OCTOBER 2010

WHAT’S INSIDEMadigan Memories............................................2Around the AMEDD..........................................3Commentary: Breast cancer.............................4Fill out your APLSS..........................................5Civilians invited to get fit with program.............5Mass casualty exercise at Madigan.....................6Madigan Heroes................................................7WTB: Soldiers receive horse therapy...............8Event remembers POW/MIA sacrifices............9Spotlighting our Soldiers’ teens..........................11Community.......................................................12

Madigan is stepping into Baldridge

Madigan Healthcare System’s leader-ship has committed to using the National Baldridge Process Improvement models as a business framework to achieve year-round focus on performance excellence. The long-term goal is to save lives through performance excellence and win the Malcolm Baldrige National Quality Award; the im-mediate goal is to take those steps required to create a new way of doing business within Madigan.

The Baldrige Award is a Presidential award that no military treatment facility has ever won; Madigan intends to be the first.

Col. Jerry Penner III has established a new Office of Strategic Quality Improvement and named Dr. John Meyer to spearhead this effort as the Baldrige project manager.

Madigan’s Strategic Quality Improve-ment Workgroup has met weekly over the last nine months to develop its new Mission, Vision, Values and Strategic Objectives. The next step in deploying this new way of busi-ness will be establishing seven Performance Excellence Teams in soon.

Madigan Healthcare System creates the premier military healthcare organiza-tion through a culture of teamwork, caring, compassion, diffusion of innova-tion and exceptional outcomes. Madigan is the best place to provide and receive care, to teach and learn clinical medi-cine, and to conduct bench-to-bedside research.

VISION

MISSIONMadigan Healthcare System provides world-class military medicine and com-passionate, innovative, academic health care for Warriors and Warrior Families past, present and future.

• Readiness• Population Health• Patient-centered Focus• Quality Workforce• Education and Research• Community Partnerships• Resource Management

STRATEGIC OBJECTIVES

• Compassion• Quality• Teamwork• Innovation

VALUES

SRP processes 18,000 Soldiers, twiceBy Tawny M. Dotson

Staff Writer

Madigan’s new ER nursing course starts

By Tawny M. DotsonStaff Writer

Taw

ny M

. Dot

son

1st Lt. Jennifer Esparza starts an intravenous flow in a patient at Tacoma General Hospital’s Emergency Room while Noelle Krueger, a civilian RN and Tacoma General employee, supervises. Esparza is a student in Madigan’s Critical Care Emergency Nurse Course and is participating in clinical rotations through an agreement with MultiCare.

It takes a partnership throughout the medical

community to train a good nurse. That’s a lesson learned from the Army’s Critical Care Emergency Nurse Course being held for the first time in Ma-digan Healthcare System and some of Tacoma’s emergency rooms.

“Right now we have a shortage of ER nurses, so Tacoma General, Mary Bridge and MultiCare are actually helping the mili-tary train ER nurses,” said Lt. Col. Spencer Dickens, director of the Critical Care Emergency Room Nurse Course. “It shows that our community is actively par-ticipating in supporting the

deploying and redeploying the largest troop contingent since the Korean War.

The SRP, made up of JBLM and Madigan Health-care System employees, pro-vided more than 56,000 im-munizations and had 78,000

visits from Soldiers during the past year, making them one of the busiest soldier readiness centers in the Army. The SRP staff’s commitment and qual-ity work is being rewarded in the achievements given to the organization.

“This is one of the first stops that a mobilizing or deploying unit comes to. It was just a very positive ex-perience for our Soldiers. It was very well planned and executed,” said Maj. Gen.

Please see NURSES, PAGE 2

The Critical Care Emergency Nurse course is the first at Madigan and partners with MultiCare’s emergency rooms to teach Army registered nurses critical care skills

military.”The program, taught by

Madigan staff, is for Army registered nurses and features a series of clinical rotations taking place in MultiCare’s Tacoma General and Mary Bridge Hospitals. Lasting 14 weeks, the course prepares nurses to function in the ER. Competencies covered include responsibilities, nursing care, teaching role, principles and techniques of staff supervision and management of patients across the life span in an emer-gency setting. All the students are active duty RNs who have

had initial Army assign-ments and a minimum of 18 months experience. They come to the course from a number of duty stations in-cluding Fort Campbell, Ky., Fort Bliss, Texas, and even an international student.

“Because of the recent in-crease in a need for ER nurs-es in combat and stateside, I proposed an emergency nurses course at Madigan,” said Lt. Col. Dana Munari, deputy director of the criti-cal care emergency nurse

The Joint Base Lewis-Mc-Chord Soldier Readiness

Processing Center recently received accolades for maintain-ing efficient processes while Please see SRP, PAGE 10

The Mountaineerwww.mamc.amedd.army.milVolume 17, No. 9

Madigan Healthcare System: “People First, Patients Always”

The Mountaineerwww.mamc.amedd.army.milVolume 17, No. 10

Madigan Healthcare System: “People First, Patients Always”

OCTOBER 2010 www.mamc.amedd.army.mil page 2

MADIGAN MEMORIES

STRATEGIC COMMUNICATION ARCHIVES

The Madigan Healthcare System Strategic Communication Office will publish photos in The Mountaineer throughout 2010 to show the history and culture that is Madigan. This photo dates back to the Oct. 27, 1982 Madigan Mountaineer. Sp4 Kenneth Reaves and partisan for the day Lt. Col. George Kernan, check the compass sighting of 1st Lt. Steven Boyer as they chart their way to Regansburg.

IN BRIEF

Flu vaccinations availableStaff flu vaccinations are available in the Tax Center

between the Internal Medicine and Letterman Auditorium on the ground floor of the Medical Mall. Immunizations will be available Monday through Thursday, 8 a.m. to 3:30 p.m. and Friday, from 7 a.m. to 3 p.m.

Vaccines for staff will be available through Dec. 15, excluding Nov. 11 to 12, and Nov. 24 to 25.

This year, you will only need one vaccine! This year’s seasonal flu immunization will include the H1N1 flu strain as well. You will be able to get your flu vaccinations in one of two ways — a nasal flu mist or by injection. The nasal flu mist will be available only for beneficiaries aged 6 months to 49 years and flu shots for those 50 years and older.

The Centers for Disease Control and Prevention is rec-ommending that everyone above the age of 6 months get this year’s flu vaccine. This is based on lessons learned from last year’s flu season. Last year, the H1N1 flu caused mild to moderate symptoms in persons mostly aged 25 to 64 years with no underlining health issues. This is the typical age group least likely to suffer from the flu.

For more information, contact Maj. Matthew Chambers, Occupational Health Resident, at 253-968-4095.

New wayfinding initiative coming soonHave you noticed our old reliable signs lying on the floor

around the hospital? Kind of looks like someone forgot to hang them back on the walls after the painters got done, huh? Well, our signs are on the ground for a reason — new signs are on the way!

“With the new signs coming in, the existing signs are temporarily placed on the ground,” said Mike Carico, chief of Madigan Facilities Maintenance Division. The new signs are expected to begin arriving in the next 60 to 90 days. “This allows for the flexibility of the installation of the new signs and besides, we won’t have to spot-paint our newly painted walls with all the upcoming sign changes,” Carico said. Once the new signs start flowing in, the facilities team will begin hanging and posting them.

The new signage was decided upon more than a year ago. Termed “wayfinding,” the new initiative was final-ized by the commander last winter. “The new signs will be a big improvement for patients, staff and visitors to navigate through the facilities because they are larger and more colorful than the current signs of white lettering on beige background against a brown wall,” said Celia Boyce, secretary for the deputy commander for administration.

The new way finding signs are different in size, color and placement from the current signs. The current signage are the originals that came with the medical center when the doors opened in 1992. The new wayfinding signage is coming in two colors: green and maroon. “The green way finding signs will be associated with the Medical Mall and the maroon wayfinding signs will be for the Hospital Tower,” Carico said.

Word of the monthACT- Webster defines Act as an action; doing. As Equal

Opportunity and Unit Victim Advocate program personnel, we encourage you to know how and when to ACT to pro-vide Diversity guidance to Commanders and our Soldiers, Airman, DoD Civilians and other service members. Each month, the JBLM EOSO features a word related to diversity or sexual assault prevention. For more information, please contact the JBLM EOSO at 253-966-3819.

All Joint Base Lewis-McChord service mem-

bers, civilians and contractors deploying to Iraq or Afghani-stan are mandated to take a 20-minute neurocognitive assessment test through the Department of Defense Au-tomated Neuropsychological Assessment Metrics center located near Madigan Health-care System.

ANAM is a proven com-puter-based tool designed to

detect speed and accuracy of attention, memory, and think-ing ability. It can be used as a baseline for the service mem-ber in case they are involved in a concussive event, typically resulting in a mild Traumatic Brain Injury.

The results may help health care staff compare a service member ’s neurocognit ive skills before and after an injury, and determine when a service member is ready to return to duty, said Felix Rios, a psychometrist and program manager with ANAM.

The assessment tool does not diagnose any medical condition.

ANAM assessment results are considered protected

By Lorin T. SmithCommand Information Officer

DoD mandated assessment test assists with mTBI diagnosis

health information and placed in a patient’s electronic medi-cal record. The test results are encrypted at the Office of the Army Surgeon General in a stand-alone database, and the only person who can see that information would be a doctor treating a service member who has suffered an mTBI.

The baseline tests and post-concussive tests are compared and provide the doctor better information about the person’s situation, Rios said. “The best way to know how you are functioning after an injury is to know how you functioned before the injury,” he added.

To date, more than 600,000 baseline tests have been given throughout the Army.

NURSESCONTINUED FROM PAGE 1

course.The nurses are integrated,

with oversight, into the ER at Tacoma General and Mary Bridge Hospitals.

“Even though it’s a large emergency room, you can only infuse so many nurses in a student mode. Our facility can only take a few as the other

facilities can only take a few,” Munari said.

The hope is that the nurses will complete clinicals and share experiences.

“A lot of them are carrying back their stories from deploy-ment and I expect that they are sharing those experiences with the civilian nurses,” Munari said. “They are experiencing what life is like for an Army nurse and what life is like as a

civilian.”The course is collocated with

the Critical Care Nurse course in order to focus on the pathway between the emergency room and the intensive care unit.

“We want to focus on the path-way and the carry over between the two,” Munari said.

The end product is a group of nurses prepared for entry-level work in the ER or ICU. The first course graduates Nov. 24.

ANAM gathers brain data for deploying personnel

Around the AMEDDOCTOBER 2010 www.mamc.amedd.army.mil page 3

Cou

rtesy

of U

SA

MR

IID

Command Sgt. Maj. Billy R. King relinquished his

responsibilities as command sergeant major of the Western Regional Medical Command to Command Sgt. Maj. Tuileama T. Nua, during a Change of Responsibility ceremony held at Joint Base Lewis-McChord Aug. 19. The event also culminated a 30-year distinguished military career for King who is set to retire early next year.

Maj. Gen. Philip Volpe, com-manding general, Western Regional Medical Command, welcomed the attendees and thanked them for being part of

such a special occasion. “Today is about honoring

our traditions, and honoring the Soldiers and civilians of the Western Regional Medical

Command as we transfer the responsibilities of our senior noncommissioned officer, our se-nior enlisted leader,” Volpe said.

For the last three years, King

Maj. Gen. Philip Volpe, commanding general, Western Regional Medical Command, passes the NCO Sword to Command Sgt. Maj. Tuileama T. Nua during the change of responsibility ceremony at Joint Base Lewis-McChord.

Western Region Medical Command welcomes new top NCO

By Sharon AyalaWestern Region Medical Command

Public Affairs Office

served as the region’s com-mand sergeant major and senior enlisted advisor for a region encompassing 20-states. From 2007 to 2009, he was dual-hat-ted as the WRMC and Madigan Army Medical Center command sergeant major. Volpe said that during that entire time, his advice and counsel were always on target.

“When he spoke, it was from the knowl-edge and experience that he gained from a career as a sea-soned Soldier, supe-rior noncommissioned officer, and magnificent leader,” Volpe said. Thank you for your noble service to our AMEDD, our Army and to our Nation.”

Nua comes to the Western Region following an assignment as the Pacific Regional Medical

Command’s command sergeant major, located in Hawaii. This will be his third time serving side-by-side with Volpe.

“I have had the privilege of serving with Nua in Korea and at Fort Bragg, and I can tell

you that he too is a Soldier’s Soldier, and a leader of enor-

mous character, energy, wisdom and passion,” Volpe said.

During his remarks, King told Nua, “You now have the awe-some responsibility

to train, mentor, and motivate over 15,000 Soldiers

and civilians that make up this great team.”

Nua and his wife, Anita, are both honored and privileged to serve with Volpe once again and they are honored to join Team Western Region.

The last two decades have shown a rise in childhood

obesity, including children in Army Families. As obesity numbers in children continue to climb, so do conditions as-sociated with obesity. Early detection and treatment can reduce the likelihood of these health problems from occur-ring. Parents need to advocate

Combat childhood obesity by promoting active lifestyle at early age

By Wendy LaRochePublic Health Command

USAMRMC wins research lab of the yearBy Lori Calvillo

Medical Research and Materiel Command Public Affairs

Deputy Assistant Secre-tary of the Army Marilyn

Miller Freeman announced Fri-day that Medical Research and Materiel Command was chosen as the 2010 Research and Devel-opment Laboratory of the Year (small lab).

The Department of the Army Research and Development Lab-oratory of the Year Awards pro-gram is an annual event in which

Army laboratories are evaluated on technical accomplishment and impact on the Army.

“It takes a team of dedicated personnel working diligently, passionately, and consistently to achieve the excellence for which these organizations have been recognized,” Freeman said.

“I commend each person who contributed to the accomplish-ments highlighted in the sub-missions and I thank the entire workforce of MRMC for all you do to provide our Soldiers with the

Decisive Edge every day.”USAMRMC competed against

five Army labs this year to win the top honor.

The review board is made up of distinguished science and technology experts from academia, industry and govern-ment.

The RDL awards program was established in 1975 to honor Army research and development labs that have made outstand-ing contributions in science and technology.

for their children by asking questions during annual well visit check-ups with their child’s health care provider and by establishing healthy habits at home.

The most widely used diag-nostic tool to identify weight problems within a population is Body Mass Index. BMI is a statistical measure calcu-lated from a child’s weight and height. For children, BMI is age and sex specific and is often referred to as BMI-for-age. BMI doesn’t measure body fat; it identifies healthy body

weight based on comparisons between a child’s height and weight as plotted on a growth curve.

A child’s BMI is typically calculated as part of an annual well-visit physical. After the BMI is calculated for children and teens, the BMI number is plotted on the Centers for Dis-ease Control and Prevention’s BMI-for-age growth charts to obtain a percentile range. The general rule of thumb is that overweight children statisti-cally fall between the 85th and 94th percentile compared

to the weight of their peers (same sex and age). Obesity is defined as the 95th percentile or above on the growth chart used.

BMI is one indicator for obesity. Your child’s doctor can identify whether your child’s weight is a concern. A parent can also help by providing Family history information to the child’s provider.

If your child is overweight or obese, try making small changes to eating habits right away. In the morning, use fat-free or reduced-fat milk

in cereal and purchase whole-grain cereals. Add fruit to the morning meal. Consider giving the child oatmeal or whole-grain waffles, and limit items like toaster pastries. Prepared lunches from home allow more control over your child’s caloric intake.

Exercise is a great Family activity. Walks after dinner are a nice way to burn calories. Let children plan the exercise and physical activity regimen.

Help combat childhood obe-sity by establishing healthy eating habits in your kids.

Parents and providers to encourage better habits

New senior enlisted leader joins commander for their third assignment together

The USAMRMC will be presented the Research and Development Lab of the Year Award Oct. 24, in Arlington, Va.

OpinionOCTOBER 2010 www.mamc.amedd.army.mil page 4

MAILBAG

Dear Col. Penner,

I underwent surgery at Madigan Sept. 10 and was admitted to the 7 North nursing unit for post-op care. I have to say that this team of nurses (7N) provided excellent care to me during my entire stay!

As my surgery was scheduled the day prior to my birthday, I did have to spend my birthday as a patient. The day-shift nurses went above and beyond giving great care and gave me the gift of genuine caring and good will! While walking around the unit, the rest of the nurses were busy decorating my room with balloons and streamers that they had made themselves! They also made me a card and had everyone sign it. What a wonderful surprise! This truly made my day as well as my stay.

I am still trying to figure out how to thank them properly and I hope that this is a good start. From my first meeting with Lt. Col. (Dr.) Mohamad Haque to the care received before, during and after my surgery, my experience here was great! The night shift nurses were wonderful and caring and don’t always get enough recognition for their role in the recovery of a patient. I can’t truly give them enough justice here; they were kind and caring with a gentle touch and a ready smile. Kudos to them as well!

Please pass along my gratitude to these outstanding nurses as well as their supervisor. They all are an asset to Madigan as well as the nursing community.

MARLA, Joint Base Lewis-McChord

Dear Col. Penner,

Just wanted to send you a quick note to thank you and your staff at the SRP Center for the quick and efficient manor in which you processed our Soldiers.

I heard from many of them and they all commented on how helpful and friendly everyone was. I also had a great experience there as I went through yesterday.

On behalf of all the “Red Bulls” I want to thank you.Brig. Gen. JERRY LANGDeputy Divison Commander34 Infantry Division “Red Bulls”

Madigan Healthcare System’s The Mountain-eer is an unofficial monthly offset newspaper for the Madigan Healthcare System, authorized under the provisions of AR 360-1.

Contents in this publication are not neces-sarily the official views of, or endorsed by, the Department of Defense, Department of the Army and Madigan Healthcare System.

For information about The Mountaineer or to submit a story idea, contact Madigan Healthcare System Strategic Communication Office’s The Mountaineer Editor Lorin T. Smith at 253-968-3821, or lorin.smith@us.army.mil. Circulation: 2,000

CommanderCol. Jerry Penner III

Strategic Communication DirectorJay Ebbeson

Command Information OfficeEditorLorin T. Smith

Staff WriterTawny M. Dotson

Warrior Transition Battalion Public AffairsSuzanne Ovel

The Mountaineer Since 1944

Breast cancer awareness: my Family’s storyBy Tawny M. Dotson

Staff Writer

It’s one of my first memo-ries from my childhood,

and it still haunts me. I was sitting in the living

room combing my mom’s hair and it just seemed to fall out — all of it. I had combed her hair hundreds of times. I loved combing her hair, but today wouldn’t be one of the better memories.

At 6 years old, I was affected by something people may never experience. Although, according to the American Cancer Society, one in eight women will.

My mother was diagnosed with breast cancer when she was 29 years old. She was a young wife and mother of a 5-year-old and a 2-year-old. I can only imagine what thoughts flooded her mind.

You see, I am 30 years old, married and the mother of a 6-year-old and a 3-year-old. I don’t have breast cancer, but my life’s obligations are so similar to hers at that time it’s a bit eerie.

October is National Breast Cancer Awareness Month. America brings out pink rib-bons and commercials about the most common cancer found in women. Campaigns kick off and fundraisers move into a higher gear. All of these aim at defeating a cancer that is killing our nation’s women. I do those things every month.

Pink ribbons are not saved for October in our house.

After almost 25 years with a cancer-free mom, being part of a Family afflicted with breast cancer has become a re-ality more than once. My maternal grand-mother was diag-nosed with breast cancer just a few years ago.

Early detection is key to survival of patients diag-nosed with breast cancer. Self-exams and mammograms are the best forms of detection. The Ameri-can Cancer Society recommends self-exams begin in your twenties.

For Fami-l i e s l i k e mine, they r e c o m -m e n d m o r e preven-tive care. I started re-ceiving mam-m o g r a m s a t 19.

I s it in the w a i t i n g room with a more mature crowd, but we are all there for the same reason - prevention. I also take part in yearly MRIs. The combination of the mam-mograms and MRIs make it possible to track any changes

in my breast tissue and arm my doctors with a baseline should I be diagnosed with breast cancer in the future.

Whether a member of your Family has had breast

cancer or not, it is a disease women and men must be aware of. Breast cancer affects everyone.

D o c t o r s h a v e told me there are things I can do to decrease my risk

of getting breast cancer. They recom-

mend I limit alcohol intake, exercise regu-

larly, and maintain a healthy body weight.

They also recom-m e n d e d b r e a s t

feeding for sever-al months with

my boys and avoid certain

h o r m o n e therapies. I f i g u r e whatever

it takes.During Oc-

tober, I always pause to remem-

ber just how strong a n d brave my mom is. I tell her I love her and I’m still proud of her.

I will don pink ribbon pins and wear pink T-shirts more often than normal. Then again, I do all of that every month.

Push the new blue button at TRICARE OnlineA new feature on TRICARE

Online now allows users to save their personal health data such as medication and allergy profiles, demographic information and a personal health summary to a Portable Document Format file on their computer.

“The new feature, called the Blue Button, is available on the TRICARE Online Personal Health Record site at www.tricareonline.com,” said Chuck Campbell, chief Information officer for Military Healthcare System. “After logging on to the secure site, users will be

able to add information to their personal health data on the site. Users will need to select the Blue Button titled “Save Personal Health Data” before they can save their personal health data to a PDF file on their local computer.”

TRICARE Online is the Mili-tary Health Systems Internet point of entry that provides all 9.6 million Department of Defense beneficiaries access to available healthcare services and information through an enterprise-wide secure portal. TRICARE Online users who receive their care at a military

treatment facility can schedule appointments, order prescrip-tion refills and view their per-sonal health records.

To learn more, go to www.tricareonline.com or visit www.

health.mil/mhscio.For more news about health IT news, subscribe to The Portal, the leading news source for mili-tary health IT at www.health.mil/mhscio.

OCTOBER 2010 WWW.MAMC.AMEDD.ARMY.MIL page 5

By Bob ReinertNorthwest Guardian

Civilians can now join Army-sponsored fitness program

Take three hours off each week and get healthier.That’s the bottom line of the Civilian Fitness

Program, which allows Joint Base Lewis-McChord full-time civilian employees three hours of adminis-trative leave for each 40-hour period over six months to exercise.

Dr. Teresa Bruder, director of the Health Promotion and Wellness Service at Madigan Healthcare System, said the program, whose next session begins Oct. 26, benefits both JBLM and its workforce.

“It helps increase the morale on base,” said Bruder, who oversees the program at Jensen Family Health and Fitness Center. “If you’re exercising, you’re just more mentally alert.”

Research shows that employees who exercise have lower absentee rates, lower reports of stress, and higher productivity.

As Bruder pointed out, the program helps busy em-ployees carve out enough time on weekdays to attend to their health.

“They’re just like everybody else — they’re swamped,” Bruder said. “Most of our civilians coming in just so much appreciate the opportunity to begin to exercise and feel like they can do it during duty time.”

Cindy Petersen, a paralegal on JBLM, enrolled in the program to increase her fitness and lower her stress and cholesterol levels. Petersen is pleased with the early results of her workout regimen.

“I worked out on my own prior to that time,” Petersen said. “It motivates me. My clothes are fitting a little

Have you received an official survey in the mail about your

visit to a provider within the Madigan Healthcare System? Don’t throw those surveys away! They are a chance to pro-vide Madigan with anonymous feedback and the command staff monitors them carefully.

The Army Provider Level Satisfaction Surveys are a 24-question, confidential survey given to patients selected on a random basis by a contractor via U.S. mail. They are designed to provide Madigan’s command staff and provid-ers with unique information about how our patients feel about their providers, the services at the hospital and clinics and access to their health care needs. Those surveys have allowed Madigan to enhance, increase, adjust and continue to provide world-class military medicine for all our beneficiaries.

“The surveys provide us both with good information, things they are happy about, as well as letting us know the things we can improve on,” said Lisa Danforth-Lewis, chief of the Quality-Services Division at Madigan.

A recent issue identified through the APLSS was the need to improve services in the Pharmacy. Patients had been waiting, on average, more than an hour to get their prescriptions filled. When the dissatisfaction was identified through a number of channels, including APLSS, the hospital worked to lower that wait time to less than 30 minutes and bring their satisfaction rate up from a 42.9 percent. The clinic recently celebrated a milestone when their department reached above a 70 percent satisfaction rate and the significant decrease in wait

bit looser than they were. I’m feeling better.”According to Bruder, employees choosing to enter

the fitness program must get supervisor approval and complete a health history signed by a physician. They then undergo an initial fitness assessment that includes blood pressure, pulse, body composition and tests to measure cardio-respiratory fitness and flex-ibility.

“We measure a whole variety of things,” Bruder said. “We do a post assessment six months later to see how they’ve done.”

Participants get the chance to change their lifestyles over the six-month period.

For more information on the civilian fitness program, call Dr. Teresa Bruder at 967-3875 or e-mail teresa.bruder@amedd.army.mil.

We want YOU to fill out those surveys!

Your opinion is valued at Madigan Healthcare System! The Army Patient Satisfaction Surveys are sent to beneficiaries to garner feedback on our services.

We review the results to ensure we are providing world-class military

medicine from every aspect. Your feedback has led to improved efficiency in our clinics, adjustments to staff levels and new furniture.

For more information contact Steve Burke at (253) 968-3013 or email: Stephen.burke@us.army.mil.

You speak, we listen!

times after a year of hard work.The surveys were originally created

to provide Madigan with an insight into what patients think about their provid-ers. The results were found to be a tool to reach well beyond that.

While most of the survey questions focus on provider feedback, the APLSS include questions on access and services. The results have led to new furniture and streamlined processes. In addition, it has identified needs in housekeeping and facility maintenance in order to ease

access to services.The goal is to get 250 surveys back

on each provider every year. An out-side contractor runs the confidential program, which provides Madigan’s commander, department chiefs, and administrative officers the results. Ev-ery set of results is analyzed for specific comments and trends are tracked. In addition, all providers have access to their own scores.

As a new aspect of the program, and to reward military treatment facilities for

Madigan encourages beneficiaries to fill out mailed surveys

By Tawny M. DotsonStaff Writer

excellence in care, the Army’s Medical Command instituted an incentive pro-gram that provides additional funding to a military treatment facility based on survey results.

The surveys remain a key tool to iden-tify areas the hospital can improve in order to continue to provide world-class military medicine. For more information about the Army Provider Level Satis-faction surveys contact Steve Burke in Quality Services at 253-968-3013 or email Stephen.burke@us.army.mil.

two years ago, but the need for it was amplified when the shooting at Fort Hood, Texas occurred.

“I would say we have the best guard force in MEDCOM,” Murphy said. “We are lucky to have great command teams that have believed in us and given the OK to go forth and do what we need to do.”

All of these efforts contrib-ute to ensuring Madigan is prepared to provide a safe environment for our, staff and beneficiaries Murphy said.

OCTOBER 2010 WWW.MAMC.AMEDD.ARMY.MIL page 6

A recent mass casualty exercise by Madigan

Healthcare System highlighted the hospital’s readiness for an active shooter and a large number of casualties. It came the day of an actual incident at Johns Hopkins Hospital, Md., where the real life situ-ation mirrored the exercise at Madigan.

The goals of the exercise were to test Madigan’s imple-mentation of the National In-cident Management System for emergency management and to test the increase in security forces at Madigan’s hospital and clinics.

Implementation of the NIMS template has occurred at Ma-digan the past few years. The exercise was the first test of the emergency plans based on NIMS. Madigan’s emergency

management plans have joined most of the country in reorga-nizing based on NIMS, which was created after Sept. 11. NIMS standardizes emergen-cy response nationwide. The system ensures a combined national effort is possible and that emergency responders can relate regardless of their loca-tion and background.

“We are moving forward rap-idly with NIMS at Madigan,” said Bill Llewellyn, emergency management coordinator for Madigan. “People are really starting to get it.”

Llewellyn, explained the system challenges conven-tional military planning. NIMS places the most experienced person in charge of a specific incident, rather than the most senior leader.

“So, if there is a building fire do we want to place a hospital administrator in charge of the incident management or a fire chief?” Llewellyn said. “Obvi-ously the fire chief is more experienced in that particular incident so we would lean on his on scene leadership.”

The second aspect of the

Story and photos by Tawny M. DotsonStaff Writer

Capt. Aaron Matlock discusses a simulated casualty’s wound while Spc. Shawn Erickson and 1st Lt. Stacie Gibson (far right) prepare the casualty for transfer. Cpl. Stacey Carroll (in red hat) gathers the patient’s information for tracking through the hospital. The team was participating in a mass casualty exercise Madigan Healthcare System held to test the active-shooter team and emergency planning within the hospital system.

exercise was the implementa-tion of an active-shooter team within Madigan’s physical security. Madigan’s security forces were recently increased to 23 guards in response to ex-tra personnel and beneficiaries at the hospital.

Security guards are also now carrying electroshock weap-ons, known more commonly by the name Taser. Madigan is one of the Army medical centers that started carrying the electronic control devices in late August. They are not a replacement, rather an addi-tion to the options available to maintain physical security at the hospital.

The active-shooter team at Madigan is led by Lead Guard-Chad Nix. Madigan maintains four active-shooter instructors in their security forces team and eight trained guards who can be members of the team. The fully-up-and-running pro-gram has been identified as one of the best in the Army Medical Command, according to Lynne Murphy, Provost Marshal at Madigan. The active-shooter program was started just over

Spc. Mason Ostrom applies a tourniquet to a simulated casualty’s wound during a mass casualty exercise Sept. 16.

Madigan tests mass casualty response, NIMS

The Madigan Health-care System Provost

Marshal Office has dedi-cated lots of time to prepare and train staff members and themselves for a mass casualty active shooter in-cident. The preparation has included assistance with departmental active shooter response plans and team training for the PMO staff.

The most recent exercise commenced with an active shooter response to Madi-gan Annex. Multiple people were killed or hurt, result-ing in the PMO calling in Joint Base Lewis-McChord military police, fire and Emergency Medical Servic-es to respond as well. Once the threat was neutralized, these agencies began the tough job of triaging the victims and transporting them to Madigan for treat-ment, while the MPs began processing the crime scene. The EMS transported 10 patients to the Emergency Room, where they were triaged, and treatment ini-tiated.

The surgeons, radiolo-gists, lab technicians, pa-tient trackers, security forc-es, emergency physicians and nursing staff swung quickly into full response mode. They performed su-perbly and validated the Madigan Healthcare Sys-tem’s Emergency Man-agement Plan. Although successful, the team did execute a detailed after ac-tion review, which resulted in recommended process changes that would stream-line future operations.

Madigan used role play-ers for the victims. The military has a lot of high-tech assets available for use like moulage, provided by the Medical Simulation Training Center, to provide a high level of realism.

Moulage consists of pros-thetic injuries such as gun-shot wounds, and fake blood product.

The role players were moulaged to meet training objectives.

Story by Lynne MurphyProvost Marshal Office

Madigan increases security forces and implements NIMS for planning

Provost Marshal excels in mass casualty exercise

Madigan HeroesOCTOBER 2010 www.mamc.amedd.army.mil page 7

Madigan HeroesOCTOBER 2010 www.mamc.amedd.army.mil page 7

Combined Federal Campaign underway at MadiganCommand Sgt. Maj. Miguel Guante-Rojas and Col. Jerry Penner III complete their Combined Federal Campaign donation slips at the official kickoff of the campaign Oct. 10. The CFC is the only authorized solicitation of employees in the federal workplace on behalf of charitable organizations. Each year federal employees give millions of dollars through the CFC. The CFC drive ends Dec. 15.

Army Junior Nurse of the Year

Capt. Jennifer Wissemann has been selected as the Association of Women’s Health, Obstetric and Neonatal Nurses Armed Forces Section Army Junior Nurse of the Year. The award was presented Sept. 29. Congratulations on a superb job well done!

Medical check-in kiosk invention

Madigan extends congratulations to Col. Gary Wheeler for his interactive medical check-in kiosk invention to efficiently check-in patients. The system allows the patient to provide initial information by scanning an ID card. The kiosk then accesses other data and makes suggested preventive health care actions.

Family Medicine Residency gets five-year accreditation

The Family Medicine Residency at Madigan Healthcare System just received a five-year accreditation. This is the longest accreditation period possible for a residency program. In June, the Residency Review Committee reviewed the Family Medicine Residency with the results announced in early October.

Congratulations to Lt. Col. Irene Rosen and the Family Medicine Residency team.

Boston Marathon qualifiers

Lt. Col. Aaron Pitney, chief, Department of Pediatrics and Maj. Jason Bothwell, a fellow in Emergency Medicine, have completed the 2010 Portland Marathon and qualified for the 2011 Boston Marathon.

PromotionsStaff Sgt. Cerron HutchinsStaff Sgt. Eric ShetkaSpc. Stanton Buch

RetirementsStaff Sgt. Roger Mclean

Meritorious Service MedalMaj. Linda GowenlockSgt. 1st Class Kenneth BurksSgt. 1st Class Wayne Mitchell

Army Achievement MedalLt. Col. Thomas HirotaMaj. Christian SwiftCapt. Jason E. Sapp

Capt. Melinda ThiamCapt. David Coots Sgt. 1st Class Andria HollingsheadStaff Sgt. Thomas LucasSgt. William EskridgeSpc. Richard Hendricks

Department of the Army Certificate of AchievementCapt. Marcos Torres-TorresSgt. George CloySgt. William Eskridge Sgt. Hilda FloreszacariasSpc. Lina AlsudaniSpc. Reed Rice

Spc. Guadalupe SanchezSpc. James StephensPvt. Jason LuisHelena Digby Charles DossMarilyn HarrisonEarl JonesChristi LamGerry McKayWanda MontonagaAlan Ross

Purple HeartPfc. Christopher GalbreathPvt. Michael Kolinski

Army Commendation MedalLt. Col. Cathleen Nelson

Army Achievement MedalSgt. Jeffrey Anderson

DA Achievement Medal for Civilian ServiceBrian DieschKeith ManleyRamona OmsbergGeorge Scanlon

DA Commanders Award

Taw

ny M

. Dot

son

for Civilian ServiceSandra BrotenMarcel Leveque

Commander’s CoinCapt. Matt Cooley Capt. Joseph KalinowskiSgt. 1st Class Timothy HasslerPfc. Shama SerrattMatthew Blanchard Tammy Bousquet-CordesMary BrownLeana Garcia Carmen GasparDoug HeathHelga Williams Robert Wood

WTB NewsOCTOBER 2010 www.mamc.amedd.army.mil page 8

Out of the Fire,Back Into the Fight

WTB NewsOCTOBER 2010 www.mamc.amedd.army.mil page 8

Out of the Fire,Back Into the Fight

Leading his horse around the stable, Sgt. Lester

Perez handled his companion with ease, getting it to “talk” before stopping to groom it.

Perez, a Warrior with Charlie Company, started riding horses as a teenager in his home country of Nicaragua, but is re-learning to ride after he severely injured both legs in an improvised explosive device blast in Afghanistan in February.

One of seven Soldiers enrolled in the Rainier Therapeutic Riding program near Yelm, Perez signed up both because, “I love riding horses, and they started this program for therapeutic riding.”

The eight-week equine therapy program brings in Warrior Transition Battalion Soldiers once a week to Serenity Farms to work with horses volunteered by their owners.

Working with horses can help Soldiers with emotional stress because animals provide therapy for humans, according to the Rainier Therapeutic Riding Program.

The second reason we believe horses can be effective for Soldiers with trauma is because horses are highly reactive,” said Bob Woelk, executive director of the group, which is associated with national program North American Riding for Handicapped Association. Horses mimic human emotions, so if handlers are upset or anxious, horses will reflect that. Although Perez is experienced with the animals, other Soldiers

Soldiers receive therapy through horsesBy Suzanne Ovel

Joint Base Lewis-McChord Warrior Transition Battalion

enter the pro-gram as complete beginners, so it’s important they are all taught to be calm to work with the animals.

“The horses aren’t going to behave functionally for you until you settle down and open up to the horse,” Woelk said. “We want to be trained to recognize horse behavior, and be trained to deal with that.”

For those Soldiers who are resistant to opening up to people, relating to animals

Katherine Grady, with FMWR in Fort Huachuca, Ariz., rides Vision around the ring at the Joint Base Lewis-McChord Riding Club during a “train the trainers” program, Aug. 18. Dozens of professionals from Warrior Transition Units and FMWR offices gathered at the club to learn how the horse therapy program could help Wounded Warriors.

New program offers emotional, physical benefits

may be an easier first step, he said. “The animal-human relationship is going to be safer for the Soldiers.”

Perez agrees that working with horses makes it easier to work with people.

“It’s very peaceful, and I guess when you make a connection with the horse, you’re very calm. You have to trust the horse… If you can trust an animal like that, it’ll help you bond with

Ingr

id B

arre

ntin

e

other people,” Perez said, noting that for him, riding also helps with balance and strengthening his legs.

The program organizers dream of adding a second phase to the program offering trail riding, mountain camping and more. “We’d like to offer advanced horsemanship in whatever direction riders want to head in,” Woelk said.

Also, while Rainier

Therapuetic Riding’s main focus is on behavioral health, the group may expand to provide more one-on-one attention for physical therapy.

Just being a part of the equine program is putting Perez on the path he wants to be on — bringing horseback riding back into his life. He’ll be out on the trails again soon, enjoying his favorite pastime.

OCTOBER 2010 WWW.MAMC.AMEDD.ARMY.MIL page 9

Quitting tobacco and maintaining a tobacco-free lifestyle may be hard, but it’s not

impossible. Nov. 18, 2010 is the Great American Smoke Out and the perfect day to start trying.

Finding the right method or quit plan is only half of the process. Examples of quit plans would be “cold turkey,” the abrupt stopping of all tobac-co products, or “fading,” the steady cutting back on tobacco products. Another quit plan includes the use of cessation medications to assist with weathering the physical craving for nicotine.

Regardless of the quit plan, a “maintenance plan” is just as important. A lot of tobacco users who are trying to quit don’t have a maintenance plan. They know how they’re going to quit, but they don’t address how they’ll avoid relapsing when they feel stress or they’re having that first cup of morning coffee. Emotions and behaviors remain very strong triggers for relapse long after the physical cravings have disappeared.

Many who quit and then relapse are amazed at how easily they start back up after being tobacco-free for years. They quickly realize that they were never cured of their nicotine addiction; they just had it under control and then lost that control. As Mark Twain once said, “Quitting is easy; I’ve done it a thousand times.”

A maintenance plan involves problem-solving skills, resources and support. Think up scenarios for yourself where you might be tempted to use tobacco and develop a plan. Practice the plan over and over in your mind.

What will you do when your stress level in-creases or you miss the camaraderie of the smok-ing area? What about your tobacco triggers, such as the cup of coffee that you usually accompany with a smoke? What coping mechanism other than tobacco products can you put into play when you’re stressed or bored?

Remind yourself of the benefits of being tobacco free including increased stamina and better endurance, improved health, more money, a healthier home and a cleaner work environ-ment. Ask your peers to support your efforts to be healthier, and explain why you want to quit tobacco. Who knows? Maybe they’ll join you. Change the environment you work or live in. Keep a supply of hard candies or gum stashed in your glove compartment and desk drawer. Carry a crossword book. Take a brisk walk break instead of a smoke break. Set up an activity area in your unit away from the smoking area where non-tobacco users can take a fresh air break. Bring in a set of horseshoes, a basketball or softball and glove.

Check out the available free resources on-line at www.ucanquit2.org, www.becomeanex.org or www.smokefree.gov or call 1-800-QUIT NOW and speak with a tobacco cessation counselor.

For a tobacco cessation appointment call TRI-CARE at 1-800-404-4506 or speak with your primary care provider. There is plenty you can do to quit and maintain control over your nico-tine addiction.

Great American Smoke OutNov. 18, 2010

Sgt. 1st Class Olga Terekhina turns over a single cup symbolizing the prisoners of war/missing-in-action service members who aren’t here during Madigan Healthcare System’s POW-MIA Remembrance Ceremony. Watching the event is former POW Dan Figuracion, a World War II Philippine Scout who was taken captive by the Japanese.

Madigan holds POW/MIA ceremonyBy Lorin T. Smith

Command Information Officer

emergencies. Examples of emergency situations are:

• No pulse• Inability to breathe• Spinal or back injury• Severe bleeding• Chest pains• Severe eye injuries• Broken bones• Car accidentIn an emergency, ben-

eficiaries should call 9-1-1 or visit the nearest emergency room. Within 24 hours after the visit, TRICARE Prime patients should call their primary care manager—especially if the visit resulted in an inpatient admission. The primary care manager could be their local mili-tary clinic.

Dan Figuracion watched prisoners of war be shot, kicked and bayoneted along the dusty, gravel

roads that made up the Bataan Death March in the Philippines in 1942. When he didn’t bow his head for a Japanese officer, a Japanese soldier hit Figuracion’s head with the butt of the rifle. Thinking he was dead, the Japanese rolled his body down a river bank. Still alive but covered in dry blood, Figuracion joined an-other POW group passing through, and continued on the 100-mile trek from Mariveles at the southern tip of Bataan Peninsula to Camp O’Donnell. “It was the worst thing I’ve ever seen,” Figuracion said.

He would eventually survive the death march, go on to retire from the Army and at 90 years old, still sharing his stories with fellow Soldiers. He recently attended a POW-MIA remembrance event at Madigan

Healthcare System to help honor those service mem-bers who were prisoners of war and made it home and those who are still missing. The Madigan Sgt. Audie Murphy Club set up a candle-lit table dedicated to those still unaccounted for and missing. “They are re-ferred to as POWs and MIAs; we call them comrades,” said Madigan Commander Col. Jerry Penner III.

Penner spoke about the struggles incurred by vet-erans like Figuracion and thousands of others who have received the title of POW or MIA. “Families have not been able to receive closure, and their loved ones served honorably and for one reason or other, because of the challenges of combat and the fog of war, we are unable to account for them,” Penner said.

Service members still classified as Missing in Ac-tion in Vietnam total more than 1,800, and more than 8,000 in Korea. Penner said those numbers would be higher if it weren’t for the diligence of Army forensic psychologists and psychiatrists, who have recovered service members’ remains from past wars and brought them home to their Families.

Save cash - know emergency and urgent care

When sickness or injury strikes,

service members and their Families may save money by knowing the difference between emer-gency and urgent care.

Understanding when something constitutes an emergency, or what to do if you need urgent care after-hours, could help you avoid longer waits and out-of-pocket costs.

Emergency CareA n y t h i n g s e v e r e

enough to reasonably be-lieve life, limb or eyesight could be threatened is an emergency. This includes maternity and psychiatric

By Shari LopatinTri-West Healthcare Alliance Urgent Care

An illness or injury that won’t cause further dis-ability or death if not treated immediately, but needs medical attention to keep it from evolv-ing into a greater threat, requires urgent care. Ex-amples of urgent care include:

• Minor lacerations• Urinary tract infections• Earaches• Migraine headaches• Sprains• Rising feverService members and

their families should use urgent care facilities through their military clinics first. If that’s not an option, they will need

to acquire an authoriza-tion to visit a community urgent care from their primary care manager or military clinic. Should they need help after-hours and are not sure who to call, they can contact TriWest Healthcare Alli-ance at 1-888-TRIWEST (874-9378) for guidance.

Beneficiaries that don’t receive an urgent care authorization for a com-munity facility may be billed under TRICARE Prime’s point-of-service option. This includes ad-ditional cost shares and a deductible.

For more information visit, www.facebook.com/triwest.

Lorin

T. S

mith

Remembrance ceremony headlined by World War II Bataan Death March veteran who recounted his 100-mile trek and time as Japan’s POW

Madigan provides a number of ways to quit tobacco and maintain a tobacco-free lifestyle including maintenance plans that can help to make the new lifestyle stick

By Cynthia HawthorneArmy Public Health Nursing

OCTOBER 2010 www.mamc.amedd.army.mil page 10

SRPCONTINUED FROM PAGE 1

Health experts estimate that 35 million Ameri-

cans suffer from upper respira-tory tract symptoms that are allergic reactions to airborne al-lergens. As fall starts, Madigan Healthcare System patients may begin to recognize the symptoms of seasonal allergies from the pollens which typically appear during this season.

Pollen allergy, commonly called hay fever, is one of the most common chronic diseases in the United States. Madigan maintains a robust clinic that handles a majority of patients’ allergy concerns and pollens are just a portion of the allergies they see.

“In the fall timeframe, as the rains increase and the leaves fall, outdoor molds, like alternaria, can be an allergic trigger for some people,” said Lt. Col Linda Brown, Allergy/Immunology chief at Madigan. “Most mold allergy is due to sensitivity to outdoor molds.”

By end of summer and early fall, weed pollens increase, but

typically are not as much of a problem for allergy sufferers as are the trees and grass.

“Many people during the summer think their allergy symptoms are caused by scotch broom…that yellow colored plant that grows along the highway and in fields, but more likely they are allergic to grass pollen,” Brown said.

The signs and symptoms of allergies are familiar to most people. They include sneezing (often with a runny or clogged nose), coughing, postnasal drip, itching eyes, nose and throat, watering eyes, conjunctivitis (red eyes often with a dis-charge), and dark circles under the eyes.

There is no good way to tell the difference between allergy symptoms of runny nose, cough-ing, and sneezing and cold symptoms. Allergy symptoms, however, may last longer than cold symptoms. Anyone who has any respiratory illness that lasts longer than a week or two should consult a health care provider.

“Allergy testing is the only way to know for sure what a person’s triggers are,” Brown said. “Testing can be done by a

blood test or by skin tests.”Initial therapy for allergic

rhinitis often starts with an oral antihistamine like lorata-dine, ceterizine, or fexofendane. These medicines work well for helping relieve mild runny nose, itching, sneezing, and eye symptoms. For more severe symptoms or if a person has a lot of nasal congestion, the most effective treatment is a nasal corticosteroid spray. Allergy eye drops can also be helpful for people with a lot of ocular symptoms.

Allergen immunotherapy is a form of treatment aimed at decreasing your sensitivity to allergens. The process involves injecting increasing amounts of an allergen to a patient over several months. Allergy shots are considered for patients whose symptoms are not well controlled on allergy medica-tions. Allergy shots are quite effective in improving allergic rhinitis and allergic asthma symptoms. However, they re-quire a big time commitment and are not for patients with se-vere lung or cardiac disease due to the small risk of anaphylaxis.

For food allergy, it is impor-tant to get testing to verify the

The Allergy and Immunology Clinic keeps up with Madigan beneficiary allergy issues year round

By Tawny M. Dotson Staff Writer

Lorin

T. S

mith

Erlinda Asuncion administers a skin allergy test to Tawny Dotson Sept. 8. The expanded version of the skin test, given to Dotson, requires placing small drops of extract with a pricking device just under the first layer of skin.

food allergen. The only treat-ment right now is avoidance and keeping epinephrine on hand in case of accidental ex-posure and anaphylaxis. There is no immunotherapy at this time for food allergy, although there is a lot of research going on in this area and hopefully someday there will be more treatment options.

“Severity of a person’s symp-toms depends on what they are sensitized or allergic to in the area they are at,” Brown said. “Some people’s allergy symp-

toms get worse when they move to the Northwest and some others actually get better. Each person is different.”

The predominant outdoor allergens in the area, accord-ing to Brown, are tree pollens, which pollinate from February through March and grass pol-lens, which pollinate from April into July.

Overall, allergic diseases are among the major causes of ill-ness and disability in the Unit-ed States, affecting as many as 40 to 50 million Americans.

Maj. Gen. Eddy Spurgin presents a plaque to Joanne Clark, readiness branch chief. The general stopped by the Soldier Readiness Processing Center to thank the staff for their work processing the 36 Infantry Dvision for their mobilization. Clark and the SRP staff processed all of Spurgin’s division through contact with their medical readiness staff over a six month period. The teamwork led to a short visit through the SRP for their mobilization.

Taw

ny M

. Dot

son

Eddy Spurgin, commander of the 36th Infantry Division, Texas National Guard. “It’s just a big part of taking care of Soldiers; not only for my unit, but for all Soldiers who come through here.”

The 36th ID is mobilizing and will be at Joint Base Lewis-McChord completing training requirements, filling equip-ment needs, and completing the mobility readiness process before their deployment. For six months leading up to their mo-bilization, the SRP staff worked with the unit to provide guid-ance and policies, assist with evaluating Soldiers for deploy-ment readiness and completed medical case reviews. More than 700 of the division’s Soldiers recently processed through the SRP in just over a week to fin-ish the process. The division is a part of more than 18,000 Active-duty, Guard and Reserve Soldiers processed through JBLM’s SRP since April.

“We did get a lot of Soldiers out the door on time in order to get them either deployed or

redeployed, but we spent count-less, long hours doing that and it was quality care from the very first Soldier in the morning until those Soldiers went home that day. We have processed them on Sundays, and early mornings too,” said Andrea Madison, chief of the medical readiness branch. “Our operational hours start at 8 a.m., but if a Soldier walks up at 7:30 a.m., do I say ‘I’m sorry we start at 8?’ No.”

The SRP is responsible for processing Soldiers, both active duty and Reserve, when they are deployed, mobilized, rede-ployed or demobilized. In order to deploy, a unit is required to complete a lengthy readi-ness process preparing them for either travel to or a return from a deployed location. Those stations include stops to update identification cards, dog tags, Servicemembers Group Life Insurance, wills, military pay records, TRICARE benefits, and medical stations such as eye, hearing, and dental checks in addition to updating immu-nizations.

Soldiers also visit the SRP site annually. The SRP staff’s commitment to the job is evident

when they discuss what a monu-mental accomplishment the past year has been to them.

“I feel very honored to be a part of this process. You have a bond with the Army that you just can’t let go even once you retire,” Madison said.

Kasanita Dees, a lead licensed practical nurse at the SRP site, recalls a number of stories about the Soldiers she remembers coming through, sometimes repeatedly.

“I’m sad to see them go, but I’m glad to see them come back,” Dees said. “To me it’s a fulfilling job because I am like a stable figure in the process. They look for me and I help them.”

In a typical day, the SRP will see more than 250 Soldiers and the providers will see around 30 Soldiers.

“For me I guess I do take it personally, because I feel like I’m helping my Family. The military has been our Family for the past five years,” said Liz Mc-Dowell, a physician’s assistant at the SRP and an Army spouse.

The team at the SRP have worked together to accomplish their mission and to do so with compassion for the Soldiers.

Pass the tissues! Allergy and Immunology is here to help

OCTOBER 2010 WWW.MAMC.AMEDD.ARMY.MIL page 11

Eight teenagers joined practitioners from the

Adolescent Specialty Clinic and participated in Madigan Healthcare System’s second teen forum designed to provide them with an outlet to discuss how this war is affecting our Soldier’s adolescents.

The comments and the dis-cussion were open, honest, and gave a view to the providers into the core of teens that have faced repeated deployments of a Family member and are coping with stress well above their peers.

“It’s a very crucial time of life. They still have an identity and a sense of self to create, and a lot of their coping mechanisms are not fully developed either. So if you just take the normal stress levels and then you add on the stress of a Family member’s deployment it can be tremendously difficult,” said Col. Franklin Wood, chief of the Adolescent Specialty Clinic.

Spotlighting our Soldiers’ teensPart 1: the teens chatter about deployment Editor’s Note: Beginning this month, The Mountaineer will be focusing a three-part series on what our health care team is doing to care for teenagers of our Soldiers

Story and photos by Tawny M. DotsonStaff Writer

Looking for help as a parent or for help for your teenager? Madigan has a number of programs avail-able to assist your teens with stress related to deploy-ments.

FAME: Walk-in appointments are available in FAME (Family Assistance for Maintaining Excellence) for parents from 8 a.m. to 2 p.m., Monday through Friday. Appoint-ments with the clinic to discuss deployment related issues are also available by calling 253-968-5140.

ADOLESCENT SPECIALTY CLINIC: If your child, aged 12 to 23, is experiencing physical, behavioral or emotional issues the Adolescent Clinic is poised to help. They provide holistic health care options by making an appointment through the TRICARE appointment line or by calling 253-968-3066 during the After Hours Clinic’s scheduled hours.

ARMY COMMUNITY SERVICES: The Joint Base Lewis-McChord main ACS Office is located in Waller Hall (the “Welcome Center”), building 2140, on the corner of Liggett Avenue and 12th Street with some programs and services located at other buildings. They can be reached by calling 253-967-7166.

FAMILY READINESS GROUP: You can contact the deployed member’s rear detachment or unit if they are redeployed for more information on the unit’s Family Readi-ness Group and services they can offer to assist with issues.

Worried about your teen?

According to Dr. David-DeWine, parents should look for tell-tale signs that their teen might need help coping with the stress of deployment.

Sleep disruption: Teens often sleep well beyond their alarm clocks, but parents should pay careful attention to teens not sleeping sound-ly, not sleeping much at all, or a significant change in their sleep patterns.

Behav ior : I r r i tab i l -ity, changes in behavior, or withdrawal. When parents are anticipating the stress-ful situation, they can look for these signs and are of-ten able to reach out much sooner for help.

There is never any harm in reaching out for help. While it is difficult to tell when a teen’s behavior is stress related or a normal change, DeWine encourages you to reach out to a pro-vider if you are concerned.

Lauren Webber listens as Ashley Hastings responds to a question about school patriotism during Madigan Healthcare System’s Teen Panel.

Paul Geye participates in the Teen Panel Sept. 14 in the Adolescent Clinic. Geye was one of eight adolescents who spoke with pediatricians and a pediatric psychologist about their Family members’ deployments. The panel was taped and will be presented to the American Academy of Pediatrics.

In order to address some of those topics, adolescents aged 12 or older were invited to par-ticipate in an open forum. The setting provided a chance to dis-cuss stressors with their peers including changes in relation-ships, increased responsibility at home and an attitude switch.

“It’s more difficult for me to miss people. If it’s someone that’s really, really close to me not so much. The fact that my dad was gone, it bothers me and I wish he was here, but less, a lot less,” said Paul Geye, a teen who participated in the panel.

While the panel was led by doctors, teens controlled the discussion amongst the group. After a few minutes the group was warmed up enough that touchy topics became common-place.

The teens relayed how their parents may or may not have acted differently when they re-turned and how their relation-ship with the deployed parent has changed after their return. The room is tense; clearly the teens are on edge as they dis-cuss personal details.

“I don’t think things ever re-ally begin to [get better],” said Lauren Webber, another teen panel participant.

Even more important, they chatted about the types of sup-port the teens received and how they reacted to it. They admitted to finding it annoying when some of their classmates, who aren’t their friends, ask if they are OK.

“It’s a customary thing for them to ask me if I’m OK. It’s not sincere. It’s my thing, it’s not theirs to worry about,” Geye said.

Following the panel, Wood and Dr. David DeWine, pediat-ric psychologist, discussed how the piece will help them provide care to teens in their clinic.

They intend to use the forum not only for reflection on future care, but also to bring aware-ness to the issue across the Pediatric field at the National Conference and Exhibition for the American Academy of Pedi-atrics, where Wood will present the video of the panel to raise awareness of the issues faced by military Family members across the Pediatrics field.

“We consider it part of our mission to worry not just about their physical health, but also their mental health,” Wood said.

For more about the Adoles-cent Specialty Clinic’s work with teens, look for our next article in the three part series in November’s Mountaineer. Want to read more about the teen’s impressions during the panel?

There is more to this story available on our website at: www.mamc.amedd.army.mil.

The Army marks National Depression Awareness

Month in October, with a theme of “Depression is Treat-able – Get Screened – Seek Care.”

Clinical depression is a se-rious medical condition that, if left untreated, may lead to other complicated medical conditions.

Seeking treatment for a medical condition is not a sign of weakness. It may prevent a good Soldier from becoming a casualty.

The National Institute of Mental Health has reported that major depressive disor-der affects some 14.8 million people in the United States.

Signs and symptoms of de-pression may include sadness, loss of interest in things you once enjoyed, feelings of guilt or worthlessness, restlessness, withdrawing from friends and Family or trouble concentrat-ing or making decisions.

Depression also may produce body aches and pains, irrita-

bility, anxiety, over eating or loss of appetite or thoughts of suicide or death.

Unfortunately, many people believe their symptoms are a normal part of life. Two-thirds of people who suffer from de-pression fail to seek the care needed.

The truth is, more than 80 percent of clinical depression cases can be treated effectively with medication, psychothera-py or both.

Often, the first step to recov-ery is a depression screening.

Anonymous depress ion screenings are avai lable through the Department of Defense (www.militarymen-talhealth.org or 877-877-3647), Department of Veterans Af-fairs (www.mentalhealth.va.gov/depression.asp) and civilian organizations (for ex-ample, mentalhealthscreening.org/programs/military/). The screening sites also provide information about how to get treatment.

For more information, see www.behavioralhealth.army.mil/.

By Jerry HarbenU.S. Army Medical Command

Army marks depression awareness

CommunityOCTOBER 2010 www.mamc.amedd.army.mil page 12

Free home repairsRebuilding Together South Sound is a local non-

profit organization that provides free home repairs and modifications to low-income homeowners. With the help of skilled volunteers they have helped hundreds of homeowners stay safe and independent in their homes.

Home Repairs are completed by volunteer teams and are done on or around the last weekend in April. Home Modifications are changes that increase the accessibility and ease of use of a home for a person with limited mobility. These projects are completed throughout the year.

To qualify for services from Rebuilding Together South Sound, you must: own your home, be low-income (contact us for specific requirements), live in Pierce County, Federal Way or Auburn (including incorporated cities), be either elderly, a person with a disability or a Family with children.

To request an application or more information, please call 253-238-0977 or visit www.rebuildingto-getherss.org.

TRICARE suspicious callRecently there has been a rash of calls to military

personnel from individuals who claimed to be with DoD and requested information under the guise of it being a TRICARE national survey.

On Sept. 15, an active duty Airman was contacted about a TRICARE survey. The member was asked for personal information such as: Social Security Number, home address and Date of Birth. Additionally, the caller asked about deployment status and length of deployments. When the Airman asked why personal information TRICARE already had on file was being asked, the caller immediately hung up. The national and local TRICARE offices were contacted and veri-fied they do conducted surveys; however, they never request the above type personal information. If you receive a call from anyone about a TRICARE survey and believe it to be false contact your local TRICARE office. The below link includes added safeguard mea-sures from the TRICARE website: www.tricare.mil/mybenefit/home/Medical/RightsAndResponsibilities/ProtectingPersonalInformation.

If you receive a call that requests personal informa-tion, do not disclose it. Ask the caller basic questions such as a call back number, name and employee num-ber, the name of the company needing the information, and why they need your personal information to help determine if the call is legitimate. Remember your per-sonal information is yours and you need to protect it.

Frank Pastizzo returnsFrank Pastizzo will return to give his customer

service sessions in November. These sessions are de-signed for new staff members and those who missed him last year.

Frank will be here on the following dates:Nov. 8 9 a.m. to 11 a.m., 1 p.m. to 3 p.m.Nov. 9 9 a.m. to 11 a.m., 1 p.m. to 3 p.m.Nov. 10 11 a.m. to 1 p.m.All events are in Letterman Auditorium.Frank Pastizzo will also be at the Nov. 4 Traumatic

Brain Injury Symposium at McChord Field Collocated Club providing entertainment and visiting with Sol-diers and Family members.

Attention Madigan Beneficiaries:

Contact your Primary Care Clinic

for more information.

The FLU Vaccine is Now Available!The FLU Vaccine is Now Available!

TRICARE Appointments 800-404-4506Madigan Flu Hotline 253-968-4744

* If you are pregnant or could be pregnant, please inform your provider.

The FLU Vaccine is Now Available!

Help clean up I-5 with MadiganMadigan has re-adopted the section of I-5 from the

Main Gate to the Madigan Gate through the Adopt A Highway program. Our first clean-up will be Oct. 23, and will meet at the Southwest Parking lot at 8 a.m.

Civilians need to meet at Galloping Gerties in Tillicum, Wash., at 8:15 a.m.

All volunteers are required to watch the safety video, found at media.wsdot.wa.gov/media/operations/adop-tahwy/AdoptaHighway.wmv.

If you would like to attend, you must call Tom Brad-bury, Strategic Communications, at 253-968-1545.

Zumba at Keeler Gym Join us for free fitness Zumba classes on Mondays

and Thursdays from 5 p.m. to 6 p.m. at Keeler Gym, next to the Special Forces Compound.

It is a great form of Latin aerobics that charges participants money outside the gates, but is being offered for free at Keeler and Jensen.

Jensen Gym offers the Zumba Class on Tuesday mornings at 6:30 a.m. and Wednesdays, at 10 a.m., usually filled with 35 customers.

More information can be obtained by calling Neil Jones or Art Woods at Keeler, 253-968-3759.