Three Rivers Community Hospital Health Newsletter June 

INTHISISSUE
TRCH Cardiovascular Lab . . . . . . . 2
Anticipating Your Pregnancy . . . . . 4
Spine Surgery at TRCH . . . . . . . . . . 6
Healthy Eating This Summer. . . . . . 8
Heart-healthy Recipe . . . . . . . . . . . . 9
Keeping Babies Close to Home . . . 10
Calendar of Events . . . . . . . . . . . . . . 11
Your Health Goes Green . . . . . . . . . 12

TRCHCARDIOVASCULARLAB | page 2
Taking Care of Your Heart TRCH Cardiovascular Lab
P
atients in Josephine County and
surrounding areas can now get
advanced diagnostic imaging
of their hearts and vascular systems as
well as treatment for peripheral vascular
disease in the new cardiovascular lab
at their local hospital, Three Rivers
Community Hospital (TRCH).
The state-of-the-art cardiovascular
and interventional radiology lab
allows cardiologists and interventional
radiologists to examine patients for
blocked arteries, heart disease, and
other conditions using a procedure
known as angiography. Last year the
hospital sent some 400 patients to Rogue
Valley Medical Center in Medford for
angiography procedures.
“This is a dramatic improvement
for our patients,” says Brad Personius,
MD, a board-certified cardiologist with
Cardiology Consultants of Grants Pass.
“With easier access to angiography,
2 | Read more about the new cardiovascular lab at www.trch.org, keyword: cardiovascular
we can expect better outcomes for our
heart patients.” Dr. Personius added
that patients who need further medical
therapy will continue to receive care close
to home. Those who need open heart
surgery or a coronary stent can be
moved to Rogue Valley Medical Center,
a nationally recognized heart center.
To perform an angiogram, a doctor
guides a tiny wire to the heart or artery
and injects contrast dye that will show up
on an X-ray. The result is vivid pictures
of the heart and the arteries, which
the doctor can see live on a computer
monitor and spot exactly where there
are blockages or other problems with
the heart, arteries, and other systems to
determine the following:
• If arteries supplying blood to the heart
muscle have become narrowed
• If the patient needs a stent—a scaffold-
like device to prop open blocked
arteries or ducts

• If the patient needs heart or vascular
surgery
• If there is an aneurysm (a bulge on an
artery caused by a blood vessel wall
becoming weaker)
“We can expect beer
outcomes for our heart
patients.” —Brad Personius, MD
Interventional radiologists will perform
many procedures in the lab, including
biopsies; opening blocked peripheral
arteries in the arms and the legs; relieving
obstructions and draining abscesses in the
liver, gallbladder bile ducts, and kidneys;
inserting ports for use in chemotherapy; and
embolizations for life-threatening traumas,
spontaneous internal bleeding, and to cut
off blood flow to tumors.
“We are very excited to use our
interventional radiology advanced training
to do many procedures, both routine and
advanced,” says Marcus Bryner, MD, an
interventional radiologist.
“It’s all part of an ongoing effort to bring
better heart and vascular care to the area,”
says Win Howard, CEO of TRCH. “Three
Rivers is a strong community hospital.”
In recent years TRCH, working with
its physician partners, added cardiac
rehabilitation services, installed a system
for fast computer retrieval of X-rays, and
introduced advanced 64-slice CT scanning
technology to the hospital to make high-
quality images of the heart and the vascular
system. With the new cardiovascular lab,
Dr. Personius; Doug Burwell, MD;
and Rick Snider, MD, of Cardiology
Consultants will be testing patients for heart
disease. Radiologists Jonathan Wood, MD,
and Dr. Bryner of Three Rivers Radiology
will provide interventional services.
WhoNeedsanAngiogram?
P atients who show symptoms of coronary
artery disease (CAD) oen get an angiogram.
With CAD, plaque builds up inside the heart
arteries, starving the heart muscle of blood
and weakening it. Over time this can result in
heart failure.
SIGNS OF CAD
Angina is the chest pain or discomfort that
occurs when the heart muscle doesn’t get enough
oxygen-rich blood. This discomfort is oen
described as pressure or tightness that occurs
during physical or emotional stress.
You may also feel discomfort in the chest,
arms, throat, or lower jaw. Frequently, the
discomfort is accompanied by nausea, shortness
of breath, or a cold sweat.
Sometimes CAD does not show signs. If you
have risk factors for coronary artery disease—
smoking, high blood pressure, high cholesterol,
diabetes, or obesity—talk to your doctor.
| 3
 Anticipating Your Pregnancy
P
regnancy is an amazing, life-
changing, and joyful journey.
“And you are already in front
of the eight ball just thinking about it,”
says Felicia Cohen, MD, of the Women’s
Health Center of Southern Oregon
in Grants Pass. “Anticipation is the
first major step to a great pregnancy
and delivery.”
Before You Get Pregnant
Choose your doctor. There are several
good obstetricians in Grants Pass, but
you should find the one who is right for
you. “You need to know that you are
being heard,” says Dr. Cohen. Even after
the first visit, if you are not happy it is
all right to make a change. “You need to
feel empowered. It’s your pregnancy;
it’s your body; it’s your baby.”
Be fit. “Many studies have shown
that pregnancy and labor are easier for
women who are in good shape,” says
4 | Read more about the Women’s Health Center of Southern Oregon at www.trch.org, keyword: your baby
Dr. Cohen. “The pushing phase is
generally easier for women who are fit.”
Be at your target weight. Starting
pregnancy overweight can put you at
risk for pregnancy-induced diabetes and
other health problems. “Ideally, you
should lose that extra weight before
you get pregnant,” says Dr. Cohen.
Take vitamins. “I recommend
prenatal multiple vitamins fortified
with omega-3 fatty acids and folic acid,”
Dr. Cohen advises, adding that low folic
acid intake can result in spina bifida in
the fetus.
Know your risks. Get prenatal
labs and test for sexually transmitted
diseases. If you are not immunized for
diseases such as rubella, get immunized.
Women tend to become anemic during
pregnancy, so make sure you are not
anemic beforehand.
Be healthy. Eat right and quit
smoking and drinking. “Smoking

increases your risk of preterm labor, premature
separation of the placenta, and abnormal
growth of the baby,” says Dr. Cohen. During
pregnancy you should not drink at all. “We
don’t know how much alcohol causes fetal
alcohol syndrome. So don’t drink.”
During Pregnancy
Make regular visits to “You need to feel empowered.
your doctor. This will
It’s your pregnancy, it’s your body,
keep you on track and help
spot any problems before it’s your baby.”
they become serious.
Stay fit. “Exercise
is encouraged during
pregnancy,” says Dr. Cohen. “You can
perform at the same level you are already
exercising until you feel like you can’t.”
Create your birthing plan. “We
always do a birthing plan with our patients,”
says Dr. Cohen. “Be honest about your
expectations, and we will listen. It’s important
to have that trust.”
WhereDoesthe
DoctorHaveHerBaby?
Take birthing classes. Your labor and
delivery will be enhanced when you know
what to do.
T hree Rivers Community Hospital,
designated “Baby-Friendly” by the
World Health Organization and UNICEF,
Pamper yourself. Eat superhealthy foods, is a wonderful, local choice for having your
get plenty of rest, keep taking those vitamins, baby, says Felicia Cohen, MD. “I have had two
and choose positive activities that will help babies there. It’s a great experience. All the
you stay centered nurses are very seasoned, and it’s a beautiful,
and happy; this is new, modern unit.”
a special time—so The TRCH Family Birth Center has
make it special. private, spacious rooms with the conveniences
“You are of home and a Jacuzzi bath. “And you have
preparing for your labor, delivery, and recovery all in the
—Felicia Cohen, MD what may be the same room,” says Dr. Cohen. “It’s the closest
most important thing to delivering at home, but you are still
part of your life,” in a hospital seing.”
says Dr. Cohen. “And I love being part of Staff and physicians at TRCH are also
people’s lives in that way, from the first flexible with your birthing plan. “You choose
day of pregnancy to delivery.” whether you want an epidural or not; you
To learn more aboutut preparing can choose to use a birthing ball if you like.
for your pregnancy, call the They make the birthing experience as positive,
Women’s Health Centerr of comfortable, and supportive as possible.”
Southern Oregon at
(541) 479-8363.
| 5
Spine Surgeon Rounds Out Orthopedic Services

J
osephine County patients needing spine surgery
now have a local choice. Bryan Gunnoe, MD,
a fellowship-trained orthopedic spine surgeon,
has recently joined Paragon Orthopedics in Grants
Pass. He is performing a full range of advanced,
minimally invasive surgeries at Three Rivers
Community Hospital and is on call for emergency
surgery, especially spine trauma.
“I am very impressed with the hospital,”
says Dr. Gunnoe. “It has well-equipped surgery
rooms with a skilled staff who have welcomed
me enthusiastically.”
Dr. Gunnoe rounds out orthopedic services in
the area, as he is the only spine surgeon in Josephine
County. Knee and hip replacement surgery and
sports-related surgeries are already provided by other
surgeons in Grants Pass.
“We live in the community, and people can
get the surgery they need right here in Josephine
County,” says Dr. Gunnoe, adding that people
traveling out of the county may have a long wait just
for an appointment.
Dr. Gunnoe discovered his passion for doing

6 | Read more about spine surgery at www.trch.org, keyword: spine


spine surgery early in his medical training. As a
resident at Loma Linda University Medical Center
in California, he performed more than 200 spine
surgeries and did another 300 cases during his
fellowship in Charlotte, North Carolina. Since he
entered practice in 1995,
he has been specializing
in spine surgery. Dr. Gunnoe is a fellowship-trained
There are many
reasons why Dr. Gunnoe orthopedic surgeon specializing in
has devoted his career spine surgery since 1995.
to spine surgery, but the
most important one is his
patients. He recalls one case, a 24-year-old who
crashed on his quad bike and suffered a fracture
at the neck. He had misplaced vertebrae and was
beginning to have compression of the spinal cord.
There were already signs of paralysis. Dr. Gunnoe
was in surgery for five hours and had to roll the
patient over to work from both the back and the
front of the neck.
“It was scary, a bit dicey,” he says. “I had so
much adrenaline going, but knowing I could
do it right there, in that small hospital, was very
gratifying.” The patient did well and had a full
recovery. “And that’s the real reason for me to be
doing this. It’s the relationships with the patients.”
Dr. Gunnoe says he has come to Grants Pass
because he enjoys working
in a smaller hospital with
advanced care where he can
be a part of the community.
He was also drawn to the
area for its beauty and
great outdoor activities. He
especially enjoys bicycling
and hiking in the mountains.
For more information contact Paragon
Orthopedics at
(541) 472-0603.
Dr. Gunnoe
at the microscope
during a spine
surgery procedure
AdvancedSpine
ProceduresatTRCH
B ryan Gunnoe, MD, is performing
many advanced, minimally
invasive spine surgeries right here
in Grants Pass. One of them is
called kyphoplasty. It is for repair of
compression fractures in the spine
usually caused by osteoporosis.
When a vertebra collapses, it
results in curvature of the spine
and can be very painful. With
kyphoplasty, Dr. Gunnoe inserts
a small catheter through the back
and into the vertebra, where he
inflates a balloon, returning the
vertebra to its proper shape; he
then injects plastic cement to keep
it in position.
For the right patients,
kyphoplasty is a safe procedure
involving a tiny incision that can
greatly relieve pain and straighten
the spine.
| 7
Healthy Eating This Summer By TRCH Dietitian Jill Calamar, RD, LD, CDE

S
ummer heat is coming, and it’s a great
time for cool, refreshing meals packed
with healthy ingredients that can help
reduce your risks of cancer, diabetes, heart
disease, and obesity.
Healthy eating puts a special emphasis
on plant foods such as brightly colored
vegetables and fruits, beans
and nuts, and whole-grain
breads and cereals. It also “Start with a stroll through
includes moderate amounts
of low-fat dairy products,
your local farmers’ market.”
fish, poultry, lean meats,
and vegetable fats low in
trans fats. Foods should be
tasty and prepared using cooking methods
that need little fat, such as baking, broiling,
stir-frying, grilling, and microwaving. Use
salt sparingly and add flavor with interesting
herbs and spices. Remember to round out
your food intake with physical activity; try to
get 30 minutes of exercise every day.
During the hot months, a salad can be
a smart main-dish choice. Build a base of
dark leafy greens—be adventurous and try
some new greens—as well as brightly colored
garden veggies such as tomatoes, cucumbers,
radishes, and peppers. Add starchy vegetables
like peas and corn, and also beans—kidney
or garbanzo—for protein. You can also
choose about 2 ounces
of lean protein such
as chicken, fish, or
mozzarella cheese. Top it
with a light vinaigrette
—Jill Calamar made with olive oil,
vinegar, and fresh herbs.
You can also opt for side
dishes of summer fruit—berries or melons
topped with low-fat yogurt—and a slice or
two of whole-grain bread.
To get your meal started, try a stroll
through your local farmers’ market and
explore the bounty of healthy salad fixings
and whole-grain breads.

8 |

Jazz up your summer eats with this heart-healthy main-dish salad.
Black-eyed Peas and Cheese Salad
INGREDIENTS
15-ounce can black-eyed peas, drained
¾ cup diced low-fat cheddar or
mozzarella cheese
⅔ cup diced red bell pepper
½ cup diced green bell pepper
½ cup diced cooked chicken breast
or lean ham
¼ cup finely chopped sweet onion
¼ cup diced celery
½ cup plain low-fat yogurt
½ cup fat-free mayonnaise
2 teaspoons red wine vinegar
¼ to ½ teaspoon hot red pepper sauce
4 leaves lettuce
INSTRUCTIONS
• Rinse peas under running water
(to remove excess salt) and drain.
• Combine peas, cheese, pepper, meat,
onion, and celery.
• In a separate bowl, stir together yogurt,
mayo, vinegar, and pepper sauce. Toss
with salad. Refrigerate 1 hour for flavors
to blend. Serve over lettuce leaves.
Makes 4 servings. Each serving has
200 calories, 13 grams of protein, 22 grams
of carbohydrates, and 8 grams of fat.
✃
For more healthy recipes, go to www.trch.org, keyword: recipes
AntioxidantsforHealth
T he U.S. Food and Drug Administration
(USDA) says foods rich in antioxidants
can be very beneficial to your health. The
USDA recommends 1,750 Oxygen Radical
Absorbance Capacity (ORAC) units per
day. The best sources are fresh fruits and
vegetables. Here are some you can find at
your local farmers’ market that are rich in
antioxidants.
ORAC value per 100 grams
(approximately 3 ounces)
Fruits Vegetables
Pears . . . . . . . . . . .2,941 Kale . . . . . . . . . . . 1,770
Apples . . . . . . . . 2,828 Eggplant . . . . . . . . 933
Blueberries . . . 2,400 Broccoli . . . . . . . . 890
Blackberries . . . 2,036 Bell peppers . . . . .710
Red grapes. . . . . 1,260 Corn . . . . . . . . . . . 400
| 9
Screening Babies Before They Go Home TRCH Foundation

O
ften one hears the happy sounds of born at TRCH need this test. In the past year,
newborns and their families at the 113 TRCH families had to take their babies to
Family Birth Center at Three Rivers RVMC for a hearing test.
Community Hospital (TRCH). Unfortunately, “It is often difficult for many struggling
some babies have trouble hearing those families to arrange time and transportation out of
joyous sounds. the Josephine County area to
Staff members deliver get this important follow-up,”
more than 800 babies Last year more than says Rashell McClintock, RN,
there every year. Each manager of the TRCH Family
tiny miracle receives a 113 babies and their families Birth Center. “It creates a lot
hearing evaluation. If had to travel to of turmoil and anxiety for
there is a problem, the them, wondering if their baby
baby must have a more
Rogue Valley Medical Center may have a hearing deficit as
advanced follow-up for advanced hearing tests. they wait for that follow-up
known as an automated appointment and the results.”
auditory brainstem The Four Way Community
response (AABR) test. It provides an in-depth Foundation has stepped in to help in the
assessment of hearing function, with the ability to purchase of AABR technology. It is providing
record the entire pathway of the ear through the $5,000 toward the purchase of the $15,000
auditory nerve to the brainstem. AABR equipment. The TRCH Foundation is
To do that, the baby must travel to Rogue asking community organizations and individuals
Valley Medical Center (RVMC), some 35 miles to match and then surpass this award with a
away in Medford. About 20 percent of babies goal to fully fund the cost.

10 | To make a gi, go to www.trch.org, keyword: giving


“I am confident that providing the
necessary follow-up with an AABR right
here in our community will be of great
value for our families,” says McClintock. Of
the 819 infants born at TRCH in the past
year, 45 were recommended for diagnostic
evaluation after an AABR. Two of these
were confirmed for hearing loss. “This early
detection leads to early intervention, which
leads to optimal outcomes for those who
are affected,” McClintock continues,
adding, “It will also alleviate unnecessary
stress and anxiety for new parents; and,
given the current economical challenges, it
is of great value for them when they do not
have to travel out of their community for
healthcare services.”
The TRCH Foundation is seeking
$10,000 in support. Your contribution
can make a big difference in the lives
of the hospital’s tiniest patients. To
learn more about how you can help,
call (541) 472-7300.
If you wish to be removed from our
mailing list, please contact Asante
Communications and Marketing at
(541) 789-4241. Articles in the TRCH Your Health
newsleer are intended for general information
only and should not be construed as medical
advice or instruction. For diagnosis and treatment
of specific conditions, consult your physician.
CommunityHealthEducation
Stroke﹕KnowtheWarningSigns
If you or someone else experiences any of these
symptoms, call 9-1-1 immediately—it may be a stroke. Even
if the symptoms, resolve in a few minutes, still call 9-1-1!
• Sudden numbness or weakness of face, arm, or leg—
especially on one side of the body
• Sudden confusion or trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden dizziness, trouble walking, or loss of balance
or coordination
• Sudden severe headache with no known cause
Learn more about stroke prevention at our TRCH community
talks this fall. To request a Community Health Education
events calendar, call (888) 688-4920 or visit www.trch.org.
BecomeaPartofYourCommunity
A sante is a community-supported organization.
To support the work we do at Three Rivers
Community Hospital or Rogue Valley Medical
Center, to honor someone, or to learn about planned
gis, contact the Foundation in Grants Pass at
(541) 472-7300, in Medford at (541) 789-5025, or
online at www.asante.org—click on make a donation.
| 11
 ThreeRiversCommunityHospital
NONPROFITORG
HelpsHealtheEnvironment USPOSTAGE

PAID
PERMITNO

T
hree Rivers Community Hospital is becoming more SWRAMSEYAVE MEDFORDOR

environmentally friendly. The hospital is using GRANTSPASSOR-

sustainable-earth cleaning products; recycled and
compostable paper products; reducing plastic and paper
usage; making the change to paperless medical records; and
developing an all-new facility plan to become Leadership
in Energy and Environmental Design (LEED) certified to
significantly lower its use of water and energy.
As part of this plan, this newsletter is now printed in
a smaller size on all-recycled paper made from farmed trees,
using eco-friendly soy-based inks. In doing so, every issue of
the new Your Health newsletter is saving 128 cubic feet
of wood while using 64 percent less energy and water and
creating 74 percent less air pollution. Another benefit:
this smaller size saves more than $12,000 annually
in postage, freeing funds for improved
patient care.

© Asante Health System.

All rights reserved. No part of this
publication may be reproduced in
any form except by prior wrien
TRCH

permission. Printed with soy ink

on recycled paper. ♼

View Your Health online at www.trch.org, keyword: newsleer