Health Magazine | Fall 2022

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Up front

OHSU and Doernbecher are Oregon’s No. 1 Hospitals

For more than a decade, U.S. News & World Report has ranked OHSU and OHSU Doernbecher Children’s Hospital among the best hospitals in the nation and no. 1 in all of Oregon. This year is no exception — six adult specialties and seven pediatric specialties ranked among the nation’s top 50 programs for 2022-2023. Among the top 50 adult specialty programs at OHSU are:

Four additional OHSU adult specialties were rated as “high-performing.” They are:

OHSU Doernbecher, the only full-service children’s hospital in the state that meets U.S. News’ criteria for excellence, was recognized in the following children’s specialties:

Get more information about our top-ranking programs at OHSU and Doernbecher

Discoveries

Marijuana use tied to drop in male fertility

Exposure to THC, the intoxicating chemical in marijuana, could lead to a decrease in testosterone levels and significant testicular shrinkage, a study conducted by OHSU researchers found. The study looked at fertility levels among nonhuman male primates who received marijuana edibles. Study subjects took edibles every day for seven months, in doses common among recreational and heavy medicinal marijuana users. At the end of the study, researchers noted that testicle size dropped by more than 50% overall among the subjects. The more THC a subject received, the more their testicles shrunk. Given that smaller testicles tend to produce fewer sperm, this could indicate a substantial connection between chronic marijuana use and male reproductive health.

Can hemp protect you from COVID-19?

Vaccinations and masks are our best bets when it comes to protecting ourselves from COVID-19, but a recent study found that we may have yet another tool at our disposal—hemp compounds. A molecular biologist and immunologist at OHSU, along with scientists at Oregon State University, made the discovery earlier this year. They looked into whether specific acids in hemp could bind to the virus’s spike protein to block the virus from entering human cells and then cause infection. Turns out, they could. Before rushing out to the store to buy all the hemp protein powders, lotions and supplements you can find, though, be aware that this was a lab study only. Researchers haven’t done any clinical testing yet, meaning we don’t yet know whether hemp compound can prevent COVID-19 in the real world.

This study appeared in the Journal of Natural Products.

Q&A

A. ALS, or amyotrophic lateral sclerosis, is a progressive and incurable neurodegenerative disease. It causes weakness in the limbs, breathing problems, trouble swallowing and death. Even with a relative who has ALS, most people do not need to get a test for the ALS gene. Familial ALS, or ALS that results from an inherited gene, is very rare, making up just 5 to 10% percent of cases. The rest are random. Doctors do not recommend testing unless your family member has a confirmed ALS-causing gene, or multiple members of your family have ALS.  If this is the case, talk to a genetic counselor or doctor about the pros and cons of testing. They will let you know whether you are eligible for testing, and they can provide information that will help you decide whether it is the right step for you to take.

Noona Leavell, M.D.
OHSU South Waterfront Neurology Clinic
503-494-7772

A. People with PAD, a condition in which the blood vessels in the legs become narrow or blocked, should aim to walk for at least 30 minutes per day, five days per week (three days per week is the bare minimum). You should walk even if you get leg pain during your walks. Pain, of course, can make it hard to move, so try building rest into your walking workouts. To do this, walk until it is too painful. Then, stop and rest. After a few minutes, start walking again. Each day, set a goal to walk no less than you did the day before. In time, you should be able to increase your pain-free walking distance and, eventually, hit that 30-minute goal. You can also try walking on a treadmill or sticking to flat surfaces, rather than hills. This may make the walks more comfortable for you.

If your walking workouts seem to make your pain worse, or if the pain becomes disabling, you should see your doctor. Call your doctor if you  have chest pain or shortness of breath at any time — not just while walking. PAD complications can include heart attack, stroke, infection and amputation.

Leo J. Daab, M.D.
OHSU Knight Cardiovascular Institute
503-494-7593

A. While it is best to head to an emergency room when the situation is urgent or life-threatening, virtual care from a doctor, nurse practitioner or physician assistant can be ideal for certain health issues. At OHSU, our virtual care team can treat everything from sore throats and stomach issues to insect bites, minor burns, sprained ankles and more. We offer two choices when it comes to virtual care—Immediate Care SmartExams and Immediate Care Virtual Visits

SmartExams are available to OHSU Health patients of all ages living in Oregon or Washington and  includes patients at Adventist Health Portland and Hillsboro Medical Center. Simply answer a few questions regarding your condition and symptoms and an OHSU provider will email you with a personalized care plan in under one hour. You will receive a treatment plan sent directly to you and we’ll even send a prescription (if needed) to your pharmacy—no video visit needed. SmartExams are $30, but we waive the fee if we determine that you need to see a doctor in person. 

To start a SmartExam:

  1. Log in to MyChart. Click “menu” and select “Immediate Care SmartExam.”
  2. Answer a few questions. This takes about 15 minutes.
  3. Watch your email for a link to your care plan.

Virtual visits take place via Zoom and are available to anyone over the age of 1 living in Oregon or Washington (you do not need to be an established OHSU patient to schedule a virtual visit). During your appointment, you’ll video chat with a provider who will assess your condition, make treatment recommendations and, if needed, prescribe medication. Virtual visits are $49 without insurance. Patients who have insurance may pay more or less depending on their plan’s benefits.

To schedule a virtual visit:

  1. Visit ohsu.edu/healthcare-now/schedule-and-prepare-your-virtual-visit to find a time that works for you.
  2. Set up a MyChart account if you do not already have one.
  3. Log in, and complete pre-check-in via MyChart within seven days of your appointment.

Immediate Care SmartExam and Virtual Visit hours

  • Weekdays, 7 a.m. to 9 p.m.
  • Weekends, 8 a.m. to 8 p.m.

Each fall, the open enrollment period gives people who qualify for Medicare, Medicare Advantage or The Oregon Health Insurance Marketplace the opportunity to either sign up for new health insurance or switch to a different plan. If you are happy with your current plan, that’s great. But you should still review your benefits to make sure the plan meets your needs. Unless you have a change in status, open enrollment is the only time you can make changes to your plan without fees until next year.

A few things to consider when deciding whether to keep your plan or switch to a new one include:

  • Your health status and any upcoming health treatments, including medications.
  • Total costs of premiums, deductibles and out-of-pocket expenses.
  • What services your plan covers.
  • Choices and availability of providers, hospitals and health networks.
  • Quality of the options in providers, hospitals and health networks.
  • Whether you also want coverage for dental, vision, hearing aids or alternative health options.

You don’t need to do anything if you decide to stick with the plan you have—it will carry over into next year. If you decide a change is in order, or if you are signing up for the first time, be sure to act  by the deadline listed in the letter so you don’t miss your opportunity to get the coverage you want.

Living Well

How to volunteer with OHSU Health

Volunteers help patients, staff and maybe even their own health

Exercise, good nutrition and quality sleep are all good for your health, but did you know that serving your community may have health benefits, too? One study, for example, found that giving at least 100 hours per year to a volunteer activity can lower your risk of premature death and depression. It can also help you feel more optimistic and, if you are over the age of 50, it may even reduce your risk of hypertension.

“Volunteering is great for your mental, physical and spiritual health,” says Lauren Ashmore, manager for volunteer services at Adventist Health Portland. “Plus, there is exercise involved, and it helps you to build social connections.”

Not only that, the positive impact of a dedicated volunteer can make a big difference in the overall patient care experience, says Cindy Mai, volunteer services supervisor at Hillsboro Medical Center.

“Volunteers play such an important role in our hospital,” Mai says. “They really help the organization run smoothly and allow doctors and nurses to focus on providing the best care.”

If you would like to find out how volunteering can benefit your own health, consider serving as a volunteer with OHSU Health. All three hospitals—OHSU, Hillsboro Medical Center and Adventist Health Portland—have opportunities for people to help with everything from ringing up sales in gift shops and restocking medical supplies to holding babies and greeting patients at the door. 

The current need, says Rob Wedlake, OHSU’s volunteer services supervisor, is significant. This is because the program is rebuilding after pandemic-related shutdowns.

“We were put on pause in March 2020, and we are now in the process of bringing our volunteers back,” Wedlake says.

To serve as a volunteer with OHSU Health, you must:

  • Be at least 16 years old, or 14 for a few select positions at OHSU.
  • Be up-to-date on all vaccines, including the COVID-19 vaccine.
  • Submit an application.
  • Answer health screening questions.
  • Pass a background check.
  • Attend training sessions.
  • Commit to serve for a minimum of six months.
  • Volunteer for at least one four-hour shift per week.

How to apply

Volunteer positions vary by location. To learn more or to  apply, visit the volunteer website for your preferred site.

Volunteer jobs

You can serve at OHSU Health in many ways. Some typical volunteer positions include:

  • Helping with clerical tasks.
  • Working at the information desk.
  • Taking patients on walks.
  • Playing games with or reading to patients.
  • Making sure patient rooms have all necessary supplies.
  • Getting comfort items for patients (extra blankets, water, etc.).
  • Changing bed linens between patients.
  • Working in the gift shop.
  • Helping nurses hold babies in the NICU. 

    Screening mammograms help detect cancer early 

    One in eight women will experience a breast cancer diagnosis. Fortunately, early detection can make a big difference in the prognosis, outcome and complexity of treatment, says Frances Ting, M.D., a breast surgeon at Adventist Health Portland. The best way to increase your chances of finding it early? By staying on top of your screening mammograms. Some guidelines recommend that annual screenings start at age 40 while others recommend starting biannual screenings at age 50. It is best to talk to your health care provider about the ideal age to start your own screenings, says Johanna Warren, M.D., a primary care doctor with the OHSU Center for Women’s Health. The decision, she says, is a very personal one based on things such as family history, general health status and other risk factors.  

    Frances Ting, M.D.  
    Adventist Health Portland Breast Surgery 
    503-256-1575

    Johanna Warren, M.D. 
    Primary Care 
    OHSU Center for Women’s Health 
    503-418-4500 

    Convenient breast cancer screening options 

    OHSU Health offers mammograms at many locations throughout Portland and the surrounding areas. This allows women to get screenings in their own communities, close to home or work. Screenings are generally quick, and insurance usually covers the cost. You can schedule your screening mammogram by contacting the clinic that is most convenient for you. You do not need a referral from your provider.  

    Learn more

    Meet Dottie, a mammography clinic on wheels 

    Another option? A visit to Hillsboro Medical Center’s mobile mammography van. Nicknamed ‘Dottie,’ after our “spot breast cancer” campaign, the van travels to OHSU’s Primary Care Clinic in Forest Grove each Monday. The rest of the week, Dottie makes its way to community events or to businesses that have arranged on-site mammography for employees. 

    Dottie features state-of-the art 3D technology, private exam rooms and professional technologists that will address all your questions and concerns. Patients are usually in and out in about 20 minutes.  

    “You will get the same high-quality mammogram that you would get at the hospital,” says Lois Reavis, mobile mammography clinic coordinator (and driver). “It is just like going to any other imaging center,” says Reavis. 

    After your mobile mammogram, the images immediately go to a radiologist for review. You’ll get your results in about 24-48 hours. The mobile clinic will bill your insurance. If you do not have insurance, the cost is $175.  

    Learn more about Dottie. To schedule an appointment, call 503-681-4015

    Look for Dottie this fall at the following community events: 

    Breast Cancer Awareness Month Kick-Off Party 
    October 3, 2022 
    Hillsboro Medical Center Health Education Center 
    334 SE 8th Avenue, Hillsboro 
    7:30am to 3pm 

    M&M Marketplace 
    October 16, 2022 
    10 a.m.-6 p.m. 
    346 SW Walnut Street, Hillsboro 

    Financial assistance for mammograms 

    If you are due for a screening mammogram but lack insurance or the resources to cover the cost, OHSU’s Breast Health for All program may be able to help. The program offers free screening mammograms at OHSU’s Breast Center to those who qualify. You do not need to be an OHSU patient — we will send the results to your doctor. To get more information or to schedule an appointment, call 503-494-4673. When you call, be sure to mention the Breast Health for All program. 

    Your Child

    Health to-dos for back-to-school

    As summer winds down, many families want to make the most of its few remaining days before the hectic fall routine kicks into high gear. While that is definitely understandable (and recommended), it is also a good idea to prioritize some important health-related back-to-school tasks while there is still plenty of time left to do so.

    “The end of summer, when schedules might be more relaxed, is a great opportunity to think about the things kids need to keep them healthy and safe as they head into the school year,” says Courtney Nall, M.D., a family medicine doctor at OHSU’s South Waterfront Primary Care Clinic. “It also helps make sure your kids meet the requirements, in advance, for full participation in school, sports and other extracurricular activities.”

    Because nobody wants to spend the season on the sidelines, we’ve put together a handy checklist of things to take care of before the first bell rings.

    Schedule sports physicals

    If your child participates in school-sponsored athletics, they need a sports physical every two years. This is to ensure that they don’t have any injuries or medical concerns that could interfere with the game. Be aware that your child must see a health care provider in person for a sports physical. A virtual visit won’t do in this case.

    Get vaccinated

    The start of the school year is a great time to make sure your kids are up-to-date on all of their routine vaccinations and boosters, including the COVID-19 vaccine. As of June, everyone aged six months and up is eligible.

    Plan for flu shots

    Speaking of routine vaccinations, flu shots might not be available quite yet, but you’ll want to get them as soon as they are. Make a note on your calendar now so you don’t forget to schedule them. Ideally, everyone in the family should get a flu shot before Thanksgiving (at the latest).

    Make well check appointments

    Starting at age two, all kids need to see their health care provider for a well check once a year. Among the many important things that occur during this visit are vision, hearing and developmental screenings. Problems or delays in these areas can impact learning, so it is beneficial to identify them — and intervene with support services — as soon as possible, says Nall.

    Provide authorization for medication

    If your child needs to take medication while they are at school, the school will need your permission to provide it to them. Talk to their health care provider about submitting an authorization letter in advance so they don’t miss any of their doses. Also, be sure to update the authorization letter whenever their dose or regimen changes.

    Inform teachers, coaches and caregivers about allergies

    Does your child have a food allergy (or some other type of allergy)? If so, be sure to let the school know. You should also tell them if your child carries an EpiPen and provide instructions on what to do if an exposure to an allergen occurs.

    Stock up on COVID-19 home tests and other supplies

    “COVID-19 is still circulating in our communities at a high level,” says Holly Villamagna, M.D., medical director of infection prevention and control at Hillsboro Medical Center. “It is hard to predict what will happen in the coming months, but it is wise to plan for another surge.”

    With that in mind, Villamagna recommends keeping a supply of tests on hand, along with other things that you typically use when someone in the family has a respiratory virus, like thermometers, tissues, throat lozenges and acetaminophen.

    Address anxiety

    Returning to school is anxiety-provoking for some students, even without all the additional stressors brought on by the pandemic, Nall says. If your child seems nervous, validate their feelings. Then, find age-appropriate ways to coach them (younger students, for example, might respond to library books about going back to school while older kids might feel better simply by knowing details about their new routine). If the anxiety seems like something more than basic back-to-school jitters, talk to your child’s pediatrician — they can help connect you with mental health resources.

    Take care of yourself

    Back-to-school season is very student-centric, but it is also a good time to make sure you are on track with all your own health-related to-dos. Is it time for a dental visit, an annual exam, a blood draw or a Tdap vaccine? Schedule them now, before everyone’s calendars fill up. Then, you can get back to enjoying whatever is left of your kids’ summer break.

    Holly Villamagna, M.D.
    Hillsboro Medical Center
    503-681-1111

    Courtney Nall, M.D.
    OHSU Primary Care Clinic, South Waterfront
    503-494-8573

    Fall sleep routines

    During the summer months, staying up late can easily become the norm for some kids. When preparing for school to start, though, it is best to double down on getting everyone to bed at a reasonable hour, says Stephanie Dewes, P.A.-C, a sleep specialist at Adventist Health Portland

    “This transition can be really hard, so make sure you give your kids enough time to slowly adjust back to an earlier bedtime,” Dewes advises.

    The amount of time kids need to acclimate to an earlier bedtime will vary, but one approach is to start tucking them in earlier every few days, in 15 minutes increments. They may resist, but consistency is important because lack of sleep can have a negative impact on learning. It is also an indicator of other health risks, like diabetes, depression and anxiety, says Dewes.

    When figuring out when to send them to bed, consider the number of hours of sleep they need based on their age versus what time they need to get up. Kids between the ages of 6 and 12 need anywhere from 10 to 12 hours of sleep each night; those between the ages of 12 and 18 need 8 to 10.

    Stephanie Dewes, P.A.-C.
    Adventist Health Portland Sleep Medicine
    503-261-4475

    Helping adolescents manage menstruation

    Menstrual cycles can be confusing and stress-inducing, especially for teens and pre-teens who are still in the process of learning about what is normal for their own bodies. If you or your daughter have questions or are concerned about her menstrual cycle, it is important to get guidance from her health care provider, says Bojan Malmin, M.D., a gynecologist with Adventist Health Portland.

    The best person to start with, Malmin says, is her pediatrician, who can address things like when to expect her period to start, how to manage side effects and signs that something might be amiss (common worries include things like heavy and painful periods, unexplained missed periods and delayed or early onset of menstruation).

    If a concern needs further investigation, her pediatrician can refer her to a gynecologist (women usually do not need to start seeing gynecologists regularly until they are 21 or until they start using birth control, whichever comes sooner). In any case, don’t brush menstruation discomfort aside as just an annoying part of life, Malmin says.

    “If her period is negatively impacting her life by causing her discomfort or causing her to miss school or other activities, it should be addressed,” he says.

    Bojan Malmin, M.D.
    Adventist Health Portland Gynecology and Women’s Wellness
    503-261-4423

    OHSU Health

    New OHSU specialty clinics arrive at Orenco Station

    Hillsboro-area residents in need of certain types of specialty medical care will soon have the option to see an OHSU provider right in their own community, thanks to the expansion of Hillsboro Medical Center’s Orenco Station Primary Care Clinic.

    Hillsboro Medical Center is an OHSU partner. Medical staff at the new clinic will all be OHSU faculty and residents.

    Joining the existing family and internal medicine practices at Orenco Station are:

    • Vascular surgery
    • Dermatology, including MOHs surgery (an in-office procedure that treats certain types of skin cancer)
    • Plastic and reconstructive surgery
    • Pediatric specialty medicine, including neurology, surgery, cardiology, gastrointestinal, urology and ENT
    • X-ray and ultrasound suites

    The clinic will also have a time-share space that additional specialists will use on designated days, a feature that offers convenience to people who would otherwise be traveling from the Westside to OHSU’s main campus for appointments.

    “Our goal is to provide more access to care for people on this side of town,” says Mohamed Alyajouri, M.P.H., practice manager for the Orenco Station Primary Clinic.

    The original target opening date for the new clinics was November 2020, but COVID-19 led to a delay. Now, the doors are slated to open in September. The clinic is located at 6355 N.E. Cornell Road in Hillsboro.

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