Balance, Summer 2018

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Balance The health magazine for Body, Mind & Motivation

INSIDE EXERCISE HELPS

Get moving to get past diabetes

POSITIVIT Y

Learn to love the body you are in

FIGHTING BACK

Clarkston man doesn’t let heart attack end his Bloomsday streak

Volume 10 – Issue 3 – Summer 2018 Published quarterly by the Lewiston Tribune and the Moscow-Pullman Daily News

ADVERTISER INDEX

Allen, Dr. Richard............................................................................................................................... 19 Alternative Nursing Services................................................................................................................. 9 Compassionate Care, Inc.................................................................................................................... 18 Electrolysis - Permanent Hair Removal.................................................................................................. 2 Huckleberry’s at Rosauers.................................................................................................................. 15 Leavitt DMD, Erin............................................................................................................................... 10 Maplewood Dental.............................................................................................................................. 5 Ozeran MD, Steven............................................................................................................................. 17 Tri-State Memorial Hospital............................................................................................................... 24 Whitman Hospital & Medical Center..................................................................................................... 7 Balance is published quarterly by the Lewiston Tribune and Moscow-Pullman Daily News and printed at the Tribune Publishing Co. Inc.’s printing facility at 505 Capital St. in Lewiston. To advertise in Balance, contact the Lewiston Tribune advertising department at (208) 848.2216 or the Moscow-Pullman Daily News advertising department at (208) 882.5561. Editorial suggestions and ideas can be sent to Tribune City Editor Mary Stone at mstone@lmtribune.com or Daily News City Editor Josh Babcock at jbabcock@dnews.com.

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Contents Balance – volume 10, issue 3 – Summer 2018

COVER STORY

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QUITTING THE COUCH

Reduce your dependence on diabetes medication

WELLNESS

BEING BODY POSITIVE

Love your body at any size

6

OUTDOORS

4

FITNESS WITH FIDO

Dogs can make exercise better

DISEASE

20

LYME DISEASE

Tick-borne diseases reach epidemic levels

PLUS A MAN’S RETURN TO BLOOMSDALE 8 | IRONMAN TO OLYMPIAN 14 | CHRONIC PAIN 16 Summer 2018 -

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Fitness with Fido Dogs can make exercise better, but make sure your pup is ready for action By ERIC BARKER

of the Lewiston Tribune

Keeping your pet happy, healthy and physically fit can deliver health benefits to you as well, but just like humans dogs need to approach exercise with some common sense caution, experts say. Dogs are great workout partners. They provide wonderful motivation for their owners to walk or run. Those who are looking to make man’s best friend into an exercise buddy should keep a few things in mind. Charlie Powell, public information officer at the Washington State University College of Veterinary Medicine at Pullman, said there are three keys to keeping your dog healthy when it comes to working out — cardiovascular health, feet conditioning and hydration.

Cardiovascular and foot fitness Just like humans need to ease into a new workout regimen and build up stamina, so do dogs. “Most people don’t start out running a marathon. Most people have to work up to it, and a dog is no different,” Powell said. “That means you take them out for progressively longer walks before you run them.”

Foot care Preconditioning includes not only dogs’ heart and lung health but also their feet. Their pads and nails can take a beating during long walks or runs. Powell said preconditioning walks should be done on the same surface, whether it’s asphalt or gravel, that dogs will experience on longer excursions. Some people, like those who run their hunting dogs in field trial events, even use commercial products like Tuf-Foot or tincture of benzoin to condition their

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Lewiston Tribune/Pete Caster Blades of grass wave in the foreground as a woman walks her dog on the Lewiston Levee Parkway Trail along the Snake River in Lewiston. Experts say exercising with dogs has benefits, but planning ahead for the pooch’s safety is important too.

dogs’ feet. Some people use booties if the dog is going to be on particularly rough terrain, such as places with prickly pear cactus or sharp basalt rock. During the dog days of summer, pet owners who are walking or running their dogs on asphalt should take care to make sure the surface isn’t too hot for the dogs’ feet. Powell said if you place the back of your hand on the blacktop and it’s uncomfortable for you, it’s too hot for your four-legged friend.

Hydration Dogs also need water to keep cool and hydrated. Powell said those who walk or run with their dogs should carry extra water and not rely on untreated sources such as lakes, streams or rivers. “If you let them drink out of surface water, you run

the risk of them getting blue-green algae poisoning or leptospirocis,� he said. Dogs need about a gallon of water every three or four hours when engaged in active exercise. “What is recommended by our vets here is clean, abundant water offered free choice or virtually free choice,� he said. Dogs are known for continuing to walk or run even when they are injured. But Powell said dogs suffering from dehydration will display easily identifiable symptoms. “If they keep lunging ahead to shaded areas, it’s a great sign either their feet hurt or they are seeking shade because they starting to get dehydrated,� Powell said. “Some dogs will get to a grassy spot, and they will immediately lie down and put their whole belly on the grass and pant. They are trying to cool off. They are trying to dissipate heat as much as they can.� Dog owners can also check their dogs’ gums to monitor for dehydration. Powell said to lift the upper lip of the dog and touch a finger along the gum.

temperatures are lower. Other recommendations from the vet school include carrying a leash, even if the dog is going to be exercising off leash, and to have a canine first-aid kit. Leashes are handy in case you encounter other dogs or even wild animals like porcupines. He said many pet stores and online retailers offer canine first-aid kits that allow pet owners to take care of minor injuries such as torn paw pads or nails. Powell said even those who aren’t looking to make their dog a serious workout partner can get health benefits simply by owning a pet. “There is a lot of research in the elderly that shows they end up walking far more than they would normally,� he said. “They end up moving more in the house while petting and playing with the dog.� A final note of caution from Powell: He said even an active dog can become obese if overfed or given a few too many treats. ——— Barker may be contacted at ebarker@lmtribune.com or at (208) 848-2273. Follow

“If it’s tacky or sticky, they are dehydrated and they need water and they need it now,� he said. Similarly, you can press a finger to their gum until it turns white. When the finger is removed the pink color should return quickly.

Dogs that are dehydrated should be given water that is roughly the same temperature as the air but not ice water, which can make them vomit. They can also be cooled with a water bath. Again, Powell said the water should be cool but not cold. “Let them get nice and wet and let them recover, and dogs will recover pretty quickly,� he said. If they don’t recover, Powell recommended seeking veterinary care. Overheating and dehydration can also be kept at bay by exercising in the morning or evening when

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‘There is no wrong way to have a body’ Body positivity advocate encourages others to love themselves for who they are By Justyna tomtas

of the Lewiston Tribune

As a junior high student, Jennifer Opdahl, like many others, struggled with self-acceptance. Years later, with the help of an online community, she was able to realize she is valuable just the way she is. The body positivity movement — which focuses on the acceptance and appreciation of all body types — has become more mainstream since Opdahl discovered it. “When I first stumbled onto it in the ’90s, it was kind of a very underground kind of thing,” she said. “You had to seek it out. Now, really, it’s kind of more available.” The first book she purchased on the topic was by Marilyn Wann. “Fat! So?” helped open the door to the self-acceptance Opdahl has found. Influencers on social media have helped spur the movement even further, as have a plethora of books on the topic. “Body positivity is loving yourself where you are at,” Opdahl, 38, of Lewiston, said. “All bodies are good bodies, and there is no wrong way to have a body.” The social movement encourages everyone to accept their own bodies — and those of others

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Lewiston Tribune/Steve hanks Jennifer Opdahl of Lewiston believes everyone should be accepted and valued for who they are, no matter what they look like.

— regardless of weight, race, disabilities or other factors. “It’s for all genders, all races, all ables — disabled people, too. It’s just the full gamut,” Opdahl said. “It’s about getting out there and seeing bodies, shapes and sizes.” Opdahl, who identifies herself as a plus-size woman, said she strives to work out at least twice a week, but she doesn’t do it to lose weight. She said it’s important to set non-weight related goals, like running a 5K or being able to do a pullup. One day after a particularly strenuous workout, still high from the endorphins coursing through her system, she realized the labor she put in at the gym actually made her feel good. “I didn’t care that this made me lose 20 calories or whatever,” Opdahl said. “This was just good for my body, it was good for my brain, it helped me destress after a stressful day at work, and it helped me work out that anger I had been holding onto.” That’s when a switch flipped. She realized she wasn’t working out because she had to lose weight; she was working out because she was able. It was good for her mentally, she said.

different. It’s part of my body; it’s not who I am.” Efforts to encourage everyone to accept others for who they are — and not necessarily focus on physical characteristics — are making a difference, Opdahl said. “In my opinion, I think it’s a great thing to be more inclusive in all body types,” she said. “It’s important to open that door and let all bodies be visible.” She encouraged people struggling to accept themselves to follow body positive individuals on social media and to seek out positive quotes. It helped her, and she thinks it can help others, as well. For Opdahl, it’s simple: Accept people for who they are, and don’t judge one’s appearance. “Maybe we could just love ourselves and eat vegetables and work out, and also have cake,” she said. “Is that cool with everybody?”

——— Tomtas may be contacted at jtomtas@lmtribune.com or (208) 848-2294.

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Corporations such as Target and Dove have helped push the body positivity movement to the forefront by including all body types in their advertisements. But there’s still work to be done, Opdahl said. Body shaming is still common as she discovered through some of her experiences with online dating, which Opdahl said is a different experience for plussize individuals.

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“One guy I talked to for a while, I just kind of decided we weren’t really a love connection, and after I told him that he instantly went to attacking my body,” she said. “Those are the things that attracted him to me in the first place, because he was into bigger girls, but it happens a lot. … It’s like yes, I am fat. I acknowledge this, but I’m also auburned hair, I’m also tall — it’s not anything

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Summer 2018 -

Keeping the streak alive Clarkston man overcomes heart attack to return to Bloomsday By KERRI SANDAINE

of the Lewiston Tribune

A Clarkston man’s running routine came to an abrupt halt after he suffered a heart attack and underwent surgery. But Steve Lee had a goal. Not only would he resume his active lifestyle, he wanted to keep his Bloomsday streak alive. The 66-year-old retiree has been crossing the finish line in Spokane since 1980, and 2018 was no exception. It wasn’t his fastest time by a long shot, but the May event marked an accomplishment that still brings a smile to the longtime Seaport Strider’s face. “A couple of months before the race, I wore a Bloomsday shirt to my doctor’s office, and said I was going to do it,” Lee said. “To me, it was a big deal, and I wanted to keep my record going. I walked it this year, and it wasn’t bad. The hills didn’t bother me, and it was fun.” His health “adventure” began more than a year ago. On June 2, 2017, Lee left Clarkston for a week in Montana. Little did he know, he wouldn’t return home until Aug. 18. During a sightseeing venture on his last day of vacation, Lee experienced unusual symptoms, such as shortness of breath, and quickly realized he

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Lewiston Tribune/Steve Hanks Steve Lee seldom misses his target of 10,000 steps a day and often uses the levee system to get those steps in.

needed medical help. “I knew something was wrong,” Lee said. “I was feeling crummy and having a difficult time breathing.” After a stop at the emergency room in Butte, Lee found out he’d had a heart attack, and a stent was necessary. He was then taken by ambulance to Providence Sacred Heart Institute in Spokane, where cardiologists repaired a hole in his heart. Following the surgery, Lee spent two weeks at St. Luke’s Rehabilitation Institute in Spokane before being released to the care of friends in the Bitterroot Valley of Montana. When he left St. Luke’s, he struggled to walk for more than 10 minutes. Little by little, he gained strength and set his sights on once more lacing up his shoes for the Seaport River Run in the Lewiston-Clarkston Valley — and for Bloomsday. He followed his physician’s orders and worked on recovering. “I had a good outlook and wanted to get better,” he said. “The doctors said I was a good patient.” Returning to the valley last August felt great, Lee said. Once home, he was able to access the Greenbelt Trail and area parks for his daily exercise. He maintains a healthy diet with no alcohol, lots of vegetables and grains, honey for his allergies and low amounts of sodium and sugar. Lee said the health care professionals he’s met during his recovery have been exceptional, including Dr. Chris Iacobelli at Tri-State Memorial Hospital. “Dr. Iacobelli told me ‘We’re going to make you as well as you’ve ever been,’ and I think he’s right,” Lee said. “I’m eating better and exercising every day. I’m feeling great and get my 10,000 steps in every day.” Before retiring, Lee commuted to Pullman where he worked on research grants at Washington State University. He is now a busy volunteer with the Lewis and Clark Trail Heritage Foundation. He served as president of the organization in recent

years and is involved with the foundation’s wellness program. Lee joined the Seaport Striders running club decades ago and has served as a race director for events, including the annual Santa Run. “I’m starting to jog again,” he said. “My goal next year is to jog Bloomsday and improve my time a little bit.” In May, he finished the 7.5-mile Bloomsday course in 2 hours, 19 minutes. It was his slowest time, but Lee said he was grateful to be on the course again. His best Bloomsday time was recorded at the age of 31. That year, Lee finished in the top 800 at 48.58 minutes with an average pace of 6 minutes, 31 seconds per mile. “It’s always been one of my favorite races,” he said. “I’m already looking forward to next year.”

——— Sandaine may be contacted at kerris@lmtribune.com or (208) 848-2264. Follow her on Twitter @newsfromkerri.

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Healthy foods can help prevent, manage dementia Water, exercise, good sleep can also do wonders for the brain By Garrett Cabeza

of the moscow-pullman daily news

While millions of Americans suffer from dementia, Marilyn Burch, director of nutrition therapy at Pullman Regional Hospital, says proper nutrition, exercise and good sleeping habits can help prevent and manage dementia symptoms. Dementia symptoms include a decline in memory and thinking skills that interfere with an individual’s daily activities.

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Burch said plant foods provide many health benefits, including phytochemicals and nutrients that can slow the aging process. She said brightly-colored fruits and vegetables are especially of benefit as they contain more phytonutrients. Most people do not consume enough fruits and veggies on a daily basis, she said. Older folks need about 2 1/2 cups of veggies per day and about 2 cups of fruits each day. Burch said elderly people should also eat 3 cups of whole grain foods a day, noting a piece of bread equals about 1/2 cup. Healthy fats are also important, Burch said, such as canola, olive and flaxseed oils. Nuts and avocados are also beneficial, but individuals should watch the quantity of those foods because they are high in fat. Coconut and palm oils and butter are unhealthy fats, Burch said. As for protein, she said the average adult should consume 5 to 6 ounces of lean cuts of beef, poultry and pork daily. Fish, especially salmon, and 2 percent or fat-free cheese are also good sources of protein. Burch said water is “super important” as a lack of it can cause confusion. She said many older folks do not consume enough water.

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10  - Balance

Thirty minutes of exercise each day and socially engaging with others stimulates the brain, which can help battle dementia as well, Burch said. She said activities such as playing the piano, putting together puzzles or “anything that exercises the brain also helps with dementia.”

Moscow-Pullman Daly News/Geoff Crimmins Jigsaw puzzles are one way to improve your memory.

Tiffany Duman, registered dietitian nutritionist at Gritman Medical Center in Moscow, said there are several different types of foods in each food group that promote brain health and cognition. Duman said research has suggested the Mediterranean diet may protect brain health and possibly slow the rate of cognitive decline. She said the Mediterranean diet emphasizes consuming whole grains, fruits, vegetables, legumes, nuts, seeds, fish, seafood, olive oil, herbs, spices, low-fat dairy and wine in moderation. Foods in the program are typically locally grown and seasonal, Duman said. The diet also encourages regular physical activity and social connections. Duman said the Mediterranean diet includes healthy amounts of fish, which is a good source of omega3 fatty acids. She said omega-3s play an important role in brain function, especially the omega-3 docosahexaenoic acid, which is found in large amounts in the brain and is important for brain development. “Our bodies are not able to make it efficiently, so we

have to rely on getting enough via food,” Duman said. To incorporate the Mediterranean style into your diet, Duman said to focus on fruits and veggies every meal. “Shift your mindset from making the meat or protein the focus of a meal to making fruits and vegetables the star,” she said. Duman said whole grains are important in the diet too, such as breads, tortillas and pastas. Popcorn, oatmeal and brown rice are great whole grains to start out with, she said. Duman said she recommends making fish a protein of choice twice per week. Fish and seafood, such as salmon, mackerel, anchovies and sardines, are high in omega-3s. She said beans and lentils are a protein-heavy source as well and can be incorporated in tacos, soups and casseroles.

——— Garrett Cabeza can be reached at (208) 883-4631, or by email to gcabeza@dnews.com.

Summer 2018 -  11

Quitting the couch People diagnosed with diabetes can reduce dependence on medication with exercise BY ELAINE WILLIAMS

OF THE LEWISTON TRIBUNE

St. Joseph Regional Medical Center diabetes educator Susan Rauch heads to a whiteboard and grabs a dry-erase marker when she explains the benefits of exercise. In her illustration, a key represents insulin, a hormone which unlocks doors to cells and allows them to accept sugar. In people with Type II or adult-onset diabetes, the keys are bent because their pancreas is malfunctioning, said Rauch, a registered nurse. They often feel tired because their cells aren’t getting the energy they need to function properly. Increased physical activity straightens the keys, Rauch said. “It’s as important as medication.” More and more people will likely need the kind of help experts like Rauch offer in the future, as the number of people diagnosed with Type II diabetes is growing quickly.

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“This is an epidemic,” she said. The illness leads to a number of issues, all of which can be slowed if people make controlling the disease a priority, Rauch said. The liver, which stores sugar, sees cells are being deprived and starts dumping more sugar into the blood stream. Beta cells that make insulin are destroyed. But about 30 minutes of moderate exercise a day mitigates those problems, Rauch said. People should be exerting themselves enough that it might be a little difficult, but not impossible, to carry on a conversation, she said. Any activity someone enjoys is a good place to start. Walking, swimming, yoga, dancing and low-impact exercise classes can all be good choices, Rauch said. Next it’s a matter of examining someone’s work and family schedule to see what’s preventing them from exercising more. “We really want to get a lifelong lifestyle change,” she said.

One patient used a smartphone alarm to remind her because she didn’t know of anyone who would be her exercise partner, Rauch said. Another woman tried putting her shoes by her recliner so she would see them when she got home from work. That failed. It was too easy to ignore the shoes on the floor, sit in the comfortable chair and watch something on television. So she made a small adjustment and put them in the seat of the chair. She grabas them from the chair and walks to a hardbacked chair in the kitchen to put them on. She doesn’t sit in the recliner until after her walk. That has worked so well the woman’s diabetes is controlled entirely through exercise, not medication, Rauch said. Doing just a little at first is fine, because it helps establish a routine. One patient Rauch worked with already went shopping every day. She began by doing a lap around the store before putting any items in her cart and added to the distance from there. When Rauch worked on the fifth floor at St. Joe’s in a former job, she switched to walking the stairs instead of taking the elevator every day. Eventually she was so strong she could run them. “It’s not all or nothing,” she said. “It’s going to start somewhere.” ——— Williams may be contacted at ewilliam@lmtribune.com or (208) 848-2261.

Tribune/Pete Caster Registered nurse Susan Rauch, a certified diabetes educator at St. Joseph Regional Medical Center, explains a diagram about how diabetes works.

Tips for starting an exercise program: Do: • Consult with a physician before you start a new exercise routine. • Make time for exercise 30 min/day. • Pick an activity you enjoy. • Find an exercise partner. You are more likely to stick with your new routine if friends are involved. Let your exercise partner be an informal accountability coach. • Drink water before and after. • Make sure your shoes fit well. • Examine your feet afterwards, including the soles, to be sure you don’t have any sores. Use a mirror to see places that are outside your line of sight. People with diabetes often lack feeling in their feet because of decreased circulation, which also makes cuts more serious because they can be slow to heal. • Consider going to a diabetes educator even if you have been diagnosed with diabetes for many years. Medical insurance frequently covers the expense. The educators can help with lifestyle changes such as exercise and diet that aren’t typically covered in medical appointments. • Record your exercise with your blood sugar in a diary to see how activity impacts blood sugar. • Expect that it will take at least three weeks to develop the new habit. If you miss a few days, take the first opportunity to start again instead of quitting. Don’t: • Stop taking insulin or other diabetes medications without the approval of your doctor. • Sacrifice getting at least eight hours of sleep to exercise. Summer 2018 -

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From Ironman to the Olympics Whitman Hospital and Medical Center orthopedic surgeon brings a wealth of experience to his patients on the Palouse By Kara McMurray

of the moscow-pullman daily news

Doug Hiller

When Whitman Hospital and Medical Center was seeking an orthopedic surgeon last year, it probably did not bargain on attracting a former Olympic triathlon chief medical officer or former chief physician for the Kona Ironman World Championships. But that is exactly what it got.

Relocating from Hawaii, Doug Hiller arrived in Colfax last November as the hospital’s new orthopedic surgeon. “I had been practicing in Hawaii for quite a while, and I was ready for a change,” Hiller said. Part of his desire for a change was wanting to be out of a big city. “I also wanted to come to a place with a small hospital and that was near a university,” he said. 14  - Balance

Colfax checked off all those boxes. Hiller said he enjoys the small town, but also enjoys being able to go to Pullman to visit the libraries and enjoy the coffee scene there. “I like being near live, active minds,” he said. Hiller mostly grew up in Hawaii and spent a lot of his time there bodysurfing and swimming. After attending college and medical school, he realized he was getting out of shape and wanted to do something about it. Someone suggested he train to compete in the Kona Ironman, which was then a relatively new event. Hiller competed in the event in 1982, 1983 and 1984, finishing the endurance race each time. The Ironman entails a 2.4-mile swim, a 112-mile bike ride and a 26.2 mile run. “(Prior to the Ironman), I’d never raced bicycles,” he said. “Running was also another whole world of learning and understanding and experience.” Around the same time Hiller was competing in the Ironman event, he was also completing a stint as a research associate at the Institute for Environmental Medicine. One opportunity he had there was to work on a project of his choice, for which he decided to complete research on extreme endurance endeavors.

The other syndrome they documented was exercise-induced hyponatremia, which is characterized by abnormally low sodium. “After the race, 30 percent of the people (we studied) had abnormally low sodium,” Hiller said. “They were either drinking too much water or losing a lot more salt.” Hiller and his co-researchers studied this condition in Ironman athlete Mark Allen in the ’80s. Allen, at that time, had competed in the Ironman six times but either failed to finish or came up short. “Every year, he crashed and burned,” Hiller said. Through research and tests, researchers were able to discover Allen had exercise-induced hyponatremia, and he was losing two grams of sodium per hour when he was competing. The team helped him to take corrective actions, and when he next competed in the Ironman in 1989, he not only took first place, he set records. “He then went from losing six times in a row to winning six times in a row,” Hiller said. “That was a big adventure.” Following his stint with the Institute for Environmental Medicine, Hiller went on to complete an orthopedic residency and then a foot and ankle fellowship and sports medicine fellowship. Eventually, he became the head doctor

for triathlon in the Olympics, serving at the 2000 Olympics in Sydney, 2004 Olympics in Athens and 2008 Olympics in Beijing. He also served as the head doctor at the 2016 Paralympics in Rio and has been a doctor at the Kona Ironman for the past 35 years. Through all of his experiences, Hiller said he has learned exercise is one of the best medicines. “Exercise is like a fountain of youth,” he said, noting that it can help to rid patients of blood pressure issues, act as a preventative measure and aid patients in reducing or no longer needing medications. Hiller is no longer able to compete in Ironmans due to a back injury, but he still swims. He said he encourages his patients to find activities they enjoy doing and that they can do even with limitations. “There’s still stuff you can do no matter what’s wrong. I help people to tune into something they enjoy and make a habit of it,” he said. “Everyone feels better if they exercise.” ——— Kara McMurray can be reached at (208) 883-4632, or by email to kmcmurray@ dnews.com.

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Hiller and others were specifically researching Ironman competitions and used the equipment at the facility to do Ironmans in the lab. Through research, the team was able to discover new syndromes that would go on to impact the sport. One of those was cardiac fatigue, a syndrome in which a person’s heart fatigues during exercise. Though information about this condition had been published prior to Hiller and his co-researchers publishing their findings, little was known about it.

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Pain, pain go away Being overweight increases odds of chronic pain Washington State University College of Nursing

SPOKANE — Overweight adults are more likely to suffer from chronic pain, according to a recent Washington State University study. Teresa Bigand, a doctoral student in the WSU College of Nursing, used data from nine largescale health studies conducted in different countries to calculate the odds of chronic pain among adults with an overweight body mass index, or BMI. Bigand found adults with a BMI greater than or equal to 25, the range of overweight and obese people, were anywhere from 14 to 71 percent more likely to suffer from a variety of chronic pain conditions than adults with a BMI below 25.

with a 30-plus BMI but also overweight adults with a 25-30 BMI and may have critical implications for millions of people around the world. Although evidence clearly indicates that being overweight is associated with chronic pain conditions, the prevalence of chronic pain among adults with an overweight BMI compared to those with a normal BMI worldwide is unclear, especially when overweight status is distinguished from obesity. “I think we need to do a better job of educating overweight people about their risk of potentially developing a chronic pain condition in addition to heart disease and other debilitating ailments,” Bigand said.

A growing problem Cori Kogan Teresa Bigand describes her research at the Inland Northwest Research Symposium.

Her work highlights the importance of weight management education for not only obese people 16  - Balance

Worldwide obesity has nearly tripled since 1975, and the number of overweight adults has increased significantly as well, according to the World Health Organization.

Today, more than 69 percent of the current U.S. population and 1.9 billion people worldwide are overweight. These are alarming statistics to Bigand and other health care providers because of the debilitating physical and mental conditions known to be influenced by a patient being overweight or obese. In addition to an increased risk of diabetes, heart disease, stroke and some cancers, overweight and obese adults also are more likely to develop symptoms of depression and of being or becoming disabled. “Adding chronic pain onto everything else makes the disease burden difficult to bear and hard to treat,� Bigand said. “Previous studies have shown that weight gain often precedes the development of chronic pain by many years, so I think our job as medical providers is to educate our patients early on and say, ‘You have a high BMI, your risk of one day developing a chronic pain condition, in addition to heart disease, is much higher. Let’s talk about how we can help you better manage your weight to lower your risk for chronic conditions like persistent pain.’�

Recommendations Bigand said nurses, doctors and other health care providers need to be informed about current national physical activity and diet recommendations to ensure proper health information is relayed to both obese and overweight patients. “The recommendations call for at least 150 minutes of physical activity per week, although that to me is just the bare minimum,� Bigand said. “Research shows that doing up to five hours of physical activity per week will give you more of a health advantage. As far as a healthy diet goes, it is difficult to say for certain because everyone is so different; however a good rule of thumb is to eat

when you are hungry until you are full, make sure your plate has at least half fruits and vegetables so you are getting plenty of micro nutrients and not to eat or drink unhealthy fats and sugars.� For people who are already overweight or obese and suffering from a chronic pain condition, Bigand said the latest research shows people who lose the largest amount of weight also have the largest drop in their pain intensity. “Essentially, weight loss is the best thing to do; however some patients aren’t quite ready for that,� Bigand said. “Patients with the highest and most severe levels of pain intensity struggle the most to lose weight. In those cases, we have to think about how we can help patients get their other symptoms under control that might be exacerbating the pain before we can start thinking about treating their overweight or obese status.�

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Summer 2018 -  17

Knowing no limits Campers with limb loss discover friends, support at Quinnipiac University By Alison Kuznitz

The Hartford Courant (TNS)

NORTH HAVEN, Conn. — Reese Buckley has no trouble keeping up with “four-limbers.” That’s amputee lingo, he said unabashedly, for able-bodied people. His own leg was amputated when he was just two weeks old. It began with twin-to-twin transfusion syndrome in the womb — and a blood clot. This life is all Buckley knows, he said, pointing to his prosthesis. “Instead of going to my heart, thankfully the clot went to just the back of my knee,” Buckley, 18, said.

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“Instead of my life, it took a knee. I’m OK with that.” When he was 16 years old, he went to a camp in Ohio for children with limb differences. He’d never experienced anything like it before. It was exhilarating. Recently he attended a similar overnight program, called Camp No Limits, at Quinnipiac University’s North Haven and York Hill campuses. He was joined by about 30 participants, ages 2 through 18, who learned adaptive life skills from physical and occupational therapists — and had access to a strong support system through five days filled with recreational activities. “It’s refreshing because you see other people struggling with the same issues that you do,” Buckley said. “If I’m struggling with something at home, I’ve gained fellow amputee friends I can just text and ask how they deal with it.” Quinnipiac has hosted the camp since 2015, with nine other locations scattered across the country. This year marked the first “Prepping for our Future” option, drawing in teenagers looking to become more independent ahead of their college years. One station featured a driving simulation, in which campers virtually cruised through city streets and navigated light traffic. Nearby, a special steering wheel was on display, equipped with a spinner knob to provide better control for those driving with one hand. “With enough time and effort, we can get them driving,” said Brandon Lesch, an occupational therapist who’s been with Camp No Limits for five years. “We’re trying to lead them down that path that these amazing resources are out there.” Prior to camp, Lesch said, many participants — and even parents — think that driving is not possible. Lesch said it’s all a matter of empowerment for these teenagers, who are oftentimes the only students in their

school district with limb loss. Izzy Cole, 13, said the simulation was fun, though she was docked a few points for not switching on turn signals. She giggled with her friend, Zyra Gorecki, about the mishap, along with a tricky real-life obstacle course they navigated with sideways jumps and hopscotch games. “Camp is amazing because everyone here knows something similar to what you’re going through,� said Gorecki, who is a unilateral below-the-knee amputee. “You’re not a freak with one arm or one leg. You’re part of the pack.� Gorecki, 16, said she doesn’t feel stigmatized, but Cole — who has a similar limb loss — has been bullied for the past few years. “People don’t really understand,� said Cole, whose prosthesis is laminated with a photo of Jimi Hendrix. “[Campers] can really be themselves here.� Justine Clifton, 28, said she wishes Camp No Limits existed when she was younger. As an above-the-knee amputee with upper-limb differences, Clifton used to sit on the sidelines and watch her able-bodied friends have fun. She didn’t trust her prosthesis. She thought people would laugh at her if she fell down. By age 14, she was ready to come out of her shell. She learned about adaptive sports, testing out rockclimbing first. Skiing, snowboarding and running came later. “I started to step outside of my comfort zone a little more each day,� Clifton, an adult amputee mentor at the camp, said. “Now, I always want to try new things. I don’t really get scared very easily anymore.� Fellow mentor Adrienne Damicis, 22, attended the early makings of Camp No Limits nearly 15 years ago. Damicis considers herself part of a tight-knit camp family, one that’s mentored her through school and relationships. “I always grew up being surrounded by amputees,� Damicis, a below-the-knee amputee, said. “Looking back, in high school it did give me so much confidence.� Throughout the week, Damicis led support groups.

Nina Cochran/ Hartford Courant Hayden Piterski, 16, at Camp No Limits, a camp for teenagers with limb loss, held at the North Haven campus of Quinnipiac University.

They were to act as safe spaces, she said, for sharing common experiences and hurdles. “You sometimes feel like you’re isolated and you’re the only one,� Samantha Clift, a Quinnipiac student volunteer, said. “But you’re not.�

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Summer 2018 -  19

Tick-borne diseases reach epidemic levels, panel says By Delthia Ricks Newsday (TNS)

LONG ISLAND, N.Y. — Tick-borne infections have reached epidemic proportions on Long Island, where children are disproportionately affected by Lyme disease and other infections transmitted by the eight-legged creatures, a panel of top scientists announced recently. “Lyme disease is mostly a disease of children and curiously mostly a disease of boys,” Jorge Benach said at a recent symposium at Stony Brook University School of Medicine. Benach, who discovered the bacterium that causes Lyme disease, is a molecular Adult deer tick, Ixodes scapularis. geneticist at Stony Brook University School of Medicine. His observation that Lyme disease is mostly an infection of children was corroborated by Dr. Christy Beneri, a pediatrician at Stony Brook Children’s Hospital. She said her institution encountered a wide range of tick-borne illnesses 20  - Balance

annually and that boys tended to outnumber girls in the number of infections. The most likely reason for the disparity, Beneri said, is the tendency among boys to play outdoors in wooded areas where ticks thrive. In the extensive pediatric research Beneri presented at the symposium was evidence of some children developing Bell’s palsy, a temporary facial paralysis that occurs when the Lyme bacterium affects a cranial nerve. The paralysis resolves with antibiotic treatment, Beneri said. Beyond the Lyme bacterium, ticks on Long Island have been found to harbor babesia and anaplasma. Babesia are protozoa, or parasitic, infectious agents that hone in on Scott Bauer/public domain red blood cells, similar to the way a malaria parasite invades the same cells. Anaplasmosis is an infection caused by the bacterium Anaplasma phagocytophilum. It can trigger aches, fever, chills and confusion. Beneri and Benach were among five leading Stony Brook experts, including university

president Dr. Samuel Stanley, who addressed what they described as a mounting epidemic of infections caused by the ever-expanding range of ticks. Stanley, who was the first speaker, is a specialist in infectious diseases. “New York bears a disproportionate impact from tick-borne diseases,” Stanley said at the symposium, which was held in a lecture hall in the university’s health sciences building. “This is a regional and state problem.” New York has the highest number of confirmed Lyme disease cases nationwide, according to the U.S. Centers for Disease Control and Prevention, which has cataloged more than 95,000 Lyme infections in the state since 1986. Suffolk County has long been ground zero for the ailment on Long Island, studies consistently have shown. “Cases in Suffolk County hover between 500 and 700, and this is just for the reported cases,” Benach said, noting that Suffolk has among the highest rates of many tick-transmitted infections because of the dense infiltration of the insects in county. Typical Lyme symptoms include fever, headache, fatigue and a characteristic skin rash called erythema migrans, said Dr. Luis Marcos, a specialist in internal medicine and infectious diseases. Marcos presented data showing the wide range of illnesses caused by ticks throughout the region, including Borrelia miyamotoi, a corkscrew-shaped bacterium identified in recent years as the cause of a relapsing fever. Dr. Eric Spitzer, a pathologist, discussed the many laboratory tests that Stony Brook used to arrive at a diagnosis of a tick-transmitted illness. He said that for years, doctors nationwide sent specimens to the university for analysis because of its well-known precision. Testing of those specimens earned the university $32 million over a 20-year period, he said. Panelists identified the most prevalent ticks on Long Island as the American dog tick; the invasive lone star tick, which migrated from Southern states; and the blacklegged tick, known as deer tick.

Mental Fitness Solution

Summer 2018 -

21

Not just the wintertime blues About one in 10 people who suffer from Seasonal Affective Disorder experience symptoms in summer; getting outside in the sun can help, counselor says By Katie Short

of the moscow-pullman daily news

Seasonal Affective Disorder, or SAD, has traditionally been thought of as the wintertime blues, but the summer months are known to bring their own seasonal side effects. SAD is a type of depression stemming from a recurring seasonal pattern. In order to be diagnosed, a person must show symptoms for at least two consecutive seasons, according to the National Institute of Mental Health. While summertime depression is not nearly as common as in the winter months, it is estimated one in 10 people suffering from SAD has symptoms during the summer. Just as winter and summer seasons are opposites, so are the symptoms those diagnosed with SAD exhibit. According to the NIMH, during the winter SAD symptoms include low energy, hypersomnia, overeating, weight gain, craving carbohydrates and withdrawing from social situations. During the summer, the most common symptoms include poor appetite with associated weight loss, insomnia, agitation, restlessness, anxiety and episodes of violent behavior. Nina Woods, a licensed clinical professional counselor at River Place Counseling and Wellness in Lewiston, said an important element in treating SAD is catching it early and knowing when a patient typically starts falling into depression. Woods said the first course of action she recommends

22  - Balance

is getting out into the sun during the day. While going outside may be the last thing her clients want to do, she said, staying inside only compounds the severity of the depression. Woods said she also recommends her clients get an exercise partner to take walks with in order to increase their motivation to get outside. “I’m not saying they have to do too much, but they just need to get out and move their body,” she said. In more severe cases, Woods said, medication is sometimes used to treat SAD. Typically, she said her clients start taking medication several weeks before the height of their seasonal depression, or the peak of a season, and then taper off as the weather begins to change again. The mental health institute also recommends light therapy in order to treat symptoms of SAD in both the summer and winter months. Woods said many of her clients who work inside use therapy lights on their desks, especially if it is difficult for them to find the time to go outside during the middle of the day. She said while SAD is more than just hitting a slump, taking a minute each day to connect with nature or find a little happiness, or finding a hobby, can help counteract some of the symptoms. In some cases, she said, something as simple as sitting on a porch and watching the birds can make a difference. ——— Katie Short can be reached at (208) 883-4633, or by email to kshort@dnews.com.

Crossword

Mental Fitness 37. Protege to Freya (Norse myth.) 1. Political action committee 38. Serves 4. Where sauces cook 39. Darken 8. Type of horse 40. Fencing swords 10. Heavy sword (Brit.) 41. Middle English 11. __ Nui, Easter Island letter 12. A type of burner 42. Go slowly 13. Spanish island 43. A type of flute 15. Rapid alteration of a musical note 16. Where priests work CLUES 17. Most impoverished DOWN 18. Tom Petty’s band 1. One who is rejected 21. Luke’s mentor __-Wan 2. Suitable for crops 22. No longer is 3. Per __, each 23. Mandela’s party 4. Indulges 24. Legislator (abbr.) 5. Preoccupy 25. A type of ‘zebra’ 6. NIN frontman Reznor 26. The common gibbon 7. Posted 27. American icon 9. Infamous Ukraine village 34. Hunting expeditions 10. Bizarre 35. What a princess wears 12. One who loves to read 36. Switched gears

CLUES ACROSS

14. The products of human creativity 15. Extinct flightless bird of New Zealand 17. Famed Chinese American architect 19. These can be used to burn trash 20. Corpuscle count (abbr.) 23. Pokes holes in 24. Peter’s last name 25. Offered as a prize 26. French river

27. Young woman 28. A pot has one 29. Of the ears 30. Full of parasites 31. Dole out incrementally 32. Citrus fruit 33. Hearty 34. External form 36. Turn violently

Sudoku

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Sudoku puzzles are formatted as a 9x9 grid, broken down into nine 3x3 boxes. To solve a sudoku, the numbers 1 through 9 must fill each row, column and box. Each number can appear only once in each row, column and box. You can figure out the order in which the numbers will appear by using the numeric clues already provided in the boxes. The more numbers you name, the easier it gets to solve the puzzle!

Solutions on page 21 Summer 2018 -

23

24  - Balance

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