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For patients with osteoarthritis or that have experienced trauma to their hip, a total hip replacement can restore function and decrease pain. This is done by replacing the damaged or diseased bone with a metal or plastic implant, which is designed to replicate a healthy hip joint. The most commonly utilized total hip replacement is the posterior approach (through the back of the hip), which has been performed successfully for decades. The anterior approach (through the front of the hip) has been utilized as long as the posterior approach but its popularity has grown in the US over the past 10-15 years. 

If you are considering a total hip replacement, this guide will help compare the two approaches and give you information to discuss with your surgeon. There are risks and benefits to each type of approach. In addition, be prepared to ask your surgeon about their experience, complications, and overall outcomes. Orthopedic surgeon, Dr. Connor King, explains the differences between these two approaches in the video below.

Hip Replacement Surgery

Posterior approach

Posterior hip replacement, the traditional approach to hip replacement surgery, involves accessing the hip joint from the back of the body. Surgeons perform this approach by cutting through muscles and tendons to reach the hip joint. Despite its longer recovery period, posterior hip replacement remains a reliable technique, particularly for patients with complex hip conditions or prior hip surgeries.

  • The majority of patients are a candidate for this type of surgery.
  • The patient is positioned on his or her side during surgery.
  • The surgeon makes a 4-6 inch incision just behind the hip, along the buttock area.
  • The surgery takes 60-70 minutes.
  • It is the most common approach and provides the greatest patient safety.

Anterior approach

Anterior hip replacement involves accessing the hip joint from the front of the body. Surgeons perform this approach through a smaller incision and by carefully navigating between muscles and tendons. This muscle-sparing technique aims to minimize damage to surrounding tissues, potentially leading to faster recovery and improved early stability of the hip joint.

  • Candidates for this approach are not significantly overweight, have no femur deformities, and normal pelvis anatomy.
  • The patient is positioned on his or her back on a special surgical table so the surgeon can manipulate the leg during surgery.
  • The surgeon makes a 4-6 inch incision on the upper thigh.
  • The surgery takes 90-100 minutes.
  • This is a technically challenging procedure. Patients should find a surgeon very experienced in this approach.
Intraoperative visualization and precision

Both anterior and posterior hip replacements can be performed using various techniques and surgical approaches. Surgeons may utilize minimally invasive techniques, computer-assisted navigation, or robotic assistance to enhance precision and outcomes. The choice of technique depends on factors such as the patient’s anatomy, the surgeon’s experience, and the availability of technology in the operating room.

Posterior approach

  • Technique allows the surgeon full visualization if the hip cup and femur.
  • No intraoperative x-rays needed.
  • Very low risk of fracture due to easier exposure.
  • When performed with the Mako Robotic-Arm there is a high-degree of precision of implant placement to recreate the patient’s natural anatomy.

Anterior approach

  • Technique allows excellent visual exposure of hip cup, but challenging exposure of femur requiring muscle and capsule release.
  • Higher risk of femur fracture due to more difficult exposure.
  • Intraoperative x-rays are often used to confirm placement of the implant due to less visual exposure.
Muscle preservation

One of the distinguishing features of the anterior approach is its emphasis on muscle preservation. By accessing the hip joint through natural muscle intervals, surgeons can minimize damage to surrounding tissues, potentially leading to faster recovery and improved function. In contrast, posterior hip replacements typically require cutting through muscles and tendons, which can result in longer recovery times and temporary weakness.

Posterior approach

  • The main incision goes through the gluteus maximus and will heal without repair.
  • Muscles that are used to externally rotate the hip are detached during the procedure and later reattached to bone and will heal without complication.

Anterior approach

  • This procedure is not entirely muscle sparing. Due to risk of nerve damage, the incision enters the compartment of the tensor fascia latae muscle to expose the hip safely.
  • The indirect head of the rectus femoris is released to allow entry into hip.
  • External rotator muscles are cut and are not reattached during this approach.
  • Most surgeons cut and do not repair the joint capsule.
Nerve damage

Nerve damage is a potential complication of both anterior and posterior hip replacements, although the risk may vary depending on the surgical approach. In anterior hip replacements, the femoral nerve is at risk due to its proximity to the surgical site. Surgeons must exercise caution to avoid damaging the nerve, which can lead to weakness or numbness in the leg.

In posterior hip replacements, the risk of nerve damage is generally lower, as nerves are less exposed during surgery. However, damage to the sciatic nerve, which runs close to the hip joint, is still possible and can result in pain, weakness, or sensory changes in the leg.

Posterior approach

  • Very small (less than 1%) risk of sciatic nerve damage from excessive retraction during surgery.

Anterior approach

  • Higher risk of injury to the lateral femoral cutaneous nerve, which may cause numbness in the outer thigh.
Precautions

Patients undergoing anterior or posterior hip replacement surgery must follow specific precautions to optimize their outcomes and minimize complications.

Posterior approach

  • Low risk of dislocation when performed by a specialty-trained surgeon with a high volume of hip replacement.
  • Discuss with your surgeon – some do not have post-operative precautions with this procedure.

Anterior approach

  • Low risk of dislocation when performed by a specialty-trained surgeon with a high volume of hip replacement.
  • Dislocations are usually anterior and can occur with external rotation of the leg during any activity.
Post-operative experience

After hip replacement surgery, the majority of our procedures are conducted on an outpatient basis, primarily at Bend Surgery Center and Cascade Surgicenter, unless patients are deemed unfit for ambulatory surgery. In some cases, joint replacement surgeries performed at St. Charles also facilitate same-day discharge whenever possible.

Patients will gradually increase their activity levels under the guidance of a healthcare professional, starting with gentle exercises and progressing to more strenuous activities as tolerated. Regular follow-up appointments with the surgeon will monitor the healing process and address any concerns or complications that may arise.

Posterior approach

  • At the St. Charles Center for Orthopedics & Neurosurgery, this procedure is most often performed in an outpatient setting (returning home the same day) at Cascade Surgicenter or Bend Surgery Center.
  • Postoperative complications are the same for both approaches, including risk to structures, blood clots, infection, death, anesthesia risks.
  • The medical equipment required for recovery for both approaches is the same. You may need a front-wheeled walker, cane, leg lifter, grab bars and an elevated toilet seat.

Anterior approach

  • This procedure is also most often performed at an outpatient surgery center such as Cascade Surgicenter and Bend Surgery Center.
  • Postoperative complications are the same for both approaches, including risk to structures, blood clots, infection, death, and anesthesia risks.
  • The medical equipment required for recovery for both approaches is the same. You may need a front-wheeled walker, cane, leg lifter, grab bars and an elevated toilet seat.
What is the difference between inpatient and outpatient surgery? 

Orthopedic surgeon specializing in total hip replacements, Dr. James Hall, talks about the benefits and risks of outpatient total joint replacement in this video.

 Return to activity

The timeline for returning to activity following hip replacement surgery varies depending on the surgical approach, the patient’s overall health, and the presence of any complications. In general, patients undergoing anterior hip replacement may experience a faster recovery and earlier return to normal activities due to the muscle-sparing nature of the procedure.

Patients undergoing posterior hip replacement may have a longer recovery period, as they may need more time to regain strength and mobility after the surgery. However, with diligent rehabilitation and adherence to postoperative precautions, most patients can expect to resume their favorite activities within a few months of surgery.

Posterior approach

  • Sedentary work – 2 weeks
  • Light activity (walking, stationary bike, etc.) – 6 weeks
  • Physical Work – 6-16 weeks
  • Sports – 3 months

Anterior approach

  • Sedentary work – 2 weeks
  • Light activity (walking, stationary bike, etc.) – 4-6 weeks
  • Physical Work – 6-16 weeks
  • Sports – 3 months
  • Typically discontinue the use of walking device 1-3 weeks sooner than posterior approach.

Anterior and posterior hip replacements are two commonly performed surgical approaches for treating hip arthritis and injuries. Each approach has its own set of benefits and considerations, and the choice between them should be made in consultation with a qualified orthopedic surgeon.

By understanding the differences between anterior and posterior hip replacements, patients can make informed decisions about their treatment options and work towards an improved quality of life.

We’ve put together a free guide to help you better understand joint replacement preparation, orthopedic surgery, and recovery. If joint replacement surgery is the best solution for you, the St. Charles Center’s orthopedic surgeons and support staff are ready to help you prepare for surgery and plan for a successful recovery. 

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Are you experiencing Anterior Tibialis Tendonitis?

  • Deep achy pain on the inner front of the ankle?
  • Loss of motion at the ankle?
  • Ankle weakness?
  • Swelling on the inner front of the ankle?
  • Increased pain in your ankle with increased activity?

These symptoms can be a result of Anterior Tibialis Tendonitis. A condition not very well known, but one that can have lasting affects if not properly diagnosed and treated.

The muscle that runs down the front of your shin is called the Tibialis Anterior muscle. This muscle works together with your Anterior Tibial tendon, located on the inner-front of the ankle to help your foot flex upward. This muscle and tendon rely on one another for proper foot and ankle function. When the muscle and tendon stop working together because of overuse or a traumatic ankle injury, Anterior Tibialis Tendonitis may occur.

Another condition that can occur in the ankle is Drop Foot. Drop Foot, also known as Foot Drop, can be caused when the Anterior Tibialis muscle and tendon stop working all together. Those with this condition experience difficulty lifting the front part of their foot, or their foot and toes drag on the floor when they walk. In most cases, this condition is treatable by addressing the underlying medical condition causing it.

In this short video, Dr. Anthony Hinz, orthopedic surgeon at the St. Charles Center, goes further into explaining the cooperative relationship between the Tibialis Anterior muscle and tendon.

Download video transcription

Who’s at risk of developing Anterior Tibialis Tendonitis?

  • Runners are known to experience symptoms because of the overuse and repetitive strain on their ankles and feet.
  • Athletes in any other sports that require repetitive use of the feet and ankles, such as soccer.
  • Those in any work environment that require performing activities of a repetitive or forceful nature, like walking up and down stairs.
  • Someone who has experienced a sudden trauma or an accident to their ankle.
  • Patients with rheumatoid or osteoarthritis may be at higher risk.

Click here to learn more about the diagnosis and treatment of Anterior Tibialis Tendonitis.

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St. Charles Health System is announcing today plans to open a pilot community pharmacy in Madras in late spring of 2025, helping to fill a critical health need and improving access to prescription medication for the region. Many community organizations came together to open this new pharmacy through funding and support, including Central Oregon Health Council, which provided $460,000 in funding for the project. The new pharmacy will be located at the site of the former Hometown Drug, near downtown Madras and only three blocks from St. Charles Madras.

“Recent pharmacy closures mean Madras has just two pharmacies and they are overwhelmed. Patients are driving outside of the area for services or sometimes going without their needed medications because getting them filled is too challenging,” said Michael Powell, chief pharmacy officer for St. Charles. “We know that when people don’t have access to necessary medications it increases their risk for hospitalizations and other poor health outcomes.”

Pharmacy closures have become commonplace across the United States including in Oregon and Central Oregon, with Oregon ranking second worst in the nation for pharmacy access. By opening this new pharmacy, St. Charles and local community partners aim to prevent Jefferson County from becoming a pharmacy desert, an access issue that disproportionally affects Hispanic/Latino neighborhoods among others.

“Our Mosaic Pharmacy in Madras has been at capacity every day since we opened a few years ago, and we’ve understood for a long time that there is a real need for additional pharmacy services in Jefferson County,” said Megan Haase, FNP and CEO of Mosaic Community Health. “We don’t have the space to expand our current pharmacy to meet the needs of the community and are fully in support of this new partnership to increase access to pharmacy services in Madras. We believe that this project will help lead to better health for all residents of Jefferson County.”

Powell anticipates demand for services at the new pharmacy will be high. Records show that the former Hometown Drug location was filling 10,000 prescriptions per month when it closed.

“We are thrilled to buck the trend and open a new community pharmacy to help provide needed access to our community,” said Dr. Leo Savage, a primary care doctor at St. Charles Madras Family Care who has worked as a physician in the community for 25 years. “Every day I talk with patients who are scrambling to get their prescriptions filled or even going without. This development will have an overwhelmingly positive impact on the lives of our patients.”

Once opened, the pharmacy will fill prescriptions (in store and via a drive-up window) and provide immunizations, medication management, injections for long-term care needs and retail sales for over-the-counter medicine and durable medical equipment (like crutches or walkers). 

“I am thrilled St. Charles and our local partners are able to bring this vital service to the communities of Madras, Warm Springs, Culver, Metolius and beyond,” said Todd Shields, Vice President and Hospital Administrator for the Madras and Prineville hospitals. “Together we are helping improve the health of Central Oregonians.”

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More than 650 people turned out to support St. Charles Foundation’s annual Prineville Hospice Auction on Dec. 7, which raised more than $180,000 to support hospice programs. The popular annual event held at the Crook County Fairgrounds Indoor Arena includes a festive live auction of handmade quilts and Christmas trees as well as dinner, raffle and more.

“The Prineville Hospice Auction is a wonderful way for the community of Crook County and beyond to show support for the hospice programs while also spreading holiday cheer and good will,” said Jenny O’Bryan, executive director for the St. Charles Foundation. “The dollars raised help provide funding for education support services, grief counseling, bedside volunteers, spiritual counseling and more for St. Charles’ hospice programs.”

Best quilt honors went to “Cabin in the Woods,” donated by The Quilt Shack and the best tree award went to “Honoring the Timber Industry: A Lost Profession” donated by Coldwell Banker Sun Country Realty, Inc. 

About St. Charles Foundation
The mission of St. Charles Foundation is to support the delivery and advancement of world-class health care in Central Oregon. Philanthropic donations fund innovation in programming, building expansions and initiatives that improve the patient experience. The St. Charles Foundation works with the community to develop and steward philanthropic resources to fund programs and capital projects that improve health, prevent disease, enhance quality of life and provide the highest quality care possible for all St. Charles patients now and in the future. Learn more about the efforts of the St. Charles Foundation: https://foundation.stcharleshealthcare.org/

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We are all prone to injuries such as ankle sprains, muscle strains, back pain, etc so it is important to understand proper at-home injury care. Knowing when to use heat or ice on an injury can help decrease your healing time and pain levels.

Using ice and heat for injuries can provide relief and aid in the healing process when used correctly and in moderation. However, it’s crucial to be aware of the risks associated with overusing these methods. Always follow the recommended guidelines for duration and application, and if you’re unsure, consult a healthcare professional for guidance. Remember that each injury is unique, and a healthcare provider’s advice can ensure the best approach for your specific situation.

When to use ice

Ice is typically used for acute injuries, such as sprains, strains, or bruises. Applying ice helps to reduce swelling by constricting blood vessels and numbing the area, thereby alleviating pain and inflammation. It is most effective when applied within the first 48 hours after the injury occurs, in intervals of 15-20 minutes with breaks in between to prevent skin damage.

  • Benefits of ice: Ice application, also known as cold therapy or cryotherapy, can help in the following ways:
    • Pain reduction: Cold temperatures can numb the affected area and reduce pain sensations.
    • Inflammation control: Ice can help minimize swelling by constricting blood vessels and reducing blood flow to the injured area.
       
  • Proper application:
    • Use ice packs, cold compresses, or even frozen vegetables wrapped in a cloth to avoid direct contact with the skin.
    • Apply ice for about 15-20 minutes at a time, allowing the skin to return to its normal temperature between applications.
    • Use ice within the first 48 hours of an acute injury, like a sprain or strain.
       
  • Risks of overuse:
    • Tissue damage: Prolonged exposure to ice can cause frostbite or damage to the skin and underlying tissues.
    • Reduced blood flow: Excessive cold can lead to prolonged constriction of blood vessels, potentially delaying the healing process.
    • Nerve sensitivity: Some individuals may be more sensitive to extreme cold, leading to discomfort or nerve irritation.

Acute injuries

An acute injury is sudden and spontaneous, resulting from a fall, hit, or another type of trauma. The first rule of thumb is to never use heat on an acute injury. That extra heat can cause an increase in inflammation and delay proper healing. Applying an ice pack within the first 48 hours of an injury can help numb pain, relieve inflammation, and limit bruising. Keep your ice pack moving to avoid ice burns and do not exceed 20 minutes.

A common acute injury is a sprained ankle or knee injury. The RICE method is an important protocol to help relieve pain, reduce swelling, and counteract the body’s initial response to the injury.

RICE stands for rest, ice, compression, and elevation.

Rest

Stop using the injured body part! Protect the area and avoid any activity that is painful or may have caused the injury. Continued activity could cause further damage.

Ice

Use ice for the first 48-72 hours after an injury. Apply ice several times a day for 20 minutes at a time, followed by one hour “off.” The cold will contract injured capillaries and blood vessels to help stop internal bleeding. Do not apply ice directly to the skin.

Compression

Wrap the injured body part firmly with an elasticized bandage, compression sleeve, or cloth – especially when you are more active. This will help speed up healing time by reducing swelling around the injury.

Elevation

Elevate the injured body part above the level of your heart to decrease swelling and joint pain.

When to use heat

Heat is a great treatment for chronic conditions such as overuse injuries, and before participating in activities to help relax and loosen tissues and increase blood flow. Do not use heat after an activity, acute injury, or where swelling is involved. Swelling is caused by bleeding in the tissue, and heat only draws more blood to the area, which can increase healing times.

Be sure to use heating pads in moderation to avoid burns, and never leave one on for extended periods of time or while sleeping.

  • Benefits of heat: Heat therapy, also known as thermotherapy, can be advantageous in the following ways:
    • Muscle relaxation: Heat can help relax tight muscles and improve flexibility.
    • Blood circulation: Applying heat can increase blood flow to the injured area, aiding in the delivery of nutrients and removal of waste products.
       
  • Proper application:
    • Use warm towels, hot water bottles, or heating pads set to a comfortable temperature.
    • Apply heat for around 15-20 minutes at a time, allowing the skin to cool down before reapplying.
    • Heat is generally more suitable for chronic conditions or injuries that don’t involve significant inflammation.
       
  • Risks of overuse:
    • Burns: Prolonged or excessive heat application can lead to burns, especially if the heat source is too hot or direct skin contact is made.
    • Increased inflammation: Applying heat to an already inflamed area can exacerbate swelling and discomfort.
    • Masked symptoms: Heat can temporarily alleviate pain, potentially masking the severity of an injury and leading to further damage.

Using ice or heat for different conditions

Applying ice or heat can be beneficial for various conditions, depending on the nature of the injury or discomfort. Here are guidelines for when to use ice or heat for specific conditions:

  • Ice therapy:
    • Arthritis: Ice therapy can be helpful during flare-ups of arthritis, especially when joints are swollen, hot, and inflamed. Applying ice for about 15-20 minutes at a time can help reduce pain and inflammation. However, ensure there is a cloth or towel between the ice pack and your skin to prevent frostbite.
    • Headaches: If you’re experiencing a tension headache or migraine, applying a cold pack or ice wrapped in a cloth to your forehead or the base of your skull can help constrict blood vessels and alleviate pain.
    • Tendonitis: Tendonitis involves inflammation of tendons. Applying ice to the affected area for 15-20 minutes multiple times a day can help reduce inflammation and provide relief. Ice can help numb the pain and reduce swelling.
    • Muscle strain: In the initial stages of a muscle strain, applying ice can help reduce swelling and pain. Ice should be applied for 15-20 minutes at a time, several times a day, for the first 48 hours after the injury.
       
  • Heat therapy:
    • Arthritis: For chronic arthritis pain, applying heat can help relax muscles and improve blood flow to the affected area. Heat therapy is especially beneficial when joints are stiff in the morning or after prolonged inactivity. Use a warm towel, heating pad, or warm bath for 15-20 minutes.
    • Headaches: If you’re dealing with tension headaches or tight neck muscles, applying moist heat (warm towel or warm shower) to the neck and shoulders can help relax the muscles and ease discomfort.
    • Tendonitis: After the initial inflammatory stage, applying heat can promote blood circulation to the affected area, aiding in healing. Use a warm compress for 15-20 minutes, a few times a day.
    • Muscle strain: After the first 48 hours of a muscle strain, applying heat can help relax tight muscles and improve blood flow to the injured area. Use a warm compress or a warm bath to soothe the muscles.

How to safely apply ice or heat on an injury

Ice:

  • Preparation: Wrap the ice pack or ice cubes in a thin cloth or towel to create a barrier between the ice and your skin. This prevents frostbite or ice burns.
  • Timing: Apply ice for 15-20 minutes at a time. Avoid prolonged contact to prevent tissue damage.
  • Breaks: Allow your skin to return to normal temperature before reapplying ice. Aim for at least a 20-minute break.
  • Elevation: Elevating the injured area while applying ice can help reduce swelling further.
  • Frequency: Apply ice every 1 to 2 hours during the initial 48 hours after the injury.

Heat:

  • Moderation: Ensure the heat source is not too hot to avoid burns. Use a warm, not hot, setting on heating pads or warm towels.
  • Protection: Always use a cloth or towel between the heat source and your skin to prevent burns.
  • Timing: Apply heat for 15-20 minutes. Longer exposure can lead to skin irritation.
  • Breaks: Give your skin time to cool down between heat applications, typically for at least 20 minutes.
  • Moist heat: For moist heat, use a damp cloth or towel over the heat source to add moisture and prevent excessive dryness.

General precautions:

  • Skin check: Regularly inspect your skin during and after application to ensure it’s not becoming too red or irritated.
  • Sensitivity: If you have reduced sensitivity in the affected area, be cautious about using extreme temperatures, as you might not feel discomfort until it’s too late.
  • Individual response: Some people may prefer heat over ice, or vice versa. Pay attention to how your body responds and adjust accordingly.
  • Consultation: If you have circulatory problems, diabetes, or any condition affecting skin sensation, consult a healthcare professional before using ice or heat.

Signs of a more serious injury include:

  • Popping or crunching sound
  • Severe pain or swelling
  • Cannot stand or support the injured area
  • Instability in joint

Remember that both ice and heat are meant to be used as temporary relief measures. If your pain persists or you experience any of the above, make an appointment with one of our orthopedic specialists.

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On Thursday, Nov. 14, St. Charles celebrated Native American, American Indian and Alaskan Native Heritage month by hosting a Native Market of artisan vendors at our Madras hospital and presenting the first physical installation of our organization’s land acknowledgment statement.

Posted prominently in the main lobby of the hospital, the land acknowledgment says:

We acknowledge that the St. Charles campuses are located within the 10 million acres ceded to the Federal Government, also usual and accustomed areas, when the 1855 Treaty was signed with the Confederated Tribes of Warm Springs of Oregon. We offer this acknowledgment to honor all Native Americans that live in this area and who are the original people of this land.

The journey to get to those 62 very important words was long, and it predates my work at St. Charles. For me, though, it started a couple of years ago, when one of our providers, Dr. Shilo Tippett — a member of the Confederated Tribes of Warm Springs, Wasco Tribe — spent a chilly fall day taking me around area, feeding me delicious luckame’n, touring the Warm Springs Health and Wellness Center, introducing me to tribal leaders and teaching me about tribal culture.

At the end of the day, I thanked Dr. Tippett for not just telling me about her history and the history of her family, but for taking time to show me how many people of the Confederated Tribes of Warm Springs live and so many places where their culture is rooted. She reminded me recently that as I thanked her, I also asked if there was anything I could do in return for the generosity she had shown me.

And that’s when she told me that about the land acknowledgment work that began before the COVID-19 pandemic and stalled as our St. Charles teams put all efforts toward saving lives for several years.

I am grateful for that day and for the work that came next, which resulted in the land acknowledgment now on the wall at our Madras campus. I’m also grateful for the many people — including members of the Confederated Tribes of Warm Springs — who worked hand in hand to develop its language and artwork, as well as our new land acknowledgment web page. I have learned so much along the way, and I view our acknowledgment as a standing invitation to each of us to be curious, to inquire, to reflect and to learn for oneself. To further extend that invitation, we will also install land acknowledgments at our other locations in the near future.

Land acknowledgments are a way for organizations to pay respects to the original inhabitants of the land upon which we reside and work and to recognize Indigenous people as the original stewards of said land. We hope that by acknowledging the past and working toward an inclusive future, we can aid in emotional healing and help set a positive tone for future generations.

Sincerely,
Steve

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St. Charles' new Gastroenterology practice is growing, both in size and scope — pun intended.

August saw the arrival of a new provider, Dr. Courtney Walker, who brings to the health system expertise in advanced therapeutic endoscopic ultrasound (EUS), a service that both expands the array of and reduces the invasiveness of treatments available to local patients.

Walker is the first provider in Central Oregon to offer EUS, which means local residents who could benefit from the procedure now have the option to get the care they need without driving to Portland or beyond.

“For patients, it should be much nicer to be able to stay here and get this procedure rather than having to cross over the mountains in the winter, for example,” she said. “Also, our hope is that referring providers will be able to get their patients in quicker rather than having to coordinate through Portland, especially when time is of the essence.”

Simply put, EUS is a procedure that uses an ultrasound mounted on an endoscope to examine and treat the gastrointestinal tract and nearby organs. Similar to an upper endoscopy, providers can go down into the intestinal tract, press the ultrasound up against the lining of the stomach or the small intestine and look through to the other side for abnormalities.

The big benefit for patients is that EUS is minimally invasive compared to other methods of examining areas deep within the abdominal cavity, including surgery or interventional radiology, Walker said.

“When you have to go through all these organs and intestines with a giant needle to try to reach something that’s maybe a centimeter or two in size, it’s a challenge,” she said. “With EUS, we’re already inside and the lymph node is just right next door, so we can easily sample tissue. It’s painless, for the most part. We get the biopsy and (the patient) is home an hour later.”

There are also a number of therapeutic possibilities with EUS. During the procedure, providers can administer injections to treat chronic pancreatitis or malignant pain related to pancreatic cancer; collect liver biopsies to learn more about abnormal liver function; determine the stage and spread of diseases like esophageal and rectal cancer and more.

Walker joins St. Charles’ new team of Gastroenterology providers, who see patients in Bend and Redmond for a variety of digestive and biliary organ conditions, including GERD, Barrett’s esophagus, swallowing issues, Crohn’s disease, ulcerative colitis, eosinophilic esophagitis, celiac disease and more.

The addition of EUS to the department’s list of specialized services is a win-win for both St. Charles and the community, Walker said.

“There are quite a few people out there who are going to benefit from this. I’m doing maybe three to five per week and that’s just a couple months in,” she said. “Our hope is that as more people know it’s available here, it will continue to grow and we’ll be able to help a lot of people across Central Oregon.”

Learn more about St. Charles Gastroenterology on our website.

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If you hear the sound of a bell ringing in the St. Charles Cancer Center in Bend, that’s a signal to smile. The new bell – hung in the Infusion Room – is there for patients or family members to ring whenever they want to celebrate or recognize a meaningful milestone.

The new bell is a gift from Sam and Shane Coleman, both St. Charles caregivers. It’s a personal gesture for Sam, who completed her last round of chemotherapy for breast cancer last summer. She was diagnosed with breast cancer at age 39 after finding a lump during a self-exam. Sam underwent five months of chemotherapy and then had a mastectomy. The surgery went well – and she’s feeling optimistic as she has no signs of cancer in her lymph nodes or genetic markers.

 

“I was very lucky to go through chemotherapy and surgery and be done with it,” said Sam, who works in regulatory affairs and quality.

Sam says her work team has been amazing.  “I feel really really lucky to have been here. My work team has been super supportive and wonderful.”

Now, with two young children at home, Sam says she’s ready to focus on getting back to normal as much as possible. 

Sam isn’t sure where she first heard about the idea of ringing a bell after finishing cancer treatment – possibly a show or story she read. She wanted to ring a bell when she completed chemotherapy, but the Cancer Center didn’t have one. She and Shane offered to purchase one, so that future patients could experience a ringing moment of celebration together. Social Services Associate Linda Robson worked with the Colemans to find and order a 7-inch brass bell designed just for this purpose.

Last week, the bell was delivered and hung in the Infusion Room at the Cancer Center in Bend. Sam wants the bell to be for everyone and not just for individuals who had “beaten” cancer – because she knows that day doesn’t come for all patients. Her goal was to make ringing of the bell something every patient could experience.

“I want it to be really inclusive. If someone got great news after surgery – go ring the bell; if you survived the first round of chemo – go ring the bell. I want people to be able to celebrate big and small wins. I hope it’s a happy thing,” said Sam. “I want something that’s a little bit more meaningful for everyone, not just those of us who are lucky enough to be done. I hope people find their reason to ring it.”

Shane hopes that hearing the sound will bring people a feeling of hope – for caregivers, patients and families. “I hope families hear the bell and think, ‘Oh, that’s a happy thing.’”

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Community members throughout Central Oregon are invited to a day of celebration in recognition of Native American, American Indian and Alaskan Native Heritage month at St. Charles Madras on Thursday, Nov. 14. The celebration will include a Native Market with 10 artisan vendors from the Confederated Tribes of Warm Springs, complimentary fry bread tacos and a presentation of the new land acknowledgment and artwork in the hospital’s Galleria. The Native Market is open to the public from 11 a.m. to 3 p.m. and the land acknowledgment presentation will take place at 1:15 p.m.

During the event, St. Charles President and CEO Dr. Steve Gordon will share why a land acknowledgement, which was developed in partnership with members of the Confederated Tribes of Warm Spring, is important to St. Charles and surrounding communities.  

“This acknowledgement is a way for us to pay respects to the original inhabitants and to recognize Indigenous people as the original stewards of the land upon which we reside and work,” Gordon said. “We hope that by sharing this acknowledgment we can aid in emotional healing, invite personal inquiry and reflection, and help set a positive tone for future generations.” 

The presentation will also include Kiksht language speakers from Madras High School and Warm Springs K8 Academy.

The land acknowledgment and accompanying artwork will be on permanent display in the main entrance at St. Charles Madras. In the coming months, the acknowledgment will also be installed at other St. Charles locations. Learn more about St. Charles’ land acknowledgment on our website.

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