Balance Fall 2011 by Moscow-Pullman Daily News

Volume 3 – Issue 3 – Fall 2011

The health magazine for Body, Mind & Motivation Published quarterly by the Lewiston Tribune and the Moscow-Pullman Daily News

FASTING FEARS

Nutritionists warn against weight-loss method

FINDING YOUR YOGA

Centuries-old practice has many styles

A DRUNK IN THE MIRROR

Experts say addiction crosses all boundaries

COVER STORY

CHANGING FACE

OF PRIMARY CARE ‘The nurse practitioner will see you now’

Fall 2011

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Fall 2011

Contents

Balance – volume 3, issue 3 – Fall 2011

COVER STORY

NUTRITION

CHANGING FACE OF PRIMARY CARE ‘The nurse practitioner will see you now’

FITNESS

FINDING YOUR YOGA

FASTING FEARS

Nutritionists warn against weight-loss method

HEALTH & WELLNESS

A DRUNK IN THE MIRROR

Centuries-old practice has many styles

Experts say addiction crosses all boundaries

ALSO

Balance

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LOCAL CONTRIBUTORS

HOLLY BOWEN

Daily News staff writer

Holly is in her third year of covering Idaho education, including Latah County schools and the University of Idaho. She stopped eating meat more than seven years ago and hasn’t looked back.

CONNOR DeVRIES Daily News staff writer

Connor DeVries began working at the Daily News as Interim Business Editor this May. He now is a full-time student at the UI, where he is working on getting his bachelor’s degree - in what, he has no idea.

KEVIN GABOURY

Lewiston Tribune staff writer

Oregon native Kevin Gaboury covers Asotin County and the city of Clarkston for the Tribune. He stays active by running, hiking, snowboarding, biking and backpacking.

KELLI HADLEY

Daily News staff writer

Kelli covers the city of Pullman and Whitman County. Because she lacks basic hand-eye coordination skills, she enjoys no-contact sports such as snowboarding, mountain biking, yoga and the occasional half marathon with her older sister.

PEGGY HAYDEN

Lewiston Tribune staff writer

Peggy has worked at the Lewiston Tribune for four years. She lives in Lewiston with her husband and dog, Chrissy. Peggy enjoys baking doggie treats for Tribune pups as well as making human treats for her friends and family.

Letter from the

Editor

The cost of health care is a big issue around the country right now but here -- in the Valley and on the Palouse -- medical offices are finding that a lot of routine care can be handled just as well by nurse practitioners as by doctors. In this issue, we also look at what it takes to make tennis a sport you can play your whole life, and how to get into the swim of things. Experts will tell us why massage works so well for pain relief, and why fasting is a very bad way to lose weight.

Lewiston Tribune staff writer

We’ll take a look at two addictions, one that’s beneficial to you and others, and one that’s self-destructive.

KATIE ROENIGK

You might be surprised by our story about who gets plastic surgery and why. And it turns out that yoga as it is practiced in the Northwest can be pretty much what you want it to be.

JOEL MILLS

Joel Mills lives with his family in Moscow. He’s currently enjoying the growing abundance of fresh, local foods available on the Palouse, and turning them (with some success) into good, healthy meals.

Daily News staff writer

Katie has worked for the Daily News for about a month covering Washington education. She moved to Moscow from Riverton, Wyo., where she lived for three years with her boyfriend, Cooper. They both look forward to exploring the outdoors of Idaho with their Australian shepherd, Skye.

Finally, we’ll show you that you can create balanced fare for tailgating that tastes really good.

KERRI SANDAINE

Lewiston Tribune staff writer

Kerri covers Asotin, Clarkston and Garfield County for the Tribune. She tries to stay healthy by running, playing tennis and eating lots of vegetables.

JESSE HUGHES Graphic designer

Jesse has worked for the Daily News and Lewiston Tribune since 2008 in the advertising department. He and his wife try to eat a healthy, well-balanced diet and stay active by walking, hiking, and being kept on their toes by two boys.

Lee Rozen Managing Editor Moscow-Pullman Daily News

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 Advertising Director Bob Reitz at breitz@lmtribune.com, or the Moscow-Pullman Daily News advertising department at (208)882.5561 or Advertising Manager Craig Staszkow at cstaszkow@dnews.com.

Editorial suggestions and ideas can be sent to Tribune City Editor Craig Clohessy at cclohessy@ lmtribune.com or Daily News City Editor Murf Raquet at murf@dnews.com. Balance

ADVERTISER INDEX

A Full Life Agency ............................................ 31 Adcope Athletic Club ....................................... 34 Allen, Dr. Richard............................................ 11 Alm, Dr. Ronald .............................................. 33 Be Moved ......................................................... 21 Bishop Place .................................................... 17 Bluesky Dentistry ............................................ 27 Clarkston Denturist Clinic............................... 25 Clearview Eye Clinic ........................................ 23 Clearwater Medical ......................................... 35 Electrolysis & Permanent Hair Removal ......... 13 Elm View Chiropractic .................................... 27 Garges, Lawrence M., M.D. ............................. 13 Gritman Medical Center.................................. 36 Henderson, Robin DDS ................................... 33 Huckleberrys at Rosauers ................................ 22 Jamms Frozen Yogurt ...................................... 30 Kingsbury, Dr. Linda ....................................... 29 La Bella Vita Medical Spa ................................. 5

Leavitt DMD, Erin........................................... 11 Lewis Clark Gastroenterology/Endoscopy ......... 7 Maplewood Dental .......................................... 31 Morlock, Bradley DDS ..................................... 22 Moscow Family Medical .................................... 5 Moscow Yoga Center........................................ 15 Palouse Medical............................................... 33 Pathologists’ Regional Laboratory ................... 23 Reiki by Lanie Bailey ....................................... 19 Royal Plaza Retirement Center ....................... 27 Schweitzer Engineering Laboratories............... 15 Schweitzer Engineering Laboratories............... 21 TenderTouch Health ........................................ 19 Total Health Physicians Group ........................ 25 Tri-State Memorial Hospital.............................. 2 Valley Medical ................................................... 3 Wedgewood Terrace ......................................... 29 Whitman Hospital & Medical Center .............. 15 Whitman Senior Living ................................... 34

LIVE LONG!! – LIVE HEALTHY!!

1) Do an exercise almost everyday that increases your heart rate for at least ten minutes. 45 minutes to an hour six days a week is ideal. Consider using a heart rate monitor. Talk to your doctor about what exercise program would be right for you but everyone should do some exercise at least six days per week. 2) Eat a well balanced calorie restricted diet emphasizing whole grains, green leafy vegetables and fruit. Eat the fruit instead of drinking the juice. Eat 2 fish meals per week. 3) Always use your seat belt. Don’t drive tired. Avoid distractions like cell phones while driving. 4) Vaccines are safe and have saved millions of lives. Get influenza, pneumonia, zoster and other vaccines as recommended by your doctor. Wash your hands or use hand sanitizer after contact with other people such as shaking hands. Wash uncooked fruits and vegetables. Make sure ground meats are well cooked throughout. 5) If meat, bread, pills and the like ever stick or stop after you swallow consult your doctor. If you have heartburn or indigestion more then once per week or use medication ever day to control your heartburn, talk to your doctor about checking for risk of esophageal cancer. If you suddenly develop “indigestion” or chest pressure it may be your heart: CALL 911! 6) Get a colonoscopy at the age of fifty or earlier if there is history of colon cancer or colon polyps in your family. Colon cancer is a completely preventable cancer that causes tens of thousands of deaths every year. A colonoscopy totally eliminates the risk of colon cancer, with rare exceptions. 7) Red blood with bowel movements often is bleeding from a tumor of the colon! Talk with your doctor about any blood associated with bowel movements, urination or coughing. 8) Work with your doctor to strictly control any elevation in blood pressure, blood sugar, LDL cholesterol, triglycerides and body weight. 9) Work with your doctor to detect cancers early. Get a mammogram or a prostate check at the recommended times. Avoid exposure to the sun; wear a hat and use at least 30 sunblock if you must be in the sun. Never use tanning booths. Have any mole or sore on the skin that has changed or does not go away checked by your doctor. 10) If you smoke or use tobacco products, STOP!! Talk to your primary care doctor about help in stopping smoking now! 11) If you drink alcohol, do so in moderation. Don’t drink every day and never average more then 2 drinks per day. Perhaps red wine is the healthiest of alcoholic beverages. 12) If you take medications always either know what your medications are and why you take them or carry a list with you. Make sure all your doctors and pharmacist know what you take and check for interaction; this includes supplements and over the counter medications. Take your medication as prescribed. Discuss any change you want to make with your doctor. Ad sponsored by Lewis Clark Gastroenterology, PLLC 319105IX-11

Fall 2011

LEWISTON TRIBUNE / STEVE HANKS

Clearwater Medical Clinic’s Nurse Practitioner Joan Richardson.

CHANGING FACE of primary care Nurse practitioners step into shoes once filled by doctors

believe the cause is a decrease in physicians in 2010-2011, up from 7,197 in 2006-2007, going into primary care. according to data from the AANP. “Physicians, in practice, are going more “The increase in nurse practitioners is into specialties — surgeons, pulmonologists, a result in the evolution of today’s health BY KEVIN GABOURY rheumatologists and everything else,” Rich- care system,” said Cathy Arvidson, associate eople are often skeptical about seeing ardson said. “I believe there’s such a shortage professor of nursing at Idaho State Unia nurse practitioner before they step of physicians that nurse practitioners are versity and director of AANP Region 10, into Joan Richardson’s office. kind of filling that gap. One thing is certain, which includes Alaska, Idaho, Oregon and “A lot of elderly patients will say, ‘I want the money is much Washington. “We have to see the physician,’ ” said Richardson, a higher for them than a shortage of primary “We do the assessments the nurse practitioner at Clearwater Medical it is in primary care. same, we order the same tests, we care providers, and Clinic in Lewiston. You’re not going to get have full prescriptive authority.” nurse practitioners can But once the appointment is over, they rich in primary care.” help fill these gaps by Joan Richardson wonder what the big deal was. Six nurse According to the providing high-quala nurse practitioner at Clearwater Medical Clinic in Lewiston practitioners and a physician at the clinic American Academy ity, cost-effective care.” provide care for about 10,000 patients in of Nurse PractitioAbout 18 percent of the Lewiston-Clarkston Valley and beyond, ners, based in Austin, Texas, the number nurse practitioners are in rural areas, which Richardson said. of nurse practitioners has exploded by 75 reflects the movement of more primary care “I think we’ve built a good reputation for percent over the last five years. By the most physicians to large cities. ourselves,” she said. recent count, there are more than 148,000 “Not only do more practice in these This situation reflects a growing nationnurse practitioners practicing in the U.S. settings, but more stay there for longer,” Arwide trend of people seeing nurse practitio- An estimated 9,500 new nurse practitiovidson said. “In my experience, part of this ners as their primary care providers. Many ners completed their academic programs reason is many nurse practitioner students

Balance

already live in a rural community and have gone back to school in order to be able to provide care to these communities. They are invested in their communities and remain there as part of the community.” While most nurse practitioners work in primary care, Arvidson said they can also be found in acute care, long-term care and specialty practices. Richardson’s background is oncology, while other nurse practitioners at the clinic have cardiology, rheumatology, dermatology and pediatric backgrounds. Richardson often receives the query: “What can the physician do that you can’t?” The answer, she said, is nothing. “We do the assessments the same, we order the same tests, we have full prescriptive authority,” she said. “I’ll go exactly as far as my knowledge will take me, and then I refer.” Richardson became a nurse practitioner about a decade ago after working as an oncology nurse at St. Joseph Regional Medical Center in Lewiston for 30 years. Most nurse practitioners have a master’s degree in nursing, and many have doctorates, according to the AANP. The six nurse practitioners at Clearwater Medical Clinic share equal ownership in the business with Dr. Celso Chavez, Richardson said. An increasing amount of people seek nurse practitioners as their primary care providers because they create a partnership

Nurse practitioners by the numbers:

Nationwide estimate (2011): 148,000 Idaho: 611 Washington: 3,611 Montana: 535 Oregon: 2,446

Specialties:

Acute care: 5.3 percent Adult: 17.9 percent Family: 49.2 percent Pediatrics: 9.4 percent Gerontological: 3 percent Neonatal: 2.3 percent Psych/mental health: 2.9 percent Women’s health: 9.1 percent

Lewiston Tribune / Steve Hanks

Joan Richardson is one of 148,000 nurse practitioners practicing in the U.S. An estimated 9,500 new nurse practitioners completed their academic programs in 2010-2011.

with their patients, Arvidson said. Many deliver a unique blend of nursing and medical care with an emphasis on helping their patients make better lifestyle and health decisions. Studies have shown that nurse practitioners spend more time with their patients, focus more on preventative health and wellness and communicate better with their patients, she said. A fundamental difference between nurse practitioners and physicians is their treat-

Education:

Baccalaureate: 1.4 percent Master’s: 73.9 percent Post-Master’s: 15.7 percent Doctorate: 0.9 percent Other: 8 percent

Average number of patients seen per day:

Less than 10: 15.7 percent 10-14: 24.1 percent 15-19: 26.1 percent 20-24: 20.2 percent 25 or more: 13.9 percent

ment philosophy, Richardson explained. “Nurse practitioners are very holistic; they treat everything about you, not just the broken foot or the knee, everything is addressed,” she said. “The time that we see you is also much longer, granted we don’t make as much money, but that’s kind of who a nurse practitioner is.” On the Net: To find a nurse practitioner in your area, visit www.npfinder.com

Other random facts:

l 87 percent of N.P.s see patients covered by Medicare and 84 percent by Medicaid l 43 percent of N.P.s hold hospital privileges; 15 percent have long-term care privileges l 96.5 percent of N.P.s prescribe medications, averaging 20 prescriptions a day l N.P.s hold prescriptive privilege in all 50 states, with controlled substances in 48 l The 2009 mean full-time N.P. base salary was $89,450, with average fulltime N.P. total income $97,340 Source: American Academy of Nurse Practitioners

Fall 2011

Sport for a lifetime Those who play agree: Tennis is good for body, mind and friendships

The attractions of the sport are many, Anegon said. For one, chasing a fuzzy yellow ball around a tennis court is a good workout. Another benefit is the mental stimulation. “There’s a lot of mano-a-mano By JOEL MILLS strategy involved.” Getting a game together only requires n the surface, Tony Anegon and one other person, and players can practice Marina Wold might not seem to alone by hitting against a wall, he said. have much in common. And getting started is inexpensive comOne is a 54-year-old attorney, the other pared to other sports, with the main costs a 21-year-old college student. But the two only a racquet and shoes. Most communiLewiston residents share an enduring love ties have tennis courts, and they are almost of tennis that will keep their bodies healthy, always free to use. their reflexes fast, their minds sharp and The best thing about the sport, Anegon their friendships strong for a long time to concludes, is that he gets better with age. come. “I was a better player at 45 than I was at “It’s just a sport that you can play for a 35, and I’m having more fun now at 54,” he lifetime,” said Anegon while sitting courtsaid. “I can compete with people half my side at Lewis-Clark State College’s indoor age.” Tennis Center. “You can play it at any level Wold plays for the LCSC women’s team, for any amount of time.” and the sport has earned her a scholarship Anegon already played golf and basthis year and last year. A senior with an ketball when he took up tennis at the age English major and political science minor, 14. “When I started playing, the balls were Wold said her dad, Tim, got her started white and the racquets were wood,” he said. relatively late in life at the ripe old age of And while he still enjoys golf as a so15. called “life sport” that a person can play But Wold said not playing as a small deep into old age, “tennis kind of took child was a benefit in her case. “Some over” his recreational people who start life, he said. “I was a better player at 45 than when they’re really He played junior I was at 35, and I’m having more little feel pushed into tennis in high fun now at 54. I can compete with it,” she said, “and school, and was “ba- people half my age.” they get burned out.” sically a tennis bum Her interest in Tony Anegon in college.” When he tennis took off, Lewiston resident and tennis enthusiast got older, his family however, carrying caught the bug. Both his kids ended up through high school and into her higher playing college tennis, and now son Ed education. And Wold said it will continue Anegon is even coaching the Pullman High to be her avocation of choice long after she School girls tennis team while he’s a gradu- graduates. ate student at Washington State University. “I think that after college, tennis will be Anegon is also a U.S. Tennis Association a way to stay in shape that I enjoy,” she said. official, performing chair umpire duties “It hones your mind and body.” and assigning other officials to regional colShe compared other forms of exercise to lege tournaments. To top it all off, he plays “banging my head against a wall.” two or three times a week with people both Wold and Anegon both pointed out older and younger than him. another, hidden benefit of an active tennis

10 Balance

Lewiston Tribune / Steve Hanks

Marina Wold’s interest in tennis carried her through high school and into her higher education.

life: networking. Anegon frequently meets with a small, all-ages group at the Tennis Center to bat around both the ball and some conversation. Sometimes, there are even three people on each side of the net. “They’re just having a ball, hooting and hollering,” he said. Wold said tennis has helped her stay close with her dad. “He still plays to keep in shape, and it’s something we do together.” It has also been an entree to many friendships, she added. “To play, you really have to get yourself out there and meet some people.” Those who are interested in getting started in the sport can visit the Tennis Center online at www.lcsc.edu/tennis, or call (208) 792-2309, said Jeanne Poxleitner, assistant facilities coordinator. The center has equipment available to check out for free, and time on the indoor courts can be reserved and lessons scheduled for a fee.

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Tony Anegon works to chase down a ball hit to his backhand at the Lewis-Clark State College Tennis Center.

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Fall 2011 11

Fasting is a bad slim-down technique Dietitians say depriving the body of food is unhealthy and a good way to gain weight

turns toward fasting as a form of weight looking to shed a few pounds should atloss. tempt a lifestyle change. “Our body needs to be fueled on a “It’s better to just eat five or six small regular basis,” said Connie Lorenz, a meals throughout the day,” Lorenz said. registered dietitian at St. Joseph Regional “Eat when you’re hungry, and stop when By Katie Roenigk Medical Center in Lewiston. “It just runs you’re just starting to get full if you really more efficiently and keeps the blood want to look at something for long-term he human body was meant to run sugar more stable.” weight loss.” on fuel. Lorenz would discourage anyone That concept may seem from fasting, whether they want to try No food, no weight-loss obvious, but many dietitians find a cleansing juice fast or go on a strict Registered dietitian Nancy Kure, themselves reminding people of water-only diet. who works as the director for nutrition the need for food “I think our services at Gritman when the body is pretty good “Eat when you’re hungry, and Medical Center in conversa- at cleansing itself,” Moscow, said fasting stop when you’re just starting tion Lorenz said. “That’s actually will cause a to get full if you really want to what our liver funclook at something for long-term person to gain weight tions do.” because the body weight loss.” Fasting has not goes into starvation Connie Lorenz necessarily gained mode. a registered dietitian at St. Joseph Regional Medical Center in Lewiston popularity of late “Your body starts according to Lorenz, to adapt, and it but she said most people tend to try it as changes the way it stores fat,” Kure said. a jump-start to weight loss. “Plus, you’re setting yourself up for one “For a lot of people it’s just havgigantic binge due to primal hunger. ing that gimmick to You’re so hungry your body will eat way get them started,” more than if you would have just eaten Lorenz said. normally.” “But it’s not In a lot of cases, the intake of large for the amounts of food just after a fast will leave long a person discouraged or feeling like a term.” failure. That is why Kure advises people The to avoid diets altogether. technique As an alternative, Kure recommends is not sus- something called “intuitive eating,” tainable, through which people listen to their own Lorenz said, bodies before deciding what to put on since people their plates. eventu“Don’t let yourself get so hungry or ally must break overfull,” Kure said. “You have to really their fast and get keyed into or aware of, ‘When am I eat a meal. really hungry?’ ” Instead People who subscribe to a diet are of eliminatconforming to someone else’s rules that ing food for dictate what they can and cannot eat. several days, Since the guidelines are not specific to Lorenz said the individual, Kure said they are more people likely not to work.

12 Balance

“You tell yourself, ‘I have a rule, and more susceptible to gallstones and heart I’ll do well as long as I follow that rule,’” arrhythmia, and Kure said the immune Kure said. “Well, system will weaken “Our body needs to be fueled on that rule will get because a body in a regular basis. It just runs more broken.” starvation mode efficiently and keeps the blood sugar is burning muscle When it comes more stable.” to fasting, it is instead of fat. Connie Lorenz good to break the “Dehydration is a registered dietitian at St. Joseph rules eventually. not a good thing, Regional Medical Center in Lewiston But there are risks and you can get to cutting off food intake for any period headaches, constipation and dry skin,” of time. Fast weight loss makes people Kure said. “You kind of mess your stom-

ach up.” Hair loss is a possibility with repeated fasts, and Kure said serious eating disorders can result as well. “It’s not a good way to go,” she said, adding that she is willing to work with people who fast for religious or personal reasons. On the Net: To learn more about nutrition and healthy eating, visit myplate.gov

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Fall 2011

Making a big

SPLASH

LEWISTON TRIBUNE / KYLE MILLS

Coach Chris Engledow runs members of the Neptunes through swimming drills at the Asotin County Family Aquatic Center in Clarkston.

Lewis Clark Neptunes coach shares love of sport, commitment to swimming

club, staying with his brother during the Since becoming coach of the Neptunes summer just so he could be a member of he has grown the group by increasing the the Lewis Clark Neptunes, he dreamed of participation of more age groups. The one day coaching the group. youngest participant currently is age 3 Engledow describes swimming as and the oldest is 67. At one time the NepBY PEGGY HAYDEN a lifelong sport that tunes was specifically crosses generations. “The Neptunes have been for ages 6 to 18. ot everyone can say they have It also is a family There’s a total of bringing swim meets to the their dream job, and not many sport that Engledow Lewiston-Clarkston Valley 87 members, which can say they were hired by their warns can be expensive consists of two competifor 50 years.” childhood idle. but worth the investtive groups — a masters Chris Engledow But Chris Engledow of Lewiston is one ment. He offers a free group and a juniors Coach of the Lewis Clark Neptunes and resident of Lewiston of the few who can say he has his dream one-week trial to be sure group. job as coach of the Lewis Clark Neptunes becoming a part of the He said members and he was hired for the job by his boyNeptunes is something a person wants to practice between three and 10 hours a hood idol, Tom Jager, current swim coach do before they make the investment. week, depending on the level they are at Washington State University. He believes swimming is a perfect swimming at and the commitment they “I had a poster of him on my wall mechanism for community health, addhave. when I was a kid,” Engledow said of Jager. ing it uses a person’s entire body without During the colder months the NepAs a kid participating in the swim jarring joints and bones. tunes practice at the Asotin County

N 14

Balance

Family Aquatic Center in Clarkston and during the summer they are at the Orchards Pool in Lewiston. The group practices 11 months of the year, taking time off in August. The competitive swimmers travel to meets all over the Northwest, including Moscow, Walla Walla, Coeur d’Alene, Missoula, Mont., and Moses Lake, Wash., as well as other places. They also compete locally, with meets at the Asotin aquatic center and the Orchards pool. “The Neptunes have been bringing swim meets to the Lewiston-Clarkston Valley for 50 years,” Engledow said. Engledow started outreach swim groups in Kamiah, Grangeville, Kennewick, Pomeroy and Colton. He also started the “Snake River Challenge,” an open-water swimming event, which is a competitive event done in waterways such as rivers, lakes, oceans and reservoirs. The event has been held each July since 2009. Since open-water swimming became an Olympic sport in 2008, Engledow said he wanted to bring it to this region with all its rivers, lakes and streams. “It’s a good place for beginners of the sport,” he said.

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Benefits of swimming According to the Centers for Disease Control and Prevention, swimming has several health benefits such as being good for chronic illnesses like arthritis, diabetes, fibromyalgia and heart disease. The CDC also credits swimming with enhancing a person’s mood and being helpful with depression and anxiety. Source: Centers for Disease Control and Prevention website, www.cdc.gov/healthywater/swimming/ health_benefits_water_exercise.html

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LaCrosse Methodist Church Tuesday / Thursday Call 509-397-5733 for more information. Fall 2011 15

Nourish Bliss

Finding the yoga you need and want BY HOLLY BOWEN

he centuries-old practice of yoga is extending physical and mental well-being to more people than ever thanks to its adaptability, local enthusiasts say. “There are so many different types of yoga now,” said Danielle Eastman, owner of Bliss, a movement studio in Pullman. “It really seems to be getting more specific toward different styles.” She said even though they’re all called “yoga,” the variety of types reflects the diversity among people and their desires and goals. “Try out a couple different styles,” Eastman said. “There’s so much variety now, and not only among styles, but among teachers. So, just keep checking them all out. Balance

They might find one they like more than the others. If they had an experience that they didn’t like with one instructor, it doesn’t mean they wouldn’t like a different style.” Bliss, for example, offers three main types of yoga courses: beginner yoga, heart bliss yoga and yoga flow. While beginner yoga includes traditional poses and techniques, heart bliss yoga and yoga flow are intended for people looking for a little something extra. Heart bliss yoga has more of an emotional focus than the other types, Eastman said. She said one of the instructors at Bliss developed the course using three different types of yoga: Iyengar, Ashtanga and Anusara. “Iyengar is traditionally seen as a style that is very alignment-focused and particular about detail,” she said. “Anusara is related to opening the heart and moving energy through the body, and Ashtanga is focused, as well.” Eastman said yoga flow integrates breathing with flowing movement of the body. “It is sort of this meditative movement flow, with much less holding positions for

a period of time,” she said. “Our particu- muscles, opens up the hips and strengthlar version of yoga flow is for everybody. ens the back. It’s meant to be for enhancing fitness to Burtenshaw said Nourish is offering really develop flexibility and strength, yoga for teens this fall for a reduced price and also get that mind-body meditation.” in the hopes that as many youth as posNourish, a movement studio in sible will become involved. Moscow, gets even “Teen yoga helps more specific with really build confi“Teen yoga helps really build its yoga course ofdence, and that’s confidence, and that’s one of the ferings, including one of the things things I’m interested in — helping prenatal yoga and people tap into their own confidence I’m interested in yoga for teenagers. and potential. It’s a really great way — helping people Nourish cotap into their own to be in the community. It’s teens owner Nancy confidence and together without feeling like they Burtenshaw said potential,” she have to be in an adult class.” prenatal yoga is said. “It’s a really Nancy Burtenshaw a good way for great way to be in Co-owner of Nourish, pregnant women to the community. a movement studio in Moscow train for labor and It’s teens together the stresses of motherhood. without feeling like they have to be in an “If you can learn to breathe and be adult class.” connected to your body, you’ll have a She said yoga for teenagers is becommuch better experience in labor and later ing more popular across the country, as a parent,” she said. with some studios offering classes for She said prenatal yoga works the leg even younger children.

Another type of yoga that Nourish offers is restorative yoga, which Burtenshaw described as “an art of non-doing.” “Normally, you go into yoga class doing a lot of movement,” she said. “Restorative yoga is really the opposite.” Practitioners of restorative yoga use blocks, blankets and other support items in their restful poses. Eastman cautioned that it could take a little while before new yoga practitioners find the style or combination of styles that suits them best. “Get a taste of them all, and decide what feels best for your body and which is the most enjoyable and will help you keep going back for more,” she said. She said no matter what style of yoga is being practiced, it’s imperative to not overdo it. “Always know your body’s going to be your best teacher,” she said. “... Really listen to your body. If your body’s in pain, that’s a signal that something’s not quite right.”

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LEWISTON TRIBUNE / KYLE MILLS

Reiki Master Lanie Bailey practices Reiki at Cynthia Bell Eclips Salon and Day Spa in Clarkston.

ART of pain relief

stressful life. after muscles tighten during training or Nick Fiore and Linda competition. McGrale, both licensed A person seeking to improve muscle massage therapists in Lewis- tone or eliminate toxins in the body may ton, want their clients to see want a Swedish massage, which Fiore said massage not as a high-ticket moves fluids throughout the body. item but as a way to improve When muscles relax, McGrale said on the body’s general well blood flow and circulation improve as enbeing. dorphins are released throughout the body. Fiore, who works at McGrale, who works out of her Lewiston Adcope in Lewiston, practices Swedish and office, said part of her job is to teach clients deep tissue massage. how to relax. Be it massage or Reiki, Swedish massage “The body is not “The body is not meant to have experts say relaxation provides relaxation constant stress. Long-term stress meant to have conand general health, can diminish sex drive, increase stant stress,” McGrale key to general health while deep tissue mas- blood pressure and lower the said. “Long-term sage gets down into stress can diminish immune system.” BY PEGGY HAYDEN muscles and lifts them sex drive, increase Linda McGrale away from the bones. blood pressure and licensed massage therapist in Lewiston It may be seen as a luxury, but some area Runners, swimmers lower the immune massage therapists are trying to promote and other athletes generally seek out deep system.” their art as a tool for a healthy and a lesstissue massage as a means to loosen up She uses a combination of breathing

The

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exercises and massage to elicit a relaxation response, returning the body to normal and promoting health. McGrale said she tries to teach breathing exercises to her clients so they know how to relax when they aren’t on her table. McGrale’s training included anatomy and pathology, but she said massage therapists do not diagnose; instead they evaluate and refer clients to other health professionals for underlying problems if needed. She warns that massage isn’t a magic pill, but added that regular massage can help everyone. It’s also important to make sure a massage therapist is licensed, McGrale and Fiore noted. Idaho doesn’t require massage therapists to have a license, which means anyone can set up shop regardless of training.

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Like massage, there are similar but less traditional alternatives that claim to promote health and well being. Lanie Bailey, of Clarkston, practices a similar art to massage based on a Japanese technique called Reiki. Bailey, a Reiki master who practices at Eclipse Salon in Clarkston, said it is a technique of manipulating universal energy through the body. Energy is responsible for the health of all living things, Bailey said, and everyone has a constant energy flow that sometimes becomes blocked, thus affecting the overall health of the individual. The practice differs from massage in that while the person lays on a table they remain fully clothed and the Reiki master doesn’t manipulate the muscle or skin, Bailey said. A Reiki practitioner place his hands gently on the affected area and follows a series of hand positions. While Reiki is promoted as a way to reduce stress and promote healing, Bailey said it has also been used in hospitals for cancer patients and others recovering from surgery. It has the ability to REIKI – see PAGE 21

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Fall 2011

An eye-opening job Plastic surgeons do a wide range of work

Dr. Steven Ozeran, a plastic surgeon based in Lewiston. Breast augmentation and liposuction are good examples of surgeries By Connor DeVries that appeal to a wider variety of people than the stereotypes suggest, Ozeran eet a couple of typical Moscow said. Most breast augmentation patients plastic surgery patients. are in their mid-to late 20s, but many of Bill and Ellie Olesen, a the patients are in their 40s. LiposucMoscow couple, both in their 80s, visited tion operations draw people from all age ophthalmologist David Leach in July to groups — college-age to 70-year-olds. undergo an operation called blepharoplasty, It was the diversity of the profesa surgical procedure which cures droopy sion that first attracted Ozeran to eyelids. pursue a career in plastic surgery. “It started to cut into my vision,” Bill said “It doesn’t limit me to one part of of the excess tissue that hung down over his the body or one type of person,” he said. eyes. “You start to look like a sick chicken, Ozeran has been practicing in Lewiston having to crane your neck up to look at since 1995, first at St. Joseph Regional Medthings.” ical Center and more recently in his new The Olesens were pleasantly surprised. private office at 1630 23rd Ave. Suite 901-A The operation took about 30 minutes for in Lewiston. He regularly sees patients from each of them, and better yet, there was no the Moscow-Pullman area. As a plastic pain, no ugly scaring and very little hassle. surgeon, he not only performs “It was easy,” Bill said. “Recovery is real cosmetic surgeries like face-lifts short. We were in and out in one day.” and liposuction, but also spends The only evidence the procedure took late nights in the emergency room, place was a little bruising around the eyes, removing gravel and glass from accident which quickly vanished. victims and repairing sliced tendons. He “In three or four days, we were out of the said 15 to 20 percent of his business comes woods,” Bill said. from car accidents. He also operates on The Olesens probably aren’t what most 80 to 100 cancer patients a year, removing would consider tumors. “I almost think people research “typical” plastic surMany of his pabuying a car more than the surgeon tients come seeking gery patients. After who will be operating on them.” all, it’s the more cosmetic treatment exotic stuff like full — usually liposucDr. Steven Ozeran plastic surgeon based in Lewiston face transplants and tion, breast augmenbreast augmentation tation, eyelid surgery that makes headlines and draws viewers on or abdominoplasty, more commonly called TV. However, any plastic surgeon would a tummy tuck. In spite of the economic probably say that the Olesens are about as downturn and the cost ($2,000-$6,000 typical as plastic surgery patients come. depending on the extent of the surgery “We don’t have a typical patient,” said and existing complications), these kinds

20 Balance

of aesthetic operations are becoming more popular both in this region and nationwide. About 13.1 million cosmetic operations were performed in the U.S. in 2010, up 5 percent from 2009. More and more people are requesting information about cosmetic surgeries, Ozeran said. He attributes some of the increased interest to advances in medical technology, which have made many operations more effective and safer. “It’s not as painful, and there’s not as much bruising or bleeding,” Ozeran said of new laser liposuction methods. “We had an office manager go back to work the very next day.”

While there have been numerous improvements in the field, cosmetic surgery is still surgery, with all the risks that entails. Dr. Jeffrey Karp, a plastic surgeon in Spokane, said people need to do their research before setting foot in an operating room. “I almost think people research buying a car more than the surgeon who will be operating on them,” he said. He said he often finds himself fixing the results of amateurish liposuctions, and advises people who may be considering an operation to do their research and find a plastic surgeon who is accredited by the American Board of Plastic Surgery. “A lot of problems come from family doctors who took two weeks to learn how to use a laser,” he said.

Reiki – from page 19

alleviate pain and anxiety in patients and it has been used during pregnancy and childbirth, relieving discomfort and pain. During a Reiki session muscles are THE BIOMAGNETIC SHEATH The aura and its etheric bodies with the chakra linkage points

Physical Aura

Patients also need to think realistically about the logistics of an operation and the limits of surgery, Karp said. “I can’t make a person look like someone else,” he said, referencing a person who asked to be turned into a Brad Pitt look-alike. “I can make them look refreshed.” Karp and Ozeran both find themselves turning down potential patients who have unrealistic expectations, (liposuction isn’t a substitute for dieting) or who are unprepared to deal with a surgery. “As a doctor, my job isn’t simply to perform surgeries; my job is to do the right thing,” Ozeran said. For more information about plastic surgery or to find a plastic or cosmetic surgeon in your area, visit plasticsurgery.org. relaxed and energy flow is unblocked, which can reduce the physical tension. And while a person may not be pain free, Bailey said the relaxation can make it easier for them to cope with their condition. Higher Crown Chakra Crown Chakra Brow/Third Eye Chakra Past Life Throat Chakra

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TAILGATING: a cultural phenomenon BY VERA WHITE

TV allowing guests to watch pregame hether watching the game on activities or other games while they visit, TV or braving the elements at eat and drink. the stadium, food and football When assigned to do a feature on have become synonymous and tailgaters tailgating food for Balance, I immediappear to be as dedicated as the fans. In ately turned to a cookbook I’ve had fact, modern tailgating has become a in my collection for several years cultural phenomenon. titled “Tailgates to Touchdowns: There are many theories about when Fabulous Football Food” by Nina and where tailgating actually originatSwan-Kohler. She dedicates the ed but one thing is certain, it has come VERA WHITE cookbook to her dad, “the first a long way since people gathered in parking person in my life to demonstrate a lots and either drugged out a picnic hamper fanatical love of both football and with food from home or set up a folding food.” grill that would produce enough heat to I’ve selected some of her recipes to share sizzle a few hamburgers or hot dogs. with readers, ones not too high in fat or Now, serious tailgaters often arrive in the sugar. parking lot and set up shop in a big motor I’m not much of a football fan, but I home complete with all the luxuries to party might be talked into attending a game if in style. In addition to completely equipped I can snag an invitation from a generous kitchens, there is likely to be a big-screen tailgater!

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Honey-Barbecue Chicken  4 to 6 split chicken breast halves (bone-in) Honey-Barbecue Sauce:  1 medium onion, finely chopped (1 cup)  ¼ cup (½ stick) butter or margarine  1 cup catsup  ½ cup water  ¼ cup pure clover honey  2 tablespoons lemon juice  1 tablespoon Worcestershire sauce  ¼ teaspoon ground black pepper Preheat grill to medium-high. Grill chicken over medium high heat 10 minutes per side to brown slightly. Reduce heat to low (or place chicken over indirect heat) and grill 40 to 50 minutes longer or until internal temperature of chicken reaches 180 degrees. Meanwhile, in a small saucepan, cook and stir onion and butter over medium heat until onion is tender. Stir in remaining ingredients; heat to boiling. Reduce heat and simmer, uncovered, 5 minutes. Brush sauce on chicken during last 10 minutes of grilling. Pass remaining sauce. If you like your foods extra saucy, simply double the sauce recipe. Store leftover sauce in refrigerator for up to one week. Makes 4 to 6 servings.

Blue Cheese Spread

l ½ cup (1 stick) butter or margarine, softened l ¼ cup crumbled blue cheese l 2 tablespoons grated Parmesan cheese In mixer bowl, beat ingredients until almost smooth. Serve with grilled burgers. Makes about ¾ cup spread.

Black Bean Salsa

l 1 15-ounce can black beans, rinsed and drained l 1 medium cucumber, peeled, seeded and chopped l 1 medium tomato, seeded and chopped l ½ cup sliced green onions l ¼ fresh lime juice (about 1 lime) l 1 tablespoon chopped fresh cilantro l 1 tablespoon olive oil l ½ teaspoon salt l ½ teaspoon ground cumin l ⅛ teaspoon ground red pepper In medium bowl, combine all ingredients. Cover and refrigerate for several hours to blend flavors. Serve with tortilla chips or over grilled pork, smoked bratwursts or sausages, grilled chicken, or salmon.

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The deadly danger of sitting Women who sit all day put themselves at great risk, study shows By Patricia Montemurri

Detroit Free Press

DETROIT — In an 18-year career at the University of Michigan, where she’s a customer service center supervisor in the payroll department, Jackie Adams figures she’s done a whole lot of sitting. And that scares her. So when her department installed a treadmill desk, Adams started using it to fit a little bit more exercise into her day. And when she heard about studies that showed that long periods of sitting can be dangerous to a woman’s health, Adams Patricia Beck/Detroit Free Press stepped up getting up at work. DTE Energy financial analyst Ardalia Jackson uses a demonstration Walkstation, a low-speed She tries to spend 30 minutes each day treadmill under a height-adjustable work surface, at DTE Energy in Detroit on a treadmill desk installed at the office. She urges coworkers to walk while they Dr. Alpa Patel, senior epidemiologist reason why it might be more detrimental talk. She stands up while taking phone at the American Cancer Society, is the to women than men.” calls. lead author of that study, the largest on Patel now walks to talk to colleagues “I heard that those who have a sithow sitting affects mortality. The study instead of using email, and she sends some down job take years off their lives. That was based on information from surveys of her documents to a printer in a differscared me. I came in here and said, of 123,000 people who participated in the ent room at her Atlanta workplace to force ‘Everybody walk at lunch. Everybody walk study between 1992 and 2006. herself to move more. She sits on a balon the treadmill,’” recounts Adams, 43, of Females who sat the longest and exerance ball in her office, rather than a chair. Saline, Mich. cised the least had twice the risk of death And she doesn’t use instant messaging to “We can’t help it if we have desk jobs, compared with women who recorded communicate with colleagues. but I don’t want to die early because of it.” more activity and less sitting. Under simi“I walk to their office to take a quick Research lar circumstances break,” she says. “There are very small released last fall for men, there was changes that you can make that collec“I heard that those who have a found that women only a 50 percent tively add up.” sit-down job take years off their who sat for more Patel says she always had a hard time lives. That scared me. I came in here greater chance of than six hours a day and said, ‘Everybody walk at lunch. death. sitting still in front of the TV. Now, she had a 37 percent Patel can’t channels that extra energy into multitaskEverybody walk on the treadmill’” increased risk of explain why sitting ing endeavors. She tries to fold laundry Jackie Adams premature death, while watching her favorite shows. She A customer service center supervisor in the pay- may be more hazcompared to 18 perardous to women’s knits. roll department at the University of Michigan cent for men. Those health. It’s unclear And she’s lost 40 pounds in the last two results stayed the same, even when factors whether the varying results are caused by years. such as an individual’s diet, amount of gender, or if there’s some other influence Office furniture manufacturers are payphysical activity and smoking were taken at work. ing attention to the research. Grand Rapinto account. “We don’t understand the biological ids, Mich., based Steelcase, for example, in

24 Balance

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2007 introduced treadmill desks — Walkstations, which combine an adjustable desk surface with a slow-moving treadmill. The Walkstation sells for $4,399. Steelcase has sold more than 2,000 of them to corporations such as Humana, Google, Kraft Foods, eBay and General Electric, says Steelcase spokeswoman Katie Hasse. The Steelcase treadmill desks were inspired by Dr. James Levine, an endocrinologist at Minnesota’s Mayo Clinic. Levine approached Steelcase with research that showed how lean people consume more calories by incorporating more movement into everyday activities — even by fidgeting. “Many corporate customers have purchased multiple units as part of wellness initiatives,” says Hasse. “We launched the product to better serve our PATRICIA BECK/DETROIT FREE PRESS DTE Energy analyst Laurie Payne of Rochester Hills, customers after multiple studies Mich., sits on a balance ball chair. which point to mixing up time spent sitting with intermittent standing as a way to engage metabolism, desks, call centers or meetings, says Susan keep nutrient and oxygen flowing to the Morgan Bailey, the utility’s program manbrain as well as burn a few more calories ager for health and wellness. than remaining seated for long periods.” The utility may order more WalkstaAt the University tions to post around of Michigan payroll offices so “employees “We don’t understand the center, Adams walks biological reason why it might could do an hour of on a Walkstation while be more detrimental to women work on them, and working on a comtake a break from sitthan men.” puter screen for about ting,” she says. Dr. Alpa Patel 30 minutes a day. She The utility also has senior epidemiologist at the asks clients if they can ordered chairs made American Cancer Society hear her footsteps or out of fitness balls to noticeable changes in her breathing, and encourage more healthy movement at they tell her they can’t, she says. work. DTE Energy just last month installed “You have to use the abdominal a Walkstation in a corridor connecting muscles to use them, so you don’t fall out buildings in its downtown Detroit camof the chairs,” Morgan Bailey says. pus. “We’re trying to find ways we can (c) 2011, Detroit Free Press. incorporate more opportunities for physi- Visit the Freep, the World Wide Web site of the cal activity in the day” of thousands of Detroit Free Press, at http://www.freep.com. Distributed by McClatchy-Tribune Information Services. employees who spend the day sitting at

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A drunk

IN THE

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Experts say addiction is widespread public problem BY KERRI SANDAINE

hen you think of someone with a drinking problem, you may picture a homeless, jobless drunk staggering through life clutching a bottle in a brown bag. However, the experts say you may need to look in the mirror or family photo album instead. Alcohol abuse and addiction is a widespread problem, affecting 10 percent of the population. Think of it this way: One out of every 10 accountants, teachers, editors, dentists and corporate executives drink too much.

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“I encourage people to kindly but honestly tell someone if they think he or she needs help,” Gurgel said. “The more people who express a concern can make it more difficult to deny there may be a problem. You may be the tipping point if someone has heard the same thing from a parent, best friend and coach.” Some of the warning signs are an increased tolerance of alcohol, difficulty con“You don’t have to hit rock bottom trolling your use, negative consequences, before you get help and, hopefully, people neglecting activities, spending significant don’t,” said Carrie Gurgel, Asotin County time or emotional energy on drinking and Community Services coordinator. “Usually unsuccessful attempts to cut down. the job is one of the last things impacted. Pay attention to who you hang out with The fact that people are gainfully employed on a regular basis, the experts say. Peer is not an indication there is no addiction groups play a big role in chemical depengoing on.” dency. Another thing to ask yourself is Addiction crosses all socio-economic whether you have the capacity to have fun boundaries and is more common than without alcohol or some kind of substance. diabetes, coronary heart disease, cancer “If you are a parent, please don’t think or Alzheimer’s combined. In the United alcohol is an innocent drug of choice,” States, 22.6 million people over the age of Gurgel said. “The younger a youth starts 12 have substance use disorders. experimenting, the more likely they are to Without treatment, addiction is progres- have problems in the future.” sive and deadly, Gurgel said. Help is available if you or a member of your family needs assistance with a drug or alcohol problem. Idaho residents can contact the Substance Use Disorder Customer Service Center at (800) 922-3406. The Idaho Department of Health and Welfare provides funds to treatment providers throughout the state. Washington residents can contact Quality Behavioral Health at (509) 758-3341, and assistance will be given to

people who have a concern, Gurgel said. In addition, Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other in an effort to solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. Many different A.A. groups meet throughout this region. For more information, call (509) 758-2821 or (208) 882-1597.

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According to the authors of this quiz, if you answer three or more of the following questions with a “yes,” there is a strong possibility that your drinking patterns are detrimental to your health and you may be alcohol dependent. An evaluation of your drinking behavior by a health care professional is suggested.

Source: John Hopkins University Hospital

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Fall 2011 27

Battling the pain Rules aimed at curbing prescription-drug deaths leave pain patients scrambling for relief By Carol M. Ostrom

The Seattle Times

SEATTLE — Dennis Murphy’s last doctor got suspicious when he saw him sitting in a restaurant. Murphy, 72, who contracted a painful nerve disorder after a case of shingles, had told the doctor his condition is so painful he often has to stand up. At his next appointment, the doctor accused him of flimflamming him: making up a story to score narcotic pain relievers. Murphy, a retired IRS pension-plan examiner and manager from Edmonds, Wash., was humiliated. Now, he has a new doctor and a new prescription — but also a growing fear that he could suddenly lose the only relief he’s found in six years. Then, he worries, he’ll find himself back in the throes of pain he describes as “a blowtorch to my testicles.” He has reason to worry. Over the last several months, an effort in Washington to curb a steep rise in prescription drug overdose deaths — the most ambitious crackdown in the nation — has prompted a number of doctors and clinics to stop taking new chronic-pain patients on opiates, and in some cases to cut off current pain patients. The hard new line marks the end of a period of relatively liberal — some would say lax — prescribing that began in the late 1980s. Before then, studies showed that pain was being seriously undertreated, even in dying patients. The statistics and stories fueled assisted-death campaigns in Washington and Oregon and prompted medical boards to reassure doctors not to fear discipline for

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Dean Rutz / Seattle Times

Dennis Murphy, shown with his wife, Judy, in Edmonds, Wash., fears that new regulations will stop him from being able to use the only thing he has found gives him relief from a painful nerve disorder.

relieving pain. But as opiate prescribing increased, so did the deaths — to alarming levels. Last year, Washington lawmakers attempted to reverse the trend, requiring licensing boards to craft tougher rules for treating pain patients, except for those with injuries, surgery, cancer or who are dying. The rules don’t take effect until Jan. 1 but already, many doctors say they will mean a lot of work, requiring them to gather records, check emergency-room reports, sign pain contracts with patients and arrange consultations as they try to assess an invisible affliction. For now, the effort has engendered more questions than answers. Are doctors simply using the new law as an excuse to dump pain patients, who can be needy and demanding — and, in some cases, addicted? Will the new rules cut down on overdose deaths — or just make life unbearable for the many patients who are legitimately hurting?

In the South Puget Sound area, a University of Washington Medicine neighborhood clinic stopped taking new chronic-pain patients on opiates about two months ago, after patients flooded in, saying their doctors had cut them off. “A lot of it is because other providers have stopped doing it,” said Dr. Peter McGough, chief medical officer for UW Medicine’s Neighborhood Clinics. “I think there’s been a fair amount of patient abandonment going on.” McGough calls the new law and rules helpful and important, saying many pain patients weren’t previously well managed. “That said, a lot of physicians are saying it’s more trouble than it’s worth, so I’m just going to send my patients away.” The swift reaction by doctors and clinics to the new rules has startled even critics who expected some negative fallout for patients. What lawmakers wanted to do was to stop the dying. The graphs and charts were ominous, and

centers and stand in line with all these guys with tattoos and pee in a bottle.” Judy Murphy recalls the day in the previous physician’s office when her husband was mortified by the doctor’s suspicion. “I thought Dennis was going to melt into this puddle of humiliation,” she said. “He was ready to run or cry or dissolve.” Others say they know they need to reduce their medication but say they haven’t been given help to do so. Eric, a Mercer Island father who has had

severe back pain for years after several failed surgeries, said he wants to cut back on his opiate dose but doesn’t know how he’d get pain relief during the process. “When I don’t have my pain meds, I sit in the corner shaking and doubled over in pain that makes me cry,” he said.

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testimony by Dr. Alex Cahana, head of the UW’s Division of Pain Medicine, among others, drew a grim picture of patients addicted or dying from lax prescribing. Cahana, chief proponent of the new regulations, thinks many doctors have been too quick with the pills, in part because they have little training in other modes of relief, a situation he is working to change at the UW. “Since when does good pain management equal opioids? Since when has the whole practice been reduced to just prescribing a pill?” says Cahana. “The U.S. is the only country in the world where overtreatment is the new undertreatment.” In a report this year, the federal Institute of Medicine estimated that chronic pain affects 116 million American adults and that relieving it should be a national priority. But on the ground, practical realities rule. At Country Doctor Community Health Centers, Dr. Hal Moore, clinic site director, said providers decided they were spending too much energy on pain patients. “Is the pain real, are they drug seeking, is mental health a factor? There are all these factors you have to consider,” he said, and the rules added another layer. As a result, Moore said, new pain patients no longer will get opiates at those clinics. Dr. Marcus Rempel, medical director for Neighborcare Health, said providers were disturbed to find that many of the patients inundating its six local clinics seeking narcotic pain relief weren’t 50- or 60-year-old workers with back injuries, but young adults of 25 or 30, asking for long-term opiate medication. “We felt like we were in a situation where we were contributing to a public health problem,” said Rempel, whose clinics closed to new pain patients on opiates. For some pain patients, the changes are unnerving. “I’m living in fear of cutoff,” says Dennis Murphy, despite being what his wife, Judy Murphy, calls a career rule-follower with no history of abuse. He understands that doctors are afraid of being disciplined, so he endures the random urine tests, although “at the age of 70-plus, it’s no fun to go down to one of these druggie

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“I’m basically just there to be her eyes,” of applicants eligible from July 2011 to July Yearsley said. “I’ll still be a competitor, I 2012. She was called in early September of still get a number, but it’s not about me. this year and will compete in November, I’m just really anxious that I’m going to be giving her two months to train for what the slow one of us.” usually requires six months to a year. By Kelli Hadley Yearsley had heard about the opporYearsley is unsure if she’ll meet her parttunity and asked ner before the race, s if a consecutive 2.4-mile swim, about it while but plans to get in “I’m basically just there to be 118-mile bike ride and 26.2-mile getting her registra- her eyes. I’ll still be a competitor, I contact with her to run weren’t enough, Jennifer tion packet for her still get a number, but it’s not about discuss training and Yearsley is going to do it while also giving second competition me. I’m just really anxious that I’m get to know each instructions. this last June. She other. It will be her going to be the slow one of us.” Yearsley, 22, has participated in two found out everythird Ironman in Jennifer Yearsley Ironman Competitions in her hometown thing is paid for by three years and her UI student of Coeur d’Alene, one in 2009 and one in the Ironman Aspartner’s first ever, 2011. For her third she is taking on a new sociation, including the flight down there, a fact relieving some of Yearsley’s anxiety. element — aiding a blind athlete in Ford hotel and registration fee, making the Training-wise, Yearsley said she was given Ironman Florida this November. She will dream even more realistic for the Univertwo months to prepare for what usually rebe bungee-tied to her 26-year-old teamsity of Idaho senior. quires at least six to 12 months of training. mate for the swimming and running porAfter applying online, Yearsley did a Yearsley trains about 25 hours a week, tions, and for biking they’ll ride tandem. short phone interview and was put on a list scheduling workouts whenever she finds a little extra time. “It’s a struggle almost every day,” she TM said. “I try to be positive but there’s a lot of days I’m not. While I’m training I’m always dressed, prepared, ready to train. It’s ridiculous but it’s addicting.” Yearsley ran cross country in high school and was inspired while volunteering for the annual Coeur d’Alene Ironman Coeur d’Alene’s Premiere Self Server Frozen Yogurt Parlor Competition. When it was time for college she turned down a track scholarship because she knew she wanted to be an Ironman. She completed her first competition Always 10 Fresh Premium Flavors of Yogurt during her sophomore year of college in 15 hours and 42 minutes and her second in 14 Over 70 Premium Toppings to hours 28 minutes — almost an hour and a Include Fresh Cut Fruit Daily YOU Choose half faster. Yearsley struggles with juvenile rheumaFlavors! toid arthritis and also deals with occasional YOU Choose plantar fascitis — a past knee surgery also bothers her sometimes as well. How Much! “I worry about getting stress fractures but it’s not anything that would stop me YOU Choose from doing an Ironman,” Yearsley said. “... Toppings! I’m so excited to do this, I was crying on 3500 N Government Suite 107 • Coeur d’Alene, ID the phone to my mom when I found out In the Costco Plaza • (208) 665-0485 because I was so happy.”

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Crowning glory Women who lose hair struggle with identity

“With some, it has to do with dramatic changes in their life: surgery, delivering a child ... having a very severe illness,” said Pamela Prescott, an endocrinologist at the By Lynn La University of California-Davis Medical McClatchy Newspapers Center. “Sometimes, it’s what we do to our hair, the styling, dyeing, straightening.” SACRAMENTO, Calif. — Shirley Stress, Prescott said, can have a major Berger holds a photo of herself taken at effect on hair growth. And for some, losVenice Beach, Calif., in 1960. She’s about ing their hair gives them more reason to 20 in the picture and looks like Elizabeth stress than the actual medical cause. Taylor: the same thick eyebrows and up“It was very traumatic,” said Kristy turned nose. She’s on her stomach, holdDeVaney, who lost all her hair after having a cigarette. A layer of her dark curly ing a negative reaction to the common hair covers her head. antibiotic minocycline. “It was very hard “My hair was so thick, you couldn’t see to deal with for a very long time. ... I kept through it at all,” Berger said. “I had a ton thinking, ‘What do people think of me? of hair.” What do I think of myself? I’m an ugly At 58, 10 years after she hit menopause, bald person.’ It’s probably the worst thing her hair started to thin and fall out. She I’ve ever been through.” bought a wig, but she hated how it felt. Maxine Craig, an associate professor in She goes to the hairdresser once a week the Women and Gender Studies program now for help hiding the thin spots. At at UC Davis, has researched just how restaurants, she maneuvers herself out of much hair means to women. the way when waiters come to the table so It means a whole lot. they can’t see the top of her head. And she “Hair is seen as a marker of gender sleeps on satin pillowcases to avoid snagidentity,” Craig said. In most Western ging her hair. cultures, short hair or no hair represents “I’m not sure I understand why men masculinity, and long hair represents can get away with aging,” said Berger, who femininity. is now 70. “These are social codes that we all learn Sitting in her Carmichael, Calif., home, she splays old photos across her kitchen MAIN CAUSES OF HAIR LOSS table. A few feature the sky-high ‘do she Telogen effluvium — Refers to any changes wore in 1976. in your body due to physical or emotional “It’s scary because all of a sudden you stress that cause hair loss. Can include a knew, just looking in the mirror every day, death in the family, surgery and illness. you knew you were aging. ... I would give Disease — Includes lupus, thyroid disease or anything if I had not lost my hair,” she other thyroid abnormalities, and alopecia. said. Hormonal changes — Often prompted by Aside from menopause, the American childbirth, menopause or use of birth control pills. Academy of Dermatology reports that 30 Medication side effects — Blood presmillion women in the United States are sure, acne, anti-depression and cholesterol losing their hair due to genetic factors. medication. Thyroid disease, medication side effects Genetics — You can inherit this from your and diet also can cause it. mother’s or father’s side. Heredity also dictates It’s estimated that one in four women the age, speed and extent of your hair loss. experiences thinning hair.

32 Balance

and learn deeply,” Craig said. “When a woman loses her hair, she may feel that she is losing something that identifies her as a woman.” Girls who cut their hair short and men who grow their hair out are considered rebels — people who want to resist the social code and be defiant. “Women who do not attempt to confirm to beauty norms are seen as somehow problematic,” Craig said. “Girls start hearing at a very young age that their looks are important ... and women are constantly getting evaluated on the basis of their appearance.” There is, perhaps, no better spokeswoman for the issue of baldness and beauty than Miss Delaware 2010 — and a Top 10 at this year’s Miss America pageant — Kayla Martell. Martell is completely bald, the result of alopecia areata, an autoimmune disease that caused her hair to start falling out when she was 10. “I remember thinking, ‘I probably will never be Miss Delaware now,’” said Martell, who had grown up attending the state pageant every year with her mother. She entered the pageant, and three times she strutted across the Miss Delaware stage sporting what she described

PREVENTING GENERAL HAIR LOSS

Make sure — Usually, hair loss is due to an external medical condition. Be sure to speak with your doctor to treat this first, before treating your hair. Eat well — Eat foods that are high in protein, such as beans or other legumes and eggs. Relax — Stress induces hair loss, so take time to breathe once in a while. Take vitamins — Biotin, a B-complex vitamin, is known to help some people experiencing hair loss. Go natural — Excessive hair drying, curling and straightening can damage hair, and tying your hair too tight can lead to a gradual hair loss known as traction alopecia.

as â&#x20AC;&#x153;peach fuzzâ&#x20AC;? on her head. Eventually, a judge pulled her aside and told her that if she wanted to win the crown, she needed to wear a wig. â&#x20AC;&#x153;I was so offended and appalled, I couldnâ&#x20AC;&#x2122;t believe what I was hearing,â&#x20AC;? she said. But after talking about it and seeing people at alopecia conferences wearing wigs, she changed her mind. Winning the pageant would give her a higher public platform from which to talk about womenâ&#x20AC;&#x2122;s baldness. â&#x20AC;&#x153;All I asked was for the judges to support me if I could go on TV and do interviews without my hair on,â&#x20AC;? she said. They agreed, and she competed with the wig. To her relief, she lost. â&#x20AC;&#x153;Obviously I didnâ&#x20AC;&#x2122;t enjoy not winning,â&#x20AC;? she said. â&#x20AC;&#x153;But I feared that if I won the very first time with a wig, so many people would say, â&#x20AC;&#x2DC;She only won now because she wore the wig.â&#x20AC;&#x2122;â&#x20AC;? It took one more try before Martell â&#x20AC;&#x201D; again with her wig â&#x20AC;&#x201D; was crowned Miss Delaware. Since winning, sheâ&#x20AC;&#x2122;s toured the country, given numerous television interviews and spoken about alopecia at charity events. Martell long ago stopped looking for treatments to regrow her hair. When she first started losing it, she applied minoxidil, or Rogaine, to her scalp every night. She also had steroids injected into her head. When nothing worked, she stopped. â&#x20AC;&#x153;Why fight it?â&#x20AC;? she said. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s a losing battle. You can stay up all night and stress about it, or stay in every Friday night, but where is that going to get you?â&#x20AC;? DeVaney, the Sacramento woman who lost her hair because of antibiotics, agreed. â&#x20AC;&#x153;I was so mentally and physically drained from losing my hair,â&#x20AC;? she said. â&#x20AC;&#x153;I just wanted to get past it and move on. Even though I couldnâ&#x20AC;&#x2122;t stand looking at myself in the mirror every day, it was like, â&#x20AC;&#x2DC;OK, Iâ&#x20AC;&#x2122;m done.â&#x20AC;&#x2122;â&#x20AC;?

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