by Guest | Jun 6, 2019 | Being Well
Rinehart Clinic’s Quality Director, Denise Weiss, presented the clinic’s “Success Stories: Diabetes Control” at a recent OCHIN Learning Forum attended by healthcare centers from across the region. (OCHIN is an electronic health record program.)
Tillamook County Wellness partners are teaming up to help people more readily access the things they need to make healthy behavior changes, because cost and convenience are often the leading barriers to developing better habits. Wellness committees are working to improve community walkability and outdoor recreation access; exploring innovative ways to ensure people have access to healthy foods like fresh produce, no matter where they live. There are community surveys and interviews being conducted about how we are screening for chronic diseases, and how to better connect patients with a network of care to lower that risk.
The Rinehart Clinic in Wheeler has been providing this level of support to their patients with much success. They recently shared their story at a regional forum so other communities can learn from their example.
Rinehart Clinic’s Diabetes Success Stories featured at Learning Forum
Rinehart Clinic’s Quality Director, Denise Weiss, recently presented “Success Stories: Diabetes Control” at a Learning Forum in Portland, sharing the clinic’s strategies for helping patients with type 2 diabetes manage the disease.
According to Denise, “One of the key factors of our patients’ success is their participation in the clinic’s healthy eating and lifestyle classes in between regular visits with their doctor. To make it easy as possible for our patients to make positive changes in their health, we offer encouragement in the form of farm-fresh veggies, vouchers for healthy foods at a local grocery store or farmers market, and free physical activity passes to help them on their journey.”
The behind-the-scenes work by Rinehart Clinic’s Panel Coordinator is also a critical part of the program. The Panel Coordinator tracks how our patients are doing, patient-by-patient and diagnosis-by-diagnosis. When it’s time for a check-up or screening to see how the patient is doing, she notes that in the chart so the care team can coordinate with the patient. Having a staff member dedicated to coordinating this tracking and working with the team on follow-up is an important part of what’s working well at Rinehart Clinic. Last year, Rinehart Clinic was recognized for being the top performing clinic for diabetes control within the Columbia Pacific Coordinated Care Organization member clinics.
Many of the lifestyle habits that reduce risk for type 2 diabetes can also help people better manage the condition. Making and sticking with healthy behavior change is difficult for most people, especially without any follow-up or encouragement. When advising a patient how to lose weight, improve blood sugar levels, or lower their blood pressure, health care providers often recommend adopting healthier eating patterns and becoming more physically active. Research has shown these types of changes can significantly improve health and prevent chronic diseases, such as type 2 diabetes, heart disease and many forms of cancer.
Changing how we eat and move requires developing new habits and routines which can be overwhelming, expensive or simply inconvenient. Having a support team such as the one at Rinehart Clinic can help, but there is a lot more to the process. Healthy food options need to be available and affordable. If someone lives a long way from a store, they need reliable transportation. Similarly, living in an apartment on a busy street does not allow for a convenient or safe space to exercise and having access to a gym costs money.
Tillamook County Wellness partners are working to remove these barriers and provide support programs to reduce the risk for Type 2 diabetes. To find out more about the Rinehart Clinic diabetes program, the Diabetes Prevention Program available through the YMCA or other resources, go to www.tillamookcountyhealthmatters.org or like the Tillamook County Wellness Facebook page.
by Guest | Apr 25, 2019 | Being Well
Protect our Community. Protect our Children. Protect Our Water. Protect Our Environment.
Old prescriptions? Leftover pills? Too often these extra pills end up in the wrong hands and the wrong places. Keep everyone safe. There are convenient, safe medication “drop box” and drop off locations in Tillamook County at: Rinehart Clinic & Pharmacy in Wheeler, Rockaway Beach Police department, Tillamook City Police and Tillamook County Sheriff’s Office during the open hours.
Flushing or dumping prescription medication down a drain is not a good way to dispose of your meds. Since Tillamook is “the land of many waters” even small amounts of medication can enter the environment, contaminate drinking water, and affect people and wildlife. Help protect Oregon’s most precious resources by taking your meds back to secure collection boxes.
Find the collection box nearest you at www.takemedsseriouslyoregon.org/disposal/disposal
Protect our drinking water
Pharmaceutical residues can affect people. Traces of medication have been detected in the drinking water of 24 major metropolitan areas across the country serving 46 million people.
Protect our lakes and rivers
Another study showed that 80 percent of the sampled streams in the U.S. contain small amounts of prescription and over the counter medicines, personal care products, and other chemicals. Sewage treatment systems cannot remove all medications from water that are released into lakes, rivers or oceans. As a result, fish and other aquatic life have shown adverse effects from medicines in the water. And small amounts of medicine have been found in our drinking water from these sources.
Sources
The Associated Press. (2018). Pharmaceuticals found in drinking water.
United States Geological Survey. (2018). Wastewater contaminants in U.S. streams.
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by Michelle | Mar 21, 2019 | Being Well
Where There’s Smoke … Second and Third Hand Smoke & Diabetes
By DeAnna Pearl, MAT, BS, CPS, SOS Tillamook Prevention Program, Tillamook Family Counseling Center
“I have diabetes but I don’t smoke – how does smoking impact me?” Most everyone is aware of “second-hand smoke.” Second-hand smoke is the byproduct of the act of smoking made up of particulates of ash and dust that holds up to 4,000 chemicals, including nicotine, which is inhaled by others.
But what about “Third-hand smoke” — what’s that? Third-hand smoke is the ash and dust that holds up to the same 4,000 chemicals, including nicotine, that gets absorbed into the surface of other materials such as walls, clothing, and floors. These are slowly released back into the air of your home and can enter the body through direct contact.
According to Prof. Manuella Martins- Green, UC Riverside CA, “Children and the elderly are especially vulnerable to Third-Hand Smoke (THS) and its impact on health. Because infants frequently crawl on carpets and touch objects exposed to exhaled smoke, they are at high risk for THS exposure. The elderly are at high risk simply because older organs are more susceptible to disease.” While the toxic byproducts of the act of smoking are dangerous, the chemical nicotine causes arteries to constrict, reducing blood flow.
This is especially serious for people who have diabetes. Complications from diabetes include being vulnerable to peripheral vascular disease or narrowing of blood vessels that carry blood to the body’s extremities, such as arms, hands, legs and feet. There is danger of a blood clot blocking a narrowed artery, and the result could be damage to or the loss of an arm or leg. Exposure to nicotine, in any form, is a major risk factor of peripheral vascular disease and more severely for smokers than nonsmokers. Diabetics who smoke or who are exposed to second/third hand smoke are twice as likely to develop this disease and increase dramatically their chances of amputation.
The good news is that when smokers quit, symptoms improve immediately, restoring blood flow to the body’s extremities. And in cases where surgery is needed, it’s more likely to be successful in people who’ve stopped smoking!
Thinking about quitting? Setting a date is a great first step – Kick Butts Day in March is a national day to encourage smoking cessation and, in particular, to end youth smoking. There is help. Ask your doctor about cessation resources covered by insurance. There are also free, effective programs through the Oregon Quit Line at 800-QUIT-NOW (800-784-8669), or www.quitnow.net/oregon.
For local programs and classes, contact SOS Tillamook Prevention Program at 503-815-5426, or www.sostillamook.og.
For more on this subject go to “Where there’s Smoke, There’s Diabetes”
https://endocrinenews.endocrine.org/innocent-bystanders/
“Thirdhand Smoke Linked to Type 2 Diabetes.” – https://ucrtoday.ucr.edu/35360
For more health tips and information about local wellness partners, visit tillamookcountyhealthmatters.org or find us on Facebook at Tillamook County Wellness.
by Guest | Mar 21, 2019 | Being Well
Community organizations are working together to focus on improving the wellness of citizens in Tillamook County. During the past year, members of the Tillamook County Wellness Task Force and committees have focused attention on one health issue – reducing the percentage of people in Tillamook County at risk for Type 2 diabetes over the next 10 years. Currently 11.3% of the population in Tillamook County have type 2 diabetes. Based on current research, nearly 30% of our population is at risk for “pre-diabetes” and most don’t even know it. A large study concluded that healthier eating patterns, increased physical activity and moderate weight loss can reduce a person’s risk for developing diabetes by as much as 58%.
What is the difference between Type 1 and Type 2 diabetes? Both Type 1 and Type 2 diabetes involve problems with the hormone insulin effectively managing blood sugar levels. Type 1 diabetes occurs when the body lacks the ability to produce insulin well, whereas, Type 2 diabetes occurs when the body does not properly use the insulin the body is producing.
What is Prediabetes? This is a stage before people develop type 2 diabetes and it occurs when a person’s blood sugar levels are consistently higher than normal but not yet high enough to be diagnosed as diabetes. There are not always symptoms, so most adults living with prediabetes likely do not know. However, prediabetes does not automatically lead to diabetes, and can be fully reversed with healthy lifestyle changes and even small decreases in weight.
What is Diabetes? Diabetes is a group of chronic conditions in which the body has a hard time controlling blood sugar on its own due to issues with the making or using of insulin. For those without diabetes, the body knows exactly when and how much to make to break down the sugars and starches we eat. For a person living with diabetes, this process doesn’t happen exactly as it should.
How does someone know if they have diabetes or prediabetes? There are several methods medical providers can use to determine diabetes risk. Screening tools and blood tests measuring blood glucose, or blood sugar, levels can provide a good indication of risk. Another blood test, referred to as the A1C, measures average blood sugar levels over a three-month period. An A1C of 5.6 or lower is considered normal. A person with an A1C of 6.4 or higher would be diagnosed with diabetes. Scores falling within the range of 5.7-6.4 are considered prediabetes.
To learn more, take a type 2 diabetes risk test on-line. Talk with your primary care physician about your risk factors and blood test options. If you have already received a prediabetes diagnosis or are interested in learning more, sign up for the upcoming YMCA Diabetes Prevention Program orientation on April 1st. For more information, call 503-842-9622 ext. 111.
Or go to www.tillamookcountyhealthmatters for more information. Watch for more information about upcoming Tillamook County Wellness committee projects that will help our communities to be happier and healthier, while reducing diabetes.
by Guest | Feb 22, 2019 | Being Well
A well-known face to many in Tillamook is Neal Lemery – some may have met him in his role as Justice of the Peace and Tillamook municipal court judge during the past decade, or now as the “community volunteer”, a board member for the Library, Master Gardeners, Fairview Grange and Art Accelerated. Lemery has always taken an active role in his community and is a renaissance man with many interests. With his retirement half a dozen years ago, Neal found the time to explore his many interests, including writing and has authored three books and many articles and blogs which he generously shares with many audiences. While chatting one day, he mentioned in an offhanded way, “Well that was after my heart attack.”
With February being “heart” month, and Tillamook County Wellness focus on sharing community members’ health behavior change stories, we asked Neal to tell us more about his wellness wake up call.
As Neal explained, being a lawyer and judge is known to be a high stress occupation, and while he was aware of the impacts, he wasn’t always proactive about making changes. In early 2011, he was experiencing extreme back pain, after several days, a lot of ibuprofen and it wasn’t getting better, his wife insisted that he go see his doctor. Grudgingly, Lemery headed to see Dr. B (Dr. Paul Betlinski at the Tillamook County Health Centers). Waiting patiently, Dr. B came out and asked why he was there and quickly assessed Lemery was having a heart attack. “Looking back now, it was all very surreal,” explained Lemery. “On the ambulance ride to Portland, I was very calm, ‘okay, so this is it.’ I thought.” Lemery’s father had died from a heart attack, and not known to him at the time, on the same day years earlier, as Neal’s ambulance ride. “What a coincidence, right?” commented Lemery.
Before his heart attack, Lemery explains that he was aware of healthy eating, but it wasn’t a focus, and exercise was something he did “sometimes.”
Fortunately for Neal, his heart procedure was successful, but the life-changing part came from a “heart-to-heart” with the cardiac nurse in the ICU, “She told me, lectured me, that I was being given another chance but it was up to me to have the right attitude and a desire to live,” explained Lemery. “I decided right then to make some changes and it wasn’t that drastic. Eat better and walking, take my medication – I was stunned when my cardiologist explained that over half of heart patients don’t take their meds.”
Lemery’s new lease on life had its challenges. About nine months after his surgery and during his healing process he wrote out his step-by-step guide on “How to be a Good Heart Patient.” He shares his ups and downs – “The depression can kill you,” he said, “The mind-body connection is amazing.” Describing himself as a “Zen Druid”, Lemery said that his time spent in nature, and as a creature of the earth were especially healing, to provide a healthy view to live life to the fullest.
“That’s why the work of Tillamook County Wellness fits for me,” said Lemery. “I’m always preaching the gospel about a positive mental attitude and an intentional desire for the important things, like family, friends and good health. I’ve become kind of an evangelist about this,” he chuckled.
Here an edited version of Neal Lemery’s “How to be a Good Heart Patient.”
- Be involved in your care. Ask questions during your doctor’s visit. Understand your diagnosis. Understand the medication strategy, the exercise strategy, the dynamics of the treatment.
- Be organized with your medication – use a pill-reminder with a copy of your meds list (printed out by your doctor) on the inside door of the cabinet you keep all your pill bottles and your pill box. Understand your meds. Knowing WHY you take a med is essential to engage your mental process into healing. Some meds need to be taken with food. Read all the info about your meds and the side effects. You WILL have side effects from some of the meds. Knowing that will ease your anxiety when you do experience the side effect.
- Adopt the mindset that all your food is medication for your body.Ask yourself if what you are putting in your mouth is nurturing your body.
- Keep a log book. Writing things down makes you more aware and focused on healing and getting stronger. It creates a self-reward system.
- Be systematic with exercise. Be aware of your body. Muscles strengthen by being used. Your body will tell you a lot. Treat yourself to special exercise clothes.
- Eat Mindfully. If the body is lacking in something, you may find yourself drawn to foods with that nutrient. Notice “cravings” and why you might be getting them. A mug of wild sweet orange tea in the evening, with a bit of honey, is my dessert.
- Have a support team. You, your log book, your spouse. Informally, I had a few friends and work acquaintances who had heart issues around the same time, and we’d connect with each other, occasionally having coffee.
- You will experience sudden, intense spurts of depression. It is part of the recovery from trauma. This will pass. Work through it. Exercise helps. Let your spouse know this is a natural phenomenon and that you are aware of it.
- Seize life. Life is precious. Do what you want to do. Don’t put it off. After my heart attack, I realized I wanted to go to California to see my foster son and his new house. So, six weeks later, I went. A reward for doing my fitness and nutrition regimen.
- I’ve found I’m a bit more blunt, and a lot more into doing things now and not “later”. So, I don’t do stuff I really don’t care to do anymore. Its liberating.
by Michelle | Jan 31, 2019 | Being Well
Making Simple Changes to Feel Better
Ian Fauver, 26, looks like a guy whose got it all together. He just started his career working at a local bank and is newly married. On the inside, however, he wasn’t feeling so good and he decided he needed to do something about it.
Recently, Fauver began experiencing debilitating digestive symptoms. He was lethargic, bloated and “just felt sick all the time.” It got so bad, he began calling in sick at work and was struggling with anxiety. He visited his primary care doctor, and listened to advice from friends, but he just wasn’t getting to the root cause of his symptoms. He became very discouraged. “I found that doing what other people said worked for them, was not working for me. I had to figure things out for myself.”
He started paying attention to how he felt after eating and noticed patterns of food sensitivity. Wanting desperately to feel better, he began preparing all his own meals, monitoring his food intake carefully and making changes based on how he felt. He read food labels and was careful to eat a balanced diet of healthy, whole foods. The results were astonishing. His stomach sensitivity improved dramatically. He had more energy and his anxiety improved. He also noticed he was saving a lot of money by not eating out.
Fauver credits his mom and his best friend as being the biggest influences along his health journey. “My mom has always been really ‘health forward.’ She used to be very overweight and worked to lose a lot of weight.” Fauver says his mom became very health conscious, sees a Naturopath and is a very spiritual person. In thinking about his mom, Fauver decided the issues he was having provided a good opportunity to make some lifestyle changes of his own, including reading the Bible and reconnecting with God.
The other main influence in Fauver’s life has been best friend, Ollie, who he also describes as being “health forward.” Ollie, also 26, attended Nursing school and has been a “gym rat” since high school. Ollie tried to get Ian to join him in the gym over the years but lifting weights just wasn’t Ian’s thing. Growing up, Fauver was active in sports but was able to show up and participate without doing any formal training. “You have to have your own reason for doing stuff. Just because someone else does it, doesn’t mean it’s going to work for you.” Ian knew he wasn’t into lifting weights, but he did miss being physically active. “I didn’t want to get bogged down with having to learn workout routines. I just wanted something simple.” He began going to the gym for a cardio workout on the treadmill, bike or rowing machine before work each morning. Fauver says, “working out has been a total blessing.” In fact, he has even added weight lifting to his morning routine and is loving how it makes him feel.
“I just feel a glow. Everything I have done has made a black-and-white difference. I have such a sense of accomplishment and it gives me the motivation to keep going with the changes I have made.
Visit tillamookcountyhealthmatters.org for more local wellness information and inspiration.
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