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

Senator Maria Cantwell stops by CHAS Health to talk about Basic Health.

United States Senator Maria Cantwell stopped by CHAS Health’s Maple Street Clinic to urge Washington State to bring back Basic Health Plan.

Basic Health is a federal program that was modeled after Washington State’s Basic Health Plan, which went away when the WA HealthPlanFinder Marketplace website was implemented. This program would help patients who have had difficulty affording the cost of Marketplace Plans.

Cantwell was joined by Washington State Representative Marcus Riccelli, CHAS Health CEO, Aaron Wilson, the Native Project CEO, Toni Lodge, and other advocates urging the state to adopt the affordable insurance program again. Cantwell said it could help about 162,000 people in Washington, who earn between $16,242 and $23,540 annually, which is just above the Medicaid eligibility rate. “The Federal Basic Health Plan will help patients maintain affordable coverage and will also reduce unnecessary health system costs by enabling patients to maintain continuity of coverage instead of churning between the Apple Health program and the exchange plans” says Wilson.Cantwell press conference chas

“Our state has been an innovator in health care in so many ways, and Basic Health is just another example of that.” Cantwell said, now that we have the basic health plan as a federal option, currently a family of 4 in Spokane with an income of 48,000 per year could have these options. Right now, paying a monthly premium of $259/month for a private plan on the exchange, that same family in New York under the Basic Health Plan is paying just $20/month. If the Basic Health Plan had similar premiums…that family could save over $2886/per year.”

Many families are, “literally one broken arm away for their kids to sending them in to financial hardship.”

It’s a plan that saves the consumer money, improves the overall health of our community, and it saves the state money. There could be more than 10,000 people in Spokane that would qualify for the Basic Health Plan.Cantwell press conference chas 3

 

Preventing Pertussis or “Whooping Cough” in the newborn.

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Pertussis, also called “Whooping Cough” is a bacterial infection that you or your baby can catch when an infected person coughs or sneezes.  Infected droplets can travel through the air, and if you inhale the droplets you can become infected with pertussis.  Whooping cough begins like a cold, with a mild fever and runny nose.  Most adults do not have severe symptoms, but they can pass pertussis on to a newborn very easily without realizing it.

Whooping cough is especially dangerous for a newborn because their immune system is not fully mature and they cannot fight this infection.  Babies cannot get the vaccine for pertussis until they are two months old.  Even after they start the vaccinations, they are not fully protected by the vaccines until they are a year old and have had three vaccinations for pertussis.  Whooping cough in a newborn is a very serious illness, and it often requires that the baby be admitted to the hospital for breathing problems or pneumonia.  Some babies who get whooping cough do not cough at all – they just stop breathing.  Newborns can die from whooping cough.

The entire family can help protect your newborn from whooping cough.  All teenagers and adults who are around your baby should get a pertussis booster, called Tdap.  The Tdap shot is a tetanus vaccine that includes pertussis.  If you are pregnant, the best time to get the Tdap vaccine is between 27-36 weeks of pregnancy.  Your body will have time to make antibodies against pertussis.  These antibodies are passed through the placenta to protect your baby.  You can protect your baby with antibodies long before your baby is old enough to get the pertussis vaccine.  After the baby is born, the antibodies are passed through your breast milk.

For more information:  http://www.cdc.gov/features/pertussis

-Kirstin Johnson, Certified Nurse Midwife

Colorectal Cancer Screening, on the Path to Success.

On Wednesday, October 28, CHAS welcomed visitors from the American Cancer Society, Great West Division. CHAS received a grant this year through the American Cancer Society, with funding from the Anthem Foundation, to improve the colorectal cancer screening rate at CHAS Maple Street Clinic. During the first six months of the grant, Maple Street’s staff have increased their clinic’s screening rate from 8.8% to 16.7%, with a goal to achieve 25% by April 2016.

Audrey Fine, Health Systems Manager, Primary Care, Great West Division, American Cancer Society, Inc., discusses colorectal cancer screening efforts with CHAS Maple Street Clinic providers and Medical Assistants

Audrey Fine, Health Systems Manager, Primary Care, Great West Division, American Cancer Society, Inc., discusses colorectal cancer screening efforts with CHAS Maple Street Clinic providers and Medical Assistants

Oftentimes patients schedule a medical visit to address an immediate need, such as congestion or fever. However, a critical component of primary care is prevention. CHAS staff actively encourage patients to receive appropriate cancer screenings. Annual tests can detect cancer of the colon, cervix, and breast at early stages.

Audrey Fine with the American Cancer Society concluded her remarks with CHAS Maple Street Clinic medical staff by sharing a very appropriate quote that beautifully captures the impact of preventative health care:

“The names of the patients whose lives we save can never be known. Our contribution will be what did not happen to them. And, though they are unknown, we will know that mothers and fathers are at graduations and weddings they would have missed, and that grandchildren will know grandparents they might never have known, and holidays will be taken, and work completed, and books read, and symphonies heard, and gardens tended that, without our work, would never have been.”

 

–Donald M. Berwick, MD, MPP, Former President and CEO, Institute for Healthcare Improvement. Excerpted from Dr. Berwick’s plenary address at IHI’s 16th Annual National Forum on Quality Improvement in Health Care (December 2004).

 

Thank you to the American Cancer Society and Anthem Foundation for their generous financial contribution, and the Cancer Society’s excellent ongoing technical assistance, to help improve access to preventive health care for CHAS patients.

BE A CHAMPION! PLEASE IMMUNIZE!

Community Health Association of Spokane Valley Clinic

It is National Vaccine Awareness Month and that means… it’s time to talk about immunizations.

I will keep this short and sweet as we want to stay focused. Please come in and talk to a provider at any time if you have any questions or concerns about vaccination so we can discuss why they are safe and so important for you, your family and your community.

 

  1. Starting in September CHAS will have flu shots available for anyone who comes to any of our clinics. We will be here and ready to go to help keep you healthy thus If you have an appointment prior to the start of September you can come back in at anytime for a nurse visit to get your annual flu vaccination. If you are wondering “Do I need a flu shot” this post from a nurse who questioned her need for the vaccine while pregnant  may be just for you. http://www.voicesforvaccines.org/nurses-vaccinate-to-protect-families-and-patients/

 

  1. Please ask our medical staff at every visit if you need any vaccines. We should check every time you come in so we take every opportunity to keep you protected and healthy. If you don’t ask, who will? One question and 30 seconds of your time could save your life or the life of someone you love.

 

  1. For Teens- In 2014, nationally, 4 out of 10 teen girls and 6 out of 10 teen boys had not even started the HPV vaccine (Gardisil) series making them vulnerable to cancers caused by HPV. Your teenager also needs to shots to protect them from meningitis and a TDaP to protect them from tetanus and Pertussis (whooping cough). Please start asking about HPV and if your teen starts this vaccine series, please remind them to finish it.

 

  1. Be a Champion! This month, I encourage everyone to be a champion for vaccine Please look up just one vaccine, any one of your choice and become passionate about it for your community. Be familiar with the results of getting such an infection and how not getting immunized can impact your community. Please go to http://www.immunize.org/vaccines/ this site will give you discussion points about each illness, pictures of what the illness looks like, and tons of resources to access so you can learn everything you need to know about vaccination. Let’s work together to make our community as safe as it can be. Please look at this resource  http://www.voicesforvaccines.org/ too as it helps you see each illness through the eyes of families and individuals affected by each preventable illness.

National Health Center Week: Aug 9-15

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This year’s National Health Center Week theme is Celebrating Our Legacy, Shaping Our Future. The theme is timely, as Community Health Centers across the nation are celebrating the program’s 50th anniversary. Each year health centers celebrate National Health Center Week to recognize the important work accomplished in communities where patient-led organizations are continually removing barriers to primary and preventive care.

CHAS is one of more than 1,300 Community Health Centers. Founded in 1994 in response to demand for healthcare services for low income and uninsured individuals in Spokane, Washington, CHAS has grown steadily from a small Health Care for the Homeless clinic to its current configuration of 11 health center sites serving more than 55,000 patients throughout Eastern Washington and Northern Idaho.

A look back at recent CHAS accomplishments provides a glimpse of how our organization is helping to shape the future of primary health care access in our community:

  • In May 2013 the American Pharmacists Association Foundation recognized CHAS nationally with the Pinnacle Award for CHAS’s pharmacist-medical team integration that has resulted in safer and more effective medication use for patients.
  • CHAS opened a clinic in Moscow, Idaho – Latah Community Health – in June 2013. Primary medical, behavioral health, and pharmacy services are provided at this site where 55% of patients are uninsured.
  • Since the state health insurance Marketplaces opened in October 2013, CHAS in-person assistors have helped enroll more than 27,000 individuals. Even with increased insurance coverage, during CY2014 CHAS provided more than 12,000 uninsured patients access to over 26,000 visits.
  • In August 2014 CHAS received a competitive patient-centered medical home capital grant to renovate CHAS’s Denny Murphy Clinic in downtown Spokane. This site serves as the home base for CHAS’s homeless outreach program. Modernizing the space to increase provider collaboration will lead to improved patient outcomes for Spokane’s most vulnerable residents.
  • CHAS’s approach to effectively integrate behavioral health services in the primary medical setting was recognized through a competitive national grant award in July 2014.
  • CHAS was recognized by the U.S. Health Resources and Services Administration in December 2014 as a “National Quality Leader”. This prestigious recognition was only designated to 57 health center organizations out of more than 1,300 health centers nationally. National Quality Leader health centers are the highest performers compared with national standards and benchmarks in key clinical areas.
  • In March 2015 CHAS opened a new site – Perry Street Clinic – in Spokane’s East Central neighborhood. During the first year of operation, the clinic is projected to provide over 14,000 encounters for more than 4,600 patients.

Looking back at these highlights, each accomplishment demonstrates how CHAS continues to implement the organization’s mission: to improve the overall health of the communities we serve by expanding access to quality health and wellness services. Over the past 50 years health centers like CHAS have been increasing access to affordable, high-quality, cost effective health care to medically vulnerable and underserved people throughout the United States. Like CHAS’s recent award and grant recognitions, our nation continues to recognize the invaluable contributions of the health center program. In April 2015 Congress passed bi-partisan legislation extending funding for Community Health Centers for the next two years. Politicians may be divided over our nation’s health care system, but they are united in support for health centers.

Community Health Association of Spokane Valley Clinic

Community Health Association of Spokane Valley Clinic

When I think of health centers, so many words come to mind: access, quality, advocacy, passion, patient-centered. I can’t sum up health centers’ legacy in just one word. Reflecting on the health center movement, it is clear that health centers have always been so much more than a doctor’s office. Yes, our patients receive medical care. But patients also get help enrolling in health insurance; they are given a bus ticket if they need help getting to their appointment; they are connected with community partners for food, clothing and housing assistance; we provide translations services; our amazing outreach workers walk outside in all weather conditions to connect with patients who don’t have a place to call home. I think the health center legacy is that we don’t just treat our patients, we fight for them. We fight for their right to access high-quality health care. We fight for continued funding for the health center program so that we can continue to see our existing patients and expand access to new patients. Regardless of a patient’s background or insurance status, we will continue to do everything we can to provide whole-person health care. What an amazing legacy to be a part of.

As we celebrate National Health Center Week 2015, I offer a humble ‘thank you’ to everyone – patients, volunteer board members, providers, advocates, elected officials – who has been part of this legacy. Here’s to the next 50 years.

– Lindsey Ruivivar, CHAS Public Policy and Development Manager

8 reasons for men to get screened…

Community Health Association of Spokane Valley Clinic

It’s Men’s Health Month, and an important part of staying healthy is engaging in routine health care maintenance (getting the screening you are due for). At age 18 men should be screened for high blood pressure, this can be accomplished quickly by an MA in provider’s office.

Men over age 18 should also be screened for depression, this can be accomplished by a quick questionnaire in the office.

If you have smoked 100 or more cigarettes in your lifetime, you should get screened once for abdominal aortic aneurysm (AAA). AAA is a bulging in your abdominal aorta, your largest artery. An AAA may burst, which can cause dangerous bleeding and death.

Annual colon cancer screening can be done with a take home stool test called the IFIT, screening should begin at age 50.  If you have a family history of colorectal cancer, you may need to be screened earlier. Colonoscopies can also be used and if normal may need to be done only every ten years.

Get screened for diabetes (high blood sugar) if you have high blood pressure or if you take medication for high blood pressure.

Get screened one time for HCV infection if you born between 1945 and 1965 (Boomers), have every injected drugs or used drugs intra-nasally, or received a blood transfusion before 1992. If you are a current injecting drug user you should get screened on a regular basis.

If you are 35 or older, have your blood cholesterol checked regularly with a blood test. High cholesterol increases your chance of heart disease, stroke, and poor circulation. Talk to your doctor or nurse about having your cholesterol checked starting at age 20 if you use tobacco, are overweight or obese, have diabetes or high blood pressure, have a history of heart disease or a man in your family had a heart attack before age 50 or a woman before age 60.

Prostate cancer screening is no longer routinely recommended, but talk to your provider if you are having symptoms for frequent urination, urgency of urine, decreased urine stream or hesitancy of urine.

It can be difficult to make the time to get a screening, but we try to make it easy. It’s never too late to start the conversation, and it will always be worth your time to make that appointment. One appointment, screening, or check up could make all the difference. It’s time to take control of your health.

 

Article by Bill Bomberger, Deputy Medical Director

CHAS Gets National Recognition for Quality!

This week the U.S. Health Resources and Services Administration announced quality improvement award funding for Community Health Centers. There are 1,300 health centers across the nation, and CHAS is one of just 57 health centers to be recognized as a “National Quality Leader”. National Quality Leaders are health centers that are the highest performers compared with national standards and benchmarks in key clinical areas. CHAS received the National Quality Leader award for exceeding national clinical benchmarks (Healthy People 2020 objectives and health center national averages) for chronic disease management, preventive care, and perinatal/prenatal care. This is a very prestigious national recognition! Additionally, CHAS was also recognized as a “Clinical Quality Improver” for demonstrating at least a 10 percent improvement in clinical quality measures between 2012 and 2013.

“This funding rewards health centers that have a proven track record in clinical quality improvement, which translates to better patient care, and it allows them to expand and improve their systems and infrastructure to bring the highest quality primary care services to the communities they serve,” said U.S. Health and Human Services Secretary Sylvia M. Burwell.

“These funds reward and support those health centers that have taken steps to achieve the highest levels of clinical quality performance and improvement,” said Health Resources and Services Administration Administrator Mary K. Wakefield, Ph.D., R.N.

One of our core values is commitment to quality improvement, with that commitment, we are psyched to be on this list!  Readthe U.S. Health and Human Services’ national press release here.

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