In this issue

• Up front: A network of care: OHSU Health
• Discoveries
• COVID-19 vaccinations
• Sweet dreams or restless nights?
• Lifestyle and prevention are some of the best medicine
• Orthopedic options to keep you moving
• Taking control of diabetes
• Events

You probably know that OHSU is good at the big things. What you might not know is that with OHSU Health, we’re good at the little things too, and everything in between.

From flu shots to physicals, screenings to surgery, OHSU Health is a full spectrum of care everyone can count on.

And we’re not just on Marquam Hill. Together with our partners at Hillsboro Medical Center (formerly Tuality Healthcare) and Adventist Health Portland, we’re in communities throughout the Portland metro area, right where you need us.

OHSU Health is a system of physicians, nurses, researchers, clinics and hospitals all working together toward a better way to wellness. The OHSU Health system includes more than 3,000 providers in dozens of care locations around the Portland metro area, including OHSU Doernbecher Children’s Hospital and three adult hospitals with more than 1,000 beds and 200 outreach programs.

OHSU Health is the only system in Oregon that connects the breakthroughs of an academic health center with the convenience of community care — a way to bring what happens in labs and classrooms to Oregonians where they live and work.

At OHSU Health, we never settle for how things have been done before. Instead, we are constantly seeking new and creative ways to serve the citizens of our state. OHSU Health is committed to easy access to care and high patient satisfaction.

To learn more, visit ohsu.edu/ohsuhealth.

When is my turn?

Though companies are working to get vaccine shots ready as quickly as possible, there are a lot of people to vaccinate! OHSU is working closely with the State of Oregon to get vaccinations to as many people as possible.

Visit ohsu.edu/covidvaccines to learn details about locations, transportation, safety and more.

Vaccines are free and by appointment only. To get an appointment, schedule at ohsu.edu/covidvaccines or call 833-647-8222 (weekdays 8 a.m. – 5 p.m.).

Research shows that the shot prevents the most common type of COVID-19 infection. However, even after you’re vaccinated, it’s important to continue to follow safety measures like:

• Physical distancing
• Wearing a mask
• Washing your hands often

Protect yourself and others by getting vaccinated for COVID-19

A vaccine will help prevent you from getting COVID-19. If you do get COVID-19, a vaccine will make you less likely to become seriously ill. If you don’t get sick, you are less likely to spread the virus to others.

This is called “herd immunity,” where the healthier people protect the more vulnerable (infants, seniors, cancer patients, pregnant mothers and many others) by stopping the fast spread of disease. Once enough people are vaccinated, COVID-19 won’t be able to spread as widely, ending the pandemic. These vaccines are safe and cannot cause disease.

Good sleep is essential for overall health

Q. During the pandemic our routines have gotten shaken up. How much sleep does my child need?

A. If there is a silver lining to the pandemic, it may be that our youth have more opportunity for sleep. However, we know adults are experiencing disrupted sleep with rising levels of anxiety and depression, likely related to pandemic stress, uncertainty and reduced physical activity and socializing. Children have the same stressors at this time, but quality sleep can help protect their physical and mental health.

Depending on age, your child’s recommended amount of sleep is:

• 9.5 hours for teens
• 10–12 hours for children 5–12
• 11–13 hours for toddlers

For better sleep, set sleep and wake times and stick to them. Keep the bed only for sleeping, not for schoolwork or gaming. Take 30 minutes to wind down and turn devices off. If your child has ongoing issues with sleep, contact your provider. By prioritizing sleep in children, we can help them grow and develop during this difficult time.

Q. I swear my husband stops breathing sometimes when he’s snoring, but he doesn’t believe me. Should I be concerned?

Yes, what you are describing is a common disorder known as obstructive sleep apnea, or OSA.

When muscles in the back of the throat relax during sleep, they can block the airflow and stop a person’s breathing for brief periods. If left untreated, OSA can lead to short- and long-term health consequences. Side effects including daytime sleepiness, irritability, worsening high blood pressure, diabetes and stroke. Untreated sleep apnea can also make it harder to lose weight.

Snoring is a warning sign that the airway is narrowing, leading to a higher risk for OSA. Getting a sleep study for your husband will settle the debate! His primary care provider can give him a referral for a sleep study. This test can be done at home or in a sleep lab, depending on a patient’s risk factors. After the test, a sleep specialist will explain the results and recommend treatment options. 

Lifestyle and prevention are some of the best medicine

Q. For a healthy pregnancy, what should I add to my diet and how much should I exercise?

A. The most important thing to add is prenatal vitamins.

For diet, you will only need about 300 more calories a day (or double that for twins). That’s about the same number of calories in three apples or bananas. Increasing your intake of fruit, vegetables and whole grains is good for you and baby. Maintaining a healthy weight helps your body adjust during pregnancy, delivery and recovery.

Exercising 150 minutes a week can help you toward this goal. During pregnancy, you should avoid contact sports or activities with a risk of falling. Usually, you can continue activities you were doing before pregnancy. Check with your provider about any modifications you might need, like switching to a stationary bike rather than a bicycle. Prenatal yoga is great for building core and back strength to help as your baby bump shifts your center of balance and to prepare muscles for delivery.

Q. If I’ve been under a lot of stress during the pandemic, could it give me heart problems?

A. More and more research shows a direct connection between stress and cardiovascular disease.

The forms of stress can vary from daily stressors over a long time to a sudden life event, such as a death or illness in the family. Stress can affect blood pressure, cholesterol levels and even cause a heart attack.

As providers, we are beginning to pay greater attention to the mind-body connection for maintaining heart health. The pandemic is a perfect storm for losing track of healthy eating and exercise goals as well as increased loneliness, depression and worry.

To keep your heart healthy, be physically active at least two and half hours a week, stay in touch with friends, keep up your health screenings, follow a healthy diet and try relaxing with mindfulness or meditation. Focusing on your well-being will help you cope with stress.

Remember, 80% of all heart disease is preventable with lifestyle choices and heart health care.

OHSU Health Adult Bone and Joint Care

With four clinic locations, OHSU Health board-certified orthopedic experts are in communities all around the Portland metro area. We are right where you need us in Beaverton, Hillsboro, Southeast Portland and South Waterfront. New patients can get seen as soon as possible in the easiest location with no referral needed. Our experts treat every kind of bone and joint condition.

Q. When am I ready for a joint replacement?

A. There is no one-size-fits-all answer. Total joint replacement can improve function and decrease pain. So, when you start having more bad days than good with your hip or knee, it’s time to consider joint replacement.

If your sore joint is disturbing your sleeping or impacting your daily life or your job, get an evaluation. Before surgery, we want to get you as healthy as possible and help your joint. This could include weight loss, quitting smoking, physical therapy and anti-inflammatory medicines or injections.

If these strategies aren’t effective, we may recommend a hip or knee replacement. With improved implants, age is not as much of a factor as it once was. About 80% of people who’ve had knee replacement are doing well with that knee up to 25 years later. These surgeries have a track record of safety and pain relief, helping people stay active for overall better health.

Q. Am I going to be in a lot of pain if I have a joint replaced?

A. Everyone has a different response to pain and not every treatment works as well for each person. That’s why we attack pain in different ways after a joint replacement.

We start before surgery by working on joint motion and improving overall health. During surgery, we prefer to use sedation medicine and numbing shots, so you sleep during the procedure without general anesthesia.

Afterward, our team will get you up and moving because this leads to better results and a quicker recovery.

We have a variety of pain medications we can use, though we limit the use of narcotics due to side effects. For knee replacement, we may use a type of pump that provides numbing medicine to the area for a few days after surgery. These types of pain management efforts are based on the latest information about how people recover from joint replacement.

Q. I’m a runner with Achilles tendonitis. How can I get back to running?

A. If you have pain at the back of the calf muscle to the heel bone, you’ll need to rest and then gradually return to exercising.

Most Achilles tendon injuries are related to overuse, and most can be treated without surgery. Athletic or daily activities like running, jumping or even walking on hard or uneven surfaces can irritate the Achilles tendon.

The first steps to healing are anti-inflammatory medicine, stretching and rest. Scaling back activities will give the tissue time to heal until it’s no longer painful to the touch. As a runner, make sure you have well-fitted footwear. If the area stays sore, you may need a heel lift or other insert if you have a high arch or flat feet, or wear a special boot temporarily.

Q. Does having diabetes put me at higher risk for COVID-19?

A. People with diabetes aren’t more likely to catch COVID-19 than anyone else, but they are more likely to get sicker from the virus than others.

Research shows that people with diabetes are three times more likely to die from a COVID-19 infection. If you have diabetes type 1 or type 2, get vaccinated for COVID-19.

In the meantime, follow safety measures for wearing masks, avoiding crowds, social distancing and only making trips that are necessary. Now more than ever, it is important to manage your diabetes.

To make it easier for you, the Diabetes and Endocrine Clinic visits our primary care offices so you can get an appointment close to home. Also, you can visit with our dietitian, who can provide one-on-one counseling about how to follow a diabetic diet on a budget.

Events

Health Equity Symposia

This online series amplifies efforts to improve health equity in our state. Join OHSU employees and students as we collectively learn about positive change underway in our neighborhoods.

Events are livestreamed on YouTube and recordings are available on this page.

Previous events:

• Trust, Science and Relationships: A COVID-19 Model for Community Health
• What Is Health Equity and Why Is it Important to OHSU?
• Anti-racism and Health Equity Futures: (Re)Imagining the Next Generation
• A Voice for Health Equity: Using Advocacy and Building Evidence to Create Change
• Health Literacy and Systemic Racism: Redressing Oppression Through Clear Health Communication
• Interprofessional Care Access Network (I-CAN) in Rockwood: A Partnership for Health Equity

Marquam Talks

Marquam Talks are virtual lectures showcasing the research and clinical advances of OHSU faculty on timely topics.