Faith Washington’s interest in helping people is a natural characteristic that reflects beyond her position as Nurse Manager at Inland Imaging. Faith’s adept interpersonal skills and contagious smile are invaluable in the environment at the Inland Imaging centers. Her dedication and work ethic enable her to set high professional standards and be a true mentor for the employees at Inland Imaging. On behalf of all the staff at Inland Imaging, we realize Faith’s compassion goes beyond her normal day at Inland Imaging.

Faith’s volunteer and community service activities bring people of all races and religions together in an inviting atmosphere, reflecting the mission of the YWCA. She has a long standing record of exemplary dedication and leadership in the area of community service at many organizations and in particular those that empower women and people of diversity to achieve their highest potential. Faith’s service and advocacy for women’s health and serving her community has resonated deeply within the community. This dedication to the greater Spokane community clearly supports her values of health, education, and making a difference in people’s lives. Faith is involved with her community in more ways than can be provided within this nomination.

Faith has been involved with the Susan G. Komen Eastern Washington Affiliate since its inception in 2002. Prior to 2002, breast cancer was a topic rarely discussed in the Spokane area. Yet, this did little to deter Faith. She was a key volunteer in providing education to the general population in Eastern Washington about this disease. She recruited and trained volunteers to go to events and teach the public about breast cancer. Tirelessly, she attends events and provides educational material to anyone she can, in addition to playings a significant role in helping Susan G. Komen become what it is today in Spokane.

Faith also serves on the planning committee of My Sister’s Temple. My Sister’s Temple is a Spokane specific organization operated through the Links Incorporated. She has been with the program since its inception in 2008. For this organization, Faith creates monthly events and programs that educate support and empower low-income minority women in the region helping them to realize their true potential through carefully crafted programs. Once a month, she plans designated events and gatherings for these women. Each event is tailored to address one of the top health issues specific to African American and minority communities. Each helps encourage healthy lifestyles to fight the despairing numbers of health related problems among these women.

In addition, once a week, Faith works with People of Much Potential. This organization works with middle school and high school students of color to prepare for college. Faith helps tutor and prepare the students for the SAT and ACT. She helps mentor the parents involved to help their children go to college. She will also assist in filling out financial aid paperwork, scholarship applications, and any counseling questions the families of the program may need.

Faith is also a member of the Spokane Gospel Mass Choir. The choir promotes cultural understanding of Gospel music while empowering, embracing and networking with others in the community. It encompasses people of all faiths, all regions, and all races of greater Spokane. The vision of the members of the choir is to impact lives through singing gospel music and performing arts. You can find Faith juggling her educational involvement and singing at events such as Unity in the Community, Martin Luther King events, and many women’s conferences.

Faith participates as a Deaconess at her Church, Holy Temple Church of Christ. As a Deaconess, she serves weekly in assisting around the church. Some of her duties include, preparing women for their baptismal, assisting the pastor, and being an usher. Faith organizes meals for families that experience death or other tragedies. She also assists in mentoring the new members of the church at weekly bible studies.

Whatever the project may be, Faith plays an integral part in every organization she serves. It’s not all that she does, but who she is through all of her activities. Faith’s sense of humor, honesty and warmth touch all those who know and work with her. Faith is a true woman of heart and a role model for her community and the women within it.

Inland Imaging is a leading provider of imaging services in Spokane County and has been providing radiology services since 1930. Since the merger of three imaging center companies and three professional radiology groups in 1998, Inland Imaging has grown to 65 subspecialty radiologists, six vascular surgeons and nearly 700 staff members.

Since its inception, Inland Imaging has provided imaging services at reduced or no charge to patients who could not afford their care. When conversations began about Project Access in 2003, Inland Imaging was at the table and ready to participate.

“I don’t think any of us had an idea of what it would evolve into,” recalls Dr. Don Cubberley, who was on the board of the Spokane County Medical Society and president of Inland Imaging at the time.

“As the only radiology group participating, we didn’t put a limitation on the number of charity care patients we would agree to see,” he continues. “We decided we would take all comers and not worry about the number.”

Inland Imaging leaders see Project Access providing value on a number of fronts.

“Traditionally, care for the uninsured and under-insured has been haphazard, fragmented and inefficient—frustrating both patients and physicians,” explains Dr. Cubberley. “Project Access coordinates the care of these patients, reducing the use of our own resources to check insurance eligibility, contact patients for appointments, secure outside medical records, and ensure follow-up.”

Inland Imaging sees value in community goodwill and avoiding the expense of billing patients who were “already in a tight spot.”

According to Chief Reimbursement Officer Dan Hiebert, the value of Inland Imaging services donated for Project Access patients in 2010 was nearly $300,000. In addition, Dr. Don Cubberley also reviews imaging services prescribed to ensure that they are necessary and appropriate for each patient. This makes the donation of the services from Inland Imaging more efficient and also reduces the time and resources spent on unnecessary imaging services. This medical screening alone saved over $55,000 in resources during 2010 that would have been expended unnecessarily without the Inland Imaging and Project Access partnership.

When natural disaster strikes, many of us passively observe as the tragedy unfolds in the daily news. Sympathetic, we might think: “I wish I could do something.”

But if you are Roxanne Gardner, you don’t wish. You act.

Gardner, a nurse at Inland Imaging, traveled to Haiti in November to help the victims of the catastrophic earthquake that hit the Caribbean country early last year. She made the trip as one of 18 members of a relief team organized through the Global Aid Network (GAiN), a worldwide humanitarian relief and development organization.

Gardner and her team spent five days of the 10-day trip caring for patients at a temporary medical clinic in a church on the outskirts of Port-au-Prince. Armed with suitcases of IVs, catheters, antibiotics, medications, scrubs and other medical supplies, most of which was donated by Inland Imaging, the group examined and treated 981 children, men and women for conditions ranging from chronic illness and emotional distress to fungal infections and diarrhea. The team also made personal visits to villages to conduct wellness checkups on children.

“We saw a real need for basic health education and sanitation classes,” Gardner says. Such classes were initiated the week after Gardner left the country, thanks in part to her team’s effort.

To get to the clinic, the relief team traveled 40 minutes each way in the bed of a pickup truck from their hotel, which had no hot water and was surrounded by armed guards. The scenery along the commute will be forever etched in Gardner’s mind.

“The roads were in extremely bad shape. There were potholes filled with water from a recent hurricane,” she recalls. “All of my senses were overwhelmed – the smell, the noises, the chaos…the air was thick with dirt and noise. Most people lived in camps. The children played amidst traffic and on sharp, rusty structures in playgrounds.”

Despite the destruction, Gardner noticed a glimmer of optimism among the Haitian people.

“They were very gracious and appreciative,” she says. “The young people are still very hopeful. Although jobs are scarce, they are eager to learn and they deeply value education.”

The Haitian children, in particular, made a profound and everlasting impact on Gardner.

“They were some of the most beautiful children I have ever seen…I will never forget their eyes,” she says. “A member of my team gave each child at an orphanage we visited a quilt. They were so thrilled to have something of their own. The smallest gifts were, to them, amazing.”

Now, in the wake of the devastating tsunami and earthquake in Japan, Gardner urges others to stop wishing they could help when disaster strikes, and “just do it.”

“Don’t be afraid of the ‘what-ifs!’ Just do it. You can’t imagine how your life will be different,” she says. “It will change your entire view of the world.”

Area health care providers display their own kind of teamwork.

Is it broken? This question was asked by hundreds of injured players at Hoopfest 2010. But, thanks to Inland Imaging and the collaboration of area medical professionals, they didn’t have to wait long for an answer.

For the first time, Inland Imaging, one of the West Coast’s leading providers of medical imaging and technology services, offered on-site X-rays at no cost to the participants of the world’s largest annual 3-on-3 basketball tournament held last month in downtown Spokane.

A total of 147 X-rays were performed over the two-day event in a tent centrally located in Riverfront Park. Inland Imaging staff used a state-of-the art portable digital X-ray unit provided by Holy Family Hospital Foundation.

The images were sent via a high-speed wireless connection to Inland Imaging’s sports injury and musculoskeletal radiologists for immediate interpretation. Within minutes, the injured players knew if they should simply put their injuries on ice, or travel to an area hospital for further treatment.

The ages of those that were injured ranged from 9 to 52 years of age, with largest group of injuries coming from the 10-14 year olds.

Inland Imaging conducted 98 X-rays on males and 49 on females.

The majority of studies performed were to evaluate the extent of ankle injuries at 54, followed by 28 finger studies, and 18 wrist injuries. Others included hands, feet, knees, elbows, shoulders, clavicles, and one nose.

The majority of positive findings came from images taken of fingers, wrists, ankles, and elbows.

Inland Imaging staff collaborated closely with volunteers at the event’s first-aid tents, which were situated throughout the downtown area and staffed by local medical specialists from Deaconess Medical Center, Holy Family Hospital, Sacred Heart Medical Center, Valley Hospital and Medical Center, and Rockwood Clinic.

“We were happy to take part in this signature community event, and to be able to assist our health care partners in their effort to provide immediate, quality care to the injured players,” said Kathleen Wilson, Inland Imaging COO. “It took an extraordinary amount of teamwork to make this service effective. All area medical providers from each tent worked closely together to provide a safe environment to the Hoopfest athletes.”

Inland Imaging is the first-ever imaging company to offer on-site X-ray services for a large-scale, outdoor athletic event such as Hoopfest. They plan to increase availability to the service at next year’s event.

Story by Daniel Walters

There’s a lot you can learn from a just a little bit of bone. Peer into it under a microscope and the shape and structure can tell a pathologist about malignancies, about deficiencies, about cancer.

Kenneth Symington, radiologist with Inland Imaging at Holy Family Hospital, would like to borrow a bit of yours.

And today, he holds in his hands a tool to do that faster than ever before.

© 2010 InHealth NW Magazine

First, let’s explore the way things used to be, the way things used to happen, the way it’s worked with very few changes for the past 50 years.

It starts with a very large needle. It’s a diagnostic needle — with a razor-sharp point and a hollow center. To get to the marrow, the doctor has to pass through the rock-hard outer layer of bone, the part that receives the brunt of the soccer cleat. It takes a hammer to pound the needle through that first layer. A scan is used to measure the distance the needle should go, preventing him from pushing through the other side.

Then, to bore down further, the doctor has to crank, crank, crank: 100, 200, 250 times — until the doctor sometimes ends up with a blister on his hand. Ideally, then, the doctor could pull up the plunger, and suck up the bone sample.

If they’re lucky the sampling process could take five minutes. Sometimes it can take an hour.

The worst part?

Many times, the sample’s no good. Maybe it’s degraded by the drilling process. Maybe it’s too hard, maybe it’s too bloody and soft. Worse, maybe the plunger doesn’t pick up the bone at all. “You would pull it out, you would have nothing,” Symington says. “The bone would stay behind.”

For the average radiologist, getting a good biopsy would take two attempts, maybe three.

“Sometimes they get frustrated and say, ‘That’s the end of that,’” Symington says.

Enter the OnControl Aspiration system.

If the old device was an auger, OnControl is a power drill. Literally. It looks like a small, sleek, sculpted orange power drill. The drill bit bores into the very outer part of the bone shell. The drill is removed, the center of the needle is removed, and then the drill returns to drilling through the bone. Once the needle is pulled out and the plunger is pulled — voila — sample.

And what a sample. “Wow!” Symington says, quoting a fellow doctor reacting to testing the device for the first time. “Look at the specimen.”

The plugs of bones that the drill produced were larger and cleaner than ever before.

“It’s like driving a little Volkswagen Bug, and then someone gives you a Mercedes to drive,” Symington says.

Fortunately, the battery in the device is reusable. You can get 300 uses out of one device. One will last an entire year.

“My takeaway is this is the best biopsy needle we’ve ever used for bones,” Symington says. “They’re much faster. We get an answer much more accurately. It’s a safer procedure because you don’t make additional passes. The fewer passes you make, the better off you are.”

So why does this new technology matter? It’s more convenient for the doctor, easier on the patient. And faster usually means cheaper.

“I believe this is a cost-saving device,” Symington says. “I just can’t quantify it.”

Symington predicts the new biopsy tool will spread rapidly throughout the medical community. It could revolutionize getting bone samples easily for stem cell research.

And the speed also gives another advantage: It just may save lives.

Sometimes in the ambulance, or in the emergency room, it’s crucial to place an IV tube to replenish fluids or blood. But try as the physician might, he or she can’t seem to find the vein. Maybe it’s a child, and the veins are small. Maybe the patient is in shock, so the veins have essentially disappeared.

But time is running out. A physician may be forced to stick the IV through the bone into the marrow instead. That’s not an easy task when it needs to be manually injected.

“In 1983, I started working on an Indian reservation,” Symington says. He talks about how he’d have to hammer in 14-inch needles in lieu of IVs in an attempt to save children. Still, “We had more kids die than adults, of Third World problems,” Symington says. “Now we have an automatic drill type of thing that’s doing the same thing,” he says. “That’s going to save a huge number of lives.”

2010 InHealth NW Magazine

We concluded the procedure training with the physicians continuing to improve their venous access skills and understanding of chronic venous insufficiency. We were joined by a new physician Yukihisa Ogawa, “Yuki” for short, pronounced; (u-key). He was a great addition; very productive and with good ultrasound skills. He seemed very young but they all look that way. This last segment concludes the training. I am relieved the 11 hour days have come to an end.

Dr. Ogawa, Dr. Nakajima, Dr. Yoshimatsu, & Dr. Raabe

I mentioned in previous entries Dr. Katayama who owns and runs the largest imaging center in Japan; he insisted we come see his center. They have 4 PET CT, 1 mamm PET CT, 2 MRI and assorted other modalities. The building is rather large with 5 floors. They employ 110 employees throughout the imaging center and have PACS/RIS, etc. I don’t believe the Inland radiologists would like the reading rooms/areas. They all sit in one large room with 2 monitors and read. No barriers or privacy at all. In certain areas you have to switch from your street shoes into the customary Japanese slippers.

Japanese slippers.

The imaging center sees 1000 patients per month who are referred to it. The center is rather stark and sterile looking, but certainly functional. We had the tour at 6pm and the whole center was closed. They conclude business promptly at 5pm. Even though this is a private pay center, the social aspect of their medicine still has an impression.

Dr. Katayama, Dr. Raabe, & Dr. Ogawa

As usual we then proceed to dinner. This time we went to an area in Tokyo which is popular with foreigners named Rowpunga. The menu is very diverse. After dinner we proceed to a Jazz Bar which is probably the smallest bar I have ever been in. In order to get to some of the seating you have to walk behind the bar. We met up with former Gonzaga player Cory Violette and his girlfriend Beatrice. They seemed to enjoy talking with Americans for a change. Cory plays for Team Toshiba. The team’s name is called “The Brave Thunders“. No one knows what a Brave Thunder is, Cory got a great laugh out of this. Cory really didn’t fit in this bar as he is 6’9″. He is quite the spectacle amongst the Japanese population.

Nate, Beatrice, Cory Violette, Dr. Raabe

The next morning we traveled to St. Mariana University Hospital to tour the radiology department. My battery died on my camera so, unfortunately, I didn’t get many pictures. The hospital is huge and I was shocked by how many patients are waiting. Chairs line most hallways and are nearly all full with people waiting. We got to meet many physicians and technologists and saw many of the same technology we use in the U.S. It is a rather stark and aged environment.

Steamed radish or something. Not my favorite.

Our hosts invited us to travel to Hokane which is a mountain town near Mt. Fuji. We stayed here one night and enjoyed the traditional Japanese baths and an immersion in Japanese customs. The first order upon arriving is changing into a Yutawka which is a casual kimono. Yes, we left on our boxers. You also have to wear these sandals which are made out of hardwood and were treacherous to walk in. I never did figure out the technique. Of course once again we eat a meal which had amazing sushi, sashimi, and other bizarre offerings.

These were actually pretty tasty, heads and all.

Sushi!!!

Traditional Japanese breakfast.

All of this travel was done by train including a switchback train which goes up a series of tracks then backs up a switchback, so on and so forth until reaching the top. It was quite snowy and cold up here. The next morning we traveled up a cable car to a view point for Mt Fuji. It was a very clear day and we got a fantastic view of Mt. Fuji.

Cable Car Station

Mt. Fuji

We boarded one of the bullet trains for our trip back to Tokyo. These babies cruise at 200 mph and ride really smooth. Watching them go by the station was incredible. As you just start to hear one it hauls by and is gone!

We are now back in Tokyo at a great hotel next to the train station, which is always important as the train is the best way to commute and get around. The difficulty with the train is the intricacy of getting the right ticket and then figuring out where to catch your train. There are 4-5 levels of basement involved in the maze of Tokyo Station. Cory Violette invited us to attend his game in Tokyo for tonight. So again we board the train with Dr. Takazawa and head to a gym somewhere in Tokyo. This was a good time, mainly watching how the game is played. They can only have 1 American on the floor at any one time, so Cory shares play time with Tyler Newton who played college ball at University of the Pacific Stockton. Tyler is 6’11″ so he and Cory walking down the streets of Tokyo is quite the spectacle. The best part of this night is eating dinner at Outback Steakhouse in Sheboyen. I am not a big fan of Outback in Spokane, but tonight it is awesome to have some American food!!

You can see where an American basketball player might stand out in Japan.

We fly back on Saturday which since you fly east there is generally a tail wind and the flight will only be 9 hours.

Thanks for reading,

-Monte

Each morning, we jump in with the mass of Japanese people and commute to the Kato Clinic where we perform and educate on the vein cases. The Japanese men seem to all wear predominantly black which makes the mass of people really seem larger than it may be. We (especially Dr. Raabe with his gray hair) stick out prominently and get some odd looks from our fellow commuters. As I mentioned before our hotel is above the main train station, so we get to see the spectacle of humanity daily.

Nate Raabe in the daily commute.

As part of our training we are trying to get the Japanese Physicians to perform the procedure on their own. The socialized medicine mentality seems to have created a “busy” but unproductive work environment. I am being very frank, but it is frustrating coming from our work culture and our adherence to being on time and effective, to a situation where that isn’t 2nd nature. We are trying to “kick them out of the nest” at this point and I am optimistic they will rise to the challenge.

Dr. Raabe instructing Dr. Yoshimatsu on an ablation case.

We performed 4 cases yesterday in an 11 hour day. This pales significantly to what we accomplished even in the early stages of developing the work flow at Inland Vascular Institute/Vanishing Veins. The language barrier is a larger hurdle than I anticipated.

I have been working with two ultrasound machines while here. The first is a Siemens X300 which I have used in the U.S. before, the second is a Konica, which I have never seen or heard of before. I think the operation of them would be simple; however all the control labels are in Japanese! So I just keep trying what seems obvious and hoping that works for gain, color, and Doppler. Very challenging. The keyboard and annotation is all in English so that’s a good thing from my self-serving standpoint.

Lunch today was Bento boxes again. The one I had is the most popular one in Japan and has been unchanged for 20 years. They are good the first time, okay the second time and not so great the third time.

The Bento Box lunch, most popular in Japan. Looks yummy doesn't it?

Kaye Suzuki took us to dinner on the 40th floor of the Princess Hotel at a really nice traditional Japanese Restaurant. This dinner was awesome. Five¬ courses with very small helpings, but a flavor explosion on each serving. The sashimi and beef is prepared meticulously. The presentation is like none other.

Drinking Saki out of little tiny glasses at the Princess Hotel.

Sashimi

The usual suspects.

Another long day is in store for tomorrow with 4 cases. We are hoping to meet up with former Gonzaga basketball player Cory Violette to go to one of his professional basketball games. Cory has played here for about 2 years. I will let you know how that turns out.

Thanks for reading,

-Monte

I don’t think I would have believed this unless I was there.

We are staying in a nice, “business” hotel. The hotel is only 1 year old and sits on top of the station for the Japan Bullet train, which travels at 200 mph around the region.

View from the 13th floor of Shin Yokohama Hotel. The Walkway goes to the train station.

The lobby of our hotel sits on the 10th floor of this complex. A very nice breakfast is included in a person’s stay. Fairly westernized food is offered at this breakfast, although they like their bacon lightly cooked and I won’t eat the fish offering again. I could taste it the rest of the day until lunch when I ate what appeared to be a seaweed wrap with rice and tuna salad. So then I had that taste filling my senses the rest of the day.

The clinic where we are performing the procedures is a short walk from our hotel. Kaye Suzuki joined us this morning to walk to the clinic. Kaye lives an hour away by train (non-bullet). Walking to the clinic with the rest of Japanese Humanity was a true cultural education. Many people wear surgical face masks while commuting to avoid illness.

Following Kaye Suzuki to the Clinic

We started the day performing some diagnostic ultrasounds on patients who had been undiagnosed or misdiagnosed for venous stasis ulcers for several years. The 1st gentleman was a sushi chef in Yokohama and a very kind man. His legs were a mess from the years of venous reflux disease. This is where it gets interesting. As we were preparing the procedure room for this gentleman’s case we realized that the laser generator was the newest model; however the laser fibers were only to be used in the older model of laser generators. These had been shipped from 2 different locations (which we were cautioned against beforehand) hence the mistake.

Nate made a trip to Starbucks.

We are now dead in the water, no way to perform the procedures, no work around despite calls all around the world for advice. The outlook was very grim for what was to be our primary reason for coming to Japan. Dr. Nakajima had a MD friend in downtown Tokyo who had been doing some of the procedures over the course of a couple years. This physician said he had an older generator that he hadn’t used in about 1 year that may work with our fibers. We checked with some contacts in the U.S. and they agreed if this generator was indeed the model cited it would work. So Dr. Raabe, Dr. Nakajima, Sagee (lab assistant) and myself jump in a small weird Toyota car and take off for a 2 hour round trip to Tokyo. On the way on the freeway (which aren’t free at all as there are toll booths every 10 miles or so) we come upon a motorcycle wreck in which we are the 2nd car on the scene. The motorcycle was a courier type of bike and there was all types of stuff spread all over the freeway. The rider was up and collecting his things, so we all jumped out and helped pick everything from hats to the fender, maps etc. Dr. Nakajima checked briefly with the rider and he seemed to confirm he was ok. It was raining pretty hard at this point. Well, we pile back in and onward we go. About 5 miles later I realize my cell phone is gone. I figure it must have fell off my belt when we helped at the motorcycle wreck. I was really bummed; I figured it was a pancake on the freeway.

Sagee the lab assistant started making calls for the rest of the 2 hours we traveled calling various police contacts to see if anyone had turned in or picked up my phone. He talked the whole time we traveled. Dr. Raabe and I were sure it was history.

First case with the sushi chef.

So we get to the MD’s office in central Tokyo and sure enough the laser works for us. We cannot believe how lucky we are to find this generator. Our whole project is back online. We pile back in to the car and head back to Yokohama. We forge ahead with the 2 scheduled cases. Both go relatively smoothly.

Near the end of the last case, Sagee runs up with a big smile and says (through interpretation) that they found my phone and have it at a police station! He takes off to get it. Our good luck continues!

The "team" from left Dr. Nakajima, Dr. Yoshimatsu, Dr. Takaza, Dr. Raabe, me and first patient completed at Shin Yokohama clinic.

Shabu Shabu, me and Dr. Takazawa.

We conclude the day at the clinic and head to dinner which once again was a culinary adventure. Shabu Shabu is raw fatty beef which you boil for 10-15 secs in a tuna stock. Then you dip into various sauces, delicious.

Long, long, lucky day. Thanks for reading,

-Monte

Monte Madsen

Eighteen months ago, Dr. Rod Raabe was asked by an acquaintance of his, Dr. Yasuo Nakajima from Tokyo, Japan if Dr. Raabe could come to Japan to teach them how to treat varicose vein disease using lasers and other methods. The initial contact was in May of 2008. Dr. Nakajima had interest in varicose vein therapy, specifically using thermal (laser) ablation.  The conversations continued with interested parties consisting of Dr. Raabe, Yasuo Nakajima MD, Nate Raabe and myself.  Nate owns a practice development company that helps vein centers in the United States use marketing and management tools to enhance their vein practices. Dr. Nakajima is a former head of the Japanese Society of Interventional Radiology. Dr Nakajima had heard of the success of Inland Vascular Institute’s Vanishing Veins Center (a company owned by Inland Imaging vascular surgeons) in Spokane from other American radiologists.

The Japanese contingency came to the United States for the first level of training in September 2009. This group consisted of Dr. Yasuo Nakajima, Dr. Kenji Takazawa (interventional radiologist, figure skater and jazz drummer) and Dr. Misako Yoshimatsu (interventional radiologist). They traveled to Phoenix, Arizona where the initial training was done.  Dr. Nakajima had some other obligations in Arizona so the timing worked well.  After the Arizona training we were asked to travel to Japan and assist them with their first laser cases and help them with some of the business and setup aspects of establishing a vein center. Angiodynamics, manufacturer and proprietor of the laser devices, came on board to help subsidize the travel and supply product for Japan.

The use of lasers to treat chronic venous insufficiency does not have a “Shonan” or their equivalent of FDA approval. It is still legal for private physicians to perform the procedure, but there is no reimbursement from the governments socialized form of healthcare, yet.

Now that we have that covered, that brings us to this “Blog”. I was asked to write a blog during our trip to Japan to give insight to Japanese culture, medicine and patients.  So here we go.

Dr. Rod Raabe, Nate Raabe and I left Los Angeles Airport at 11:39am on Saturday, January 30^th, 2010.  The flight to Tokyo’s Narita airport is 10.5 hours long. So after 4 movies, a feeble attempt at sleeping and lot’s of food and drink provided by United Airlines, we arrived in Tokyo at 4:30 pm on Sunday, January 31^st, 2010. Did I mention we flew Economy Class?  So you can do the math You lose nearly one whole day somewhere over the Pacific Ocean and you never flew at night. I had always heard the random expression “it’s halfway around the world.” Well, Japan is halfway around the world. We all felt good, though.

We were met at the airport by Dr. Takazawa, Dr. Yashimoto, and an internal medical MD – Atsushi Katayama. We boarded into a large new Toyota van that isn’t sold in the U.S. and drove 80 minutes to Yokohama, Japan, which is southeast of Tokyo. Shin Yokohama or “New” Yokohama is Japan’s second largest city. Yokohama’s port to Tokyo Bay was one of the first ports to be opened to foreign trade in 1859. Consequently, Yokohama quickly grew from a small fishing village into one of Japan’s major cities.

A picture says a lot. Click to enlarge

Arriving in Yokohama, I am impressed by the modern appearance and cleanliness of the city.  I am amazed by the automation of doors, parking meters and, frankly, the toilets. The first picture is the controls for the toilet in my hotel room.  Even the public restrooms have this high degree of technology.  Heated seats, by the way.

After arriving, we picked up “fast food” which consisted of Bento boxes which have a combination of rice, vegetables, sweet eggs, shrimp, chestnuts and what they told me was a pork-something or other. It looked like raw sausage, but tasted great.  The fast food joint was positioned like a small off-ramp from the freeway; you just drive up, pick up and turn right back into 65 mph traffic.

Dr. Atsushi Katayama who drove the van is an internal medicine physician who doesn’t practice but owns and operates the largest imaging center in Japan. He drove us by the center on the way to the clinic where we were going to perform the procedures and it was very impressive even by Inland Imaging standards. I don’t recall the exact numbers, but within a 5 story imaging center they have 3 MRI machines, 2-3 standard CT systems, 3 PET CT units and the only Mamm PET machine in all of Japan. Ultrasound, Nuclear Medicine are all there as well. What most impressed me was there are 2 cyclotrons in the imaging center as well! Interesting guy!

Dr. Katayama and Keisuki (Kaye) Suzuki at the Kato Clinic.

We then visited the clinic where the training and procedures will take place; very modern and space efficient.  Space comes at a premium in Japan so it appears no space is wasted.

We made contact with a Japanese businessman, Keisuki Suzuki, when this project started. He is well known in the U.S. and has provided help to medical device companies with regulatory pathways, etc., for introducing products into Japan. Very cool character. He is basically our liaison for this trip.

I was asked to come for the ultrasound training aspect and am looking forward to that.

It was a busy first day. The jet lag is in full force, so waking up at 4 a.m. Japan time has given me the time window to write this.

Thanks for reading,

-Monte

Janet (not her real name) is a woman who was prepared to deal with crisis. As the regional public affairs director for one of the area’s largest employers, she dealt with government relations and public policy issues, legislative matters, public and media relations, crises (as in multiple) communications, and more. And while that may seem like more than a full plate to most of us, Janet’s role as a wife and mother was every bit a full-time vocation as well.

Her years of experience, education and training, and the guidance of strong mentors meant Janet understood and performed her roles very, very well.  It went without saying that she was more than prepared to deal with just about any crisis she might confront.

“Expect the unexpected. Hope for the best, but prepare for the worst — these are the watchwords of crisis management,” says Janet. And as prepared as she was for most contingencies, there was little that readied her for an unwelcome discovery one morning in 1986.

During one of the monthly self-examinations she’d occasionally performed for years, Janet found a lump in her breast. A follow-up examination by her physician and a mammogram at Inland Imaging confirmed it. Janet scheduled her mastectomy surgery and began planning for her recovery. “I didn’t want to waste time and felt like moving forward with surgery would mean a better chance at beating the disease, getting my recovery going, and coming back to my life sooner,” says Janet.

Following a successful procedure and six weeks away from the job, Janet returned to work. “It took time, energy and the support of my family and friends, the doctors and medical staff, my colleagues at work, and too many others to thank to get me through it all. It almost seems unreal to say, but it’s true — I’m a 23 year breast cancer survivor who’s living well and feeling strong,” says Janet.

In the years since her surgery, Janet has handled governmental affairs for several city administrations, and most recently opened her own business as a public affairs consultant serving corporate, governmental, and non-profit clients.

Through it all, she remains committed to the support and promotion of efforts to help women battling breast cancer. “Information, education, prevention and awareness are critical to beating the disease. I participate in the Komen Foundation’s Race for the Cure, and other efforts to promote breast cancer awareness and fund research. And most recently, I joined Inland Imaging’s Every Woman Can Campaign by commenting on its Facebook page,” says Janet.

“I encourage the women I know to be informed and educated on the subject, too. Along with the intellectual part of breast cancer awareness, another huge piece of the puzzle is simply being aware of your own body — and taking the time to do regular self-exams every month. Every extra day you gain through early detection gives you more time to put medicine to work for you. The science has come so far — today if breast cancer is caught early enough, it’s more and more treatable and survivable.”

For many women though, just the prospect of finding a lump can be enough to put them off doing regular exams. “That seems counter intuitive, but it’s true. Just the idea of finding a lump can be frightening and a lot of women would rather not think about it,” says Janet.

But according to Janet, the experience doesn’t have to be daunting. “It’s to every woman’s benefit to self-examine monthly and schedule a screening mammogram every year. I make my own appointments for my annual mammograms and have always done them at Inland Imaging. I’ve been impressed with how the people there make what could be an emotionally overwhelming experience easy and less stressful. The atmosphere is light and friendly, as I find humor often overcomes adversity. It’s something every woman should do.”

And every woman can.