Lab Testing in Boundary County Part 1

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Laboratory Testing for COVID-19 in Boundary County

By: Greg Botkin, MD, Medical Director, Boundary Community Hospital

Part 1 of 2

Dr. Greg Botkin

I will try to teach this using questions and answers:

1) I am somewhat skeptical about COVID (SARS-CoV-2) tests after all the critical reports I have heard in the news. Does Boundary Community Hospital have the kind of lab tests we need for meaningful results?

I think skepticism is understandable at this point. The tests everyone had in the early months of the pandemic were of questionable reliability, and we are still not sure how accurate the published numbers were. But the world’s best biotech companies were working on the COVID problem from the beginning, and in recent weeks they have brought out technology which should be far more reliable.

Our Hospital has pushed hard to obtain these products. We have now put together a set of instruments and reagents that should be as accurate as any testing platform in the country. By the time this article is published we will have run almost three hundred tests here in our lab. The results merit a high degree of confidence. When we inform patients about the presence or absence of active disease we believe we are providing the most accurate report that medical science can now provide.

2) How were you doing COVID testing before you had in-hospital tests?

We took the nasal swab here at the Hospital, sealed it up and shipped it to the state lab in Boise, where they tested with technology supplied by the CDC. That biochemical process was developed very early in the pandemic and was far from ideal, especially if one is transporting samples from hundreds of miles away. We sent tests from about a hundred Boundary County residents; all registered negative for active disease. Some of us question the accuracy of those results. We began in-house testing as soon as we received everything we needed for solid technique.

3) There seem to be many different kinds of COVID lab tests. Why isn’t testing simpler?

It would be simple if we were counting germs in a Petri dish. This is complicated because the body’s response to an invading virus is highly complex. Part of the challenge is to make a test that targets only the SARS-CoV-2 virus. A positive test must show a reaction to SARS-CoV-2 (the COVID virus) and nothing else. And it must be sensitive enough, theoretically, to detect every sample that carries the virus.

The BCH Clinical Medical Laboratory has several machines to perform COVID-19 tests.

4) Sort out the different COVID tests for us. Which one do I need?

We should draw this out on a chalk board because the molecular biology is a beautiful thing. That will have to wait. Think of it like this: if you think you might be acutely ill with COVID we need to test you for active viral presence. The virus organisms multiply rapidly in the body after one is inoculated; our tests should be able to detect viral particles about a week later, when one begins to show symptoms of infection. When the infection has run its course the virus is harder to find because your immune system has identified it and torn the viral organisms apart. There are some exceptions to this, and if you hear about individuals who test positive for months it does not mean they are harboring an active infection. It means that for some poorly understood reason our tests are still sensing viral fragments.

In our lab here we have three tests which work very well to detect active viral presence. Two of these detect the virus’ RNA (usually called a PCR test), the other detects a specific viral protein (usually called an antigen test). We need a nasal swab to run either of these tests. If we think one of our patients might be actively infected we confirm this with at least two different tests, and then we repeat the process with a second sample a few hours later. If final results are positive it means (subject to the limitations mentioned above) that you have an active COVID infection, and that you are infected now.

These tests are being run with increasing frequency in our Boundary Community Hospital laboratory. The demand may become heavy enough that we run into some logistical limitations, so if you find yourself in a slowly moving line please be patient with us.

There are pressing reasons to know which of us are carrying an active infection, and we are now capable of providing that intelligence with a reliable test that takes about thirty minutes to show results. You will need a physician’s order to have the test done here. The Hospital web site provides details about what one must do to be registered and have a sample taken by lab personnel.

5) What about antibody tests? They were supposed to answer all kinds of questions about COVID, like how far has it spread, and when can we safely go back to work, play, and school.

Antibody tests are very different from the PCR and antigen tests described above. Scientists, physicians and policy makers have great hopes that antibody testing will draw back the curtains and show us just how far this virus has invaded society. Our hospital is fine-tuning our antibody testing technology and it should be ready to serve our community very soon. I will write more about that next week.

Due to the increased number of tests requested locally, Boundary Community Hospital is limiting COVID-19 testing to 10 am to 3 pm Monday through Friday. Your provider will tell you where to park to register for the lab tests when they write the order and send it to the lab. Lab Techs will take the samples at your vehicle and send the results to your provider.

Eating Well Through Summer

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Eating Well Through Summer
By: Shantel Pluid, RD, LD
Registered Dietician, Boundary Community Hospital

Summer is in full swing and that means access to more grilled foods, delicious fruits and savory vegetables. Picnic food does not always necessarily mean healthy and low calorie, but it does mean tasty! There are a few things to steer clear of, while still leaving plenty of other appetizing options to choose from.

Before filling your plate at a barbecue, take inventory of all the options available and prioritize what you would like to eat. Taking the time to think about your meal before filling your plate will give you some time to think about portioning and how you can balance your food groups.

Salads/Side Dishes:

  • Opt for a salad with a vinaigrette or yogurt base. Often salads with mayonnaise as the dressing can bump calories up significantly. Potato, macaroni and coleslaw are picnic staples and are often loaded with mayonnaise. A German potato salad is a wonderful alternative because the dressing is mostly comprised of vinegar and mustard.
  • Baked beans are a smart option. Beans are a great source of fiber and protein and are quite nutritious as long as they’re not doctored up with too many extra calories.
  • Simple raw vegetables like baby carrots, grape tomatoes, broccoli, and celery are easy to add to your plate and can be a crunchy and satisfying side, just be mindful of how much “veggie dip” you use!

Grill Options:

  • Burgers are a lasting summertime favorite. As long as you use lean ground beef, you can still have your favorite food on a bun. If you are having a starchy side such as corn, beans, potatoes or macaroni, you might want to turn your burger into an open-faced sandwich or skip the bun all together. This will help to help balance the amount of carbohydrates at your meal.
  • Skinless chicken breasts and seafood of most any kind are among the leanest options for the grill. These options with a marinade are an absolutely wonderful option as well. However, some marinades can be high in sugar, so if you know who is making the food you could ask what went into the marinade.
  • Vegetables on the grill are another perk of summer picnics, so make sure to load up! Marinated veggie kabobs or slices of red peppers, mushrooms, and squash all can make a great addition to your meal.

Desserts:

  • Watermelon is a permanent fixture at any summer BBQ and also a wonderful dessert option.
  • Fruit salads, fruit kabobs, and bowls of grapes or cherries can provide a refreshing, and nutritious finish to all those sweet treat lovers. Fruits that are grilled: pineapple, bananas, peaches or pears typically only have a light dusting of cinnamon; therefore they make a great option as well.
  • Angel food cake with fresh berries and light whipped topping is another alternative that everyone loves and is reasonably low in calories.

The abundance of summer can bring temptation at the picnic table. For your health, remember to choose wisely.

TSE and COVID-19

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Here to Help – TSE and COVID-19

By: Wanda Wilkerson RN, BSN, CEN
June 4, 2020

Boundary Community Hospital, Boundary Ambulance, and Life Flight Network work as a team to get patients to the highest level of care as swiftly as possible for better outcomes.

The Covid-19 Pandemic has had many negative impacts on the medical field, but one unanticipated impact is on community members who are experiencing Time Sensitive Emergencies (TSE) like stroke and heart attack.

When the Pandemic began, all across the nation people were directed to remain at home and not come into hospital emergency departments (ED) in order to avoid overtaxing front-line emergency staff. People listened, they stayed home and self-isolated and watched the news and became more fearful. According to the Washington Post, ED volumes have been down by more than half all over the country. This in itself is not a bad thing until you wonder what has happened to all the heart attack, stroke, and trauma patients. From the highest acuity to the lowest acuity, people seem to be avoiding needed medical care out of fear of infection from the Covid-19.

It is extremely important to seek medical help for those emergent time sensitive events such as Heart Attacks, Strokes, and Trauma; for those times when every second counts to save heart muscle and brain matter; for those times when any delay in care and medical treatment can have a huge impact on the health of the patient and their families for the rest of their lives.

The news media have placed the fear in us to the point that many very sick people are not following up with their physicians or seeking emergency care, or even calling 911 for an ambulance when it is needed. There is so much misinformation out there resulting in people often not knowing who or what to believe. The increased stress alone would have us believe that there would be more heart attacks not less.

According to the Washington Post: “A report to be published by the Journal of American College of Cardiology on nine high volume Cardiac Catheterization labs across the country found a 38 percent drop in patients being treated for a life threatening event known as a STEMI – the blockage of one of the major arteries that supplies oxygen-rich blood to the heart. The study compared what happened this past March, when Covid-19 cases were climbing, with the treatments delivered from January 1, 2019, through Feb. 2020.”

The number of Stroke patients seeking medical help is also down by 30 percent in emergency departments as reported by the Washington Post.

Don’t delay if you recognize any symptoms of a STEMI heart attack which include chest pain, shortness of breath, dizziness, nausea, sweating, and possible pain up into the jaw or down the arm. Stroke symptoms include facial drooping; arms drift downward when asked to hold them up, as well as slurred speech. If the person shows any of these symptoms, call 911 immediately. Fast emergency medical services (EMS) transport to the hospital with pre-hospital notification that they are on the way can save valuable time when time is of the essence.

“Please seek medical attention when you or your loved ones need it,” says Emergency Nurse Wanda Wilkerson, RN. “Boundary Community Hospital has changed what we are doing and have new regulations, policies, and guidelines to help keep you and your loved ones safe as well as keeping the hospital and emergency staff safe. The key is to make sure people with symptoms overcome their fear and get prompt treatment that may save their lives or avoid long-term complications of untreated heart attacks and strokes.”

Boundary Community Hospital has been designated as a Level II STEMI, Level III Stroke, and Level IV Trauma Center by the State of Idaho. The designations for the Hospital are part of the Idaho Time Sensitive Emergency System (TSE) and are reserved for Hospitals that meet the stringent criteria established by the State as part of the statewide TSE system of care that includes three of the top five causes of death in Idaho: trauma, stroke, and heart attack.

PT Dry Needling

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Dry Needling for Pain Relief

Dr. Jessica Seaburg, PT, DPT, OCS
Boundary Community Hospital Rehabilitation Services

By: Dr. Jessica Seaburg, PT, DPT, OCS
Boundary Community Hospital Rehabilitation Services

Dry needling is a technique physical therapists (PTs) use for the treatment of pain and movement impairments. You may have heard of the “opioid epidemic” and be concerned about how to manage pain without these addictive drugs. Dry needling can be a big part of the solution. It is an effective and very safe way to resolve muscle pain without pain medicines and their side effects.

What does dry needling look like?
During the treatment, a PT will insert a very thin, solid, “dry” needle, one without medication, into a muscle. This allows the PT to target trigger points, which are taut bands of skeletal muscle that may not be treated effectively by massage. PTs wear gloves when dry needling and observe all relevant safety guidelines.

Does dry needling hurt?
The sensation experienced with dry needling is typically a deep ache or cramp, which quickly subsides within about 30-60 seconds. Often the muscle will twitch or jump as the needle is inserted.

What can I expect from dry needling?
Dry needling is like pressing a “reset button” for the muscle. People typically have immediate improvement with pain and the ability to move the problematic area. It is common to experience some mild to moderate residual soreness for 1-2 days after treatment. Most people are nervous before receiving dry needling and then say, “Wow, I’m glad I tried that!”

What conditions can dry needling help?
Because dry needling treats muscle pain, it is especially helpful for conditions such as muscle strains, trigger points, tension headaches, and post-surgical muscle pain. Many people think all their pain is coming from arthritis or disc problems, when in fact much of it is coming from their muscles – and this pain can be greatly improved with dry needling.

I’m scared of needles – can a PT help me without dry needling?
Absolutely! Dry needling is just one tool in a large toolbox. In cases when PTs use dry needling, it is one technique that is part of a larger treatment plan. PTs have a host of other effective treatment options to help reduce pain without dry needling. In my experience, however, combining dry needling with other therapeutic treatments allows patients to return to their prior level of function more quickly.

Is dry needling the same as acupuncture?
No. Dry needling is not acupuncture, a practice based on traditional Chinese medicine and performed by acupuncturists. Dry needling is a part of modern Western medicine principles and supported by research. While acupuncturists and PTs use similar types of needles, the assessment, technique, and purposes of the treatment are different.

Is dry needling safe?
Yes! PTs are experts in human anatomy and receive extensive post-graduate training to be certified in dry needling, so the risks are minimal. Your PT will thoroughly evaluate you and provide education on possible risks prior to treatment.

Want more information on dry needling?
Check out: https://www.choosept.com/dryneedling

Where can I get dry needling?
Dry needling is a specialty for Physical Therapists. You should look for someone who has completed extensive post-graduate training in “Functional Dry Needling” through KinetaCore or similar program with experience in dry needling in a rehabilitation setting.

Dr. Jessica Seaburg, PT, DPT, OCS is a Physical Therapist at Boundary Community Hospital who specializes in restoring functional movement and is a Board-Certified Clinical Specialist in Orthopedic Physical Therapy.

OT Myths and Misconceptions

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By Dr. Yahtil Huaute, OT, DOT
Boundary Community Hospital
April 8, 2020

Yahtil Huaute, OT, DOT is the Occupational Therapist at Boundary Community Hospital.

April is National Occupational Therapy Month! There are plenty of myths and misconceptions about occupational therapy services, the providers, and the history. Here are the top 5 myths or misconceptions of occupational therapy:

1. Occupational therapists help you get a job. Occupational therapy addresses tasks that occupy your time, not your employment. Occupational therapists (OTs) can assist in work hardening skills to allow you to return to your employment, or in the ergonomics of your working tasks, however the term occupation is pertaining to tasks that occupy your time. This can include working, homemaking, caregiving for others, taking care of yourself, cooking, cleaning, shopping, driving, and so on. The goal is to get you back to living the life you want!

2. Occupational therapy is for old people. OT’s work with every age, from birth to death. Approximately 1/3 of the national occupational therapy caseload is with children, this includes newborns in the NICU, toddlers in early development, school age children, and older children all the way up to transitioning into college. In working with the pediatric population, therapist are treating the whole family to allow for the best outcomes. Many adults attend occupational therapy for a variety of reasons including hand/arm injury, job ergonomics, or debility due to illness.

3. Occupational therapists only work in a medical setting. OTs can work almost anywhere! The most common settings are school districts, private clinics, home health, nursing homes, and hospitals. There are less common settings as well, including mental health settings, programs in the community, or within a private company. Working in a private company allows therapists to address employee needs and to avoid work injuries through good equipment placement, proper body mechanics, and adjusting the environment to avoid repetitive movement injuries.

4. Occupational therapists and physical therapists (PTs) are the same. There is some overlap between the two, however OT is focused on what people need to do in their daily lives and PT is focused on strength and movement. For example, if you have a stroke, PT will work on restoration of movement, coordination, gait and balance whereas OT will work on tasks like feeding yourself, dressing yourself, and other tasks you need to return to your life. OT will also make recommendations for, and provide training with, adaptive equipment as needed.

5. OT’s just play games and do puzzles with kids. Kids learn through play, so the play is therapy in disguise. A puzzle can be used to work on fine motor skills, visual scanning, attention to task, and the ability to see patterns. Playing with a ball works on kid’s hand-eye coordination, timing, adjusting how hard or soft to throw the ball, and visual convergence. If a kid looks like they are playing during OT, then they are doing exactly what they are supposed to be doing. Play is essential to children’s growth and development.

Rehabilitation Services including Occupational Therapy, Physical Therapy and Speech Therapy are considered essential healthcare services. The team at Boundary Community Hospital offers appointments Monday through Friday in Outpatient Services with some pediatric telehealth appointments.

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April 15 2020 Hospital Update on COVID-19

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Hospital COVID-19 Update to the Community

April 15, 2020

Bonners Ferry – Boundary Community Hospital has established a COVID-19 Task Force made up of department managers and medical staff which has been meeting frequently to provide guidance and discuss internal protocols as well as continuing to assess the ever-changing environment and regulatory direction.   Some of the changes instituted by the Task Force include:

Curbside Check In for Emergency in the Ambulance Bay off Kaniksu Street

Emergency Check In – For the safety of everyone, including patients and staff, the Emergency team has instituted a new process for accessing Emergency Services.  Patients driving in should park in the designated Check-in Parking spot under the Ambulance Bay and call the Registrar phone number listed on the sign.  Once checked in and screened, a nurse will come out to assess/triage and give further instructions.  If you are in an emergency situation, please call 911. As always, the Emergency team is ready 24/7 to serve you and care for our community.

Lab Testing – Drive Up Lab Testing is available Monday through Friday 8 am to 3 pm. Park in one of the designated parking spots by Outpatient Services and call the number to register.  The lab tech will come out and take the needed samples at your car.

Acute Care – The Acute Care/Emergency lobby is closed.  A video intercom has been installed so you can talk with the health unit coordinator directly about your needs. For Saturday Outpatient Services (Lab or X-Ray), please call ahead to make sure the paperwork is in order and they will give you instructions on where to park and enter the facility.

Extended Care – Strict visitor restrictions are in place for the extended care facility/nursing home.  The nursing and activities staff are doing a wonderful job working with the residents.  Community members have been sending in stories and pictures to share with the residents. Share your blooming photos via email to [email protected].

Rehabilitation Services – Outpatient appointments with Physical, Occupational and Speech Therapists are considered essential services and are continuing.  All patients are screened before coming in and some pediatric patients are being seen through telehealth.

Primary Care – Many patients still need to see their primary care provider for a variety of reasons.  With existing patients, Dr. Layeux and Mike Yourzek, PA-C are conducting telehealth appointments when appropriate.  The Boundary Community Clinics team have patients wait in their vehicle until a medical assistant can escort them directly to the exam room.

Housekeeping – The housekeepers wanted to know how well the cleaner that is currently used kills all living micro-organisms including viruses and bacteria.  The Lab took samples of areas in various departments and multiple surfaces cleaned by Housekeeping and then tested them proving that the current method of cleaning is eliminating all bacteria and viruses. Great job housekeepers!

Drive Up Lab Testing Monday through Friday near Outpatient Services off Comanche Street

COVID-19 Testing – If you have symptoms and believe you need to be tested, CALL your Primary Care Provider to be screened.  Tests require authorization by primary care providers following the CDC and Idaho Department of Health and Welfare guidelines for testing and the authorization of Panhandle Health District.  If you have the provider order and need the test, please use the drive up lab testing which is available Monday through Friday 8 am through 3 pm. A copy of the provider lab order must be faxed to the lab by the provider before you can be tested. Test results have been taking three to five days and are provided directly to your provider. All COVID-19 samples accepted at BCH are sent to the Idaho State Lab for testing at this time. These tests are recorded by County of Residence and not by where the samples are taken. As of 11 am on April 15th, 31 samples have returned negative and 10 samples are pending results from the Idaho State Lab.

Everyone at Boundary Community Hospital and Boundary Community Clinics are grateful for the wide community support for our team.  A special thank you to the Disabled American Veterans for the nebulizer which we were able to put into service immediately.  The Hospital Auxiliary has donated head covers for the Emergency, Surgery and Clinics teams.  The cloth masks, takeout food deliveries, good wishes and prayers help keep the morale up and our staff focused on the essential tasks at hand — Caring for Our Community, Every Day.

Some Thoughts on COVID-19 in Boundary County

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Some Thoughts on COVID-19 in Boundary County

April 1, 2020

By: Greg Botkin, MD, Medical Director, Boundary Community Hospital

I will begin with an apology. If you are reading this with hope of finding scientific clarity you will be disappointed. I thought the best way to do this would be to address the questions that now haunt the people of our county.

Is COVID here? As of noon on April 1, we have no laboratory confirmed cases in Boundary County. The hospital has sent out 20 or so. 16 came back negative, four are pending. I think it a mistake to estimate viral presence by lab results. We may have had COVID in this community for weeks or months without knowing it. The signs and symptoms are often very mild.

How many of us will be infected? As stated above, there may already be some penetration into Boundary County. Corona Viruses are highly contagious and spread through a region pretty easily, especially if the population is immunologically naive. Isolation may slow this down. I do not believe it will stop it. I cannot guess at percentages because we have not yet been able to collect critical immunological data. That should begin to change this week as we start measuring IgG antibodies.

Are the isolation mandates reasonable? This is impossible to answer without good prevalence data. We hope we are slowing the surge in emergency departments and ICUs in the areas hardest hit, which now seems to be worth the sacrifice. I am watching the numbers from Singapore, wondering if lockdown really stops viral spread. Prescient governance with balanced liberties ought to be a work in progress. The ecology of COVID will be better understood in a few weeks; one would hope such intelligence would increasingly inform policy.

Why do a few people get deathly ill with COVID while many, perhaps most, have minimal symptoms? We don’t know. This is being looked at very closely. We are desperately trying to find treatments that block the metabolic breakdown we see in our most severe cases. Maybe it’s personal genetics, or past infections, or environmental exposures, or some combination of these. Thankfully extreme disease seems to be rare.

Are there things I can do, besides isolation, to lessen my risk? There are no shortages of folk remedies for COVID. Many are biochemically plausible. Garlic, fungi, zinc, Vitamin C, strong teas, Brazil nuts, etc. We have good research explaining the anti-viral properties of some of these measures, none of it specific for COVID. Do your homework and try these protections if you are so inclined. Getting outside for exercise, work, and gardening may be the best medicine of all, especially during the beautiful springtime weather just ahead.

Why has testing been so ineffective? The science of building a reliable chemical test is highly complex. It takes trial and error to get it right and no one had time for that. The biochemists brought us the best tests they could make. It was an amazing bit of chemistry but far from perfect. In addition, sampling technique must be precise for reliable results, and no one knew what made for best technique. Nasopharyngeal sample? Oropharyngeal? Bronchial washings? Automated or manual processing? Then came the shortages – not because of conspiracy or mismanagement, but because you can only cook so many pancakes at once and some people have to wait. The shortages necessarily forced eccentric testing philosophies. Whom should we test? Asymptomatic juveniles? Yesterday’s trauma death? The various tabulations are going to paint very different pictures of COVID’s virulence.

We are now looking back with the realization that many of the negative tests were probably false negatives.  There are estimates of 50% error rate in China, and what we have used here in the states through the CDC may not have been any better.

Expect a change this week. A new generation of very precise tests has been cleared by the FDA and is being shipped to the front lines.

Can we have some of those tests? Yes and no. Our hospital has been capable of doing this kind of analysis for a couple of years. We have the instruments here to run the most accurate testing protocols available with a turn-around time of about 45 minutes. Unfortunately all the new testing reagents are going to the areas hardest hit by the pandemic. We will begin next-generation testing the moment we receive our reagents.

Will we, the Boundary County public, know the results? We report numbers to the CDC as mandated so they can monitor trends. I believe locals should have effortless access to local data. Names and identities must remain private, so we must take care to publish results accordingly.

If I develop cold-like symptoms could it be COVID? Are there other viruses still going around? When we evaluate respiratory disease here at our hospital we screen for 17 pathogens that commonly cause upper and lower respiratory disease. This is a lab test. So we usually have a rough idea of active infectious disease in our county. There are currently a handful of pathogens that could masquerade as COVID.

If I get severely ill what can I expect? Is our hospital ready? I have been impressed with the work the hospital is doing to get ready for this. We have a college of well-trained and well-informed workers who are putting the pieces together with careful confidence. But please remember: when a Boundary County resident becomes ill they should expect support from a network of caregivers – not just our hospital. Your primary care provider will play a big part. Paramedics are ready for specialized transport if necessary. Suppliers will be needed for home oxygen and equipment. Our Panhandle Health District will assist us with organization, especially as we follow those who remain ill in their own homes. Kootenai Health in Coeur D’Alene or other hospitals in Spokane may be part of your care, and their state of preparedness is both smart and strong. Together we will master this, one case at a time, although none of us know how that will look.

I would like to cut through the fog and read the scientific papers myself. Can I do this? The journals I read are making daily updates. If you have access to the internet you can read the same reports. Look at UpToDate for clinical summaries. Their material is reliable, succinct and easily understood. Go to the American Society for Microbiology for molecular biology, epidemiology, testing and policy recommendations. The American Chemical Society covers the molecular details of the science, some of it very complex, some of it plain. These three publishers, along with many others, have established open access to their COVID-19 materials. Boundary County residents should take advantage of this unprecedented movement in scientific publishing.

What comes next? What comes next will be difficult. We will have some positive test results from people right here in our county. When you get that piece of news it may feel like the demon of plague has planted his feet on our soil and started swinging his scythe. We will feel even more frightened than we feel today, and we will be tempted to reach for whatever weapons we have in our defense.

In my mind something else is happening.

These positives, these members of our community who show current or recent infection, are the earliest pioneers of an emerging society. Some will be actively fighting this thing, crushing and shredding viral particles day by day, killing this disease, perhaps preventing it from coming to your door. Think about that. These souls will be quarantined, largely unaided by medical science, isolated from the community’s companionship, supported entirely by devoted (and co-infected) friends and family. Some positives will have finished that battle, perhaps effortlessly, perhaps through indescribable pain and struggle, a few having come within heartbeats of death. And some positives we may lose. These will be our most fragile neighbors, lost in that fight, lost in the same way we lose neighbors every year to influenza and norovirus and cold viruses and heart disease.

As we do more testing in Boundary County the number of positives will probably rise. This does not signal the end of our world. It does signal the need for unusual courage, careful analysis, and extraordinary compassion. Medical science cannot stop this storm. But it can assist a good community that is determined to gracefully and courteously push through to the other side. And after twenty three years of practicing medicine here I believe this is who we are.

Are you finished yet? Almost. I would like to tell you some of those things that crowd into my mind in hard times…because this disease, like so much in medicine, can break your heart. I would like to write some of the things I am thankful for.

I am thankful we have time to prepare. We can look at Italy and China and Seattle and try to calculate what might best serve us here. I am thankful for the personnel and infrastructure in our medical community, which I believe to be unusually solid. I am thankful for the heroes I work with, nurses and lab technicians and physicians, all these with families at home, putting on their gear and going out to do the exam, collect the samples and ascertain the extent of a patient’s illness, every time, every case. I am thankful for the brilliant and cooperative spirit I have seen in medical sciences worldwide, and for open access, for the internet, and for educational and cultural opportunities for those isolated at home.

I am thankful that winter is on the run, that the fields are ready for the farmer’s wisdom and the farmer’s seed, and that an extravagant inland northwest is about to dress herself in springtime’s glorious light and quickening perfumes.

I am thankful to be reminded of human frailty, remembering that it is common and universal, as are spontaneous expressions of human mercy. In our suffering, as in our instinctive turning to attend the suffering, we are opening for discovery the deeper and mysterious qualities of who we truly are, and the similarities now manifest in every region of the earth confirm our enduring place in the family of man.

I am thankful for our immune systems. I am deeply thankful that this virus touches our little ones with a light hand. I am thankful for those who have fought this virus and crushed it, for the way these raise their fatigued bodies and tested minds, and for the way they seize hold of today, ready to receive the best gifts their new world has to give.

 

Renewal

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Renewal
By: Tari Yourzek
Chief Nursing Officer
Boundary Community Hospital

Re·new·al an instance of resuming an activity or state after an interruption.
The replacing or repair of something that is worn out, run-down, or broken.
Many in the North have commented that this past winter has been a particularly dark one. As winter retreats and light returns to our world, one can’t help but think that Spring is on its way.

Spring is a time for renewal, growth, and expansion; we feel it in the air. Even though technically, we can do this at any time during the year (New Year’s Eve for example), it feels just right to do it as we renew the soil and plant the new season’s gardens. We seem to have that extra energy and focus to bring out our creative gifts and reach new levels of achievement, wellness, happiness and success.

Spring is truly a time to reflect within ourselves, reawaken our spirit and get a fresh start.

Here are a few ways to celebrate this season and renew:

  • Shine some sunshine on yourself. Spring is a natural time to take a deep breath and engage in overdue self-care and self-compassion. This may mean re-prioritizing what events land on your calendar and rebalancing those schedules that have gotten a little out of hand so we can take better care of ourselves and those important in our lives.
  • Find what renews you and keep doing it! For me, putting my hands in the soil and watching my seedlings grow, reminds me of the more important things in my life. If you are having trouble doing this, ask yourself the question “If tomorrow was the last day of your life, how would you live it?” If that answer doesn’t match up with the life you’re living today, it’s time to make some changes!
  • Mark the occasion. Our daily lives are so busy, that often those remarkable moments are passed by with merely a nod. This can include those commitments and goals we have made to ourselves and don’t announce to our friends because we are afraid of failure or disappointing ourselves and/or our friends later on. But in minimizing our intent, our goals and even our dreams, we rob ourselves of an important opportunity. It is important to reflect on our lives, what are we most proud of? “How many lives have I changed for the better?”
  • Re-energize your health and nutrition goals. We’ve all been told to eat right, exercise more and watch our weight – not so easy in the winter but now that the sun is out more, take advantage. Get out and walk. Do your chores with a smile and some extra enthusiasm. Play with your kids, grandkids and your pets.

Regardless, Spring’s unique energy offers us a chance to reflect and renew ourselves or even reinvent our passion for growth and recognizing the beauty that surrounds us every day; a beautiful sunrise, the return of the Osprey (one I always look forward to) that brings a smile.

I hope you will try a few of these suggestions and hopefully share some of your own with others. Take advantage of Natures’ energy to renew and revitalize your life. Happy Spring!

Boundary Community Hospital and COVID-19

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By: Preston Becker, CEO, Boundary Community Hospital

As tents pop up near the Emergency Rooms at other Northwest Hospital Alliance* Member Hospitals in our area, I felt it was important to reassure Boundary County residents that your local community hospital is prepared if we are needed.  Boundary Community Hospital, Extended Care Facility (Nursing Home), and Boundary Community Clinics’ priority is the safety of our patients, their families, our staff and our community.

These are some steps we have been taking to ensure the safety of all.

  • Our staff is prepared – we have annual training, drills and protocols in place for handling pandemics and infectious diseases. We have daily meetings with all departments to discuss any issues. Chinna McKechnie, RN is our Infection Prevention and Control Director and she is doing an outstanding job ensuring that all staff are properly trained and willing to care for any COVID-19 patients.
  • While some items are in short supply for ordering, we currently have the supplies we need and have been working on contingency plans to keep everyone safe.
  • Our nursing staff are managing visitor access and movement within the facilities (Acute, ED, Outpatient, Clinic, and ECF). Our Extended Care Facility and Hospital Acute Care are performing extra screening for visitors and volunteers. We remind everyone, if you are not feeling well, call the patient or resident you want to visit instead of coming in person.
  • We continue to network with Panhandle Health Department, Idaho Department of Health and Welfare, Northwest Hospital Alliance, Boundary County Emergency Management Public Information Officer (PIO), Boundary Ambulance, and Boundary County School District.
  • Signs and symptoms include respiratory symptoms and fever, cough and shortness of breath. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome and sometimes death. High-risk patients for severe coronavirus disease are older and have comorbidities (other health issues). Remember to stay home and call public health, or your healthcare provider directly, if you experience any of these symptoms. It is best for our healthcare providers to treat you over the phone.  Additionally, the Emergency Department is not the treatment of choice for COVID-19, and should not be utilized unless your symptoms become severe or emergent.

On an additional note, it is important that we maintain a healthy blood supply for our facility.  “In these difficult times, giving blood is something healthy individuals can do to help the sick. The only source for blood—literally in many hospital procedures, the source of life—is another human being,” said Dr. Ralph Vassallo, Vitalant’s chief medical and scientific officer. “We need people to donate blood today, while following guidance from the CDC and other agencies.”

We encourage our community to participate in the local Vitalant blood drive on March 17th at the LDS Church. It is absolutely critical to avoiding another public health crisis: not having enough blood to meet basic patient needs.

As of March 13th, there continues to be no confirmed cases in the state of Idaho. Our own Infection Prevention and Control Director, Chinna McKechnie, is staying on top of the information and guidance in order to be prepared as a front-line hospital organization. Our top priority is to protect our community and staff in the event of a potential outbreak and we are prepared to do just that.

Stay informed: The Panhandle Health District has a hotline dedicated to assisting the public. If you have any questions about coronavirus or think you may be displaying symptoms, call 1-877-415-5225 or visit their website http://panhandlehealthdistrict.org/

 

* The Northwest Hospital Alliance includes: Boundary Community Hospital in Bonners Ferry, Benewah Community Hospital in St Maries, Bonner General Health in Sandpoint, Kootenai Health in Coeur D’Alene, Shoshone Medical Center in Kellogg,  Syringa Hospital and Clinics in Grangeville, Clearwater Valley Hospital in Orofino, and St. Mary’s Hospital in Cottonwood.

 

March 13, 2020

2020 Festival of Hearts Recap

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With Grateful Hearts

February 2020 Bonners Ferry Herald

Fry Healthcare Foundation Board members received a demonstration of the new Bipap and Ventilator
funded at the Festival of Hearts. Right to Left – Kevin Callos, Vice President; Phyllis Karnes; Janis Kerby, Secretary; Patti Duscher, BCH Cardiopulmonary Manager; Preston Becker, BCH CEO; Jenny Fessler; Ed Sample; and Blanche Studer

With grateful hearts, the Fry Healthcare Foundation Board of Directors has announced that the Festival of Hearts gala raised over $52,000 this year. Most of the money will be used to help fund the recently installed 3D Mammogram equipment at Boundary Community Hospital.  Tickets sold out early with many tickets going to the sponsored tables.

The atmosphere was elegant and the food prepared by the master chefs at Kootenai River Inn was delightful. Teresa Rae, Treasurer of Fry Healthcare Foundation and Boundary Community Hospital Trustee Dennis Dinning joined forces as emcee and auctioneer extracting high amounts for the auction items while keeping the event fun and relaxed.

The Dessert Dash returned this year and was a rousing success, raising $6,605.75.  “This fun event has tables pool their money to be the first to choose from all of the wonderful desserts donated by local businesses and bakers. The extra dollars and cents in the total are important as tables strategized on what to bid and which dessert the table wanted to win,” said Teresa Rae.  It is a fun way for everyone at the event to participate and share the desserts with many take-home boxes providing an extra amount to share.  A special thank you to the restaurants and individuals who created the beautiful and delicious dessert array.

During the event, many of the attendees raised their paddles so the Hospital can purchase a Trilogy 100 BiPap and Ventilator for emergency and respiratory therapy.  According to Patti Duscher, BCH Cardiopulmonary Manager, “We may not need to use the BiPap and ventilator very often, but when we do, it will save a life. We appreciate the generosity of the community in funding this essential, life-saving equipment.”

During the Festival of Hearts, Dennis Dinning and John Mace presented a check for $3,306 to Fry Healthcare Foundation from the “For the Ones” Corn Hole Tournament to benefit the 3D Mammogram Capital Campaign.

Boundary Community Hospital Trustee Dennis Dinning with his cousin John Mace presented a check for $3,306 which were the proceeds from the recent For the Ones Corn Hole Tournament. “John and I believe that the Corn Hole Tournament was a success and we’re glad we could have an event to bring awareness and help fund 3D mammogram exams for this community.  A special shout out to the sponsors of the Corn Hole Tournament – Mi Pueblo Restaurant, Edward Jones Investments, Riverside Auto Center, Bonners Ferry Veterinary Clinic, JB’s Tire and Automotive/Les Schwab Tires, Boundary Tractor, Boundary Abstract, Super 1 Foods and VFW Post #3622, as well as everyone who braved the snow and participated.”

The Fry Healthcare Foundation and our community have raised $1.4 Million to benefit the hospital over the past 22 years. A heartfelt thank you to everyone in the community for your continued support of the Foundation and its fundraising efforts on behalf of Boundary Community Hospital.

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