Hole Health 2010

HOLE Health

April 28, 2010

A special supplement to the Jackson Hole News&Guide

e d d n w u e o l l r n l e l ss e W

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Getting enough shuteye can mean the difference between a good day and total exhaustion. Experts at the St. John’s Sleep Disorder Center explain how they diagnose and treat sleep disorders.

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INSIDE Running out of fuel can incapacitate an athlete on race day or during training.

Exercise nutrition pros and personal trainers say the proper mix of carbohydrates and protein helps keep muscles moving.

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Cleanses – full of uncooked fruits, nuts vegetables, juices or supplements – expunge toxins from the body, resulting in better sleep, improved digestion and more energy, nutritionists say.

St. John’s community Health Fair • 9 a.m. to 1 p.m. Saturday • Snow King center • See story on page 16

2 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010

Considering your health as a whole

W

hether you’re cleansing your digestive tract, boning up on the latest and greatest in exercise nutrition or trying to map out a spring workout routine, health is something that weighs on the mind of just about everyone.

It is, however, a mercurial goal that can require a varied approach. And many pieces of that pie are ones that are not always the most obvious.

A good place to start is the St. John’s Community Health Fair, a free event that includes everything from teddy bear checkups to skin cancer screenings.

One of the most basic elements of a healthy lifestyle – sleep – is one we rarely consider, but it can have a profound influence on a person’s waking hours, as seen in a story in this issue of Hole Health about the sleep lab at St. John’s Medical Center.

Jim Ambler had spent three decades of his life battling constant exhaustion only to find that he wasn’t breathing properly through the night.

As Ambler said in the story, we don’t always think about how the simplest things can affect our health. Sleep, for example,

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can affect blood pressure, memory and motor skills, among other things.

Being aware of one’s health can also mean being aware one’s environment, as evident in stories about high-altitude hair and skin care, avoiding the potentially hazardous effects of smoke from wildfires and fueling one’s self for the epic adventures that so many Jacksonites seek.

As much as we wish otherwise, there is no silver bullet for health. It is something that takes a holistic and sometimes creative approach. Some people build greenhouses to more closely monitor their food, others turn to seemingly odd concoctions and elixirs that are meant to rid their bodies of toxins and some try to tweak the philosophical model of how people deliver health care.

Sifting through these treatments and routines can be daunting, but it is a process that has to be tailored to the individual. A cayenne pepper, maple syrup and lemon juice cleanse might not be for everyone. That’s why this year’s edition of Hole Heath takes a look at heath issues as varied as the people of Jackson Hole.

– Cory Hatch and Kevin Huelsmann

n Elderly Balance/Fall Risk Programs n Custom Orthotics

PT, DSc, OCS, Owner

Jeff Shirley PT, DPT

Publishers: Michael Sellett, Elizabeth McCabe Associate Publisher: Kevin Olson

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V. Norene Christensen

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

1090 S. Hwy 89, Jackson Wy 83002 307.733.5577

Editors: Cory Hatch, Kevin Hueslmann Layout and Design: Jenny Francis

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Copyright 2010 Jackson Hole News&Guide P.O. Box 7445, 1225 Maple Way Jackson, WY 83002 (307) 733-2047 FAX: (307) 733-2138, www.jhnewsandguide.com

(Blepharoplasty)

The eyelids function to protect our eyes from the outside world, and they also project to the world (sometimes inaccurately) our state of being. Many feel that their eyes betray their underlying energy and healthfulness, instead projecting the appearance of being tired. Upper eyelid skin may drape over the eyelash margins, resulting in eye fatigue and obstruction of vision.

Blepharoplasty, or eyelid surgery, is performed to improve the appearance of the upper and lower eyelids. Frequently, upper eyelid blepharoplasty is medically indicated (covered by insurance) to improve peripheral vision.

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HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010 - 3

screening

Sweet dreams

Tired? St. John’s Sleep Disorder Center helps restless patients get rested.

NEWS&GUIDE PHOTO / ASHLEY WILKERSON

After being diagnosed with sleep apnea nearly 15 years ago, Jackson resident Don Harger demonstrates how he sleeps with a device he has used for two years to help treat the condition.

J

By Kelsey Dayton

im Ambler spent about 30 years of his life living in a state of exhaustion.

Ambler, 71, was in good shape and went to bed at a decent time, but by the middle of each day, he’d become tired. Sometimes he felt like he couldn’t move, even reading and errands exhausted him. His daily hour and a half naps didn’t help.

Ambler tried various doctors — nothing seemed to work. He resigned himself to a life lived in fatigue.

Then, last year, his doctor suggested he try a sleep study at St. John’s Medical Center. The visit changed his life.

The St. John’s Sleep Disorder Center is the only accredited sleep clinic in Wyoming, said Joe Burke, director of the center. It earned its accreditation in February 2008.

The center holds two bedrooms with twin beds. Every year, staff at the center study up to 220 patients in the lab, Burke said. Other patients come to the center, but not everyone needs a sleep study.

Patients check in for the night and are hooked up to machines that monitor brain wave activity, heartbeat and rhythm, oxygen levels, leg movement and muscle tone of the face, which all help show how

Common sleep disorders • Insomnia: The inability to fall asleep or stay sleeping. Some people with insomnia wake hours early and can’t fall back asleep.

• Narcolepsy: Those who have narcolepsy are excessively sleepy during the day and also have sudden muscle weakness. Episodes of narcolepsy are sometimes described as “sleep attacks” and can occur while doing physical activity.

• Restless leg syndrome: The hallmark characteristic of restless leg syndrome is an unpleasant creeping sensation, often starting in the lower legs and associated with aches and pains throughout the legs.

• Sleep apnea: Snoring may be more than just an annoying habit – it may be a sign of sleep apnea. People with sleep apnea gasp or snort, interrupting their sleep.

Source: Centers for Disease Control and Prevention

deep a person sleeps and for how long.

Some people worry they won’t be able to sleep, knowing that someone is watching them. But others find the monitoring comforting, Burke said. A big part of sleep is a sense of security.

The lab sees patients throughout the week and treats all ages from kids to senior citizens.

Insomnia – the inability to fall asleep, stay asleep, or get enough sleep – is a the most common sleep problem.

If a person experiences insomnia for more than two weeks they should seek help Burke said. The sooner sleep disorders are addressed, the easier they are to resolve.

The biggest cause of insomnia is stress. People need to slow down in their lives, Burke said. One tip is to have patients make to-do lists - for the next day, or upcoming week, before they get into bed so worry doesn’t keep them awake.

Those with serious sleep issues will wake up to 150 times an hour for just a few seconds before falling back asleep. Lack of sleep affects blood pressure.

Sleep also affects memory and motor skills.

“Making time for sleep is as important as eating,” Burke said.

There are people who manage to function fine, like one patient Burke saw, even though they don’t sleep much. That patient also drank two liters of Pepsi a day, Burke said.

“People are just not getting enough sleep,” Burke said.

Kids up to about 18 years old should be getting about nine to 9.25 hours of sleep a night. Adults need about eight hours, Burke said.

There are a few people who are genetically short sleepers. Even as young children, they won’t sleep as much as others. There are also a few people who are genetically long sleepers who need between 10 and 12 hours of sleep a night.

When Ambler came to the sleep center in 2009, he knew he wasn’t getting enough sleep, but he was trying. His problem wasn’t the ability fall asleep, but the lack of quality of his slumber.

He didn’t sleep well in the sleep lab hooked up to all the machines, but it was good enough for the doctor to realize he had sleep apnea, a disorder where his breath stopped in short bursts while sleeping.

Ambler returned to the lab and was fitted with a face mask he now wears while sleeping. The mask keeps his airway from closing and pumps room air through his nose.

“It’s not the most attractive looking thing,” he said.

But within days Ambler noticed a chance in how

Tips for getting a good night’s sleep and staying rested Adults

4 Go to bed at the same time each 4 4

4 4

night and rise at the same time each morning.

Make sure your bedroom is a quiet, dark and relaxing environment, which is neither too hot or too cold.

Make sure your bed is comfortable and use it only for sleeping and not for other activities, such as reading, watching TV or listening to music.

Remove all TVs, computers, and other “gadgets” from the bedroom.

Physical activity may help promote sleep, but not within a few hours of bedtime.

Avoid large meals before bedtime.

Adolescents/Young Adults

4 Avoid caffeinated drinks after lunch.

4 Avoid bright light in the evening.

4 Avoid arousing activities around bed4 4 4

time such as intense studying or long conversations.

Expose yourself to bright light upon awakening in the morning.

Sleeping in on weekends should be no more than three hours past the usual wake time.

Avoid pulling an “all-nighter” to study.

Source: Centers for Disease Control and Prevention

he felt.

He woke up refreshed in the morning instead of tired. He had more energy during the day. His memory improved.

Ambler thinks he will have to wear the mask while he sleeps for the rest of his life.

“But to feel as good as I do, it’s worth it,” he said.

As Ambler continues to get better sleep, he continues to notice improvements in his health. He no longer struggles to keep his eyes open when he’s at the symphony or a show in a dimmed theater. He feels decades younger and can’t believe something so simple took so long for him to correct.

4 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010

screening

whole grocerite (n): A smart and thrifty person who sees the big

Get tested and

picture. Eats fresh food and prefers to buy locally. Enjoys all types of foods, usually buying a hybrid mix of both organic and conventional groceries. Whole Grocerites are confident and unafraid to express their own styles or be inspired in their choices. Often enjoys visiting with friends while shopping for groceries.

Whole-hearted and loves good food

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Brain cells working at maximum potential

Huge Smile from the warm-friendly vibe at JWG

If you are sexually active, getting tested for an STI protects you and your future partners

Bright pearly whites from using Tom’s of Maine Toothpaste

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By Johanna Love

etter safe than sorry.

There’s no shame in getting tested for a sexually transmitted illness, says Terri Gregory, Fresh-baked homemade Teton County Public Health departChoice meats muffins and bread made ment director. Public Health, located & wild caught fish from scratch at 460 E. Pearl Ave., provides screening for chlamydia, gonorrhea and HIV in people who don’t exhibit symptoms.

People might want to be tested if they’ve changed partners, Gregory said, and if they want to ensure they are disease-free before beginning a sexual relationship with a new partner. If you’ve had unprotected sex, that’s another good reason to be tested.

“I think people think about [sexually transmitted infections], but it’s not something that’s discussed,” Gregory Shopping cart filled Delicious smoothie from said. “The nurses are so easy to talk to JWG Juice Tonic Bar Canvas bag filled w/ with award-winning about personal health and ways to profresh, locally-produced organic and tect themselves.” veggies and fruit traditional produce Public Health also offers free condoms. Nurses are happy to give samples 192153 of a female condom, too.

“Even if your partner isn’t willing to wear a condom, you can still protect Please proof and call Amy at 739-9542 or return via Fax at 733-2138. Thanks!

PDF PROOF? yourself,” Gregory said.

A gonorrhea or chlamydia test for Caring for Tomorrow’s someone without symptoms costs $15 Leaders Today at Public Health. If someone has symptoms of a sexually transmitted disease, such as itching, soreness, burning or discharge, Public Health will refer them elsewhere, such as Western Wyoming Family Planning’s Jackson office.

HIV tests are free and confidential.

Chlamydia is the most common sexually transmitted illness in Teton County.

In 2006, there were 45 new infections; in 2007, there were 17.

According to the Centers for Disease Control, the bacteria that causes chlamydia can cause irreversible damage to a woman’s reproductive organs, in cases rendering her infertile. In men, it usually presents as discharge from the penis. It can be transmitted through vaginal, anal or oral sex.

Gonorrhea cases are reported in

Jackson Pediatrics PC

Istock Photo

Using a condom is the most effective way to prevent the spread of sexually transmitted infections.

Teton County at a rate of about one per year, as are new infections of HIV. Although it may seem like a friendly, small town, the diseases lurking within our population are largely unknown, Gregory said, especially with the number of tourists and transient residents who might be sexually active in larger cities.

“Even though these numbers look low for our residents, that doesn’t mean our exposure is low,” Gregory said. “We don’t know how many cases are out there that can’t be identified.”

For any sexually transmitted illness test, just call Public Health at 733-6401 for an appointment. They’re open from 8 a.m. to 5 p.m. on weekdays.

Western Wyoming Family Planning charges $35 for STD tests. Call 732-1694.

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HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010 - 5

screening

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When to test Below are some common forms of cancer followed by what tests and at what age they should be administered on a regular basis.

Cancer Test Breast Mammogram Prostate DRE/PSA Colon Colonoscopy

Age 40 50 50

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You eat right,

You exercise, but are You forgetting to care for Your teeth?

healthY living

Source: American Cancer Society

clusive. Factors such as age, race, past medical procedures, a prostate infection or an enlarged prostate could affect PSA levels.

Of cancers affecting both men and women, colorectal cancer (cancer of the colon and rectum) is the second leading cancer killer in the United States behind lung cancer.

Colorectal cancer incidence increases with age, and more than 90 percent of colorectal cancers occur in adults aged 50 or older, according to the Federal department of Health and Human Services.

Colorectal cancer typically develops from precancerous polyps in the colon or rectum. A colonoscopy – an examination of the colon and distal part of the small bowel with a fiber optic camera – can often find precancerous polyps so they can be removed before they turn into cancer.

The CDC recommends annual screenings beginning at age 50 but as early as age 45 if one has a history of the disease in the family.

People should discuss with their doctor when the right time is to get undergo these screenings. Cancer screenings are also available at St. John’s Medical Center.

(307) 732-CARE Joshua G. Wagner, D.D.S. Paula J. Wagner, D.D.S. 610 West Broadway Ave in the Centennial Building

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Cancer screenings can be the difference between life and death hen it comes to surviving cancer, early detection is often one of the keys.

But how soon, and how often, should one begin getting cancer screenings?

The American Cancer Society says it depends on family history and the type of cancer.

For women, breast cancer is the most common form of cancer aside from nonmelanoma skin cancer, with close to 200,000 new cases reported annually.

The American Cancer Society recommends annual mammograms for women beginning at age 40. A mammography is a low-dose X-ray that can detect masses in the breast. Other forms of detection are the self breast-exam and a clinical breast exam.

A mammogram is the best method to detect breast cancer early when it is easier to treat, according to the Centers for Disease Control and Prevention.

For men, prostate cancer is the most common form of cancer. In 2006, 203,415 men were diagnosed with prostate cancer, according to the CDC. The American Cancer Society also recommends yearly tests for prostate cancer for men beginning at age 50. Men who have a history of prostate cancer in their family should begin yearly exams at age 45.

Tests commonly used to screen for prostate cancer are digital rectal exam and a prostate specific antigen test. A digital rectal exam involves a doctor or nurse inserting a lubricated finger into the rectum to feel the prostate. A prostate specific antigen test is a blood test that measures the level of PSA in the blood.

Typically, higher levels of PSA in the blood mean a prostate problem is present. However, this test is not always con-

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6 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010

nutrition

G

Mountain-town

gardening

Growing your own vegetables in a high-altitude environment can be tough. Having a greenhouse can make it easier

By Sarah Lison reenhouses can help ensure your health and the planet’s health, and some can heat your home or put energy back into

the system.

But a few valley residents who have greenhouses say another important benefit is that they simply make you feel better.

“It’s a super satisfying, wonderful thing to do for starting seeds,” said Wilson resident Carole-Malia Schneider. “But it’s also just the mental and emotional health of growing baby plants and having an outside space where it’s sunny and warm to go before the real warm is here.”

Schneider said her greenhouse – “a funky little sunroom that got put in our yard by our friend” – also set her on a career path she hadn’t previously considered.

She started Mansion Gardens Ltd. in 1996 and now designs, digs and maintains landscapes and gardens for seven months each year.

She doesn’t use her greenhouse for her business at all, and she uses it solely for a workshop in the winter. In the spring, she buys baby heirloom tomato plants online and has them delivered. It’s the only plant she grows in the greenhouse these days, she said.

“I only grow tomatoes because that’s what I find the most satisfying,” she said.

She also maintains a garden; growing crops such as raspberries and strawberries, oregano and chives, lettuce and onions, and a variety of root vegetables.

Schneider is part of a growing group of food lovers that have become more concerned about where their vegetables come from, how they’re grown and the environ-

News&Guide photo / Brent McWhirter

Cucumbers are starting to sprout in Dick Shuptrine’s greenhouse while tomatoes in the background are ready to be transfered to a larger greenhouse in his backyard.

mental costs of shipping those foods to the dinner table. A key ingredient of the slow food movement, greenhouses provide an environmentally friendly, pesticide-free way to keep your family fed, healthy and free of consumer guilt.

Take, for example, Lynn Hammond, who has two 5-by-5-foot greenhouses on her property on Fish Creek Road and

lite lunch

grows tomatoes and basil during the summer months. She started lettuce, spinach and peas in one of the greenhouses April 14, she said. Hammond also grows other crops such as onions, carrots and potatoes in her garden.

Once she starts harvesting, she can provide enough produce for her family to last three months. She likes knowing exactly

what goes into her food and she makes her own composts, she said.

“I’m an organic gardener – that’s the main reason, the health reasons,” she said when asked why it’s important to grow her own produce. “But also it’s a bit of a spiritual experience, I think, for most gardeners that grow their own food.”

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HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010 - 7

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Dick Shuptrine, owner of Mountain Meadow Gardens, has been gardening most of his life and sells produce he grows in his greenhouse at the farmers market.

Much more work needs to be done before the greenhouse can be built, but the Jackson Hole Grocer has agreed to buy produce grown there to sell at its store, Michel said.

Michel and others said another reason locally grown produce is so important is because it cuts down on emissions created by trucks and airplanes used to ship produce into the valley.

Michel said produce loses valuable nutrients over time, so locally grown produce is healthier because it gets to consumers’ tables faster.

He said Whole Grocer already buys products from a variety of local farmers and ranchers, but there is enough demand to support the addition of a vertical greenhouse.

“There’s still a lot of room for growth,” he said.

Shuptrine agreed.

“The more the better,” he said. “Just about anything that anyone grows around here, we find a market for.”

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While gardening in a greenhouse is time consuming and, therefore, not all that economical, Hammond said working with the earth makes a person more aware of his or her environment. “You’re probably not saving money by gardening, but it’s good for your soul,” Hammond said.

She said it’s been important for her to share her experiences with her family and get them involved, too.

Dick Shuptrine, who operates Mountain Meadow Gardens, also enjoys being part of a community that’s promoting sustainable lifestyles.

Shuptrine said he grew up gardening with his father and has never stopped. He does extensive composting and uses no herbicides or pesticides, he said.

“I have very good soil, and I know exactly what goes into producing everything that I have to eat,” he said. “It’s healthier.”

Shuptrine has two greenhouses on his property in Game Creek, a small structure attached to his house and a free-standing 20-by-48-foot structure.

In the summer months, he grows tomatoes, cucumbers and a variety of herbs in his greenhouses. He grows other crops – several varieties of lettuce, spinach, peas, bush beans, kale, swiss chard and more – in his gardens.

Shuptrine said he was starting seeds April 15 in the greenhouse attached to his home and that it was 80 degrees in there that day.

“I’ll probably create all the heat that I need in my house today,” he said.

A group working on plans for a vertical greenhouse next to the parking garage in town hopes to do more than be energy neutral. Organizers hope the project, which is sponsored by Slow Food in the Tetons, will put energy back into the system, provide jobs for the developmentally disabled and create learning opportunities for schoolchildren.

“The idea of the project is to create a place in town where we can grow vegetables throughout the year.” said Steven Michel, a board member for Slow Food and director of sustainability at Jackson Whole Grocer.

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8 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010

nutrition

Beat the bonk Keeping the body fueled properly can make exercise more fun

By Cory Hatch

A

couple of years ago, on a mountain bike ride with friends along the Bangtail Divide Trail in Montana, I bonked.

After unwisely refusing food on the final stretch back to the campsite, the muscles in my legs used up their last reserves of energy. I broke into a cold sweat and became light-headed.

My bike seemed to get heavier with each push of the pedals.

After a few minutes, I could barely move at all, even over relatively flat ground.

I checked the mechanical integrity of my bike, but there were no flat tires, broken chain links or sticks jammed in the gears.

Then I started craving a hamburger. Not just any hamburger, but a thick, dripping hunk of grilled cow meat smothered in cheddar cheese.

My mouth started watering.

Finally, the pedals refused to move. I got off and pushed my bike the final quarter mile to camp, where my friends harassed me with cheers and laughter as I finally staggered over the imaginary finish line.

What I didn’t understand is that the human body can run out of energy the same way a car runs out of gas. Without the proper fuel, not only is a several-hours-long bike ride, run or hike difficult, it’s practically impossible. Further, bonking in an inconvenient spot, say 10 miles deep into a trail run in the Teton Wilderness, can leave an incapacitated athlete in a dangerous situation.

Luckily, the Lance Armstrongs of the world have helped scientists develop a better idea of what type of food the body needs during sustained, intense exercise. A number of companies have developed products designed to keep athletes stocked with carbohydrates, electrolytes and protein, and experts also tout some traditional foods to help keep the body moving.

Some of the more advanced nutrition regimes aren’t for everyone. The weekend warrior who goes on an hour-long run twice a week might subsist fine on water.

But people who plan to exercise for

NEWS&GUIDE file photo

Dave Bergart, center, competes in a recent Lotoja, a more than 200-mile bicycle race from Logan, Utah, to Jackson Hole. Competitors must stay properly fueled just to complete the event.

longer than 75 to 90 minutes will probably need to replenish their energy reserves at some point during their routine.

For people who do exercise for longer periods, personal trainers and exercise researchers stress that athletes need to focus on nutrition before, during and after exercise.

One nutritional piece that people often neglect is the pre-exercise meal, according to Christopher Rasmussen, a research associate with the Exercise & Sport Nutrition Laboratory at Texas A&M University.

“Eat at least four hours prior,” said Rasmussen, adding that the problem with many endurance events is that they start early in the morning. “Some people wake up and eat at 3 or 4 a.m. [Other] people will focus their pre-race meal the night before.”

Rasmussen also suggested a prerace snack consisting of between 300 and 400 calories, preferably with lots of carbohydrates and a little bit of protein. Ready made shakes are one option, but choco-

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late milk and a banana or a bagel with peanut butter can also work.

“You never want to try something on race day that you haven’t tried in practice,” he said. “I always like [a protein/carbohydrate shake] and then I combine it with a banana.

My wife, she doesn’t eat anything a lot of times and that works for her.”

Finally, he said some people like to drink between eight and 10 ounces of a sports drink right before they start an activity.

Both Rasmussen and Eric Orton, a personal trainer and owner of the Jackson-based trainwitheric.com, emphasize that people need to experiment with exercise nutrition to find what works best for their bodies.

“People read all this stuff that’s put out there by companies selling products,” Orton said. “They stick with that and it might not work for them. They hesitate to experiment.”

During exercise, Orton said a good place to start experimenting is consuming anywhere from 200

to 300 calories per hour. Just how much your body needs is not only a function of how long you exercise and at what intensity but also how much you’ve taxed your body in the days before the event.

“The more you’re doing throughout the week, the more you’ll probably have to be concerned about what you’re doing on the longer day,” he said. “If you’re doing some intense stuff constantly throughout the week, you’re burning more calories. You have tapped into those reserves throughout the week.”

As with pre-workout nutrition, people have options for the calories they take in during the ride, hike or run. For a 90-minute workout, a sports drink might be enough. But for a four-hour ride, an athlete will need calories and fluids every hour, Orton said.

Rasmussen said that during exercise, athletes need to eat something with a high glycemic index, carbohydrates that are easy to digest so that the glucose can See Bonk on 9

Our Practice Specializes in: Sports medicine • Fracture and trauma care Joint replacements of the shoulder, elbow, hip, knee and ankle Conservative and surgical care of the spine Comprehensive arthritis care Arthroscopic surgery of the shoulder, elbow, hip, knee, and ankle Foot and ankle surgery On sight x-rays and MRI services Electrodiagnostic testing (nerve testing) Traditional and endoscopic carpal tunnel release Computer navigation for hip and knee replacements 192112

HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010 - 9

Bonk

Continued from 8

be shuttled rapidly into the muscles, as opposed to something like oatmeal, which is more of a slowly digesting type of carbohydrate.

“You want something that’s going to get into your system quick,” he said.

It doesn’t necessarily take a fancy powder or gel to get the needed boost of energy.

“We did a study looking at honey as a nutritional supplement as opposed to power gels,” Rasmussen said. “We saw very similar results because honey is a natural form of sugar.”

Some of the latest research shows that drinks and gels that have small amounts of protein have an added benefit.

“They help to inhibit muscle breakdown,” Rasmussen said.

Orton said a new trend with sports nutrition is a blend of maltodextrin, fructose and dextrose.

“That combination has been recently shown to be a very good mix to allow your body to absorb that drink as quickly as possible,” he said. “I still would say something is better than nothing, if all you have is a Snickers bar, go for it.”

People should stay away from sucrose, a simple sugar, though, he said.

Orton said some athletes, even ultra endurance athletes, simply listen to their bodies.

“You hear all this stuff about going with what your body craves,” he said.

“You hear about bacon and cheese. A lot of people like figs and dates. Dates are really good, a high source of carbohydrates that are natural. There are even some natural gels out there that use brown rice syrup. That’s where the experimentation comes in.”

Another piece of the nutrition puzzle that people often neglect is a post nutrition snack, Rasmussen said. Getting some food in the body quickly after a workout is especially important for athletes who must recover for an event or

Eating for endurance exercise tips 4 Nutrition is important before, during and after exercise

4 Eat four hours before an

WARNING:

activity

4 Consuming calories during

an activity may be required when exercise exceeds 75 to 90 minutes 4 Try 8 to 10 ounces of a sports drink before exercise 4 During long activities, consider eating 200-300 calories per hour 4 Consuming small amounts of protein during exercise may keep muscles healthy 4 Eat a snack within 30 minutes of completing exercise to help muscles recover 4 Listen to your body and experiment with different foods

Your cellphone may be hazardous to your health.

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more training the next day.

“You really need to ingest something right away, within 30 minutes after completing the event,” he said. “That’s where a lot of these post-race recovery drinks come into play.”

“Personally, right after a race ... the last thing I want to do is eat some hot food,” Rasmussen said. “A pretzel with some peanut butter and bagels are always popular.”

Aside from experimenting to find out what works best for your body, Orton emphasized consistency. “[You need] consistency with your training, consistency with your nutrition throughout the week, and consistency throughout the workout,” he said.

“Your stomach likes to be topped off.”

“Sometimes people, if their body is not used to getting fuel, they don’t realize how good it can be, how good they can feel,” Orton said.

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10 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010

body

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TETON WELLNESS INSTITUTE

News&Guide photo / brent Mcwhirter

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At Jackson Whole Grocer, Kim Degma prepares a celery, kale, spinach and cucumber concoction. Green juices are part of the store’s cleansing regimens.

Saying ta-ta to toxins

OCTOBER 1, 2 and 3, 2010

Cleansing fasts rid your body of impurities, make you feel better, advocates say

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By Cara Rank

t happens every off-season when I want to have people over for dinner.

So-and-so is only eating raw. He’s off sugar and dairy. She’s on supplement-spiked smoothies.

So no, they say, pasta and puttanesca sauce sounds amazing, but we can only have the salad. Can you hold the Parmesan and dressing?

If I lost a pound every time I heard “I’m cleansing,” I’d look like Calista Flockhart.

“We’re exposed to so many toxins,” said Babs Melka, of Roadrunner Apothecary. “A cleanse gives the body more of a rest to be able to process these toxins and get them out. It’s like cleaning the basement. Every six months, you’ve got to do another cleaning.”

Toxins, such as cortisol, pesticides, chemicals and heavy metals, can come form anywhere, she said. Stress, the environment and food are vehicles.

“When we cleanse, we are lowering the toxic load we are putting into our systems by using clean, easily digestible foods,” Melka said. “Then the body can reduce its toxic load.”

It kind of sounded like hocus pocus.

Once I tried to detox and broke the regiment after eight hours by eating Cheetos.

So I set out to find out what this cleansing business is all about.

My search started with dinner, to which a friend brought raw “pizza.” The

“crust” was a mash of soaked, pureed nuts and was topped with “cheese,” a blend of tahini and several other ingredients. The “sauce” was made of pureed tomatoes and garlic, topped with basil and olives.

We scooped up the room-temperature mush with a fork.

The friend was doing a 10-day cleanse, which consists of uncooked vegetables, fruits, nuts, juices and supplements. The regimen, developed by Robby Tozzi, of East Wind Wellness, removes toxins from the cells and the entire digestive system by eating clean foods, he said.

“Most people will experience better sleep, better digestion, better energy,” Tozzi said. “People with sinusitis and allergies will see a big change.”

Are there really toxins in the atmosphere that our bodies cannot resist?

Haven’t we adapted to the changing world?

“The top clinics in the world are treating things like cancer — and getting results — with live foods and cleansing,” he said. “I think it’s kind of crazy when people these days say we have adapted. I don’t think adaptation is the thing. There are so many chemicals in our system; close to 50,000 new chemicals have never been tested since World War II.” That’s not to mention round the clock Wi-Fi waves and cell phone streaming.

“It’s a toxic world,” he said.

Tozzi has hundreds of clients who See Toxins on 11

HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010 - 11

Toxins

Continued from 10

follow the program annually. For $199, clients receive supplements, support and a meal plan that includes lots of fruits and veggies and some whole grains and legumes. They cut out items such as sugar, meat and salts.

“All the stuff that most people eat and think is really good tasting lets the body hold onto stuff,” he said. “Sugar is a big one. If you can cut sugar, the body starts going into a cleansing process.”

Many times, what you choose not to eat can be just as important, he said.

“Can I drink alcohol?” I asked, seriously.

He laughed. “No,” he said.

But I get grungy (grumpy and hungry), I told him.

“I’d be surprised if I couldn’t do something for you,” he said. “There are many modifications and a lot of tricks that people can do.”

I considered Ka Formula’s Clear the Toxins next.

The 10- and 20-day programs consist of drinking fruit smoothies blended with a protein powder that is spiked with additional nutrients. Clients use supplements to expedite the cleansing process.

“Part of the reason people cleanse in the off-season is because people are less active, there are fewer things to do,” founder David Johnson said.

Johnson said clinical trials found that users lost weight, reported less joint pain, had increased energy and lowered their cholesterol levels. One person reduced his cholesterol more than 100 points.

Clear the Toxins allows clients to eat fruits, vegetables, quinoa and avocado.

After 10 days, they can add animal protein and brown rice to their diet.

They even get a piece of dark chocolate every day.

“The other programs are typically starvation programs,” said 47-year-old client Andrew Gellman. “With Dave’s program,

Other cleanses available

We are occupational therapists specializing in upper extremity rehabilitation

• Jackson Whole Grocer offers 3- and 5-day fasts in which you drink live green juices and teas and nosh on salads.

Prices range from $75 to $165.

Carpel tunnel releases • Fractures/splinting Wound care • Overuse/ Tendonitis Shoulder rehabilitation • Ergonomics Functional capacity evaluations

• Roadrunner Apothecary has a variety of cleansing products. 732-0540

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• Cate Stillman offers a spring and fall yoga cleanse. www.yogahealer.com

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Hand & Upper Extremity Rehabilitation

if you’re ever hungry, it’s your own fault.”

Gellman cleanses four times a year for 10 days. The first time, his body fat dropped from 11 percent to 8 percent and he said that his energy multiplied threefold.

“The reason I still do cleanses is that my habits regress, meaning I still reach for comfort foods,” he said. “So every quarter I like to reset my clock, my habits, to remind me of how good I feel when I put nothing but the purest foods in my body.”

But, I told him, part of my daily routine is cooking with a glass of wine.

The alcohol is the hard part, Gellman said. Cooking is not.

“My wife makes baked yam french fries, and they’re great,” he said. “We have exotic, interesting salads. Have you ever had baked broccoli, asparagus and cauliflower with garlic and olive oil? It’s a little more restricted, but it’s so good. Cara, after you hear all of David’s disciples talk about the program, I’d be shocked if you don’t give it a try yourself.”

I’m not totally ready to give up coffee and cheese for 20 days. But I have put down the Gummy Bears I was noshing on while writing this.

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We are currently accepting patients for pregnancy care, gynecology, & infertility.

We also offer services for urinary incontinence repair, pelvic reconstruction & laparoscopic surgery.

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We look forward to seeing you and being partners in your healthcare!

Gros Ventre OB/GYN P.O. Box 1844, Jackson WY, 83001 Phone: (307) 734-1005 | Fax: (307) 734-1165 192071

12 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010

body

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By Katy Niner

oisture. At high altitudes, the air lacks it, and the epidermis acutely feels – and shows – its absence. To combat this assault, local skin care experts recommend moisturizing and protective skin and hair care regimes.

In this lofty locale, a bevy of spas and boutiques have cropped up to cater to parched skin and hair. Shannon Asbell, owner, aesthetician and nail technician at Body & Soul Spa, highlighted the crucial elements of an effective daily skin care regime: always wear sun protection, and before bedtime, apply a heavy night moisturizer and eye cream. She recommends using organic products as an antidote to the chemicals swirling around us.

Keep hair hydrated, too. “The key to beautiful hair in a harsh climate in Jackson is moisture,” Asbell wrote.

Asbell recommends that individuals moisturize hair with deep conditioning treatments and at-home masks. Trim ends to keep hair healthy. Also, hair glossing treatments can be used to help restore shine and health, and keep hair “looking its best,” Asbell said.

Beyond the day to day, a potent skin care program will consider seasonal transitions.

Each season carries different skin concerns, so switch up your regime, said

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Tessa Kienow, area spa director at Terra Resort Group. Winter requires diligence in strengthening immunities and combating cold, windburn and reflective damage, while summer requires vigilance to prevent sun burn and dehydration.

Spring presents an opportunity to replenish winter-weary skin.

“Spring is a time of renewal, both in nature and in our own bodies,” Kienow said.

Channel this energy into a change in your skin care routine or adopt a new program.

“Living at high altitude can wreak havoc on the skin of our face and bodies,” she said.

Kienow offered several tips “to keep skin fresh and young.”

• Step up exfoliation: This increases cell turnover and skin metabolism.

“Removing dry and damaged skin can do wonders for its appearance and feel,” she said.

• Use professional skin care products: Solitude Spa stocks Ling Skincare, a line developed by Ling Chang which boasts ingredients like hyaluronic acid, a wonder compound that retains up to 500 times its molecular weight in water. Such ingredients “ward off excessive dehydration, improve barrier function of the skin and keep skin soft and healthy.” Chan, an icon in the skin care industry according to Kienow, feels dehydration lies at the root of skin issues.

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and behavioral needs of children and their families.

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HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010 - 13

All of your Orthopaedic needs covered under one roof by fellowship trained specialists!

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istock Photo

Living at high altitude is tough on the skin, but experts say there are several steps people can take to compensate.

Continued from 12

• Treat capillary damage: At high altitudes, skin shows accelerated signs of age because it becomes more vascular due to the lack of oxygen. The redness in your cheeks is actually capillary damage. Assuage such stress with treatments like the Red LED light therapy offered at Solitude Spa, which “reduces redness by increasing circulation and strengthening capillary walls.” At Solitude, Red LED can

be added to any facial “to prevent damage or speed healing.”

• Tone and rehydrate skin: Skin can feel dry and damaged after a long winter.

Rejuvenate parched skin with essential oils. Kienow recommends taking a bath with natural hydrators like milk and honey and “add in a few drops of essential oils of grapefruit, juniper and lavender to aid internal cleansing and improve overall moisture.”

• Drink water: At high altitudes, water, lots of it, is the fundamental skin elixir.

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Te l lHealth Minded

Consumers

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• nutrition • fitness • women’s health • holistic healing

advertise in the

in conjunction with the St. John’s Health Fair

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•

Robert Tozzi, L. Ac. 307-732-0206 • 1010 S. Park Loop • www.eastwindwellness.com

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JoAnne Scott, RN • Certified Practitioner 557 E. Broadway • 734-9591

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We enhance physical performance thru training for post rehabilitation, pre/post natal, targeted weakness/pain, and sport specific.

Augustine Hernandez, Exercise & Performance Specialist Katie Jackson, Exercise & Performance Trainer 307-413-1621 · 307-690-3261 ·1116 Maple Way · www.t2bb.com

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Walkabout Healing Arts

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Gentle treatment for chronic pain, injuries, asthma and much more.

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Suzie Ornowski, PharmD, Babs Melka, PharmD Your Local Compounding Pharmacy Pharmaceutical grade supplements available 307-732-0540 • 310 E. Broadway, Suite 9

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When it comes to your kids,

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HOLE HEALTH Special Section

publishing April 28, 2010

These businesses provide health or wellness services.

acupuncture

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Wide variety of skin care treatments, laser hair and tattoo removal, varicose vein treatment & chin enhancement.

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For listing information, call your sales rep at the Jackson Hole News&Guide at 732-7070.

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Read weekly articles by columnists on various topics:

FOR YOUR HEALTH 189336

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14 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010

exercise

BoB SkaggS

M. Coun., L.P.C. Licensed Professional Counselor • Children • Adolescents

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Board Certified Internal Medicine Board Certified Holistic Medicine Master’s of Pharmacology/Immunology

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he blue skies of summer quickly hazy during fire season. It won’t only ruin your view, but smoke in the air can be hazardous to your health. Most exposure to smoke during fire season will only have shortterm health affects on eyes, ears, nose, throat and lungs, said Dr. Timothy Ryan, environmental public health section chief with the Wyoming Department of Health. But even low-levels of smoke can be irritating if you already have respiratory issues like asthma or emphysema.

While life doesn’t need to shut down during the haziest days, outdoor exercise does. Exercise increases the amount of air — and during fire season, smoke — drawn into the lungs, Ryan said.

If you can smell or see smoke in the

air, take your exercise inside.

The Centers for Disease Control and Prevention recommend staying inside and using an air conditioner during the smoky season. And, people should not only limit outside exercise, but they should also limit physical chores that put extra demand on the lungs and heart.

Dust masks, bandanas or other cloths, even if wet, will not protect against the smoke, the CDC’s Web site said.

Don’t let the smoke totally derail your fitness plans. Use smoky days as a chance to cross train, hone needed muscles and take your fitness to the next level with suggestions from personal trainer Hannah Steele. Don’t forget to end all of your workouts with core work and stretching, important elements, no matter your sport.

You can always do what you love, even inside Hike: Try the stair climber at the gym, or pick a flight of stairs at work or home and use them for intervals. Add some lower body strength exercises for your glute muscles, quads, hamstrings and calves. Don’t forget balance work, such as walking the length of a foam roller, round side down, to prepare you for those log crossings on the trail.

Climb: Try heading inside to a climbing gym to keep skills honed by bouldering or top roping with a friend. Climbing uses pulling muscles, such as lats, shoulders, biceps and forearms, so lift weights focusing on those areas. But work the pushing muscles, like pectorals, anterior deltoids and triceps, with push ups, dips and reverse flys. Balancing the muscle groups increases mobility which prevents injury.

307.732.1039

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T

By Kelsey Dayton

Bike: Try hitting a spin class or putting your bike on a trainer at home — training on the bike you ride inside will get you more comfortable on it outside. Tackle intervals. You can use a heart rate monitor or body awareness to do some hard bursts. The length and intensity of intervals depends on where you are in your training. Intervals should get longer and harder as you progress. Intervals strengthen the heart and train your body to have the extra “oomph” for a hill or to make a move to pull out in front of the pack. Off the bike, do squats and lunges.

192551

treating the body, mind, and spirit.

Fire-season smoke is dangerous; protect your lungs and work out inside

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just don’t breathe it in

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Run: Try jumping rope, which is still weight bearing and keeps the heart and lungs prepped for runs. Runners need strong lower bodies, so add some squats, lunges and calf raises. Don’t neglect the hamstrings — a common mistake runners make. Hamstrings are needed to stay balanced and injury free.

HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010 - 15

St John’s Medical Center 192002

16 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010

event

Fair for all

ages Annual health event covers issues important to everyone

T

By Kevin Huelsmann

here will be hospital beds and fire trucks, yoga and Zumba classes, skin cancer screenings and tests for memory, hearing, vision and dental care.

This seemingly incongruous amalgamation of events and equipment comes together, and makes sense, once a year at the St. John’s Community Health Fair. The free event, scheduled to run from 9 a.m. to 1 p.m. on Saturday at Snow King Center; brings a wide array of medical services and informational presentations to Jackson Hole residents who might not normally get an identification card for their child or seek out a discussion about prescription drugs.

“It’s family-orientated, but we try to bring in things that anybody can enjoy,” said Catherine Holland, who coordinates the health fair.

To do that, the fair offers activities and information about everything from pediatrics to geriatrics.

For kids, Jackson Pediatrics will conduct a teddy bear clinic and bring in a hospital bed that children can sit in, so they can be hooked up for faux medical tests.

“We always focus on offering kid-friendly activities so children learn the importance of taking care of one’s health from an early age,” hospital spokeswoman Karen Connelly said.

Bell Fitness also is slated to host two exercise classes for children, including activities such as jumping on See Fair on 17

NEWS&GUIDE PHOTO / BRADLY J. BONER

Deputy Steve Hansen of the Teton County Sheriff’s Office measures 8-month-old Devyn Vontz for a child identification card during a recent Community Health Fair.

KEYNOTE SPEAKER

MAY 28 - 31

Sun Valley Idaho Memorial Day Weekend

Over 50 presentations on Mind, Body and Spiritual Wellness

Workshops on everything from golf to herbal remedies to belly dancing

Jamie Lee Curtis Live Wisely, Love Well

FEATURED SPEAKERS Abraham Verghese and Lama Surya Das

SUNDAY, MAY 30

Exhibit Hall and Hands-On-Hall FREE and Open to the Public Over 50 Vendors selling fabulous products and offering massages and other treatments

www.sunvalleywellness.org 208-726-2777

Special Musical Performance

by Grammy Award Winner

Colbie Caillat 191700

HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010 - 17 Continued from 16

“It is never too late to be what you would have been.”

9 a.m. to 1 p.m. Saturday at Snow King Center 9:30 to 10 a.m.

Zumba Fitness with Manny Sanchez, demonstration and a brief class

George Eliot

9:30 a.m. to 12:30 p.m.

Pharmacy Brown Bag With pharmacists to check medications for duplications, safety and whether they are expired 10:30 to 11:30 a.m.

Fit Kid Class with Bell Fitness, children’s activities

Elizabeth Cheroutes, MSW Licensed Clinical Social Worker

Therapy for Individuals and Couples Specializing in trauma and pre-natal and postpartum mood disorders.

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11 a.m. to noon Yoga Class with Inversion Yoga, demonstration and brief class 11:30 a.m. to noon Zumba Fitness with Manny Sanchez, demonstration and brief class

www.JacksonHoleTherapy.com • elizabeth@jacksonholetherapy.com

191909

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er h T

r Individuals & C o f y ou ap

ple s

trampolines and maneuvering through hula hoops.

Also, staff from the Teton County Sheriff ’s Office will issue identification cards for children, and Jackson Hole Fire/EMS is slated to offer safety checks for car seats in the lower parking lot near the arena.

This year’s fair expands some of the exercise classes that have been offered in past years. In addition to the children’s exercise classes, organizers plan two Zumba fitness classes and a yoga class.

Another new event this year is a pharmacy brown bag lunch discussion in which pharmacists will review people’s medications to make sure the prescriptions are not duplicates, the drugs work together effectively and the medications have not expired.

The pharmaceutical review is just one of the many practical services offered by the fair.

Physicians and specialists will also offer a multitude of opportunities for blood pressure, body fat, vision, hearing, dental, orthopedic, memory and skin cancer screenings and tests, all of which are free.

The only portion of the fair that costs anything is the blood draw, which the hospital will administer in advance of the fair.

Those tests, which can be scheduled until April 30, will not be offered at the fair. Those hoping to have their results analyzed need to bring their results to the event, unlike in years past.

For those not looking to delve into tests and screenings, there are myriad informational booths slated for Saturday.

Staff from St. John’s Living Center will talk about living wills and longterm care, and physicians will talk about cognitive health, pre-natal care and the importance of sleep. There’s also an

St. John’s Community Health Fair events

12:30 to 1 p.m.

Fit Kid Class with Bell Fitness, children’s activities informational booth about the potential hazards of cell phone use.

The fair is meant to address all areas of wellness for community members.

“An important goal of the St. John’s Health Fair is to improve community wellness by providing health information and screenings at a fun, interactive social event,” Connelly said.

Spanish-speaking interpreters will be available at the event.

The Future Isn’t Fixed.

Let’s collaborate for change.

Penny Mohan, LCSW 307.690.3014 * 420 S. Jackson St. Blue Cross participating provider

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191866

Fair

PDF

Healthy Minds Healthy Bodies Healthy Smiles S. Ed Owens, DDS, MSD Shannon E. Owens, DDS, MS Specialists in Orthodontics and Dentofacial Orthopedics Treatment For Children, Adolescents, Adults Local Orthodontic Care Certified by the American Board of Orthodontics Invisalign® Certified Orthodontists

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18 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010

policy

Creating

proper protocols Doctor on a quest to refine treatment

192473

St. John’s Community Health Fair May 1, 2010 9am - 1pm Snow King Arena Bring Your Blood Screening Results for Free Interpretation • Eating for Good Health • Free Vision, Hearing, Dental, Orthopedic and Skin Cancer Screenings • Diabetes Education • Cancer Prevention • Teddy Bear Clinic • Body Fat Analysis • Car Seat Safety Checks • Ambulance Tours • Community Volunteer Opportunities • Stress Management And Much Much More

No blood drawS available at tHe HealtH Fair.

Zumba Fitness 9:30 - 10:00 with Manny Sanchez

Pharmacy Brown Bag

9:30-12:30 bring in current, original prescription bottles and a pharmacist will: • Ensure no medications are duplicated or expired.

• Check that all medications are working effectively together.

No supplements or herbals please.

Fit Kid Class 10:30 - 11:00 with bell Fitness

Yoga Class 11:00 - 11:30 with inversion Yoga

Zumba Fitness 11:30 - 12:00 with Manny Sanchez

Fit Kid Class 12:30 - 1:00 with bell Fitness

Sponsored in part by

St John’s

Community Health Fair 192003

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Subscribe to 52 weeks, only $46 outside Teton County Subscribe to 52 weeks, only $39.00 outside 42 and $45 for the e-edition. Just call 307-733-2047

Teton County (in the USA). Just call 307-733-2047.

D

By Kevin Huelsmann

r. Jerry Katz is trying to take some of the subjectivity out of practicing medicine at St. John’s Medical Center.

While in the past some have viewed medicine as part art, part science, Katz is introducing a stronger reliance on following protocols. His approach relies on a set of order sheets, each with its own set of instructions and guidelines for how to treat particular ailments.

“If someone comes in with a gastrointestinal bleed, the doctor can go pull the order sheet for that and it will have recommendations for treatment, for pathogen tests, transfusion recommendations, consultation suggestions; everything is right there,” said Katz, a hospitalist at St. John’s.

The system seeks to implement a more standardized level of care that connects doctors with the most current information on drugs and treatments, and helps them consider all scenarios when treating patients.

The push toward this type of system is one that is being considered at hospitals across the country.

Katz said the protocols are based on a grading system that rates the credibility of the research completed for a certain drug or treatment as well as the strength of evidence backing that research. The scale rates research on a scale of one to three, one being the best. Research is graded with an ‘A’, ‘B’ or ‘C’; ‘A’ being the best in this case.

For example, a double-blind experiment, in which patient and physician are unaware of whether they are testing a placebo or a real drug, that has had a substantial amount of evidence backing its use, is often graded as 1A. “You want every medicine prescribed to every patient to be 1A,” Katz said. “But that can’t always be the case. Let’s use aspirin as a recommendation to treat headaches.

It might be 1A for most patients, but for someone who has a particular condition or reaction to that it might be a 1C.” Despite the push for decisions based on research and evidence, there is still a fair amount left up to individual doctors.

“It gives doctors guidelines and current thoughts about how to treat something, but the fine-tuning of those guidelines is where the art comes in,” he said.

There will still be intangible elements to practicing medicine that require the skill-set of a well-trained physician, such as being able to properly diagnose a patient’s malady, gauging that person’s ability to cope with certain treatments or even the condition itself and employing an effective bedside manner.

“Anyone can do an order sheet, but to know why they are doing it and how it will affect the patient; that’s the art,” Katz said. “It’s like the difference between a chef and a cook.”

The difference, Katz said, is the amount of subjective decision-making that goes into treatment.

“Right now, you put a great deal of faith in your physician in Jackson Hole to treat everybody without difficulty,” Katz said.

“And, for the most part they do, but there can be things that they’re not entirely up to date on or haven’t had time to take See Protocol on 19

HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010 - 19 Katz has about 20 order sheets written and expects to finish up another 40 to 50 sheets. Once completed, those sheets will make their way through various medical review boards at St. John’s before being put into place in the hospital.

That, however, is not the end state. The sheets are meant to be frequently updated to include new findings in medicine.

“It’s like finishing dry wall,” Katz said.

“You throw a lot of plaster on the wall at first and then you sand it down and shape it to a form.”

To help figure out what that wall will actually look like, Katz is relying on a whole host of physicians and specialists to review the order sheets.

“There are dieticians and pharmacists and critical care physicians all looking at this,” Katz said, naming off a portion of the individuals who are helping review the sheets. “It takes a village to do this and that’s what you want. That helps to give you a community standard that everyone 192091 supports.”

Protocol Continued from 18

educational classes about.”

The strength of evidence-based medicine comes in the ability to give doctors more access to information.

“A doctor might not be up to date with all of the literature in a certain area of medicine,” Katz said. “But a pharmacy committee that is reviewing this sheet would be up to date with all of that knowledge.”

The system is meant to be constantly evolving. As physicians use sheets and find new articles about certain treatments and drugs, they are supposed to provide links to the new information on the sheets, which, eventually, will be digitized.

“In an ideal world, a doctor would fill out an order sheet and it would immediately be sent to all of the nurses and pharmacists, the lab and x-ray technicians, everyone,’ Katz said.

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20 - HOLE HEALTH, Jackson Hole News&Guide, Wednesday, April 28, 2010

ASPENS WELLNESS CENTER 19 Independent Businesses, Under One Roof, Dedicated To Your Well Being - In The Aspens on The Teton Village Road

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ExpEriEncEd and accrEditEd pErsonal trainErs Joan Lapham, AAHFRP-CPT, 307-413-2895 Matt Delgado, NSCA-CPT, 307-690-0504 Jessie Aufderheide, NSCA-CPT, 307-690-2103 Sandy Humphrey, ESA-CPT, 307-699-3337 Greg Litzelman, AAFRP –CPT, 307-690-6092 Tim Gibbons, Cooper Inst-CPT, 307-690-3935 Jackson HolE pHysical tHErapy Sports Medicine and Rehabilitation Scott E. Harmon PT,OCS,SCS,ATC,CSCS Brian Prax, MA,PT 307-734-9005

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