Toilet Training Your Child

A Publication for Friends and Patients of The Everett Clinic
FALL 2015
Medicare open
enrollment for 2016 is
October 15 – December 7.
Toilet Training Your Child
By Susana Myers, DO and Aisha Reuler, MD
The Everett Clinic Pediatrics team
B
y the time your child reaches their
second and third years of life, the
daunting task of getting them out of
diapers and transitioning to using the
toilet has probably crossed your mind
or is on your to-do list.
Medicare Open
Enrollment
I
t’s open enrollment time again! The
federal government regulates the open
enrollment period for changing Medicare
plans. This year, enrollment will occur
October 15 – December 7, 2015. Coverage
begins January 1, 2016.
Did you know you have options when
choosing a Medicare plan? Do you
understand what your options are? The
Everett Clinic would like to help you
understand the issues associated with
Medicare at our complimentary open
enrollment information sessions. At these
sessions, we will provide information to
help you understand:
■■ Background on Medicare
■■ The Everett Clinic Medicare policy
■■ Why managed Medicare Advantage
plans are encouraged
■■ Tools and resources for decision-making
To find out the time and location of open
enrollment sessions, and to register for
these free sessions, visit: everettclinic.
com/medicare.
Medicare Advantage
Whether you already have Medicare or are
turning 65 and about to join, The Everett
Clinic encourages you to choose coverage
from a Medicare Advantage plan. Medicare
Advantage offers several benefits over
original Medicare, especially coordinated
care. That’s why we only contract with
Medicare Advantage plans that focus on
preventive care and disease management.
We believe the best way to be healthy is to
stay healthy.
To find out which Medicare Advantage plans
are accepted at The Everett Clinic, and to
find a list of resources that can assist you,
visit: everettclinic.com/medicare.
Open Enrollment:
October 15 – December 7, 2015
Coverage Begins:
January 1, 2016
Medicare Education Sessions:
everettclinic.com/medicare
everettclinic.com
In the first 12 months of life, children
are not able to control their bladder
or bowel movements, but by 18 to 24
months many children have reached
this milestone. If your child is showing
signs of readiness, they may be ready
to be potty trained.
Your child may be ready to begin
toilet training if they:
Always ask your pediatrician
if you have questions or
concerns about your child.
■■ Express interest in toilet training
■■ Demonstrate independence and use the word “no”
■■ Can follow simple instructions
■■ Are dry at least two hours at a time during the day or after naps
■■ Have recognizable cues that they are about to urinate or have a bowel movement
■■ Can walk to the bathroom, sit, and pull clothes up and down independently
Keep in mind that it can be normal for some children to be ready later than this
and children with certain medical conditions or developmental delays
may be embarking on toilet training at even older ages.
Toilet Training 101:
■■ Make a plan. Decide when and how you want
to start, how to handle accidents, and when to
back off (i.e. illness, arrival of a new sibling,
toilet training resistance). Discuss your plan with
your childcare providers.
■■ Take it slow. Mastering the various steps of potty
training can take a few days to a few months.
Let your child take their time and they will move
from one stage to the next at their own pace.
■■ Buy the right equipment. Buy a floor level
potty training chair that allows your child’s feet
to touch the floor when they sit down on it.
■■ Practice. Have your child practice sitting on
the chair. Watch for signs they need to use the
bathroom such as holding the genital area or
pulling at their pants.
■■ Motivate your child. Use gentle reminders
and encouragement. If your child uses the potty,
make sure to reward them with treats, stickers,
and plenty of praise and hugs.
■■ Transition when ready. Once your child is
using the potty training chair, introduce loose
fitting underwear they can easily pull up and
down by themselves. Once you start your child
wearing underwear, use diapers only for naps,
bedtime or when traveling.
■■ Remember, it’s a process. It’s likely your
toddler will have many accidents before being
completely potty trained. Avoid getting angry,
yelling, or punishing.
If your child starts to resist at any step, it’s okay
to back off and try again in a few weeks. If it
continues to be a struggle, or if you have any
questions about the process, always talk to your
pediatrician.
Susana Myers, DO, MPH, and Aisha Reuler, MD, are
pediatricians with our Harbour Pointe Pediatrics Team.
Both Dr. Myers and Dr. Reuler are board certified in
pediatrics. Meet them at everettclinic.com/HPPeds.
Flu Shot Clinics
Have you received your flu
shot? The Centers for Disease
Control and Prevention (CDC)
recommends a yearly flu
vaccine for everyone six months
of age and older as the first
and most important step in
protection from influenza.
There are still a few flu shot
clinics available, so if you
haven’t received yours yet, visit
everettclinic.com/flu to find the
next flu clinic near you.
Update Your Flu Shot
Information in MyChart®
If you have MyChart and received a flu shot
somewhere other than The Everett Clinic,
send a message to your provider’s office
through MyChart stating when and where
you received your flu vaccination. We will
update your medical record for you!
On average, 1 in 5 Americans will get the flu.
Protect yourself – get the flu vaccine!
Urinary
Incontinence:
Loss of Bladder Control
By Stephen Mock, MD
The Everett Clinic Urology team
U
rinary incontinence is defined as the loss
of bladder control and is a common and
often embarrassing problem. Urinary
incontinence isn’t a disease, rather a symptom
that can be caused by everyday habits, underlying
medical conditions or physical problems.
Factors that increase your risk of developing
urinary incontinence include:
stress incontinence. Pregnancy, childbirth,
menopause and normal female anatomy
account for this difference. However, men with
prostate gland problems are at increased risk
of urge and overflow incontinence.
Age. As you get older, the muscles in your
bladder and urethra lose some of their
strength. Changes with age reduce how
much your bladder can hold and increase the
chances of involuntary urine release.
■■ Being overweight. Extra weight increases
pressure on your bladder and surrounding
muscles, which can weaken them and allow
urine to leak out when you cough or sneeze.
or diabetes may increase your risk of
incontinence.
By Sara Worden, MD, FASCRS
The Everett Clinic Surgery team
■■ Overflow incontinence. You experience
frequent or constant dribbling of urine due to a
bladder that doesn’t empty completely.
■■ Mixed incontinence. You experience more
than one type of urinary incontinence.
If incontinence is frequent or is affecting your
quality of life, it’s important to seek medical
advice. Urinary incontinence may indicate a more
serious underlying condition, cause you to restrict
your activities and limit your social interactions,
or increase the risk of falls in older adults as they
rush to use the restroom. For most people, simple
lifestyle changes or medical treatment can ease
discomfort or stop urinary incontinence.
Keeping a healthy colon
The good bacteria
■■ Focus on probiotics, such as yogurt
This all means that bacteria are part of our normal
intestinal environment and serve a very useful and vital
purpose in our everyday body function. In order to make
sure your colon is healthy and working at its full potential,
here are some habits to keep in mind.
Our colons are full of good bacteria. In fact, approximately
100 trillion organisms call our bowels home. These bacteria
in the gut fulfill a variety of important functions, such
as aiding digestion, stimulating cell growth, blocking the
growth of harmful bacteria, training the immune system
to respond to disease causing pathogens and defending
against some diseases.
■■ Get plenty of prebiotics, such as whole grains, onions,
garlic, leeks and artichokes
■■ Get plenty of fiber (aim for 20-25 grams daily)
■■ Avoid fatty food
■■ Control your stress
■■ Don’t hold bowel movements
■■ Get adequate hydration
The bad bacteria
Sometimes the good bacteria in the gut die as a result of
illness (such as the flu) or taking antibiotics. When the
good bacteria are killed, it upsets the balance of bacteria
in your colon, which results in diarrhea (watery bowel
movements) since your colon can’t absorb water as it
normally does. It can also cause an upset stomach.
Did you know that colon
cancer can develop in
people who have no
symptoms or family
history? Colon cancer
is preventable when
detected early so don’t
delay… one test can
make a big difference.
Our gastroenterology
department is currently
able to see patients
within the same
week. To schedule an
appointment, call
425-339-5421.
■■ Exercise regularly
■■ Get a colonoscopy screening if appropriate
Sara Worden, MD, FASCRS, is a colorectal surgeon with our surgery
team. Dr. Worden is board certified in surgery and colon and
rectal surgery. Meet Dr. Worden at everettclinic.com/worden.
For a healthy colon,
eat 20-25 grams
of fiber daily.
Behavioral Health
Behavioral Health continued
Behavioral Health continued
Cancer/Oncology continued
Dermatology
Family Medicine continued
Gastroenterology continued
Arjun Bansal, MD
Laura Donnell, ARNP
William Kelleher, PhD
Elizabeth Tadina, ARNP
Mill Creek
425-339-5453
Smokey Point
360-454-1953
Everett
425-297-5560
Mary Kay Graves,
ARNP
Jonathan Wolman,
ARNP
Corina Manea, ARNP
Everett
425-339-5453
Everett
425-339-5417
Stanwood
360-629-1504
Family Medicine
Gastroenterology
Comprehensive
Pain Center
Elizabeth Bielstein,
ARNP
Smokey Point
360-454-1953
Cristin Cunnington,
LICSW
Smokey Point
360-454-1953
Everett
425-339-5421
Constance Guy, LF
Cary Peterson, LH
Dhavan Parikh, MD
Everett
Lake Stevens
425-339-5453
Everett
425-339-5453
Everett
425-339-5421
Cancer/Oncology
Christopher Merifield, MD Luis Enriquez, MD
Everett
425-304-8476
Silver Lake
425-357-3304
– Jeff Bissey, MD, COO
| PAGE 2 |
Age 50?
Had that
colonoscopy?
he colon is a misunderstood organ – most people have
heard of the colon, but many people do not understand
the important tasks it performs in the human body. A
healthy adult colon is about six feet long and works to
remove water from waste material before it leaves the
body, as well as helping remove toxins and absorb various
vitamins and nutrients into the bloodstream.
“The Everett Clinic
is growing fast to
meet the needs of
our community.
We have already
hired over 120
providers this
year alone and
will maintain
that pace for
years to come.
We plan to add
new sites and
expand many
of our current
locations over the
next five years! ”
■■ Urge incontinence. An involuntary loss of
Your Gut Healthy
T
Welcome
New
Providers
coughing, sneezing, laughing, exercising or
lifting something heavy.
Stephen Mock, MD, is a urologist with our Urology team.
He has a special interest in Urodynamics, Female Pelvic
Medicine and Urogenital Reconstruction. Meet Dr. Mock
at everettclinic.com/mock.
■■ Other diseases. Neurological disease
Colon Health: Keeping
■■ Stress incontinence. Urine leakage with
urine associated with a sudden and intense
urge to urinate.
■■ Gender. Women are more likely to have
■■
There are many types of urinary
incontinence:
Everett
425-339-5421
Marie Wydra, ARNP
Supriya Kang, MD
Mill Creek
425-339-5453
Jianfeng Cheng, MD,
PhD
Everett
425-339-5421
Yoshio Inoue, MD
Everett
425-297-5560
Weiging (Alan) Ng, MD
Andrew Selvarajah, MD
Everett
425-304-8476
Harbour Pointe
425-493-6004
Smokey Point Medical Center
T
he Occupational Medicine team at The Everett Clinic is here to treat your workplace
injury and help you return back to daily activities as soon as possible. The
Occupational Medicine providers in
Everett and Smokey Point are specialists in
work-related injuries and can help coordinate
Occupational Medicine
your care and return to work processes. The Everett Clinic Occupational Medicine
providers can help navigate the complicated
workers compensation system and:
Growing to meet the
needs of the community
■■ File your claim at your first appointment,
if not done previously
The Everett Clinic Smokey Point Medical Center opened in
2012 with over 20 medical specialties in more than 60,000
square feet. To meet the growing needs of our community,
we recently completed an expansion that includes:
■■ 20 new exam rooms
■■ Growing our Behavioral
Health, Podiatry,
Gastroenterology, Family
Medicine, Imaging,
Orthopedics, Pediatrics,
Physical Therapy and
Walk-In Clinic teams.
■■ Navigate the L&I system and pull
together the resources you need
■■ Be a liaison to your employer and L&I
team regarding your claim
“We are excited to open
our newly expanded
addition in our Smokey
Point location. We are
continuing to grow and
add additional services
for our patients, with
a focus on improved
access and innovation.”
■■ Athletic trainers joining our
Sports Medicine team
■■ Coordinate your care as your attending
provider or provide a one-time
consultation
■■ Assist to reopen your prior claim
- Colleen Clark, Director
■■ An additional self-check-in kiosk
■■ Addition of Exilis laser to Cosmetic Surgery
For more information, visit everettclinic.com/occmed or to schedule an appointment,
call: 425-339-5489.
To learn more, visit everettclinic.com/smokeypoint.
Self-Check-In Kiosks:
Making Check-In Easier
“We checked
in at the
kiosk and
the nurse
met us
around the
corner no waiting!”
Staff
frequently
wipe down
the kiosk to
eliminate
germs
Caring for
Injured Workers
If you are injured on the job, you should
seek care for acute injuries that need
immediate attention. Most of our Walk-In
Clinics are open seven days a week and the
Walk-In Clinic (or your primary care provider)
may refer you to us. The Everett Clinic is
one of six Centers of Occupational Health and Education (COHE) in Washington State.
Our objective is to improve worker outcomes and reduce disability by training providers
and coordinating the medical treatment of our patients with work-related injuries.
Decreased
appointment
check-in
time
Pay your
bill or
co-pay
Hand
sanitizer
available at
every kiosk
station
A receptionist is always
available at our self-check-in
kiosks to provide help.
Increased
convenience
and
privacy
Update
personal
information,
verify insurance
information and
sign electronic
documents
Available
at most
Everett Clinic
locations
Receptionist
always
available
Heart ' Vascular
Nephrology
Ophthalmology
Pediatrics
Pediatrics continued
Physical Therapy continued
Podiatry
Surgery
Apurva Badheka, MD
Katrina Carli, MD
Yasmin Shayesteh, MD
Daniel English, DPT
Elizabeth Kurtz, DPM
Sara Worden, MD
Everett
425-339-5413
Everett
425-339-5435
Sarah Bergman Lewis,
MD
Tracy Whittaker, ARNP
Everett
425-339-5411
Marysville
360-651-7492
Smokey Point
360-454-1945
Smokey Point
360-454-1907
Everett
425-339-5442
Occupational
Medicine
Orthopedics
Smokey Point
360-454-1900
Feng Wang, MD, PhD
Everett
425-339-5411
Internal Medicine
Carolyn Hawk, MD
Yury Filitovich, PA-C
Hee Yon Sohng, MD
Everett
425-339-5489
Smokey Point
360-454-1947
Smokey Point
360-454-1900
Urology
Stephanie Wu, MD
Dean Myers, MS, PT
Megan Wilder, DPM
Lake Stevens
425-397-1702
Smokey Point
360-454-1945
Everett
425-339-5407
Stephen Mock, MD
Everett
425-339-5443
Physical Therapy
Kristine Takamiya,
ARNP
Harbour Pointe
425-493-6001
Mark Friedman, MD
Everett
425-339-5447
Harbour Pointe
425-493-6002
Agnes Borjal, PT
Harbour Pointe
425-493-6080
Everett
425-339-5419
For detailed information, visit:
everettclinic.com/physicians
| PAGE 3 |
Emily Wallingford, DPT
Emily Waight, ARNP
MyChart: Your Health on Your Time
With MyChart®, our online medical record
system, you can access your health information
whenever you need it, wherever you are. With
MyChart you can:
■■ Schedule an appointment for primary care
and select specialty departments
Get a new
look this fall!
Bring in this
coupon for
3O
■■ View your health summary, current health
conditions and health history
■■ View current medications and request
prescription renewals
■■ Make payments to your Clinic accounts
Sign up for MyChart by
calling 425-258-3904,
or ask the next time
you come in for an
appointment.
■■ Schedule an E-visit for select conditions
%
■■ View most lab results within hours of your
test and trend them over time
off
Online
scheduling
through MyChart
now available for:
Primary Care
Allergy
Endocrinology
Heart & Vascular
Neurology
Rheumatology
Kate Spade, Nike, Nine West and Flexon
frames with lens and frame purchase.
Coupon valid through 11/30/15. Cannot be combined with any
other offer or discount. Not compatible with most insurance plans.
Everett n Harbour Pointe n Smokey Point
425-339-5436 | everettclinic.com/vision
You can access MyChart using the mobile
app available in your app store!
Are your symptoms
really allergies?
How can we help you today?
When you call any of our primary care departments,
your call is directed to our Resource Center. The
Everett Clinic Resource Center is a dedicated team
of nurses, medical assistants, pharmacists and phone
representatives working together to assist our patients.
Our Resource Center staff is located outside clinical
offices, which gives them the time and opportunity
to address all your needs while on the phone – you
are their top priority. For more
information about how we
help expedite your
primary care call, visit:
everettclinic.com/phone.
3901 Hoyt Avenue
Join the conversation
facebook.com/TheEverettClinic
twitter.com/EverettClinic
youtube.com/TheEverettClinic
Familytalkblog.com
■
Everett, WA 98201
Customer
Services:
425-258-3900
Monday – Friday:
7 am – 7 pm
Would you like to
receive the Connection
newsletter via email?
Sign-up at
everettclinic.com/connection.
PRSRT STD
U.S. Postage
PAID
K&H
Dementia Caregiver Support Group
Saturday, November 14, 10 am – 12 pm, or
Wednesday, December 9, 1 – 3 pm
Everett: This complimentary course covers the difficult
Everett: This free support group provides a caring place
for caregivers and is open to all care partners, family and
friends of individuals with dementia or memory loss. To
register, call: 425-317-3482.
Conquering Anxiety Group
At The Everett Clinic, your hearing aid purchase includes
all follow-up service to adjust and maintain your optimum
hearing over time. Make an appointment today.
any wireless hearing aid
| PAGE 4 |
Stay connected!
Your Life, Your Wishes
decisions faced as the end of life nears. These matters can
be hard to discuss, but having conversations ahead of time
can ensure the best of care. Includes FIVE WISHES™,
advanced directives, power of attorney and POLST forms,
and other end of life related issues. To register, visit:
everettclinic.com/classes, or call: 425-257-1492.
n 425-339-5401 n
everettclinic.com
Community
Classes
S u p p o r t · W e l l n e s s · I n f o r m at i o n
Fall savings
for better
hearing!
4027 Hoyt Ave., Everett
■
The Everett Clinic “Connection” IS Published by The Everett Clinic Marketing Department ■ To be added or
removed from The Connection mailing list, please visit: everettclinic.com/connection or call 425-304-1132.
Are you still suffering from allergy
type symptoms even though allergy
season is over? Many times, chronic
infections can feel like allergies. Make an appointment with one of our
board certified Allergists today to
determine the cause of your symptoms. Same day appointments are available!
To schedule an appointment,
call 425-339-5412. Everett
Harbour Pointe
Lake Stevens
Marysville
MILL CREEK
Silver Lake
SMOKEY POINT
Snohomish
Stanwood
Coupon valid
through 11/30/15.
Present at time
of order. Cannot
be combined with
any other offer or
previous purchase.
everettclinic.com/hearingaid
Everett: Learn mindfulness and acceptance, relaxation
techniques and how to cope with panic attacks as you
develop skills and strategies for conquering your anxiety.
To register, call: 425-339-5453.
Empowerment Group
Everett: Reconnect with your own personal power in life
by learning to take action, be assertive, set boundaries and
enhance your wellbeing. To register, call: 425-339-5453.
DBT Skills Training Group
Everett: Dialectical Behavior Therapy skills can help
people live happier, healthier lives. A referral from your
Behavioral Health provider is required to join this sixmonth training course. To register, call: 425-339-5453.
Newborn Basics
Everett: Join our pediatricians as they help you prepare
for your newborn’s first few months of life. Topics include:
feeding, sleeping, soothing, safety, signs of illness and
much more. To register visit everettclinic.com/classes, or
call: 425-258-3900.
Getting Better Group
Everett: The Getting Better Group is for those dealing
with pain (chronic or injury related) or other physical
symptoms that affect their mental and emotional health.
Learn to cope with anxiety and depression related to your
physical symptoms. To register, call: 425-339-5453.
Teen Skills Group
Mill Creek: For teens ages 13-19, this group focuses
on anxiety, depression and your peers. Develop skills to
manage anger, anxiety and depression more effectively
and learn about conflict resolution. To register, call:
425-339-5453.
The Everett Clinic offers a variety of classes and support groups. For current listings, visit everettclinic.com/classes.