DOC'S LIFE
BRITISH COLUMBIA
 The Family! Next to the Columbia River, Trail. KB doctors are innovating again with the opening of a new Chronic Pain Clinic in Trail. The clinic is the brainchild of Kootenay Boundary Regional Hospital’s Dr. Sri Kollipara, Acting Head, Anesthesia and Pain Medicine. Dr. Kollipara came to the region as a locum and shortly after joined KBRH’s Anesthesiology team full-time.
The Kollipara family are excited about working and living in the beautiful Kootenay Boundary region, likening it to a working vacation. “You don't need to take a break to go somewhere. Every day you are in vacation mode!” says Kollipara. “My wife, Dr. Szilvia Szarvas (also an anesthetist at KBRH), and my daughter like going out on their bikes. We enjoy walking along the river and driving around taking in the breathtaking views.” Dr. Kollipara, one of the thirty FRCPC certified in Pain Medicine in the country, was motivated to expand regional chronic pain services to benefit individuals and communities in Kootenay Boundary. Along with other practitioners in the region, he is keen to explore how this common source of suffering for upwards of 20% of area residents could benefit from new, innovative, and proven approaches. Supporting chronic pain sufferers Dr. Kollipara is taking a very proactive approach to pain management, knowing the benefits of facing this mountain head on. If pain is not treated early, the patient’s journey can go off track and they can end up with longer term, chronic pain. The Clinic’s team is working hard to reduce the serious, long-term side effects that come with pain, knowing it can affect families, work, and quality of life, leading to more clinic visits, hospital stays, and pain medications. “Chronic pain can lead to a decrease in community productivity, misuse of opioids, addiction issues and their consequences,” says Kollipara. “Supporting patients during their vulnerable times is very important.” The KB Pain Clinic is one of two IH supported Advanced 1 and 2 pain intervention sites. The team is combining professional strengths to search for solutions. Patients are actively involved in their own treatment and ongoing self-management. “As a region, we can be proud of this new clinic and the impact it will have in helping our patients manage their chronic pain,” says Kollipara. “The KBRH Foundation did a fantastic job gathering the community's support. Every patient who walked into the Clinic expressed gratitude to the Interior Health Authority for making this happen. Every colleague was very excited about this venture.” Kollipara reflected on the community collaboration. “I have not seen this togetherness anywhere else since leaving India 25 years ago.” Strength in numbers Pain management usually starts with the family doctor, but the multi-disciplinary approach of involving pain management practitioners, physiotherapists, occupational therapists, and other specialists is at the heart of the Clinic’s method. Dr. Kollipara partners with Dr. Rodica Janz of Solis clinic, Nelson, as a physician lead for the chronic pain steering committee. They are also fully connected with Bill Nelem's pain and research center in Kelowna. As it evolves, primary, community, and Indigenous partnerships will be formed, and more services added. “We would like to provide neuromodulation programs with spinal cord stimulation and advanced procedures for cancer patients locally, to help reduce people’s travel time and get them the support they need, locally. Dealing with this gigantic problem from the grassroots level, while delivering the tertiary care, is important to me,” he says. If you want to learn more about this initiative or anything else about living and working as a physician in Kootenay Boundary, please get in touch with Sylvain Turgeon, Head of the KB Doctors Recruitment Team. Check out the Anesthesia position available now (February 2021) at the Kootenay Boundary Regiona Hospital, Permanent or Locum. Like, Share and Follow us @kbdoctors.ca Facebook l Instagram l LinkedIn l Youtube  Dr. Aaron Krenkel, Psychiatrist, Kootenay Lake Hospital (KLH) Guided by their shared desire to return to their mountain roots, in 2020 Dr. Aaron Krenkel and his family packed up and moved from urban Portland, Oregon to the rural Kootenay Boundary region, where Dr. Krenkel hoped to build on a career foundation in psychotherapy-centered psychiatry. “While I love individual psychotherapy work,” says Krenkel, “I wanted to explore translating those interests into smaller community psychiatry. I also wanted to work collaboratively with folks in allied fields, such as nursing and social work, to extend the benefits to an entire clinic and community.”  Of course, patient services in rural areas can face many challenges, communications being one of them. Mix in COVID best practices restricting travel and the need for creative solutions increases. For the Kootenay Boundary region, designing and implementing a tailored tele-psychiatry initiative to help patients and overcome access issues became the best solution. Pandemic increases tele-psychiatry need “The pandemic accelerated many clinician's adaptation of telemedicine,” adds Dr. Krenkel. “In the space of a few days in March, I went from never having done any, to providing 100% virtual care. I quickly became ready to take on some new adventures with telemedicine.” Kootenay Boundary’s tele-psychiatry project was initiated by forward-thinking psychiatrist Dr. Karen Trueman, reacting to the changing needs in rural communities made more critical by the COVID pandemic protocols. The program caught psychiatrist Dr. Aaron Krenkel’s attention and he joined shortly after moving to Nelson, British Columbia. He describes Dr Trueman as a generous mentor and trail-blazer. “Dr Trueman’s commitment to and understanding of the region's needs, including the way smaller and isolated communities need psychiatric services, put the focus on how different specialities could help each other and our communities.” Technology bridges a service and distance gap Before formally joining the Tele-Psychiatry initiative, Dr. Krenkel had been providing telemedicine services during the pandemic, connecting with patients in outlying areas like Crawford Bay, Balfour and Kaslo. Consulting with staff at Kootenay Lake Hospital, Nelson, could be just the tip of the telemedicine iceberg as this service grows. “There's a saying that 90 percent of communication is non-verbal. We can tend to devalue the importance of the non-verbal and non-symbolic forms of experiencing,” he adds, referring to body language, sharing space and experiences. “The challenge of tele-psychiatry, for me, will lie in balancing access to care with preserving embodied experiences; our nervous systems are not just those brains up there!” Krenkel says. With psychiatrists a call away, doctors can now book a tele-consultation for their patients. Protocols are in place to respect the privacy of the patient and the practitioner. It is a short-term answer that may have a long-term impact. “In some form or another, I think telemedicine will be here to stay after COVID restrictions ease,” says Dr. Krenkel. “I envision a future where I meet with patients occasionally via telemedicine, but where we'll also have some in-person experiences, and the two will complement each other.” Would you like more information on Specialist Positions available in the Kootenay Boundary in beautiful British Columbia? Contact Sylvain Turgeon, Head of KB Doctors Recruitment directly. Like, Share and Follow us @kbdoctors.ca Facebook l Instagram l LinkedIn l Youtube  Dr. Sue Babensee, KBRH Physician and Project Lead. Kootenay Boundary Regional Hospital (KBRH) Project Spotlight One thing that was a standard normal for our profession and services became a new normal for our patients in 2020. Masks. But, while many of us are comfortable with masks, and find them necessary and often preferable, for others it is uncomfortable and un-welcome. Wearing masks for safety may have grown in acceptance and practice but at the same time so did an increased desire to see people’s faces. Patients want to see their doctors’ faces. The solution: the Kootenay Boundary Physicians Association (KBPA) Face Button Project. KBPA’s goal is to supply all physicians, nurses, admin staff—anyone working at KBRHs—with their own smiling face button to wear for the public, patients, and colleagues. We are committed to this ‘face time’ project and participation is growing. It's a simple solution to the complex COVID protection protocols. The US National Centre for Biotechnology Information (NCBI) recently reported on the severe affects and challenges wearing face coverings are producing during the pandemic. They explore how “…the face mask can hinder interpersonal communication…”, an important component of our services. A key side-effect of masks is blocking facial expressions critical in comprehension. The facial muscles that create expressions, predominantly moving our nose and mouth, are important when conveying emotions and information. As communication is a two-way street, we are experiencing even more congestion as both parties communicating are wearing masks. The smooth flow of information is prone to being blocked. The KBPA are supporting the #KBRHSmiles to provide a face button with a head and shoulders photo so everyone can see the smile behind your mask. Dr. Sue Babensee, KBRH physician and Project Lead, wears hers with pride, loving the positive response she gets when others see her happy face. We’ve made it easy for KBRH IH Staff and physicians to join in. Take a selfie or chose a photo and contact your department head or our Project Co-Ordinator: kpegg@kbpa.ca. The rest is up to us. We’ll send your button and you can join the growing number of project supporters.
Get your smile out from behind your mask. Let’s face it. Putting our real face forward is a prescription for better connections, so important at this time. Date: January 2021
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