Heidi Lyman, left, of Kansas, Okla., receives instruction from Brenda Fowler, a registered nurse for W.W. Hastings Hospital’s Diabetes Management, on how to use a glucometer to test her blood sugar level. JAMI CUSTER/CHEROKEE PHOENIX
Tribes Diabetes Program receives national award
TAHLEQUAH, Okla. – The Cherokee Nation Diabetes Program was recently awarded the John Pipe Voices for Change Outcomes Award, which recognizes federally funded Special Diabetes Programs for Indians or SDPIs that have excelled advocacy, outcomes and innovation.
CNDP Director Teresa Chaudoin said the award is named in memory of diabetes advocate John Pipe, of Wolf Point, Mont., who served as a member of the American Diabetes Associations’ Native American Initiatives Subcommittee.
“The awards are named in memory of his longstanding advocacy efforts reached from his local community to Washington, D.C., and affected countless tribal communities,” she said. “The Special Diabetes Program for Indians is a $150 million per year grant program that is funded through congressional legislation and administered by the Indian Health Service.”
The CNDP received the award for demonstrating outcomes such as significant improvement on clinical measures of patient care for diabetes patients throughout the CN health system, as well as demonstrating measurable success in health lifestyle change and weight loss in people with pre-diabetes who participate in the CN Diabetes Prevention Program.
This is the first time the CNDP has received the award and Chaudoin said being recognized for doing good work in one’s chosen field is always nice.
“And this award belongs to all the different disciplines of providers in the Cherokee Nation health system – physicians, nurses, dietitians, lab techs, pharmacists, certified diabetes educators, health educators, behavioral health providers, dentists, optometrists, podiatrists – who work together as teams every day to provide excellent care to help their patients with diabetes live healthier lives, and to help people at risk for diabetes to reduce their risk,” she said.
Chaudoin added that the award is a “wonderful reflection on all those people with diabetes or at risk who take an active role” in improving their health.
“Our receipt of this award also demonstrates to Congress and to other agencies that the funding we have received to treat and prevent diabetes in Cherokee Nation has been well-spent,” she said.
The award focuses more on clinical outcomes, Chaudoin added.
CN provides services and supplies to more than 10,000 diabetic patients each year in the 14-county jurisdiction.
“Our program uses a diabetes systems of care approach to prevent and treat diabetic complications, and employs clinical staff from multiple disciplines that are located at nine facilities throughout the Cherokee Nation health system,” she said.
The funding from SDPI for the diabetes program is also shared with CN Healthy Nation and its activities to allow partnering with schools and communities to increase physical activity.
“They have so many things going on…and all those things keep people with diabetes healthier and help prevent diabetes in people who are at risk for developing it,” Chaudoin said.
TAHLEQUAH, Okla. – To help place the Cherokee Nation’s Behavioral Health services in a more centralized location, tribal officials recently purchased the Clinic in the Woods building located at 1325 E. Boone St. between the Northeastern Health System Tahlequah and the tribe’s W.W. Hastings Hospital.
“We have been leasing space for years, and to purchase this at a very good price, and the location, made it a good opportunity for the tribe. But also the location will make it convenient for patients so they can go see their providers, and then they can just go over to Hastings to get their medication,” CN Health Services Executive Director Connie Davis said.
According to CN documents, the tribe purchased the building on Nov. 3 for $1,078,500.
Davis said the building was appraised for more than $3 million. She added that her sister was the realtor of the Clinic in the Woods but removed herself once the tribe became interested in the building.
Davis said there wouldn’t need to be many renovations except painting and new carpet.
She added that she was hoping the location would be open before March.
According to the CN website, Behavioral Health offers programs such as mental health services, substance abuse treatment and community-based programs promoting mental health. It also offer programs designed to help prevent substance abuse.
Presentations and technical assistance to schools and community organizations are available on topics including alcohol and drugs, violence, mental health, suicide and reproductive health. Outpatient services include individual and family therapy, substance abuse counseling, relapse prevention, parenting skills for disorders of childhood, psychological testing and crisis intervention.
Behavioral Health also started Project Launch in 2013, which offers training for practitioners to help circulate programs and provide those services to families in Cherokee communities. One program of Project Launch is a three-day training Triple P-Positive Parenting Program, a parenting and family support system designed to prevent and treat behavioral and emotional problems in children and teenagers, according to its website.
Triple P aims to prevent problems in the family, school and community and to create family environments that encourage children to realize their potential.
MARGIBI COUNTY, Liberia, Africa – Three Cherokee Nation citizens are serving in Liberia with the U.S. Public Health Service helping to stop the Ebola epidemic in West Africa.
Capt. Kevin Brooks, chief pharmacist at the Whiteriver Indian Health Service hospital in Whiteriver Arizona; Cmdr. Dana Hayworth, registered nurse at CN W.W. Hastings Hospital in Tahlequah, Oklahoma; and Lt. Cmdr. Julie Erb-Alvarez, epidemiologist at the IHS Oklahoma City Area Office, are serving at the forefront of the U.S. government response to the Ebola outbreak. They are among the USPHS officers staffing the Monrovia Medical Unit, a 25-bed field hospital that has been reconfigured to function as an Ebola Treatment Unit.
The team consists of doctors, nurses, infection control officers, pharmacists, laboratorians, behavioral health specialists and administrative management staff. They are providing support and care for health care workers and responders who are combatting the disease.
“I am very proud that I have been able to come to Liberia and represent the Cherokee Nation and the United States as we assist the people of Liberia overcome this unprecedented outbreak that has devastated their country,” Brooks said. “I went into this mission not for any recognition but just to help people in need, which is why I became a United Stated Public Health Service pharmacist with the Indian Health Service. In just the short time that the USPHS has been here helping, you can see a significant benefit to the Liberian people, and I greatly hope that this partnership continues in areas other than Ebola.”
The medical unit’s focus is to provide care to international and local health care workers and responders who become infected with the Ebola virus. By providing that care, they, in turn, can care for other Ebola patients in the region. The USPHS team arrived in Liberia in December, but USPHS officials did not say when the team would return home.
“I understand the positive impact that this mission is having for our tribe, our country and globally. I am grateful to be a part of the response and appreciate the love and support I have received from friends, family and my workplace,” Erb-Alvarez said. “As an epidemiologist working for the Indian Health Service, I have followed the West African Ebola epidemic from early 2014 until it turned into a full global public health crisis. From the beginning I have wanted to help and this experience is life changing.”
USPHS health care workers are providing medical care to Ebola responders who are at a high risk of getting infected with the virus if they come in contact with symptomatic or infected patients and with vomit, diarrhea, blood and soiled bedding.
“This mission in West Africa is a chance to offer hope and healing to these people in Liberia who are devastated by the Ebola virus. It has wiped out entire communities, towns and families. There are children who have lost both parents to the disease and are now being raised by siblings and the community that remains,” Hayworth said. “This mission is also a chance to help contain the EBV before it spreads to other countries and continents on the level it is here. So I feel that by participating in this mission, I am providing humanitarian care that is desperately needed here in country while at the same time attempting to protect my nation against the spread of this deadly disease.”
Hayworth said she misses her family, friends and job and that her co-workers have been supportive of her mission and have sent cards, care packages and emails.
“I am very thankful to them. The have all supported me and kept things running smoothly at home,” she said. “Christmas Day was especially hard but some of our team members spent time with some children in the community who were also without family because they had died from Ebola. It put things in perspective for me. So, I was blessed on Christmas like never before by sharing it with these precious children.”
Erb-Alvarez said Liberians have welcomed them “with open arms” and the USPHS team are thanked everywhere they go in the country.
“I have been told over and over that because of us, they now have hope. Being here has allowed me to experience in-person the devastation that this epidemic has had on the people of West Africa and gain a first-hand understanding of what we in the United States only occasionally see or read about in the news,” she said.
She added she misses her husband and daughter, her “granny’s smile” and her mom, dad and brothers.
“I miss all my pets. There are no animals here, only lizards, bats and bugs. I miss being able to hug and shake hands. We have to maintain social distancing at all times. It will probably be tough to come home and have people hugging me and shaking hands,” Erb-Alvarez said. “I really miss good food, driving and good roads. I don’t really miss the cold weather though. I am actually enjoying the African heat and humidity.”
TAHLEQUAH, Okla. – Cherokee Nation officials in 2013 announced an expansion to the tribe’s Health Services, which included a new W.W. Hastings Hospital in Tahlequah. On Jan. 15, tribal officials said the Indian Health Service has awarded the CN a Joint Venture Program project to help pay for a new Hastings.
As part of the agreement between the CN and IHS, the tribe will fund the construction of a more than 250,000-square-foot facility on the hospital’s Tahlequah campus. IHS initially provides up to $30 million per year for 20 years for staffing and operations, according to CN Communications.
The tribe was among more than 30 applicants and one of the top three selected for the project.
“Cherokee Nation Health Services cannot be more excited about the future of W.W. Hastings Hospital and our tribe’s health system as a whole,” Health Services Executive Director Connie Davis said. “With the millions of dollars from the joint venture project, the Cherokee Nation will continue to offer first-class health service at a state-of-the-art health facility.”
Davis said she’s worked within the walls of the current hospital since 1988 and knows firsthand the challenges of not having enough room as both a patient and a nurse.
“And so when I had the opportunity to have this job it was more than I could have ever dreamed when the (principal) chief (Bill John Baker) readily said ‘OK, let’s make some expansions’ and had support of the council and put that money where their mouth is,” Davis said. “We’ve got a great team of people and the chief pushing forward to get this done.”
Davis said in August 2013 the Tribal Council passed a resolution to apply for the joint venture with IHS. The resolution was submitted that September.
“We were notified Oct. 15 of the same year that we were in the top running. And just this past year, or this week, notified that we were selected,” she said.
Hastings CEO Brian Hail said in conjunction with IHS, CN would begin the planning process with the new hospital following program requirements.
“We estimate we’ll have that completed by the end of the summer then hopefully we can have construction completed within the next two to three years,” Hail said.
Principal Chief Baker said it took work from several people and departments to bring the tribe’s health services where it is today.
“But I stand before you today to tell you that this is probably the greatest news of the modern Cherokee Nation,” he said. “Yes, we started gaming some 10 years ago and that was great news, but over those 10 years we averaged about $20 to $25 million a year coming into the tribe for direct services to our people. But because of this announcement today we have been approved for a joint venture on the W.W. Hastings Hospital campus to proceed...right away.”
He added that CN official would do everything in their power to maximize the dollars to make the lives and the health care of the Cherokee people.
“So we don’t know exactly how it’s going to look because there is going to be some negotiations and give and take, but it very likely could mean more dollars per year than the dollars they gave us when we took over Hastings Hospital five years ago,” Baker said.
According to a press release, the “expanded hospital campus will help alleviate the strain on the current hospital, which was built 30 years ago to serve 65,000 outpatient visits each year. The hospital currently serves more than 400,000 patient visits per year. The new facility will include more than 100 exam rooms and dozens of specialty rooms.”
The release also states that in the early 1990s, IHS started a Joint Venture Program to help tribes develop better health care facilities for its citizens “while alleviating financial strain on the federal government.”
WASHINGTON – To improve and enhance the health and fitness of American Indians and Alaska Natives across the nation, the Indian Health Service recently signed a Memorandum of Understanding with Nike USA Inc. to collaborate on the promotion of healthy lifestyle choices for American Indians and Alaska Natives.
One focus area for this collaboration will be on supporting and promoting physical activity programs among Native youth before, during and after the school day.
“Regular physical activity and healthy food choices contribute to better health by reducing obesity and the many chronic conditions associated with it, including diabetes and heart disease,” Dr. Yvette Roubideaux, acting IHS director, said. “This partnership will serve American Indian and Alaska Native communities by expanding the information available on the importance of physical activity and healthy lifestyle choices.”
This MOU continues a partnership between the IHS and Nike that started more than 10 years ago, when they initially began to identify opportunities to work together to inform and educate Native communities about healthy lifestyles and choices. In the past decade, the partnership has made progress in encouraging American Indians and Alaska Natives to take charge of their health with innovative exercise and nutrition programs.
“N7 is Nike’s long-time commitment and mission to inspire and enable two million Native American and Aboriginal youth in North America to participate in sport and physical activity,” Sam McCracken, Nike N7 general manager, said. “We are proud of Nike’s unique partnership with IHS and our shared commitment to unleash the potential of American Indian and Alaskan Native communities through the power of movement.”
With the new MOU, the IHS and Nike are focusing on ways to motivate and inspire American Indians and Alaska Natives of all ages to continue on the path to a healthier future.
TAHLEQUAH, Okla. – It’s 5:15 p.m. and Cherokee Nation citizen Angie Cone is alone at the front of the room. Dressed in a shade of red-orange, her workout clothes are color coordinated down to her socks and sneakers. She stands at the stereo, shuffling her playlist and stretching.
Women make their way into the cardio room at the Male Seminary Recreation Center, the gym owned and operated by the CN. A few are first timers to Cone’s Zumba® class.
As Cone steps in front of the group, she asks, “Anyone here new to Zumba®?” A few hands go up.
The room is bright and flanked by floor-to-ceiling mirrors at its ends. Class regulars claim their spots, creating ordered ranks for the newcomers to find spots.
Cone assures everyone that it’s normal to feel awkward at first, especially when confronted by the huge mirrors and learning something new. She tells them it takes two to three classes before they feel like they know what they’re doing.
“I’ve heard people say my class is hard,” Cone said. “Just do what you can do. My mom is back there in the back row. Just do what she does. She lasts the whole hour.”
Cone’s mother, Debra Johnston, is in a back corner, strategically positioned in front of the room’s single wall-mounted fan.
It’s all business once the music starts. A warm-up routine accelerates until most women are breathing heavier and have a worked up a light sweat. Then come the squats, jumping jacks and crunches. The routines are a blend of dance and calisthenics performed to Cone’s blend of catchy popular music, Christian rap and A Tribe Called Red’s ‘Electric Powwow.’
Cone calls out the moves two beats ahead and gestures directional prompts, helping everyone keep up. Every set is done in counts of two, four or eight.
During a challenging squat-filled routine, she yells, “Your legs should be on fire!” Many nod as they
grimace through the song blaring over the speakers.
At the end of the hour, the women wipe away sweat, grab their water bottles and promise to see each other next time.
Azar Rahmani, a front-row regular, owns Azar’s Mediterranean Kitchen in Tahlequah’s “North End.”
“I stand on my feet all day. It makes me feel good to move,” she said. “It makes me stronger.”
One woman in class said since she’s been doing Zumba®, she can eat whatever she likes.
According to Harvard Health Publications, one can burn 360 to 532 calories an hour of just dancing fast. Cone’s heart rate monitor and calorie tracker puts her hour-long total consistently between 900 to 1,000 calories.
“With Zumba® , you burn a lot of extra calories compared to a steady-state exercise like jogging,” states Dr. John P. Porcari of the American Council on Exercise.
For Cone, Zumba® was a way to bust through a diet plateau and empower herself.
“I’ve always been kind of fitness minded and then you’d hit a plateau and just nothing works anymore. I saw it (Zumba®) advertised on TV and said to her (Johnston), we should do that but she didn’t want to do it,” she said. “We would go to the gym and I’d use the elliptical machine and the treadmill and a little bit of weights and stuff. But I could never get out of that plateau.”
Undeterred, Cone pitched in with co-workers to buy the Zumba® DVD set to exercise to at work. But it just wasn’t the same as being in a live class.
“I thought they looked like they were having fun and they weren’t in agony,” Cone said.
Zumba® is marketed as “exercise in disguise” for a reason.
“This is the first thing that I’ve done that you’re getting a total body workout and you don’t even realize it,” she said.
Cone started taking classes at the MSRC with instructor Tonya Wapskineh, who leads classes on Monday, Tuesday and Thursday on the gym’s floor.
“At first it’s intimidating. We (she and her mother) were out there on the floor thinking ‘this is embarrassing, I don’t think I can do it,’” Cone said. However, she said, “once everything starts, you just forget and you just do it.”
From this experience, she knows what it’s like as a beginner.
“When we first started, it was brutal because everybody had their own spot to stand. We’d get there like 45 to 30 minutes early. We’d get in a little workout beforehand, but we’d make sure we were up there in that room in our spot ready to go when class started,” Cone said. “If you got our spot, we’d just look at you like, ‘I don’t know, you’re going to have to move…’”
Respecting each other’s “spot” is unspoken Zumba® etiquette.
“It’s like at church, you know. These people are really nice until you get in their pew,” Johnston said. “Then they’re not that nice!”
The Zumba® “spot” may be something the pair laughs about, but Johnston’s diabetes was not. Cone decided she had to get her mom to exercise more even if it meant teaching a class herself.
“I started out just substituting for Tonya,” she said.
However, to teach Zumba®, instructors have to be trained and certified through the Zumba® company. Cone did the all-day training and said students are taught not only how to perform the steps and develop a class, but also how to make teaching Zumba® a business.
“I didn’t want to make it a business. But I knew what it did for me and I saw how it changed other people’s lives so maybe I could do that. Maybe if I taught, my mom would want to come.”
And her mom did come. She needed to exercise more, or at least differently. She was struggling to manage her diabetes.
“My numbers got better right after I first started. I started losing weight and getting toned. I’ve lost 40 pounds, or something like that, so far,” Johnston said.
Through teaching Zumba®, Cone has helped not only her mother but other women in the CN get more fit and have fun doing it.
“At least within a month, I can see a difference in them. They’re standing up taller. They’re happy to be there. They want to be there. They can feel a difference. They’re telling me after class that now they can do this or they’ve done that,” she said.
Cone’s mother is her biggest fan.
“It’s just fun. You feel like you’re just dancing. Remember your clubbing days? That’s what you’re doing out there. You’re just shaking and twisting and it’s fun,” Johnston said.
Cone said she tries to make it fun.
“I feel that if I can’t do it, that I can’t teach you anything. My main focus is that you are moving and having fun because if you’re not having fun, you’re not coming back,” she said.
– REPRINTED WITH PERMISSION
The Male Seminary Recreation Center is located at 1501 Graham Ave. To join the class, one must have a MSRC membership or pay a $5 one-day pass. Con also leads a class at Surefire Fitness located at 106 West Division in Stilwell. For more information, email ConeAngela1976@gmail.com. If not in the Tahlequah or Stilwell areas, find a Zumba® class by visiting www.zumba.com.
SALLISAW, Okla. – Roland Junior High School Principal and Cherokee Nation citizen John Speir changed his life for the better after losing 170 pounds with the help of Cherokee Nation’s Healthy Eating for Life Program and self-determination.
Before seeking out the program at W.W. Hastings Hospital in Tahlequah, Speir weighed 398 pounds and often became winded and felt pain when monitoring the school’s hallways. Now, the 43-year-old weighs 228 pounds and is taking back his health.
“Before any weight loss, I was a really big guy,” the Sallisaw resident said. “If I did a lot of strenuous work, or walked a long way, my knees and back hurt and I felt pain down my legs. That stuff doesn’t happen now.”
Speir’s doctor at the Redbird Smith Health Center referred him to HELP in summer 2013.
According to a CN press release, the HELP includes a team of nurses, surgeon, psychologist and counselor certified in the medical study of obesity provide patients with nutrition education, weight loss support groups and possibly bariatric surgery.
“I wanted to make sure I was going to be around to see my girls graduate high school and college and to one day walk them down the aisle,” Speir said. “I made my mind up right then that I had to do something different. I had to change.”
The program urged Speir to keep a food journal, cut out soft drinks and fast food and start exercising. In a year’s time he lost 100 pounds and qualified for the Lap-Band surgery this past summer.
“My surgeon, Dr. Hope Baluh, was very thorough and stringent on her requirements for surgery,” he said. “In the months that I went to the HELP clinic before surgery, they taught me how to think differently about so many things, which has helped me continue to lose weight after my surgery. I couldn’t have done it without them.”
After the surgery Speir lost an additional 70 pounds. With the weight loss, Speir looks forward to spending the summer being more active with his daughters’ sports teams.
“We really want our HELP clinic to be different in the way that people aren’t just left hanging in the breeze after being given some information,” Maggie Parker, a W.W. Hastings Hospital certified bariatric nurse, said. “The goal is to teach our participants how to have a healthy life and then for them to teach their children to keep their families healthy.”
There are two surgical procedures provided through the clinic, the Lap-Band and laparoscopic vertical sleeve gastrectomy. The Lap-Band is an adjustable device that goes around the patient’s stomach and the laparoscopic vertical sleeve gastrectomy is a procedure, which consists of removing a large portion of the patient’s stomach to reduce food consumption. Patients must have a referral submitted by a primary care provider from a tribal facility and they must meet strict guidelines to qualify for bariatric surgery.
“Dr. Baluh and the HELP clinic are truly changing lives for the better every day at W. W. Hastings Hospital, and we believe that a personal success story like Mr. Speir’s helps more of our Cherokee Nation citizens realize the changes they can make to improve their own health,” Hastings Hospital CEO Brian Hail said.
The tribe’s HELP aided approximately 1,500 patients in 2014 and is one of the fastest growing bariatric clinics in the area.