Living on the Peninsula - Fall 2012 by Port Townsend Leader

FALL 2012

PATHS TO WELLNESS

Supplement to the Sequim Gazette and Port Townsend & Jefferson County Leader

Pg. 7

The North Olympic Peninsula Walk to end Alzheimerâ&#x20AC;&#x2122;s

Pg. 10

Water aerobics

Pg. 22

Diabetes: The not-so-silent epidemic

Pg. 26

Victorian-inspired health

Pg. 30

Preventing suicide

Pg. 32

Mind your exercise

Pg. 34

ECCHO: What goes out, comes back

Pg. 36

Stroke: Lives changed ... not ended

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Living on the Peninsula | FALL | SEPTEMBER 2012

Your journey to beating cancer just got shorter. You don’t have to leave the North Olympic Peninsula to get exceptional cancer care. Located in Sequim, Olympic Medical Cancer Center delivers world-class cancer care close to home. This year, we’re celebrating the anniversary of our 10-year affiliation with Seattle Cancer Care Alliance, which gives our patients full access to the world-renowned therapies developed at Fred Hutchinson Cancer Research Center, UW Medicine and Seattle Children’s. If you’re dealing with cancer, Olympic Medical Cancer Center can help. To learn more, visit omcforhope.com or call (360) 683-9895.

14 25

DEPARTMENTS

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Heart & Soul

Nothing stays the same

Food & Spirits

At Finn River, it's cider time

SPOTLIGHT

Walking toward hope

The North Olympic Peninsula Walk to end Alzheimer’s

Water aerobics: gentle, effective and fun!

John Anderson: Master Beachcomber

A century in the making

Sequim prepares for yearlong Centennial celebration

The Living End

How healthy are we on the North Olympic Peninsula?

Now & Then

Photographic journal

Diabetes: The not-so-silent epidemic

25 30

Victorian-inspired health

Mind your exercise!

Preventing suicide

Peninsula Behavioral Health center Why physical activity is the key to a strong mind

ECHHO: What goes out, comes back

Stroke: Lives changed … not ended

Cover photo: 226 Adams St., Port Townsend, WA 98368 360-385-2900 Fred Obee: fobee@ptleader.com

Hummingbird on a crocosmia ‘Lucifer’, snapped by Jay Cline. Cline has worked for newspapers on the North Olympic Peninsula for more than 30 years. He is now a graphic designer for the Sequim Gazette and plays with cameras in his spare time.

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LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

Walking toward

hope The North Olympic Peninsula Walk to end Alzheimer’s

Members of the North Olympic Peninsula Walk to End Alzheimer’s steering committee encourage community support for the important and fun event on Sept. 29. From left, front row, are Carol Kruckeberg and Kate Sullivan; back row, Jan Orr, Sky Heatherton, Sheila Linde and Pam Scott. Photo by Kelly McKillip

By Kelly McKillip

liminating Alzheimer’s disease through research, support and preventative care is the mission of the Alzheimer’s Association. In an effort to fulfill their vision of a world without Alzheimer’s, more than 600 communities across the nation participate in the annual Walk to End Alzheimer’s. Although there have been previous walks in the Sequim area, the North Olympic Peninsula (NOP) Walk to End Alzheimer’s will kick off its first annual event at the Boys & Girls Club on Saturday, Sept. 29. Event coordinator and Discovery Memory Care Community Relations Director Pam Scott says that 100 percent of the proceeds from the walk will go to the Alzheimer’s Association. There will be something for everyone at the fun event, no matter the age or physical ability. A 2.3-mile hike is planned for those who are able, plus a 0.7-mile walk and a shuttle bus. Food, music, water stations and door prizes will be on scene throughout the day’s festivities. Individuals and families are encouraged to join in and are welcome to bring canine companions on leashes. Local companies are invited to become sponsors, with several beneficial rewards for their businesses such as placement of vendor tables.

The long goodbye

What makes the awareness and fundraising goals of

the Walk so critical is the devastating nature of this deadly disease. According to the Washington Alzheimer’s Association, 5.4 million people are living with this form of dementia, often without receiving the care that could greatly improve the quality of their lives. It is the sixth leading cause of death in the U.S. Unlike other illnesses such as cancer, heart disease, stroke and HIV, which have shown a steady decline in death rates, the incidence of Alzheimer’s is skyrocketing. If nothing is done to curtail the current trajectory, 16 million Americans will be affected by 2050. The staggering cost to care for individuals with this disease is projected to be $200 billion this year alone. The cost of human suffering is incalculable. There are many factors involved in the escalating and complicated nature of Alzheimer’s disease. The percentage of older Americans continues to increase. An aging population is more susceptible to the condition, although early Alzheimer’s that occurs before age 60 also is on the rise. There are few fears worse than losing one’s mental faculties and people avoid getting help because of the stigma involved. More than 1 in 7 individuals with Alzheimer’s live alone, unable to care for themselves adequately. Any co-existing maladies such

Event Calendar:

Saturday, Sept. 29 • Boys & Girls Club 400 W. Fir St., Sequim Registration: 9-10:30 a.m. Pre-Walk Program 10:30-11 a.m. Walk to End Alzheimer’s: 11 a.m.-12:15 p.m. Post-Walk Ceremony 12:15-12:45 p.m.

Living on the Peninsula | FALL | SEPTEMBER 2012

as diabetes or heart disease are much more difficult to manage when dementia is a factor. Medicare costs are three times higher for patients with Alzheimer’s. All forms of dementia not only have a devastating effect on the victims, but also their loved ones. It only takes a few minutes in the company of a family member who has cared for someone with Alzheimer’s to realize that this disease is one of the most heart-breaking and difficult conditions to manage, especially without professional assistance. Feelings of shame and embarrassment often cause withdrawal from daily activities, which lead to further isolation and a worsening quality of life. Personalities change. A sweet-natured person who has been honest all his or her life may develop hostile behavior and engage in activities such as shoplifting.

Losing a loved one twice

Individuals with this deadly disease begin to lose their memories in a retrograde manner. Parents forget their own children, often only remembering earlier relationships such as siblings or their own parents. Discovery Memory Care’s executive director, Sheila Linde, remembers the shock of calling her father in England and after 10 minutes realizing that he didn’t have any idea who she was. The generation of elderly people

Walk Information

For information, to volunteer, donate, register or become a sponsor for the NOP Walk to End Alzheimer’s, call Pam Scott at 360-461-3402, Carol Kruckeberg at 360-6834739 or Kate Sullivan at 360-683-2424. Contact the steering committee by e-mail at nopalzheimerswalk@yahoo.com. Register at the Sequim Open Aire Market on Cedar Street and on site during the event. Also, visit online at www.alz.org, click on: Walk to End Alzheimer’s and choose Washington and Sequim on the map. The first 100 people to register will receive a free water bottle. Anyone raising $100 will be given a walk T-shirt.

alive today tend to be highly self-sufficient and often resist seeking help and care for a spouse with memory loss. Linde watched as her mom lost 80 pounds during the struggle with her dad’s disease. Many adult children try desperately to care for their parents with dementia because they feel that placing them in a care facility is letting them down. To the contrary, experienced, professionally staffed services often can do far more in providing a better quality life. Carol Kruckeberg, who is now a co-chairman on the Walk to End Alzheimer’s steering committee, remembers feeling devastated by the thought of placing her mom in a care facility until she realized that doing so would enable her afflicted parent to live a much fuller life. Not only did her mom have professional care and ongoing activities, but also socialization with her peers. Additionally, there was support and education for her and her family from the staff at the care center, communication with members of other families going through the same ordeal and support groups for spouses. John Bridge visits his mom, Rosemary, almost every day at Discovery Memory Care. Although she often thinks he is her brother, it makes him happy when people now tell him how nice she is. He wishes he could do more for her, but it is a great relief that at age 93, she seems at peace and without the pain, anxiety and turmoil that threw their life into chaos seven years ago. Rosemary had been a very active member of the community when her thinking started to become fuzzy. She had trouble managing her checkbook and medications. Insurance payments and other bills began to lapse. Accidents and mishaps caused Bridge to become alarmed that his mom’s physical safety was at risk. He began a long trek to finding suitable living arrangements for her. For reasons such as facility closures, inadequate levels of supervision and his mom just not

John Bridge visits with his mom, Rosemary, at Discovery Memory Care. Photo courtesy John Bridge.

being happy, Bridge and his wife made the decision to care for her at home. They rearranged rooms, put locks on doors and added a monitoring system. As a failsafe, Bridge slept on the couch so if his mom attempted to leave the house in the middle of the night, he could intervene. Bridge remembers the painful day when his mom became belligerent, told him she did not want him around and stormed off to a store on foot. Bridge followed her into the shop where a patron misinterpreted Bridge’s concern as harassment and threatened to call the police to have him detained.

Percentage Changes in Selected Causes of Death (All Ages) Between 2000 and 2008 Percentage 80

+66%

-8%

-3% -13%

-20%

-20

-29%

-40 Cause of Death

Alzheimer’s Disease

Stroke

Prostate Cancer

The incidence of Alzheimer’s disease is skyrocketing

Breast Cancer

Heart Disease

HIV

Chart courtesy of The Alzheimer’s Association.

Although no one could love her as much as he does, moving his mom into a professional facility has kept her safe, happy, in less pain and taking fewer medications. Now he can remember the great lady who raised and taught him so much. Bridge plans to discuss with his family what they should do if he meets the same fate as Rosemary, so they will not suffer the anguish and guilt that plagued his efforts to help his parent. If an inpatient facility is not feasible for someone, there are other ways to manage the disease so caregivers do not have to go it alone. Day and respite care are available locally at the facilities listed below. Kate Sullivan, also a co-chairman on the Walk committee, felt fortunate that during the 10 years her father suffered with Alzheimer’s they had the resources to provide activities from home with professionals intervening as necessary. Although bringing up the subject of a decline in a person’s mental capacity can be very difficult, the first and most important step to help someone who seems to be having more than normal memory problems is to take action. Getting a health check-up with the doctor is a great place to start. Basic memory screening tests are generally available through physician’s offices and also are offered for free through Discovery Memory Care in Sequim. Further testing can be done via PET scans and CT scans. Information on the disease, warning signs, help and support can be found at www.alz. org. The Alzheimer’s Association helpline is available at 800-272-3900. Four facilities for memory care are available in Clallam and Jefferson counties: Discovery Memory Care, Dungeness Courte and Sherwood Assisted Living in Sequim and San Juan Villa in Port Townsend. Each facility has its own personality and all are equipped to assist the individual and the family to maximize the potential quality of life.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

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Water aerobics:

gentle, effective and fun! By Elizabeth Kelly

ne of the many benefits of exercising in the water of a heated pool is the relief from arthritis pain and stiffness. Because of the soothing warmth and buoyancy of the mildly temperate water, even those with arthritis can participate in an exercise program that not only tones and strengthens the body, but also increases circulation in a gentle, relaxing and fun way. Mollie Lingvall, an aerobic instructor at William Shore Memorial Pool and Sequim Aquatic and Recreation Center (SARC), holds a current certificate from the Arthritis Foundation Aquatic Exercise Program and considers her training with them as “the best training I’ve ever had.” Her first training session with the Arthritis Foundation was in Poulsbo in 2009 and in April of this year, she went to Spokane to be retrained for her current certification. “They use their own instructors,” Lingvall said, “and have very specific guidelines. The day-long session consisted of a half-day book learning and a half-day in the pool.” Continuing, she explained, “To be a good water exercise instructor, you must first of all know your audience – their physical abilities, age, injuries, surgeries and their ability to move successfully in the water.” She added that the water’s resistance and assistance are the best tools for guiding and instructing people through the exercises. With time and patience, their bodies will be strengthened and they will build endurance to keep moving. Since exercising in the water is 12 percent harder to do than out of the water, any kind of exercise – walking, jogging or an aerobic workout is a win/win for the participant, she said. Born in Port Angeles, Lingvall learned to swim in the “old, outdoor pool that was located where the courthouse parking lot is today.” She

Sequim Aquatic Recreation Center pool

worked at the pool as a swim teacher, lifeguard and cashier when she was in high school. “That was when it cost 26 cents for kids to swim and 52 cents for adults.” Besides being a water aerobics instructor, today she also teaches swim lessons to both children and adults, is a lifeguard and teaches water walking exercises. She holds certifications from the American Red Cross for water safety instructor and lifeguard. Lingvall believes that the deep-water exercises provide the best exercise. “You put on a flotation belt and jog away without ever touching bottom. There is no impact on your knees, hip or ankle joints.” And, she added, the exercises can be modified for those with injuries, illness or who are recuperating from surgeries, giving them the ability to move safely with the right exercise to strengthen a particular part of their body and help them in the process of getting well and becoming fit. Not only does the Arthritis Foundation recommend water exercise to keep your joints moving and to restore and preserve your flexibility and strength, it also claims the exercises can help to protect your joints against further damage. The foundation believes that regular exercise also can lead to mood enhancement, an improved sense of self-esteem and a feeling of accomplishment. “I have seen people come in using walkers or canes and shortly after I see them come in and there are no walkers with them,” Lingvall said, adding with a smile, “That does my heart good.” Many times after joint replaceMollie Lingvall, ment surgery, patients will be told by their water aerobics instructor

doctor or physical therapist to follow up their therapy with water exercises. Karen Hunt, instructor for balance classes, along with shallow and deep-water aerobics, agrees. “When a new person comes in, we always ask them what sort of experience they have had in the water, what they want to get out of their pool exercises and what their physical abilities or disabilities are. The important thing we tell them is to take it easy at first and not to try to do too much. Everyone works at his or her own pace,” she said. Shallow water balance classes are good therapy for people recovering from a stroke or with Parkinson’s disease, she explained. Beginning participants in water aerobics would be introduced to an instructor and told to stay near the teacher during the classes for the first few sessions. The various types of equipment used would be explained to them and they would be carefully watched. Hunt explained that a basic routine usually starts with slow stretches, after which slightly more vigorous warm-up exercises would start. After a few minutes, the body warms up and the cardio exercises (where the heart rate is raised) can begin. During the routine the swimmers always are reminded to take deep breaths – the more oxygen they have the better for their energy and circulation, she said. Reminders to relax their hands and shoulders between exercises also are given. A cool-down period at the end of the class is helpful to stretch and relax all the muscles used in the routine.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

Above, left and at right: Karen Hunt has been living and teaching water aerobics in Hunt leads a water aerobics class Port Angeles for nearly two years, having moved to the penat William Shore Pool. insula from Santa Monica, Calif. She learned from personal Photos by Mollie Lingvall. experience how beneficial water exercises can be. In 2006, she need until they gain their had back surgery and after undergoing post-surgery physical confidence. After just a few therapy, she continued her therapy on her own by going to a pool. “You sessions they usually are start with baby steps,” she said, “but any kind of movement is good.” performing the exercises Just walking back and forth in shallow water is a good way to start. along with the entire class. One benefit is that you are safe when walking in the water. “If you fall, “You don’t have to know you don’t hurt yourself,” she added. “You might be sore, but you’re not how to swim to take part going to break anything.” in the deep water class.” Receiving her initial training in California, Hunt also holds an ArthriShe said she gleans ideas tis Foundation certificate for water aerobics training. She said that one of for new moves when she the points stressed by the foundation is posture and positioning. works as a lifeguard and watches other instructors at work. She also “If a person is not using good posture, they are misusing the exergets ideas from computer programs. cises. We constantly remind people while they are doing the routines Regular water exercise can only benefit your body in ways that seem to hold in their stomachs, tighten their core muscles, hold their head miraculous. It definitely has the power to give you some flexibility, straight and to use the water as a resistance,” she said. strength, balance, stability and endurance, Lingvall believes. Those “I like doing the workout myself,” Hunt said. “It reminds me of what who miss several classes due to travel or other circumstances tell her I should be doing and how I can better teach and explain the exercises that their bodies craved the feeling of being in the water and doing the to the class. I like helping others,” she said. routines they had become used to. Making it fun along the way is one way to keep the water aerobic While water aerobics are commonly advised to those people with classes going, Lingvall added. “We change it up with music, using water arthritis or for older adults, participants of all fitness levels and ages can exercise equipment such as noodles, kick boards, balls, water horses reap the benefits associated with the routines. and a variety of buoys.” Occasionally someone will want to join the class Lingvall said the average age of the people in her classes (both men who cannot swim or has a fear of getting into the deep (12 feet) water. and women) is 60 and above. “There are several 80-plus-year-olds and Lingvall explained that they could start by wearing more than one one 91-year-old who can work your socks off if ever they were chalfloatation device and staying in a corner of the pool where their hands lenged. ” Smiling, she added, “They are my inspiration!” can easily grab onto the edge. That gives newcomers the comfort they

Sequim Aquatic Recreation Center (SARC) 610 N. Fifth Ave. Sequim, WA 98382 360-683-3344

William Shore Memorial Pool 225 E. Fifth St. Port Angeles, WA 98362 360-417-9767

Port Townsend Public Pool 1919 Blaine St. Port Townsend, WA 98368 360-385-7665

Meet Heather Jeffers Administrator

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~ Your Life. Our Commitment ~

Olympic Rehabilitation of Sequim

1000 S. 5th Ave. • Sequim • 360-582-3900 • Fax 360-582-3935

www.avamereolympicrehabofsequim.com

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

We are all moving forward, whether we choose to live fully or not.

HEART Soul

Nothing Stays the Same Y

esterday Amy and John sailed off in their trimaran for two months exploring the fjords of Vancouver Island. They are journeying into unknown territory and don’t know what adventures to expect. Each day brings its unknowns (although 99 percent of the time we can count on it being overcast and between 56 and 66 degrees). It is often our response to the events of the day that shapes our lives and gives them meaning. My friend Shawne explained how her experience with multiple sclerosis changed her relationship to her father, who had Alzheimer’s disease. “Every time I visited him in the nursing home,” she said, “he was a different person and I was a different person.” Years of meditation practice had given her an understanding of impermanence, the constant flow of being and becoming. It was as if Shawne and her father repeatedly met for the first time and had the opportunity to start over with no baggage. The alterations for her physically and for him mentally shifted the way that they interacted. Instead of thinking about their conditions as deterioration, she understood them as ongoing life changes similar to those most of us undergo. The multiple sclerosis also gave her a new perspective on the nursing home her dad was in. Away from that place she was in the minority in a wheelchair and often ignored or shunned because of her obvious disability. But in the nursing home, she blended in. “No one looked away,” she noted, “we were all in the same boat.” She also had been worried about her father’s initial reaction to her MS because the last time he had seen her she had been active and walking. But, “he didn’t even notice the wheelchair because everyone in the nursing home was using some kind of walking aid and I fit right in.” I don’t believe that suffering builds character but that we can apply the character we’ve built to making meaning of dis-

By Karen Frank

tress with whatever ragtag shreds of religion and philosophy we possess. Shawne was able to take two difficult situations and see them as still offering an opportunity for intimate relationship and spiritual growth. We all are different people from one morning to the next just like the water that flows down the river is not the same water as yesterday’s, although the river looks the same. Just last week Dana’s mother, Else, told me that I was really patient. She said that I could get a job working with old people any time I wanted. Me patient, I thought. Nah. But maybe she’s right. Maybe I am a different, more patient, Karen and I haven’t noticed that. Sometimes we carry around old images of ourselves. I still think of myself as shy, but I’m not, just a little bumbling and awkward. Dana and I both still think we can scale mountains, and perhaps we can (if someone carries me up or wheels me in a little red wagon). A nurse recently told me that my low blood pressure often meant high blood pressure later in life. “I’m already later in life,” I told her. As are we all, day by day. One of the women at the Port Townsend Writer’s Conference read a poem from her book about her mother’s death that was so graphic it made me want to flap my ears shut like my cats do when I try to give them ear drops. That was her way of working through the unwanted change in her life. She needed to delve into it, digging her way through to the other side. I think each of us has to transform ourself in response to the events of our lives or go diving into the deep dark hole of depression. Sometimes depression precedes the transformation or cycles back through. We’re not always happy with the circumstances of our lives no matter how spiritual we are. Dana’s mother, Else, is one of the most resilient people I know. She was born in a tent in Poulsbo because her mother

had TB. She grew up in her aunt’s household and the bachelor surroundings of her crusty Norwegian father. She knows most of the history of Bremerton and Poulsbo and never wanted to leave there. Just last year, though, she decided to move up here to be closer to Dana and me. Still independent, she lives in an apartment by herself and has made many friends. She hated bingo, but it was one of the activities she could participate in so she did it to meet new people. She could have sat in her apartment watching daytime television and scarfing down chocolate chips, but she chose to move forward in her life. We are all moving forward, whether we choose to live fully or not. Anne Sexton called it “that awful rowing toward God,” a concept which proved unbearable to her. Her vision was not of exploration, of the kind of adventures Amy and John anticipate. Instead, like many of us, she expected and imagined the worst possible outcome. It’s true that we move toward an inevitable conclusion. And yet we eat honey pie in New York with fellow writers, each savoring a sliver of that delectability. We munch on caramels with sea salt that friends brought from France. We watch the Emmons glacier slide down Mount Rainier through the snow and the filthy glacial moraine until it emerges as a trickle of the Interfork of the White River. Sometimes Shawne walks without assistance. We can explore all the nooks and fjords of life. Sometimes we’ll witness grizzly bears traveling along river bars. Other days we’ll wonder why we bothered to visit that particular bay. Or we’ll wind up temporarily becalmed, waiting for the wind to pick up and carry us skimming across the sea. Nonetheless, each day we start all over again. Karen Frank received her master’s degree in spirituality at Seattle University. She is a spiritual director and photographer in Port Townsend. Feel free to write to her with questions or comments at karenanddana1@q.com.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

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A landmark tower made of thousands of recycled floats stands in John Anderson’s front yard at his family’s Andersonville complex in Forks.

JOHN ANDERSON Master Beachcomber

Story and photos by Chris Cook

aster beachcomber John Anderson of Forks is gaining national acclaim for his expert knowledge of the flotsam and jetsam that wash ashore along the Pacific coast of the Olympic Peninsula from Queets to Neah Bay. Anderson has been searching for, collecting and interpreting the ocean debris that washes up on these beaches for over 35 years. The pinnacle of his beachcombing is his landmark front-yard tower comprised of multicolored plastic fishing floats topped by a large magenta-colored iron float. Anderson, who is the only licensed plumbing contractor based in Forks, began in 1986 hanging his found-floats on a 40-foot-tall steel latticed logging crane boom. John thought of beachcombing book author Amos Wood during the tower’s construction. He had visited the renowned beachcomber at his home in Mercer Island and showed him photos of the tower just prior to Wood’s death. The Forks-based beachcomber started beachcombing in 1976, about four years after his graduation from Forks High School. His dad, Art Anderson, might have given his son the

collecting bug. Art focused on a collection, in John’s words, of “strange things,” unusual antiques collected around the Olympic Peninsula, which he displayed in a building located on the grounds of West End Motors just north of Forks proper. The business is run today by John’s brother Dan and his family, and RV parts and accessories are now stored in the former antiques branch of the family business. John recalls, “I started looking for glass floats with a friend while packing plastic floats from the beach and putting them on the side of my parents’ driveway in Beaver.” Later, living in a duplex in Forks, John chose a driveway fence on the property for his display, until their weight knocked down the fence. Following his marriage to his wife, Debbie – whom he coincidentally met on the coast while she was up from her home in Southern California working at the now-gone Harley’s Resort formely located upriver of the Coast Guard station at LaPush – he began displaying the ever-growing number of beachcombing finds, hanging some in trees in the couple’s yard at

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

their Andersonville home. Andersonville is a block of family owned land where the homes of John and other Anderson family members live, located adjacent to West End Motors. Debbie, while attending nursing school, which led to her career at Forks Community Hospital, joined John beachcombing, trying to keep up with her long-legged husband. His advice for beachcombers is to be prepared when they venture out in isolated areas. Bring first aid supplies, water, rain gear and always take a camera to record found objects too large to pack out or that they feel are unsafe to touch. A general tip is to hit the beach after a big storm, especially a spring storm with westerly winds. For precise instructions John says he offers the same advice a veteran fisherman would when asked where the fish are biting, that is no tips on specifically where to look. You need to be observant and focused on your search, he adds, telling of looking through binoculars and seeing a string of beach strollers along the coast walk right past choice glass balls. Today, nearing retirement from his years of plumbing on the West End, John is looking forward to fulfilling his dream of opening up a beachcombing museum in sheds located adjacent to his home. More publicity than you could whip up if you hired a Seattle public relations firm is coming to John and his museum concept, thanks to the arrival of Japanese March 2011 tsunami debris along Washington coasts. He has become one of the handful of top go-to experts on the tsunami debris arrival for the media in Seattle and beyond. The debris was dramatically washed out into the Pacific by huge tsunami waves that swept inland along the northeast coast of Honshu, Japan’s main island. The debris is making big news now and started to arrive in noticeable quantities on the Washington coast in November 2011. What has been found, John and other beachcombers say, represents just the first wave of what’s yet to float ashore. Off Vancouver Island a large abandoned fishing vessel has been found and sunk before it crashed on the coast. In Oregon an 80-foot-long hunk of a Japanese dock washed ashore with millions of tiny foreign, possibly invasive, marine critters

along for the ride, requiring thousands of dollars in removal and sanitation costs. Besides becoming a regular contributor to Northwest TV news and newspaper reports, and website mentions, John has been videotaped for the national news on ABC, NBC and CBS. His photo was in a report on the debris published in Smithsonian magazine and he will be appearing in documentaries on the tsunami debris. “The debris started coming in around last November or December,” John says during an interview inside his shed filled literally to the rafters with beachcombing finds. He reckons a little more of the debris is arriving every day, mostly lots of styrofoam likely used in aquaculture floats in a Japanese fishery. He’s beginning to find unusual items, too, like a little child’s pedal car and a weather-beaten volleyball encircled with schoolboy names and sayings written in Japanese characters. “It’s going to get trashy,” he predicts of the Japanese debris on the coast. “It’s hard to tell how bad; it will be pretty

Above: This pile of hard-plastic floats and foam inserts floated across the Pacific from the ravaged northeast coast of Honshu Island in Japan to the Pacific beaches of the West End. The tsunami hit Japan in March 2011. Because the floats are high in the water, Pacific winds are carrying them faster than the mass of tsunami debris heading east from Japan. Below: This tub of Nike athletic shoes recalls a container ship spill that washed up on Washington beaches in the 1980s.

This signed volleyball, plucked from the West End shore, is apparently a movingaway gift from friends of its owner. Japanese news media reporters are attempting to find its owner.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

Above, left: Plastic and glass bottles are common finds along the Pacific Coast, such as these on display in John Anderson’s beachcombing collection. At right: An international array of found caps, each with a unique name or logo on its face, that hangs from a rafter in John Anderson’s shop.

spread out, sporadic, we might get batches.” How the Pacific climate and its North Pacific ocean gyres (large systems of ocean currents) shuffle the debris should likely determine how big and bad the impact might be on the Washington coast. It can takes years for an item that doesn’t make land along its way to drift across the top of the North Pacific from Japan to the west coast of the United States then back, from east to west in a lower latitude, to Japan. This pattern should provide years, if not decades, of Japanese tsunami finds along the Washington coast. Warnings on being careful around tsunami debris have been posted by NOAA. A recent press release states: “If you don’t know what it is, don’t touch it. Collect as much information from a safe distance as you can – including photos – and report the debris to DisasterDebris@noaa.gov. If the item appears unusual or hazardous, contact your local authorities for specific guidance and instructions.” A brochure on tsunami debris safety is available online at www.ecy.wa.gov (855-922-6278).

balloons, crab pot tags, an oversized wooden container filled with Nike athletic shoes that fell off of a container ship in the 1980s, signs and even a piece of a Boeing 747 engine. John also provides keen observations in interpreting his finds. Especially interesting are the Japanese saki and whiskey bottles usually found with their caps tightly on and a shot or so of liquor still in them. He explains that superstitious Japanese sailors toss their almost-empty bottles overboard as an offering to their gods for safety and good luck on voyages. Practical finds include lengths of lumber John has used in constructing the shed that houses his so-far private museum. Outside the museum in another stack are 120 mahogany boards with Japanese character stamps on their tail ends. These may go into a deck. Bottles with messages wash up occasionally, sometimes from school children in Washington, sometimes from students overseas, and from researchers seeking information on drift currents. John keeps a log of such finds and writes in results when he connects by mail with those who cast the

Ocean Shores. A fair also is held in Sitka, Alaska, and John has traveled to Florida to pursue another of his interests, the collecting of sea beans and other collectible natural vegetation found on beaches. In speaking of Florida, John pointed out that a dive team from Forks dove with famed underwater treasure hunter Mel Fischer prior to his famous Atocha dive that recovered hundreds of millions of dollars in gold coins from a historic Spanish shipwreck. He also tells of an aunt and uncle who ran a general store at LaPush. The Russian freighter Lamut, bound for Vladivostok from Puget Sound during World War II, shipwrecked in March 1943 at the rock formation known as The Needles off First Beach at LaPush. One of the sailors salvaged chinaware from the ship and traded the goods for supplies at their store. A sample of the chinaware is in his collection. John works closely with Seattle-based Curt Ebbesmeyer, who holds a Ph.D. in oceanography from the University of Washington, and is an expert on ocean currents and their

“If you don’t know what it is, don’t touch it. Collect as much information from a safe distance as you can – including photos – and report the debris to DisasterDebris@noaa.gov. If the item appears unusual or hazardous, contact your local authorities for specific guidance and instructions.” National Oceanic and Atmospheric Administration While the Japanese tsunami debris is making the news today, and putting the spotlight on him, John’s long-term goal is opening his beachcombing museum. He provided a tour of the collection to me and I quickly discovered it is much more extensive then expected. Gill net floats used by fishermen along the edges of drift nets up to two miles long off Japan number 25,000. He has a stack of rough beach wood hiking sticks, “one for every time you go the beach,” John joked. There’s discarded naval gear, including smoke bombs from a Navy man-overboard rescue kit. NOAA weather

bottles into the sea. Japanese origami storks, precisely formed from colored paper, were a surprise find in one bottle. Like most Washington beachcombers, John values finds of glass balls. He stores and displays his prize glass balls in cabinets. In addition to clear, aqua-green Japanese floats round and tubular, double-blown and indented, he has rare Norwegian glass balls and Russian floats, and glass balls made by Corning Glass in New York to what appears to be scientific specifications. Each March John checks in with the ranks of Northwest beachcombers at the annual Beachcombers Fun Fair held in

effects on floating objects. He hosts a the Flotsam Hour radio show, which is like an Antiques Roadshow for beachcombers, his website states. He produces a quarterly Beachcombers Alert newsletter and his blog at beachcombersalert.blogspot. com is an excellent source of information on the arrival of the Japanese tsunami debris and other beachcombing-related topics. John, who can be reached at dabeach@centurytel.net, advises anyone who finds a potentially hazardous piece of tsunami debris on the coast to report it at www.flotsmetrics.com.

Living on the Peninsula | FALL | SEPTEMBER 2012

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Living on the Peninsula | FALL | SEPTEMBER 2012

A century in the making Sequim Centennial postcard with logo

Sequim prepares for yearlong Centennial celebration

By Reneé Mizar, Communications Coordinator, Museum & Arts Center in the Sequim-Dungeness Valley

rom a downtown street dance and old-fashioned Fourth of July picnic to historical walking tours and geocaching events, organizers of the yearlong Sequim Centennial celebration of 2013 promise ample opportunity for locals to “get into the Sequim of things.” Years spent planning a historical salute the likes of which Sequim has never seen will come to fruition in a matter of weeks when the Sequim Centennial celebration officially begins on Saturday, Oct. 27, 2012. Kickoff events include a community-wide pancake breakfast at the Sequim Prairie Grange and an evening reception at the Holiday Inn Express in Sequim. The Sequim Centennial Committee, which has been meeting for about two years to plan the festivities, is headed by Sequim City Clerk Karen Kuznek-Reese and comprised of interested residents, city employees and representatives from local businesses, community organizations and non-

profit groups. Its mission is to educate, celebrate and commemorate the 100 years since the city’s incorporation. “So many towns have disappeared in 100 years. Like my hometown in Michigan, it has a post office but no grocery store, no gas station. It’s fading,” Sequim Centennial Committee member Priscilla Hudson said. “That’s why we need to celebrate Sequim. We need to highlight past things so that they will be maintained in an honorable way and celebrate the work of those who went before us, and record what we’re doing now to leave our mark for those who come 100 years hence.”

Party by the decade

With a full year of events ahead, one way in which the Sequim Centennial Committee plans to link the ongoing festivities together is by highlighting a different decade theme each month. The theme schedule begins in Novem-

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

ber 2012 with a pre-1900 motif, will groove to the 1970s in July 2013 during Lavender Weekend festivities and culminate in October 2013 with the years 2000-2013. The decade theme list, as well as a regularly updated Centennial events calendar, is available on the City of Sequim website at www.sequimwa.gov. Individuals are encouraged to dress in decade-fitting attire at Centennial events and groups, businesses and organizations to tie in the given month’s theme with their own events whenever possible. Organizers of the 118th Sequim Irrigation Festival, for example, chose a “Dancing Through the Valley” festival theme to reflect the Centennial’s 1950s decade theme for May 2013. Along with in-fashion revelry, the public is encouraged to celebrate in style by donning official Sequim Centennial merchandise that ranges from baseball caps and T-shirts to jackets, fleece vests and commemorative

label pins and is available for purchase at City Hall. Kuznek-Reese said all merchandise sales directly support the Centennial effort and a Centennial poster designed by Port Townsend artist Cindy Mangutz depicting Sequim-Dungeness Valley landmarks through time also is available. Also being planned are a special Sequim Centennial coffee blend created by Rainshadow Coffee and wine label by Wind Rose Cellars, both of Sequim.

Public art projects

In addition to Centennial events, the Sequim Centennial Committee has organized several public art projects to encourage creativity and community participation throughout the year. This includes a tile art project, where for $10 people can decorate a tile that will be glazed and installed as part of a public art display. “This will be a way to get everyone from the community involved,” Kuznek-Reese said of the tile project, also noting sponsorship opportunities are available for many Centennial projects and events. Paying homage to the Sequim-Dungeness Valley’s roots as a leading dairy-producing community, the Sequim Centennial Committee also is seeking artists to decorate vintage milk cans that have been donated by area residents. Evergreen Collision in Sequim donated its services to clean and prime the 14 milk cans, each of which will bear the names of its respective artist and donor, and be displayed throughout Sequim for the duration of the Centennial. The milk cans then will be auctioned off as a fundraiser during the Centennial Grand Finale on Saturday, Nov. 2, 2013.

Projects in print

Several publications also are in the works, including a calendar filled with vintage images and historical tidbits being produced by the Museum & Arts Center in the SequimDungeness Valley and a book chronicling the 100-year history of the Sequim Police Department compiled by longtime police volunteers Bobbie Ryan and Priscilla Hudson and edited by Glynda Peterson Schaad. Opportunities for individuals and businesses to sponsor the police book, which tells of a bygone era in policing and chronicles the evolution of the department through historical images and eyewitness accounts of police personnel and citizens past and present, are available by contacting Sequim Police Chief Bill Dickinson at 360-683-7227. The Sequim Centennial Committee also plans to produce a historical, anecdotal cookbook filled with recipes, family stories and photographs contributed by longtime

and new area residents alike. City of Sequim Communications and Marketing Director Barbara Hanna, who is helping oversee the cookbook project, said she is hoping to receive 50-100 submissions by the Oct. 31, 2012, deadline. “Whether you’ve lived here four years or 40, there’s a reason you live here and those are good, interesting stories,” Hanna said. “We want this cookbook to be about the people who live in our corner of the world. It’s a way to tell the story of Sequim, not just historically, but as a sense of place and of us as a people.” Among the first to contribute to the cookbook was Jamestown S’Klallam tribal elder Rosie Zwanziger, who submitted a photo and story about the salmon, clam and oyster bakes held at Jamestown in the 1960s and 1970s. Organized and hosted by her aunt and uncle, Iris and Harris “Brick” Johnson, Zwanziger said the community-wide beachfront events also served as fundraisers for the Sequim Valley Lions Club, VFW and Sequim Irrigation Festival. “Those events were really big deals. There were 500 people down here and everybody who attended brought some kind of side dish,” said Zwanziger, noting the “Happy Crab” clubhouse that still stands on Jamestown beach was built to accommodate the events. “We cooked oysters, clams and salmon in the traditional style and they always had entertainment. Uncle Brick was a musician, so he always got a little band together and he’d always have kids perform the traditional dances. Those were fun times.” Recipe submission details are available at City Hall, 152 W. Washington St. in Sequim, online at www.sequimwa.gov, and by contacting Hanna directly at bhanna@sequimwa.gov.

Matt Awles of Evergreen Collision in Sequim preps one of the 14 vintage milk cans donated by area residents. Evergreen Collision donated its services to clean and prime the milk cans. Photo by Reneé Mizar At left: For the Sequim Centennial cookbook, Rosie Zwanziger submitted this photo of her aunt, Iris Johnson, tending salmon at one of the numerous fundraising salmon bakes held at Jamestown in the 1970s. Photo by Rosie Zwanziger Below: The Sequim Centennial Committee tapped Port Townsend artist Cindy Mangutz, shown here in January 2012 with her painting – in-process – to create the official Sequim Centennial poster. The poster is available for purchase at City Hall. Photo by Reneé Mizar

Be a part of history

The Sequim Centennial Committee is open to all who wish to participate and will continue to meet monthly throughout the Centennial year. Meetings are held at 1 p.m. on the third Wednesday of each month at the Transit Center, 190 W. Cedar St. in Sequim. “We all moved here for some reason and that reason is because Sequim is a community,” Sequim Centennial Committee member and community volunteer Joe Borden said. “We all need to get involved in our community.” Additional Sequim Centennial information, including art project details and the evolving online events calendar, is accessible on the City of Sequim website at www.sequimwa.gov. To discuss event and activity sponsorship opportunities, contact Kuznek-Reese at 360-683-4139 or kkuznek@sequimwa.gov.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

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Diabetes: The not-so-silent epidemic

Story and photos by Mary Powell

Nearly 10.9 million Americans age 65 and older have diabetes and the numbers are expected to increase.

1938, when my maternal grandmother was 50 years old, she died from complications of diabetes. My mother was only 19 at the time, the youngest of four children. I remember my mother talking about having to give her mother insulin shots, and considering insulin wasn’t discovered until 1921, I assume my grandmother had Type 2 diabetes that had escalated to the point of being insulin-dependent the older she got. At the time, diabetes wasn’t as prevalent as it is today and research was in its infancy as to how to control and live with the disease. Today, what with the tremendous strides that have been made in the management of diabetes, my grandmother most likely would have lived well beyond the age of 50 and may very well not have been insulin-dependent. If it seems as though the incidence of those diagnosed with diabetes, most being Type 2, is on an upward swing, it is. So much so the Centers of Disease Control has termed the rapid increase an epidemic. The numbers tell the story. In 2000, according to the World Health Organization, at least 171 million people worldwide suffered from diabetes, or 2.8 percent of the population. It is estimated that by the

year 2030, this number will almost double. In 2011, according to the American Diabetes Association, nearly 10.9 million Americans age 65 and older had diabetes, 90 percent of those Type 2. Since the prevalence of diabetes increases with age, the numbers of older persons with diabetes are expected to grow as the elderly population increases. The National Health and Nutrition Examination Survey demonstrated that, in the population over 65 years old, 40 percent have either diabetes or its precursor, pre-diabetes. OK, that’s a lot of numbers and percentages and facts. The question is why is this particular disease becoming epidemic, especially in older people? A combination of reasons, says Susan Sorensen, a registered nurse and diabetes educator in Sequim. “We are more sedentary, fatter, our portion sizes are out of control, we eat too much, we’ve become a nation of excess,” she says, not mincing words. “Incidents of diabetes are skyrocketing as our general population increases

Do I have diabetes? Symptoms:

Type 1: • Frequent urination • Unusual thirst • Extreme hunger • Unusual weight loss • Extreme fatigue and irritability

Type 2: • Any of the Type 1 symptoms • Frequent infections • Blurred vision • Cuts/bruises that are slow to heal • Tingling/numbness in the hands/feet • Recurring skin, gum or bladder infections

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

Right: Susan Sorensen, right, registered nurse and diabetes educator, sits with a group of women who regularly attend the diabetes support group offered at the Sequim Senior Activity Center. From left are Harriet Hopgood, Lani Low and Susan White. Below: Susan Sorensen leads a diabetes support group once a month at the Sequim Senior Center. Here she lays out "plastic" food so that the group could put together a day's worth of nutritional meals.

in age. One reason, we exercise less and eat more.” Sound easy enough, right? Eat less, exercise more and viola, no diabetes, right? It’s not that simple, as Sorensen well knows. Yes, diet and exercise are crucial, not only to prevent diabetes, but a host of other diseases, especially as the population ages. But there are other factors that contribute to developing diabetes, such as ethnicity and genetics. African Americans, Hispanics, Asian Americans or Native Americans have a higher incidence of diabetes. “Both Type 1 and Type 2 are genetic in nature,” says Sorensen, meaning the chances of having diabetes increases if it runs in families. Sorensen’s mother had diabetes, but she does not. However, that does not by any means minimize her passion for educating and supporting those with diabetes.

A caring educator

Sorensen is retired military, and without sounding cliché, it’s not difficult to imagine her a nurse in the United States Air Force. Tall, with a commanding presence, Sorensen is self-assured and authoritative, especially when it comes to issues regarding diabetes. This is especially evident when counseling someone recently diagnosed with the disease or leading a class of seniors who have battled high blood glucose for years. There is an aura about her that says, “I care about you, I’m going to help you get through this.” Sorensen attended nursing school in Cleveland, Ohio, and earned her master’s degree while in the Air Force. Her interest in diabetes education began while serving in the Air Force after she began conducting classes for those with diabetes. Another interest developed as well: She met her husband. After the couple retired in the mid-1990s, they took a vacation that landed them in Sequim, and lucky for us, decided to live here. “I wanted to contribute to the community,” Sorensen

What is diabetes?

recalls. “What better way than to give knowledge to make people (with diabetes) healthy.” Today, Sorensen is an independent certified diabetes educator, working with Sequim Medical Associates, educating diabetics in all phases of the disease. “One of the doctors will tell me they have a newly diagnosed patient with a ‘deer in the headlights’ look. They say, ‘You need to talk to Susan.’” The first Wednesday of the month finds Sorensen at the Sequim Senior Activity Center, leading a diabetic support group. She also spent a number years writing a column concerning diabetic issues for the Sequim Gazette. “If I could educate just one person on how to take care of themselves, then it is a good day,” Sorensen says. “I can’t change the world. I can change one person at a time.”

Diabetes defined

What is diabetes, anyway? First, there are three major types of diabetes: Type 1, Type 2 and gestational diabetes. Type 1 diabetes affects about 5 percent of all people who have diabetes. It is typically diagnosed during childhood or adolescence, but people of any age can develop Type 1 diabetes. People with Type 1 diabetes require insulin treatment daily to sustain life. At least 90 percent of adult individuals with diabetes have Type 2 diabetes. It is typically diagnosed in adulthood, usually after age 45. Type 2 diabetes usually is

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

Type 1: Usually diagnosed in children and young adults, previously known as juvenile diabetes. In Type 1 diabetes, the body does not product insulin. Only 5 percent of people with diabetes have this form of the disease. Type 2: The most common form of diabetes. In Type 2 diabetes, the body is partially or completed unable to use insulin. Insulin is necessary for the body to be able to use glucose for energy. At least 90 percent of adult individuals with diabetes have Type 2 diabetes. Gestational diabetes: Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes. It is estimated that gestational diabetes affects 18 percent of pregnancies.

controlled with diet, weight loss, exercise and oral medications. However, more than half of all people with Type 2 diabetes require insulin to control their blood sugar levels at some point in the course of their illness. Gestational diabetes is diagnosed for the first time during pregnancy and occurs in about 3 percent of all pregnancies. Defining the whys of diabetes can be complicated, but simply put, the body cannot regulate the amount of sugar — specifically glucose — in the blood. Glucose’s main job is to supply the body with energy. The liver converts the food we eat into glucose, which is then released into the bloodstream. In a healthy person, hormones, primarily insulin, regulate the blood glucose level. The pancreas, a fist-sized organ just behind the stomach, produces in-

Richard Garcia, Sequim, tests his blood glucose using a monitoring system meter. Garcia, 74, was diagnosed with Type 2 diabetes 15 years ago and last year, began taking insulin. His mother was diabetic, giving Garcia about a 12 percent of having the disease as well.

genetics and lifestyle factors. To be sure, being overweight does increase the risk for developing Type 2 diabetes and a diet high in calories, whether from sugar or from fat, can contribute to weight gain. That doesn’t mean it’s OK to go to town on the sugar intake. Unfortunately, just about everything we eat conLiving with diabetes tains sugar, either naturally or added by the manufacturer. “Diabetes is a very treatable and manageAgain, it’s all about portion control. able condition,” is the first principle Sorensen It’s not always easy living with diabetes but it’s not the imparts to those who take advantage of her end of the world. With support groups and educators like classes. Sorensen, diabetics are learning to manage their disease Second is that exercise and eating right are and lower their risk for complications. the keys to managing diabetes. The stories are varied among those who attend the The July diabetic support group at the monthly diabetic support group at the Sequim Senior Sequim Senior Activity Center, then, starts out Activity Center, yet they share the common denominator with Sorensen asking the group if they want to of living with diabetes. play with plastic food in order to plan a day's sulin. Insulin allows glucose to move out of the blood into Alice McCracken, who recently turned 70, was diagmenu or to learn about reading nutritional labels on food cells throughout the body where it is used for fuel. nosed a couple of years ago. Her doctor told her to watch products. People with diabetes either do not produce enough her diet. She began following the exchange diet to the letter, The plastic food wins out. For the next hour, particiinsulin (Type 1 diabetes) or cannot use insulin properly she says, started exercising, got a dog, which meant more (Type 2 diabetes), or both, which occurs with several exercise, and in a year dropped 40 pounds. But, she forms of diabetes. warns, it can slip away easily. With diabetes, glucose in the blood cannot move “It has to be a lifelong commitment because diaefficiently into the cells, so blood glucose levels rebetes is a progressive disease,” McCracken says. main high. This not only starves all the cells that need Susan White, a 66-year-old from England, admits the glucose for fuel, but also harms certain organs she likes to eat and likes the sweet stuff. Diagnosed and tissues exposed to the high glucose levels. in 1989, she has needed to take insulin for the past With Type 1 diabetes, the body stops produc10 years. ing insulin or produces too little insulin to regulate “In England we don’t use as much sugar,” she tells blood glucose levels. With Type 2 diabetes, although the group. “I always cut the sugar in half.” She says the pancreas still secretes insulin, the body is parthe best thing for her is not to have what she calls the tially or completely unable to use the insulin. The “bad stuff ” in the house. pancreas tries to overcome this resistance by secretOthers say after learning how to regulate their ing more and more insulin. People with insulin blood glucose, they do feel better. Harriet Hopgood, resistance develop Type 2 diabetes when they fail 65, has been on oral medication for diabetes for 20 to secrete enough insulin to cope with their higher years. Once she got her blood sugar under control, demands. she says she could take fewer medicines. When glucose levels are high, excess glucose While most of us think sticking fingers to test begins to spill over into the urine, causing increased The monthly diabetic support group, held at the Sequim Senior for blood sugar levels every few hours would be the urination and, therefore, increased thirst. Because Activity Center, includes tips on eating the right foods, reading food toughest part of having diabetes, not so, say those the cells cannot take in glucose, they become starved product labels for nutritional content and a variety of topics related who must do it. Hopgood tests her blood glucose for fuel, thus causing hunger and fatigue. Untreated to living with diabetes. after every meal. diabetes can cause severe complications. To deter“I’ve discovered what triggers a blood sugar spike; pants decided how to “exchange” foods throughout the day mine if you have diabetes, it’s important to see the doctor, that’s very important to how I manage diabetes.” in order to keep blood sugar levels in check. who will test blood glucose levels. Sorensen wraps it up for the group. “There is no food you cannot eat,” Sorensen tells the Make sense? So, now, how to control this disease called “This is your life,” she tells them. “You are in control. group. “It’s the portion sizes.” And, she added, it’s impordiabetes. It’s a wake-up call when you see someone who hasn’t tant to read those nutritional labels when determining controlled their diabetes having to have a foot amputated when enough is enough. or their eyesight deteriorate.” Sorensen goes on to give more tips. For instance, losing Whether my grandmother had any of the severe comBy the numbers 10 percent of body weight can help toward maintaining plications such as losing a limb or eyesight, I don’t know. blood glucose in the normal range. Or, carbohydrates have My mother, however, was lucky; she never had diabetes • 25.8 million children and adults the biggest impact on those with diabetes since they are and lived to be 93 years old. Had my grandmother had the in the United States — 8.3 percent composed of chains of glucose molecules. Or how about knowledge diabetics have today, perhaps she would have of the population — have diabetes. this one: It takes 20 minutes for the brain to realize we are lived long enough so that I might have known her. • 18.8 million people diagnosed full (during a meal), so we need to give the body a chance Resources: • 7 million people undiagnosed to recognize it is full. • 79 million people considered prediabetic The diabetic support group meets from 10-11 a.m. on the And how about sugar? It used to be, diabetes was • 1.9 million new cases of diabetes diagnosed first Wednesday of the month at the Sequim Senior Activity called sugar diabetes, with the inference that eating sugar in people 20 years and older in 2010 Center, 921 E. Hammond St., Sequim. All are welcome. was the cause of diabetes. The fact is diabetes is caused by The American Diabetes Association, www.diabetes.org.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

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Sarah and Gabriel Chrisman enjoy riding their bikes around Port Townsend. Sarah’s is a new Gazelle brand bike made by an Amsterdam company that has been making bikes since 1892. It has a skirt guard. Gabriel’s is an antique Singer bike called an ordinary, also known as a high-wheeler or pennyfarthing bike.

Story and photos by Allison Arthur Sarah and Gabriel Chrisman are living a Victorian life in a Victorian house in Port Townsend where the two also do what the Victorians did to stay healthy. They walk, bicycle, eat as much local food as they can and try to avoid needing health care services because, like the Victorians, they don’t have health care insurance. While the 30-something couple have and use modern devices like a computer, a refrigerator and a washing machine, they devote a lot of time to learning about Victorian culture by actually practicing it – wearing Victorian clothes, pedaling around town on Victorian bikes, restoring their home to Victorian period, living in 2012 much as the Victorians did in the mid-1880s. Their quest for knowledge about the period has led to lectures in their home on everything from Victorian fashion and myths of the corset – which Sarah wears daily – to talks on Victorian health. Health, in fact, has become a major part of their Victorian adventure. One of the rooms in their home has been converted into a massage studio, Gilded Age Massage Experience, where Sarah offers massages, including a “Swedish Movement” massage, which was popularized by Pehr Ling, also known as the Father of Massage. “The massage has to do with bringing every muscle in the body into a full range of motion. That’s the ideal,” Sarah says. The massage studio, just off the dining room, is gradually being transformed from a plain

white room with a bare wooden floor to a room representative of a Victorian spa setting – from period wallpaper, to pressed tin metal used as wainscoting to antique artifacts such as wash basins and kerosene lamps.

Fashion history, posture

It was their mutual love of history that put them on the Victorian lifestyle path. “We were interested in history together and we started collecting things and talking about things,” says Gabriel, who studied computer science at the University of Washington before earning a history degree and a master’s in library and information science. Gabriel, who is working part-time at the Jefferson County Library, also has experience in bicycle mechanics and small business management. He also owns a 1982 DeLorean car, similar to the one made famous in the movie “Back to the Future.” Sarah has degrees in French and International Studies from the University of Washington in addition to a massage therapy license. “We started collecting historic clothes, and things like that, and what led to the corset is that the clothes didn’t fit,” Gabriel explains. That led to Sarah wearing a corset, writing a book about it, “Waisted Curves: My Transformation Into a Victorian Lady,” and now she’s working to make her own corset. Gabriel also has had Victorian-style clothes tailored for him.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

What the two learned from their first experiences with clothes is that Victorian men, women, and even children, needed to stand up straight to fit into the clothes. Even children wore posture-improving undergarments. And staying in shape was a focus for everyone back then, so much so, in fact, that school textbooks talked about health and noted the need for children to play outside and exercise. “For both men and women there was a lot of effort tied up in keeping yourself in shape because keeping in shape was your best form of health insurance,” says Gabriel. Books also talked about how the body worked – and what was good and what wasn’t. “Here’s a little bit about how the human body works,” Sarah says of what one book tells, “And alcohol is bad. And tobacco is bad. And here’s a little more about how the human body works. And alcohol will kill you and tobacco is poison.” Sarah emphasizes the words “kill” and “poison” and a vivid picture emerges of how people were getting concerned about what they put in their bodies.

Concern about food

Even back in the 1880s, there was concern about chemicals being introduced into candy and chalk being used to stretch foods like flour. “There was no FDA at the time. There was no control over what they put in food,” reminds Gabriel. In particular, one talk they give includes Sylvester Graham, a prominent preacher and namesake of the Graham cracker. “He first came into prominence in New York to the lower-middle class,” says Gabriel. “He told them they were being endangered by people who were playing fast and loose with their food in the 1840s.” Flour was being bleached. Cows were being fed mash by-products of alcohol and were becoming anemic so they didn’t give good milk. Business interests got stirred up over Graham and tried

to get him tossed out of town. One Eastern college tried to follow Graham’s diet – which banned alcohol, meat, tea, coffee and even spices. It didn’t last very long. “Graham sounds very ahead of his time, but there were things Sarah Chrisman listens as Gabriel where we don’t agree with him. tells a group what He said meat and spices made he learned about the people lustful and it made people corset, which Sarah sin, which is why he was against is modeling. Gabriel bought her first corthem,” says Sarah. set several years For the record, he did popularago. She liked what ize his own flour, but his crackit did for her posture ers had water and salt – and no as well as appearance. Her waist was sugar. 32 inches before the Sugar, in fact, was a source of corset. It took less some controversy in the Victorian than a month to get times. to a 28-inch waist and now she has a “We would not need to be quite 22-inch waist. so much afraid of a little candy if it were not for the poison with which it is colored,” wrote one 1880s author, who suggested the best way to check the purity of candy was to dissolve it in water. If there was a residue at the bottom, the author suggested not eating it.

“For both men and women there was a lot of effort tied up in keeping yourself in shape because keeping in shape was your best form of health insurance.” — Gabriel Chrisman But then advertising and magazines came into vogue and a Lady’s Journal of Good Housekeeping in 1888 talks about how “nourishing sweets are” and how one’s body “wouldn’t have such a craving for it if it weren’t good for us.” In that same year, the Sarah publication offered a recipe Chrisman stands in her for “Invalid Ice Cream” that massage room in her could be easily digested by home in Port Townsend. someone sick. Alas, it inHer business is called the Gilded Age Massage cluded cream and sugar. Experience (GAME). As for tobacco, people Submitted photo in the day thought smoking was a dirty habit that should be relegated to outside. Sarah notes that she learned that Prince Albert’s smoking room was the only room of the palace that Queen Victoria forbade to have her initial engraved in because she disapproved of the habit. So that room has an “A” only.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

Dealing with technology

What fascinates the Chrismans is how people in the Victorian era – an era that began during Queen Victoria’s reign from 1837 and ended with her death in 1901 – dealt with technological changes. “They had to work out ways to live with technology,” says Gabriel. “There’s a certain amount of etiquette they were challenged by with the telephone and the telegraph. It was the intrusion of having a phone right in your home.” People also were starting to become aware of how repetitive stress, like working in a factory and doing the same thing over and over again, posed problems. In today’s society, most people have cars. But Sarah doesn’t drive. “I’ve never had a driver’s license, or even a learner’s permit, a conscious choice which necessitates that I get a great deal of exercise, through walking and biking, in the course of my everyday life.” “It has the added benefit of not polluting the air, which contributes to the general health of the world,” she says, adding that she’s amused when she passes the fitness center and sees people inside on a treadmill. From Sarah’s perspective, machines that force exercise are an inappropriate use of technology – since it isn’t really needed and one can exercise by simply walking. “I think it makes me healthy,” she said of walking or biking or riding the bus.

Going to the doctor

In the Victorian era, Sarah says people took an interest in how their bodies functioned and were skeptical of doctors, which is unlike the modern-day thinking that health is “something which should be left to the professionals” and “only doctors know what’s best for us.” Neither Sarah nor Gabriel have had health insurance since they’ve been married so they rarely go to doctors. “When we do go, we’ve had horrible experiences,” said

Gabriel as Sarah leaps out of the chair to explain how she broke her foot in two places four years ago in judo practice. Doctors told her she needed surgery on both feet “or I’d never walk again.” Although she’s grateful to the emergency room doctor who put her foot in a cast, she remembers vividly how she walked to a clinic on crutches in Seattle only to discover, after waiting for hours, that she had been given an appointment with a shoulder specialist. As she was being wheeled out of the clinic, her leg black and blue, other doctors intervened and said she couldn’t be released in such a condition. Ultimately, Sarah ended up borrowing a walking boot from friends. She also exercised her foot by putting marbles in a wash basin and then practiced curling her foot to take out the marbles and put them back in the basin. “Since I didn’t want surgery, especially not on my healthy, uninjured leg, the hospital basically washed their hands of me, and I carried out my own treatment techniques.” Back in the Victorian era, hospitals were a place where poor people went to die, she says. “The rich would die in their own houses. They’d bring doctors to them. Hospitals were the last refuge of the poor. You tended to get sicker when you went to the hospital.”

Changing times

But times were changing in medicine. While Sarah and Gabriel know all the Victorian “quacks” well, Sarah is quick to remind that the Victorian era also

“brought us (Louis) Pasteur and the knowledge that diseases are caused by germs.” “It brought us the knowledge that bad water makes one sick. It brought us anesthesia. Ether and chloroform were both invented in the Victoria era. “It was the first time a woman was able to survive a Caesarean section. Before that it was cut the baby out and maybe the baby would survive,” says Sarah. While Victorians might have been known best for their attitudes about sitting up straight, they also were modernizing a few things that helped them with, well, lying down, to be ladylike about it. Birth control forms were quite in Sarah Chrisman gave a presentation earlier this year about the Temperance vogue. There was the French cup, as a movement. She and her husband, Gabriel, give regular talks about the VicSubmitted photo diaphragm was called, and a French torian era. sleeve, as a condom was called. Much of what they’ve learned about health, for example, relates to illness prevention. So they eat well, sit up straight, exercise daily by walking and biking. “Many of the most important things about health “We started out being interested in the history of the were known long ago, says Gabriel of what the young period, but we ended up learning a lot of things that we couple has learned about the past and plans to carry can apply in our every day life,” says Gabriel. into their future.

Back to the era

At Finnriver, it’s cider time Fall is the perfect time to enjoy finely crafted hard ciders By Fred Obee

n a hillside above the Chimacum Valley is Finnriver Farm, famous for blueberries but now also a popular stop on the hard

Keith and Crystie Kisler with sons River and Coulter pose for a family portrait on their family farm and cidery in Chimacum.

cider trail. Cider wasn’t on their mind when Keith and Crystie Kisler first settled in at Finnriver, but the financial realities of small farms drove them to consider specialty products with higher profit margins than berries and vegetables, and by happenstance they wandered into a nationwide cider revival. Since then, they’ve ramped up production several times, adding equipment that increases their output and they are constantly working on new varieties of cider. “At Finnriver, we gather and ferment the flavors of the land to offer you hand-crafted sparkling hard ciders and spirited fruit wines,” the farm’s promotional literature says. “We are inspired by the allure of the

fruit, the ancient history of the craft of fermentation and the lively traditions we now seek to revive.” Finnriver is a certified organic family farm and cidery located alongside a restored salmon stream. They grow fruit and berries for their products but also glean and buy fruit from other organic farms and orchards in Washington. Keith and Crystie welcome visitors to the farm, which also features a cider-tasting room. October-April they are open Friday-Sunday noon-5 p.m. and May-September, ThursdayMonday, also from noon-5 p.m. A $5 tasting fee is waived with a purchase. Finnriver can be reached at info@finnriverfarm. com or by calling 360-732-6822 or 360-732-4337. The farm’s website is www.finnriverfarm.com.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

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www.clallampud.net 29

Peninsula Behavioral Health center offers 24-hour crisis intervention Story and photos by ASHLEY MILLER

Often, the calls involve a threat to jump off of the Eighth Street bridges. Other people, she said sadly, never make the call for help that can save their life.

Suicide is a rising problem. More people die by taking their own lives each year in the U.S. than by homicide. In Clallam County alone, 168 people died because of intentional self-harm between 2000-2010, according to the Washington State Department of Health. In comparison, 17 people died as a result of assault or homicide during the same time period. Wendy Sisk, supervisor of crisis intervention services through Peninsula Behavioral Health, Peter Casey is the reports that at least two people Peninsula Behavioral contact the crisis center per day Health executive director of six years. with suicidal thoughts or plans.

Risk factors

While suicide is tragic, it’s often preventable. Knowing the risk factors and who is at risk can help reduce the suicide rate. “Men are more likely to complete suicide, while women are more likely to attempt it,” Sisk said, as a general rule. “Perhaps that is because men tend to choose deadlier methods.” Suicide doesn’t discriminate. People of all genders, ages and backgrounds are capable of taking their own lives. People most at risk, however, tend to share the following characteristics, according to the National Institute of Mental Health: • Depression, other mental disorders, or substance abuse. • A prior suicide attempt. • Family history of a mental disorder or substance abuse. • Family history of suicide. • Family violence, including physical or sexual. • Having guns or firearms in the house. • Incarceration, being in jail or prison. • Being exposed to others’ suicidal behavior, such as that

of family members, peers or media figures. Just because someone exhibits some risk factors doesn’t mean they will attempt to kill themselves. That’s because suicide isn’t a normal reaction to stress, Sisk reminded. Nonetheless, suicide is a sign of extreme distress and is not a harmless bid for attention.

Warning signs

The following signs may mean someone is at risk for suicide, according to the National Suicide Prevention Lifeline. The risk of suicide is greater if a behavior is new or has increased and if it seems related to a painful event, loss or change. • Talking about wanting to die or kill themselves. • Looking for a way to kill themselves, such as searching online or buying a gun. • Talking about feeling hopeless or having no reason to live. • Talking about feeling trapped or in unbearable pain. • Talking about being a burden to others. • Increasing the use of alcohol or drugs. Katijean Thorpe, crisis line therapist, in the office.

Suicide facts at a glance

From the Centers for Disease Control and Prevention: • In 2007, more than 34,000 suicides occurred in the U.S. This is equivalent to 94 suicides per day or one suicide every 15 minutes. • Among young adults ages 15-24 years old there are approximately 100-200 attempts for every completed suicide. • In 2009, 13.8 percent of U.S. high school students reported that they had seriously considered attempting suicide during the 12 months

preceding the survey; 6.3 percent of students reported that they had actually attempted suicide one or more times during the same period. • Males take their own lives at nearly four times the rate of females and represent 78.8 percent of all U.S. suicides. • In 2008, 376,306 people were treated in emergency departments for self-inflicted injuries.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

• Acting anxious or agitated; behaving recklessly. • Sleeping too little or too much. • Withdrawing or isolating themselves. • Showing rage or talking about seeking revenge. • Displaying extreme mood changes. Other people show no warning signs for suicide at all. “The people often most serious about it don’t have warning signs,” Sisk said. “A lot of completed suicides are in the moment and very impulsive actions.” Why do people commit suicide? The reasons vary from person to person, but more often than not it has to do with the termination of an important relationship, Sisk said. “Suicide happens when somebody is profoundly depressed and thinks ‘Everybody’s life would be better without me.’ They feel a burden to other people, are totally disconnected and can’t fathom a solution.”

Knowing when to ask for help

When should a person call the crisis line? “Feeling any sort of feelings is OK, but if you feel that you can’t control your feelings and might act on them, then you should seek help,” Casey said. Calling the crisis line or utilizing services at Peninsula Behavioral Health doesn’t mean a person is “unstable” or “mentally ill.” “We’ve tried to change the ambiance (because) this is not a place where ‘the crazy people go,’” Casey added. “We are a growing agency providing a range of services to diﬀerent people.” Katijean Thorpe, a licensed therapist, started answer-

ing the crisis line last March. “You see people at the very worst, scariest time desperately seeking a human connection,” Thorpe said, although that doesn’t make it all negative. “It’s very rewarding to see immediate progressive steps forward but when I’m on the phone with somebody in need, I do.”

Helping people grow and change

Peninsula Behavioral Health is a licensed mental health and certified chemical dependency treatment organization. Psychiatric and psychological services for children, families, individual adults and senior citizens have been available throughout the county since 1971. While the organization primarily served mentally ill patients in the beginning, that all changed in 2000 when the need for broader services became obvious. As services expanded, so did the number of patients. In addition to counseling, community support, medical, residential and educational services, Peninsula Behavioral Health offers 24-hour crisis intervention. The crisis line is staffed all day and the regional number takes over at night. The crisis team is experienced and can help resolve problems by “talking them out” or can offer advice on how to utilize local resources. Peter Casey, Peninsula Behavioral Health executive director, stresses the fact that reaching out for help isn’t a “bad” thing. “It’s absolutely fine for people to seek help,” Casey said. “Everybody has difficult times in their lives and sometimes it’s overwhelming. But it can always help to talk to somebody.”

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To learn more about suicide and to get help, consider the following resources: In a crisis, contact: • Peninsula Behavioral Health crisis line 360-452-4500

• The National Suicide Prevention Lifeline A 24-hour, toll-free crisis hotline links callers to a nearby crisis center. • www.suicidepreventionlifeline.org or call 800-273-TALK (8255)

For more information about suicide and mental illness: • American Association of Suicidology - A resource and education organization dedicated to the understanding and prevention of suicide. www.suicidology.org or call 202-237-2280 • National Strategy for Suicide Prevention A comprehensive national plan to confront suicide in the U.S. www.mentalhealth.samhsa.gov/ suicideprevention • The Trevor Helpline - A national 24-hour, toll-free suicide prevention hotline aimed at gay and questioning youth. www.thetrevorproject.org

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The exact mechanism of how exercise works to prevent and treat depression and improve mood is unknown. However, it is believed that exercise releases “feel good” chemicals such as neurotransmitters and endorphins in the brain. The increased brain circulation produced by exercise also may be partly responsible for overall brain health.

Increasing your brainpower through exercise

Why physical activity is the key to a strong mind By Jay Bryan, M.S., exercise physiologist, and Kenny Hall, B.S., personal trainer

xercise has many proven benefits. These benefits include reducing the risk of cardiovascular disease, diabetes and several types of cancer; strengthening the bones and muscles; helping with weight management and reducing stress levels. However, exercise is not just about the body. There is a growing amount of evidence that physical activity is a powerful medicine for the brain.

Exercise and mental health

According to the American Heritage Dictionary of the English Language, mental health is defined as a state

of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society and meet the ordinary demands of everyday life. Limitations that can affect a person’s mental health and overall well-being are depression and anxiety. Recent studies from the Mayo Clinic in Rochester, Minn., suggest that there are psychological and physical benefits of exercise and lowering/reducing anxiety and improving mood. As early as the 1980s, observational studies began to show that Americans who exercised were not only less likely to suffer from depression than those who did not exercise, but also were less likely to become depressed in their golden years. Several studies have found exercise effective in reducing symptoms of both anxiety and depression. In one case, exercise was as effective as a popular medication. In 1999, Duke University researchers demonstrated that depressed adults who participated in cardiovascular exercise improved their symptoms of depression as much as those treated with sertraline – aka Zoloft – a drug that earned Pfizer over $3 billion a year before its patent expired in 2006. It is estimated that nearly $15 billion are spent annually on anti-depression medications.

In a recent study published in the Archives of Internal Medicine, researchers from Vancouver looked at 155 women, split into three groups who did either one time per week of resistance training, twice per week of resistance training or only performed stretching and balance training. After a year, they measured mental acuity, focus and attention through various tests. The twice per week group that did resistance training (also known as strength training or weight lifting) had significantly better scores on all tests, including scoring better on a conflict resolution test. The stretching/toning/balance group scored lowest. In an early observational study at the Mayo Clinic, investigators looked at the relationship of physical activity and mental function in about 6,000 women who were 65 and older, over an eight-year period. The researchers found that the women who were more physically active were far less likely to experience a decline in their mental function than the women who were physically inactive. According to the January 2012 issue of Archives of Pediatrics & Adolescent Medicine, multiple studies performed in the United States, Canada and South Africa were reviewed and found significant evidence that there is a strong relationship between physical exercise and academic performance. So the term “dumb jock” may not be entirely accurate. Exercise increases the blood flow to the brain that carries oxygen, which we need to think. Also, the growth factor FGF-2 that is produced during exercise is thought to be a large contributing factor in the generation of new neurons in the brain. It also appears that exercise actually increases the number of cells in the region of the brain called the hippocampus. All of these changes may result in better cognitive and mo-

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

tor function, better short-term memory and focusing and maintaining attention, all of which may result in better academic performance and better quality of life.

Exercise and Alzheimer’s

A 2008 study from the Alzheimer’s Association predicted that about 10 million baby boomers would develop Alzheimer’s disease in the United States by 2010. This is an alarming number. That is close to one out of every eight baby boomers. How can we help these numbers from growing? Physical exercise is still the go-to preventative therapy for Alzheimer’s. Dr. Ronald Petersen, the director of the Alzheimer’s Research at the Mayo Clinic states, “Regular physical exercise is probably the best means we have of preventing Alzheimer’s disease today, better than medications, better than intellectual activity, better than supplements and diet.” That is a powerful statement by a prestigious individual. There must be something to this exercise stuff.

Stroke prevention and management

High blood pressure and high cholesterol levels are both risk factors for stroke. It just so happens that exercise helps with both, especially hypertension. Even a single bout of cardiovascular activity for as little as 10 minutes can lower one’s blood pressure post-activity for several hours due to its stress mitigating qualities. Regular exercise also can boost the “good” cholesterol, high-density lipoprotein (HDL), which is protective for all cardiovascular and cerebrovascular events. As well as rais-

ing the HDL levels, regular exercise can lower the “bad” cholesterol levels known as low-density lipoprotein or LDL. But not only does exercise play a role in preventing stroke, it also is a major component of the rehabilitative process. Increasing and restoring circulation and neuron-pathways is essential to stroke recovery.

How much exercise is ‘enough’?

The American College of Sports Medicine set a guideline in 2011 of 150 minutes of moderate-intensity per week as a minimum. That’s less than 22 minutes a day and 150 minutes in perspective is really not as much of the week as you think. There are 10,080 minutes in the week and 150 of those minutes account for 1.5 percent of the week. Any amount of exercise of almost any kind can be helpful due to the protective circulatory effects of increasing one’s heart rate. However, as long as you do not overdo and wear out the rest of your body, more exercise of higher intensity and greater variety is better when it comes to the brain. Consult a health and fitness professional. If you want to improve your mood, your attitude, your attention, your mental acuity or you want to decrease your risk

of depression, stroke or Alzheimer’s, exercise must be your first move. It seems the longer we study exercise and its powerful effects, the more we learn that there is no medicine like it. It has more benefits and fewer side effects, at a lower cost than expensive doctor visits and prescriptions. Exercise allows us to move better, work better and live better.

Are you off the couch yet?

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LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

Far left: Marge Luther of Port hadlock demonstrates how a lift works to put her scooter in a van. Pete hubbard, who took the photo, needed to know how to work it because his wife needs one. Submitted photo Left: Walt hill checks out a wheelchair to a Port Ludlow family that needs help moving someone from his home into the car and into the doctor’s office.

story and photos by allison arthur

ECHHO: What goes out, comes back Medical equipment loaned out, volunteers help with transportation

Marge Luther used to volunteer to drive people to medical appointments in Jefferson County and beyond. Now she’s on the receiving end of the same little-known nonprofit organization she once volunteered with – Ecumenical Christian Helping Hands Organization (ECHHO). “There are so many people who are able to stay in their homes because of ECHHO,” says Luther in gratitude. “They’ve given me back the ability to get out and continue to do things I enjoy,” she says of the equipment she uses daily that is on loan from ECHHO. Luther points to a plastic form that helps her put on her socks in the morning and the $3,000 lift that helps her get her scooter into her van – and out to parades from Port Townsend to Port Hadlock, where she promotes ECHHO.

Little-known

Although ECHHO has been around for 15 years, it’s not a headline-grabbing organization. It is headquartered at 1110 Jefferson St. in Port Townsend, in a home converted into an office, donated by the First Presbyterian Church. The house originally was set to accommodate a pastor, but the pastor opted to move elsewhere and church offered it to ECHHO.

Since then ECHHO has filled the house – from living room to basement – with lift recliners, wheelchairs, walkers, chairs with tables attached. There are canes and crutches, some dating back to when Jefferson Healthcare Hospital handed over its equipment to ECHHO years ago. There’s a commode closet in one hallway. Where a family might have put play equipment in a basement, ECHHO ExecuDane tive Director Ken Dane and employee Walt Hill find everything from suction-cup grab bars to Hoyer lifts to knee scooters to two-legged walkers, all equipment that’s available to be loaned out at a moment’s notice. Dane estimates ECHHO has loaned out more than 900 pieces of equipment to 550 people in 2012. In 2011, the organization served some 898 people with volunteers driving 45,926 miles delivering care recipients, as ECHHO calls those who need transportation assistance, from East Jefferson County to appointments across the peninsula and into King, Kitsap and even Pierce counties. The tiny nonprofit, which operates on a shoestring budget of $79,000 a year, also offers people free help with chore services

– not just to low-income people and seniors, but anyone in need. “We’ve had people come through and say ‘How much does this cost?’ I say ‘Normally, nothing, but we’ll charge you double,’” Dane likes to say of the equipment on loan. “It all provides mobility, stability, safety, all those things with ‘ty’ on the ends,” Dane says of what ECHHO does.

Tourists and newcomers

And while more than 99 percent of care recipients are from East Jefferson County, not all are. One family stopped by the Jefferson County Chamber of Commerce not long ago, looking for a place to rent a wheelchair so that a family member could enjoy the Olympic Peninsula. They were directed to ECHHO where they found a portable wheelchair. They used it, then returned it after their jaunt. “The purpose started out to help lowincome people and disabled and seniors, but it’s evolved over the years to address anyone with a need,” said Dane. Dane says more and more people seemingly need help these days. He suspects it has to do with people moving into a community and aging, but not having had time to make lifetime friends or connections.

“It’s easy to make friends here, but it’s not as easy to ask someone to drive you to Poulsbo to have your eyes fixed,” Dane says of the migration of people into Jefferson County over the past decade. A decade ago, for example, ECHHO served some 277 people: It served three times that in 2011 and Dane believes that will continue to grow. He has a saying, in fact, that, “My own sense of it is that I’m one person, my wife, away from needing ECHHO myself.” “We go up every year in terms of our numbers,” he says. “It’s a modest increase, but increase nonetheless. We keep active cases on the transportation board and there are three or four transports virtually every day now.”

Super drivers

Of all the some 75 active volunteers with ECHHO, Chester Prudhomme is one of the superhero drivers. He’s driven a staggering 17,843 miles in seven years. Now 69, Prudhomme retired from Jefferson County Public Health years ago, where he had worked as a mental health and alcohol abuse counselor. “I’m one of those people who came for a visit one afternoon some 39 years ago and I’m still here,” says Prudhomme. “I’m still trying to figure how to get out.” He says that jokingly because he’s the

Living on the PeninsuLa | FaLL | sePteMBeR 2012

You’ll be resting in the comfort of your own home the SAME DAY .

one calls up, we need to know where they are going.” “We’re not in the business to set up barriers to people using the service,” Dane says of asking a lot of questions. Reimbursement for gas for volunteers is one of ECHHO’s major expenses. All of the employees, Dane included, work part-time.

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driver who has a car with great gas mileage and so is often asked to take people to those far-away appointments. Mostly, he says he goes to Virginia Mason Hospital & Medical Center, Swedish Medical Center and Harborview Medical Center. “I love telling people about the area and often find that people haven’t met other people to talk to. So I get them turned on to available resources,” Prudhomme says. “I’m a walking encyclopedia of events and who’s who and since I’ve driven almost 18,000 miles, I have plenty of time to talk.” Prudhomme also leads the volunteers in the number of hours volunteered – 2,448, ECHHO figures. Mac Magary, who has logged 13,807 miles and 937 hours of service, also qualifies as a super driver, Dane says. Prudhomme says he loves the volunteer job because he gets to meet so many people. “It bolsters my contention that this is one of the most cosmopolitan small areas you’ll ever go to. I’ve met people who’ve been all over the world. Everybody’s got a story.”

e th

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Where ECHHO gets help

It’s not uncommon for Wendy Johanson says she loves eChho, especially people who receive services its name, and appreciates volunteers like Chester Prudhomme, who picked her up recently to take her to donate what they can, to an appointment. says Dane. About 40 percent of ECHHO’s budget comes “The very next day the equipment from donations from community-minded groups and businesses, including Edenmanager said, ‘We don’t need to ask. We saw Community Cancer Foundation, have it here in the storage,’” she recalls. Peninsula Cancer Center (Poulsbo), Port That has helped Luther get back her Townsend Rotary Club, Seven Cedars freedom to travel to the Tri-Area Senior Casino, Edith Grobe Foundation and the Center, where she touts the services of Belkin Foundation. ECHHO, hoping more people will get to ECHHO also gets help from the know a service that has helped her. Olympic Area Agency on Aging, Jefferson “I’m very proud of ECHHO,” says Healthcare and United Good Neighbors. Luther. “It’s a marvelous organization. I It does not ask anyone who needs encourage people to volunteer or contact transportation or medical supplies for them when they need help.” either money or medical information and so ECHHO doesn’t know for sure what people are being treated for. For more information about ECHHO, to “We don’t try to collect a lot of medical volunteer, or to borrow or donate medical information,” Dane says. “So we don’t re- equipment, call Executive Director Ken Dane ally know what people have. But if some- at 360-379-3246 or go to echhojc.org.

Living on the PeninsuLa | FaLL | sePteMBeR 2012

At our new location:

Stroke Lives changed … not ended

Story and photos by Patricia Morrison Coate

time of treatment is of the essence because “Time is brain.” “So far this year (Aug. 13) our providers have listed the An emergency dispatcher trips a local ambulance squad: primary impression of a patient as stroke/CVA 86 times,” A 58-year-old male caller says his arm feels numb and he’s said Capt. Bryan Swanberg, Clallam County Fire District 3 dizzy; the dispatcher also advises the medics his speech is medical safety officer. “We have been dispatched 13 times to beginning to slur. A woman in her mid-70s complains she has a chief complaint of stoke from our dispatch.” the worst headache of her life and wants to sleep it off but her A stroke or cardiovascular accident occurs when a blood husband sees one side of her face is drooping. He immediately clot forms in any vessel in the brain (ischemic), blocking calls 9-1-1. They both blood from delivering oxygen and nutrients and causing cell may be having and tissue death; or when a blood vessel bursts (hemorrhagic) a stroke and such as in an aneurysm, the ballooning of a vessel to the point of rupture. Brain tissue past the tear will starve for oxygen and die. Of the 800,000 Americans annually who have a stroke, about 140,000 of them will die. Stroke is the third-leading cause of death in the U.S. after heart attacks and cancer. About 87 percent of strokes are ischemic. A stroke is a sudden, rapidly evolving event and always is a medical emergency. It can occur in any part of brain and is described as being left-sided, right-sided or brain stem. The residual effects of each differ because each portion is the seat of separate physical and cognitive functions and one side of the brain controls the opposite side of the body. Someone whose stroke happened on the right side of the brain, according to the American Stroke Association, could have left-side paralysis, vision problems, a quick, inquisitive behavioral style and memory loss. In a left-side stroke, there will be paralysis on the right side, speech and language problems, a slow, cautious behavioral style and memory loss. It’s doubly damaging when the stroke occurs in the brain stem because generally paralysis is bilateral and the patient also loses the ability to speak. What’s key to ameliorating the damage is to dissolve the clot or repair the rupture within a threehour window. “Time is brain” is the mantra of all emergency medical personnel and the odds of a better recovery have improved on the Olympic Peninsula since Olympic Medical Center in Port ace: Does one side of the face droop? Angeles (2010) and Jefferson Healthcare in Port Townsend (2009) partnered with rms: Is one arm weak or numb? the Swedish Neuroscience Institute in Seattle in its TeleStroke program which peech: Is the speech slurred? links stroke team experts to local emergency room physicians 24/7 for real time diagnosis and treatment. ime: Time is critical. Call 9-1-1 immediately!

THINK F*A*S*T: F A S T

If you or someone with you has one or more of these signs, call without delay: • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body • Sudden confusion, trouble speaking or understanding • Sudden trouble seeing in one or both eyes • Sudden trouble walking, dizziness, loss of balance or coordination • Sudden, severe headache with no known cause

36 36

Azella’s story

Most strokes occur in people over age 65 but can happen at any age, so stroke symptoms shouldn’t be ignored in anyone. Azella, who prefers to go by a single name, knows that better than most. Now living in Sequim, she suffered sudden cardiac arrest at a friend’s house in Olympia in 2005 at age 52. A right-sided stroke followed in the hospital.

“My friend began CPR and I remember nothing of that weekend. I do know that the Big Guy had everything all planned because had this happened at home alone, I wouldn’t be here today,” Azella said, from her rocking chair. “I threw a clot in the hospital and I’d not be able to do the things I do without having been in the hospital when it happened. The doctor said if 10 people had the stroke I had, nine would be dead. People believe old wives’ tales that’s stroke only in the elderly, but stroke doesn’t know age, sex or color. A baby carried in the womb can experience a stroke,” Azella said. She speaks with deliberation and clarity, a battle hardwon over the past seven years. “While I was in the hospital, someone told me I’d never walk again, but she did me a favor. ‘Well, you just watch,’ I said. AZELLA I may not be graceful but I do walk.” Weeks of inpatient rehabilitation were followed by months in intensive outpatient physical therapy with Azella relearning how to walk, as the stroke had partially paralyzed her left leg. “I remember the first time I took a step, I screamed with joy! I had to relearn how to dress, to eat slowly and carefully because when I first had the stroke, swallowing was an issue.” Two more stints of rehab followed, the last in Sequim “because I was just not progressing the way I wanted to progress.” Since then Azella’s heeded the advice of one of her therapists — just to live her life. She lives on disability and manages her activities of daily living with two part-time caretakers. Although she says her leg is “cooperative” now with a walker, her left arm isn’t and she’s unable to undress and dress or bathe without assistance. Azella gets together with friends, moves around downtown in her scooter chair, cooks and bakes, is active in the local chapter of the Brain Injury Association of Washington, and her church, the Olympic Unitarian Universalist Fellowship, and vocally advocates for the disabled. “I may not like having had a stroke but I understand why,” Azella said. “Now I fight and advocate for the disabled and educate people about stroke.” She would like to start a stroke support group and give presentations about stroke; call her at 681-3191. Azella said she and others with brain injury too often feel minimized by the rest of society regarding their personhood. “Just because we’re not whole doesn’t mean we’re not human. A lot of people believe once you become disabled, you have no rights.” To dispel that misguided assumption at an official level, Azella is on the steering committee of the Disability Rights of Washington as a voice for change. She is vigorous in supporting and educating the public and elected officials on strokes

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

to bottom and is organized. “When someone’s had a stroke, often I see a random, unorganized search strategy. It’s very discombobulating, as visual attention is a critical prerequisite for cognitive functioning. For example with reading, if a person is not attending to his left side, he'll be missing the beginning of the lines; with the right side, he might only read half way across the line, so reading can be a real issue.” The brain is remarkably adaptable and in many instances, with repetition, new pathways can be formed to take over for damaged areas. Klawitter said much of her work revolves around retraining patients in compensation, which Occupational therapist Liz Klawitter works with 65-year-old Jim Kelly of can include strategic scanning of Port Angeles on the DynaVision to improve his visual perception. their environment for obstacles. in particular and the rights of the disabled. “If they can mentally picture and anticipate their space, “I have strong beliefs about the disabled,” she said. “They they have much more confi dence in moving about it,” Klawitshould be encouraged to be as independent as they possibly ter said. can, for example, you only help me when I ask you for help. One of the aids she and patients use to improve their visual I am a champion for them. I may not like having to be, (beperception is the DynaVision, a large square wall-mounted cause all people should be treated equally), but it is what I do. board with lights that flash on in programmed patterns. AcPeople who are disabled do not want more than others; we cording to the company’s website, “For persons with visual only wish to have the same.” and visuomotor impairment, the apparatus is used to train compensatory search strategies, improve oculomotor skills such as localization, fixation, gaze shift and tracking, increase Liz Klawitter, an occupational therapist specialized in low peripheral visual awareness, visual attention and anticipavision rehabilitation with Olympic Medical Physical Therapy tion, and improve eye-hand coordination and visuomotor & Rehabilitation in Port Angeles, is a career veteran with 22 reaction time.” years of experience in helping people regain as much of their Klawitter has been using the DynaVision with 65-yearpre-stroke function as possible. old Jim Kelly of Port Angeles for several sessions after his “Stroke is a game changer in many people’s lives,” Klawitstroke and they’ve both seen his improvement. ter began. “We are so defined by what our bodies can do for “The response time is recorded for visual search speed and us. If suddenly our physical bodies don’t function the way accuracy and the device can be programmed to challenge they used to, as with a stroke, we have to go through a process divided attention skills between your central and peripheral of redefining who we are now. That becomes a key element visual fields,” Klawitter said. “Visual and cognitive skills can in the occupational therapeutic process.” improve because if you can increase visual attention to be able As with Azella, most of Klawitter’s stroke patients have to see and respond to your environment, you have a chance had inpatient therapy prior to outpatient. of performing as independently as possible.” “An occupational therapist addresses the functional Klawitter said she’s drawn to her patients for their deterlimitations created by the stroke in activities of daily living mination to overcome or adapt to their deficits. and works to restore or remediate functionality,” Klawitter “The people I work with are at a critical point in their lives. explained. “The types of things I work on include physical Although life has often changed for them, they come to see skills, visual perceptual and cognitive skills. For example, a that it’s not over. Therapy can give them another shot at it.” person may have weakness and lack of coordination of their arm and hand in using it to get dressed, feed themselves or open containers. Another limitation can be a visual-percepThe use of language to understand and be understood is at tual impairment where a person is having difficulty visually the core of human communications. When a stroke damages attending to the side of the weakness. A functional visual a person’s language center, as in 25-40 percent of stroke assessment is an important part of the occupational therapy survivors, he or she will have problems with any or all of these evaluation for a stroke patient.” functions: speaking, comprehending, reading and writing, Klawitter explained that part of a person’s field of vision collectively known as aphasia. It’s a very lonely, bewildering may be diminished or absent so he doesn’t “see” completely and frustrating place to be. to that side. “He’s going to have trouble moving around and “Speech therapy after a stroke treats aphasia, the loss will be bumping into things.” of language skills in understanding others or expressing Visual-perceptual problems also can impair a person’s yourself.” said Jim Everrett, a speech-language pathologist, ability to read or see things accurately at close range. A noralso with Olympic Medical Physical Therapy & Rehabilitation. mal visual search strategy is typically from left to right, top “Someone may experience word-finding problems, have

A game changer

The gift of speech

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

Did you know?

• Some 800,000 people in the United States experience a new or recurrent stroke each year. • Stroke is the third-leading cause of death in the U.S. and the leading cause of disability. • Stroke kills about 140,000 Americans each year. • 3 million Americans currently are disabled from stroke. • In the U.S., stroke costs about $30 billion per year in direct costs and loss of productivity. • Two-thirds of strokes occur in people over age 65 but they can occur at any age. • Strokes affect men more often than women, although women are more likely to die from a stroke. • Strokes affect black people more often and are more likely to be fatal. difficulty following instructions. I do an evaluation to determine where the areas of need are.” Speech-language disorders related to stroke and other brain injuries may include aphasia, apraxia, dysarthria and dysphagia. “Apraxia is knowing what you want to say but the brain damage may not let the words out,” Everrett explained. “Dysarthria or slurred speech may develop due to weakness in the mouth muscles. People often develop difficulty swallowing or dysphagia due to weakness in the mouth and throat. It’s rare that I would find a person without a mixture of conditions.” Everrett designs an individualized treatment plan to work on all the speech-language deficits a stroke survivor has. Some of them include naming items in pictures, categorizing items by groups and giving synonyms and antonyms. “I also evaluate and treat changes in cognitive communication such as problem solving, numerical reasoning, organizational skills and multitasking,” Everrett said. “For example, there can be a change in orientation such as not knowing time, year and place for yourself. Sometimes people are aware of that and sometimes not. If it’s very disturbing to them, they may withdraw within. Therapy gives them confidence to practice and improvement can be made,” he said, noting the best window of opportunity for recovery is within three months post-stroke. However, good recovery can be made within a year after a stroke, he said. Everrett related that one of his most memorable cases was a man in his mid-50s, a mechanic by trade, who’d lost his ability to speak after a stroke. He was his family’s sole breadwinner. “Eventually, he was able to return to work and his family was so grateful that speech therapy allowed him to return to work. I find this a very rewarding job because I can help a person return to work, to the community to live a good quality life.” Unfortunately, about 18 percent of Americans who have a stroke die from it. However, everyone understanding that “time is brain” and knowing the warning signs of stroke can have an important impact on the quality of life of the 82 percent who do survive a stroke by getting them to a hospital immediately. Remember F*A*S*T (see box) and act fast to save a life.

Jefferson County

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Jefferson County

THE Living END

By Dr. Tom Locke Public Health Officer of Clallam and Jefferson Counties

e all have a general sense of how healthy we are as individuals. Many have annual check-ups with their health care providers and get a professional assessment of their health status. But how healthy are we as a community? Is it even possible to answer this question? As it turns out, the answer lies in the realm of what is known as Population Health. Health care services can be thought of as falling into two general categories: personal health and population health. Personal health services (also known as medical care) focuses on effective responses to illness and injury as well as certain preventive services like cancer screening, nutrition counseling and physical activity promotion. In the United States we spend about 96 percent of our annual $2.6 trillion health care budget on personal health services. The other part of the system, population health (often referred to as public health), focuses on the things we cannot do on an individual basis — control outbreaks of communicable disease, ensure that our food and drinking water is safe, conduct programs targeted at vulnerable populations such as infants and young mothers, and collect and analyze large volumes of health information. Population health programs are supported by about 1 percent of our health care dollars. One of the key responsibilities of the public health system is to conduct Community Health Assessments (CHA). They are akin to an annual check-up for the whole community. This is where you can find the best answers to the “How healthy are we?” question. Two local health departments serve the North Olympic Peninsula — Clallam County Department of Health and Human Services and Jefferson County Public Health. Both conduct community health assessments on roughly 3-year intervals. Jefferson County updated its most recent assessment in June 2011 and has made its results available on its website (see resources below). Clallam County last conducted a CHA in 2009 and is in the process of updating it by the end of 2012. Keeping track of community health trends serves a number of important functions – assessing the impact of specific public health programs, providing crucial information for elected officials in prioritizing the use of scarce health resources and providing interested, engaged citizens an opportunity to get involved with improving community health in very specific ways. In addition to local health departments, the Washington State Department of Health (DOH) and several non-governmental

How healthy are we on the North Olympic Peninsula?

organizations provide county-specific health data tracking a variety of health indicators. Washington DOH has a handy website for accessing both its local public health indicators and the national County Heath Ranking system sponsored by the Robert Wood Johnson foundation (link below). Another critical element of the “How healthy are we?” question is your frame of reference. We have a large and expanding number of measures of community health. To make sense of these health measures, we need something to compare them to. Comparing county-level data to the whole country has little practical value. Even comparing ourselves to state averages has limited usefulness. Washington’s population statistics tend to represent its largely urban population. Rural Clallam and Jefferson counties tend to have more in common with each other and with other medium-sized rural counties than we do with our urban neighbors. The most valuable comparison of all often comes when we look at ourselves over the course of time. These comparisons are known as community health trends and help policymakers determine whether key aspects of community health are getting better or worse. So what do our local health report cards show? It depends on who is doing the grading, of course, but the overall trend is worrisome. The prolonged national recession has a lot to do with this. We also are seeing the effects of a chronic lack of investment in basic prevention programs. As a state and a nation we have long failed to make the fundamental investments that other economically developed countries make in health care access, women and children’s’ health programs and chronic disease prevention. International health comparisons tell this story in disturbing detail – while we spend almost 45 percent of the world’s health care dollars in the United States (on 5 percent of the world’s population) we are clearly losing the “community health Olympics” when it comes to most community health measures. We rank near the top only in those areas (obesity, diabetes and cost of care) where we would like to be at the bottom of the list! And finally, when you ask the “How healthy are we?” question, the perspective of the respondent is a crucial factor. As the health officer for Clallam and Jefferson counties, it is part of my responsibility to monitor and make sense out of the steady flow of community health data that is being generated. What concerns me most are some of the low grades on our community health report card that impact future generations – high rates of smoking by pregnant mothers, declining graduation rates, more and more community members living without health insurance, high rates of substance abuse and

fatal drug overdoses. These are preventable problems. These are areas where we should be world leaders. But we are not. The “How healthy are we?” question can be answered with broad generalities or numbing statistical specifics. To me, an even more important question is “How healthy do YOU want your community to be?” If you care about questions like that, the next step is to get informed. Sit down at your computer (or one of the many available at our public libraries) and investigate the links below. To get a preview of what Clallam County’s 2012 assessment will look like, check out the 2010 Health of Jefferson County Report. Interested in county by county comparisons? Go to the Washington Department of Health’s website and look over both the local health indicators and the national county health rankings. Yearning for more of an international perspective? Try the OECD (Organization of Economic Cooperation and Development) website for comparative data on the top 34 developed countries (Spoiler Alert: no gold medals for Team USA). And finally and very importantly, get engaged locally. Jefferson County’s community health data is on its website. Clallam County’s assessment will soon be completed and available for public review. It will be presented to the Clallam County Board of Health before the end of the year and it is our plan to hold one or more community meetings to gather public comment. Healthy communities don’t just automatically happen. Like our individual health and that of our families, it is a matter of the choices we make, the access we have to quality health care, good nutrition and physical activity, and the priorities we set as a community, a state and a nation in terms of public health investment. Thomas Locke, MD, MPH, serves as health officer for Clallam and Jefferson Counties. He is board certified in Preventive Medicine and on the faculty of the University of Washington School of Public Health and Community Medicine. Resources Health of Jefferson County Report www.jeffersoncountypublichealth.org/index.php?health-ofjefferson-county Washington Department of Health Community Health Assessment Website ww.doh.wa.gov/PublicHealthandHealthcareProviders/ PublicHealthSystemResourcesandServices/ CommunityandStateHealthAssessment.aspx OECD “At a Glance” International health measures report www.oecd.org/health/healthpoliciesanddata/49105858.pdf

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

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ow housing Hurricane Coffee Co., the building at the northwest corner of Sequim Avenue and Washington Street in downtown Sequim was, at the turn of the 20th century, home to the Sequim Trading Company. Owned and operated by prolific area businessman Charles Franklin Seal, namesake of nearby Seal Street Park, the mercantile offered customers a one-stop shop for groceries and an array of dry goods, including seasonal fashions. The Sequim Trading Company also holds the historical distinction of having employed Sequim’s first mayor, Jilson White, who worked as resident manager. One of the city’s oldest commercial buildings, it has stood adjacent to the Sequim Opera House, which Seal also owned, for more than 100 years. Historical photo from the Mary Dittmer Collection, Museum & Arts Center in the Sequim-Dungeness Valley. Current photo by Reneé Mizar, Museum & Arts Center in the SequimDungeness Valley.

Union Wharf

he 1880s to the 1920s were the golden years for Puget Sound’s Mosquito Fleet. The steamboats sailed from port to port, linking communities and people around the sound. Some high traffic routes ran speedy, passenger-only boats, while other routes carried a mix of cargo to pay the bills, like passengers, mail and freight. In this photo from early in the 20th century, the Whatcom pulls up to Union Wharf in Port Townsend, while another Mosquito Fleet boat departs. Today, the venerable Union Wharf that served the steamboat trade is long gone, a victim of rot and neglect. In its place stands a new wharf that is more recreational than commercial, providing temporary moorage for visiting boaters and the occasional small tour boat. In today’s photo, a Washington State ferry now does much of the work once left to the steamers. Photo courtesy of The Leader Collection. Today’s photo by Fred Obee.

LIVING ON THE PENINSULA | FALL | SEPTEMBER 2012

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Living on the Peninsula | FALL | SEPTEMBER 2012