Hole Health 2019

Hole Health

May 1, 2019

A special supplement to the

Helping rescuers help you Wilderness first-aid skills are useful in the backcountry or at a car crash. See page 6.

Cover photo: Rescuers practice how to properly package and transport a patient.

COURTESY PHOTO

St. John’s Community Health Fair • 9 a.m. to noon Saturday • See story on page 3.

Pop goes the ligament

Hokey or helpful?

Living high could bring you down

ACL surgeries and recovery are the bread and butter of life in a ski town. Here’s what they really entail. See page 9.

A reporter reviews three alternative therapies.

See page 14.

Research finds a link between high altitudes and depression. See page 5.

2 - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019 Raising great kids & great parents together!

Helping families with: • Challenging behaviors • Defiance & aggression • Discipline & power struggles • Reasonable expectations • Risky behaviors • Stress and anxiety • Homework hassles • Bedtime battles • Sibling rivalry • Meltdowns & strong emotions • Maintaining a strong relationship • Managing digital media use • Prenatal & postpartum support • Parenting from your values

Dear readers,

Offering classes, coaching, consulting, and customized groups for parents/caregivers of children & teens!

Growing Great Families helps you understand the world from your child's perspective so you can connect with them and teach them the skills they need as they grow into kind and thriving adults.

Rachel Wigglesworth, M.S, M.Ed. www.growinggreatfamilies.org 307.732.0413

From the editor

362350

A backcountry ski accident afforded me an unexpected look inside Jackson Hole’s medical services over the last year.

As the Jackson Hole News&Guide’s health reporter I write about people who are injured or sick and the services available to them. I cover health care policy and costs, insurance, the business realities driving providers, wellness and local research.

I never anticipated being inside an MRI machine, experiencing the trials and tribulations of physical therapy or grappling with the stress of surgical bills myself. I’m thankful my injury isn’t more serious or more permanent. But here I am — nine months out from anterior cruciate ligament surgery and still not feeling quite like my old athletic self — with renewed empathy for my sources and the firsthand knowledge of how confusing America’s

health care system can be.

I took the opportunity to address the quintessential mountain town ACL surgery on page 9. If this ordeal had to happen to a reporter, at least it was the one who covers health, right?

This section is packed with a variety of stories, from reporting on Jackson’s disability-friendly status (page 12) and a story on altitude and depression research (page 5) to a feature on medical interpretation (page 8). Also don’t miss learning more about chronic wasting disease’s connection to human health (page 4) and why you should take a Wilderness First-Aid class (page 6).

Happy reading. If you’re recently injured and need a shower chair, crutches or a straight leg brace, you know how to reach me.

Hole Health Editor

Special supplement written, produced and printed by the Jackson Hole News&Guide Publisher: Kevin Olson Associate Publisher: Adam Meyer Editor: Johanna Love Managing Editor: Rebecca Huntington Deputy Editor: Melissa Cassutt Layout and Design: Andy Edwards, Samantha Nock Photographers: Bradly J. Boner, Ryan Dorgan, Rebecca Noble Copy Editors: Jennifer Dorsey, Mark Huffman, Tom Hallberg Features: Melissa Cassutt, Jennifer Dorsey, Allie Gross, Tom Hallberg, Mike Koshmrl, Kylie Mohr, Emily Mieure, Cody Cottier

362364

Programs and Services at

Advertising Sales: Karen Brennan, Tom Hall, Chad Repinski, Megan LaTorre, Oliver O’Connor Advertising Coordinator: Maggie Gabruk Creative Director: Sarah Wilson Advertising Design: Lydia Redzich, Taylor-Ann Smith, Luis Ortiz, Chelsea Robinson Pressroom Manager: Chuck Pate Pre-press: Jeff Young Press Supervisor: Dale Fjeldsted Pressmen: Steve Livingston, Lewis Haddock

Emergency and Community Services

Child and Family • School based services • Home based services • Play Therapy • Summer Day Treatment • Consultation with local agencies and childcare facilities (Head Start, Van Vleck)

Office Manager: Kathleen Godines Customer Service Managers: Lucia Perez, Rudy Perez Circulation Manager: Kyra Griffin Circulation: Jeff Young, Jayann Carlisle

• 24 hour crisis support • Walk-in crisis

©2019 Teton Media Works Jackson Hole News&Guide P.O. Box 7445, 1225 Maple Way Jackson, WY 83002 Phone: 307-733-2047; Fax: 307-733-2138, Web: JHNewsAndGuide.com

• Hospital assessments • Jail services • Support for community incidents

Adult • General Outpatient • Individual • Groups • Masters Level Therapists • Psychiatrist & Advanced Nurse Practitioner for medication management

• Outreach and education

Healthy Minds • Healthy Bodies • Healthy Smiles

• Suicide prevention • Mental Health First Aid

Shannon E. Owens, DDS, MS S. Ed Owens, DDS, MSD

ALL services are offered on a sliding fee scale, based on income and ability to pay

Specialists in Orthodontics and Dentofacial Orthopedics

Mountain House Adult Therapy Outreach Center • Drop in Center • Job coaching and Career support • Skill building • Social/Recreational activities • Advocacy • Case Management • Psycho-education • Psychiatrist & Advanced Nurse Practitioner for medication management

Call 307-733-2046 to make an appointment Walk-in crisis help available M-F 8-5pm - After hours 24/7

Treatment For Children, Adolescents, Adults | Local Orthodontic Care | Certified by the American Board of Orthodontics | Invisalign® Certified Orthodontists 327824

1130 S. Hwy 89 733-3848 x2

www.owensortho.com 361339

HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019 - 3

Get screened, educated at health fair Mental health testing and housing info join a long lineup of free screenings.

Free exams and evaluations – Mental health screening – Injury and balance screening – Orthopedic injury exams – Sleep assessments for adults, kids and newborns – Coupons for free in-office audiology screenings – Atrial fibrillation screening – Cognitive screening – A1C screening

By Melissa Cassutt Those without a primary doctor may enter through the inflatable colon.

Those with wonky warts, those who need their eyes checked, and kids who want free goodies and maybe a bike helmet are also invited.

The polyp-lined intestine, an educational attraction hauled in by Wyoming Cancer Resource Services, is the gateway to a labyrinth of free screenings and healthy giveaways at the annual health fair.

Teton County/Jackson Recreation Center doors open at 9 a.m. Saturday for the 2019 St. John’s Medical Center Community Health Fair.

Booths, of which there will be nearly 50, will be staffed until noon.

“I really see it as the onestop shop for the underserved in this community,” St. John’s Wellness Director Julia Heem-

Exhibitors The 2019 St. John’s Medical Center Community Health Fair includes nearly 50 exhibitors offering education, screenings and giveaways. Visit JHNewsAndGuide.com for a full list of exhibitors.

– Drawing for a free mammogram – Fall risk and functional movement screenings – Blood panel interpretations – Prostate screening – Immunization screening – Skin cancer screening – Hand and finger strength evaluation – Concussion screening

Spring Runoff 5K run and walk AMBER BAESLER / NEWS&GUIDE FILE

Runners and walkers start the 5-kilometer course at 9 a.m.

Saturday at North Park.

Participants must register for the event prior to race day; there is no race-day registration. Entry costs $10 and includes a race souvenir. Register at TetonCountyWY.gov or at the Teton County/ Jackson Recreation Center by 3 p.m. Friday.

Dr. Karin Klee shows an X-ray to Ian Sanchez, 6, and his sister Jessica, 4, at last year’s Community Health Fair. The “teddy bear clinic,” where kids can bring stuffed animals for checkups, will be part of this year’s fair, too.

stra said, “whether it’s someone who just has a tweaked knee from ski season but doesn’t have insurance … or someone who’s wanting to do an atrial fibrillation screening and talk to a cardiologist.”

All health fair evaluations are free, including cardiology, vision and cancer. St. John’s has also expanded its offerings this year to include mental health screenings for depression, anxiety and other illnesses.

“We’re really putting a focus on doing some strong mental health screening,” Heemstra said. “For the first time ever we’ll have more than one booth providing that screening.”

Also new for 2019: hernia screening, “which we’re really excited about,” she said; concussion screening, which is re-

turning after a hiatus; and affordable housing information.

“We feel very strongly that housing is one of the primary social determinants of health in this community,” Heemstra said. “It’s part of looking at health and wellness from a holistic perspective.”

Representatives of the Jackson/Teton County Affordable Housing Department will distribute information on housing options.

Teton County Victim Services will be on hand to discuss housing discrimination and landlord-tenant disputes.

“All of this is about raising awareness about what the community can do to create an environment for whole-person health,” Heemstra said.

Some booths will be staffed by people who are bilingual;

otherwise, Spanish-speaking interpreters will be available, and Wellness Department staff armed with iPads can translate dozens of languages.

One of the most popular parts of the fair, blood panel interpretation, will also be available, though patients need to have their blood drawn by today for results to be ready to read. Those wanting an A1C screening — which tests average blood glucose levels over the past three months, and can be used to diagnose diabetes — can have a finger stick and reading at the fair.

“We have more physicians that are participating this year than we ever have before,

and I think the reason why is we’re asking them to use their true skill sets,” Heemstra said. “We want them to actually be screening patients as they would be in the office.”

In 2018 about 850 screenings were performed at the fair.

The fair will also have stations for kids, like a “teddy bear clinic” and tours of a fire truck and an ambulance. Coffee and snacks will be served in the newly remodeled Rec Center entry, a sneak peek of the remodel before the grand reopening.

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

TETON LASER CENTER Maura Lofaro, M.D., Jan Bauer R.N., Jenny Christensen, L.E.

555 East Broadway Suite 108 • Jackson, WY 83001

Call 734-0711 to schedule your appointment.

OFFERING BELLAFILLTM

THE ONLY FILLER FDA APPROVED TO LAST FOR FIVE YEARS.

Botox™ Juvederm™ & Restylane™ Products Radiesse™ Latisse™ 15% OFF Obagi and Alastin Skin ALL GOODS & Care Products™ SERVICES GloMinerals Makeup™ IN MAY! Hair Removal Skin Rejuvenation Photo Facials Fractional CO2 Laser Skin Resurfacing Achieve instant, glowing results with a customized, non-invasive chemical peel including Obagi’s Radiance peel and Glo Therapeutics chemical peels.

362317

“My back and neck fusion surgeries have changed my life. I am amazed at what I’m able to do considering all I’ve been through.”

Jeff Hanson Jackson, WY

tetonhospital.org/spine | 307.739.6199 To speak with someone who has had neck or spine surgery, call the Better Way Back® at 800.745.7099.

362339

4 - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019

Healthcare made personal Theresa Lerch Family Practice Welcoming New Patients

Caitlin Shea FNP-C

Lori Bowdler

Theresa Lerch

FNP-BC

RYAN DORGAN / NEWS&GUIDE FILE

CNM, CFNP

Matt’s Custom Meats owner Matt Froehlich, second from left, processes between 800 and 1,000 elk each year from September to mid-January. Preliminary evidence suggests people should not eat CWD-positive meat.

320 E. Broadway, Suite 1C 733-4585 www.theresalerch.com

Now’s the perfect time to start a fitness routine or try out a new class!

Spring Run Off 5K This Saturday May 4th

Join in the fun with fitness classes at the Teton County/ Jackson Recreation Center

CWD is scary. Can it affect humans?

Research is underway to determine if deadly prion disease can hop species to humans.

Classes Weekly Including:

• HIIT • StrongHER • Yoga • Water Fit • Zumba • Core & More • Refit • Sweat Therapy

By Mike Koshmrl

$8 to drop in, or save even more with a punch card Visit us online for more information

www.tetonparksandrec.org 307.739.9025 361340

Your workday ended but your cough didn’t minor medical* Mon-Fri 4-8pm 30 East Little Ave | Driggs 208.354.1156 tvhcare.org

*retail clinic: does not accept insurance. Please visit our website for more details on how this type of clinic can reduce your healthcare costs.

361425

A scary, incurable neurodegenerative wildlife sickness officially landed in Jackson Hole last fall after decades of movement across the landscape toward northwest Wyoming.

After chronic wasting disease’s arrival, made official by a mule deer buck that was road-killed near Kelly, the dialogue quickly turned to what land and wildlife managers should and would do to limit spread among the malady’s usual hosts, deer, elk and moose. Concurrently, a global discussion is underway about whether human beings — specifically people who eat wild game — can contract CWD, which is closely related to two diseases we can acquire: mad cow and Creutzfeldt-Jakob.

“The best available evidence suggests that people shouldn’t be eating CWDpositive meat,” National Elk Refuge biologist Eric Cole said, “but there’s very little evidence that people can contract it environmentally, or contract it at all.”

Although a human case has never been confirmed to date, research on interspecies transmissibility is underway. One high-profile Canadian study suggests there’s no absolute barrier protecting primates from the always deadly disease. The decadelong study exposed 18 macaque monkeys to CWD’s vector, misfolded proteins called prions, in different ways: Some had it injected into their brains, some were fed infected meat and given blood transfusions, and others were cut and had wounds wrapped in infected deer brain tissue to simulate what would happen to a hunter while field dressing.

“At this point what we would like to stress — my collaborators and I — is that we have some evidence that it might infect nonhuman primates,” Canadian Food Inspection Agency lab researcher Stefanie Czub recently told High Country News for a story titled “The disease devastating deer herds may also threaten human health.”

Four of Czub’s test subjects have shown clinical signs of CWD, two monkeys whose brains were injected with prions and two that ate infected meat.

But other research has found less evidence that the strain of CWD North American ungulates carry can cross over to humans. Research at the University of California-San Diego and UCDavis, according to the High Country News story, suggests that human prions are not capable of misfolding in the way that chronic wasting disease corrupts

deer and elk prions.

Further muddying the waters is the newfound realization that there are several strains of CWD, which may have different abilities to be transmitted from one species to the next. New strains appear to have recently emerged in European cervids.

Even if the book is not yet closed on whether people are truly at risk, the general consensus is that eating meat from infected animals is ill-advised. The Centers for Disease Control and Prevention advises hunters to have all game meat tested and to not eat animals that turn up positive. The Wyoming Game and Fish Department echoes that advice.

Jackson Hole filmmaker and biggame hunter Shane Moore is one local who would “absolutely not” consider eating infected meat.

“I’m not thrilled with the idea of having an animal processed in a facility that has other animals going through that are positive,” Moore said.

The horror-movie-esque nature of chronic wasting disease stems partly from its durability. Prions can survive for years outside their animal hosts, embedding in soil, moving through water and even uptaking into grass that grows over infected ground. Detoxifying an infected landscape is exceptionally difficult, which is part of the reason that Teton County and other land managers are exploring the acquisition of a large incinerator that can burn over 1,000 degrees to dispose of carcasses.

For now the discussion of CWD in Jackson Hole will continue to revolve around steps that can be taken to reduce its impact on wildlife populations. The Wyoming Game and Fish Department, National Elk Refuge and other wildlife managers are in the throes of modifying management plans and trying to figure out how to limit high concentrations of animals like elk by reducing or eliminating feeding programs.

Arguably, there are some linkages between wildlife management and the human health side of chronic wasting disease.

In Cole’s view, the British breakout of mad cow disease in the late 1980s offers a cautionary tale. Prions were being spread through commercial feed that infected millions of cattle that, in turn, millions of people consumed.

At some point the misfolded proteins mutated into a prion disease that humans could contract, and eventually 177 people died.

“The best way to prevent that from happening with CWD is to maintain low prevalence rates in the native ungulates,” Cole said. “It’s not unprecedented. It has happened with other prion-based diseases.”

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

HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019 - 5

Living high in the mountains could bring you down With gain in elevation comes increased risk of suicide and depression, research finds.

By Mark Huffman The mountains attract people who want a change, people who think leaving sea level behind will improve their lives.

But though the scenery may boost you, there’s evidence that going higher could simultaneously bring down your mood.

That’s the conclusion of researchers at the University of Utah who think there’s a link between high altitudes and depression. It’s the result of less oxygen and its subsequent ill effect on brain chemistry, and the effect may also hinder the usefulness of common drug treatments.

There is “epidemiological evidence that increases in the altitude of residence are linked to the increased risk of depression and suicide,” said Drs. Perry Renshaw, Douglas Kondo and Brent Kious in a study published last year in the Harvard Review of Psychiatry.

In their paper the doctors argue that “hyperbolic hypoxia” — that’s what the specialists called a lack of oxygen caused by low air pressure — “could promote suicide and depression by altering serotonin metabolism and brain bioenergetics.”

In an email, Renshaw said he and his colleagues “would probably say that hypoxia caused by any conditions (COPD, asthma, sleep apnea, anemia, thin air due to altitude) is likely to lead to increased rates [and] severity of depression, anxiety and suicide.

“Individuals who come from families with increased rates of low serotonin disorders (depression, anxiety, migraine, alcohol abuse) are likely to feel worse at higher altitude,” he said.

Serotonin is a hormone made by the brain that acts as a neurotransmitter.

Low serotonin is generally recognized as a cause of depression, and treatments for depression focus on increasing serotonin in the brain. Among treatments are drugs called selective serotonin reuptake inhibitors. Though the exact mechanism of how SSRIs work isn’t known, what is known is that keeping serotonin levels from falling too low is essential.

Dr. Cheryl Collins, a psychiatrist in private practice in Jackson, said serotonin “regulates mood,” and without a healthy level of it “your mood is going

SUICIDE MORTALITY BY STATE IN 2017 WA

WT ND

MT OR

CO

IL

NJ

OH

IN

WV

MO

OK

NM

MD

KY

DC

NC SC

AR MS

TX

DE

VA

TN AZ

CT

PA

IA

KS

CA

RI

MI

NE UT

MA

NY

WI

WY

NV

ME

MN

SD

ID

NH

AL

GA

LA

FL

AK

MEAN ELEVATION OF THE WESTERN UNITED STATES HI

WYOMING

MONTANA

Mean elevation: 6,700 feet

Mean elevation: 3,400 feet

IDAHO

Age-adjusted suicide mortality rates per 100,000 total population

COLORADO

Mean elevation: 6,800 feet

Mean elevation: 5,000 feet

UTAH

Mean elevation: 6,100 feet

WASHINGTON

20.3 — 28.9

Mean elevation: 1,700 feet

18.2 — 20.3 15 — 16.9 13.4 — 15 8.1 — 13.4 States are categorized from highest to lowest rate. Although adjusted for differences in age distribution and population size, rankings by state do not take into account other state-specific population characteristics that may affect the level of mortality. When the number of deaths is small, rankings by state may be unreliable due to instability in death rates.

OREGON

Mean elevation: 3,300 feet

CALIFORNIA

Mean elevation: 2,900 feet

NEW MEXICO NEVADA

ARIZONA

Mean elevation: 5,500 feet

Mean elevation: 5,700 feet

Mean elevation: 4,100 feet

Source: CENTERS FOR DISEASE CONTROL AND PREVENTION, CARPENTER, ALAN AND CARL PROVORSE. THE WORLD ALMANAC OF THE U.S.A.

ANDY EDWARDS / NEWS&GUIDE

Research links lower oxygen levels at high elevation with a higher risk of depression and suicide.

to go down.”

“It’s a very interesting idea,” Collins said of the potential of a link between low oxygen and serotonin, and the related idea that low oxygen might also interfere with the efficiency of SSRI drugs such as Prozac, Celexa and Lexapro. “There is apparently something about low oxygen concentration above 3,000 feet that may cause people to have lower serotonin.”

The question is of special impor-

tance in Wyoming, which — for whatever combination of reasons — a recent study concluded is the 11th most depressed state in the country.

At depression’s extreme manifestation, suicide, the rate in Wyoming is fourth highest in the country and has been rising in recent years: from 17 per 100,000 in 2004 to 24 per 100,000 in 2016. The national rate is 14 per 100,000. Joining Wyoming in the top five in the country were Utah, Mon-

tana and New Mexico. Suicide rates increase sharply at between 2,000 and 3,000 feet, the research found.

Depression is usually regarded as the most widespread psychological affliction in the United States.

“Depression is one of the most common mental disorders there is,” Collins said. “Anxiety and depression are sort of neck and neck for being pretty ubiquitous.”

See Living high on 18

Summer Ready?

Free cosmetic consultations during May and June. Call for an appointment.

A local choice for:

Cynthia Griggs • Elizabeth Logan • Cassie Lawless • Kris Quandt • Shane McCormick • Greer Burnside • Gina Ricks

Teton Hand Therapy “Let Us Give You A Hand”

Hand & Upper Extremity Rehabilitation Shoulder, Elbow, and Hand Rehabilitation • Custom Splints • Ergonomics Wound Care • Preventative Care 307-734-2877 • 310 E Broadway, Jackson • tetonhandtherapy.com

357582

› › › › › › › › ›

Breast augmentation Breast lift Breast reduction Eyelid surgery Face/Neck rejuvenation Abdominoplasty (tummy tuck) Liposuction/Body contouring Laser skin resurfacing Botox®/Fillers

John C. Payne, DO

Board Certified in Plastic and Reconstructive Surgery

555 E. Broadway, Suite 211, Jackson, WY tetonhospital.org/plasticsurgery

6 - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019

We believe life is all about your vision.

How clear is your vision?

Hole Family Eyecare is a leading provider of optometry services and vision care products in the Jackson community.

Let us help you achieve and maintain a clear vision.

COURTESY PHOTO

Jacob Urban, right, helps with rigging training.

Wilderness first-aid skills help rescuers • New Patients Welcome • Free Meet-and-Greet Visits for Expectant Parents • Major Insurance Carriers & Medicaid Accepted • SE HABLA ESPAÑOL

Dr. Karin L. Klee, MD

361727

(307) 734-0242 • www.cowboykidspediatrics.com Suite 216 - St. John’s Professional Office Building

Educating yourself can make things easier if someone needs to move you out of the field.

By Emily Mieure Anthony Stevens recalls the time a student used her wilderness first-aid skills to assist someone after a bad wreck on a rural highway.

“She was driving back to Muddy Gap, Wyoming, and came across this accident,” Stevens said.

The woman was the first on scene in a remote area, and she knew how to stabilize the patient because of her wilderness first-aid skills, Stevens said.

“It’s not just about skiing and backpacking,” he said.

Stevens, 44, is the training advisor for Teton County Search and Rescue and a field instructor for the National Outdoor Leadership Institute and the Jackson Hole Outdoor Leadership Institute.

He likes debunking the myth that wilderness first aid is used only on long, strenuous outdoor trips.

“We live in a changing world,” See WFA on 7

“I have been enjoying an active retirement of travel, kayaking, snorkeling, and skiing.

I barely missed a beat with my recent total knee replacement at St. John’s.”

Franci Tryka, MD, former medical director St. John’s Medical Center clinical laboratory

Now offering robotic-assisted surgery.

361959

To learn more about St. John’s innovative Peak Joint Replacement program, call 307.739.6199 or visit tetonhospital.org/joints 362337

HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019 - 7

WFA

Continued from 6

Stevens said. “There are terrorists threats and mass shootings. Wilderness medicine doesn’t always mean you’re in the woods.”

Wilderness first aid means caring for someone in a location that isn’t a medical facility.

It’s about using the resources you have in your backpack or the ones in your current setting, like applying an extra layer of clothing to a bleeding wound or employing a trekking pole as a splint.

“It’s about doing more with less and thinking outside the box,” Stevens said. “People feel more in control over their reality and their knowledge. It’s terrifying to be in a situation where you don’t know what to do.”

Stevens carries ski straps in his backpack, no matter the season, because they’re a good tool to hold a splint together, he said.

“I carry six of them in my bag at all times,” he said.

As a member of Search and Rescue, Stevens has witnessed the difference between patients who have wilderness first-aid training and those who don’t.

“When we do our primary questions those people understand why we are asking them,” he said. “We don’t have to water down any information.

When you are rescuing someone who has had that training it’s easier to have those conversations.”

Those patients often can correctly package an injured friend, Stevens said, and save rescuers time in the field, getting them to a hospital faster.

Outdoor culture and organized rescues in Teton County are unique, said Jacob Urban, owner and operator of the Jackson Hole Outdoor Leadership Institute.

“People here expect to be rescued,” he said. “Recreationalists are going out in dodgy conditions, and then there is expectation for help to come.”

Urban’s outdoor education institute teaches rescuers, guides and amateurs the skills needed to bridge the gap between the rescuer and the person needing rescued.

“I think it’s important for them to be able to coordinate to the level that the rescuers need them to,” Urban said. “It makes it safer for everyone involved.”

Urban also used to be on Teton County Search and Rescue. He served on the short-haul team and worked as training advisor before Stevens took over that role.

He said the Jackson Hole Outdoor Leadership Institute has different levels of classes and encourages outdoor enthusiasts of all skill levels to attend.

“Everyone brings something to the table,” he said. “The diversity of the users helps us understand each other better because everyone has different life experiences.”

In those classes students learn some key skills: how to manage an airway, how to stop bleeding, how to manage an unstable skeletal injury and how to keep the injured person warm, dry and comfortable and packaged for transport.

When Urban is hiking, skiing or traveling, he carries aspirin for a heart attack, Benadryl for allergic reactions and a tarp.

“I carry a very lightweight tarp because I can turn it into a tent,” Urban said. “Or I can use it as a stretcher to move someone.”

His institute, which has been around for a decade, educates about 2,000 students annually.

Stevens, who’s an instructor there, said he has seen an increase in the general public, not just professional guides, coming to take courses, which he believes is a great thing for Jackson Hole.

“I think we all want to help in our community,” Stevens said. “If you’re the first to arrive you might be the best person to help.”

Contact Emily Mieure at 732-7066 or courts@jhnewsandguide.com.

We can help you find solutions.

Jackson’s premier counseling & therapy provider.

COUNSELING SERVICES • • • • • •

CONTACT US • (307) 690-2153 • Info@JHFamilySolutions.com • Laura Santomauro, LMFT

Marriage Family Parenting Individual Substance use/abuse Intensive Marital Retreats

www.JHFamilySolutions.com

JACKSON HOLE

WOMEN’S CARE Currently accepting

new patients Accepting all Wyoming and Idaho insurance plans including Medicare, Medicaid, and marketplace plans.

362198

307-201-1489 • www.JacksonHoleWomensCare.com

Local News NOW Get Notifications

of Jackson Hole’s latest news, as it happens.

Scroll more, know more.

® t Hold Me Tigh

Workshop splash screen: path

splash screen: outlined

p ws Ap JHNe 2018 | 1 01 | 2 4 reen sh sSAcpp Spla n ew: Tow JHhN P o| 2to1 | 2018 01 een 4 h Scr Splas Town : Photo

icon: path

icon: outlined Mary E. Girling, MD, OB/GYN Camille S. Mellijor, MD, OB/GYN

Compassionate and caring gynecologic and obstetric care.

Jackson Hole Couples Workshop

e less conflict epted by your partner and hav • Do you want to feel more acc in your relationship? , responsive your partner is more accessible • Would you like to feel like you? and emotionally engaged with icate in new ship and learn how to commun tion rela r you e rov ?

• Is it time to imp tion nec erstanding, closeness and con ways that promote better und used Foc ally tion ples Workshop based on Emo • We can help you in our Cou Dr. Sue Johnson Therapy (EFT) and the work of urday) 10:00-4:00 -4:00 October 19, 2019 (Sat October 18, 2019 (Friday) 9:00 uple 0/co $45 : Fee rch al Chu Location: St. John’s Episcop s.com tion solu mily Jhfa • 153 0-2 Registration: 307-69 Space is Limited

JH Family Solutions. The fee for St. John’s Episcopal Church and een betw hip ch ners part a is ram This prog munity by St. John’s Episcopal Chur idy generously provided for our com . programming reflects a 50% subs Hole son of Jack and the dedicated EFT therapists

8 - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019

Get Full Access to the Latest News: As a valued Jackson Hole News&Guide subscriber, you can access news and information through our digital products.

Activate your account by going to jhnewsandguide.com/subscribe.

Call 307.733.2047 if you need assistance.

REBECCA NOBLE / NEWS&GUIDE

La Voz interpreter Elisabet Telecher, right, explains information from Dr. Doug George, left, to patient Edith Hernandez during Hernandez’s ultrasound appointment at St. John’s Medical Center. “Because I don’t speak English she translates what the doctor tells me,” Hernandez said in Spanish. Telecher helped convey the news that Hernandez is having a girl.

Interpreters offer access to services Bilingual speakers help residents with limited English talk to doctors, lawyers and professionals.

TRX • Yoga • Treadwall • Barre CrossFit • Spin • Group Fitness • Cardio

By Allie Gross

Massage • Hot Tubs • Sauna • Pool

Edith Hernandez, 20 weeks pregnant, lay on the bed, her belly slathered with ultrasound jelly. Obstetrician Dr. Doug George was ready to deliver the news.

“Do you want to know if it’s a boy or a girl?” George asked.

But Hernandez turned for help to a third person in the room who stood next to the bed: Elisabet Telecher, a Spanish-language interpreter, who relayed the message in Spanish.

“Si,” Hernandez replied with a smile.

“Because I don’t speak English she translates what the doctor tells me,” Hernandez said in Spanish.

“You leave without any doubts because they’re here to tell us what the doctor tells us.”

Jackson Hole is home to many people for whom English is a second language, which can make receiving health care services from Englishspeaking providers challenging. But under the Civil Rights Act, those with limited English proficiency are

spec

sleep better IN THE ASPENS AT THE BUS STOP

www.TetonSportsClub.com • 307-733-7004 • info@tetonsportsclub.com

See Interpreters on 19

Did you recently have a

newborn?

We’d love to include you in our monthly baby page!

FEEL BETTER LIVE BETTER

Fulfilling dreams since 1852

entitled to equal access as native speakers to services like medical care. Teton County providers and nonprofits collaborate to achieve that standard, especially for the Spanish-speaking population.

“It’s a matter of engaging Spanish speakers in all levels of being part of our community,” said Sharel Lund, executive director of One22. “And having access to the same things everyone else does. It’s a matter of integration, really, because otherwise people are only able to participate in their community to the same degree of their language skill, which for some people is a fairly limited sphere.”

Offices at St. John’s Medical Center outsource interpretive services to a company called LanguageLine Solutions, which provides remote, virtual interpreters who appear via mounted tablets, Chief Communications Officer Karen Connelly said.

The hospital also hires One22 interpreters as needed. One22’s language access program extends beyond the medical field and offers assistance in settings like social services and legal matters.

Another group of five interpreters, La Voz, focuses on services for private practices, such as OB-GYNs, dentists, pediatricians and orthope-

While we sleep miracles happen.

Body and mind work harmoniously so that we can live a better life.

All you have to do is sleep.

Please submit your newborn to babies@jhnewsandguide.com.

Handcrafted with care from all natural materials

We just need a full name, date of birth and a photo.

linenalleyjh.com | 307.734.7424 | 185 Scott Lane, Jackson Hole 362299

362565

HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019 - 9

Your ACL pops, and that’s just the start Suffering and fixing knee injuries is part of life in a ski town.

The anatomy of a knee Quadriceps

By Kylie Mohr If you’re a skier, orthopedic surgeons say the question isn’t if you’ll tear your anterior cruciate ligament — it’s when.

The anterior cruciate ligament, or ACL, is the primary knee-stabilizing ligament. It prevents anterior translation and rotation of the tibia relative to the femur, making it critical for cutting and pivoting sports. Overall, tearing it is the most common ligament injury in the United States, happening roughly 200,000 times a year and resulting in approximately 100,000 surgeries.

It doesn’t take a backcountry ski accident to tear your ACL. You can hear the dreaded “pop” cruising a groomer, playing soccer, slipping on ice — or even something a little more absurd.

“I wish I would’ve written them down,” said Dr. David Khoury of Teton Orthopaedics. “Falling over in the lift line, stepping off a curb, Wii bowling, chasing a chicken ...

I’ve seen over a thousand ACL tears — I’m sure I’m forgetting some.”

Whether you tear your ACL depends on your activity, your strength and your anatomy.

Gender and hormones are also potential factors. Women are three times more likely to tear their ACL. In cutting and pivoting college sports like soccer, basketball and rugby women are almost four times as likely. But skiing tends to equalize the playing field, and surgeons here see just about as many men as women in their offices.

They say April showers bring May flowers, but in Jackson, it’s more like February snow brings March surgeries. It’s the busiest month for surgeons like Khoury, who does 30 to 50 surgeries during ski season, sometimes up to seven a week, and between 50 and 100 a year.

Surgery or not?

ACL INJURY

Femur

Femur

Articular cartilage

Articular cartilage

Patella

Medial collateral ligment

Meniscus

Lateral collateral ligament

Meniscus Tibia

Anterior cruciate ligament

Fibula

Posterior cruciate ligament

Torn anterior cruciate ligament

ANDY EDWARDS / NEWS&GUIDE

Source: MAYO CLINIC

In March alone, he said, he’d probably see 400 patients total. For comparison, most surgeons perform fewer than 10 ACL procedures a year.

“If the mountain’s busy,” Khoury said, “then we’re always busy.”

Under the knife Surgeons say they like having the ability to put people back together.

“Being an active person, the idea of restoring people to their health and curing traumatic injuries was very appealing to me,” said Dr. Bill Neal of Orthopedic Associates. “I enjoy doing things with my hands.”

H o w Dr. Bill Neal quickly the procedure is scheduled postinjury depends on individual surgeons, their availability and how long they like to wait for inflammation to go down.

Start to finish, an uncomplicated ACL surgery takes about an hour. “You don’t

BRADLY J. BONER / NEWS&GUIDE FILE

Dr. Peter Rork, right, and his orthopedic team work to replace an ACL during a knee surgery in 2009.

want to rush through something, but you also don’t want to waste time when someone’s under anesthesia,” Khoury said.

Former orthopedic surgeon Dr. Peter Rork called the surgery a “very straightforward thing.”

“The anatomy of the ACL hasn’t changed in 75 million years,” he said. “You have to know where it originates and where it inserts. And once you

master that, you’ve got it.”

During that time the torn ACL is taken out and a tendon is turned into the new ligament, attached to bone for better healing and fixation.

After a patient is under anesthesia the surgeon and his or her team examine the anterior cruciate ligament and surrounding structures.

Roughly half of ACL patients also have damage to their meSee KNEE on 10

Followers of the outdoor scene likely know of Caroline Gleich, a mountaineer living in Utah. She’s attempting to summit Mount Everest with a torn ACL and plans to have surgery when she returns from the Himalayas.

Is this crazy?

Surgeons say the answer depends on the person, if the tear is full or partial and the type of activity they’d like to return to. Gleich isn’t the first to delay surgery until after a planned event.

“I would brace them up and let them go,” Peter Rork, a retired orthopedic surgeon, said. “And I’d say, send me a postcard.”

There are some people called “copers” who do better without an ACL through strength or anatomy compensation.

“It’s really hard to predict, but there are some people that have even played pro sports without an ACL,” surgeon David Khoury said. “But most people can’t do that.”

Without an ACL, people are at higher risk of having an instability event and damaging other parts of their knee.

“One of the greatest challenges in practicing orthopedics is making the best recommendations to people as to whether or not they even need surgery,” Neal said. “With a torn ACL, you may engender a lot of patient satisfaction because some of those people would have been fine anyway.

“One of the most satisfying things for me in my practice is to have people come in who say, ‘I want a second opinion, I’ve been told I need an ACL reconstruction.’ When I’m able to tell those people they don’t need surgery, we can treat them with a brace and treat them with rehab — then they’re happy and I’m happy.”

When in doubt, talk to your surgeon and get a second opinion.

Harnessing the mind to heal the body Visualizing a traumatic accident that results in bodily injury can be an intense experience. Revisiting mine, a scary fall on Cody Peak, wasn’t fun. I remembered everything vividly: The screams as I tumbled downhill with one ski on, the hyperventilating, the struggle for my friends to get me out with wobbly legs.

It’s safe to say both mind and body need to recover after an injury.

That’s where Nick Krauss, an injuryrecovery coach at Medicine Wheel Wellness, can be helpful — at least in my experience. Full disclosure, I was a patient of Krauss last year.

The effects of my thoughts on my body were clear; as Krauss led me through a visualization of the fall my heart rate went up markedly.

Krauss looks at the body as a team and helps his clients, who range from athletes to weekend warriors and children, learn how to make decisions about fear and trust during the healing process. He speaks with a soothing voice, reflective and reassuring in tone.

“You get these patients going through their exercises at home, and 98% of the time, they’re not in front of that physical therapist,” Krauss said. “Their only company is their own mind.”

The goalie of the Moose Hockey team, Krauss has struggled with chronic injuries. He’d lie awake at night, his knees pulsing with the pain of patellar tendonitis, and also worked through back and hip pains too.

As a student at St. Olaf College, he began taking biomechanics and psychology classes, as well as starting his own meditations. He completed his thesis on guided visualization and injury recovery, and was surprised to find not a lot of research in the area.

“What I have learned is that your body speaks its own language,” Krauss said.

Taking the time to listen and learn more about that language is key, he believes, not just in life but also specifically with injury recovery. The way we talk to our body shouldn’t always be done with an authoritarian, “just push through it” mindset, he said.

Guided visualizations like the one I mentioned earlier are a big part of Krauss’ practice, as are nutrition and breath work. Krauss had me focus on breathing more fully, helping me get oxygen in to help healing and calm the mind. He tweaked my diet to incorporate more protein as I tried to build back muscle.

He also felt a bit like a therapist,

helping me work through fear in the recovery process. Athletes visualize a great race before they have one; he told me I should do the same when facing unfamiliar, scary exercises — picture the first hop going well, for example, instead of the alternative. It really works.

“Everything I’m doing is supporting the brain,” he said. “Because your brain is the one that’s going to help you make decisions. Certain mental states actually allow us to heal and regenerate.”

Being hurt can be lonely and miserable at times. There are setbacks, and progress is rarely linear.

Krauss said the first step isn’t trying to be entirely positive, rather, it’s trying to find middle ground. Don’t try to skip neutral. Find it.

My version of “finding neutral” included writing short-, middle- and longerterm goals for myself. Some I’d satisfy in a week, others, a year. It made progress bite-sized and helped me celebrate where I was in the process. In the beginning that looked like walking without crutches or getting my leg totally flat on the ground.

The ultimate goal (for next winter) is getting back on the slopes.

Krauss is building up his client base in Jackson and elsewhere. He hopes to create online programs and connect

RYAN DORGAN / NEWS&GUIDE

Nick Krauss

with physical therapy offices around the country with his visualization work, and he’d like to have a podcast someday called the art of injury recovery.

“If you can optimize your inner environment, your body’s going to be able to do things that maybe nobody thought was possible,” Krauss said. “It really is.”

10 - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019

Knee

Continued from 9

niscus, a pad of cartilage in the knee that acts as a shock absorber. A meniscal repair affects initial recovery, generally in that a patient is unable to put weight on the knee for longer, depending on the tear pattern.

After going through a “timeout” routine, in which members of the team ensure, among other things, that they’re operating on the correct knee, the surgeon threads an endoscope into the body to look around the joint.

If nothing new is discovered during that diagnostic arthroscopy, a graft is harvested. The surgical team prepares the graft while the surgeon removes the torn ligament and determines where it was once attached between the femur and tibia. That’s the place they’ll drill into your bones to position and then attach the graft.

“That’s where you make your sockets,” Khoury said. “You try and make it anatomic so it re-creates normal anatomy.”

The graft is fixed to both sides using a screw to the tibia and a titanium “endobutton” to the femur. Harvest sites are closed with sutures, stitches are put in and, voila, new ACL. Surgeons say everything — from arthroscopic technology to fixation techniques — has changed for the better over the years. Surgeries now have a more anatomic, or similar to the origi-

RYAN DORGAN / NEWS&GUIDE

Dr. David Khoury

TETON ORTHOPAEDICS

This is what the inside of a knee with a torn ACL looks like, courtesy of reporter Kylie Mohr’s surgery in July 2018. Surgeons go inside the damaged joint with a small camera called an arthroscope so they can see where they’re operating.

nal structure as possible, end result.

Plus, nerve blocks and better anesthetic techniques mean less time in the hospital. But when the block wears off, you’ll still need strong medication.

“It can be a real eye-opener,” Rork said. “There’s no pain like bone pain.”

Research continues into the

Knees by the numbers • Number of ACL surgeries “King of the Knees” Dr. Peter Rork performed in his heyday: 6,000 over the course of his career • Average length of recovery: six to 12 months, with full performance restoration taking up to two years • Surgical time: 45 to 60 minutes with no meniscus damage • Length of ligament in question: About 3 centimeters • Degrees of motion you need to obtain in your first week: From 0 to 90 degrees • Every week after: 5 degrees • Chance you’ll tear your meniscus at the same time as your ACL: At least 50% • News&Guide staffers with new ACLs: 3, plus 1 dog

possibility that stem cells might help with ACLs, but surgeons say it’s too early to tell amid the hype.

“I believe stem cells will be the future,” Khoury said. “If you could at some point grow your own new ligament and not have to harvest and have comparable results … I don’t know how far away that is. But you should always be a little wary about accepting new treatments. You really want to see that it works and it’s durable.”

“It will be wonderful if and when that happens,” Neal said.

Here’s a big question When it comes to ACL surgery, where to harvest a graft is the million dollar question.

Quad, hamstring, patellar tendon?

The choice varies from surgeon to surgeon and has evolved over time.

“It’s seen the coming and going of

different fashions and fads as they came along,” Neal said.

Each professional has a preference about what to use to replace the ACL, and the studies to back that choice.

But all say they’re roughly equal in terms of stability and functional outcomes.

“They will all work if they’re done by a good surgeon who does the surgery well,” Khoury said.

Rork started using the hamstring graft in the late ’80s.

“Boy, I caught a lot of heat for that,” he said. “But I knew it was the right thing to do. And now everybody does hamstring grafts.”

Like Rork, Khoury likes the hamstring best. Neal feels strongly about the quad. In the late ’90s he heard about efforts to use the distal quadriceps tendon and started closely following the literature about it.

“By about 2010 I was pretty enthusiastic about trying to find a way to harvest that tendon to get the advantages of the quadriceps tendon without sacrificing the hamstring tendons and See ACL on 11

You take care of them, We’ll take care of you L O C AT I O N S T O S E R V E Y O U I N J A C K S O N , DRIGGS AND PINEDALE

We are currently accepting patients for pregnancy care, gynecology, & infertility. We also offer services for urinary incontinence, pelvic reconstruction & minimally invasive surgery.

Dr. Maura Lofaro, F.A.C.O.G. Dr. Shannon Roberts, F.A.C.O.G. Christina Kitchen, C.F.N.P. Lauren Hinkle, C.N.M.

Please call (307) 734-1005 to schedule an appointment.

Gros Ventre OB/GYN | P.O. Box 1844, Jackson WY, 83001 | Phone: (307) 734-1005 | Fax: (307) 734-1165 | www.gvog.net 362313

HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019 - 11

ACL

A $50k injury

Continued from 10

without taking a third of the patellar tendon,” Neal said.

He designed instruments, made locally, in 2012 that allow him to harvest the tendon and leave only a small scar.

Jackson surgeons have largely moved away from the patellar tendon.

It’s not as big or strong, they say, creating a size mismatch. Patients may also experience additional pain and potential for arthritis that isn’t as likely with other choices.

Despite differences in graft preference, there are a lot of overlaps with the orthopedists here in Jackson. Rork and Neal both did their fellowships under renowned knee specialist Dr. Richard Steadman in South Lake Tahoe, California. Rork and Khoury trained at the same residency program at the University of New Mexico.

One thing they can agree on? Cadaver grafts are less than ideal. Allografts were popular because they saved surgeons time and resulted in fewer patient incisions, but they don’t tend to work as well, especially in young people, and have high failure rates, they said.

Even when left with your own two legs as the choices, something’s got to give.

“We don’t have spare parts,” Khoury said, “you’re taking something. There is some consideration because you are sacrificing something to rebuild your ACL.”

Your recovery varies The months (and months, and months) of physical therapy after ACL surgery focus on rebuilding balance, regaining a full range of motion with extension and flexion, and bolstering quad, hip, hamstring and glute muscle strength. In other words, be prepared to do so many squats and lunges that you might be able to crank out sets in your sleep. And be prepared for exercises that used to be

Charges prior to any insurance payments adjustment chronologically: • Morning-after-injury urgent care appointment: $231 • X-ray at urgent care: $97 • Crutches and knee immobilizing brace: $189 (Hack: A friend may have these. Medicine Wheel Wellness and Excel Physical Therapy also share a “Hurt Locker” with lightly used donated supplies for people to borrow.)

• MRI: $1,210 easy, like box jumps or standing up with one leg, to be incredibly difficult and a little terrifying the first time you try them.

In a hard-charging place like Jackson, recovery can feel like forever. And you won’t get sympathy from the bowtie-wearing, often joke-cracking Rork, who also admitted he had an abrasive bedside manner.

“People would tell me, ‘Well, I can’t have this done because I have to ski,’” he said. “I said, ‘What are you, an infant?

You don’t have to ski. You want to ski.

And I understand that, but the ‘have to’ thing, you need to get over that.’

“I’m not a mollycoddling, handholding kind of guy.”

You can’t rush the process. A return to sports might take place around the nine-month mark, but patients and doctors agree it can take a year for your joint to feel totally normal again.

There are two components to healing, Khoury said. First, “the aspects you have control over,” such as regain-

• • • • • • • • •

Radiology reading of MRI: $252 First consultation appointment with surgeon: $233 Knee brace: $726 Compression socks: $25 Decided to proceed with surgery, second appointment with surgeon to discuss specifics: $148 Surgeon: $8,646 Physician’s assistant: $1,729 Facility fee: $11,475 ($300 deposit day of) Anesthesiologist: $2,970 Prescription medications: $78.06 Ice/compression machine for two weeks: $385.71 not including ice Shower chair: $74.95 Toilet riser: $40.23 Physical ‌ therapy: $17,600 This is calculated at a $220 per visit rate, which includes therapeutic exercise, manual therapy etc, insurance covering 40 visits a year and me using all 40 visits for two calendar years.

Total charges pre-insurance - $46,409.95 cal reconstructions will fail.

“There are two kinds of surgeons who don’t have failures and complications,” Rork said. “The non-operating guys like me, and the liars.”

If you tear your ACL in the winter, chances are you’ll join a pack of fellow Jacksonites who are one, two, three weeks ahead of or behind you in the process. Rork said it results in a “herd mentality” that can be helpful when navigating the ups and downs of recovery. See that person walking without crutches?

See that person doing jump squats with nary a grimace? That’ll soon be you.

Your doctor and physical therapist are likely almost as excited as you are for the eventual return to outdoor adventures in the Tetons.

“People go into medicine for a lot of reasons, but most people want to help,” Khoury said. “It’s really nice to help people and see them go back to the activities they enjoy.”

Contact Kylie Mohr at 732-7079 or health@jhnewsandguide.com.

You’re closing the door to cancer.

361812 327763

Talk to your child’s doctor about

HPV vaccine is

327763

P U B L I C H E A LT H

www.cdc.gov/vaccines/teens

ealth offers the HPV vaccine. For more information ule an appointment, call (307)733-6401.

e t g r x.

HPV vaccine is cancer prevention.

Stuart Palmer, Jackson

against HPV.

You’re closing the door to cancer.

W Y O M I NG

P U B L I C H E A LT H

“I’m working on my bionic certificate.

I had a double knee replacement and hiked through the mountains of Wales six months later. I just had my hip replaced.

Dr. Goetz is our hero.” vaccinating your 11–12 year old

You’re door to closing cancer. the door to cancer.

Teton County Health Department the HPVFor vaccine.

For more Teton County Public Health offers theoffers HPV vaccine. more information information or to schedule an appointment, call (307)733-6401. or to schedule an appointment, call (307)733-6401.

HPV vaccine is cancer prevention.

You’re not You’re HPV vaccine is opening cancer prevention. not Talk to your child’s doctor about the door vaccinating your 11–12 year old opening to sex. against HPV. You’re the door www.cdc.gov/vaccines/teens closing to sex. the

CS249586-E

• • • • •

ing motion, strength and function. The second: biology.

“You can’t change the biology,” he said. “No no matter how far ahead you are with the aspects that you can control, you can’t change tendon to bone healing or tendon ligamentization.”

But if you want to rush the process and disregard your doctor’s orders, Rork said he’d love to know how it goes.

“This is your first ACL tear, not my first rodeo,” Rork said. “If you do everything I tell you to do, you’ll get a good outcome and I’m not going to learn a damn thing about it. But if you want to go out on your own, I mean, I’m not allowed to experiment on people. So go out and see what happens, that’s fine.

I’m curious, too.”

If surgery is successful and the graft heals, with full strength you’ll be back to your baseline risk, meaning it’s just as likely to tear either ACL. Even if you do everything right, scientific literature indicates 10% to 15% of surgi-

Talk to your child’s doctor about

You’re not opening the door to sex.

“Oh, did you ‘just’ tear your ACL?” is a common refrain around town. But that little word, ‘just,’ doesn’t come close to covering the financial impact a major knee surgery can have.

I added up all the relevant charges from my knee injury — before, during and after surgery — to get an idea of the expense of this injury. If you’re having surgery, make sure to check with your facilities of choice first for an accurate price quote at the time.

It’s also worth noting that everyone’s insurance coverage varies. Premiums and deductibles swing widely depending on your plan.

Now offering robotic-assisted surgery.

To learn more about St. John’s innovative Peak Joint Replacement program, call 307.739.6199 or visit tetonhospital.org/joints 362338

12 - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019

It’s up and down for Jackson’s disabled The community welcomes people who have trouble getting around, but the environment — not so much.

Existing and recommended handicapped parking spaces in Jackson

By Cody Cottier

A

s a mountain town with heaps of snow and heaps of dough, Jackson is both a hardship and a blessing to people with disabilities.

Though the wealthy community is uniquely poised to accommodate its wheelchair- and walker-using population, the environment itself is decidedly opposed to that mission. Becky Zaist, executive director of the Jackson Hole Senior Center and leader of Age Friendly Jackson Hole, summed up the conundrum.

“There are some things that are feasible to change,” she said, “and some things that aren’t.”

Age Friendly formed in 2014 with the goal of making Jackson more navigable for the elderly, people with disabilities and, well, everyone. The group campaigns to improve sidewalks, intersections, parking and all the other amenities that, if botched, can turn a simple trip downtown into a logistical nightmare.

And the winter months, especially in a year like this, create a new host of obstacles. Snow hides handicap spaces from those who need them while icy street crossings prove treacherous even for those with impeccable balance.

Zaist lauded the town’s efforts to clear snow throughout the record-breaking storms of the past couple of months, but she acknowledged that doing that job perfectly would be a Herculean task. Age Friendly stepped in where it could this winter, placing ski poles at sketchy intersections to help pedestrians negotiate the ice.

“People are using them,” said Zaist, and she knows so because a handful have disappeared. “They’re preventing some falls.”

Even in fair weather, though, satisfying the standards of the Americans with Disabilities Act is a tall order. Much of Jackson, from buildings to intersections, was “built long before there was any thought of ADA,” Town Manager Larry Pardee said.

He said the town has tried to meet those obligations when upgrading infrastructure over the years, but it’s expensive and therefore slow going. Plus, many decades-old buildings were built with nonconforming

Jean St.

Moose St.

Gill Ave.

Clissold St.

Cache St.

Broadway Ave.

E. Simpson Ave.

E. Hansen Ave. E. Kelly Ave.

W. Kelly Ave.

E. Hall Ave.

Glenwood St.

W. Karns Ave.

Off-street, town/county maintained

Off-street, private businesses

On-street spaces

Suggested new spaces

Source: AGE-FRIENDLY JACKSON HOLE

ANDY EDWARDS / NEWS&GUIDE

This map, created by Age Friendly Jackson Hole in 2016 with the help of a large group of volunteers, is the most up-to-date compilation of handicap parking spots throughout town. Age Friendly urged town officials to add a handful of spaces, and they plan to tick off a couple this summer.

features, like tricky entrances and tight bathrooms, that are now grandfathered in.

“I don’t know if any community can absolutely guar-

antee every square inch meets ADA requirements,” Pardee said. “It’s just so massive.”

See Disabilities on 13

Read our

HEALTH-FOCUSED COLUMN found in the Valley section of the News&Guide every week.

7B

6B - JACKSO

N HOLE NEW

A good night’s sleep is good fo r your mind S

sses pro These busine

vide health

or wellness

services:

Health Behavioral oral Health and Behavi feedback HEALTH Bio

oner & more ified Practiti d Pressure • BIO A BCN Cert p Issues • Bloo Lundeen, RNB • Anxiety • Slee Joy Nelson • Resilience yoming.com ance • Stress • biohealth@w Peak Perform ay adw 2 • 555 E. Bro 307-739-753

meopath Classical Hoe Medicine & Prana Yoga Traditional

Chines

-7848

• 307-690 L.Ac., CHom. r, MATCM, Amanda Botu m wyoming.co homeopath@

Meditation

Hole of Jackson

th, , heart heal ation Center stress reduction life. e, wellness, nced ental Medit e for inner peac more enjoyable and bala Transcend-bas ed techniqu a thinking, and The evidence , clear creative ay brain function adw 1 • 350 E. Bro tion-jackson 307-690-451 ntal-medita /transcende n www.tm.org , Non-Sectaria

boundaries 5 pm.

Council - No Meditationitation, 45 min. Fridays, 6-6:4Scott Ln, Jackson Via silent med essMeditation.net • 215 lfuln James@Sou ). Free. parking back (alley door,

hetics Medical Aest Center Teton LaserM.D. & Jan Bauer R.N.

, tattoo removal laser hair &

For more information about participating in these advertising opportunities, call 307-732-7070.

ro, Maura Lofa treatments, of skin care Wide variety e 108 treatment. varicose vein 555 East Broadway Suit 1• 307-734-071

at the New

Nutrition

s&G uide at

n ral Nutritio ccoli Beyond Bro RD, CEDRD. Individual Behavio

H E A LT H

fyoforouyrrour

732 -707 0

MEDITATION (no boundarie

COUNCIL

Enjoy

TM

s, non-sectarian)

Counseling

Introduction Refreshers - AdvanInstruction ced Programs

307-690-4511

ion Peak Nutrit

ery Tours RD ulting • Groc e Metherell, g • Group cons Therese Low ate counselin mail.com ritionist • Priv trition68@g 4 • peaknu Dietitian Nut • 307-733-534 ning Plan u • Men

www.tm.org/tran

your body.

Nutrition with food and nt Mind Body Make peace Tanya Mark le self, body, mind and spirit. gy Coach. Body Image Moveme who h to nutriPsycholo Nourish your -diet approac ner. Eating anti titio an Prac ng, rapy itive eati Nutrition The ializing in intu Spec dor. assa Global Amb 307.690.6076 le health. mark.com • tion and who • www.tanya amark.com tanya@tany

to console council, & co , -lead via silent medi tation, 45mi n

Every Friday, 6–6:45 pm FR EE 215 Scott Lan e, Jackson

James@Soulfuln

essMeditation.ne

Fitness

t

scendental-medit

ation-jackson

o n 6 8 @g m a i

Peak Nutritio

N

INDIVIDUALIZ ED

NUTRITIO

N COUNSELING There se Lowe Meth

erell, RD

Registered Dietiti Nutrition Cons an ultant

l .c o m

MAKING

H E R E Mental Health A PRIORIT Y

CALL 307-73 2-7070

332696

Biofeedback & Behaviora l Health 362052

73 3 - 5 3 4 4 • peaknutriti

YOUR BUSINE SS

“I can’t sleep . I get to sle ep, then I wake up an d my mind just won’t tur off. Can bio n feedback he lp with that?”

Yell rams and sma s, it can. Le LLC rdable prog t’s talk.

Balanced,Pers Be attention, affo the pegboard climber, l To ona g inin like

BIOHEALTH

A healthy diet can eliminate the need for med s.

325924

ADVERTISE

g, nal Coachin . ing, Nutritio Wellness, Inc ng, ChiRunn One to One ning, Active Isolated Stretchi Trai llness.com Functional h more!

• www.121we 0. muc & #11 ing Rd. h School Metabolic Test 8 • 1705 Hig 307-734-280

ning al equipment ormance Trai Home of Perf Work out with tradition . g bags. cialists. group settings ds, ropes and punchin ditioning Spe ban kettle bells, ngth and Con Certified Stre om Nationally bb.c w.t2 1 • ww 307-413-162

High Cholest erol?

®

Transcendental Meditation Center Of Jack son Hole

MS, oli.com Mary Ryan, eyondbrocc 5 • Mary@b 307-690-578

Tra

body, brain

Sound Mind

D I R E C TO RY

sale s rep , call you r For listing info

il 3, 2019

Healthy z’s for

Sisters want to stay a pair

WELLNESS

nesday, Apr

pring seems to be finally poking imp through the roving mental snow.

After a Certain cond health. growing long long winter the days are er cially sensitive itions may be esperising. But whil and temperatures are such as atte to sleep troubles, e the extra sunl refreshing to man ntio ight is tivit y disorder, anxn-deficit/hyperacincreased ener y, the longer days and iety, depress bipolar disorder gy that come with Healthy sleep is can also come , schizophreni ion, spring psyc key with sleep trou hotic disorder a and The National Sleep to physical and mental well-being bles.

Sleep often s. . goes Anx Foundation recom iety unn disorders freq onight’s sleep: ticed until a mends the follow uently presperson is exing tips for estab ent periencing prob with sleep • Avoid napping lishing a restful during the day, beca lems with as insomnia issues such it on either • Avoid caffeine and nicotine close use it can interfere with your abilit excessive wor caused by spectrum. Butend of the • Avoid alcohol y to sleep at night to before heading to bedtime. . mares. Sleep ry or nightsleep, generally adequate snoo bed. ze, it disrupts sleep Although alcohol identified feels like it may patterns and can can also incr deprivation as seven to meta bolize help ease keep you awake it. for anxiety diso the risk later as your body with your a night, is eight hours • Get plenty of exerc rders. essential to begins to ise, but avoid vigor Sleep prob physical hea • Stay ous lem lth and men away from exercise s are also common tal well-being. certain foods, and meals too close to bedtime. Also too close to bedtime. avoid them befor keep in mind your with bipolar in those Sleep is whe e bed. body’s sensitivitie • Ensure you get s to When in a man disorder. rests and proc n the brain sunlight for at least adequate exposure to natural light a person may ic episode ories, stress esses memcircadian rhythm 15 minutes a day. Light exposure and vitamin D. Try to get outside from the day feel a dein the in crea can play an impo main and emotion sed need Deidre Ashley rtant role with natur • Try to avoid emot taining healthy sleep-wake cycle s. which in seve for sleep, al toration help That ress. ionally upsetting re • If you are strug s regulate movies or conversatio lead to that cases can your moods and gling ns before going to with sleep, try to screens or reading individual sleep. associate your bed goin concentration. increases focus and while with sleep by avoid ing. Such prof g days without sleep• Make your sleep you’re trying to fall asleep. ing when you don The inverse happens oun TV, d ing loss environment pleas of sleep can exacerbate sym ’t temperature. ant, with a comf get enough qua sleep enough or don’t ortable bed and a person’s risk ptoms and increase comfortable your risk for lity sleep, increasing a depressive for psychosis. During and disturba emotional reactivity hypersomnia episode, insomnia or ute to psychosis, nce.

— sleeping even in othe heal thy — too rwis may adu much e lts.

Signs of someth occur.

If you notice periencing psyc Many individuals exprob ing lems Res earc dee try the suggestio h suggests hotic symptom per Sleep problem be sleeping ns from the some of that roug s may Slee 75 Nationa p Fou in people with s occur frequently alsopercent of people with depr hly or too littl inconsistently, too muc h consider ndation (see box). But alsol ession e. Changes face problem mental illne can be one that your slee to s with sleep. ss and with of the first p problems may Those terns can also be an earl sleep pat- be an indi constant stre indi that somethi ng is going on. cators with sleep diso ss tend to also deal chosis in those with schiy sign of psy- lem. If cation of an underlying prob you zophrenia. rders. People Inadequate cont nose you may wan inue to have trouble to the onset sleep can contribute the d with insomnia — which diag- Go od nig ht’s t and snooze tor about med to talk with your doctal health prob severity of a men- ute result of depression and can be ications or natu Understanding contribedies and rule ral remthe imp health problem lem, and a mental to to it — are five times mor out medical prob e likely sleep for physical and menortance of develop major lems. bate sleep prob can cause or exacer- time can tal depr aid heal essi early interven th Deidre Ash on and 20 lems. Being s more like tion ley and dealing with sleep issuaware of ety-related diso ly to develop an anxi- lish healthy sleep habits. and estab- of the Jack is executive director can be an effe Many of us are son rder es Counseling Cen Hole Community ctive interven early Harvard Medical , according to the thatdealing with such hectic schedules tion in ter. She is a we forget Sleep deprivat Review. licensed help with slee to foster habits that will clinical social worker ion can also cont and has p. mas In ter’s fact, some turn rib- habits that exacerba to Contact degree in social wor a te the issue. k. her columnists@ jhnewsandguide via .com.

think of at people ry about wh ce to wor pled $20. one will to anypla not going in my rum on this getaway no ted to I am also ed stand Also ita. Just wan well-dress ed to their where, Dan any the I’m g , ere goin check your glu , “Hi wh hour, eyes wait to dine say I’ve come to obody was . w an said kno for nt you y age line the airline er and all the eens, as the es and grilled let psite carcass pole.” places with scr ne pho cam s cy cak going to “The pow internet line,” on delectable fan s.

I’m sick of s and all the ock t ere dwiche phone line afternoon till 5 o’cl cheese san going to anyplace wh by carcass poles. at I’m doing is thaof wh d were out all I am not Not that out in the middle surrounde g ly shut on a bus she said. ch better, where the cactuses s all ignorin I will sit had basical mu ual ort ivid t airp ind else and Ou The zly bears 13 masses of pretending no one nowhere. before. griz opn day dro tha feel , the s, etly down each other, tends to make me grow bigger ry about tarantula ponded qui bees, which “Oh,” I res I have to wor tlesnakes, killer ulders. nev- exists, Sonoran ing my sho was canceled, but I nt very lonely. be in any cies of rat ns and the I will not (darn it) spe My flight airline age els bark scorpio notice. The rdfancy hot ht spot a pid. bea toa e: er received , I looked at ert issu Des a lizard me where I mig g on my tiny looked at There’s alsobanded, horned, col-t tha rn geon snoozin afternoon at her.

Courtesy Photo ed, Weste h creepy one tell what I can balcony eac en both of us lared and a really me “Let me see Let s. leg wh d . its hin 4 o’clock n-high Kianah do,” she said moved like can run on I see a shi t.

Kiska and ert take a res inn that will you something: If Her fingers pays to be h the des oug le thr litt g It ne The nin t pla lightning. e away from lizard run I’m on nex y have at the airbe my hom vacation will on his hind legs the first oneit is 5 in the believe the if home this soul to Florida. I don’t ter beetles at the port, even gically I was a gentle not have and red blis r opthere is no morning. Ma arrived at old Batline ng black Beach Club, where an views and Arn ed like shi out a ch oce rer t Boc e coin-wa tion not mu tension, jus Doreen Tom erating a my destina my original stodgy pre t style of elegance. the n efoo ng Kianah are later tha chine. coins for 31 and a bar other hand, livi er to s Kiska and ely. r washed r when ma in ’t be able Malamute ers who have nev re On the flight. Lov Mr. Batline stin St. Francis time of yea ugh to Boca I won sist mo eno the We This is the guests cushy life in ts of interesting sto at 5-year-old ted. Kiska is the ky rs luc ting yea is ven e. sor Nopre us are everywher been separa the two, and Kianah until he tell you all being in Middle of ee many of Francisco, , and ves re San glo s the of ir thr e, Thi confident 91 years ries about soiling the travel her packing for weeks. h 16 books, and at . wit d dfrom one a, die . goo ed zon n 3. He road trip the reserv looking for sweet, ions, where, Ari ercolors, bug spray ure I have bee on a long an infi- retired in 199 ng are wat sec goi pan ls, If you and year I am k recently journa big sun hat that I can friendly com d. , no airports to hide extra old. at the ban lly natured and are what you nee poNo flights When I was yed the money she a rea t the wind. places ing ers of er driv sist oth ber be pla se ins ntdis the aga nite num na I will not before cou se girls and the teller the Jackso Meet the This year ka and stopping for y to give me d trip you shoes. ras panions at , lowas going icac go on a roa tential comnty Animal Shelter ms through Neb f and cabbage del be When you many shoes as you ing it out. she asked. bee ps, as s. I won’t bills OK?” I said.

Teton Cou of town at 3150 Ada runza, the can bring pers, flip-flo is Nebraskan in Hugo, “Are these ,” n h heels, slip ved by all ed south els fine to me cat belo ney cam look mo ey n want. Hig s, sneakers. My pla and els ve.

“Th .com six for new clea . seeing clowns maybe I’ll see cam Canyon Dri nShelter.Petfinder ptsandals, flat t, limiting myself to “People ask vacation,” she said ma, but See Jackso descriptions of ado know. go on an who Oklaho to travel ligh es. and I’ll let you when they typ kind of womwrinkled in Arizona. for photos where the s a basic shoe Am I the to a place eone a with the ide $45 for dog pleable pets.

I am going hand som fees are e is toying consultant. but someh the com ld n wit Tom no, wou ptio ed een say Ado aslud like to kets Dor a travel @ cats. waffles inc akfast are not Tex $10 bill? I’d ff change in my poc columnists and $30 for of becoming bre via her se and my mentary es, I stu pur t tim a tac ry ry Con car . de.com e to wor e I don’t shaped. ewsandgui I do not hav rs jump- becaus small. ’t have jhn This year boa wallet is ors or wild I really won about alligat bushes.

On this trip the ing out of no hogs. r, yea s Thi

JH Senior

S&GUIDE, Wed

Joy Nelson

Lundeen RN, 307.739.7532 BCN • biohealth@wyo ming.com

Nationally Acc redited at the Highest Standa rd rapi

Best Practice The

es including Cognitive Beh Dialectical Beh avioral Therapy avioral Therapy , and EMDR.

Same day acc ess appointme SLIDING SCA

LE FEE | WE ACCEPT

24-Hour Crisi

s Services | 733-

2046 | 640 East

nts available.

ALL INSURAN

CES

Broadway | www .jhccc.org

340369

ere dle of nowh id m in g in Relax N

10, 2019 -

Pets of the Week

295451

sday, April

E, Wedne

WS&GUID

HOLE NE

343876

JACKSON

362365

HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019 - 13

Disabilities Continued from 12

Another hindrance to mobility is Jackson’s patchwork system of sidewalks. Some streets have two, others one and stills others none, forcing people to use the street. Even on Town Square some stretches of the boardwalk are essentially off-limits to wheelchairs.

Pardee said officials are “slowly and systematically” working to improve — or simply build — sidewalks through the town’s “Complete Streets” approach to design, which is intended to accommodate everyone who uses them, regardless of age and ability.

The Town Council recently included sidewalks on a list of its top priorities in coming years, though it’s unclear what the result will be. Such projects are pricey and time-consuming, and that item on the priorities list has so far received less attention than others, like housing.

“We recognize this all costs money,” said Jean Day, head of one of Age Friendly’s committees. “But we have a long, long wish list, and we’re going to chip away at it.”

Granted, Age Friendly is a small grass-roots group with limited resources, but it has made moves toward a more hospitable Jackson.

For one, Day said, the group has mapped all the handicap parking around town and identified about a dozen areas that “really are crying out for an accessible parking space.” Pardee said the town plans this summer to look into adding spots in those areas.

It’s a caring community Day said Jackson is “blessed with the resources to address this stuff,” and some local organizations exist to do just that.

With Teton Adaptive Sports, which brings outdoor activities to people with disabilities, and the Senior Center, with its exercise programs and social events, Jackson’s older adults and those with disabilities don’t have

to abandon those sources of joy and well-being.

Carolyn Worth, director of the Jackson branch of Community Entry Services, which helps people with developmental disabilities, said Jackson is “unbelievably supportive.”

“We have all sorts of different businesses and nonprofits around that we work with to make all the clients’ lives more meaningful and productive,” she said.

Telling people about it Another of Age Friendly’s committees focuses on community relations, because in many cases, Zaist said, impediments to accessibility can be attributed to lack of awareness. Business owners may not notice the faults in their own buildings, though they would be willing to fix them if they did.

“Someone said to me, ‘It’s not that we don’t care about senior issues, it’s that we don’t know,’” Zaist said. “We have a very caring community. But if they don’t know that someone can’t get into their business, then they don’t know that maybe it should be looked at.”

People who are young and fit also have good reason to care on selfish grounds — Day noted that problems of mobility aren’t restricted to octogenarians and the handicapped. Watch a 20-something with a torn ACL hobble over snowbanks or a parent with a stroller struggle up a ramp-less curb and witness the universal need for accessibility.

“I think there are more young people on crutches this time of year than old people,” Day said. “Anything that helps an older person helps a younger person on crutches.”

She mused that in the long run, we’re all only “temporarily able-bodied.” And since there is still plenty of room for progress, perhaps today’s agile athletes should consider what kind of world they want to age into tomorrow.

Contact Cody Cottier at 732-5911 or town@jhnewsandguide.com.

The Results You Want...

With over 70 years of combined clinical experience we will keep you from being sidelined whether from hiking, climbing, mountain & road biking, kayaking, school sports, swimming, or walking in the neighborhood...

Did you

Know?

Not only do we offer pregnancy tests and ultrasounds, but we also offer education on ALL pregnancy options

PREGNANCY OPTIONS COUNSELING PREGNANCY LOSS/POST ABORTION SUPPORT PARENTING CLASSES HEALTHY RELATIONSHIP EDUCATION SERVICES ARE ALL FREE, CONFIDENTIAL, AND FOR MEN AND WOMEN All services available in English and Spanish.

307.733.5162 TURNINGPOINTJH.ORG

361919

Medicine Wheel Wellness Welcomes New Members to our Group Classes!

2-week unlimited: $40 | 1-month unlimited: $99

Also,

take advantage of our *May Specials*

* 5 pack of Group Classes - $65 ($15 savings) * 60 Minute Personal Fitness Training - 2 people for the price of 1 - $70 ($35 savings) Grab a buddy!

Please call to book your session or purchase your group classes. *PRICING OPTIONS ABOVE ARE VALID FROM MAY 1st - MAY 31st.*

Medicine Wheel Wellness 120 WEST PEARL AVENUE | JACKSON HOLE, WY 83001 www.MWWJH.com | 307.699.7480 Visit www.MWWJH.com for current classes, descriptions and other offerings.

362304

Spending too much time in here?

Prostate issues could be slowing your flow.

Ted Morgan, MD

3 LOCATIONS: 1090 S Hwy 89, Jackson, WY 307-733-5577 Rafter J, 3000 W Big Trail Dr. Jackson 307-248-8055 46 Iron Horse Rd, Alpine, WY 307-654-5577 www.fourpinespt.com

362340

307.739.7690 | tetonhospital.org/urology

14 - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019

Separating the hokey from the helpful It can be hard to know which ‘complementary’ treatments are science or sham.

By Tom Hallberg The inevitable will happen to you at some point.

That’s not some veiled reference to human mortality, but a recognition that if you are an athlete in Jackson (or anywhere, really) injury will eventually strike. It could be catastrophic like a broken limb or the kind of nagging musculoskeletal injury that tricks you into thinking you’re 100 percent before recurring while you’re training for your next ultramarathon or multistate bike race.

Either way, when it comes you’ll be faced with a plethora of treatment choices. Do you do rest, ice, compression and elevate? Do you go all in on physical therapy, with its dry needling, giant rubber bands, box jumps, weight training and escalating medical bills? Do you buy a brace and try to stretch, hoping your body will somehow pull a Benjamin Button and age backward?

The options can be overwhelming, so you should probably ask your doctor. But there are options for what Medicine Wheel Wellness owner Francine Bartlett calls “complementary therapies,” treatments designed to go with whatever your doctor says is best for you. As someone who has sustained all manner of injuries, from those needing surgery to the annoying sprains, I’ve tried a few alternative therapies to get you started.

Cryotherapy Using cryotherapy, a new treatment

Medicine Wheel Wellness offers dry needling, a pain relief treatment.

Cost: An introductory session is $29, and a single session after that is $49. Package deals are available as well, with the best per-session pricing being a 15-pack that runs $450.

Dry Needling BRADLY J. BONER / NEWS&GUIDE Photos

Gina Hoogendoorn, owner of Healing Waters Therapeutic Float Center, talks to News&Guide reporter Tom Hallberg through a cryotherapy session. Liquid nitrogen is used to lower the ambient temperature, but clients are not in direct contact with it. The idea is that skin reacts to the extreme cold, sending messages to the brain, stimulating regulatory functions of the body and assisting areas that might not be working to their fullest potential.

offered at Healing Waters Therapeutic Float Center, is simple: You stand in your skivvies, gloves and slippers in a chamber with minus-230-degree air for three minutes, which lowers your skin temperature to between 30 and 50 degrees. The resulting vasoconstriction pulls blood to your core, removing toxins from distal muscles and returning oxygenated blood to the body once you exit the chamber, according to Healing Waters’ website.

Purported benefits are quicker muscle healing after exercise, relief from chronic pain and an energy boost. When I tried it I couldn’t be sure if the energetic feeling was the therapy working, a placebo effect because I knew the claimed benefits or

Obstetrics & Gynecology Family Care Including Pediatrics S. Douglas George, M.D.

Giovannina M. Anthony, M.D.

Obstetrics & Gynecology, Board Certified

Obstetrics & Gynecology, Board Certified

Laura M. Vignaroli, M.D.

Kathryn Noyes, M.D.

Family Medicine, Board Certified

Family Medicine, Board Certified

Adair Flynt, CNM FNP Certified Nurse Midwife and Family Nurse Practitioner

just my body’s relief at not being subject to sub-Arctic temperatures.

The science on cryotherapy is just as vague as my reaction to it. Studies finding benefits from it have been varied and often small, so they do not offer a consensus on its effects, according to the Harvard University Medical School. A blog post from the school that reviewed recent evidence said cryotherapy may simply mimic the effect produced by icing an injury or sitting in a cold-water bath after exercise.

But anecdotal evidence doesn’t always match what the science says.

“We have people that come in every day,” Healing Waters owner Gina Hoogendoorn said.

If you are queasy around needles, dry needling is not for you.

The acupuncture-like technique, which is gaining popularity with physical therapists, has been shown to provide pain relief by simulating an injury (being stuck with a needle) in and around areas experiencing pain and tightness, which induces a release of the body’s antiinflammatory defenses.

“As physical therapists it’s one trick out of our toolbox,” said Medicine Wheel Wellness’ Bartlett.

When I went to Medicine Wheel with hip pain Bartlett was clear that dry needling wasn’t going to fix everything, but she said it could provide quick pain relief. Though I felt some weird heat-flash sensations down my leg when she hit the most inflamed part of my hip flexor, the pain relief wasn’t instantaneous.

It took several hours for my hip muscles to start loosening, and the See Therapies on 15

WE’RE DEDICATED TO KEEPING YOU HEALTHY SO YOU CAN ENJOY WHAT YOU LOVE MOST

Receive complete and unmatched medical care close to home.

tvhcare.org

Please call 734-1313 for an appointment

555 E. Broadway, Suite 108 whfcjackson.com

361426

HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019 - 15

You don’t know the Hole until you know the half of it!

E 8, 2019 N JU | N O H T E HALF MARA

HOL THE JACKSON

BRADLY J. BONER / NEWS&GUIDE

Though they may not work and medical research disputes their efficacy, inversion tables purport to stretch out the spine, giving relief from pain related to compressive spinal injuries.

Therapies Continued from 14

pain took two days to disappear. But it did lessen in severity quickly, which gave me the chance to do some stretches that had felt awful before the dry needling.

Medical research may bear out my experience. Following an injury, “Studies provided evidence that dry needling may decrease pain and increase pressure-pain threshold when compared to control/sham or other treatment,” a literature review from the Journal of Orthopaedic and Sports Physical Therapy says.

But dry needling is far from a panacea and, as Bartlett said, it should be just one part of a larger treatment schedule.

“No difference in functional outcomes exists when compared with other physical therapy treatments,” the review concluded.

Cost: A 30-minute session at Medicine Wheel is $80; Excel Physical Therapy hosts a twice-a-month clinic that costs $30. Dry needling as part of physical therapy can be billed to insurance.

Inversion Table This one is a little hokey. I live with someone with back problems, and inversion tables purport to offer spinal traction (lengthening of the spinal column). In theory this should relieve pain caused by compression injuries like herniated or bulging discs.

Lying like a bat on the inversion table does feel good, though the whole thing kind of looks like a torture device. After a couple minutes of lying partially upside down, my back feels stretched out and relaxed.

But medical professionals say it’s not all it’s cracked up to be.

“Instead of increasing disk space, traction is more likely to stretch the muscles and ligaments around the spine and temporarily relieve muscle spasm,” Celeste Robb-Nicholson, the

editor in chief of HarvardWomen’s Health Watch, wrote in a blog post for the university.

To be fair, most people I’ve talked with have experienced that short-term relief, as have I, but the tables don’t seem to provide the type of traction that would actually lengthen the spine and provide more room for the discs that keep your vertebrae from grinding against each other, which would offer long-term relief. And they are not without risks.

Increasing the angle of the table or spending too much time on it right away can lead to a risk of blood clots, and lying upside down can increase blood pressure and heart rate, so people with those problems should avoid the therapy altogether. Though using an inversion table is something that requires only an up-front cost, rather than per-session payments, and you can do it from the comfort of your home in your PJs, Nicholson wrote that “the only setting in which I would consider use of an inversion table” is “in a comprehensive program for back pain.”

Cost: Tables start around $100, but higher-end ones with massage features and heating pads can run you about $500.

• There you have it, all the information you need to get back out on the trail. Just kidding, these are just a few of the many options, and it can be hard to know which therapies will lead you down the road of rehabilitation. Learn what seems to help your body heal; use things like foam rollers, stretching and massage to guard against injury; and when the inevitable happens, slow down and take your doctor’s advice, because by the time that happens to you, there will probably be another slew of complementary therapies you know nothing about, and that’s what they get paid the big bucks for.

e : 7am | Walk Start Tim am 8 : e m Ti t 8am | 5k Star illage Run Start Time : tside of Teton V ou h at p e ik B t: Star n x Park in Jackso Finish : Phil Bau Glory : Eternal half.com tact : info@jh n o C | m co F. LINE: JHHAL REGISTER ON

Nourish your WHOLE self. Mind. Body. Soul.

Spring Intuitive Eating Special OFFICE + VIRTUAL APPOINTMENTS 5 Sessions Special $399 Offer Expires: May 31, 2019 307.690.6076 Gift Certificates Available* TANYA@TANYAMARK.COM Office + Video Conference Call Sessions

307-690-6076 www.tanyamark.com

tanya@tanyamark.com 362046

Pilates and Movement Specialist

Contact Tom Hallberg at 732-5902 or thallberg@jhnewsandguide.com.

Dr. Lisa Brady Grant CHIROPRACTOR and Senior International Lecturer for the Barral Institute

• Pre/post Natal fitness and education • Neurological Conditions • Osteoporosis • Breast Cancer Recovery Programs

Leading Classes in Jackson Hole: • Visceral Manipulation • Neural Manipulation • Viscerovascular Manipulation • Manual Articular Manipulation

For more information on any of the above class opportunities, go to www.skidancer.com 362233

290 W. Kelly - SE Corner of Kelly & Jackson - 307-739-0553

362363

• Scoliosis

(No More Mommy Tummy) - Diastasis Recti healing - Reactivation of Pelvic Floor and Core - Safe and effective

• Foot Health

protocols for Prolapse

• Back Health

- Leaky Bladder Remedy

• Post surgery/rehab fitness

• Home Fitness

Kim Armington PTA, CPI korealignpilates@gmail.com • 715-413-1313 www.facebook.com/KoreAlignPilates 362109

16 - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019

5G Antennas Will Bring Wireless

Radiation Radiation

Doctor emphasizes individual treatment and lifestyle choices versus ‘pills for ills.’

Closer To You and Migrating Animals!

5G

Book gives women a heart health plan

By Jennifer Dorsey

is a Trojan Horse

Under the guise of 5G, 3G and 4G antennas will move from mountain tops into your neighborhood Streetlamps

Research indicates this can cause cancer, lead

to damaged sperm and developing brain cells, and impair honey bee production - a part of why many nations have more stringent regulations regarding tower proximity.

Implore your elected officials to be selective in placement: No Schools, etc. And require signage so people can maintain safe distances.

Don’t repeat the same mistakes we made with tobacco.

Remember that scene in the movie where Meryl Streep clutches her heart, gets red and sweaty in the face and falls to the ground?

No? If you can remember such a scene it probably involved a guy, because in films that’s generally who has a heart attack — think Don Corleone in “The Godfather” or Harry Sanborne in “Something’s Gotta Give.” And if filmmakers were to show a woman suffering a heart attack it might be more accurate to have her rub her jaw or throw up than to dramatically collapse.

“Women sometimes present heart attacks differently than men,” Jackson Hole’s Dr. Mark Menolascino writes in his new book, “Heart Solution for Women.” “Although most have pressure or pain in the chest, some women can instead experience vomiting and/or stomach, back, or jaw pain — symptoms easily confused with other, less lethal ailments.”

No area of modern medicine, Menolascino writes, is less understood than heart health in women, and obliviousness to some of their heart attack symptoms is just one piece of that.

Heart disease research has often included zero female subjects or, when both sexes have been involved, has not taken into account the differences between men’s and women’s bodies, including hormones.

“We’re all terrified of breast cancer, but in fact more women die from cardiovascular disease in the United States than from any other cause,” he writes.”

“I have no hesitation in saying,” he later writes, “that the biggest ball the medical community has ever dropped — in part because of the misleading data on the protective qualities of estrogen — is women’s heart health.”

But “Heart Solution for Women” isn’t about griping. Menolascino, who operates The Meno Clinic in Wilson, where a large number of clients are women, focuses most of the book on exploding “myths” about heart disease and laying out the steps women can take to maintain a healthy ticker.

He calls his approach “functional medicine,” which involves looking at the whole body, not just symptoms. It’s “combining the art and science of integrative, holistic medicine with cuttingedge diagnostics and individual treatment plans that include nutritional and lifestyle advice, supplements, and pharmaceuticals to heal the individual, not just relieve symptoms.”

Dr. Mark Menolascino’s book explores a subject he feels has been neglected by the medical community. It’s filled with details about what women can do for cardio health.

Among the “myths” he takes aim at are that high cholesterol causes heart disease, that fat is bad for your heart and that statins are a safe, sure-fire way for everyone to reduce their risk of heart attack. In fact, he says, inflammation is the root cause of heart disease (and many other ailments); some fats, like extra-virgin olive oil and avocados, are good for us; and lifestyle changes can be more effective than cholesterol-lowering drugs.

And even if heart disease runs in the family, don’t view that as your destiny. According to Menolascino, you can turn your bad genes on through poor lifestyle choices and turn your good genes on to protect your heart by making smart choices.

For smart choices he goes to the seven laws health laid out by Galen (130-210), a Greek physician, surgeon and philosopher in the Roman Empire.

They are: Eat proper food, exercise, get adequate sleep, drink the right liquids, have a daily bowel movement, control your emotions and breathe fresh air.

With those as the foundation Menolascino delves into all sorts of areas, including the relationship between brain, heart, gut and genes; thyroid function; hormones; diet; food sensitivities; probiotics; meditation; exercise; intermittent fasting; supplements; and, when appropriate, working with your doctor to wean yourself off pharmaceuticals.

“Heart Solution for Women” goes in depth but does it in a plain-English way.

It’s a good read for any woman of any age looking to take charge of her health.

Contact Jennifer Dorsey at jennifer@ jhnewsandguide.com or 732-5908.

5G

The Bodies of Evidence are Clear

Can You Hear Me Now? “Both the courage and trust of those who place their babies

for adoption and the enthusiasm of those who adopt them are

overwhelmingly vindicated by the tens of thousands of successful

adoptions that take place in this country every year.”

-Editorial; The New Yorker

For more scientific information, visit ehtrust.org

362315

Right to Life of Teton County P.O. Box 8313, Jackson, WY 83002 • 307-690-7245 • Elaine Kuhr

HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019 - 17

Nourish your body, nurture your brain A

Physician Grade Supplements Bio-Resonance Health Evaluation Frequency Therapy • HOCATT Transcranial Electrical Stimulation (IASIS) • BioCharger

Ionic Foot Bath • Rife Salt Therapy Room • Thermography (MIGUN) Pain Relief Therapy Table

Your one-stop shop to take back your health naturally.

Jennifer Nelson-Hawks Sarah Felton

www.simplyhealthjh.com

307.732.0540 1325 S. HWY 89 Smith’s Plaza Suite 113 Jackson, Wyoming

362334

Now offering: MDSolarSciences™ Developed by a dermatologic oncologist, this lightweight sunscreen provides physical UV protection, but it goes much further than that!

Jam-packed with antioxidants like vitamin C, pomegranate extract, cranberry fruit extract, and green tea, it helps with radiance, improving the skin tone, firming the skin, protecting against free radical damage, and all-around anti-aging.

Nutrition

“Maintaining a health gut biome has been shown to reduce symptoms of many chronic problems.”

Holistic Wellness Center

Sheasjh.com • 307-203-2273 250 Scott Lane, Suite 101

362327

Experience the

HIMALAYAN - Salt Stone MASSAGE

Warmed Himalayan Crystal Salt Stones replenish & nourish the skin with 84 trace minerals during a full body massage. Resonating at the earth’s frequency, Himalayan salt balances and neutralizes the ill effects of toxic frequencies, improves circulation, lightly exfoliates, and relieves stress. The massage focuses on balancing Tsing points and meridians to relax body, mind & spirit.

307.732.6865

361731

powerful connection exists be- about gut biomes recently, and for tween our physical state and good reason. Maintaining a healthy our mind. There’s even a su- gut biome, or digestive tract, has per-long word to describe the study been shown to reduce symptoms of of it. Psychoneuroimmunology is many chronic problems like rosacea, the study of “the interaction be- attention deficit hyperactivity distween psychological processes and order, autism, depression and digesthe nervous and immune systems of tive disorders.

To really give your gut the casino the human body.”

If you’re not observing your advantage, it’s important to create thoughts and emotions as they re- a diverse environment (think rain late to chronic symptoms like PMS, forest over mono crop) and have a back pain, irritable bowel syndrome, positive balance of “good” gut bacteheart disease, psoriasis, migraines ria, which progressively reproduce or weight gain, you’re most likely not to create a stronger digestive tract looking in the right places. over time.

One of the core philosoHere are the basic phies of integrative nutrirules to harness a healthy tion is that the primary microbiome: Apply the lifestyle choices you make simple rules of eating nuabout movement, spiritutritiously. Add pre- and ality, relationships and probiotics to your diet.

Eliminate pesticides, your career are the main herbicides and antibiotpredictors of good health, ics that kill bacteria in happiness and longevity. your gut and around your That is not to say that body. Get quality sleep. nutritional choices don’t Jessica Yeomans Learn how to engage the have a huge impact on forces of the mind on the the well-being of the mind and body; they do. And luckily, healthy nutri- body through meditation, and exertion choices are simple and can ben- cise to burn off stress chemicals and efit our minds and body simultane- increase brain derived neurotopic factors, which strengthen brain ously.

Observe the basic rules of good cells and turn on genes to produce nutrition: Eat plenty of different new pathways, in the body.

Like they say in Vegas, “Take care vegetables, whole grains (if your body type can have them), clean of the vagus, and the vagus takes proteins and healthy fats. Avoid care of you!” OK, they don’t really anything highly processed or super say that, but it works here. sweet. But knowing and doing is not Bringing it all together necessarily easy, and becoming conIf you’re stressed, clean up your fused by fads, quick fixes and adverdiet. But if you have symptoms that tising is.

Ever wonder why the four top- don’t go away, it might be time to let selling grocery store items — caf- some of your secrets out.

Women’s health activist Dr. feine, sugar, alcohol and nicotine — are all drugs we use to manage Christiane Northrup has found that our mood and energy? Imagine the when a woman enters her clinic with symptoms difference in our of menopause, health care econinfertility or omy if we had fibroids, the more knowledge cause is almost of how deepalways a buildseated beliefs up of unreleased contribute to the emotional fuel development of that has manidisease. fested itself as a For example, physical glitch. sugar is the root She advises the cause of chronic patient to folinflammation and also affects low a hormonethe immune sysbalancing diet, tem, the brain to take suppleand the gut. Countries with high mental vitamins and (enter famous sugar intake have high rates of “Frozen” melody here) to “let it go.” stress and depression.

If we knew more about how emo- Stress is not a friend tions physically disrupt the body’s According to Dr. Jennifer Weinnatural ability to heal itself, might berg, stuck or repressed emotions we be a society that places higher appear to be especially harmful value on healthy relationships, pur- to physical health. Over time, she pose and nutrition? said, chronic psychological stress can change the way the body funcVagus, Baby tions at a hormonal and immunologSo how does this work? A nerve ic level, contributing to the developlies within our bodies that extends ment and progression of cancer and a two-way network of communica- cardiovascular disease. tion between the brain and major Understanding the mind-body organs. Vagal pathways regulate connection is really quite simple. things like anxiety, respiration and The most powerful things we can do heart rate. The vagus nerve is your to improve our holistic well-being is body’s longest nerve and extends to be ourselves, sleep, eat well, love, from your brain into your gastroin- move and enjoy. testinal tract. It functions like a superhighway, transmitting biochemi- Jessica Yeomans is an integrative nutrition health coach and the executive cal signals in both directions.

For example, the vagus nerve is director of Girls Actively Participatresponsible for those butterflies in ing. She uses ’80s pop hits to bring your stomach when you’re next to out her creativity in the kitchen and a hottie. Because the vagus nerve wishes, just once, she’d remember to connects your brain to your gut, it’s listen to Ira Flatow’s “Science Fricrucial to preserve a healthy gut en- day” show on NPR. Contact her via vironment. There’s been lots of buzz jessyeomans16@gmail.com.

E WE'V ED! ND EXPA

Confused

about your Health Fair Labs?

Need a Nutrition

reboot?

Therese Lowe Metherell, RD

Registered Dietitian • Nutrition Consultant

733-5344

PEAK NUTRITION INDIVIDUALIZED

NUTRITION

peaknutrition68@gmail.com 361729

COUNSELING

18 - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019

Living high

oxygen on depression and depression drugs “could be a big problem” for everyone involved, Collins said. But she said it’s just one factor in dealing with a condition in which there’s a lot of balancing to find the right program for each person.

Some people might still respond to drug treatment at common doses; others might require more or need a different drug.

“There are medications that work on other neurotransmitters,” Collins said, “and if what we start with does not work then we would try other medicines to see if we get a different response.”

Renshaw said the drug sertraline, brand name Zoloft, was found in animal studies to be “the most effective SSRI antidepressant at altitude.”

It’s important to note that not Dr. Cheryl Collins everybody who moves to high Jackson psychiatrist altitude has low serotonin, and Renshaw acknowledged that the complexity of brain chemistry makes generalization difficult. He mentioned dopamine, another neurotransmitter associated with good feelings that is boosted by exercise and other activities, as an additional factor to consider.

“Increased brain dopamine levels (which frequently occur in going to the mountains) will make whatever one is doing more fun and enjoyable,” he said.

To reach the National Suicide Prevention Lifeline, call 800-273-TALK (8255). You can also text a crisis counselor by messaging 741741.

Continued from 5

LLC 362330

WHITNEY E. FESSLER, MSAc, LAc, FABORM

Offering Acupuncture & Traditional Chinese Medicine, with a focus on women’s health and fertility 70 S. WILLOW STREET | 307.774.0110 GRANDTETONACUPUNCTURE.COM | WFESSLERLAC@GMAIL.COM

Physical Therapy doesn’t have to hurt.

Experience the difference with our warm Therapy Pool!

Our clients spend a full hour with a Physical Therapist at every appointment.

ALL Body Therapy

307-733-7037 1116 Maple Way www.AllBodyTherapy.com

362887

As society has come to know in recent decades, depression is more than feeling down for a while.

People with depression feel sad, have low energy, exhibit lack of interest and have trouble concentrating. They may feel guilty for no apparent reason or that they are worthless. They often lose their appetite and either have trouble sleeping or find themselves fighting to stay awake. Many people have thoughts of suicide pop into their heads and have trouble stopping them.

For people experiencing depression — and especially those receiving no treatment — the anguish “can be quite extreme,” Collins said.

Though about 15 percent of people are what — are called “nonresponders” — seemingly immune to any intervention — Collins said about 85 percent respond to one of three treatments that are known to have some benefit, or, more likely, to all three of the treatments.

“In most major studies, medication, talk therapy and exercise were better than any one of those alone for depression,” Collins said. “The response to those treatments is pretty good.”

People who are treated feel their mood lift, and professionals can usually see what their patients are feeling.

“I notice people are feeling better,” Collins said. They start to say, ‘[I] feel more like myself ’ or ‘I’m enjoying things like I used to’ or ‘My thinking isn’t as fuzzy.’”

Contact Mark Huffman at 732-5907 or The effects of high altitude and low mark@jhnewsandguide.com.

“There is apparently something about low oxygen concentration above 3,000 feet that may cause people to have lower serotonin.”

8th Annual

Cognitive Health Speaker Series

Team Jackson is climbing!

Climb Out of the Darkness is the largest international event for perinatal mood and anxiety disorders. Together we are building community, raising money and normalizing the conversation surrounding mental health for expecting families and those with young children.

Join us!

June 22, 2019 • Phil Baux Park at the base of Snow King 9:00 am Registration • 9:30 am Start of Hike postpartum.z2systems.com

Featuring author of Diet for the MIND, Martha Clare Morris, ScD The MIND Diet for Brain Function and Health Thursday | June 13 | 6:00–7:30 pm National Museum of Wildlife Art $10. Tickets go on sale May 4 at tetonhospital.org/wordsonwellness

Funds raised by Team Jackson will benefit local efforts to shine light on perinatal mood and anxiety disorders.

Supplements and the Brain www.postpartum.net

If you or someone you know is suffering PSI can help: Call: 1.800.994.4773 or Text: 503.894.9453

It Takes a Valley WANT TO GET INVOLVED LOCALLY? It Takes a Valley offers free and low-cost gatherings to Teton area families as they navigate pregnancy, welcoming a new baby into the family, and maintaining & growing their senses of self and community.

Contact charlotte@ittakesavalley-wy.org for more information on resources, meetings and gathering available to Teton area families!

362298

Friday | June 14 | noon–1:00 pm Snow King Ballroom Free. General seating Book signing to follow.

This presentation will be followed by a Q&A session with Dr. Morris and Martha Stearn, MD, Director of St. John’s Cognitive Health.

Questions? 307.739.7399

tetonhospital.org/wordsonwellness

362342

HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019 - 19

Interpreters

Community interpreter training

Continued from 8

dists. Director Vida Sanchez said La Voz helps with every aspect of health, from calling to schedule an appointment, to following up with lab results, to attending to the bill and navigating insurance.

“Your one 15 minutes with a provider could have taken five hours to get you there,” she said.

Sanchez said language access services foster broader health care access for immigrants.

“You open the door, and that’s the first step towards patients being able to get services and the guidance and the care they need in order to be as healthy as possible,” Sanchez said.

People who use interpreters’ services aren’t necessarily monolingual, One22 Program Director Carey Stanley said. In fact, many clients have substantial English skills but lack the vocabulary for crystal clarity in a specific setting, like a doctor’s or lawyer’s office, where they may encounter complex medical jargon or “legalese.”

“Someone may be able to talk to the secretary at their school or check into a doctor’s appointment, but then when you take that further and you go into a higher register, or you’re giving instructions on how to care for a wound, or how to care for a sick child afterwards, they may not fully comprehend that,” Stanley said.

Not just anyone who speaks two languages can be an effective interpreter.

It’s important for interpreters to be professionally trained and adhere to a code of ethics.

La Voz and One22 interpreters use different programs, but all interpreters go through professional training.

Interpreters are expected to be impartial and communicate exactly what’s said by each party without inserting their own emotions or judgments, in order to “respect the communicative autonomy of both parties,” One22 interpreter Emily Gomez said.

“You are there to be an impartial person and to render the meaning of what’s being conveyed in the other language,” Gomez said. “You are not there to be putting your own bias [or] experience into it.”

At the same time, sometimes interpreters must sometimes take cultural differences into account.

For example, in the doctor’s of-

One22 plans to bring back a 40-hour Community Interpreter training to Jackson Hole the week of Oct. 7-11. Visit One22JH.org for information. Limited financial assistance is available to pay for the training. fice at Hernandez’s appointment, George asked his patient if she wanted the baby’s sex written down and sealed in an envelope. In her interpretation Telecher explained in Spanish that some people want the gender to be a surprise.

There are linguistic differences, too: Telecher is from Argentina, but most of her clients in Teton County are from Tlaxcala, Mexico. Words and connotations can sometimes differ. Through her work interpreting she said, she has learned to adjust her vocabulary and more about Mexican culture.

“I have to change my Spanish a little bit to make sure they will understand what the doctor is saying,” she said.

Interpreting can build a relationship.

Sanchez said interpreters can provide a sense of familiarity when patients are entering unfamiliar medical territory, as well as “an increased sense of security and guidance, so people feel confident they are — Emily Gomez taking the best possible One22 interpreter steps toward what they need to do to improve their health.”

Because Jackson is a small town, Telecher said she has provided interpretation services at childbirths and then been called to attend the kids’ checkups throughout their childhood. Just as she was there for the gender reveal, it’s likely Telecher will be there when Hernandez delivers her baby girl, and maybe even for appointments after.

“We get to know them for years,” Telecher said. “It’s amazing.”

When the time for the reveal came — una nina! a girl! — and Hernandez broke into happy tears, Telecher broke out of her strictly interpretive role.

“Felicidades!” she offered, smiling and grabbing Hernandez a tissue.

May is National Better Hearing Month

Free hearing screenings* and

$200 off on hearing aids* Call 307.739.7690 for an appointment. Bring this coupon.

*Available May 2019 only.

Screening takes 30 minutes and is valued at $55. Discount applies to purchase of hearing aid set.

362341

“You are there to be an impartial person and to render the meaning of what’s being conveyed in the other language.”

DIGESTION

FATTY ACID BALANCE

• Start listening to your guidance system!

• Get clarity on how to remedy what nags you.

• Nutritional Therapy redefines your pathway to healing by determining what nutritional deficiencies are at the root of your discomfort.

“I am so glad I found ALL IS WELL. Lorrie’s wealth of knowledge has put me on the road to recovery from leaky gut. Thank you for going the extra mile with me.”

T.T. Age 72 “My search for answers has lasted over 5 years, and I have visited with over a dozen “experts” in western and alternative medicine. I highly recommend Lorrie’s services to anyone seeking improvement.” L.T. Age 54

of

We fix We fix We fix

Serving Teton County and the surrounding

MINERAL BALANCE

Nutrient-dense, whole foods are THE true foundation of optimal health.

.

You Play

BLOOD SUGAR BALANCE

HYDRATION

Contact Allie Gross at 732-7063 or county@jhnewsandguide.com.

ne.

Play ou You Play

tetonhospital.org/audiology

W.19 Broadway, Serving County and communities the surrounding communities over years. Ste. 202 Teton County andTeton the surrounding for over 19 years. for945 communities for over 19 years. communities for over 19 Serving Teton County and the surrounding years.

307-734-5999

Lorrie Lee Wells N.T.P. • 307-690-3650 The only certified Nutritional Therapy Practitioner in the state of Wyoming.

NEW LOCATION!!!

290 West. Kelly Ave, Jackson 362252

You pick the game and we’ll pick the medicine.

Mary C. Neal M.D. | William C. Neal M.D. Excellence and experience in Orthopaedic care.

362368

20 - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, May 1, 2019

May 2019

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

Complimentary Support Groups Beyond Cancer Support Group

For cancer survivors and caretakers. Led by St. John’s oncology social worker Lynnette Gaertner, MSW, LCSW. Thursdays, May 2 and 16 4 pm Suite 206, Professional Office Building, Entrance E 555 E. Broadway For information, call 307.739.6190

Teton Parkies (For those

affected by Parkinson’s Disease)

Open Discussion Tuesday, May 14 5:30-7 pm Jackson Whole Grocer

Teton Parkie Partners A support group for partners of loved ones with PD Wednesday, May 8 1:00– 2:30 pm Jackson Whole Grocer Contact Elizabeth at 307.733.4966 or 614.271.7012

Weight Management Support Group

Open to everyone interested in weight loss and those considering (or who have had) bariatric surgery Tuesday, May 7 Noon Suite 206, 555 E. Broadway For info call, 307.739.7634

Grief Support Group

Led by St. John’s Hospice social worker Oliver Goss, LCSW Drop-ins welcome, but please call ahead Wednesdays, May 8 and 22 Noon – 1 pm Call 307.739.7463

Teton Mammas

For new babies and their families Wednesdays, May 8 and 22 10 am–Noon Birth Center waiting area St. John’s Medical Center For information, call 307.739.7572

Memory Loss Support Group

For those suffering from persistent memory problems; family members and caregivers welcome Wednesday, May 8 Noon – 1 pm For information, call 307.739.7434

Health & Wellness

Exploring Options for Returning to Work

Finding the Balance Between Breastfeeding and Work Wednesday, May 15 10 am – noon Boardroom St. John’s Medical Center Register online at tetonhospital.org/calendar

Children’s Grief Support Program

For children ages 5 and up (and their families) who have experienced the death of a loved one Led by St. John’s Hospice social worker Oliver Goss, LCSW Tuesday, May 21, 5:45–7 pm Call 307.739.7463

Caregiver Support Group

For those caring for someone with a debilitating illness Led by St. John’s Hospice social worker Oliver Goss, LCSW Thursday, May 23 Noon – 1 pm Suite 114, Professional Office Building, Entrance C Call 307.739.7463 ! Concussion/Traumatic Brain Injury NEW Recovery Group Led by St. John’s social worker Oliver Goss, LCSW, and speech language pathologist Christopher Smithwick, MA, CCC-SLP Tuesday, May 28 4 pm Wellness Flex Room 625 E. Broadway For information, call 307.739.7399

Motherhood: This Isn’t What I Expected

A free and confidential group for perinatal (pre- and post-natal) mental health Led by St. John’s social worker Lynnette Gaertner, MSW, LCSW. Wednesdays 4–4:45 pm Wellness Flex Room 625 E. Broadway For information, call 307.739.4840

Type 2 Diabetes Prevention Group in Spanish In Spanish! ¡En Español! Zumba with Elvis.

Family friendly.

Mondays and Wednesdays 5:30 pm For information, call 307.739.7678

Annual Community Health Fair Free medical screenings.

Saturday, May 5 9 am-noon Teton County/Jackson Parks and Recreation Center

Spring Run-Off

5k Walk/Run Saturday, May 5 9:00 am start $10 pre-registration. No race day registration. tetonparksandrec.org For information, call 307.739.7399

tetonhospital.org/calendar

!

NEW Pain Management Classes Learn to use your brain to manage your pain in this free, 8-class series Wednesdays, May 8 – June 26 5:30 to 7:00 pm For more information and to register, call 307-739-7589

Prenatal Bootcamp

Preparing expectant parents for labor, delivery, infant care, and more.

Friday, May 10, 6–8 pm and Saturday, May 11, 8:30 am–4 pm Register online at tetonhospital.org/calendar.

For information, call 307.739.6175

Yoga for Expectant and New Moms

Thursdays Pre-Natal Yoga, 5:30–6:30 pm Post-Natal Yoga, 4–5 pm Wellness Flex Room 625 E. Broadway $10/class; financial assistance available Taught by Rebecca Zulueta, registered prenatal yoga teacher For information, call 307.739.7399

POWER UP!

A movement and voice class.

Mondays, 1 pm, Senior Center, $4 for ages 60 and up; $7 under 60 Contact Elizabeth at 307.733.4966 or 614.271.7012

Spine Classes

Information for people considering or scheduled for spine surgery Monday, May 6, 1-2:30 pm Tuesday, May 14, 3-4:30 pm Wednesday, May 22, 3-4:30 pm Tuesday, May 28, 3-4:30 pm Physical Therapy Room St. John’s Medical Center Call to register, 307.739.6199

Joint Classes

Information for people considering or scheduled for joint replacement surgery Wednesday, May 1, 2-3:30 pm Tuesday, May 7, 4-5:30 pm Wednesday, May 15, 2-3:30 pm Friday, May 24, 8-9:30 am Wednesday, May 29, 2-3:30 pm Physical Therapy Room St. John’s Medical Center Call to register, 307.739.6199

Auxiliary

Monthly Luncheon

“St. John’s Brand Update,” by Karen Connelly and Allie Knetzger Thursday, May 2, Noon–1 pm Boardroom St. John’s Medical Center For information, call 307.739.7517

60th Annual Spring Fling Gala

A Diamond Jubilee Saturday, May 25, 6 pm Jackson Lake Lodge For tickets, go to stjohnshospitalfoundation.org or call 307.739.7517

625 E. Broadway, Jackson, WY 362336