Healthy Idaho | MAR '15 by Healthy Magazine

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March 2015

ADVANCED KNEE TECHNIQUES OFFERED IN THE TREASURE VALLEY

RECOVER QUICKER Rapid-Recovery Knee Replacement/Resurfacing

• RECOVER AT HOME! • SHORTER HOSPITAL STAY • QUICKER RECOVERY TIME • REDUCED POST-OPERATIVE PAIN

la Dr. Nico on ly surge is the on alley e a s u re V in the Tr icepse Quadr h t g in and per form chnique e t g in r Spa zed Knee omputeri C t n e ti a Outp nee ment/K Replace cing! Resur fa

Minimally Invasive Quadriceps-Sparing Technique And Computerized Navigation

Find Out If You Are A Candidate Outpatient Knee Resurfacing / Knee Replacement

(208) 895-0888

George A. Nicola, M.D.

Learn more at WestIdahoOrthopedics.com and DrGeorgeNicola.com

2 HEALTHY IDAHO

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PROTECT ME From Measles

The number of measles cases in the U.S. is at the highest it’s been in 20 years. Here are a few things you may not know about measles: • Measles is incredibly contagious and the virus can live on contaminated surfaces for up to 2 hours. • Babies under 12 months old aren’t well protected against measles and rely on those around them to be vaccinated. • On an average day, 18 children every hour die of measles worldwide. • The MMR vaccine is extremely effective at protecting against measles. Contact your healthcare provider right away to make sure that you and your family are protected.

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March 2015

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Silly questions can have serious answers. From diapers to degrees, having a child means having questions. What’s normal? What isn’t? Get answers to your health-related questions—even the silly ones—from experienced nurses like Cory. She’s a mom, too. It all starts with one good choice.

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March 2015

22. Taking On Cancer Two woman diagnosed with myeloma, who previously knew little about their disease, are changing the lives of everyone who shares their misfortune and causing ripples in the research community.

MARCH 2015

VOL. XV № 3

10. THREE TRICEP

EXERCISE YOU CAN RELY ON

Don’t forget about your triceps! Here we present a few exercises to help you better focus on this important muscle group .

11. DO MARATHONS RUIN JOINTS? It’s probably one of the most annoying things a marathon runner hears: “aren’t you worried about your knees?” Let’s break down what’s fact and what’s fiction.

28. SHOULD YOU DONATE TO A CANCER NONPROFIT? Most of us understand how terrible cancer is. But how can we be sure that our money is actually doing something good, something that actually matters?

6 HEALTHY IDAHO

36. CANCER SCREENING PROS AND CONS 39. TABLET HABITS There are a lot of voices telling us to get screened for cancer, especially after we pass a certain age. But a new voice is warning us about the potential complications of cancer screenings.

It’s pretty common to have a gander at the tablet or smart phone right before we get some shuteye, but those two activities may not actually belong together.

38. E-CIGARETTES: A NEW PUBLIC DANGER? Research has tied e-cigarette use to future substance abuse, and there are a number of other disturbing trends related to vaping.

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TAKE BACK YOUR HEALTH Obesity is the greatest non infectious disease of our time.You don’t die of obesity; you die of the diseases that “travel” with it. Treating all of these conditions separately will cost you a lot of time and money. Endocrinologist 1st visit charge: $125-175

METABOLIC SYNDROME

HEART DISEASE

DIABETES

Cardiologist 1st visit charge: $150-250

HIGH BLOOD PRESSURE

HIGH

DEMENTIA

CHOLESTEROL

OBESITY

ARTHRITIS

DEPRESSION

CANCER RISK

STROKE

Neurologist 1st visit charge: $125-175

SLEEP APNEA

Orthopedist 1st visit charge: $150-250

ASTHMA Oncologist 1st visit charge: $125-175

Pulmonary/sleep medicine 1st visit charge: $125-175

Effective weight loss often eliminates the need to treat these conditions. Medical Doctors Board Certiﬁed in Obesity Medicine Specializing in Medical Weight Loss

Don’t “weight” any longer Facebook.com/HealthyIdaho

Call 208.343.3652

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March 2015

Healthy

Editor’s Note

IDAHO

BONUS DAYS.

WITH

MARCH 2015 VOLUME VII, № 3

EVERY ONCE IN A WHILE, STEP OUTSIDE YOUR BUSY LIFE AND LOOK AROUND. TAKE NOTICE OF OTHERS AROUND YOU. OBSERVE. WHEN YOU DO, YOU WILL SEE SOME PRETTY AMAZING THINGS. AND YOU MAY FEEL ELATED JUST TO BE ALIVE. This month we are devoting most of this issue to cancer awareness. Life is a gift and every day is precious. And, you just never know what tomorrow will bring. In the course of working with dozens of people with amazing stories and oft-times heroic experiences as people seek life, liberty and the pursuit of happiness, I once again came across a simple, yet powerful story of survivorship. Maybe it’s because I know Janie James, but her experience with breast cancer deeply touched me, causing me to step back in wonder. Her words of optimism and powerful perspective echo in my mind— ‘Every day is a bonus day.’ Sometimes it’s easy to get our priorities derailed. So much of our daily lives matter, but it can be difficult to ferret out the part of our daily lives that matter less. But just the thought that today is a ‘bonus day’ can quickly prioritize things. If today is a bonus, then our thought shouldn’t be to just get through the day, but rather, what can I do

JOHN A. ANDERSON,

EDITOR-IN-CHIEF @JOHN_A_ANDERSON

with this day? So many great opportunities are sprinkled amongst the details of daily life, and if we don’t pay attention to little events, we end up missing the opportunities. So, what do we do with today? This question gets at the heart of our ultimate happiness. The focus on our daily activities—at work, at home—shouldn’t be so much on what we are getting, but what we are becoming. Getting and becoming are intertwined because what we become largely influences what we get. Daily ‘becoming,’ or personal development is the real key to our success, and our station in life rarely exceeds our daily personal development. One of life’s great mantras is this:

“To have more than you’ve got, become more than you are.” If we don’t treat each day like a bonus, focusing on our personal development—on what we are becoming—the opposite will come true: ‘Unless you change how you are, you’ll always have what you’ve got.’ Each day we are becoming something. Smarter. Smoother. Faster. Funnier. Happier. Healthier. (Hopefully). And yet, there are those darn statistics that keep saying we are not getting healthier. Heart disease, diabetes, cancer, and of course, obesity, are all on the rise. And so many of these rising health indices are behavior based. Behavior is choice and effort; or lack of effort. We can choose to exercise or choose to be sedentary. We can choose to become more fit or more fat. We can choose to become healthier. We can choose to treat today like a bonus and become more than we are. Choose to step outside your life for a moment. In fact, choose right now to just step outside. Go ahead. After all, today is a bonus day.

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EDITOR-IN-CHIEF | PUBLISHER John A. Anderson | john@healthy-idaho.com CHIEF INFORMATION OFFICER Kenneth J. Shepherd | ken@healthy-idaho.com SALES AND MARKETING Julie Guyer 208.371.4533 Steve Wallace 208.850.4983 sales@healthy-idaho.com DESIGN EDITOR Phillip Chadwick design@healthy-idaho.com MANAGING EDITOR Michael Richardson | michael@healthy-mag.com MAGAZINE EDITORS Gayleen Webb, Emma Penrod DIRECTOR OF OPERATIONS Lyn Timboe | lyn.timboe@healthy-mag.com CONTRIBUTING WRITERS Caitlin Schille, Angela Silva, Megan Moore, Brooke Kittel, Jill Castle, David Joachim, Lisa Mathews, Mark Saunders CIRCULATION Healthy Idaho Magazine is printed monthly and delivered extensively throughout Boise and surrounding areas—direct mailed to doctors, dentists, practitioners, health clinics, banks and other businesses and subscribers and is made available for pick up at hundreds of locations. If you would like to have Healthy Idaho Magazine delivered for distribution in your place of business, please contact us.

HEALTHY IDAHO MAGAZINE info@healthy-idaho.com 866.884.3258

PLEASE NOTE: The content in this publication is meant to increase reader awareness of developments in the health and medical field and should not be construed as medical advice or instruction on individual health matters, which should be obtained directly from a health professional. The opinions expressed by the authors and advertisers are not necessarily those of the publisher. Call for reprint permission. All photography courtesy of Shutterstock.com unless otherwise noted.

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March 2015

FITNESS

Triceps Exercises THAT WORK

W RITTE N B Y J E NNA KO F O R D

FOR THOSE WANTING TO TONE THEIR UPPER ARMS, THESE SIMPLE TRICEPS EXERCISES ARE A GREAT PLACE TO START. 1. Bench Dips

2. Body Up

3. Close Grip Bench Press

Like its name suggests, the Bench Dip exercises usually involve a bench, chair, or other piece of sturdy furniture.

Start in a plank position, supporting your body with your toes and forearms. Your forearms should be shoulder-width apart.

Use a narrower grip than the traditional bench press to really work your triceps area. But not too close. Many people mistakenly put their hands so close that they are almost touching, which only adds strain to the wrists and elbows.

While facing away from the bench, place your hands shoulder-width apart behind you on the bench. Extend your legs forward, bending at the waist. Lower your body by bending your elbows until you reach an almost-90 degree angle between your upper arm and your forearm. Use your arms to bring your torso back up to the starting position. To make the exercise more challenging, place your feet on a bench in front of you as well.

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Press your palms into the ground, with elbows pointing toward your feet, and triceps aligned with your back, extend through the elbows to lift your body up higher. Lower your forearms back to starting position. Keep your torso as rigid as possible. This exercise will feel similar to that of a push-up, but youâ&#x20AC;&#x2122;ll feel the backs of your arms working.

Your grip should be so that the elbows are pointing to the feet, rather than out away from the body, like you would for a normal bench press. Ensure muscle growth by adding weight to the bar, but start with a low number of reps in order to get used to the new grip. Before any warm up, stretch your arms and elbows especially. Elbows are the most common area injured during triceps exercises. Also, avoid overtrainingâ&#x20AC;&#x201D; many experts recommend working on triceps once or twice a week along with chest and shoulders.

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Do Marathons Ruin Joints? THE TRUTH ABOUT A COMMON CARDIO MYTH People who say they don’t run marathons because they want to save their joints may have to eat their words. Studies published in the last few years find little connection between distance running and joint injury or future arthritis. In fact, some research suggests that running may even protect people from joint problems later in life. Of particular note is the Stanford University study that followed 1,000 runners and non-runners for 21 years. None of the participants had arthritis when the study started. The study concluded with the finding that the knees of both parties were neither worse nor better than the other. In fact, even when comparing runners who ran a ton versus runners who ran little, there was no statistical difference. In addition, the running group experienced less physical disability and had a 39 percent lower mortality rate.

BUT MARATHON RUNNING IS DIFFERENT THAN REGULAR JOGGING, RIGHT? “There is no evidence that supports the statement that marathon running ruins the knees,” says Rasmus Nielsen, PhD, a postdoctoral researcher at Aalborg University in Denmark who studies injuries related to marathons. In fact, Nielsen says novice runners running low mileage face a significantly greater injury risk compared with marathon runners. Of course, running excessive distances too soon can increase the risk of knee injury, but if runners are adapted to the training stimuli, marathons don’t make them vulnerable to injury, he says. But in the last few years, studies involving MRIs of runners’ knees before and after marathons have revealed new questions. Some of these studies show that marathoners have great knees. Another study conducted at the University of California at San Francisco found that certain biochemical

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changes happen in marathon runners’ knees during the race, changes tied to cartilage degeneration. How permanent these changes are is still an unanswered question, but it doesn’t look like it leads to arthritis. Regardless of one’s preparation, running isn’t easy on the body. A runner’s step places about eight times the body weight on the knee compared to a walking step, and that can sometimes lead to injury (for those who aren’t mathematicians, a 150 lb. runner would experience 1,200 lbs. of impact in the knee). “Exceeding the body’s limitations will, if the stress is severe enough, lead to overuse injury,” Nielsen says. This begs the question, how many people adequately prepare for a marathon, and how many people just go for it after some light preparation? This is how marathon running is dangerous. Research shows that excessive increase in running distance or speed in injurious. “Limited evidence suggests an increase in weekly distance greater than 30 percent increases the risk of specific

injuries like patello-femoral pain, runners knee and jumpers knee,” Nielsen says. That means if you run 10 miles one week, then you shouldn’t up your mileage to more than 13 miles the following week. In the end, running isn’t a risky activity. What’s risky is overstepping your body’s capacities, which is true of any physical activity.

OTHER RUNNER ERRORS LEADING TO INJURY • The roller coaster runner: going for long periods of inactivity and then begin running again. This roller coaster running will almost surely make your body hurt, and will probably cause injury. • Running on an injury: if you have a knee injury, or if you’ve had knee surgery, running may increase your risk of arthritis. • Not being weight-conscious: If you’re overweight, don’t start off with intense running. This extra weight may traumatize joints.

March 2015

FITNESS

11 Habits

OF FIT PEOPLE 12 HEALTHY IDAHO

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DO YOU KNOW PEOPLE THAT SEEM TO EFFORTLESSLY MAINTAIN A FIT PHYSIQUE? WHILE THEY CERTAINLY PAY ATTENTION TO THEIR DIET AND EXERCISE REGIMENS, THEY SEEM TO BE GENETIC “FREAKS OF NATURE.” IN ACTUALITY, FIT PEOPLE TEND TO ADHERE TO SEVERAL COMMON PRACTICES THAT GIVE THEIR METABOLISM AND PHYSIQUE AN EXTRA BOOST.

EDUCATE themselves regarding nutrition and exercise. Knowledge is power!

EXERCISE IN THE MORNING. Many people find too many diversions as the day progresses. Fit your workout in early and get it over with!

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Look for ways to “MIX UP” their fitness routine. The body is constantly adapting to the forces imposed upon it. If you do the same thing at the gym everyday, you’ll limit your results and eventually hit a plateau.

AVOID FAD DIETS. If it sounds too good to be true, it is. Maintaining an ideal weight is about sustainable, life-long lifestyle changes – not the trendy weight loss gimmick of the moment.

EAT WHAT THE CAVEMEN ATE. Think unprocessed, whole foods like grass-fed beef and poultry, wild-caught seafood, and plenty of organic fruits and vegetables.

MAINTAIN TIDY HOMES. These folks perform indoor and outdoor chores themselves rather than hiring these tasks out or forgoing them all together. Just think of the added calorie burn per hour: Vacuuming = 238 calories; mopping floors = 250 calories; trimming bushes = 215 calories; mowing the lawn= 408 calories.

HAVE AN EXERCISE BUDDY. It doesn’t matter if that buddy is an acquaintance, friend, cycling club, group exercise instructor or personal trainer. Numerous studies have shown that exercise consistency markedly increases when you have a support and accountability framework in place.

HYDRATE, HYDRATE, HYDRATE WITH WATER. Water is the magic elixir. It flushes toxins from the body, reduces bloating from excess dietary sodium and assists in maintaining proper fluid balance in the cells. When cells are lacking in water, they shrivel resulting in muscle fatigue. Ideally, one should consume 64 ounces of water daily. This number increases as heat, humidity and/or activity level increases. .

FORGIVE THEMSELVES FOR SETBACKS AND MOVE FORWARD. So you missed a workout? So you had a piece of cheesecake for dessert? So what! Chronically fit people jump right back in the exercise and nutrition “saddle” after small setbacks.

ABOUT THE AUTHOR

MAKE EATING OUT THE EXCEPTION RATHER THAN THE RULE. Restaurant food is notoriously loaded with excess fat and calories. If you cook it yourself, you control what you put in your body.

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PURGE THE JUNK IN THEIR REFRIGERATORS AND PANTRIES. Don’t fool yourself. If your weakness is mint chocolate chip ice cream and you have mint chocolate chip ice cream anywhere in your living space, you WILL indulge yourself. Wave the white flag and surrender those things that you cannot resist to the garbage can. Don’t set yourself up for failure.

Brooke Kittel

Treehouse Athletic Club

Treehouse has also been named among the TOP 20 GYMS in AMERICA by FITNESS MAGAZINE and has received Business of the Year and many other accolades. Treehouse offers family fitness in a beautiful and fun environment. TAC has state-of-the-art equipment, certified personal trainers and many programs and events that help keep you excited about working out and staying fit.

March 2015

FITNESS

Fresh Air Workouts

FIT PEOPLE BALANCE GYM TIME AND SUNSHINE

orking out outdoors can be one of the best ways to switch up your workouts and avoid hitting a plateau. If you ever fall into a rut at the gym or need a way to take your workouts to the next level to drop your body fat percentage and give you a tighter and toned look then here are a few tips you can use right away.

HIT THE HILLS

Hill running/workouts are an excellent way to build up your legs and stimulate your body’s natural fat burning and muscle building hormones. If you are someone who has struggled with sculpting your legs to have a more muscular look or dropping body fat then hill running can be that missing link. What you will want to do is find a hill with a decent incline that will challenge you. There are several ways to tackle a hill. • • •

Sprints of ten to forty yards with a thirty to sixty second rest in between each sprint. Run for a dedicated time (like fifteen minutes), going up and down the hill to create a dynamic the body is not used to. For variety: run backwards up the hill and jog forward coming down the hill. This will create a different feel and challenge the body, therefore helping you break through or even avoid a plateau.

Remember the more variety you have in your workouts the better and more consistent your results and progress will be.

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P LYO M E T R I C P O W E R

The next technique you can use while working out outdoors is plyometric exercise. These exercises are designed to target different muscle fibers which can help in building more muscle and burning more fat. The first exercise you can use is what we call a jump squat. With a jump squat you want to get yourself in a squatting position and then jump as high as you can. Once you land on the ground, jump right back up and repeat this movement for repetitions or a set time such as thirty to sixty second rounds. The next exercise you can use is a bench jump or curb jump. You will want to find a stable bench or a curb where you jump on and off of for repetitions or a set time such as thirty to sixty second rounds. The goal is to do the jumps as quickly as possible, while staying safe, to boost your heart rate up and challenge new muscle fibers.

Truly fit people utilize both the gym and the outdoors for maximum muscle gain and fat loss. The key to success in outdoor workouts is to allow creativity while simultaneously still pushing yourself. Take techniques that you use in the gym and utilize those same fundamentals outdoors and add on to them. Most importantly have fun and remember this is a lifestyle.

ABOUT THE AUTHOR

Greg Marshall

Greg Marshall is the personal training manager at The Gym at City Creek. He has run the personal training departments in up to eight locations at once, owned his own personal training company and has been in the industry five years. To contact Greg for a free consultation email him at gregmarshall17@ gmail.com

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moving boise forward

Boise.GreenBike.com Being green has never been so easy! Smart transportation is coming to downtown Boise this spring.

Boise GreenBike. Smart, fun, healthy and green. I N D E P E N D E N T P R A C T I C E S I N C E 19 9 6

Now Accepting NEW PATIENTS Jamie L Ruiz, PA-C • • • •

Family medicine Preventive health Women's health Minor surgery

• Behavioral medicine • Work related physicals • Dot exams

Jamie Ruiz is a certified Physician Assistant with experience practicing in both family medicine and urgent care. She particularly enjoys women’s health, preventative medicine, and pediatrics. She lives in Meridian with her husband, 2 children, and 2 dogs. Jamie enjoys spending time with her family, reading, cooking, playing the piano, and camping.

208-377-5055 www.selahmedical.com Facebook.com/HealthyIdaho

March 2015

K n o w i n g W h a t Yo u E a t

Distracted Eaters Eat More Researchers from the University of Liverpool found that people distracted by games, TV or reading eat significantly more than they would otherwise.

Bananas: 4 Things You Didn’t Know 1. There are hundreds of varieties of bananas, many of which aren’t edible. Many contain giant, hard seeds. 2. The Cavendish banana, the one you see in every market, is a hybrid species that can’t reproduce on its own. Human cultivation is the only reason it still exists. 3. The most popular banana before 1960 was different than the Cavendish, but a plant fungus wiped that variety out. 4. The average American eats 27 pounds of banana per year, making them the most popular fruit in the country (more than oranges and apples combined).

Did You Know...

Why Honey Lasts Forever Archeologists working Egypt discovered pots of honey, thousands of years old, that were not spoiled. How? Honey contains little water in its natural state, meaning few bacteria or microorganisms can survive in it. Secondly, honey is very acidic, which kills off microorganisms. Bees themselves are important in making honey so resilient. When they flap their wings, they dry out the nectar, and they transfer an important enzyme from their bellies to the nectar, which further protects the honey.

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Not Quite Booming

Baby boomers, characterized as being born between 1946 and 1964, have the highest rates of depression, compared to all other generations, a recent Gallup poll shows. One in seven baby boomers say they are currently being treated for depression.

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“A journey is a person in itself; no two are alike. All plans, safeguards, policing, and coercion are fruitless. We find that after years of struggle that we do not take a trip; a trip takes us.” -John Steinbeck

“The most beautiful people we know are those who have known defeat, known struggle, known loss, and have found their way out of those depths.” -Elizabeth Kubler-Ross

“Tomorrow is the most important thing in life. Comes into us at midnight very clean. It’s perfect when it arrives and it puts itself in our hands. It hopes we’ve learned something from yesterday.” -John Wayne

“Three grand essentials to happiness in this life are something to do, something to love, and something to hope for.” -Joseph Addison

“The best advice comes from people who don’t give advice.” -Matthew McConaughey

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K e e p I t I n Pe r s p e c t i ve

WELLNESS

“Courage is grace under pressure.” -Ernest Hemingway

“I know that in life there will be sickness, devastation, disappointments, heartache—it’s a given. What’s not a given is the way you choose to get through it all. If you look hard enough, you can always find the bright side.” -Rashida Jones

“The real man smiles in trouble, gathers strength from distress, and grows brave by reflection.” -Thomas Paine

“I tend to think you’re fearless when you recognize why you should be scared of things, but do them anyway.” -Christian Bale

March 2015

But issues of awareness and stigma still persist. Not so with breast cancer. Possibly the most marketed cancer battle, breast cancer gets among the highest amount of donated dollars for any cancer. Billboards, professional and collegiate athletes, front doors and a million other places have dawned pink or the pink ribbon. The underlying message: get screened for breast cancer.

Lung Cancer’s

While breast cancer deaths are decreasing and survival rates rise, some highlight the negative consequences of so much awareness. A study published in the New England Journal of Medicine found that in the last 30 years, mammograms have led 1.3 million women to seek treatment for cancer that never would have harmed them. Mammograms can detect certain risk factors for breast cancer that will almost never see negative outcomes, but women still seek treatment, which can have harmful side effects. There are also critics of prostate cancer testing who say the inaccurate tests lead to unnecessary procedures.

CHANGING HOW WE THINK ABOUT THIS DEADLY DISEASE

Fundraising and awareness campaigns for lung cancer research have some unique challenges. As science has essentially confirmed that smoking causes a huge proportion of lung cancer cases, some feel it makes sense that we don’t spend billions trying to solve a puzzle that is already mostly solved. On top of that, there is the sense that lung cancer victims brought the disease upon themselves, therefore sympathy levels are lacking. These attitudes are problematic, however. First of all, many cancers are related to bad habits besides smoking. Diet, obesity and other lifestyle factors are known risk factors for many types of cancer, including breast cancer, so if you won’t donate to cancer victims who possess culpability, youre donation options are limited. In fact, chances are you currently have habits that increase your odds of getting cancer. Projections by the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) indicate that obesity will result in about 500,000 new cancer cases by 2030. Further reason why the blame game doesn’t work for lung cancer patients: many lung cancer victims smoked before smoking was known to be bad, and quit long before they got cancer. In many cases, lung cancer victims can only blame hard luck.

18 HEALTHY IDAHO

The second problematic issue—not investing in lung cancer research because we know what causes it—leaves out an important aspect of all cancer research: survival rates. One of the biggest victories breast and prostate cancer researchers claim is a drastic improvement in 5-year survival rates since the 70s. Someone diagnosed with prostate cancer today has a 99 percent chance of living 10 years, the American Cancer Society says, and the 5-year survival rate was just 70 percent in 1980. Survival rates from breast cancer have also drastically increased. But for lung cancer, the improvement hasn’t been much. The fiveyear survival rate now sits at about 16 percent. But this isn’t to say lung cancer research hasn’t progressed in the last few decades. Billions of dollars have gone toward lung cancer research, and incidence has seen a serious decline in men since the 80s. Messages about the dangers of smoking have done serious work. And though lung cancer still kills thousands each year, the number of deaths from the disease have been on a steady decline for a decade. Still, the facts remain. Lung cancer kills more people than the next three most common cancers (pancreas, breast, colorectal) combined. In 2014, an estimated 159,000 Americans are expected to die from the disease, says the American Lung Association. Researchers are discovering lung cancer subtypes and broadening their understanding of the disease, meaning patients are now getting more specific diagnosis and targeted treatment, which will mean better survival. More progress lies in the future.

Otis Brawley, MD, chief medical officer of the American Cancer Society (ACS), cautions against what he calls “disease Olympics,” which is decreasing funding for one disease to increase funding for another. A better practice is to simply fund the best science, “as judged by the rigors of scientific peer review.” Often researchers find that discoveries about one type of cancer help the battle against other kinds of cancer. Therefore, if research is advanced in one field, don’t stop the supply of money. “One can argue that funding the best ideas in, say, lung cancer and not the better scientific idea in another cancer could possibly hold back the advancement of lung cancer research,” he wrote in one ACS blog. Equal monetary distribution across all cancers isn’t what we need. It’s just important to realize that just because a cause gets a lot of attention doesn’t mean there aren’t other causes that are just as significant. In the end, where you donate is a personal choice, but be informed.

1/2

Half of cancer deaths in the US are from preventable causes. Tobacco is responsible for 30 percent of cancer deaths. 1/3 of all new cancer diagnoses in the US are related to being overweight, obese, physically inactive or having a poor diet. Healthy-Idaho.com

Source: American Association for Cancer Research

quick flip through TV channels or a magazine would probably lead one to believe that breast cancer and prostate cancer are the most serious cancer threats we face. While those battles are of great importance, many don’t realize that lung cancer is actually the number one killing cancer.

The answer isn’t to stop funding these causes, however.

Let us help you get back in the game!

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westidahoorthopedics.com March 2015

WELLNESS

“Under-the-tongue”

allergy drops or tablets

(SUBLINGUAL IMMUNOTHERAPY)

The Truth Unfolded! T

ime and again, I am asked by my patients if sublingual or “under-the tongue” allergy drops or tablets are an option for their allergy and asthma management and control. Allergen immunotherapy has been a long term relief option for patients who have severe symptoms, when medications fail OR when patients do not like dependence on medications and are looking for a “natural” cure. There are several ways to administer immunotherapy. Subcutaneous allergen immunotherapy (SCIT), or “allergy shot,” has been around since the early 1900s. It is considered a safe and well-accepted therapy for allergic rhinitis and asthma. Sublingual immunotherapy (SLIT) or “allergy under-the-tongue tablet treatment” has collected a great deal of attention lately. The FDA recommended approval of Oralair™ and Grastek™ tablets, which are meant to treat grass pollen allergy symptoms and Ragwitek™ for ragweed pollen allergy symptoms. These tablets are available in the market currently on prescription by an allergist. While we at The Allergy Group are excited about new therapies for allergic and asthmatic disorders, it is definitely worrisome about what is starting to happen in the medical community. It is definite, based on research studies, that these pharmaceutical company manufactured sublingual tablets are effective, but it is not at all certain that compounded sublingual or under-thetongue “allergy drops” (liquid treatments made up from allergen extracts that are only approved for injection therapy) will benefit patients. There are various reasons for this concern.

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First, the dose needed for effective compounded sublingual “allergy drops” therapy should be 30 times more than that needed for allergy injection therapy. This is because the enzymes present in our gastrointestinal symptoms can digest these liquid drops rendering them ineffective if given at any less doses. Secondly, there is no research data or FDA approval on compounding these allergens or their efficacy in treating more than one allergen. In Europe, where sublingual immunotherapy is famous, only one allergen or just few allergens at a time are used. However, this cannot apply to Americans who are usually sensitive to more than one environmental allergen (like pollen, animal dander, dust mite, mold etc.). Thirdly, allergy shot (SCIT) therapy has a disease modifying effect, which mean that, on completion of the injection therapy, the body’s immune system retains the immunity even after stopping the treatment (and hence no, or reduced need for asthma and allergy medications to control symptoms). This phenomenon is not well studied or known to happen with other forms of the allergy liquid or sublingual immunotherapy treatment. There is no question that the idea of sublingual treatment is an attractive one- being able to use it at home, and no involvement of needles, however, the question is why waste your resources if it’s not going to be effective treatment in the long run.

ABOUT THE AUTHOR

SLIT will have a place in certain situations and board-certified allergists at The Allergy Group can help to decide what’s best for the patient. However, we strongly suggest to the people in Treasure Valley to be cautious and aware of the limitations of sublingual immunotherapy.

Learn more from Dr. Talreja at www.theallergygroup.com or call 377-4000

Dr. Neetu Talreja

Dr. Neetu Talreja is a Board Certified Allergist/Immunologist with The Allergy Group in Boise and Meridian.

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WHY DOES IT MATTER THAT I KNOW MY

Family Health History? W RITTE N B Y A NG EL A S I LVA

IMAGINE YOU’VE WOKEN UP IN THE MORNING AND AS YOU LOOK AROUND, YOU NOTICE SPOTS FOLLOWING YOUR EYES. EVERYWHERE YOU LOOK DARK SPECKS APPEAR AND IMPEDE YOUR VISION. YOU’RE TERRIFIED. THEN YOU REMEMBER READING IN YOUR GRANDMOTHER’S JOURNAL THAT SHE EXPERIENCED THE SAME THING! YOU PULL OUT THE OLD JOURNAL AND READ ALL ABOUT HER EXPERIENCE, WHAT IT WAS, HOW SHE DEALT WITH IT, AND WHAT CAUSED IT. YOU SAVE YOURSELF A TREMENDOUS AMOUNT OF TIME AND MONEY AND ARE ABLE TO TELL THE DOCTOR ABOUT YOUR GRANDMOTHER, AND HE’S ABLE TO TAKE CARE OF YOU IMMEDIATELY.

Just like your hair color, eye color, and other physical attributes can be passed down from parent to child, so can diseases and health disorders. Just like you’ve learned to love the Boston Red Sox from your old man, you may also have learned to eat a big steak every day from your old man. And just like your grandfather loved working with his hands, you’ve learned to love hobbies such as wood-working and welding. Taking the time to learn about your family health history can prepare you for your own future and provide insight into conditions to which you are predisposed. Being predisposed to a condition doesn’t necessarily mean it’s a genetic factor,

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either. If you were to look back on the death certificates of your family members and notice a trend of heart disease, you may be able to look into their lifestyles and realize they ate a lot of red meat and smoked. You can avoid these habits and hopefully change your own fate if you adopted changes. Similarly, if you become aware of several family members that suffered from cancer, your doctors may encourage you to have frequent screenings and at an earlier age than otherwise recommended. Understanding your family health history can paint a more complete picture of your health and help keep you healthier longer.

So where do you start? A complete family medical history should include at least 3 generations, including children, siblings, parents, aunts, uncles, nieces and nephews, grandparents and cousins. Try to find basic information such as age, date of birth, name of condition and age the condition was contracted, and if applicable, death and cause of death. This may seem like a lot, but you probably know a lot of it already for those closest to you. Other information may not be as readily available. For this information, public records can be accessed to find obituaries and death certificates. Perhaps the best way to gather medical information is simply to ask family members at your next family gathering. Asking your grandparents about any health conditions they had or have, and at what age they occurred, is a great place to start. They may also have information on other family members to help you. Make sure you find this information for both your mother’s and father’s sides of the family. Learning your ethnic background can also be helpful as some health conditions occur more frequently in certain ethnic groups. Update your family history record regularly and keep it up-to-date. Share it with your doctor and other family members to help everyone stay healthy and prepared. Technology and medicine have come a long way and many conditions can be prevented before they become problems by early screening and detection.

March 2015

Taking on Cancer HOW TWO CANCER PATIENTS ARE CHANGING WHAT IT MEANS FIGHT THE DISEASE

ancer looms as an almost impossible hurdle in the eyes of many. Research is progressing quickly, but people are still dying, and cures seem so slow in coming. With many cancers, patients feel like their fate is sealed, that they’re powerless in the face of such a mighty enemy. While cancer’s devastation leaves many in a truly powerless state, two women with myeloma (see sidebar next page) are showing the cancer community just how big an impact individuals can have for progress. Jenny Ahlstrom and Lizzy Smith decided to help even though nobody asked them to, because they couldn’t just sit and wait for the end to come. Both started with little understanding of medicine or myeloma, but four years later their work has significantly advanced myeloma medicine and has shaken the perception of what a cancer patient is capable of. CLEARING CONFUSION After Jenny was diagnosed and began to progress through different treatments, she worried about relapsing and looked for new treatment options. She found a complicated world. She was interested in joining a clinical

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trial for myeloma research, but found 450 such trials to choose from, and didn’t understand much of what any of them were trying to do. She began to see that the large majority of myeloma patients (and cancer patients in general) didn’t know much about their disease, and therefore couldn’t offer much input to their medical professionals or researchers. Myeloma, and many other cancers, have multiple avenues of diagnosis and treatment, and patients are often unaware of important tests they haven’t taken or treatment options they haven’t been offered. But the doctor should be directing treatment, not the patient, right? True. But Jenny says the outcomes from care vary widely for myeloma patients, depending on who they see and what treatments they get. Those who see a myeloma specialist can expect to live years longer than someone seeing a general oncologist. She says people who don’t see a specialist are often seeing only half of the story and half of the possibilities. Patient education is vital, Jenny says, because it gives hope, improves quality of care, and helps research progress.

So Jenny took action. She began interviewing leading myeloma researchers and publishing a radio program that now has an international audience of more than 500,000 listeners. Jenny and Lizzy launched a myeloma website (myelomacrowd.org) that has hundreds of thousands of visitors, where they interpret complicated research language for a normal reader. A quick glance at the numbers suggests that Jenny and Lizzy are reaching an enormous portion of myeloma patients, and the numbers are growing. PUSHING RESEARCH FORWARD On the radio program and on the website Jenny and Lizzy work to dispel misconceptions about clinical research and educate patients about opportunities to participate. It is essential that cancer patients get involved in clinical research, for a variety of reasons: • Getting participants is among a researcher’s most difficult tasks, and is often the reason why research is slowed. • Clinical trials are a way for patients to try the most modern treatments. Participation could save a patient’s life. One reason why cancer patients don’t join clinical trials is because they don’t understand

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the trials and what may be involved, or don’t want to feel like a guinea pig. The website and radio shows are changing that, at least for myeloma research. “It’s been extremely valuable,” Jenny says. Many cancer patients are diagnosed, and just sit around and wait for “smart” people to cure them, Jenny says. They don’t realize how much researchers value a patient’s support and help. She says researchers love that someone is spreading the word about their work, bringing them participants, and interpreting the findings. “My whole approach has been, ‘how can I help you do your job?’” Jenny says. “I don’t feel like I need to get permission to help. Researchers don’t have time to distill their research down and explain it to patients. We’ll be their marketing arm, in a way.” Of course not everyone with cancer is capable of rallying to the research flag. Cancer and its treatments bring exhaustion, illness and other debilitations that make what Lizzy and Jenny do largely impossible. Others find themselves completely overwhelmed and therefore immobilized. It may be for this type of patient that Jenny and Lizzy have done their greatest work. Their website brings together myeloma patients in a powerful way, and patients who were once alone now have a thriving support group and a steady stream of comprehensible, up-to-date information from trusted voices that helps them get the best treatment for the best outcomes. “Peers give the power of hope,” Lizzy says. Peers and education about the illness are big reasons why Lizzy says she isn’t afraid of the disease. FROM CHRONIC TO CURE As Jenny and Lizzy dug deeper into the myeloma research scene, they found that much of the funding and research initiatives were directed at developing treatments for myeloma as a chronic condition. In other words, researchers were trying to find ways to extend the life expectancy of a patient, rather than search for a cure. This represents a disconnect between patients and researchers, Jenny says. She, along with the majority of patients, care little for such research, and would rather see funds devoted to research for a cure. This year, the Myeloma Crowd Research Initiative, which Jenny and Lizzy had a key role in creating, seeks to fix that disconnect, by bringing together doctors, researchers and patients to discuss research direction. This is important because it is able to compromise the various opinions in the myeloma field. Some have little belief in the possibility of a cure, others have more hope. “You need scientific validation, but you also need patient input,” Jenny says. “You need all stake holders involved.” Some may see Jenny and Lizzy’s story as two rabble-rousers wreaking havoc among cancer doctors. But the truth is, oncologists have told Jenny that she knows more about myeloma than many cancer doctors. An important argument for patient involvement in these processes is the story of a drug called thalidomide, now one of three staple drug classes for myeloma. A patient had heard about this drug, and asked the doctor if it could be used, even though it wasn’t accepted as a worthwhile treatment. The doctor tried it, mostly out of compassion for the patient, not out of faith in the drug. Eventually, this doctor found that the drug brought excellent responses in many patients. This hopeful urgency is what a patient has to offer, and it can be valuable. “The patient has the motivation of living life and death every day,” Jenny says. Understandably, many feel hopeless in the face of cancer. But Jenny says that there is value in a patient being his or her own advocate. “My efforts help me cope,” Jenny says. “It’s like it flips a switch where you were the victim of cancer and you transition to being an independent person who has the freedom to act.”

Myeloma

(a.k.a multiple myeloma) Cancer of the plasma cells in the bone marrow. According to the National Cancer Institute, about 45 percent of patients survive 5 years. In 2014, 11,000 Americans died from myeloma. More than 80,000 Americans live with the disease.

THEIR STORIES LIZZY SMITH Lizzy’s myeloma diagnosis led to drastic life changes. At age 44, she was married to an abusive alcoholic, and had children, along with a high-powered corporate job. Her husband dismissed her cancer diagnosis, and she soon left him and her job in California and moved to her parent’s basement in Utah. In Utah, she filed for divorce and had stem cell transplants for her cancer. She also began regular treatment at the Huntsman Cancer Institute. She responded well to treatment, and still receives weekly treatment.

JENNY AHLSTROM Jenny was diagnosed in 2010, in Mexico City, where her husband worked in venture capital. She came to Utah for six months, and then made trips twice a month to Texas for treatment.

Both Lizzy and Jenny were diagnosed at an early age. The average age of diagnose is 70.

Keys for Every Cancer Patient 1.

Find the right oncologist or specialist.

Get educated.

Get involved in clinical trials. This will help the patients in your generation and following generations.

Get connected with others.

Don’t be afraid to get a second or third opinion.

-Lizzy Smith

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March 2015

Sharing the

Burden

HOW TO HELP A LOVED ONE WHO HAS CANCER

A CANCER DIAGNOSIS CAN FLIP LIFE ON ITS HEAD. OFTEN PEERS OR FAMILY MEMBERS AREN’T SURE HOW TO HELP OR HOW TO UNDERSTAND THEIR LOVED ONE. HERE ARE SOME IMPORTANT THINGS TO UNDERSTAND. CANCER PATIENTS HAVE LOST MUCH OF THEIR FREEDOM. Many cannot drive, can’t be alone and can’t eat what they want. This means that they probably need help every day with multiple tasks. On top of that, they have to deal with feeling trapped by a loss of freedom, a loss of independence, and having to ask for help, which can be humiliating. Be understanding.

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MANY NEED HELP ON A 24/7 BASIS. A favor every once in a while is meaningful, but it may be hard for a patient to see great worth in it. Don’t feel snubbed because someone doesn’t come to tears when you bring them dinner.

MANY LACK THE ENERGY TO TAKE CARE OF CHILDREN. Many suffer from severe exhaustion. Added to that is the mental burden of cancer, with its worries about life and death and family, which can squash motivation. Friends and family can be conscious of these physical and emotional burdens, and look for ways to alleviate them.

EMOTIONS AND WELLBEING FLUCTUATE WITH CANCER PATIENTS. Sometimes the physical and mental burdens are easier to bear, and other times they are crushing. Friends must be understanding of these ups and downs, and learn to recognize them. You need patience with cancer patients.

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PROMISING CANCER DRUGS of 2015

THE FDA APPROVED NINE NEW CANCER DRUGS IN 2014. BECAUSE OF THE SUCCESS OF LAST YEAR’S CANCER ONCOLOGY DRUG RESEARCH, 2015 WILL PROVE TO OPEN THE CANCER DRUG FIELD TO MORE COMPETITION, MORE EXPERIMENTATION, AND MORE RESULTS.

lung and kidney cancer cases, and it will cost about $12,500 per month.

Immune-oncology (IO) is developing to combat cancer. Also called cancer immunotherapy, these treatments use the body’s immune system and its proteins to boost the immune system and attack specific cancer cells.

Others condemn this drug hype by saying that these IO drugs are not real cures and only offer life extensions or alternatives. Some attack the healthcare system in general and say this may only benefit the rich.

Last year, the Journal of Science Translational Medicine conducted a five-person study with IO drugs and found the results of the drugs to have “life-saving potential.” Though many see harmful side effects and high expenses, this new line of research may have a bright future.

These drugs can cost upwards of $150,000, and for personalized drug treatments, the prices can reach even higher.

The number one most promising medicine for 2015 is Keytruda, an FDA-approved IO drug that targets melanoma found in skin cancers. The drug has potential to work in

Sources: Bloomberg, Global Health, cancer.org, IMS Institute for Healthcare Informatics global outlook report

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Bloomberg’s article comments that the IO industry may be worth $30 billion in the next decade. Many condemn this estimate by saying that research is only seeking more money instead of cures. There are still no IO drugs on the market in America, and many believe we won’t see any for a long time. One commenter said that most of these drugs take 7-10 years to get on the market after rigorous clinical tests.

There are 374 cancer drugs in mid-stage trials, and 25 to 30 percent of those are immunotherapy drugs.

Global Health lists the top ten most promising medical breakthroughs to look for in 2015: 1.

Keytruda by Merck: skin cancer

Dengue Fever Vaccine by Sanofi: mosquito-borne viral disease dengue fever

Sifalimumab by Astra Zeneca: lupus

LCZ696 by Novartis: reduces cardiovascular death

Olysio by Johnson & Johnson: hepatitis C

Nivolumab by Bristol-Meyers Squibb Co.: skin cancer

Kadcyla by Roche: breast cancer

Palbociclib by Pfizer: breast cancer

OFEV by Boehringer Ingelheim: lung cancer, idiopathic pulmonary fibrosis

10. Cyramza by Eli Lilly and Company: stomach cancer

March 2015

HEALTHSMART

WRITTEN BY KTVB

ALZHEIMER'S

Day Care When Matthew Housel's mom got Alzheimer's disease he was forced to work from home. “I’m what’s called a sandwich,” said Housel. Sandwiched between taking care of his 72 year old mother and his young child – a prospect many people are facing as baby boomers are aging. Alzheimer’s, affects one in nine, or 11 percent, of people age 65 and older according to a 2014 study by the Alzheimer’s Association. That equates to over five million Americans living with Alzheimer’s today. Housel wanted those aging Alzheimer’s patients to have a productive way to spend their day while at the same time giving people like him, sandwiched between parents and kids, a break. That’s why he started the Alzheimer Dementia Center in Caldwell. “I wanted to make a place where people can come and drop off a family member, have them in a safe, secure environment,” said Housel. “They’re not sitting there watching TV, there’s actually something for them to do.” He says the idea of adult daycare for people with Alzheimer’s is gaining traction around the country. In Idaho, Housel says there are only a handful of adult Alzheimer’s and dementia daycares that are not part of a hospital or assisted living facility. "It's a novel idea for people in Idaho," Housel said. "Maybe it goes back to our rugged independence of, 'I don't need any help and I'm going to take care of it,' but evidence has shown that people who try to do it all by themselves burn out." Projections show the number of Americans over 65 will grow from 44.6 million in 2013 to around 88.5 million by 2050 which means the desire for adult daycare is also likely to grow.

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Healthy IDAHO

速

Watch News at Noon every Wednesday with Kim Fields & Healthy Idaho to learn life strategies for better health.

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March 2015

Should You Donate to

Fight Cancer?

THE ISSUES SURROUNDING THE BILLIONS RAISED TO FIGHT THE DEADLY DISEASE AS AMERICANS LEARN MORE ABOUT CANCER CHARITY ORGANIZATIONS AND NONPROFITS, THEY OFTEN AREN’T HAPPY WITH WHAT THEY FIND. BIG SALARIES, SUSPICIOUS DISTRIBUTION OF FUNDS AND LACK OF RESULTS CAUSE SOME TO CLOSE THE WALLET. THE CONTROVERSY ISN’T UNWARRANTED, BUT A CLOSER LOOK AT THE ISSUES REVEALS THAT NOT DONATING AT ALL ISN’T THE RIGHT CHOICE. HERE ARE SOME COMMON QUESTIONS AND THEIR ANSWERS FOR THOSE CONSIDERING MAKING DONATIONS TO FIGHT CANCER.

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WHEN I DONATE MONEY, WHY DOESN’T ALL OF IT GO TO THE CAUSE? Many cancer nonprofits have fallen under scrutiny for their skewed ratios of money raised versus money given to the cause. For example, recent reports from the Center for Investigative Reporting revealed a handful of charities that gave less than 10 percent of what they raised to cancer victims. How could that be? In this particular investigation, it was discovered that these organizations paid millions of dollars to companies that solicit donations. In one case, $80 million was raised and almost $60 million went to solicitor fees. A report in Bloomberg Markets Magazine showed that in 2010 the American Cancer Society (ACS) hired a company to gather donations. The company raised $5.3 million, but in the end that money only paid solicitor fees, and none of it went to cancer research. In fact, the ACS actually had to pay $113,000 in additional fees.

But those who donate should be comfortable with the idea that not all of the money they donate will be seen directly by cancer victims. Even good cancer charities must spend donations on fundraising efforts and administration. However, when a nonprofit is spending more than 35 cents to get a dollar, that can be a red flag. WHY DO SOME CANCER CHARITY LEADERS GET SIX-FIGURE SALARIES? Seeing the salaries and benefits received by the leaders of many nonprofits is enough to keep some people from donating. But the reason why nonprofits sometimes pay their leaders a lot is the same reason why for-profit businesses pay their leaders a lot, says Rick Cohen, Director of Communications and Operations at the National Council of Nonprofits. “Nonprofits have to compete for top talent,” he says. “At the end of the day, for all organizations, you need to hire the right person.” America’s best leaders often won’t take jobs without competitive salaries. The outrage some feel when seeing a big nonprofit salary most likely stems from a misunderstanding of the nonprofit sector. Nonprofit doesn’t mean everyone at the company volunteers.

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Nonprofits must pay what is often a host of full-time employees to keep the organization running. According to Cohen, 10 percent of the American workforce is in a nonprofit organization. “The main difference between a nonprofit and a for-profit business is simply that a nonprofit is driven by a mission, and a for-profit is charged with increasing profit,” Cohen says. All this said, sometimes salaries at cancerrelated organizations are exorbitant. Cohen says that a good nonprofit will have performance and compensation reviews in place to keep leaders accountable. These reviews aren’t required, but potential donors can find out if a nonprofit is keeping leaders accountable through the website guidestar. org. Cohen says to look at what is called Form 990 for a nonprofit to understand leadership salaries. “The best kind of donor is an educated donor,” he says. “Ask the organization for information and if they don’t give it to you, move on.” WHAT ABOUT CANCER NONPROFIT SCAMS? There are many organizations that have gotten rich off the kindness of others. It is the essence of despicable: create an organization with a legitimate-sounding name, create some deceptive marketing and throw in some accounting tricks, and you’re rich. Take the Reynolds family, which created the Cancer Fund of America. The Center for Investigative Reporting found that over a span of three years the charity raised $110 million. Of that, $75 million was paid to solicitors, meaning people who went out and got money from people. Salaries within the company took more than $8 million in 2011 alone. The organization gave misleading information about what they did with the money, or outright lied to donors. And it isn’t like nobody noticed. They’ve paid more than $500,000 to settle chargers, including the charge of lying to donors, but that is a small fraction of the money they were raking in. Jim Reynolds Sr. used to work for the American Cancer Society, but after eight years was told to resign or be fired. ACS accused him of sloppy bookkeeping, irregular hours and taking a car meant to be auctioned for charity. That’s when Reynolds started his own charity, basically rewording the name of the organization he previously worked for. He sent out volunteers to collect and they raised millions in the first year. Little of the money was used for direct financial aid to cancer patients. Reynolds got businesses to donate things, then he repackaged them and gave them to cancer patients. Meanwhile the money went to the professional fundraising organizations and salaries for his extended family. Overall, in a decade, cancer patients received $890,000, along with some donated items like

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shampoo, paper plates and toys. Reynolds family members received $5 million. Solicitors received $80 million. The Cancer Fund of America was rated the second worst charity in America by the Center for Investigative Reporting. Stories like this are enraging, and unfortunately lead to people giving less, understandably. “One shady character harms the efforts of other nonprofits,” Cohen says, “even though the overwhelming majority of nonprofits are making a difference in their communities.” Part of the reason why these few unsavory characters are able to do so much damage to the cancer nonprofit world is because the IRS has a hard time enforcing regulations in the nonprofit sector, Cohen says. “The IRS department that deals with nonprofits is under-funded and under-staffed,” he says. “We need congress to fund the IRS to enforce regulations.” But, Cohen says, the dishonest nonprofits make up a miniscule percentage of all the nonprofits, even though the media exposure might make it seem otherwise. “There are true heroes working all across the U.S.,” he says. Deciding not to give at all because of families like the Reynolds might be a rash decision. Surveys show that nonprofits struggle to keep up with demand, and that demand is always increasing. In other words, most nonprofits could help more people if they had more donations. In fact, the American Cancer Society can’t fund 90 percent of the research that is submitted and deemed worthy of funding, according to Otis Brawley, MD, chief medical officer of the ACS. HOW CAN I KNOW IF A CHARITY IS WORTH DONATING TO? Many cancer charities aren’t out to take advantage of people, but are simply run badly. Just because a nonprofit has a great goal doesn’t mean they are a good organization to donate to. An example of a good cancer charity is the Entertainment Industry Foundation (EIF), which organized Stand Up To Cancer and many other events. They received a 91 out of 100 on Charity Navigator, a respected watchdog of the charity sector. Of the $50 million they raised in 2012, 78 percent went to the programs and services it was designed to provide. The rest went to salaries and fundraising. While some might look at the remaining 22 percent and cry fraud, this is actual a great ratio. It takes a lot of money to make a lot of money, even in the nonprofit world. For sake of comparison, let’s take a look at the American Cancer Society, which also has a bunch of big events throughout the country each year.

They raised more than $880 million in 2012. Of that, $60 million went to administrative expenses, and almost $340 million went to fundraising expenses. That left $586 million, or 59 percent of the money raised to go towards the many different areas of cancer research and assistance. Charity Navigator gives the ACS, a prestigious cancer organization, a 76 out of 100 score. So is the ACS bad and the EIF good? Rick Cohen says expenditure numbers aren’t a complete and accurate measure of nonprofits, and that potential donors shouldn’t shun organizations just because administrative costs are high. “Costs can vary from year to year,” he says. “New equipment, new initiatives and other things can make administrative expenses seem high, but in fact they are making the nonprofit better.” Charity Navigator and GuideStar are great tools for donors to learn more about organizations. Become an educated donor. WHAT EXACTLY IS MY MONEY GOING TO DO? Donors have a right to know what their money will do, but the responsibility to gain that knowledge is largely on their shoulders. Some nonprofits work to make life better for cancer patients. Other nonprofits work to fund research institutions working to find cures and better treatments. Put your money where you want. A related question some may ask is this: “will my donation actually do anything?” What have the billions donated to cancer actually achieved so far? And why is it taking billions of dollars?

Taxes & Cancer You pay taxes? You’re so charitable! In 2013 Congress gave the National Institutes of Health $5.27 billion to put toward cancer research. Source: report.nih.gov

March 2015

Let’s take a trip back to the 70s. President Nixon signed the National Cancer Act in 1971. Government funding started flowing into the fight against cancer at that time, and public attention grew. Researchers today realize that our understanding of cancer in 1970 was weak, to say the least. We used to think cancer was a single disease, but we now know cancer to actually be more like 200 distinct diseases, with different causes and requiring different treatments. This has opened the door to treatments, survival and cures. Cures? Yes! Thanks to years of clinical trials and medical research, testicular cancer can be cured in the vast majority of men, especially if detected early. Hodgkin lymphoma, which used to be fatal, is now routinely cured, thanks to clinical research. Survival rates in common cancers have improved drastically. Death rates from cancer dropped 22 percent for men and 14 percent for women from 1990 to 2007, according to a report from the American Association for Cancer Research. Among children, 80 percent can expect to survive childhood cancer now, compared to 52 percent in 1975. Today there are more than 14 million living cancer survivors, compared to just 1.5 million in 1970, according to John Sweetenham, MD, Executive Medical Director at Huntsman Cancer Institute (HCI). “There have been extraordinary advances,” he says. One incredible area of cancer research is the Human Genome Project, which is continually discovering genetic drivers of cancer. Specifically, the Cancer Genome Atlas is searching for what gene changes cause a cell to become cancerous. This research is especially important for identifying specific subtypes of cancer, which means treatment can be more specific. There now exist dozens of FDA-approved targeted cancer drugs.

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Sweetenham says cancer research is so expensive in part because it is so labor intensive. “A very large component of cancer research is the expertise, the people,” he says. Researchers in labs make discoveries, other researchers try to develop treatments from those discoveries and still more experts must navigate the appropriately stringent FDA regulations for new medications. “It requires a lot of people in different areas of expertise,” he says. “It requires an infrastructure.” The government helps support this research. In 2013 Congress gave the National Institutes of Health $5.27 billion for cancer research. But progress still depends on nonprofits. “If non-National Cancer Institute funding went away tomorrow, it would have an enormous impact on what we are able to do,” Sweetenham says. Cancer nonprofits do gather quite a chunk of change, but it is very little compared to the money cancer takes from America every year. Sweetenham says that in 2012, cancer cost the U.S. between $200 and $220 billion, in cancer care and economy impact. Even with all the progress, we’re losing too many people every year to cancer. It is without a doubt worth donating for. WHICH CANCER SHOULD I DONATE TO? This is largely a personal decision, based on your experience with cancer. Those not swayed by personal experience may wonder if breast cancer and prostate cancer are the most important cancers to donate to. Organizations that fight these cancers have great marketing and awareness campaigns, leading to these cancers getting the most monetary donations every year. But these aren’t the cancers that kill the most people.

Lung cancer is the biggest killer. So why don’t more people donate toward that cause? Lung cancer is unique in that smoking is a known cause, therefore sympathy isn’t as great for lung cancer victims compared to other cancer victims. But lifestyle factors play into about half of all cancer deaths, according to the American Association for Cancer Research, so it is illogical to base donations on culpability. The truth is that survival rates for lung cancer haven’t improved nearly as much as they have for other cancers, and more donations would do good. But just because you don’t donate to lung cancer doesn’t mean you won’t help that science. Discoveries with one cancer often apply to others, according to Sweetenham. “What we often find is that mechanisms at work in one cancer are relevant in others,” he says. In multiple instances, cancer drugs have failed for the cancer they initially target, but are found to improve outcomes in other cancers. A drug called cisplatin was developed as a treatment for testicular cancer, and now it is the most commonly used chemotherapy for lung and ovarian cancer. Remember, however, that just because an organization markets well doesn’t mean their cause is more important than others. Sources: ascopost.com, healthland.time.com, charitynavigator.org

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SHOULD YOU DONATE TO FIGHT CANCER? WE SAY YES! SUSAN G. KOMEN, IDAHO IS A LOCAL AFFILIATE TO HELP IDAHOANS IN THE FIGHT AGAINST BREAST CANCER. WHEN I DONATE MONEY, WHY DOESN’T ALL OF IT GO TO THE CAUSE? Komen Idaho spends 75 percent of all money raised and donated on the mission, to end breast cancer forever. WHY DO SOME CANCER CHARITY LEADERS GET SIX-FIGURE SALARIES? Komen Idaho currently employees four full-time employees and provides service in 28 Idaho counties. Salaries at Komen Idaho make up less than 15 percent of the overall budget. WHAT ABOUT CANCER NONPROFIT SCAMS? To discuss any concerns you may have about our organization, contact us at 208-384-0013 or email us at sgkinfo@ komenidaho.org. HOW CAN I KNOW IF A CHARITY IS WORTH DONATING TO? Komen Idaho invites you to research all nonprofits before you make a donation. Visit www.charitynavigator.org, type Susan G Komen for the Cure in the search bar. You will see we have an overall rating of 81.96 with an accountability and transparency rating of 97.00. Visit www.guidestar.org, type Susan G Komen Idaho in the search bar to view our 990 reports. WHAT EXACTLY IS MY MONEY GOING TO? Komen Idaho is very transparent with where their donations go. Since 1999, Komen Idaho has invested more than $5.3 million in community grants and national research, including the following for Idahoans: • 19,506 MAMMOGRAMS • 9,785 CLINICAL BREAST EXAMS • 261 WOMEN RECEIVED TREATMENT ASSISTANCE • 2,846 HAD ACCESS TO DIAGNOSTIC SERVICES. • 88,841 RECEIVED BREAST CANCER AND BREAST HEALTH INFORMATION WHICH CANCER SHOULD I DONATE TO? Your money should be donated to an organization you believe in. If you would like to donate to Komen Idaho or if you have any questions about our work in Idaho do not hesitate to call us at 208-384-0013 or visit www.komenidaho.org.

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KOMENIDAHO.ORG March 2015

nutrition

Six Packs are Made In the Kitchen A DIETARY GUIDE TO BEING LEANER WHILE IT IS NOT NECESSARILY IN MY BEST INTEREST AS A CROSSFIT GYM OWNER TO TELL YOU THIS OLD ADAGE, “YOU ARE WHAT YOU EAT.” MOST OF US KNOW THE BASICS. STAY AWAY FROM TRANSFATS, SODA AND FAST FOOD. BUT THERE ARE OTHER NUTRITION PRINCIPLES THAT MUST BE ADOPTED IF ONE IS TO GET LEANER. Log your carbohydrate intake: So often, CrossFitter’s tell me how healthy they are, and proceed to tell me all about their fruit and whole wheat intake. Remember, carbohydrates that don’t get used as initial energy are going to be stored as fat. This includes the carbs in fruit and whole wheat. Sure, fructose is better for you than sucrose, and usually comes with vital vitamins and minerals, but don’t overdo it. Likewise, whole wheat (including whole wheat pasta and brown rice) provides you with more fiber than regular refined white bread and will thus digest more efficiently, but that doesn’t mean it isn’t dishing out serious carbohydrates. Cut out wasted calories: Ensure you are not overdoing it on wasted sugars, which is one of the more harmful ways to ingest calories. In fact, if you can, try to cut something you know is bad out of your diet. For me, it was soda. In high school, I cut soda out of my diet completely for my freshman year of wrestling. After the season, I tried to go back to drinking soda, but I had lost the taste for it and I never really drank it again since. The amount of calories wasted on soda can now be used on protein. If you consider that one can of coke is the same caloric intake as 3-ounces of beef, the decision from a lean-body perspective is clear and obvious. Don’t be extreme in dropping calorie intake: If you weigh 200 lbs, then don’t immediately start eating 1,200 calories a day in an attempt to get lean. While you will see an initial drop in your weight, you are starving your body far too quickly and your basal metabolic rate will plummet because your brain will think you are starving, and therefore will need to conserve what energy reserves you have left. This will leave you lethargic and will eventually lead to your body packing on the pounds when you inevitably start eating more. The general rule of thumb is to eat 12 calories a day for every pound you weigh. In other words, if you are 200 lbs and you want to stay 200 lbs, eat about 200lbs x 12 = 2,400 calories. If you would like to drop some weight, try cutting your calorie intake to 2,000 calories. Focus on losing a pound a week for the first 20 weeks of your program. All this said, eating less is not always essential for going lean, but it can be an important lifestyle change for a healthier body. Eat lean beef: Lean beef is loaded with things that are conducive to lean muscle gain. While low in calories, lean beef packs a mean punch, providing your body with Vitamin B, Zinc and Iron, as well as a tremendous amount of amino acids. Meat also helps you maintain the lean mass (muscle) you already have. Keeping lean muscle mass is the ultimate key to increasing your metabolism.

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Phil Gephardt FACTUM Head CrossFit Instructor, MMA, Wrestling, Jiu Jitsu, CrossFit and Muay Thai instructor FACTUM is a fitness club in Sandy, UT that offers training for martial arts and CrossFit as a way to get healthy or compete. A lifelong wrestler and jiu jitsu practitioner, Phil left his NCAA D1 wrestling career to try his hand at MMA halfway through his freshman year of college. Opening this gym has been Phil’s passion, and he’s excited to share this passion with his students.

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nutrition

T H E

D I L E M M A WRITTEN BY ANGELA SILVA

IT SOUNDS PRETTY GOOD, DOESN’T IT? FLUSHING OUT ALL THE BUILT-UP TOXINS FROM YOUR CELLS, CLEANSING OUT YOUR “PIPES” AND GETTING YOUR BODY BACK TO RUNNING AT 100 PERCENT? AND WOULDN’T IT BE SO NICE IF YOU COULD DO THIS JUST BY DRINKING JUICE? OR TAKING A PILL?

SORRY TO BURST YOUR BUBBLE, BUT YOU CAN’T. That’s right, the detox “solutions” you hear all about these days are scams. And here’s why.

Gasp! How can they trick us like that? How can they sell and market something that doesn’t do what they say it does?

Your body is beautifully created, perfectly capable of clearing out its own toxins. If you had these so-called built-up toxins in your cells and organs, you’d probably be dead. It’s the specific job of your liver and kidneys to eliminate any toxins from your body and keep you running at full capacity. If you suspect a build-up of “toxins,” it would mean you probably have organ failure and you should talk to your doctor, not start a juice fast.

They sell it because we’ll buy it.

In fact, as it turns out, many of the companies that offer a “detox” product don’t even know what the term “detox” means. In 2009, scientists working for the UK charity Sense about Science asked for evidence from the manufacturers of 15 so-called “detox” products. What evidence were they given? None. Not a single manufacturer could tell them what they meant by “detoxification” and couldn’t name even one “toxin” it claimed to remove.

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Peter Ayton, a professor at City University London, explains that we are bombarded by so much information in our world that we are quick to trust anyone who might have a deeper understanding than us. If a doctor appears on your TV screen telling you that he/she found the magic pills that clean out your cells and help you lose weight, it wouldn’t be that difficult to believe him/her. Hey, who isn’t trying to lose weight? And he’s a doctor so he/she must be telling the truth, right? Wrong. “People assume that the world is carefully regulated and that there are benign institutions guarding them from making any kind of errors. A lot of marketing dripfeeds that idea, surreptitiously. So if people see somebody with apparently the right credentials, they think they’re listening to a

respectable medic and trust their advice,” says Ayton. So how can we protect ourselves against frivolous advertising and “health” products? The first step to avoid being suckered in to these marketing ploys is to recognize that there are no quick fixes. The same advice you’ve heard for years still holds true: don’t smoke, exercise regularly, and eat a balanced diet. If you have a specific medical problem or question and you think you’ve heard of a product that can help you, be skeptical and ask your doctor. Your doctor isn’t trying to make money off those products so he/she won’t try to sell you on something that won’t help. When in doubt, ask your doctor. Unless your doctor is Dr. Oz or the person on the TV promoting the product, you’re in safe hands going to him/her for advice.

Dr. Allen Rader, local medical weight loss specialist with Idaho Weight Loss, agrees. “There is no scientific evidence that cleansing helps and, in fact, it can cause harm. Do your home work! Check the ‘SEAM’ (Safety Effective Affordable and Maintainability) of every program or treatment. Ask for numbers. Ask for proof."

March 2015

WELLNESS

Vaccinate to Protect Yourself, Your Family and Community Idaho Immunization Program

s a parent, you may find yourself worrying about your children. You may worry if they are sleeping enough. You may worry if they are eating right. And you may worry about other ways to keep them healthy. To help them get enough sleep, you can encourage them to take naps and go to bed at a reasonable time. To ensure they are eating right, you can give them a variety of nutritious foods. Another way to help keep them healthy is by choosing to vaccinate your children and yourself against preventable diseases. With the recent nationwide measles outbreak and the outbreak of mumps here in Idaho, many parents are asking how they can protect their children from getting these infectious diseases. Diseases like mumps, measles, and other vaccine-preventable diseases have a harder time spreading when people are fully immunized. However, if many otherwise-healthy people are not fully immunized against a disease, the germs can infect them, and then be spread to babies who are too young to be vaccinated and

34 HEALTHY IDAHO

people who cannot be vaccinated because of medical reasons. Infants under the age of one are typically too young to be vaccinated against measles, mumps, and rubella. The measles, mumps and rubella (MMR) vaccine is the best way to protect children against these diseases, but the first dose of MMR is not recommended until ages 12 through 15 months. The second dose is received before kindergarten, at 4 through 6 years of age. The measles virus is highly contagious and can be spread through the air when an infected person coughs or sneezes. Symptoms may include fever, runny nose, cough, red eyes, sore throat, and a rash that spreads all over the body. Measles infection can also lead to secondary illnesses such as pneumonia or sm person-to-person via droplets of saliva or mucus, usually when an infected person coughs, sneezes, or talks. Mumps symptoms may include fever, headache, muscle aches, and swollen or tender salivary glands under the ears on one or both sides of the head.

The most common complication of mumps infection in males who have reached puberty is testicular inflammation, which can lead to infertility. Rare but serious complications include meningitis, inflammation of the ovaries, deafness, and swelling of the brain. As a parent, there are enough things to worry about. Having your child infected with a frightening, yet preventable disease shouldnâ&#x20AC;&#x2122;t be one of them. Review your familyâ&#x20AC;&#x2122;s immunization records with a health care professional to see if anyone is in need of vaccination. Vaccinate to protect yourself and your family, and vaccinate to protect your community, especially those vulnerable members who are too young or unable to protect themselves.

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March 2015

Cancer Screenings:

Pros and Cons The medical world has made tremendous progress in cancer screenings and prevention. It is important for everyone, men and women alike, to understand their risk factors for certain types of cancer, and to be tested appropriately. There are sometimes different screening methods for each type of cancer and risks and benefits associated with each. Here are a few common types of cancer screening for men and women and the pros and cons of each. Please note that this information is not meant to discourage cancer screenings, but simply to provide information and encourage each individual to do their own research and make educated choices.

WOMEN

MEN

1. BREAST CANCER - mammogram

1. PROSTATE CANCER

A. PROS – Much research has found that mammograms do decrease the risk of dying from breast cancer. Several studies have shown a higher survival rate among women over the age of 50 who have regular mammograms. The American Cancer Society’s current recommendation is that women over the age of 40 should have a mammogram every year. B. CON –False positives can occur, and many frequently detected cancers rarely develop into aggressive life-threatening cancers. As a result, many women are over-treated. In addition, a mammogram is ineffective for women with dense breasts or breast implants.

2. CERVICAL CANCER – Pap smear A. PRO – Cervical screening can prevent three in four cervical cancers by early detection and intervention. B. CON – This is one of the more invasive tests and is also known for bearing false positives, where cell changes evident on the test would clear up on their own and not lead to cancer. This can cause unnecessary anxiety and further tests and treatment.

3. OVARIAN CANCER

- Ultrasound and blood test

- PSA screening (Prostate-specific antigen), which is a blood test. A. PRO – PSA screening is used for early detection of prostate cancer. Detecting prostate cancer early significantly improves survival rates. Treatment and patient recovery for prostate cancer is much more successful with early detection. The survival rate has increased dramatically since the invention of PSA screening. B. CON – According to the Mayo Clinic, most prostate cancers are slow-growing, which can mean a few things. Sometimes this means the cancer will never spread or grow enough to be life-threatening. It can also mean that a PSA screening won’t detect it. On the other hand, PSA tests can also give a falsepositive, which leads to unnecessary treatment and all of the corresponding side-effects.

2. COLON CANCER - colonoscopy A. PRO – This is the most sensitive test available, and a biopsy can be done at the time of the exam if any abnormalities are detected. A large, long-term study conducted by the Harvard School of Public Health found that with regular colonoscopies, 40 percent of all colorectal cancers could be prevented. B. CON – A colonoscopy still might miss small cancer or polyps. In addition, diet and medication changes may be necessary prior to the colonoscopy.

3. TESTICULAR CANCER – self-exam

A. PRO – When diagnosed early, ovarian cancer has a 90 to 95 percent survival rate.

A. PRO – A self-exam is easy to perform and is effective at detecting abnormalities and catching any cancer early.

B. CON – A transvaginal ultrasound can frequently produce abnormal results when no problems exist. A blood test measures for the CA-125 protein which is released by the ovaries and would be elevated if cancer was present, but that protein is also frequently released by other normal cells.

B. CON – It can be easy to mistake blood vessels and tissue for irregular bumps or growths, leading to unnecessary appointments or further, more invasive treatments. The best way to ensure an accurate self-exam is to perform one regularly so you are familiar with your own anatomy, so if anything out of the ordinary does appear you’ll notice it immediately.

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March 2015

WELLNESS

E-Cigarettes MAY BE A GATEWAY TO SUBSTANCE ABUSE, RESEARCH SHOWS

IC H A E N BY M W R IT T E

HEALTH PROFESSIONALS CALL FOR REGULATION AND RESEARCH, AND CITIES PASS ANTI E-CIG LEGISLATION Years of research by Denise and Eric Kandel have shown that nicotine may enhance the effects of cocaine and marijuana by lowering inhibition and activating reward signals in the brain. Their studies show that most who start taking cocaine were smoking at the time. The Kandels (Eric is a Nobel Prize winner and Denise is a professor of psychiatry at Columbia University Medical Center) believe that e-cigarettes lead to similar effects on the use of illegal drugs compared to regular cigarettes, even though e-cigs (a.k.a electronic cigarettes) don’t have tar and other harmful byproducts. “Although e-cigarettes eliminate some of the morbidity associated with combustible tobacco, they and related products are pure nicotine-delivery devices,” they write in New England Journal of Medicine, adding that “they pose the same risk of addiction to other drugs and experiences.” The health community and many governing bodies are increasingly suspicious of e-cigarettes, which are lauded by some as a stepping-stone for quitting smoking.

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R L R IC H A

DSON

The suspicion comes from the lack of research and data so far about the effects of electronic cigarettes on health. The American Heart Association (AHA) recently released a statement that called for regulation of e-cigarettes, especially for youth. “Over the last 50 years, 20 million Americans died because of tobacco. We are fiercely committed to preventing the tobacco industry from addicting another generation of smokers,” said Nancy Brown, CEO of the American Heart Association, in the statement. “Recent studies raise concerns that e-cigarettes may be a gateway to traditional tobacco products for the nation’s youth, and could renormalize smoking in our society. These disturbing developments have helped convince the association that e-cigarettes need to be strongly regulated, thoroughly researched and closely monitored.” The AHA called for a ban on e-cigarettes for minors, and for FDA regulation identical to regulation for regular cigarettes. Currently, the FDA doesn’t regulate e-cigs. A study published in Pediatrics found that youth exposure to e-cigarette advertising rose by more than 250 percent from 2011 to 2013. Other research suggests that young people who aren’t interested in traditional smoking may be interested in

trying e-cigarettes. In fact, more high schoolers smoke e-cigarettes than regular cigarettes. There are thousands of flavors, which appeals to younger people. Studies also show that young people consider e-cigs to be “high-tech.” Many e-cigs contain nicotine but not tobacco, and therefore people are using them to wean off regular cigarettes. Data on the effectiveness of this cessation technique is limited. The FDA doesn’t approve of the method, but some studies do show effectiveness similar to nicotine patches. The AHA statement said that using e-cigs to quit smoking should only be used when conventional treatment fails. Many use e-cigs because they’re allowed in places where smoking is banned. But this is changing quickly. New York City recently banned electronic cigarettes in public places, and New Jersey, Utah, Los Angeles and North Dakota are in the same boat. In Chicago, “vaping,” as it is called, is banned in indoor public places. In Toronto, they’re banned for teenagers. Despite the bans, TIME reports that 10 new e-cig companies are coming to market every month. Wells Fargo predicts that e-cigarette sales will hit about $10 billion by 2017. Sources: TIME, thestar.com

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Tablet Habits A HIDDEN SLEEP SIDE EFFECT OF OUR ELECTRONIC DEVICES W RITT E N B Y C A I T L I N S CH I L L E

CCORDING TO A GALLUP POLL, THE AVERAGE AMERICAN SLEEPS 6.8 HOURS PER NIGHT. NOT ONLY IS THIS BELOW THE RECOMMENDED MINIMUM OF SEVEN, BUT IT IS ALSO A SOLID HOUR LESS THAN THE AVERAGE OF THE 1940S. While there are many factors affecting sleep deprivation, one of the hidden culprits is tablet and smart phone use. A study from Brigham and Women’s Hospital and Harvard Medical School detailed the harmful effects that tablet and smart phone use is having on sleep quality and quantity. Using a two week period to monitor participants in a sleep lab, the researchers had some participants read a tablet before bed, and had other participants read a paper book before bed. The participants who were assigned to read a tablet took an average of ten minutes longer to fall asleep, and had less rapid eye movement (REM).

happens to be the light given off by electronics like computers and cell phones, and also by energy efficient bulbs. This light has been shown to delay the release of melatonin which is a sleep inducing hormone.” Lack of sleep impairs cognitive ability, leading to decreased concentration, alertness, and critical thinking skills. Chronic sleep deprivation is linked to many serious health complications, including diabetes, stroke, heart attack, heart failure, and high blood pressure. So, are you feeling busy, tired, and stressed? Put the tablet down and pick up a book.

“Try and keep electronics out of the bedroom, especially those used at close range, for at least an hour before bed,” says Dr. Maya Thomas, a sleep specialist in Murray, UT. “The circadian rhythm is sensitive to light with short wavelengths, particularly blue light in the 460 nanometer range of the electromagnetic spectrum, which

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March 2015

WELLNESS

3. Learn to set healthy boundaries and say the word “no.” Through life coaching you may find that setting healthy boundaries can be a major step in getting unstuck in your life. The word “no” was probably one of the first words you learned as a baby, so why is it so difficult to say now? You need to recognize that your life, your time and your energy belong to you. When you own this simple truth, you recognize that you have the absolute right to say no to people without having to provide an explanation

simplify your life BY DR. GARY STOLLMAN

We often start on projects or set goals and then find ourselves getting detoured or bogged down by other things in our lives. Things that divert our attention can range from a cluttered desk to a problem in our relationship with a significant other. Here are six easy ways to simplify your life so that nothing stands between you and your goals:

1. Set aside time just for you. Put time aside daily just for you. It really doesn't matter how much time as long as you make a concerted effort to set aside some time for yourself. It can be as little as 15 minutes a day if you don't have too much extra time to set aside. It's also important that you "unplug" from the electronic devices that often work as "electronic leashes" during your time out. In other words, turn off your phone, shut down your computer and turn off your PDA. Simply create a brief time and space just for you that you can consider your own without interruption. You may want to pray, read, write in your journal, or just sit in silence. That time is yours to do with what you want.

4. Clear your mind. You need to clear your mind and empty your brain of your internal to-do list and emotional baggage. A life coach can help you verbalize all the things you need to do and the feelings that go along with that. Lighten your mental load by writing down the things that are taking up space in your mind.

2. Steer clear of energy vampires. There are two types of people in the world; those who give to you and those who take away or "drain" you. For some clients, an essential component of my life coaching practice is helping them to eliminate the relationships that tend to drain their energy. If there are people in your life you absolutely need to spend time with, creating life balance may mean taking steps to limit your time with them, especially if they don't contribute to you being your best self. You might also consider setting boundaries around what activities you do with certain people you associate with. Think about who is helping you and who is dragging you down. Who makes you feel supported and energized? Who is eating up your time and energy and giving nothing in return? Hang on to people who add value to your life and avoid people who are toxic.

40 HEALTHY IDAHO

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5. Drop the emotional baggage. It is important to work on achieving a sense of closure on the past and on relationships that have weighed you down. In order to move forward in life you may have to forgive those who have hurt you. The resentment you feel only weighs you down and stops you from achieving your goals. A qualified life coach can help you to strategize ways for you to do this. For example, you might decide to call that person up or write them a letter â&#x20AC;&#x201D; just do whatever it takes to help you let go of a negative situation from the past. Why continue to rob yourself of tomorrow by being stuck in yesterday?

6. Clear your environment of clutter. A big part of simplifying your life is de-cluttering your environment. Start with a small area like a junk drawer or a small portion of your work desk. You can move on to other spaces once you have taken an initial step. A clean and clutter-free home or office or car will give you one less thing on your to-do list, thus, one less thing to stress out about. When your environment is free of unnecessary distractions, you may find that your thinking becomes clearer and your ability to concentrate dramatically improves.

Dr. Gary Stollman is a professional life coach and psychotherapist. He has helped thousands of people improve upon their lives and their relationships. He offers a free 15-minute consultation for first time callers. For more information, visit the Web site www.talkwithdrgary.com/coaching.html.

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March 2015

Recipes

Japanese Ginger ‘Noodle’ Bowls This aromatic one-bowl dinner features a classic combination of Japanese flavors, but the spicy, gingerinfused sauce is what sets the dish apart.

Makes 4 servings 1 2 tbsp 1 tbsp 11⁄2 cups 1⁄4 cup 2 tsp 2 cups 8 oz 1 tbsp 1⁄4 cup 1.

spaghetti squash (about 2 lbs) minced gingerroot coconut sugar coconut water liquid coconut amino acids Asian chile-garlic sauce thinly sliced onions firm or extra-firm tofu, cut into 1⁄2-inch cubes virgin coconut oil Fine sea salt and freshly ground black pepper thinly sliced green onions

Pierce squash all over with a fork. Place on a paper towel in the microwave. Microwave on Medium-High (70%) for 13 to 15 minutes or until soft. Let cool for 5 to 10 minutes. Meanwhile, in a small saucepan, whisk together ginger, coconut sugar, coconut water, amino acids and chile-garlic sauce. Bring to a boil over medium-high heat. Add onions, reduce heat and simmer, stirring occasionally, for 5 to 7 minutes or until softened. Add tofu and cook, stirring, for 1 to 2 minutes or until heated through. Cut squash in half, remove seeds and scoop out pulp. Transfer pulp to a bowl and, using a fork, rake into strands. Add coconut oil and toss to coat. Season to taste with salt and pepper. Divide squash among four bowls and top with tofu mixture. Sprinkle with green onions.

TIPS •

The spaghetti squash can also be prepared in the oven. Preheat oven to 325°F and lightly spray a small rimmed baking sheet with nonstick cooking spray (preferably olive oil). Cut squash in half lengthwise and remove seeds. Place squash, cut side down, on prepared baking sheet and bake for 35 to 40 minutes or until a knife is easily inserted. Let cool for 5 to 10 minutes, then scoop out pulp and continue with step 3.

•

An equal amount of gluten-free soy sauce can be used in place of the liquid amino acids.

42 HEALTHY IDAHO

Courtesy of The Complete Coconut Cookbook by Camilla V Saulsbury, 2014 © www.robertrose.ca Reprinted with publisher permission. Available where books are sold.

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Recipes

Nonna’s Mini-Meatball Soup (kid-fav) This soup reminds of the one I’m served when I visit my friend Maria’s house. Her mother always has a pot of soup on the stove, or if she doesn’t, she will quickly make one for you with whatever ingredients she has on hand. You’ll need: Minimum 5-quart slow cooker

Makes 6 to 8 servings 1 lb 1 lb 1 cup 1 cup 2 1 1⁄2 tsp 1⁄2 tsp 6 cups 2 cups

lean ground beef lean ground pork finely grated Parmesan cheese fine dry Italian bread crumbs eggs, lightly beaten bunch flat-leaf (Italian) parsley, finely chopped (about 1 cup) salt freshly ground black pepper chicken broth packed baby spinach, coarsely chopped,

or chopped escarole 2 cups cooked small pasta, such as elbows, tubetti, shells or stars Freshly grated Parmesan cheese (optional) 1.

2. 3. 4.

In a large bowl, combine beef, pork, Parmesan, bread crumbs, eggs, parsley, salt and pepper. Using your hands, roll into 3⁄4inch (2 cm) meatballs. Place meatballs in slow cooker stoneware. Gently pour in broth. Cover and cook on Low for 8 to 9 hours or on High for 41⁄2 to 5 hours, until soup is bubbling and meatballs are cooked through. Stir in spinach. Cover and cook on High for 10 to 15 minutes or until greens are wilted, bright green and tender. Stir in cooked pasta. Ladle into bowls and sprinkle with additional Parmesan, if desired.

Tip

If you don’t have homemade chicken stock, use ready-to-use chicken broth. I like to keep 32oz Tetra Paks of broth on hand, especially the sodium-reduced variety. They come in handy when you’re making soups and stews. Another option is to use three 10-oz cans of broth and add enough water to make 6 cups. Avoid broth cubes and powders, which tend to be salty.

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Courtesy of Easy Everyday Slow Cooker Recipes by Donna-Marie Pye, 2014 © www.robertrose.ca Reprinted with publisher permission. Available where books are sold.

March 2015

FOOD

eat right for your workout

Are you stumped about if, when and what you should eat before and after exercise? If your answer is “yes”, you’re not alone. This is one of the most common questions that I receive from my clients. While it is no secret that nutrition is paramount to workout results, the “particulars” seem to elude the most ardent exercise fans.

Here are the basic, albeit, crucial guidelines: Before, during and after: • Hydrate! Hydrate! Hydrate!

Before: • Eat a light snack to give your muscles fuel. This can be a small serving of fruit or oatmeal.

After: This is your “window of opportunity” to maximize your muscle gains and replenish your energy stores. During this “window”, your body will act like a nutrient sponge to increase protein synthesis (needed for muscle building) and glycogen replenishment (needed for additional carbohydrate energy). Do it within an hour of your exercise session.

BY B ROOKE KITTEL

Specifically follow these guidelines: • Combine carbohydrates and protein (i.e., a well-balanced nutrition shake or a turkey sandwich on whole wheat tortilla/bread) • Incorporate 0.8 grams of carbohydrates per 1 kilogram (kgs.) of body weight to restore glycogen stores/speed up muscle carbohydrate replenishment. A 110 pound woman = 50 kgs. (Carbohydrate requirement would be 40 grams of carbohydrates). * • Add 0 .2 grams to 0.4 grams of protein per 1 kgs. of body weight. A 154 pound male = 70 kgs. (Protein requirement would be 14-28 grams of protein).*

Feeding the body is just as important as moving the body. Feeding correctly, with proper timing, will provide you with maximal recovery results. Good luck and “cheers” to good eating in 2010!

About the author: Brooke Kittel is a Personal Fitness Trainer at the Treehouse Athletic Club.

*The formula for kilogram to pound conversion is: lbs / 2.2 = kilograms

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Contact Rehab Systems for a free consultation on the latest O&P techniques and technologies. Boise: 7446 West Lemhi 208.342.4104

Twin Falls: 542 Addison Ave. West 208.736.7330

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Keep comfortable and warm with help from Idaho Power’s Weatherization Solutions program. Weatherization improvements are provided at no cost to eligible customers who own or rent an electrically heated home. Upgrades may include: • Additional insulation • Reduction in air leakage • Duct sealing • Furnace efficiency improvements

Enjoy Time Spent in Your Home Program continuation, eligibility requirements and terms and conditions apply.

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For more information, call a contractor in your county:

Energy Zone, LLC (208) 459-0066 Adams, Boise, Canyon, Gem, Payette, Valley, Idaho, Washington Power Savers (208) 377-0700 Ada, Elmore, Owyhee

Learn more: idahopower.com/weatherizationsolutions

March 2015

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801-369-6139 stardocs.com March 2015

“And up next in the bobsled event...” Maybe this is a good time to mention our shorter ER wait times. Why rush to the ER only to wait around to be seen? Our Triage Express Service and board-certified physicians are here 24/7 to ensure better, faster care when you need it.

Text “ER” to 23000 for wait-time updates. westvalleyER.com 48 HEALTHY IDAHO

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