“I know I’m going to be somebody’s memory. When you come to work, you’re going to be your patient’s memory for the rest of their lives so you have to decide whether you’re going to be a good memory or a bad memory. So when I walk into work every day, I think, ‘What kind of memory am I going to be today?’”

- Dana, Family Birthing Center

St. Charles Family Care in La Pine now scheduled to open in April 2018

FOR IMMEDIATE RELEASE
Feb. 23, 2017

Due to unanticipated changes to the scope and impact of site improvements and infrastructure upgrades, St. Charles Family Care in La Pine will now open in April 2018.

Road, utility and site prep work will begin in March, and structural work will begin shortly thereafter.

“We’re very excited to break ground on the clinic this spring,” said John Weinsheim, president of St. Charles Medical Group. “This clinic, which will provide primary care, Immediate Care, radiology, lab, occupational and specialty services, will be a medical home to south county residents.”

St. Charles Medical Group has begun recruiting for primary care physicians, with the goal of having them hired in time to allow for training in clinical systems, patient flow and St. Charles’ new electronic health record (EHR) system, Epic.

St. Charles Foundation is also continuing to work toward its campaign goal of $1.5 million to build the clinic. To date, the Foundation has received $900,000 in cash and pledges from individuals, foundations and businesses who want to see expanded health care in the south county area.

“The Central Oregon community is generously making this much-needed clinic a reality,” said Corinne Martinez, capital campaign co-chair. “Our team of dedicated volunteers will continue raising money throughout 2017 to support this vital project. We’re looking forward to introducing prospective caregivers to our wonderful community.”

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 3,800 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

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HPV vaccine prevents cancer, saves lives

St. Charles Cancer Center has banded together with Deschutes County Health Services, Central Oregon Pediatic Associates and a long list of other health care providers to deliver a simple, yet potentially life-saving message:

The humanpapilloma virus, or HPV, can cause cancer. But getting a vaccine can prevent it.

HPV is the most common sexually transmitted infection in the United States, according to the Centers for Disease Control and Prevention, or CDC. It is so common, in fact, that most sexually active men and women will get at least one type of HPV during their lifetime.

Most people will never know they have the virus, as it often doesn’t lead to symptoms or health problems. But for others, it can cause cancers of the cervix, vagina, vulva, penis, anus and back of the throat.

Between 2005 and 2010, the number of these HPV-related cancers doubled in Central Oregon.

About 27,000 cancers diagnosed each year are caused by HPV, said Dr. Linyee Chang, a radiation oncologist and medical director of St. Charles Cancer Center. While the good news is these cancers can be stopped with the HPV vaccine, she said, the bad news is too few people are electing to get the shots.

“The message from providers needs to be clearer and stronger: The HPV vaccine prevents cancer,” she said. “But we need to educate the public about it.”

Healthy People 2020, a federal health promotion and prevention initiative, calls for greater than 80 percent HPV vaccination among 13 to 15 year olds by the year 2020. Just four years out from that benchmark, Oregon hovers around 28 percent. In Crook and Deschutes counties, rates are even lower at 20.7 and 25.8 percent, respectively. Jefferson County is the regional leader at 33.6 percent.

“We have a lot of work to do,” Chang said. “Nationwide it’s a problem. Statewide it’s a problem.”

But Central Oregon’s HPV coalition is determined to see that change.

After identifying HPV vaccination as its prevention topic of the year, St. Charles Cancer Center applied for grant funding to help spread its message far and wide. Now health departments and clinics throughout the region have agreed to distribute educational materials highlighting the important role the HPV vaccine plays in cancer prevention.

“If people focus on the sexual transmission part of HPV, they’re losing the message,” Chang said. “The message from us, the coalition, needs to be HPV vaccination as cancer prevention, because it is very powerful cancer prevention.”

The HPV vaccine is most beneficial when given to girls and boys between 11 and 12 years old, before they are exposed to the virus, Chang said. The vaccine, which is considered safe and effective, is administered as a series of three shots over a six-month period of time and is covered by most health insurance plans.

For most people, Chang said, the choice should be easy: “Cancer treatment is toxic—we cut, we burn, we poison. Prevention is just a series of three shots.”

Sexual dysfunction refers to a problem occurring during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle traditionally includes excitement, plateau, orgasm and resolution. Desire and arousal are both part of the excitement phase of the sexual response.

While research suggests that sexual dysfunction is common - 43 percent of women and 31 percent of men report some degree of difficulty - it is a topic that many people feel uncomfortable discussing. Treatment options are available for many of these issues. We welcome your concerns and the opportunity to help you achieve satisfaction in your sexual life.

Sexual dysfunction generally is classified into four categories:

• Desire disorders —Lack of sexual desire or interest in sex
• Arousal disorders —Inability to become physically aroused or excited during sexual activity
• Orgasm disorders —Delay or absence of orgasm (climax)
• Pain disorders — Pain during intercourse

Women with sexual concerns most often benefit from a combined treatment approach that addresses medical, as well as relationship and emotional issues.

The Behavioral Health Specialist can help evaluate the possible psychological, social and behavioral aspects of your specific concern and partner with your OB/GYN or midwife for a holistic, integrative understanding and treatment approach.

Jacqueline Sario spent the first nine years of her life in Japan, where Reiki and acupuncture were considered an important part of every day health. She remembers how difficult it was for her family to adjust to life without regular access to these healing therapies when they moved to the United States in the 1970s.

So when Sario was diagnosed with breast cancer this year, she was overwhelmed to discover that the St. Charles Cancer Center offers integrative therapies including Reiki, acupuncture, massage, art and music therapy, to patients undergoing chemotherapy and radiation.

"I was so grateful," Sario said. "My symptoms from treatment are not bad. I believe the services I took advantage of have made a huge difference."

The St. Charles Cancer Center has a comprehensive integrative therapies program that is funded by grants through the St. Charles Foundation. These evidence-based complementary therapies are offered to patients at no cost. Thanks to a recent grant from Les Schwab Tire Centers, a Healing through Music program supports musicians performing music on a weekly basis in the infusion room. An art cart in the infusion room is supplied with crafts and projects. The grant also funds "Staying Nourished During Treatment," a class for patients and their caregivers. Participants sample food, receive recipe ideas and nutrition resources. An oncology-trained massage therapist is funded by both Les Schwab and Sara's Project. Massage is offered to patients in the infusion room and through scheduled appointments.

Reiki, a Japanese technique that promotes deep relaxation, is provided by more than 30 volunteer practitioners, said Marian Boileau, integrative therapies manager. Funding from Sara's Project and Wendy's Wish, supports acupuncture which is currently a pilot project. The project will determine the level of interest in the service from patients and the potential for St. Charles to support the service long-term.

"These are all evidence-based techniques that support the health and healing of the whole person," Boileau said. "Undergoing cancer treatment can be stressful physically, mentally, emotionally and spiritually. Research shows that complementary therapies help promote relaxation and restore balance supporting the body's ability to heal. Benefits may include a reduction in pain, anxiety and fatigue, boost immune function and enhance one's overall sense of well-being."

For David Gravance, acupuncture, massage and Reiki have all made a difference in his recovery. He recently completed radiation treatment for prostate cancer and said he was suffering some fairly sever side effects from the treatment including gastro-intestinal distress.

"I had one acupuncture treatment and the next day it was gone," Gravance said. "This alternative thing that St. Charles came up with — with the acupuncture, the Reiki and the massage — it's incredible. St. Charles looks at you spiritually, medically, the whole ball of wax."

To support the St. Charles Integrative Therapies program, contact the St. Charles Foundation at 541-706-6996.

What is a midwife?

At St. Charles Center for Women’s Health the value of collaborative care has been identified as a cornerstone for providing the best care to the women in our communities. Since our doors have opened on both the Bend and Redmond campuses, we have offered group care with physicians, certified nurse-midwives, nurse practitioners and clinical psychologists.

Many people misunderstand what midwives do and how they are trained. All of the midwives at St. Charles Center for Women’s Health are certified nurse-midwives (CNMs) with a minimum of a master’s degree in nursing from accredited universities. We are also certified through the American College of Nurse-Midwives. CNMs are independent practitioners who provide the full spectrum of women’s health care including prenatal care, labor and delivery, postpartum care, well-woman care, contraception, common problems and menopause management. Like our physician partners, we order labs, write prescriptions and create care plans. We also assist in surgical cases such as Cesarean sections. We work closely with our partners and consult and refer as needed for complicated cases. Most CNMs deliver babies in hospitals. In 2013, 7.8% of babies born in U.S. hospitals were into the hands of CNMs, a number that has been on the rise since 1989 (Martin, et al 2015).

Midwifery is the art of being with women in childbirth, a term that dates back to 1303, and a profession that can be traced back to the beginning of time. The English term midwife is derived from mid, which means “with,” and wif, which means “wife,” that is, a woman” (Rooks, 1997). The first midwives in North America were traditionally trained natives. With European immigration came women who were professionally trained. Midwives arriving to the new world on the Mayflower cared for three women giving birth on the high seas (Ament 2007 p. 22).

Midwives are the experts in care for low-risk healthy women during the childbearing year. The primary roles of the midwife are to educate, support and attend women and their families. The history of nurse-midwifery in the United States began with Mary Breckenridge, a public health nurse in Kentucky, who founded the first CNM service to provide prenatal and preventive health care to the poor, rural coal mining families (Ament, 2007). The union of nursing and midwifery creates a unique profession that is both an art and a science.

Ament, L.H. (2006). Professional Issues In Midwifery: 1st Edition. Burlington, MA: Jones & Bartlett Learning.
Martin, J.A., Hamilton, B.E., Osterman, M.J.K., Curtin, S.C., Mathews, T.J. (2015). Births: Final Data for 2013. National Vital Statistics Reports; Vol 64, No 1. Hyattsville, MD: National Center for Health Statistics. 
Rooks, J.P. (1997). Midwifery and Childbirth in America. Philadelphia, PA: Temple University Press.

Since Dr. Wendy Hatcher started working in the St. Charles Center for Women’s Health office in Bend she’s noticed a trend. Not only are the physicians referring patients to her for behavioral health care – the front desk staff and medical assistants are also identifying patients who may be struggling with life changes or health-related news.

“They’ll notice that an 18-year-old who just found out she’s pregnant is really having a hard time and they tell her, ‘Hey, we’ve got Dr. Hatcher here and she’s great to talk to,’” said Hatcher, a clinical psychologist embedded in the clinic.

“The work is totally amazing. It makes my heart sing.”

St. Charles Medical Group began integrating psychologists into its family care clinics five years ago. Now the model is expanding to include specialty clinics like the Center for Women’s Health. Having psychologists in the same location as physicians gives patients ready access to care for their physical and mental health needs.

“Some issues affect women disproportionately more than men. Depression is one of those things,” said Dr. Kim Swanson, a clinical psychologist embedded in the St. Charles Family Care and the Center for Women’s Health clinics in Redmond. “Depression can affect clinical outcomes for lots of things including surgery. Until now, people weren’t thinking about that as a potential barrier to getting a good outcome from a C-section or hysterectomy.”

Hatcher and Swanson perform pre-surgical evaluations on patients and through a variety of screening tools can better gauge if a woman is prepared emotionally for the procedure she is facing. Sometimes it is as simple as making sure the patient has a clear understanding of what to expect after the surgery that sets her up to recover well.

While post-partum depression is a common diagnosis in the women’s health clinics, Hatcher said she also works with women throughout the lifespan and during every phase of life. For some, times of major transition like menopause can be difficult to navigate emotionally as well as physically. Others may have just received a cancer diagnosis and still others are young, healthy women thinking about having a baby and how that might impact their lives.

“Women take care of everything,” Hatcher said. “In our culture, it’s not OK to be depressed. Very few people can listen and hold the space for women. I feel like the experience here is a village. We are all collaborating to take care of the whole person.”

Sewing has been an important part of Marie Rosenau’s life for about as long as she can remember. Her mother and grandmother taught her to sew when she was not even 10 years old.

“My mom was a seamstress and she was awesome and I would drive her crazy with my sewing,” Rosenau said. “She would go without patterns and I had to read every word of the instructions.”

The first quilt that Rosenau put together on her own is one of the most special, she said, because it is the only one her mom was able to see before she died. Another quilt – one the 57-year-old Terrebonne resident made for her son when he went away to school – is special because it came back to her when she needed it most.

After suffering a debilitating stroke in March 2014, Rosenau spent time at St. Charles Bend and at a rehabilitation hospital in Portland before coming back to Redmond for additional care at a skilled nursing facility. It was there that her son put his quilt on her bed to give her comfort and inspiration.

“They can tell me that I can’t clean anymore,” said Rosenau, who worked as housekeeping supervisor at Whispering Winds retirement community before her stroke. “But sewing is something that I just had to try. It’s been such a part of me for such a long time.”

Thanks to months of rehab and an indefatigable spirit, she has learned to quilt using just one hand. Her left side is impaired from the stroke, but thanks to special clamps she is able to hold material steady. With her right hand she can use a rotary cutter and her sewing machine. She is working on hand stitching, which has been the most difficult sewing task to master.

Gwen Jones, an occupational therapist at St. Charles Outpatient Rehabilitation in Redmond, has helped Rosenau research tools and techniques for one-handed quilting.

“I think that Marie has been so successful because she has been flexible and adaptable,” Jones said. “She has chosen to redefine her life within her current disabilities. She hasn’t wanted to wait until she’s better to start back to living her life. Hers is a story of physical healing, but more importantly, emotional and psychological healing.”

Although she has not been able to return to her former position at Whispering Winds, she is back to working two days a week as the resident relations coordinator, which includes working with the quilting group she began called Sew and Tell. When she’s not quilting, she also makes brightly colored pillowcases for an organization that donates them to children with cancer.

“When I feel bad about my situation, I make a pillowcase and think about the kids,” she said.

Serving as an inspiration to other stroke survivors is important to Rosenau – especially those who are at the beginning of their rehabilitation and are feeling sad about their situations.

“If I can do something to encourage somebody else, I want to do it,” she said. “I’m impaired right now, but I’m going for 100 percent.”

Meredith Wampler-Kuhn has worked with cancer paients for more than 17 years and has been interested in starting a rehabilitation program focused specifically on helping them for the past five.

Her vision is now a reality at the St. Charles Cancer Center in Bend where two rooms have been dedicated to providing physical therapy, occupational therapy and speech therapy to patients in the same location as their cancer treatments.

“About 10 years ago I did some clinical research on balance impairments in patients with breast cancer,” said Wampler-Kuhn, a physical therapist who has worked for St. Charles for the past two years. “I can’t believe I’m finally getting a chance to implement all of these ideas.”

Because so many advances have been made in treating cancer, Wampler-Kuhn said she sees a greater need for rehabilitation services focused on the unique needs of cancer survivors.

“Treatment has advanced so much, people are surviving cancer,” she said. “They are wanting to get back to living their lives. That’s where we come into play – getting people back to doing what they love.”

Chemotherapy can cause neuropathy that affects balance and can lead to falls. Surgery to remove lymph nodes can cause swelling in the arms or legs known as lymphedema. And radiation for cancers in the head and neck can often result in swallowing difficulties.

All of these issues and more can be treated with rehabilitation services. Other common problems associated with cancer or cancer treatments include fatigue, weakness, pain, restricted joint mobility from surgery or radiation, vision changes and what’s known as “chemo brain,” or problems with thinking and memory. These problems can lead to limitations in day-to-day mobility and function at home or work, which can be frustrating for patients.

“We know that many of our patients with cancer experience symptoms related to their cancer or to our cancer treatments,” said Dr. Linyee Chang, medical director of St. Charles Cancer Center.

“These symptoms can be quite disabling. By identifying and treating these symptoms earlier, we can improve their quality of life.”

By housing rehabilitation services in the cancer center, Chang said, it will be easier to incorporate them into patients’ treatment schedules. WamplerKuhn said she believes that because the therapists will become part of the cancer team, patients who may benefit from the services will receive earlier intervention resulting in better outcomes.

“Not 100 percent of people will need rehab,” she said. “We’ll identify high-risk folks and watch them closely throughout their treatments. We are also happy to see anyone who has self-identified a problem that may be helped by rehabilitation services. They will just need to ask their physician to make a referral to rehabilitation services.”

Being located onsite at the cancer center will make it possible for rehab appointments to be tagged onto other cancer treatment services so that patients only need to make one trip to the hospital for their care.

“We are all people who have a passion for oncology rehab,” Wampler-Kuhn said. “We want to help patients get back to doing what they love to do.”

To learn more, visit our Oncology Rehab page. To make an appointment with a prescription from your doctor, call 541-706-5800 and ask for the oncology rehab scheduler.

The most deadly form of skin cancer, melanoma can be prevented by staying covered. That means applying sunscreen generously and often, wearing protective clothing and avoiding excess sun exposure between 10 a.m. and 4 p.m.

Protection from the sun is especially important for babies and children, who are much more sensitive to the sun than adults. In fact, about 80 percent of a person's lifetime sun exposure happens before age 18. "We always counsel people to cover up to protect themselves from sun damage, but when you get to the pool, especially for kids, sunscreen is often the last thing on the mind," said Lizzi Katz, cancer education coordinator for St. Charles Health System.

To help protect the public from skin damage, St. Charles Cancer Center has installed sunscreen dispensers at Juniper Swim and Fitness Center, near the outdoor pool; Redmond Parks and Recreation's Cascade Swim Center and at Crook County Parks and Recreation's Prineville swimming pool.

The dispensers — which feature a high quality, water-resistant broad spectrum sunscreen offering UVA and UVB protection — are available for use by both swimmers and staff.

According to the Oregon Division of Public Health, the state's melanoma death rate was the eighth highest in the country during the years 2000 to 2006. In that same time period, the rate of new melanoma diagnoses in Oregon was the fourth highest in the United States, or 36 percent higher than the national average. Deschutes and Crook counties had the second and fourth highest rates in the state.

"With skin cancer rates on the rise, especially in the high desert, we need to change our mindset about protecting our skin," Katz said. "By making sunscreen available for a vulnerable population — kids and adults who are out to enjoy the summer weather — we can offer convenient, no-cost protection to our community."