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December 2017
To Help Ensure a Safe and Enjoyable Journey, Visit the PMH Travel Health Clinic
     Thinking of getting away to somewhere warm, maybe planning a trip abroad to volunteer or work? Most people, when thinking about travelling are usually focused on what to pack, but you need to think beyond the suitcase.
     The Prairie Mountain Health (PMH) Travel Health clinic should be one of your first stops when preparing for trips outside of Canada.  The clinic staff want to ensure you have a healthy, positive travel experience.  They will provide you with information and immunizations that will reduce your risk of travel-related illnesses.
     Travel Health consultations are much more than just vaccines.  PMH Travel Health nurse Arla Kirk has a Certificate in Travel Health (The International Society of Travel Medicine) and has extensive travel experience herself sharing that knowledge with you when visiting the clinic.  The clinic is a federally designated Yellow Fever Vaccination Centre and meets the standards of the Public Health Agency of Canada for the Practice of Travel Medicine. 
     Where you plan to travel to will affect the length of your visit to the clinic, so when you book your appointment be prepared to stay awhile.  The Travel Health nurse will review your personal health history and past immunizations. She will discuss the destination, purpose, and mode of travel, length of stay, accommodations, and food and water sources. You will be provided a complete health risk assessment. This includes recommendations for immunizations and information about how to stay healthy while travelling, for example, the use of insect repellent or mosquito nets. If recommended, the Travel Health nurse may also provide you with a prescription for Malaria medication. The recommended vaccines are available in the clinic so one visit may be all you need to be ready for your trip.
     A few things to remember:
  • All clinic visits are by appointment only
  • No referral necessary
  • Book appointments 6-8 weeks in advance of travel
  • Vaccinations are more effective if given early
  • Some immunizations require two doses of the vaccine given four weeks apart
  • Travel Health is a non-insured service.  There is a service or consultation fee in addition to vaccine costs payable at each appointment
  • Service for groups that are travelling together may be requested (for example groups of five or more travelling to the same place at the same time or an occupational group). We ask that everyone commits to attending the same clinic appointment time.
     Visitors to our clinic had this to say about the services:
     “I had no idea that we were going to get so much useful information. I thought we were going to come and be told what vaccines we needed. We’ve done a lot of travelling, and we actually learned a lot today!”
     “Arla was very knowledgeable and made me feel comfortable. I received more information than I thought and learned a few things. Love all the written information that gets sent along.”
     “Arla was amazing.  My son was terrified, and she handled the situation with ease and helped him to feel comfortable.”

     The PMH Travel Health clinic, do not leave this off your travel itinerary. Call and make an appointment today to ensure a safe and enjoyable journey.
     The PMH Travel Clinic is located at Unit A5-800 Rosser Ave. (Town Centre) in Brandon. For more information or to make an appointment call 204-578-2521.  Visit our Prairie Mountain Health website for Travel Health information and to find out more about the service and vaccine charges for the clinic.
Other websites that might be of interest include:
Government of Canada Website for Canadians Travelling or Living Abroad:
Centers for Disease Control and Prevention: Vaccines. Medicines. Advice.
International Association for Medical Assistance to Travellers

 

PMH Travel Health nurse Arla Kirk can provide you with information and immunizations that will reduce your risk of travel-related illnesses.
The PMH Travel Clinic is located at Unit A5-800 Rosser Ave. (Town Centre) in Brandon. For more information or to make an appointment call 204-578-2521.

Do you have COPD or care for someone with COPD?

Prairie Mountain Health invites you to participate in this survey which will help inform COPD care.

Family Physicians Learn About Farming Hazards
     Rural Manitoba offers many unique opportunities for family medicine trainees and the University of Manitoba’s Parkland training site offered just that September 21st. The Parkland Family Medicine Residency Unit is situated in Dauphin amongst a vast abundance of rich agricultural land.  They value and recognize the importance of connecting with the local agricultural community to discuss health and wellness challenges.
     This year’s resident trainees traveled to three farms in the Dauphin and surrounding area
, to learn first-hand of the dangers and joys of farm life. The group’s day began at a grain farm situated north of Dauphin. The group met with grain farmers to discuss the financial aspect of farming, weather conditions, equipment, and harvest practices. The group watched as the farmers explained the potential hazards of an auger, swather, grain truck, combine, and anhydrous ammonia and what injuries residents may see in the local emergency departments.
     The group ventured further north to a combined grain/dairy farm. The group toured the dairy farm and learned first-hand about occupational hazards that can occur while working with cattle. Newborns feeding practices, average milk production, and animal health were discussed.
     The group ended their tour at a bee farm. A tour of the honey harvesting facility, honey extracting plant and the honey barrel warehouse allowed for an interesting look into what a day entails for a bee farmer. The group also learned about new and upcoming concerns bee farmers are facing with increasing rates of deer ticks in our area. Chief Resident Dr. Jordan Cram summarized the experience of farm day by noting ‘As medical trainees, we are often faced with the task of managing farming/workplace injuries, especially in rural Manitoba. This experience allowed us to see first-hand how some of these injuries can occur, which can make a difference in how we treat these patients. We were very grateful for the opportunity to tour the farms and meet the wonderful families who own them.’

Extended Clinic Space Opens in Treherne

     Many excited local residents, physicians and municipal representatives gathered at the Tiger Hills Health Centre on October 18th to celebrate and tour the new extended clinic space.
     The link to the six new examination rooms, washrooms, and consultation room is the result of the communities’ fundraising and support from Prairie Mountain Health.
     Greetings were brought by the RM’s of South Norfolk Treherne and Victoria, Penny Gilson CEO, Prairie Mountain Health, MLA of Midland Blaine Pedersen. Dr. Alwyn Vorster spoke on behalf of the physicians and staff.

L-R: CEO PMH Penny Gilson, Dr James MacTavish, PMH Board Chair Catheryn Pedersen, MLA of Midland Blaine Pedersen, Reeve RM of Victoria Harold Purkess, Reeve RM of South Norfolk Treherne Craig Spencer.

BRHC Auxiliary Receives RBC Grant Money
      Brandon Regional Health Centre (BRHC) Auxiliary is a recent recipient of a $500 grant donated through the RBC Employee Volunteer Grant Program. The bank’s program recognizes employees and retirees for the good work they do in their personal time, by volunteering in their communities.
     Employees and retirees who donate more than 40 hours per year to a charitable organization can apply for a grant of up to $500 for their organization. As a long-term employee of RBC, Gwenda Forrest has since retired and dedicates many hours of support to the BRHC Gift Shop.  The Auxiliary appreciates Gwenda’s dedication and sense of community and philanthropy.
     Proceeds from the Gift Shop are donated to the BRHC Auxiliary which provides funds for equipment purchases and bursaries for nursing students at Assiniboine Community College and Brandon University.

L-R Auxiliary Director/Gift Shop Coordinator Brenda Burgess, Auxiliary Director/Nearly New Coordinator Sharleen Gunston, Volunteer Extraordinaire Gwenda Forrest, Auxiliary Assistant Janice Meadows & Auxiliary Director Marlene Brichon.

DRHC Redevelopment Project Update: Move to Temporary ED Complete

     The Dauphin Regional Health Centre (DRHC) has completed an initial phase of the $23-million dollar redevelopment project. On November 14, 2017, the move to a newly-constructed temporary Emergency Department (ED) occurred. This allowed the ED to remain open throughout the day while logistical moves to the new space took place.
    
Construction on the Temporary ED began in the spring of 2017 and was completed at the end of October. With the move to the (3,400 square foot) space, the next phase of the redevelopment project has now begun. This secondary phase will see demolition and new construction take place within the former ED area. The temporary ED will remain in operation until the old ED is reconstructed. Information on that specific timeline will be identified in early to mid-2019.
    
The redevelopment project has also had a significant impact on entrances and exits to the facility. In early November, both of the main public entrances at the front and back of the DRHC closed to the public to allow for future stages of construction.
    
As a result, a new temporary entrance was built, and opened for the DRHC off of Jackson Street effective November 6, 2017. A designated emergency pick up/drop off area for patients was created near the temporary entrance to assist those with mobility or other health-related challenges. As well, visitor and public parking areas were also enhanced within the main parking lot at the back of the hospital.
     More information on the DRHC entrance changes can be found on the PMH website.

Not-So-Happy Holidays: Managing Holiday Stress and the Holiday Blues

     In the film, Meet Me in St. Louis, Judy Garland sang the line "Have yourself a merry little Christmas, Let your heart be light. From now on, our troubles will be out of sight." Unfortunately, many people struggle with heavy hearts and numerous stressors over the holidays. The term "holiday stress" reflects increased symptoms of anxiety, impatience, fatigue, and depressed mood that many people experience over the holiday season. A number of factors tend to contribute to holiday stress, including financial concerns, tight schedules and heavy demands, loss of loved ones, isolation, and unrealistic expectations. And when stress is at its peak, it can be very hard to stop and regroup.
     Stress cannot always be prevented; however, the following tips can be helpful to manage stressors during the holiday season.

  • Be aware of your feelings. If someone close to you has recently died or if you are away from loved ones, realize that it is normal to feel sadness and grief. It is also important to express your feelings. Do not try to "force yourself" to be happy just because it is the holiday season.
  • Have realistic expectations. Too many people expect that the holidays need to be "perfect." There is no such thing as perfection and having those expectations will only add to the stress of the season. An asymmetrical tree or an over-cooked turkey will not ruin your holiday; rather, it will create a family memory. Perennial movie favorites, such as A Christmas Story or A Charlie Brown Christmas are reminders of the endearing qualities of these imperfections.
  • Stay within your budget. Before you shop for gifts and food, decide how much money you can afford to spend. Then stick to your budget. Do not try to buy happiness with a mountain of gifts. Some alternatives include: giving homemade gifts and starting a family gift exchange. If your children’s wish list exceeds your budget, have a talk with them about reasonable expectations and remind them that the holidays are not about expensive gifts.
  • Manage your time and set boundaries. Saying yes when you should say no can leave you feeling resentful and overwhelmed. Friends and colleagues will understand if you cannot participate in every project or activity. Set priorities and let go of impossible goals. Do not spend all of your time planning activities for your family. You might end up feeling drained and unappreciated. Take the time you need to finish tasks that are important to you. Do not try to complete everything at once and ask others to help you complete chores.
  • Keep healthy and take time for yourself. All too often, when people feel stressed-out and overwhelmed, they forget about their self-care. Also, the holiday season is ripe with opportunities to overindulge. Make sure that you are eating regularly and healthily, that you are getting a decent night’s sleep and that you are getting enough physical activity into your day. This can be difficult when the weather turns cold. Finally, pace yourself. Give yourself opportunities to rest and replenish. By slowing down, you will have more energy to accomplish your goals.
  • Do something for others. By volunteering or assisting others, we can get out of our experience for awhile. Helping out at a food bank, or a shelter can also provide us with some perspective in terms of our worries and concerns.
  • Stay connected and seek support. When we feel sad or overburdened, we often isolate or avoid others that can add to our burden. Ensure that you are connected with others, and seek support if needed. Getting things out in the open can help you manage your feelings and find solutions for your stress.

     If you are experiencing a mental health crisis, call the following numbers for assistance: OVER THE AGE OF 18: 1-888-379-7699 or UNDER THE AGE OF 18: 1-866-403-5459.
     To access mental health services in your area, call 1-866-403-5459 (under that age of 18) or 1-855-222-6011 to be connected with the service provider nearest you.

Dauphin Joins Brandon On Board With Emergency Department Information System
     A second site within Prairie Mountain Health (PMH) has now implemented the electronic Emergency Department Information System (EDIS).  Dauphin Regional Health Centre went live with EDIS towards the latter part of November 2017 and joined Brandon Regional Health Centre (BRHC) as the two regional sites now linked to the province’s standardized emergency patient tracking and monitoring system. Also in November, BRHC expanded EDIS, which they have been using since 2013, to include electronic charting. This new system aims to improve communications to support timely and safe patient care. The most visible change within Emergency Department (ED) waiting areas is the wait-time display board.
     The public wait-time display board shows information such as the number of patients waiting, how long most patients have been waiting and the longest time a patient has been waiting.
     As always, the most ill or injured patients take priority and are seen first. The triage nurse assesses each patient on arrival to determine the priority of their situation.  The system will also alert the triage nurse when another check of a waiting patient is due.
     The display boards inside the ED will provide staff with an up-to-date electronic view of patient activity and care. The Patient Tracking Board, located inside the ED, displays information about each patient admitted to the ED such as length of stay, location, name of care providers, lab and  tests ordered and general plan of care. The information displayed conforms to the Personal Health Information Act (PHIA), which is legislation designed to protect personal health information from unauthorized use.
     EDIS also helps to speed up the process of gathering patient information because of its easy tracking of patient histories.   If you are a returning patient to the ED, information from prior visits can now be called up, which saves time for both the patient and the staff.  If you had been seen at an emergency room at any hospital using EDIS, that information is now available for health care providers when you visit EDs in Brandon or Dauphin.  New and updated information will still need to be gathered and patients should still bring their provincial health card and a list of current medications and allergies when visiting the emergency department. This ensures that the hospital has the most up to date information to provide safe care for patients who come to the ED.
     EDIS was originally introduced at St. Boniface Hospital in Winnipeg about 10 years ago and has been brought on-line in all Winnipeg hospitals as well as hospitals in Selkirk and the Northern and Southern Health-Santé Sud regions. Manitoba eHealth indicates that other rural sites are planned for the future.

DRHC ED staff Raeleen Timlick, Darren Slack and Lisa Rempel stand in front of the newly installed EDIS display monitor.

Parkland Family Medicine Residency Unit Hosts Rural Residency Exposure Program (RREP)

     Three second-year medical students travelled from Winnipeg spending time in Dauphin on October 19th and 20th.  Here they were introduced to rural medicine and the Parkland Family Medicine Residency Unit based in Dauphin since 1991.
     Upon arrival, they were greeted by Chief Resident Dr. Jordan Cram and a few of the current family medicine residents. Discussion around benefits of training in a rural area; the years of experience the supervising preceptors have and the support from the communities were all discussed.
     Attending the MJHL Dauphin Kings hockey game was a great introduction to the support of the community in events that are held and a taste of rural lifestyle.
     Students had an opportunity to follow a supervising preceptor in the Emergency Room, Obstetrical Ward and Dauphin Medical Clinic walk-in. This clinical component is an integral part of the weekend and we thank Dr. Jillian Ungarian, Dr. Sara Scott and Dr. Mike Nichol for their continued support.
     Hands-on training in ultrasound and suturing wrapped up the successful weekend. This informal training offers opportunities for continued networking and further discussion around the Parkland Unit.
     Thanks to the Office of Rural and Northern Health, Prairie Mountain Health, residents, faculty and staff of the Parkland Family Medicine Residency Unit for their involvement in the success of 2017 Rural Residency Exposure Program (RREP).
     "I had such a wonderful experience in Dauphin for the RREP. This trip gave me the opportunity to discover first-hand what it would be like to potentially train and work in the Parkland Unit. I was so impressed with the healthcare facilities, and appreciated the insight from the current family medicine residents. I look forward to learning more about the Parkland Unit, and I hope I will have the chance to return to Dauphin for further exposures throughout my educational career." Ashley Olsen, RREP 2017 Participant

U of M Med II students participating in RREP in Dauphin - Carly McClennan, Ashley Olsen, Vadieh Hamidi and Dr. Jordan Cram, Chief Resident (Parkland Unit).

Brandon Regional Health Centre Auxiliary Pave
the Way to Improved Clarity

     The Brandon Regional Health Centre (BRHC) Auxiliary has donated over $235,000 for the purchase of a Zeiss ophthalmic surgical microscope for BRHC, thanks to donations it receives from the BRHC Gift Shop and the Nearly New Shop.
     The Lumera 700 is one of the most sophisticated microscopes being used in eye surgery and the Brandon Regional Health Centre now has one, thanks to the Auxiliary. This piece of equipment has optical and illumination features that provide enhanced 3D vision for surgery. The detailed vision of the surgical site helps eye surgeons perform delicate procedures making it safer for patients and improving outcomes. This microscope can also connect to other diagnostic equipment for correction of astigmatism.
     The Lumera 700 will be used for cataract, glaucoma and corneal surgery.

L-R BRHC Auxiliary Assistant Janice Meadows, Care Team Manager of the BRHC Surgical Suite Janet Twerdoclib, Coordinator BRHC Gift Shop Brenda Burgess, Ophthalmologist Dr. Guillermo Rocha,  BRHC O.R. Clinical Resource nurse for Ophthalmology program Carmen Saban, Helen Dalling, Coordinator Nearly New Sharleen Gunston, Marlene Brichon, all BRHC Auxiliary members.

Operation Walk Nicaragua, 2017
 
     With the memories and impact of last year’s Operation Walk mission to Nicaragua still firmly embedded in our minds, Brandon operating room nurses Rachelle Lesy and Stephanie Phillips, surgeon Dr. Norm Klippenstein, and newly recruited nurse Lisa Cobbe once again joined the Winnipeg team and returned to that Central American country to provide life-changing knee replacements to those who otherwise could not hope for such transformative surgery. We spent another intense and unforgettable week in an inner city hospital in Managua to help the team of about 60 achieve its humanitarian goals, once again reaping the intangible rewards that such service often brings. The spirited solidarity of medical personnel, support workers, and volunteers was a tribute to the common commitment to this mission and the people of one of the poorest countries in the Americas. 
     This year we targeted an even larger number of debilitated patients, continuing to build up the hospital’s depleted and outdated equipment needs, and once again going outside our medical mandate to visit several schools and social agencies. This ambitious agenda required a full year of fundraising, collection of donated supplies, and development of a medical and volunteer team to address the many facets that such a complex joint replacement service requires. Once again the team rallied the necessary support, overcame unpredictable yet seemingly perpetual  challenges, and at the end of the week declared this year’s mission to be the best of the six annual trips yet.
     A shipping container of donated equipment and supplies arrived in Nicaragua about a month ahead of the team, once again requiring negotiation and management of red tape to allow it to be unloaded. The drugs we brought for the anaesthetics were initially considered illegal, but were eventually cleared. An advance group arrived several days prior to the rest of the team to preview and select those patients most in need of surgery, and ensure the safe transfer of the shipped supplies. One of the 10 donated hospital beds had been diverted by a high-ranking government official and had to be delicately retrieved, and a critical set of knee implants which didn’t arrive had to be brought with the Brandon team’s air luggage at the last minute. The local wards were cleared to prepare for the dozens of new post-op patients. A lost passport and a last minute scheduling conflict left the team without two anaesthetists, requiring the recruitment of local staff to fill in on short notice.
     Once we started operating the first day, it became evident that work flow would be an additional challenge. The minimally equipped and outdated sterilizing facilities at the hospital were unable to accommodate the high pace, significantly restricting the availability of clean operating equipment. This resulted in delays and the need for some staff to work 18 hour days to support the planned procedures. Cats in the hospital and flies in the O.R. were accepted as unavoidable local conditions. Supplies that we would normally discard after each case at home, were carefully collected by their staff for recycling. The limited air conditioning in the crowded hospital seemed to only minimally temper the 30 plus degree heat. The roads to the rural schools we visited had been washed out by torrential rains the week before, and were just being rendered passable by road crews on our arrival. Each day additional challenges required ingenuity to ensure the ongoing success of the mission.
     Despite these and other obstacles presented by the realities of working in a developing country, the Operation Walk team performed 69 joint replacements in three days, in a hospital that typically performs 40 or 50 joint replacements a year, and only for those that can pay. This represented the most ever by our team, and for what were probably the most challenging deformities encountered by our Nicaraguan missions to date. Some patients had not been able to walk for several years. Many could not work or look after their families. Working dawn to dusk, disregarding the usual division of responsibilities we maintain in our Brandon O.R., innovating and substituting for gaps in equipment availability, working constantly through Spanish interpreters, and feeding off a high level of group energy and encouragement, we pushed the pace with minimal breaks and our usual conveniences.
     This year we brought previously used knee braces and other orthopaedic appliances which had been donated through the Brandon Clinic for distribution in Nicaragua. It is hoped that this project can be further developed to help those who cannot make it onto operating lists or who might not be candidates for surgery. There were many conversations around ideas for introducing resources and initiatives into a society that has a seemingly endless need for medical and other support.
     Incorporating local medical personnel into our work has become an appreciated hallmark of Operation Walk, distinguishing our Canadian approach from other groups who have preceded us. Once again the outpouring of gratitude from the patients and their families was overwhelming and humbling. Embraces, tears and prayers were offered in thanks for our members. And again the individual stories and personalities gave the surgical and rehabilitative component of our mission a profoundly unforgettable human element that can’t be measured by straightened limbs or extended walking distances.
     A parallel initiative to visit an orphanage, a centre for troubled young mothers, and several schools gave additional opportunity to bring donated supplies and encouragement to areas of need that were a sober reminder of the vast disparity between our respective societies. A festival put on for a rural school, with piñatas, pizza and face painting was just as joyous, however, as any school party in our country, and donated baseball and soccer equipment allowed the children to show off sporting skills that had been honed on much shabbier gear. There is no greater stimulus to inspire hearts and humanitarian efforts than seeing needy situations where such a small contribution can make such a big difference.
     And so the four of us returned to Brandon the richer for the experience and the happier for the opportunity to serve an area of need in such a unique way. Back home our Canadian jobs take on new meaning in light of the unforgettable experiences of this short but intense surgical mission and the wonderful people of Nicaragua we were able to engage. We are most grateful for the generous donations made in support of this trip, for the backing and encouragement we have received from our medical community, and for supportive friends and family who will be hearing many more stories from our adventure.

 

One of the more severely debilitated patients, Ernesto. He had right and left knee replacemtns performed together.

Helping out in MDR (Medical Device Reprocessing) Lisa Cobbe, Rachelle Lesy, Stephanie Phillips, Abby Gagnon (Winnipeg)

Dr. Klippenstein and 80 year old patient Maria, who couldn’t stop thanking them.

Setting up for surgery. Dr. Taranjit Tung (Winnipeg), Rachelle Lesy, & Stephanie Phillips
A school fiesta with facepainting, piñatas and the children proudly wearing the T-shirts we brought.
Copyright © 2017 Prairie Mountain Health, All rights reserved.


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