HEART HEALTH IS A FAMILY MATTER MIDWIFERY DELIVERS NEW BIRTHING CHOICES OHSU ER CARE COMES TO THE EAST SIDE LIVING WELL PAGE 15 Find ways to add more joy to your life. PAGE 7 Heart health is personal to cardiology nurse practitioner. PAGE 4 3D mammography catches ‘cancer lite.’ SPRING 2 0 2 3
SPRING 2023 Join Us for Living Well Classes and Events @AdventistHealthNW @AHNW Adventist Health Portland @AdventistHealthNW AdventistHealth.org/Portland CONNECT WITH US ONLINE Check out the full list, including self-paced birth and parenting classes, at AdventistHealth.org/ Events-Calendar, or scan the QR code. Living Well Magazine | Spring 2023 10123 SE Market Street Portland, OR 97216 AdventistHealth.org/Portland 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 Photography: C.J. Anderson and Laurel Rogers Design: Coffey Communications Would you prefer to read Living Well online and opt out of print? Visit AdventistHealth.org/ Portland. 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. 2023 © Coffey Communications, Inc. All rights reserved. 2 LIVING WELL 4 Smaller Is Better: Catching Cancer Early 6 East Side Emergencies, OHSU Care 8 Making Healthy Hearts A Family Matter 10 Don’t Ignore That Snore: It May Be Hurting Your Heart 12 Family Birth Place Provides a Cozy New Beginning 14 Volunteers on a Mission 7 12 8 SCAN ME
Editor’s letter We are invested in anticipating community needs so we can meet them with compassionate, quality care centered around you. 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. Your partner in living well A lot has changed since Adventist Health arrived in Portland in the late 1800s. What hasn’t changed is our long-term dedication to being here for our community with the complete care they need, from gentle birthing to healthy aging and everything in between. That commitment shines in areas like meeting the growing need for birthing care in east Portland through our expanding women’s health program. Inside this issue, you’ll read how our new midwifery team is giving women more choices in their pregnancy and birth care. We are invested in anticipating community needs so we can meet them with compassionate, quality care centered around you. To do that, we’ve spent years handpicking extraordinary providers and other members of our care teams. People — like cardiology nurse practitioner Haley Pacholec, featured in these pages — who combine clinical excellence with a passion for patients and each other naturally create exceptional clinical outcomes. Our patients notice the difference, not only in our trusted cardiac program but throughout our network of clinics, emergency room and hospital. Through our unique partnership with Oregon Health & Science University, we’re bringing more expertise in more specialties right to where you and your family live and work. We’ve also enhanced our technology to help people get lifesaving answers sooner. Now we’re excited to share more about how Adventist Health Portland supports you in living well today, tomorrow and beyond. I appreciate your taking the time to explore the following pages. Even more, I value the trust you place in us as your health care partner. Kyle King President, Adventist Health Portland Guest Editor AdventistHealth.org/Portland 3
It’s the difference between a speed bump on the road and a sink hole. — Vivian Robertson, breast cancer survivor Oncology 4 LIVING WELL
3D mammography catches ‘cancer lite’ Pylarify PET/CT Clearer imaging of prostate cancer locations is possible thanks to Pylarify PET/CT scans. These scans use an imaging agent that accumulates within prostate cancer tumors. Clearer images of prostate cancer enable doctors to detect and treat tumors earlier. 3D mammography Breast tomosynthesis, also known as 3D mammography, uses low-dose X-rays to take many pictures as cross sections of the breast. These pictures are then blended into one image. This more detailed view improves accuracy and reduces false positive rates. CT lung screening Studies have shown low-dose chest CT scanning is a valuable tool for detecting lung cancer before symptoms develop — at its earliest and most treatable stages. Annual low-dose CT scans for current and former smokers may reduce the risk of lung cancer death by as much as 20%. When Vivian Robertson got a call about something irregular on her annual screening mammogram, she wasn’t too concerned. She knew callbacks were common. Using 3D mammography, the Adventist Health Portland radiology team found tiny spots of calcification impossible to feel during a physical exam. The spots were so small, radiologist Robert Scott Israel, MD, asked Vivian to come back in a few months to see if they grew. “I almost blew it off,” Vivian admits. But eight months later, she had another 3D mammogram. The spots had indeed grown and had some irregularities that concerned Dr. Israel, who scheduled her for a needle biopsy. The results came back quickly: She did, indeed, have cancer. ‘Here for you’ Dr. Israel sent Vivian to see Frances Ting, MD, a breast surgery specialist at Adventist Health Portland, to have the tiny cancer removed. Before surgery, Dr. Ting personally introduced Vivian to the entire surgical team. “Everyone in this room is here for you,” she told Vivian. “We are here to do nothing but take care of you.” With such tiny tumors, Vivian’s cancer was removed with clear margins and no sign of spread. She didn’t have to have radiation or chemotherapy. “I’m very fortunate it was small and caught early,” she reports. “It’s very tuned in to estrogen and progesterone. I just have to take an oral medication that blocks the cells from getting those hormones.” Vivian has a strong family history of breast cancer, so she was always careful to do self-exams as well as schedule her annual screenings. But she credits 3D mammography with catching her cancer early. “It’s the difference between a speed bump on the road and a sink hole,” she says. “I got diagnosed with ‘cancer lite’ thanks to 3D mammography.” High-Tech Health Adventist Health Portland’s advanced screening technology helps find and treat disease sooner. Is Better Smaller AdventistHealth.org/Portland 5
LEVEL 1 LEVEL 2 LEVEL 3 LEVEL 4 LEVEL 5 Level 1: Life-threatening emergency Unstable patient, heart or breathing trouble, major bleeding Level 2: High-risk/severe emergency Unstable patient, potentially life-threatening Level 3: Stable emergency Stable patient in need of emergency care Level 4: Less urgent Stable patient with injury or illness that needs attention within hours Level 5: Not urgent Stable patient with minor illness or injury Who’s Next? To save lives, emergency rooms see patients in the order of their emergency, not their arrival. Emergency medicine doctors. These physicians are trained to recognize, evaluate, stabilize and treat people with all medical and trauma conditions. They are expert at treating both children and adults during emergencies like heart attack, stroke, drug overdose and car accident injury. Emergency physician assistants. Physician assistants (PAs) are trained to do some of the same things as doctors. Their certification process includes rigorous coursework as well as hands-on clinical experience. Though PAs work under the supervision of a doctor, their patients may not actually meet the supervising physician. Emergency medicine East Side Emergencies, OHSU Collaboration As part of the OHSU Health partnership, Adventist Health Portland’s ER is staffed by Oregon Health & Science University doctors, physician assistants and nurse practitioners who specialize in emergency medicine. These providers work as an integrated team with Adventist Health Portland nurses, technologists, support staff and others to provide the best care as quickly as possible. Emergency nurse practitioners. Nurse practitioners (NPs) are registered nurses who gain additional classroom and clinical diagnostic and treatment training, but in classrooms and in clinical settings. Because of their extensive training, NPs can treat patients in Oregon. To learn about our emergency room and physicians, go to AdventistHealth .org/PortlandER. 6 LIVING WELL
While growing up as a competitive Nordic skier, Haley Pacholec occasionally would pass out for no apparent reason. Each time, the evaluation came back normal. Finally, an episode in college with an incredibly slow heart rate made it clear Haley needed intervention. “I ended up getting a pacemaker when I was 19,” she says. While that ended her competitive career, it sparked her professional one. “I think it really just opened my eyes to the medical system, because I wasn’t really sure what I wanted to go into at that point in time,” she recalls. She decided to go to nursing school. Cardiology Heart to Heart I feel like an understanding from a patient’s perspective . . . has made a really big impact on my ability to take care of patients. — Haley Pacholec, NP Patients seem to sense the power of this committed and collaborative team. “I have so many patient interactions where they tell me that they’ve been coming here for years, and every single person that they interact with is just absolutely wonderful,” Haley says. “It’s just a special place.” A dream come true As she goes through her workdays, Haley finds her own experience with heart trouble shapes how she approaches patient care. “I feel like an understanding from a patient’s perspective — especially going through procedures and what to expect and just the nerves that are associated with that — has made a really big impact on my ability to take care of patients,” she says. “I think it’s most important for patients to know I really care and I want to be able to be there for them as much as possible.” From cardiac patient to cardiology provider People make it everything After years as a registered nurse, including in the Northwest Regional Heart & Vascular cardiac catheterization lab, Haley decided to complete a master’s degree and nurse practitioner studies. When Fawaz Alhumaid, MD, Northwest Regional Heart & Vascular arrhythmia services director, heard Haley was graduating, he encouraged her to stay at Northwest Regional Heart & Vascular— now as a cardiology nurse practitioner. Haley says the offer was too good to ignore. “It’s the people at Adventist Health Portland that really make it everything,” she says. AdventistHealth.org/Portland 7
Making Healthy Hearts Restrict screen time. Set limits for each child to balance media use with other healthy behaviors. a Family Matter On a list of the greatest gifts you could give your kids, a healthy heart would be near the top. After all, heart disease is the nation’s No. 1 killer. And it often starts in childhood. Helping your kids develop lifelong heart-healthy habits, especially those centered on eating well and being active, is one way to give that gift. Use these tips to make heart health a family affair. Don’t insist on a clean plate. Allow your children to stop eating when full. Model this for them too. Primary care Emphasize healthy foods. Make fast food the exception, not the rule. And when you cook at home, go for heartfriendly foods, including as many plant-based ones as possible. Increase fruits and vegetables. They help with weight and blood pressure control. Plan some family fun. Ask everyone to set aside time during the week and on weekends for fun family fitness. You might all go for a bike ride or a short hike, for example. 8 LIVING WELL
Helping your kids develop lifelong healthy habits is one way to give the gift of a healthy heart. Sources: American Academy of Pediatrics; American Heart Association Cheer your children on. Find a sport or activity your children enjoy, like swimming or dancing. Then provide opportunities for your kids to participate — and maybe do it with them. Check in with a doctor. Ask your and your children’s provider if any of you should be screened with blood pressure, blood glucose, cholesterol or body mass index (BMI) tests. These offer clues about heart disease risk. Add active toys to the toy box. Think a jump rope, a soccer ball or in-line skates — with the recommended safety gear. Find time to eat together. Frequent family meals promote healthier eating and healthy weight. Live by example. Kids pay attention to what you eat — as well as how much you exercise and whether you engage in habits like smoking that are unhealthy for the heart. Prioritize play. Fit at least one hour of physical activity into your children’s daily schedule. It could Create family fitness challenges. For instance, see who can do the most situps during a TV commercial. be active playtime or something more organized — anything to get your kids moving. SCAN ME Ready to take an important step toward protecting your heart health? A few minutes answering questions in our heart risk assessment will give you a report describing where you’re doing right by your heart — and where you can do better. You can take your report to your health care provider and ask what else you can do to manage and reduce your cardiovascular disease risks. Learn more at NWRegionalHeart.com/HRA or scan this QR code. Quick Quiz What Is Your Risk? AdventistHealth.org/Portland 9
Quality sleep isn’t a luxury. It’s a necessity. Our Getting to Sleep Guide can help. Learn more at AdventistHealth.org/PortlandSleepGuide or scan this QR code. Sometimes snoring is more than just snoring. Sometimes it’s a sign of sleep apnea, a potentially dangerous condition that, among other things, can be hard on your heart. The most common type, obstructive sleep apnea (OSA), causes breathing to stop as much as 30 times or more per hour during sleep. “These pauses momentarily wake a person up, although they may not remember being awake,” explains Chad Hagen, MD, a board-certified sleep medicine specialist with Adventist Health Portland. “Breathing pauses can cause oxygen levels to drop, which puts a big strain on the heart and brain.” OSA also can increase the risk of: ● Heart failure ● High blood pressure Sleep medicine SCAN ME Get Free Sleep Tips Don’t Ignore That Snore It may be hurting your heart ● Atrial fibrillation (an irregular heartbeat) ● Type 2 diabetes ● Stroke Could I have OSA? “Loud snoring is the most obvious hallmark of OSA,” Dr. Hagen notes. “But if you live alone, you may not have had anyone tell you that you snore.” Other signs include: ● Stopping breathing while you’re sleeping. ● Waking up gasping or choking. ● Waking frequently. ● Having headaches in the morning. ● Feeling sleepy or tired during the day or having problems concentrating. How to treat OSA Your first step is to talk with your primary care provider if you suspect you may have OSA. The condition can be diagnosed by a sleep study or with an athome sleep apnea test. OSA can be treated with a continuous positive airway pressure (CPAP) device, which involves wearing a mask while sleeping that keeps air pressure flowing in your airways so they don’t close down. It’s important to not shrug off OSA as just a snoring problem. Treatment is vital to your heart — and your overall good health. Sources: American Academy of Sleep Medicine; American Heart Association 10 LIVING WELL
Do you ever suddenly remember during the evening or on the weekend that you need to make a medical appointment, ask for a refill on an expired prescription, check on lab results or ask your health care provider a question? Now you can do these things and more online. Just sign up for your provider’s patient portal. It’s a password-protected website available anytime from your computer or a smartphone app. What is a patient portal? Many hospitals and clinics have websites called patient portals. These provide an easy way to connect online with your provider and your health information. When you sign up for a patient portal, like Adventist Health Portland’s OHSU Health MyChart, you create a unique login name and private password. That means the site and your information are secure. Why should I sign up? It’s always important to be in control of your health and health care. Portals can save you time. Plus, they help you get care and support between in-person visits with your provider. On your patient portal, you can access information and summaries about visits and hospitalizations, plus review records of your medications and immunizations. Adventist Health Portland’s version of OHSU Health MyChart lets you: ● Securely message your provider. Q How do I sign up for MyChart? A: Go to AdventistHealth.org/PortlandMyChart and select “Sign Up Now.” You will need your access code and medical record number (MRN) from your After Visit Summary. If you lost your access code or do not have one, please contact the OHSU Health MyChart help desk at 503-494-5252. Q How do I get MyChart for a loved one? A: Under age 15: Only parents or legal guardians may request access to a child’s account. If you have an OHSU Health MyChart account, you can get proxy access online or by visiting or calling their provider’s office. Everyone 15 and older: Older teens and adults must fill out, sign and submit a release of information form to grant someone else access to their MyChart. Then you log in to your own MyChart account and set up the proxy access with your child or family member. Scan this code to learn more about the OHSU Health MyChart and access the release of information form. Primary care Make MyChart Your Chart How to track health care records with your patient portal ● Request prescription refills at OHSU retail pharmacies. ● Request nonurgent appointments and virtual visits. ● Update your contact information. ● Pay your bill. ● Download visit summaries and test results. ● Search a medical library. MyChart Q&A SCAN ME Ask your health care provider about their patient portal. If you’re a patient with Adventist Health Portland, just ask us for an enrollment code at your next visit. You’ll be glad you did. Sources: JMIR Aging; National Institute on Aging; Office of the National Coordinator for Health Information Technology AdventistHealth.org/Portland 11
Adventist Health Portland’s Family Birth Place opens the door for new birthing options Naomi Campean grew up in a big family. Her mom always talked about how giving birth with the help of a midwife was her best birth experience. So when Naomi learned she was pregnant, there was no question what birth experience she wanted. “I knew right away I wanted an unmedicated birth,” she remembers. “I wanted an atmosphere that didn’t feel like a hospital.” Just a few months before her due date, Naomi learned her midwifery center was closing. Luckily the midwives were joining OB-GYNs at Adventist Health Portland’s Women’s Clinic, with their deliveries going to the Family Birth Place. At first, Naomi was concerned about the change to a hospital setting. The midwives assured her Adventist Health Portland was remodeling some birthing suites to create a midwifery unit inside the New Beginning A Cozy More than Babies Certified nurse-midwives do more than deliver babies. CNMs also: Provide well-woman exams, screenings and vaccines. Counsel about family planning. Prescribe treatments and medications. Help women navigate menopause and beyond. Source: American College of Nurse-Midwives SCAN ME Learn more about our certified nurse-midwives at AdventistHealth.org/ PortlandMidwives or scan this QR code. Certified nurse-midwives 12 LIVING WELL
hospital. These suites would feature cozy amenities like a normal bed, low lights, reduced machinery, and birthing support gear like labor tubs and birthing stools. When Naomi woke on Jan. 2, 2023, she felt the first signs of labor. “I knew, deep down, ‘It’s starting,’” she says. After rest, food and a shower, she and her husband, Jonathan, headed to Family Birth Place and checked in to one of the midwifery suites. Heading to the Family Birth Place Jonathan hung up Christmas lights, and Naomi settled into labor. The lights were cozy and low, and the many cushions and balls helped her find the most comfortable positions. Soon the midwives, led by nurse-midwife Carissa St. Onge-Carneiro, filled up the laboring pool. Naomi slipped into the comfort of the warm water while the midwives got right down on the floor next to the tub to be with her every minute. When Naomi was close to delivering, the midwives helped her move back and forth between leaning into the bed and using the birthing stool. Naomi prayed her way through her contractions and soon delivered her son. She held him right away as the midwives tucked them both into bed. As Naomi settles into life with a newborn, she’s grateful for her experience with the Adventist Health Portland midwives. And when she and Jonathan decide to expand their family, she has no doubt she will return to midwifery care. “I would do it again,” she says. Education to Support Your New Journey Expectant parents can complete our online, self-paced classes at their convenience. Understanding Birth Understanding Natural Childbirth Techniques Understanding Your Newborn Understanding Breastfeeding SCAN ME Ready to get started? Scan the QR code to learn more. AdventistHealth.org/Portland 13
environment that requires cooperation and connection. It’s also such a social job, and now volunteers are having potlucks and texting each other. The physical movement and social connections are good for everyone’s mental health. Q What do our volunteers do? A: Volunteers run our gift shop, which raises funds to purchase patient care equipment and fill other needs. They help in the mail room, central supply and our discharge/escort service. They deliver meal trays and run errands — basically anything they can do to enhance how our clinical teams care for patients. Q How do they contribute to the Adventist Health mission? A: Our mission is living God’s love by inspiring health, wholeness and hope. That means we Volunteers on a Mission are here to love people the best way we can, in any way we can. Sometimes we are the first and last encounters with patients, and we want them to experience an environment where they feel valued and respected. I remind our team, “Everything you do matters because it helps patients feel taken care of well.” Community The volunteerrun Rose Petal Gift Shop provided funds to help create midwifery birthing suites in our Family Birth Place. Learn more about midwifery on page 12. Lauren Ashmore recently celebrated her 15th anniversary with Adventist Health Portland, where she serves as the volunteer services manager. We asked her to share her thoughts about what volunteers mean to patient care, Adventist Health Portland’s mission and each other. Q Who exactly makes up our volunteer team? A: Our volunteers range from age 16 to 90. Students are often looking for experience in the health care industry or need volunteer experience to help with college and scholarship applications. Our older volunteers are typically retired and have a lot to give, still, to their community. Q What happens when you put those generations together? A: The older volunteers get the students to help them with technology like their cellphones. The younger people learn how to work with diverse ages in an Make a Difference: Be a Volunteer Visit us at AdventistHealth.org/ PortlandVolunteers or scan this code to get started. SCAN ME 14 LIVING WELL
Collect sayings or photos that make you smile. Play a song you love. Go for new experiences. Seek out happy people. Spread happiness. Do something you loved as a kid. Develop your playful side. Sources: HelpGuide; Mental Health America at life’s hassles. Laugh Take a nature B R E A K. Let your imagination … wander. 10 Ways to Add More to Your Life JOY Inspiration AdventistHealth.org/Portland 15
Nonprofit Org. U.S. Postage PAID Walla Walla, WA Permit No. 44 10123 SE Market St. Portland, OR 97216 To begin your personal health partnership with one of our primary care providers, call 503-261-6929 or scan this code. Welcome to Our New Providers Richard Brandes, MD Gastroenterology Clinic Michael Dirks, DO Primary Care – Sandy Chad Hagen, MD Sleep Disorders Clinic Amanda Hansen, PA Northwest Regional Heart & Vascular Chloe Manchester, DO Sleep Disorders Clinic Jaclyn McLaughlin, FNP Primary Care – Clackamas Michael Owens, MD Gastroenterology Clinic Huongly “Ly” Vo, FNP Primary Care – Parkrose Wendy Waibel, FNP Primary Care – Damascus SCAN ME Need a Doc?
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