THE EXAMINER

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Did you know?...

Robert E. Bush Naval Hospital

“Serving with Pride and Professionalism since 1993”

You have the right toexpress your concernsabout patient safety and

quality of care.There are several avenues opento you:* Through the ICE website.* The Hospital CustomerRelations Officer at 760-830-2475, or any of the CustomerRelations representatives in theHospital clinics, or directly tothe Joint Commission via: E-mail at complaint@jointcommission.orgFax: 630-792-5636

The Joint CommissionOak Renaissance BoulevardOakbrook Terrace, IL 60181

To report Fraud, Waste andAbuse contact one of thebelow offices by calling:

Naval Hospital: 760-830-2344Combat Center: 760-830-7749NavMedWest: 1-877-479-3832Medical IG: 1-800-637-6175DoD IG: 1-800-424-9098

http://www.med.navy.mil/sites/nhtp/pages/default.aspx

An Award Winning Publication

Patients seen in July -- 13,559Appointment No Shows in July -- 831In July we had an 6.1 percent no show rate. We need to keep trendingdownward by keeping the appointments we make, or by canceling in enoughtime for someone else to use the slot...To help patients obtain appointments, the Naval Hospital now shows thenumber of open appointment slots each day on the hospital Facebook site,check it out. On Facebook, search: Naval Hospital Twentynine Palms.

To make an appointment call -- 760-830-2752To cancel an appointment call -- 760-830-2369

New DFA On BoardIt’s easy to fit in when you sharea similar background. That’sexactly what NHTP’s newDirector for Administration,Cdr. Gary Grothe (pronounced,Growthee), is finding among thecommand staff. He shares adental tech background withCommand Master Chief, CarolMerricks, and he graduatedfrom the same high school asNHTP Commanding Officer,Capt. Jay Sourbeer (Largo HighSchool, Largo Florida). In termsof command philosophy, he hasa wait and see approach. “I wantto meet everybody, see howthings aregoing and geta feel for howthings operatebefore I makeany judgmentsor have anybig decisions,”Cdr. Grothesaid shortlyafter arriving.“I know theJoint Com-mission andMed IG visitsare coming up,so that’s obvi-ously numberone on myradar rightnow,” he said. Cdr. Grothearrived fromNaval BranchHealth ClinicPort Huenemewhere he wasOfficer in Charge for the pastthree years. He’s been in theNavy for just over 15 years, andwas a non-commissioned officerin the Air Force for over 10years. “I was a dental tech, E-6select, when I switched over,”he said.

The Medical Service Corps offi-cer has a positive outlook and isimpressed by the high deserthospitality. “The people aroundhere are very friendly,” heremarked. “It’s very much likean OCONUS (OutsideContinental United States) loca-tion,” he said. “People seem tobe looking out for each otherand taking care of one another.”Cdr. Grothe earned hisAssociate’s Degree from theCommunity College of the AirForce. He earned his Bachelor’sdegree from Wayland BaptistUniversity and his Master’sdegree in Management from

ColoradoTechnicalUniversity,ColoradoSprings,Colo. Hobbiesmostlyinclude“spendingtime with myfamily.” He’shere with hiswife, CarolAnn, and twoyoungestdaughters,Graziella(born inSigonella,Italy), agenine, andHannah, age13. His twooldest sonsare married

and his third son is enrolled atDallas Baptist University. The Grothes plan to live onBase and are relieved to be outof temporary housing with their90-pound Labrador Retriever,Buddy.

The Family Readiness Group(FRG) at Naval Hospital 29Palms hosts themed monthlymeetings and everyone is invit-ed to attend (children are wel-come). Meetings are held on thefirst Tuesday of every month at5 p.m. in the hospital inBoardroom. The themes for theremainder of the year areSeptember: Desert Fun/Thingsto Do in 29 Palms; October:Disaster Preparedness (we willalso be collecting children'stoys/snacks for use at the NavalBall); November:Finance/Budget; and December:Holiday Celebration. The FRGis an all-hands volunteer organi-zation open to active duty, fami-ly members and retirees. Formore information please email:frg29p@yahoo.com or visit ourFacebook page FR+G 29 PalmsFamily Readiness Group.

Cdr. Gary Grothe

FRG SeeksNew Members

TeamSTEPPS!HN Henry Dawson (left) is pre-sented with a gift card by Cdr.Kristina Morocco. In late July,Dawson was a member of asurgical team planning a hem-orrhoid banding procedure.Noting a latex allergy in thepatient notes, Dawson took itupon himself to examine thesurgical band packaging anddiscovered they were 100 per-cent latex. “His interventionpotentially saved that patientan adverse reaction,” Cdr.Morocco noted. Proving onceagain, TeamSTEPPS works! Ifyou see a problem, speak up!

2 -- The Examiner -- September 2014

Published by Hi-Desert Publishing, a private firm in no way connected with the Department of Defense, the UnitedStates Marine Corps, United States Navy or Naval Hospital, Twentynine Palms under exclusive written contract withthe Marine Air Ground Task Force Training Command. The appearance of advertising in this publication, includinginserts or supplements, does not constitute endorsement by the Department of Defense, the United States MarineCorps, the United States Navy or Hi-Desert Publishing of the products or services advertised. Everything advertisedin this publication shall be made available for purchase, use, or patronage without regard to race, color, religion, sex,national origin, age, marital status, physical handicap, political affiliation, or any other non-merit factor of the pur-chaser, user or patron. If a violation or rejection of this equal opportunity policy by an advertiser is confirmed, thepublisher shall refuse to print advertising from that source until the violation is corrected. Editorial content is pre-pared by the Public Affairs Office, Naval Hospital, Twentynine Palms, Calif.

Commanding OfficerCapt. Jay C. Sourbeer, MC, USN

Executive OfficerCapt. Angela S. Nimmo, NC, USN

Command Master Chief HMCM (FMF/AW/SW) Carol Merricks, USN

Public Affairs Officer/EditorDave Marks

Command OmbudsmanBright Opoku (760) 910-2050 email: nhtpombudsman@yahoo.com

The Examiner welcomes your comments and suggestions concerning the publication. Deadline for submission of arti-cles is the 15th of each month for the following month’s edition. Any format is welcome, however, the preferredmethod of submission is by e-mail or by computer disk.

How to reach us...Commanding Officer Naval HospitalPublic Affairs OfficeBox 788250 MAGTFTCTwentynine Palms, CA 92278-8250Com: (760) 830-2362DSN: 230-2362E-mail: david.marks@med.navy.milHi-Desert Publishing Company56445 Twentynine Palms HighwayYucca Valley, CA 92284Com: (760) 365-3315FAX: (760) 365-8686

By Tanya Stuckey

Have you ever met someoneand thought, “Hmm, he’s an oddone?” It is far easier to judgeothers than to look within our-selves. Let’s face it, we all doweird things. We have thoughtsthat we share with only ourclosest friends; and in some-one’s eyes, we are the strangeone.

The Surgeon General definesmental health as “the successfulperformance of mental function,resulting in productive activi-ties, fulfilling relationships withother people and the ability tochange and cope with adversi-ty.”

Do a quick self-assessment.How is your mental wellness? Ifyou aren’t feeling productive,connected or fulfilled, it may betime for a tune-up. Taking careof ourselves means the wholeself. We all have a bad day oreven a bad week. Many of ushave suffered a big loss, experi-enced change that we have diffi-culty adjusting to or feel onedge on occasion. What do youdo to move past these difficul-ties and get back on track?

Here are a few suggestions forstaying on track or regainingyour positive attitude:

• Practice Mindfulness- Live inthe present moment and beaware of your mental state. Youhave the power to change yourperception and attitude.

• Eat well and exercise-- keep-ing your physical self healthywill have a positive impact onyour mental health.

• Call a Friend- Surround your-self with people who you enjoyspending time with and practicebeing a friend to those you love.

• Avoid Drama- Social net-works, television and relation-ships that promote drama haveno place in building a healthylifestyle.

• Be Grateful- Spend time eachday reflecting and make a list ofthings and people for whom youare grateful.

• Be Realistic- Set attainablegoals for yourself and thosearound you. Unrealistic expecta-

tions lead to disappointment andthey sabotage progress.

If you are pleased with theresults of your self-assessment,then sit back and enjoy thequirkiness that lies within and inthose around you. There maybe things you can’t addressalone. Don’t be afraid to ask forhelp. Acknowledging that wecannot solve all problems our-selves is a sign of strength andtrue insight.

Resources staffed with peoplewho care and who want to helpyou reach your full potential areavailable at no cost: • NHTP Primary Care (760)830-2752

• NHTP Mental Health/ Deploy-ment Health (760) 830-2785

• MCCS Behavioral Health(760) 830-7277

• Marine Advisor (855) 763-7542

• DStress Line (877) 476-7734

• Military OneSource (800) 342-9647

• National Center for Telehealth& Technology:http://www.t2.health.mil

• Operation Live Wellhttp://www.health.mil/Military-Health-Topics/Operation-Live-Well

• FOCUS Project 830-3818

We Are All A Little Off

FOCUS (Families OverComingUnder Stress) is a resiliencytraining program for militaryfamilies. FOCUS providesstrength-based training fortoday’s military family, toinclude communication, prob-lem solving, emotional regula-tion, and goal setting skills.This evidenced-based programis unique, flexible, confidentialand is individualized for fami-lies. Individualized familytraining is not therapy and isdesigned for the proactive fam-ily wanting to shore up itsstrengths to meet the dailychallenges of military life. Itconsists of weekly meetings towork toward personalizedgoals. FOCUS also has a spe-cialized track for families fac-ing wounds, illnesses orinjuries.

Lt. Daniel Crouch, NHTP Assistant Emergency Manager (center), briefs the Camp Pendleton 1st CivilAffairs Group during Large-Scale Exercise 2014 aboard the Marine Corps Air Ground Combat Center.The 14-member 1st Civil Affairs Group visited NHTP Aug. 14 and split into two groups, a medicalgroup to assess medical services, and a facilities group to learn about building capabilities. In the CivilAffairs Group’s training scenario, NHTP represented a hospital in a war-torn region with an influx ofrefugees. The purpose of the training scenario was to allow the Civil Affairs Group to practice the sameskills that would come to bear in an actual conflict with U.S. Marine force intervention. Senior membersof the 1st Civil Affairs Group have experience performing these tasks in Iraq and Afghanistan. Duringthe August 14 visit, Lt. Crouch changed hats and as NHTP Environmental Health Officer, briefed themedical group on strategies to prevent and treat the spread of infection and related illnesses. Photo byAlex Hogan.

The Examiner September 2014 - 3

2X3Smith’s Family

Properties

Preventive Medicine CornerSubmit Questions/Concerns and Tanya Will Provide Answers

Tanya StuckeyPreventive medicine is the keyto good health! In this sense,medicine does not mean pillsor potions, but good healthhabits that prevent the onset orprogression of illness.Remember the old adage, “anapple a day”? All the goodthings seem to find their wayback around. Note: This ruleshould not always be applied tofashion; do you remember“hammer pants”?

This month’s question is a per-fect lead into self-care and thetype of medicine that has nonegative side effects:

Dear Tanya,I have an active-duty spousewith depression and a childwith asthma. I know the easyanswer is to make sure mentalhealth appointments are keptand make an appointment formy child with the pediatricdepartment, but I'm wonderingif you have any tips for what Ican do to increase my family'shealth.

Answer:

Needless to say, I will alwaysrecommend keeping up withappointments and any medica-tion or advice you have beengiven by your medical provider.There are also things you cando on your own (and they arefree) to keep yourself and yourfamily on the right track to

good mental and physicalhealth.

Let’s start with depression; adiagnosis does not define you.There are measures that youcan take in addition to thoseabove that can significantlyimprove mood and energy. Forexample, taking family walksafter dinner. Not only does thephysical exercise increaseblood flow and oxygen to thebrain allowing us to feel andthink better, but it gives thefamily some good healthy timetogether. Talk while you walk.This helps to regulate yourpace and you’ve just made timeto catch-up on conversationthat is often missed when wespend time in front of the TV,gaming, returning emails,checking social media or tex-ting. It may be difficult at firstto muster up the motivation,but you can do it! We are nottalking about training for amarathon, just get moving. Adaily dose of vitamin D from

our beautiful desert sun is anexcellent booster too! Just besure to wear your sunscreen(every day and year-round).

Now what about asthma? Well,there are plenty of allergenseverywhere you turn and in aneffort to minimize the use, orincreased use of an inhaler;here are just a few tips fromthe Asthma and AllergyFoundation:

• Washing sheets and stuffedanimals once a week in 130-degree water.• Placing unwashable stuffedtoys in the freezer once a weekfor 24-hours.• Making sure all clothes arefully dry before putting them indrawers and closets.• Use the fan/vent when show-ering to keep air circulatingand reducing moisture in theair.• Vacuum furniture and cur-tains/drapes once a week

Dust is made up of a collectionof allergens and we have lots ofit here! Be sure to wipe all sur-faces and vacuum weekly toreduce the amount of dust inthe home. When possible,

use HEPA (high-efficiency par-ticulate air) filters in yourwhole house central air system,or in room air cleaning devicesand be sure to replace filtersregularly.

Healthy families are happyfamilies! There are so manybenefits to adopting a healthylifestyle. Pass it on!

For more information on creat-ing a healthy lifestyle plan,make an appointment to seeany of our great resourceslocated conveniently hereaboard the installation.

• NHTP Dietician: (760) 830-2274•NHTP Stress Management/Re-laxation classes: (760) 830-2814• MCCS Semper Fit/ Gyms:(760) 830-6451l

If you have medical/healthquestion that you would like tosee addressed in print, pleasecontact Tanya Stuckey (760)830-2173 or email: tanya.stuck-ey@med.navy.mil

Suicide Prevention Involves Taking Ship Shipmate and Self To HeartBy Lt. Nnamdi G. OhaeriNHTP Suicide PreventionCoordinator

September is Suicide PreventionMonth, and I wanted to take thisopportunity to talk about infor-mation pertaining to suicideawareness and prevention.

The Substance Abuse andMental Health ServicesAdministration (SAMHSA)defines suicide as “death frominjury, poisoning, or suffocationwhere there is evidence that aself-inflicted act led to the per-son's death.” I often hear thequestion, “How can you tellwhether someone is actuallygoing to commit suicide?”Unfortunately, there isn’t a reli-able way to predict who willultimately commit suicide.

That we cannot predict an indi-vidual’s suicide probability doesnot mean we stand idle.

The majority of psychiatricpatients have multiple suiciderisk factors; however, the major-ity of psychiatric patients do notcommit suicide. This alsoapplies to individuals who do

not have a mental health history.Stable chronic risk factors areusually not a reason for psychi-atric hospital admission. Acutestressors must be considered inthe context of an individual’spresentation to determine theappropriate treatment.

Therefore, risk factors should beconsidered in the context of theentire evaluation of the individ-ual and in the context of theirspecific circumstances.

So what are the risk factors? Asindicated by the NationalSuicide Prevention Lifeline, riskfactors can often become con-fused with the warning signs ofsuicide. It is important to bemindful that factors identified asincreasing risk are not factorsthat cause or predict suicide.Furthermore, risk factors can beconceptualized as characteristicsthat may increase the probabili-ty of an individual’s considera-tion of suicide. Some risk fac-tors for suicide include, but arenot limited to, mental disorders(particularly mood disorders,schizophrenia, anxiety disordersand certain personality disor-

ders), alcohol and other sub-stance-use disorders, hopeless-ness, impulsive and/or aggres-sive tendencies, history of trau-ma or abuse, major physical ill-nesses, a previous suicideattempt, family history of sui-cide, job or financial loss, lossof a relationship, easy access tolethal means, lack of social sup-port and sense of isolation, stig-ma associated with asking forhelp, lack of health care (espe-cially mental health and sub-stance abuse treatment), culturaland religious beliefs (such asthe belief that suicide is a nobleresolution of a personal dilem-ma), and exposure to otherswho have died by suicide.

Protective factors are character-istics that make it less likelythat individuals will considersuicide, and they may include,but are not limited to, receivingeffective clinical care for men-tal, physical and substance-usedisorders, having easy access toa variety of clinical interven-tions, restricted access to highlylethal means of suicide, strongconnections to family and com-munity support, support throughongoing medical and mental

health care relationships, skillsin problem solving, conflict res-olution and handling problemsin a non-violent way, if feasiblethe removal of an individualfrom a stress-inducing environ-ment, and/or cultural and reli-gious beliefs that discouragesuicide and support self-preser-vation.

So how do these concepts applyto us at NHTP or to any person-nel working aboard the CombatCenter? We can all, at times,

acknowledge that working with-in the military environment inand of itself can be stressful.With the stressful nature of ourwork environment in mind, it isour duty and responsibility to bemore mindful of our positionalauthority and rank, and howthose variables can be perceivedwhen one is struggling. Some ofour shipmates may be strugglingoccupationally or interpersonal-ly, but because of external

Please see Suicide Preventionon Page 7

4 -- The Examiner -- September 2014

Super Stars...

Hospitalman Nolan W. Bronson (right) receives a Letterof Commendation from NHTP Commanding Officer,Capt. Jay Sourbeer, for “outstanding performance ofduties while serving as General Duty Corpsman, AdultMedical Care Clinic, Naval Hospital Twentynine Palms,California, from September 2012 to September 2014.Hospitalman Bronson consistently performed his dutiesin an exemplary and highly professional manner. Heassisted nine providers in the treatment of 641 patientsincluding 99 blood draws, 70 infant heel sticks and hear-ing screenings, 47 intravenous therapy placements,seven electrocardiograms, four toenail removals, onenasogastric tube insertion, and one lymphoma removal.As an Advanced Cardiac Life Support instructor, hequalified 10 physicians and 20 Corpsmen of NavalHospital Twentynine Palms staff to meet their trainingrequirements in support of the hospital mission of quali-ty care. Performed 10 hours of medical coverage forHeadquarters Battalion Marines where he oversaw thecare of 40 Marines over the span of three weeks andtreated 18 injuries. He volunteered 26 hours to YuccaValley’s Public Library Reading Program where he setup the community area for performances and arts andcraft activities with the younger generation. HospitalmanBronson’s exceptional professional ability and loyaldevotion to duty reflect great credit upon himself and arein keeping with the highest traditions of the UnitedStates Naval Service.” (Signed),Bruce L. GillinghamRear Admiral, Medical CorpsUnited States Navy

Mr. Edell Buckley (right) receives a Federal Length ofService Award from NHTP Commanding Officer, Capt. JaySourbeer, in grateful recognition and appreciation for 10years of faithful service to the Federal Government.

Hospital Corpsman First Class Raul M. Cervantes(right) receives a Letter of Commendation fromNHTP Commanding Officer, Capt. Jay Sourbeer,“for outstanding performance of duties while serv-ing as Leading Petty Officer, Directorate SurgicalServices, NHTP, from January 2014 to March 2014.Petty Officer Cervantes consistently performed hisduties in an exemplary and highly professional man-ner culminating in his selection as Naval HospitalTwentynine Palm’s ‘Senior Sailor of the Quarter’for the Second Quarter, Fiscal Year 2014. Heachieved this distinction by demonstrating excep-tional leadership, initiative and dedication to duty.This prestigious recognition sets him apart as a trueprofessional and personifies the enlisted communi-ty’s reputation of high standards of performanceand conduct. His enthusiasm and contribution epit-omize the Navy Medical Department’s motto, ‘WorldClass Care--Anytime, Anywhere’ and provides tangi-ble evidence of the vital role that the enlisted com-munity plays in today’s Navy. Petty OfficerCervantes’ exceptional professional ability and loyaldevotion to duty reflect great credit upon himselfand are in keeping with the highest traditions of theUnited States Naval Service. (Signed),

B. L. GILLINGHAMRear Admiral, Medical CorpsUnited States Navy

Lt. Yekaterina L. Anderson (right) receives a Navy andMarine Corps Commendation Medal from NHTPCommanding Officer, Capt. Jay Sourbeer, “for meritoriousachievement while serving as Chief Information Officer,Information Management Department, NHTP, fromSeptember 2011 to August 2014. Lt. Anderson was instru-mental in Branch Health Clinic China Lake achievingNational Committee for Quality Assurance Medical HomeLevel Three recognition. She increased IMD staff by 35 per-cent, decreased help desk ticket back logs by 86 percentthrough streamlining processes, and continually merginglocal objectives with regional and Navy Medicine informa-tion technology strategies. Lt. Anderson’s exceptional profes-sional ability, distinctive accomplishments, unrelenting per-severance, and steadfast devotion to duty reflect credit uponherself and are in keeping with the highest traditions of theUnited States Naval Service.”

The Examiner -- September 2014 -- 5

Mr. James Cox (right) receives a Federal Length of ServiceAward from NHTP Commanding Officer, Capt. JaySourbeer, in grateful recognition and appreciation for 25years of faithful service to the Federal Government.

Hospital Corpsman Third Class Christopher R.Garcia (right) receives a Navy and Marine CorpsCommendation Medal from NHTP CommandingOfficer, Capt. Jay Sourbeer, for “professionalachievement in the superior performance of hisduties while serving as Navy Corpsman, 3rdBattalion, 4th Marines, 7th Marine Regiment, 1stMarine Division, from December 2011 to May2014, in support of Operation EnduringFreedom. HM3 Garcia performed in a superiormanner on and off the battlefield. While deployedhe was instrumental to care under fire and tacti-cal field care of a fallen comrade. His decisiveand methodical actions saved the of life of asquad member who suffered from a gunshotwound to the head. In keeping with the Naval tra-dition of courage, he also provided medical treat-ment for an Afghanistan local national who suf-fered a life-threatening injury from a previousengagement. Due to his superior knowledge, hewas promoted to sick-call supervisor, responsiblefor the high quality of medical care found withinThird Battalion, 4th Marine’s battalion aid sta-tion. HM3 Garcia’s initiative, perseverance, andtotal dedication to duty reflect great credit uponhimself and uphold the highest traditions of theMarine Corps and United States Naval Service. (Signed),J.M. BargeronColonel, U.S. Marine Corps7th Marine RegimentCommanding

Cdr. Cynthia R. French (left) receives a MeritoriousService Medal presented by NHTP Commanding Officer,Capt. Jay Sourbeer, which reads: “The President of theUnited States takes pleasure in presenting the MeritoriousService Medal to Cdr. Cynthia R. French, Nurse Corps,United States Navy, for service as set forth in the followingcitation: For outstanding meritorious achievement as ClinicalNurse Specialist and Department Head, NHTP, from July2012 to September 2014. Cdr. French consistently per-formed her demanding duties in an exemplary and highlyprofessional manner. She distinguished herself as aneffective clinical leader through her development ofadvanced training for clinical staff to provide quality nurs-ing care. She oversaw 60 personnel and equipment valuedat 1.5 million dollars. Commander French improved theinpatient bed utilization from 31 percent to 65 percent andprovided nursing care to 5,610 outpatient encounters. As aDepartment Of Defense Navy Training Officer, Cdr.French implemented Mosby Skills training and ensuredthat updates were accessible for staff. She developed andimplemented the Nurse of the Day and the NurseResidency Initiatives that promoted a culture of safety andsupport for junior nurses. The professional ability, stead-fast initiative, and selfless dedication to duty exhibited byCommander French highlight the culmination of her 21years, 11 months, of honorable and dedicated service. Cdr.French’s exceptional professionalism, personal initiative,and loyal devotion to duty reflect great credit upon herselfand are in keeping with the highest traditions of theUnited States Naval Service.

For the President,(Signed),

B. L. GILLINGHAM Rear Admiral, Medical CorpsUnited States Navy

Hospitalman Darius L. Woods (right) receives a Letter ofCommendation, presented by NHTP Commanding Officer,Capt. Jay Sourbeer, for outstanding performance of dutieswhile serving as Pharmacy Technician, PharmacyDepartment, Directorate of Clinical Support Services, NHTP,from January 2014 to March 2014. “HN Woods consistentlyperformed his duties in an exemplary and highly profession-al manner culminating in his selection as Naval HospitalTwentynine Palms ‘Blue Jacket of the Quarter’ for the sec-ond quarter, FY 2014. He achieved this distinction bydemonstrating exceptional leadership, initiative, and dedica-tion to duty. This prestigious recognition sets him apart as atrue professional and personifies the enlisted community’sreputation for high standards of performance and conduct.His enthusiasm and contributions epitomize the NavyMedical Department’s motto, ‘World Class Care...Anytime,Anywhere!’ and provide tangible evidence of the vital rolethat the enlisted community plays in today’s Navy. HNWood’s exceptional professional ability and loyal devotion toduty reflect great credit upon himself and are in keepingwith the highest traditions of the United States NavalService.”(Signed),BRUCE L. GILLINGHAMRear Admiral, Medical CorpsUnited States Navy

6 -- The Examiner -- September 2014

Sub Offer5X3

Introducing New Staff -- Welcome Aboard!

Jamie Snell HN Lillian ThomasLt. Karen Sanchez Lt. William PhanLt. Amelia ButtolphJamie Snell recently joinedNHTP’s Maternal InfantNursing Department. Shearrives from BrennerChildren’s Hospital in Winston-Salem, N.C., where she was apediatric nurse for the pastthree years. Snell married atthe end of March to 1st Lt.Mark Rothrock, assigned to 1stTanks, and anticipates a namechange in the near future. Inaddition to her nursing degree,Snell has a Bachelor’s degreein sociology from theUniversity of North Carolina,Chapel Hill. Hometown isPinehurst, N.C. Snell loves thehigh desert. “There aren’t asmany green things as I’m usedto, but it’s fun being some-where that’s new and differ-ent,” she said. Snell is a runnerand isn’t afraid to get downand dirty in a mud-run race.She enjoys cooking and baking.Her signature dishes includeoatmeal chocolate chip cookiesand barbecued chicken.

HN Lillian Thomas arrivedfrom Naval Hospital CampLeJeune where she spent thepast two years working in theCardiology Department. She’sbeen in the Navy for threeyears and hails fromChattanooga, Tenn. For leisureactivities, Thomas enjoys draw-ing and specializes in natureand landscape themes usingcharcoal and pastels. HNThomas considers herself an“outdoorsy” person and enjoyshiking and other outside pur-suits. For music, Thomasenjoys “a little bit of every-thing” but if she had to pick aPandora station “it would be90s music,” she said. Readingtaste tends to the murder/mys-tery genre. At NHTP, Thomaswill be assigned to the PostAnesthesia Care Unit (PACU).Thomas enjoys the diversityshe’s found among Navy per-sonnel. “You meet so manypeople from all over theworld,” she said.

Nurse Midwife Lt. KarenSanchez arrived at NHTP fromGeorgetown University whereshe just completed herCertified Nurse Midwife andWomen’s Health NursePractitioner Degree. At NavalHospital Bethesda, Sanchezworked for two years on theLabor and Delivery MotherInfant Care Center and for ayear and a half on theInpatient Pediatric Floor. Ifshe had to pick a hometown itwould be Herndon, Va., but shesays that reluctantly admittingthat her government-workerparents moved frequently.When asked about hobbies, shementions her three children, an11-year-old son and twodaughters, ages 10 and 3.Sanchez is accompanied by herhusband, Dustin, who she metwhen they were both Marines.The Sanchez family live inTwentynine Palms. Lasagna isher favorite dish to prepareand she enjoys country music.

Lt. William Phan is NHTP’snewest pharmacist. He arrivedfrom Naval Hospital Jackson-ville, Fla., where he wasDivision Officer in the pharma-cy. Originally, from Viet Nam,Lt. Phan arrived in DesMoines, Iowa, when he was 13.He attended Drake University,also in Des Moines, where heearned his undergraduate andMaster’s degrees. When askedwhether he’ll make the Navyhis career, Phan replied thathe’s taking it “three years at atime.” Phan’s parents are re-tired and live in Viet Nam. Hisbrother, who came to the U.S.with him, is a certified publicaccountant in Iowa. Lt. Phan isunaccompanied. He became apharmacist “because I reallyenjoy the aspect of using sci-ence combined with medicineto help people.” Phan enjoysreading, exercising, videogames and symphony music.Lt. Phan is currently househunting in Twentynine Palms.

Lt. Amelia Buttolph performedher family medicine residencyat Naval Hospital Bremertonwhere she spent the past threeyears. At NHTP, she’s assignedto the Family Medicine GoldTeam as a staff physician. Lt.Buttolph earned her medicaldegree from the University ofWisconsin. She grew up in amilitary family (her father wasa Navy Corpsman), and livedall over but she considers LaCrosse, Wisc., home. She’sbeen in the Navy for threeyears and likes that it takes herdifferent places. Lt. Buttolphenjoys running, hiking, “any-thing outdoors,” and travel, “asmuch as possible.” She likesthe high desert and describes itas “a different kind of beautythan the Olympic Mountains,but still quite beautiful.” Sheexpects to find a home in YuccaValley. Music taste runs thegamut from classical to electricto her current fave, Kid Koala.

The Examiner -- September 2014 -- 7

MBTA2X8

Tendons are the tough but flexi-ble bands of tissue that connectmuscle to bones. You haveabout 4,000 tendons throughoutyour body. Tendons make it pos-sible for you to bend your knee,rotate your shoulder, and graspwith your hand.

Tendinitis is inflammation of atendon. (When you see “itis” atthe end of a medical word, itmeans inflammation.) In ten-dinitis, thetendon getsinflamed andcan rubagainst bone,making move-ment painful.

Tendinitis isusually causedby repeatedmotion, stress,or injury tocertain mus-cles or joints.A sports orjob-related injury is a commonway to get tendinitis, but thecondition can happen to anyone.Your risk for tendinitis alsoincreases with age. “Tendonslose health as we get older andbecome less able tohandle the load,”says Dr. EvanFlatow, an orthope-dist at Mount SinaiRoosevelt Hospitalin New York.

Any activity thatrequires repetitivewrist turning orhand gripping,jumping or bending,pulling, pushing, orlifting can irritatethe tendons. Someof the most commonplaces to get thecondition are in theshoulders, elbows,hands, wrists, knees,and ankles.Gardeners, carpen-ters, musicians, and other peo-ple whose work regularly placesstress around the same tendonsare at increased risk for devel-oping tendinitis.

If treated early, tendinitis is usu-ally a short-term condition. Butit can come back if the tendon isaggravated over and over again.If tendinitis keeps affecting thesame area over time, the tendoncan weaken and tear or break.If you have pain or swelling--

and especially if you can’t movea joint at all--contact a primarycare doctor or an orthopedist.They can perform tests to pin-point the exact areas of inflam-mation. You may also get anMRI scan or X-ray to check fora tear in the tendon or rule outother conditions, such as arthri-tis.

The first step in treating tendini-tis is to reduce pain and

swelling. Besure to restthe swollentendon so itcan heal. “Wehave to breakthe cycle ofinflammationto allow thera-py to work,”Flatow says.A doctor mayprescribemedicines thatrelieveinflammation

(such as aspirin or ibuprofen),give steroid injections, or giveyou a splint or brace. Then gen-tle exercises can help strengthenthe tendon.

If a tendon becomestorn, surgery mightbe needed to repairthe damage. NIH-funded researcherssuch as Flatow areworking to developnew ways to repairand regenerate ten-dons without sur-gery.

Regular physicalactivity helps keepmuscles, bones, andtendons strong, andcan lower your riskof injury and ten-dinitis. But be care-ful not to overdo itso you don’t injureyourself.

“Keep joints limber,” Flatowadvises. “Warm up and stretchbefore physical activity to pre-vent sudden injury.” Take careof your tendons so they cankeep you painlessly bending andflexing your muscles long intoold age.

Reprinted from NIH News inHealth:http://newsinhealth.nih.gov/issue/june2014/feature2

Don’t Take Tendinitis Lying Down

Preventing Tendinitis

• Exercise regularly tostrengthen muscles aroundthe joints.• Begin new activities orexercise routines slowlyand gradually increase theintensity.• Position your body prop-erly when doing dailytasks. • Take frequent breaksfrom repetitive exercisesand motions.• Stop activities that causepain.• Use padding, gloves, orgrip tape to cushion jointswhile using tools andsports equipment.

things like fitness reports, high-er tenure, the potential threat ofdiscipline, reluctance to be per-ceived as unreliable, perceivedfairness of job assignments--it’sdifficult for some personnel toadvocate for themselves. Attimes, we can begin to feeloverwhelmed. Sometimes all ittakes is a sudden rush of nega-tive emotion or an act ofimpulse for one’s stress toevolve into suicidal ideation,and, unfortunately at times, anactual suicide attempt.

With the suicide risk factors inmind, we should be looking atthings like whether someonewho is normally squared awaybegins to lose some bearing orlooks somewhat disheveled intheir uniform; those who arenormally engaging may with-draw socially and isolate them-selves; showing up to formationor work late; body languagechanges; decline in work per-formance.

As leaders, subordinates andpeers, it’s important to be awareof those around us and howthese factors may affect col-leagues and acquaintances. Yes,life in the military can be tough,but we should not take forgranted the naturally expectedpressures that come with ourwork. We should also keep inmind the human element andindividual respective stressthresholds. To whom much isgiven, much is expected; but inthe same breath, no one’s well-being should be compromisedto the point of suicidal consider-ation. It is important that weadvocate for ourselves and oneanother if things begin tobecome too arduous, and let usnot condemn but support oneanother should we decide toseek help and support.

We may not ultimately beresponsible for the actionsanother decides to take; but wehave the responsibility to helpand support one another if wenotice someone struggling. Asthe Commanding Officer hasproclaimed, Ship, Shipmate,Self--not just for SuicidePrevention Month--but forevery month.

Suicide Prevention, continuedfrom Page 3.

NHTP’s MarineLiaison, Gunnery Sgt.Joseph Saunders,demonstrates SemperFit’s Paramobile,designed for disabledyouths and adults. Tocheck out a Paramobileon Mainside, contactSherry Powell at (760)401-3850; to check oneout at the Desert WindsGolf Course, ContactChuck Mastropoalo at(760) 898-4820.

Farewell! May You Have Fair Winds and Following Seas...

August is the cruelest month. Hospital personnel who have become friendsPCS, retire and bid a fond farewell disappearing over the horizon. This sum-mer we said goodbye to our Director for Administration, our Director forClinical Services, our Director for Surgical Services, our Chief InformationOfficer, our Director for Public Health; our Assistant Director for MedicalServices as well as to a number of retiring staff, some of whom were heresince the Robert E. Bush Naval Hospital opened its doors in 1993. Clockwisefrom top left: Outgoing DFA, Cdr Brennan Autry (left), receives a commemo-rative hospital picture from Lt. j.g. Lincoln Stuart; former director of ClinicalServices, Capt. Sandra Morris PCSed to NAS Patuxent River; formerDirector of Surgical Services, Cdr. George Newton PCSed to Naval SupportActivity Naples, Italy; Pediatric Nurse Jennie Pyle receives a going-away cer-tificate from Lt. Timothy Chinnock; Norma Noble, Medical Clerk in theEmergency Medicine Department retired July 30 with 36 years of federalservice; Assistant Director for Medical Services, Cdr. Cynthia French, retiredAugust 1; Director for Public Health, Cdr. Brenda Smith, PCSed to CampPendleton; Dr. Vivianne Wersel (audiologist) accepted a position at WalterReed National Military Medical Center; Chief Information Officer Lt.Yekaterina Anderson PCSed to post-graduate school in Monterrey, California.

Cdr. Brennan Autry (left)

Capt. Lisa Morris Cdr. George Newton Registered Nurse Jennie Pyle (left)

Medical Clerk Norma Noble

Cdr. Cynthia FrenchCdr. Brenda SmithDr. Vivianne WerselLt. Yekaterina Anderson