Category Archives: health care

Kenai vets get Choice in care — New VA program expands health care options for veterans

By Jenny Neyman

Redoubt Reporter

Representatives from the Veterans Administration in Alaska had good news to share at a town hall meeting Thursday evening at Kenai Peninsula College — veterans on the Kenai Peninsula eligible for VA health care now have more options to receive timely, localized care, and even have a free way to get to that care.

The meeting was to explain the changes that came with the Veterans Access, Choice and Accountability Act of 2014.

The Choice program offers just that. In the past, veterans eligible for VA benefits generally had to receive their care directly from a VA facility, which could mean a lot of traveling and waiting in areas where VA facilities are limited or understaffed to meet demand. With the Choice program, eligible veterans who live more than 40 miles from a VA facility, or if the VA isn’t able to provide care within 30 days, can obtain care in the private sector, with the VA pitching in to cover the bill, as much as it would if a VA clinic was providing the care.

Susan Yeager, director of the Alaska VA Healthcare System, said that the purpose of the program is to give the VA time to increase its capacity to meet patient needs, and in the meantime, give vets better care.

“When this bill was passed, for Choice Act, the idea was that it was a three-year pilot, allowing the VA to build up their staff, so that at the end of three years the VA has enough staff so that veterans can get the care they need, when they need it, at a VA,” she said.

Alaska is one of three states, Hawaii and New Hampshire being the other two, where all vets eligible for VA health benefits can utilize the Choice program. To do so, a vet would call the number on their Choice card and request to see a private-practice provider. The VA’s vendor for the program, Tricare, is currently creating a network of preferred providers in the state. But even if a provider isn’t part of the arranged network, Tricare can contact that provider and try to negotiate a rate at which the VA will compensate for services.

Initially, it was difficult to get private providers to be willing to work with Tricare, because the reimbursement rate was not very competitive, Yeager said. The rate was recently increased, and more providers are joining the network.

“I think we’re going to see more access opening up in Alaska,” she said.

The program is especially well suited here, where access to care is a big challenge. The VA has a shared agreement to use the U.S. Air Force Hospital 673rd at JBER in Anchorage, but doesn’t have its own hospital in the state. And Anchorage is a long way away from most communities.

The VA operates regional, community-based outpatient clinics, including the one in Kenai, which is rated to serve the 2,589 eligible vets on the Kenai that have enrolled for VA services. But even Kenai, and VA services in Homer, can make for a long trip for patients. And in rural areas of the state, accessing a VA clinic can mean a plane or boat ride.

“It’s a big challenge, I think, up here, more than other VAs I’ve seen in the Lower 48, because of our distances and lack of roads. And that’s expensive, too,” Yeager said.

Continue reading

Leave a comment

Filed under health care, veterans

Punctuation on health — Unique teaching tool underscores importance of colon cancer screening

Photos courtesy of M. Scott Moon/Kenaitzie Indian Tribe. Deb Nyquist, wellness director at the Dena’ina Wellness Center in Kenai, and Fridrick Gudmundsson, youth services clinician, talk about the Nolan the Colon display at the center March 9.

Photos courtesy of M. Scott Moon/Kenaitzie Indian Tribe. Deb Nyquist, wellness director at the Dena’ina Wellness Center in Kenai, and Fridrick Gudmundsson, youth services clinician, talk about the Nolan the Colon display at the center March 9.

By Jenny Neyman

Redoubt Reporter

Let’s just get the puns out of the way: The Southcentral Foundation and Dena’ina Health Center wasted no time eliminating misinformation about colorectal cancer on March 9, leaving curious visitors flush with information to digest.

OK, enough with the crappy jokes. But when you’re traveling with a giant inflatable colon, a silly sense of humor is required.

“Oh yeah, you have to. For the most part people laugh. First, they don’t know what it is. If they have kids it’s like, ‘Oh, a bouncy house.’ And then they come over and they’re like, ‘Oh,’” said Cherise Cummings, health educator with the Southcental Foundation.

Cummings brought the unusual teaching tool to the Kenaitze Tribe’s Kenai health facility March 9, as March is Colorectal Cancer Awareness Month. The 12-foot, inflatable, anatomical replica illustrates a healthy colon and the development of colorectal cancer, and gives information on how to prevent the disease. The pinkish, tunnel-shaped novelty comes complete with polyps, and a name.

“This is Nolan the Colon and it’s just a great visual to get people to open up and talk about getting screened for colon cancer,” Cummings said.

Nolan gets a workout during the winter, with health educators taking him on the road to communities served by the Southcentral Foundation, an Alaska Native health care organization established by Cook Inlet Region, Inc. He also makes appearances at various high-profile community events in Anchorage, along with Cummings and her associates dressed in bulbous, red, Nolan-related costumes.

“I do have a polyp costume, so I’m a polyp princess. I do show up at events. So I ran with the reindeer last week, on Saturday, along with Doc Polyp and another polyp princess,” she said. “… There’s a group of them that were actually in the Fur Rondy parade with Nolan the Colon, waving. We just really talk about screening. Screening is so important because there aren’t always signs and symptoms, and that’s the scary part.”

Continue reading

1 Comment

Filed under health, health care, Kenaitze, Native

Horse senses — Unique summer program uses riding as tool for kids’ therapy

Photo by Jenny Neyman, Redoubt Reporter. Lachlan McManus captures a ring during an exercise in his hippotherapy session with Nature’s Way Rehabilitation Service on July 30 in Kenai.

Photos by Jenny Neyman, Redoubt Reporter. Lachlan McManus captures a ring during an exercise in his hippotherapy session with Nature’s Way Rehabilitation Service on July 30 in Kenai.

By Jenny Neyman

Redoubt Reporter

Lachlan McManus was having a blast. What 10-year-old on a horse wouldn’t be? Especially when there’s a sword involved, as there was during the Kenai boy’s riding session July 30 in an arena off Kalifornsky Beach Road near Kenai, with Lachlan plunging the sword forward in a fencing-style thrust, or extending it straight overhead as though he’d just freed Excalibur from its rock.

In his head, he could be a swashbuckling pirate or a knight of the Round Table galloping off to battle, wielding his nimble blade in one hand and guiding his powerful steed with the other.

The reality, of course, was less dramatic. The sword was a blunt-edged toy, lacking the heft to make a swashing sound, much less damage anything with which it might accidentally make contact. The only buckles involved were those on the riding gear and the safety belt fashioned around Lachlan’s waist. As for the horse, full speed ahead was more of a mosey than a trot, and direction came from the helpers walking along each side, rather than the rider having the reins.

But the lack of daring and danger didn’t bother Lachlan, nor did the fact that he wasn’t really getting a riding lesson. As far as he was concerned, he had an activity to enjoy on a summer afternoon, he was playing games and getting undivided attention, and he was on a horse — ergo, he was enjoying himself, period.

To those around him, though, Lachlan’s enjoyment was just the starting point of the afternoon’s purpose. Because he was enjoying himself he was easily engaged with his helpers, willing to listen to instructions, carry out the tasks being presented as games and try to achieve each incremental increase in challenge.

To the helpers — certified therapists and volunteer assistants with Nature’s Way Rehabilitation Services, the session was therapy. To Lachlan, it was just plain fun. To both parties, the day’s success was made possible in large part because of the horse.

That’s the world of hippotherapy — a physical, occupational or speech/language treatment strategy that incorporates horses. It’s a program that’s been available to kids with disabilities on the central Kenai Peninsula for six summers now, through Nature’s Way. It’s one of only a few programs of its kind available in Alaska, and the only available on the peninsula, or anywhere outside of the Anchorage area.

Part of the appeal of using horses in therapy is kids enjoy the sessions and are motivated to pay attention and follow instructions. Add games and fun props, such as this sword, and they’re even more engaged.

Part of the appeal of using horses in therapy is kids enjoy the sessions and are motivated to pay attention and follow instructions. Add games and fun props, such as this sword, and they’re even more engaged.

“I just think it’s incredible that there’s an actual hippotherapy opportunity for kids around here, because it is so specialized. Living on the peninsula, you wouldn’t think that something like that would be available, and they’re making it available, and I think it’s phenomenal for kids that could definitely benefit from it,” said Jami Wight, of Soldotna, who has had two of her kids in the summer hippotherapy program.

The term comes from the Greek “hippos,” meaning horse, as opposed to the Latin “equus,” for horse. It’s under the larger umbrella of equine therapy, though it’s not therapeutic riding, where specific riding skills are taught, or horse therapy, where interaction with horses is used to support therapeutic outcomes.

Hippotherapy specifically utilizes the movement of horses to create adaptive responses in patients and facilitate physical, occupational and speech/language treatment goals.

Therapy for kids needs to be fun and engaging to be effective, which is why various approaches incorporate games, toys and activities. In that sense the horse is a tool, just like a ball or tricycle, only way more fun — thus, way more engaging.

“It’s an amazing tool. It’s kind of like putting a kid in a swing or on a ball or trampoline or something like that, but it’s a horse, and what kid doesn’t like horses? We haven’t really met one yet,” said Noelle Miller, a speech therapist with Nature’s Way. “The beauty of horse therapy is it’s such a holistic environment and such an exciting environment that a lot of times you just get more verbal output from kids and more interactive output from kids because it’s real. You’re doing something with people, with animals. You’re not trying to stage a situation that demands interactions and reactions, it just happens naturally.”

Continue reading

3 Comments

Filed under health care, youth

Health center is well of care, renewal — Wellness facility represents sea change for Kenaitze Tribe

Photos by Patrice Kohl, for the Redoubt Reporter. A “Łuq’a Nagh Ghilghuzht” sculpture by Joel Isaak depicts traditional Dena’ina life at fish camp outside the Kenaitze Indian Tribe’s new Dena’ina Wellness Center in Old Town Kenai.

Photos by Patrice Kohl, for the Redoubt Reporter. A “Łuq’a Nagh Ghilghuzht” sculpture by Joel Isaak depicts traditional Dena’ina life at fish camp outside the Kenaitze Indian Tribe’s new Dena’ina Wellness Center in Old Town Kenai.

Clarification: It was incorrectly reported that the Dena’ina Wellness Center is currently seeing all veterans and is considering expanding medical services to the public. Currently, only Alaska Native and American Indian veterans receive VA services through the Dena’ina Wellness Center. As a community mental health center, behavioral health services are open to the public. Other services are available to Indian Health Service beneficiaries.

Through the joint venture award, Indian Health Service funding supports operation and maintenance for a minimum of 20 years. The state of Alaska Department of Commerce, Community, and Economic Development Division of Community and Regional Affairs provided $20 million to the project.

 

By Jenny Neyman

Redoubt Reporter

For the Kenaitze Indian Tribe, a new building in Old Town Kenai is an indication that the tide has turned.

A gradual erosion of culture, connection and community has reversed, and what was washed away, grain by grain, as if by the lapping pull of receding waves, is rushing back in, not only replacing what’s been lost, but reaching a new high-water mark.

That mark is a substantial one, both in its 52,000-square-foot physical form — the Dena’ina Wellness Center in Kenai — and in what it represents for the tribe.

“The Dena’ina word for it is ‘naqantughedul.’ For the tribe it means the tide is going out and it’s turning and going back in,” said Jaylene Peterson-Nyren, executive director. “It means the culture, the people, the land and just the lifestyle has been going away for many, many years, and it has taken a turn with this facility. It’s coming back.”

The building isn’t just a health clinic, nor was the motivation to construct it simply some tipping of an equation of funding and client base and service needs. It grew from a need to come together — to reconnect, strengthen and grow — and to improve health beyond just the physical.

The lobby of the new, 52,000-square-foot Dena’Ina Wellness Center is meant to be an area for gathering and socializing, more than just a medical clinic reception lobby.

The lobby of the new, 52,000-square-foot Dena’Ina Wellness Center is meant to be an area for gathering and socializing, more than just a medical clinic reception lobby.

“We wanted to design not just a health clinic, but we wanted to look at wellness from a holistic perspective, and that means not just that you’d have your checkups and you check out well. It means social and economic wellness, it means educational wellness — knowledge. It encompasses relationships across the board with customers who come in to seek services and for staff who are all working together on behalf of our customers,” Peterson-Nyren said.

Fittingly, then, the facility consolidates the tribe’s three health services programs under one roof — medical, dental and behavioral — as well as expands new services to address the wellness of a person as a whole, not just whether they’re running a fever.

“We try to focus on prevention and intervention. We want to encourage people to return. That’s one of the reasons we built the Gathering Space (building entrance room) is we want people to want to be here,” she said.

Along with being a center for holistic wellness, the brand-new facility, with construction starting in August 2012 and the grand opening ceremony June 12, is also a hub of social connection — an area of wellness which the tribe believes also needs care.

It’s designed to facilitate both — new equipment and the latest technology to aid the delivery of quality medical services, and a welcoming, calming, comfortable design to encourage people to come and enjoy the facility. The entry leads into the Gathering Space, with a large, open, airy design and windows stretching floor to the second-story ceiling above. A stage area anchors the wall facing the doors, while a reception desk, curved as if beckoning a visitor further into the building, stands to the right of the stage. To the left of the entrance is a wide staircase giving the feel of floating upward as it parallels the windows looking out over Old Town toward the mouth of the Kenai River and Cook Inlet. Upstairs are balcony railings to allow a bird’s-eye view of the stage and circular Oculus feature below, which will have a commissioned art piece suspended above it.

The whole space can be configured for large gatherings, such as the grand opening of the facility, which was packed to standing room only. Over 1,000 people came through the facility during the two days of tours, presentations and festivities, Peterson-Nyren said.

“I think the response has been tremendous,” she said. “It was amazing to feel that community support, just everyone showed up.”

Continue reading

Leave a comment

Filed under Dena'ina, health care, Kenai, Kenaitze

Rally with Relay for a cure — Annual event offers hope, way to help fight cancer

Photo by Jenny Neyman, Redoubt Reporter. Phyllis Swarner snuggles with her cat, Mutto, in her home in Kenai. She will be one of many volunteers and survivors at the Central Peninsula Relay for Life on Friday and Saturday at the Kenai Central High School track.

Photo by Jenny Neyman, Redoubt Reporter. Phyllis Swarner snuggles with her cat, Mutto, in her home in Kenai. She will be one of many volunteers and survivors at the Central Peninsula Relay for Life on Friday and Saturday at the Kenai Central High School track.

By Jenny Neyman

Redoubt Reporter

May 19, 1999, was the worst day of Phyllis Swarner’s life, but also the day it changed for the best.

She was 52 years old, living in Florida, working for the civil service at Eglin Air Force Base. Life was going along just fine. Until it wasn’t.

“I got a phone call at 5 o’clock that morning that my dad had passed away,” she said. He had been sick. Even though it wasn’t entirely a surprise, the grief and sadness were more than enough to leave her reeling.

And yet, then came another call, at 9 a.m., with the results of her recent mammogram. It was merely a routine scan, as there was no history of breast cancer in her family. She felt fine. There was no reason to think anything would be found. But something was — a 2-centimeter lump in her left breast.

“So it was the day that my life changed,” she said.

Still, given her lack of risk factors, her doctor wasn’t overly concerned. It could be benign. Go to the funeral, deal with your dad’s death and we’ll do a biopsy when you get back, she was told. A month later when the biopsy was done, it showed the lump was cancer, and that there was infiltration into the lymph nodes.

“I found out not only was it cancer, but I had a second precancerous condition, as well,” she said.

“When you hear you’ve got cancer you think you’re dead. I don’t care what they say, you just think, ‘Start preparing for your will and your last days, because life’s over, period,’” she said.

But her life, in a way, had just begun again. In 1995 she had attended her 35th high school reunion and reconnected with her classmates from Fairbanks, where she’d begrudgingly spent her childhood.

“I’d hated Alaska growing up,” she said. “Fairbanks was so remote and cold, and I had roots in North Carolina. I was close to my grandparents there, so Fairbanks felt so far away from everyone and isolated at that time. And 50 and 60 below zero is cold weather. So I swore I’d go as far south as I could, and I did, I went to Florida.”

But she was finding herself more and more pulled back to Alaska, particularly to one classmate — Dennis Swarner, who had become an optometrist in Kenai.

“Dennis and I knew each other since the third grade. We have known each other forever. We graduated from high school together. And I’ve never been intimidated by the ‘Dr. Swarner’ part. He was that corny kid I had to put up with in third grade and he hasn’t changed since,” she joked.

But her feelings for him certainly did. They reconnected and stayed in touch. He came to Florida for a conference, looked her up, dropped by, and that was that.

“My life has never been the same since,” she said.

As if long-distance romances aren’t challenging enough, this was about as long a distance as the U.S. offers — Florida to Alaska. He had a practice in Kenai, and she wasn’t too keen on moving back north. Then came the cancer diagnosis and the years-long process of surgery and recovery. That could easily have spelled the end of the relationship. Instead, it was the beginning of Swarner’s new life trajectory.

“Pow, I had cancer, and that put everything in a different perspective,” she said.

Continue reading

Leave a comment

Filed under community, fundraiser, health, health care

Birth center gets new lease on life — Management change keeps Women’s Way in operation

Photo by Joseph Robertia, Redoubt Reporter. Russet and Bill Morrow, of Massachusetts, watch as Andrea Stiers, a certified direct-entry midwife, performs a neonatal exam on their granddaughter at the Woman's Way Midwifery in Soldotna. Stiers recently retired and in January the midwifery came under the management of Heritage Birth Centers, which also runs midwiferies in Anchorage and Palmer.

Photo by Joseph Robertia, Redoubt Reporter. Russet and Bill Morrow, of Massachusetts, watch as Andrea Stiers, a certified direct-entry midwife, performs a neonatal exam on their granddaughter at the Woman’s Way Midwifery in Soldotna. Stiers recently retired and in January the midwifery came under the management of Heritage Birth Centers, which also runs midwiferies in Anchorage and Palmer.

By Joseph Robertia

Redoubt Reporter

In TV shows, giving birth often entails a woman in a hospital, lying in a mechanical bed, her knees held up to her shoulders and the doctor and nurses yelling, “PUSH!”

In life off the TV screen, though, not all women opt for this type of birth, preferring a range of options beyond the hospital model. On the central Kenai Peninsula, with the assistance and supervision of a midwife, some women choose to give birth at home or in the spalike setting of the only out-of-hospital birth center on the peninsula, which recently came under new management.

“We began managing it at the end of January and it’s all just happenstance, really,” said Kirsten Gerrish. She, along with her business partner, Lena Kilic, are the owners of Heritage Birth Centers in Anchorage and Palmer, and recently assumed management of Woman’s Way Midwifery in Soldotna.

Gerrish and Kilic are both state-licensed certified direct-entry midwives and have certifications in neonatal resuscitation, CPR and IV, and they said they weren’t necessarily looking to take on the responsibilities of a third birth center.

However, Andrea Stiers, the longtime manager and CDM midwife at Woman’s Way Midwifery, was preparing to retire to spend more time with her own family, and the other midwife there, Heather Forbes, had never managed a birth center of her own.

“We just thought the idea of there not being a birth center or any midwives on the peninsula, besides Homer, was just sad,” Gerrish said. “The community seemed supportive of keeping it going, there was the need, there already were the facilities with the license and a midwife already, so we decided to keep it going.”

Gerrish added that, populationwise, there aren’t more midwife services in the area.

“Alaska doesn’t have enough midwives or midwiferies to meet the need. The largest concentration is in Palmer, where there are three, currently, and a new one opening soon. Anchorage has two, Fairbanks has two and Juneau one, and with the population of the Kenai-Soldotna area it makes sense to have one,” Gerrish said.

Continue reading

3 Comments

Filed under health care

Do you know what doulas do? Event to raise awareness of birth options

By Joseph Robertia

Redoubt Reporter

When it comes to giving birth, the image that often comes to mind is a woman in a hospital bed, surrounded by bright lights and blue-clad doctors and nurses, with everyone shouting “Push!” This might be the most familiar birthing option these days, there are others around the central peninsula, some that are alternatives to a hospital birth and some that complement going the traditional route.

Bethe Smith, of Soldotna, has had three children and experienced dramatically different births with each, so much so that the last one inspired her to pursue a career assisting other women during childbirth.

“I have three children — Ciara, 11, Rennen, 8, and Taryn, almost 2. When I had my first I was 21 and I put full trust in my doctors and did not question much,” she said.

Smith was advised to have her labor induced, rather than waiting for birth to begin on its own. She was given several birth-inducing drugs, as well as an epidural to relax her and prevent her own discomfort.

“After a long nap I was told it was time to push. So I did. She was coming and they were not ready so they told me to stop. They had to announce over the intercom over the whole hospital that we needed a doctor in room 418 STAT. Yikes. I did not know who the doctor was. It was very scary and I felt very out of control,” she said.

Her firstborn ended up suffering from gastroesophageal reflux disease and there were problems with the child latching on during breast-feeding. The delivery of her second child was an equally less-than-pleasant birth experience.

“With my second I was given directed pushing and I started hemorrhaging. Again, I was scared and felt out of control,” she said.

For the birth of her third child, Smith wanted to try an alternative to the at-the-hospital model of birth. She researched her options and decided to use a birthing center at Woman’s Way Midwifery in Soldotna and midwife there to deliver the child.

“My last one I had at the birth center and it was amazing. I labored at home with my husband. Then when I got to the birth center she was here 15 minutes later. It was very calm and relaxing. I was allowed to listen to my body as I had her. I wanted this for every mother,” Smith said. “With my birth experiences I know that the hospital can be very intimidating and nursing does not always go smoothly, so I wanted to help women make educated decisions about their birth and parenting choices.”

Continue reading

Leave a comment

Filed under health care