[360] Healthy Living 2013

Marysville • Arlington • Smokey Point • Quil Ceda Village • Tulalip

[360] Healthy

2013

HEALTH & SAFETY FAIR September 14, 2013

Health & Safety Fair Vendor Map Inside!

�orth �ounty

Outlook

A Special Supplement to North County Outlook | Published September 4, 2013

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September 4, 2013 North County Outlook

[360] Healthy Living Guide

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Table of Contents Personal Health, Community Health. . . . . . . . . . . . . . . . . 2 Cascade Valley Health & Safety Fair. . . . . . . . . . . . . . . . . . 3 Healing from the Inside-Out. . . . . . . . . . . . . . . . . . . . . . . 4 Award-Winning Wound Care. . . . . . . . . . . . . . . . . . . . . . 6 Plasma Donors Help Medical Research . . . . . . . . . . . . . . 8 Healthier Schools, Healthier Kids. . . . . . . . . . . . . . . . . . 10 Improve Heart Health. . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Create a Healthy Sleep Environment . . . . . . . . . . . . . . . 12 New Clinic Serves Uninsured. . . . . . . . . . . . . . . . . . . . . 13 Living Well After Retirement. . . . . . . . . . . . . . . . . . . . . . 14 Health and Safety Fair Information. . . . . . . . . . . . . . 16-17 Health District Warns About Bats. . . . . . . . . . . . . . . . . . 18 Dental Care Worlds Away. . . . . . . . . . . . . . . . . . . . . . . . 19 Insurance Exchanges Open in October . . . . . . . . . . . . . 20 Keep Medications Secure. . . . . . . . . . . . . . . . . . . . . . . . . 22 Directory of Medical Providers. . . . . . . . . . . . . . . . . 23-27 Directory of Dental Providers. . . . . . . . . . . . . . . . . . 28-29 Fighting Cancer at the Dinner Table. . . . . . . . . . . . . . . . 30 Shedding Excess Weight After 50 . . . . . . . . . . . . . . . . . . 31 Cost-Effective Knee Replacement. . . . . . . . . . . . . . . . . . 32

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[360] Healthy Living Guide

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September 4, 2013 North County Outlook

Personal health tied to community health

By Beckye Randall Staff Writer/Editor

This year’s [360] Healthy Lifestyles publication serves a double duty. In addition to distribution to readers of North County Outlook, visitors to Cascade Valley Hos-

pital’s upcoming Health and Safety Fair, set for Sept. 14, will also receive the publication as their official guide to the event. For that reason, the centerfold section includes a handy map of the vendor locations and activities planned

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North Snohomish County is becoming a magnet for world-quality health care providers, while still offering access to private practitioners for personalized care.

Whether you’re looking for a primary care physician, a great orthodontist, treatment for a sleep disorder or nutritional counseling, chances are all your health care needs can be met without ever leaving the Marysville-Arlington area.

Our civic leaders are also mindful of the health needs

of area residents. Initiatives that include expanded walking and biking trails promote active lifestyles for all ages, and classes offered by Parks and Recreation departments provide opportunities for all kinds of exercise—both mental and physical. And don’t discount the benefits of social interactions provided by local hobby clubs and community service organizations.

Health may begin at home—on our dinner plates and in the yard—but it expands outward to encompass the entire community in which we live.

And healthy communities, in turn, are necessary for us to thrive individually.

That whole circle of life thing.

[360] Healthy Living Production Team Complimentary examinations Jason R. Bourne, DDS, MS Member– American Dental Association Washington State Dental Association Snohomish County Dental Society American Association of Orthodontists Pacific Coast Society of Orthodontists Washington State Society of Orthodontists

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Editorial Content, Photography. . . . . . . Beckye Randall, Christopher Andersson Advertising Manager . . . . . . . . . . . . . . . . Sue Stevenson Advertising Sales. . . . . . . . . . . . . . . . . . . . . Brenda Felder Sales Assistant. . . . . . . . . . . . . . . . . . . . . Debbie Glidden Page Design & Composition. . . . . . . . . Beckye Randall Graphic Design, Cover Design. . . . . . . . . . Carrie Harris Administrative, Billing. . . . . . . . . . . . . . . . . Teri Lemke Cover Photography. . . . . . . . . . . . . . . . . Gabe Rodriguez

Published by North County Outlook P.O. Box 39 • Marysville, WA 98270 September 4, 2013

September 4, 2013 North County Outlook

[360] Healthy Living Guide

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Find resources at Health & Safety Fair On Saturday, Sept. 14, the public areas at Cascade Valley Hospital will host a wide range of resources and vendors to help local residents embrace a safe, healthy lifestyle.

The hospital’s first Health and Safety Fair, which runs from 10 a.m. to 2 p.m., will offer something for everyone, from low-cost flu shots courtesy of Costco, to an interactive “Blood and Guts” exhibit, courtesy of Pacific Science Center. Visitors can also take advantage of a wide variety of free and reduced-cost health screenings, as well as great health and safety resources

from organizations in our community.

F r e e and lowcost health screenings will include blood glucose levels, cholesterol, hearing and vision, bone density and even Body Mass Index (BMI).

15-foot walk-through models of an inflatable heart and brain provide a unique viewpoint into our major organs.

Seniors will also find information on assisted living options, Medic are and other topics.

Community safety education is also on tap for the one-day event, including free car seat safety checks and hands-on tours of Arlington fire trucks.

Learn about Germbusters, Mr. Yuk, and Snohomish County Safe Kids.

As a well-respected health provider in north Snohomish County, the staff at Cascade Valley Hospital is looking forward to not only providing helpful resources for local residents, but also acquainting potential users with all the services the hospital offers.

Health fair attendees can take self-guided tours of the facility, which was completely renovated a few years ago to incorporate galleys filled with local artwork, state-ofthe-art exam and treatment rooms, and a cafeteria that gets high marks for freshness and quality.

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[360] Healthy Living Guide

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September 4, 2013 North County Outlook

Healing patients from the ‘inside-out’

By Christopher Andersson Staff Writer

The nerves that run through your spine are signals from the brain sent down to all parts of the body. Dr. Shawn Gay, of Arlington Family Chiropractic, described the brain as a computer and the wires that come out of that computer are the nerves that control your bodily functions. They are meant to connect and transmit commands, which makes the spine and nerves vitally important for your body to function correctly.

Chiropractic doctors use established methods to improve their patients’ spines and encourage nerves to heal from the inside-out.

Dr. Gay has been adjusting spines since he opened Arlington Family Chiropractic in 1999 and has grown his practice ever since. This year the business is the platinum sponsor of the Cascade Valley Hospital Health and Safety Fair.

The office, located at 20218-77th Ave. NE in Arlington, has three chiropractors on staff: Dr. Marcus Woodall, Dr. James Stirton and Dr. Gay.

Whatever we can do to help [our patients] or make things better for them, that’s what we do.

n (From left) Dr. James Stirton, Dr. Shawn Gay and Dr. Marcus Woodall provide expert patient care at Arlington Family Chiropractic.

Sometimes patients don’t know how far-reaching the benefits will be, said Dr. Gay. Because the nerves reach all parts of the body, chiropractic adjustments can have positive effects in many places throughout the body.

Patients of Arlington Family Chiropractic not only see results for back and neck pain, but also for headaches, heartburn, bed wetting, allergies, sciatic pain, and more.

New patients are also surprised that the adjustments don’t hurt.

“People who have never been to the chiropractor before hear that popping noise and they think it hurts because they’ve been brought up watching Jean-Claude

Van Damme or Steven Seagal movies. The first thing that you hear from people who get a manual adjustment is ‘that didn’t hurt’ or ‘that feels good’,” said Dr. Gay. Arlington Family Chiropractic is also a comprehensive health and wellness center.

The practice offers acupuncture and massage therapy. The massage therapists are approved providers through most insurance companies, including Regence.

Many health services are available, including digital xrays, custom-made orthotics, exercise and rehabilitation programs and nutritional counseling for healthy living.

A new counselor who spe-

cializes in the ‘ideal protein’ weight loss diet will also be available soon.

Arlington Family Chiro­ practic’s doctors and staff really try to listen to the patients and make the experience personal for each one, said Dr. Gay. “We tend to spend extra time with patients that need extra time,” he explained.

“Some people want to get in and out and some people want more time. We customize our care to the patient.”

Their treatment plans are also tailored for each individual person’s need.

“We adjust our treatment plans for the patient. We don’t recommend the same Continued next page

September 4, 2013 North County Outlook

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Chiropractic Continued from previous page

treatment plan all the time, because different problems require more or less care,” said Dr. Gay. Patients feel comfortable coming in because the staff is friendly and loves the community.

“People actually like to come and see us,” said Dr. Gay. “You know when you’re doing good when patients bring you food. I get lots of food.”

The business has been easy to grow because patients keep coming back, he said.

The first patient that came to Arlington Family Chiropractic is still a patient.

All the staff members at Arlington Family Chiropractic love their jobs, which really helps with the healing, he said.

“That’s the benefit for us really, watching a patient walk in in misery and then a week later walking out with a big smile on their face. That makes our day. And whatever we can do to help them or make things better for them, that’s what we do,” said Dr. Gay. Dr. Gay said that he also tries to make his business as accessible as possible for patients.

The office has late hours on Mondays, Wednesdays,

patients and new patients can get same-day adjustments.

The doctors can also make house calls, he said.

“If a patient is stuck at home and they can’t get to our office, we’ll make an effort to get them adjusted at their house,” he said.

They are on-call for 24 hours for emergencies as well and the office phone transfers to Dr. Gay’s phone during the night. He assures callers he is always available to talk. n Chiropractic practitioners For more information focus on restoring healthy spine go to www.arlingtonfamily and nerve functions. chiropractic.com or phone and Fridays, and they’re also (360) 654-6359. open on Saturdays. Walk-ins are welcome for returning

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[360] Healthy Living Guide

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September 4, 2013 North County Outlook

Award-winning wound care in north Snohomish County

By Beckye Randall Staff Writer/Editor

With consistently high standards and positive patient outcomes, the Wound Care Center at Cascade Valley Hospital has racked up another award to add to its trophy wall.

For the fifth time, the Wound Care and Hyperbaric Medicine Center in Arlington has been recognized as a “Center of Distinction” by Healogics, Inc., the nation’s largest provider of advanced wound care services.

The statistics back up the award. While treating 3,500 patients over a twelve-month period, the center achieved a 91 percent wound healing rate within 30 days and scored a 92 percent in patient satisfaction scores.

Over the center’s 15-year life span, that healing rate exceeds 96 percent, and 98 percent of all patients indicate they would “highly recommend” its services.

Dr. Peter Wolff, the Wound Care Center’s medical director and a vascular surgeon, talked about the need for specialized, aggressive wound care.

“If a wound hasn’t healed within 30 days, it usually won’t heal with traditional methods,” said Dr. Wolff. “Yet many patients being treated by primary care physicians continue to undergo months or even years of futile treatment.”

According to its online statement, the mission of the Cascade Valley Hospital Wound Care and Hyperbaric Medicine Center is to provide expert,

n Staff members at Cascade Valley Hospital Wound Care and Hyperbaric Medicine Center proudly display the Center of Distinction award. (From left) Nancy Lewis, RN; Teri Burt, RN; Connie Egaas, RN; Nancy Roach, MA, HT; and Peter Wolff, MD. evidence-based medical treatment to patients who suffer from wounds that have failed to heal despite usual medical treatment.

The staff at Cascade Valley Wound Care Center is in the business of “limb salvage.”

Their efforts are geared toward avoiding amputation through the use of aggressive treatment strategies that have been shown to be effective over a nationwide sampling of cases.

That aggressive approach makes a difference, according to Dr. Wolff, but it’s not always the easiest course.

“We have to justify the higher costs up front, because in the long run, taking these aggressive measures will be more cost-effective,” said Dr. Wolff.

“Consider the long-term costs of amputation—prosthetics, re-

habilitation, possibly the need for continued nursing care— plus the decline in a patient’s quality of life. If we can save that limb, it’s actually better for everyone—even the insurance company.”

That mindset also means the patient must be 100 percent onboard with the prescribed treatment.

“If you miss an appointment, we’ll hunt you down,” said Handley, only slightly exaggerating.

Dr. Wolff is equally as adamant about patient lifestyle changes. If a patient with vascular damage, which is interfering with wound healing, refuses to stop smoking or maintain a healthy diet, he or she may be discharged from the program.

“It should be a national policy that to qualify for ag-

gressive limb salvage treatment, you can’t be a smoker,” said Dr. Wolff. “Just like for organ transplants—patient cooperation is critical for the success of the treatment.”

Teri Burt, R.N., is the clinical nurse manager at the Cascade Valley Wound Care Center. She has worked at the center since its opening 15 years ago and is a Certified Wound Specialist.

“It’s important that we all work as a team,” said Burt. “My job is to make sure we’re following all the protocols, that the staff is cross-trained effectively, and that we work together efficiently.”

As part of the Healogics network, physicians and nurses in the Arlington center can draw on the knowledge and exContinued next page

September 4, 2013 North County Outlook

[360] Healthy Living Guide

Wound Continued from previous page perience of thousands of wound care specialists located in more than 560 centers across the country.

As a Mentor Center, the wound care specialists at the center are also sharing their knowledge with healthcare professionals locally.

“Being a Mentor Center means we have reached a level of expertise, from a clinical and business standpoint, where we have valuable information to share with others,” explained program director Michael Handley. “We teach a lot of students—nurses, physicians, nurses’ aides and others.”

The Wound Care Center features two chambers for hyper-

n Tammy Herald, LPN, checks in with Louise Hall of Marysville during her hyperbaric treatment. baric oxygen therapy (HBOT).

The clear tube-like chambers deliver 100 percent oxygen at increased pressure—equivalent to being underwater at about 40 feet.

Wound care patients who are

prescribed HBOT—and not all patients are good candidates for the procedure—visit the hyperbaric chamber for two hours every day for 30 to 60 days.

“It’s the only known therapy that helps grow blood vessels,”

7 said Handley. “Wounds have a tough time healing without good blood circulation. In order to heal, a wound must bleed.”

Physicians and specialists at the center treat a variety of wound types, including diabetic foot ulcers, ischemic wounds caused by insufficient blood flow, venous stasis or slow blood flow, pressure ulcers, vascular diseases and post-surgical wounds.

Most patients who come to the Cascade Valley Wound Care and Hyperbaric Medicine Center are referred by their primary physician, but about 10 percent are self-referrals. The center treats 20 to 25 patients each day.

To find out more about the Arlington wound care specialists, visit www.cascadevalley.org and click on “Clinics.”

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[360] Healthy Living Guide

September 4, 2013 North County Outlook

Plasma donors help medical research People with certain types of medical disorders may also have unusual antibodies in their plasma associated to their condition.

PlasmaLab International, a biomedical facility in Everett specializing in collecting plasma from donors with severe allergies and autoimmune diseases, has expanded its new donor room to hold more donors and is celebrating its twenty-eighth year in business.

“The building remodel and expansion was the natural next step,” says PlasmaLab CEO Kay Hill. “My dream is to double our lab capacity and help advance medical research worldwide. As a community we are helping to create a healthier tomorrow for those suffering from allergies or autoimmune conditions today.”

PlasmaLab is looking for people who suffer from severe allergies or autoimmune diseases to participate in the Donor Program. Donors are pre-screened through email or by phone, then once accepted into the program, they are generously compensated for their donations. Donors with high antibody levels to foods can earn up to $200 per plasma donation.

“Each donor is unique but all are deeply valued and appreciated,” said Hill. “We’ve had donors with us for more

than 20 years; some donors have given their plasma over 1,300 times. A few years ago we had the Ladies Blood Club, a group of women that met while here at our facility and bonded over their similar diseases. They came to rely on one another and always booked their appointments together, chatting away and supporting each other through difficult times. Often our donors find validation here, where in their real world they may not encounter people who completely understand their medical challenges.”

PlasmaLab International was established in 1985 when its founders sensed an increased need in the biomedical industry for a reliable, cost effective source for high quality diagnostically relevant human plasma.

Since that time, PlasmaLab has become a major supplier of an expanding array of specialized human in-vitro products for distribution to diagnostic, regulatory, and research facilities worldwide and is licensed by the U.S. Food and Drug Administration (FDA).

n The Donor Lounge at PlasmaLab International.

To find out if you or someone you know qualifies for the Donor Program, please submit your request to become a qualified donor through our web site at www. plasmalab.com.

Hill noted, “This is an incredible opportunity for people who suffer with certain diseases to earn extra money and make a difference. We hope you can become one of our special donors.”

What is plasma?

Blood is made up of cellular and liquid portions. The liquid portion is plasma and may be up to 55 percent of the blood. The plasma is 92 Plasma Donor percent water but also contains the vital proteins and Programs PlasmaLab is actively re- antibodies to help fight infections. People with certain cruiting individuals with: types of medical disorders, • Autoimmune diseases such as allergies, may also • Severe allergies to foods, have unusual antibodies in mold, stinging insects, their plasma associated to weeds their condition. It is these • Red blood cell antibodies types of antibodies that are

crucial to diagnostic and research facilities. Plasma can be donated as often as twice in a seven-day period, with at least 48 hours between donations. Plasma is quickly and easily restored by your body within 24 hours.

Giving Back

PlasmaLab supports various community events to help raise awareness for medical research such as the Alliance for Lupus Research Walk With Us to Cure Lupus and is a proud sponsor of the upcoming Arthritis Foundation’s Jingle Bell Run/Walk this December in Seattle. Contact Deanna at deanna@plasmalab.com to support our team with a financial donation or to walk with us!

To learn more about PlasmaLab International, visit our website at www.plasma lab.com or find us on Facebook and Twitter.

September 4, 2013 North County Outlook

[360] Healthy Living Guide

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A light lunch for the workday Lunch is a meal that can provide an energy boost or make you feel drowsy.

In the middle of the workday, a big meal can make it much more difficult to be productive as the day goes on. For those looking for a light lunch, consider the following recipe for Nicoise Pasta Lunchbox.

Dressing

Serves 2

Cook the pasta in a saucepan of lightly salted boiling water for about 12 minutes or until tender. Add the green beans to the pan for the last 3 minutes of cooking time. Drain the pasta and beans, then refresh briefly with cold water.

Meanwhile, add the egg to a small saucepan of cold water. Bring to a boil, then simmer for 6 minutes. Drain and rinse under cold water until cool. Peel

Nicoise Pasta Lunchbox

40 grams whole-wheat pasta rotini 4 ounces green beans, cut into thirds 1 egg 1/3 cup imported black olives 6-1/2 ounces canned tuna steak in spring water, drained and flaked 1 cup cherry tomatoes, halved 2 small heads Bibb lettuce, leaves separated

1 tablespoon freshly squeezed lemon juice 1 tablespoon extra virgin olive oil 1 small garlic clove, crushed 2 heaping tablespoons chopped fresh basil Sea salt and freshly ground black pepper

the egg and cut in half.

Beat the dressing ingredients together with the seasoning in a mixing bowl. Mix in the pasta and beans, olives, flaked tuna, and cherry tomatoes.

Divide the lettuce leaves between two lunch boxes or bowls and top with the Nicoise pasta and the hard-cooked egg halves.

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[360] Healthy Living Guide

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September 4, 2013 North County Outlook

Healthier schools, healthier kids Because children spend most of their time in classrooms, schools are an ideal setting for healthy behaviors to be taught and modeled.

Therefore, parents are speaking up and getting involved in an effort to improve the health of their children at schools.

One Washington, D.C. mother of two Roots Charter School students recognized the need for her children’s school to incorporate more physical activities into the school day.

“The obesity rate among children is at an all-time high, so getting our kids to

be active is more crucial than ever,” said Michelle Jones. “I want to make sure my children live their lives to the fullest, and getting exercise can help them do that.”

Michelle banded together with other parents to form an advisory council that works with local schools to host events focusing on health and wellness. Activities like yoga, Zumba and healthy eating inspires students, parents and community members to be physically active and make healthier food choices.

Other schools are making healthy changes through programs with the Centers

for Disease Control and Prevention (CDC). A New York City school district made 800,000 daily meals healthier by ensuring that foods and drinks meet certain standards for sodium, fat and calories. A school district in Las Cruces, New Mexico has opened physical activity space to the community during after-school hours.

Eating well and participating in regular physical activity not only has health benefits, but they also have been linked with better academic achievement by enhancing important skills like concentration and attentive-

ness. For example, students who eat foods rich in protein, vitamins, and minerals are more likely to perform better than students whose diets are heavy in unhealthy foods, like sweets and fried foods.

To support healthy schools, parents can recommend ways to increase physical activity during the day and ask that healthy food and drink options be made available to students throughout the school day.

Parents can learn more about improving health in their local schools and communities at www.Making HealthEasier.org.

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September 4, 2013 North County Outlook

[360] Healthy Living Guide

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Simple tips to improve heart health Heart disease is one of the leading causes of death across the globe. According to the World Health Organization, ischaemic heart disease, in which blood supply to the heart is reduced, is the leading cause of death in middleand high-income countries and the fourth-leading cause of death in low-income countries.

Perhaps the most troubling fact about the prevalence of heart disease is that it can be largely preventable. The American Heart Association notes that there are several ways to easily improve heart health and avoid becoming

can be as simple as walking around the neighborhood, can help men and women lower their blood pressure, maintain a healthy weight and lower their bad cholesterol, which can circulate in the blood and cause blockages that can lead to heart attack.

Easy on the salt

one of the millions of people to succumb to heart disease.

Get moving

Aerobic exercise is essential to cardiovascular health.

Daily aerobic exercise, which

Adopt a low-sodium diet that’s also low in cholesterol.

Diet can be a friend or foe in regards to heart health. A heart-friendly diet that’s low in sodium and cholesterol can help you maintain healthy cholesterol levels as well as a healthy blood pressure.

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September 4, 2013 North County Outlook

Create a healthy sleep environment It is easy to overlook the benefits of a good night’s sleep. Without adequate rest a person can be left feeling irritable, distracted and sluggish. Those who repeatedly do not get enough sleep could be facing other health problems as well. For some, the secret to getting a better sleep is modifying their sleeping environment.

Information from the Centers for Disease Control and Prevention indicate insufficient sleep has become a public health epidemic.

An estimated 50 to 70 million American adults report having a sleep or wakefulness disorder, and women are twice as likely to suffer from insomnia than men. Plus, one in three people suffer from some form of insomnia during their lifetime, offers the organization Better Sleep for Life.

In some instances, lack of sleep or too much sleep might be indicative of a medical condition, but it could just be related to poor sleep hygiene and an uncomfortable sleep-

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as traffic outside or a partner snoring. White noise can come from a special alarm clock that provides soothing sounds of rain or waves.

Many people find running a fan in the bedroom provides the right amount of noise and also helps circulate air throughout the room.

Cozy, clean and fresh

n A good night’s sleep is an important key to good health.

ing environment. Making could provide the room you some changes could make all need. If you cannot afford a new mattress, buying a matthe difference. tress topper in memory foam Check your mattress could mask any problems for You will spend between the time being. seven to 10 hours in your bed each and every night. Balance light and dark In order to trigger sleepiAn uncomfortable mattress could be an underlying fac- ness at the right time, it is tor in your sleep problems. essential to get at least 30 If your bed is several years minutes of natural sunlight old, it could pay to invest in a each day during the morning new mattress and box spring. or afternoon. In the evening, If you sleep with your spouse begin dimming the lights and your bed is too small, to trigger the body’s natural upgrading to a larger size internal clock and stimulate the production of the natural hormone melatonin, which • We can coordinate your relaxes the body into sleep. medication refills • We have free delivery within the Keep a dark bedroom—incity limits vest in blackout curtains if • We compound and flavor prescriptions to meet your needs need be.

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Add white noise

Giving your brain a noise to associate with relaxing sleep can help you drift off more quickly. White noise can also mask other sounds that may distract sleep, such

Make the bedroom a cozy retreat. Your bedroom should be a relaxing sanctuary. Fill it with cozy cushions and pillows. Make sure the room is clean and clutter-free. Relaxing blues and purples can be soothing colors to use in decorating, and the use of lavender essential oil could also add to the relaxing environment.

Avoid distractions

When setting up your bedroom, do not fill it with electronics, such as a computer, tablet and television.

These devices could contribute to wakefulness and actually impede your ability to get the rest you need.

Keep cool

A cool bedroom is key to drifting off to sleep. Sweating and overheating can keep you awake, so drop the temperature down at night and dress lightly for bed. You want to feel comfortable and not too hot or cold.

If sleeplessness becomes a chronic problem and is not alleviated by changing the sleeping environment, visit a doctor.

September 4, 2013 North County Outlook

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New clinic serves needy, uninsured Community Health Center of Snohomish County opened its newest branch August 12 in a low-slung building next to Cascade Valley Hospital, at 326 Stillaguamish Avenue in Arlington. The facility, which has undergone a $2.4 million facelift, offers both medical and dental care.

The nonprofit clinic is specifically dedicated to providing health care to uninsured children and adults in north Snohomish County.

“Our mission is to see any patient, regardless of the ability to pay,” said Larry Warner, board chair of Community

Health Center of Snohomish County during a grand opening event last Friday.

“Eighty-eight percent of our patients are below the poverty level, but we know they deserve quality health care, and that’s why we’re here.”

CHC is also one of a dwindling number of clinics that will accept Medicare and Medicaid patients.

Even before it opened, the CHC dental clinic had booked 51 appointments.

Dentists and hygienists on staff are expected to serve approximately 200 patients each month, primarily children but including adults

who need urgent dental care.

The medical clinic on the ground floor can accommodate 150 patients each month. The clinic provides services on a sliding fee scale, but as Warner mentioned, no one is turned away due to an inability to pay.

The medical clinic is open

from 8 a.m. to 5:30 p.m.

Mondays, Tuesdays, Wednesdays and Fridays, and 9 a.m. to 5:30 p.m. Thursdays. Call 360-572-5400 for appointments.

The dental offices are open 7 a.m. to 5:30 p.m. Monday through Friday. Call 360572-5430 for appointments.

Marysville Vision Source Kim M. Kron, O.D. • Jessie L. Liu, O.D.

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September 4, 2013 North County Outlook

Living well after retirement

By Beckye Randall Staff Writer/Editor

As the years tick by for many retirees, the prospect of living independently becomes less and less certain.

But even though it may be time to leave the family home, seniors can still maintain a healthy, active lifestyle by choosing a residence in a facility like Marysville’s Windsor Square.

Windsor Square, located at 9912-48th Drive NE in Marysville, is a senior apartment complex that offers fully-equipped apartment homes combined with meal services, social activities, housekeeping and transportation. The combination of independence and amenities helps seniors who don’t need specialized care maintain their sense of self-determination while providing peace of mind for their families.

“Windsor Square is much more than a collection of apartments,” said executive director Sharon Shaw.

“Our residents are provided

n Windsor Square’s professional staff includes (from left) Nicole Booth, dining room coordinator; Angela Martin, business office manager; Pam Schreurs, activity director; and executive director Sharon Shaw.

breakfast and dinner, all their utilities except phone service, weekly housekeeping and laundry services, and lots of activities.”

In addition to informal movie nights, crafts and card games, the center’s activity

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director, Pam Schreurs, also plans a monthly Ladies’ Tea and Men’s Breakfast, special birthday parties and other celebrations. Residents have full use of Windsor Square’s library, beauty and barber salon, laundry facilities and areas to host family gatherings.

Most of the 95 apartments feature one bedroom, a living/dining area, a small but functional kitchen and surprising amounts of storage, all within 575 square feet. With big windows and lots of light, the units offer attractive views of the mature landscaping surrounding the buildings.

There are also six 2-bed-

room units in the complex, measuring 700 sq. ft.

Each unit also comes equipped with several safety pull cords, located in the bedroom and bathroom, in case of an emergency. Staff responds immediately to help the residents and summon emergency medical care if needed.

The apartments are undergoing complete remodels as they become vacant, updating the finishes and replacing traditional bathtubs with walk-in tub/showers.

In fact, the entire building is slated for remodel beginning this fall. The spacious Continued next page

September 4, 2013 North County Outlook

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Retirement living Continued from previous page

dining room and kitchen facilities will be expanded, and the public areas will be modernized.

“We’re hoping that our mural in the main entry, which was painted by Gene Waggoner, will remain,” said Shaw. “In fact, the residents signed petitions asking for it to be saved, so we’re hopeful we’ll be able to maintain it.”

Those living at Windsor Square are often asked their opinions about the facility’s operations and amenities, according to Shaw.

“Our residents don’t have the worry of taking care of a home, and they enjoy being surrounded by others with the same life experiences and

n The media room is a favorite hangout for Windsor Square’s residents, with comfy chairs and a large screen TV.

similar needs,” said Shaw.

“They’re able to make choices for themselves. They’re in charge of their own daily schedule, their meal choices, but they know if they need

some help, we’re here to provide that.”

Transportation to and from medical appointments, or for grocery shopping or other errands, is provided

at no charge for residents.

Windsor Square employs more than 20 staff members to maintain the facility and provide services.

“We provide a lifestyle, not just an apartment,” said Shaw.

Windsor Square is one of thirteen senior residences in Washington owned by Campbell-Hogue and Associates of Bellevue. The company also operates apartment homes in Texas, Arizona and Utah.

One-bedroom apartments are priced at $1,995, including all amenities.

Tofindoutmoreortoschedule a tour,visit www.windsorsr living.com or phone (360) 653-1717.

Accepting New Patients – Most Insurances Accepted

“I would do it all over again.”

When I moved to Washington from Oregon in 2000, I was concerned about finding a new dentist for my family. I asked at my new Job at the American Cancer Society if anyone had a great dentist for my kids. Luckily, someone recommended Dr. Gosch and he took care of my kids and me with diligent attention to prevention and repair. As I age he has moved along to installing implants as needed and additional prevention “After a long period of resisting going to the dentist my wife go work see for advice for aging teeth. I am grateful for the staff person thatsuggested has long leftI my the secret my dentist.

Dr. Gosch and I amofreally glad I did. Dr. Gosch and his staff are very friendly, implant you and see was frontsure of myyou mouth and very important caring andMy professional theyin the make understand the carefor youit toareappear staff’s attention to working aroundup a busy family and receiving. Inatural. had a His tooth thatconscientious was in really bad shape, it ended breaking andwork schedule has beendo a blessing. meover email in my appointments and texting to I towould it Letting allDr. again! needed be extracted.

After talking with Gosch I chose to get an implant “After a long period resisting the resources dentist my wife suggested I go remind me of of them.

So, asgoing I passtoalong to cancer patients in my job,see I am Dr. I ammyreally Dr.ifGosch and his are very friendly, andGosch I wasand surprised that wasIasdid. easy not easier thanstaff getting a filling.

The sharing dentistitglad resource to you! caring and professional and they make sure you understand the care you are work wasIdone in was visits and Gosch’s office. visit receiving. tooth really bad both shape, ended breaking and Ihad can’tabasically help it Ithat love toonly helpin2people....hmm mustinbeitDr. why I wasup drawn to theOne dental needed to be extracted.

After with Dr.one Gosch to get implant to do the extraction and placetalking the post and visitItochose get my newantooth and it practice of Dr Gosch. and I was surprised that it was as easy if not easier than getting a filling. The turned outdone great.

I stillwith need more work and haveinevery confidence in Dr. Gosch work was basically inmy only 2 visits and both Dr. Gosch’s office.

One visit Still smiling implanted front tooth!

I would do it all over again!

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Grove Street Family Clinic has been providing quality care in the region for more than 13 years as a primary care practitioner. We are able to handle the “day to day” needs of the entire family at affordable prices.

toand do his the staff extraction and place the post them and one visit to get my new tooth and it andIIstill would recommend to anyone.” turned out great. more of work and have confidence in inDr. GoschCounty.

Jerri Wood, whoneed is the Quality Life Manager for theevery American Cancer Society Snohomish and his staff and I would recommend them to anyone.” Craig Bishop-Marysville Craig Bishop-Marysville

Gregory J. Gosch, DDS

Gregory J. Gosch, DDS Implant and Adult Dentistry Cosmetic & Restorative AdultRestorative Dentistry, Implant Surgeon Diplomate, Congress •of360-659-7617 Oral Implantologists 4825 GroveInternational Street • Marysville www.drgosch.com Member, American Academy of Sleep Medicine

Implant and Adult Restorative Dentistry 4825 Grove Street • Marysville • 360-659-7617 www.drgosch.com

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September 4, 2013 North County Outlook

Cascade Valley Hospital and C yoga | wellness coaching nutritional counseling | personal training

Maxwell Waiting Room

Cascade Valley Hospital & Clinics Diabetes Education Blood Glucose and Cholesterol Novo Nordisk • Abbott Diabetes Care

Outdoor Pavilion

Cascade Hallway Reception

Restrooms

Lobby

Entrance

Heart & Brain Exhibit Main Lobby

Arlington Family Chiropractic • be.well. • Autumnwood Dental American Red Cross • Harman Eye Clinic Cascade Skagit Health Alliance • Marysville Foot & Ankle Cascade Valley Hospital & Clinics Wound Care & Hyperbaric Medicine Center Cascade Valley Hospital & Clinics Orthopaedic Clinic Cascade Valley Hospital & Clinics

First Floor

Sno-Isle Food Co-op Marysville YMCA Marysville Care Center Back Country Horsemen - Leave No Trace Gentiva Home Health Community Life Jackets - SNOCO Safe Kids City of Arlington Pregnancy Aid - WIC Sunrise Services Community Health Center Life House Youth Ministries Mountain View Rehabilitation & Care Center American Cancer Society Regency Care Center Full Life Care Stillaguamish Senior Center Merrill Gardens Stillaguamish Valley Genealogical Society North Snohomish County Head Start

September 4, 2013 North County Outlook

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Clinics Health and Safety Fair Rainier Room

Flu Shots

Rainier Hallway

Pilchuck Room

Restrooms

Symmetry Chiropractic • Arlington Public Library Warm Beach Care Center • Brad Larreau, DDS Victim Support Services • TB Photovoice Vibrant USA • Cascade Valley Surgery Center Cascade Valley Hospital Pain Clinic Health First Chiropractic • Stillaguamish Athletic Club Olympic Avenue Massage

Rainier Hallway Vendors:

Pilchuck Hallway

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[360] Healthy Living Guide

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September 4, 2013 North County Outlook

Health district warns about bats The Snohomish County Health District is reminding locals about the dangers of the small bats that call the Pacific Northwest home.

Most bats are harmless, but a few carry rabies, a deadly disease that can be passed on to humans through small bites and scratches. Nine rabid bats were found in Washington last year, and one of them came from Snohomish County.

Bats like to “hang out” in vacation cabins, attics, barns and outbuildings, and wherever there are plenty of insects they can eat. A bat bit a toddler in Pasco this year after falling out of a patio umbrella. The toddler got treatment to prevent rabies even before it was confirmed that the bat had the disease.

According to Bats Northwest, Washington bats are quite small for the most part, and can squeeze through an opening 1” x 5/8”. Attics and walls provide good roost sites and bats often can enter these areas where the sides of a house meet the roof or chimney. If an entry Dr. Devin Brossard

has been used for any length of time, it becomes stained and easier to identify.

You can also find entries by watching in the evening for the bats to emerge.

Anyone who might have been bitten, scratched or was simply sleeping in a room where a bat is later found should contact Snohomish Health District Communicable Disease staff at (425) 339-5278. In the Northwest, bats are the only animals likely to carry rabies.

People often call a pest control company to get rid of bats in or near their home. Those companies should also refer people to the Health District to make sure the client was not exposed to rabies. A South Carolina woman who died from rabies in 2011 had sought help for bats in her home, but was never referred to public health for advice about preventing rabies.

Bats found in a home or setting where they may have contacted humans should be safely caught and refrigerated. Call Snohomish Health District to see if the bat needs to be tested. If a bat

is not available for testing and people have been exposed to it, rabies shots are usually necessary.

Any mammal can contract rabies, but cats are especially susceptible because they are natural hunters of flying creatures and often catch bats. It is very important to have your pets vaccinated against this disease, even if they are “indoor” pets.

To safely capture a bat, find a small container like a box or a large can, and a piece of cardboard large enough to cover the opening in the container. Punch small air holes in a cardboard box or large can. Put on leather work gloves.

When the bat lands, approach it slowly and place the container over it. Slide the cardboard under the container to trap the bat inside. Refrigerate the container until talking with Snohomish Health District staff.

For more information about bats and rabies, visit the state Department of Health website: http://www.doh. wa.gov.

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Providing dental care a world away Recently, Marysville dentist Greg Gosch led a dental mission team to San Ramon, Nicaragua, with Corner of Love Ministries, to provide much needed dental care to people in the surrounding villages. Joining him on the mission were his wife Susan, a dental hygienist, staff members Cynthia Fox and Jolene Hollingsworth, both dental assistants, Dr. Bud Dubay and his wife Darlene who reside in Stanwood, patient and dental hygienist Carlos Valverde, and dental assistant Ramona Lujan.

Nicaragua, a tropical land that produces some of our favorite Starbucks coffee, is one of the poorest countries in Central America. It is a country of extremes: incredible beauty, a tropical climate, fertile soil that can grow almost anything, yet the majority of people live in tiny shacks, some made out of plastic sheets and branches, others of mud bricks. In this remote area, only one in 53 “homes” have potable water. Less than 20 percent of the children are able to attend school for lack of basic needs like clothing or shoes, as well as nominal tuition fees.

After landing in Managua, the capital of Nicaragua, Dr. Gosch and his team, along with the 60 medical team members, were bused for 3 hours along winding mountain roads to San Ramon. All team members are housed and fed at the Quinta, a beautiful facility completed in 2009. The next day, donated medical, dental, and clothing supplies brought in old suitcases by team members were unpacked, organized and added to the existing stock. Plastic bins were packed with pharmaceuticals, donated clothing items and shoes, donated personal items and dental supplies in anticipation of our first village work day.

Each morning two teams of 30 to 35 volunteers would depart the Quinta in brightly colored buses for a 3-hour ride into the mountains to small country vil-

n Dr. Gregory Gosch (right) of Marysville spent several weeks, accompanied by his office staff, helping underserved patients in rural Nicaragua during a recent mission.

lages. Every day brought a new adven- are the most kind and caring people you ture. The beautiful scenery and strange could imagine.” plant life made the bus rides amazing.

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SightConnection.org “Nothing could have been more rewarding than taking a child out of pain, Enhancing the ability of people keeping a wage earner healthy and pro- with vision loss to lead active, ductive, knowing that each day lives independent lives were being changed and improved,” Visit our store! said Dr. Gosch. “The people were gracious and thankful for everything they SightConnection.com were provided. Their smiles were contaProducts for living well with vision loss gious and in spite of their poverty, they

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September 4, 2013 North County Outlook

Insurance exchanges open next month State officials hope that health exchanges will bring transparency and clarity to the health insurance buying process.

By Christopher Andersson Staff Writer

2014 will be the first year that U.S. citizens are required to have health insurance, but a clearer view of their options is coming with Washington Healthplanfinder, the state’s insurance marketplace.

As part of the Patient Protection and Affordable Care Act (a.k.a. Obamacare), states are mandated to create insurance marketplaces for easier comparison/purchasing and greater competition between health plans.

The marketplaces, known as ‘health exchanges,’ allow for a direct comparison of cost, benefits and quality of the multiple health plans available in Washington state.

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The state’s exchange will begin enrolling customers on Oct. 1. The site will be located at www.wahealthplan finder.org.

“An exchange is a mechanism for organizing the health insurance marketplace to help consumers and small businesses shop for coverage in a way that permits easy comparison of available plan options based on price, benefits and services, and quality,” writes a U.S. Department of Health and Human Services official in a guidance letter for states.

All plans available must cover ten basic services: ambulatory patient care (e.g. outpatient services/clinic visits), emergency services, hospitalization (e.g. room/ board/care while hospitalized), maternity and newborn care, mental health and substance use services, prescription drugs, rehabilitative services and devices, laboratory services (e.g. blood/tissue testing), preventive and wellness services (e.g. routine physicals) and pediatric ser-

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The health plans are given metal grades, bronze being the lowest, platinum being the highest. Bronze plans pay 60 percent of the health costs for the patient on average, while platinum plans pay 90 percent of the cost on average.

Four companies, LifeWise, Premera Blue Cross, Bridgespan, and Group Health Cooperative, were approved to sell health plans in the Washington state exchange.

“Unfortunately not all of the insurers who applied were approved,” said Mike Kreidler, Washington Insurance Commissioner in a statement. “Several of them struggled to guarantee access to certain providers and hospitals. It’s our duty to make sure that if you buy a health plan, you can actually see the doctor or hospital that provides the service you need.”

The four companies will provide a total of 31 health plan options. Residents in some counties are limited in

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the choice of plans; however, all are available in Snohomish County.

Help navigating between your health insurance options will be offered online, in-person or over the phone.

The call center for phone assistance opened on September 3, 2013. The toll-free number is 1-855-923-4633, and is available weekdays 7:30 a.m. to 8 p.m. with help provided in 175 different languages.

In-person assistance will be provided by the Whatcom Alliance for Health Advancement in Bellingham.

Online assistance may not be available until later, according to the Puget Sound Business Journal. A mobile app may also be available later as well.

Open enrollment, the time of the year you are free to make changes to your health coverage, begins on Oct. 1 and ends on March 31, 2014.

New health coverage would begin January 1, 2014.

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Marketplace Continued from previous page

Act every­one is required to have health insurance in 2014, or they will pay a fee when filing their income tax return.

There are some exceptions, including: individuals with an income below $10,000 or families with an income below $20,000; if you would have to pay more than eight percent of your income taking into account tax credits; those that are part of a Native American tribe; or those that are part of a religion opposed to acceptance of benefits from a health insurance policy.

The fine for an individual being uninsured will begin at $95 in 2014, increase to $325 in 2015 and increases again to $695 in 2016.

According to Kreidler, 1.1 million people in Washington state are unin-

sured. That includes 112,400 in Snohomish County.

Medicaid and tax credits for those with low income are expanding under the Affordable Care Act and could help an estimated two-thirds of Snohomish County’s uninsured.

Under new guidelines, any Washington state adult earning below 138 percent of the federal poverty level ($15,856 annual income) would be eligible to enroll in Medicaid, accord-

ing to Washington State Health Care Authority.

People with income below 400 percent of the federal poverty level ($45,960 for an individual, $94,200 for a family of four) will have subsidies available to pay a portion of their monthly premium and will have a cap on out-of-pocket expenses if they bought their insurance from an exchange.

For more information go to wahb exchange.org or wahealthplanfinder.org.

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September 4, 2013 North County Outlook

Keep medications secure, safe Prescription medications of all kinds can pose a danger if taken by someone other than the patient. While some may produce uncomfortable side effects, the powerful drugs used to combat cancer can be deadly.

A cancer diagnosis is seldom easy for the person receiving the news or his or her loved ones. Cancer treatment often involves weeks of intensive medical therapy that can include radiation, chemo­therapy and oral medications.

Though such medications can be a key component of successful treatment, extra pills in the home can pose additional hazards to children and even elderly residents who may inadvertently get into unsecured pills.

Cancer patients may be prescribed a number of prescription medications during the course of their treatments.

Antidepressants, opioids, steroids, anti-convulsants, and radiopharmaceuticals may be prescribed to treat pain and other side effects of cancer. When taken in the right doses, these medicines can help patients withstand and ultimately overcome their disease. In the wrong hands, the same drugs can prove poisonous, especially to young children.

According to Safe Kids Worldwide, 500,000 parents and caregivers per year call a poison control center because a child accidentally ingested

medicine or was given the wrong dose. In 2011, 67,000 children were treated in an emergency room for medicine poisoning. Based on emergency room visits, many children come in contact with these medications in places other than the medicine cabinet. Kids may find spare pills on the ground, in a purse or bag or on a counter or nightstand.

The United States Centers for Disease Control and Prevention reports a 160 percent increase in poisonings in children from 1999 to 2009, 91 of which are the result of a drug overdose. The Cincinnati Children’s Hospital says

that kids ages five and younger are the most likely victims of prescription drug poisoning. In homes where there is an abundance of medications being used to treat cancer or other illnesses, diligence is needed on the part of adults.

Childproof bottles are seldom enough. Very often adults forget to close the lids properly. Tenacious children can sometimes figure out how to get lids off of bottles even if they are touted as childproof.

Cancer patients taking medication might want to employ some additional safety measures in order to protect young children.

• Do not advertise medication use to your children.

Take pills away from curious eyes so that youngsters are not tempted to try Mom or Dad’s medicine, which for all intents and purposes, looks like candy to a child.

• Store medications high up, ideally in a locked cabinet.

Remain careful when returning pill containers to these locked cabinets after use.

• Use individual-dose cases, many of which can be locked with a key or a combination code. This can protect against spills should the case fall on the floor.

• Ask for medications to be prescribed in blister packs that are more difficult to open.

• Dispose of any expired medication or pills you no longer need so there are no extras lying around the house.

• Dispose of pills in an outside garbage receptacle so that children or pets cannot find them and swallow them.

• Never store pills in a container other than the prescription container or a medication dispenser.

When cancer treatment necessitates the taking of additional medications, it becomes even more important to protect children from accidental—and sometimes intentional—ingestion of medications.

September 4, 2013 North County Outlook

[360] Healthy Living Guide

Directory of Local Medical Providers CHEMICAL DEPENDENCY/ ADDICTION MEDICINE Greg Bauer, Owner Alpine Recovery Service Inc. 16404 Smokey Point Blvd. #109 Arlington • 360-658-1388 Catholic Community Service Recovery Center 1227 2nd Street Marysville • 360-651-2366 Compass Health 3320 173rd Place NE Arlington • 425-349-8700 Compass Health 4308 76th Street NE Marysville • 425-349-7352 Focus 509 N West Avenue, Ste. B Arlington • 425-349-8130 Scott Wykes, PhD Clearview Counseling 1106 Columbia Avenue #100 Marysville • 360-651-5693

CHIROPRACTIC Donne Bates, DC Granite Falls Chiropractic 13821 Jordan Road Arlington • 360-691-7731 Melanie Bober, DC Peterson Family Chiropractic 415 N. Olympic Avenue Arlington • 360-435-9200 Dennis L. Booth, DC Fourth Street Chiropractic Center 1606 4th Street Ste. E Marysville • 360-659-2938 Devin A. Brossard, DC Symmetry Chiropractic & Wellness

Center 3710-168th St. NE Marysville • 360-722-1578 David G. Brown, DC Brown Family Chiropractic 4505 107th Place Northeast Marysville • 360-653-4774 Bob DeFever, DC Marysville Chiropractic 1617 Grove Street Marysville • 360-659-6241 Michael Eberle, DC Eberle Chiropractic Clinic 1603 3rd Street Marysville • 360-653-7333 Loren C. Ernst, DC Ernst Chiropractic Clinic 16714 Smokey Point Blvd.

Arlington • 360-659-8464 Shawn Gay, DC Arlington Family Chiropractic 20218 77th Avenue NE Arlington • 360-435-3900 Jay F. Goodwin, DC Smokey Point Chiropractic 4113 172nd Street NE Arlington • 360-653-4626 Tony Gutierrez, DC Gutierrez Family Chiropractic 3704 172nd St NE, Ste. N Arlington • 360-658-3818 Craig Hedlund, DC Hedlund, Welly & Schultz Chiropractic 17432 Smokey Point Blvd. #105 Arlington • 360-653-2222 Doron Kantor, DC Chirocare 9528 State Ave, Ste. B Marysville • 360-659-6554

Michael Keehn, DC Keehn Chiropractic Clinic, P.S. 1241 State Avenue #101 Marysville • 360-659-8411 Stephen Keehn, DC Keehn Chiropractic Clinic, P.S. 1241 State Avenue #101 Marysville • 360-659-8411 Matt McCann, DC McCann Family Chiropractic 11605 State Avenue #111 Marysville • 360-657-7183 Gordon Myco, DC State Street Family Chiropractic 919 State Avenue, Ste. 102 Marysville • 360-653-6010 Douglas A. Nordstrom, DC Nordstrom Chiropractic Center 1818 Grove St. Marysville • 360-653-6533 James Oosterwyk, DC Arlington Chiro & Wellness 113 W. Division Street Arlington • 360-435-5200 Scott Peseau, DC Arlington Spine Center 215 E. 3rd Street Arlington • 360-474-9900 Les Peterson, DC Peterson Family Chiropractic 415 N. Olympic Avenue Arlington • 360-435-9200

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[360] Healthy Living Guide

CHIROPRACTIC (Cont’d)

ENDODONTICS

Jeffrey B. Ronning, DC Ronning Chiropractic 3116 188th Street NE, Ste. A Arlington • 360-653-8307

Kathleen Mulligan, DDS 1513 10th Street Marysville • 360-658-2577

Stan Rosebrook, DC Arlington Chiropractic Center 514 N West Avenue Arlington • 360-435-3052 Ken Shotwell, DC Shotwell Chiropractic 118 E. Haller Avenue Arlington • 360-435-2222 James Stirton, DC Arlington Family Chiropractic 20218 77th Avenue NE Arlington • 360-435-3900 Marcus Woodall, DC Arlington Family Chiropractic 20218 77th Avenue NE Arlington • 360-435-3900

DERMATOLOGY North Sound Dermatology Dieter Schmidt, MD FAAD FACMS K. Mireille Chae, MD FAAD Katrina Bassett, MD FAAD Craig Baucher, MPAS PA-C Vena Melendez, MMSc PA-C 16410 Smokey Point Blvd., Ste 300 Marysville • 425-385-2009

FAMILY PRACTICE Jared M. Anderson, MD Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900 Lise Alexander, MD Tulalip Health Clinic 7520 Totem Beach Road Marysville • 360-651-4511 Charles T. Chaffee, MD Arlington Family Medicine 7530 204th Street NE Arlington • 360-435-8810 Harold Clark, MD Marysville Family Medicine 4404 80th St NE Marysville • 360-659-1231 David A. Dunnington, MD Smokey Point Family Medicine 16410 Smokey Point Blvd., Ste. 101 Arlington • 360-659-4440 Jennifer Engstrom, MD Providence Medical Group – Marysville 18630 State Avenue Marysville • 360-658-6800

Amy Cheng, MD Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900

Susana Escobar, MD Marysville Family Medicine 4404 80th St NE Marysville • 360-659-1231

Alexander Jack, MD Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900

James R. Fletcher, MD Whitehorse Family Medicine 875 Wesley Street, Ste. 250 Arlington • 360-435-2233

DIALYSIS

Vernon Hall, DO Cascade Valley Health Alliance 3823 172nd Street NE Arlington • 360-618-5000

Puget Sound Kidney Center 18828 Smokey Point Blvd Arlington • 360-454-5280

September 4, 2013 North County Outlook

Anne Herbert, PA-C Cascade Valley Health Alliance 3823 172nd Street NE Arlington • 360-618-5000 Mark Holland, MD Marysville Family Medicine 4404 80th St NE Marysville • 360-659-1231 David W. Janeway, MD Whitehorse Family Medicine 875 Wesley Street, Ste. 250 Arlington • 360-435-2233 David Jimenez, MD Seamar Clinic 9710 State Avenue Marysville • 360-653-1742 Ann C. Kammeyer, MD Marysville Clinic 1416 8th Street, #1 Marysville • 360-659-3191 Robert J. Klem, MD Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900

September 4, 2013 North County Outlook

FAMILY PRACTICE (Cont’d) Mark A. Lucianna, MD Arlington Family Medicine 7530 204th Street NE Arlington • 360-435-8810 Dennis S. Mann, DO Smokey Pt Osteopathic Family Medicine 16410 Smokey Point Drive Arlington • 360-651-1833

[360] Healthy Living Guide Philip Zylstra, MD Cascade Skagit Health Alliance 3823 172nd Street NE Arlington • 360-618-5000

GENERAL SURGERY Ekaterina Knowlton, MD Cascade Surgeons 875 Wesley Street #230 Arlington • 360-435-6097

Jose Mata, MD Seamar Clinic 9710 State Avenue Marysville • 360-653-1742

Monroe C. Whitman, III, MD Cascade Surgeons 875 Wesley Street #230 Arlington • 360-435-6097

Sean McElhaney, MD Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900

HEALTH CARE CENTERS

Tuyen Nguyen, MD Seamar Clinic 9710 State Avenue Marysville • 360-653-1742 Carmen Oprea, MD Cascade Skagit Health Alliance 3823 172nd Street NE Arlington • 360-618-5000 Anne E. Pham, MD 4420 76th Street NE Marysville • 360-651-7490 Tari Lynn Roche, DO Cascade Valley Smokey Point Clinic 16410 Smokey Point Blvd., Ste. 200 Arlington • 360-653-4569 Greg Sanders, MD Seamar Clinic 9710 State Avenue Marysville • 360-653-1742 Philip Smith, MD Marysville Family Medicine 4404 80th St NE Marysville • 360-659-1231 Mark Spencer, MD Cascade Skagit Health Alliance 3823 172nd Street NE Arlington • 360-618-5000

4th Street Medical Care 1602 4th Street Marysville • 360-659-4141 10 Minute Walk-In Clinic 540 N West Avenue Arlington • 360-435-8262 10 Minute Walk-In Clinic 9528 State Avenue, Ste. A Marysville • 360-658-0233 Cascade Skagit Health Alliance 3623-172nd St. NE Arlington • 360-618-5000 Community Health Center 326 Stillaguamish Ave. Arlington • 360-572-5400 Grove Street Family Clinic 1630 Grove Street Marysville • 360-653-3500 Marysville Family Medicine 4404 80th Street NE Marysville • 360-659-1231 Providence Medical Group – Marysville 11603 State Avenue Marysville • 360-658-6800 Sea Mar Community Health Center 9710 State Avenue Marysville • 360-657-7910

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The Everett Clinic – Marysville 4420 76th Street N Marysville • 360-651-7490 The Everett Clinic – Smokey Point Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900

INTERNAL MEDICINE Michael John Andreoni, MD Providence Medical Group – Marysville 11603 State Avenue Marysville • 360-658-6800 Don B. Andrews, MD Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900 Sidra Aslam, DO Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900 Seyed “Sam” Hejazi, MD Cascade Skagit Health Alliance 3823 172nd Street NE Arlington • 360-618-5000 L Albert Labib, MD Providence Medical Group – Marysville 11603 State Avenue Marysville • 360-658-6800 Patrycja Turek, MD Cascade Skagit Health Alliance 3823 172nd Street NE Arlington • 360-618-5000

OBSTETRICS/GYNECOLOGY David M. Gran, MD Cascade Valley Women’s Health 903 Medical Center Drive Arlington • 360-435-0242 Ann A. Hoffman, DO Cascade Valley Women’s Health 903 Medical Center Drive Arlington • 360-435-0242

26 ONCOLOGY Mehrdad Jafari, MD Cascade Skagit Health Alliance 3823 172nd Street NE Arlington • 360-657-8660 Kiarash Kojouri, MD Cascade Skagit Health Alliance 3823 172nd Street NE Arlington • 360-657-8660 Bruce Mathey, MD Cascade Skagit Health Alliance 3823 172nd Street NE Arlington • 360-657-8660

OPHTHALMOLOGY

[360] Healthy Living Guide OTOLARYNGOLOGY (EARS, NOSE, THROAT) Gary L. Brown, MD Cascade Medical Group 20302 77th Ave NE Arlington • 360-435-6300 Jonathan Regan Grant, MD Cascade Medical Group 20302 77th Ave NE Arlington • 360-435-6300 James R. Gross, MD Cascade Medical Group 20302 77th Ave NE Arlington • 360-435-6300

Bruce J. Ballon, MD Harmon Eye Clinic 903 Medical Center Drive Arlington • 360-435-8595

Natalie Higgins, MD Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900

Michael J. Fleming, OD Harmon Eye Clinic 903 Medical Center Drive Arlington • 360-435-8595

David Hock, DO Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900

R. Lee Harman, MD FACS Harmon Eye Clinic 903 Medical Center Drive Arlington • 360-435-8595

Gary K. Johnson, MD Cascade Medical Group 20302 77th Ave NE Arlington • 360-435-6300

Bruce E.Wietharn, MD Harmon Eye Clinic 903 Medical Center Drive Arlington • 360-435-8595

David A. Riley, MD Cascade Medical Group 20302 77th Ave NE Arlington • 360-435-6300

ORTHOPEDIC SURGERY

PEDIATRICS

Edward W. Eissmann, MD Cascade Valley Orthopedics 328 Stillaguamish Arlington • 360-435-6641

Krista Galitsis, MD, PhD Cascade Skagit Health Alliance 3823 172nd Street NE Arlington • 360-618-5000

Rodney E. Johnson, MD Cascade Valley Orthopedics 328 Stillaguamish Arlington • 360-435-6641

Rosana L. Go, MD Cascade Valley Arlington Pediatrics 875 Wesley St., Ste. 130 Arlington • 360-435-6525

Paul E. Naumann, MD Cascade Valley Orthopedics 328 Stillaguamish Arlington • 360-435-6641

Susana Myers, DO, MPH Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900

September 4, 2013 North County Outlook

Denise Shushan, MD Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900 Doina A. Stefan, MD Cascade Valley Arlington Pediatrics 875 Wesley St., Ste. 130 Arlington • 360-435-6525

PHYSICAL THERAPY Elaine Andersen, PT Cascade Rehabilitation Associates 3710 168th St NE, Ste. A102 Arlington • 360-658-0508 Annie Balok, DPT, L/ATC Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900 Dawn Bostic, PT, OCS IRG 7728 204th St. NE, Ste. A Arlington • 360-403-8250 David Kalahar, MPT Cascade Rehabilitation Associates 3710 168th St NE, Ste. A102 Arlington • 360-658-0508

September 4, 2013 North County Outlook

PHYSICAL THERAPY (Cont’d) Stephanie Kiel, OTR/L, CHT Cascade Rehabilitation Associates 3710 168th St NE, Ste. A102 Arlington • 360-658-0508

[360] Healthy Living Guide Stephanie Wilson, DPT Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900

Gary L. Brown, MD Cascade Medical Group 20302 77th Ave NE Arlington • 360-435-6300

Chris LaPolla, PT IRG 7728 204th St. NE, Ste. A Arlington • 360-403-8250

Natalie Higgins, MD Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900

Joan Myrick, LMP IRG 7728 204th St. NE, Ste. A Arlington • 360-403-8250

PODIATRY

Katy Osmundson, ATC IRG 7728 204th St. NE, Ste. A Arlington • 360-403-8250 Debbie Phibbs, OTR/L, CHT IRG 7728 204th St. NE, Ste. A Arlington • 360-403-8250 Jim Romo, PT Reaction Physical Therapy 3131 Smokey Point Drive, Ste. G Arlington • 360-658-8400 Catherine Schneider, PTA IRG 7728 204th St. NE, Ste. A Arlington • 360-403-8250 Katie Templin, PTA IRG 7728 204th St. NE, Ste. A Arlington • 360-403-8250

Todd C. Skiles, DPM Marysville Foot & Ankle Clinic 9516 State Avenue, Ste. D Marysville • 360-653-3354

PLASTIC/COSMETIC SURGERY PSYCHOLOGY

Amy LaBorda, PT, DPT IRG 7728 204th St. NE, Ste. A Arlington • 360-403-8250

Brittany Olson, DPT Cascade Rehabilitation Associates 3710 168th St NE, Ste. A102 Arlington • 360-658-0508

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Fred J. Hawley, Jr., DPM Alpine Foot & Ankle Clinic 17432 Smokey Point Blvd., Ste. 103 Arlington • 360-653-2326 Jeff Korab, DPM Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900 Jessica Lund, DPM Smokey Point Medical Center 2901-174th St. NE Smokey Point • 360-454-1900 Michael B. Riojas, DPM Foot & Ankle Specialists of Washington 875 Wesley Street, Ste. 110 Arlington • 360-474-9600

Frank J. Hammer, PhD Cascade Medical Center 326 S. Stillaguamish Avenue, Ste. 7

RADIOLOGY Kristin R. Grant, MD Cascade Radiology Consultants 330 Stillaguamish Avenue Arlington • 360-435-0504 Ross P. Hartling, MD Cascade Valley Hospital 330 S. Stillaguamish Avenue Arlington • 360-435-2133 Pierre Lanthiez, MPH, MD Cascade Valley Hospital 330 S. Stillaguamish Avenue Arlington • 360-435-2133

SLEEP MEDICINE Muhammad Sayed, MD Cascade Valley Sleep Disorders Center 875 Wesley, Ste. 240 Arlington • 360-435-7374

[360] Healthy Living Guide

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September 4, 2013 North County Outlook

Directory of Local Dental Providers David J Abdo, DDS 122 E Maple St. Arlington • (360) 435-8411

Patricia V Conn, DDS 7825 47th Ave NE Marysville • (360) 659-1223

Kevin A Harrison, DDS 16410 Smokey Point Blvd # 305, Arlington • (360) 653-7654

Greg Adams, DDS 1083 State Ave. Marysville • (360) 659-0864

Dirk T De Young, DDS 1222 2nd St. Marysville • (360) 653-2783

John D Hixson, DDS PS 7825 47th Ave NE Marysville • (360) 659-1223

Allen Creek Family Dentistry 6618 64th St NE Marysville • (360) 651-2900

Bryce K Duskin, DDS 20210 77th Ave NE Arlington • (360) 435-2151

Donald R Hodges, DDS 3210 Smokey Point Dr # 102 Arlington • (360) 657-3965

Arlington Dental Clinic 520 N Olympic Ave. Arlington • (360) 435-4043

Eagle Family Dental Center 20210 77th Ave NE Arlington • (360) 435-2151

J DR Hong, DDS 1809 4th St. Marysville • (360) 653-1114

Arlington Family Dentistry 3911 171st St NE Arlington • (360) 658-7741

Jonathan Erhardt, DDS 7825 47th Ave NE Marysville • (360) 659-1223

Tara Hudson, DDS 1622 Grove St. Marysville • (360) 659-5611

Arlington Family Dentistry, DMD 17306 Smokey Point Dr Ste 21 Arlington • (360) 658-7806

Alan D Erickson, DDS 302 E Division St. Arlington • (360) 435-3661

Jeff D Huleatt, DDS 20210 77th Ave NE Arlington • (360) 435-2151

Arlington Pediatric Dentist 3710 168th St. NE Suite B-105 Arlington • (360) 657-1650

Jeffrey L Erwin 7825 47th Ave NE Marysville • (360) 283-5936

George R Hussey, DDS FAGD 16825 Smokey Point Blvd Arlington • (360) 653-5197

Autumn Wood Dental 430 N West Ave. Arlington • (360) 474-9163

Holly E Eydenberg, DDS 3943 116th St NE # 103 Marysville • (360) 651-9580

Roger Knaphus, DDS 6618 64th Dr NE Marysville • (360) 651-2900

Avenue Dental Care 3402 173rd Pl NE Arlington • (360) 659-8777

Gentle Dental Marysville 3943 116th St NE Marysville • (360) 836-1872

Chia C Lee, DDS 3131 Smokey Point Dr # H2 Arlington • (360) 658-3131

Timothy Bennett, DDS 3943 116th St NE Marysville • (360) 651-9580

Shahram Ghafghazi, DDS 3943 116th St NE Marysville • (360) 651-9580

Dennis I Booth, DPC P 1606 4th St. Marysville • (360) 659-2938

Beth A. Gold, DDS 5100 Grove St. Marysville • (360) 659-6732

Kulits Ortho 3325 Smokey Point Dr. Arlington • (360) 659-5749 Paul E Kulits, DDS 302 E 3rd St. Arlington • (360) 435-2764

Boulevard Dental 16825 Smokey Point Blvd.

Arlington • (360) 653-5197

Gregory J Gosch, DDS 4825 Grove St. Marysville • (360) 659-7617

Cedar Family Dentistry 505 Cedar Ave. Marysville • (360) 659-3232

Otto J. Hanssen 3533 172nd St NE Arlington • (360) 436-6932

Lakewood Dental Care 2704 171st Pl NE Marysville • (360) 652-1400 Brad A Larreau, DDS 3210 Smokey Point Dr. Arlington • (360) 653-5577

September 4, 2013 North County Outlook

[360] Healthy Living Guide Olaru Serban, DDS 4922 Grove St. Marysville • (360) 659-8548 R Sharma, DMD 6618 64th St NE Marysville • (360) 651-2900 Shaw Orthodontics 4305 76th St NE Marysville • (360) 653-4114 Lu Lisa Shuwen, DDS 3325 Smokey Point Dr Arlington • (360) 653-7098

Misky K Lopez, DDS 9710 State Ave. Marysville • (360) 653-1742

Kathleen Mulligan 1513 10th St. Marysville • (360) 659-2577

John B Ludu, DMD 6618 64th Dr NE Marysville • (360) 651-2900

Northwest Smile Design 5100 Grove St. Marysville • (360) 658-7750

Shawn E Magelsen, DMD 5100 Grove St Ste B Marysville • (360) 658-7750

OM3 Oral Surgery 16410 Smokey Point Blvd Arlington • (425) 743-0227

Nanda K Manogaran, DDS 16410 Twin Lakes Ave # 107 Marysville • (360) 652-0800

Phillip A Paulsen, DDS 4403 76th St NE Marysville • (360) 659-6774

Marysville Children’s Dentistry 919 State Ave # 104 Marysville • (360) 659-8100

Kelly B Peterson, DDS 5100 Grove St # B Marysville • (360) 658-7750

Marysville Dental Center 7825 47th Ave NE Marysville • (360) 659-1223 Matthew J Maynard, DDS 3325 Smokey Point Dr # 101 Arlington • (360) 659-7633

Pleasant Smile Dental 16410 Twin Lakes Ave Ste 107 Marysville • (360) 652-0800 Pioneer Denture Clinic 619 Cedar Ave. Marysville • (360) 659-6300

Samuel A McClary, DDS 3823 172nd St NE Arlington • (360) 653-4569

Eustaquio Rivera Jr 10528 66th Ave NE Marysville • (360) 657-1549

McClary Kim & Wahan, DDS 16410 Smokey Point Blvd, Arlington • (360) 658-8822

Bart F Robison, PS 3710 168th St NE Arlington • (360) 651-9394

Smokey Point Family Dentistry 3533 172nd St NE Arlington • (360) 658-3000 Smokey Point Orthodontics 3325 Smokey Point Dr # 102 Arlington • (360) 659-5749 Smokey Point Smile 16825 Smokey Point Blvd Arlington • (360) 653-5197 Stillaguamish Family Dentist 4126 172nd St NE Arlington • (360) 657-3687 Robert & M A Strom 7115 77th Ave NE Marysville • (360) 658-6102 Sunrise Dental of Arlington 3131 Smokey Point Dr. Arlington • (360) 658-3131 Jeff E D Theis, MD, MSD 3325 Smokey Point Dr Ste 102 Arlington • (360) 659-5749 Thomas Family Dentistry 17432 Smokey Point Blvd Arlington • (360) 659-8406 Christopher Vanderhoef, DDS 3911 171st St NE Arlington • (360) 658-7806

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[360] Healthy Living Guide

September 4, 2013 North County Outlook

Fighting cancer at the dinner table Few, if any, families can say they have never had an experience with cancer. Cancer is a potentially deadly disease with no cure. While cancer can be treated effectively, there is no way for men and women to eliminate their risk of developing cancer.

Though cancer may strike even the healthiest of persons, there are ways men, women and even children can reduce their risk. One such way is to consume certain foods that researchers feel can reduce cancer risk. Though precisely how these foods fight cancer remains a mystery, cancer researchers feel they can effectively lower an individual’s cancer risk when combined to form a healthy diet.

Beans and Legumes

Beans boast numerous healthy attributes, and their potential to reduce cancer risk is one such attribute. Beans contain many phytochemicals that researchers feel protect the cells from the type of damage that can ultimately make a person susceptible to cancer. Beans also have been shown to decelerate tumor growth and prevent tumors from releasing potentially harmful substances that can damage nearby cells.

n Tomatoes, whether served fresh or as a paste or sauce, have been linked to reducing a person’s risk for various cancers, including cancers of the prostate, lung and stomach.

pact on cancer risk, but colorful fruits and vegetables contain more cancer-fighting nutrients than fruits and vegetables that aren’t as flashy.Consuming such fruits and vegetables also helps men and women maintain a healthy body weight, an important benefit when considering overweight and obesity increases a person’s risk for multiple cancers.

Foods with folate

Folate is a B vitamin that can reduce a person’s risk of developing several cancers, including those of the colon, rectum and breast. Those who are fond of a healthy breakfast to begin their day may already be getting healthy doses of folate, which can be Colorful fruits and found in eggs, fortified breakvegetables fast cereals, orange juice, and It may seem odd that a strawberries, among other food’s color can have an im- foods. If toast is your break-

men’s risk for prostate cancer. One such study, a 1995 study from researchers at the Harvard Medical School, found that men who ate 10 or more servings of tomatoes per week reduced their risk of developing aggressive prostate tumors by nearly 50 percent. Later research from the author of the 1995 study found that processed tomatoes, such as those found in tomato paste and tomato sauce, were even more effective at reducing cancer risk than fresh tomatoes. Tomatoes have also been linked to lowering a person’s risk for lung and stomach cancers.

fast of choice, opt for whole wheat toast, as whole wheat products are a good source of folate.

Water Grapes Water may not qualify as a food, but it may protect peoStudies have shown that resveratrol, a key ingredient in ple from bladder cancer. Pograpes, may prevent the type tential cancer-causing agents of damage that triggers the in the bladder are diluted production of cancerous cells. when drinking water. In adThough scientists are not yet dition, the more water you comfortable saying grapes, or drink the more frequently beverages like grape juice and you’re likely to urinate, which wine, can reduce cancer risk, means cancer-causing agents they believe that the antioxi- have less time to come into dant and anti-inflammatory contact with the lining of properties of grapes make your bladder.

Many foods can help inthem a healthy option. dividuals in the fight against Tomatoes cancer. Though one food Tomatoes are widely be- alone may not be potent loved, and perhaps that love enough to do the job, when affair stems from the to- several cancer-fighting foods mato’s role in fighting can- are included in a person’s cer. Though the reasons are diet, the effects may be sigunknown, tomatoes have nificant. been linked to lowering

September 4, 2013 North County Outlook

[360] Healthy Living Guide

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Shedding those excess pounds can be difficult but worthwhile Losing some weight is a goal for many people regardless of age. While youngsters and young adults might be able to get away with a few extra pounds without suffering any significant consequences, older adults carrying some extra weight might be putting their overall health at considerable risk.

Shedding weight after the age of 50 is not always easy.

As a person ages, muscle mass tends to dwindle while body fat has a tendency to increase.

Since fat burns fewer calories than muscle, weight gain as a person ages is bound to happen. But that doesn’t mean such weight gain is inevitable. In fact, men and women willing to make certain changes with regard to diet and exercise can shed pounds after 50 while preventing future weight gain.

Diet

n Diet and exercise are the keys to healthy weight loss at any age, but losing excess weight as we age becomes more difficult.

regard to what you’re eating but also how you’re eating and even how you shop for food. Men and women used to dining out for lunch every day can start bringing their own lunches so they can gain greater control of their daily caloric intake. For those who find they’re frequently too exhausted to cook each night, they can prepare meals in advance to have healthy, homemade meals waiting instead of always ordering takeout or delivery. When shopping for food, people should avoid doing so on an empty stomach so they’re less inclined to buy unhealthy snacks.

Men and women need fewer calories as they age.

For example, men and women in their 40s may need as many as 200 calories more per day than they will when they reach their 50s. Counting calories might seem difficult, so men and women in their 50s and older who don’t think they can count calories can try to eat more low-calorie foods like fruits, vegetables and whole grains.

Consuming fewer calories often requires changing Exercise dietary habits, not only with Exercise is another essen-

tial component to shedding pounds after 50, though men and women over 50 should always consult a physician before they begin a new exercise regimen. The Centers for Disease Control and Prevention points out that regular exercise can help older men and women prevent the onset of a host of ailments, including heart disease and diabetes. In addition, the CDC notes that regular physical activity as one ages helps muscles grow stronger, which increases the chances that an individual will be able to perform necessary daily activities without the assistance of others. Maintaining that independence into older

adulthood is a goal for many men and women, and it’s a goal that’s far more realistic for men and women who exercise than it is for those who don’t.

When coupled with a healthy, low-calorie diet, routine exercise can help men and women over 50 shed extra weight and keep the weight off once it’s gone.

According to the CDC, older adults need at least 2 hours and 30 minutes of moderate-intensity aerobic activity, such as brisk walking, every week and musclestrengthening activities on 2 more days a week. These muscle-strengthening activities should work all the major muscle groups, including the legs, hips, back, abdomen, chest, shoulders, and arms.

Muscle-strengthening activities include lifting weights, working out with resistance bands, exercise such as pushups and sit-ups that use body weight for resistance, and yoga. Even gardening that involves digging and shoveling can be considered a muscle-strengthening activity.

Weight gain is often an expected side effect of aging.

But men and women don’t have to gain weight as they get older. Some simple dietary changes and a commitment to routine exercise is all it takes to shed weight after 50 and keep that weight off once it’s gone.

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[360] Healthy Living Guide

September 4, 2013 North County Outlook

Knee replacement a cost-effective option for osteoarthritis At the age of 46, elementary school teacher Linda Seward started noticing difficulty maintaining mobility and keeping up with her class due to constant knee pain. After years of pain medication and alternative treatments, Linda, like many other Americans who face osteoarthritis of the knee, didn’t see measurable improvements and the pain was affecting her quality of life and ability to work.

“It got to a point where I couldn’t walk more than a few yards without pain and it was very difficult to stoop, bend, or kneel. I was literally hanging onto walls when I walked students down the hall,” said Linda, who ultimately underwent knee replacement surgery as a last resort at the age of 56.

“Since my surgery, there’s not a day that goes by that I’m not amazed at how I’m able to move without pain. I never have to take pain medication and it’s like I’m in my thirties again.”

There is a desire among the aging population to stay active and remain in the workforce. The combination of the aging population and the rising epidemic of obesity can lead to an increasing demand for joint replacement.

The demand for total knee replacement is expected to exceed 3 million by the year 2030—up from 600,000 in 2009, according to the Agency for Healthcare Research and Quality.

A new study published this month in the Journal of Bone and Joint Surgery ( JBJS) demonstrates the importance of maintaining access to knee replacement surgery for those suffering from osteoarthritis.

Researchers found that the societal benefits for working-age knee replacement patients far outweigh the actual

cost of the surgery and rehabilitation, compared to non-surgical treatments for osteoarthritis of the knee. The direct costs for knee replacement surgery and rehabilitation of a Medicare patient averaged $20,704 and these costs are offset by an average indirect savings of $39,697. The end result is a lifetime societal net benefit ranging from $10,000 to $30,000 per patient.

“Most of the societal savings come from the patient’s ability to maintain employment and increase earnings over a longer time in the workforce. We also found benefits from fewer missed worked days and lower disability payments,” said study author and health care economist Lane Koenig, Ph.D. “This methodology application has opened the door for a broader set of health care services to be evaluated using a societal perspective, which is truly exciting.”

More than 90 percent of people who have total knee replacement surgery experience a dramatic reduction of knee

pain and a significant improvement in the ability to perform common activities of daily living, allowing them to return to work and tremendously enhance their quality of life. The new study, “The Direct and Indirect Costs to Society of Treatment for End-Stage Knee Osteoarthritis,” shows how knee replacement surgery can be a valuable and cost-effective treatment for patients with end-stage osteoarthritis, estimating lifetime societal savings of about $12 billion from the more than 600,000 total knee replacement surgeries performed in the U.S. in 2009.

“The demographic profile of a knee replacement patient is changing,” said John R. Tongue, M.D., American Academy of Orthopaedic Surgeons (AAOS) past-president. “Half the patients getting knee replacements now are younger than 65 years of age and most of them are still in the workforce.”

Dr. Tongue added, “We know that when a knee replacement is done on patients at the appropriate time, it adds tremendous value to their lives. It gets them back to work and back to their families. It improves their quality of life and allows them to be productive and active again. But until now, that value has been hard to quantify. This study allows patients to see the big picture effect on their daily lives and in the long term.”

The full JBJS study, identifying a quantifiable view of the value of knee replacement surgery compares costs for direct medical care, long-term medical care, home modification and long-term nursing home use for both surgical and non-surgical treatments among patients age 65 and older. See www.ANationIn Motion.org/Value/Knee.

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