Healthy Outlook 2013

Healthy Outlook 2013 • 1

SMALL STEPS TOWARDS A

Healthy Outlook

Supplement to North Coast Citizen, Cannon Beach Gazette and Seaside Signal

2013

2 • Healthy Outlook 2013

Providence North Coast Clinic-Cannon Beach

Exceptional care, close to home.

At Providence Medical Group-Cannon Beach, we provide convenient, personal health care for our neighbors in Cannon Beach, Tolovana Park, Arch Cape, Manzanita, Wheeler and Nehalem. Close to home and play, our newly remodeled clinic offers primary care services for patients of all ages, in a comfortable, family setting.

At Providence, it’s not just health care, it’s how we care.® Now accepting new patients.

171 N. Larch St. Suite 16, Cannon Beach To schedule an appointment, please call 503-717-7556.

Visit us at www.providence.org/northcoast.

Julie Paquette, M.D. Family Medicine

Healthy Outlook 2013 • 3

The hidden emotional side of diabetes Heather A. Bee, Psy.D. Licensed Psychologist, Astoria, Oregon

‎ L iving with diabetes is more than eating right and taking medications. Living well with diabetes takes a great deal of emotional strength. Regrettably, the personal and emotional side of diabetes--the felt burden of living with a chronic disease--is often neglected in the management of this condition.

The effects of diabetes on the individual are more complex than can be measured by blood sugar level. Diabetes is a long-term condition which requires careful selfmanagement to minimize the risks of physical illness and complications. Diabetes can feel like an enemy that interferes with your daily routine and limits the choices you are allowed to make. Not surprisingly then, the impact of diabetes on emotional and psychological well-being can be profound.

Many with diabetes, especially those recently diagnosed with this condition, are frightened and believe they are doomed to suffer terrible complications. Feeling a little panicky can be a powerful motivator for adopting healthy and consistent habits that minimize the risks of physical illness and complications. However, too much fear can lead to hopelessness and helplessness. Seeking support in finding your own “optimal dose of anxiety” is critical.

The prevalence of psychological conditions such as depression, anxiety, and eating disorders is significantly higher among people with diabetes than in the general population. With depression, diabetes can be challenging to manage and blood sugar levels are likely to rise. Conversely, when diabetes is out of

The effects of diabetes on the individual are more complex than can be measured by blood sugar level.

control, it is harder to escape depression. It is a vicious cycle. It is important to be educated on the warning signs of depression-particularly your warning signs--and to take actions to avoid depression.

Understanding your own “diabetes identity” can be a powerful way to gain insight and awareness about the extent you have accepted and integrated this diagnosis into your overall identity and how diabetes informs your sense of yourself. The degree to which you accept this diagnosis,

adjust to the demands of the self-care routine, and cope with the progression of the condition, has likely impact on the odds of developing long-term complications. As a person living with a chronic disease, it is important to maintain a positive self-conception and a sense of consistency and continuity. Who you are has persisted through other major life events and endures with diabetes. In times of major change, and particularly with the lifestyle changes required by diabetes, it is important

to hold onto routines and practices that remind you of life before diabetes. Surround yourself by supportive loved ones and engage in activities that make you feel able, confident, and competent.

Ideally, your diabetes treatment team is a multidisciplinary group of health care professionals that consists of a physician, diabetes nurse educator, dietitian, and psychologist. Although the role of mental health provider may be filled by various professionals (e.g., psy-

chologist, medical social worker, or psychiatrist), the term “psychologist” is used in this article to denote a mental health professional.

The psychologist’s role is to provide direct support to you through promotion of healthy behaviors and treatment of psychological problems. Psychologists will also coordinate care and consult with your medical team on how to integrate psychological principles with medical interventions to enhance benefits and outcomes. Most psychological services in diabetes care are provided to individuals who do not have diagnosable psychological problems. For example, non-adherence to the diabetes plan is the most common reason for psychological referral, although in a statistical sense it represents the norm and not the exception.

The following are objectives of psychological treatment for all diabetic patients: • To improve adherence to the diabetes treatment plan • To promote pro-diabetic coping behaviors (e.g., diet and exercise) • To extinguish highrisk health behaviors (e.g., smoking, high fat intake) • To improve family functioning as it relates to communication and problem-solving about diabetes • To provide support for subclinical distress related to diabetes

These additional objectives may be added for diabetic patients experiencing more severe emotional distress: • To evaluate and treat psychopathology, particularly depression, anxiety, and eating disorders • To refer for psychotropic medication as needed Stress and distress are a given in life. It is crucial that you attend to the emotional side of diabetes in order to feel more confident and in control. The emotional and psychological needs of people with diabetes can be described on a continuum from healthy coping, through diabetesrelated distress, to psychological and psychiatric conditions. The broad aim of emotional and psychological care is to support you, your family and other carers, and your medical support team in preventing and reducing any distress that has a negative impact on your general well-being and ability to self-manage diabetes effectively.

Dr. Heather Bee is a licensed psychologist in private practice in Astoria, Oregon. Her practice specialties include: psychotherapy with adults; cognitive, learning, and psychological evaluations; and professional consultation. Dr. Bee works with many individuals who experience co-occurring medical and psychological conditions. She can be contacted at 503-550-7873.

4 • Healthy Outlook 2013

Men’s wellness: Is it time for a prostate cancer screening?

By Richard Zobell, M.D.,

urologist, Providence Medical GroupSeaside

If you’re a man of a certain age, you may wonder: Should I get a prostate cancer screening?

The answer: It depends.

Screening for prostate cancer typically is done through a prostate-specific antigen, or PSA, test. For the past 15 years, this simple blood test has been the goto method to detect early prostate cancer in men in their 40s, 50s and 60s. Most diagnoses were given when prostate cancer was already in its advanced stages.

Last year, however, the U.S. Preventive Services

Dr. Richard Zobell Task Force recommended against PSA screening for healthy men who have no

cancer symptoms. Why? The task force determined the test has the potential to do more harm than good.

While the PSA test can detect prostate cancer in its earliest stages, the task force’s research found the test resulted in more false-positive results than positive results. To confirm a true positive (an elevated PSA doesn’t always mean cancer), a patient needs a biopsy. This can be painful and carries risks, including fever, bleeding, infection, difficulty urinating and hospitalization.

Also, nearly 90 percent of men with PSA-detected cancer undergo some kind of early intervention. Surgery,

radiation or other therapies may cause long-term adverse effects, including urinary incontinence, erectile dysfunction or surgical complications, such as infection.

Evidence shows, however, that many men have asymptomatic prostate cancer – that is, their tumor may not grow at all or may grow so slowly that they likely will die of something other than prostate cancer. A PSA test can’t predict the rate at which cancer will progress, if it progresses at all. Finally, the task force found in two major PSA screening trials that early screening has little impact on the mortality rate for prostate cancer, even 10 to 14 years out from the date

of screening.

Prostate cancer is the most commonly diagnosed non-melanoma cancer among men in the U.S., according to the Centers for Disease Control and Prevention. The lifetime risk of dying from it is 2.8 percent, with 75 percent of prostate cancer-related deaths occurring after age 75.

Much like the task force’s 2009 recommendation that women get regular mammograms beginning at age 50 instead of 40, this recommendation has left some in the medical field frustrated about how to proceed with patients.

So what is my recommendation? Talk with your

health care provider. The decision is a personal one, and it should be made with your best interests at heart.

Your health, family history, lifestyle and age all can help determine if a PSA test is right for you. The test is rarely done after age 75, and some physicians may recommend against a PSA screening if you have certain chronic conditions. Your medical history and overall health can help you and your doctor determine whether PSA screening benefits outweigh the risks.

Dr. Zobell sees patients in Astoria, Seaside and Wheeler. To schedule an appointment, call 503-7177556.

Respiratory infection strategy: Get a flu shot, and get enough vitamin D

By David Stauth 541-737-0787

Your best defense against influenza, by far, is to get the flu vaccine. Washing hands, a healthy diet and lifestyle are also important.

But after that, a growing body of research suggests the next best thing you should consider for the prevention of flu and other upper respiratory infections is to make sure you have adequate levels of vitamin D. Most Americans do not.

As one of the worst flu seasons in recent years spreads its misery across the nation, experts in the Linus Pauling Institute at Oregon State University say that more people may want to get their blood levels of vitamin D checked. If too low, they could consider supplements to reach optimal levels of this “sunshine vitamin” that both laboratory and epidemiological studies suggest can help reduce respiratory infection.

The winter cold and flu season corresponds – perhaps by coincidence, perhaps not – with the time of year when most people also get the least sun exposure and, as a result, drop to their lowest levels of vitamin D. It can be difficult in winter to get adequate vitamin D from diet alone.

“Vitamin D affects a wide range

of immune functions, both innate and adaptive, that can help a person recognize and respond to both bacteria and viruses, not just the flu but many others,” said Adrian Gombart, an OSU associate professor of biochemistry and biophysics, principal investigator with the Linus Pauling Institute and international expert on vitamin D and the immune response.

“The number of people in the U.S. with insufficient levels of vitamin D is probably above 60 percent, especially in the northern states, most of Europe and all of Canada,” Gombart said. “This problem is critical in the elderly, who may get little of it in their diets, don’t get outside as much, and synthesize vitamin D from sunshine at a rate only about 20 percent that of younger adults.”

Vitamin D has antiinflammatory effects, may improve vaccine response, and is important for the response of immune and epithelial or “barrier cells” in the lungs. Without adequate vitamin D, these cells don’t adequately express cathelicidin, an antimicrobial peptide gene. Labo-

ratory studies have shown that this antimicrobial peptide reduced both infection and inflammation, and protected mice against an influenza challenge.

“Many studies have been done, both in the laboratory and in

clinical trials, and some have conflicting results,” Gombart said. “One explanation may be that some study participants already had adequate levels of vitamin D. If you aren’t deficient in this nutrient, adding more to your diet isn’t going to offer much benefit. We still need more well-designed clinical trials with a vitamin D deficient population.”

Many scientists believe that at least 32 nanograms per milliliter of vitamin D in the blood is a reasonable minimum, Gombart said, and some research has found increased protection against upper respiratory infection in people with levels around 38 ng/ml.

But the level now considered insufficient, based primarily on bone health rather than other health outcomes, is less than 20 ng/ml.

The official RDA for vitamin D was recently raised, and is now 600 IU daily for most adults, 800 IU for the elderly. An intake of 2,000 IU per day for all adults and 400 IU for children should get most people to a blood level of 32 ng/ml or higher.

But this is difficult to achieve through diet alone – a cup of vita-

min D fortified milk, for example, has about 100 IU. Historically, studies about adequate vitamin D were focused on bone health, including overt deficiency diseases such as rickets.

Scientists now understand this vitamin plays a much larger role in many physiologic functions, especially an appropriate immune response.

There are estimates that one billion people around the world may be deficient, mostly in the temperate zones and higher latitudes, and any population with darker skin color also faces higher risk. Some experts say that in the U.S. more than 90 percent of black, Hispanic and Asian populations have insufficient levels. The primary source of this fat-soluble nutrient is a metabolic response to UV-B radiation in sunshine. Diet plays only a limited role.

The regulation of cathelicidin by vitamin D, which was discovered

by Gombart, is a unique biological pathway that can help explain vitamin D’s multiple roles in immune function. This pathway exists only in two groups of animals – humans and non-human primates. Its importance for their immune response against infection is highlighted by its conservation through millions of years of separate evolution.

Healthy Outlook 2013 • 5

A new vocabulary is good for our community

By Diana Smith An early childhood memory in Astoria was going to the Liberty with my grandmother to see an Oscar winning performance by Audrey Hepburn starring in the Nun’s story. I recall this event because my grandmother left abruptly without explanation during the movie, and I left with her.

The last scene I watched, truly bewildered, was Hepburn playing a young nun assigned to work in a women’s insane asylum. Showing compassion and gullibility, Hepburn was tricked into opening a padded cell door and was immediately attacked by the dangerous woman within. My only other memory from that movie was women in bathtubs. Their writhing heads poked through a hole in the canvas coverings of the tubs. It appeared from the women screaming and the steam escaping from the edges of the tub, as they couldn’t, that they were being boiled in hot water.

After my grandmother’s death at the age of 83, I learned that she had a brother who died young. When I asked relatives about him, I got little information. He died in a mental institution sometime after WWI. Apparently, he suffered from shell shock. Perhaps that cinematic glimpse inside a mental hospital frightened us both.

My grandmother did not have the words to express what she saw on the movie screen, and I didn’t have the words to ask her. Mental illness did not have a vocabulary. It had a terrifying and severe stigma from words like crazy, lunatic, possessed, psycho, deranged, dangerous and evil.

As our culture has evolved and made efforts to eliminate slander and attacks regarding a person’s race, religion, medical conditions, sexual orientation or developmental disabilities; we continue to fall silent when it comes to speaking coherently or kindly of mental illness.

Since the horrific shooting of children in Sandy Hook

Diana Smith Elementary, the prevention rhetoric embodies the worst of stigmatizing mental illness.

If a person was suffering from depression, how fast would they seek treatment when someone on the news was calling for a “data base of these lunatics” [the mentally ill]? The more people are discouraged and stigmatized for getting help, the more people are going to suffer and remain untreated. These people are our friends, our neighbors, our families and possibly you.

Why does this message about mental illness belong in a health section? To have a healthy, productive, safe and caring community, we must have a collective language that encourages mental health treatment without fear or discrimination for the one in four people that mental

illness affects. I am one of those people who have been profoundly affected.

Approximately 15 years ago I worked in a psychiatric hospital as a medical social worker. At that time my son had recently been diagnosed with schizophrenia. He experienced auditory hallucinations. The diagnosing psychiatrist informed me that my son would never function outside of a group home and I needed to accept that fact for his good. I don’t routinely believe it is wise to disregard a professional’s advice. I did get the prescription for antipsychotics and took my son home. He slept on and off for three days and woke up tired and groggy from the medication. I made a precarious plan at that time to help him have hope for a future that didn’t define him as his illness.

I went to work in a psychiatric hospital to learn about mental illness and move beyond my own fears.

Both the original psychiatrist and I were wrong. I couldn’t love my son back to who he was before his illness, as I had hoped. There were no miracles of biblical portions that I felt he deserved. But the doctor was also incorrect about how much recovery my son could accomplish.

The firs years were indescribably painful: The doctors, the therapists, the treatments,

the cocktails of medications, the isolation, the losses of normalcy, friends, potential, money and mostly a decade of his life.

Today is a momentary respite. No medications, doctors or therapy. I still read about treatments and stay current on drugs. The illness is there, but less functionally debilitating for him. It is a day-to-day struggle to manage his active symptoms and isolation. He does have a full time job, pays taxes, votes and takes loving care of his dog. He doesn’t miss work and is always on time.

Sometimes he lives on his own, other times he shares my house or lives with his sister and her family. Stability, financial resources, a loving family and mental health treatment have provided a different outcome than predicted. There is still so much to learn about how the mind works. It is difficult not to remain optimistic.

Outside of his immediate family or close friends, I’ve never mentioned his illness.

I don’t know what people think about my adult son living with me or how quiet and remote he appears. I’m waiting for a new vocabulary to say that he isn’t crazy, he is courageous. He isn’t evil, he is empathic. He isn’t a lunatic, he is loving. He is not a person to fear.

Most of all he is a brother, an uncle, a nephew, a son, a neighbor and a co-worker who has an illness without a way to talk about it.

Diana Smith, MSW is an accredited clinical social worker with over 20 years of experience. Her practice,

at Oregon Coast Counseling Services specializes in children three years and older (play and art therapy), individuals and couples using Gottman methods of therapy.

She can be contacted at www. coastcounselingservices.com or 503-440-9234.

March 1-3, 2013

Friends of 5aystack 9ock presents the 3rd Cannon <each =oga Festival, March 1-3, 2013.

Full Festival Pass: $350 Partial Festival Pass: priced by class Full Festival PassD E350G E325

Early <ird by 2G1G13 Join World-class yoga teachers for workshops and lectures in yoga, meditation, Ayurveda, Join World-class yoga teachers for drawing, workshops and lectures yoga, living. meditation, Nyurveda, drawing, music and inhealthy music and healthy living.

• Clinical Herbalist & Nutritionist • Fair-trade and Organic 200+ bulk herbs, teas & culinary spices • Nutritional supplements for people and their pets • Aromatherapy supplies & natural body care

More than just a gift store!

Open Tues thru Sat from 11-6

1139 Commercial Street Astoria, Oregon 97103 J10319

503-338-4871

Oirtan P Community Dance Party with Shantala Saturday,3/2 3G2 7D30-TD30, or included Saturday, 7:30-9:30, $20 E20 or included in Pass.in Pass.

For details, see see eventevent website: For full fullfestival festival details, websiteD Cannon<each=ogaFestival.com or call 503-440-1V4T

SpaceisiseWtremely extremely limited. limited. Register Space 9egistertoday.

Xoday.

G0220

6 • Healthy Outlook 2013

The future of routine eye care is here

By Dr. Knutsen The standard of care in both optometry and ophthalmology in today’s world is changing. We all know that comprehensive visual care involves an annual evaluation of the function and health of your ocular structures. While a dilated retinal examination is highly recommended in order to identify ocular and systemic conditions, some syndromes can often be invisible unless a more in depth look is taken with the help of the latest imaging techniques.

Today’s advanced technology allows physicians to not only visualize the retinal anatomy but also differentiate between certain pathologies.

The Optical Coherence Tomograph (OCT) was invented just twenty years ago and is rapidly becoming

Dr. Knutsen more popular in eye clinics. The retina is a complex system located in the back of the eye, responsible for transforming images and light into an electrical signal carried to the brain through the optic nerve. By provid-

ing a cross-sectional view of the ten layers of the retina, the OCT can provide critical differentiation and allows physicians to interpret layers and shapes. Many eye conditions often look similar when viewed through a routine microscope; the OCT acts as a CT scan for the eye and is capable of showing the precise layers a defect is located in and as a result gives the patient a firm diagnosis. Common conditions that are found and studied through OCT scans include retinal detachments, AgeRelated Macular Degeneration, certain dystrophies, and abnormal fluid accumulation that commonly occurs with diabetes.

While the OCT scans all ten layers of the retina, the Heidelberg Retinal Tomograph (HRT) analyzes one

specific layer called the nerve fiber layer. A laser light performs sequential scans of the retina creating a three dimensional topographic image when combined. The physician is able to review these scans in order to obtain a description of any subtle changes noted in the optic nerve pertaining to its shape, size, and nerve fiber thickness. In Glaucoma, thinning and damage of the functional integrity of these nerve fibers occurs, therefore, the HRT is most beneficial in diagnosing and evaluating Glaucoma patients. Glaucoma is the second leading cause of blindness worldwide, which makes the HRT a necessity for early detection and treatment to help prevent any vision loss.

Both the HRT and OCT are significant in the fight

against many pathologies of the eye. They compare a patient’s results to healthy age-matched normals in order to determine if they are atypical.

Subsequent measurements can be compared to show trends over time and help monitor a response for certain treatments. By having these advanced tools in the office, patient education has become more in depth in addition to easier.

The next time you have an eye examination, don’t

be surprised if your ophthalmologist or optometrist suggests a baseline assessment from one or both of these valuable techniques. They are extremely convenient by being noninvasive and not requiring the use of any eye drops.

Patients enjoy this simple, fast, and painless process. The vast amount of information these images provide will assist in the early detection and treatment of many common eye conditions. For more information, don’t hesitate to contact your local provider.

577 18th Street • Astoria, OR 97103 (503) 325-4401 1703 Pacific Ave. S • Long Beach, WA (360) 642-3214

(503) 436-2812

819 Holladay • Seaside, OR 97138 (503) 738-5361

503-368-6397

Dr. Darren Thorsen

Dr. Nina Nemetz

Dr. Marissa Knutson

www.coastaleyecare.com

(503) 738-5561

Don’t miss out on life’s beauty because of blurry vision!

J10295

Healthy Outlook 2013 • 7

Be the picture of good health.

Get screened.

Vascular diseases threaten the health – and lives – of millions of Americans. Most people with a vascular disease don’t know they have it and go untreated. If you’re 55 or older, have a family history of heart disease or think you’re at risk, getting screened could save your life.

Talk to your health care provider about scheduling an appointment for Providence’s painless, non-invasive coronary calcium screening. The test takes only minutes, but the benefits could last for years. There is a screening fee. Call 503-717-7556 for fee information.

Providence Seaside Hospital is the only facility on the north coast offering coronary calcium scans. Talk to your health care provider about a screening. Or you can make an appointment with cardiologist, Robert Morse, D.O. – expert cardiac care close to home.

Robert Morse, D.O. Cardiologist

To schedule an appointment with Dr. Morse, please call 503-717-7850. www.providence.org/heart

8 • Healthy Outlook 2013

Heart-healthy diet: Eight steps to prevent heart disease

By Dr. Robert Morse So many Americans are struggling with ways to lose weight and to have a healthier life style. We asked Providence North Coast cardiologist, Robert Morse, D.O. to give us some tips on heart-healthy eating that will also trim our waistlines.

1. Control your portion size How much you eat is just as important as what you eat.

Eating more of low-calorie, nutrient-rich foods, such as fruits and vegetables, and less of high-calorie, high-sodium foods, such as refined, processed or fast foods, can shape up your diet as well as your heart and waistline.

2. Eat more vegetables and fruits Vegetables and fruits are good sources of vitamins and minerals. Vegetables and fruits are also low in calories and rich in dietary fiber.

3. Select whole grains Whole grains are good sources of fiber and other nutrients that play a role in regulating blood pressure and heart health. You can increase the amount of whole grains in a heart-healthy diet by making simple substitutions for refined grain products.

4. Limit unhealthy fats and cholesterol Limiting how much satu-

Dr. Robert Morse rated and trans fats you eat is an important step to reduce your blood cholesterol and lower your risk of coronary artery disease. A high blood cholesterol level can lead to a buildup of plaques in your arteries, called atherosclerosis, which can increase your risk of heart attack and stroke.

The best way to reduce saturated and trans fats in your diet is to limit the amount of solid fats — butter, margarine and shortening — you add to food when cooking and serving.

5. Choose low-fat protein sources Lean meat, poultry and fish, low-fat dairy products, and egg whites or egg

Eating more local produce, like the vegetables shown here at the Cannon Beach Farmers Market, can be an important step towards a healthier lifestyle.

substitutes are some of your best sources of protein. Fish is another good alternative to high-fat meats. Legumes — beans, peas and lentils — also are good sources of protein and contain less fat and no cholesterol, making them good substitutes for meat.

6. Reduce the sodium in your food Eating a lot of sodium can contribute to high blood pressure, a risk factor for cardiovascular disease. Reducing sodium is an important part of a heart-healthy diet. The Department of Agriculture recommends: • Healthy adults have no more than 2,300 milligrams (mg) of sodium a day (about a teaspoon) • People age 51 or older, African-Americans, and people who have been diagnosed with high blood pressure, diabetes or chronic kidney disease have no more than 1,500 mg of sodium a day Although reducing the amount of salt you add to food at the table or while cooking is a good first step, much of the salt you eat comes from canned or processed foods, such as soups and frozen dinners.

7. Plan ahead: Create daily menus You know what foods to feature in your heart-healthy diet and which ones to limit.

Now it’s time to put your plans into action.

Create daily menus using the six strategies listed above.

8. Allow yourself an occasional treat Allow yourself an indulgence every now and then.

A candy bar or handful of potato chips won’t derail your heart-healthy diet. However, don’t let it turn into an excuse for giving up on your healthy-eating plan.

Providence Heart Clinics - North Coast are located in Astoria, Seaside and Wheeler. To schedule an appointment with Dr. Robert Morse at any of these locations, please call 503-717-7850.

B

F W

w

Berries like these sold at the Cannon Beach Farmers Market are delicious and nutritious.

a""e$ting new $atients

Healthy Outlook 2013 • 9

Teach your children well, and it will last a lifetime

By Alexander Gloria, M.D.

Family medicine, Providence Medical GroupWarrenton

The best gifts we give our children are not the things we buy them for the holidays, but the things we teach them every day.

Toys are soon forgotten, but the health habits that we teach our children form the foundation for their well-being for life. As we round the bend of another year on the calendar, let’s resolve to teach them well these four things:

Teach them to play it safe

Accidents are the No. 1 cause of death and disability in children ages 2 and older. While parents can’t protect kids from every bump and bruise, we can teach them how to reduce their risks of accidents. Check this list to make sure you’re covering the safety essentials with them: • Use car seats correctly and make sure all other passengers – including you – always buckle up.

• Make sure your toddlers know your name, phone number and address in case they get lost, and how to dial 911 in case of an emergency.

• Teach youngsters about stranger danger.

• Make sure your kids wear

Dr. Alexander Gloria helmets when riding bikes, scooters and skateboards – and wear one yourself.

• Teach kids the rules for street safety – and follow the rules yourself.

• Drive safely, and teach your teens to be safe drivers.

Show them how fun it is to be active For optimal health, kids need to run, jump, skip, lift, climb and be active in other ways for at least 60 minutes a day, starting at age 6. Physical activity helps

them build strong bones and muscles, boosts their immune systems, improves academic performance, reduces stress and depression, keeps weight in check and improves their overall health. Not only that, but when kids grow up with physical activity as part of their daily lives, they’re much more likely to stay active – and healthy – into adulthood. Show them how fun it is to live an active life: • Be a good role model by making regular exercise a priority for yourself.

• Instigate short, fun activity bursts throughout the day: a quick walk together, a 15-minute jump-rope challenge, a spontaneous “silly dance” contest.

• Remind your kids that they are waterproof – they won’t melt if it’s sprinkling a little outside.

• Recognize that TVs, computers and video games are the enemy of activity. I recommend limiting screen time to less than an hour a day, establishing a

weekly screen-free day, and using screen time for education as well as entertainment.

Set a healthy example at mealtime Teaching our children to make healthy food choices can help them avoid obesity, diabetes, high blood pressure and a host of other serious health problems that can start in childhood and continue throughout their lives. Get your kids off to a great start in life by making it easy for them to make healthy choices: • Fill your cart with healthy foods by staying away from the aisles of chips, sweets, sodas and and sugary fruit drinks.

• Stock healthy snacks– keep a bowl of fruit on the counter, cutup vegetable sticks in the fridge, and whole-grain crackers in the cupboard.

• Kids can be picky about vegetables, but chances are, they like at least one. Offer that one, plus another one, at each meal, and keep

trying new ways to add more fruits and vegetables to the family diet.

• In the cloudy Northwest kids need to get most of their vitamin D from food. Low-fat milk and fortified cereals (low in sugar and high in fiber) are good choices for supplying vitamin D.

Make sure they never become smokers Remember, we are our children’s primary teachers. If we smoke, they are much more likely to become smokers, as well.

That’s a lot to think about, and there’s more, to be sure. It’s a big responsibility, this parenting stuff.

We can’t just go to the store and buy our children a healthy future.

But we can take them out for a walk, give them nutritious food choices and show them, through our daily examples, how to live an active, healthy life. That’s a gift they’ll appreciate for life.

To schedule an appointment with Dr. Gloria, please call 503717-7556.

10 • Healthy Outlook 2013

Healthier mouth means a happier you doesn’t give up without putting up a strong fight. Bacteria must be on your teeth for an extended amount of time to cause a cavitation in your tooth where a filling is needed. Again, this is the primary reason why we brush and floss.

By Scott N. Santos, DDS Remember when the dentist told you to brush your teeth twice a day and floss once a day so you won’t get cavities? Have you ever been dedicated to that philosophy only to get burned? Have you ever had a close friend or relative that never brushes their teeth, eats all the candy under the sun, and routinely gets good checkups? Could it be that you are using the wrong toothbrush, the wrong toothpaste, the wrong floss? Perhaps not.

As you may have already figured out, having a healthy mouth and getting a good checkup involves several factors. While a new toothbrush and good floss are important, they are only a piece of the puzzle.

Healthy mouths and healthy teeth begin with understanding how cavities begin and then being proactive with healthier decisions rather then being reactive and needing to treat a cavity. Let’s take a look at the five components that must exist to cause a cavity to develop.

Bacteria

Mouths are full of them and it’s impossible to eliminate them.

All we can hope to do is contain them. Bacteria reproduce very quickly and as the bacteria number increases, the environment

Teeth

This is the most important factor in developing a cavity. Bacteria must populate somewhere and to get a cavity, they must land on some teeth. If you didn’t have any teeth, we wouldn’t be having this discussion. Since teeth are something we generally like to have for looks and function, we do what we can to keep them around.

Dr. Scott N. Santos changes and the bacteria worsen.

There are literally hundreds of bacterial types that can be found in the mouth. This is the primary reason why we brush and floss.

Our goal is to the lessen the number of bacteria in the mouth.

Time

Even though we have hundreds of types of bacteria in the mouth, enamel is arguably the hardest substance found in the body. So it

Fuel Source

Yes bacteria need food to survive. They eat what we eat.

Their primary food sources are fermentable carbohydrates such as sucrose, fructose, and glucose.

That means bacteria can get their energy from not only candy bars and pastries, but also from juices, energy drinks, cereals, breads, and some fruits. Be mindful of what you put in your body. Your teeth will thank you.

Acid

After the bacteria eat, they

release acid, causing a drop in oral pH, thus causing the tooth to demineralize and lead to a cavity.

High acid = Low pH. This drop in pH will normally last about thirty minutes after your last bite or drink of something. The more you snack, the more acidic attacks these bacteria can have.

Besides bacteria altering the pH of the mouth, some people have a more acidic mouth normally. This is very bad. This may be caused from high acidic food consumption, acid reflux or GERD, or

when the mouth does not produce enough alkaline rich saliva. If you naturally have high acid levels, your teeth will constantly be in a state of demineralization. After you eat, chew sugar free gum to increase saliva, use a mouth rinse to increase pH, or brush your teeth to help reduce the bacteria numbers.

If you remove any one these five components from the equation you will not get a cavity. Brushing and flossing help reduce the bacteria load and time on the teeth. So if you are in the camp where you have mastered brushing and flossing, but continue to struggle with cavities, its likely that you have an issue with the types of food you eat and/or the acidic content of your mouth.

So be encouraged that if you are a sufferer of cavities, know that you are not alone and there are answers out there. Unfortunately it means that you must work harder than someone who routinely has good checkups, but doesn’t deserve them. You must be aware of what you put in, how to properly care for, and how to manage increased acid levels in your mouth. Do this and you will find a healthier, happier you.

You too, can have a good dental checkup.

An unexpected way to keep healthy ankles

By Carol Hungerford This has been a blessedly mild winter, but not so a couple of years ago. Do you remember snow and ice? And cold winds? Ick. While walking my dogs on one of those cold, snowy, icy mornings I took a bad fall and twisted my ankle rather impressively.

It was embarrassing as well as painful. Had I been paying more attention to my footing, a logical notion considering the conditions, I would not have crashed to the pavement.

Carol Hungerford The ankle went through all the dramatic stuff of

a serious sprain, swelling, pain and then colorful bruising, probably a combination of the swelling and smacking it good on the ground.

Gradually I regained use of the damaged ankle, but it never was 100%. A full year later I was still favoring it when walking and it was tender to touch. At my annual exam I whinned to my doctor that my ankle was a daily reminder of growing older.

He laughed and then suggested some physical therapy. He promised

a simple set of exercises, done regularly for a couple of weeks, would get my ankle back to its robust self.

And, he further promised, I could do these exercises at my desk. And, best of all, he added, they are the perfect exercise for somebody in the newspaper industry.

This routine of physical therapy? Using my big toe, trace in the air the alphabet.

Start with “A” and work all the way down to “Z”.

Then do it again. I could use upper case or lower case. If I got bored with the alphabet, I could start

tracing words. My name, my family’s name, any ole’ thing.

And it worked.

Within two weeks.

So recently on a sunny day my husband and I went for a walk to enjoy the day. We were talking and walking and he stepped off a the sidewalk at a driveway that wasn’t flush with the street. You guessed it, turned his ankle and was in some significant discomfort.

(Although he was much more graceful than me, and managed to not fall!)

So, I shared my past success with the alphabet physical therapy. And he tried it. And it worked for him too!

Each year I get older I find that I have to become more cautious about balance and the depth perception messages my eyes send my feet. But if I should get in a rush and twist my ankle again, I am fully prepared with this simple exercise.

If you see me tracing the alphabet with my toe at my desk or at meetings, I am just keeping my ankle healthy!

Healthy Outlook 2013 • 11

2013 fitness options for the north coast Story by: Margie & Dan Leary It’s a New Year and many folks want to meet their fitness goals. Many will go to gyms with no guidance and fail. Here are some 21st century options for you to meet your fitness goals with a minimal investment of gear or space.

We’ve outlined how a good workout should happen, step by step as well as show you some new gear out there that give you the most bang for the buck. Most of the ideas in here require minimal space and could fit in the trunk of your car or bedroom closet for storage.

First and foremost, a good dynamic warm up is not only necessary but a key component of injury prevention. A good warm up can be as simple as 5 minutes of jump roping or as extensive as you want.

The key is to get your heart rate up and get a good sweat on, which will warm up the muscles and prepare them for the workout. For warm up ideas check www. coreperformance.com.

For the main part of any workout, I recommend you remember this phrase: push, pull, legs/hips and core. This means the workout should have an upper body push exercise, an upper body pull exercise, a legs or hips (alternating between workouts) exercise and a core exercise.

Armed with this knowledge, let’s consider options for gear. A primary consideration is bodyweight, which requires no equipment at all. Using just your body, you can set up a workout something like this: Push: 10 pushups; Pull: 10 pull ups; Legs/ Hips: 10 single leg squats; Core: 20 sit ups. This should be structured as a circuit and you should complete five rounds with minimal rest in between exercises in order to keep your heart rate up. This can

Swimmers at Seaside High School train in the weight room. Cross training is important for competitive atheletes and can help everyone improve their fitness. easily be completed in less than 30 minutes!

The next tool in our fitness kit-sandbags! I love sandbags as they are easy to use, durable and are constantly moving. I also don’t have to worry about them getting damaged as they are easily replaced. You can make you own to save cost or purchase Josh Henkin’s Ultimate Sandbags (www. ultimatesandbagtraining. com). I have used both and can honestly say that these sandbags are the way to go.

The sandbag workouts are awesome because the bag is constantly moving, causing you to stabilize while you exercise. Any exercise you use with dumbbells or barbells can be done with a

Since 1974 248 N. Spruce, Cannon Beach

sandbag; you can find hundreds of great workouts on the above site. Check it out.

Cost: $100.00 The TRX Suspension trainer is a great deployable fitness option that taxes you using only your bodyweight with its patented suspension system. It’s a great core workout and major muscle builder. You can use it by itself or mix it up with other tools or bodyweight exercises. I never travel without one. Cost: $200.00.

Although Kettlebells are the new fitness craze, they have been around for centuries and originated in Eastern Europe.

The Kettlebell can be used for conditioning or building strength; most people need

only one or two 35 pound or 53 pound Kettlebells to get a great whole body workout.

Kettlebells bulletproof your body with ballistic exercises such as the Swing, Snatch, Clean and Press or the ever so challenging Turkish Get Up. Working with kettlebells activates multiple muscle groups and works your body through ranges of motion that most people would not otherwise encounter in the gym.

Cost: $100 for a 35lb and $120 for a 53lb kettlebell.

Check out Dragon Door for a list of exercises and protocols (www.dragondoor.com).

Looking at all these tools one can certainly see the myriad of fitness and training options. What’s important is to have a plan- a training plan that provides you with a road to fitness success.

Margie & Dan Leary are certified CrossFit, USAW, TRX & HKC kettlebell instructors. Margie is an Ironman Triathlete and competitive marathoner.

The Learys volunteer as Seaside High Schools Strength & Conditioning Coaches as well as training clients out of their garage gym.

Together they enjoy making Seaside High School athletes explosive, fast & bulletproof. Contact them at 360-461-6922 if you are interested in training.

Be Fit Be Happy

Push: • dumbbell, kettlebell or barbell press • incline dumbbell or barbell bench press • push ups • dips Pull: • pull ups • chin ups • dumbbell, kettlebell or barbell rows • TRX inverted rows • rope climbs • kettlebell swings • kettlebell snatch Legs: • bodyweight squat • kettlebell goblet squat • dumbbell or barbell squat

• single leg squats • TRX single leg squats • banded squat Hips: • dumbbell or barbell dead lift • single leg squats • TRX assisted single leg squats • TRX leg curls • glute ham bridge • single leg deadlifts Core: • sit ups • planks • leg raises • kettlebell Turkish Get Ups • kettlebell halos • kettlebell windmills • mountain climbers • get ups

Oregon Coast COUNSELING SERVICES Professional Effective Confidential Supportive Diana Smith, MSW

IndIvIdual, Couples & FamIly Therapy

• Bicycles • Sales • Service • Accessories • Apparel

Please call or e-mail for appointment.

503-440-9234

Hours: 10:30 am - 5:30 pm Thur - Mon (closed Tue and Wed) mikesbike.com 503-436 -1266

Examples of different types of exercises

diana@coastcounselingservices.com www.oregoncoastcounselingservices.com G02180

J10303

12 • Healthy Outlook 2013

Providence Seaside Hospital

Looking out for your well-being: It’s what neighbors do.

At Providence, we provide exceptional, personal health care for our neighbors on the North Oregon Coast.

With our state-of-the-art technology and our team of experienced and compassionate physicians and providers, Providence Seaside Hospital offers seamless care, both locally and regionally, for patients of all ages, through all stages of life.

We’re proud to continue our Mission of compassion and excellence, one person at a time. It’s not just healthcare, it’s how we care.TM

www.providence.org/northcoast