Jennifer Van Syckle  0:00  
Thank you for joining us for this episode of Talking Health in the 406, where we're one community under the Big Sky. I'm your host, Jennifer Van Syckle, longtime health care worker turned health educator. today's podcast is about the community integrated health program and how your local Emergency Medical Services can help you.

So Aubrie, I guess to even start? So tell me about you. Tell me about your background. You know, where did you grow up? Where's, where's home? Where are you from?

Aubrie Carey  0:35  
I actually grew up in Colorado, kind of a small town mountain town. And I always wanted to be a cowboy. So when I graduated high school, I decided to come to Montana to go to college. I went to Montana Western in Dillon, go Bulldogs. And loved it. I remember when I first came to visit Montana, we drove up. And I distinctly remember when we came through, because we took the back road, actually, we went through Whitehall, and then down into Silver Star Twin Bridges and took that way to Dillon, And I remember when we came through Silver Star, and I was like, I love this place. I love this place. Montana, felt like home. And Dillon, felt like home. And so I didn't even apply to any other colleges. I applied to Western and that was it. And so I went to college there. And when I graduated, I moved to Missoula, and decided I was gonna climb the corporate ladder with my little business degree. corporate ladder climbing took me back to Denver. The day came when I was talking to one of my friends. She said, You're not happy? And I said, I know I'm not. She said, You need to come home to Montana. And I said, I know I do. And she said, You can live on my couch. And I said, Okay, kind of may or may not have put in my two weeks notice the next day, and sold slash gave away everything I owned, except for what could fit in my pickup truck. And I drove to Montana, and got here on a Thursday night had a job interview at 10. In the morning, the next day, got the job started Monday,

Jennifer Van Syckle  2:08  
about another corporate job with a ladder to climb.

Aubrie Carey  2:10  
No, this time. This time, I decided to really do some soul searching. What do I like to do? What are my strengths? What makes me feel alive? And the answer was serving people. I like to be behind the scenes and and make others look good. So I became an assistant. It was wonderful. And I loved it loved all the people there and kind of got a little exposure into like the rodeo cowboy world through there, and lived on my friend's couch for six months going to church in Missoula. And some of the church gals, they told me, they said Aubrie we went to the staff retreat for all the staff at all the church campuses across the state. And there's this guy who serves he's on staff at the Helena campus, and we just think you need to meet him. He's a cowboy. And he's really handsome. And we just think that you do get along wonderfully. And I said, No. And about a week later, I was doing the whole online dating thing, ended up matching with this guy who lived in Boulder. And I was still in Missoula at the time. And I was like, well, that's kind of a big stretch. But you know, I guess we'll talk and so we said hi. Conversation kind of ended until a few days later. It was Saturday night and he sends me a little message to the app and he says, Hey, what church you go to tomorrow? Like no, hey, how's it going? How's your Saturday? None of that just hey, what church you go into tomorrow? And I told him, I was like, I'm gone to, you know, this one church in Missoula. And he says, No way. I'm on staff at the Helena location. And I

Speaker 1  3:36  
was like, No, this is the cowboy. Wow. And so

Aubrie Carey  3:41  
a week later, we met in person. And a year later, we got engaged. And a year after that, we got married. And three and a half years after that we had our baby, our little boy. Oh,

Jennifer Van Syckle  3:54  
cool. Isn't it amazing how the universe and the world and how it sometimes just fits? That is so cool. That's such a great story. And so you've left Missoula, then I take it Yeah,

Aubrie Carey  4:05  
actually was only a couple, like a month into dating him. I moved to Whitehall. He's like, hey, there's a job here in Whitehall, that I think you would be good at and you should take it was an assistant position and it paid twice as much as what I was making in Missoula with half the cost of living. And so I was like, Well, yeah, like, even if this doesn't work out with you. This is a really awesome job. And I loved my job. I loved it. Oh, it was so fun. That was kind of my first time really digging into like bookkeeping and stuff. And I just love the people I've worked with. I got to work with the Jefferson Local Development Corporation most of the time, so I got to be really hands on with developing the local community and helping small businesses it

Jennifer Van Syckle  4:48  
it was really cool. Yeah, that's a great organization. Definitely. They do a lot of good work. So you live outside of Boulder now. Yep. ended up

Aubrie Carey  4:55  
working at the local high school I worked for, for goodness, the last like four For four years or so, last four years, and even just left there in June. And again, I was in an assistant position working in the district office there, and I loved it. But having a baby and no childcare, you know, the joys of Small Town Living in Montana, I was unable actually to continue my job there. I didn't have anywhere to send my boy. So I ended up having to leave. And I was enormously blessed with the opportunity to work from home now for an accounting firm out of Bozeman. So I do bookkeeping and payroll for them. And that has just been amazing and wonderful, and enormously blessed to be able to stay home with my baby.

Jennifer Van Syckle  5:43  
So then how was it after you had your baby because I know you ended up getting tied in with what's called our community integrated health program, which is through a local ambulance service. Can you tell us about that?

Aubrie Carey  5:55  
So my journey with community integrated health actually started prenatally, it started, when I first found out I was pregnant, I was considered from the moment we found out I was pregnant, I was considered high risk for postpartum anxiety, postpartum depression, and even postpartum psychosis. That was something based on my mental health history that they were very conscious of. And they wanted to do everything they could to reduce the potential risk of basically have my spiraling out of control, I guess it's very, is one way to put it. So when I first found out I was pregnant, first of all, it came as a huge shock, because about six months earlier, we had received a diagnosis that I could not get pregnant. And my husband and I had grieved and had come to terms with the fact that Okay, our life is not going to include biological children, you know, we're going to accept this. And we're going to move on, assuming that, you know, knowing that we can't have kids. And then I got pregnant. And the terror was was real, completely unexpected. And I remember telling my husband, he was farming, and it was nighttime. And it was actually a lunar eclipse, which is pretty cool. And I drove out into the middle of the field, and he was worried that something was wrong, because, Oh, yeah. Why am I in the field at nine o'clock at night? And I drove out there. And I whipped out, you know, two positive tests in a ziploc sandwich baggie out of my pocket, and I said, you're going to be a daddy, and he was over the moon. And I asked him, I said, Are you scared? And he said, No. He said, Are you and I said, I'm terrified. And I've burst tears. So we set up my first appointment with St. James, which is now Intermountain Health in St. James OBGYN. Yep, good. And so at my first appointment there and I went in, they knew some of my mental health history, and they looked at my big old questionnaire, and they said, Okay, so I actually had a caseworker through my whole pregnancy. And beyond. The caseworker, recommended me to therapy. So I went and I got therapy through my entire pregnancy. And also after I had my baby for several months. So we started there. And then there was actually a friend of mine, and she, she is an EMT, on the Jefferson Valley emergency services, JVEMS. And she and I were talking and I opened up to her about how I was high risk. And she said, Well, have you heard of community Integrative Health? And I said, No, what is that? And she said, well, it covers a lot of stuff. And she said, mainly what what she says through the ambulance service, it's funded by a grant. And so there's no cost to the patients. And she said that mainly to how the JVEMS was working it right then all their patients were the older folks who maybe didn't have family nearby to help. And so she said, she would just go and visit with them to see ih provider, she would just go and visit and sit with them. Or she would even go pick up their prescriptions. She said part of the point of it was to reduce calls to emergency services to 911. Because there are people who don't have help and assistance and they call 911. Because they just need to prescription picked up, or they need a ride into town for a doctor appointment. And they're calling the ambulance to get that because they don't have any other option. So part of what CIH did for those people is provide a different method for them to get that support that they needed from somebody in the community. And so it was a really beautiful program. Well, they also have a prenatal and postnatal part of it to provide support to moms who, who don't get that support. And so she said you just need to run it by your doctor and have them right to a referral. So I brought it up with my midwife, and she had never heard of it. But she was very interested and she wanted to know all about it. And I told her as much as I could I showed her the referral form and she signed it got me all signed up, and, and then I had my baby and that we started weekly visits, which ended up being a godsend because I, at two weeks postpartum was, they weren't sure yet if it was postpartum depression or postpartum anxiety, or if it was just a severe case with the baby blues. But things got really serious, really fast. My provider, my community integrated health provider actually ended up having to reach out to my midwife and say, Hey, she's not doing well, I had to take one of those little questionnaire, things to describe like my depression and stuff, I can't remember what the scale is called. But she said, she scoring really low, and she needs help, and she needs it now. And within a couple of hours, my midwife called me and said, Hey, I got your notes. Can you come in tomorrow morning, and I went in the next morning, and they talked me through it, they got me some, you know, anti anxiety medication. And they said, let's start you there. And we'll see you back here in a few days. And it was amazing. It was amazing how the healthcare was so comprehensive. And I think the best part of all was the visits with CIH were all in my home. I didn't have to go anywhere. And it was just hard when you have a newborn baby.

Jennifer Van Syckle  11:38  
What did those visits look like? Also, were you still seeing your therapist at that time? Yes, I

Aubrie Carey  11:43  
was still seeing my therapist. And she was not included as part of the CIH but I did talk to her about it. My next appointment. And like, she loved it, too. She thought it was so great for me. But those visits, what they looked like was my provider would come to my house at a scheduled time, she would schedule with me like we kind of the same day, same time every week. And she'd come to my house, and she would first, she would take all of my baby's vitals, she would do like his pulse, and she would take his weights, and she would get his height. And she would just kind of look at his body condition. And she'd asked me questions about him, you know, howa eating hows, he's sleeping and and then she would ask me questions about me. And she'd have me kind of go through that whole postpartum depression scale thing. And we kind of go through all those questions like, Have you been having suicidal thoughts? or thoughts about harming yourself thoughts of harming your baby? Are you able to still laugh and smile about things? That sort of thing? So she'd asked me all that, and then she would kind of leave the conversation open. And I could just kind of tell her, you know, anything that was going on anything that was bothering me, I could ask questions. She would take a lot of notes. And then it ended up being like, she would say, Okay, what do we need today for your mental health? And so like, there was one time actually several, several of her visits where I haven't slept in 24 hours, can I please go take a nap while you hold the baby? Or there was one time I haven't taken a shower, will you please hold the baby so I can go take a shower. There was like I you know, breastfeeding is really hard. It was really, really difficult. For something that's supposed to be so natural, it's probably the hardest thing I've ever done. And so she would help me like with my latch, you know, if I needed it, or she would you know, and she never claimed to be like a lactation consultant. She never claimed to be a doctor or a physician, you know? And if she didn't know the answer to a question, she would say, I'm going to put this in your notes, and I'm going to send it to your midwife. She would always admit, if she didn't have the answer. She just came and she, she just was so helpful to me. And just made it really easy for me to be able to open up and ask questions, it was just easier for information to get relayed to my doctor, because sometimes I didn't even know if something was an issue. Like I didn't realize that I had slid so far into this anxiety and this depression, and she was able to pinpoint that. And she told me, she said, we need to pay attention to this, we need to do something about this. Because this level of of hopelessness is not normal. And it's not your fault, but we need to take it seriously. And we need to take action. And so she was just like, the greatest support.

Jennifer Van Syckle  14:34  
Yeah, it makes me think of a what do they say it takes a village to raise a child but I mean, it's kind of like she was your village and something to probably look forward to. When she gets here. I can breathe. Yes,

Aubrie Carey  14:45  
yes, absolutely. That was exactly how it was. It was I looked forward to the visits, you know, and there came a time then where we started to wean me off. I say that we may off where we spaced them out then to every other weak. And then when when I was ready, then we said, Okay, we're done. And she said, You know, I'm going to I'm going to discharge you as a patient. And, you know, so then our visits ended. One of the other things, you know, she was also my son's provider in a way, because she was taking his vitals and his weight and everything. It was actually because of her that we figured out, he wasn't gaining weight at one point. And so we were able to figure that out. And I was able to take him to his pediatrician. And we could we figured that part out and I could go to a lactation consultant, then like, I wouldn't have known that, that he wasn't gaining weight like he should if I didn't have her and her visit. Yeah,

Jennifer Van Syckle  15:42  
twofold. That's awesome. And did you ever get a bill for any of this, or anything like that? No,

Aubrie Carey  15:48  
I even remember telling my provider I remember telling her, I feel so bad. You're driving all the way out here, you know, to come see me. And mostly you're just talking to me and listening to me, like, like, whine and complain and ask a bunch of questions about motherhood, and I'm not paying you for your mileage or anything. And she said, that's what the grant is for. That covers my time and my mileage being here. And I was like, Wow, no way. Very high was really cool. Yeah.

Jennifer Van Syckle  16:13  
And something we definitely need more of, in so many ways in Montana, you know, I can remember one future Mom, where she said, I have to drive 15 miles down a dirt road before I hit the highway. And it's going to take me two hours to get here into Butte to deliver this baby. You don't even realize how far and how, you know, quickly you can become alone, you know, like you your husband's probably out with cows or, you know, depending on what time of year your son was born? January, January. Yeah, calving season for a lot. So he's dealing with babies too, but just in a different way. Yeah, yeah. Did she ever share some of the other work that they did with community integrated health program at all?

Aubrie Carey  16:59  
I mean, there's there's HIPPA. So right, share a whole lot. But she, I mean, for her, her biggest interest definitely was the pre and postnatal. She's a she's a foster mom and a mom of three. And so So babies are kind of her thing. And she has worked with other moms, I do know that. And I think that the beautiful thing about the program that I really appreciate it and living out in the middle of nowhere, like we do, it's an hour to the nearest hospital, we do have a medical clinic in the town of Boulder, and we also have one in Whitehall, they are having appointment clinics. Now, otherwise, if you wanted to go to a walk in clinic, you're looking at an hour to get there. You know, we're in this weird triangle spot where Bozeman, Butte and Helena are just about equal distances from where we are, and we're stuck in the middle of this triangle. You think about the mountain passes, you have to go through to get there. And then you think about the rest of the state, the whole state is the vast majority of the state is rural. And when you think about that, and and how many crises, how many emergencies could be prevented by just that awareness, like for example, with my baby when he, you know, I didn't realize he wasn't gaining weight, it was caught, it was caught so quickly. And so we were able to address it before it became an emergency. And you think to about the people who don't have support and they need medication, or they have high cholesterol or they have, you know, mental health issues to be able to be checked on like that is? Yeah, it's what an amazing tool. Yeah, an amazing service without clogging up emergency services themselves,

Jennifer Van Syckle  18:46  
right? Think about town like Boulder, Whitehall, Jefferson Valley, and a lot of the state is like that, that probably not multiple people sitting behind that phone, when you call 911. It's probably one person that can get a hold of a handful of volunteers that are running an ambulance service. And if there is a really real emergency when you need them, and you need them quick, if there was something that could have been prevented. And just the preventative medicine of you have diabetes, let's check your feet. Take your socks and shoes off. I know you can't see down here, you got to cut let's get you scheduled with your doc so we can get that taken care of before it grows, gets infected. So yeah,

Aubrie Carey  19:22  
and telehealth absolutely has its place. What an amazing thing that we can do with technology today that you can meet with a therapist or a doctor through telehealth, that's great. But there's not somebody there in person, like you said for a diabetic, like what are they supposed to do? Like try and hold the phone to look at their bottom of their foot? Feel like that's it's not the same and it's and I think the point of community integrated health is that first word, community. It's people who are in your community. These aren't these aren't just some, some stranger on the internet. You know some random Doctor whose talking to you, this is somebody in your community who is there to serve, and who cares to know your name, and who cares about what's going on in your life, and wants to make their community a better place. I just think that there's something that's really special about that there's something about an actual person coming to you in the warmth and comfort of your own home. To You know, it's like those old doctor house calls that they don't do anymore, right? Yeah, no, yes, it's there. It's it's different. It's personal. Yeah.

Jennifer Van Syckle  20:36  
And there's parts that you know, you know, I hadn't even thought of until I started working more with professionals who do go into the home, like home visitors, for instance, you know, and they talked about, I walked through the door, and I could smell the mold or pet dander. And maybe that week, he came to see you, she walked in the door, and she noticed your house was a little messier, or she noticed, Aubrie looks like it's been even longer than usual since her last shower or something like that, that might have had other bells going off in her mind that we don't even think of the kind of that human element. And

Aubrie Carey  21:09  
then to she was able to facilitate like her her treatment, for lack of a better term. She could come in and she could, you know, ask me questions. Like, when was the last time you went outside? When was the last time you got some fresh air? I don't know. It's been two weeks, like, Okay, I you know, instead of somebody on the phone saying Aubrie, you should go outside. I know, it's 20 degrees out, but you should go outside. And here I am like I have a newborn baby. I can't just go outside. You know where she was able to stay. Aubrie, you need some fresh air, it's going to do you a world of good. I'm going to hold your baby. You go outside for 15 minutes and go on a little walk and come back. And I was able to do that. And it it was like life changing who knew 15 minutes outside could be so life changing. But she was able to not just recommend a treatment but to facilitate the treatment.

Jennifer Van Syckle  22:04  
Thank you so much on behalf of myself, and the crew behind the scenes to Aubrie for sharing her story with us and she did a fabulous job. If you would like more information on what was discussed today. Visit our website at TalkingHealthinthe406.mt.gov. And if you haven't already, please remember to like, subscribe and share our podcast. Until next time, take care

Transcribed by https://otter.ai