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Press Release: More Services for Moscow!

CHAS TO ADD DENTAL SERVICES IN MOSCOW CLINIC EXPANSION

 

Spokane, WA. December 5, 2016 – Palouse residents will soon have increased access to dental services thanks to the upcoming expansion of Latah Community Health, a CHAS Health clinic in Moscow, Idaho. This service builds on the already comprehensive services of the clinic including medical, behavioral health, and pharmacy.

CHAS Health will reopen the health center in the new Gritman Medical Center on December 12th. The move will increase the health center facility from 2,500 square feet to 9,800 square feet. All existing services will continue to be provided at the new site, and the additional clinic space will allow for more primary medical and behavioral health care. The new space also allows CHAS Health to bring dental services on-site. All services will continue to be available to everyone, regardless of insurance status.

 

“We are excited to have the opportunity to grow in this community,” states Aaron Wilson, CHAS Chief Executive Officer, “Expanding dental services to Moscow-area residents is one step further in ensuring quality healthcare for everyone.”

 

Latah Community Health originally opened in 2013 due to a combination of efforts by the City of Moscow, the League of Women Voters, Gritman Medical Center, and CHAS Health. This was a response to the growing number of requests for social services in the Palouse. The clinic currently serves over 1600 patients in the Moscow area.


About CHAS Health

The mission of CHAS Health is “to improve the overall health of the communities we serve by expanding access to quality health and wellness services”. Check out their website (www.chas.org) to learn more about their available services and facilities. 

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Gestational Diabetes: Do I HAVE to drink that?

 

Short Answer:  Yes.

Long Answer:  You actually don’t HAVE to do anything you don’t want to do.  We won’t MAKE you do anything you don’t want to do.  This concept supports your autonomy as a patient.

However, you trust us to be the lifeguard of your pregnancy.  Throughout your pregnancy, we will monitor your blood work, vital signs, and the baby’s growth and development by using ultrasound, drawing your blood, listening to your baby’s heartbeat, and measuring the size of the uterus.  Trust us when we say that the second trimester glucose screen is very important to the health of both you and your baby.  We might even recommend it earlier in the first trimester if we are concerned about impaired glucose tolerance.

One complication of pregnancy that we screen for and treat is called gestational diabetes.  Gestational diabetes can occur in women of any size, even without a personal history of family history of diabetes.  Insulin is a hormone produced by the pancreas, and the body uses insulin to help transport blood glucose (sugar) from the bloodstream into the cells of the body.  The hormones of pregnancy can cause you to be resistant to insulin.  If you become resistant to insulin, your blood glucose levels become elevated and the glucose easily transports across the placenta to your baby.  This can cause the baby to grow very large, and at the same time it impairs the development of the baby’s lungs.  You can end up with a very large baby who, at the same time, has very immature lungs and needs help breathing after birth.

Maternal Complications of Gestational Diabetes:

  • You have a 70% chance of developing Type 2 Diabetes within 10 years
  • You are at a higher risk of high blood pressure or preeclampsia in pregnancy
  • You might require medication to help manage your blood glucose
  • You are at higher risk of miscarriage or stillbirth

 

Fetal Complications of Gestational Diabetes:

  • Your baby can grow very large
  • Your baby might experience a shoulder dystocia at delivery, which is an emergency situation where the head delivers but the large body is stuck behind your pelvic bones.  We might have to break the baby’s collar bone to help your baby deliver.
  • Your baby might require assistance breathing at delivery or in the first few days
  • Your baby might need to be observed or treated in the special care nursery for low blood glucose.

What happens if your one hour glucose screen comes back elevated? 

We will ask you to take a three hour glucose screen.  If the three hour glucose screen comes back elevated, you will have the diagnosis of Gestational Diabetes.  At that time, we will send you for a consultation with a Maternal Fetal Medicine physician called a Perinatologist.  These physicians are specially trained in high-risk pregnancy and obstetric ultrasound.  They can help us monitor the growth of your baby.  In addition, a diabetic educator will teach you how to test your blood glucose daily.  They will also teach you how to eat well to keep your blood glucose as stable as possible.  You will also be asked to increase your daily exercise, which will help your body be more sensitive to insulin and help you regular your blood glucose.

 

The glucose screen is usually done at the 24-28 week visit.  We ask that you eat normally that day, with good protein and not a heavy carbohydrate load.  Plan for the visit to take at least an hour because we have to draw your blood one hour after you finish drinking the liquid.  Pack a healthy snack with protein for the ride home.

 

So… yes.  Your midwives are aware that the glucose screen can cause nausea and discomfort.  You may not like the taste of the drink.  However, it is an important screening test that can help us provide the very best care for you and your baby.

 

For more information:

http://www.diabetes.org/diabetes-basics/gestational/

http://www2c.cdc.gov/podcasts/player.asp?f=11504&loc=WhatIsGestational

By: Kirsten Johnson | Certified Nurse Midwife

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5 Things to know about open enrollment this year

  1. Open enrollment for the individual marketplace begins on November 1st, 2016 and ends on Jan 31st, 2017. During this time, consumers can select a new plan, renew their existing coverage, or change plans. It’s also a good time to review their application and report any changes in income or household size. The individual marketplaces for Washington and Idaho are the Washington Healthplanfinder (wahealthplanfinder.org) and Your Health Idaho (www.yourhealthidaho.org). Both sites are where individuals can purchase health plans and see if they qualify for free or low-cost health insurance. 
  2. At CHAS Health, all of our Patient Services Coordinators are available to help patients and community members to apply and enroll in Medicaid or Qualified Health Plans. Every CHAS Health PSC is a certified navigator in the Washington Healthplanfinder; the PSCs at Spokane Valley CHAS Health, Spokane Urgent Care – Valley, Lewis and Clark Health Center, and Latah Community Health are also certified Enrollment Counselors for Your Health Idaho. This means that they provide free, unbiased assistance to help consumers understand their options for health coverage to get covered and stay covered. To see a PSC, call 509.444.8200 to schedule an appointment or walk in to any CHAS Health location. For a list of information to bring with you to your appointment, click here. You don’t have to be a patient at CHAS to see one of our Patient Services Coordinators. We welcome everyone!raw
  3. New for 2017! WA Healthplanfinder is offering adult dental plans. One of the biggest disappointments for many Washington consumers over the last few years was the fact that the Qualified Health Plans offered on the WA Healthplanfinder did not provide dental coverage for adults. This year, adults will have the option to purchase an adult or family dental plan from Delta Dental, Dentegra, or Dental Health Services. An adult must purchase a health plan to also purchase a dental plan. Premium tax credits can only be applied to the health plan. Adult dental premiums range from approximately $19-$39 per month.
  4. Washington Healthplanfinder saw lower increases related to average premium and deductible increases from 2016 to 2017 than the national marketplace. Pat MacEwan, CEO of the Washington Health Benefit Exchange, said in a recent news release, “in contrast to much of the country, the Washington individual insurance market is competitive and healthy. Customers in Washington will find a choice of plans and carriers on the Exchange.” The amount of carriers offering health plans in the exchange has helped to create competition and keep prices low. While the national average for the second lowest cost silver plan increased 25%, Washington experienced an average increase of only 8%. Consumers in Washington will continue to have many affordable choices when it comes to choosing the health insurance that fits their individual needs. Read the full news release from Washington Health Benefit Exchange here.
  5. Enrollment in Medicaid programs is open all year, but ‘tis the season for WA Apple Health renewals! There are no open enrollment periods for Medicaid in Washington or Idaho so residents of either state can apply for Medicaid medical coverage at any time during the year. However, in Washington, many Apple Health (Medicaid) members will need to renew their coverage over the next few months. Apple Health renewals can be completed 1) online at wahealthplanfinder.org, 2) by calling WA Healthplanfinder Customer Support Center at 1-855-923-4633, 3) by paper, or 4) by seeing a certified navigator in the community. At CHAS, our Patient Service Coordinators are ready to help you with your Apple Health renewals. To see a PSC at CHAS, call 509-444-8200 to schedule an appointment or walk in to any CHAS Health location.

 

Happy Open Enrollment!

 

Julie Becker

Patient Services Administrator

 

Get covered. Stay Covered. Come see a CHAS Patient Services Coordinator today.

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Too sick for school?

Fall is officially here and the school year is in full swing! Unfortunately, this also means we are nearing the peak of cold and flu season. Over the next few months, many parents of ill children will be faced with the decision whether or not to send their child to school. The most important thing for parents to consider when making this decision is if the child will be able to learn and participate in school activities. We also don’t want to unnecessarily expose other children to illness causing germs. However, we all want to minimize missed school and work days for both students and their parents. Below are a few guidelines that can help parents make this often tricky call.

 

 

 

 

 

 

 

 

 

 

Fever

A fever is body’s way of fighting off infection and is the most common reason parents keep their children home from school. The definition of a fever is a temperature of 100.4 or higher, though some schools and daycare centers will have their own rules. The general rule of thumb is to keep your child home until they have been fever free for 24 hours.

 

Upper respiratory Infections

Most children will have several different cold viruses each winter. A child with typical cold symptoms including a runny nose, sore throat, and cough can usually participate in school without any restrictions. Coughs may linger for several weeks after the other symptoms have resolved. It is important to go over the importance of coughing or sneezing into an elbow or a tissue and proper hand washing techniques with your sick child to limit the spread of these germs.

It may be necessary to keep a child home if they have more severe symptoms, such as extreme fatigue, loss of appetite, or anything else that will keep them from learning and participating at school. If a child has influenza (the “flu”), they should be kept home from school until their symptoms have resolved. The flu is similar to a cold but is accompanied by high fevers and body aches. We recommend an annual influenza vaccine to help lower the risk of this illness.

If your child has an ear, sinus, or strep throat infection it is recommended that they stay home from school until at least 24 hours after antibiotic treatment has been started. Conjunctivitis (also known as “pink eye”) can be caused by allergies or a virus, but when it’s caused by bacteria it is very contagious and needs antibiotic treatment before the child returns to school.

 

Vomiting and Diarrhea

Children with vomiting and diarrhea should also be kept home until their symptoms have resolved. If there are no other symptoms, older children with mild diarrhea that are able to use the toilet and wash their hands on their own may go to school if they don’t have any other symptoms.

 

Skin

Most childhood rashes are caused by viruses and most are not cause for concern. Certain rashes, such as chicken pox are more severe and highly contagious. If a rash is accompanied by a fever, the child should not attend school. If you are unsure what is causing a child’s rash, it’s a good idea for them be seen by their healthcare provider to find out what the rash is and any precautions that should be taken.

 

Lice is another common reason for children to miss school. In the past, many schools had a “no nits” policy. Experts now agree that these absences are unnecessary and children can return to school as soon as they have had one lice treatment.
Illnesses are a normal part childhood. We can’t keep our children home for every sniffle and sneeze, but we do want to minimize the spread of germs and make sure that our children go to school ready to learn. If you have any questions about whether or not to send your child to school, talk to your child’s healthcare provider.

Autumn Barbero, Pediatric Nurse Practitioner

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5 Rules for Screen Time.

 

 

 

 

 

 

 

 

 

 

Everyone loves screen time.  Whether it is watching a movie, playing a video game, reading the news, or talking with friends, technology is at the center of all of our lives.  Media and screen time, like most things, should be used in moderation.  While technology use is important in most facets of life today, too much screen time has been linked to obesity, difficulty sleeping, problems in school, aggressive behavior, and bullying.  It is important to help your child find a healthy balance.  A few simple guidelines can help keep screen time in check for you and your family:

  1. Remove all screens from the bedroom. Kids with TVs in the bedroom have been found to watch 1 ½ hours more TV than kids without TVs in the bedroom.  TVs in the bedroom have also been linked to obesity.  Availability of internet and texting in your child’s bedroom gives them unmonitored access to anything on the internet.  Keep all screens (including your own) out of the bedroom.  Try setting up a charging station for all devices in a common area.
  2. Monitor what your children are doing during their screen time! Just like you would ask who they are spending time with on the weekend, ask who they are spending time with on social media.  It is important to teach children what is and is not appropriate to share on social media.  Also, be aware of the websites they are going to and the apps they are using.  Play apps and video games with them!  Then you know what they are doing and if it is appropriate.
  3. Make sure screen time is age appropriate and educational. Not sure if a movie or video game is good for your child? Check out commonsensemedia.org.  This website is run by a nonprofit organization that provides independent ratings for movies, TV shows, video games, and apps.  It provides you with a summary of the game or video and suggested ages for appropriate use.
  4. Limit screen time for everyone in the family. All children should spend no more than 2 hours in front of a screen for non-school purposes.  Think of things you can do as a family that does not involve a screen: go for a walk, play a board game, go to the park, or read a book together.  Any activity that provides family interaction is preferred to screen time!
  5. No screens after dinner. We know that looking at a screen keeps your body from releasing melatonin.  Without melatonin you don’t feel sleepy when bedtime comes.  Sleep is important to help with mood, concentration, and learning.  If sleep is a problem for your child, try a screen fast (by eliminating electronic device use for a few weeks) to see if this helps restore a good sleep pattern.

 

Screen use is here to stay.  Help your child form good, healthy screen habits!

-Ashlee Mickelson, MD Pediatrician

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Birth Plans!

Should I write a Birth Plan?

Many women want to write out a birth plan to clarify the care they hope to receive while they are in labor.  A birth plan can be a short wish list or a long explanation of your circumstance, such as if you are adopting the child out or if there are known anomalies incompatible with life.

Is a Birth Plan required?  No.  The nurses, midwives, and physicians are highly trained professionals who will take care of you to the best of their abilities.  We have not performed routine shaves, enemas, or episiotomies for over 25 years, so you do not need to request that we refrain from these procedures.  We have many tools in our bag of tricks to help your labor progress well and hopefully avoid complications.

In addition, every woman and every labor is different.  It is a good idea for you to relax, let go, and accept the labor that comes to you.  There really is no other choice but to deal with the reality of the moment.  Your care providers will help you.  Honest.  That’s what we have chosen to do for our career.  We want the best outcome for you and your family.

I do recommend that my mammas write up a short, one-page wish list that gives the labor team a frame of reference of what experience you are hoping for in labor and delivery.  It is a good idea to designate one person to speak for you if you are unable to speak for yourself due to an intense labor.  It tells us if you have specific requests, such as dad cutting the umbilical cord or your desire to avoid an epidural or even GIVE ME THE EPIDURAL THE MOMENT I WALK IN THE DOOR!

Bring your birth plan to one of your prenatal visits to discuss with your midwife or physician.  Then when you have a final draft, bring a printed copy for the nurse caring for you in labor and delivery.  That way, your entire team is on board with the plan and works with you!  Remember to keep it short and flexible.

Some ideas of what women specify in a birth plan:

  • Who will be present for the birth?
  • Are you bringing a doula?
  • Will there be siblings present?
  • Do you want mobility or do you want to stay in bed?
  • What activities or positions do you plan to use (walking, birthing ball, standing, tub, squatting, etc)?
  • What is your plan for pain relief (massage, hot packs, position changes, hypnobirthing, Lamaze breathing, jacousi tub, medication)?
  • How do you feel about fetal monitoring?
  • Who will care for the baby?
  • What is your plan to feed your baby?
  • Do you want to wear your own clothing and listen to music?

 

You can always google “birth plans” on the internet for more ideas, remembering to keep your wish list to one page!

-Kirstin Johnson, Certified Nurse Midwife

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National Health Center Week 2016: Open Houses

CHAS Health is celebrating National Health Center week with a series of open houses! Whether it’s our remodel at the Denny Murphy clinic or our dental expansion at our Cheney Health Center, we have some exciting updates to share with you. Meet our staff, take a tour, enjoy some refreshments, and learn more about what our clinics have to offer.

 

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Menopause

Menopause

AKA

The Climacteric, The Change of Life, or my favorite:

MANopause.  That’s right, fella’s, back away slowly…

Throughout a woman’s life, hormones are constantly shifting and changing, rising, and falling, performing an intricate dance.  When the ovaries reach the end of their lifespan, on average around the age of 50, they no longer produce the hormones estrogen and progesterone.  For some women this happens suddenly and they are thrust into distressing symptoms such as irregular periods, heavy  bleeding, hot flashes, night sweats, vaginal dryness and pain with sex, low sex drive, anxiety, irritability, and even depression.  Perimenopause, the years before the official diagnosis of menopause, can last 10 years or more.  When you have not had a period for an entire year, we can officially say you are in menopause.

One of the most common distressing symptoms are called “hot flashes”. Hot flashes begin as a sudden sensation of heat centered on the upper chest and face that rapidly becomes generalized.  The sensation of heat lasts from two to four minutes, is often associated with profuse perspiration and occasionally palpitations, and is sometimes followed by chills, shivering, and a feeling of anxiety.  Hot flashes may range from less than one each day to as many as one per hour during the day and night.  On average, symptoms last 5 years but 30% of women have symptoms for 10 years and 9% of women have symptoms for 20 years

Modern medicine can offer relief from distressing symptoms, but there is no “cure” for this very natural life process.  As with any medication, there are risks and benefits.  A discussion with your provider can help you decide if medication or hormone replacement therapy is right for you.

Thankfully, there are many things you can do to manage symptoms at home.  These suggestions are basic recommendations for self-care:

For the management of hot flashes and night sweats:

  1. Lower the room temperature
  2. Use fans
  3. Dress in layers that can be easily shed
  4. Wear a base layer that wicks moisture away from your skin.
  5. Avoid spicy food, hot drinks, alcohol, stress
  6. Weight Loss

To keep your mood and emotions steady:

  1. Daily Exercise
  2. Daily Yoga or other mindful meditation and relaxation

For vaginal dryness and pain with sex:

  1. Use a vaginal moisturizer three times a week.
  2. Use lubrication for sex.
  3. Sorry, we have no great medical solution for libido

 

To protect your bones, support your immune system, and promote sleep:

  1. 1200mg of Calcium
  2. 400mg Magnesium
  3. 2000IU Vitamin D daily.

Calcium is only absorbed 500mg at a time so taking a supplement twice a day with meals, in addition to at least one serving of dairy or other calcium fortified food daily will supply what you need. The Vitamin D helps your body absorb the calcium and it activates it in your muscle and bone cells so it can work for you.  Magnesium and Vitamin D help with mood and a healthy immune system, too.

For more information on perimenopause and menopause, you can explore the following:

The Wisdom of Menopause, by Christiane Northrup, M.D.

www.menopause.org/for-women

https://www.nia.nih.gov/health/publication/menopause

-Kirstin Johnson, Certified Nurse Midwife

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Pokémon Go, For Your Health?

If you’ve seen an increased number of people walking and biking around town with their phones glued to their faces, there’s a strong chance they are searching for a Charmander, Snorlax, or one of the other 151 Pokémon varieties. Of course we’re talking about Pokémon Go, the latest interactive app to blow up your Facebook and Twitter feed. The coolest part of the app (aside from finding a Squirtle in your backyard), is it’s actually helping people to get outside and exercise more.

Released last week, Pokémon Go is an interactive game that uses your phone’s GPS, camera,  and clock to detect where and when you are in the game and make Pokémon “appear” around using augmented reality. The Pokemon that the players catch can be powered up and used to take over or train at local gyms (usually monuments, churches, other public spaces). Different types of creatures appear as you move around your city, with the variety changing as you move from block to block. You’re literally chasing Pokémon around your city, which is making this game a huge hit and an excellent addition to your exercise regimen.

Many people using the app have seen significant increases in their steps since they began playing.

In addition, some Pokémon Go players are seeing mental health benefits. Simply by getting outside and taking a short walk (sometimes with friends) players are helping themselves to battle anxiety and depression. The game can be played solo or with a group of friends/strangers.

Tumblr user Ari is one of them. She has anxiety and depression and for the past three years has avoided leaving the house unless absolutely necessary.

“I have struggled with motivation and energy since I was 9, when I developed severe depression. After that, when I was 15, I developed CPTSD [complex post-traumatic stress disorder] from an abusive relationship that left me completely socially phobic, and starting then I was barely able to leave my house for fear of seeing people.

“But as soon as I got Pokemon Go I was able to leave the house, and I walked outside for hours and suddenly found myself enjoying it. I had the instant rush of dopamine whenever I caught a Pokémon, and I wanted to keep going. Then today and yesterday I purposely put myself in social situations, going to the mall, just to play. And best of all I enjoyed it.

“I think it’s partially because it gives an instant reward. It’s not like going out, having an awful experience, and getting praise after. It’s going out and getting that instant positive affirmation that makes going outside a good experience. I guess most people get that with being social or doing other activities.”

 

Of course the exercise is a side effect of playing Pokémon Go, which is at its core an incredibly fun way  to try and see if you can “catch ‘em all”. It brings back a sense of nostalgia, childhood wonder, and lets players explore their environment.

Now, if someone can help me find a Pikachu in Spokane, that would be amazing.

-Matt Grebe & Rachael Chambers, CHAS Health Communications Team