Adventist Health Portland | Living Well | Spring 2024

LIVING WELL PAGE 12 Heart-smart tips for every age — try them today. PAGE 6 ‘The program is absolutely amazing’: Jenny’s weight-loss story. PAGE 4 What is polycystic ovary syndrome? SPRING 2 0 2 4 PROTECT YOURSELF AND YOUR HEART FROM DIABETES HONORING OUR NURSES SUMMER SAFETY TIPS

2 LIVING WELL @AdventistHealthNW @AHNW Adventist Health Portland @AdventistHealthNW CONNECT WITH US ONLINE Living Well Magazine | Spring 2024 10123 SE Market Street Portland, OR 97216 Living Well is Adventist Health Portland’s biannual magazine providing health information, news and tips for our neighbors in east Portland and surrounding communities. Contributing editors: Laurel Rogers and Heather Pease Contributing writers: Loree Chase-Waite and Sydney Fuentes Design: Coffey Communications Would you prefer to read Living Well online and opt out of print? Visit Information in LIVING WELL comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your health care provider. Models may be used in photos and illustrations. 2024 © Coffey Communications, Inc. All rights reserved. Join Us for Living Well Classes and Events Check out the full list, including self-paced birth and parenting classes, at PortlandEvents or scan the QR code. SCAN ME Spring 2024 4 Polycystic Ovary Syndrome: Get the Help You Need 6 Added Energy, Better Health: A Nurse’s Weight‑Loss Story 8 How We Invest in Our Nurses 10 Minding Your Mind’s Health: Why It Matters 11 Tips to Help You Stay Safe This Summer 15 True Story: How Our Team Members Help Each Other 11 15 4 3 Adventist Health Portland, an OHSU Health partner, includes a 302-bed medical center with an emergency room, dozens of medical and urgent care clinics, and home care and hospice services. Our many physicians and employees are dedicated to caring for you as a whole person — mind, body and spirit — not just as an injury or illness. We are also part of Adventist Health, a health care network of more than 20 hospitals and countless clinics and services spanning California, Oregon and Hawaii. Guest Editor Editor’s letter More excited than ever You could say nursing is in my DNA. When my family left Romania and came to America when I was a child, my parents started taking care of elderly residents in our home. That’s where I learned how important it is to treat patients the way we would treat our own family. Now, as Adventist Health Portland’s nursing executive, I work every day to make sure that same sense of family comes through every nurse into each moment you share with us. Our mission to live God’s love by inspiring health, wholeness and hope drives our team to value you — and each other — as family. I see that sense of community all over our hospital, clinics and programs. I see it in the life-changing choice one of our nurses made to improve her health and energy, as described on page 6. I see it in how nurses shape almost every aspect of health care, which you can read about on page 8. I see how we are investing in the next generation of nurses through partnerships, education, residencies and advancement and how we are investing in each other through the Employee Assistance Program (page 15). Coming out of the pandemic, nurses are driving innovation, shared decision-making and evidence-based care with renewed energy. Most important, we are making a real difference for you, our patients. I’m more excited than ever about nursing, and I hope the following pages give you a little peek into why. Diana Erdmann, RN, MSN Nursing executive Our mission to live God’s love by inspiring health, wholeness and hope drives our team to value you — and each other — as family.”

4 LIVING WELL Women’s health Get the Help You Need Polycystic ovary syndrome 5 Adventist Health Women’s Clinic 971-231-7790 | you deal with unstable menstrual periods, facial hair and acne, you may be one of the 5% to 26% of women with polycystic ovary syndrome, or PCOS. PCOS is common among women between the ages of 15 and 44, or during their childbearing years. Most patients are diagnosed when they struggle to get pregnant in their 20s and 30s. In fact, PCOS is the most common reason for infertility. The disorder is caused by an imbalance in reproductive hormones, which hinders a woman’s egg release and ovulation cycle. Since PCOS is a health problem that affects so many women of childbearing age, it’s important for you to know the facts. Signs and symptoms PCOS can trigger a variety of signs and symptoms in women, such as: ● Irregular periods. Some women have no periods, and some have more than one period per month. ● Cysts on the ovaries. ● Weight gain or trouble losing weight. ● Excess hair growth on the face, chest and back. ● Loss of hair on the scalp. ● Bad acne. ● Oily skin. ● Darker, velvety and sometimes thicker patches of skin (acanthosis nigricans). Many complications Although infertility is one of the biggest complications of PCOS, the condition also can cause problems once a woman does get pregnant: Her If Get in touch with us chances for miscarriages, gestational diabetes and preeclampsia — dangerously high blood pressure — go up. The complications go beyond the reproductive system alone. Women with PCOS are at risk of developing anxiety, depression, sleep problems, obesity, uterine cancer, high blood pressure, unhealthy cholesterol levels, and diabetes and insulin resistance. Finding help for PCOS If you think you have PCOS, the first step is to talk to your primary care or women’s care provider. “Your treatment plan should be based on your situation and symptoms,” says Gina Cardona, Adventist Health Portland certified nurse-midwife. “For example, medication can help with insulin resistance, skin and hair problems, and regulating your periods. If you struggle to become pregnant, your midwife or OB-GYN can work with you to improve your chances of conceiving through medication or other interventions.” If you’re overweight, changes in diet and exercise can also help. Losing even a small amount of weight may help regulate your periods and improve fertility. Although PCOS has no cure, treatment can help manage the condition and its complications. Work with your provider to figure out the best treatments for you. Sources: American College of Obstetricians and Gynecologists; National Institutes of Health; Office on Women’s Health

6 LIVING WELL In a crisis, Jenny Azevedo wastes no time. She’s a charge nurse at Adventist Health Portland’s emergency room, where she works fast to save lives and help people navigate their toughest moments. So when Jenny’s own health reached a critical point, she knew she had to make a major change. “I’ve always been a bigger person and carried extra weight,” she says. “I’d lose a little, and then I’d just yo-yo, up and down. Finally, when my highest weight was 302 pounds, I got to a point where I said enough is enough.” At work, Jenny was feeling the effects of extra pounds. She’d get so fatigued, she’d drink lots of coffee and power drinks to perk up. On lunch breaks she’d take naps. Even at home, just trying to sleep, she couldn’t get comfortable. Perhaps most concerning, Jenny’s blood pressure was consistently high. Jenny talked with her doctor about options, including weightloss medications. Her doctor suggested she contact Oregon Health & Science University, an Adventist Health Portland partner, to see if she might qualify for weight-loss surgery. “That springboarded things,” Jenny recalls. “I reached out to OHSU, took their online assessment tool and found out that, yes, I would likely be a candidate for weightloss surgery. I was both relieved and a little bit nervous.” The plan takes shape Jenny met with her surgeon, Ryland Stucke, MD, at Adventist Health Portland. “I didn’t make the final decision until after I met Dr. Stucke and got an in-person vibe with him,” Jenny says. “He’s great. He’s super nice and has such a great bedside manner. He and his team answered all my questions.” Another part of Jenny’s presurgery plan was meeting with nurse practitioners, dietitians, physical therapists and psychologists. The goal, over several months, was to prepare physically and mentally for surgery and life afterward. “The biggest thing they told me was to start thinking about healthier eating habits,” Jenny says. They also gave Jenny a binder full of information about what to expect and what her daily life might look like before and after surgery. Jenny Azevedo, RN, has lost nearly 100 pounds. “I feel amazing,” she says. Added Energy, A nurse’s weight-loss story 7 The support Jenny received from her sons, husband, friends and colleagues made a huge, empowering difference too. “They told me, ‘You are so strong-minded, you’ll be able to do it.’” Counting down When the big day arrived, a close nurse friend from work took Jenny into the presurgery unit and stayed with her until surgery time. Others checked in and helped too. “It was comforting being at the hospital where I work,” Jenny says. The surgery, which Dr. Stucke performed robotically through four tiny incisions, took about an hour. Afterward, while Jenny was in recovery, Dr. Stucke checked on her. The next day, Jenny was able to go home. In the following days and weeks, Jenny took it easy. She took 10 days off work, avoided lifting heavy things and only drank liquids for the first week. After that, she slowly tried a bit of soft food. Since then, Jenny continues to lose weight steadily, a bit at a time. By eating wisely and exercising regularly, she’s reached 212 pounds and is coming close to her personal goal, which is to weigh less than 200 pounds. “I feel amazing,” she says. “It’s incredible to see my body change. One of the greatest things is being able to shop at a normal store again.” Jenny’s natural energy and stamina have returned. Squatting down to reach low shelves doesn’t make her knees ache and pop now, and she can perform demanding tasks without sweating and getting exhausted. She’s sleeping better too. Even Jenny’s family members are taking note. Her preteen son joins her in strength training, and her husband takes walks with the family. “Better habits are spilling over into the whole family,” she says. Passing it on Jenny credits the medical experts who helped set her on a healthier path. “I have nothing but great things to say about Dr. Stucke and his team,” she says. “The program is absolutely amazing.” Better Health For others considering weightloss surgery, Jenny shares four main points of advice: Pace yourself. When deciding on weight-loss surgery, it’s important to conquer the inner head part, Jenny says. “I would say 90% of it is a head game,” she explains. Give yourself time. Make gradual eating and exercise changes. “You really have to pay attention not only to what’s on your plate, but what’s in your head and body,” Jenny says. Seek support. Whether it be with friends, family, co-workers or online support groups, look for ways to connect with others on your journey. Ask questions, be open about what you need and lean on your support team. Go forward with confidence. Obesity and the way people lose weight still has some stigma around it, Jenny says. But don’t let that stop you from making the right choice for your health. “You shouldn’t feel shameful because you’re doing something to save your life,” she advises. Words of wisdom Could it help you? Learn more about our metabolic and weight-loss surgery program by visiting or calling 503-912-8083. SCAN ME

New Horizons in Nursing Contrary to what movies and TV shows would have us believe, nurses don’t spend their days walking around saying, “Yes, doctor.” They are vital to modern health care, from clinics and bedsides to education and executive leadership. As we move into the post-pandemic world, nurses are taking on exciting, challenging roles that will shape health care for generations to come. Educating for tomorrow Adventist Health Portland has a long history of depending on nurses while educating the next generation. In fact, our first nurses’ training program began here in 1897 and evolved to become the Walla Walla University School of Nursing, located next door to our hospital. Some of our nurses serve as preceptors to student nurses, giving them vital, real-life, clinical training. That education doesn’t end when nurses graduate and become licensed. Our clinical educator nurses keep our teams updated with the latest evidencebased practices. Connecting and caring Nurses also fill important roles to help patients access the care they need to get and stay well. With their advanced education and training, nurse practitioners see patients in primary care and specialty clinics, assist in surgeries and procedures, and provide emergency care. Similarly, certified nurse-midwives provide gynecology and pregnancy care and help bring our tiniest patients into the world. These advanced practice nurses give our community more choices and easier access to needed care. Care managers help patients in the hospital get set up with all the follow-ups they need in order 8 LIVING WELL

About the Illustrator This page was illustrated by Angelina Dukhonina, a Russian artist living in Vancouver, Washington. She also works as a patient access representative at Adventist Health Portland. After studying at Leninogorsk Art and Music Pedagogical College and then at the Film and Television University in St. Petersburg, Angelina earned a bachelor’s degree in animated arts at Pacific Northwest College of Arts. “I have always loved to draw, and my family has always been very supportive of me in my endeavors,” Angelina explains. Angelina is interested in visual development, animation, illustration and storytelling. She works in traditional and digital media. “Through my work, I want to learn how to show people God’s light and His love,” Angelina says. “In addition, I really love illustrating books. Through this I can fantasize and depict people, their feelings and emotions, and tell their stories.” In her free time, Angelina reads, writes stories, creates music, writes songs and plays musical instruments, such as piano, ukulele, guitar and drums. to be discharged. House supervisors work closely with the OHSU Transfer Center to help patients from all over Oregon quickly find the care they need. Special care for special needs Some nurses train in specialized types of care. For instance, wound care nurses assess and treat a wide range of wounds. This is vital to helping people heal and avoid infections and even amputations. Patients with serious, chronic or life-threatening conditions often can stay in their residence instead of the hospital, thanks to the special work of palliative care nurses. They coordinate with physicians, pharmacists, rehabilitation therapists and more to support the physical, mental and spiritual health of patients and their families. Nurses are also vital in our Improving Addiction Care Team (IMPACT). IMPACT supports hospitalized patients with substance use disorders and connects them to the care and tools they need to make a meaningful recovery. Leading into the future All aspects of hospitals depend on the leadership of nurses. Emergency department director? A nurse. Surgical services? A nurse. In addition to directing clinical care, nurse leaders coordinate staffing, administer budgets, manage capital planning and purchases, forecast supply and staffing needs, report on quality, mitigate risks, and much more. Some nurses specialize in managing quality and risk programs, while others lead the integration of technology and data to manage clinical information systems that are vital to how we provide safe, consistent and quick care. Nurses also serve in the highest levels of hospital and health care executive leadership. In almost every area of health care, nurses are driving and leading change that leads to lower risks, higher safety and better outcomes. Their work today means a healthier tomorrow for us all. 9

10 LIVING WELL Mental health You know that protecting your physical health is important. But how about your mental health? Isn’t that important too? Absolutely. If you’re feeling overwhelmed by stress and other challenges, don’t hesitate to ask for help. You can start with your primary care provider, who can connect you to a mental health professional or counselor. Many people benefit from counseling. In the meantime, you can take simple steps in your everyday life to manage stress and perhaps find a little more happiness. Here are some strategies to try. Lean into your social circle. Social connections can act as a buffer against stress and make life more enjoyable. If something’s bothering you, try talking with a trusted friend. You can also make social connections by joining a club or volunteering. Make time for what you love to do. That could be anything from listening to music or playing with your kids to investing in a hobby or going out with friends and family. Get plenty of rest. Sufficient sleep may help relieve stress and lower your risk for anxiety and depression. Most adults need from seven to nine hours of nightly shut-eye. Sources: Centers for Disease Control and Prevention; Mental Health America Maximize your sleep Sleep is needed and natural. But sometimes it’s hard to fall asleep or stay in dreamland. Our sleep team has free tips for sound slumber in our Getting to Sleep Guide. Visit or scan the QR code. SCAN ME Minding Your Mind’s Health 11 Refresh your summer safety know-how with these i ps. Safety Contact us today To make an appointment with one of our providers, visit us at, scan the QR code or call 971-231-0413. SCAN ME Watch for concussions. If someone takes a fall or hits their head, then seems dazed, forgetful or clumsy or they complain of headache, nausea or just not feeling right, they may have a concussion. Take them to a health care provider right away. Take shelter from storms. Thunder means lightning can strike. Stay inside a sturdy building or hop into a car for at least 30 minutes after the thunder stops. Avoid water, elevated areas, trees and anything that conducts electricity. Swim smart. Swim safely by choosing lifeguardprotected areas. Before any swimming trip, talk to kids about water safety. And if you have kiddie pools, make sure you drain them and flip them over after each use. Check your first aid kit. Whether you buy one or put it together yourself, check your first aid kit for missing or expired items. Keep one in the car and one at home so you’ll always be prepared. STAY SAFE This Summer Sources: American Academy of Pediatrics; American Red Cross; National Weather Service; U.S. Food and Drug Administration Grill with caution. Set up your grill outdoors, far away from anything that could catch fire (like your house). Don’t walk away from your hot grill, and never let kids or pets near it. Handle fireworks with care. Store fireworks away from kids. Always wear eye protection, and never relight a dud.

12 LIVING WELL Heart health In the kitchen, yard and beyond: Loop your family members in to fixing and eating nutritious foods. Reduce couch time and invest in physical activities. Through your family tree: Refresh your knowledge about your family health history. Tell your provider about any heart problems in your family so you can discuss preventive measures. In the stress zone: Over time, stress can increase heart rate and blood pressure. Learn ways to manage stress, including breathing techniques and making time for things you enjoy. On your calendar: Find a health care provider and have regular wellness exams and heart health screenings, like blood pressure, cholesterol and body mass index checks. In your lungs: Avoid smoking and secondhand smoke. If you started smoking as a teen, stop now so you can maximize the benefits. If you’ve never smoked, don’t be tempted to try. In (and out of) the gym: Be active and stay active. It’s easier if you start at a young age. HEART-SMART TIPS FOR THE MOST PART, OUR HEARTS JUST HUM ALONG. Even under extra stress or physical demand, they simply work harder. Hearts are so dependable, in fact, they’re easy to ignore. Meanwhile, arteries can harden or narrow. Blockages may form. Heart disease can creep in. You may not even notice unless something major happens, like a heart attack. Never too early or late There’s great news, though. For most people, heart disease is preventable. “Healthy hearts depend on healthy choices,” says Hoang Nguyen, MD, a cardiologist with Northwest Regional Heart & Vascular. “No matter what your age or stage is in life, you can take proactive steps to help protect your heart. It’s never too early or too late.” 30s 20s All ages On your plate: Load up on plants — fruits and veggies, nuts, legumes and seeds, and fiber-rich whole grains. Limit sugary drinks and red meat. If you decide to eat meat, choose the leanest cuts possible. In your mind: Learn the warning signs of heart attack and stroke, including differences between women and men. In your shoes: Live an active lifestyle with at least 2½ hours of moderate-intensity activity, like brisk walking, each week. for Every Age 13 On the scale: Metabolism may start to slow in your 40s. Try to avoid putting on extra pounds by eating a heart-healthy diet and staying active. At checkups: Ask your provider about what screenings you need and how often you need them, based on your health and family history. Blood pressure and blood sugar screenings are typical. On the pillow: If you or your partner snores or pauses breathing during sleep (sleep apnea), talk with your provider. These conditions can raise your heart risks. At home: More than ever, try to double down on choosing a healthy diet, getting plenty of exercise and watching your weight, Dr. Nguyen says. Address any health issues as they crop up. At checkups: Track your numbers and ask your provider about screenings for heart and peripheral artery disease. Keep a list of anything that seems amiss so you and your provider can go over your concerns. In your memory: Review the warning signs of a heart attack and stroke, keeping in mind they can vary between men and women. Don’t delay getting emergency care if you have symptoms. What are your risks? Take a free heart risk assessment at or scan the QR code. SCAN ME At the table: Push back on unhealthy eating habits. Reach for nutrient-dense foods like fruits and vegetables, whole grains, fish, nuts, legumes, and seeds. In your head: Memorize all the warning signs of a heart attack and stroke. Remember, some of the signs are more subtle than we see on TV. On your list: Pay attention to conditions that increase your risk for heart disease or stroke, including high blood pressure, high cholesterol and diabetes. Stay on track with your treatment plan. 40s 50s 60sand beyond Today is the right time to keep your heart in mind. Don’t worry about what you did or didn’t do yesterday or last year. Love your heart well from now on, so it can do the best job possible for you.” — Hoang Nguyen, MD Quick quiz

14 LIVING WELL Staying healthy Diabetes and heart disease are more connected than you might think. A person with diabetes is twice as likely to have a heart attack or stroke compared to someone who doesn’t. That’s because high blood sugar can damage the blood vessels and nerves around your heart. Luckily, there is a lot you can do to help prevent both diabetes and heart disease. It starts with managing the diabetes ABCs: A Get your A1C tested regularly to track your average blood sugar over time. B Watch your blood pressure and keep it in the zone your health care provider recommends. C Stay on top of your cholesterol levels. Keep them balanced with lifestyle changes and medications your provider may prescribe. S Don’t smoke. If you smoke, find a smoking cessation program and stick to it. Here are some other things that reduce your heart disease and diabetes risks: ● Manage stress. Not only can it increase blood pressure, it might also make you want to do other things that raise your risk, like overindulge in sweets. ● Eat right. Pile on the produce, lean proteins and whole grains. And skip processed foods as much as you can. ● Exercise. Physical activity helps lower blood sugar. When done regularly, it can help prevent or manage diabetes. ● Lose weight. If you’re overweight, losing even a few pounds can help reduce triglycerides and blood sugar. Diabetes and Your Heart ● Consider medicine. Drugs can reduce blood pressure, lower cholesterol, manage blood sugar and help you lose weight. Talk to your provider about what’s right for you. ● Get tested. Your health care provider can tell you which tests to schedule to evaluate your heart’s current health and heart disease risk. Sources: American Diabetes Association; American Heart Association; Cardiovascular Research Foundation; Centers for Disease Control and Prevention Experts on your side If you have questions about diabetes or heart disease or want to talk about screenings, make an appointment with our heart team. Visit or call 971-231-0414. 15 Giving 2023 employee gifts to the Adventist Health Portland Foundation “I will evict you.” Sasha’s* heart sank. Less than a month earlier, she had a good roommate and was getting ready for the holidays. Everything was normal. Suddenly, nothing was. Sasha walked into her home to find her roommate moving out. The roommate had decided to move in with their significant other with no notice — and months left on their shared lease. With no roommate to share the cost, Sasha realized she might not be able to afford rent. When she went to talk to her new property manager, out came those four horrible words. “I was helpless and embarrassed,” Sasha recounts. “I had no idea what to do. I am supposed to be this young, successful woman, to have it all together. But I can’t always.” The weight on Sasha’s shoulders was heavy. She had no next steps. She felt hopeless. One day her supervisor at Adventist Health Portland asked if everything was OK. “I broke down crying at my desk,” Sasha admits. Sasha’s supervisor immediately gave her information about how to apply for the Employee Assistance Program, a fund entirely by employees for employees in need. Sasha’s need was approved right away. “[The head of the EAP committee] asked me how he could get the check to me the quickest,” Sasha remembers. Each leader who knew about her situation checked in with her, and her team was a huge support during this time. Best of all, Sasha kept a roof over her head. With her situation stabilized, Sasha has been donating to the EAP fund for the next person who needs it. “If you can change a person’s life, it is everything,” she says. *Name changed for privacy. A Roof Over Her Head TOTAL GIFTS: 5,583 TOTAL VALUE: $195,340

Come With Us GROW JOIN OUR TEAM Nonprofit Org. U.S. Postage PAID Walla Walla, WA Permit No. 44 10123 SE Market St. Portland, OR 97216 For every hand you’ve held. For every tear you’ve shed. For every heart you’ve healed. Thank you National Nurses Month May 2024