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An EMG is done to help diagnose diseases that damage muscle tissue, nerves, or the junctions between nerve and muscle.

EMG/Nerve Conduction Studies are done to help diagnose injuries or diseases that damage muscles, nerves, or the junctions between the nerve and muscle. This diagnostic test can help find the cause of pain, numbness/tingling, or weakness. EMG measures the electrical activity of muscles at rest and during contraction. Nerve conduction studies measure how well and how fast the nerves can send electrical signals.

To prepare for these tests, ask your referring physician for any special instructions. You should bathe before the test and DO NOT apply any body lotion. Take your regularly scheduled medications. Tell the doctor that is performing your test if you are taking a blood thinner (i.e. Coumadin), if you have a pacemaker, or if you have hemophilia.

There are very few risks or side effects from these tests. Each study is designed specifically for your symptoms so the length of the test can vary, but they are usually between 30-60 minutes. Watch this short video to learn more about what to expect.

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St. Charles Center for Orthopedics and Neurosurgery

Diverse by design, our team of highly trained orthopedic, neurosurgical, occupational medicine, and physiatry doctors offer a wide range of recovery solutions meant to meet the needs of our assorted patients – a community as expansive and varied as the Central Oregon landscape itself.

We treat our patients with compassion because we understand how important their passions are to them – be it working outside, getting out on the water, or a walk in the woods; we all know what it means to get back to what you love, to find your strength again.

It’s all of us thriving together that make our home in the High Desert special.

Recovery isn’t always easy, it can be challenging – both physically and mentally – and not just for our patients! Every injury brings something new, and we embrace each patients’ challenges as an opportunity to better ourselves, our practice, and our community.


Our team is ready to help you schedule an appointment. Call 541-382-3344 Monday – Friday, 8 a.m. – 5 p.m.

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Chris McClellan 

Chris McClellan is a managing director at the management consulting firm Huron. He joined the board in 2025 and brings experience working deeply with many health care clients. He understands the challenges facing rural hospitals and believes in their critical importance to the communities they serve. 

McClellan received a bachelor’s degree in business administration and religious studies from the University of Oregon. 

Reason for service: “A community hospital saved my three-year old son’s life when he contracted COVID. This experience furthered my conviction that maintaining the presence of rural hospitals is non-negotiable as they are often the only feasible means of timely, life-saving care for their communities.”

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Advanced imaging for accurate diagnosis

Endoscopic Ultrasound (EUS) is a cutting-edge diagnostic procedure that combines endoscopy and ultrasound technology to obtain detailed images of the digestive tract and surrounding organs. This minimally invasive technique provides high-resolution images, enabling healthcare providers to diagnose and assess various gastrointestinal (GI) conditions with precision.

What is Endoscopic Ultrasound?

EUS involves the use of a thin, flexible tube called an endoscope, which is equipped with a high-frequency ultrasound probe at its tip. The endoscope is carefully guided through the mouth or rectum to reach the area of interest. The ultrasound waves create detailed images of the esophagus, stomach, pancreas, liver, gallbladder, and nearby lymph nodes, allowing for enhanced evaluation of abnormalities.

Why is EUS Performed?

EUS is recommended for various diagnostic and therapeutic purposes, including:

  • Evaluating digestive diseases – Helps detect conditions such as tumors and pancreas cysts.
  • Assessing pancreatic conditions – Provides detailed imaging of the pancreas to diagnose cysts, tumors, or pancreatitis.
  • Staging cancers – Determines the size, depth, and spread of gastrointestinal and lung cancers for better treatment planning.
  • Guiding biopsies (Fine-Needle Aspiration - FNA) – Enables precise tissue sampling for accurate diagnosis.
  • Detecting gallbladder and bile duct diseases – Assists in identifying gallstones, blockages, and other biliary conditions.

What to Expect During an EUS Procedure

EUS is typically performed as an outpatient procedure under sedation. During the examination:

  1. A specialist gently inserts the endoscope through the mouth (for upper GI imaging) or rectum (for lower GI imaging).
  2. The ultrasound probe captures real-time images of the targeted areas.
  3. If necessary, a biopsy or fluid sample may be taken using fine-needle aspiration or fine-needle biopsy.
  4. The procedure usually lasts 30-60 minutes, and patients can return home the same day after a brief recovery period.

Benefits of Endoscopic Ultrasound

  • Minimally invasive with high accuracy
  • Provides detailed imaging beyond standard endoscopy or ultrasound
  • Allows for real-time tissue sampling
  • Aids in early detection and better treatment planning

Schedule Your EUS Consultation

If your doctor has recommended an Endoscopic Ultrasound, our experienced specialists are here to guide you through the process. Contact us today to learn more or schedule an appointment.

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Sutab Bowel Prep Instructions 

Download Instructions

Medications:

  • Contact your prescribing provider for instructions regarding your blood thinning medications, such as: Aggrenox, Brilinta, Coumadin, Eliquis, Plavix, Pradaxa, and Xarelto, Warfarin etc.

  • Diabetic Patients: Contact your prescribing provider for directions regarding your diabetes medications.
    **DO NOT stop taking these mediations until directed by your prescribing provider**

One Week Prior:

  • Continue taking Aspirin products (including baby aspirin - 81 mg) unless directed otherwise by your provider or nursing staff.

  • Stop taking anti-inflammatory products such as: Aleve, Excedrin, Ibuprofen, Alk-Seltzer, etc. **Tylenol (Acetaminophen) is allowed if needed**

  • Stop taking ALL over the counter supplements and vitamins.

  • Stop taking GLP-1 medications (daily, weekly, oral, injectables) EXCEPT those mixed with insulin a minimum of 7 days prior to procedure (not including date of procedure).

    Phentermine

    Weqovy

    Ozempic

    Trulicity

    Mounjaro

    Saxenda

    Victoza

    Byetta

    Bydureon

    Others as directed by medical staff

  • Avoid eating: seeds, nuts, granola, corn, quinoa, and popcorn.

3-4 Days Prior:

  • Stop taking SLGT2 as listed below:

    • Jardiance

    • lnvokana

    • Farxiga

    • Synjardy

    • Steglatro (hold 4 days prior)

You are responsible for contacting your prescribing provider for holding instructions for all other prescription medications. 

One Day Before Procedure:

  • CLEAR LIQUIDS ONLY - no solid food

    • Allowed

      • Clear fat-free broth (any flavor)

      • Tea or coffee (no creamer or dairy) - sugar/honey are ok

      • Clear juices - apple, white grape

      • Carbonated beverages - Coke, Pepsi, Ginger-Ale, 7up, Sprite, Ice (flavored water)

      • Gatorade or other sports drinks

      • Flavored gelatin (Jello)

      • Popsicles (without milk or fruit pieces)

      • Electrolyte water (Propel, Smartwater, Fuji Water)

      • Clear Ensure - NOT chocolate, strawberry or vanilla

        NOTHING THAT IS RED, BLUE OR PURPLE

    • NOT Allowed

      • No dairy products (including oat and soy milk)

      • No alcohol

      • No juices with pulp (orange, pineapple, grapefruit, including lemonade)

It is important that you drink fluids and stay well hydrated prior to your procedure. 

You MUST remain on a clear liquid diet until after your procedure.

  • Medications

    • You must stop erectile dysfunction medications 24 hours prior - including Viagra and Cialis

Bowel Prep:

  • Follow these instructions - DO NOT FOLLOW INSTRUCTIONS ON THE BOX

SUTAB INSTRUCTIONS

For your procedure, you will take one half of the prep the evening before the test, and the other half the day of the test.

  • Dose one: 5 p.m. the day prior to your procedure, fill the provided container with 16 ounces of water and swallow each tablet (12) from the first bottle of pills with a sip of water and drink the entire container over 15-20 minutes. Approximately 1 hour after the last tablet is swallowed, fill the container again with 16 ounces of water and drink the entire amount over 30 minutes, and repeat with another 16 ounces of water in 30 minutes. It is very important to consume all water as directed for prep to be effective.

DAY OF PROCEDURE

  • Dose two: 6 hours before your ARRIVAL TIME, repeat above directions using the second bottle of tablets (12). Please drink additional clear liquids (water, black coffee (without milk or cream), apple juice, soda or club soda) until 4 hours prior to your ARRIVAL TIME.

Day of procedure

  • Stop all nicotine products (including ZYN pouches), stop all vaping, do not chew gum, or have hard candies/mints

  • ONLY CLEAR LIQUIDS - no solid food

    • Water

    • Black coffee (no creamer or dairy products) - sugar/honey are ok

    • Apple juice

    • Clear soda (7up, Sprite, club soda)

NOTHING BY MOUTH 4 HOURS PRIOR TO ARRIVAL OR YOUR CASE WILL BE CANCELLED

You should expect to spend up to 2.5-3 hours in our procedures unit, longer if you are scheduled to have an additional test done on the same day.

Transportation:

  • Driving is not allowed after a procedure with sedation/anesthesia.

  • It is required that you identify a driver for transporting you home. If you are unable to identify a driver, please let us know as soon as possible as your procedure may need to be cancelled/rescheduled.

Care at home:

  • For your safety, it is recommended that you have a responsible adult with your for 8-24 hours after a procedure to support you in the case of a complication or medication side effect.

It is the responsibility of the patient to understand if your procedure is covered - including difference between screening and diagnostic. Please contact your insurance carrier for further benefit coverage information.

If you have questions or must reschedule/cancel your procedure, please call GI - 541-706-4220. We request a minimum 72-hour notice for all cancellations and reschedules.

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Restoring maximum function when injury, pain or disability get in the way. Physical medicine and rehabilitation physicians (physiatrists) specialize in state-of-the-art diagnostics and non-operative treatment of a variety of musculoskeletal and neurologic conditions including:

  • Acute/persistent neck or back pain, may be associated with radiating extremity pain (pinched nerves)
  • Acute/persistent joint or muscle pain
  • Numbness, tingling and weakness
  • Sports injuries
  • Occupational injuries
  • Motor vehicle injuries
  • Concussions
  • A variety of neurologic conditions including spinal cord injury, stroke, brain injury, cerebral palsy, spasticity, dystonia and multiple sclerosis.

Physiatry offers a different approach to treatment. At the St. Charles Center, our physical medicine and rehabilitation doctors work with you to diagnose the cause of your pain or disability. This involves a detailed medical history and physical exam, and may involve additional diagnostic tests including imaging studies, electrodiagnostic testing (EMG) and lab testing. A non-surgical treatment program will be created, beginning with education regarding your condition and a discussion of treatment options. Treatment may include the following:

  • Physical therapy program
  • Injection therapy (potentially under x-ray or ultrasonic guidance)
  • Medications
  • Platelet Rich Plasma (PRP) therapy injections
  • Botox injections for spastic neurologic conditions
  • Concussion management
  • Other non-surgical modalities
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Cerebrovascular disease includes the brain abnormalities that affect the circulation of blood to the brain, including stroke, carotid stenosis, vertebral stenosis, intracranial stenosis, aneurysms, and vascular malformations. Cerebrovascular disease can result in stroke or bleeding in the brain (hemorrhage).

Causes and risk factors

Cerebrovascular diseases primarily affect elderly people, those with diabetes or heart disease, or smokers. Hypertension is the most common cause. Continuous hypertension changes the structure of the blood vessels and makes them susceptible to blood pressure changes. A sudden rise in blood pressure can cause ripping of blood vessels and a hemorrhage. A drop in blood pressure could cause stroke.

Treatment

The majority of cerebrovascular problems can be identified through imaging tests like an MRI or CT scan. These tests allow neurosurgeons to view the brain tissue, arteries, and vessels. Treatment is determined by the extent of the brain abnormality and the condition of the patient. For some people, medication is prescribed to help reduce the risk of ischemic stroke. These include medication to control high blood pressure, medications to reduce cholesterol levels, and anticoagulants to thin blood and prevent it from clotting. For some people, surgery may be required.

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What is a concussion?

A concussion is a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. It is a serious condition that requires specialized medical expertise. The majority of concussions are not associated with a loss of consciousness. After an injury to the head, a person with a concussion may not be able to recall events around the injury time, may appear dazed or stunned, be confused, move clumsily, speak slowly, or have other behavior changes. Other concussion symptoms include headache, nausea, sensitivity to light or noise, dizziness, confusion, and changes in attention, concentration, and/or memory.

Signs and symptoms

If you suspect you or someone else has a concussion, monitor for the following symptoms:

  • Loss of consciousness: Even a brief loss of consciousness warrants medical evaluation. However, most concussions do not involve losing consciousness and instead result in altered awareness.
  • Confusion or memory issues: The individual may appear dazed, unable to answer simple questions, or forget the incident.
  • Clumsiness or unsteady movements
  • Slow speech or behavioral changes
  • Headache
  • Nausea or vomiting
  • Sensitivity to light or noise
  • Dizziness
  • Difficulty concentrating or remembering information

Emergency symptoms

Seek immediate medical attention or call 911 if any of the following occur:

  • Loss of consciousness
  • Convulsions or seizures
  • Severe confusion or inability to recognize familiar people or places
  • Repeated vomiting
  • Unequal pupil size
  • Difficulty waking up
  • Slurred speech, weakness, numbness or lack of coordination

Signs and Symptoms PDF

Risk factors

Certain individuals are at higher risk of complications from a concussion, such as older adults on blood thinners. If someone in this category experiences a head injury, prompt medical attention is essential to rule out brain bleeding.

Do you suspect a concussion?

If you or your child have a concussion, or if you’ve been diagnosed and need additional care for lingering symptoms, call 541-382-7329 to make an appointment. At the first visit, a physical medicine and rehabilitation provider trained in concussion management will evaluate the patient. Patients will leave with a customized plan to get them back to activity. The appointment may include:

  • Cognitive testing
  • Assessment for school accommodations
  • Assessment for speech therapy. (This is sometimes needed to give strategies for children that compensate for symptoms of confusion, lack of concentration, or problems multi-tasking.)
  • Vision assessment
  • Social/emotional evaluation; if a patient is depressed or has anxiety about concussion, they may need to see a neuropsychologist for more in-depth assessment
  • Balance assessment
  • Neck pain and injury assessment; with referrals to physical therapy as needed

Concussion management

For ongoing concussion management, we holds concussion clinics to help patients manage the symptoms that can linger for months after their injury.

The St. Charles Center for Orthopedics & Neurosurgery coordinates care with athletic trainers, providers from High Desert Education Service District (HDESD), neuropsychologists, neurooptometry, speech therapists, occupational therapists and physical therapists. For more information, ask your primary care provider or call us at 541-382-3344.

Collaborative concussion support in schools

When a student has a concussion, it’s critical that the school staff knows what to do to ensure the student’s best chance of concussion recovery. The St. Charles Center interfaces with the athletic trainers in Bend, La Pine, Crook County, Sisters and Madras high schools, which allows us to implement our concussion treatment protocols within the high schools. Often times, the follow-up post-injury testing can be done at the high school. When a younger child has a concussion, we keep in close touch with school nurses and counselors. If there are more complex needs, we work closely with High Desert Education Service District (HDESD) to ensure that we provide collaborative support.

Virginia Tech has done extensive research to help parents evaluate youth helmets. Click below to view their ratings*.

*This information is for informational purposes only. The St. Charles Center does not recommend any specific helmet type. Any player in any sport can sustain a head injury with even the very best head protection.

Helmet Ratings

Concussion resources

For more information on concussion, visit these websites:

Videos

categories:
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Grand Rounds - February 7, 2025
"Illicit Drug Update: What’s Trending and What’s Pending"

Speaker: Richard Shih, MD. Professor of Clinical Biomedical Science, Director of the Division of Emergency; Medicine and Program Director of the Emergency Medicine Residency Program, Florida Atlantic University.

 

 

Objectives

  1. Manage “date rape” OD/poisoning by recognizing the effects and street terminology.
  2. Assess possible “designer drug” use and recognize the limitations of laboratories in identification.
  3. Differentiate between the (2) primary methods illicit drugs are obtained for personal use and the common associated demographics.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals.

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

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