MID-COLUMBIA MEDICAL CENTER Fall/Winter 2009www.mcmc.net

A New HeartSpecialist

DigitalMammography

Flu Facts

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Dear Neighbor,

The contents of this issue of Well Aware should leaveno doubt that change is in the air at Mid-Columbia

Medical Center. I’m happy to say that this is great newsfor those we serve throughout the region.

First, our new venture with Oregon Health & ScienceUniversity to expand access to orthopedic care is off theground and running. Patient activity has been brisk at thenew MCMC | OHSU Orthopedics clinic on 12th Street inThe Dalles since the doors opened in April.

I have written previously in this space about the need for additional orthopedicprofessionals to adequately serve the level of need in our communities. The high patientvolume we are experiencing is a clear sign of the pent-up demand for these services. We arevery pleased that our unique relationship with OHSU allowed us to fill this gap in care quicklywith an outstanding group of orthopedic specialists.

The initial component of our second venture with OHSU, around the care of heart patients,also is off the ground — literally, in some cases. Our new joint protocol that ensures thetimeliest and most efficient care of patients who arrive at the MCMC Emergency Departmentwith heart attack symptoms is now in place.

This system involves a highly coordinated plan of action for assessing patients locally andtransferring to OHSU via LifeFlight those who need prompt treatment to stop their heart attack.

The second component of the MCMC, OHSU heart agreement kicks into gear later thissummer when the region’s first full-time cardiologist opens his practice in The Dalles. We arelooking forward to welcoming Dr. David Guarraia to our community in August and know he willbe as warmly received as our new orthopedic providers have been.

You also can read in this issue about our first major construction project since Celilo CancerCenter — Water’s Edge in Lone Pine Village. As the name implies, this beautiful new facility willoverlook the Columbia River and serve as the commercial anchor tenant for the exciting newneighborhood being developed at Lone Pine.

We are anxious to see the building begin to take shape in the coming months, and areeagerly awaiting its opening next spring.

As I said, lots of change in the works as we stay at work looking for ways to expand ourcare to meet the growing needs of our communities.

Duane FrancisPresident/CEO

Change is Good

WA_Summer09July28:Well Aware Spring 08 7/29/09 4:49 PM Page 2

A Mission ofGiving Back

Two things happened recently at Mid-Columbia Medical Center that reminded me why I feel so fortunate to be

working for a not-for-profit organization. I hope that the sharing of these activities helps you understand the depth of our commitment to residents of this region and the benefits of being served by a healthcare provider that is guided by a mission of community service. First, I am pleased to announce that our Employee Community Tithing Fund was activated this year and, as a result, MCMC was able to donate $65,000 to 36 community organizations. Tithing donations are made in any year in which we exceed our financial projections. When this happens, we tithe 10 percent of the excess dollars to area organizations, projects and programs that build healthy communities and for which hospital employees volunteer. The remaining dollars are used to expand services, add technology and otherwise improve healthcare in our community. This is a wonderful program approved by the MCMC Board of Trustees several years ago as another way to give back to the many important organizations that share our vision of community health and wellness. The second recent example I want to relate is our hiring of a part-time certified athletic trainer for The Dalles Wahtonka High School, giving students and athletes access for the first time to an on-site professional for fitness guidance, injury care and other important services. This was an important need identified by the school, and again the MCMC Board stepped forward and approved the hiring of Brad Aytes to fill this position. This arrangement is similar to one we have had in place for several years, in which we subsidize the school nurse program to ensure students have access to on-site health services. While I am pleased to announce these activities, I am also compelled to emphasize that our ability to continue and grow our community-service mission is entirely dependent on our continued financial health. And there are many forces at work that promise to make our already-challenging healthcare environment even more so in the near future. Nationally, healthcare reform of some sort is on the way, and it is clear that hospitals and other healthcare providers will once again be expected to provide more care without being given adequate resources to do so. Locally, next year we know our business will suffer from a new competitor who sees an opportunity to make a profit on outpatient surgeries in this community. Ultimately, the choices patients make about where to have their surgery will decide the impact this new competition has on the health of their community hospital and major healthcare provider. But certainly every surgery performed for profit in the future will have an impact on the activities we are able to pursue as a not-for-profit organization. That, to borrow a phrase from the for-profit world, is the bottom line.

Duane FrancisPresident/CEO

It is Our Mission.. . .To lead and act as a catalyst in

promoting health for all people.

To recognize the individual as a wholehuman being with different needs that

must be enthusiastically met.

To communicate a vision of health, art,education, technology and create a centerfor healing which will continually upgrade

the quality of life in the communityenvironment in which we live.

To empower people to becomepartners in their health care.

Mid-Columbia Medical Center is a not-for-profit healthcare organization offering comprehensive services to the Mid-Columbia Region, and is governed

by a volunteer Board of Trustees:

Robert L.R. BaileyDaniel Boldt

Paul Cardosi, M.D.Duane Francis

Gretchen KimseyCarina Schmidt

Wallace Wolf, Jr., D.V.M.

WellAware is published byMid-Columbia Medical Center

1700 East 19th StreetThe Dalles, OR 97058

(541) 296-7545

All rights reserved. No information may be reprintedwithout the written consent of MCMC.

Photo Credits:Jim Semlor Photography; cover and pages 2, 4, 5, 13, 16

Cory Eldridge page 8

Printed with Agri based inks onrecycled paper, 10% post consumer

Inside ScoopFall/Winter 2009

(ON THE COVER)He’s All HeartCardiologist David Guarraia, M.D., opens his practice, giving Gorge residents access to a full-time heart specialist.

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a Designated Planetree Patient-Centered Hospital

a Designated Planetree Patient-Centered HospitalA Designated Planetree Patient-Centered Hospital

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Rare CareMCMC becomes the first Oregon hospital to achieve national accreditation for its comprehensive Center for Breast Care.

Night and DayBrisk activity is a sure sign The difference between traditional mammography and digital mammography, now available in the Gorge only at MCMC, is crystal clear.

Sisterhood of MammogramsMCMC’s all-female mammography tech staff have a common bond with their patients.

An Alternative to MastectomyNow available at Celilo Cancer Center, brachytherapy can shorten radiation treatment from six weeks to five days.

Influenza - The FluWhat you should know about H1N1.

Perfect TimingBrisk activity is a sure sign Brian MacArthur, M.D., joins the care team at Columbia River Women’s Clinic.

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David Guarraia, M.D, who recently became the first cardiologist ever to practice full-time in

the Mid-Columbia region, has devoted the last 12 years of his life preparing to care for patients with heart-related conditions. First there were two years of graduate school, followed by four years of medical school and, after that, three years of residency training capped off, with an intensive three-year cardiology fellowship at Oregon Health & Science University (OHSU). After all those years of training, “I am very glad to be caring for patients in my own practice,” Dr. Guarraia says. Having full-time access to a physician of Dr. Guarraia’s (pronounced GWAR-ee-uh) caliber and in the specialty area of cardiology is a rarity in a region the size of the Mid-Columbia. Dr. Guarraia’s presence in town was made possible by a unique arrangement between Mid-Columbia Medical Center and OHSU. The two organizations collaborated to recruit him and he remains an assistant professor on the medical school faculty.

He lives and practices in The Dalles, but travels once a week to OHSU to see patients, participate in research activities and pursue still more educational opportunities. “This arrangement is the best of all worlds, both for Dr. Guarraia and for heart patients throughout the region,” says MCMC President/CEO Duane Francis. “We benefit from the care of a highly trained heart specialist who practices in our community full-time, but also remains closely tied with the vast resources of a highly respected health and research university. And Dr. Guarraia is fulfilling his desire to practice state-of-the-art cardiology care in a small community.” Dr. Guarraia earned his bachelor’s degree from the University of Colorado, then a master’s degree in pharmacology from the University of Missouri School of Medicine. He pursued his medical degree at St. George’s University, a program that included two years in the Caribbean followed by two years of clinical training in San Francisco and New York. Dr. Guarraia then spent three years at the University of Arizona, where he completed an

He’s All Heart

Dr. David Guarraia opens an office in The Dalles, giving Gorge residents access, for the first time, to the services of a full-time cardiologist.

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By Dick Baltus

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internal medicine residency program. His three-year cardiology fellowship at OHSU followed. In The Dalles, Dr. Guarraia, says he has found the ideal setting in which to practice and, with wife Caroline, raise his two children, ages 21 months and 1 month. “We were very attracted to the lifestyle here,” he says. “I love to windsurf; Caroline is an avid cyclist. We’re very happy to be here.” As a cardiologist, Dr. Guarraia provides comprehensive care for patients with, or at risk of, heart disease. Either in his office or in conjunction with OHSU Dr. Guarraia has access to a vast spectrum of resources for diagnosing and treating heart conditions such as chest pain, heart failure and high blood pressure, the most common heart-related conditions. He is trained to perform advanced procedures such as coronary angiography and pacemaker implantation. Dr. Guarraia says he is looking forward to the opportunity to build a cardiology practice from the ground up. He shares his office with fellow cardiologist Mark Hattenhauer, M.D., a native of The Dalles who has provided part-time cardiology care in the community for many years. “I like the idea of building something in this community that hasn’t existed before,” he says. “We have the opportunity to dramatically change the way cardiovascular care is delivered in this community, and that’s very exciting.”

“I like the idea of building something in this community that hasn’t existed before”

MCMC has become the only hospital in Oregon, and just the third on the West Coast, to earn national

accreditation for its breast care center. MCMC’s new Center for Breast Care was surveyed in late September by the National Accreditation Program for Breast Centers (NAPBC), whose chairman, David Winchester, M.D., remarked afterward: “There is no reason why any patient receiving any kind of breast care would need to go to any other institution; the best of care is available right here at MCMC.” MCMC’s Center for Breast Care is a comprehensive and multidisciplinary approach to breast health and care that utilizes services, expertise and resources throughout MCMC and in collaboration with Mid-Columbia Surgical Specialists. By integrating screening, early diagnosis, patient advocacy and treatment, MCMC’s Center for Breast Care offers important resources for women along the entire health spectrum. “We are here for all women – those with both benign breast disease, those with malignant breast disease and healthy women as well,” said surgeon Ann Harris, M.D., of Mid-Columbia Surgical Specialists. “This is a comprehensive breast center, not just a breast cancer center.” One out of eight women who undergo biopsies has cancer, Dr. Harris said. “That means seven out of eight do not. Benign breast disease is much more prevalent and much less cared for, but just as important to treat as malignant breast disease. Our center is here to help women with all their breast-related issues.” The Center for Breast Care is “not a place,” Dr. Harris added, but a collaboration of physicians, other health professionals and staff and an understanding of how women should be cared for in an organized and efficient manner. “It is a collaboration between Celilo Cancer Center, Mid Columbia Surgical Specialists and MCMC’s radiology, pathology, rehab and educational departments. It involves radiologists, pathologists, breast surgeons, plastic surgeons, medical oncologists, radiation oncologists, physical/ occupational therapists, a nurse coordinator, nursing staff, social work and administration. It is truly comprehensive and collaborative.” Dr. Harris directs the center and led the effort to pull together existing services and health professionals at the hospital into a coordinated continuum of care that could pass

the stringent requirements for NAPBC’s accreditation. She said that, just like women with breast cancer, those with benign breast disease have significant needs, and often don’t know where to turn. “There is a large population of women with benign breast disease who think they have cancer; that’s just the woman’s psyche,” Dr. Harris said. “Those women need support and education and to know exactly what their options are, and in a lot of facilities they don’t get it.” NAPBC-accredited centers must offer a complete range of state-of-the-art services and equipment; a multidisciplinary team approach to coordinating the best available treatment options; information about ongoing cancer clinical trials and new treatment options; access to prevention and early detection programs, cancer education, and support services; and ongoing monitoring and improvements in cancer care. MCMC meets these requirements in many ways, including:

• Providing access to state-of-the-art screening and diagnostic tools, including digital mammography and stereotactic breast biopsy, as well as advanced treatment options, such as intensity-modulated radiation therapy and brachytherapy.

• Devoting a full-time breast care coordinator to help newly diagnosed breast cancer patients navigate through their options and available resources.

• Serving as a center for clinical research to investigate promising new options for treating breast cancer.

• Offering access to highly trained specialists in medical oncology, radiation therapy and breast cancer surgery.

MCMC now offers access to one of only 80 accredited breast health centers in the United States. MCMC is the smallest facility to achieve accreditation. Dr. Harris hopes the significance of this accomplishment is not lost on women throughout the Gorge, especially those diagnosed with breast cancer. “A lot of women who are diagnosed feel they have to go to a major center to get their care,” she said. “But this accreditation signifies that we are giving the exact same level of care, if not higher, right here. There is no reason to go anywhere else.”

MCMC becomes the only hospital in Oregon accredited for its comprehensive and collaborative Center for Breast Care.

Rare Care

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By Dick Baltus

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Digital Film

Before she joined the radiology team at Mid-Columbia Medical Center, Paula Lee Valkov, M.D., already

had “eyes-on” experience with images produced by state-of-the-art digital mammography. The difference between digital images of breast tissue and the film versions produced by traditional mammography, she knew, was night and day. Given that, Gorge-area women will be happy to hear things just got a lot brighter in MCMC’s Mammography Services department with the recent installation of two new digital mammography machines. Addition of the new technology, along with upgraded stereotactic breast biopsy equipment, is the latest step in the state-of-the-art digital makeover of MCMC’s diagnostic imaging department. The project is being supported with generous community

gifts made through the Mid-Columbia Health Foundation’s Next Century Campaign. That funding covered the entire $640,000 bill to purchase the equipment and remodel the space it is housed in (see Page 17). MCMC is now the only hospital in the Gorge with digital mammography technology, which offers many advantages over traditional film systems, Dr. Valkov says. In a non-technical nutshell, digital mammography provides better images faster. The technology converts X-rays to electronic images of the breast, which can be viewed, optimized and stored on a computer. In a recent study, digital mammography was better than traditional film mammography in detecting breast cancer in women under 50 years of age. In addition, Dr. Valkov says, “Digital mammography also is a more effective tool for detecting cancer in patients with

Digital technology has advanced by light years the effectiveness of mammography in the early detection of breast cancer.

Nightand DayBy Dick Baltus

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Along with being screened by the most advanced digital technology, when patients come to the

mammography department at Mid-Columbia Medical Center they are in the care of four women who share decades of experience in radiology. Debie Myers, Pamela Anderson, Didi Abbas and Donna Culp, each came to mammography from different routes — whether through X-ray or ultrasound or CT scan — but each found greater fulfillment in her current position. The job, they say, creates a unique camaraderie: the techs have had the same experience as the patients. “I’m here to serve them and make it as comfortable as possible,” Myers says. “If someone wants to joke, I joke. It’s all about them, because when I go to my medical

appointments, I want it to be all about me.” They all also feel a deep responsibility to educate their patients on the value of regular scans and self-checkups. Anderson takes this personally. Her mom survived breast cancer because a scan found it early. Learning a patient tested positive for breast cancer is the hardest part of their job. But if cancer is there, they want to find it. And, while the new digital mammography technology is great, fabulous even, it’s only as good as the mammographer. And a mammographer is only as good as they treat their patients. These four are fabulous too. What’s it like to have a mammogram at Mid-Columbia Medical Center? Experience the sisterhood at www.mcmc.net and go to Center for Breast Care. - Cory Eldridge

Debie MyersPamela Anderson Donna CulpDidi Abbas

The Sisterhood of the Mammogram Exam

dense breasts, who tend to be younger women.” Because the technology is faster, it will shorten exam times for patients. And, with two mammography units in the department, long waits for appointments are history. Dr. Valkov says the digital technology also means fewer women will have to be called back for a second appointment and retest. If another angle or different image is needed, technologists will know that immediately, while the patient is still there. In addition, the digital system will link with MCMC’s recently installed PACS system, allowing images to be viewed instantaneously and enabling physicians to discuss images in real time from remote locations. “I can now discuss cases in real time, when necessary, with an oncologist at Celilo Cancer Center or our breast cancer surgeon,” Dr. Valkov says. “When we were using film, images could only be in one place at one time. That required a lot of transporting from one site to another.”

It also required a lot of film storage space, a problem that was solved with the transition to digital technology, much to the delight of Joe Abbas, director of diagnostic imaging. But the most important beneficiaries of digital technology will be area patients and their physicians, who now have access to the best tool available for the early detection of breast cancer. Women have a one in eight risk of developing breast cancer

in their lifetime. The Centers for Disease Control and Prevention reports that the incidence is even

higher in women living in Oregon and Washington. Mammography is still the best tool available for the early detection of breast cancer, but adding digital capabilities is the first major advancement of the technology in years. “It’s not that film was bad,” says Abbas. “But that technology was invented in the early 1900s and it hasn’t changed dramatically until now.”

“Digital mammography also is a more effective tool for detecting cancer in patients with dense breasts, who tend to be younger women.”

UPCOMING EDUCATION PROGRAMS FROM THE CENTER FOR MIND & BODY MEDICINE AT COLUMBIA MEDICAL CENTER

Mind, Body HealingPre-registration required; please call 296-7319to register unless otherwise indicated.

Free ConsultationAre you interested in improving your health but don’t know where to start? Do you wonder if your insurance will cover the cost of a program? Perhaps you would like to try a free yoga class and would like to know how to sign up? Contact Barb at 296-7414.

Cardiac Rehabilitation ClinicCardiac Rehabilitation is the next stepafter a heart attack or heart surgery, adiagnosis of stable chest pain or othercardiac conditions. A 10-week clinic that includes supervised exercise, nutrition and education in heart health management, this clinic will help you regain strength, lessen fatigue while learning the tools to reduce cardiac risk factors. Classes are offered throughout the year and covered by most insurance plans

Pulmonary Health ServicesThis 10-week clinic is designed for patients with chronic respiratory disease (COPD), emphysema, asthma, chronic bronchitis, pulmonary fibrosis and other chronic lung conditions. This class explores the relationship between breathing disorders and physical activity. Participants in this class will learn lifestyle changes that will help improve their endurance and quality of life.

Goals are:•decreasingshortnessofbreath;• improvingphysicalconditioningand exercisetolerance;• improvingemotionalwellbeing

MedicalSymptomandStress Reduction ClinicPeople with a wide variety of medicalconditions will benefit from this nonmedication approach to improving overall health. People with chronic pain or illness, autoimmune disorders, back pain, irritable bowel syndrome, headache/migraines, hypertension, insomnia, sleep disorders, anxiety and depression, fibromyalgia, cancer, diabetes, asthma, eating disorders, stress related to job/family/financial can learn how to better manage symptoms and gain greater control of your life. The Medical Symptom Reduction Clinic will help you explore ancient and modern evidence-based researched healing techniques. You will experience gentle meditative yoga and other natural techniques, called mindfulness relaxation practices, to help you activate your own natural healing powers.

The practice allows you to obtain:

• lastingdecreasesinphysicaland psychologicalsymptoms;•anincreasedabilitytorelax;• reductionsinpainlevelsandan enhancedabilitytocopewithpain thatmaynotgoaway;•greaterenergyandenthusiasm forlife;• improvedself-esteem;•anabilitytocopemoreeffectively withbothshortandlong-term stressfulsituations.

LivingHealthywithDiabetesMONDAYSEVENINGCLASS:Jan., 11,18, 256 to 9 p.m.Medical Center Office Plaza

The Diabetes Self-Management Education Class is a learning experience for people who are newly diagnosed or have a history of diabetes. In this class, you will learn blood sugar monitoring, nutrition and meal planning, stress reduction, medications and much more. We encourage a support person to attend, at no additional fee. Day and evening classes are available through out the year. The Diabetes Education program at MCMC is accredited by the American Diabetes Association.

IndividualDiabetesNutrition EducationMeet one on one with our registereddietitian. Together you will customizea healthy eating plan that will supportliving healthy with diabetes.

CertifiedDiabetesNurse EducatorMeet one on one with our registered nurse, certified in diabetes education, and learn about the many aspects ofblood sugar management. Leave thisvisit with no question unanswered.

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&Core Health Wellness Clinics

&Exercise Movement

ALL CLASSES ARE HELDAT CELILO CANCER CENTER

T’ai Chi TUESDAYS,beginsJan.26$48 for 8 weeks

DAYCLASS:1 to 2 p.m.

EVENINGCLASS:5:30 to 6:30 p.m., beginning students6:30 to 7:30 p.m., continuing students11:30 Balance

T’ai Chi practices involve movement andmeditation based on ancient Chinesephilosophies. Research indicates T’aiChi may promote improved mental andphysical health, vitality and longevity.There is growing evidence that T’ai Chipractices may be among the best formsof physical activity since they are lowimpact, low cost and easy to learn.Classes are offered throughout the year. Please call 296-7319 for moreinformation.

FlowYogaWEDNESDAYS5 to 6:30 p.m., $40 for 5 sessions,$60 for 10 sessions or $10 drop-in

Flowing from pose to pose, this yoga class is a moving meditation that helps

rest the anxious, stressed mind while bringing strength, flexibility andbalance to the body. No previousexperience necessary.

YogaAllLevelsMONDAYS&THURSDAYS5:30 to 7 p.m., $40 for 5 sessions,$60 for 10 sessions or $10 drop-inUnwind and rejuvenate your mindand body with yoga stretching,breathing exercises and relaxation.This class is designed for all agesand levels of fitness. Increase yourflexibility, strength and balance.

GentleYogaWEDNESDAYS8 to 9 a.m., $40 for 5 sessions,$60 for 10 sessions or $10 drop-in

This easy-does-it class is perfect forbeginners or people with limited mobility. Stretch, breathe and ease your way into greater flexibility.

Yo-Kids!MONDAYSNov. 23 & 3010 to 10:45 a.m.Ages 3 to 5, $30 for 4 sessions

Bring Mom, Dad or a grandparent andcome have fun at Yo-Kids! Use yourimagination as you stretch like a cat, a dog or a cobra. Stand on one leg like aflamingo, roar like a lion and breathelike a bunny. We finish our class with a rest and a story. You and your grown-up will leave with a smile on your face. Builds body awareness, self-esteemand focus. Space is limited, call 541-296-7319 to pre-register.

IndividualYogaConsultationsBy appointment only, $50 per hour

Work one on one with our yoga instructor and design a safe and effective home yoga program individualized to your specific needs. Suitable for back pain, asthma, fibromyalgia, depression, multiple sclerosis, stroke, anxiety, weight loss and many other health concerns.

Yoga

PersonalTraining$45.00 for 1 hour; $120.00 for three 1-hour sessions.Call 296-7209 for more information or to schedule an appointment.

Pilates ClassThursday 10:30 & 11:30 a.m.This is a mat based core stabilization class lead by a certified Pilates instructor.All fitness levels welcome. Space is limited; call 541-296-7209 to pre-register.

CircuitTrainingTuesdays, noonInterested in building strength while simultaneously getting a great cardio workout?All fitness levels welcome. This class is led by an exercise physiologist.

MONDAY5:30 to 9 a.m. & 4 to 7 p.m.

TUESDAY&THURSDAY5:30 to 1 p.m. & 4 to 7 p.m.

WEDNESDAY5:30 to 9 a.m., 11 a.m. to 1 p.m. &

4 to 7 p.m.

FRIDAY5:30 to 9 a.m. & 4 to 6 p.m.

SATURDAY7:30 to 11:30 a.m

MCMC Fitness Center Fitness available to the community

Please call 296-7201 for more information, or visit during hours listed.Medical Center Office Plaza, Suite 226

Fitness Members Community Membershipindividual: $30/month, couples: $55/month

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&Mind, Body Healing Workshops Clinics

Freshstart® TobaccoCessation ClassesFree

TUESDAYS&THURSDAYS2weeksessionsbeginningfirstTuesdayofeachmonth6:30 - 7:30 pmDec.1,3,8,10

There’s never been a better time to quitsmoking or using tobacco than right now.Freshstart provides you with the structureand support you need to help you quit and stay quit for good. Tobacco CessationCoordinator Emily Curtis leads you through four one-hour classes designed to help you discover the keys you need to leave tobacco behind for good. Freshstart will be offered monthly. For class times and dates or to register, call 541-296-7319.

GuidedRelaxationwithHarpWEDNESDAYS&THURSDAYS10:15 to 11 a.m.MeditationRoom, Celilo Cancer CenterSusan Erikson, InstructorAnna Fiasca, Harpist

Free

This 45-minute session can help you reduce stress and relax with the use of guided imagery and beautiful music.

HealthyWeightSolutionsWEDNESDAYS,beginsJan.206:30 to 8:30 p.m.Call for class schedule.

This outpatient program is a unique8-week progressive weight loss andwellness clinic that will provide asafe and supportive environment for

weight loss achievement, stressreduction and disease prevention. The program will focus on a holistic solution to weight management. The multi-disciplinary team includes a dietitian, registered nurse and physician. The curriculum will include research-based integrative strategies that are simple, practical and lifelong.

Individual Nutrition ConsultsMeet with our registered Dietitian for one-on-one coaching.

A dietitian provides reliable, objective nutrition information by separating facts from fads and translating the latest scientific findings into easy-to-understand nutrition information. By appointment only.

ArthritisandNutrition 5:30-6:30pmJan.12$10 (fee includes support person)

Eating healthy is a smart way to manage or prevent disease. Jennifer Zimmerman, RD will discuss the value of eating healthy to better manage the symptoms of arthritis and to feel your best.

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JournalWritingEVERYWEDNESDAY11 a.m.Meditation Room Celilo Cancer CenterSusan Erikson, InstructorFree

You will be guided in journal writing techniques designed to help you process life events and to open to inspiration.Research indicates drumming can work alongside conventional medicine to improve moods, immune function, physical movement and decrease burnoutand stress. And, it is incredibly fun!

&Therapeutic Body Work

Healing TherapiesMassageTherapyCelilo Cancer Center60 min for $55/90 min for $80

Massage therapy is one of the oldestforms of health practice. It has been used to enhance healing and general well being since ancient times. This therapy manipulates the skin, muscles and joints for muscle relaxation, improved circulation and stress relief. The therapists at Mid-Columbia Medical Center offer a variety of massage techniques tailored to your specific needs.

To schedule an appointment or purchase a gift certificate for a massage, please call 506-6998.

AcupunctureTherapyCelilo Cancer Center

Acupuncture is one discipline taken from the heritage of Chinese medicine. The technique involves the insertion of very fine needles at specific points in the body which have been shown to be effective in the treatment of various conditions. Call 506-6998 for appointments or for more information.

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ORTHOPEDICREHABILITATIONOur physical and occupational therapists can evaluate and manage conditions/ injuries of the joints and soft tissues for all ages, to include dysfunctions of the hand, elbow, shoulder, hip, knee, foot and spine.

NEUROLOGICALREHABILITATIONOur team is trained to treat a variety of neurological conditions including stroke, multiple sclerosis, traumatic brain injury and spinal cord injuries.

SpecializedRehabilitationProgramsPhysicalTherapyOSTEOPOROSISThis program is designed to help individuals recognize risk factors for osteoporosis and how to address them, participate in an exercise program designed to increase bone strength and posture, understand the impact medications may have on bone health, and to make wise food choices to reduce advancing osteoporosis. Following a DEXA or bone density scan your doctor may refer you to the program.

MOBILITY&SEATINGCLINICThis clinic is designed for individuals who need a power or manual wheelchair for the first time (pediatric, geriatric, athletic); are experiencing current or recurrent issues with wounds; have had recent changes in seating or positioning needs; have equipment that is older than five years or is broken or unsafe.

VESTIBULARREHAB&BALANCETHERAPYVestibular rehabilitation is an alternative form of treatment involving specific exercises designed to decrease dizziness, increase balance function and increase general activity levels.

OccupationalTherapyLymphedemaTreatmentandTherapyA therapy program that will help minimize and manage the symptoms of lymphedema.

HandTherapyandUpperExtremity RehabilitationAppropriate for individuals with upper extremity wounds, scars, damaged tendons or nerves, fractures and amputations.

SpeechTherapyDysphagiaOur speech-language pathologists are specially trained in treating swallowing, voice and other language/communication impairments.

BringingEducationtotheWorkplaceMind Body staff members are available for educational presentations at your place of employment. We are happy to work with your staff to tailor presentations based on your specific needs. Topics can be as diverse as stress management, nutrition, aromatherapy, fitness, yoga, tai chi,lung and heart health.

Contact Barb Robison, directorCenter for Mind & Body Medicine at 296-7319.

With a physician’s referral, these therapies are covered by most insurance plans,including Medicare. We will assist you to determine your insurance benefits.

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An Alternative to MastectomyNow available at Celilo Cancer Center, brachytherapy represents for many women an easier way to treat breast cancer with radiation therapy.

For many women diagnosed with breast cancer, radiation therapy

has been an effective, and far less physically and emotionally taxing, alternative to mastectomy. Several studies have shown that treatment combining tumor removal with external radiation therapy has produced the same cure rate as total breast removal. Yet, despite the obvious advantages of radiation treatment, many women still choose to have mastectomies — usually for the wrong reason, says The Dalles surgeon Ann Harris, M.D. “Many women are basing their decision for mastectomy on the availability and/or convenience of radiation therapy rather than medical necessity,” she says. Dr. Harris and the other health professionals who comprise MCMC’s innovative new Center for Breast Care (see on page 6) are determined to change that reality in the Gorge. In late October a new procedure became available at Celilo Cancer Center that dramatically shortens the radiation therapy process, virtually eliminating the inconvenience factor from many breast-cancer patients’ decision-making process. Patients who qualify for “brachyther-apy” will benefit from an internal radiation treatment regimen that lasts only five days, compared with the six weeks required for external radiation therapy. The advantage of having such a treatment available in a cancer center that serves such a wide and rural geographic region is significant. While Celilo has always offered the most advanced radiation therapy technology, there is ample evidence that

suggests the long treatment period is a deterrent for many patients within MCMC’s service area. “Research shows that the farther cancer patients live from a radiation therapy center, the less likely they are to have radiation treatment,” says Keith Stelzer, M.D., Ph. D., medical director

of radiation oncology at Celilo. “Only half the patients who live more than 75 miles from a center get radiation treatment after breast tumor removal, and it should be almost 100 percent.” Brachytherapy is not a new technology. In fact, says Dr. Stelzer, “The use of radioactive implants is the oldest form of radiation therapy.” However, using brachytherapy for breast cancer is a relatively new idea. At Celilo, the procedure will be considered as an option for most women who qualify for breast conservation therapy. (Brachytherapy also may be an option for patients with certain gynecologic, endometrial and cervical cancers, according to Dr. Stelzer.) Dr. Harris received considerable experience with brachytherapy while training under a surgeon who specialized in the procedure. With breast cancer patients, she explains, the treatment involves placing tiny plastic catheters in the

breast where the tumor or mass was surgically removed. Radioactive implants are delivered through the catheters and connected for a brief period with the brachytherapy equipment. “Using this internal method we are able to deliver higher doses of radiation to very defined areas of the breast

without affecting surrounding tissue,” says Dr. Stelzer. The stronger, more precisely directed doses allow for significantly shorter treatment times. Treatments occur twice daily for five days, last only about 15 minutes each and are painless. Drs. Stelzer and Harris will work closely with patients, both in determining which patients are candidates for the procedure and

throughout the treatment process. Dr. Harris will perform the surgery

to remove breast lumps and prepare the site for radiation therapy, and Dr. Stelzer will plan and oversee the radiation treatment. Adding brachytherapy to the array of treatment options available at Mid-Columbia Medical Center is “a real service” for cancer patients in the region, according to Dr. Harris. “I did my brachytherapy training in an urban setting, but a lot of patients came from the surrounding rural areas,“ she says. “It was very difficult for people from outlying communities to come for six weeks of radiation therapy for breast cancer. A lot of them would opt for the more aggressive mastectomy treatment instead.“ “It is a very similar situation here, so adding this capability will help ensure people are making decisions about their cancer care based on sound medical reasoning rather than matters of convenience.”

Dr. Ann HarrisDr. Keith Stelzer

Strains of FluSEASONAL: The seasonal flu is a virus that causes respiratory illness and is transmitted person to person. This flu comes around every winter, changing each year. Most people have some immunity to the seasonal flu, yet in the United States flu causes an annual average of 226,000 hospitalizations and 36,000 deaths.

H1N1: The H1N1 flu is a new influenza virus first detected in the U.S. in April 2009. It causes the same type of illness as seasonal flu, but very few people are immune to this virus strain.

SymptomsThe symptoms for both seasonal and H1N1 flu are the same:

Protect Yourself; Get VaccinatedSEASONAL FLu: Vaccination is the best protection against the seasonal flu. The seasonal flu vaccine will not protect against H1N1 flu. The vaccine is available in either

a nasal spray or injectable dose. People who shouldn’t take nasal spray doses are pregnant women, children under the age of 2 and people with asthma and other chronic respiratory conditions. The seasonal flu vaccine is safe for pregnant women, although they should take an injectable dose, NOT the nasal spray.

H1N1 FLu: Vaccination is the best protection against H1N1 flu. The seasonal flu vaccine will NOT protect against H1N1 flu. The H1N1 vaccine has been developed in the same way as the seasonal flu vaccine and is just as safe.

The H1N1 vaccine is available in either a nasal spray or injectable dose. People who shouldn’t take nasal doses are pregnant women, children under the age of 2 and people with asthma and other chronic respiratory conditions.

The H1N1 vaccine is safe for pregnant women, although they should take an injectable dose, NOT the nasal spray.

• Fever• Cough• Sorethroat• Bodyaches

• Headache• Chills• Fatigue

• Sometimes diarrheaand vomiting

DoyouknowthedifferencebetweenseasonalfluandH1N1flu?

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Vaccine Priority GroupsSeaSoNalFlu: This year there is not a shortage of seasonal flu vaccine. If there were a shortage, vaccinations would be given to priority groups first.

• Children aged 6 months to 19 years• Pregnant women• People age 50 and older• People with chronic medical conditions• Healthcare workers

H1N1Flu:Since this is the first year the H1N1 vaccine has been developed the initial supply is limited, therefore vaccinations will be given in priority order first.

• Everyone aged 6 months to 24 years• Pregnant women• People caring for or living with infants under 6 months of age• People aged 25-64 with underlying medical conditions (such as asthma, immune deficiencies, etc.)• Healthcare workers, emergency medical responders and frontline law enforcement and public safety workers

Slowing the Spread of Flu VirusThe best ways to prevent the spread of both the seasonal flu virus and the H1N1 flu virus are the same:

• Wash your hands frequently and use alcohol-based hand

sanitizers• Cover your cough

with your sleeve or a tissue• Stay home if you are sick

When to See the DoctorThe warning signs to let you know when you should see your doctor are the same for both the seasonal flu and H1N1 flu.

INCHIlDReN, emergency warning signs that need urgent medical attention include:

• Fast breathing or trouble breathing • Bluish or gray skin color • Not drinking enough fluids • Severe or persistent vomiting • Not waking up or not interacting • A child who is so irritable that he/she does not want to be held • Flu-like symptoms improve but then return with fever and worse cough • Fever with a rash INaDultS• Difficulty breathing or shortness of breath • Pain or pressure in the chest or abdomen • Sudden dizziness• Confusion • Severe or persistent vomiting

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Many physicians know they want to be doctors early in their lives. Brian MacArthur, M.D., was already a

college graduate when he finally discovered his career calling. Columbia River Women’s Clinic’s new obstetrician and gynecologist had grown up in a single-mother household with no insurance, so he was out of college before he ever visited a doctor. He was working at a bronze factory when an ear infection got the best of him. When he went to a family physician in Molalla for treatment, it was the first time he sat on an examination table, the first time a nurse recorded his weight, blood pressure and pulse. Maybe that’s why what the doctor did changed the future doctor’s life. “He knew the organism that was causing the infection and was able to give me the right antibiotic for it, and I got better quickly,” Dr. MacArthur says. “I thought it was cool to know all that stuff. I was kind of jealous of him for having all of that at the front of his mind.” Within a month, he enrolled at Portland State University to knock out the science prerequisites for medical school. Two years later he was studying at Oregon Health & Science University. Dr. MacArthur moved to Phoenix for his residency at Banner Good Samaritan Medical Center. There he learned the finer details of his specialty, how to work with patients, everything that goes into making a doctor who impresses his colleagues and instructors. He also learned he wanted to return to the Northwest and work in a small town. “I’ve always loved the Gorge,” he says. “I like the climate and the terrain of Eastern Oregon, so I felt like The Dalles had all the things that I’ve enjoyed most in Oregon. It just seemed like a perfect location. It turned out that the people are great here, too.”

He sent his resume’ to Columbia River Women’s Clinic, and it arrived at the perfect time. The clinic’s medical director James Faherty, M.D., had been searching for a year for a candidate to fill the shoes left when longtime The Dalles physician David Mack, D.O., retired. Dr. Faherty was impressed that Dr. MacArthur had applied not just because a job was available but because he wanted to live in The Dalles. Dr. MacArthur knows and understands small towns, and that’s critical, says Dr. Faherty. “In a small community, you can see your patients at the grocery store, at a ballgame, at a school,” Dr. Faherty says. “That type of relationship is different and unique from working in a big city. Having an awareness of this is a requirement for Columbia River Women’s Clinic. It’s all about community and longevity.” Dr. MacArthur’s path to becoming a doctor started in a small town, in another doctor’s small clinic. Now, like the doctor who had such an impact on his life, he is eager to use his own knowledge and skills to help area women. Appointments with Dr. MacArthur can be made by calling Columbia River Women’s Clinic, 541-296-5657.

Dr. David Mack’s retirement opens the door for a new women’s specialist who sees the Gorge as a perfect fit.

Dr.BrianMacarthur

Perfect Timing

By Cory Eldridge

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Becoming the first and only hospital in the Gorge to offer the most advanced digital mammography

technology to area women is only possible because of the Mid-Columbia Health Foundation and the generous donors who support it. As part of its ongoing Next Century Campaign, the foundation covered the entire cost of purchasing two digital mammography units, in addition to another important diagnostic tool, a stereotactic breast biopsy unit. Then, the foundation stepped forward to fund the remodeling of the space inside MCMC where the new equipment is housed. Total cost of the investment in the health of area women was $640,000. “I am just amazed at what the foundation and this community have been able to accomplish,” says Joe Abbas, director of MCMC’s diagnostic imaging department. “Everything the foundation has been involved in, from the annual golf tournament and paddle-raising event to their successful grant-writing activities, have just had remarkable results.” Abbas says the original intent was to purchase just a single digital mammography unit and a stereotactic unit, the latter an important non-surgical option for taking breast tissue biopsies. However, because of the state of the economy, Abbas was able to purchase two mam-mography units and the stereotactic equipment for only slightly more than a single mammography unit cost a year ago. When Abbas approached the foundation again to help to cover the increase in his budget, the foundation went back to fund-raising, and once again its donors came through. The second unit will help ensure timely appointments for women scheduling mammograms, and the completely upgraded department will provide many other advantages that residents of the area will benefit from for years to come.

Donors toThank for Digital Mammography

Christine Rood

Bob Bailey

Co-chairs, Next Century Campaign

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Effective January 1, 2010, the Mid-Columbia Medical Center campus will be 100 percent

tobacco free. Smoking and the use of tobacco products will be prohibited on the entire campus and MCMC affiliates. This includes Celilo Cancer Center, Columbia Hills Family Medicine and all physician clinics, all parking lots and grounds. Previously, smoking has been prohibited within 10 feet of the hospital. “Mid-Columbia Medical Center is a place of healing. An important part of our mission is to encourage and model healthy behaviors and to assist in the protection of the health and safety of our patients, employees, physicians, volunteers, and guests,” says Duane Francis, president and CEO. “Providing a tobacco-free campus is fundamental to the health of the people we serve. Our tobacco-free policy helps promote a healthier environment where healing can take place.” The majority of U.S. hospitals currently have

tobacco-free campus policies in effect, according to a recent study. More than 60 percent of 1.900 hospitals surveyed have tobacco-free policies in effect this year. At each of these hospitals, the use of tobacco products is completely prohibited anywhere in the hospital or on the grounds or parking lots. More than 6,821 Oregonians die each year from tobacco-related causes, according to Oregon Department of Health statistics. Studies confirm the dangers of second-hand and third-hand smoke. A recent U.S. Surgeon General Report concluded there is no safe level of second-hand smoke — smoke left in the air by tobacco users and breathed by others around them — so any encounter with tobacco smoke poses a health risk. MCMC will provide tobacco counseling for hospital patients who smoke. The hospital also provides free tobacco-cessation programs for the community. To register for a class call 296-7319.

COMING JANUARY 1, 2010TOBACCO FREE CAMPUS

November23 Resuming Intimacy

Bonnie Taylor, PhDUnderstanding the importance of our intimate relation-ships and the challenges that we may face resuming intimacy after a cancer diagnosis.

30 ExpectationsSusan Shipman, M. Div.Carole Anderson, MAAcknowledging and exploring thoughts and feelings that surface at cancer diagnosis, during treatment, and after the completion of treatment allows us to experience cancer as a turning point in our lives

December6 ExhaleSteve McLennon, MDJessica Pembroke, MSW, CSWALearn the art of relaxation and the importance of calming the “fight or flight response”. This session will help you examine fear of the unknown, and help develop a plan of action for when stresssets in again.

January4 Employment

45 minutesJessica Pembroke, MSW, CSWAHow to address employment concerns, Family Medical Leave Act (FMLA), returning to work.

11 Communication and OrganizationMelodi Johnson, RN, BSN, ONCJessica Pembroke, MSW, CSWAWhat to say and ask when speaking with your healthcare team: a discussion about optimal communication between you and your health care team to achieve the best results for your cancer treatment.

18 Healthy Meal Cooking

Tracy Dugick, MS, RD, CDEMike Wheeler, ChefLearn the elements of a healthy diet and how to prepare healthy meals.

25 SleepPaul Cardosi, MDDr. Cardosi will lead a discussion on the importance of sleep and what can assist people with sleeping. Learn why sleep matters, and how to get more of it or regulate for the best overall results. Specific to cancer-related fatigue, this discussion will include:

•Whysleepis important to our health

•Howillness can impair sleep

•Tipsfor maximizing sleep quality

•Sleepdisordersthatcan affect sleep quality

CanCer qu iCk leCture SerieSThis 20-week lecture series is designed to help cancer patients and their loved ones learn how to live with, through and beyond cancer. You are welcome to join us for one session or all 20. Each seminar will last approximately 30 minutes (unless otherwise noted) with a question and answer period following. For additional information please contact Jessica Pembroke, MSW, CSWA, 541-506-6927.

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NON-PROFITU.S. POSTAGE

PAIDMID-COLUMBIA

MEDICAL CENTERPERMIT #161

a Designated Planetree Patient-Centered Hospital

a Designated Planetree Patient-Centered Hospital

CURRENT RESIDENT

1700 E. 19th St. The Dalles, OR 97058