Hole health

Hole Health

May 4, 2016

A special supplement to the Jackson Hole News&Guide

10 0 years of

health care cture to a From a log stru t. John’s S medical center, erve the s has evolved to page 4. e e community. S

Dick Sebold’s picture maps of Jackson and Jackson Hole, published in the summer editions of the Jackson Hole Guide in the 1960s, included such landmarks as the Silver Spur Cafe, the post office and St. John’s Hospital.

St. John’s Community Health Fair • 9 a.m. to 1 p.m. Saturday, May 7 • See story on page 15.

New tech for breast health

Starting midsummer, 3-D mammograms will provide St. John’s doctors, patients better screening capabilities. See page 10.

Listen up

Children’s hearing tests begin in St. John’s new audiology booth, an update from the old facility. See page 12.

Quiet the mind

Meditation techniques tame the mind for better mental, physical and spiritual health.

See page 16.

2 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016

Contents

Women’s Health

& Family Care

Obstetrics & Gynecology Family Care Including Pediatrics

We take care of your entire family!

S. Douglas George, M.D.

Obstetrics & Gynecology, Board Certified

Laura M. Vignaroli, M.D. Family Medicine, Board Certified

• Obstetrics • Gynecology • Menopausal Consults • Pediatric Well Care & Immunizations • Adolescent Health Care • Infertility • Preventative Health Care for the entire family

Giovannina M. Anthony, M.D. Obstetrics & Gynecology, Board Certified

Kathryn Noyes, M.D.

Family Medicine, Board Certified

• Acute Care visits • Sports Physicals • Men's Health • Behavioral Health (ie: ADHD, Depression, Anxiety) • Minimally Invasive Surgery • Chronic Disease Management • Doctor Supervised Weight Loss Program

Local surgeons tap into the emerging field of 3-D printing for shorter surgeries and custom repairs

4

St. John’s Medical Center celebrates 100 years of health care in Jackson Hole

5

Frontier doctor Charles Huff treated Jackson’s Spanish influenza outbreak while sick himself

7

Remembering Doc MacLeod, one of Jackson’s first physicians

8

Ultra athletes train their bodies and minds to go the distance

9

Experts continue to gain insight on Zika and what it means for travelers and pregnant women

10

3-D mammography gives doctors better diagnostic capabilities

12

St. John’s hearing tests get a boost with a new audiology booth

14

Board of Public Health pushes for more prescription drop-off locations

15

Health Fair features booths, demonstrations and screenings

16

Age-old mindfulness techniques promote mind and body wellness

Special supplement written, produced and printed by the Jackson Hole News&Guide

Please call 734-1313 for an appointment WOMEN’S HEALTH & FAMILY CARE

Publisher: Kevin Olson Associate Publisher: Adam Meyer

555 E. Broadway, Suite 108

www.womenshealthandfamilycare.com

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Teton Pinky Promise Breast cancer screening rates are an important indicator of women’s health in our communities. Wyoming and Idaho rank lowest in the country. St. John’s Medical Center and five regional health partners developed Teton Pinky Promise to improve screening rates.

Editor: John R. Moses Deputy Editors: Richard Anderson, Johanna Love Hole Health Section Editor: Melissa Cassutt Layout and Design: Kathryn Holloway Photographers: Bradly J. Boner, Ryan Dorgan, Ryan Jones Copy Editors: Jennifer Dorsey, Mark Huffman, Erika Dahlby Features: Richard Anderson, Emma Breysse, Melissa Cassutt, Erika Dahlby, Clark Forster, Mike Koshmrl, Frances Moody, John Moses Advertising Sales: Andra Adamson Foster, Karen Brennan, Matt Cardis, Tom Hall, Chad Repinski Advertising Coordinator: Oliver O’Connor Creative Services Manager: Lydia Redzich Advertising Design: Natalie Connell, Sarah Grengg, Jenna Mahaffie Pre-press: Jeff Young Pressmen: Dale Fjeldsted, Johnathan Leyva, Steve Livingston Office Manager: Kathleen Godines Customer Service Managers: Lucia Perez, Rudy Perez Circulation: Kyra Griffin, Hank Smith, Jeff Young, Georgi McCarthy ©2016 Teton Media Works Jackson Hole News&Guide P.O. Box 7445, 1225 Maple Way Jackson, WY 83002 , 307-733-2047 Fax: 307-733-2138, www.jhnewsandguide.com

WHITNEY E. FESSLER, MSAc, LAc, DiplAc

Visit www.TetonPinkyPromise.com to pledge to

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a talk to your health care provider about your risk for breast cancer a make an appointment for recommended screenings #GoPinkJH

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HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016 - 3

RYAN JONES /NEWS&GUIDE PHOTOS

Williams fits a piece of Hutchison’s hip bone into a 3-D printed model to ensure proper fit.

3-D models guide surgeons

Surgeons use 3-D printing as a way to streamline a complicated repair.

By Melissa Cassutt

I

t may seem simple or silly, but Mary Hutchison is most looking forward to being able to fix her hair again.

It’s a task she hasn’t been able to handle since September, when she broke her right wrist after falling from a step stool in her Riverton home. Before the cast even came off, she knew something was wrong.

When the plaster was cut, her suspicion was confirmed: Her wrist had healed at an unnatural angle, placing undue stress on a tendon in her thumb.

After months of strain the tissue eventually snapped and she lost the ability to fold her thumb into her palm.

For months her hand has been almost entirely unusable.

Her husband, Randy, has been doing his best to help out — he cooks, he cleans, he clasps her jewelry. He visited with her stylist to learn the right curling technique for her ’do.

But nothing compares to using her own two hands.

And in just a few weeks, she’s expected to be able to do just that.

In late March Hutchison underwent surgery that used 3-D printing, an emerging technology for the medical field that local orthopaedic surgeons say streamlines procedures, resulting in shorter anesthesia times and anatomically correct repairs.

It starts with a computerized tomography scan taken of both wrists that serve as templates for what become physical models, “printed” by the additive manufacturing company

The tendon to Mary Hutchison’s thumb is sutured during a March operation with a piece removed by Dr. Rafael Williams from a nearby tendon.

Williams working inside the wrist.

Materialise.

The left wrist — her healthy bone — becomes a customized model for surgeons to replicate when they go in to fix the right one. Doctors also receive models of a repaired version of her bad wrist, showing them exactly where to cut and realign.

“The beauty of doing it the way we did is it makes the procedure more predictable and more precise,” said Dr. Rafael Williams, an orthopaedic surgeon at Teton Orthopaedics, “which gives her a better long-term outcome.”

In the operating room the team of surgeons, anesthesiologists, nurses and techs bustles about, covering Hutchison in blue drapes and unpacking surgical packs. It’s expected to be a short surgery — well, shorter than if the doctors didn’t have a 3-D-printed model to work from.

The models give Williams and his colleague, Dr. Heidi Jost, a road map for the repair, laying out the bulk of the procedure before they open the skin. And while there is still a struggle to align all the moving parts into a normally situated wrist, having a model to mirror and guides to show where to drill for the plate saves the team an enormous amount of time in

A shorter surgery Early in the morning of March 23, Hutchison is tucked in a hospital bed

at St. John’s Medical Center. A catheter has been placed in her left arm, and black ink scribbled on her right palm, marking the spot where her hand will be filleted open and fixed.

She’s 71 years old, and is not afraid.

If anything, she’s excited.

“A person doesn’t realize how much they use that thumb,” she says.

The surgery is complicated, and has a lot of moving parts — literally. A chunk of bone will be chipped out of her left hip and grafted into her right wrist, which will be sawed apart, realigned and held together with a metal plate. Her shredded tendon will be sutured back together with a graft from a nearby slice of tendon.

See printing on 18

4 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016

100 years of health care

From a log structure to a medical center, St. John’s has evolved to serve the community.

By John R. Moses

O

utgoing St. John’s Medical Center CEO Dr. Lou Hochheiser is in a unique position to look forward as well as back at the hospital’s achievements and its future.

In practice 30 years ago, he remembers the technology and knowledge base doctors then had to work with.

Having ushered St. John’s through its most recent expansion, he sees a road map for future improvements, especially in custom-tailored medical treatments and how the hospital fits into the community.

But mostly he sees a cherished past and a bright future for a medical center that caters to a diverse array of residents and tourists, some of whom arrive by chopper after serious accidents in the great outdoors.

The hospital’s founders were a tough and dedicated bunch that did the seemingly impossible: raise a log structure amid the dust and sage and turn it into a facility that 1920s and 1930s medical journals gave high marks to for cleanliness and professionalism.

“It’s pretty unique,” Hochheiser said, “and it has been the doctors and the commitment of the church.”

Gathering logs and supplies In 1958 the Jackson Hole Guide ran Elizabeth Weid Hayden’s poetic account of the fateful day when St. John’s Episcopal Church rector the Rev. Royal H. Balcom is said to have told newspaperman Dick Winger of Jackson’s Hole Courier, “‘Let’s build a hospital without delay!’

“Dick, not a fellow to be taken aback,

Stephen N. Leek / American HeritAGE

An American Legion escort arrives at St. John’s Episcopal Church and hospital on June 17, 1921, with the casket of Curtis Ferrin, who was killed overseas in World War I. This photo was taken several years after the hospital opened.

yelled, ‘You’re on,’ and at once got on track.”

(Winger actually said, “I’m with you, come in,” according to his own account.)

Jackson’s first full-time physician, Dr. Charles Huff, and the good reverend agreed that a hospital was needed, and the church took on the project.

The Jackson Hole Historical Society and Museum Chronicle newsletter of fall 2008 described the hospital’s founding.

The article said “members of the Men’s Club met in the pool hall of the Hostel

and decided that a church and hospital needed to be built. Jackson’s first and only doctor, Dr. Charles W. Huff, needed a place to work. The hat passed and T.W. Lloyd, a local businessman, announced he would donate one city lot and sell a second for half price — $87.50!

“Three days later volunteers felled logs up Cache Creek to begin construction.”

The need was dire. The nearest hospital was two days away via a horse team and wagon, then a sled over Teton Pass.

The Episcopalians, Baptists and Mormons and those of other faiths gave equally, according to a 1977 article in the Guide.

The St. John’s Hospital Association was born, and at $5 a member the roster saw husbands and wives joining separately to double family contributions.

The association had 140 members in its first year.

Two people took care of patients when the five-bed hospital opened, acSee st. john’s on 5

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HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016 - 5

100 YEARS

Dr. Huff ministered to Jackson for nearly 25 years

Continued from 4

cording to the Guide’s 1958 article. By contrast, the hospital now employs more than 650 people.

While locals provided the volunteer work crews, summer residents and donors from outside the valley provided the construction equipment, according to the Guide’s 1977 account.

In 1927 the hospital added a wing to meet growing demand. Another wing was added in the mid-1930s so the hospital could accommodate 28 beds and eight bassinets.

Today its website lists 108 beds: 48 acute care or primary care beds and 60 long-term care beds in the St. John’s Living Center.

While the founders thought there would be few surgeries in the hospital (Dr. Huff’s first surgery in Jackson took place successfully on a kitchen table) more than 20 operations were done in the first few months, according to a 1977 article in the Guide.

The hospital’s website says that in fiscal year 2015 the hospital performed 2,793 surgeries.

The modern St. John’s Medical Center campus is a far cry from the hospital’s humble roots, but even those roots raised a facility that in its day was considered a beacon in the wilderness.

Good old days, rough old days Back in the 1950s Jackson had hotels, restaurants and even some gambling in the catacombs beneath the Wort Hotel.

Promotional materials from Crystal Springs Ranch soothed the fears of parents by telling them their girls would learn to ride horses and enjoy hayrides at the dude ranch, and a small but “well-equipped” hospital was only 12 miles away.

That brochure was printed in 1958, when many in the community were working hard at raising funds to build a modern facility for Teton County and the region. The wooden hospital’s facili-

He gave aid through the 1918-19 Spanish Flu epidemic, even though he suffered himself. ‌

By Richard Anderson The influenza pandemic of 1918-19 killed 50 million people or more worldwide. In Jackson Hole it hit just before Christmas, with “quite a number of cases” reported the Dec. 19, 1918, edition of Jackson’s Hole Courier, “but at this writing there are no very critical cases.”

A week later the banner headline was “Influenza Sweeping the Valley.”

The paper reported that influenza had spread to every part of Jackson Hole. The January 1919 edition of the Journal of the American Medical Association reported 300 cases by Jan. 1 with five deaths on Dec. 31 alone.

Among the afflicted was Dr. Charles Huff, the community’s only physician. Nevertheless, Huff continued to keep tabs on patients throughout his own sickness and even left his home “to personally attend to the most urgent cases.”

There were medical men and women in Jackson Hole before Dr. Huff. Pioneer midwives delivered much more than babies. In an online historic resource study Grand Teton National Park alluded to a Dr. Woodburn, who was said to have practiced here as early 1894, as well as a Dr. Luther Palmer, who was listed in the 1900 census and treated patients during a 1902 diphtheria epidemic.

But in 1913, when Huff came to Jackson Hole, just 24 years old and recently graduated from the University of Maryland, there was no practicing physician here.

Invited by the Episcopal bishop of Wyoming to set up practice in Jackson, he accepted, because the Western climate had been recommended to him as a treatment for symptoms of tuberculosis. His wife, Edna, a nurse, came with him.

“Stories abound of his exceptional service as a physician,” the document nominating Jackson’s Huff Memorial Library for the Register of Historic Places states, “including one description that summarizes his medical service as ‘almost 25 years of constant day-andnight practice, ministering to the sick, closing the eyes of the dead, ushering in new lives. By horse-and-buggy,

by automobile, on skis or snowshoes, on horseback, by sled, and of foot, he called on the homes in the valley, and was to all the beloved “country doctor” as well as the skillful surgeon.’ ” Aside from such medical heroism, Huff also became active in Jackson’s civic life. He was part of the board that helped run the valley’s first library, which in 1915 was established in St. John’s Church. Nearly immediately upon his arrival he set to work planning and even helping to build St. John’s Hospital, which was built and dedicated in 1916, also as part of the church.

He served as mayor of Jackson from 1929 to 1938. During that time he oversaw the creation of a clean water supply for the municipality, led the county Civil Works Administration, which turned the dump in the middle of town into George Washington Memorial Park, aka Town Square, and held many other offices.

But Huff ’s busy, proTOWN OF JACKSON / COURTESY PHOTO Dr. Charles Huff ductive career was cut short. In September 1937 he died at the age of 49. His funeral “was without doubt the largest ever held in Jackson Hole,” the Courier reported, and the Town Council and city employees followed the hearse to the city limits.

While much about the individual has faded with history, the name Huff lives on throughout town. In addition to the handsome log building on South King Street that once was the Huff Memorial Library (it now houses several government offices), there’s Huff Lane, which runs behind MovieWorks, and the Huff House, a bed and breakfast near Jackson Elementary School that was his home. One of his sons, Charles W. Huff II, also became a doctor, honing his surgical skills in a MASH unit during the Korean War and later practicing in Casper. He died in 2015 at the age of 89 in Kalispell, Montana.

Contact Richard Anderson by calling 732-7078 or emailing rich@jhnewsandguide.com.

See st. john’s on 6

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Nationally, 30% of prisoners don’t commit new crimes after release.

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6 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016

st. john’s

St. John’s Facts

Continued from 5

ties, by then 42 years old, were simply worn out.

The automobile forever changed the valley and its medical needs.

Back to the poem: “… but cars bigger grown brought in thousands of tourists, all accidentprone. And old St. John’s was to set many a bone.”

Not poetic were reports from the Joint Committee for the Accreditation of Hospitals, whose Dr. Peter Ward, of Chicago, deemed the wooden hospital and its additions a fire hazard in the late 1950s.

A multiyear commitment was sought between 1958 and 1960 for annual donations to a building fund. In the end the town had a fire-resistant and modern-looking hospital when the facility moved to its current home on East Broadway, next to the National Elk Refuge.

The new campuses St. John’s became the Teton County Hospital District in 1976 and changed its name to St. John’s Medical Center to reflect the expanded level of services it offers. It has an elected board of trustees. The hospital was no longer connected to the Episcopal Church by then but kept the St. John’s name.

Beds: 48 acute and primary care beds plus 60 long-term care beds in the Living Center Surgeries in FY 2015: 2,793 Employees: 650 Babies delivered in FY 2015: 467 People admitted in FY 2015: 1,847 Source: St. John’s Medical Center website

COURTESY PHOTO

Privacy curtains were available in the hospital’s patient rooms, which had plenty of room for visitors, as seen in this undated photo.

The current campus was built in 1991 and underwent a large renovation in 2005 to add beds. The hospital that had opened in 1960 became professional offices.

It wasn’t until 2014 that the ever-expanding hospital dusted off its newest additions, including a birthing center. It has “six new labor, delivery and recov-

Centennial Celebration The St. John’s Hospital Foundation secured bluegrass band The SteelDrivers to headline a community celebration honoring the hospital’s 100th anniversary in July.

The free event kicks off with the Hootenanny Allstars, featuring several members of the Jackson Hole Hootenanny, followed by Brent Moyer and Friends with special guest, Nashville artist Mike Dowling. The Grammy Award winning SteelDrivers will close the concert.

The celebration kicks off at 4 p.m. on July 31 at the Snow King Ball Field.

Food trucks and beverage vendors will be on site, alongside the Jackson Hole Public Art mobile studio. Kid-friendly activities, giveaways and tips for healthy living will also be available.

ery rooms; the Oncology Pavilion with six infusion bays and two private exam and treatment rooms; and three new surgical suites featuring state-of-theart integrated operating room technology and equipment,” the website says.

Reaching out As CEO, Hochheiser has seen changes in the physical plant, but it’s the changes in attitude, he said, that are also making a difference.

“The reason we’re getting stronger relates to us starting to focus not on ourselves but on the needs of the patients,” he said.

The hospital focuses on outreach and groups to manage such conditions as diabetes, and it annually holds a large health fair.

Meeting — and identifying — those community needs has always been the tricky part. Back in 1958 articles noted the influx of summer tourists and the impact on St. John’s.

Today, Hochheiser said, the patients

include seasonal workers and seasonal residents, folks who may not (though they should) have a local doctor but still need medical care.

Not only Teton County residents and visitors use the hospital.

“Twenty percent of our patients in the hospital are from Sublette County,” Hochheiser said, with a lesser number from Fremont County.

That makes St. John’s a rather specialized part of the region’s health care system, because not every service is the right fit or will serve enough patients to be financially prudent.

Also, specialists need to see enough patients to keep their skills sharp, Hochheiser said.

“Radiation treatment has changed pretty dramatically,” he said, as have other treatments for cancer.

While people must travel to get radiation treatments now, Hochheiser said the future of cancer treatment seems to be moving into individualized treatments and drugs targeting specific cancers.

“It’s amazing what’s going to happen,” he said.

But in the meantime, one thing that did make sense was to bring in an advanced mammography machine.

“That’s something where we can screen in a better way,” he said.

Another role the hospital often plays is stabilizing patients who need major surgery or specialized procedures for transport to larger Idaho or Utah hosSee st. john’s on 7

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HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016 - 7

Jackson’s second physician was ‘next to God’ for residents

By Emma Breysse For years popular wisdom in Jackson Hole put Dr. Donald “Doc” MacLeod “next to God.” The year before MacLeod’s death in 1983, the Wyoming Academy of Family Practitioners put his name on a plaque as the recipient of its first award for family practice service.

During those years the valley’s second full-time physician was all over the valley, delivering more than 2,500 babies, driving a horse-drawn sleigh to rescue patients and, in the early years, occasionally pinch-hitting as the area’s only veterinarian.

“I’ve had a lot of interesting cases. ... I’ve had a lot of fun, too,” the Jackson Hole Guide reported him saying when he received his award.

MacLeod literally fell into medicine after a broken leg from a horseback riding fall in Colorado ended his early career in forestry. Without antibiotics he spent a year on crutches and feared he was no longer physically capable of his first choice of work.

So he attended and graduated from the University of Colorado School of Medicine and set up shop in Sheridan. He stayed there for only three years, but that was long enough to be the first Wyoming doctor to use antibiotics in 1936.

A year later a friend convinced MacLeod to pack up his wife and kids and practice in a tiny log cabin in Jackson Hole.

The valley’s first doctor and a major architect of St. John’s Hospital, Dr. Charles Huff, had recently died of tuberculosis, and the community needed a replacement.

MacLeod stayed for 40 years, then spent another 20 years running a guest ranch in the summers, enough time for most of the valley’s residents in those days to have at least one “Doc” story.

In Gap Pucci’s 2015 collection of Jackson Hole tales, MacLeod features prominently for his unorthodox problem-solving.

As the story in Pucci’s book goes, MacLeod and a friend went out to help a hunter who broke his leg while out in the woods. Before taking him down they had to put out a large fire with no dirt or water.

st. john’s Continued from 6

pitals.

“That’s another piece of what we do,” Hochheiser said. “Get people to the place where they can get the treatment they need.”

He recalled a time when a visitor, away from his doctor, experienced a re-

JACKSON HOLE WOMEN’S CARE Mary E. Girling, MD, OB/GYN

Gynecologic and obstetric care by a single physician

EMROY ANDERSON / NEWS&GUIDE FILE

This is Dr. Donald “Doc” MacLeod in 1977.

The book says MacLeod suggested that the group “start peeing.”

In early days he was the region’s only doctor, and he covered the medical needs for families and pets throughout the area.

MacLeod eventually hung up his veterinarian’s hat after the valley attracted a full-time vet, but he kept serving as a country doctor until the early 1960s.

MacLeod made it into most areas of valley life between attending the sick, wounded and pregnant.

He served as a “pillar” of the Jackson Hole Mountain Resort Ski Patrol in its early days, according to a fellow patroller quoted in Jackson Hole Skier magazine.

He helped to organize what was then the Teton Historical Society, and in later life he was a staunch advocate for conservation and public lands.

When MacLeod remarried it was to longtime friend Louise “Weezy” Murie, a member of the well-known conservation family, and he believed just as strongly in the need to preserve Wyoming’s open spaces.

He served as a repository of information on the valley’s history, featuring prominently on St. John’s Medical Center’s 100th anniversary website with his many stories of the area.

Historian Jack Daugherty, author of “A Place Called Jackson Hole,” noted MacLeod was a trusted friend to the entire valley.

“Dr. Don MacLeod was the country doctor in the valley from the 1930s until his retirement in the 1960s,” he wrote. “I know of no one who knew the people of this valley during that period better than MacLeod.”

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Contact Emma Breysse at 732-7066 or courts@jhnewsandguide.com. curring heart condition that was recognized by doctors at St. John’s.

They didn’t do the procedure he needed here, but a helicopter ride to a major medical center literally saved the day.

“It’s one time when the little rural hospital helped,” Hochheiser said.

Contact John R. Moses at 732-7063 or john@jhnewsandguide.com.

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8 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016

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Endurance athletes train their bodies and minds for the journey.

By Clark Forster

T

his valley boasts some of the strongest endurance athletes the world has to offer. Once you’ve lived here long enough, someone could tell you he ran to the moon and back and you might believe him.

The athletes this valley has bred and welcomed push their bodies and their minds further than most can fathom. But how do they get to that point? What drives them to develop and maintain a lifestyle comparable to world-class professional athletes?

For ultra runner Michael Evans it’s about the satisfaction of putting in long hours of work to achieve something extraordinary, all while making every other task in his life seem like no matter at all.

“The first time I did 100 [miles] I based everything on that,” Evans said.

“After you’ve done that once, and it only takes once, you base everything, the level of difficulty, on that.”

Chores, work, errands — none of those seem like obstacles to Evans. He has put his body and mind through some of the most physically demanding feats he could conjure.

Most recently Evans and three fellow athletes traveled to Chile to compete in the Patagonia Expedition Race. The event pitted the foursome against land, water and roughly 700 kilometers (373 miles) of terrain to hike, bike and paddle through.

Only four of the 18 teams finished.

Evans’ wasn’t among them. One of his teammates became severely dehydrated on the second day, and the team was forced to bow out.

They knew going every other day without sleep while trying to navigate their way through 60 mph winds, constant rainfall, jagged mountains and rivers and lakes would be tough.

That’s what they signed up for.

“You’re going to come back a completely different person,” Evans said.

“You’re going to be so mentally and physically broken down. That’s just how it is. That’s why we do it.”

Evans and his crew will attempt the journey again next year.

But events such as the one in Patagonia aren’t simply objectives spread across a calendar. They are all part of the lifestyle that comes with being an endurance athlete.

“I specifically set out a job a couple years ago that allows me to train all day long and go work at night,” Evans said.

By night he is a custodian at the high school. By day he is an intense athlete working out multiple times

during the day to get his body where it needs to be to dominate.

Another endurance athlete, Katie Steinberg, doesn’t have the demanding schedule Evans does. But the ultra runner still must sacrifice to get her body where it needs to be to compete in 50-mile races.

“I think the hardest part with your health is the time it takes,” Steinberg said. “The time it takes away from family, friends, from going out. It’s about making sure you’re doing the things so that you can actually perform at a high level.”

Such as taking breaks.

“The hardest thing to do is to taper and rest,” Steinberg said. “The benefits, that high you get, the productivity you get, the good feeling your body has ... it’s really hard to take that away when you’re used to that.”

Therein lies the balance.

Evans said he almost got sick of running because of how often he did it. He eventually had to hit the pause button on running while keeping his body in shape in other ways. Just so he could continue to do what he loves in the future.

Steinberg balances by taking winters off. She stays in shape through long treks on her skis, so when February and March roll around she’s ready to tie on the running shoes again.

Once your body is used to that base, she said, it’s a lot easier to “jump into your shoes and run 15 miles. The more your body gets used to longerdistance running the easier it is to jump back into it after taking time off or switching sports.”

Evans and Steinberg say they go to great lengths to keep their bodies healthy after something as demanding as a 50-mile run. Yoga, a good diet, recovery runs, sleep and more sleep are some of their methods.

But no matter how good one’s body feels, it will often tell the brain it’s time to give up. So they train that as well.

“As an endurance athlete you have to learn how to push through,” Steinberg said, “and how to put away the million excuses you come up with and know that the hardest part is getting over that mental aspect of being out there for a long time.”

Steinberg often trains when tired to create the feeling of pushing through that mental wall. Evans reminisces about his first 100-mile race when he was tired, and he knows from experience that he will push through.

And the rewards can be anything from a beer to a simply a good night’s sleep.

“It’s similar to any sort of uncomfortable situation,” Steinberg said. “Everything is more enjoyable afterwards.”

Contact Clark Forster at 732-7065 or sports@jhnewsandguide.com.

Zika news is bad, keeps changing

By Mark Huffman

B

y the time you read this some of it might have changed.

That’s because it’s about Zika, a disease that few had heard of just a few months ago and that, as it has come into public consciousness, has been changing regularly and rapidly.

Zika has gone from a medical book footnote to newspaper front pages.

The reaction has been alarming.

“It’s a scary time, but eventually we figure these things out,” said Dr. Travis Riddell, a Jackson physician who serves as Teton County public health officer. “Before we understand these things there’s always a period of uncertainty that adds to the scariness of the situation. ... We are in that phase.”

One thing scientists can say for certain is that Zika’s spread is new and sudden, much is unknown, and that means fear. The disease “has the potential to be a major global health disaster,” Riddell said.

Though there’s no evidence that the particular mosquitoes that carry the disease have arrived in Wyoming, Riddell said, Jacksonites could be worried because they travel so much. It’s not just a matter of the disease coming here but of people here going to where the disease already is.

“We live in a much more globalized society where things such as this can travel much more rapidly because of people moving around,” he said.

Like many “new” diseases, Zika has been around. But then — for reasons that remain murky — the disease that has existed in one place suddenly finds its way to a broader population. When that broader population is a Western population with instant communication, the reaction is usually that the disease has come from nowhere.

Not out of nowhere Zika, though, didn’t come from nowhere, but from Africa, the world’s never-ending source of exotically unpleasant pestilences. Zika was known in the jungles of Uganda by the 1950s, spread to southern Asia and arrived in Brazil in 2015.

Public reaction has been heightened because of Zika’s effects. Those who catch the disease — spread mostly through two species of mosquitoes though there’s recent evidence of sexual contagion — most often feel nothing and suffer no symptoms. Others might have a fever and a rash, sometimes sore joints and eyes. Nothing

anyone would worry about.

Unfortunately, that’s not the end of it. Zika has now been confirmed to almost certainly cause mircocephaly, an ornate Latin word for “small head.”

Pregnant women who catch Zika can give birth to babies with the condition, characterized by underdeveloped brains that mean the child will suffer neurological deficits and never develop normally. The thousands of cases in Brazil since Zika was identified in the country compare with hundreds before the disease arrived.

Connecting a disease to an outcome is complicated, Riddell said, and “there’s a whole science of determining causation: How do you know that X causes Y?” But studies in recent months have eliminated most of the doubt: “There’s been a lot of active research going on with that, and the evidence for a link between Zika and brain anomalies has gotten much stronger,” Riddell said.

Chilly weather a plus The United States — as usual — has advantages over less-developed countries in handling disease. One is natural: Unless the disease jumps to mosquitoes better suited to our weather, much of the United States is too cold for Zika to spread by bug bites.

There’s also a public health advantage: “We probably won’t have the big outbreaks you see in Central and Latin America because of good mosquito control programs” here, Riddell said.

But controlling mosquitoes in the U.S. won’t stop Jacksonites’ traveling ways, and many head south for vacations and work. What about them?

For now, Riddell said, if you’re in the high-risk group you shouldn’t increase the danger if you can avoid it.

“If they’re pregnant I would advise them not to go,” he said. “If they’re not pregnant I would advise them to take precautions to not get pregnant.”

There’s also Jackson’s big immigrant community, the Hispanics who make up nearly 20 percent of the county.

“We have a fairly large population of people who are from Zika-infested areas … who might go back and visit,” Riddell said. “I’m not sure the message is getting to them.”

While scientists are investigating infection rates, Riddell said caution is the safe choice given that “if you catch it and you’re pregnant … the effects on your offspring are drastic.”

Perhaps the only thing that is certain, Riddell said, is that Americans will have to live with Zika from now on, that “the virus is coming — it’s only a matter of time.”

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New tools improve mammography

All St. John’s patients will soon have access to the 3-D screenings.

A malignancy easily missed with conventional 2-D Mammography was clearly seen with Hologic 3-D Mammography

By Erika Dahlby

C

ome midsummer, when a woman walks into St. John’s Medical Center looking to get her annual mammogram she’ll be getting the latest technology in breast imaging at no extra cost.

Digital tomosynthesis, 3-D mammography or breast tomography — call it what you will, the machine that performs this new imaging will be installed the last week of May thanks to the St. John’s Medical Center Auxiliary, Teton Pines Women’s Golf Association and the St. John’s Hospital Foundation.

The new machine, manufactured by the Massachusetts company Hologic, has 2- and 3-D mammography capabilities and an upright biopsy feature.

There are only two other 3-D mammogram machines in the state, in Worland and Rock Springs.

With 2-D mammography — what hospitals have been using in recent times — all the breast tissue is in a single compressed image. When radiologists view the image they’re searching for an abnormality masked by the normal tissue from two flat images.

The big step forward with 3-D mammography is that radiologists are able to take the images in an arc and reconstruct the breast in slices, said Dr. C. Sean Haling, a radiologist at St. John’s.

“Instead of having to look through all the breast tissue to find an abnormality, now we can do it by kind of scanning through the breast and looking at each image,” Haling said.

COURTESY PHOTO

Two-dimensional mammography takes a single image of the breast tissue, while the new 3-D technology takes the images in an arc-like motion and reconstructs the breast in slices.

The procedure will feel similar to a 2-D mammogram. The positioning is the same, but instead of a single image the machine will move in an arc motion to acquire the multiple images.

Instead of a second-long capture it will take 3.7 seconds.

The compression felt in the 3-D will be comparable to the 2-D, and a soft pad can still be used on the machine during the screenings. The radiation dose is also comparable to the 2-D technique, but overall the dose will most likely be lower because fewer additional views are required.

The 3-D mammogram will be more detailed and sensitive. According to Hologic, increased cancer detection,

decreased callback rates, help in localizing structures in the breast and improved lesion and margin visibility are all features of the technology.

“Detecting more means you’re finding those invasive cancers earlier,” Haling said. “It’s going to be smaller, and we can deal with it sooner. I think a negative tomogram is more reassuring, especially for people with denser breast tissue.”

A breast is biopsied when an abnormality or lump is found in the breast tissue, but the majority of biopsies are benign. Haling sees a huge spectrum of abnormalities on mammograms.

Some calcifications he knows right away aren’t of concern, and others he

immediately knows need further investigation. But then there’s a gray area, calcifications that look dangerous or present in a worrying way, such as a cluster.

“That big gray area is where we perform biopsies,” Haling said.

The Hologic machine came with the option to add an upright biopsy feature, which is another type of stereotactic biopsy. When the biopsy device is used a woman will be sitting upright as opposed to lying on a table.

Last year St. John’s performed 22 stereotactic biopsies.

During the upright biopsy a single 3-D mammogram is performed, and the lesion is targeted. The coordinates of the lesion’s location are then calculated from the image.

The advantages of the upright biopsy performed on the same machine are improved visibility of lesions, faster lesion targeting, fewer X-ray exposures and reduced procedure time, according to Hologic.

“We’re probably going to do more biopsies because it’s more sensitive,” Haling said, “and we’re going to see things earlier.”

Because the new technology is 3-dimensional, it doesn’t translate directly onto a 2-D device. But Hologic created C-View software exclusive to the machine. It generates a 2-D image from the 3-D reconstruction. When radiologists view the results of the 3-D mammogram on the computer they can scroll through the breast, but now they can also print out each individual slice of a cross section.

The software also helps when comparing previous 2-D mammograms with the newer screenings. It can create an image that is similar to the mammogram a woman had last year, See Mammography on 11

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Mammography Continued from 10

and the years before.

Results from a two-year study of 12,631 screening evaluations in Oslo, Norway, showed just how much better the newer technology detects cancers and abnormalities than the 2-D mammography alone.

Detection of invasive cancers increased 40 percent. Overall cancer detection increased 27 percent. And the rates of false positives decreased by 15 percent.

“All the experience and all the studies are showing that it is better than 2-D digital mammography,” Haling said.

Other hospitals and imaging centers that offer 3-D mammography do so at a surcharge. Most insurance covers only the basic, bare-minimum screening, essentially the 2-D digital mammogram. But that is not what St. John’s is going to be doing.

“St. John’s is not looking to make extra money by doing this,” Haling said. “We’re doing this at the same rate of a standard mammogram and making sure everybody gets it no matter what.”

There’s another reason the 3-D technology won’t cost patients extra.

The machine is being donated by the St. John’s Medical Center Auxiliary, the Teton Pines Women’s Golf Association and the St. John’s Hospital Foundation.

“Since it was bought with philanthropic dollars we weren’t going to raise our price of the exam,” said Director of Radiology Michelle Kren, who is also a member of the auxiliary.

The auxiliary pledged with the women’s golf club, a first for the organizations. The remaining funds are supplied by the hospital’s foundation. The auxiliary is hoping to raise the bar for women’s health care in Teton County.

“This is a donated piece of equip-

ment, and this is for the betterment of the health of our women in this community and surrounding areas,” Haling said.

The money has already been pledged, but the organizations are still holding events to raise funds.

The auxiliary is hosting its annual Spring Fling Gala on May 28, and the St. Johns Auxiliary Golf Tournament will take place September 26.

The auxiliary expects to complete the pledge this year.

Due to American College of Radiology rules, the installation is a two-step process. When the women’s imaging center reopens June 8 only 2-D mammography will be available. But after a month the 3-D equipment will be operational, and the upright biopsy will go live on July 18.

In the past few years St. John’s has teamed with other regional hospitals to increase the screening rates for women in Wyoming, which are among the worst in the country. The Teton Pink Promise is an initiative to raise awareness and increase mammograms in Idaho and Wyoming to 80 percent.

Last year the hospital performed 3,492 mammograms.

Whether it’s accessibility, lack of concern or just not enough time in the day, mammograms are something that all women need to be informed about and do when it’s the right time. The screening takes less than an hour once a year. St. John’s recommends women with no risk factors, like family history or genetic markers, start getting annual mammograms at age 40.

If you’re confused or just want more information, talk to your doctors. They will be able to talk you through the steps and what is right for you.

To schedule a mammogram call 739-7531 or visit TetonHospital.org/ patient-services/diagnostic-imaging/ womens-imaging-center.

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The audiology booth at St. John’s Medical Center is just a month old and was paid for in part by the Kiwanis Club of Jackson Hole.

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erte Hirschfield has so much passion for the hospital’s audiology department you can hear it.

In some cases, that’s all but a literal statement.

That’s not all you can do either — you can see it, touch it and put its headphones on your child’s ears.

With the inauguration of St. John’s Medical Center’s new audiology booth, Hirschfield’s mission to bring

greater resources for children with hearing loss is real enough to take your kids to it.

“We have been very lucky to have someone with that kind of passion, who found some of our doctors who also were dedicated on the medical end,” hospital spokeswoman Karen Connelly said. “It’s enabled us to do something that will really benefit the kids in this valley.”

The booth, along with services and programs funded by the St. John’s Hospital Foundation’s Pediatric Audiology Project, is designed to help doctors diagnose and treat hearing loss in children with the help of the See hear on 13

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hear

can help a wide range of kids without requiring that trip to Salt Lake City.”

Continued from 12 Children may be born deaf or may hospital’s certified audiologist. lose some or all of their hearing as a The older booth that the hospital result either of genetics or of an illness had was donated to the Teton County like chronic ear infections or a serious School District, Connelly said. infection like measles as an infant.

The push for greater resources The field of pediatric audiology exstarted with Hirschfield’s own grand- ists to identify that hearing loss and children, two of whom are deaf. mitigate its impact on a child’s life.

The American Academy of Audiology At the time the now-grown children discovered their hearing loss, notes in its public literature that good the resources to diagnose and treat hearing is a key component of learning to talk and developing language and them were thin on the ground.

Hirschfield and the children’s other social skills, and so early screening is highly encourfamily members aged. That’s espetraveled to Salt cially true when Lake City and as parents notice far away as New potential warnYork to find the ing signs from a tools and specialyoung child. ists they needed Common signs to manage their in babies include health. not responding “For them, to sounds, from that worked,” — Karen Connelly failing to startle Connelly said.

Hospital Spokeswoman at a sudden noise “Berte will say to not looking tohow lucky they ward the source are to have the of interesting resources themselves to make those things happen. sounds, including voices. Eventually a That’s not the case for everyone, and child with no hearing loss should begin Berte has a huge drive to bring those imitating speech sounds and talking. resources they worked so hard to find In older children delays in develophere to Jackson Hole.” ing language skills can be a sign of A nine-member advisory committee trouble with hearing. made up of medical professionals from An audiologist with the proper around the valley, along with repre- tools can administer tests to detersentatives from the St. John’s Hos- mine whether those signs are indeed pital Foundation, the school district, pointing to a hearing problem. and Hirschfield, guided discussion of “The research all says that early what resources were needed, and how detection is one of the best things to raise the funds for them. The Ki- you can do for a child with these conwanis Club of Jackson Hole pledged cerns,” Connelly said. “Having the $25,000 toward the new booth. tools to do that right here is going to Last month the first patients en- be a big benefit to families, and we’re tered the booth to be screened. very excited things came together to “We’re so excited to be able to offer do that.” this service,” Connelly said. “We don’t always have the services for children, Contact Emma Breysse at 732-7066 or but this is something we have that courts@jhnewsandguide.com.

“Having the tools to do that right here is going to be a big benefit to families.”

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14 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016

Progress made on drug disposal

Health board is still pushing for pharmacy drop-off sites.

By Mike Koshmrl

T

eton County residents may soon have the option of throwing out years-old prescription drugs cluttering their medicine cabinets while they’re in the process of picking up new medication.

Drug drop-off boxes are already mounted in the lobbies of the Teton County Sheriff ’s Office and Jackson Police Department, but those locations can be prohibitive for some people — like those who don’t drive or find it hard to negotiate icy sidewalks — public health experts say.

“It’s not necessarily convenient to find a place to park downtown to drop these things off.”

— Joe Burke Teton county public health secretary

“A lot of people, especially elderly people, have a medicine cabinet full of old stuff, and it’s not necessarily convenient to find a place to park downtown to drop these things off,” Teton County Board of Health Secretary Joe Burke said. “So there they sit.”

It’s an undesirable outcome for public health professionals who worry that old medicines like opioidbased painkillers will fall into the wrong hands, be abused and lead to new addictions.

“What we would like to see done is to allow these drop boxes to go in pharmacies,” Burke said.

A commonplace way to get rid of prescription drugs historically was with the flush of a toilet, but nowadays the method is discouraged.

“Not so many years ago, when the No. 1-selling drug in the country was Prozac, the amount of Prozac still in peoples’ urine was significant enough that in large metropolitan areas it was getting into the waterways,” Burke said. “Anything can get back into the system.”

But prescription drugs do safely disappear when

RYAN DORGAN / NEWS&GUIDE

A MedReturn drug collection unit outside the Jackson Police Department allows people to dispose of their unwanted or expired prescription and over-the-counter medications in a safe manner.

vaporized at very high heat. A Lincoln County incinerator is the destination when they’re deposited at county drop boxes or the biannual drug collection days held at Jackson’s grocery stores. The Jackson Police Department received more than 60 pounds of old pills at one of its recent drug collection events, and when the Sheriff ’s Office drop box was emptied recently there was a 27-pound haul.

Burke wants to see an even higher percentage of the county’s prescription medications be safely disposed of. The Board of Health has already made good headway.

The board, Burke said, successfully leaned on Sen. Mike Enzi’s office in the past to change federal law

so that police didn’t have to be present during the act of disposing of prescription drugs. Now the board is working with Enzi staffers to make pharmacies a legal disposal site. Gov. Matt Mead’s office, Burke said, is working on the issue on the state level.

One impediment has been the pharmaceutical lobby, which has broadcast concern that drop-boxes could be a target for thieving addicts and become a liability.

Burke doesn’t think there’s much to the claim.

“That would be like poaching fruit in an orchard and only picking it up from the ground instead of from the tree,” he said.

Contact Mike Koshmrl at 732-7067 or environmental@ jhnewsandguide.com.

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HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016 - 15

Health fair happenings St. John’s Community Health Fair will offer screenings, demonstrations, activities.

Health Fair Who: St. John’s Medical Center and several other Jackson health organizations What: St. John’s Community Health Fair When: 9 a.m. to 1 p.m. Saturday Where: Teton County/Jackson Recreation Center How much: Free

By Frances Moody

T

hose who are the picture of health focus on mind, body and spirit wellness, which is why the St. John’s Community Health Fair represents the ins and outs of a healthy lifestyle.

From a Teton Spirit Connection booth to free vision screenings, the event is a way for people to get information on their health needs and to scope out health care professionals. It also provides fun activities for kids.

“The purpose of the health fair is to make medical services available to the public and to really demonstrate what health services we do have available in this community,” said Julia Heemstra, director of St. John’s Medical Center’s Wellness Department.

This year’s health fair runs from 9 a.m. to 1 p.m. Saturday at the Teton County/Jackson Recreation Center and the neighboring Davey Jackson Elementary.

It takes months for the fair’s coordinators to plan what booths, demonstrations and screenings are available. Heemstra said the planning process has become more extensive since the fair has grown over the 20 or more years it has existed.

But all that planning is worth it, because every year fair attendees walk away with a new breadth of health care knowledge.

As always this year’s happening includes professional assistance in interpreting blood screening results, and ambulance and fire engine tours.

Spring Runoff Who: Teton County/Jackson Recreation Department What: Jackson Hole Spring Runoff 5K Race When: Saturday with an 8 a.m. start for walkers and 9 a.m. start for runners Where: Start-finish line at Jackson Hole and Greater Yellowstone Visitor Center on North Cache How much: $10 till Friday, $25 day of race

RYAN DORGAN / NEWS&GUIDE

The annual fair serves as a reminder for residents to schedule wellness screenings, such as blood panels. St. John’s Medical Center recently unveiled its new facility for blood draws.

There also will be free healthy snacks and coffee provided by local businesses and free on-site screenings for vision, concussions and other conditions.

“We always have representation from physical therapy offices in town,” Heemstra said. “We also will have a chiropractor there and representatives who will be talking about organic food supplements.”

Heemstra said the giant inflatable colon will return to this year’s fair.

The colon, complete with polyps, was a big hit for kids when it made its health fair debut last year.

There also are new additions to this year’s health fair. The St. John’s

Medical Center Emergency Room and Eastern Idaho Regional Medical Center will be giving bike helmets to kids.

“They are going to be passing out a limited number of free bike helmets to children to create an awareness around protecting our children from head trauma,” Heemstra said.

Fire/EMS staff will be at the fair to demonstrate hands-only CPR, where a person attempts to revive someone with chest compressions rather than mouth-to-mouth resuscitation.

Like last year, the annual 5-kilometer Spring Runoff footrace is scheduled to take place the same day as the health fair. Its start-finish line will be at the Jackson Hole and Great-

er Yellowstone Visitor Center. Race participants are encouraged to run or walk to the fair’s festivities after they finish.

Walkers start at 8 a.m., and runners take off at 9 a.m. Race registration is $10 till Friday and $25 the day of the runoff.

“The runoff will start and essentially end near the health fair,” Heemstra said. “Part of the purpose of doing that again is to reiterate that health also is about getting out and being active. This creates an environment for families to do that together.”

Contact Frances Moody at 732-7079 or schools@jhnewsandguide.com.

Health fair booths Focused on Post Operative, Mobility and Home Medical products: Home and Portable Oxygen Concentrators | CPAP and all CPAP supplies Game Ready | CPMs | LymphaPress | Negative Pressure Wound Therapy Lift Chairs | Hospital Beds | Bed Rails | Bath Safety Orthotic Knee, Ankle and Back Braces, Walking Boots and Slings Medela Maternity Products | TENS | E-Stim and Ultrasound Compression Socks | First Aid Kits | Kinesio Tape | Humidifiers

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Kirsten Corbett leads a movement and meditation class last month at Akasha Yoga Studio.

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Call 307.733.2047 if you need assistance.

Practicing ‘mindfulness’ is credited with a legion of health benefits.

By Richard Anderson

Y

ou argued with your significant other last week, and even though it has been days, it’s still gnawing at you.

On top of that you’ve got a big work deadline in three days, your house is a mess and you’re cutting it close between incoming cash and outgoing bills.

Sounds like a job for mindfulness.

“Meditation was taught to help us tame our own minds,” Kelly resident Dr. David Shlim wrote in an email from Bhutan.

A longtime and frequent visitor to the Himalayas, he has been practicing and teaching a Buddhist form of mindfulness or meditation for years.

While there are many forms — some contemplative forms associated with religions as well as a more contemporary, secular variety — they all have the effect of calming the mind.

“The benefits of having a calmer mind are manifold,” Shlim wrote. “A calmer mind is naturally kinder and can think more clearly, which can have great benefits in our lives.”

In addition there is an ever-growing body of evidence that meditation

and mindfulness have positive physiological effects, such as lowering blood pressure and boosting the immune system, Shlim said.

Sasha Dingle practices and teaches mindfulness meditation. Her definition of “mindfulness” is based on that of Jon Kabat-Zinn, one of the leading figures in the Western, secular discipline.

“It’s paying attention on purpose to the present moment, without judgment,” she said. “It’s a methodology, a practice to bring ourselves back to that direct experience — what’s known through our senses — before we start building this whole associative story.”

The story — replaying last week’s spat over and over, imagining the consequences of flubbing that deadline — is just that: a story. It can grow and loom and take over our minds until it crowds out other things, like what we are doing or have to do right now, this moment.

Dr. Bruce Hayse started meditating as a teenager.

“It’s a thing I’ve always been interested in, my own mind,” he said, “interested in the mind and how it works.

You can focus on your mind, train your mind and understand how your mind works. That’s fascinating in itself, but then you start to realize the things to be gained from watching the mind.”

Kirsten Corbett and Margaret See mind on 17

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HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016 - 17

mind

Continued from 16

Thompson lead a group called Move and Meditate at 8:30 a.m. Fridays at Akasha Yoga.

“The reason I do meditation is because I need it,” Corbett said. “And the more I dive into it the more rich it becomes.”

Corbett said meditating “changes the quality of my day-to-day life.” If she misses a day or two, she notices it in her ability to be present, “my ability to savor things.”

Paths to mindfulness There are many ways to practice mindfulness, but Corbett said one simple method is paying attention to your breath.

“Find where you feel your breath in your body and use that as an anchor for attention,” she said.

Simply notice it flowing in and out of your body.

“If you get carried away by a thought or your legs falling asleep or something else that comes up, an emotion” — and you undoubtedly will — “be kind, let it be there and then return to your breath.”

Dingle — who is the founder of the Mountain Mind Project, through which she is planning an intensive eight-week course in mindfulnessbased stress reduction that is set to start May 4 — says another way to practice is to do a “body scan.”

“You focus your attention on a place in the body and release the tension there, and then you move on to another part of the body,” she said.

It doesn’t have to be passive, Dingle said. Movement can be added. Yoga teaches body awareness and thus can be an approach to mindfulness.

There’s also walking meditation and even “informal practices,” she said, “like noticing pleasant experiences or unpleasant ones … even just brushing your teeth. Can you do that while paying attention to the sensations? And every time your mind is pulled away, can you pull it back to this moment?”

As Corbett put it, “It’s simple, but it isn’t easy.”

No one can be completely present all the time. With practice, though, it becomes easier to get there.

“There are still times I lose it,” Corbett said. “That’s part of being human.”

But Dingle, who got into body awareness as a competitive mountain biker and skier, said mindfulness training is similar to physical training in that you improve with practice.

Your ability to pay attention to the present can be strengthened. And as that happens, some remarkable outcomes are possible.

The focus of her teaching is on stress control, but as Shlim mentioned there are many positive physical effects, too. Hayse said meditation can be more effective than medication to treat depression.

“The benefits have been pretty well

documented now with a lot of different studies demonstrating things like improvement in mood, improvement in things like empathy, compassion,” he said. “You might think that focussing on yourself with mindfulness sounds like a selfish sort of thing, but it’s actually not at all. People who do this have been shown to be more empathetic ... less angry and better able to deal with complex tasks.”

MRI brain scans, Hayse said, actually show physical changes to the brain in people who practice forms of meditation.

“If you take people who start meditating, you will see their prefrontal cortex gets larger,” Hayse said.

That’s an area of the brain that deals with judgment and higher thinking.

“They’re actually building up more networks of nerves.”

You also see a decrease in activity in the amygdala, a small area at the center of the brain that controls emotions, including the “flight or fight” instinct.

“That’s part of the reason why people who practice are better at being less at the mercy of their emotions,” he said.

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Many places to do it St. John’s Medical Center includes mindfulness in its Workplace Wellness program, through which it has introduced the concept to an estimated 1,300 people in Jackson, said St. John’s Wellness Director Julia Heemstra. It has also hosted experts including Dr. Richard Davidson, the founder of the Center for Healthy Minds at the University of Wisconsin; Daniel Goleman, the author of “Emotional Intelligence”; and Joseph Goldstein, who is among the first teachers to introduce meditation to North America and is the founder of the Insight Meditation Society.

“There’s one little problem here,” Hayse said, “and that is there hasn’t been a place where people can learn about it.”

Varied groups meet throughout the week in various spaces, but Hayse and a handful of others have been talking about creating some sort of nondenominational center for classes, meetings and practicing.

In the meantime, in addition to Move and Meditate at Akasha Yoga, the Chiropractic and Sports Injury Center at 215 Scott Lane is the hot spot for mindfulness, with groups meeting at 6 p.m. Mondays and Fridays. And there are plenty of other choices, including Transcendental Meditation, Deeksha and Zen groups.

“You can just walk in and start,” said Hayse, who sits with the Friday group.

No special training is needed to get started, though it can be helpful to do it with a group. Families can do it together — one expert said age 5 is a good time to start with children — and it’s never too late to pick it up, Corbett said.

Contact Richard Anderson at 732-7078 or rich@jhnewsandguide.com.

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18 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016

309929 RYAN JONES /NEWS&GUIDE

Dr. Heidi Jost removes stitches from Hutchison’s wrist during a follow-up appointment April 1 at Teton Orthopaedics. A 3-D model helped guide Hutchison’s wrist repair.

Rapha Massage

printing Continued from 3

the surgical suite.

The 3-D models and guides aren’t required for a successful outcome, nor do they promise faster healing. What Williams can say, however, is the technology makes for a custom fit and repair, modeled off a patient’s own body.

“There’s a lot of duplication in our bodies so we can take advantage a little bit,” Williams said. “It still takes time for the body to heal, but we have a better fit.”

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“This is the best place to get a big structural piece,” says Williams as he stands over Hutchison’s exposed hip bone and asks for the saw. “Unfortunately, this will probably hurt as much as the other procedure.”

It does. Hutchison’s hip will throb so badly it’s hard for her to sleep for several days after the surgery. For the next few weeks she limps so prominently on her left leg that the arthritis in her right hip flares up. It won’t be until five weeks post-surgery that it starts to feel better.

“I heard them say the hip will probably bother you more, but I couldn’t fathom that until I went to walk on it,” Hutchison said weeks later. “Then I knew.”

When possible Williams prefers to use a graft from the patient’s body.

That piece of the procedure actually does have a pretty significant effect on healing, he says, as grafts taken from the patient — as opposed to a cadaver, for example — have been shown to be stronger.

As Williams chisels out a chunk from Hutchison’s hip, Jost slices open Hutchison’s wrist. The tag-team approach also saves anesthesia time, allowing Williams to excavate a pur-

plish-red hunk of bone while Jost begins pulling back muscles, tendons and ligaments to get down to the radius, where all the heavy lifting will occur.

“You can see why it’s nice to have two surgeons,” Williams says.

Once the bone graft is removed, Williams hustles it over to the table to check how it will sit in the model, shaping it to fit tightly into the printed version of what her wrist bones should look like by the end of the surgery.

Six printed parts were shipped in before the procedure — a preoperative model, a model of the planned outcome, a model of the graft and three guides to help place the plate. The sterilized pieces sit on a blue towel on a table of tools, including a box of drill bits, mallet and various power tools.

“This just makes it pretty seamless,” he says.

The printed pieces speed up the surgery, but by no means is it a quick process. Once the radius is cut, the first guide is placed between the body of the bone and the head, showing Williams where to drill holes for the metal plate. Then another guide is placed, secured by Kirschner wires, and more holes drilled. Then the third guide is used.

One of the wires breaks during the process, shearing off at the bone.

It’s a piece that Williams can’t retrieve without digging into the bone, so it will be left behind. There’s adjusting and fitting and refitting until the plate is in place and they screw it down.

Once the bone is set Williams and Jost turn to the frayed tendon. The ends will have to be cut because “you can’t sew a mop to a mop” before a slice of a nearby tendon can be sutured in.

See printing on 19

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Dr. Monroe is a board certified ophthalmologist with more than 20 years of experience. She performed a fellowship in cataract and glaucoma surgery at the University of Utah and has held positions at the University of Utah and Vanderbilt University training other eye surgeons.

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HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016 - 19

printing Continued from 18

“You always do these transfers a little bit tighter because they stretch out,” he explains. It will take between four and six months to grow together, and somewhere between two and three to stretch out, Williams said.

The closing team comes into the room a little after 10:30 a.m. to place sutures and prepare to move Hutchison into recovery. Williams estimates that without the 3-D prints the threehour surgery would have taken 45 minutes longer.

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Rest and recovery In a checkup appointment a week later Hutchison unstraps her hardshell pink brace and holds her hand palm up for Jost to inspect. Even though she’s been told not to move her thumb, and she swears she hasn’t been, she gives it a little wiggle.

“Look, your tendon’s intact! Isn’t that fabulous?” Jost says, smiling.

Her skin is settling into the yellowgreen bruising phase, and with regular icing, the swelling has come down. The incision is pink, but much less angry.

“My mom, who was in the medical field, said with surgery, you need to do everything they tell you,” Hutchison says, “and a little bit more.”

The brace largely ensured she followed instructions, which basically consisted of keeping her hand immobilized.

As a nod to his wife’s struggle, one night Randy offered to eat his dinner with his left hand as well. It goes about as well as expected, she says, laughing. He maintains the odds weren’t stacked fairly.

“She’s actually been having to use her left hand and she’s a lot better at it than I am,” he says.

“We might as well laugh about it,” Hutchison says. “It doesn’t do any good to cry about it so we might as

Not anymore!

RYAN JONES /NEWS&GUIDE

Hutchison’s wrist was twisted before her recent surgery. She suffered from the deformed wrist because it was improperly set when she broke it.

well have some fun with it.”

As Jost pulls the sutures from her skin, she comments on how well Hutchison has healed. Bruising and scarring notwithstanding, her wrist looks straight again.

“It definitely wouldn’t have turned out this well without this new system,” Jost says. “It’s really healing up nicely.”

She’s fitted into a brace, the final support system she’ll wear before she transitions out entirely. In a few weeks she’ll start physical therapy, slowly stretching and strengthening her thumb and wrist again.

The first thing she wants to do when she has full use of her hand again?

“Eat,” she laughs. “Stab something with a fork and cut my own food.”

And, of course, “Curl my own hair.”

Contact Melissa Cassutt at 732-7076 or county@jhnewsandguide.com.

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20 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, May 4, 2016

May 2016

St. John’s Calendar of Events Most events are free unless otherwise noted.

Health Education

Support Groups Cancer Support Group for Patients, Survivors, and Caregivers

Led by cancer survivor Carol Poole, RN, OCN Thursday, May 5 Thursday, May 19 3 pm Chapel St. John’s Medical Center For information, call 307 739 6195

Type 2 Diabetes Support Group

Get helpful tips about managing diabetes. Friends/supporters welcome.

Tuesday, May 10 1 – 2:15 pm Bison Classroom St. John’s Medical Center For information, call 307 739 7678

Teton Mammas

For newborns and their families.

Wednesday, May 11 1 – 2:30 pm Moose-Wapiti Classroom St. John’s Medical Center For information, call 307 739 6175

Memory Loss Support Group

For those suffering from persistent memory problems; family members and caregivers welcome.

Thursday, May 12 Noon – 1 pm Morningstar Senior Living For information, call 307 739 7434

Community Health Fair

Join us for the Jackson Hole Spring Runoff 5K, free health screenings, information booths, tours of emergency vehicles, and complimentary snacks.

Saturday, May 7; 9 am - 1 pm Teton County/Jackson Rec Center For information, call 307 739 7466

Joint Classes

Information for people considering or scheduled for joint replacement.

Tuesday, May 3, 4-5:30 pm Thursday, May 12, 8-9:30 am Tuesday, May 17, 4-5:30 pm Thursday, May 26, 8-9:30 am Tuesday, May 31, 4-5:30 pm Moose-Wapiti Classroom St. John’s Medical Center For information, call 307 739 6199

Foundation Weight Management Support Group

Teton Parkies (For those

affected by Parkinson’s Disease)

Gather for mutual support, discussion of disease and therapies, and more.

Tuesday, May 10 5:30 – 7 pm Community Room Jackson Whole Grocer Contact 307 733 4966 or 614 271 7012

Grief Support Group

Led by Christina Riley, LCSW Drop-ins welcome, but please call ahead Wednesday, May 11 Noon – 12:50 pm Eagle Classroom St. John’s Medical Center Call 307 739 7482

tetonhospital.org/calendar

Open to everyone interested in weight loss and those considering (or who have had) bariatric surgery.

Thursday, May 19 4 pm Boardroom St. John’s Medical Center For information, call 307 739 7634

Type 2 Diabetes Prevention Group in Spanish

In Spanish! ¡En Español!

Every Tuesday 5 – 6 pm Moose-Wapiti Classroom St. John’s Medical Center For information, call 307 739 7678

Growing Through Grief

For those experiencing the loss of a loved one Thursdays, May 5 - June 16 1 - 2 pm Group size is limited.

To register, call 307 739 7482

Meals with a Mission Casino Night

A fundraiser to provide meals for cancer patients Elks Club Thursday, May 12 5 pm cash bar; 6 pm dinner $20 at the door To RSVP or make a donation, call 307 739 7517

Auxiliary Auxiliary Meeting

Thursday, May 5 Noon – 1pm Moose-Wapiti Classroom For information, call 307 739 7517

St. John’s Auxiliary’s 57th Annual Spring Fling Gala

Saturday, May 28 OUT! D L O S 6 pm Jackson Lake Lodge $100

1916 2016

625 E. Broadway, Jackson, WY 309960