Monthly Matters:

• A Note on Health Matters
• Dr. Paula Koeller joins GreenField Health
• Hypnosis: An Altered State of Consciousness
• Heart to Heart Summer and Fall Registration Open
• Office Notes

GreenField’s Health Matters: June, 2005

We apologize to those who joined us in the last 6 months because we recently determined that our email distribution list was not properly updated, meaning that new members were not receiving the newsletter.

All Health Matters are available on our web site - so you can take a look at all our prior issues.

We do also mail a recent copy of Health Matters with your yearly GreenField renewal letter. We do this as a reminder for those individuals who may not get it electronically because they don't use email, or for those who have stopped getting Health Matters because it is blocked by their firewall at work or it has gotten caught up in your spam filter. Our Health Matters is an "opt in" newsletter--it is not spam--so if you have stopped getting it electronically, you may want to check to see if it is being blocked.

You can now start enrolling your children with our usual family discount of 10%. If you would like to meet Dr. Koeller, please call GreenField to schedule a brief meeting, or join us for our First Tuesday Open House on June 7th or August 2nd. Dr. Koeller will attend both of these meetings, and they start promptly at 5:30 PM.

Dr. Koeller will start working on Tuesdays and Thursdays with the addition of Mondays as her practice grows. As usual, she will be available via email and phone throughout the week.

In our May issue of Health Matters, we talked about the value of biofeedback. In this issue, we explore hypnosis. Both of these methods take advantage of the mind-body connection, and like biofeedback, we do not yet fully understand the positive effects of hypnosis. Both hypnosis and biofeedback have been shown to be beneficial in many medical conditions including helping to control pain and to improve asthma management.

Hypnosis is an altered state of consciousness. This state of consciousness is generally artificially induced and is different from your everyday awareness. When you're under hypnosis:

• Your attention is more focused
• You're more responsive to suggestions
• You're more open and less critical or disbelieving

The purpose of hypnosis as a therapeutic technique is to help you understand and gain more control over your behavior, emotions or physical well-being.

It's not clear how hypnosis works. However, it appears to affect how your brain communicates with your body through nerve impulses, hormones and body chemicals such as neuropeptides. Hypnotherapists say that hypnosis creates a state of deep relaxation and quiets the mind. When you're hypnotized, you can concentrate intensely on a specific thought, memory, feeling or sensation while blocking out distractions. You're more open than usual to suggestions, and this can be used to improve your health and well-being.

Who is hypnosis for?
Hypnosis may have the potential to help with a wide variety of conditions, but it's not a magic bullet. It's typically used as a part of an overall treatment plan rather than as a stand-alone therapy. Like any other therapy, it can be very helpful to some people and fail with others - it works best in those who are highly motivated and who work with a well trained therapist.

Hypnosis can be used to:

• Manage chronic pain
• Treat pain during childbirth and reduce labor time
• Relieve abdominal cramping and other symptoms associated with irritable bowel syndrome (IBS)
• Reduce blood pressure
• Manage chemotherapy-associated nausea and vomiting
• Reduce the intensity or frequency of migraine headaches
• Treat asthma
• Improve psoriasis, eczema and other skin conditions
• Change negative behaviors, such as smoking, bedwetting and overeating
• Manage fear, stress and anxiety
• Eliminate or decrease the intensity of various phobias

Types of hypnosis
A variety of hypnotic techniques exists. The approach you choose depends on what you want to accomplish, as well as your personal preferences. Your hypnotherapist may make a recommendation regarding the best technique for your particular situation.

For example, in one method, a hypnotherapist leads you into hypnosis by talking in gentle, soothing tones and describing images that create a sense of relaxation, security and well-being. While you're under hypnosis, the hypnotherapist suggests ways for you to achieve specific goals -- for example, reducing pain or stress or helping to eliminate the cravings associated with smoking cessation.

In another technique, once you're under hypnosis the hypnotherapist helps stimulate your imagination by suggesting specific mental images to see in your mind's eye. This conscious creation of vivid, meaningful pictures in your mind is called mental imagery, and it's a powerful way to help bring about what you want to achieve. For example, hypnotherapists can help athletes specifically visualize what they want to accomplish before they perform it physically.

Self-hypnosis is a third technique. A certified hypnotherapist needs to teach you how to induce a state of hypnosis in yourself. You then can use this skill to help yourself.

Although hypnotherapists, like other health care practitioners, each have their own style, expect some common elements:

• A typical session lasts from 30 to 60 minutes
• The number of sessions can range from one to a series of several
• You generally bring yourself out of hypnosis at the end of a session
• You can usually resume your daily activities immediately after a session

Dispelling some myths about hypnosis
Everyone has heard of hypnosis being used for entertainment as people are placed into a trance state as a part of a stage act. This has led to many myths about hypnosis. Legitimate hypnotherapy is not the same as that performed on stage.

A common myth is that you surrender your free will when you are under hypnosis. The reality is that hypnosis is a heightened state of concentration and focused attention in which you do not lose your personality, free will or strength. A small number of people can go into a very deep hypnotic state and experience spontaneous amnesia. However, most people remember everything that occurs under hypnosis.

Another myth is that the hypnotherapist controls you. The reality is that you do hypnosis voluntarily for yourself and a hypnotherapist only serves as a knowledgeable guide or facilitator. You cannot be put under hypnosis without your own participation. Successful hypnosis depends on your willingness to experience it and even with voluntary participation, not everyone can be led into a hypnotic state.

How to choose a qualified professional
Hypnosis as a practice is not regulated in most states. Certified lay hypnotists are individuals who have completed 200 or more hours of training in hypnosis but don't have additional professional health care training. Licensed health care professionals who practice hypnotherapy, such as psychologists, doctors and social workers, are trained in hypnosis in addition to their university training.

Apply the same care in choosing a hypnotherapist as you would a doctor. Ask someone you trust for recommendations. When you find a potential hypnotherapist, ask questions such as:

• Do you have training in a field such as psychology, medicine, social work or dentistry?
• Are you licensed in your specialty in this state?
• Where did you go to school, and where did you receive your other training?
• If you're a lay hypnotist, how much training have you had and from which school?
• How long have you been in practice?

When conducted under the care of a trained therapist, hypnosis is generally safe as a complementary treatment method.

Managing High Blood Pressure (Hypertension)
Hypertension is the medical term for high blood pressure. 'Blood pressure' is the pressure exerted by the blood on the inner walls of body's arteries. Hypertension refers to high tension within the blood vessels, and thus high blood pressure. The pressure is generated by the heart which pumps the blood, and the arteries whose walls are made of muscle. The arterial wall muscles can constrict to tighten the arterial pipes and thereby increase the pressure or they can relax and reduce the blood pressure.

Blood pressure consists of the 'systolic' pressure - the upper number - and the 'diastolic' pressure - the lower number. Blood pressure varies naturally over the course of a day and naturally over a person's lifetime, and it normally increases with age. Blood pressure also goes up as a normal response to physical activity and stress. Individuals with hypertension have high blood pressure even at rest.

High blood pressure, or hypertension, is defined by a systolic pressure of more than 140 and a diastolic pressure of more than 90. It is based on the average of two or more blood pressure readings taken at different times. If your blood pressure is consistently elevated into this range, then it is appropriate to start treatment. For those with pre-existing conditions such as kidney damage, prior heart attacks, or diabetes, it is frequently prudent to treat high blood pressure even at lower levels of elevation. This is a decision that you and your GreenField physician will make together.

Most adults with hypertension have "essential hypertension" and the cause is not known. A small number of individuals have secondary hypertension in which an underlying and potentially correctable cause can be identified, but this is relatively rare.

How common is high blood pressure? Hypertension is very common, occurring in about 32% of African-Americans and 23% of whites and Mexican-Americans.

Hypertension is more common as people grow older - among those over age 60, it occurs in 65% of African-American men, 80% of African-American women, 55% of white men and 65% of white women.

Why worry about high blood pressure? What are the effects of hypertension? Hypertension is called the "silent killer" - silent because high blood pressure generally does not cause symptoms. However, longstanding elevated blood pressure can lead to devastating effects including strokes, heart attacks, heart failure, kidney failure, and blindness. The elevated pressure puts strain on the heart and arteries, eventually damaging them over the course of many years.

What should you know about treatment? When we do start treatment, it is very important for you to know that our target is a systolic (upper number) consistently less than 130 and diastolic (lower number) consistently less than 90. We want you to be very aware of these numbers. If you are not at these targets, then we should continue to work together quite regularly until we have you on the right treatment to achieve the targets of less than 130/90. In other words, you are the best person to monitor your own blood pressure and you should continue to work with us until we have achieved adequate control.

Here are the critical components of blood pressure management:

• Purchase an automated blood pressure cuff and record your blood pressure several times per day until your blood pressure is adequately controlled, and then weekly thereafter for regular monitoring
• Know that your goal is a systolic blood pressure (the upper number) of less than 130 and a diastolic blood pressure (lower number) of less than 90. Make sure we manage your blood pressure together until you have achieved these targets
• Know your blood pressure medications and how you can adjust them at home
• Exercise daily and control your weight
• Minimize your salt intake
• Drink alcohol in moderation only
• Take your medications every day

These are the critical aspects of hypertension management at GreenField. In the upcoming July issue of Health Matters, we will discuss the treatment of high blood pressure, including the differences in medications that can be used for this condition.

Heart to Heart Summer and Fall Registration Open
Heart to Heart is a Support Group for women who are living with heart disease or a heart condition. It is facilitated by GreenField patient Janice Isenberg, LCSW, a licensed clinical social worker with over 25 years experience, who is living with heart disease.

Past sessions have been very popular! Registration is being accepted for new groups beginning in the summer and fall with time and place to be determined. If you'd like to register, please call 971-235-1014. The fee is $25.00 for a 6 week session. Group size is limited, so we encourage you to call early to reserve a spot.

Office Notes
Please note that the office will be closed on Monday, July 4 in observance of Independence Day. As always, one of our physicians will be on call to address any urgent needs that arise. Enjoy your summer!

Sincerely,
Your GreenField Health Team:
 

Beth Davis, your Benefits Coordinator and Biller (email)
Chuck Kilo, MD (email)
Cynthia Ferrier, MD (email)
Dia Gaede, CMA, your Health Coordinator (email)
Elizabeth Hays, MD (email)
Eric Murray, MD (email)
Jill Arena, your Clinic Administrator (email)
Joel Swartzmiller, IT Manager (email)
Pam Mockenhaupt, CMA, your Health Coordinator (email)
Paula Koeller, MD (email)
Ron Potrue, Clinic Management Consultant (email)
Shelly Banta, your Clinic Manager (email)
Tiana Schmitt, MA, your Health Coordinator (email)

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GreenField Health System
9427 SW Barnes Road, Suite 590
Portland, OR 97225
Phone: 503.292.9560
Fax: 503.292.9510
Web: http://www.greenfieldhealth.com

questions, concerns, comments appreciated:
questions@greenfieldhealth.com

© 2003-2005 GreenField Health