Adventist Health Portland | Living Well | Fall 2023

LIVING WELL PAGE 12 Q&A: Taking the mystery out of menopause. PAGE 6 ‘Absolutely…the best decision for me and my health’: Cassie’s story. PAGE 5 High schoolers get an inside look at health care careers. F A L L 2 0 2 3 CARE BEYOND HOSPITAL WALLS GRATITUDE, GRACE AND GIVING BACK HEALTHY WAYS TO HANDLE HOLIDAY STRESS

2 LIVING WELL @AdventistHealthNW @AHNW Adventist Health Portland @AdventistHealthNW CONNECT WITH US ONLINE Living Well Magazine | Fall 2023 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 Photography: C.J. Anderson and Heather Pease 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. 2023 © 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 Events or scan the QR code. SCAN ME Fall 2023 4 Care Beyond Hospital Walls 5 Student Healthcare Leaders: The Eyes of a New Generation 6 The Best Decision for a Big Change 8 A Heart-to-Heart With Thomas Molloy, MD 11 How to Spot the Signs of RSV 14 5 Tips for Managing Weight During the Holidays 8 11 5 3 The gift of making a difference Life is busy. It’s so easy just to go to work, then go back home, over and over. But all of us have the gift of making a difference somewhere. That’s what I love about working at Adventist Health Portland. We are a big team all working together to make a difference — not just at the hospital and clinics, but in our community. In the following pages, you’ll read about how our organization is living our mission, improving health care access in east Portland and supporting our community through outreach initiatives. You can explore how our teams are making a difference for patients and how patients are giving back. You’ll learn health tips for the holidays, as well as what a top cardiac surgeon values most about helping our patients. And while you read, ask yourself how you can be part of transforming the health of our community. You don’t have to work in health care. Explore volunteering — just like I did as a teen at this very hospital. Check on your neighbors. Offer to drive someone to their appointments. Imagine the transformation we can make if we all use our gifts to make a difference today. Dr. Terry Johnsson Mission integration executive 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 Among many points of community service, Dr. Johnsson is one of Portland’s Royal Rosarians, who promote the best interests of the city and the Portland Rose Festival as ambassadors of goodwill. Mission integration executive Dr. Terry Johnsson shares the gift of culturally sensitive food with seniors in the community. Editor’s letter

4 LIVING WELL Mission in action The CPE program trains ministers and laypeople to support people of any — or no — faith tradition when they need it most. “It provided a space for me to learn to be present with myself and with others,” says Katie Wagner, an Adventist Health Portland CPE graduate, now serving as the mission and spiritual care leader at Adventist Health Columbia Gorge. “Through CPE, I’ve learned so much about empathy, compassion and grace.” CLINICAL PASTORAL EDUCATION (CPE) ● Free and discounted care. ● Health-improvement activities. ● Education and research. ● Aid to underserved people and older adults. ● Subsidized community health care. INVESTING IN A HEALTHY FUTURE For many years, we’ve hosted a free Christian music concert in November. In return, guests have donated more than 10,000 pairs of socks and several tons of food to support the houseless and disadvantaged in our region. Our mission — living God’s love by inspiring health, wholeness and hope — isn’t just a statement. It’s our foundation, our core and our true north. A TWO-WAY STREET In 2022, Adventist Health Portland gave more than $53 million directly to Portland community needs through: Instead of assuming what our community needs, we’ve asked. A recently completed community health needs assessment is steering our priorities and partnership for the next three years. We will work with community organizations to focus on: ● Access to care. ● Food security. ● Health risk behaviors. ● Housing. A PLAN TO MEET COMMUNITY NEEDS Community health care isn’t just about bringing people into the hospital and clinics for health services. It’s about working together — clinical and nonclinical staff, employees, and neighbors — to share health, wholeness and hope all around our community. Care Beyond Hospital Walls ER nurses (from left) Erica and Eric make sure the community closet stays stocked with new and gently used clothing for patients in need. 5 The Eyes of a New Generation High school students get an inside look at health care careers How do you help the next generation consider careers in health care, especially if no one in their family has experience? Mission integration executive Dr. Terry Johnsson asked that question, and that’s how the Student Healthcare Leaders (SHL) program was born. “When I was in high school, I had the opportunity to volunteer at Adventist Health Portland,” he explains. “At age 15, spending time behind the scenes at a major medical center with a director, Beulah Stevens, was the chance of a lifetime. This experience showed me that I, too, could work in the medical field one day.” A priceless opportunity This after-school program offers high school students behind-thescenes and hands-on exposure to the health care industry. Students apply to the program and, if accepted, meet weekly to explore the clinical, technical and service roles that allow health care professional teams to deliver health, wholeness and hope. It’s a priceless opportunity, provided for free. “Besides the once-in-a-lifetime experiences, this program allowed me to talk and ask questions to doctors, CEOs, nurses and other hospital staff, which is something you can’t always just do on your free time,” says a graduate of the program. Unlike many programs, SHL considers which students might benefit most from learning about their potential in health care. That means participants come from diverse backgrounds and a wide range of GPAs. Since its inception in 2018, the program has hosted nearly 200 students representing 30 area high schools — from Beaverton and Camas to Portland, Gresham and Clackamas. SHL is excited to be hosting its 10th session this fall. One alumnus now works at Adventist Health Portland. Many others are in nursing or medical school or already working in health care. Chart your course If you are a high school student or know one interested in learning about health care careers, you can find information and an application at Under the watchful eye of surgeon and chief medical officer Wes Rippey, MD, students try their hands at using the da Vinci surgical robot.

6 LIVING WELL That proved challenging to her weight in several ways. “Food was comfort,” she explains. “And weight gain was a side effect of my medications.” No matter what she tried, nothing moved the needle. She consulted with her primary care team and tried appetite-suppressing medications. Even an epilepsy medication known to suppress appetite didn’t help. “I tried a year of keto. I tried a year of a food elimination diet,” Cassie recalls. “I would lose a little, and it would come back. Nothing was working.” “One of my friends had gastric sleeve surgery with great success,” Cassie says. She asked her cardiologist, who said Cassie was a good candidate for the gastric sleeve. Bariatric surgery Cassidy Tyre had struggled with her weight her entire life. At just age 12, she was diagnosed with epilepsy. The Best Decision for a Big Is it right for you? Meet Cassie’s bariatric team at or call 503-912-8083. CHANGE Cassie felt some initial unhappiness realizing she needed surgery to help with her weight. Then she decided to move forward and met with the Oregon Health & Science University (OHSU) bariatric program. That’s how she found out about Ryland Stucke, MD, who works with the OHSU program to offer bariatric surgery at Adventist Health Portland. Rigorous preparation She was super nervous and poured herself into a lot of research, so she came to her first appointment very prepared. “I absolutely peppered them with questions,” she remembers. “That first appointment, I met Nikki [Davis], the nurse navigator, and Dr. Stucke. Both of them were incredibly helpful and answered every question I had.” Nikki, who is also the program manager, even gave Cassie her number to call if she had any questions. Cassie recognized the bariatric team really wanted her to be sure this was the right decision for her. 7 Cassie was convinced, so she entered the program and embraced its rigorous preparation for surgery. Her presurgery program included appointments with nurse practitioners, dietitians, physical therapists and psychologists. Through weightloss classes, she learned how she needed to eat after surgery to stay healthy and keep her weight loss on track. The day of surgery arrived, and, as Cassie recalls, “Everything was just perfect.” Her anesthesiologist met with her before surgery and made her feel more comfortable. Nikki stopped by to visit. Cassie’s surgery went smoothly, and soon she was back to a new normal for her life. “It’s definitely been life-changing,” she says. “Living a healthy lifestyle is a big adjustment, but it absolutely was the best decision for me and my health.” A focus on feeling healthy Cassie says she’s lost about 80 pounds so far. Her confidence has gone up, and she enjoys being able to walk into a store and just buy clothes. With less stress about her weight, Cassie’s seizures have eased. And while she used to weigh herself every single day before surgery, she’s now focused on feeling healthy. Cassie has gained confidence and lost 80 pounds since undergoing weightloss surgery. “Nothing was working,” says Cassidy (“Cassie”) Tyre about her efforts to lose weight. “It’s definitely been life-changing. Living a healthy lifestyle is a big adjustment, but it absolutely was the best decision for me and my health.” — Cassidy Tyre “Dr. Stucke and Nikki definitely helped me change that,” she says. “They’ve been instrumental about changing my life.” While she still struggles with body dysmorphia and sometimes worries she really hasn’t lost weight, Cassie hasn’t felt alone. Her bariatric team is still there for her. “They are a great resource,” she explains. For anyone considering weight-loss surgery, Cassie’s advice is clear: “Do your research, and don’t let outside contributors who aren’t in the health care field make the decision for you,” she advises. “Get all your questions answered. Take the process beforehand really seriously, and lean into the team.”

Northwest Regional Heart & Vascular’s robotic surgery pioneer, cardiac surgery team leader and avid pilot offers an inside glimpse into his work, his team and his passion for helping patients. 8 LIVING WELL Heart health With Thomas Molloy, MD Heart-to-Heart Q You’re known as a pioneer of robotic-assisted heart surgery, especially for valves. How did this become your passion? A: People don’t like open-chest surgery. Splitting the sternum is painful, and the recovery is long. In the late 1990s, I started performing valve and coronary bypass surgery using smaller incisions to approach the heart between rib interspaces. This required long-shafted instruments and a 2D camera. “Heart port” technology developed by Dr. Stevens at Stanford University in the 1990s was also necessary to allow circulatory support and protection of the heart during cardiac procedures without dividing the sternum, or breastbone. In 2007, I added robotic-assisted minimally invasive surgery for cardiac bypass, as well as mitral and

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 or scan this QR code. What Is Your Risk? Quick Quiz Dr. Molloy gives one of his daughters an early flying lesson. 9 aortic valve repairs and replacements. The da Vinci surgical robot, developed by a surgeon I trained with, allows my hands to remotely control precise, wristed instruments introduced through ports the diameter of a pen. This avoids the need for a mini incision. With the 3D da Vinci camera, I can zoom to 10 times magnification. This means we can offer exceptional results with a faster recovery, less risk and pain, and a shorter hospital stay compared with open-chest surgery or even surgery that uses a mini incision between the ribs. Q With so many advantages, why are there so few heart centers doing robotic valve surgery? A: Good outcomes require more than just advanced technology. There is a steep learning curve for both the surgeon and operating team. A consistent team of dedicated, talented experts performing robotic surgery regularly is required to achieve good outcomes. Our valve team of surgeons and cardiologists reviews all cases to determine whether catheter-based, minimally invasive or robotic-assisted surgery is most appropriate. I handpick our operating team and brief every case with them the day before surgery. Patients are cared for in a universal bed cardiac unit — the first in Portland — to ensure they receive consistent care by experienced cardiac nurses. It takes a lot of time to build a team like this. Q What do you enjoy most about your work? A: Most of all, I appreciate being able to offer patients a life-changing surgery that isn’t available anywhere else in the Northwest. Great satisfaction comes from working as a team to fix something as complicated as a damaged or poorly designed cardiac valve. Finally, follow-up in our clinic, with our patients restored to a normal quality and quantity of life, is very rewarding to our team. Q You’re also an experienced pilot. How did that come about? A: I worked a variety of jobs as a teen to pay for my flying lessons and soloed at age 16. I got my private pilot license when I was 17. That same year, I ferried the first of many bush planes to Alaska for resale. I earned commercial and flight instructor ratings, which helped finance my Stanford undergraduate and Dartmouth medical degrees. These days, I fly to meetings, to visit other centers to proctor robotic surgery and for pleasure with my family.

10 LIVING WELL A lot of people imagine philanthropy is just for the rich and famous. But one Northwest Regional Heart & Vascular patient begs to differ. David* was no stranger to heart issues. His father died of a heart attack at age 61. When David’s heart went into an irregular rhythm and his pulse was low, it was Northwest Regional’s Eugene Spear, MD, who saved him. “He paddled my heart four times,” David recalls. Dr. Spear referred David to Thomas Molloy, MD, Northwest Regional heart surgeon. “Luckily, through medications, Drs. Molloy and Spear [have kept] me from surgery, at least to this point.” While working on his estate planning, David felt inspired to make Adventist Health the beneficiary of one of his retirement accounts and called Dr. Molloy to find out how. “Not too many men make it to age 80, and I have. I felt the advancement in cardiology has kept me going, along with God’s grace,” he explains. “So, I just particularly wanted to direct my gift to the cardiovascular department. Maybe it’ll help somebody else.” *David is a pseudonym for this donor, who wishes to remain anonymous. Eugene Spear, MD, with a heart patient. Gratitude, Grace and Giving Back An ‘average Joe’ shares why he hopes to help others Giving Every Gift Matters Every gift of every size can make a difference in our community. To learn more about our events and initiatives, visit PortlandFoundation. 11 Respiratory syncytial virus (RSV) is so common that nearly all children have had it by their second birthday. But what is RSV? And why is it important to recognize when your child has RSV — especially RSV that may be getting worse? RSV is a coldlike illness that affects the lungs, nose and throat. Most kids who get RSV recover on their own in a week or two. But young children with RSV can sometimes get very sick. They may get bronchiolitis (inflammation of the small airways in the lungs) or pneumonia and need to be hospitalized for a few days. Spot the signs RSV often starts like a mild cold. The symptoms may include a runny nose, a cough, and a fever of 100.4 degrees or higher. Very young babies with RSV may only be cranky, tired and less interested in feeding. If RSV gets worse, children may have additional symptoms, like fast breathing or wheezing (a whistling sound when they breathe). Family health RSV Plus tips for easing the symptoms Skip the line If you or your child needs care outside of your provider’s hours, you can save your place in line at our Sandy and Parkrose urgent care clinics by visiting When to call the doctor You should call your child’s doctor if your child has: ● Trouble breathing or other worsening symptoms. ● Trouble drinking. ● Signs of dehydration (such as fewer than one wet diaper per eight hours). ● Decreased alertness. Caring for a child with RSV There is no cure for RSV. But you may be able to ease symptoms until the virus runs its course by: ● Using nasal saline and a suction bulb to clear a stuffy nose for easier breathing. ● Giving your child over-the-counter medicines as directed by your child’s doctor. ● Helping your child drink plenty of fluids to help prevent dehydration. Sources: American Academy of Pediatrics; Centers for Disease Control and Prevention How to Spot the Signs of

12 LIVING WELL Women’s health It’s a musical. It’s the focus of an Oprah special. And if you are or care about a woman, it’s either lurking in your life or in your future. It’s menopause, and it raises a lot of questions. OB-GYN Bojan Malmin, MD, and certified nurse-midwife Katie Butler, both part of Adventist Health Women’s Clinic, have the answers. Q We often hear about missed periods and hot flashes as the signs of perimenopause. Do women always experience these? What other signs should we watch for? A: Dr. Malmin: Not all women experience missed periods or hot flashes. Many women have normal or slightly irregular menses for years prior to menopause. Some women have no symptoms at all. Most often, periods may become slightly heavier, longer or more spaced out. Other common symptoms include night sweats, difficulty sleeping, mood changes, irritability and brain fog. Taking the Mystery Out of 13 Q What would be helpful for women to understand about menopause before they approach it? What should I think about in, say, my 30s or 40s? A: Katie: Some people experience perimenopause fluctuations over many years, as long as seven to 10, while some never notice a thing! Track your cycles. Knowing what your “normal” is holds a lot of power. Regular exercise or movement, a well-balanced diet, and routine mindfulness practices can all help you live a healthy life and treat symptoms of perimenopause and menopause. Q What do partners need to know about menopause to best support their loved ones? A: Dr. Malmin: Some people will need care and attention; others will want to avoid talking about it. Just be supportive and know many factors — including aging, loss of fertility, life transitions, fatigue, anemia, metabolism, sleep and changing hormones — contribute to feelings about this time of life. Q In perimenopause and as we age, how can women safely control the risk of pregnancy? A: Katie: The irregular, unreliable cycles common in perimenopause make it difficult to know when one is fertile. The best practice to prevent conception is using barrier methods or another form of birth control. Many women in perimenopause opt for a hormonal IUD or a combined oral contraceptive, if you don’t have certain risk factors. Q Since menopause is a natural process, isn’t it best to avoid hormone replacement therapy? A: Dr. Malmin: Natural is a tricky term. Many “natural” processes happen to our bodies that make us feel worse, and we weigh the risks and benefits. The impact of menopause is different for each individual. Often, the benefits of treatment outweigh the risks, and women are happier and healthier with additional hormones. The best plan is to talk to an expert about your needs, risks and goals. Q Does menopause mean I don’t need gynecological care anymore? A: Katie: It does not! The American College of Obstetricians and Gynecologists recommends cervical cancer screening with co-testing for HPV every five years (if normal) from age 30 through 65. Plus, your gynecology provider loves to see you annually to check in with breast health, overall health and well-being. Q What are safe and/or natural ways to reduce symptoms? A: Katie: Some people are eligible for topical estrogen cream to alleviate symptoms such as vaginal dryness and shrinking as well as vasomotor symptoms. However, you and your provider should have a conversation and make an informed decision together. You can also discuss herbal remedies, aromatherapy, cognitive behavioral therapy (CBT), nutrition and exercise. Questions about menopause or any other phase of life? Call our women’s clinic team at 971-231-7790.

14 LIVING WELL Nutrition Managing Weight During the Holidays Use a smaller plate. It’s an easy way to limit portions and encourage you to savor every bite. Eat breakfast. A protein-rich start to your day will help you make wise choices later. Start with a snack. Before a buffet or party, eat a small meal or snack. Jump into festivities before you find the table. Don’t skip meals. Getting too hungry results in overeating. Take a pause. Your brain needs 20 minutes to catch on that you’re full, so give yourself time before you think about seconds. SAVE THE DATE Hope Through the Holidays Monday, Nov. 20, at 6 p.m. Join us to honor loved ones you’ve lost with a special gathering. Presented by Adventist Health Portland Spiritual Care 503-251-6105 | 15 It’s that time of year again: The holidays are fast approaching! For many of us, that means a lot of joy — and sometimes a lot of stress. If you feel your stress level starting to skyrocket during the holidays, try these stressbusters for a healthier and merrier season. Practice self-care. Carve out a few minutes daily to leave the hustle and bustle behind. Read. Listen to music. Take a relaxing bath. Enjoy a feel-good holiday movie. Remember your healthy habits. Drink plenty of water. Work in a workout. And be sure to get enough sleep. Budget your spending. Plan your gifting based on what you can truly afford for gifts. Spend more time connecting than buying. Manage your expectations. Holiday traditions evolve over time. Keep the ones you love, but don’t be afraid to ditch the ones you no longer enjoy. Declutter your calendar. Give yourself and your loved ones the gift of time before, during and after the holidays. Seek help if you need it. A professional counselor — in person or virtually — can help you get a grip on your stresses and find solutions that work for you. This can be particularly helpful when grieving over the death of a loved one or dealing with difficult people and situations during the holidays. Sources: American Heart Association; American Psychological Association; National Alliance on Mental Illness Mental health Healthy Ways to Handle HOLIDAY STRESS

Nonprofit Org. U.S. Postage PAID Walla Walla, WA Permit No. 44 10123 SE Market St. Portland, OR 97216 Adventist Health Portland hosts this free annual event as an expression of gratitude for our community’s faith and support. Admission to the event is free with: ● Your ticket. ● A nonperishable food item for Portland Adventist Community Services (PACS). ● A new pair of socks for Portland Rescue Mission to share with houseless people in our community. Make a Difference Share your time and talent! Learn more about volunteering at PortlandVolunteers or scan this code. Adventist Health Portland presents a Celebration of Thanksgiving Friday, Nov. 17, at 7 p.m. (doors open at 6:30 p.m.) East Hill Church Gresham, Oregon Featuring Get your tickets and learn more at or call 503-251-6105. SCAN ME Maryanne J. George, with Maverick City Music