Vaccinations during pregnancy

More videos about vaccinations during pregnancy can be found on the ACOG website.

Community members are invited to take part in the 25th annual Heaven Can Wait 5K fundraiser to support breast cancer in Central Oregon. Registration is open now for the event set Sunday, Oct. 6 at 10 a.m. at Redmond High School. Over the years, this family-friendly walk/run has raised hundreds of thousands for Sara’s Project, which helps provide vital support services to people in Central Oregon with breast cancer.

“Heaven Can Wait is a time to show love and support for the breast cancer community in Central Oregon, including patients, survivors, family members and caregivers,” said Jenny O’Bryan, Executive Director for St. Charles Foundation. “This year will be particularly special, as we celebrate the 25^th anniversary of Heaven Can Wait.”

O’Bryan says organizers have a lot of fun extras in store and want to raise the bar for support.

“In honor of our 25th year, we hope to raise an additional $25K for patient support programs that help provide free wigs, post-surgical bras, transportation, education of early detection and massage therapies for those in need,” said O’Bryan.  

This year’s event will kick off at Redmond High School’s football stadium and will wind through Dry Canyon. Dogs are not permitted at the event.

Individuals can sign up online at HeavenCanWait.org. Individuals can also sign up to volunteer to support the event.

Your total joint surgery is complete! It’s time to relax and focus on your recovery. You’ll be making progress day by day, but you’ll most likely have some questions come up along the way. Here are some of the questions we are frequently asked by patients after their joint surgery.

WHEN CAN I RETURN TO WORK?

This depends on the type of work you do. A walking or support cane may be required for up to four weeks after surgery, which may or may not affect your ability to perform your job. Many times, part-time work is recommended at first. Every person is different in their recovery rate and rehabilitation, so returning to work will differ patient by patient. Work with your surgical and physical therapy teams to determine a plan that will work for you and your recovery.

WHEN CAN I DRIVE?

You may not drive until your pain medications (opioids) are discontinued. Your orthopedic surgeon will also want you to have regained range of motion, strength, and reaction time before clearing you to drive.

CAN I RETURN TO SPORTING ACTIVITIES AND/OR HOBBIES?

After surgery, you should be able to return to walking, hiking, bowling, golf, horseback riding, hunting, and most of the other activities we enjoy as Oregonians. The goal of your surgery is to allow you to perform your favorite activities without pain, and staying active is important. Avoid strenuous, high-impact activities such as running and aggressive skiing until discussed with your orthopedic surgeon. https://www.youtube.com/shorts/MPay97E3aHU?feature=share

WILL I BECOME ADDICTED TO MY PAIN MEDICATIONS?

Be sure to take your pain medications as prescribed and taper back if your pain feels like it’s under control. It is uncommon for people to become addicted to pain medications following joint surgery, and most people will be off all pain medications within 2-3 months.

WHAT IS THE BEST WAY TO TAKE CARE OF MY JOINT REPLACEMENT?

Follow any surgical precautions as outlined by your surgeon or physical therapist. Working on strengthening and walking is key to a successful recovery. For knee replacements, work consistently on your range of motion exercises. Try to focus on a healthy, high fiber diet, drink plenty of fluids, and avoid smoking and tobacco products. In addition, maintaining a healthy body weight will reduce wear on your new joint.

WHAT ARE THE NORMAL SYMPTOMS I MAY EXPERIENCE AFTER SURGERY?

A low-grade fever, swelling, redness, clear drainage, and constipation are all common symptoms seen after surgery. Be sure to call your surgical team if you have any of the following:

• Calf pain/swelling or inside thigh pain/swelling that does not decrease with elevation
• Redness or drainage that does not decrease over time
• A temperature of 101.5 degrees or higher
• No bowel movement within 72 hours, or persistent nausea and/or vomiting

Don’t hesitate to contact your orthopedic surgeon or physical therapist with any other questions or concerns that may arise. Feel free to contact us here at the St. Charles Center. 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 Center’s orthopedic surgeons and support staff are ready to help you prepare for surgery and plan for a successful recovery. Click below to sign up and receive our free joint replacement guide.

JOINT REPLACEMENT GUIDE

For Keith McCray, an attendant with St. Charles Bend’s Environmental Services team, the fulfillment he finds in his job comes not from his day-to-day tasks, but from the people he meets along the way.

“This is the best place I’ve ever worked, because I get to go into patient rooms and clean their rooms and talk with them,” he said.

“And they’re having a bad day, man. They’re in the hospital,” McCray continued. “So to bring them a little joy and a little conversation is fantastic to me. I wish I’d known about this job when I was 21 years old, because I would’ve been doing it all along.”

McCray brings to those patient rooms a sense of perspective and empathy that not everyone can provide. A few years ago, he was working at a national home improvement retailer when he fell off a truck and suffered a traumatic brain injury.

“I was in the hospital for a week and off work for two months, trying to relearn how to talk correctly and walk correctly,” he said. “So for me, especially when I’m working on the third floor (home to Bend’s Ortho/Neuro unit) and I’m meeting patients with head injuries, I feel like I know what they’re going through.”

Among other duties, McCray’s job is to empty the trash cans, change soiled linens and mop floors. But like many of St. Charles' EVS workers, he also gives patients a chance to talk with a non-clinical caregiver – someone who isn’t in the room to discuss test results or deliver potentially worrisome news.

“We were looking for something for Keith that would fit with his personality, and he always wanted to be able to connect with people,” said his wife of 26 years, Kelly. “He’s a chatty, outgoing guy, and he felt like he didn’t matter at his previous job. He feels like he matters here.”

A chance encounter brought McCray to St. Charles. In late 2021, when Kelly’s mother was in the hospital for surgery, she started talking to the guy who cleaned the room. Recognizing that working in the hospital would give her husband the kind of people- and service-driven work he needed, she encouraged him to apply for a job.

He was hired shortly after his interview.

“Moving 425-pound refrigerators starts to wear on your body after seven years,” McCray said. “So I gave my two-week notice and came to the hospital. It’s the best place I’ve ever worked.”

Before he worked at the home improvement retailer, McCray was a mechanic for more than 30 years.

“I was the kind of guy that I could pull your transmission out, take it apart and fix it, put it back together, and you're good for another 200,000 miles, but I couldn’t do that now to save my life,” he said with a laugh.

“But now, I wake up every morning and I’m excited to go to work,” McCray said. “I get to help people when they need it most. I get to work with a wonderful team of nurses and everyone else. I get to work in a positive environment where I have the support I need. And I like being a part of that.”

Simply defined, arthritis is the inflammation of one or more of your joints. Although there is no cure for arthritis, The Center doctors offer treatment plans to help ease pain and get you back to your favorite activities.

Anatomy of the Shoulder

Your shoulder is made up of three bones: the humerus (upper arm bone), scapula (shoulder blade), and the clavicle (collarbone). There are also two joints in the shoulder. One is located where the clavicle meets the tip of the shoulder blade (acromion), called the acromioclavicular (AC) joint. The other is located where the humerus fits into the scapula, called the glenohumeral joint. To provide you with the best care, your physician will need to find which joint is affected and what type of arthritis you have.

Types of Arthritis that Affect the Shoulder

Osteoarthritis This condition is also known as “wear-and-tear” arthritis as it destroys the outer covering of the bone. As the cartilage wears away, it becomes frayed and rough causing the bones to rub against each other and resulting in a lot of pain. Osteoarthritis is most commonly found in people over the age of 50. Rheumatoid Arthritis (RA) Unlike osteoarthritis, which can occur in a single joint, rheumatoid arthritis usually affects the same joint on both sides of the body. RA causes the lining in your joints to swell that results in pain and stiffness in the joint. Known as an autoimmune disease, RA attacks its immune system causing damage to cartilage, ligaments, and softening bone. Posttraumatic Arthritis Posttraumatic Arthritis is a form of osteoarthritis caused by a traumatic injury such as a fracture or dislocation of the shoulder. Rotator Cuff Tear Arthropathy This can develop from a long-standing rotator cuff tendon tear. The torn rotator cuff can no longer hold the head of the humerus (upper arm bone), causing unwanted friction and ultimately resulting in arthritis. Avascular Necrosis Avascular Necrosis (AVN) occurs when a bone’s blood supply is disrupted. The bone cells die, and the dead bone weakens and may begin to fracture and collapse, leading to arthritis.

Symptoms of Shoulder Arthritis

The most common symptom of shoulder arthritis is, of course, pain. This can get progressively worse over time, especially after participating in an activity that aggravates the area. Another common symptom is having a limited range of motion, as arthritis causes stiffness in your joints.

Treatment Options for Shoulder Arthritis

Nonsurgical Treatment When a patient is ready to address their arthritis, treatment will first be approached from a nonsurgical standpoint. The orthopedic doctors at The Center have a number of different non-surgical options they will first discuss with their patients and have them try before considering surgical treatment options. These include physical therapy, injections, medication, etc. Surgical Treatment Should pain reach the point of disability for a patient and non-surgical treatment is no longer effective, a doctor may recommend surgery to help restore function. As with all surgeries, there are some risks. Your doctor will discuss the possible complications with you before your operation. Arthroscopy: Your doctor may recommend arthroscopy if your arthritis is unresponsive to non-surgical treatments such as physical therapy, medication, or injections. The surgical instruments used during this procedure are thin so your surgeon can use very small incisions. Pain relief is the main benefit of this procedure, although if it continues, further surgery may be needed. Arthroplasty: Advanced arthritis can be treated with arthroplasty, in which the damaged parts of the shoulder are replaced. There are several reasons your doctor may recommend a shoulder replacement, such as:

• Severe shoulder pain that interferes with your daily activities
• Loss of motion
• Pain while resting, preventing a good night’s sleep

Advanced anesthesia techniques allow the vast majority of these procedures to occur in surgery centers, rather than in hospitals, going home the same day to recover. Dr. Jacobson, shoulder specialist at The Center, describes the anesthesia and pain management for patients during this procedure. This regimen creates a very smooth, safe, and efficient procedure for patients.

As you may have read, St. Charles has entered into a letter of intent with The Center to explore expanding our relationship with the goal of preserving and strengthening access to orthopedic, neurosurgical and physical medicine in the region. I want to review our announcement with you here because this effort is so important to our region and to the health system.

St. Charles has longstanding ties with The Center, which has 27 surgeons and 27 advanced practice providers offering orthopedic, neurosurgery and physical medicine care in Central Oregon. We currently own The Center’s clinic building on our Bend campus and we co-own Cascade SurgiCenter — also located in that building — with The Center physicians. 

Our announcement means we are exploring the possibility of employing a substantial number of The Center physicians, providers and employees. If the transaction ultimately moves forward, The Center’s providers will become part of the St. Charles umbrella of services.   

This is, simply put, the right thing to do. While not without risk, St. Charles is in a position to step in and help support a service line that is critical to our community. Due to ongoing reimbursement challenges and rising operating costs, Central Oregon has lost a dramatic number of orthopedic surgeons in the region in the past 18 months. I regularly hear from patients who are frustrated at long delays in orthopedic care. It currently takes patients in need of a joint replacement six months to receive an initial consultation appointment and another six months before surgery is scheduled.   

Working closely with The Center’s leadership, we understand the clinic is at risk of losing additional providers without immediate financial support, which also puts St. Charles Bend’s trauma program at risk. We rely on The Center’s team of orthopedic and neurosurgeons to help us care for more than 2,000 trauma patients every year.   

So, we are embarking on an exciting time where our teams will complete a due diligence process and put together a plan and timeline with a goal of completing the transition as soon as possible without disruption to patient care. As part of this process, we have applied to the Oregon Health Authority for an emergency exemption of its Health Care Market Oversight review to expedite the transaction and more quickly shore up services.   

Exploring a potential transaction with The Center is possible only because of our recent efforts to stabilize St. Charles. I’m incredibly proud that we are in a position to help support a critical health care service in our region. 

Sincerely,
Steve

Grand Rounds - July 19, 2024  
"Long COVID: A Primer For Primary Care"

Speaker: Eric Herman, MD. Assistant Professor of Family Medicine, Oregon Health Sciences, University School of Medicine.

Objectives

1. Define Long COVID.
2. Identify common signs and symptoms of Long COVID.
3. Discuss the proposed etiologies for Long COVID.
4. Discuss evaluation and management of Long COVID.

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].

St. Charles Health System announced today recipients of a variety of Community Benefit grants, awarding more than $106,000 to 16 local organizations in Central Oregon. The grants were awarded to provide basic needs, to support local diversity, equity and inclusion initiatives, to sponsor local events and as part of St. Charles’ Priority Grant to increase a sense of belonging and reduce loneliness and isolation.

Local nonprofit Friends of the Children Central Oregon will utilize the priority grant funding from St. Charles to start a brand-new cooking class series designed to teach youth and families essential culinary skills and health eating habits while strengthening community connections.

“We are incredibly grateful to St. Charles Health System for their generous grant funding. With this support, we can offer hands-on cooking lessons, guided by professional chefs, that not only teach practical skills but also inspire confidence and independence in our participants. Together, we are building a brighter future for Central Oregon's youth, one meal at a time,” said Chloe Manke, development director for Friends of the Children Central Oregon.

Organizations receiving funding to reduce isolation and increase belonging include:

• BEAT Children’s Theatre received funding to offer theater programs for students with developmental disabilities.

• Better Together Central Oregon will use funding to support the organization’s LatinX Family and Youth Family Councils.

• City Club of Central Oregon will use funding to expand engagement opportunities.

• Friends of the Children Central Oregon received funding to start a new cooking class series to encourage healthy eating and connection for youth from under-resourced families.

• Namaspa Foundation received funding to support their program “Empowerment, One Breath at a Time.”

• Newberry Regional Partnership will use funding to begin a large-scale community engagement effort in southern Deschutes County.  

• The Peaceful Presence Project received funding to support a program that connects and supports family members serving as caregivers for seriously ill loved ones.

The Center Orthopedic and Neurosurgical Care & Research and St. Charles Health System have signed a letter of intent to explore expanding their relationship to preserve and strengthen access to orthopedic, neurosurgical, physical medicine and rehabilitation medicine in the Central Oregon region.   

Central Oregon is experiencing a rapid reduction in access to care across many different types of medicine. As costs to provide care are increasing while reimbursements for services remain flat to declining, many independent providers have left the market and smaller specialty groups have closed their doors. The number of orthopedic surgeons in Central Oregon has decreased dramatically in the past 18 months making access to necessary care a significant burden for patients and their families.

Although it has tried to fill current care gaps on its own, The Center is facing similar operating headwinds as other independent specialty practices that are making it difficult to retain and recruit providers and staff. A transaction of this nature will be subject to review by the Oregon Health Authority under its Health Care Market Oversight program. However, given the urgency of the current situation and the threat to patients, The Center and St. Charles intend to seek an emergency exemption from the Health Care Market Oversight review process in the hopes of expediting the integration plans and the parties’ ability to more immediately stabilize care in the community. 

“The physicians, advanced practice providers and staff of The Center are committed to providing exemplary and efficient care to our beloved Central Oregon community,” said Dr. Christopher Healy, an orthopedic surgeon and president of The Center’s board. “With the ever-mounting challenges facing independent physician practices, a partnership with St. Charles will allow us to better meet the needs of our growing community. St. Charles also shares a mission of providing exceptional care to our region, so aligning with their organization is a natural path forward to delivering orthopedic, neurosurgical and physical medicine care.”

The Center operates three clinic locations in Bend and one in Redmond, with outreach clinics in Sisters, Prineville, Madras, La Pine, Burns, and John Day, enabling patients to receive expert care close to home. The Center employs 27 physicians, 27 advanced practice providers, and approximately 200 support staff.

“St. Charles and The Center are both local organizations that are committed to providing the best possible care for Central Oregonians,” said Dr. Steve Gordon, president and CEO of St. Charles. “St. Charles has the ability to step in and help shore up these services for our patients and community, which is not only the right thing to do it’s critical to ensuring continued access to a wide variety of services throughout the region.”

Without immediate financial support, Healy said The Center leadership team is concerned more providers will leave the region worsening the long delays patients are experiencing for care. It can take up to six months to schedule an initial orthopedic evaluation with a total joint replacement surgeon and another six months to schedule surgery.

“Physicians from The Center have been active members of the St. Charles medical staff for decades,” Healy said. “St. Charles is the right partner as they are the leader in health care in our area and will help provide stability to musculoskeletal care in the region.” 

In addition, St. Charles Bend’s designation as a Level II Trauma Center is dependent on having a robust group of orthopedic and neurosurgeons available to provide on-call coverage for trauma surgeries when needed, Gordon said. More than 2,000 patients are treated annually for acute and often life-threatening trauma at St. Charles, especially in the summer months when regional recreational activities increase.

“Six of the orthopedists at The Center regularly share daily trauma service shifts, three more provide occasional shifts and all of The Center physicians provide night and weekend assistance,” Gordon said. “The loss of these physicians could result in an ‘orthopedic desert’ in Central Oregon and the loss of Level II trauma services for tens of thousands of square miles east of the I-5 corridor. We can’t let that happen.”

The Center and St. Charles will put together a transition plan and have a shared goal of completing the transaction as swiftly as possible without any disruptions to patient care. The Center currently provides care to all residents of Central and Eastern Oregon, including rural counties and individuals who may face barriers to care. In the past year, The Center has provided:

• At least 1,000 visits by patients from each of seven Oregon rural counties (Deschutes, Crook, Klamath, Jefferson, Grant, Lake and Harney) and more than 100 visits from patients from Wheeler and Wasco counties

• More than 45,000 visits by seniors, including more than 8,000 by patients over age 80

• More than 6,000 pediatric visits (age <18)

• More than 19,000 visits provided in Redmond, thus preventing patients from having to drive 20 miles further south to Bend for care

• More than 450 visits provided to residents of Warm Springs

• More than 12,500 visits to Oregon Health Plan (Medicaid) members

Shannon Edgar, MBA, BSN, RN
Vice President, Chief Nursing Executive

Shannon Edgar serves as the Chief Nursing Executive for St. Charles Health System. In this role, she oversees nursing practices across St. Charles hospitals and ambulatory care, guiding clinical practice, professional development, and quality and safety programs. Shannon began her journey with St. Charles as a Certified Nursing Assistant (CNA) in 2001. She has led various nursing teams, fostering a collaborative and patient-centered care environment across diverse areas within the health system. Shannon holds a Bachelor of Science degree in Nursing from Linfield College and a Master of Business Administration with a focus on Healthcare Management from Western Governors University.