Balance, April 2019 by Moscow-Pullman Daily News

Balance Volume 11 | Issue 2 | Spring 2019

The health magazine for Body, Mind & Motivation

ADVERTISER INDEX Tri-State Hospital ....................................... 2 Whitman Hospital and Medical Center ......... 6 Electrolysis - Permanent hair removal ........ 7 Maplewood Dental ..................................... 14 Leavitt Dentistry ...................................... 14

Balance

Rosauers .................................................. 16 Snake River Community clinic.................... 16 Dr. Steven Ozeran ......................................22 Dr. Richard Allen ...................................... 22

Balance is published quarterly by the Lewiston Tribune and Moscow-Pullman Daily News and printed at the Tribune Publishing Co. Inc.’s printing facility at 505 Capital St. in Lewiston. To advertise in Balance, contact the Lewiston Tribune advertising department at (208) 848.2216 or the Moscow-Pullman Daily News advertising department at (208) 882.5561. Editorial suggestions and ideas can be sent to Tribune City Editor Mary Stone at mstone@lmtribune.com or Daily News City Editor Josh Babcock at jbabcock@dnews.com.

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MOSCOW LOCATION, OPENING SOON! Balance / Spring 2019

The highs and lows of Whole30 COMMENTARY

JUSTYNA TOMTAS Diet is designed to identify which foods have a negative effect on your body WHEN I WAS PEER-PRESSURED into a 30-day elimination diet, I was not excited. Cutting out some of my favorite foods like bread, cheese and sugar seemed like a daunting task. But, that’s exactly what I did as I embarked on the Whole30 journey, which also calls for the elimination of soy, legumes and alcohol. Similar to the Paleo diet, but more restrictive, Whole30 isn’t meant to be sustainable over long periods of time. Its purpose is to cut out the food groups the program’s creators deem bad for your body, so you consume only “whole foods” — items processed as little as possible and free from artificial substances and additives. At the end of the 30-day trek — and believe me, it’s PETE CASTER/FOR BALANCE a trek — you’re supposed Smashed potatoes are topped with olive oil, fresh oregano and parsley prior to being baked in the to reincorporate foods

oven. Participants in the Whole30 diet work from a list of approved foods, eliminating certain foods,

>> See Whole30, Page 4 then adding them back in.

Balance / Spring 2019

Whole30 from Page 3 you’ve cut out to see how they affect your body. For example, the first stage of reintroduction could include incorporating grains back into your diet, then eating clean for a few days before moving to the next food group that was eliminated. People experience different symptoms while navigating the 30 days. For me, the first few days were a breeze, which set me up to falsely believe the remainder of the time would be easy. I was excited to try new recipes, learn what is in my food and, overall, eat healthier. Despite the advice from the Whole30 book, I failed to prepare myself for “the hangover” stage, the time when your body starts to react to the lack of sugar and other substances it has become dependent on. I experienced pounding headaches, irritation and was generally not a pleasant person to be around. From there, came the constant tiredness. Coffee helped fuel me through this stage as I consumed more of the drink than I thought was humanly possible. After several days, I rebounded as my body began to adjust to its new, much healthier intake. I experienced what many Whole30 enthusiasts dub “tiger blood.” The new wave of energy is supposed to hit about halfway through. I never felt the intense motivation and insane energy said to come with this phase, but I did notice a difference. Tasks that once sat unattended at the end of a long day were now easily incorporated into my schedule. I had more pep in my step, and I got out of bed much easier. Coffee no longer became a crutch or a necessity. The feeling is something I wanted to continue past the 30-day mark, but

I also began to miss the comforts of simple items like ketchup, mayo or salad dressing — all of which were difficult to find in a sugar-free formula. And the alternatives just didn’t measure up to the real thing. In the end, I learned a lesson that I wouldn’t have otherwise: Non-gluten grains aren’t my thing. It’s a food group I had never even considered. During my reintroduction phase, I discovered corn, rice and items like quinoa made me feel groggy and made my joints hurt. The experience helped me become a more informed consumer. Reading labels — although tiresome — was an eye-opening experience. And an added The cover of the “The Whole30,” written by bonus is that I did shed some pounds. I’m unlikely to partake in another Melissa Hartwig and Dallas Hartwig. round of the elimination diet. I would, I had grown tired of cooking three however, recommend it to others, if meals a day. I became frustrated with only for the fact that it helps pinpoint analyzing every label, which made food groups that cause inflammation, shopping excursions incredibly difficult. bloating or other minor problems There are about a million ways that sometimes are ignored. companies manage to sneak sugar or artificial sweeteners into pretty much everything, under disguise Tomtas may be contacted at jtomtas@ of names like dextrose, fructose, lmtribune.com or (208) 848-2294. Follow her aspartame and maltitol. on Twitter @jtomtas.

Balance / Spring 2019

METRO NEWSPAPER SERVICES

A recent study found that people use their beds for activities other than sleeping, including reading books and working on laptops.

Your bed: It’s not just for sleeping anymore Survey finds people spend more time playing games than getting intimate Balance / Spring 2019

they watch television while in bed. Fifty-seven percent use social media, 48 percent read, WHILE BEDS ARE MEANT FOR 42 percent play mobile games SLEEPING, that nightly activity and 39 percent get intimate. only scrapes the surface of what The survey also found 35 percent people do between the sheets. take selfies, 33 percent clip their In fact, more people reported toenails, 29 percent pay bills and playing games on their cellphone 9 percent do taxes. A whopping 61 in bed than getting intimate. percent said they eat pizza in bed. According to a survey of Mitch Gaskey, who represents 1,000 Americans in February, 92 Fort Mason Games as a client percent reported doing activities success manager for a public in bed other than sleeping. relations company called PR The survey was commissioned by Hacker, said he was surprised to Fort Mason Games, which creates see what people did in bed instead mobile games, such as Confetti of playing mobile games — like Slots and Lucky Scratch, that eating pizza, doing taxes and target women’s gaming interests. >> See Bed, Page 6 Sixty percent surveyed said

By GARRETT CABEZA FOR BALANCE

Feeding fido is no walk in the park Experts: Balanced dog food is ‘incredibly complex’ and difficult to whip up at home ingredients like peas, lentils and other legumes or potatoes for grain. Such commercial dog foods VETERINARIANS AND THE FOOD AND DRUG ADMINISTRATION often are made by small companies that don’t have a ARE WARNING pet owners to history of detailed and longbe careful when choosing term diet-testing studies. grain-free and other While the correlation boutique dog foods or between dilated do-it-yourself dog diets. cardiomyopathy — Over the past several enlargement of the heart years, researchers have — and the boutique diets established a correlation is strong, the precise way between a specific kind of such foods or particular heart disease and exotic diets. The dog foods or diets ingredients may lead to the disease has not been in question often are grain free, contain exotic meats or established. In some but no meat at all and substitute not all or even most cases,

By ERIC BARKER FOR BALANCE

Pamela Lee, a foods as healthy cardiologist at attracts dog owners the Washington to the brands that State University veterinarians place Veterinarian under the acronym Teaching Hospital at BEG — boutique, Pullman, said dogs exotic ingredient, with diet-associated grain free. DCM have a Lee likens it Pamela Lee taurine deficiency. to marketing of “We don’t know human food that the actual cause or the promises to deliver clean ingredient in the diet that and healthy eating. is causing the heart disease “People look at their or if it’s an interaction of pets and consider their pets ingredients,” Lee said. family members. You want She said not all grainthe best thing for them, and free dog foods or diets have if you think the best thing the correlation. Instead it for you is to eat a clean diet, tends to be associated with it’s an easy mental jump smaller manufactures with a that ‘I want to feed that to short history of food-testing >> See Feeding, Page 7 trials. Marketing of such

Bed from Page 5

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other activities one would not associate with bed. Gaskey said he was happy to find that 42 percent of people play mobile games in bed. He said around 60 percent of people who play Fort Mason Games are women. The company is largely run by women and creates games mostly for women, he said. The company has found many women play Fort Mason Games in the evening hours after they come home to de-stress. They then go offline, perhaps to spend time with their children, and return to playing games at about 10 p.m. or later.

According to the survey, 35 percent spend more than 15 minutes playing mobile games in bed every night; 58 percent said playing mobile games reduces stress, and 72 percent reported winning a prize while playing a mobile game would improve their mood. While studies suggest looking at a brightly-lit phone screen before bed can negatively impact sleep, Fort Mason Games’ survey reported 50 percent of those surveyed fall asleep in 10 minutes or fewer, 33 percent toss and turn for an hour before nodding off and 17 percent need more than an hour to fall asleep. Cabeza can be reached at (208) 883-4631, or by email to gcabeza@dnews.com.

Balance / Spring 2019

Feeding from Page 6

my dog as well,’ ” she said. “Dogs, as much as we love them and consider them family members, are not small people from a physiological standpoint, from a medical standpoint.” Dogs have evolved over time to eat a specific and complicated balance of ingredients. Lee recommends choosing a dog food company that has been around for decades and has conducted extensive feeding trials of generations of dog lives. “We do have dog food companies that have been around for decades and have been feeding their dogs for generations, and so have a lot of data about how dogs do on these diets. They collect and use it to modify their diets.” Lee recommends dog food brands that follow World Small Animal Veterinary Association, or WSAVA guidelines. Charlie Powell, a spokesman for the WSU College of Veterinary Medicine, recommends that people look for labeling that includes the terms “complete and balanced” and “tested in feeding trials” on the packaging. Powell said putting together a diet for a dog that gives it all the nutrients it needs is “incredibly complex.” “For people who think they can just perceive what a canine should be eating and because they think it’s good and will be good for their dog, that is not necessarily the case. They should be consulting with a veterinarian or a vet nutritionist,” he said. When diet-responsive DCM is caught early, Lee said it is often reversible

Balance / Spring 2019

TRIBUNE/PETE CASTER

Kita, a 6-year-old German Shepherd border collie mix, chomps away at her daily meal of Pedigree Adult Complete Nutrition brand dog food. Charlie Powell, a spokesman for the Washington State University College of Veterinary Medicine, recommends people look for labeling on dog food that includes the terms “complete and balanced” and “tested in feeding trials” on the packaging. by changing to a different dog food. The college recommends that people feed their dogs food from a “wellestablished manufacture” that uses chicken, beef, rice, corn and wheat. If a dog has a medical condition requiring a different diet, the college again recommends going with food made by an established company that has undergone testing by Association of the American Feed Control Officials. It also recommends consulting with a veterinarian.

For dogs that have been diagnosed with DCM and are eating a nonstandard diet, the college recommends switching to a traditional diet, to have the dog’s taurine levels tested and to follow a veterinarian-prescribed regimen of heart screening. More information is available at http://bit.ly/2GnaEgA. Barker may be contacted at ebarker@ lmtribune.com or at (208) 848-2273. Follow him on Twitter @ezebarker.

‘Hidden disabilities’ 37,000 Idahoans are living with a traumatic brain injury; those in northern part of the state have few support options but they may get more soon traumatic brain injuries often want to lead THE BRAIN INJURY ALLIANCE OF an independent life, but depending on IDAHO IS NEARING A DECADE the severity and the nature of their of providing education, injury that can be difficult without advocacy and support for Idahoans with stronger systems of public support. traumatic brain Many living with brain injuries and is looking injuries have difficulty holding to expand to the down a job or a place to live. northern and eastern Jaeger’s 30-year-old son, reaches of the state. who sustained a brain injury According to in a traffic collision, doesn’t the U.S. Centers drive, making the need for Disease Control, an for public transportation estimated 1.7 million traumatic crucial to his ability to lead a brain injuries occur in the country reasonably self-sufficient life. annually, resulting in about 52,000 Jaeger said some traumatic deaths — about 2,200 of them children. brain injuries are known as Karen Jaeger, Brain Injury “hidden disabilities” because Alliance of Idaho co-chairwoman, the person may have no outward said about 5.3 million Americans — or roughly manifestations of their condition. 2 percent of the population — are living with “You could be talking with permanent disabilities related to a brain injury. someone and not know that they were Brain injuries in Idaho are exceedingly common, Jaeger living with a brain injury,” she said. said, noting the state ranks seventh in the However, Jaeger said brain nation for per capita hospitalization and rate By SCOTT JACKSON injuries can have a restrictive effect of disability from traumatic brain injuries. FOR BALANCE on many aspects of daily life. “They’re estimating that in Idaho, we Symptoms associated with traumatic have about 37,000 Idahoans living with a brain injuries can range from physical severe traumatic brain injury,” Jaeger said. “That doesn’t sensations, like dizziness or blurred vision, to impeded include concussions or milder forms of brain injury.” memory, motor skills and emotional functions. Now in her second year leading the nonprofit, Brain Injury Alliance of Idaho also Jaeger said she and her co-chairwoman, Mary Kelly, works to prevent such injuries. have set their sights on establishing more traumatic Jaeger said with the vast majority of traumatic brain injury support groups throughout the state. brain injuries caused by falls or traffic collisions, With that goal in mind, she said they plan to much of the risk can be eliminated by observing visit northern Idaho in the coming months. proper seatbelt and helmet safety etiquette. Despite how widespread such injuries are in the state, She warns that brain injuries range from “mild” to “severe,” Jaeger said there are only two brain injury support groups and even concussions can result in lasting brain damage. in Idaho, both in southern Idaho; northern Idahoans Those with concerns they or someone they know has must travel to Spokane to participate in such a group. experienced a brain injury can find more information at Jaeger said in addition to providing much needed www.biaid.org, or call (208) 385-3013 with questions. moral support and solidarity, the groups often feature guests who can speak to issues related to brain injuries, like memory strategies, mindfulness and nutrition. Jackson can be reached at (208) 883-4636, While each brain injury is unique, Jaeger said those with or by email to sjackson@dnews.com.

Balance / Spring 2019

As spring and summer weather sets in, health care professionasls remind patients that sun protection is important every time they leave the house. BARRY KOUGH/ FOR BALANCE

By JOEL MILLS FOR BALANCE

WITH THE WOES OF A DARK WINTER AND WET SPRING quickly receding into the rearview mirror, minds are quickly turning to summer and sun. And that means a refresher on protection from harmful ultraviolet rays may be in order. Most people have long been aware of the hazards of prolonged and unprotected time in the sun, which include sunburn, premature skin aging and skin damage. But the problem is still getting worse. The nonproﬁt Skin Cancer Foundation estimated that nearly 200,000 new cases of melanoma skin cancer will be diagnosed this year, an increase of 7.7 percent. And 90 percent

Balance / Spring 2019

Here comes the sun: Be prepared Most common mistakes in fight against skin cancer are not using enough sunscreen and applying it improperly of nonmelanoma and 86 percent of melanoma cases are caused by sun exposure. Protection is therefore essential to preventing skin problems that cost the U.S. an estimated $8.1 billion per year in treatment. Luckily, there are plenty of ways to provide protection that don’t include hiding in a dark basement all summer.

Sunscreen is an obvious must. But there are many different types, with pros and cons to each. They can be divided into two general categories: physical and chemical. Physical sunscreens use minerals like zinc oxide or titanium dioxide to deﬂect ultraviolet rays away from the skin. Chemical sunscreens use

carbon compounds to convert radiation to heat, which is later released from the body. Most chemical sunscreens include chemicals like oxybenzone or octinoxate. Physical sunscreens excel at blocking both types of harmful ultraviolet rays, UVA and UVB. They work quickly, are unlikely to irritate the skin and can limit heat reactions like redness and rosacea. Plus, they have a long shelf life. But physical sunscreens come off easily, especially when in contact with water or sweat. They’re harder to rub in and don’t work well under makeup. In contrast, chemical sunscreens are more resistant to sweat and water. They can also cover larger areas and their thinner > See sun, Page 10

Sun from Page 9 formulas make them easier to apply. But chemical sunscreens are only effective 20 minutes after their application, while physical sunscreens can be fully absorbed in about 15 minutes. Chemical sunscreens are also more likely to irritate the skin, especially those with higher sun protection factor, or SPF. And that protection can diminish over time when skin is exposed to direct sunlight, requiring more frequent application. Chemical sunscreens can also worsen acne by clogging pores, and they can irritate the eyes. Valley Medical Center nurse practitioner Carol Chandler said she prefers physical sunscreens because they offer protection against a broader spectrum of harmful rays. But the type of sunscreen won’t matter if it’s misapplied. “I think the biggest mistake people make is they just don’t use enough sunscreen, and they don’t apply it properly when they start,” Chandler said. She recommended about an ounce of sunscreen to cover an average body. It’s more effective to apply before dressing so clothing isn’t in the way, then allowing enough time for full absorption so sweat and water are less likely to wash the sunscreen away. “So ideally you would be thinking about it before you leave the house.” And skin protection should be a part of everyone’s daily ritual from spring through fall, even if they spend most of their time indoors or in a vehicle since harmful UVB rays can penetrate most windows, Chandler said. “Even if it’s just a moisturizer with an SPF,” she said. “And there are even some that have zinc in them.” Clothing can also provide a highly effective barrier against the sun’s rays. Chandler recommended covering up as an essential part of any sun protection regimen, including the use of hats and sunglasses to protect the back of the neck, face and eyes. Many companies now offer clothing with embedded SPF. But they can be rather expensive, so Chandler recommended stocking up when off-season and holiday sales roll around. Rash guards are another clothing option that can be worn either wet or dry. They are generally made of lightweight materials like spandex, nylon or polyester, with a relatively tight fit. And even though they were originally designed for use by surfers as protection against the chafing that can be caused by surfboard wax and sand, rash guards have become a popular alternative form of protection. They aren’t supposed to replace sunscreens, but can add an extra level of protection when they are used in tandem. Mills may be contacted at jmills@lmtribune.com or (208) 848-2266.

Cannabis in cars no laughing matter WSU survey suggests more than half of marijuana users believe it is safe to drive while high on marijuana said. “We just wanted to get a better sense of just how many people think that it is actually safe and A NATIONAL SURVEY CONDUCTED BY RESEARCHERS at how many people actually Washington State University engaged in the practice.” Cuttler said a similar found more than 52 percent proportion of respondents, of marijuana users think about 52.4 percent, admitted it’s safe to drive high. The survey was conducted to driving within an hour of consuming marijuana, in collaboration with researchers at the University but only about 4 percent reported experiencing any of California and the kind of traffic accident Bastyr University Research Institute between November while driving high. She said while marijuana 2013 and December 2014 may not impair users on and reached nearly 2,000 the same level as alcohol, participants in 50 states. high driving still about Carrie Cuttler, assistant doubles the risk a motorist professor with WSU’s will get into an accident. department of psychology, Cuttler said drunk drivers said the work found are about eight times more the public more or less likely to get into an accident split on the issue. than if they were sober, and “With legalization, those who text while driving people seemed to be quite are about 25 times more concerned that people are going to be driving high, and likely to get into an accident. Driving is already that’s going to pose a major a dangerous activity public safety risk,” Cuttler

By SCOTT JACKSON FOR BALANCE

Balance / Spring 2019

ABOVE: Even though it’s legal in Washington to purchase marijuana products from MJ’s Pot Shop in Pullman, it’s not legal to drive high. It also doubles the risk a motorist using the drug will get into an accident. RIGHT: Corinna Nicolaou, left, helps customer Rusty Shackleford at MJ’s Pot Shop in Pullman. GEOFF CRIMMINS/ FOR BALANCE

without throwing drugs into the mix, she said. Ideally, she said, drivers are not only sober but free of distraction and focused on the road. Marijuana consumption may not be equivalent to a blood alcohol

Balance / Spring 2019

level beyond .08, but that doesn’t make it “safer.” “There is a significant increase in risk — it’s not a huge increase, but there is still a significant increase,” Cuttler said. “You’re just adding to

the risk unnecessarily.” Cuttler said there are no known reliable indicators of acute marijuana intoxication — making it difficult to measure the degree of impairment at traffic stops. Currently, police can test

a driver’s blood for THC metabolites associated with imbibing cannabis, but frequent users could carry those in their blood stream for up to a month since their last puff. Also, level of impairment isn’t necessarily tied to quantity consumed. She pointed out more regular users may experience less of an intoxicating effect than those who are new to the drug. Cuttler’s research identified a number of interesting correlations, including that older people with less education who use more cannabis tend to be more comfortable with high driving. Inversely, younger people with a comparable level of consumption who are well-educated are also fairly likely to drive within an hour of consuming marijuana. Cuttler’s findings suggest states that legalize recreational marijuana consumption actually trend downward in terms of respondents who admit to driving high. “Since legalization, the prediction would be that people are thinking that cannabis is less risky, people might think that it’s more safe to drive, people might actually be driving high more,” Cuttler said. “We found the opposite. We found decreases. We found that fewer people said it’s safe to drive high, and fewer people reported driving high since legalization.” Jackson can be reached at (208) 883-4636, or by email to sjackson@dnews.com.

NURSE OF THE FUTURE WSU scientists test device to help elderly patients at home By TOM HOLM FOR BALANCE

A DECEPTIVELY SIMPLELOOKING ROBOT is being tested by Washington State University scientists to assist the elderly at home. The Robot Activity Support System, or RAS, has a base of three wheels that motors along its plastic and metal housing to approach people with an about chest-high pole along its middle. At its “head” is a camera and a touch-screen tablet with an animated face that looks like an emoji. The robot receives information from WSU’s smarthome that is equipped with sensors embedded throughout. Those sensors, along with the robot’s camera, allow it to perform simple tasks like locating objects and leading a person to the object. The project is a crossdiscipline effort of engineers, roboticists, psychology and nursing students to pull together both the technical aspects of building the robot and making it useful for elderly adults that need in-home care. Bryan Minor, a postdoctoral researcher in the WSU School of Electrical Engineering and Computer Science, said he has worked in WSU’s smarthome for a number of years and began working

AT LEFT: Nisha Raghunath replies to questions from an elder care robot at the Washington State University smart apartment in Pullman. GEOFF CRIMMINS/ FOR BALANCE

Balance / Spring 2019

ABOVE: Bryan Minor, (left) and Christopher Pereyda work with an elder care robot from the control room at the Washington State University smart apartment in Pullman. RIGHT: An elder care robot moves to assist Nisha Raghunath after recognizing an error in a daily task during a demonstration at the apartment. Raghunath is a master’s student in psychology at WSU. GEOFF CRIMMINS/FOR BALANCE

on RAS after a research grant was awarded to complete the project. “It’s an augmentation to, say, just a caregiver,” Minor said. “The smarthome reduces the burden that a caregiver has. And it allows the person to have some autonomy and not necessarily have the caregiver there all the time.” The smart home has oval, smoke detector-sized sensors embedded in the walls that track motion and feed into the robot’s neural network. The robot has several prompts and can

Balance / Spring 2019

perform simple tasks like assisting a person through the steps of taking a dog for a walk. Minor said one of the experiments the group ran through college student volunteers and then healthy adults was to have the participants introduce errors in the steps to walk a dog and see if the robot could identify the error and assist the participant in completing the step. The error might be forgetting a leash for the dog or an umbrella if there’s rain in the forecast. The camera allows the robot to identify an object and lead a person to it to grab it. Seeing and grabbing an object seems simple to a person, but the wealth of data included in that video and machine-learning process for RAS takes a lot of computing power. The “brains” of the robot are held at its base and fit onto an about foot-wide square. “It’s kind of like a glorified Roomba,” Minor said. The robot doesn’t have any anthropomorphised features or appendages like arms. It has no metal shell or sci-fi lights and gizmos. It is a functional and seemingly simple device designed to put people at ease and help with basic assistance, not confuse or disrupt someone. A key feature of the machine is its simple access, with touch-screen prompts and eventually, voice activation. Minor said graduate students >> See Nurse, Page 14

Nurse

The elder care robot assists Nisha Raghunath during a demonstration at the WSU smart apartment in Pullman.

from Page 13 are working to equip the robot with Alexalike qualities to improve user interface. An estimated 5.5 million Americans have Alzheimer’s disease, an incurable progressive brain disorder. Paired with other age-related illnesses, the disease causes many adults to require increased care, but the costs of assisted living can be prohibitive. Minor is a researcher in the lab of Diane Cook, regents professor of electrical engineering and computer science and director of the WSU Center for Advanced Studies

GEOFF CRIMMINS/ FOR BALANCE

in Adaptive Systems. For the last decade, Cook and Maureen SchmitterEdgecombe, a WSU professor of psychology, have led researchers in the development of

smarthome technologies focusing on elderly adults and trying to facilitate their unique needs at home. Minor said part of the development of this robot and smarthome technology

is to try to eventually offset the costs associated with in-home care both financially and emotionally. “The emotional toil that a lot of caregivers go through, we’re trying to provide tools to leverage technology to be able to reduce those burdens and hopefully improve quality of life,” he said. Holm may be contacted at (208) 848-2275 or tholm@ lmtribune.com. Follow him on Twitter @TomHolm4

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Balance / Spring 2019

Sisters of Countenance The right makeup and a little know-how give facial features the right flair ONE OF MY FIRST MEMORIES ABOUT MAKEUP involves an elderly aunt. She would draw on her eyebrows in half moons with a single stroke, possibly with eyeliner, to compensate for the lack of hair above her eyes. Back then, thinner was better and many women would painfully tweeze their eyebrows almost to the point of nonexistence. Since that time almost half a century ago, eyebrows have moved out of the shadows. They’re not something to fix. Absent a unibrow, they’re something to thicken, highlight and enhance. The trend has birthed dozens of products and services. Some are simple and inexpensive like Maybelline’s brow color, which costs $6 for 2.9 grams COMMENTARY and comes with its own applicator. Others cost more. Klassy Permanent Cosmetics in Clarkston charges $800 to create lasting eyebrows. If you’re feeling adventurous, you can dye your brows at home. (Beauty publications recommend moustache dye over hair dye since it is more forgiving — fading faster and carrying a much lower risk of burning the eyes.) With so many options, I decided to consult an expert. I made an appointment with Kristen Graves, the owner of My Minerals, a Lewiston business. Graves’ eyebrows used to be an afterthought. She would maybe

BEFORE

AFTER BARRY KOUGH/FOR BALANCE

TOP PHOTO: Without makeup, one of my eyebrows is so thin, it almost disappears. BOTTOM PHOTO: Eyebrow pomade highlights the color in my blue-green eyes. MY MINERALS Phone number: (831) 207-9492 Address: 450 Thain Road, Suite E, Lewiston Hours: 11:30 a.m. to 5:30 p.m. Tuesday through Friday and 11 a.m. to 4 p.m. Saturday.

ELAINE WILLIAMS

Balance / Spring 2019

add a little color with an eyebrow pencil. Now she hardly ever leaves the house without doing them. “It really makes your eyes pop,” she said. “That’s what brows do.” The eyebrow pomade at My Minerals sells for $8 for 5 grams, an amount that lasts about a year. “It’s extremely smudge proof,” BARRY KOUGH/FOR BALANCE Graves said. “I could go swimming,

Pomade and a small angled brush are used to add color to eyebrows.

>> See Sisters, Page 16

Sisters

Shawn Stone, who uses natural, sustainably sourced materials for all her products. from Page 15 A former cosmetologist, Stone started her own and this would still makeup line after her be on my face.” skin began breaking out The store will do a custom from wearing cosmetics, blend at no extra charge if it something she was required doesn’t already have a shade to do for her job. She spent that is right for someone’s thousands of dollars looking hair and complexion. for something that worked, Typically the color should before deciding she could be a shade darker than your blend her own with higher hair. Any darker than that, quality for less money. and it starts to look artificial. Her friends liked what People should also pay she did, began clamoring attention to undertones to wear her cosmetics in their hair. For instance, and urged her to go into Graves said my blond business for herself. has touches of ash (a She started with a booth diplomatic word for gray). at the Nez Perce County Fair Graves applied the pomade about three years ago. Graves with an angled brush ($5) originally got involved and smoothed it over with to help with marketing, a tool called a spoolie that because sales were so brisk looks like a small comb (less it was a challenge for Stone than $5). She recommends to keep up with orders. following the shape of the Eventually Graves brows, remembering that acquired the business your body, including your so Stone could focus on face is not symmetrical. production. She spends “Your brows are sisters, a lot of time giving free not twins,” she said. demonstrations about how Adding more color and to apply makeup to eyebrows volume to your brows and other facial features. doesn’t damage the skin “We just want (people) to or hair, as long as the try the product,” Graves said. color is made from quality ingredients, Graves said. The pomade at My Williams may be contacted Minerals is formulated at ewilliam@lmtribune. by the business’ founder, com or (208) 848-2261.

Personal Trainer

Some tips on running form Running gives you lots of time to feel how you are using your muscles and think about how you are moving your frame.

Make all your motion forward Redirect all muscular effort that is not pointed forward, such as these movements Bouncing up and down Swinging your arms from side to side

Relax as you run Loosen your shoulders, face and hands; carry your hands low enough to touch the waist of your pants A trick for keeping your hands relaxed Imagine that you are running with a potato chip in each hand and try not to break it

Shift your weight on hills Going uphill, raise your arms a little, which will raise your center of gravity

Going downhill, lower your arms and center of gravity

Touch the ground lightly A good way to monitor how heavily you are stepping is to listen to the sound your feet make on the pavement Source: Personal Best Training and Fitness Programs Graphic: Paul Trap

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Balance / Spring 2019

The writing on your artery walls Doctors’ long-running advice: Get checked before attempting to run a marathon By WILLIAM J. KOLE OF THE ASSOCIATED PRESS

BOSTON — IT WAS THE DEATH HEARD ‘ROUND THE RUNNING WORLD. In July 1984, acclaimed author and running guru Jim Fixx died of a heart attack while trotting along a country road in Vermont. Overnight, a nascent global movement of asphalt athletes got a gut check: Just because you run marathons doesn’t mean you’re safe from heart problems. Fast-forward 35 years, and Boston Marathon race director Dave McGillivray is amplifying that message for marathoners, especially those who have coronary artery disease or a family history of it. “Being fit and being healthy aren’t the same things,” says McGillivray. He should know. Six months ago, the lifelong competitor underwent open-heart triple bypass surgery after suffering chest pain and shortness of breath while running. As marathons, ultramarathons, megamile trail races and swimbike-run triathlons continue to explode in popularity, doctors are re-prescribing some longstanding advice: Get a checkup first and talk with your primary care physician or cardiologist about the risks and benefits before hitting the road. For McGillivray, 64, the writing was on his artery walls. Both his grandfathers died of heart attacks; his father had multiple bypasses; his siblings have had heart surgery; and a brother recently suffered a stroke. Neither McGillivray’s marathon personal best of 2 hours, 29 minutes, >> See Walls, Page 18

Balance / Spring 2019

AP PHOTO/JERRY MOSEY, FILE

In this photo taken in November 1977, marathoner Jim Fixx runs on a road near his home in Conn. In July 1984, the acclaimed author and running guru died of a massive heart attack while trotting along a country road in Vermont.

Walls from Page 17 58 seconds, nor his decades of involvement in the sport could protect him. “I honestly thought that through exercise, cholesterol-lowering medicine, good sleep and the right diet, I’d be fine,” he says. “But you can’t run away from your genetics.” Aerobic exercise such as running, brisk walking, cycling and swimming is known to reduce the risk of heart disease, high blood pressure, stroke and certain types of cancer, and it’s been a key way to fight obesity, Type 2 diabetes, osteoporosis and more. Studies have shown those who exercise regularly are more likely to survive a heart attack and recover more quickly than couch potatoes. But new research is providing a more nuanced look at “extreme exercise” and the pros and cons of running long. In a study published in December in Circulation, the journal of the American Heart Association, researchers in Spain found signs suggesting that full marathons like Boston may strain the heart. They measured substances that can signal stress and found higher levels in runners who covered the classic 26.2-mile marathon distance compared with those who raced shorter distances such as a half-marathon or 10K. Only about one in 50,000 marathoners suffers cardiac arrest, the researchers said, but a high proportion of all exerciseinduced cardiac events occur during marathons

KATIE MCGILLIVRAY VIA AP

In this Sept. 5, 2018, photo provided by Katie McGillivray, Boston Marathon race director Dave McGillivray gives the thumbs-up after undergoing an angiogram at Massachusetts General Hospital in Boston. — especially in men ages 35 and older. The Boston Marathon and other major races place defibrillators along the course. “We typically assume that marathon runners are healthy individuals, without risk factors that might predispose them to a cardiac event during or after a race,” writes Dr. Juan Del Coso, the study’s lead investigator, who runs the exercise physiology lab at Madrid’s Camilo José Cela University. Running shorter distances, he says, might reduce the strain, especially in runners who haven’t trained appropriately. Dr. Kevin Harris, a cardiologist at the Minneapolis Heart Institute at Abbott Northwestern Hospital, says he had a patient preparing for the Twin Cities Marathon who struggled to exceed 10 miles in training. The man’s family doctor insisted he get a stress test, and he wound up needing

double bypass surgery to detour around dangerous blockages in his arteries. “Running is good, and we want people to be active. But your running doesn’t make you invincible,” Harris says. “The bottom line is that individuals with a family history — especially men who are older than 40 and those people who have symptoms they’re concerned about — should have an informed decision with their health care provider before they run a marathon.” That family history is crucial. Fixx, whose 1977 bestseller “The Complete Book of Running” helped ignite America’s running boom, was 52 when he collapsed and died. An autopsy showed he had blockages in two of his heart arteries. He had a mix of risk factors. His father died at 43 of a heart attack, and although Fixx quit smoking, changed his eating habits and dropped

60 pounds, it turned out he couldn’t outrun those risks. Facebook COO Sheryl Sandberg’s late husband, tech entrepreneur Dave Goldberg, was 47 when he died while the couple was vacationing in Mexico in 2015. Goldberg had been running on a treadmill when he fell, and an autopsy revealed he had undiagnosed heart disease. Former U.S. House Speaker Paul Ryan, who is 49, has said his own strong family history of heart disease is what motivates him to work out regularly and watch his diet. His father, grandfather and great-grandfather all died of heart attacks in their 50s. “If you’re going to take on strenuous exercise later in life, and especially if you have active heart disease, it’s clearly in your interest to be tested and make sure you can handle it,” says Dr. William Roberts, a fellow and past president of the American College of Sports Medicine. McGillivray says his doctor has cleared him for Monday’s 123rd running of the Boston Marathon, which he’ll run at night after the iconic race he supervises is in the books. It will be his 47th consecutive Boston, and this time, he’s trying to raise $100,000 for a foundation established in memory of a little boy who died of cardiomyopathy — an enlarging and thickening of the heart muscle. “Heartbreak Hill will have special meaning this year,” McGillivray says. “My new mission is to create awareness: If you feel something, do something,” he says. “You have to act. You might not get a second chance.”

Balance / Spring 2019

REVOLUTION = EVOLUTION

Telemedicine, walk-in clinics cloud role of the traditional family doctor AP PHOTO/JEFF CHIU

Dr. Megan Mahoney (center) examines patient Consuelo Castaneda, as medical scribe Anu Tirapasur documents the visit April 9 at the Stanford Family Medicine ofﬁce in Stanford, Calif. Some patients are dropping their family doctor as other choices like telemedicine, walk-in clinics and free health screenings at work grow. By TOM MURPHY OF THE ASSOCIATED PRESS

LISA LOVE HASN’T SEEN HER DOCTOR of 25 years since she discovered telemedicine. Love tried virtual visits last summer for help with a skin irritation and returned for another minor problem. She doesn’t feel a pressing need to seek care the oldfashioned way, especially since she also gets free health screenings at work. No more waiting for

Balance / Spring 2019

the doctor’s ofﬁce to open. Convenience rules in health care now, where patients can use technology or growing options like walk-in clinics and urgent care centers to get help whenever they need it. A survey last year found that about a quarter of U.S. adults don’t have a regular doctor. Some like Love wonder how much they still need one. “Telemedicine probably can’t do everything ... but

for most of the things I might ever have, I’m pretty sure they can take care of it,” the Twin Falls, Idaho, resident said. Health care experts say the changing, fragmented nature of care is precisely why people still need someone who looks out for their overall health, which is the traditional role of primary care physicians like family doctors and internists. They know patients’

medical histories, and they’re trained to spot problems that may be developing instead of just addressing symptoms that prompted the patient’s visit. They also can make sure medications don’t conﬂict with regular prescriptions, and they can help make sense of the information patients dig up with a Google search. But the nature of > See Evolution, Page 20

Megan Mahoney, noting that this push depends on insurers expanding what they will cover. Doctors also are continuing to focus more on coordinating care for people with complex health needs. Bryant Campbell’s care team includes a primary care doctor, a pharmacist and specialists to help manage his chronic liver condition and rheumatoid arthritis. The Portland, Ore., man said his team members talk frequently to avoid problems like duplicate tests, and their approach gives him more confidence. “I sometimes think as patients we feel isolated in our health care, and this team-based approach helps a patient be as involved as you AP PHOTO/JEFF CHIU need or want to be,” he said. Megan Mahoney types into a computer April 9 at the Stanford Family Medicine office. Doctors say the expanded scope of their practices is On top of all the chains, CVS Health and changing how they interact competition for patients, Walgreens, now run about with patients. Dr. Russell the field also is fighting 1,500 clinics combined. from Page 19 Phillips frequently responds a shortage of doctors as More recently, employers have started adding worksite medical school students opt to email or cellphone primary care is changing for higher-paying specialties. questions from his patients. clinics, and thousands of as patients branch off to He also refers them to Primary care practices urgent care centers have drugstore clinics and urgent clinics for minor issues like have adjusted by adding opened around the country care centers. Practices are urinary tract infections. physician assistants or to treat emergencies that slowly shifting to more of a The Harvard Medical nurse practitioners to aren’t life-threatening. Then team-based approach that School professor says primary handle annual physicals there’s telemedicine, which care is evolving into more of focuses on keeping patients patients can use to connect to and other routine care. a flowing, virtual relationship healthy and reserves They’re also creating a doctor in minutes without where patients have more visits with a doctor for teams that help them take leaving their home or office. frequent but briefer contact the more serious cases. a broader look at patient Love said she’s hooked with their doctor’s office “The idea that the health. Those teams might on virtual visits. They only instead of just office visits primary care physician is the cost $42, or less than half include mental health maybe twice a year. one-size-fits-all solution ... specialists who screen for the price of an office visit “Getting medical care is that’s going to change pretty under her insurance plan. depression and health such a complex activity that dramatically,” said Sam coaches who can improve “I like technology and I people really need somebody Glick, an executive with the diet and exercise. like new things and I like who can advise, guide and research firm Oliver Wyman. saving money,” Love said. “It The idea is to keep coordinate for them,” Phillips This evolution began was worth it to me to try it.” patients healthy instead said. “People still really years ago when drugstores About 25 percent of adults of waiting to treat them want a relationship with started providing flu after they become sick. don’t have a regular doctor, someone who can do that.” shots and opening clinics “We want to do as the nonprofit Kaiser Family that handle minor issues much outside the walls of Foundation found last year. like ear infections or That jumps to 45 percent for the clinic as we can,” said Follow Tom Murphy on Twitter: Stanford University’s Dr. those younger than age 30. pink eye. The two largest @thpmurphy

Evolution

Balance / Spring 2019

HOME REMEDIES: THE BAD BREATH BATTLE JASON SALMON/DREAMSTIME/TNS MAYO CLINIC NEWS NETWORK

There are many causes of bad breath, also called halitosis. Your mouth may be the source. The breakdown of food particles and other debris by bacteria in and around your teeth can cause a foul odor. If your mouth becomes dry, such as during sleep or after smoking, dead cells can accumulate and decompose on your tongue, gums and cheeks, causing odor. Eating foods containing oils with strong odor such as onions and garlic, can lead to bad breath. Foul-smelling breath also may be a symptom of illness, such as lung disease, diabetes or liver failure. To reduce or prevent bad breath, you should: Brush your teeth

Balance / Spring 2019

after you eat. Keep a toothbrush at work to use after eating. Brush using a fluoridecontaining toothpaste at least twice a day, especially after meals. Toothpaste with antibacterial properties has been shown to reduce bad breath odors. Floss at least once a day. Proper flossing removes food particles and plaque from between your teeth, helping control bad breath. Brush your tongue. Your tongue harbors bacteria, so carefully brushing it may reduce odors. People who have a coated tongue from a significant overgrowth of bacteria such as smoking or dry mouth may benefit from using a tongue scraper. Or use a toothbrush that has

a built-in tongue cleaner. Clean dentures or dental appliances. If you wear a bridge or a denture, clean it thoroughly at least once a day or as directed by your dentist. If you have a dental retainer or mouthguard, clean it each time before you put it in your mouth. Your dentist can recommend the best cleaning product. Drink plenty of water to avoid dry mouth. To keep your mouth moist, avoid tobacco and drink plenty of water — not coffee, soft drinks or alcohol, which can lead to a drier mouth. Chew gum or suck on candy — preferably sugarless — to stimulate saliva. For chronic dry mouth, your dentist or physician may prescribe an

artificial saliva preparation or oral medication that stimulates the flow of saliva. Adjust your diet. Avoid foods such as onions and garlic that can cause bad breath. Eating a lot of sugary foods also is linked with bad breath. Regularly get a new toothbrush. Change your toothbrush when it becomes frayed — about every three to four months. Also, choose a soft-bristled toothbrush. Schedule regular dental checkups. See your dentist regularly — generally twice a year — to have your teeth or dentures examined and cleaned. Chew fresh parsley. Chewing parsley may improve bad breath temporarily.

Why is the measles virus so contagious? MAYO CLINIC NEWS NETWORK

Measles is a highly contagious viral infection that spreads through coughing or sneezing. “It’s one of the most contagious infectious diseases,” says Dr. Nipunie Rajapakse, a Mayo Clinic pediatric infectious diseases specialist. “Measles infection is spread through the airborne route, which means you have to inhale the infectious virus. And because it is very tiny droplet nuclei, those can remain suspended in the air for up to two hours after someone with

measles has left an area.” “It is one of the factors that makes measles so contagious and so prone to creating outbreaks when there is a case,” she says. “You can become infected with measles, even if you don’t come face to face with someone who is infected. It is why vaccination is so important. You can’t control who was in the airspace

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before you, so having a good level of immunity is critical to staying protected.” Symptoms of measles include: Fever A skin rash made up of red flat blotches, often starting on the head and spreading downward Dry cough Runny nose Sore throat Inflamed eyes (also known as conjunctivitis) Tiny white spots with bluishwhite centers on a red background found inside the mouth on the inner lining of the cheek — also called “Koplik’s spots” Complications may include ear infection, pneumonia and encephalitis, which can result in permanent brain damage. Each year, for every 1,000 children who get measles in the U.S., the Centers

for Disease Control and Prevention (CDC) reports one or two children will die. Measles can be prevented with the measles, mumps and rubella vaccine, also known as the MMR vaccine. The CDC recommends the MMR vaccine for all persons 1 year and older. During outbreaks or if traveling to an area where measles is common, children 6-12 months old may be eligible to receive an early dose of the vaccine for protection. If you haven’t been vaccinated, Rajapakse says it’s not too late. “If you are an adult and you’ve never been vaccinated, there are catch-up schedules to get all of the recommended vaccines for your age group.” If you’re not sure if you’ve been vaccinated, Rajapakse recommends checking with your primary care provider.

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Balance / Spring 2019

tips for back pain relief during pregnancy

As your baby grows, your center of gravity shifts forward. DREAMSTIME/TNS

back — which can strain the muscles in your lower back and contribute to back BACK PAIN DURING pain during pregnancy. PREGNANCY ISN’T SURPRISING, but it still deserves attention. Keep these principles of good posture in mind: You’re gaining weight, your  Stand up center of gravity changes, straight and tall. and your hormones are  Hold your chest high. relaxing the ligaments in the  Keep your shoulders joints of your pelvis. Often, back and relaxed. however, you can prevent  Don’t lock your knees. or ease back pain during When you stand, use a pregnancy. Consider seven comfortably wide stance ways to give pregnancy for the best support. If you back pain the boot. must stand for long periods of time, rest one foot on a 1. Practice good posture low step stool — and take As your baby grows, time for frequent breaks. your center of gravity Good posture also means shifts forward. To avoid sitting with care. Choose falling forward, you might compensate by leaning a chair that supports your MAYO CLINIC NEWS NETWORK

Balance / Spring 2019

back, or place a small pillow behind your lower back. 2. Get the right gear Wear low-heeled — not ﬂat — shoes with good arch support. Avoid high heels, which can further shift your balance forward and cause you to fall. You might also consider wearing a maternity support belt. Although research on the effectiveness of maternity support belts is limited, some women ﬁnd the additional support helpful. 3. Lift properly When lifting a small object, squat down and lift

with your legs. Don’t bend at the waist or lift with your back. It’s also important to know your limits. Ask for help if you need it. 4. Sleep on your side Sleep on your side, not your back. Keep one or both knees bent. Consider using pregnancy or support pillows between your bent knees, under your abdomen and behind your back. 5. Try heat, cold or massage While evidence to support their effectiveness is limited, massage or the application of a heating pad or ice pack to your back might help. > See Back pain, Page 24

Back pain from Page 23 6. Include physical activity in your daily routine Regular physical activity can keep your back strong and might relieve back pain during pregnancy. With your health care provider’s OK, try gentle activities — such as walking or water exercise. A physical therapist also can show you stretches and exercises that might help. You might also stretch your lower back. Rest on your hands and knees with your head in line with your back. Pull in your stomach, rounding your back slightly. Hold for several seconds, then relax your stomach and back — keeping your back as ﬂat as possible. Gradually work up to 10 repetitions. Ask your health care provider about other stretching exercises, too. 7. Consider complementary therapies Some research suggests that acupuncture might relieve back pain during pregnancy. Chiropractic treatment might provide comfort for some women as well. However, further research is needed. If you’re considering a complementary therapy, discuss it with your health care provider. Be sure to tell the chiropractor or acupuncturist that you are pregnant.

Feeling stressed? Go take a hike

DREAMSTIME/TNS

phone calls, conversations and reading.” In addition to accommodating the subjects’ busy lifestyles, the team also IF YOU’RE FEELING STRESSED, spending factored in the natural drop in cortisol levels some time in nature might help, that can occur naturally throughout the day. according to a new report. After analyzing the results, they found Researchers from the University having a 20-minute nature of Michigan recently conducted experience reduced cortisol ONLINE a study, published in Frontiers levels. In fact, those who spent in Psychology, to determine 20 to 30 minutes sitting or The full report the association between nature walking outside had the greatest can be found and stress hormone levels. decrease of cortisol levels. at https://bit. For the assessment, they asked a “Our study shows that for ly/2UxVkWj. group of adults to take “nature pills,” the greatest payoff, in terms or to spend some time either sitting of efficiently lowering levels or walking in nature. They were required to of the stress hormone cortisol, you spend 10 minutes or more in nature at least should spend 20 to 30 minutes sitting three times a week for an eight-month period. or walking in a place that provides you Once every two weeks, the scientists with a sense of nature,” Hunter said. measured the participants’ levels of cortisol, The team said their findings provide the a stress hormone, using saliva samples fi rst estimates of how nature can impact taken before and after a nature pill. our daily lives, and they hope healthcare “Participants were free to choose the providers take advantage of the evidence. time of day, duration, and the place of “Our experimental approach can be their nature experience, which was defined used as a tool to assess how age, gender, as anywhere outside that in the opinion seasonality, physical ability and culture of the participant, made them feel like influences the effectiveness of nature they’ve interacted with nature,” lead author experiences on well-being,” Hunter MaryCarol Hunter explained in a statement. said. “This will allow customized nature “There were a few constraints to minimize pill prescriptions, as well as a deeper factors known to influence stress: take the insight on how to design cities and nature pill in daylight, no aerobic exercise, and avoid the use of social media, internet, wellbeing programs for the public.”

By NAJJA PARKER

THE ATLANTA JOURNAL-CONSTITUTION

Balance / Spring 2019