Rogue Valley Medical Center Health Newsletter Summer 

INTHISISSUE
ASSET Program . . . . . . . . . . . . . . . . . 2
Skin Cancer Prevention . . . . . . . . . . 4
Future of Spine Surgery. . . . . . . . . . 6
Backpack Safety. . . . . . . . . . . . . . . . . 8
Mediterranean Wrap Recipe . . . . . 9
Navigators Help
Psychiatric Patients. . . . . . . . . . . . . . 10 Roger and
Lindy Rife
Primary Stroke Center . . . . . . . . . . . 11 ASSETprogram changed
Community Health Education . . . . 12 the lives of Roger and Lindy Rife.
Story on page 2

It’s Not Always an Elephant on Your Chest
M
any think a heart attack feels like an
elephant on the chest. But that is not
always the case. Roger Rife of Yreka,
California, knows this all too well. A retired
policeman, Roger moved from southern California
to the beautiful Yreka area with his wife, Lindy.
They had a brand-new house,
and they were busy getting
everything moved. “We
“I looked a little pale, but only to survive but to
everyone figured, Well, he’s
also enjoy an active life.” work together to immediately
working hard,” Roger recalls. “I
—Kent Dauterman, MD
kept having this gastric condition,
like heartburn, really bad.” But
he had none of the classic heart attack symptoms:
chest, back, neck, or arm pain or shortness
of breath.
Before Roger was to make a return trip for
some of their furniture, the heartburn became
intense. Lindy insisted he see a doctor. That may
well have saved his life.
His physician, Stephen Kolpacoff, MD, did an
EKG (electrocardiogram) in his office. The results
Roger Rife
2 | To find out more about the ASSET program, go to www.rvmc.org, keyword: ASSET
One Man’s Experience with the ASSET Program
were a shock: Roger was having a heart attack—a
big one—right now. Dr. Kolpacoff got Roger to
Fairchild Medical Center in Yreka. The emergency
department physician, Henry Edelstein, MD,
activated the ASSET program, and the ambulance
brought Roger directly to Rogue Valley Medical
Center (RVMC).
With the ASSET program,
want patients not hospitals and ambulance
services throughout the region
transfer patients suspected to
be having a heart attack to the
Heart and Vascular Center at
RVMC. They call ahead so that the heart team is
ready for the patient.
“I went straight through the Emergency
Department to the cardiac cath lab,” recalls
Roger. “They were standing there, waiting for me.”
Within minutes Kent Dauterman, MD, of
The Heart Clinic of Southern Oregon & Northern
California, PC, ran a tiny wire through Roger’s
arteries to the site of the blockage and opened it
using a stent, a scaffoldlike device that props
open arteries.
“I felt better immediately,” Roger says.
“Mr. Rife was having a large heart attack, but
by our opening the artery rapidly, he ended up with
only a small amount of heart damage,” explains
Dr. Dauterman, adding that Roger has made a
complete recovery.
A normal heart pumps 50 to 60 percent of the
blood out of its main pumping chamber every time
it squeezes. “His heart is at 55 to 60 percent, so he still
has a good V-8 engine.”
“In my job I saw a lot of hospitals—and never saw
anything like this,” says Roger. “I just cannot believe
the concern and the treatment you get there.”
Dr. Dauterman, a board-certified cardiologist, and
his staff have also helped Roger live a healthier life.
Thanks to their encouragement and education, he has
quit smoking, changed his eating habits, and is taking
medication that helps the heart recover and reduces
the likelihood of another coronary event.
“We want patients not only to survive but to also
enjoy an active life,” says Dr. Dauterman. “Mr. Rife
shouldn’t have any limitations.”
“They are committed to healthy people,” says
Roger. “I feel better, I breathe better—the whole shot.”
What Is the ASSET Program?
The coronary arteries are the fuel lines that bring
oxygen-rich blood to the heart muscle so that it can
work. In a heart attack, blood flow is cut off.
Time is muscle. To reduce the time from heart
attack to opened arteries, a unique partnership called
ASSET (Acute ST-Segment Elevation Task Force)
was established in 2003.
ASSET is an agreement among five local
hospitals and eight emergency ambulance services to
immediately route heart attack patients directly to
the RVMC Emergency Department, where they go
straight to cardiac catheterization. This program
has saved more than 800 lives and helped patients
maintain their quality of life. Forty years ago a major
heart attack carried a 30 percent risk of death. With
medication, balloons, stents, and the ASSET program,
the mortality rate in our region has decreased to
3.8 percent (the national average is 8.7 percent).
WhatAretheSymptoms
ofaHeartAttack?
A s Roger Rife learned, it’s not
always chest pain. If you have
any of the following symptoms,
you may be having a heart aack.
Dial 9-1-1.
• 50 percent of patients have chest
heaviness, pressure, tightness, or
squeezing—the classic elephant
on the chest.
• 30 percent of patients have
symptoms that are more challeng-
ing to sort out: shortness of
breath, indigestion, or neck, jaw,
or arm pain.
• 20 percent of heart aacks are
“silent,” meaning that patients
don’t have any symptoms other
than fatigue and weakness. If
you are feeling short of breath
or tire quickly doing your usual
activities, see a doctor.
| 3

Enjoy the Great Outdoors but Be Nice to Your Skin
S W
outhern Oregon is a hotspot for skin cancer,
says dermatologist David Trask, MD. A 2008
study ranked Oregon sixth in the nation in skin
cancer, and incidences of skin cancer in southern Oregon
are higher than in the rest of the state. It’s sunny and
there’s lots of outdoor recreation and work. In addition,
many retired residents in the Rogue Valley traditionally
worked in forestry, logging, farming, and ranching—all
occupations where spent a lot of time outdoors.
“It’s absolutely an issue here,” says Dr. Trask, adding
that the incidence of skin cancer since 1988 has gone from
one in 250 to one in 70. “You need to protect yourself,
especially in the summer months when the sun’s ultraviolet
rays are the strongest.”
Be Savvy in the Sun
• Do not get sunburned. One severe sunburn is more
likely to result in skin cancer than repeated exposures
that are mild, says Dr. Trask. “People used to think it
was okay to go to the beach occasionally and get fried,”
he says. “We know better now.”
• Keep children protected. “It’s sun you have by age 20
that will haunt you later,” says Dr. Trask. “Just one severe
4 | To find out more about being safe in the sun, go to www.rvmc.org, keyword: skin cancer
sunburn for a child can lead to problems
later in life.”
Ultraviolet (UV) rays,
which cause skin cancer, are
strongest from noon to 2 p.m.
• Wear sunscreen. Dr. Trask recommends
a sunscreen with a sun protection factor
(SPF) of 30. There are more-expensive
sunscreens with higher ratings, but they
have diminishing returns. Apply sunscreen
evenly over exposed areas one half hour
before going out so that it penetrates the
skin. Sun rays deactivate the blocking
chemical in sunscreen, so reapply it every
two to three hours or every time you get
out of the water, even if the label says it is
waterproof.
• Cover up. UV rays penetrate clothing,
especially cotton. Dr. Trask recommends
wearing light sunscreen under your shirt
and wearing clothes made from tightly
woven material. There are fabrics that block
UV rays. Read the label on the clothes.
• Enjoy the shade when the sun is most
intense. Ultraviolet rays, which cause
skin cancer, are strongest from noon to
2 p.m. and in the summer months. In
the morning and evening hours, the sun
is at an angle to the atmosphere, so less
UV light gets through.
• It’s never too late to be safe in the sun.
Even if you are older and have had a lot
of sun damage, Dr. Trask says covering
up and wearing
sunscreen can
reduce your
risks or severity
SP
of skin cancer. F-
30
• Have fun. Don’t
totally avoid the
sun, but be smart.
PreventSkinCancer﹕
BeYourBestAdvocate
ith cancer early detection is the key
to a cure. Dr. Trask recommends
doing a skin self-exam every month: “You
can see 95 percent of your skin on your
own. We ask people to put aside a day of
the month they can reliably remember.”
Look for spots that are new or changing
in color, size, or texture. For example, if
a spot was flat and smooth last month
and this month it is raised and rough, you
should get it checked.
“And age is important,” says Dr. Trask.
“The older we get, the more we worry
about a new growth.”
A monthly self-exam is very important,
but you should also be examined by your
doctor or a dermatologist at least once
a year. Not all skin cancers are visible or
easily detected through a self-exam.
For more information contact your
family physician or call a dermatologist.
| 5

The Future of Spine Surgery
N
eurosurgeons at Rogue Valley Medical Center
(RVMC), the spine surgery leader in southern
Oregon, are now using the most advanced
image-guided system for back surgery: the O-arm
Multidimensional Imaging System.
Precision is critical to success in spine surgery.
Surgeons at Medford Neurological and Spine Clinic
chose the O-arm because it provides precise, detailed
imaging to help them get exact alignment and
placement of instruments and implants.
The O-arm is a portable imaging device with a
C-shaped arm that fits over the surgical table to take
traditional two-dimensional X-ray images. During
surgery it converts to an O-arm like a CT scanner
to take three-dimensional images in real time so that
surgeons can track placement and alignment of the
spine and the implants during surgery.
“This is a tremendous advance,” says Donald A.
Ross, MD, a board-certified neurosurgeon. Dr. Ross
said he first saw the new $650,000 system in 2007 and
had been working to bring it to RVMC ever since.
Dr. Ross and David H. Walker, MD, a fellowship-
trained spinal neurosurgeon, says the O-arm gives
6 | Read more about the O-Arm Multidimensional Imaging System at www.rvmc.org, keyword: O-arm
Is Here Now at Rogue Valley Medical Center
surgeons incredible three-dimensional views of
spinal anatomy and implant hardware, resulting in
greatly improved accuracy and the ability to make
adjustments at the time of surgery.
“RVMC is the only hospital
between Seale and
San Francisco providing
O-arm surgery.”
—Donald Ross, MD, Neurosurgeon
“Safety and time are critical in the operating
room,” says Dr. Walker, director of neuro and
spine services at RVMC. “The O-arm offers
multidimensional images in about 30 seconds
and real-time imaging not offered by other
technologies. This allows maximum safety.”
Initially intended for use in spinal and orthopedic
procedures, the O-arm system features the design
flexibility to allow for expansion to additional surgical
GettingItRight
theFirstTime
D uring a spine surgery (see
applications. RVMC operating-room manager Kristi
Blackhurst, RN, expects the O-arm to be used in photo below), Miroslav P.
cranial surgeries as well. Bobek, MD, views a screw he is
using to repair a vertebra as he
Patient Benefits places it. This allows for exact,
• Safer, more accurate placement of spinal precise, and safe placement.
instruments for improved surgical outcomes
Without the O-arm, surgeons must
• Less time in surgery install instruments without a real-
• Reduced risk of the need for repeat surgery time view and must look at X-rays
• Less radiation exposure from imaging later to see if they are correctly
located. If not, they must do
Features
surgery again. The O-arm prevents
• CT imaging without leaving the operating room the need for repeat surgeries.
• “Smart” system remembers positioning, so the
O-arm can return to preset positions for imaging
• Surgeon can view implants in real time during
insertion
Neurosurgeons Using the O-arm at RVMC
Medford Neurological and Spine Clinic Providers:
Donald A. Ross, MD; Miroslav P. Bobek, MD;
David H. Walker, MD; and Thomas J. Altstadt, MD
| 7
 Don’t Let Back to School Mean Back Pain for Your Child
W
hen you send your kids off to
school this fall, make sure their
backpacks are fitted and used
correctly. Backpacks that are too heavy or
misused can lead to severe back, neck, and
shoulder pain as well as posture problems for
your child.
A loaded backpack should not exceed
15 percent of a child’s body weight. “Get
one that is not too big. If your child can
stuff 30 percent of his or her weight into
it, it is not appropriate,” says Margaret
Rawlings, physical therapist at Rogue Valley
Medical Center.
Margaret provides these guidelines for
a good fit:
• Posture is important. The shoulders should
line up with the hips when you look at
the child from the side. If the child is bent
forward, the pack is too heavy or does not
fit right.
• Make sure the backpack rests high. With
straps tightened, it should fit close to the
8 |
body and not hang more than 4 inches
below the waistline.
• The shoulder straps should be padded,
wide, and adjustable; the wider the strap,
the better.
• Use both straps. Many kids sling the pack
over one shoulder. This may cause them to
lean to one side, stressing the spine, which
may cause injury.
• Find a pack with multiple compartments
so that weight can be evenly distributed.
• Look for packs with additional padding
near the lower back and hips, and a waist
belt to help distribute the load more evenly.
• If the child has back, shoulder, or neck
pain or tingling, numbness, or red marks
that don’t go away, make adjustments
immediately.
• Don’t buy cheap. If you go with these
recommendations, you are going to get
a good backpack.
A Heart-healthy Meal in the Hot Summer Months
By Nicole Hanks, Registered Dietitian, Outpatient Nutrition Counselor, Rogue Valley Medical Center
I
t’s roasting outside, but you can stay
cool and healthy with some delicious
Mediterranean garden wraps and seasonal
Oregon berries for dessert.
Recent research reviewing 50 years of
studies has weeded out the diets that claim to
be healthy and found that the Mediterranean
diet, which includes incorporating plenty
of vegetables, legumes, fruits, nuts, whole
grains, fish, and small amounts of cheese or
yogurt, legitimately promotes heart health.
A major study on fruit and vegetable
antioxidant content in the Journal of
Agricultural and Food Chemistry (June 9,
2004) found that berries provide many
antioxidants for the dollar. Antioxidants
are disease-fighting compounds that help
prevent the stress of oxidation and promote
cell health.
Why heat up your kitchen when you can
stay cool and healthy with these recipes?
Mediterranean Garden Wraps
Make this extra wonderful by purchasing your vegetables at your local farmers’ market.
INGREDIENTS
1 cup Greek or low-fat yogurt, or hummus
1 tablespoon each chopped fresh mint, chives,
and cilantro
1 cup each shredded carrots, sliced cucumbers,
or any delicious fresh vegetables you have on hand
½ cup sliced red onion and/or cooked peas
4 sheets whole-wheat lavash (a soft, Mediterranean
flatbread found in most grocery stores) or whole-
wheat tortillas
2 tomatoes, halved and thinly sliced
INSTRUCTIONS
In a small bowl, combine yogurt and herbs; set
aside. In a medium bowl, combine carrots and
other vegetables except tomato slices.
For more healthy recipes, go to www.rvmc.org, keyword: recipes
Across the center of each flatbread, spoon the
yogurt, add sliced tomatoes, then arrange the
vegetable mixture over the tomatoes. Fold the
flatbread over the vegetables, roll up, and enjoy.
OREGONBERRIES
Serve with a side of seasonal Oregon berries
topped with yogurt. You can also freeze berries
individually by spacing them on a tray in
the freezer. Local blueberries are fresh in July
and August; and in August and September,
blackberries are at their best!
Serves 4
Per serving: 385 calories; 5 g fat; 571 g sodium;
✃
67 g carbohydrates; 30 g sugar; 20 g protein;
11 g fiber; and 5 g cholesterol
| 9
 RogueValleyMedicalCenter BecomeaPart
Navigators Help Psychiatric Patients through $250,000 Grant IsanAccreditedPrimaryStrokeCenter ofYourCommunity

A sante is a community-supported

T R
he Asante Foundation recently prescription refills, and medication side
received $250,000 from the Regence effects—a primary reason why patients stop
Foundation to launch Navigating taking prescribed medications.
Troubled Waters, a program for patients The navigators are at La Clinica,
with mental illnesses. Community Health
In Jackson and Centers, and Rogue
Josephine counties, In Jackson and Josephine Valley Medical Center’s
mental health treatment Emergency Department.
counties, mental health
is identified as the greatest “We see a lot of
treatment is identified as
unmet need. Jackson mental health patients
County has the third- the greatest unmet need. in the emergency room
highest rate for psychiatric because they simply
hospitalizations in Oregon. don’t have anywhere else to turn,” says
“Southern Oregonians shouldn’t have Richard Phillips, MD, a psychiatrist at the
to travel hundreds of miles for essential care hospital. “What might have been managed
or, worse, to go without it,” says Michael in the community, had the resources been
Alexander, Regence Foundation board chair. available, then becomes a crisis, which is
Navigating Troubled Waters will train usually much more difficult to treat.”
three patient care coordinators, called The Asante Foundation is always
navigators, to work with patients to help working to improve the health and
prevent mental health crises and provide wellness of the community. To learn how
a rapid response when one occurs. They you can help, call the Foundation at
will also monitor medication management, (541) 789-5025.
esearch has shown that stroke patients by dissolving the blood clots that are causing the
treated at a certified Primary Stroke stroke. After the three-hour mark, tPA is no longer organization. To support the work
Center have better outcomes. This is beneficial, although there are other treatments that we do at Rogue Valley Medical Center
a result of these centers’ using evidence-based can improve outcomes. or Three Rivers Community Hospital,
protocols to guide the treatment of stroke patients. At Rogue Valley Medical Center, every stroke to honor someone, or to learn about
If you are experiencing strokelike symptoms, call patient gets a CT scan of the brain and laboratory planned gis, contact the Foundation
9-1-1 immediately. tests upon arrival so that doctors can determine in Medford at (541) 789-5025, in
If a stroke patient arrives at the hospital within what kind of stroke the patient is having. Patients Grants Pass at (541) 472-7300, or
three hours of the onset of symptoms, patients may who receive tPA will spend the first 24 hours in online at www.asante.org—click on
make a donation.
qualify to receive a medication called tPA (tissue the Intensive Care Unit so that nurses can monitor
plasminogen activator), which can halt damage them carefully.
KnowtheWarningSignsofaStroke
Know the symptoms and what to do if you experience them:
• Sudden numbness or weakness of the 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, difficulty walking, or loss of balance or coordination
• Sudden severe headache with no known cause
If you experience any of these symptoms, call 9-1-1 immediately—
you may be having a transient ischemic attack (TIA) or a stroke.

10 | Read more about the Asante Foundation at www.rvmc.org, keyword: foundation To make a gi, go to www.rvmc.org, keyword: giving | 11
Asante Community
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