All Posts tagged tvhc

Decisions and consequences

Keith Gnagey

Keith Gnagey, TVHC CEO

Within hours of the 2-1 vote by our county commissioners to vacate the current ambulance service contract held by TVHC and give this service to the Teton County Fire Protection District, 20 of our EMS employees received calls from hospital leadership telling them their employment would be ending. Twenty employees and their families are now uncertain about their careers and livelihoods.

We’re sorry. We’re sad. We believe we gave our county leaders every supportable document, testimonial, report and statistic available to show that the service provided by our EMS crew, medical staff and nurses — our team — was clearly the best choice at the best cost for our residents and tourists. And then on Monday, May 16, we lost a service we’ve been providing contractually for 13 years; a service that began with a volunteer force in 1975.

From 1939 to 1975, people in dire emergencies had to find their own way to Teton Valley Hospital. One physician used his station wagon to pick up people and bring them in. Bob Bean, the local funeral director, brought patients to the hospital in his hearse! We have a long and proud history of emergency volunteers and later, paid professionals, who built this service to a high-level paramedic-certified department. These people immersed themselves into the clinical team that’s on hand 24/7 to care for you on what could be the worst day of your life.
Taxpayers voted the Ambulance Service District into existence over a decade ago. On Monday, two people voted to terminate the existing contract, give all operations to the fire district, and wind down the Ambulance Service District. Instead of working together to provide ambulance service in the county, we are now going to have one provider, the fire department. At TVHC, we have expressed, time after time, a desire to forge a true partnership with Fire only to be rebuffed time after time regardless of the greater good that such a partnership could have brought to our community.

To all of our EMS employees and to those in the past who served or supported Teton Valley Ambulance, we give our deepest regards and appreciation. We’re sorry we weren’t able to continue your legacy. We’re sorry that we have families now in turmoil as they try to move ahead with their lives. We’ll continue to place our focus exactly where it should be: on caring for our patients, their families and our community.

We’ll continue to make available all documentation, letters, etc. that we offered to our county commissioners and community throughout this process. Anyone may access these here.

This article appeared in the opinion section of the Teton Valley News.

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Global issues, local impact: infectious disease preparedness

 

Keith Gnagey, CEO

Keith Gnagey, CEO

The three-pronged media surge about enterovirus D68 (EV-D68), influenza and Ebola has heightened awareness about the presence of infectious diseases and the methods of preventing the spread of those infections. Information is a good thing. Of course, becoming a victim of any of the three would not be a good thing.

Whether you believe the dangers of these viruses are overhyped or not, you should know that locally, Teton Valley Health Care stays current with global and national health concerns and makes every effort to share up-to-date treatment and prevention recommendations with our community and our staff.

Training for all employees who could have contact with a potential Ebola patient has already begun. In virtually every way, our clinical personnel know and follow preventive measures as part of their regular routine. With a deadly infection like Ebola, extra care must be taken in terms of information gathering, hazardous material disposal and decontamination. In the unlikely event that TVHC would have contact with an Ebola patient, we would certainly render initial care and then follow protocols to transfer the patient to an appropriate facility.

Rural hospitals and clinics such as ours are not immune to the health issues of our world. Although we may not have to worry about an onslaught of guinea worm, we do need to be prepared for diseases that have the ability to travel to and spread among our population, in addition to the contagious illnesses that sprout from within our community such as giardiasis, influenza, and chicken pox. The unfortunate resurgence of some childhood diseases such as pertussis and German measles are also potentially deadly illnesses for which we must be prepared.

As a community, we should take every viable opportunity to defend ourselves against diseases. This includes becoming informed from reliable sources, getting proven vaccinations and following the basics: wash your hands often and thoroughly, cover your coughs and sneezes, and stay home if you’re sick.

 

At Teton Valley Hospital, we have a visitor restriction policy in place. At both clinics and our hospital, face masks and hand-cleansing stations are posted at each entryway. We’ve increased the number of facility cleanings and our admissions employees clean their patient area stations after encounters.

We continue to offer free pulse-oximetry tests for anyone who is concerned they – or their children – may have EV-D68. Flu shots are available for $25 although most insurances do cover flu and other vaccinations.

If you need vaccinations or medical treatment but can’t afford it, please contact our financial counselor at (208) 354-6331 about our financial assistance plans and charitable care availability. Whether or not you choose to have medical services at our clinics or hospital, we can also help you understand your health insurance policy so you get the full benefits of your coverage.

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Health ABCs from a PA-C: Cholesterol 101

When you have your blood drawn for lab tests either as prescribed by your doctor or as part of a health fair, one of your options for those draws is blood chemistry profile. With this test you’ll get a good overview picture of your kidney and liver health, blood count and lipid profile. The lipid panel means you’ll get a measure of your HDL (high-density cholesterol), LDL (low-density cholesterol) and triglyceride levels. But what does this mean to you?

Let’s start with the basics. Cholesterol is a waxy, fat-like substance found in your body and many foods. Your body needs it to build healthy cells and function properly. Too much cholesterol can accumulate in your body and cause plaques on your arteries. These plaques can block blood flow causing a heart attack or stroke.

We monitor two main types of cholesterol through blood work. LDL, “bad cholesterol” makes up the majority of the body’s cholesterol. LDL is known as “bad” cholesterol because having high levels can lead to a buildup in the arteries and result in heart disease. HDL, “good cholesterol” absorbs LDL and other cholesterol molecules and carries it back to the liver, which flushes it from the body. High levels of HDL, or “good” cholesterol, reduce the risk of heart disease and stroke.

Here is a list of appropriate blood levels:

Desirable Cholesterol Levels
Total cholesterol Less than 200 mg/dL
LDL (“bad” cholesterol) Less than 100 mg/dL*
HDL (“good” cholesterol) 40 mg/dL or higher
Triglycerides Less than 150 mg/dL

 

Treatment options for high cholesterol first start with TLC (therapeutic lifestyle changes). The first and most important lifestyle modification we encourage is to maintain a healthy weight. The important thing about weight loss is understanding it isn’t about short-term dietary changes. It’s about a lifestyle that includes healthy eating, regular physical activity, and balancing the number of calories you consume with the number of calories your body uses. Fewer calories in than calories expended is the way to lose weight. To better understand how many calories you need for your body and health concerns, see your primary care provider.  AHA graphic physical activity

Increasing your physical exercise is another lifestyle modification essential to maintaining a healthy heart and keeping your weight stable which in turns prevents chronic illness. Studies have shown that 30 minutes of aerobic activity five times a week is beneficial as primary prevention of heart disease. It is also important to try to maintain your target heart rate while exercising. This can be calculated by counting your pulse for 10 seconds and multiply by 6 to find your beats per minute. You want to stay between 50 to 85 percent of your maximum heart rate. This range is your target heart rate. Your maximum heart rate is 220 minus your age. If you are taking blood pressure medications, your target heart rate may be different, and you should consult your doctor before beginning a new exercise program.

Another way to control high cholesterol is with medications. Statins are a commonly prescribed medication with great value. They have proven to reduce risk of heart attacks and strokes. These medications are essential for people with cholesterol resistant to TLC and/or people with moderate to high levels of cholesterol.

An alternative therapy for people with mild high cholesterol is Red Yeast Rice. Red yeast rice (RYR) is the product of yeast (Monascuspurpureus) grown on rice. It is a dietary staple in some Asian countries. It contains the same compound found in statins, (HMG-CoA) reductase inhibitor. Studies have shown this product to be effective for treatment of hyperlipidemia (high cholesterol). More specifically, decreases in total cholesterol (TC), LDL cholesterol (LDL-C), and triglycerides (TG) have been noted. Consult with your primary care provider to see if this therapy may be beneficial to you.

Hopefully this gives you a better understanding of cholestrol in general and how you can work to keep your cholesterol levels within normal ranges.

Anna Gunderson, PA-C is a nationally certified Physician Assistant. She works at the Driggs and Victor Health Clinics and is currently accepting new patients. Call (208) 354-2302 to make an appointment or visit tvhcare.org for more information on the services offered at Teton Valley Health Care.

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