Cherokee Nation citizen Stacie Guthrie receives a flu shot from licensed practical nurse Sharon Morton at the Gadugi Health Clinic in Tahlequah, Okla. JAMI CUSTER/CHEROKE PHOENIX

Influenza hits CN but vaccines still available

Nationwide, during the week that ended on Jan. 12, 4.6 percent of patient visits reported to the U.S. Outpatient Influenza-like Illness Surveillance Network were due to influenza-like illness. This percentage is above the national baseline of 2.2 percent. CENTERS FOR DISEASE CONTROL By Jan. 12, the Centers for Disease Control reported that the flu had reached 48 states and influenza activity remained elevated in the United States. CENTERS FOR DISEASE CONTROL To help fight against influenza and inform people about the virus, Dr. Jorge Mera, of Cherokee Nation Health Services, provides a presentation on Jan. 18 in Tahlequah, Okla. TESINA JACKSON/CHEROKEE PHOENIX
Nationwide, during the week that ended on Jan. 12, 4.6 percent of patient visits reported to the U.S. Outpatient Influenza-like Illness Surveillance Network were due to influenza-like illness. This percentage is above the national baseline of 2.2 percent. CENTERS FOR DISEASE CONTROL
BY TESINA JACKSON
Reporter
02/01/2013 08:01 AM
TAHLEQUAH, Okla. – With more than 230 people testing positive for influenza within the Cherokee Nation, officials say tribal health clinics have vaccines available and urge people to get one.

Flu is a contagious respiratory illness caused by viruses. It causes mild to severe illness, and at times, leads to death. Some people, such as older people, young children and people with certain health conditions, are higher risks for flu complications.

“The flu is a virus and viruses are very, very smart you might say,” Dr. Roger Montgomery, CN medical director, said. “They change themselves every year and try to morph themselves so they can have a better success of causing illness. And there are also different strains out there, and so the CDC tries to come up with an idea of what strains of virus will cause illness each year and the vaccine has three different kinds of strains of virus in it.”

According to the Centers for Disease Control, this flu season has produced a high outbreak with more than 3,600 people hospitalized since October, most of them older than 65, and at least 20 children’s deaths.

By Jan. 12, the CDC reported the flu had reached 48 states and activity remained elevated. On average, 5 percent to 20 percent of the population gets influenza. This season, it’s hit more than 30 percent.

According to the Oklahoma State Department of Health, flu season began on Sept. 30. Since then there have been more than 500 related hospitalizations and eight related deaths in the state.

There are three types of flu viruses: A, B and C. Types A and B cause the epidemics that have up to 20 percent of the population sniffling, aching, coughing and running fevers. Type C also causes flu, but its symptoms are less severe.

The Type A virus constantly changes and is spread by infected people. Type B flu may cause a less severe reaction, but occasionally it can still be harmful. Type C viruses are milder than type A and B. People generally do not become extremely ill from them and they do not cause epidemics.

The flu usually starts suddenly and may include fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue and tiredness. Some people have vomiting and diarrhea, though it’s more common in children.

Some complications caused by flu are pneumonia, dehydration and worsening of chronic medical conditions such as heart or lung disease, asthma or diabetes. Children may get sinus problems or ear infections.

“The deaths that you see reported are not really from the virus itself. They’re from the super-imposed illness that occurs after they’ve had influenza that causes them to develop respiratory failure and pneumonia,” Montgomery said.

The flu spreads by droplets released by coughing and sneezing. Occasionally touching something with a virus on it and then touching the mouth or nose may cause infection. People with the flu can spread it to others up to about six feet away.

“That’s why we emphasize if you’re out there going to work, going to public places, touching objects that other people touch don’t take your hand and rub your nose without first washing your hands thoroughly and wash them frequently,” Montgomery said.

People with flu are contagious and can infect others beginning one day before getting symptoms. Adults remain contagious up to seven days after getting sick, and children can remain contagious even longer.

“If you came in contact with the person who had the flu, you’ve contracted the virus,” Dr. Sohail Khan, of CN Health Services, said. “Within two days you will start to develop symptoms, and the important thing to remember is that you can be infectious for the next five to seven days.”

The best way to prevent the flu is vaccination. The vaccination rate for the American Indian/Alaskan Native population is 29 percent, according to Indian Health Services.

“I think as a group, because the prevalent of diabetes is so great, that it’s just recommended broadly that all Native Americans be vaccinated,” Montgomery said.

According to WebMD, the vaccine is highly effective for preventing the flu, though not 100 percent. People can get the flu despite getting vaccinated, although it’s usually less severe and resolves quicker. According to the CDC, vaccines given this year appear to be about 62 percent effective overall. Of people who got the flu, 32 percent were vaccinated.

“It can either completely eliminate you from having any symptoms at all or it can, the word we use is, attenuate,” Montgomery said. “It can lessen the severity of the duration of symptoms that you have.”

There are two types of vaccines: the shot and nasal spray. The shot is contains a dead virus that’s given with a needle. The shot given in the muscle is for people older than 6 months, including healthy people and people with chronic medical conditions. The shot given below the skin is for 18- to 64-year-olds.

The nasal spray vaccine contains live, weakened viruses. It’s for healthy people ages 2 to 49 who are not pregnant. Neither vaccine causes the flu.

It takes about two weeks for antibodies to develop that protect against infection for the entire year. Flu vaccines will not protect against illnesses caused by other viruses such as the common cold.

If positive for flu, there are antiviral drugs that can be used to treat the illness.

“The main one that most people have heard about is called Tamiflu,” Montgomery said. “It’s most effective if you start it within 48 hours of the onset of your symptoms.”

Annual vaccination is recommended for everyone regardless of past vaccination status or flu infection. Vaccination should begin in September or as soon as the vaccine is available and continue throughout the flu season, which can last as late as May.

To view a CN Health Services flu presentation, visit http://legislative.cherokee.org/StreamingEvents.aspx
and click on influenza presentation.

tesina-jackson@cherokee.org


918-453-5000, ext. 6139

About the Author
Born in Dayton, Ohio, Tesina first started working as an intern for the Cherokee Phoenix after receiving the John Shurr Journalism Award in 2009. Later that year, Tesina received her bachelor’s degree in journalism from Ball State University in Muncie, Ind., and in 2010 joined the Phoenix staff as a reporter.    

In 2006, Tesina received an internship at The Forum newspaper in Fargo, N.D., after attending the American Indian Journalism Institute at the University of South Dakota. She also attended the AIJI summer program in 2007 and in 2009 she participated in the Native American Journalists Association student projects as a reporter. Tesina is currently a member of NAJA and the Investigative Reporters & Editors organization.
TESINA-JACKSON@cherokee.org • 918-453-5000 ext. 6139
Born in Dayton, Ohio, Tesina first started working as an intern for the Cherokee Phoenix after receiving the John Shurr Journalism Award in 2009. Later that year, Tesina received her bachelor’s degree in journalism from Ball State University in Muncie, Ind., and in 2010 joined the Phoenix staff as a reporter. In 2006, Tesina received an internship at The Forum newspaper in Fargo, N.D., after attending the American Indian Journalism Institute at the University of South Dakota. She also attended the AIJI summer program in 2007 and in 2009 she participated in the Native American Journalists Association student projects as a reporter. Tesina is currently a member of NAJA and the Investigative Reporters & Editors organization.

Health

BY JAMI MURPHY
Reporter
02/27/2015 08:00 AM
TULSA, Okla. – Cherokee Nation citizen Tyler Moman and his wife Destiny said they were “blessed with two miracles” on Jan. 7 when Rylie Dawn and Haylie Reece – a set of monoamniotic twins – were delivered at 28 weeks and 6 days in gestation at St. John Medical Center. The difference between monoamniotic twins and other twins are that monoamniotic twins share the same amniotic sac and placenta. This means umbilical cords can easily tangle or kink as the twins grow in the womb. Monoamniotic twins are rare and have a 50 percent birth survival rate, Tyler said. Destiny said the twins must be monitored closely because as they grow in the womb they can strangle one another with their umbilical cords. “With mono-mono twins, at 24 weeks they always want to start monitoring you because about 24 weeks is when the babies start getting their growth spurt and start moving around more often, and they want to keep an eye on their heart rates,” she said. “Because the babies’ cords can knot or wrap around each other’s throats and strangle each other or cause harm between the two, which is kind of what started to happened with my two.” Tyler said Destiny started having problems as the babies’ heart rates dropped on Jan. 6 while being monitored at the hospital. The Grove couple welcomed the babies early the next morning. At birth Rylie weighed 3 pounds and Haylie was 2 pounds, 10 ounces. Both babies had to be on oxygen and feeding tubes. Destiny said they were also in isolation early on, monitored every few hours and still have a long way to go but are much improved. Other problems the girls may face is a “slower development of growing.” “At a year old they might look 6 months old or something or a little smaller, but then again there’s been twins that have grown tremendously compared to, you know, most twins,” Destiny said. Both babies have heart murmurs, but Destiny said those are expected with premature babies. Most often murmurs remedy themselves with medication and growth. “Rylie now weighs 4 pounds, 15 ounces. She’s been off oxygen now for 6 days (as of Feb. 9). She still has her VSD (ventricular septal defect – a hole in the wall of the heart between the bottom two chambers) but that’s normal for her. They say hers is so small it might close on its own in her first year,” Destiny said. “So Rylie has knocked out three of her milestones. She can breath on her own, keep her own temperature and is over 4 pounds.” Destiny said Haylie now weighs 4 pounds, 10 ounces, and like her sister, is off the oxygen tube but still uses a feeding tube. “She is keeping her own temperature up also. They both have almost outgrown their preemie clothes. They both have been taken off their Prolacta (human milk-based nutritional product) and are now on a different fortifier that gives them 24 extra calories. My milk gives them only 20 calories…They no longer have a pic line in anymore so no more IV fluids,” she said. “They get a vitamin once a day. They should be off their caffeine soon. They both still have their feeding tubes but they moved them to their noses so they can nipple feed. They will keep those in till they can take 50 percent of their feedings and then they will take them out.” She said the girls are getting better and stronger every day and she cannot wait until they can go home. A Go-Fund Me Crowdsource fund has been established to raise funds to allow Destiny to stay at the hospital, as well as car seats tailored for premature babies. Visit <a href="http://www.gofundme.com/k48zww" target="_blank">www.gofundme.com/k48zww</a> for more information.
BY ASSOCIATED PRESS
02/23/2015 09:30 AM
OKLAHOMA CITY (AP) – While state leaders remain steadfastly opposed to a Medicaid expansion offered under the federal health care law, some of Oklahoma’s 39 federally recognized Native American tribes are exploring opportunities for a federal waiver that could mean health insurance for about 40,000 low-income uninsured tribal citizens. Oklahoma Health Care Authority CEO Nico Gomez said talks are underway about seeking an expansion of the state’s Insure Oklahoma program to include some of the estimated 80,000 Native Americans in Oklahoma without health insurance. Gomez estimated as many as half of those tribal citizens could qualify for the program, depending on where the income threshold is set. Although still conceptual, Gomez said the idea would involve the tribal citizen paying a portion of the health insurance premium, the tribe paying a portion and the federal government paying the largest part. “We’re not looking at tapping into any state revenue, not now or in the future,” Gomez said. “Frankly, if it required any state revenue, I’m not sure we’d even be having this conversation.” Gomez said the proposal was initially discussed the first week of February with tribal representatives, and that he planned to brief members of the Health Care Authority’s governing board during its regular meeting on Feb. 12. Some of the state’s largest tribes, including the Chickasaw and Cherokee nations, are involved in discussions, Gomez said. Insure Oklahoma provides health coverage to about 18,000 low-income Oklahoma residents, mostly through a program in which the cost of premiums are shared by the state (60 percent), the employer (25 percent) and the employee (15 percent). The state portion of the program is funded through a tax on tobacco sales, but a federal waiver that allows the program to operate has only been approved through the end of the year. Gomez said expanding the program to include a tribal option could help ensure the federal waiver continues. Billy James, a 31-year-old University of Oklahoma student and a citizen of the Chickasaw Nation, said he wants to have health insurance but can’t afford the premiums. “I’m trying to hold out as long as I can,” said James, who is finishing his master’s degree and currently unemployed. “I’m kind of scared about not having insurance, but I’ve got to tough it out a little while longer.” A spokesman for Gov. Mary Fallin, a staunch supporter of the Insure Oklahoma program, said the governor is excited about the potential of a tribal expansion. “We’re particularly excited about the fact that it would not cost the state any tax dollars, which is important as we deal with our current shortfall,” Fallin spokesman Alex Weintz said. Currently, there are about 130,000 Native Americans in the state’s Medicaid program, which is about 16 percent of the overall Medicaid population in Oklahoma.
BY STAFF REPORTS
02/21/2015 04:00 PM
WASHINGTON – Veterans can now track the status of most of their prescriptions online, thanks to an innovative idea by a Department of Veterans Affairs employee. The new 24/7 service allows online tracking for most prescriptions mailed from the VA Mail Order Pharmacy. VA employee Kenneth Siehr, a winner of the President’s 2013 Securing Americans Value and Efficiency Award, recommended the Prescription Tracker server. Siehr’s idea focused on the use of technology as a way to save money and improve the services VA provides to its patients. “Our nation’s veterans deserve a first-class pharmacy and quality customer service as a part of the exceptional health care available from VA,” said Siehr, the national director for Consolidated Mail Outpatient Pharmacies. “It is an honor to be part of serving veterans and to have been recognized for an idea that enhances our services to them.” More than 57,000 Veterans are currently using the service through My HealtheVet, an online feature that allows veterans to partner with their health care team. The number is expected to grow as VA starts to educate veterans about the new feature. Later in February, the tracking feature will include images of the medication that dispensed. Over the next year, a secure messaging alert will be added so that veterans know when a medication was placed in the mail. “VA prescription refill online is an excellent example of how one employee looked at the process of VA prescription tracking through the eyes of our veterans and came up with an idea that better serves veterans,” said Interim Under Secretary for Health Carolyn M. Clancy. “This idea is both innovative and transformative, and it is certainly one, when put into action, improves customer service for America’s veterans.”
BY STAFF REPORTS
02/21/2015 12:00 PM
SALLISAW, Okla. – To provide a sense of comfort for health care patients and their families, Cherokee Nation officials are adding a second prayer feather sculpture to the landscape at a second CN health facility. In September, Cherokee artists, and father and son, Bill Glass and Demos Glass placed the first of the culturally significant sculptures at the A-Mo Health Center in Salina. Recently, a second sculpture was installed at the Redbird Smith Health Center in Sallisaw. “Dad and I wanted to do this symbolic ‘Prayer Feather’ for our clinic in Salina because the staff is very friendly and courteous. We also wanted to do this in loving remembrance of my grandmother Jean Justice Glass, who was a trained Army nurse,” Demos said in a September Phoenix article. “I primarily designed the feather, and he had a ceramics portion in it. The ceramic’s got an inset detail with a nice four (crossed) logs motif. It’s just our symbol for prayer.” The material used was fabricated stainless steel, so it began as a sheet of steel that had to be cut and welded to create the 8-foot, 2-inch tall and 24-inch wide sculptures. Tribal officials hope the sculptures will give patients and their families calmness as they enter health centers. “Our first priority is to better the lives of our citizens by continuing to provide them with excellent health care,” Health Services Executive Director Connie Davis said. “We are excited to include these beautiful pieces as part of providing an overall positive experience for our patients.” The hand-constructed, stainless steel sculptures stand more than 8 feet tall. Each sculpture features a unique base. The ceramic base at the A-Mo Health Center represents the creator’s world above and the four logs of the stomp dance fire on earth. “As Cherokee citizens are undergoing health care, displaying this important part of our culture may bring a sense of peace to what they are experiencing. Feathers symbolize strength and are key instruments in traditional Cherokee medicine and healing,” Principal Chief Bill John Baker said. “I am proud that along with world-class health care, our centers are showcasing Cherokee culture and world-class Cherokee artisans like the Glass family.” Funding to procure the sculptures was set aside through renovation and new construction projects. In accordance with tribal law, when the price of a renovation or new construction project exceeds $500,000, 1 percent of the cost is set aside for procurement of Cherokee art. The tribe is also planning to emplace a third prayer feather at Sequoyah Schools.
BY TESINA JACKSON
Reporter
02/18/2015 12:00 PM
TAHLEQUAH, Okla. – Recently, tribal officials purchased the Clinic in the Woods and the Cascade property located next to the Cherokee Nation W.W. Hastings Hospital to help place the tribe’s Behavioral Health services in a more centralized location. One building will be used strictly for the HERO Project, which focuses on children and families, and the other will be directed more toward adult services. The buildings are expected to be open in the spring. For more than 20 years the tribe’s Behavioral Health has offered several programs, including mental health services, substance abuse treatment and community-based programs promoting mental health. “I do think it’s a great program,” Connie Davis, CN Health Services executive director, said. “I’ve had personal experiences with my family who has used the Behavioral Health services and I feel that they have been treated very well and have been very successful.” Behavioral Health also offers programs designed to help prevent substance abuse and other risky behaviors. “They’re counseling services for thousands of potential diagnosis,” Davis said. “Generally the patient population we see is depressive type of disorders and then we see a lot of substance abuse patients have supports groups for their treatment.” Behavioral Health currently has 42 licensed providers at 11 health clinics within the tribe’s 14-county jurisdictional boundaries. They are the Tahlequah Health Living Campus, Hastings Hospital, Three Rivers Health Center in Muskogee, Redbird Smith Health Center in Sallisaw, Bartlesville Health Center, Will Rogers Health Center in Nowata, Sam Hider Health Center in Jay, A-Mo Health Center in Salina, Jack Brown Treatment Center in Tahlequah, Vinita Health Center and Claremore Indian Hospital. Outpatient services include individual and family therapy, substance abuse counseling, relapse prevention, parenting skills for disorders of childhood, psychological testing and crisis intervention. Davis said to be seen at Behavioral Health, one calls the clinic and requests an appointment. “It’s based on what the patient conveys to the receptionist as what their need is,” Davis said. “If they need to see someone that day then we’re seeing same-day emergencies. If they feel like they need to talk to someone immediately then they can transfer the call to a provider there at the clinic or a health center.” Davis added that follow-up appointments vary because it’s an individualized treatment plan and it depends on the patient and his or her needs. If a patient is prescribed medication, a Behavioral Health therapist or a primary care physician refers them. Because psychiatry is a specialty clinic, it allows the Behavioral Health staff to assure that the referrals are appropriate. Primary care physicians are then able to continue medication management. Primary care physicians or Urgent Care may also be able to provide prescriptions. “You have to see someone with prescriptive authority,” Davis said. “In most centers we try to have someone available if not, then you do have to see your primary care provider.” Behavioral Health 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. Triple P aims to prevent problems in the family, school and community and to create family environments that encourage children to realize their potential. On Nov. 3, the CN purchased Clinic in the Woods, which is located near Hastings along Boone Street and the Cascade property, which is located near Northeastern Health System Tahlequah and Hastings. For more information, email <a href="mailto: behavioralhealth@cherokee.org">behavioralhealth@cherokee.org</a> or call 918-453-5000 or 1-800-256-0671.
BY STAFF REPORTS
02/05/2015 08:18 AM
OKLAHOMA CITY – The Oklahoma Caring Foundation revealed its new “Caring Van” on Jan. 13 that will serve American Indian citizens statewide. The “Caring Van” will be coordinated and staffed by the Oklahoma City Area Inter-Tribal Health Board and administered by the Oklahoma Caring Foundation. “With this new caring van we are expanding our geographic reach, as well as the lifesaving preventive services we offer,” Brooke Townsend, Caring Foundation manager, said. “We are proud to partner with the Oklahoma City Area Inter-Tribal Health Board to serve tribal citizens across the state.” The vehicle will support the “Oklahoma Caring Van Program” in providing consistent, year-round preventive health services at tribal sites and community events. Staff manning the van will focus on oral health, diabetic screenings and other preventive health services and education for American Indian children and adults. The “Oklahoma Caring Van Program” has provided nearly 260,000 lifesaving immunizations and is a proud contributor to Oklahoma’s immunization efforts, according to an Oklahoma Caring Foundation press release. The vans help make health care more accessible by eliminating the barriers of inconvenient clinic hours, long wait times, transportation and cost. The Oklahoma Caring Foundation Inc. is a nonprofit organization administered as an in kind gift by Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company. These companies are independent licensees of the Blue Cross and Blue Shield Association. For more information, visit <a href="http://www.oklahomacaringfoundation.org" target="_blank">oklahomacaringfoundation.org</a>.