Sudden Infant Death Syndrome remains a mystery
TAHLEQUAH, Okla. – Cherokee Nation citizen Angela Garrett remembers the cold day in January 1993 as one that began like a normal day.
She had just per her 2-month-old son, Blaine, down for a nap in his crib. She checked on him frequently, but despite that, one hour later Blaine died in his sleep. The cause was Sudden Infant Death Syndrome.
October is Sudden Infant Death Syndrome, or SIDS, Awareness Month. SIDS occurs at a rate of about 0.5 per 1,000 births. However, in American Indian and African American populations, the rate is around one per 1,000 births.
SIDS is considered the death of a child less than 1 year old that remains “unexplained” after a thorough investigation including an autopsy, review of clinical history and investigation of the scene of death, said Dr. Tom Kincade, chief of Pediatrics at the Cherokee Nation Three Rivers Health Center in Muskogee.
“I think it is important for our communities to know abut SIDS due to the increased rates in Native Americans and also to be aware of the factors that can help prevent SIDS,” Kincade said.
SIDS remains a leading cause of death in healthy infants less than 1 year old, and approximately 2,100 infants in the United States die of SIDS per year, he said.
Parents can reduce the risk of SIDS by placing babies on their backs to sleep.
“Studies show that over 90 percent of infants that died from SIDS were not sleeping on their backs,” he said. “Most were sleeping on their stomachs.”
Garrett said she put Blaine on his back for his nap, but when she found him, he was on his stomach and his face was in the crib mattress.
“Somehow, at 2 months old he rolled over,” she said. “He was already gone when I found him. I didn’t even call 911(immediately.) I called my mom because he was already gone.”
She said afterward she was in a state of shock, and since then she’s blocked out most of the memory of losing Blaine to SIDS.
“I don’t even remember them taking him out,” she said. “I thought he was still in the room after the ambulance got there and everything. It was a couple of hours later and I thought he was still there.”
Even now, 14 years later, Garrett said she’s stilly trying to understand SIDS.
“From the moment I found him, I don’t remember too much of anything else,” she said. “He wasn’t sick. He didn’t have a cold. There wasn’t anything wrong with him.”
Studies have also shown that letting babies use pacifiers while sleeping can reduce the SIDS risk, Kincade said. He added that infants should sleep on a firm sleeping surface, should not be overdressed while they sleep and stuffed animals, excess bedding and blankets should be avoided.
“When babies leave the hospital nursery they should be able to maintain a normal body temperature which means if parents feel comfortable in shorts and a tee shirt, their babies will too,” he said.
Educational materials about SIDS have been placed in the clinic and exam rooms at the Three Rivers Health Center, and other tribal clinics have been encouraged to do the same, Kincade said.
AUSTIN, Texas – Casting for Recovery, a national nonprofit organization providing free fly fishing retreats for women with breast cancer, will hold a retreat exclusively for Native American women in October in Tahlequah, Oklahoma.
Set for Oct. 13-15, Native American women who reside in Oklahoma and have received a breast cancer diagnosis are eligible to apply. Up to 14 women will be randomly selected to attend the retreat at no cost. Meals, lodging, equipment and supplies will be provided for each participant. The deadline to apply is Aug. 11.
CfR officials said Native American women face numerous cultural and economic barriers to cancer care. By providing support, education and resources, CfR officials said they hope to improve the quality of life for Native American women, creating a ripple effect for health in their communities.
CfR officials said the program empowers women with educational resources, a new support group and fly fishing, which promotes emotional, physical, and spiritual healing. For more information or to apply for this retreat, visit <a href="https://castingforrecovery.org/breast-cancer-retreats/arkansas-oklahoma/" target="_blank">https://castingforrecovery.org/breast-cancer-retreats/arkansas-oklahoma/</a> or call Susan Gaetz at 512-940-0246.
CfR is a 501(c)(3) nonprofit founded in 1996 featuring a program that combines breast cancer education and peer support with the therapeutic sport of fly fishing. Officials said its retreats offer opportunities for women to find inspiration, discover renewed energy for life and experience healing connections with other women and nature. CfR’s retreats are open to women of all ages, all stages of breast cancer treatment and recovery, and are free to participants.
?For more information, visit <a href="https://castingforrecovery.org" target="_blank">https://castingforrecovery.org</a>.
TAHLEQUAH, Okla. – A letter from the Cherokee Nation’s Health System Provider Compensation Committee is asking tribal Health Services officials to increase base salaries and incentives to “recruit and retain top quality (health care) providers” to care for patients.
According to the letter, Health Services has increased base salaries once in the past eight years, leading to recruitment difficulties, a loss in providers and increased wait times for patients.
The letter states CN providers are paid $48,000 less annually than the $218,000 base salary outlined in a 2016 physician compensation report. It also asks that base salaries be “adjusted equal to or above market averages” to alleviate turnover.
It states the lack of salary increases have caused providers to resign “after accepting jobs elsewhere for better compensation,” leaving remaining providers to “experience the undue burden of taking on the additional workload for those many empty positions.”
Charles Grim, Health Services deputy executive director, said the organization currently employs 250 providers, of which 160 are physicians and mid-level providers, at all of CN’s health facilities.
He said there were 11 physician vacancies in the past year and that the organization has an average vacancy rate of 10 percent.
In response to the letter, the Tribal Council on May 15 held a meeting in which Health Services Executive Director Connie Davis and Executive Medical Director James Stallcup proposed to instead pay providers annual bonuses based on relative value units or RVUs.
According to a physician search and consulting firm, RVUs calculate the volume of work or effort done by a physician when treating patients. The more complex the visit, the more RVUs a physician earns.
When translating RVUs to revenue, Stallcup said the hospital collects $120 from third-party billing for every RVU delivered by a provider. Once the provider is paid a share of roughly $65, the facility is left with approximately $55.
“The providers actually lose us money because the salary and fringe is higher than the collections per RVU,” Stallcup said regarding raising base pay only. “We don’t have any incentive that provides more service for going above and beyond.”
He said the RVU proposal could increase positive revenue per RVU by 12.5 percent while not eliminating the possibility of base salary increases, which could happen in the first quarter after the RVU system was operational.
“I think that in the first quarter after implementing this we are going to see a revenue jump that is sufficient to provide all of the base salary increase that we need,” he said. “Right now, without some sort of cuts that results in more available funds, I don’t know how we could pursue it. But I would be willing to reconsider it the moment the needle moves on the revenue.”
Davis said RVUs were “a great place to start” to pay providers and increase health care access for patients.
“We can’t take a big jump and devastate our health system revenue and our finances in doing so,” she said. “We’ve got to take steps and be very cautious on how we do it but keep our good docs and let them know we appreciate what they do at the same time.”
However, some Health System Provider Compensation Committee members who attended the May 15 meeting voiced concerns about moving to RVU- based compensation before raising base pay because of “inefficiencies” in the electronic health records system.
Dr. Johnson Gourd, a physician at Three Rivers Health Center in Muskogee, said the EHR system has decreased the amount of patients he sees.
“It’s difficult to navigate a clinic so large by virtue of the system that I don’t have control day-to-day over staff or other things that would allow it to be efficient,” Gourd said. “Ten years ago I was seeing 30 (patients) give or take a day in regular practice. It just doesn’t happen that efficiently here now, so there’s other issues that we have concerning seeing patients. It’s the efficiency and part of that has to do with turnover.”
He also said the EHR system does not allow him “control of all variables” to complete his job efficiently. “If my nursing is under an entirely different structure, if there’s a nursing shortage, then they pull one of my nurses. It’s not part of my decision-making process for the day, it’s just I show up, I don’t have a nurse. She’s been pulled to cover on another clinic, so I’m down a person.”
He also raised concerns about new providers entering under RVU-based compensation and suggested using RVUs as “an incentive program” for more- seasoned providers.
“You don’t just jump right out into it because if you are brand new out of school you may only see eight or 10 (patients),” he said. “You’re given a guaranteed salary as you transition to RVUs, as you work up to enough patients to pay your overhead, to pay your staff. I don’t want to assume, but there would have to be a period of time where that was transitioned in and looked for without penalizing the providers.”
At the June 19 Health Committee meeting, Tribal Councilor Dick Lay proposed a resolution to “find a good management process” and address concerns outlined in the compensation committee’s letter.
Councilors tabled the resolution, with Health Services administrators saying they are working on a plan that would be presented for the 2018 budget cycle.
OKLAHOMA CITY, Okla. – The Oklahoma City Indian Clinic will hold its annual Adolescent Health Fair for students 12-18 years old from 8 a.m. to 4 p.m. on July 28 in the OKCIC lobby.
OKCIC will provide Native American students with free immunizations, physical exams, sports physicals and vision, hearing, dental, and behavioral health screenings. School supplies also will be provided while supplies last.
“Oklahoma City Indian Clinic tries to take the stress out of preparing for school by making it an easy and positive experience,” Jennifer Williams, OKCIC pediatrician, said. “We like to incorporate exciting activities to the health fair. This makes children more willing to go through the health fair and helps ensure they will have a healthy and successful year.”
Each year the OKCIC hosts the Adolescent Health Fair in conjunction with the Children’s Health Fair as part of a back-to-school program.
A Children’s Health Fair was held July 14-15 for children ages 4-11. The fair had an attendance of nearly 300 patients who received vaccines, physical exams, fluoride treatments, sports physicals and health, hearing and vision screenings, as well as school supplies and a free lunch. While attending, families were able to enjoy various activities including, crafts, outdoor games, a face painting booth and a petting zoo. Several community partners also set up information booths.
OKCIC is a 501(c)(3) nonprofit clinic that provides healthcare and wellness services to American Indians in central Oklahoma. Every year, the clinic staff cares for more than 18,000 patients from more than 200 federally recognized tribes. American Indian patients can receive services including medical, dental, pediatrics, prenatal, pharmacy, optometry, physical fitness, nutrition, family programs and behavioral health services.
For more information on OKCIC or the Adolescent Health Fair, call 405-948-4900 or visit www.okcic.com.
TAHLEQUAH, Okla. – Since its 2009 inception, several of the 41 W.W. Hastings Hospital Surgical Technology Program graduates have returned to the Cherokee Nation, committed to helping provide fellow Cherokees health care.
One graduate is Rochelle Lewis, a certified surgical technologist who completed the program in 2011. She spent four years at Northeastern Health Systems, formerly Tahlequah City Hospital, before returning in 2015 to teach the program.
“I think it’s imperative for me to be able to go back and help my fellow Cherokees, to be there in a time where they are most vulnerable,” Lewis said. “We are the eagle eye to make sure that a patient has the most healthy outcome possible. I think being able to do that for fellow Cherokees is a great responsibility and a great privilege.”
The CST’s responsibilities are providing patient support in the operating room, gathering operating supplies, keeping count of supplies used, overseeing the operating room’s sterilization and handing surgeons surgical tools.
The program is 9-1/2 months and conducts two classes annually. Each class admits five students.
“It’s really nice to have that size of class,” Lewis said. “If they get into this program, it’s an extreme privilege because of how hard it is to get in. We don’t have a lot of space, but we get lots of one-on-one with them.”
Entrance is based upon points earned by taking a dexterity test, completing an entrance exam, writing an essay, completing a personal interview and attending a skills lab “boot camp.”
Once admitted, students earn a $7.25 hourly stipend and spend the first five months in the classroom before moving to clinicals. During clinicals, they see patients at 10 sites in Oklahoma and Arkansas for two to three weeks at each site.
“When they go to clinicals, the first day we say to them ‘you can watch one surgery to get the feel of it,’ and then we expect them to start being as hands on as possible,” Lewis said. “They should be scrubbing in and setting up cases the first week. For accreditation they have to get so many cases in different specialties.”
The final month is spent preparing for the national certification exam, which is four hours and has 200 questions. To become certified, 118 questions must be answered correctly.
“You need to be dedicated,” Cheryl Gullett, a fellow CST and program instructor, said. “This has to be a number one priority. Students have to treat it as a job, if not a little more seriously.”
Gullett graduated in 2010 and worked for Northeastern Health Systems and St. John’s Hospital before returning to instruct in 2015.
She said the program’s financial impact on graduates is also important.
“I think the program in general is an amazing thing because you’re not only providing health care to people, but you’re providing a substantial amount of income to yourself,” Gullett said. “When these students graduate, they have a job that can provide for their families. You don’t need subsidies to help you survive anymore.”
That was the case for CN citizen Baron O’Field, a CST who graduated in 2013.
“Before I was a surgical tech, I worked as an intern for the Cherokee Nation,” he said. “I was in that position for about three years, so there was really no place for me to advance. I was kind of just stuck at that minimum wage gap.”
When O’Field neared graduation, he had job offers from Northeastern Health Systems and Hastings, where he worked for nearly two years before working as a traveling CST.
“It was a great experience to leave and come back and share some of my knowledge. I think it has helped me a lot. Situations that I would have gotten into early on in my career here, I would have been nervous and kind of intimidated. Now, it’s not that big of a deal,” he said.
He said his time as a traveling CST in Missouri, Kansas and Ohio also helped illustrate the need for more Native Americans in health careers.
“I know whenever I left I never came across another Cherokee as a traveler, or just another Native American period,” he said. “I know I did go to a place where there was a high population of Native Americans, but I never bumped into (a CST).”
As the profession grows, O’Field hopes more Cherokees will serve in it. “If you have a good work ethic and you’re willing to learn and adapt, I think any hospital in America is going to hire you.”
For more information, call Patricia Sumner at 918-453-5000, ext. 4186 or Lewis at 918-453-5000, ext. 4178.
MUSKOGEE, Okla. – Eating healthy on a tight budget is a possibility for families if they make minor changes in the way they shop, plan and cook meals.
Many people believe they can’t eat healthy on a budget, but that’s not true, Denise Goss, clinical dietitian and dietician advisor at the Three Rivers Health Center, said.
“One of the big things is for people to plan ahead,” she said. “Don’t go into the grocery store without making a grocery list first and planning out the meals for the week.”
She said people tend to make “impulse buys” when they don’t make grocery lists and stick to them.
“They’ll spend more on food than they actually need,” Goss said. “A lot of times they’ll buy extra things like pop, chips and cookies. Those types of things aren’t nutritious but do cost a lot and add up on that grocery bill.”
Shopping for generic brands of commonly used groceries is another way to save money.
“They’re going to be less expensive and have just as much as far as quality goes as brand names,” she said.
Purchasing fruits and vegetables – the staples of a healthy diet and meal – in season will save money, too.
“If you can’t get them in season, do the canned or frozen,” Goss said.
If vegetables must be bought canned, she advised rinsing them in water before cooking to get rid of the extra sodium from the canning process. Canned fruits should also be rinsed to rid the syrups and sugars.
In the summer, people can shop at local farmers markets to buy locally grown produce, which is fresher than store produce.
“When you can, buy locally,” she said. “Farmers markets are great. They are a great resource for people because usually they’re going to be fresher and they don’t have to worry about what’s on them, like pesticides.”
Or better yet, growing a garden to get those fruits and vegetables is another option, Goss said.
Another money-saving tip is to clip coupons from the newspaper.
“Look at the sales ads in the newspaper and plan your menus around those sale items,” she said. “Clip coupons for items they’d normally purchase, and don’t clip the ones on items they don’t usually buy.”
Making meals from scratch is cheaper and healthier than making boxed meals, she said. Some meals to make from scratch include beans, stew or chili, which can be prepared in large quantities then reheated later for another dinner or lunches. These meals also allow for beans as meat substitutes, which is cheaper.
“Try using beans in recipes for a protein source instead of meat,” she said. “(Use) half and half – half beans and meat – for chili or tacos to save a little bit of money, too.”
Shoppers can also buy their items in bulk sizes, which allows a larger quantity of product for a cheaper price than buying several small quantities, she said. Some of those include pasta, dried beans, generic bagged cereals and meat, which can be frozen in smaller portions for future meals.
Also, allowing the children to help plan the menu, shop and prepare meals will get them excited about eating healthier, Goss said.
“Have a family fun night where they pick out a healthy recipe they want to have one night, and let them help,” she said. “Let them be a part of it when you’re planning your menu for the week, and ask them what they want for the week. Have a list of meals for the week. Kids like that.”
<strong>Plan ahead:</strong> Plan a menu at the beginning of each week. Then make a grocery list before shopping. Planning ahead helps save money so you’re not wandering around the grocery store randomly throwing items into the cart.
<strong>Don’t impulse buy: </strong> Stick to the list. Don’t shop while you’re hungry and don’t throw in soda, chips and cookies as you’re waiting in the checkout line.
<strong>Look for generic brands:</strong> Generic store brands are considerably cheaper than name brand grocery items yet have the same quality. The savings begin to add up when you buy generic brands each shopping trip.
<strong>Buy fruits and vegetables in-season:</strong> In-season fruits and vegetables are less expensive. Also, shop local farmers market to get fresh produce at cheaper prices.
<strong>Clip coupons:</strong> Clipping coupons may sound tedious, but the money saved is worth it. But only clip and use coupons on items you normally buy.
<strong>Buy in bulk:</strong> Purchasing meats, cereal, flour and other items in bulk can save money, and you won’t have to shop for those items as often. If you buy meats in bulk sizes, freeze them in sizes you can defrost and use later.
<strong>Sneak in some fruits and vegetables:</strong> It’s possible to sneak in fruits and vegetables during the day, even while sitting at work. Pack an apple or banana with your lunch or pack raw carrots or broccoli in small portions. Vegetables can even be dipped in low-fat dressing for added taste.
<strong>Let the kids help:</strong> Let the kids help plan the menu. If they’ve helped decide what meals they want, they’ll be more likely to eat it. Let the older children help prepare meals by cutting vegetables and other tasks, and let the younger kids help set the table.
CLAREMORE, Okla. – Blue Cross & Blue Shield of Oklahoma will be at the Claremore Indian Hospital on July 20 to assist patients with signing up for free to low-cost health insurance through the Affordable Care Act.
The insurance company will be in Conference Room 2 from 9 a.m. to 3:30 p.m. to help people sign up for health insurance.
“We will be hosting another ACA Outreach and Enrollment Fair here at Claremore,” Sheila Dishno, patient benefit coordinator, said. “Even though members of federally recognized tribes have a special monthly enrollment status, it is important for American Indian and Alaska Native individuals and families to learn about their insurance options. Whether it’s purchasing insurance through the Marketplace or qualifying for SoonerCare, knowing that you have quality coverage provides peace of mind.”
Dishno said people who attend the fair should bring their Social Security cards, pay stubs, W-2 forms or wage and tax statements, policy numbers for any current health insurance and information about any health insurance they or their families could get from an employer.
The minimum income guidelines for households are as follows:
• 1-person: $11,880
• 2-person: $16,020
• 3-person: $20,160
• 4-person: $24,300
• 5-person: $28,440
• 6-person: $32,580
• 7-person: $36,730
• 8-person: $40,890
The hospital is located at 101 S. Moore Ave. For more information, call 918-342-6240, 918-342-6559 or 918-342-6507.