Dear Patients March 31 2020

Dear Patients, Friends and Community members,

Life is shifting so fast around us, that I hope that everyone had a chance to take a breath and enjoy the beginning of Spring.

Vida in the Times of Corona:

On March 19, our Governor Kate Brown signed an executive order prohibiting elective and non-essential medical procedures to be cancelled through June 14, 2020. This directly affects our Integrative Medical practice in the following ways:

  • Acupuncture by Serena Bordes and Pain Management Clinic by Chris Kleronomos will be suspended until further notice.
  • Behavioral Health visit by Jerry and our Psychiatric Nurse Practitioner, Adrienne Maynard will primarily be held via a virtual visit. When patients need to be seen in person, both of them will be practicing in our Behavioral Health office at 1105 Liberty St.
  • All Preventative Care visits including Well Women Visits, Physical Exams and Well Child exams where immunizations are not needed or parents who have elected to not vaccinate, will be postponed until after June 15, 2020.
  • Medicare Adult Wellness Visit will be done virtually, if possible, or postponed until June 15, 2020.
  • Our hours through the month of April are 7 am-5 pm. We have canceled evening hours for the time being.
  • We will be doing all our non-essential visits: medication checks, lab reviews, mental health, etc through a virtual office visit.
    • To schedule a virtual visit please call our office at 503-399-1400 and request to schedule with your primary care provider.
    • The day before your visit you will be emailed a link to access at the time of the visit. If you do not see the email check your spam/junk folder.
    • You can use any type of phone that has internet access and a camera or a computer/laptop that has speakers and a camera. If using a computer/laptop your default web browser needs to be chrome or firefox, internet explorer does not work with the program we are using for virtual visits.
  • We will continue to triage any other medical needs. Any visit that needs to be in office, but not sick visits, will be done in the morning.
  • The last hours of our day will continue to be reserved for any ill patients who need direct care.
  • Testing is still limited. We will continue to be doing the majority of testing outside in patients’ vehicles. Anyone needing to be seen in the office will be met at their car with a mask and brought directly into a room.
  • We ask that no non-essential people accompany patients into the office.
  • We will be setting up an outdoor tent to see ill patients in the next week or so as we expect an influx of concerns.

New Procedure for Check In:

  • When you arrive to our office: Please TEXT us at 971-240-3122
    • Your initials and date of birth.
    • The make, model and color of your car.
    • Please remain in your car.
    • A Medical Assistant will come to your car, take your temperature and if appropriate place a mask on you and ask that you sanitize your hands.
    • You will be taken directly into an exam room.

Managing Anxiety: Balancing “What If’s” and the “What Is”

These are times of great uncertainty in all our lives. So many of us are dealing with the “What If’s”. The “What If” helps us be prepared, to create a plan of action and be ready for what is yet to come. Yet, too much of  “What If”  takes us on a hard journey into anxiety. Anxiety not only stresses our hormone system, depletes our immunity, but blinds our ability to be in the NOW of “What Is”. Take a deep breath. Plant your feet on the ground. Open your eyes and look at the beauty that surrounds you. Listen to music, sing or move your body to it. Smile. Yes, it’s hard when you are scared, depressed, anxious, lonely or sad, but not impossible.

Some things that you can do to support yourself; eat healthy meals, go for a walk, try to get a full night of sleep. Limit your use of TV and news. Try to be aware of how the news changes your mood or makes your thoughts more negative, taking a breather with mood-lifting activities like listening to music, exercising or watching something that makes you laugh can help. Meditation can be very helpful and there are apps that are readily available (Headspace, Insight Timer, Calm are a few). Avoid heavy use of substances like alcohol, caffeine and cannabis.

Jerry our therapist, and Adrienne Maynard, our Psychiatric Mental Health Nurse Practitioner, are available during this time as well. Please reach out to us if you are struggling.


This is an intense moment in our lives. We are being called to create physical distance to be in social solidarity with one another. This can be a pivotal moment to recognize how much we mean to each other. While our fears and anxieties tell a story of scarcity: of food and supplies, touch, economic devastation, illness and death, we can re-frame that to one of abundance of the joys and pleasures we continue to have.

It is more important now than ever to reach out to one another. There are so many events available to us virtually. Events on Zoom for free can be found on FaceBook and Meetup, A telephone call to hear the voice of a friend can be powerful medicine. People are using FaceTime, Zoom to come together in creative and unique ways.

This CAN be a time of healing and acting with the best humans have to offer: kindness and care. Please remember that we are here for you as part of your community. If you need anything, we can send out a home health nurse to provide services. Dr. Dacker is also part of a Covid 19 mobile crisis unit that will be put into effect in the next few weeks.

How to Stay Healthy:

It really is simple,

  • Wash your hands after you touch anything that you have not cleaned. This means doorknobs, desks, shopping carts, groceries, and anything else your hands may come in contact with. A squirt of hand sanitizer sing a song for 20 seconds, and you have just killed any virus on your hands.
  • Don’t touch your face. This means creating new habits. Some people found that wearing a bandanna can help. Others keep a handkerchief that they use to scratch their face with. Keeping your hands away from your face will prevent the virus from entering your body.
  • Maintain a 6-foot distance from people that you don’t share space with. While you may be “Covid-bonded” with those you live with, everyone else can be introducing it into your personal space.
  • Anyone who feels “off” or ill, needs to self-isolate including having their own bathroom if possible. This will help reduce the risks of passing it on to others in your household.
  • Practice clear and direct communication. It is important to know who is allowed within your personal space, their risks of personal exposure and who else is in their sphere. Consent is always important with all voluntary interactions with others. We need to take this even further. Someone who you pass in the grocery store cannot consent to exposure. We know that for everyone who comes back positive with CV-19, they pass it on to 2-5 others, usually in the asymptomatic phase.

Therefore, to keep yourself and others healthy:  cleaning your hands often, keeping them away from your face, maintaining a social distance of 6 feet from others and staying at home, away from others who cannot consent to possible exposure.

We are here to support you, in any way we can.