Health Magazine | Winter 2019
In this issue
Up Front: Welcome to your home at South Waterfront
Nearly half of OHSU’s patients live in rural Oregon or neighboring states. Finding temporary housing in Portland can be difficult and costly when they need to travel to OHSU and Doernbecher Children’s Hospital for complex treatments, such as surgery, bone marrow transplants and clinical trials.
See what the Rood Family Pavilion offers guests
A new guesthouse — named in honor of Gary and Christine Rood of Vancouver, Washington — provides affordable housing close to OHSU. The new building has 76 guest rooms on the top five floors, half reserved for families of children who are patients and half for adult patients. This represents a sizable increase in available rooms, and the rates are lower than local hotels.
Read about the opening of CHH2 and Rood Family Pavilion
Family members of child patients gave input on the guesthouse design with the goal of creating a comfortable home away from home, adding friendly touches including a fireplace, warm carpets and other cozy details. Other features in the Rood Family Pavilion include shared kitchens, a fitness room, an indoor play area and beautiful outdoor spaces, including the Silver Family Children’s Park and the George and Janet Boldt Healing Garden.
Ronald McDonald House Charities of Oregon and Southwest Washington will subsidize and provide programming for the pediatric portion of the guesthouse and contract with OHSU to operate the entire facility.
Discoveries
Sleep apnea's long-term health effects
Research shows that the length of breath interruption is just as critical and number of breath interruptions in sleep apnea.
Link between weight and puberty
Researchers have found a molecular chain linking higher body weight to early puberty in girls.
Blood pressure regulation identified
New research has revealed the 3-D structure of a membrane channel that's critical in controlling blood pressure.
Health Spotlight
Going to the dogs ... for companionship at the hospital
Golden retriever Davis joined Hope in the OHSU Doernbecher Children's Hospital therapy dog program.
“Not all medicine is administered by doctors or nurses,” said Dana Braner, M.D., F.A.A.P., F.C.C.M., Credit Unions for Kids chair and professor of pediatrics (critical care medicine), OHSU School of Medicine; and physician-in-chief, OHSU Doernbecher Children’s Hospital.
“Animals offer true healing powers that, for many patients, complement the results of traditional medical treatments. With Hope and Davis as a part of our patient-care team, we are now able to provide the most complete care to more children than ever before.”
Good health hinges on clear communication
Have you ever gotten home from a visit to a health provider and realized you don’t remember all the instructions you were given? Or can’t explain the provider’s answers to your spouse? Lots of data prove you aren’t the only one who gets easily confused by medical jargon, explanations and complex care instructions.
No matter your education or background, visiting a clinic or hospital is stressful, and typically you aren’t at your best due to anxiety, illness or pain.
Providers are becoming more aware of their responsibility to communicate clearly, and Cliff Coleman, M.D., M.P.H., of OHSU Family Medicine is training the next generation of physicians to recognize the connection this makes to good health.
Read more about OHSU's programs to teach future providers compassion in communications
“All of your health care professionals are caring people who know their business but don’t realize when they are making information harder to understand,” Dr. Coleman says. “As a patient, you can help lower barriers to understanding by making sure you know the answers to these three questions by the end of the visit: what was the main problem we discussed today, what should I do about it, and why is doing that important?”
Rachael Postman, D.N.P., F.N.P.-C., of OHSU Family Medicine at Richmond, emphasizes that questions are not only OK, they are welcome. Patients may feel shy about quizzing their providers, but Dr. Postman encourages patients to speak up.
“We want you to feel like you are getting information that makes sense, so you know what to do next,” she says.
Drs. Postman and Coleman suggest that patients help providers by:
- Bringing a written list of questions/concerns.
- Bringing another person to help listen.
- Taking notes.
- Asking for explanations of any words or instructions you don’t understand.
- Asking for a written summary of the conversation.
- Asking for information in your native language using an interpreter and/or in writing.
- Getting instructions for follow-up questions.
- For prescriptions, asking the provider to list the reason for the medicine on the label.
Q&A: Your Questions, Expert Answers
A: Yes, you will be up and moving right after your joint replacement. A physical therapist will have you walking the same afternoon as your surgery. At OHSU orthopaedics, we use rapid recovery protocols, so getting moving quickly is important. The other key is reducing or avoiding the use of opiates. Instead, we use a variety of other medications to reduce swelling and pain. By following these two methods, data show people have fewer problems and get back to their normal lives quicker. Many joint replacement patients go home the same day as the surgery with an at-home exercise plan. Knee patients start physical therapy about a week after surgery. Most of the healing happens within three months, however, you may continue to improve for up to a year after surgery.
RYLAND KAGAN, M.D.
OHSU Orthopaedics and Rehabilitation
503-418-8889
www.ohsu.edu/ortho
A: Early treatment is key. The sooner we treat these birthmarks (hemangiomas), the better the results. Though we don’t know what causes them, these red birthmarks usually need treatment, especially when on the face or neck. They can grow a lot in the first six months of life and cause lasting changes in the skin. With early treatment, we can keep hemangiomas from getting bigger and make them fade faster. Unfortunately, I often see babies after the birthmark has grown significantly, because parents didn’t know how important it is to seek early treatment. Though the color will fade over time, the skin is never normal where the hemangioma grew. As soon as you discover the birthmark, plan to meet with a pediatric dermatologist or an ear, nose and throat specialist for guidance. At OHSU Doernbecher, we have both types of specialists working together in the Hemangioma and Vascular Birthmarks Clinic.
CAROL J. MACARTHUR, M.D.
OHSU Doernbecher Children’s Hospital
503-346-0640
www.ohsudoernbecher.com
A: Yes, there are medical and lifestyle options to improve hot flashes. About 80 percent of women have hot flashes and night sweats in the four years or so before menopause, and some women will have these symptoms long after their periods have stopped. Each woman has to decide how much intervention she needs for daily comfort and function. For some, loose clothing, exercise and a fan at the ready are enough. For others, we can prescribe estrogen therapy, which will stop hot flashes within about three weeks. There are some other prescription alternatives that can also help. Other common symptoms of menopause include sleep and mood disturbance, vaginal dryness and low libido. Just know that you don’t need to suffer. If any of these symptoms are negatively impacting your life, speak to your health care provider. At OHSU, we have the Menopause and Sexual Medicine program to address multiple issues.
KAREN ADAMS, M.D.
OHSU Center for Women’s Health
503-418-4500
www.ohsuwomenshealth.com
A: Heart disease is the leading cause of death and certain people are more at risk than others. A preventive cardiologist can identify your risk for a heart attack and suggest the right plan for managing that risk. Some people have risk factors at a younger age, but any man over 55 and woman over 60 will benefit from an expert evaluation to avoid a cardiac event. Also, anybody who has already survived one heart attack or stroke should be seen to help avoid a second one. Preventive visits include a review of family history, blood tests, nutrition advice and, in some cases, imaging tests. Preventive cardiology is a specialized service not available everywhere. OHSU Center for Preventive Cardiology is accepting new patients.
SERGIO FAZIO M.D., PH.D.
OHSU Knight Cardiovascular Institute
503-494-1755
www.ohsuheart.com
A: We recommend that women over 21 get tested periodically for cervical cancer because it is a type of cancer that doesn’t have symptoms until the disease is advanced. Importantly, it is a type of cancer that we can prevent. We can reliably catch precancers with swab tests – Pap and HPV – and resolve them with less traumatic treatment than if the disease progresses. Current guidelines recommend that women ages 21-29 get a Pap test every three years. Women ages 30-64 should get the same, or a co-test of Pap/HPV every five years. HPV is very common in the population now, and we know it is a driver for causing cervical cancer. If you have a positive HPV status, your provider will follow you more closely and may recommend additional testing.
ELIZABETH MUNRO, M.D.
OHSU Knight Cancer Institute
503-346-1500
www.ohsuknightcancer.com
A: Recent reports show a worrying increase in vaping among youth, with about one-fifth of high schoolers now vaping. By law, vaping (using a device to breathe in flavored products that usually contain nicotine) is restricted to people over 18 years old, but that hasn’t stopped curious teens. Youth, and even parents, often view vaping as having no health consequences and as safer than cigarettes. However, vaped nicotine can be addictive, especially for teens, whose brains are still developing. The aerosols also contain toxins, such as metals and formaldehyde, which may have as-yet unknown effects. Vaping fluids come in delicious-sounding flavors such as mango and crème brulee, avoiding the tobacco smell, making it easier to avoid detection by parents and teachers. One popular type of vaping device (Juul) looks like a thumb drive, not a cigarette. Parents should inform children about how unhealthy and addictive vaping is and that it is not harmless.
SHELLEY SELPH, M.D., M.P.H.
OHSU Family Medicine
503-418-1500
www.ohsu.edu/walkin
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