Hep C Program Comes to Life at CHAS
April 2012
By Katie Kolbet, Communications

Dr. Ethan Angell, Primary Care Provider - Community Health Association of Spokane

Dr. Ethan Angell and Michelle McCartney, Medical Assistant, are pioneers of sorts here at CHAS.  About 5 years ago while working together in family practice they started to notice a cycle of patients presenting with Hepatitis C.  Sadly, a lot of people don’t realize that they have Hep C until they are in the process of liver failure. There also are not many clinics that accept or know how to really deal with this condition. “We knew there had to be a better way to service patients with Hep C, to be able to build a relationship with them, get them clean (which is a requirement for the program) and help them deal with the side effects of the medications that clears the virus,” states Michelle.

Dr. Angell recalls the main motivation behind the push for the Hep C program. “A few years ago we had a patient who we became very close with.  He was in need of a liver transplant and was sent over to the University of Washington.  Two days before his appointment there, he passed away.” “It was the first funeral Dr. Angell and I attended together,” adds Michelle.

From there, they pushed to get a pilot program started that would help people with this curable disease. In 2009, they were allowed to take on five patients.  All five cleared the virus, meaning no trace of Hep C could be found in their systems. This was a great result and showed the impact that could be made.

The Hep C program is tough to get into and is growing by leaps and bounds. But with Dr. Angell only seeing Hep C patients on Tuesdays and Wednesdays, the demand is growing.  Below is a synopsis of 2011:

• 192 referrals made
• 100 patients attended the educational classes (a requirement for all participants)
• 103 patients met with Dr. Angell
• 20 patients are currently undergoing treatment
• 9 patients are ready to start treatment
• 25 patients completed treatment!

Many of the folks who are seen by Dr. Angell and Michelle are drug addicts – most contracting Hep C from sharing dirty needles or snorting cocaine.  Amazingly, the virus can live on a dollar bill for four days!  And most patients find out they have the disease by the plasma clinic where all blood is screened before a donation can be made.

When speaking about the program, Dr. Angell adds, “this is not something that people can just jump in and out of.” In order to be accepted into the program the patient must remain clean for 6 months, and must be emotionally and mentally stable. Patients must be committed to staying clean, or they are removed from the program.  Then there are others that experience side effects that are too much for them to deal with or and yet others that simply do not respond to treatment.

“There can be terrible side effects from these drugs,” says Dr. Angell.

One of the benefits of treating patients for Hep C, who are also primary care patients, is Dr. Angell and Michelle already know them, there is a trust built, and they can treat the side effects better than a Hepatologist would be able to in most cases.  They are also able to give patients their weekly injections at the clinic, because for some, injecting themselves is a trigger of their prior drug use.

For the Hep C program to successfully continue, Dr. Angell and Michelle know that case management is the key! “We are their medical home, a lot of patients are sad when treatment is over – we are part of their family,” Michelle adds.

Congratulations and appreciation to Dr. Angell and Michelle for instituting such a beneficial program at CHAS!

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By Dr. Roberta Knorr,  Pediatrician

Today, there are many points of view when it comes to vaccinating children – Community Health Association of Spokane’s newest Pediatrician, Dr. Roberta Knorr, weighs in on the topic.

The old adage, “an ounce of prevention is worth a pound of cure”, could not be truer in the pediatric world.  There are so many things now days that parents would never do or let their defenseless child do. You would never put your newborn infant in a car seat without buckling him or her up, or let your toddler play in the bathtub without supervision, allow your 4-year-old to cross the street by themselves, or let your 6-year-old ride a bike without a helmet.  It’s the small things that help keep our children out of harm’s way.

Yet 40% of parents in the U.S. declined or delayed vaccines for their children in 2008. 66% of children remain unvaccinated against influenza annually, despite the fact that influenza causes more than 8% of the fatalities during the flu season.  Children 5 years and under are especially susceptible to serious infections and hospitalizations when left unvaccinated.

There are far more benefits than risks when it comes to vaccinating children. Children who get vaccinated not only prevent serious illness in themselves, but also help prevent the spread of disease to the elderly and other high risk groups.  The average cost of Influenza management and treatment in the U.S. per year is $126.8 BILLION!  The average cost to achieve herd immunity in the U.S.  (getting the majority of patients immunized and protected against serious disease) per year is estimated to be $21 BILLION.  You chose.

Don’t be like Benjamin Franklin who regretted the loss of his 4 year old son to Small Pox because he neglected to vaccinate him.

Dr. Rutherford is a retired orthopedic doctor. But upon observation, it seemed as though I have a different perspective of what it means to be retired. As he walked in and out of patient rooms with a medical student, he appeared to be as active as any medical staff member. And it was apparent – he truly loves what he does.

Dr. Rutherford has been volunteering at CHAS for the last ten plus years. He can be found one day a month at the Denny Murphy Clinic, in Downtown Spokane. He sees between 8-12 patients each day, depending on the presence of a student. “I love CHAS patients; they might not receive care otherwise, so I am happy to help.” Rutherford said.

In addition to volunteering at CHAS, Dr. Rutherford also volunteers at Dirne Community Health Center, Spokane Guilds’ School, and Project Access (a network of providers who perform services to patients who could not otherwise afford them). Once a year, he travels to New York for six weeks to volunteer his services. Additionally, he spends time training interns, as well as offering continuing education classes for current providers.

When asked why he volunteers, he simply states because it provides something for him that cannot be explained, and that someone needs to help people who otherwise would not be able to get the services they need.

From the time spent with Dr. Rutherford, it is clear that he truly loves what he does, and loves that he can do it around a schedule that is now working for him and his family.

We’d like to take a moment to thank you Dr. Rutherford for all you provide to CHAS and the community at large. Your contributions have benefited so many and your commitment to helping others in need is truly admirable!

By Katie Kolbet, Communications Specialist

If you haven’t met the CHAS Homeless Outreach team consisting of Lee Nelson and Ilze Zarins-Ilgen, you should. They are both amazing people who work extremely hard in the local homeless community. Fortunately for me, in early December, I had the pleasure of spending a day out in the community with this phenomenal duo.

CHAS serves a huge population in Spokane and some of our regular patients are part of the homeless community. CHAS often holds employee sock, blanket and clothing drives. Lee collects these items and hits the streets in search of those in need. On the day I accompanied the team, we visited Shalom Ministries, City Gate, Transitions Women’s Center and House of Charity. We also made stops under bridges, next to railroad tracks and even into urban forests.

While in the forest we met a man who showed me how much of an impact the CHAS outreach team really makes. The man was new to the encampment and his only source of income was food stamps. In his words, he is just “trying to survive”. As with everyone else we met that day, we were welcomed with hugs and stories. “Three adults and a dog in a tent, keeps us warm, but we don’t get a lot of sleep,” he said with a smile.
As we were getting ready to leave, Lee handed out hygiene packs with basic necessities like razors, soap, deodorant, a washcloth, a granola bar, and a pair of warm wool socks. Upon receiving this gift from CHAS, tears welled up in the man’s eyes. . .I don’t know that I have ever seen someone so happy to get a pair of socks. But I know it wasn’t just the socks, it was the kindness and time given to understand an undoubtedly unique situation.

Remember, it’s the small things in life that can make a big difference.

Hello! It´s Dr. Moorman, Pediatrician at the North County Clinic. Welcome to the holiday edition of your children and their health. Please remember that this is a great time of year to get in quickly for a nurse visit for a flu vaccine and maybe even a new toothbrush for their stocking or for travel. Please remember that during travel we encounter all kinds of new wonderful experiences but that also means we contact new germs as well. Please remember to use good hand washing to stay healthy. When soap and warm water are not available, use a hand sanitizing product to help clean your hands. This is especially important when holiday shopping or playing with sample toys at stores that hundreds of children have already handled. Lastly, when sick, remember to cough into your elbow, not your hands, and make sure your children know how to do this so they don’t pass along germs to others.

The holidays are for family and friends and the memories we create. Please help keep those memories healthy and germ free.

Hello!

It’s Dr. Moorman, Pediatrician at the North County Clinic. Summer flew by and it’s already time for back to school! Does your child have everything he or she needs to remain healthy this year?

I put together a few questions to help you figure out if your child is back to school ready. If you answer NO to any of the following questions, give us a call at 509-444-8200 to schedule an appointment.

• Has your child had a Sports Physical completed for athletics?
• Is your child up to date on all of his/her Immunizations? Have your teens and pre-teens received immunizations too?
• Does your child have a new Epi pen or Inhaler for his/her Asthma? The cold and flu season is just around the corner.
• Does your child have fluoride supplements?
• Has your child gotten a Dental check up?

Get this school year started off right. If your child struggled last year with behavior or school work and you need a Pediatric evaluation to help get them the help and services they need this year to thrive, please make an appointment today!

Dr. Dan Moorman

Welcome spring and summer! Bye-bye colds and flu. It’s time for spring cleaning and that includes not only your homes but time to make sure you are getting your family’s health in order as well. Dental care is often overlooked or forgotten, but it’s time to get back in for that dental visit if this has slipped your attention. Pediatric and Adult Dental services are available at CHAS. Dental services are important because living in the Spokane area provides many challenges for dental care as our community does not have much, if any, fluoride in our water systems and wells. The current guidelines are for supplemental fluoride for children from 6 months old up to 16 years old. If you have run out of fluoride or forgot to get it at your last medical or dental visit please give us a call so we can make sure we are protecting your children’s teeth as best as possible.

It’s also time to dig out those old immunization records along with that house cleaning and make sure your children are up to date on all of their immunizations for the year. If you are not sure please give us a call so we can help you figure out what may be needed.

With the Sunshine returning to our area it’s time to think about sunburns and protecting our skin and our children from sunburns and potential skin cancer later in life. A light and breathable layer of clothing plus a hat is a great physical barrier, and is a better sun blocker than liquid sun block as it provides the right protection for your infant as well as for any family member. When wearing less than full coverage; a good sun block with both UVA and UVB provides the most protection. The American Academy of Pediatrics Recommends a SPF level of at least 35 for all children, but remember that sun block can wear off with sweat or with water. Remember to reapply sun block as needed to avoid that summer burn.

Also, along with spring cleaning it’s time to find that old book you haven’t read in a while. New books are always nice but search for that old favorite too. Remember to read to your children daily or better yet, have them read to you when old enough. Help them to read their old favorites to continue that love for reading and make sure they have books to read for their Spring and Summer breaks. The library is always a good place to find new favorites and it doesn’t cost you anything. So get out there and read and explore new worlds, you’ll be glad you did.

Daniel Moorman, MD

CHAS has recently transitioned the upper level of the Valley CHAS clinic into a Women and Children’s Wellness Center.  This new location offers an on site Pediatrician, OB-GYN, as well as other providers from our OB team, and our loved First Steps program staff.  CHAS is happy to be able to offer a family friendly atmosphere for the women and children we serve.  As always, our other locations also provide pediatric and pregnancy care as well, but this new option will definitely appeal to some of our patients.  I encourage you to check it out and visit our Women and Children’s Wellness Center in the Valley CHAS clinic!!

Most of us have some sort of chronic condition we deal with every day, right? Wouldn’t it be great to learn how to better live with that condition? If you have a chronic condition like diabetes, asthma, depression, heart disease, chronic pain, arthritis, or high blood pressure, our Healthy Living Workshops can help! This program is a great way to help you take control of your health and get more out of life.

The program was designed at Stanford University and is proven to help people gain self-confidence in their ability to control their symptoms and understand how their health problems affect their lives.   The best part of this is that people who are able to self-manage their chronic conditions are healthier in the long run and lower their medical bills.  We like to hear that!

The program is open to all CHAS patients with chronic conditions, and/or their caregivers, and is free of charge! The group meets one day per week for 2½ hours for 6 consecutive weeks.  If you  join the workshop, there’s an optional workbook you can buy for $10, but if you complete the class, you’ll get your money back!

Don’t miss this great opportunity! Ask your provider for a prescription. Upcoming workshops starts March 7th at the Market Street Clinic in Spokane, April 9th in Clarkston, WA, and April 18th in Lewiston, ID.
For a complete list of Healthy Living workshops log on to www.chas.org/healthy-living.

CHAS will be participating in a couple of mommy and baby friendly events in Spokane!  The first event is the Baby Fair, which is held at the Spokane Convention Center on Sunday March 13, 2011 at 11:00 a.m.  At this event CHAS will be represented and will give away some great gift baskets as well as offer some great activities for the audience.  Please come by and learn more about what CHAS can offer you and have a little fun while doing it!

CHAS will also be present at the first ever Mother’s Gala hosted by Community  Health Education & Resources (CHER) at the Glover Mansion on Saturday March 26, 2011 from 10 a.m. to 2 p.m.  This event is focused on finding a balance between motherhood and personal life and will offer information about women’s health and wellness.  Both of these events are great opportunities to learn more about what Spokane has to offer for the women and mothers in our community.   So come by and see us at one or both of these fantastic events!!  See you there!