussions led to a better understanding of the lab testing and medications prescribed, even if this is not their first pregnancy.

Why did Bogachiel Clinic and Forks Community Hospital adopt this program?

The reasons are vast, more time with patients, proven increased patient safety, increased patient satisfaction, reduced preterm birth rates, and building of community are among the top reasons. Another reason is that Clallam County has the HIGHEST INFANT MORTALITY rate in the state of Washington. CenteringPregnacy is directly linked to lowering infant mortality rates. These reasons also led to the United States Army adopting CenteringPregnancy as its prenatal care model. Centering CEO, Angie Truesdale is on TIME’s 2018 list of The Most Influence People in Healthcare. Robin Marty stated, “The U.S. has the highest maternal mortality rate of any developed nation… As Centering Healthcare Institute’s CEO, Truesdale launched a major expansion of CenteringPregnancy, a group prenatal-care program proven to improve birth outcomes, especially in undeserved communities.”

CenteringPregnancy is a program developed to meet the unique needs of our families, neighbors, and friends.
Our goal is to offer more choices, you are in charge of deciding what is best for you and your family.

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 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

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.

Centering Pregnancy - Appointments and Privacy

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

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.

Centering Pregnancy - Frequently asked Questions

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

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.

Cervical Health Awareness

Cervical Health Awareness

In my practice I diagnose at least 4-5 women with cervical cancer every year.  This year in the United States, over 13,000 women will be diagnosed with invasive cervical cancer caused by the human papilloma virus (HPV).  HPV is quite common, in fact, is estimated that 79 million Americans currently have HPV. The majority of HPV infections cause no harm and the body’s immune system clears the virus over the course of two years. Besides causing cancer, HPV is also responsible for genital warts, and some cancers of the penis, anus, vulva, and throat.  The good news is that vaccination against HPV and screening programs with pap smears can help decrease the risk of cervical cancer in women.

A pap smear can find the cell changes to the cervix caused by HPV. During your pap smear your provider can conduct and HPV test to help them to know if you are at a high risk for cervical cancer. There is no treatment for HPV, however, providers have options for treating the diseases HPV may cause.

HPV is transmitted when infected genitals come into contact with other susceptible areas. Condoms only protect the skin they cover and transmission is still highly probable.  The incubation period of HPV can be weeks, months, or years after exposure.

As of today, the CDC recommends that all boys and girls receive the HPV vaccine at age 11 or 12. When the vaccine is taken in pre-teen years it produces a stronger immune response. A three series vaccine is available for both men and women up to age 45.  In countries such as Australia where a high percentage of people are receiving the vaccine, the rates of cervical cancer continue to drop significantly.

Talk to your primary care provider to find out more about HPV, cervical cancer, and preventative measures.

Dr. Rebecca Pfaff, FPOB

January 13, 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.

Practical Suggestions to Stay Safe in Winter

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

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.

Energy Drinks - Not Worth the Risk

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

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.

End the Addiction Stigma

End the Stigma

The stigma attached to people with addictions is often harmful or false and it interferes with efforts to find relief from the very real damage that addictions cause to individuals, their families, and their communities.

No one is immune as addictions impact people from all walks of life, and it makes no sense that the same people who likely feel the impact of this problem within their own communities or families can also contribute to the biggest barriers to finding help and moving forward: the barriers caused by addiction-related stigma.

The Cambridge dictionary  defines stigma as  “a strong lack of respect for a person or a group of people or a bad opinion of them because they have done something society does not approve of.”

People with addiction are often harnessed with a stigma that brings shame and discrimination and these feelings of shame are often the main reason people do not seek help.

“Junkie. Druggie. Crackhead. Dope Fiend. Alcoholic.”

It doesn’t take much to see these words getting thrown about on social media these days or hearing them in conversation.

Words can hurt.

Addictions, also referred to as substance use disorders, impact people differently than other diseases. Legal issues, damaged relationships, employment problems, school problems, health issues, or mental health problems are all among symptoms of a disease that has an impact on ones behaviors–including the ability to make healthy choices.

No one wakes up one day and decides they want to become addicted to drugs or alcohol. Addiction is described as a progressive, chronic disease of the brain. This means it gets worse over time and never really goes away.

According to the American Society for Addiction Medicine (ASAM), addiction is a combination of genetics (family history) and environment (relating to your surroundings). This is comparable to other chronic diseases like diabetes or hypertension.

This combination “can result in physical changes to the brain’s circuitry, which leads to tolerance, cravings, and the characteristic compulsive and destructive behaviors of addiction that are such a large public health burden for our nation,” states ASAM.

The good news is that those same symptoms that contribute to addiction-related stigmas or discrimination are easily addressed in treatment. These symptoms are diminished when one enters treatment and maintains their recovery.

The not so good news is that only about one in ten Americans who have a substance use disorder gets professional help.

According to the Danya Institute’s Anti-Stigma Toolkit, addiction-related stigmas exist for various reasons. “Some of the reasons why stigmas are sustained are conscious and purposeful, some are unconscious, some are personal, and some are social and institutional.”

The reasons behind addiction-related stigma include:  maintaining distance, expressing disapproval, to feel superior, to feel safe, to promote agendas, to control others, to express fear, and to hurt others.

This only worsens the situation and more benefit can occur when individuals, families, and communities work to prevent addiction-related stigma.

Working to prevent stigma involves various approaches according to the Danya Institute publication and recommendations include:

  • Learn more about addiction, treatment and recovery. Get informed.
  • Speak out when you notice misinformation or discrimination and prejudice.
  • Keep hope alive and don’t give up.
  • Treat people with dignity.
  • Think about the whole person.

When, and if, we are able to overcome addiction-related stigma, more individuals will be able to access a life of recovery. They will benefit. Families and their communities will be strengthened.

Words can heal.

Mike Salsbury; Substance Use Program Coordinator

West End Outreach Services

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.

Respiratory Care Week 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

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 Flu and You

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

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 Behavioral Health Program and West End Outreach (WEOS) - Substance Use Disorder Treatment Program

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

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.

Vaccinate - Save Lives

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

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

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.

Antibiotic Awareness Week

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.

Do you have a question you would like answered by an expert from Forks Community Hospital? Please submit your questions to information@forkshospital.org and we will do our best to answer them here and in the Forks Forum.

Click on a question below to view the answer:

“What is Coronavirus?"

What is Coronavirus?

What is Coronavirus?

Coronaviruses are a large family of viruses. Some cause respiratory illness in people, and others circulate among animals such as camels, cats, and bats. There are seven different coronaviruses that are known to infect humans. Most coronaviruses cause mild illness – an upper respiratory tract infection that looks a lot like the ‘common cold.’ People can also get a runny nose, headache, cough, sore throat, fever, or just do not feel well. Occasionally certain human coronaviruses can cause pneumonia or bronchitis, a more serious respiratory illness. People with weakened immune systems, infants, and older adults are more at risk of infection and can have a more severe case of illness. SARS is a coronavirus you may have heard of that originated in animals and then moved to infect humans. MERS was another coronavirus that has been in the news. Recently Novel Coronavirus (2019-nCoV) has been showing up in Wahun, China, causing pneumonia and some deaths.

How is it transmitted?

The theory is that 2019 – nCoV is spread by respiratory droplets similar to the way influenza is spread. It is unclear, yet, how this new Coronavirus has spread to people. Typically, Coronaviruses can be spread through the air; by coughing and sneezing, through close personal contact like touching or shaking hands; touching an object that has the virus on it, then touching your mouth, nose, or eyes before washing your hands; and, very rarely, through fecal contamination.

How is this different than influenza or SARS?

New (or novel) viruses appear through mutation. The World Health Organization and the Centers for Disease Control (CDC) and other agencies watch and test to evaluate whether a new mutation or Coronavirus has been discovered and whether it can affect humans. The CDC currently feels that 2019-nCoV will not cause severe illness in America. However, those who are immunocompromised, the very young, and the very old are always at an increased risk. The CDC will continue to provide updates, and they are working closely with health authorities here in Washington to evaluate this first case.

What can I do to protect myself and my family?

WASH YOUR HANDS!! Avoid touching your eyes, nose, or mouth with unwashed hands. Avoid close contact (within 6 feet for a prolonged period) and direct contact (shaking hands, touching, etc.) with others who are sick. If you are sick, stay home and do not go back until you are well. Wash hands frequently with soap and warm water for 20 seconds or more. Cough or sneeze into a tissue, or, if one is not available, cough or sneeze into your sleeve or elbow, NOT into your palm. Take care of yourself. Drink plenty of fluids, rest. Treat fever and headache with over-the-counter medications (remember not to give aspirin to children), and see your healthcare provider if you are concerned about your symptoms.

 

Information from cdc.gov/coronavirus/about/index.html Accessed 1/21/2020

 

Deborah Dillon, RN, Director of Quality and Patient Safety

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.

“What are the three steps of early detection?"

What are the three steps of early detection?

“The 3 Steps of Early Detection” were established to allow patients to take an active role in their care and are advocated for by various cancer and illness societies across the nation. Early detection of medical issues often allows for greater treatment options, higher survival rates, and better quality of life.

Step One- Remember What Great Feels Like

Pay attention to how your body feels when you are healthy and well rested. Knowing what “Great” feels like will help you take notice of little changes to your overall health. Sometimes these small changes can be signs leading to a larger health related issue. Know what your sleep, weight, skin, and restroom habits are normally and take notice of changes.

Step Two – The 2 Week Rule

Have you notice a change to your normal wellbeing that has lasted over two weeks? Any health change that has lasted over 2 weeks is worth discussing with your primary care provider. Most of these small changes will not be a cause for concern. However, waiting when it is a larger medical issue can lead to a progression of the illness canceling out earlier and more effective treatment options.

Step Three – Share Honestly with Your Primary Care Provider

Sometimes bodies and health are embarrassing. It is important to be honest with your health care provider no matter what. Honesty allows for your provider to make informed decisions and get you back to health quicker.

Taking notice of your health and taking action when there is a lengthy change is one of the most effective ways to advocate for your own healthcare. Remember, sometimes not all symptoms are visible, especially in earlier stages of major illnesses. In these cases your primary health provider can only make decisions based on what you are telling them. It is crucial you are able to articulate the differences honestly.

 

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.

“What are AED's and how do they work?"

What are AED’s and how do they work?

An AED or Automatic External Defibrillator is a small portable device used to restore a heart beat in a person suffering from sudden cardiac arrest.  This is done by measuring the persons heartbeat and electrical rhythm and if appropriate, administering an electrical shock to the heart to restore a normal rhythm.

 

AED’s are a simple device to operate, yet very sophisticated in what they do.  An AED typically has one or two switches on them.  One switch will turn on the device, the other will deliver the shock.  The term Automatic means that the device will automatically analyze the patient’s heart rhythm, determine if there is a shockable rhythm, then set the correct power level and alert the user that it is ready.  The AED will only deliver the shock when the user presses the shock button.

 

When the device is opened and turned on (some will turn on when the lid is opened), the device will give prompts to follow.  The AED will direct the user to place the pads on the patient’s chest, once the AED senses the pads are on, it will then prompt the user to stay clear of the patient, do not touch the patient.  This prevents an error in the heart rhythm analysis, which may cause an incorrect shock or no shock at all.  If the AED detects one of two rhythms, either Ventricular Tachycardia (very rapid heartrate) or Ventricular Fibrillation (no heartbeat, but the heart is “quivering”) the AED will announce “Shock Advised” and start charging up for the shock to be delivered.  Once the AED is ready, it will say to stay clear of the patient and deliver the shock.  The shock button is usually placed in the center of the device and will blink or glow brightly and have a warning tone.  The user must make sure no one is touching the patient before delivering the shock, otherwise that person touching the patient may be shocked instead of the patient.

 

A simple way to remember how to use an AED is to remember the phrase; “Power on, follow the prompts”.

 

When to use an AED?

 

When someone suffers sudden cardiac arrest, it means that the heart is no longer beating, or is quivering in a way that does not pump blood.  Early CPR with AED defibrillation has been proven to greatly increase survivability in patients who suffer from sudden cardiac arrest.  If you find a person who is not breathing, check the area around you to ensure you are not in danger.  Call for help, call 911 and put it on speaker phone and follow the instructions of the 911 dispatcher. Look for chest rise for about 10 seconds.  If the patient is not breathing, and you have been trained in CPR, otherwise know how to administer CPR, or instructed by the 911 dispatcher, begin CPR.  Place your hands in the center of the chest, and push hard, deep and fast. About 2 inches deep on and adult, 1 ½ inches on a child.  Do compressions at 100 to 120 beats per minute.  If you can give rescue breaths, do so after every 30 compressions.  If you are not able to give rescue breaths, compression only CPR is advised.  When the AED arrives, turn it on and follow the prompts.  The pads have a picture on them showing proper placement.  If a shock is delivered resume CPR.  The AED will analyze the patient every two minutes, follow the prompts and resume CPR.

 

In the case where the AED does not deliver a shock, this doesn’t necessarily mean hope is lost, only that the rhythm is not shockable.  When EMS arrives, we have tools and drugs we can use to treat the patient, and continuous high-quality CPR is the patient’s best chance of survival.

 

Will you get in trouble if you use an AED and the patient dies?

 

In Washington State, we have a Good Samaritan Law.  RCW 4.24.300 states that if someone provides care to a patient, and does not expect to be paid or compensated, and who does not commit an act of gross negligence or willful or wanton misconduct shall be immune from civil liability for damages.

 

Simply put, if you try to help someone, and don’t expect to be paid, and don’t do something you know you shouldn’t do, you may be protected under the law from liability, even if the results are poor.

 

Early high-quality CPR with AED application saves lives.  If you are interested in learning more, or becoming CPR certified, please contact the Ambulance Department at Forks Community Hospital for class times and locations. (360) 374-6271 ext. 625.

 

Tim Wade – Forks Community Hospital Ambulance Supervisor / RMVAC Liaison

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.

“What is the difference between same day appointments and walk in appointments?"

What is the difference between a walk in appointment and a same day appointment?

Walk In Appointments

Walk in visits in a clinic setting are not pre booked. You must physically walk in to the clinic to be seen by a provider and then are seen in order of arrival or severity of your medical need.  Walk in patients do not call ahead.

Same Day Appointments

Same day appointments are just that; they are scheduled that day.  We have a daily schedule for these visits and they are pre booked by calling into the clinic the day of.  With one provider serving this need we have a limited number of those visits each day.  For one provider the max is usually 18 to 20 in a day so if you need to be seen call early as appointments fill up fast.

Things to Remember

Bogachiel Clinic offers same day appointments, not walk in appointments.

Call Early! Same day appointments are booked that day. All 18-20 appointments are often scheduled prior to lunch.

Same Day means THAT Day. Same day appointments cannot be booked in advance.

Same Day Care is NOT Primary Care. Same day appointments should not replace visits with your primary care provider.

Barbara Schmidt, Clinic Administrator

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.

“What is Heart Valve Disease?”

What is a Heart Valve Disease?

National Heart Valve Awareness Day is on February 22nd. As many as 11 million Americans may have heart valve disease, (HVD), according to the Alliance for Aging Research. HVD is a potentially disabling and deadly disease, yet 3 out of 4 Americans know little to nothing about the disease.

In an article published by Mayo Clinic on Heart Valve disease, they focused on identifying symptoms, causes, risk factors and complications. The following is an excerpt from that article.

In heart valve disease one or more of the valves in your heart does not work properly.

Your heart has 4 valves that keep blood flowing in the right direction. In some cases, one or more of the valves don’t open or close properly. This can cause blood flow through your heart to your body to be disrupted.  Your heart valve disease treatment depends on the heart valve affected and the type and severity of the valve disease. Sometimes heart valve disease requires surgery to repair or replace the heart valve.

Some people with heart valve disease might not experience symptoms for many years.

Signs and symptoms of heart valve disease may include:

  • Abnormal sound (heart murmur) when a doctor is listening to the heart beating with a stethoscope
  • Fatigue
  • Shortness of breath, particularly when you have been very active or when you lie down
  • Swelling of your ankles and feet
  • Dizziness
  • Fainting
  • Irregular heartbeat

 

Heart valve disease may be present at birth (congenital). It can also occur in adults due to many causes and conditions, such as infections, hypertension and other heart conditions.

 

Heart valve problems may include:

  • Regurgitation.In this condition, the valve flaps don’t close properly, causing blood to leak backward in your heart. This commonly occurs due to valve flaps bulging back, a condition called prolapse.
  • In valve stenosis, the valve flaps become thick or stiff, and they may fuse together. This results in a narrowed valve opening and reduced blood flow through the valve.
  • In this condition, the valve isn’t formed, and a solid sheet of tissue blocks the blood flow between the heart chambers.

 

Risk factors

Several factors can increase your risk of heart valve disease, including:

  • Older age
  • History of certain infections that can affect the heart
  • History of certain forms of heart disease or heart attack
  • High blood pressure, high cholesterol, diabetes and other heart disease risk factors
  • Heart conditions present at birth (congenital heart disease)

 

Complications

Heart valve disease can cause many complications, including:

  • Heart failure
  • Stroke
  • Blood clots
  • Heart rhythm abnormalities
  • Death

If you develop any symptoms that may suggest heart valve disease, see your doctor.

How is valve disease diagnosed? According to the Cleveland Clinic, your doctor will talk to you about your symptoms and medical history; then perform an exam and diagnostic tests. Those results will help the doctor make a diagnosis.

The physical exam may show that you have fluid in your lungs, an enlarged heart, or a heart murmur. A heart murmur is the sound made by blood moving through a narrowed or a leaky valve.

Diagnostic tests help determine the location, type and extent of your valve disease. They help your doctor see how severe the leak or stenosis is and how it is affecting your heart’s function and ability to pump blood. These tests may include and are available at Forks Community Hospital:

  • Echocardiogram(echo): A graphic outline of the heart’s movement. High frequency sound waves are sent through a transducer wand that is placed on your chest. This produces pictures of the heart’s valves, chambers and pumping action of the heart. An echo can show a narrowed or insufficient valve.

 

  • Electrocardiogram (EKG or ECG): A picture on graph paper of the electrical impulses traveling through the heart muscle. Electrodes (small, sticky patches) are placed on the body, and they send the information that creates the picture. An EKG can detect abnormal electrical activity in the heart.

 

  • Cardiac Stress Test: The cardiac stress test involves exercising on a treadmill while you are closely monitored. This test is used to screen for unrecognized coronary artery disease, high blood pressure (hypertension) and abnormal heart rhythms (arrhythmias).

 

  • Pharmacological Nuclear Stress Test: For those who cannot exercise on a treadmill due to a physical condition, a Nuclear Cardiac Stress Test may be ordered. A pharmacological nuclear stress test is a diagnostic test used to evaluate blood flow to the heart. During the test, a small amount of radioactive tracer is injected into a vein. A special camera, called a gamma camera, detects the radiation released by the tracer to produce computer images of the heart.

 

  • Cardiac Catheterization: Cardiac catheterization is a procedure used to diagnose and treat cardiovascular conditions. During cardiac catheterization, a long thin tube called a catheter is inserted in an artery or vein in your groin, neck or arm and threaded through your blood vessels to your heart. These are performed by a cardiologist at major medical centers.

If you suspect you may have Heart Valve Disease, please contact your physician.

If you would like to get involved and share information about the disease with the community, please visit the National Heart Valve Disease Awareness Day website at: www.valvediseaseday.org

Doug Devine

Director of Cardiopulmonary

Forks Community Hospital

January 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.

“What is a Certified Athletic Trainer?”

What is a Certified Athletic Trainer?

National Athletic Training Month is held every March in order to spread the awareness about the important work of the Certified Athletic Trainers (ATCs). What many people think of as Sports Medicine is actually Athletic Training. In short, the profession of Athletic Training encompasses the prevention, examination, diagnosis, treatment and rehabilitation of emergent, acute or chronic athletic injuries. They work closely with physicians and other healthcare providers such as a Physical Therapist (PT) in order to provide unique, efficient and responsive healthcare to the community. Athletic trainers are integral members of the health care team in secondary schools, colleges and universities, professional sports programs, sports medicine clinics, hospitals, corporate /industrial, and other health care settings.

The American Medical Association (AMA) first recognized Athletic Trainers as an allied healthcare profession in 1991. Since then, many other national healthcare organization such as the Health Resources Services Administration (HRSA) and the Department of Health and Human Services (HHS) have acknowledged the importance of ATCs in the field of healthcare.

To become an ATC, one must first graduate from accredited baccalaureate or master’s program in athletic training. While in college, the individual will be expected to complete a rigorous program that entails a combination of formal classroom and clinical instruction and clinical experience. They will then have to pass a national board exam and in most cases become licensed by the state department of health. Once these criteria have been met, the athletic trainer is prepared to provide health care within each of the following content areas:

  • Risk management and injury prevention
  • Pathology of injuries and illnesses
  • Clinical examination and diagnosis
  • Acute care of injury and illness
  • Pharmacology
  • Therapeutic modalities
  • Therapeutic and rehabilitative exercise
  • General medical conditions and disabilities
  • Nutritional aspects of injury and illness
  • Psychosocial intervention and referral
  • Health care administration
  • Professional development and responsibilities

Are Certified Athletic Trainers the same as a Personal Trainer or Strength Coach?

Despite being a recognized allied health care profession for almost three decades, the profession of athletic training is often miss-understood. Many people compare Athletic Trainers to personal trainers or strength coaches. This is understandable as the profession does bear the name “athletic training”. However, these professions are much more different than you think. In short, ATCs don’t train athletes. As described above, they are healthcare providers who provide care for both athletes and non-athletes alike.

As noted earlier, The ATC must go through a rigorous education program and pass a national exam. Personal trainers, on the other hand, are fitness professionals and NOT healthcare professionals. There is little or no regulation of their professional practice and there are very few requirements to obtain a personal training credential (some of which can be obtained with as little as a weekend course). The only similarity between Athletic Trainers and personal trainers is that both work with athletes, but our jobs are very different.

Where can you find a Certified Athletic Trainer?

Fortunately, the Physical Rehabilitations Department at Forks Community Hospital does have a Certified Athletic Trainer on staff, in addition to its physical therapy and occupational therapy staff.

Aaron Gee, PT, DPT, MA, ATC, CSCS

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.

“Can you tell me more about Emergency Medical Services in Forks?”

Can you tell me more about Emergency Medical Services in the Community of Forks?

The community of Forks is served by a unique brand of Emergency Medical Services, we are a Hospital based Ambulance service who’s crews also work within the Hospital. Forks Ambulance has a long history of serving the Forks community, from volunteers using their own vehicles to transport patients to the present day. The core of the EMS agency is the Ray Ellis Memorial Volunteer Ambulance Corps or REMVAC for short. These volunteers have devoted their own time to train and respond to medical emergencies. We train to the King County EMS standards, each month we hold training on current practices and new procedures. As a hospital based EMS agency, we will respond to the residence or incident scene, care for and transport the patient, stay with the patient in the ER and assist the doctor and nurses there.

If the patient is admitted, our EMT’s also work inside the hospital as aides to the doctors and nurses. This provides a higher level of care for those patients that return to the hospital or need EMS services at their residence, as we are familiar with the patient, their history and their needs. There are 3 full time EMT/ER Techs and 20 per diem EMT volunteers. Currently, 8 of those volunteers are in training to receive their Advanced EMT rating. When they graduate, REMVAC will have 15 Advanced EMT’s on the roster.
Our EMT volunteers are the backbone of the service; they work the late shifts, responds from home, in the middle of the night, away from the dinner table, on holidays and weekends. At all times of the day or night, someone is listening for the call, and they are ready to respond. They will respond to the Hospital in their own vehicle, a green blinking light will identify them as responding to an emergency. So if you see a green light behind you, and you can safely move to the side, please do so. We work closely with the Fire Dept. and Police Dept. in being prepared for any emergency response that may arise.

REMVAC has trained with and responded with the National Park Service, Dept. of Natural Resources, La Push Police, Clallam County Sheriff’s Office, Washington State Patrol, Forks Police Dept., Forks Fire Dept., Quileute Valley School District, the FBI, Quileute Fish and Wildlife, Clallam Bay Fire, Neah Bay Fire and many others in the Northwest Healthcare Network. We have transported patients as far away as Spokane, Seattle, Bellingham, Sequim, Aberdeen and many other places as well.

If you want to be a part of this dynamic family, contact the Forks Community Hospital and ask for the Ambulance Department, we will be holding an EMT basic course in late August.

Timothy T. Wade | Ambulance Supervisor / REMVAC Liaison

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.

“Do I need to include herbal supplements on my list of medications?”

Do I need to include herbal supplements on my list of medications when talking to my Doctor?
Can I over dose on herbal supplements?
Who controls the quality of supplements?
Is there risk in taking too many types of supplements?

Your provider needs to know about all medicines you are taking whether herbal products, Over-The-Counter (OTC) medications, prescriptions, or illicit drugs.

Let’s start by identifying what is a drug: Drugs are used to diagnose, treat or prevent disease. and can include prescriptions, OTC and herbals, just by the way they act in the body. Even though herbals are not licensed as drugs, they may still act like drugs following this definition. They are all subject to toxicity and to interactions with other drugs, diseases, or foods.

As we just reviewed some of the similarities of these things, here is some background on the differences between these products when it comes to governmental regulation. Prescriptions and OTC drugs are tested by the Food and Drug Administration (FDA) who then licenses these drugs when they are proven to be considered safe.

Herbal supplements follow the Dietary Supplement Health and Education Act of 1994 to make sure products are not adulterated or misbranded. FDA does not review dietary supplement products for safety and effectiveness before they are marketed. Manufacturers and distributors are responsible for evaluating the safety and labeling of these products. Dosing is standardized by the manufacturer and some issue a COA or Certificate of Analysis. For more detailed information about bacterial or fungal levels, heavy metal contamination, pesticide and herbicide residues in the herbal, you might need to contact the manufacturer. Should a health problem arise or be reported to MedWatch about an herbal supplement, FDA studies the threat and takes action.

This is why the consumer needs to research any supplement before taking it and certainly before taking herbals with other drugs because they can interact and affect your health. Even if the supplement is termed “all natural” it can still cause adverse effects.

The FDA has good tips before taking an herbal supplement: Check with your provider first especially if you have chronic conditions, are taking other medications, or if you have a surgery coming up.

We have seen how herbals can act as drugs in the body. At some amount, every drug is possible to overdose. Herbals can interact with other herbals, with other drugs, with foods, and pre-existing conditions and/or diseases. The more herbals you take, the more risk of ill effects. One caution is that the effect you want will probably take longer to achieve with the herbal than with a prescription or OTC drug.

While much of this discussion has focused on caution with herbals, bear in mind that some people get great benefit from them. Self-treating may be a good start for minor discomfort or improvements in mood or energy levels. These symptoms should not be ignored too long before getting help from a provider.

This is why a provider or specialist is responsible for managing drugs and herbal use. Pharmacists also have a lot of expertise in answering questions about drugs and herbals. Before prescribing, a provider reviews more than just your request for help and your history, the provider checks lab tests or other ways of determining what is wrong or even what to avoid in your care.

Treating herbals with the same respect as other drugs is important to avoid toxicity, drug interactions, and safety issues. Drugs are a major advantage in our healthcare arsenal.

The goal of drug therapy is to cure when possible, to relieve often, and to comfort always.

Janet Schade, MS, RPH

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.

“Do over the counter medications effect my prescription medications?”

I have a cold. I want to take over the counter medications and Vitamin C. Do I need to ask my doctor first?
Will cough medicine effect my prescription medications?

Whether you have a cold, want to take an Over-The-Counter (OTC), or herbal product for any reason, drug interactions are a concern, especially when you already use prescriptions drugs.

There are three basic kinds of drug interactions: Drugs interacting with other drugs; drugs interacting with food or beverages; and drugs interacting with chronic conditions you already have, that may not even be related to the interacting drug you want to take. OTC drugs, vitamins, and herbals all act like drugs and potential drug interactions need to be monitored. Some drug interactions can be beneficial but many more can be dangerous.

For that reason, many drug to drug interactions need to be avoided. The herbal product St. John’s Wort has actions similar to antidepressants so some people like to take it for that reason. The problem is that this herbal remedy interacts with prescription antidepressants and can cause very serious reactions. Avoid the use of these two together unless a provider says to take both. In another case of drug interactions, timing is everything. As an example, a person taking thyroid medicine should avoid other drugs at the same time, including vitamins: To do that, the thyroid prescription is taken early in the morning on an empty stomach and the vitamin is taken an hour later with breakfast, avoiding the interaction and allowing both drugs to be taken.

Drug interactions with food or beverages sometimes go beyond a simple dietary choice. For example, there is an antibiotic tablet, metronidazole, which reacts significantly with alcohol. Even if you say you don’t drink, your body doesn’t know the difference of this interaction with alcohol from cough syrup, herbal liquid supplements, or even some kinds of candies, and rum cake. This unpleasant combination of drug and alcohol can cause violent vomiting and a bright red hot flushing of the face and torso.

Another example of the need to avoid certain food or beverages with a drug is due to the fact that alcohol is known for deadly reactions with narcotics and sedatives. Many deaths have occurred from what the small label on your prescription warns: “Use of alcohol may intensify the effect of this drug” followed by cautions about driving impaired or using machinery.

Sometimes drug-disease interactions occur because of multiple ingredients in the drug. For example, the active or main ingredient of a cough syrup may be fine with a prescription to improve control of blood sugar, but the extra ingredients of alcohol or sugar in the cough syrup can cause problems with that chronic disease, diabetes. Vitamin C can affect blood sugar too and has other interactions with several drugs that affect blood clotting.

There are likely more drug interactions possible than there are drugs. Read labels and whether you want to take something for relief or comfort for a temporary situation, note that there are many drugs with significant interactions. The best advice is to contact your pharmacist to review your prescription profile and receive well researched and practical counseling before taking any OTC drugs, vitamins, or herbals.

Janet Schade, MS, RPH

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.

“Is handwashing really that important?”

“Is handwashing really that important?”

Clean hands saves lives by stopping germs from spreading from person to person. Many diseases are spread when we don’t wash our hands with soap and water. Wash your hands after using the bathroom, petting animals or handling raw meat. Body waste from people and animals carries germs like Salmonella, Norovirus, C-difficile and E-coli that can make you very sick with diarrhea, nausea and vomiting. Other germs get onto our hands by touching an object someone has sneezed or coughed on. If these are not washed off we can spread them to ourselves by touching our eyes, nose or mouth or to others by touching them. The flu and other respiratory illnesses are spread this way.
Handwashing can also help in the fight against antibiotic resistance – by reducing the spread of germs there are fewer sick people taking antibiotics.
So, the CDC says….

Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
Rinse your hands well under clean, running water.
Dry your hands using a clean towel or air dry them.

Melene Bourm RN, Surgery Manager

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.

“How many years should pass between colonoscopies?”

“How many years should pass between colonoscopies?”

A Colonoscopy should be done at age 50, unless there is a family history of Colon Cancer. If there is a history of Colon Cancer the person should have a colonoscopy prior to that age – usually 5-10 years before.  Example:  Father had colon cancer at age 49, son should have a colonoscopy at age 39-44.

If a person has rectal bleeding or spotting, get a colonoscopy ASAP.  This holds true no matter the family history.
If polyps are found, colonoscopies need to be done 3-5 years thereafter.
If checked and no polyps are found, it is usually 10 years before you will need another colonoscopy.

“Do I need to see my Primary Care Physician prior to scheduling a colonoscopy?’”
Yes, see your primary care physician to get scheduled for a colonoscopy.  Most insurance companies require this visit.

“Does my Primary Care Physician do my prostate exam or do I have to get a referral to a specialist?”
Primary care physicians can do the prostate exam, and order labs or tests if needed.

“Do I have to go to Port Angeles to have a colonoscopy?”
No, General Surgeon Dr. Chang can perform your colonoscopy locally at Forks Community Hospital.

Melene Bourm RN, Surgery Manager

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.

How does my prescription add to medication resistance? What is medication resistance?

How does my prescription add to medication resistance? What is medication resistance?

First, let’s look at antibiotic prescriptions only. Antibiotics are built to kill bacteria (bugs) or stop bacteria from growing. In people, antibiotics are used to fight infections caused by bacteria but can cause side effects and antibiotic resistance at the same time.

Antibiotic resistance occurs when the bacteria become able to live in the presence of the antibiotic even though the antibiotic is supposed to kill the bacteria. Then the bacteria multiply and another treatment is needed to stop the infection.

How does antibiotic resistance occur? By misuse which can be taking antibiotics when they are not ordered or taken incorrectly, and by overuse when antibiotics are unnecessary like for a cold or flu and are given too often. Every time a person takes antibiotics, even when it is the right thing to do, some bacteria live (resistant bacteria) and over time there are more bacteria that are resistant to that antibiotic.

Some antibiotics that were used in the past can no longer be prescribed for the same infections treated earlier due to bacterial resistance. This can be deadly. If a bug can no longer be treated with antibiotics, those infections can lead to disability or death. Projections are that in the next 50 years, unless we manage antibiotics correctly, people like the toddler or kindergarten child in the family may die in their middle age of what is now a simple infection because that bug will no longer be treatable.

Why should anyone be concerned about antibiotics that someone else is taking? Bacteria are everywhere. The resistant bacteria grow in general society too. Anyone who misuses or overuses antibiotics contributes to the increasing problem of resistance.

The smart use of antibiotics is very important to control the spread of resistance.

What is smart use of antibiotics? Many diseases can be prevented with a vaccination so make sure you are current. Tell your doctor you prefer taking steps to get better without antibiotics if possible. Ask if your condition is from a virus and if so, decline antibiotics designed for bacteria. It might be difficult to tell if you have a virus that will clear up in another day or so or if you have a bacterial infection that needs an antibiotic so the doctor may write a prescription but ask you to wait and fill it in a day or so only if you feel worse. If you do get an antibiotic, take it as directed by the doctor and avoid skipping doses. Most will tell you to stop taking it when you feel better in several days anyway. When your treatment is completed, throw away any remaining antibiotic by adding water to the bottle with soap or coffee grounds so it is unusable by anyone else. It is important that you avoid saving it for a future illness and do not give any to a family member or friend.
These actions help prevent resistant bacteria.

This is everyone’s problem. We are partnering with you to do something about this.

At Forks Community Hospital we have a multi-disciplinary team who started a focus on Antimicrobial Stewardship over 2+1/2 years ago. We have been participating in a tele-conference every week with the University of Washington to combat this problem. Our efforts have been well done and we have received awards annually from the Washington State Department of Health. Last year we presented our program at a conference of the Washington State Hospital Association, and even won a grant to enhance our services and education to staff.

During this holiday season, protect you and your loved ones by frequently and thoroughly washing your hands: Sing the Happy Birthday song twice in a row to make sure you spend enough time with the soap and water. Cover your cough and even wear a mask, even if you are well and want to stay that way by avoiding germs of others. Stay rested and minimize anxiety. Gratitude helps. The best gift for everyone is the gift of health.

Janet Schade, MS, RPh, Director of Pharmacy.

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.

I saw an advertisement for a pharmaceutical on the television. Why did my doctor choose to prescribe something else?

I saw an advertisement for a pharmaceutical on the television. Why did my doctor choose to prescribe something else?

When going shopping, many people make a list. Often times, patients treat a trip to the doctor as they do a shopping outing, with a list of drugs they would like to try. Maybe a prescription ad on TV or in a magazine looked like something for you? Perhaps your friend or neighbor has a pharmaceutical they swear by? Maybe you just want to feel better and think a prescription might help?

Sometimes, a drug is exactly what you need. Drugs can identify a disease, treat the symptoms and basic condition, or even cure it.

However, the drug you want may not be the right one.

Let’s look at your trip to the clinic as an opportunity to get the best help from your doctor, whether it is better drug or a different type of treatment.

What is a better drug? It is the one that does what it is supposed to do (the benefit) with the least side effects (the risks). Picking the best drug is a detailed process your doctor carefully considers. If you want an antibiotic and your infection is caused by a virus, an antibiotic will not work. Some drugs do not go with other ailments you have or other drugs you are already taking. Several are not to be used if you are younger than the age of 18 years. A few may be beneficial but the side effects are too much of a risk. You may already have been caring for your condition with home remedies or medication from the store. It helps the doctor to know what you have tried so far.

Over-The-Counter (OTC) drugs that you buy without a prescription can be very good for taking care of mild symptoms or for even treating a problem for a short time. They are labeled with directions for how to take them and with warnings about interactions with your conditions or other drugs you take so you know if you need to avoid them. Doctors actually recommend some OTC drugs. Also, certain herbal products can help. Often it takes longer for herbals to take full effect and they do not have the same labeling as OTC products so it is less clear if you should take them at all or what amount to take.

What is a different type of treatment? In many cases, Physical Therapy offers benefits. Here are some other ideas: For an injury, apply ice and elevate the area, use distraction like music or television; for a respiratory illness, use a humidifier or a dehumidifier as the case may be; for an infection, take a probiotic to prevent upset stomach that can occur when taking antibiotics.

Be involved in your healthcare. Be honest about what you have done and want to achieve. Be willing to follow your doctor’s instructions even if you do not get the drug on your list.

Janet Schade, MS, RPh, Director of Pharmacy.

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.

These videos were created by Dr. Michelle Dickinson and Dr. Panda Toto Time with the intention to help you explain social distancing, hand washing, and Coronavirus to children. Please view each video prior to watching with your child or children to ensure the content is something you would choose to share.

The Science Behind how Soap Destroys Coronavirus.
How Does Soap Make a Super Shield?
Coronavirus Explained! (for kids)
Nanogirl and Moe Talk About the COVID19 Lockdown.
How to wash hands properly to kill all Germs, Hand-washing Steps Using WHO Technique, Doctors style
Coronavirus Outbreak | How to protect yourself | Kids Learning Cartoon | Dr. Panda TotoTime (Video 1 of 3)
Coronavirus Outbreak | What is a virus? | Kids Learn Cartoon | Dr. Panda TotoTime (Video 2 of 3)
Coronavirus Outbreak | How did it start? | Kids Learning Cartoon | Dr. Panda TotoTime (video 3 of 3)
Bogachiel Medical Clinic

Bogachiel Clinic provides a full range of high quality, comprehensive family health care. Located at 390 Founders Way.

Clallam Bay Medical Clinic

Clallam Bay Medical Clinic is a certified Rural Health Clinic and a department of Forks Community Hospital.

Forks Family Medical Clinic

Forks Family Medical Clinic is a certified Rural Health Clinic and a department of Forks Community Hospital.

West End Outreach Services

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