Surgeons Outlook - Proliance Surgeons

a publication from proliance surgeons, inc., p.s. volume 3 • issue 1 Winter 2010 

PROLIANCE 

This Is Africa 

by Glenn Knight, PA-C 

My Hearing 

Aid Can 

Do What? 

by Suzy Jackson, AuD, F-AAA 

Orthopedic 

Physician Associates’ 

Childhaven Campaign 

Surgeons Outlook 

® 

www.proliancesurgeons.com | 1

2 | www.proliancesurgeons.com

Proliance SurgeonS ® outlook 

A publication from Proliance Surgeons, Inc., P.S. 

Central Office 

805 madison st., suite 901 

seattle, Wa 98104 

(206) 264-8100 

(206) 264-8689 fax 

www.proliancesurgeons.com 

president 

Jeffrey remington, mD 

ceo 

David g. fitzgerald 

cfo 

gary mayberry 

Proliance Surgeons ® Outlook, a publication from 

proliance surgeons, is an educational resource for 

health care professionals as well as the general public. 

the publication communicates educational news 

and trends involving both orthopedic and general 

surgery topics and contains various health-related 

articles of interest. proliance surgeons’ goal is to 

increase public awareness of surgical techniques and 

innovations and their significant roles in orthopedic 

and general health care. 

the information contained in this publication is not 

intended to replace a physician’s professional consultation 

and assessment. please consult your physician 

on matters related to your personal health. 

Proliance Surgeons ® Outlook is published 

by innovative publishing ink. 

10629 Henning Way 

louisville, KY 40241 

502.423.7272 

innovative publishing ink specializes in creating 

custom publications for businesses and associations. 

to find out how your organization can have its own 

magazine, contact aran Jackson at 502.423.7272 or 

ajackson@ipipub.com. 

www.ipipub.com 

opening remarks 

by David fitzgerald, ceo 

PROLIANCE 

® 

Surgeons Outlook 

proliance surgeons ® , inc. has long 

been recognized as providers of specialty 

orthopedic; general surgical; and 

ear, nose and throat services throughout 

the puget sound region. However, 

this presence is not just restricted to 

direct health care delivery; it extends through a 

myriad of volunteer efforts within Washington and 

far beyond the state. 

proliance endorses a number of programs that benefit the 

community, including local and global initiatives that provide 

resources for a variety of programs, such as childhaven, the 

pacific northwest chapter of the arthritis foundation, King 

county project access, caring clowns international, disaster 

relief efforts on behalf of the red cross and volunteer work in 

third World countries, among countless other programs. 

the generous spirit of staff members and health care providers 

has inspired other proliance employees and practice sites 

to donate time, resources, equipment and money to advance 

multiple causes. in 2009, proliance’s physician clinics and ambulatory 

surgery centers donated a combined $5.25 million of free 

services/charity care, enabling hundreds of patients to receive 

medical and surgical care free of charge. although monetary 

contributions and unpaid medical services are important, it is 

the hard work of employees who altruistically collect donations, 

publicize their causes and invest in the programs that make a 

difference in people’s lives. Whether soliciting funds, wrapping 

packages, coaching sports, running a marathon or rendering 

medical care, employees literally set the pace for charitable contributions! 

proliance is proud to stand behind the big and the 

small campaigns that promote independence and positive health 

outcomes among those most in need. 

this issue celebrates this giving spirit. thank you, everyone! 



In thIs Issue… 

06 This is africa 

an account of a medical missions trip to tanzania and 

the difficult conditions residents there face every day in 

regards to basic health care and treatment. 

12 my Hearing aid can Do What? 

The latest advances in hearing-aid technology that make 

life easier for hearing-impaired patients to do simple, 

everyday things like talk on a cell phone, watch television 

or listen to the sermon at church. 

13 orthopedic physician associates’ annual 

charitable Drive for childhaven 

opa’s annual charity event that benefits childhaven, a 

local organization that provides therapeutic day care for 

infant and child victims of abuse and neglect — now in its 

fifth year of giving the gift of christmas to area children. 

3m medical ................................................................................4 

amerinet .....................................................................................9 

arthritis foundation .................................................................18 

berntson porter & company pllc ......................................16 

cardinal Health ........................................................................16 

fain anderson vanDerhoef, pllc ........................................18 

Hanger prosthetics & orthotics ..............................................17 

Healthcare management administrators ...............................16 

Johnson, graffe, Keay, moniz & Wick llp ..........................18 

contents 

14 feeling faint? Diagnosing and 

treating syncope 

an overview of syncope — the medical term for fainting 

or passing out — and an examination of common causes 

and treatment methods for this condition. 

In every Issue… 

03 opening remarks 

Welcoming remarks from the ceo of proliance surgeons ® 

10 proliance surgeons ® Directory 

proliance surgeons ® would like to thank the following list of advertisers, 

without whom this issue of Proliance Surgeons ® Outlook would not have been possible. 

Kibble & prentice .......................................................................2 

law offices of stephen l. Henley, sr., p.s., ltD ..................18 

md-it ..........................................................................................16 

pacific medical, inc. ..................................................................15 

rbc Wealth management ......................................................19 

seattle radiologists ...................................................................20 

u.s. bank ...................................................................................17 

Washington archives management ........................................19 

Xoran technologies ..................................................................19 



This Is 

Africa 

by glenn Knight, pa-c 

i had the opportunity to travel to tanzania in may and 

June with an organization, e3 partners, to participate as 

part of a medical team that was a component of a larger 

missions-oriented group. The medical team consisted of 

me, a dermatologist, two nurses, a dental tech, two student 

nurses and a medical student, all from the united 

states. There was also an ophthalmologist from tanzania 

and a tanzanian who was doing Hiv/aiDs testing. The clinic provided primary care, eye 

refractions and Hiv/aiDs testing and counseling. We worked with many nationals who 

served as aides and translators in the clinic. 

this was my third trip to tanzania. every year 

that i go, i have to relearn a phrase … tia. 

“this is africa.” this refers to the way that things 

happen in africa that are different, even counterintuitive, 

to the way americans think or go about 

their daily lives. for example, when breakfast is 

scheduled for 8 a.m. and clinic to start at 9 a.m., 

and the breakfast isn’t even ready until 9:15 a.m., 

only the americans get anxious — not the nationals, 

not the patients waiting in line since sunrise, 

just the americans … tia. 

the first week, our clinic was in a community 

named tabora. this is in western tanzania. We 

were scheduled to be in a government facility 

that was empty because of remodeling. Well, it 

wasn’t empty. there was a government clinic in 

operation, and their plan 

was to charge for our free 

services and medicines 

… tia. although this 

was not acceptable, we 

did agree to do this just 

for that day because so 

many people had shown 

up to see us. the hospital 

agreed to accept referrals 

from us for patients 

who needed surgery or 

care that was beyond 

the scope of our clinic, even though we 

would not be seeing these patients at the 

government facility. 


the next day, we were running our clinic out of an episcopal 

church in a more rural setting so we could reach people who could 

not otherwise afford medical care. We saw between 80 and 120 

patients a day between the dermatologist and me. common ailments 

included malaria, hypertension, diabetes, gastritis, arthritis, 

parasites, irregular menses and any of the things you would expect 

to see in primary care in the united states. 

probably the most unusual patient i saw in tabora was complaining 

of back pain. because there is minimal privacy in the clinic, 

patients only disrobed when absolutely necessary. i was doing a 

back exam with the patient still wearing his shirt. When i began 

to press on his spine, about half a dozen small cockroaches scurried 

out from under his collar and down his back … tia. 

8 | www.proliancesurgeons.com 

We had catered lunch at the clinic every day. it was beans and 

rice, or some days it was rice and beans. there would also be a few 

chunks of meat, sometimes tender enough to swallow. the scheduled 

12:30 lunch often arrived between 2 and 3 … tia. 

after a week in tabora, we were scheduled to move on to Karatu, a 

village in northern tanzania not far from mount Kilimanjaro. We 

showed up at the tabora airport to catch an air tanzania flight to 

Dar salaam to connect to a flight to Kilimanjaro. air tanzania has 

a fleet of two aircraft. the day we were scheduled to fly, they said, 

“no, come back tomorrow.” the next day, we showed up for a 10 

a.m. flight that finally left at 2 p.m. my boarding pass said i was in 

seat 10 J. this was on a plane that is only four seats wide … tia. 

We made it to Karatu in time to start our scheduled clinic there, 

but our day of rest was spent traveling. our clinic site was in a very 

rural setting down a bumpy dirt road. the facility was pretty openair. 

in the evening, it served as a dance hall/bar. 

in this clinic, i saw several patients with systolic blood pressures 

over 200. When asked if they had ever been treated before, most 

replied “Yes.” their story was that they had received medicines 

that did not work. pursuing this, i discovered that they had 

received three months of an antihypertensive. after they quit taking 

the medicine, their hypertension came back. their expectation 

was that, after three months, their problem should be cured; therefore, 

the medicine had not worked … tia. 

We saw a group from a local orphanage who came for a general 

checkup. they all had a scalp fungus that had been spread by using 

the same hair clippers on all the orphans. 

the last couple of days at this clinic, the temperatures were in the 

mid-70s. this led many patients to complain about the maladies 

they suffer in the “cold season.” When i explained how cold it got 

in seattle, patients’ eyes would open wide, and they would say, “i 

could never live there.” 

in the time we were there, more than 500 people were tested 

for Hiv/aiDs. about 7 percent tested positive. these people 

were immediately set up in a government treatment program. 

the 7 percent was less than we had expected. the government 

of tanzania has developed a program for Hiv/aiDs education 

and treatment that seems to be working. it is important to test 

people in the 20- to 40-year-old group. this is the high-risk

group, and many in that group assume they have Hiv/aiDs and 

do nothing to protect themselves. once they know they are Hiv/ 

aiDs-negative, they act more responsibly and take appropriate 

actions to protect themselves. 

We were able to provide hundreds of pairs of glasses. these were 

both reading glasses and corrective lenses up to +/-4 diopters. 

glasses are hard to come by in tanzania, and when available, the 

cost often puts them beyond the reach of most people. 

the hardest day of clinic is the last day. so many more people are 

lined up than we would be able to see. people are desperate for care, 

and it is hard to walk away from the need, but our days in africa 

have to end, for now. 

i am under no illusions that what we did will contribute a lot to the 

long-range medical care of those we were able to treat. but i believe 

what we did supply was hope. a hope that arises from a realization 

that somebody from thousands of miles away cares enough to travel 

to tanzania and stretch out a hand and say, “i see your plight, and 

i want to help.” 

i would encourage you to use your skills to reach out to a people in 

need — in africa, in asia, in central or south america, or in the 

united states. it could be with a team like e3 partners that seeks 

to meet spiritual as well as physical needs or a purely medical team. 

reach out to provide hope where desperation is the order of the day. 

the reward is unbelievable. take the adventure. 

i would be remiss if 

i did not acknowledge 

some people 

who made this trip 

for me possible. 

first, the surgeons at 

surgical associates 

of edmonds, Drs. 

carol cornejo, Kurt 

H a r m o n , t h o m a s 

J u r i c h , s t e p h e n 

m a c f a r l a n e a n d 

m i c h e l l e s i n n e t t , 

who supported me in 

many ways. also to 

the medical staff at stevens Hospital, whose generous donation 

provided the medicines needed to treat the hundreds of patients 

who came through the clinic. thank you! 

Glenn Knight is a physician assistant at Surgical Associates of 

Edmonds. He has worked there for the past 11 years. His first 

exposure to medicine was as a medic aboard an evacuation 

helicopter in Vietnam. He is married to Lisa, an operating room 

nurse. They have two children and five grandchildren. Glenn likes 

photography, playing golf and taking his Old English bulldog on 

walks. He has done medical missions to Honduras, Nepal and 

three trips to Tanzania. Future trips may include Uganda or a 

return to Tanzania. 


proliance surgeons ® Directory 

as one of the country’s largest 

surgical practices, proliance 

surgeons, inc., p.s., performs 

emergency and elective operations, 

treating illnesses and injuries that affect 

us all. proliance’s orthopedic surgeons 

have expert knowledge of general 

orthopedics and additional specialized 

training in sports medicine, joint reconstruction, 

arthroscopic surgery, spine 

surgery, hand surgery, foot surgery, 

fracture care, and major orthopedic 

trauma. our general surgeons have specialized 

training in vascular, bariatric 

and colorectal surgery. our otolaryngologists 

specialize in all aspects of ear, 

nose and throat surgeries. 

care centerS 

Bellevue ear, nose and 

throat clinic 

1135 116th ave. n.e., suite 500 

bellevue, Wa 98004 

(425) 454-3938 

510 8th ave. n.e., suite 310 

issaquah, Wa 98029 

(425) 454-3938 

cynthia K. anonsen, mD 

thomas a. Knipe, mD 

alice lee Kuntz, mD 

samson J. lee, mD 

Daniel r. seely, mD 

roger s. Zundel, mD 

cedar Surgical 

3124 s. 19th st., suite 220 

tacoma, Wa 98405 

(253) 301-5050 

leaza m. Dierwechter, mD 

W. michael Johnson, mD 

James J. schopp, mD 

virginia a. stowell, mD 

edmonds orthopedic center 

7320 216th st. s.W., suite 320 

edmonds, Wa 98026 

(425) 673-3900 

James r. alberts, mD 

brian D. cameron, mD 

Darcy s. foral, mD 

lawrence J. fowler, mD 

michael b. lee, mD 

Wren v. mccallister, mD 

Jeffrey p. remington, mD 

everett Bone and Joint 

1100 pacific ave., suite 300 

everett, Wa 98201 

(425) 339-2433 


Howard b. barker, mD 

lawrence J. fowler, mD 

ralph t. Haller, mD 

todd W. Havener, mD 

bill K. Huang, mD 

peter J. Kinahan, mD 

Jeff r. mason, mD 

John D. pryor, mD 

clay m. Wertheimer, mD 

evergreen orthopedic clinic 

12911 120th ave. n.e., suite H-210 

Kirkland, Wa 98034 

(425) 823-4000 

14841 179th ave. s.e., suite 330 

monroe, Wa 98272 

(360) 794-3300 

8301 161st ave. n.e., suite 102 

redmond, Wa 98052 

(425) 882-1661 

richard l. angelo, mD 

James a. champoux, mD 

camille m. clinton, mD 

mark a. freeborn, mD 

robin r. fuchs, mD 

ronald v. gregush, mD 

Kenneth c. lin, mD 

craig m. mcallister, mD 

gregory J. norling, mD 

J. scott price, mD 

James r. robbins, mD 

Jeffrey l. stickney, mD 

James D. swenson, mD 

evergreen Surgical clinic 

12333 n.e. 130th lane, suite 420 


(425) 250-4700 

Kelly a. clinch, mD 

John s. ebisu, mD 

marion c. Johnson, mD 

Harry a. Kahn, mD 

James g. mhyre, mD 

michael a. towbin, mD 

northwest orthopaedic clinic 

10330 meridian ave. n., suite 270 


(206) 526-8444 

2409 north 45th st. 


(206) 633-8100 

Herbert r. clark, mD 

robert s. clawson, mD 

timothy p. Daly, mD 

allen W. Jackson, mD 

northwest Surgical Specialists 

1560 n. 115th st., suite 102 


(206) 363-2882 

mark t. brakstad, mD 

paula l. Denevan, mD 

alison l. perrin, mD 

orthopedic Physician associates 

601 broadway 


(206) 386-2600 

m. Kevin auld, mD 

James p. crutcher Jr., mD 

Justin l. esterberg, mD 

alexis falicov, mD 

Jeffery l. garr, mD 

K. elizabeth garr, mD 

lawrence e. Holland, mD 

scott e. Hormel, mD 

e. edward Khalfayan, mD 

Jason c. King, mD 

richard m. Kirby, mD 

frederick b. lee, mD 

martin g. mankey, mD 

michael K. mcadam, mD 

charles a. peterson, mD 

John W. robertson, mD 

nicholas r. seibert, mD 

todd J. seidner, mD 

eugene “pepper” toomey, mD 

sean D. toomey, mD 

William J. Wilson, mD 

robert a. Winquist, mD 

eva Young, mD 

orthopedic Specialists of Seattle 

1801 n.W. market st., suite 403 


(206) 784-8833 

2409 north 45th st. 


(206) 633-8100 

philip r. Downer, mD 

Jonathan l. franklin, mD 

charles a. peterson ii, mD 

scott D. ruhlman, mD 

Joel a. shapiro, mD 

J. michael Watt, mD 

Wayne m. Weil, mD 

Proliance eastside ent 

1800 116th ave. n.e., suite 102 


(425) 451-3710 

8301 161st ave. n.e., suite 200 

redmond, Wa 98052 

(425) 869-4855 

tom f. gumprecht, mD 

Jennifer l. Heydt, mD 

eric f. pinczower, mD 

Proliance orthopaedic 

and Sports Medicine 

1135 116th ave., n.e., suite 510 


(425) 455-3600 



(425) 392-3030 

clayton b. brandes, mD 

James D. bruckner, mD 

thomas H. castle Jr., mD 

thomas D. chi, mD 

Jeremy a. idjadi, mD 

todd e. Jackman, mD 

gregory a. Komenda, mD 

peter r. mandt, mD 

ashit c. patel, mD 

steven s. ratcliffe, mD 

matthew J. robon, mD 

michael J. sailer, mD 

John l. thayer, mD 

Puget Sound ear, nose, and throat 

21616 76th ave. W., suite 112 


(425) 775-6651 

15021 main st., suite K 

mill creek, Wa 98012 

(425) 337-4810 

9730 3rd ave., n.e., suite 201 


(206) 526-9999 

Henry s. chang, mD 

tyler g. Kimbrough, mD 

John t. parker, mD 

Duncan a. riddell, mD 

shawn e. rogers, mD 

Puget Sound orthopaedics 

7308 bridgeport Way W., suite 201 

lakewood, Wa 98499 

(253) 582-7257 

1515 martin luther King Jr. Way 

tacoma, Wa 98405 

(253) 572-2663 

Julian s. arroyo, mD 

W. brandt bede, mD 

John m. blair, mD 

spencer a. coray, mD 

Jon f. geffen, Do 

sean ghidella, mD 

Dale l. Hirz, mD 

michael J. martin, mD 

gavin H. smith, Dpm 

steven m. teeny, mD 

alan b. thomas, mD 

rainier orthopedic institute 

3801 5th st. s.e., suite 110 

puyallup, Wa 98374 

(253) 845-9585

20920 sr 410 e 

bonney lake, Wa 98391 

(253) 845-9585 

Wendall W. adams Jr., mD 

steven c. brack, Do 

Wendy l. Heusch, Do 

frederic l. Johnstone ii, mD 

eric g. puttler, mD 

neal H. shonnard, mD 

John t. steedman Jr., mD 

anthony b. vanbergeyk, mD 

steven K. Yamamoto, Do 

Skagit island orthopedics 

1401 s. laventure rd. 

mount vernon, Wa 98274 

(360) 424-2400 

2511 m- ave., suite D 

anacortes, Wa 98221 

(360) 424-2400 

Don H. bodley, mD 

Jimmy Y. cui, mD 

Daniel m. Hanesworth, mD 

curtis W. rodin, mD 

Jonathan b. shafer, mD 

richard v. Williamson, mD 

South Seattle otolaryngology 

16259 sylvester rd. s.W., suite 505 

burien, Wa 98166 

(206) 242-3696 

David c. green, mD 

peter f. maurice, mD 

patrick H. mcclean, mD 

Southwest Seattle orthopaedic and 

Sports Medicine 

16259 sylvester road s.W., suite 501 


(206) 243-1100 

alan D. barronian, mD 

William l. clark, mD 

charles K. fujisaki, mD 

roger Y. Wong, Do 

Surgery associates 

16122 8th ave. s.W., suite D-1 


(206) 244-1680 

andrew J. Haputa, mD 

michael m. Kennelly, mD 

r. Holmes troutman, Jr., mD 

Surgical associates of edmonds 

7315 212th st. s.W., suite 201 


(425) 778-8116 

carol J. cornejo, mD 

Kurt e. Harmon, mD 

thomas J. Jurich, mD 

steven D. macfarlane, mD 

michelle J. sinnett, mD 

Valley orthopedic associates 

4011 talbot rd. s., suite 300 

renton, Wa 98055 

(425) 656-5060 

27005 168th pl. s.e., suite 201 

covington, Wa 98042 

(253) 630-3660 

michael D. allison, mD 

craig t. arntz, mD 

William p. barrett, mD 

traci g. barthel, mD 

susan r. cero, mD 

b. Daniel chilczuk, mD 

John m. Hendrickson, mD 

christopher r. Howe, mD 

John p. Howlett, mD 

fredrick s. Huang, mD 

eric J. novak, mD 

mark c. remington, mD 

niket shrivastava, mD 

Jason H. thompson, mD 

martin s. tullus, mD 

robert g. veith, mD 

Dan Wilcox, mD 

Washington Hand Surgery 



(425) 823-4224 

1200 112th ave. n.e., suite c-154 


(425) 283-5230 

todd m. guyette, mD 

allison J. maclennan, mD 

edward r. north, mD 

steven l. reed, mD 

steven D. sun, mD 

loryn p. Weinstein, mD 

With 36 care centers, eight mri 

centers, six physical therapy clinics 

and 12 surgery centers conveniently 

located throughout Washington’s 

King, snohomish, pierce, island, san 

Juan, and skagit counties, proliance’s 

165 physicians and its providers 

deliver the highest quality care available. 

for more information, including 

a list of physicians and directions 

to our clinics and centers, please visit 

www.proliancesurgeons.com. 

Additional services... 

aMBulatorY 

SurgerY centerS 

edmonds center for 

outpatient Surgery 

7320 216th st. s.W., suite 140 


(425) 673-3750 

everett Bone and 

Joint Surgery center 

1100 pacific ave., suite 100 


(425) 317-8535 

evergreen orthopedic 

Surgery center 



(425) 216-7000 

evergreen Surgical clinic 

ambulatory Surgery center 

12333 n.e. 130th lane, suite 420 


(425) 250-4700 

lakewood Surgery center 

7308 bridgeport Way s.W., suite 102 

lakewood, Wa 98499 

(253) 584-5252 

Proliance Highlands Surgery center 



(425) 507-0800 

Seattle orthopedic center Surgery 

2409 n. 45th st. 


(206) 633-8100 

Seattle Surgery center 

900 terry ave., 3rd floor 


(206) 382-1021 

Skagit island orthopedic 




(360) 434-2480 

Southwest Seattle ambulatory 


275 southwest 160th st., suite 200 


(206) 988-0927 

the Surgery center at rainier 

3801 5th st. s.e., suite 210 


(253) 445-4285 

Valley orthopedic associates 

ambulatory surgery center 

4033 talbot road s., suite 270 

renton, Wa 98055 

(425) 226-2041 

Mri 

eastside Mri 



(425) 823-4226 

edmonds orthopedic center Mri 

7320 216th st. sW, suite 320 


(425) 673-3900 

everett Bone and Joint Mri 

3102 colby ave. 


(425) 258-8110 

orthopedic Physician 

associates Mri 

900 terry ave, suite 100 


(206) 694-6665 

Proliance Highlands Mri 



(425) 507-0810 

ProSports imaging n.W. 

3801 5th st. s.e., suite 120 


(253) 864-4106 

Seattle orthopedic center Mri 

2409 n. 45th st. 


(206) 633-8100 

Star Mri 

8009 s. 180th st., suite 105 

Kent, Wa 98032 

(425) 656-0711 

PHYSical 

tHeraPY 

edmonds orthopedic therapy 

7320 216th st. s.W., suite 320 


(425) 673-3916 

evergreen orthopedic 

Physical therapy 



(425) 216-7075 

Proliance Sports therapy 

and rehab of Bellevue 

1200 112th ave. n.e., suite c-260 


(425) 462-5006 

Proliance Sports therapy and rehab 

of issaquah 



(425) 313-3055 

Seattle orthopedic 

center Physical therapy 

2409 n. 45th st. 


(206) 633-8100 

Skagit island orthopedic 

Physical therapy 



(360) 424-2400 


one of the questions i get asked more 

and more when i am discussing 

hearing-aid options with patients is 

how well they work with a cell phone. it used 

to be a difficult question that often meant a 

conversation with their cell phone carrier to 

find out about the hearing-aid compatibility 

of their cell phone. now it’s a question i can 

answer easily. many hearing aid manufacturers 

have answered their consumers’ call for 

instruments that are in step with today’s technological 

trends. traditionally, if you wanted 

to use a landline phone, a hearing-aid wearer 

would access a device in his or her hearing aid 

called a telecoil. the telecoil uses the electromagnetic 

field generated by the phone, and 

the signal is then amplified as needed for the 

wearer. cell phones do not have this electromagnetic 

field, so they must be manufactured 

to be hearing-aid compatible through the 

telecoil; however, most of my patients report 

that the quality is not very good. 

patients are now much more tech-savvy 

then they had been in the past, and a 

greater number of hearing-aid wearers are 

using cell phones. now that cell phones 

are typically bluetooth-compatible, hearing-aid 

manufacturers use this compatibility 

through accessories that interface 

with both the hearing aids and the cell 

phone (and other bluetooth-compatible 

devices). several manufacturers have developed 

devices that, when worn around your 

neck, create a little wireless network for the 

hearing-aid wearer. most of these devices 

also have a jack to plug in other mp3 players 

or music players. in some cases, these 

devices also act as a remote for the hearing 

aid to make volume and program changes. 

When at home, patients and their families 

often complain about the volume of 

the television being either too quiet for the 


hearing-impaired individual or being too loud 

for other members of the household. this 

complaint has lead to another capability that 

has been incorporated into the new hearing 

aid interface devices. oticon and phonak, 

two of the leading hearing-aid manufacturers, 

have developed a small box or transmitter 

that is paired to your interface and plugged 

into the audio output at the back of the tv 

to send the sound from the tv directly to the 

wearer’s hearing aid, allowing another individual 

to control the volume of the tv itself. 

oticon has even developed a transmitter for 

the landline phone. i fitted a patient with 

a set of his or her hearing aids and the full 

connectline set (streamer, connectline tv 

and connectline phone), and after one week 

of use, he happily reported that not only was 

it very easy to set up, but it had also allowed 

him to become a complete couch potato. He 

could sit on his couch, watch tv and answer 

the phone (which sat in the kitchen) all with 

the push of a button. the mp3 located on 

the hearing-aid interface allows patients to 

hear music amplified for their hearing loss 

sent right to their hearing aids. i love seeing 

my patient’s faces light up when they hear 

music sound clear and natural — better than 

it has in a long time. 

another change that is coming down the 

road is the increased use of loop systems 

(an “older” technology), already in wide use 

throughout the united Kingdom and the 

nordic european countries. at Heathrow 

airport, a hearing-aid wearer can switch his 

or her hearing aids into the telecoil program 

and hear all of the announcements broadcast 

to their ears, eliminating difficulties caused 

by background noise, and using your telecoil 

at Westminster abbey will allow you 

to hear the sermon clearly without the echo 

inherent in speech in a large cathedral. in 

My Hearing 

Aid Can 

Do What? 

by suzy Jackson, auD, f-aaa 

new York city, 13 taxis tested the use of 

loop systems, which was so successful that 

it resulted in the nYc taxi and limousine 

commission approving voluntary installation 

in all of its licensed vehicles. in many 

cities, the local Hearing loss association 

chapters are advocating the use of loops in 

public venues, such as grand rapids airport 

in michigan. in the seattle area, there are 

churches and retirement facilities that have 

installed induction loops. Highline christian 

church, Des moines methodist church, 

salt Water universalist unitarian church, 

fauntleroy united church of christ, West 

seattle christian church, Wesley Homes 

and the chapel at Judson park are a few of 

the facilities that have the devices installed for 

use with telecoils. the great thing about the 

loop systems is that they are relatively inexpensive 

(around $250 for a system to loop a 

home living room), easy to install and require 

little upkeep. an in-home loop system can 

be used with many patients’ current telecoilequipped 

hearing aids to increase the clarity 

of the television or stereo by decreasing or 

eliminating competing noise. 

i am so excited about the ways hearing aids 

can be used and interfaced with other devices 

now because it has helped hearing-impaired 

people reconnect with the things they enjoy. 

Suzy Jackson, AuD, F-AAA, 

is a doctor of audiology at 

South Seattle Otolaryngology. 

Dr. Jackson obtained her doctorate 

of audiology from Salus 

University and her Masters 

of Audiology from Western 

Washington University.

Orthopedic Physician Associates’ 

Annual Charitable Drive for Childhaven 

sheila cahill is a surgery scheduler at orthopedic 

physician associates (opa), a busy orthopedic practice 

located in seattle. scheduling surgery requires meticulous 

attention to detail, multi-tasking, excellent communication 

and commitment to patients. each year, sheila 

parlays these skills into coordinating opa’s annual 

charity event that benefits childhaven, a local organization 

providing therapeutic day care for infant and child 

victims of abuse and neglect. 

several years ago, while living in nevada, sheila volunteered for a child 

service organization and sought a similar charity to which she could 

donate her time after moving to seattle. childhaven is a nonprofit 

agency in King county dedicated to the mission of healing young and 

vulnerable victims of abuse while breaking the cycle of violence and 

trauma. childhaven provides developmental therapy and individual 

attention to children and their families in an effort to prevent abuse 

and promote enduring relationships. multiple resources are necessary 

for carrying out this mission, including staff members, social workers, 

mental health counselors and health care staff members. providing 

comprehensive care poses a financial and resource burden, which is 

alleviated by the commitment of individuals such as sheila. 

in addition to rendering the basic care and attention to childhaven’s 

clientele, there are special initiatives that contribute to the children and 

their families. one such project is the christmas gift drive that guarantees 

each child receives a toy and basic clothing, including a coat, shoes, 

pajamas, undergarments, etc. many of these children have never had 

new toys or clothing; a new gift is beyond expectations for children who 

are accustomed to chaos and uncertainty. 

beginning in late october or early november, childhaven provides 

sheila with a list of enrolled children ages 6 months to 5 years, although 

the majority of kids are between the ages of 2 and 5. at this point, 

sheila shifts into high gear, distributing flyers among her coworkers and 

the health care providers at orthopedic physician associates, seattle 

surgery center, swedish orthopedic institute and various service and 

equipment vendors, identifying each child’s name, age, clothing size 

and favorite book/television character or toy. many employees “adopt” a 

child and purchase clothing, toys and educational products for the child. 

other employees, many of whom have similar-aged children, donate 

several popular toys and books for general distribution among the kids. 

some employees contribute cash, allowing sheila and her helpers to 

purchase gifts. ensuring that every child receives gifts and clothing 

requires hours of shopping and a system for tracking the purchases, as 

well as gift bags, wrapping tissue, ribbons, etc. each evening, sheila 

dedicates approximately three hours for coordinating these activities 

and turns her dining room into a temporary warehouse. Weekends are 

spent shopping, taking advantage of holiday sales offered by various 

retailers. once shopping is completed, sheila assembles festive bags 

containing each child’s gifts and then arranges delivery to childhaven 

in early December. 

there were approximately 68 children in 2005, the first year that sheila 

began this campaign. the number of children has increased every 

year, with 105 children receiving gift bags in 2009. the generosity of 

employees at orthopedic physician associates has met this increasing 

demand despite a sagging economy. according to sheila, helping others 

is the ultimate gift and symbolizes the true meaning of holiday charity! 


more commonly referred to as fainting or 

passing out, syncope is the medical term for 

a momentary loss of consciousness. syncope 

is by no means an unusual occurrence. in 

fact, the majority of the general population 

will experience it at some point in their lives. 

most experiences of fainting are not dangerous 

and not a cause for alarm, but determining 

what is and is not dangerous can be a 

challenge for physicians. 

causes 

identifying causes for syncope can be difficult 

because a wide range of possibilities can result 

in fainting. the most common type of syncope 

is vasovagal. it is a drop in blood pressure, 

which can result in the brain not receiving 

enough oxygen and then a loss of consciousness. 

this type of syncope generally follows 

the body’s reaction to certain triggers, such as: 

• the sight of blood 

• stress 

• Having blood taken 

• Hunger or dehydration 

• caffeine 

• alcohol 

• Heat 

• standing for too long 

• exertion 

being careful to avoid triggers responsible for 

syncope and watching for early symptoms 

can be useful tools to prevent fainting. some 

of those symptoms include lightheadedness, 

losing color in the face, nausea and feeling 

weak. the best response to these symptoms 

is to lie down and elevate the feet, preventing 

the blood from pooling in the legs. 

syncope testing 

although the vast majority of syncope cases 

are benign, contacting a physician is always 

a safe course of action. syncope can, in some 

circumstances, result in life-threatening con- 


Feeling Faint? 

Diagnosing anD TreaTing syncope 

by Deanna strange 

on a busy morning, you rush out of the house without taking time for breakfast. You hurry through a 

jam-packed morning of meetings, projects and deadlines, only slowing down for a quick cup of coffee. 

You stand up to head out for a late lunch — but instead, the world around you starts to go dark, and 

you feel yourself sliding to the floor. You have just experienced syncope. 

ditions. after any first episode of syncope, a 

person should come in to see a physician. 

as a diagnosis of the cause of syncope can be 

complicated, the first step is a detailed history 

of what led to the episode. Determining if 

the patient was sitting or standing, if he or 

she had just eaten or taken any medications 

or alcohol and if there is a history of heart 

attack or stroke can provide the physician 

with critical information. a possible next 

step is the tilt-table test. fainting episodes 

can be difficult to witness, but this test allows 

circumstances to be recreated in a controlled 

and safe environment. the patient will lie 

down on a table that tilts from horizontal to 

vertical. electrodes are placed on the body 

and connected to an electrocardiogram, and a 

blood pressure cuff will be on the arm. this 

test evaluates how the body responds to the 

vertical position and can help determine if a 

drop in blood pressure from standing causes 

the fainting. 

some heart conditions, such as arrhythmias, 

or abnormal heartbeats, or the rare 

hypertrophic cardiomyopathy can result in 

syncope and need to be monitored carefully. 

ultrasound is another useful test for determining 

cardiac irregularities. it can recognize 

a prior heart attack, aortic valve stenosis — an 

abnormal narrowing of the aortic valve — 

or congenital heart disease. to get a more 

accurate assessment of the cardiac electrical

system, a patient may have to take home 

and wear a device called a Holter monitor 

for a period of time. the monitor records a 

patient’s heartbeat over a 24-hour period. 

treatment 

like diagnosing syncope, choosing the correct 

treatment method can be challenging. 

vasovagal syncope generally doesn’t require 

treatment, but in some cases where episodes 

occur a couple times a week, anti-depressants 

or anti-anxiety medications may be prescribed. 

vasovagal episodes are abnormal 

reflexes — part of the sympathetic nervous 

system, which produces the flight-or-fight 

response. certain people, when shocked or 

surprised, abnormally trigger the sympathetic 

nervous system, which sends out an inappropriate 

signal, causing blood to rush from 

the head, and they pass out. beta-blockers 

are also commonly used to treat vasovagal 

syncope because they block signals to the 

nervous system that cause fainting. another 

treatment method a physician may recommend 

is compression stockings, which help 

with low blood pressure and preventing blood 

from pooling into the legs. 

the trouble with treating syncope is being 

sure it is benign syncope and not cardiacrelated. 

at a lower risk for danger are people 

who have a drop in blood pressure. if someone 

comes in to a physician’s office who has 

passed out while walking and is uninjured, 

the episode of syncope happened slowly and 

was probably low blood pressure. by contrast, 

if the patient comes in with a fracture, it 

happened quickly and is more likely an 

arrhythmia. arrhythmias or other heart conditions 

may be treated with a pacemaker, an 

implantable cardioverter defibrillator, cardiac 

ablation or medications, depending on the case. 

While rare, syncope can be confused with 

narcolepsy and cataplexy. narcolepsy is a 

neurological disorder that causes a sudden 

and unavoidable need for sleep, and cataplexy 

is the sudden loss of voluntary muscle tone. 

like vasovagal syncope, sleepiness caused 

by narcolepsy can generally be recognized 

in time to prevent major accidents, such as 

falling asleep while driving. the most recognizable 

difference to someone who is undiagnosed 

would be the side effects upon waking, 

as someone with narcolepsy will usually wake 

up feeling normal, whereas someone with 

syncope will usually wake up feeling terrible. 

syncope can be a confusing condition for 

patients to understand. but with the help of 

a trained, qualified physician, syncope doesn’t 

have to be a condition that leaves patients in 

the dark. 

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