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The latest on COVID-19 vaccines (July 20, 2021) 

  • Grants Pass Clinic is giving COVID vaccines
    • We now have all the vaccines we can handle, so we’re giving COVID vaccines to anyone age 12 or older.
  • We are giving the Pfizer vaccine
    • The 3 vaccines with emergency use authorization in the U.S. are made by Pfizer-BioNTech, Moderna, and Johnson & Johnson. With the Johnson & Johnson vaccine being temporarily withheld from the market, we’re giving the Pfizer vaccine. It’s given as 2 shots 3 weeks apart.
  • What’s the deal with the Johnson & Johnson vaccine?
    • A very small number of patients (<10 out of nearly 7,000,000 vaccine recipients) developed a blood clotting disorder within 2 weeks of receiving the Johnson & Johnson vaccine, so the CDC took a ”pause” in using the vaccine until it could be better understood. This problem has not been reported with the more than 180,000,000 doses of the Pfizer or Moderna vaccines, so we’re still using those. Because of the way the vaccine is made, this complication is likely to be from only the Johnson & Johnson vaccine or the AstraZeneca vaccine, which hasn’t gotten U.S. approval.
    • The Johnson & Johnson vaccine is also being studied for a possible connection to Guillain-Barré syndrome. At this point, neither the Pfizer vaccine nor the Moderna vaccine are suspected to cause Guillain-Barré syndrome.
  • Will the vaccine cause heart trouble?
    • There have been rare cases of heart inflammation (myocarditis and pericarditis) after getting the Pfizer and Moderna COVID-19 vaccines. Cases are usually mild and occur most often in adolescent and young adult males age 16 and older.  It is still recommended that all people age 12 and older get the vaccine, as the benefits of the vaccine far outweigh the potential risks.
  • How do I schedule a vaccine?
    • Call us at 541-476-6644 and get transferred to the COVID vaccine hotline. We also take walk-ins, but an appointment works better.
  • Where are the vaccines being given?
    • Grants Pass Clinic, located at 495 SW Ramsey Avenue in Grants Pass.
  • How much does it cost?
    • Nothing is free, but the vaccine has already been purchased by the federal government and our costs are covered by the County so we aren’t charging for the vaccine or its administration. We won’t bill you or your insurance company anything.
  • Can I get a $25 Visa Rewards card?
    • Yes! Josephine County Public Health supplied us with gift cards to give to anyone who gets a COVID-19 vaccine at Grants Pass Clinic.  This offer is not retroactive.
  • What about vaccine supply shortages?
    • What we have is a demand shortage: not enough people are getting the vaccine. The disease has killed 1 out of every 50 county residents who have been diagnosed with COVID (62 deaths out of 3063 cases as of April 19), so getting the vaccine is clearly the smart thing to do. The vaccine is way easier than having even a mild case of the disease.

What? Dress in Blue Day lets allies everywhere join our mission to end colorectal cancer. By wearing blue you bring awareness to this disease—as well as honor all who are impacted by colorectal cancer.

When? Dress in Blue Day is Friday, March 6. All of March is National Colorectal Cancer Awareness Month.

Why? This year, more than 147,000 people will be diagnosed with this highly preventable disease. They will join more than 1.4 million colorectal cancer patients and survivors living today. We go blue for them, their families, and their community.

Anyone can get colorectal cancer (CRC). The lifetime risk for colorectal cancer is 5%, or one in 20. Colorectal cancer affects both men and women, as well as people of all ages, races, and ethnicities. It is one of the only truly preventable cancers thanks to screening.

In March 2014, American Cancer Society released data showing colon cancer incidence rates have dropped 30% in the U.S. in the last 10 years among adults ages 50 and older due to the widespread uptake of colonoscopy, with the largest decrease occurring in those ages 65 and older.

The likelihood of dying from colorectal cancer has been decreasing due to screening.

Over 60% of deaths from colorectal cancer could be avoided with screening.

Over 90% of people diagnosed with colorectal cancer are over age 50. As we age, we are more likely to grow colon polyps which may undergo gene changes that turn normal tissue into cancer.

Talk to your Doctor about appropriate screening  (including colonoscopy) to decrease your risk. I am happy to meet you in the office or even at the facility to get your colonoscopy done.   Call us at GP Clinic to set it up at your convenience.

What else you can do to decrease your risk:

Don’t smoke, and if you do, stop smoking

Increase your physical activity (get at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity each week)

Maintain a healthy body weight

Avoid overall body fat, especially fat around your waist

Reduce how much red meat and processed meats you eat

Check out this great resource – https://fightcolorectalcancer.org/

Don’t forget to wear blue!     – Andrew Pitzak D.O.

“What is a NP or PA?”

          “My Doctor recently retired and I have been assigned to a new provider, but they are a Nurse Practitioner or a Physician Assistant. What does that mean, and what is an NP or a PA?” This is a common scenario that may have happened to you, and it may be a bit confusing.

            Both “PAs” and “NPs” have become an integral part of the healthcare team and are providing needed access to care. This is especially true in the realm of primary care. Due to a number of factors, including less primary care physicians and more patients, there is a shortage of providers to deliver care to all the patients in need. This is where PAs and NPs have become integral to meet the ever increasing demand for healthcare.

            What is the training of these providers? NPs and PAs obtain a Master’s Degree at an accredited school for Nurse Practitioners or Physician Assistants. Most students will have completed a Bachelor’s Degree prior to entering their program. The Master’s program is typically 2-3 years. In addition, prior medical experience is required to apply to a PA or NP program. In the case of NPs, they practice as a registered nurse prior to applying to a Nurse Practitioner program. For PAs they may have experience as a phlebotomist, medical scribe or any number of other healthcare related areas. As with traditional medical school, there are multiple science based undergraduate requirements to qualify for a PA or NP Master’s program. Many of the NP and PA programs are also associated with a medical school that includes training for traditional medical students. The programs for these future providers include both classroom training and internship training. The internship year of schooling entails spending time with both specialty and primary care providers to put the classroom knowledge to work in the real world of medicine. When the schooling is completed, both NPs and PAs must take a certification exam to test their medical knowledge. This certification exam is required before a Nurse Practitioner or Physician Assistant can enter practice and treat patients.

            I believe the most important part of any provider’s practice is to use the knowledge and experience you have gained to treat patients to the best of your ability. Sometimes, that means acknowledging that you may need the assistance of a more experienced provider or specialist to assist you in the care of a patient. As a Physician Assistant and primary care provider I am part of a healthcare team. By accessing the healthcare team, I use the advantage of combining my own knowledge and experience with other providers. This includes my colleagues, and specialists. By doing so, the goal is always to create the best possible outcome for the patient. When you come to the Grants Pass Clinic, no matter which provider you see, you will have a team of well qualified individuals caring for you. 

 

By: Ben Moss PA-C

Proud Member of the Healthcare Team at Grants Pass Clinic

   Timothy E. Roberts, MD    

 

 

 

 

 

 

 

 

There is quite compelling evidence that we all should be getting some regular exercise, even those that are late bloomers. Click here to read an article about this very subject. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2727269?

utm_source=JAMA_Network&utm_medium=referral&utm_campaign=ftm_links&utm_term=030819

This is something I myself spend a great deal of time counseling patients about, but also counseling myself about. I too have always had a hard time sticking with it!

When it comes to what kind of exercise and how much, it seems pretty clear there is not a ‘one- size fits all’ answer.  In my experience, people who’ve mastered the art of consistent exercise have one thing in common; most of them seem to get joy and satisfaction out of it. 

The variety of exercise that patients are able to stick with is very interesting.  Swimming, walking, softball, rock climbing, bicycling, square dancing, weight lifting, soccer, mountain biking, hiking, surfing, gardening, paddle boarding, kayaking, Aikido, Tai Chi, Zumba.  And I know this is just the tip of the ice berg!

I am currently running and walking consistently, with fairly regular gardening and light weightlifting.  I find that I enjoy running with other people, so I am trying to make that happen more regularly.  Click here https://www.meetup.com/SOREnthusiasts/ to find out about Southern Oregon Running Enthusiasts on MeetUp.  In the past, I have also enjoyed bicycling and swimming, but seemed to be pretty inconsistent with those activities.  I enjoyed soccer for a number of years.  I hung up my cleats after breaking a wrist and a finger—yeah, in game in which you aren’t supposed to use your hands!  My wife and I have tried dancing lessons a couple of times, but it was tough with our four left feet.

So I really encourage patients to get out there and shop around.  What sounds fun?  What are your friends doing?  What is cheap?  What is nearby?  Mix it up and look for the activity that you enjoy and isn’t a chore.

                                                                                                                                                                                                                                                                                                                                          

 

                                                                   

“When your (forests) on fire / You must realize / Smoke gets in your eyes” *

Fire and smoke season is upon us again, with orangey skies in the morning and red sunsets at night. I’m frequently asked what people should do about the smoke. The answer, unfortunately, is that the only effective thing you can do is get away from it. That means staying inside in air conditioning when possible, with the windows closed. If you must be outside, especially working, try to do it in early in the day when the smoke is less severe. The people most at risk are those who have lung problems such as asthma, emphysema, or chronic bronchitis, and anyone who is on oxygen. People with poorly controlled heart failure should be more careful, too. Children are also at higher risk because their lungs and airways aren’t fully developed yet and they breathe a lot more air relative to their size than grownups do.

Masks? The little blue paper “dust” masks you commonly see are useless for smoke. They are good for keeping large particles, such as sawdust, out of your airways, but they do not block the tiny particles which make up the harmful smoke. A heavier mask labelled “N-95” or “N-100” will help. These masks have two straps for above and below your ears and fit snugly over your nose and mouth. Please adjust your mask before helping others. They may be hard to breathe through, especially for people with breathing problems, but they work.

Heavy smoke causes dry, scratchy eyes and throats. The answer is drinking lots of water to keep your throat wet and using moisturizing drops as needed for your eyes.     

How bad is the smoke? The current air quality index (AQI) can be found at airnow.gov, where you can search by Zip Code to find the local conditions. The AQI is reported in the Daily Courier and on the TV weather as well. If the number is above 150 the air is considered unhealthy, above 200 is pretty bad. As I write this at noon on Friday, July 26th, the AQI is 153 and predicted to peak at 180 today. By comparison, our AQI in Grants Pass is usually in the single digits. Beijing often hits 500.

In summary, if the smoke is bothering you, get into clean air, just like moving to the other side of the campfire. If you can get away, the coast is always nice. And of course, don’t make it worse by smoking cigarettes. They’re way worse than any forest fire smoke.

by Spencer Countiss, MD

* Quote adapted from “Smoke Gets In Your Eyes” by The Platters, with my apologies.

 

                 

                                                                                                                                                                                                                                                                                                                                           

 

 

March is Colon Cancer Awareness Month! The dark blue ribbon has not yet reached the prominence of the pink ribbons we see every October for breast cancer, but its message is the same – dispel the myths and raise awareness of a deadly disease.

Colon cancer is the third leading cause of cancer deaths in men AND women. Research shows that more and more cases are being found in younger and younger people. Much can be done to prevent and treat this cancer through proper screening and early detection. Most cancers start out as small polyps. Colonoscopy is one of the only ways we can actually prevent a cancer from developing by removing these growths before they become malignant. Most other colon cancer tests are aimed at detecting already growing tumors.

An excellent bowel prep and a thorough and skilled examination are essential in getting the best results from your colonoscopy. Experience matters. Talk with your provider about who, how, where and when you should have this done. Here are some important quality indicators for endoscopic:

Adenoma Detection Rate (ADR) – Describes percentage of patients in whom adenomatous polyps (precancerous) are identified and removed. Higher percentage is better cancer prevention.

Cecal Intubation Rate – Shows provider skills in examining the whole colon.

Withdrawl Time – You want the provider doing a thorough exam. Increased time has been repeatedly associated with increased ADR, thus reducing a patient’s risk of cancer.

Post-Polypectomy Bleed Rate – Most common complication after colonoscopy. May be delayed hours to up to 14 days.

Please check out some links I have included to learn more about inherited risks, when to screen, and how often.  Also a humerous tale by Dave Barry (although we have made some significant improvements to the prep he used).  It’s really not all that bad.

https://www.cdc.gov/cancer/dcpc/resources/features/colorectalawareness/index.htm

https://medicalschoolhq.net/forums/topic/colonoscopy-journal-funny/

 

 

 

 

 

It’s About the People

 In the busy world of healthcare we often times feel the healthcare we receive is more about the mighty dollar and less about the individual patient. When I first came to interview at Grants Pass Clinic I noticed a difference in the environment of the clinic.  All of the providers I met were genuinely invested in the best interest of patients. I also noticed that many of the employees had been with the clinic for greater than 10 years, from the providers down to the office staff. Having worked as a provider for nearly 15 years and in multiple clinics, this said something about the environment in the Grants Pass Clinic.  Satisfied employees serve patients better. I have met many patients who have been with the clinic for many years because in their own words, it is the people at Grants Pass Clinic.  I have now worked here as a provider for 3 years and come to work excited, because at Grants Pass Clinic “it’s about the people”, patients and employees alike.

Well Child Checks – Why So Many?

By the time a child turns 18, the American Academy of Pediatrics recommends that they have 29 check-ups, also called “well child checks”. Ten of these visits are supposed to happen before they are 3 years old. Why does a healthy child need to see the doctor so often? Some people might say that these visits are for giving shots. While it is true that there are scheduled shots at a lot of the early visits, most of these well child checks are shot-free. The reality is that there are many other great reasons to bring your child in to see their doctor that have nothing to do with vaccines.

In addition to listening to the heart and lungs, there are a lot of other things happening at a typical well child check. Height and weight are checked every time and are plotted on the growth curve to see how well your child had been growing since the last visit. A developmental screen is done at every visit in the first 5 years to pick up on any concerns so that children can quickly get access to all the help they need to achieve their potential. As children get older, hearing and vision are checked. In the teenage years, behavior patterns and mood are screened and discussed. And, of course, any questions children or parents have about growth and development are answered.

Some of my favorite parts of the visit are just getting to know your child a little bit better. For young children, that means finding out their likes (dinosaurs!), or favorite activities (dancing!). As kids get older, we talk about school, sports and friends. As they near puberty I enjoy answering their questions about their body and helping them understand how to stay healthy. In the teen years we start to talk about healthy habits that will help them as they enter adulthood.

Well child checks are important even after a child is no longer an infant.  Your pediatrician wants to see them once a year. If it’s been a while since your child was seen, give us a call and we will talk about scheduling that important well child appointment.

Monika Froehlich, DPM, FACFASWHAT IS A NEUROMA?

Patients will present with a sharp, burning pain in the ball of the foot, especially when walking. There may be tingling or numbness between the toes and in the ball of the foot. Often patients will describe a feeling like their sock is wrinkled or wadded up in the ball of the foot or you have a stone in your shoe. They may notice improvement of symptoms when the shoe is removed.

A neuroma is a painful growth of the nerve tissue in the foot, most often between the toes. The nerve gets irritated from activities, tight shoes, high heels or poor-fitting shoes. Injury or foot deformity can also cause a neuroma. If the nerve continues to get irritated it will swell. The most common location of neuroma is between the 3rd and 4th toes.

Some simple things to try is change of shoes, arch supports, ice and non-steroidal anti-inflammatories. If pain persists then it is time to see a podiatrist to make the correct diagnosis of your foot pain and proceed with further treatment options such as cortisone injection to reduce inflammation and irritation to nerve. There are some patients who present with recurrent neuroma symptoms which get relief for period of time following conservative treatment that will require surgery to remove the neuroma.

To learn more, a podiatrist (specially trained foot doctor) will evaluate you. You will be asked questions regarding your health and will examine your feet to make sure your pain is not caused by other problems. You may need to get x-rays of your foot.                                         

                                                                                               

Is heel pain slowing you down? You could be suffering from plantar fasciitis. The plantar fascia is a ligament on the bottom of your foot that helps to hold up the arch. This ligament can become inflamed or irritated, and make every step you take agonizing. Symptoms can include a sharp, stabbing pain in the bottom of your heel with the first step out of bed in the morning, or it may feel like a deep “stone” bruise. Early on, the pain will often get better once you get moving. Plantar fasciitis can stop you from doing the things you love.

Two of the most common causes of plantar fasciitis are poor quality shoes, and a tight Achilles tendon (the strong tendon in the back of your leg). When you are wearing worn out or very flexible shoes, your plantar fascia is under more stress and can become inflamed.

One of the best treatments (and prevention strategies) is to replace your shoes before they show signs of excessive wear. Shoes are similar to tires on your car. They are not designed to last for longer than a year of frequent use, and they wear out much quicker in a more active person.  In the most active people, a new pair of shoes may only last 3 months or so.  Generally, a stiffer-soled shoe will help the pain more than a softer shoe. Most over-the-counter inserts do not help significantly. The more effective types of inserts are usually stiffer.

The majority of people with plantar fasciitis have a tight Achilles tendon. This contributes to the heel pain because a tight Achilles puts more strain through the plantar fascia, and causes overuse.

Standing Achilles stretches are effective in helping to reduce heel pain. A simple exercise involves standing in a lunge position facing a wall, with your hands lightly pressed against the wall for support, and both heels pressed to the floor. This is commonly called a runner’s stretch. The key is to do the stretches multiple times per day, every day.  Consistency is important for successful pain relief.

Ultimately, if home care is not working, there may be other problems that are contributing to your heel pain. The Podiatry department at Grants Pass Clinic is happy to evaluate you and discuss options to help get you out of pain and back to doing what you love.

Patient Centered Medical Home Blog

COVID Vaccine News! by Spencer Countiss, MD

The latest on COVID-19 vaccines (July 20, 2021)  Grants Pass Clinic is giving COVID vaccines We now have all the vaccines we can handle, so we’re giving COVID vaccines to anyone age 12 or older. We are giving the Pfizer vaccine The 3 vaccines with emergency use authorization in the U.S. are made by Pfizer-BioNTech, […]

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