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KVH Stories

Josh Kirk

Josh Kirk

HealthNews · May 7, 2019 ·

Josh Kirk

“I like art. I like science. Dentistry is a perfect blend of the two.”
 
Dr. Josh Kirk’s childhood was cavity-free. “It was always fun. I loved getting my teeth polished. I still do.” But at 16, Kirk was surprised when a dentist started to numb his mouth without telling him why: he had his first cavities. Kirk left abruptly, and returned to his childhood dentist, who performed the procedure. “He did a fantastic job,” says Kirk, who still has those first fillings.

For Kirk, that childhood experience was also a lesson in the importance of provider/patient communication.
 
These days, you’ll find 33-year-old Kirk at his own bustling practice, Mountain View Dental Center, where his wife, Amy, also works as office manager. “I couldn’t do it without her,” admits Kirk, who spends roughly ten hours a day in patient care. 
 
The couple first met in dental school: Kirk was a student, and Amy on staff. “I knew right away I wanted to marry her,” declares Kirk. And so they wed, and soon after moved from Arizona to Texas, where Amy experienced her first snow. “It snowed a lot there, actually,” he recalls. “We got tornadoes, blizzards, extreme flooding. It was incredible! The northwest seems mild by comparison.”
 
The couple moved to Ellensburg in 2017 with their son James, now three years old and big brother to ten-month old Julianna. The move brought Kirk back to his roots. Born in Kennewick, his parents live in the Tri Cities. “But my mom went to college here, and so did I. So did my siblings. We’re all honorary Ellensburgians,” Kirk grins.
 
Last year, the extended family was celebrating Thanksgiving together when Kirk noticed a protrusion in his lower abdomen. “I don’t know how it happened,” he jokes, “but I’m sure that the second helping of turkey didn’t help. It didn’t hurt at first, so it’s hard to say when or how it began.” 
 
Over the next few weeks, the inguinal hernia continued to grow and become painful. After a consult with Dr. Tom Penoyar, Kirk was scheduled for surgery.
 
“He told me it could be done laparoscopically,” recalls Kirk, who was then given written instructions for the days leading up to his surgery. Kirk was grateful for the details. “It’s all good information to know. I’d hate to schedule surgery, take time off work, and then need to cancel because of something I hadn’t done correctly.” As a dentist, Kirk regularly performs in-clinic surgeries. Now in the role of patient, despite his jovial nature, Kirk was serious about preparing for his own procedure.
 
When the day for surgery arrived, Kirk answered routine questions while being prepped for surgery. While he describes the staff as professional, “I could tell everybody was in good spirits. I was happy to be there.” Kirk has nothing but praise for everyone involved – from check-in, to pre-op, to the OR where the nurse anesthetist explained his process to Kirk, and the nurse started an IV.
 
When he woke up after surgery, Kirk felt nauseous, a typical side effect of anesthesia. “They gave me all the time I needed,” says Kirk, “and brought me some gentle foods, including chocolate pudding – my favorite.” A short time later, Kirk was ready to leave. Amy drove him home and got him in the recliner.
 
Dedicated to his patients, Kirk returned to work the following Monday. It might have been a little too soon. “I only missed two days of work, but that first day back was tough,” he says.
 
After a visit with Dr. Penoyar two weeks later, Kirk was officially cleared for all activity. And Kirk is nothing if not active.
 
Already an avid cyclist and runner, Kirk put mountains on his 2019 bucket list. After climbing Mt. St. Helens with his brother-in-law in 2017, this year, the two plan to tackle Adams, Baker, and then Rainier. “That’s the big one,” Kirk says, eyes shining with anticipation.
 
As a life-long learner who embraces new challenges, no one who knows Kirk doubts he’ll scale any obstacles in his way. Now fully back on his feet, he’s eager to let the community know about the quality of “awesome care” he received.
 
“What would that say about me, if I’m asking people to come to me as a local provider and yet I’m not willing to receive local care?” Kirk asks. “You have a choice. You can stay local and support your community, people that live down the road from you. So, why not? Give them a chance. They won’t let you down.”

Carmen Dupuis

Carmen Dupuis

HealthNews · Feb 1, 2019 ·

Carmen Dupuis

It began with a small sore on her leg that wouldn’t go away.

Carmen Dupuis didn’t want to go to the doctor. “Like most people,” she grins. After all, her daughter’s wedding was coming up. There was so much to do. She’d wait until after the festivities to take care of her health, and at the top of the list was a hip replacement.

After weeks of trying different home remedies while watching the open wound grow to the size of a quarter, Dupuis knew she needed help. “I didn’t tell anyone – not even my husband. I’d hide it or cover it up. It got really bad, and then another one appeared next to it.”

Despite her health issues, Dupuis continued to work 8-hour days as a checkout clerk. “You just push through it, because everything is more important than your pain.” She made it through the wedding, but only just. “I felt like my body just broke. That was it. I couldn’t walk anymore.”

Dupuis returned to KVH Orthopedics to see Dr. Bos, the surgeon who had previously replaced her knee. X-rays proved what she already suspected: “My hip was bone-on-bone.” She needed surgery.

So Dupuis took a deep breath and shared her secret, right there in the clinic exam room. It was the first time she’d shown her wounds to anyone.

Bos referred her to the new wound care service at KVH. “You’re going to see them, and we’re going to get this taken care of.” Dupuis felt the timing was providential.

Soon, she was being examined by KVH Wound Care provider Mary Nouwens. “She took off the wrap and talked to me. She was comfortable and sweet,” says Dupuis. “I got my first dressing and the team planned out their line of attack to make this wound heal.”

Over the next month, Dupuis returned to Wound Care twice a week for continued treatments. “Every time I’d go in, the wound was smaller. It was so exciting.”

Adding to that excitement was a sense of camaraderie between the care team and their grateful patient. “It felt like I was just going to visit friends each time I went,” says Dupuis. “They made me comfortable, and they’d always tell me what they were doing.”

Concerned for her patient’s probable underlying condition, Nouwens referred Dupuis to a vascular surgeon, who later diagnosed her with bulging veins. During Dupuis’ final wound care visits, Nouwens brought in KVH Occupational Therapist Kat Newton, who fitted her patient with compression hose and wraps – tools Dupuis would need when she returned to work and to long days on her feet.

“I’m 57. I’m not going to change my occupation,” says Dupuis, a dedicated Safeway employee who after 20 years still loves where she works and what she does.

Privately, Dupuis couldn’t help feeling she was to blame for her condition. That somehow she caused this to happen by not taking care of herself. So when she learned the wound care team members also wore compression stockings daily, she felt immense relief. “I realized this wasn’t my fault,” says Dupuis.

These days, Dupuis is back at work and enjoying the camaraderie she has with colleagues and customers. She’s rediscovering the forgotten joys of daily life, like chasing her granddaughter, and caring for the family’s horses. “There I was, feeding them carrots,” she says, “when I suddenly realized I couldn’t remember the last time I’d walked the uneven ground out to the pasture. I was so afraid of falling, I’d just watch from my back deck and leave it at that.”

With her husband and two married daughters living in this community she’s grown to love, Dupuis has no plans to leave. And her experiences with local healthcare have validated that decision as she enters 2019 without the debilitating pain she’d known for so long. “It’s like a cloud has been lifted off my head and I can see things, really see things, for the first time in a long time. It’s a new beginning.”

Meghan Young, DO

Meghan Young, DO

HealthNews · Jan 19, 2019 ·

Meghan Young, DO

“I’ve always loved kids.”

Meghan Young was just a kid herself when she knew she wanted to become a doctor, one that cared for children the way her own pediatrician did. “I grew up with various medical problems,” she explains, “and my times in the hospital sparked an interest in medicine.”

Of course, it didn’t hurt that Young’s mom, grandma and aunts were all nurses.

“When I got into high school, I went to work at my pediatrician’s – my first official job,” says Young. As a records clerk, she experienced “the front desk side of medicine” while learning about the various roles that supported the clinic’s work.

Now a practicing pediatrician, Young enjoys building relationships. “I get the privilege of meeting new families, sometimes at birth – such an intimate, sacred moment – and then not only watching children grow, but entire families as they evolve and develop.”

While you’d expect pediatricians to be up to speed on things like childhood illnesses and physical development, our pediatric clinic takes a multifaceted approach to patient care that includes working as a team to stay informed on rapid changes in technology, and the impact of social media on children and families.

“We understand there are risks and pitfalls to parenting in a technological world,” says Young. “We also recognize the benefits of technology for kids with special needs or communication disorders. We try to help families find balance.”

Because pediatric patients range from birth to age 18, the clinic’s providers also stay informed and aware of trends, studies, and solutions for families with pre-teens or adolescents dealing with issues like stress, mental health, and substance abuse.

Young encourages those who may feel overwhelmed. “We’re in this together,” she says. “We’re a team – the provider and the family. Together, we work towards ensuring people have the tools they need to succeed and keep their kids safe.”

When it comes to childhood safety, no topic seems more controversial than immunizations. “It’s understandable why some parents feel confused and overwhelmed, with all of the information out there, some factual, and some not,” says Young. “People are really trying to make the best decision they can for their child. I always try to keep that in mind.”

“That being said,” notes Young, “Vaccinations are one of the most extensively studied things in pediatrics. As a pediatrician, I feel very confident to say that these are effective, these do make a difference, they are recommended, and we want to keep your child safe and other children in this community safe by vaccinating.”

“It can be a delicate dance,” admits Young, but her clinic welcomes candid conversations and does its best to be a safe place to have them. The providers begin by listening to learn more about the family’s views. “Then we work to find a solution that balances any fears and questions while also trying to maintain the safety and health of their child.”

Spoken like a pediatrician who is successfully fulfilling her childhood dream.

Young was born in Missouri, near Saint Louis. The youngest of four girls, she remained in the Midwest through medical school, then ventured north to Minneapolis for a fellowship in pediatric hospice and palliative care. “And from there, we moved out here,” she notes, “we” being Young, her pharmacist-husband Phil, and their Saint Berdoodle, Murphy.

“We’re just loving the Northwest,” says Young. “This is the most rural community we’ve lived in and we absolutely love it. People are warm and welcoming, the scenery is beautiful, and we love not having traffic. We’ve settled in really nicely and are excited to lay down roots and continue to get to know the community.”

For those who judge the mettle of a pediatrician by what they do outside the office, in her free time, Young decorates cakes, creates abstract art, plays piano, and loves board and card games with family and friends.

In other words, the kind of things enjoyed by children of all ages.

Teresa Beckett, PA-C, ARNP

Teresa Beckett, PA-C, ARNP

HealthNews · Jan 19, 2019 ·

Teresa Beckett, PA-C, ARNP

Teresa Beckett “always knew” she wanted to be a nurse, a dream cemented the summer she helped her aunt care for a grandmother. What she didn’t know was how far that dream would take her, how her career would prove a calling, or the role she would play in the lives of other women.

Beckett and her family moved to Ellensburg in 1970. After graduating from Ellensburg High, she earned an associate’s degree in nursing at Yakima Valley Community College, then landed a job as a registered nurse with the Kittitas County Public Health Department. There, she met Judy Hargis, a physician assistant who was doing women’s health care.

“She was an amazing woman,” recalls Beckett. “She loved her job. She loved teaching. You saw how good she was with her patients, how much she cared.” Beckett also saw the advantage of advanced training.

When the health department offered to fund her schooling to become a women’s health ARNP (advanced registered nurse practitioner) in exchange for a promise to return for a set period of time, Beckett enrolled in a program at Harbor-UCLA Medical Center, graduating in 1989.

In 1994, she applied for a position with the Valley Clinic (now KVH Family Medicine – Ellensburg). It was a hard sell, Beckett recalls. “At the time there were no mid-level practitioners working in that clinic,” she says. “I almost had to sell my soul. So I asked to meet with providers. I said, ‘Just hire me for three months. I’ll be my own nurse. If you don’t want me at the end of three months, you’re not out anything.'”

She did the three months – and stayed on for fifteen years.

To broaden her role to include family practice, she enrolled in a University of North Dakota program that trained registered nurses to be physician assistants. With the financial support of the clinic, and with the emotional support of her husband, children, and parents, she graduated in 1996.

“So I did family practice and women’s health at the Valley Clinic for a while,” she says. But a new opportunity loomed.

In 2008, she moved to KVH Women’s Health.  For Beckett, the commitment to compassionate women’s health care grew out of her own experience. As a teenager, she’d once endured a pelvic exam when her doctor suspected appendicitis. The physician was less than compassionate.

“He was rude and abrupt. It was terrible,” says Beckett who believes her experience as a woman coupled with what she’s learned from patients help her empathize with patients.

“As a woman you know what other women have gone through,” says Beckett, who is warm and personable by nature and who routinely tells patients to call her by her first name. “I want women to come in and feel comfortable, almost like they’re seeing a friend, so they can open up and ask questions about their bodies.” It’s a two-way street, she says. “There’s so many times you learn from a patient. What I’ve learned from my patients has been amazing.”

She’s upbeat – her optimism obvious – when she talks about the changes she’s seen in women’s healthcare over the course of her career. Those include expanded birth control options, advances in hormone replacement treatment, treatments for heavy bleeding that may help women avoid surgery and “dramatic improvements” in cancer treatment.

“Like with breast cancer, we have so many options now,” she says. Ten or fifteen years ago, that was not always the case.

The reward of her work is personal as well as professional. “There are women who tell me things they haven’t told anyone else in their life. They inspire me,” she says. “There are women who have been diagnosed with cancer and you’ve been part of their journey and they’ve learned they’re stronger than they ever thought they could be.

“It tells me I’m doing what I am meant to do.”

Want to know more? See Teresa’s medical education and clinic information here.

Peg Coble

Peg Coble

HealthNews · Jan 1, 2019 ·

Peg Coble

As a nurse, Peg Coble forged a long career helping others. In retirement, she’s still at it.

Only this time it’s as part of KVH’s Volunteer Bereavement Group, a small corps of specially-trained volunteers who work on-call providing emotional and spiritual support to families in crisis.

Because KVH Hospital is small, social service staff work during the day, when most patients are discharged from the hospital. “But we have families in crisis 24/7,” says Rhonda Holden, chief nursing officer and administrator of patient care services at KVH. To fill that gap, last year KVH put out a call for volunteers, a call that was fueled by the Patient and Family Centered Care Advisory Council.

Coble signed on.

A former westsider, she’d come to Kittitas County with her family in 1980. By then, her career already included time at several hospitals, including five years at Harborview in Seattle. In Kittitas County, work in a nursing home would be followed by 20 years with Hospice.

“People that are in Hospice don’t have a job, they have a calling,” says Coble, a woman of deep compassion and strong faith.

For Coble, the Volunteer Bereavement Group provided a perfect niche. Volunteers take weekly turns on-call from 4 p.m. until 7 a.m. responding to the emergency room in the event of a death or traumatic event.

When a woman traveling through Ellensburg with her family suffered a heart attack at a gas station, Coble was with the family while the patient was stabilized at KVH Hospital before being transported to Yakima Regional’s cardiac center. “I was able to help the family by explaining things, giving them directions to where she was going and information that would help them when they got there,” she says.

When a woman was brought in with serious injuries, Coble was at the family’s side as doctors battled three and a half hours trying to save her life. “Her son and his fiancée were visiting from California,” Coble says. When the woman died, “I was able to counsel the son’s fiancée about how to get him help with grief when they got back home.”

Grief training prepares volunteers to provide appropriate support in the midst of trauma, Coble says. “It’s called companioning. It’s no time to preach. There’s a term called ‘therapeutic presence.’ You may just sit silently with them, or just sit and listen, let them talk and cry, give them a hug. Sometimes they want you to pray with them.

“Each family really dictates what happens.”

Wyman Renfrow

Wyman Renfrow

HealthNews · Jan 1, 2019 ·

Wyman Renfrow

As a retired Ellensburg firefighter, Wyman Renfrow knew the exhilaration of saving lives. As a volunteer at KVH Hospital Renfrow, now 80, also knows the satisfaction of making life easier for others.

Flash back 40-plus years. Renfrow and another firefighter are out doing inspections when dispatch signals a house fire. First on the scene in their pickup truck, the two men find flames visible – and a baby trapped upstairs. Renfrow tries the inside stairs but is forced back by heat, smoke and exploding ammo.

A fire truck arrives and begins raising a ladder to the upstairs window. “I started climbing even before the tip hit the window sill,” recalls Renfrow, who found the baby, took her to the window and handed her off to another firefighter.

And yes, he says, there is a “rush” to saving lives.

The truth is, he didn’t set out to become a firefighter. A 1952 Ellensburg High grad, he  enrolled at CWU intending to become a teacher. That summer he also began volunteering with the Ellensburg Fire Department, drawn by the lure of public service.

In 1956, Renfrow landed a job as a firefighter with the Seattle Fire Department and four years later joined the Ellensburg Fire Department, eventually rising to the rank of captain. Along the way, he and another member of the firefighters union co-founded Local 1758 Life Support Fund, a fund that allows the public to make charitable donations to support fire department services.

Retired after 27 years as a professional firefighter, Renfrow, who had driven a school bus during college and been a substitute driver while working as a firefighter, went back to driving a bus. “I liked the kids,” says Renfrow, who was a bus driver for 50 years and director of transportation for two.

But even when he was done with that, he wasn’t really done.

In 2008, Renfrow signed on as a volunteer at KVH Hospital and now works six hours a week at the desk in the Surgical Outpatient (SOP) department and four more at the courtesy desk in the hospital lobby.

Karen Schock, volunteer director at the hospital, currently manages 65 to 70 community volunteers like Renfrow. In 2014, they donated 13,170 hours, a contribution valued at more than $300,000, Schock says.

But their role is really priceless.

Readily distinguishable in their blue KVH volunteer jackets, Schock says community volunteers offer a comforting personal touch aimed at reducing the anxiety patients and their visitors may feel in what might otherwise seem an impersonal, clinical environment.

In SOP, volunteers provide a warm transition from check-in to the point where a registered nurse takes over.  At the front lobby courtesy desk, volunteers greet the public, often personally escorting patients or their visitors to the appropriate area.

“After a patient checks in, we’re the first smiling face they see,” says Renfrow whom Schock calls an outstanding example of KVH Hospital’s volunteer corps.

“He trains volunteers in the SOP desk and courtesy desk positions,” Schock says. In the SOP department, “he notices what the department needs to provide patients and their families with an experience that is exceptional.”

Example: SOP appointments start at 6:30 a.m. But volunteers didn’t start until 7:15 a.m. When Renfrow realized that some patients were arriving as early as 6:15 a.m., he changed his schedule so that he also arrives at 6:15 a.m. to start the setup process, make coffee and be ready for early arrivals.

New volunteers are now expected to do the same thing. He also helped develop written standards for the courtesy desk and SOP desk, ensuring that all volunteers know what is expected and how to make it happen.

“I wanted to do something to help,” Renfrow says. “This is a way I could help the community. It’s fun and I enjoy it. I feel like I’m helping the hospital – and the people who go here.”

Hartwig Vatheuer

Hartwig Vatheuer

HealthNews · Jan 1, 2019 ·

Hartwig Vatheuer

When it comes to improving health care for his community, Hartwig Vatheuer puts his energy where his heart is. But then, he always has.

Now 77 and with a long-established reputation for civic leadership, Vatheuer has served eight years as a member of the board of The Foundation at KVH, an organization that has given $1.5 million to Kittitas Valley Healthcare over the course of its 30-year history. Add to that his role as a member of the Hospital District 2 Board of Commissioners where he’s spent 15 years helping guide healthcare in the Upper County.

Both positions reflect his passion for making things better where and when he can. Consider it a philosophy forged of family tradition and shaped by early challenge.

Born in Germany in 1939 just days before the start of World War II, he was 6 when, as the war was ending, his desperate mother packed up her six children and fled several hundred miles west from their home in Pomerania (then a province of Germany, now part of Poland) in advance of Russian occupation forces. The family found refuge in a forester’s house but Russian troops soon overtook them.

Seven-plus decades later, memories of that time are still vivid for Valtheuer.

His family was among millions of Germans caught in a chapter of post-war history few in America understand. It was a time of hardship, hunger and constant fear. Food supplies were limited. “The Russians took everything,” Vatheuer says, recalling Russian soldiers with stolen wristwatches lining their forearms. When a Russian soldier demanded his mother’s wedding ring and she had trouble twisting it off, her children feared rumors they’d heard of Russians cutting off fingers to get rings might be true. Instead, she got the ring off and handed it to the soldier who examined it, tossed it to the ground and stomped on it.

Resourcefulness was born of necessity. His sisters knitted, unraveling old sweaters for yarn, then using old bicycle spokes for needles. Despite the hardships, the family celebrated Christmas, exchanging gifts they’d made themselves.

His father, who had been working as an agricultural administrator in the Ukraine during the war, wrote to Vatheuer’s mother, advising her to try to get to the British-occupied sector. Determined, she followed his advice though it took multiple attempts – and in the end required forging one word of his letter – to get the family out of the Russian sector.

In the British zone, the family was among a thousand people “re-settled” to a town of the same population. “We had a room in a castle,” Vatheuer says. “It was so cold there were two inches of ice on the window.”

In 1947, the family reunited. “Dad came,” Vatheuer recalls. “He’d been in a POW camp. He was all skin and bones.”

Vatheuer’s parents were intent on leaving Germany and, in 1953, the family came to the United States sponsored by a family in Idaho through the World Lutheran Federation. “To come you had to be in excellent health and able to work,” Vatheuer says, recalling how a sister with health issues had to remain behind.

The family eventually ended up in Wapato where they ran a truck farm and Vatheuer graduated from high school. Intent on attending college, he delayed that dream to help his family, went on to serve three years in the U.S. Army, then enrolled at Portland State University.

It was in a German class there that he met a pretty coed named Mary. She was shy. So was he – but not so shy that he didn’t walk her to her bus stop and ask to see her again.

Flash forward a few years. After a year at Portland State, Vatheuer transferred to Oregon State University where he earned a degree in forest management and went on to a 32 year career.

Married in 1969, he and Mary bought eight acres in the Cle Elum area in 1984 and built a home where their two sons grew up and where he and Mary still live. A doer by nature, Vatheuer soon became involved in the community.

South Cle Elum Way, the road that connects Cle Elum to South Cle Elum, doesn’t bear his name but maybe it should. The 70 or so Norwegian maples that line the sides of that roadway – green in spring and summer, an eruption of brilliant yellow each fall – are a Kiwanis Club project that testify in part to his trademark role: a steady, determined man, sleeves rolled up figuratively and literally, leading by example.

Armed with a grant from the Plum Creek Foundation that he helped obtain, the club planted half the trees one year, the rest a decade or so later. “I hounded them so much they made me a member of their board,” says Vatheuer who spent five or six years on the board. He figures he helped procure $140,000 for various projects in the county over the years.

At one point, when Cle Elum’s old swimming pool needed cleaning and painting, it was Vatheuer and his family who did it. And when the chamber of commerce decided to transform an old phone company building downtown into public restrooms, Vatheuer helped coordinate the project, even enlisting Mary and his boys to help hand dig the sewer line.

He’s also been involved since inception with the Kiwanis Club’s annual Christmas tree sale, a project he estimates has raised $60,000 plus over 24 years. Vatheuer has cut many of those trees. His contributions have not gone unnoticed. In 2006, he received Puget Sound Energy’s Pioneer Award, presented annually to an individual in Kittitas County who has demonstrated leadership and vision to benefit the community. Two years later, a brass plaque honoring him was placed at Flag Pole Park.

Among his admirers: Michelle Wurl, executive director of The Foundation at KVH. “He embodies the true spirit of giving back to the community,” she says. “His tireless devotion to our county and his willingness to help wherever needed is an example we all should follow.”

But Vatheuer shies away from the term “giving back.” “To me, I think what I do means being part of the community. You should be doing not just talking about it,” he says.

Once, he recalls, one of his sons asked why he does what he does. “I never really thought about it,” he says. “Basically I probably would have to say that I grew up in a Christian environment and I had many good examples in my life – especially my mother. You don’t just live for yourself but also for others.”

He’s proud of his roles on the Hospital District 2 board and as a member of the board of the Foundation at KVH. “The hospital doesn’t take in much in taxes but is financially stable,” he says. “It’s a public entity that stands on its own two feet. The foundation is a well-run operation. Without it the hospital might have to raise taxes.”

As for KVH Hospital, “I’ve been a patient several times,” he says. “It always seems efficient and the people are friendly. But the quality healthcare is the most important thing. The hospital wins all these awards. That must mean something.”

Tom Penoyar, MD

Tom Penoyar, MD

HealthNews · Jan 1, 2019 ·

Tom Penoyar, MD

He loves tools, working with his hands and problem solving. He was headed toward a career in mechanical engineering. Then a stint in a tissue engineering lab as a graduate student at Case Western Reserve University working with equipment that tested cadaver bone put Dr. Tom Penoyar of KVH General Surgery on a different path.

Penoyar enrolled in biology and chemistry courses, finishing the prerequisites for medical school and his master’s in mechanical engineering at almost the same time. He went on to the University of Washington School of Medicine followed by an internship at Beth Israel Deaconess Medical Center in Boston, a teaching hospital affiliated with Harvard Medical School. Finally, he completed a surgical residency at Lahey Medical Center in Burlington, Mass., a teaching hospital affiliated with Tufts University.

When it came time to launch his practice, Penoyar and his wife Lauren, now parents of three children aged 6 months to four years, wanted a place where recreation was close at hand and family wasn’t far away. “My whole family is in Washington State. We knew we would come back here,” says Penoyar who grew up in the small town of South Bend, Washington, the third of five siblings whose parents are lawyers.

As a teenager he was into hot rods, his “lifted” truck and mud-bogging. As an adult, he’s an active outdoor enthusiast whose interests range from mountaineering and back country skiing to ice climbing, rock climbing and snowmobiling.

Convinced the eastern slopes of the Cascades offer the best opportunities for recreation, “my approach was that if we could find an appealing opportunity in the region we’d take it,” he says. And they did.

Penoyar says Ellensburg offered “lots of well-educated people who are a joy to be around,” groups of active recreationists who share their interests and a house he and Lauren love.

In September 2015, he opened his practice at KVH General Surgery. At 35, he’s the youngest member of the staff and relishes the chance to work alongside seasoned veterans. “I much prefer talking with someone like that than someone with the same age and experience as me,” he says, adding that he also enjoys sharing some of the newer techniques in minimally invasive laparoscopic surgery that he’s learned along the way.

In contrast to conventional surgery, laparoscopy uses small incisions and specialized instruments to manipulate tools at the end of a rod. While not appropriate in every situation, when it is it can reduce recovery times for patients.

Penoyar says surgery suits him not just because of the technical challenge involved but also because of the unknown. “There have been many occasions when you dive into the surgery and find something that is not what you were expecting,” he says.

Sometimes those experiences are unforgettable. Case in point: an emergency surgery during his residency.

A middle-aged woman who had undergone gastric bypass surgery years earlier arrived at the emergency room with acute abdominal pain, her abdomen so swollen she screamed when it was touched. “We went straight to the operating room,” he recalls. “It looked bad. Her small intestine was dusky gray. There was no blood flowing to it.

“It was life-threatening so it was stressful. It was dramatic for everyone in the room.”

Ten minutes into the surgery Penoyar and the surgeon working with him discovered that the woman’s small intestine had worked its way through a small hole that had formed as a result of her previous surgery, cutting off oxygen to the intestine. “We found the hole and, inch by inch began pulling her small intestine back through the hole,” Penoyar recalls. “As it came back, it went from ash gray to pink. We finished and put three or four stitches in to close the hole.”

Then Penoyar and the other surgeon sank down onto chairs. “We were physically and emotionally spent,” he says, recalling that moment.

Two days later their patient walked out of the hospital.

“I like the technical aspect of the surgical field, the problem solving, the definitive therapy of it when the last stitch is placed,” says Penoyar. “I like having something real and tangible to offer patients.”

Want to know more? See Dr. Penoyar’s medical education and clinic information here.

Liahna Armstrong

Liahna Armstrong

HealthNews · Dec 10, 2018 ·

Liahna Armstrong

She’s semi-retired from a distinguished career in academia, passionate about animal rescue, loves sports and for 11 years has been the only woman in a fantasy football league where she readily holds her own. She’s also no slouch when it comes to poker.

But Liahna Armstrong, who earned her doctorate in English at UCLA and went on to a career that includes 22 years at Central Washington University, doesn’t play games when it comes to healthcare. She wants quality care in a caring environment.

After two decades on the board of commissioners of Kittitas Valley Healthcare, Armstrong is no stranger to the role KVH plays in her community.

When an attempt to play peacemaker between her dog and a neighbor’s cat left her with scratches, a deep cat bite and a dangerous infection, Armstrong experienced firsthand just how important that role can be.

Flash back to May 19, 2017. “My dog had the cat’s head in its mouth. The cat was terrified,” recalls Armstrong who rushed to intervene, saving the cat but not without suffering scratches and a cat bite above her left ankle in the process.

Early the next morning, she woke screaming in pain, her ankle totally swollen. Her husband Jim carried her to the car and drove her to the KVH Emergency Department where she was treated and released.

But Armstrong’s ankle remained swollen and painful. On May 24, Armstrong went back to the Emergency Department where Dr. Frank Cruz immediately had her admitted to the hospital. “I was there ten days,” she says. “They finally found an antibiotic I could tolerate and sent me home thinking I was getting better. But I wasn’t.”

Liahna Armstrong

Jim Repsher, a physician assistant at KVH Orthopedics, ordered an MRI. “After he got the results he told me, ‘You have a huge infected mass that’s going to require surgery,'” Armstrong says.

The next day, KVH Orthopedics surgeon Dr. Gary Bos removed the infected tissue. Armstrong says she was still in recovery when Bos approached her husband after the surgery. “I think I just saved her leg,” Bos reportedly said.

Those words aren’t lost on Armstrong. She praises Cruz’s fast action in admitting her to the hospital and the KVH Orthopedics providers, especially Repsher and Bos, for saving her leg.

Armstrong sported a lime green soccer guard to protect the wound area for a time and received IV antibiotics as an outpatient for several weeks. By mid-August of last year she was “pretty much back to normal” and enjoying hikes near the cabin she and her husband own at Chinook Pass.

Two decades after she first took office at KVH, she says her own experience affirms what she believes about the quality of care at KVH in general and KVH Orthopedics in particular.

“I was the sandwich generation,” she says of her decision to get involved in KVH. “I had a young child and aging parents. I became very cognizant of healthcare. I saw it from both ends.

“Doing the job of commissioner well involves a huge amount of knowledge,” she says, flashing a smile. “I’m still learning.”

But Armstrong says the time and effort have been worth it. “I’m proud of KVH’s commitment to the well-being of patients and employees,” she says. “I see it all the time.”

It’s what the community she fell in love with deserves, she says.

“Ellensburg is a wonderful place to live. Most people are very warm. I love being surrounded and embraced by good people in a good community.”

GNP Care

A history of GNP care

HealthNews · Nov 26, 2018 ·

GNP Care

Familiar ground: GNP Jean Yoder, in the main conference room at KVH’s Radio Hill Facility. The room was once a dining area for assisted living residents at Royal Vista, where Yoder made weekly rounds. (Thumbnail photo: Radio Hill exterior.)

Jean Yoder has been a local fixture in senior patient care for the past 23 years.

“I’ve always liked working with elderly people,” says Yoder, who first ventured into the world of healthcare as a young candy striper, bringing meals and other items to patients in their hospital rooms. Years later, Yoder found her calling as a Geriatric Nurse Provider (GNP), bringing medical care to patients in their homes.

Yoder’s was the first class of GNPs at the University of Washington. “We learned from them and they learned on us,” she laughs. Then, after working with geriatricians in the Seattle area, Yoder learned about a program in Ellensburg led by then-director of Home Care and Hospice Carol Detweiler.

A fellow UW GNP graduate, Detweiler’s vision was to bring medical care delivery out of the traditional patient care setting and into the community, particularly for the frail elderly. It was a vision Yoder shared. “We wanted to make care available for those who couldn’t access it,” she recalls, “whether they were physically frail, struggled with dementia, or had other issues that made it difficult to get in and out of the home for medical visits.”

Soon, the program was underway with Yoder as the sole practitioner.

Yoder’s territory included Royal Vista (a skilled nursing facility) and Kittitas Valley Health and Rehabilitation. Every week, she spent two days at each location, and was on daytime call for both. Nights and weekends were covered by patients’ primary care physicians.

From the outset, the program included a collaborative practice with physicians in the community, starting with Drs. Wise, Schmitt and Anderson in Cle Elum, later expanding to Ellensburg and physicians such as Dr. Solberg, who was struck by the increased level of care his patients were receiving under the GNP program. “He and I made monthly rounds together in the skilled nursing facilities for years,” says Yoder.

The steady presence of a GNP helped fill the care gap for patients and their physicians, whose schedules didn’t often allow for regular visits to these facilities. “We could be on-site, evaluate an individual, see where their code status was, talk to family, talk to staff, and get a plan in place to set up and provide care.”

“We were very busy,” she recalls. “With up to 65 patients in each facility, there’s a lot that goes on from one day to the next.”

Covering the community.

Soon, a second GNP was hired, and Yoder began spending a day each week seeing assisted living patients at Mountain View Meadows (now Meadows Place), and eventually Hearthstone.

“It’s not quite as intense as a skilled nursing facility,” says Yoder. “We focus on treating patients in their environment, keeping them healthy and hopefully away from the E.R.”

The GNP team worked with staff to prevent or treat conditions like urinary tract infections, pneumonias, skin tears, cellulitis, etc. With so many variables, says Yoder, “you never knew what your day would be like.”

Another major shift occurred when GNP Anna Collins entered the picture, joining forces with Yoder to divide up days and locations, increasing overall coverage. Collins took on Meadows Place, while Yoder continued at Hearthstone. “We added on Dry Creek (now Pacifica). And in the middle of all that, we started doing home visits.”

According to Yoder, GNP home visits serve those “who fall through the cracks, in the sense that they have many medical problems, but don’t qualify for the Medicare A Home Program” which covers services from KVH Home Health.

Thankfully, Medicare does allow nurse practitioners to do home visits. “It used to be called a doctor’s home visit,” explains Yoder. “We go through the physician to get a home visit, evaluate the patient and, with the patient’s permission, set up a care plan.”

Once they’ve established care with a patient in their home, GNPs make monthly visits unless a change in health brings them by sooner. “If there’s a spell of illness, or an issue like a wound needing frequent dressing changes, or someone is really fragile and needs more attention and services, we work with a physician to bring in Home Health.”

Taking on the trends.

One big change Yoder’s seen during her time as a GNP is the amount of medications taken by seniors. “It used to be that five medications was remarkable. Now, we have people on 15 or 20,” she says. “We look at the whole picture to see how it’s all working, and focus on comfort while getting rid of unnecessary medications and testing.”

Another trend Yoder sees is a faster discharge from hospitals. “Even if a patient rehabs in a skilled nursing facility, what happens once they get home?” The GNP program will soon begin making home visits after patients are discharged. “You can see when you walk into the environment, what’s working, or isn’t, and what we need to do. It involves quite a bit of detective work.”

The next chapter.

Last month, the GNP office relocated to KVH’s newly remodeled Radio Hill facility – formerly known as Royal Vista, the place where Jean first began her GNP rounds in Kittitas County.

Now that things have come full circle, Yoder is set to retire. “I’ve let go of a lot of things already,” she says, as the GNP team has grown to include practitioners Nenna Nzeocha, Marquetta Washington, and Mary Nouwens. “It’s great to have them here. They want to do this work, and they’re not frightened by the scope and intensity of it.” And while she’s ready to focus on family and home remodeling, there are things Yoder will deeply miss – especially her working relationship with Anna Collins. “We’ve enjoyed each other and we communicate well together. We worked hard!,” she laughs.

Yoder is confident that the GNP program, under the visionary direction of KVH Chief Medical Officer Dr. Kevin Martin, is positioned to continue a pattern of growth in caring for patients throughout the county. Yoder’s optimism rests on a legacy shaped by years of faithful service.

“Nurse practitioners make a difference for patients, family, and staff,” she says. “I really believe that.”

Managed by Kittitas Valley Healthcare, HealthNews does not provide medical advice. For medical advice, please see your healthcare provider.

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