What to expect when
you’re approved for
hearing aids through
Contract Health
Services (CHS)
You will be referred to Costco for
hearing aids. Costco hearing aids cost
50-60 percent less than other provid-
ers with equal quality.
Your CHS team will help you
obtain a Costco membership and help
with transportation barriers.
We look forward to working with
you.
Change in Siletz
Clinic check-in times
The Siletz Clinic asks all patients
with appointments to check in 15
minutes prior to your scheduled
appointment time. This allows for any
necessary paperwork to be completed
prior to your appointment with your
provider. Thank you!
Siletz Clinic implements new No-Show Policy for patients
The Siletz Community Health Clinic
has a new No-Show Policy. The policy is
in effect as of Feb. 17, 2017.
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The providers’ limited time and
resources are wasted because they
prepared for an appointment that did
not happen
Patient will be required to utilize the
walk-in clinic for 180 days, after which
patient will be able to return to scheduling
appointments.
When does a no-show happen?
A no-show happens when a patient
does one of the following:
What happens if a patient is a
no-show?
Medical, Lab and Radiology Services
•
•
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Does not arrive to his or her appoint-
ment
Cancels the appointment with less
than 24 hours’ notice
Checks in more than 10 minutes after
the scheduled appointment, which
results in the provider not being able
to see the patient
Who is impacted when a
patient doesn’t show up for an
appointment?
•
•
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The health and all treatment for the
“no-show” patient is impacted
The health and all treatment of
another patient who could have been
seen in the appointment slot
Waiting times and subsequent treat-
ment for the rest of the patients on
the schedule for the day
First No-Show – After the first no-
show, the patient will receive a letter and
a copy of the policy for review.
Second No-Show – Patient will
receive a letter providing notice about
the two no-show appointments and their
requirement to utilize the Walk-In Clinic
for medical appointments. The Walk-In
Clinic is available first-come, first-serve.
Patient will be required to utilize the
walk-in clinic for 90 days, after which
patient will be able to return to scheduling
appointments.
Third No-Show – Patient will receive
a letter providing notice about the three
no-show appointments and their require-
ment to utilize the Walk-In Clinic for
medical appointments. The Walk-In
Clinic is available first-come, first-serve.
Dental and Optometry Services
First No-Show – Patient will receive
a letter providing notice about the no-
show appointment and their requirement
to utilize the department’s Walk-In Clinic
for appointments. Walk-in availability is
first-come, first-serve.
Patient will be required to utilize the
Walk-In Clinic for six months, after which
patient will be able to return to scheduling
appointments.
How to avoid getting a no-show!
•
Confirm the appointment.
•
Arrive 10-15 minutes early.
•
Give a minimum 24 hours’ notice
when canceling appointments
You can pick up a copy of the
new policy at the Siletz Clinic
or download it from the Tribal
website – ctsi.nsn.us.
Can nutrition reduce or prevent chronic pain?
By Nancy Ludwig, MS, RDN, LD,
Siletz Tribal Head Start Nutrition
As part of my role as consultant
nutritionist to Siletz Tribal Head Start, I
offer information for families. While I was
recently reviewing the role of nutrition in
pain prevention and possible treatment, I
once again was encouraged to note that
these are, in fact, the same principles
demonstrated when embracing traditional
foods (and nutritional equivalents).
Pain is a symptom that signals a need.
There is a root cause behind pain (or many
contributing factors). Granted, there are
times when pain intensity and timing
warrant medications. The purpose of this
article is to focus on the possible role(s)
of nutrition as it relates to pain and pain
management or prevention. Nutrition can
influence both acute and chronic pain.
The benefit may be greatest, however, for
chronic pain.
Optimal nutrition lays the foundation
for pain prevention. This does not mean
that when we trip and fall we will not
feel pain. It does, however, mean that our
innate healing and resilience will likely
occur more quickly.
Additionally, and perhaps most sig-
nificantly, attention to nutrition and its
role in the inflammatory pathways can
ease pain associated with chronic illness.
Most chronic illness has, at its founda-
tion, some form of inflammation. Exam-
ples include diabetes, high blood pressure,
high cholesterol levels, cardiovascular
disease, obesity, depression, Alzheimer’s
disease, Parkinson’s disease, cancer,
asthma, arthritis (osteo and rheumatoid),
fibromyalgia, Crohn’s disease and more.
Dietary fat plays a key role in inflam-
mation, which is linked to pain and
chronic illness. The types and quality of
dietary fats can either increase or decrease
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Siletz News
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the inflammatory response (also called
the balance of pro- vs. anti-inflammatory
load). The science can get overwhelming
quickly, yet the basic principles do not
require scientific knowledge.
Fats and oils are healthiest when
fresh or carefully stored away from heat
and air. Rancid smell is a sign that fat is
no longer healthy. Quality fats also mean
“clean” fats since harmful environmental
chemicals can be stored in fat. When we
consume animal foods that were exposed
to environmental toxins, we also ingest
those stored toxins (primarily in the fat).
There appears to be no clear agree-
ment around “how much” fat we need.
There is a great deal of information about
“which types” of fat to eat. Yet, I don’t
believe that there is enough emphasis on
the importance of “quality fats.”
Historically, traditional diets have varied
in total fat intake. Often, amount is deter-
mined by climate. Colder climates, such as
in the arctic, require higher fat content.
The Salish Food Mound, encompass-
ing the Siletz region, as described by Drs.
Korn and Ryser, comprises 33 percent
leafy greens, berries and fruits; 45 percent
meat, fish and fowl; 20 percent fats and
fish oils; and 2 percent roots and sweets.
Because the traditional diet is not very
starchy and leaves are not very filling, the
caloric needs are met primarily through
proteins and fats.
Fats and oils are vital in nutrition.
While total amount is important, our pri-
mary focus in this feature is about choos-
ing healthy fats and attention to fat quality.
Traditional sources of healthy fats
include bear fat, crab, herring, fish eggs,
nuts and seeds, halibut, oolichan, salmon
oil, seal oil and whale oil. Many of these
sources have become rare or impossible
to get.
Oolichan (smelt) oil is one of the most
important foods of the Salish people. The
March 2018
decline of oolichan has been a great con-
cern. It is not only a favored condiment
for dipping foods and binding dried fish
or berry cakes for winter food, it is also
very healing for the skin.
Oolichan oil is very high in DHA
(docosahexaenoic acid) and EPA (eicosa-
pentaenoic acid), which are used to treat
diabetes, depression, post-traumatic stress
disorder, addictions, auto-immune dis-
eases, learning disorders and chronic pain.
Essential fatty acids, referred to as
omega 3 and 6, are important for health
and are derived from fish, meats, nuts and
seeds such as flax oil, evening primrose
oil, borage oil, black currant, and cattail.
The term essential means that we can only
get it by consuming it. Our bodies cannot
make them from other fats.
EPA and DHA are two types of omega
3s. While omega 6s are also essential,
most Americans get too much. It is prob-
ably best to focus on cold-water fish for
omega 3 fatty acids.
In addition to our need for healthy
fats and essential fatty acids to prevent
inflammation and pain, other nutrients
can be identified. Correcting nutrient
deficiencies can also help reduce pain.
Key nutrients include magnesium and
vitamin C as well as phytonutrients found
in colorful fruits and vegetables. Again,
these nutrients are consistent with tradi-
tional diets.
Attention to carbohydrate quality also
addresses pain because carbohydrate foods
influence the inflammatory process. There
is a correlation between post-prandial
glucose concentration (blood sugar after
a meal), oxidant stress and inflammation.
Fiber in the diet slows absorption
time of sugars and helps to optimize
glucose metabolism, which avoids a high
glycemic load and an insulin-driven rise
in C- reactive protein (CRP), an inflam-
matory marker. Some types of fiber act as
prebiotics and support gut health (micro-
biome). The nutrition focus is on mini-
mally processed high fiber carbohydrates
while limiting total intake to minimize the
inflammatory response.
What can we do nutritionally to pre-
vent or reduce pain? Place a pain-relieving,
anti-inflammatory diet on the menu to help
reduce or avoid chronic pain. Eat clean fats
from wild and/or sustainable, organically
raised foods.
Focus on uncontaminated, cold-water
fish. Include leafy greens and a variety of
fruits and non-starchy vegetables in your
diet. Embrace traditional foods and their
nutritional equivalents, support health at
the deepest level.
As the Head Start consultant nutri-
tionist, I am available to support families
by discussing nutrition related concerns
via telephone. There is no charge for Head
Start families.
Resources
Preventing & Treating Diabetes Natu-
rally The Native Way by Leslie E. Korn,
Ph. D., MPH and Rudolph C. Ryser, Ph.D.,
DayKeeper Press, Olympia, WA, 2009
Feeding the People Feeding the Spirit
– Revitalizing Northwest Coastal Indian
Food Culture, by Elise Krohn, Valerie
Segrest and the Northwest Indian Col-
lege, 2010
Plants That We Eat – From the tra-
ditional wisdom of the Inupait Elders of
Northwest Alaska by Anore Jones, Uni-
versity of Alaska Press, 2010
O’Keefe JH, Gheewala NM, O’Keefe
JO. Dietary strategies for improving post-
prandial glucose, lipids, inflammation,
and cardiovascular health. J Am Coll Car-
diol. 2008;51(3):249-255. doi:10.1016/j.
jacc.2007.10.016
Galland L. Diet and inflammation.
Nutr Clin Pract. 2010;25(6):634-40.
doi:10.1177/0884533610385703