Page 2
Health and Wellness 2010/11
Green Lotus
Massage John Hanron, LMP WA lic. #MA60101600
E CAL S S G LL IDIN SE CA L S • OU • H
Tele. 509.341.4411 104 Glover St., #208 in downtown Twisp www.greenlotusmassage.com
Health and Wellness 2010/11
Page 3
Paul Butler publisher
Sue Misao editor
Robin Doggett ad sales
Callie Fink ad sales
Methow Valley
Health & Wellness
Dana Sphar
ad design/production
Linda Day ad design
Marilyn Bardin office manager
Janet Mehus
2010/2011
office assistant
A publication of the
Contributors
Methow Valley News PO Box 97 Twisp, WA 98856 509.997.7011 Fax 509.997.3277
Joyce Campbell Sally Gracie Patrick Hannigan Ashley Lodato Ann McCreary Bob Spiwak Marcy Stamper Amy Stork
editor@methowvalleynews.com www.methowvalleynews.com
To your health! As people, we are continually faced with health-related issues, from the moment of our birth to our final resting day. In that finite window of time, we strive to achieve and maintain wellness, while many others strive to help us in our pursuit of that goal. The Methow Valley Health & Wellness guide probes into a few preconceived notions of what may or may not be good for you; examines some often-ignored elements of our physiology; and offers links to genuine local support in times of need. It also journeys into the medical institutions we take for granted and examines the pros and cons of life in the beautiful Methow, where, until now, may have seemed nothing short of a hearty and healthful paradise. Turn the page to find out more....
Contents Coffee and other vices
The secret to a long and prosperous life.........................p. 4
Emergency rooms
Where the buck stops after the breaks start...............p. 5
Toes
Far from the brain but important to remember.....p. 6
We support you
A network of help............................................................................................p. 8
Country life
Clean air but danger abounds.................................................p. 11
Medical marijuana
A gateway drug?..........................................................................................p. 12
Home birth
A private and peaceful option..................................................p. 13
Hospital infections
Understanding HAI’s................................................................................p. 14
Directory of Advertisers
Supporters of this guide......................................................................p. 15
Cover photo courtesy of Blue Bradley
Page 4
Health and Wellness 2010/11
The upside of vices By Amy Stork
W
Est. 1983
ant to live a longer, healthier, If you are now wondering if there’s such smarter and happier life? Put a thing as too much coffee, the answer is yes. away the supplements and Coffee can be abused, is associated with anxiety pick up a cup of coffee, a glass and other psychological disturbances, and can of wine or a shot of whiskey. lead to chronic migraines. Mounting scientific evidence Although caffeine addiction isn’t considered points to the health benefits of all these traditional a clinical condition like alcoholism or other drug vices – when they’re consumed in moderation, abuse, it is definitely habit-forming for some of course. people – and stopping suddenly may lead to Good news for the more headache and other unpleasthan half of American adults ant symptoms. who have a daily coffee habHowever, a casual surit: In addition to living a bit vey conducted recently in longer on average, you seem the Methow Valley found to be less likely to develop that coffee wakes people up a host of common diseases when they are tired, and on than those who seldom or average this makes them never drink coffee. happier. In an analysis of 17 studDrinking a pint of whisies relating coffee consumpkey or a jug of wine a day tion to diabetes, scientists isn’t good for anyone, and at the George Institute for chronic alcohol abuse can International Health in lead to liver disease, carSydney, Australia, reported diovascular problems, car that as coffee consumption accidents and family and rose, the risk of developing social problems. Type 2 diabetes fell sharply But dozens of studies – with a 7-percent reduction now show a correlation in risk of diabetes for each between moderate drinking daily cup. and healthier, longer lives. Coffee’s tendency to Moderate drinking usuPhoto by Sue Misao ally translates into one-tostave off diabetes may come from its ability to make A glass or two of wine each day three drinks a day, dependthe body more sensitive may benefit some people. ing on your size and gender. to insulin and prevent the To get any health benefits, development of high blood sugar. The benefits the drinks have to be consumed daily, not all at seem to come not from the caffeine (decaf works once on Friday night. just as well) but from other compounds found in A passel of studies links those one or two coffee and some teas. drinks a day to decreased risk of heart disease, Meanwhile, at the Florida Alzheimer’s particularly for men, and for people over 55. Disease Research Center, they’ve been feeding Both teetotalers and heavy drinkers tend to caffeine to mice with Alzheimer’s disease – and fare worse. replicating the results of European studies showAccording to the Mayo Clinic, such moderate ing that people who drink three-to-five cups of alcohol use can also reduce your risk of heart atcoffee a day are more likely to stay sharp in old tack, stroke, gallstones and possibly diabetes. age. (Mice who ingested caffeine equivalent to Of all the drinks, red wine appears to have the 10 cups of coffee a day fared even better.) most benefit. Researchers think that’s thanks in Researchers have also linked coffee con- part to antioxidants called flavonoids that occur sumption to decreased risk of cancers of the head, in colorful vegetables and fruits as well as wine, neck, prostrate and liver – perhaps because it and appear to protect the lining of blood vessels contains high levels of antioxidants, the chemicals in the heart. Studies in mice show resveratrol, thought to protect cells from aging and toxins. another antioxidant contained in wine, may help For women, coffee may have cardiovascular prevent arteries from becoming clogged with benefits, too. One study found that women who fatty blockages. drank one-to-three cups of java a day reduced Scientific evidence for the benefits of drinktheir risk of cardiovascular disease by 24 percent. ing whiskey aren’t as forthcoming – except one Another showed a 19-percent lower risk of stroke study conducted by a consultant to the single among women who drank coffee. malt scotch industry that showed a link between Besides its preventative benefits, coffee is that particular beverage and cancer prevention. also used as medicine. It can ease the occasional Hmmm. headache, relieve constipation and reduce asthma Not so long ago, whiskey figured promisymptoms. Some parents are even using caf- nently in frontier medicine for its anesthetic and feine to address attention-deficit hyperactivity antiseptic properties. Folk medicine also calls for disorder (ADHD) in their children – it has the liquor in treatment of stomach ailments (brandy) same paradoxical calming and focusing effect and colds (rum), and as a dressing for everything as Ritalin and other stimulants. from cracked nipples to snake bites.
Health and Wellness 2010/11
Page 5
Emergency! By Marcy Stamper
T
he common image of an emergency room, inspired by television and movies, is one of high-pitched drama and heroics, but, fortunately, the scene at local ERs is not quite like the one at Chicago’s County General. “It can be either calm or hectic, depending on the day,” said an ER nurse at the Okanogan Douglas Hospital in Brewster. Both the Brewster hospital and Mid-Valley Hospital in Omak are certified Level IV trauma centers and provide comparable emergency services. As Level IV facilities, they have critical- and intensive-care units and can arrange to transport a patient by air if necessary. Okanogan Douglas has an emergency room nurse and a doctor, physician’s assistant or nurse practitioner, all with specialized ER training, on staff at all times. They call in other specialists as needed, said chief nursing officer Emily Canwell. “We have ever yt hing needed for trauma, heart attacks – anything that comes in,” she said. Mid-Valley is staffed ’round-the-clock by a physician and nurses, all certified in trauma care, according to Rachel Weber, their critical care services manager. They care for more than 7,000 patients annually in the emergency room, although most cases fall within the non-urgent and urgent categories, she said. Still,
Photo by Marcy Stamper
Local hospital emergency rooms in Okanogan and Brewster are fully staffed with highly qualified medical professionals. it is not uncommon to have six patients arrive by ambulance each day. Okanogan Douglas has four private main rooms and an overflow room, but will use other areas when necessary to accommodate patients. They once had 13 trauma cases and had to use the dining room and hall, said Canwell. Okanogan Douglas’s busiest times are weekends, particularly during the summer, when they treat more injuries and broken bones. During harvest season, the hospital sees many injuries associated with apple picking, such as falls from ladders, said Canwell. Virtually all emergency cases are transported to one of the two hospitals (generally the one that is closer), where people are assessed
and stabilized. Patients with a heart attack, stroke or serious trauma and those requiring complicated surgery are typically transferred to hospital with a higher level of care after they are stabilized. What can you expect when you arrive at the emergency room? A triage nurse will ask about symptoms and take vital signs – blood pressure, pulse, and temperature – and then decide if immediate attention is required, said Canwell. While some people without health insurance or a primary-care physician rely on emergency rooms for their basic medical care, because there are no clinics or urgent-care centers open after hours or on weekends, local ERs also treat people with conditions that
require attention but are not emergencies, said Canwell. Mid-Valley has almost completed a renovation of its emergency room, tripling the space and providing eight private rooms, including two
trauma rooms, said Weber. The hospital is also remodeling its laboratory and moving the respiratory-therapy department so it is closer to the ER. The new facility will have private areas for triage and blood draws, a designated ambulance entrance and a separate waiting room. The renovations are being funded by a voter-approved levy. Okanogan Douglas also hopes to renovate its emergency room and is currently applying for a grant to fund the project. Plans call for a new layout to make things more efficient, allowing one nurse to monitor all rooms from a central location, and for modernizing equipment, said Canwell. Patients can help health providers in the ER give them the best care by bringing their medical history, including a list of medications and allergies, and information about past surgeries and illnesses, said Canwell.
Page 6
Health and Wellness 2010/11
Stay in balance with clean, healthy toes By Bob Spiwak
T
Photo by Sue Misao
As an important part of our anatomy, toes deserve and need to be treated with caring devotion. are hidden beneath a layer of socks, which in turn is under a layer of shoe or boot. It gets quite warm and dank down there in the nether regions, and the warmth produces transpiration of liquid matter that lies in the dark recesses between the toes – an ideal breeding ground for icky stuff. Thus, toes should be washed daily or nightly – better yet, both. Each foot contains five toes. From right to left, or left to right if you choose, there is the big toe, the one next to it, the one next to that and the one next to the little toe, also known in medical terminology as the “pinky” toe. The big toe is so named because it is large and burly. Its job is to crash against obstructions in a maneuver medically known as “stubbing.” Stubbing can produce a mild ache or great pain, both of which are a warning to the rest of the body to back up, or if tripping,
to protect yourself as you fall. It has also been reputed to be protection for its fellows on the individual feet. My big toe on the right foot is named “Brutus” because he is a tough hombre, his mate on the other foot is called “Big Toe.” There is some question about the use of all the other toes. Without them, at first glance (if you can see them), there probably would not be athletes’ foot. But they do serve a purpose, for what they do is bend upward while walking, enabling the body above to push off, as well as perform push-ups. There has long been controversy over the need to have a pinky toe, which, according to historians, has been shrinking for millennia and someday may be only a residual stub, if extant at all. Toenails adorn the top of each toe. Their purpose is to protect the lower regions from harm. The problem with this
is they frequently enjoy harming their hosts, frequently by becoming ingrown. This occurs when, through poor clippage or injury, a portion of the nail will enter the surrounding flesh somewhere and grow in that direction. Even normally growing toenails must be clipped properly because, along with other maladies, horny fungal growths can breed under the nail, resulting in a malodorous condition and just plain ugliness. It is a little known fact that nail polish was originally invented not for the fingernails, but for the toes. Once painted they were very attractive, especially when worn with open-toed sandals as in medieval times. By now, you may have removed your shoes and socks or looked through the gap in your sandals at your feet. Good. Looking closely, you will note that the toes march away from the foot, big toe at the front (or back – your choice) of the line in a 45-degree angle, give or take
E OF RS HO
A DIFFERENT
CO LO R
oes are kind of like fingers except they are not. Granted, there are five of each and they have what...for some reason...we call “nails.” But fingers are to most people far more useful and this is correct. I could not type this with my toes, although my editor might wonder if I did. Anyhow, toes do play an important part in our physiology. It would be very hard to balance without them and we should take care of them. This is frequently overlooked because we only see them when removing our socks or in the shower or tub. Dr. Del Schweitzer, the leading podiatrist in Edelweiss, advises that toe health, along with the attached feet, is a very important thing. Therefore, since they are out of sight, out of mind, further amplification of the toes is crucial to this publication devoted to health. Out of sight yes, but out of mind? Have you ever had athlete’s foot, or worse, an ingrown toenail? Ouch. Athlete’s foot is a layperson name for fungus between the toes, on the toes and sometimes on the foot, which, as already mentioned, is attached to the toes. It can be itchy, annoying, and odoriferous and can require constant applications of antifungal creams, salves or sprays. At its worst, more draconian measures may be required, and the podiatrist is the person you will turn to. Why are toes so prone to fungal disease? Because not only are they out of sight, they
a few degrees. This is a marvel not only anatomically but how it came to be, which has been extensively studied by scholars of evolution. Toes, you see, used to face directly forward from the foot. It is a marvel of rapid evolutionary change, all beginning around 1400 AD. There were a lot of wars in those days and the soldiers, when lined up in formation at attention had to point their feet outward, not surprisingly at a 45-degree angle. This was very hard on the ankles, and nature recognized this anomaly and in her own way, albeit rapidly, began to change the configuration of the foot and its toes, thus making it easier not only to point outward, but to perform a snappy “about face,” pushing off as noted above with the rear toes. Do remember to remember your toes. They need attention even if you are not cleansing the rest of your body in the shower or bath. Your feet will thank you for it. So will your mate.
Health and Wellness 2010/11
Page 7
Page 8
Health and Wellness 2010/11
We support you By Ann McCreary
“People come to share experience, strength, and hope.” –Local Alcoholics Anonymous member
“People need to be able to share those fragile moments and come away stronger.” –Jocelyn Murray, Breast Cancer Support Group facilitator
“Support groups are a good means of creating a framework for life change.” –Adrianne Moore, Domestic Violence Support Group facilitator
S
upport groups provide a place for sharing what’s difficult in our lives, learning from the experience of others and finding the strength to make changes to improve our lives. In the Methow Valley, several groups meet regularly, providing local residents a place to join with others to talk about common interests and experiences. From Alcoholics Anonymous, which has held meetings here for about 30 years, to a Domestic Violence Support Group founded about one year ago, our small community is developing a growing network of support for its residents. Several of the groups are sponsored or hosted by Room One in Twisp, the valley’s primary provider of social services. The Domestic Violence Support Group
and a Mothering Group are sponsored by Room One because they “speak specifically to some of our core goals,” which include decreasing domestic violence and increasing parent and child health, said Karissa McLane, Room One director. “We have an excellent facility and we want to make that as available as possible,” McLane said. There is still a need for other types of support groups in the valley, McLane said. Two ideas suggested by community members include a grief support group and a co-parenting support group. She hopes that eventually facilitators will come forward to launch those groups. Following are descriptions of several active support groups in the Methow Valley.
Alcoholics Anonymous The 75-year-old granddaddy of support groups, with an estimated two million members worldwide, has been active in the Methow Valley “for as long as I can remember,” said one member. “Some members have been attending for 30 years.” In its literature, AA doesn’t describe itself as a “support group,” but as a “fellowship” or “informal society” that is concerned solely with the personal recovery and sobriety of individuals who turn to the fellowship for help. According to AA, “the relative success of the AA program seems to be due to the fact that an alcoholic
who no longer drinks has an exceptional faculty for reaching and helping an uncontrolled drinker.” “The disease of alcoholism is very widespread, through all classes of people,” the local member said, adding, AA “supports those people trying to change their lives.” AA’s strength, the member said, lies in its singleness of purpose – helping members live without alcohol – and its enduring commitment to anonymity for its members. “Anonymity, like sobriety, is a treasured possession.” AA meetings are held seven days a week at locations throughout the valley. Attendance at the meetings ranges from 10 to 40 people, the local member said. On holiday weekends the numbers increase as visitors to the valley attend local meetings during their stay. Meeting times and locations are listed each week in the “What’s Happening” section of the Methow Valley News.
Narcotics Anonymous Narcotics Anonymous grew out of the Alcoholics Anonymous program in the late 1940s, and is modeled on the same recovery and peer support approaches pioneered by AA when it was founded in 1935. The local NA groups meet three times a week, and attendance ranges from two to 12 people, a local member said. Participating in NA “helped me see I needed to change my life and it helped having people
Health and Wellness 2010/11
Page 9 also confidential. For information, call 997-2050.
to talk to who knew what I was going through,” the member said. NA meeting times and locations are published each week in the “What’s Happening” section of the Methow Valley News.
Non-violent Communication
Domestic Violence Support Group Established about a year ago, the Domestic Violence Support Group offered by Room One provides a safe environment for women to meet with others who have experienced domestic violence in their lives. “In dealing with any traumatic event…particularly longstanding events that have become part of your life, it’s extremely beneficial to process that in a group,” said Room One director Karissa McLane. McLane said participants in the Domestic Violence Support Group find strength in “realizing you’re not alone in that situation and hearing other people’s experiences, and how they’ve worked through them and made changes in their lives.” The group is facilitated by Adrianne Moore, who studied public health with a focus on marginalized women, and who previously founded and managed shelters for women before moving to the Methow Valley. Moore said women who participate in the domestic violence group come from two different situations. “One is where a woman has come from a safe background and entered a domestic violence situation. The other is women who have been lifelong domestic violence survivors and have just started to come out of that darkness.” In either case, the women’s personal beliefs about their world are shattered, Moore said. Women who saw the world as a safe place before experiencing domestic violence “will often have their beliefs traumatized,” and lose faith in their own perceptions. Women with long
Illustration by Tania Gonzalez Ortega
Sometimes a shared burden is less of a burden. histories of domestic violence “may never have created positive life beliefs.” They feel, says Moore, that “the people I love hurt me and I can’t trust people.” “Both are left with the feeling that the world is unsafe, they can’t trust anybody, and lose faith in themselves,” Moore said. In the support group, the women examine their beliefs about five basic needs – safety, trust, control, self-esteem and intimacy. “We look at the core belief that makes you feel angry, or uncared for, or unloved,” Moore said. Through this work, and with each others’ support, the women gain insight and strength to heal themselves and move forward in their lives. Before joining the group, women contact Room One and are interviewed by Moore to make sure they will fit into the group and can uphold the rules of confidentiality that are a key part of the group. To join, they must sign an agreement to keep everything that is said in the group confidential. The group meets twice a month, and meeting times and location are
Formed about two years ago, the Non-violent Communication Group focuses on learning to communicate in a manner that is more direct, honest and empathetic. “It’s not really a support group in the typical sense,” said facilitator Rocklynn Culp. “It’s a group where we discuss and practice these particular communication techniques.” “Non-violent communication” is a technique developed by psychologist Marshall Rosenberg. It is also known as “compassionate communication,” a term Culp said may better express the goal. “It’s a technique that’s really simple but really challenging because it requires a person to change the way they think and communicate based on making observations, expressing feelings and needs, and making requests.” Culp began studying the non-violent communication techniques about six years ago, and two years ago she and Dierdre Luvon of Twisp organized a local group and brought a trainer in to offer a workshop. The group has continued to work together to learn and practice the communication methods. The approach is about the way people communicate with others, and the way they communicate with themselves, Culp said. It teaches how to have empathy with people even when you don’t understand their actions, she said. “It contributes to more feelings of compassion for ourselves and others. A lot of us go around blaming ourselves for what happens. Non-violent communication helps us create more gentleness with ourselves.” Continued on Page 10
Page 10
Health and Wellness 2010/11
Continued from Page 9 The group allows participants to practice the communication techniques together. “It’s really like learning a new language. It feels really awkward at first,” Culp said. “The practice group is taking it from the level of a form to a practice you can embody.” Because the current members have already done a lot of work to learn the technique, Culp encourages any potential new members to spend time working with someone who has been involved for a while to learn the concepts and read some of the materials about non-violent communication. The group meets on the first and third Thursdays of each month at 7 p.m. at Room One. For more information contact Culp at 997-4480 or e-mail rocklynnc@yahoo.com.
moksha studio ...enhance your well-being Ayurvedic Spa Treatments pre- and post-natal yoga Jivanmukti yoga men’s yoga movement + bodywork private instruction
space available for rent 996-3735 201 Glover St Twisp mokshastudio.com
Breast Cancer Support Group Women in the Breast Cancer Support Group give each other both emotional and practical support, said facilitator Jocelyn Murray. Members may share information about ways to control nausea, what to do in Wenatchee while living there during treatment, or what medical specialists they really liked. Or they may simply listen quietly while a woman talks about the physical and emotional pain she is going through. “Sometimes people share on a level that they feel vulnerable, and they just want to be heard. We’re not there to fix each other, but we’re there to share,” Murray said.
The group ranges from seven to 14 members, and includes people in all stages of breast cancer, from newly diagnosed to 15 years post-treatment. “People who are starting out (in cancer treatment) are so reassured to see people who are that far down their walk with cancer and whose lives are so rich and full,” Murray said. Meetings include mild exercises and time for sharing. Occasionally a special meeting is scheduled to provide education with a guest speaker. Murray, a registered nurse for 30 years, has not had breast cancer herself but has a mother, grandmother and aunt who had breast cancer. When three of Murray’s friends were diagnosed with breast cancer about three years ago, she realized that they needed support and began facilitating the group. “With my medical background, I make sure that privacy is respected and confidentiality is maintained, and our vulnerabilities are respected,” Murray said. “All of us are fragile at times in our lives, and this is one of our times.” The Breast Cancer Support Group meets on the third Sunday of every month from 3-5 p.m. at Room One. For information contact Murray at 997-2819 or e-mail imagine@methownet.com.
Mothering Group Especially for new mothers with infants, the job of mothering can be a lonely one. Nicole O’Driscoll, a facilitator of the Mothering Group, knows that from experience. “I started going to the Mothering Group last winter when my daughter was five months old. I was getting kind of cooped-up in the house. In the valley in the winter time, it’s hard to get around with an infant.” The group provided her the camaraderie and shared experience that is so helpful for mothers of young children, O’Driscoll said. “They understand and they listen, and say ‘Oh yeah, I’m so there right now.’” The Mothering Group meetings provide an informal, confidential place to share feelings and information. Participants may discuss a healthy diet for babies, bring a speaker in to talk about positive discipline for toddlers, or simply talk about their kids’ latest exploits. The women develop a network of friends they can call to support them outside the meetings as well, O’Driscoll said. “I’ve met moms that I wouldn’t have gotten to know otherwise,” she said. The group meets the first and third Wednesday of each month, from 10:30 a.m. to 12:30 p.m. in Room One. As an added benefit, a teenage girl attends to keep the young ones entertained so the moms can have some uninterrupted time.
Health and Wellness 2010/11
Page 11
Country living may include side effects
M
any folks who visit or live in the Methow do so because they want to live a healthy life. They value clean water, fresh air, good food, physical exercise and mental relaxation. But do they really appreciate how country living can be hazardous to their health? For a hypochondriac, life in the Methow is downright terrifying. The valley has a variety of dangerous wild animals, a potpourri of environmental hazards and a smorgasbord of stinging, biting or poisonous insects that carry several debilitating diseases. Wolves are probably the most infamous predators roaming the Methow, but of all the big animals here, these warm, fuzzy creatures are probably the least dangerous. They don’t generally eat people, but they do have an annoying habit of huffing and puffing and blowing houses down. Even so, nobody need be afraid of them except the three little pigs. Cougars are a bit more of a concern. Many folks here have stories about hiking along and then turning around only to find cougar tracks on top of their own. The best thing to do if you encounter a cougar on the trail or at a local bar is to turn and run screaming in the opposite direction and hope you are faster than the slowest member of your group. Black bear are common in the valley. If you are attacked by one, first take a moment and try to determine why the bear is chewing on your leg. If it is protecting its cubs, play dead. If it is actually trying to eat you, first douse yourself with bear spray (bears generally don’t like spicy food) and fight back. Moose are fairly uncommon here, but what they lack in numbers they make up in size and an irritable predisposition to stomping anything that threatens them into a bloody pulp.
By Patrick Hannigan Deer are by far the most dangerous large animal in the Methow. In an average year, there are around 400 deer/car collisions in the valley that result in numerous injuries and deaths. The safest way to deal with deer is to run them over. Seriously. When faced with the choice of swerving into oncoming traffic or driving off the road, the best choice to preserve your health is to simply hit the brakes and hit the deer. Smaller local carnivores like wolverines, coyotes and badgers can be hazardous if cornered or hugged. But if you value your health, why would you go around cornering badgers or wolverines? Rattlesnakes top the list of local creepy crawlies that pack a potent bite. Living as I do on Rattlesnake Way, I have lots of experience dealing with these critters. One tip: Don’t weed-whack in tall grass while wearing ear plugs and flip-flops. Mice may not appear harmful, but they are known to have fleas that can carry bubonic plague. Stranger still, several people in North Central Washington have actually died after inhaling mouse poop. Mouse droppings can carry a disease called hantavirus, and once the droppings are dry and dusty, breathing that dust while cleaning the shed out back can be fatal. Packrats are common in the valley and their greatest threat is to your mental health because they will drive you insane as they chew their way through your life. They can make a mess of your car’s wiring and they love to move into attics or crawlspaces, where they will keep you up all night by making more noise than a troupe of intoxicated tap dancers. We have two kinds of mosquitoes here in the Methow: Big Slow Bloodsuckers and Small Fast Bloodsuckers. Sure, the bites are annoying, but with every bite one also has to wonder: Did
Photo by Sue Misao
Dive now, itch later. I just get West Nile Virus? (Yes, this mosquito-borne illness has now spread to our region.) Black widows and brown recluse spiders lurk in every woodpile and outbuilding in the Methow. Recluses are actually the scarier spider: their bite causes a slowly expanding, flesh-rotting wound that can grow to alarming proportions. As winters in the valley become milder, ticks have become more common. Hello Rocky Mountain tick fever and Lyme disease! Any mention of troublesome insects would be incomplete without a shout-out to the yellow jacket – our unofficial mascot here in the Methow. If you haven’t been stung yet, you will be. Health tip: Don’t drink out of soda cans or beer bottles without first
checking for swimmers with stingers. Another icky bug in the Methow is schistosomatidae, which is a parasite that lives in goose poop and then burrows under human skin causing a rash known as “swimmers itch.” Swimmers itch is most commonly found in late summer in waterfowl-filled marshy lakes around the valley. Oh, and while you are swimming, fishing or playing along the lakes and rivers in the valley, don’t forget to keep and eye out for poison ivy, which thrives in this climate. Speaking of climate, the Methow has a full menu of weather-related hazards. Temperatures here can swing between -30 in the winter and +105 degrees in the summer, which means that you can experience frostbite, hypothermia, sunburn and heat exhaustion all in a span of five months! Lightning storms are a common occurrence in the valley and can quickly turn otherwise healthy outdoor recreational activities such a hiking, golfing, biking or boating into hair-rising, neardeath experiences. Wildfires are a frequent threat to health in the Methow. Not only are they dangerous because they can burn you up, but every summer or three wildfires blanket the valley with smoky smog so thick it makes the air of L.A. or Beijing look positively pristine. Other local hazards to your health include avalanches, flash floods, falling trees, crazed hunters, windstorms, blizzards, earthquakes, porcupines, icy roads, skunks and poisonous plants. On top of it all, the nearest hospital is an hour-long drive from the Methow. The valley does, indeed, offer reprieve from the industrial pollution, violent crime, traffic and other sundry stresses and dangers of urban living. On the other hand, we have plenty of our own challenges to living a healthful life right here in the Methow.
Page 12
Health and Wellness 2010/11
Medical marijuana: Gateway to pain relief By Joyce Campbell
A
n increasing number of authorized medical marijuana patients in the Methow Valley are discretely adding the cannabis plant to their indoor and outdoor gardens, harvesting the leaves and flowers that relieve their suffering. One local patient who suffers chronic nausea from a rare illness is looking forward to his first marijuana crop grown indoors under lights. “Pot is wonderful for nausea. It keeps me sane,” said the patient, who, like all the patients interviewed for this story, requested anonymity. “I’m looking forward to eating it for longer lasting relief.” He said smoking marijuana gives relief for an hour or more, but he expects to get up to six hours of relief by ingesting the herbal medicine. Another patient takes a daily dose of homemade tincture to reduce symptoms of glaucoma. Another is experimenting with extracting the active ingredient in marijuana to use with butter in cooking, especially desserts, to relieve chronic pain. Still another patient resorts to taking pain pills at work, and smoking marijuana at home. Smoking has adverse effects on the lungs and heart, according to the National Institute of Drug Abuse website. Scientific studies showed the active ingredient (THC) acts on parts of the brain that influence pleasure, memory, thoughts, concentration, sensory and time perception, and coordinated movement. Adverse effects included distorted perception, impaired coordination, difficulty in thinking and problem solving, and problems with learning and memory.
Patients said they were informed about the risks and satisfied with their choice to use medical marijuana. All said they were ingesting or planning to prepare edible medicine, and smokers had been advised to use a vaporizer to reduce respiratory irritation. One said, “I don’t have to get pills with six pages of side effects.” State law acknowledges that marijuana “appears to be beneficial” and provides for its medical use, while federal law outlawed the substance in 1970 and only allows its use in federally approved research. The illegal federal status prevents doctors from prescribing it and pharmacies from dispensing it, according to a report on patient access to medical marijuana prepared by the state health department. Washington voters approved the state law in 1998 that authorized the medical use of marijuana by patients with terminal or debilitating illnesses, including chemotherapy-related nausea and vomiting in cancer patients, AIDS, severe muscle spasms associated with multiple sclerosis and other spasticity disorders, epilepsy, acute or chronic glaucoma, and some forms of intractable pain. Local patients each told a similar story about how they acquired a written recommendation from medical marijuana clinics in the Puget Sound area. They each provided supporting medical records from their primary health care providers in the valley. One patient who said he has used marijuana illegally for pain followed a Little Nickel ad to a clinic in Burlington, where he said people were professional, polite and informative. He paid $200 for the visit and with his legal paperwork in place said he felt like a first-class citizen for the first time. “I had to hunt to get a doctor,” said one patient. He contacted The Hemp and Cannabis Foundation
online and for $200 followed the foundation’s process and received the written doctor recommendation that is good for one year, along with a registration card and information packet on the laws and how to deal with the police. He did deal with the police when a helicopter circled his yard recently. He called the drug task force and they asked how many plants he was growing and requested that he fax his paperwork. “Make sure your paperwork is in place and stay within the guidelines. We have no problem with that,” said Okanogan County Sheriff Frank Rogers. He said it is a learning process for patients and some try to grow a few too many. The only legally protected source of medical marijuana in Washington state is homegrown by patients or their designated providers, according to Donn Moyer, Department of Health spokesperson. Patients are allowed to possess15 plants and 24 ounces of dried marijuana, which lawmakers identified as a 60-day supply. “The law doesn’t legalize marijuana or authorize transactions,” said Moyer. He said it allows people to grow their own supply and offers a legal defense to criminal charges. “It’s against the law to buy or sell it, and there are a lot of misconceptions about how to get it. There is no registration for patients and no tracking or reporting of patients in the state. There is no legal dispensary,” he said, advising people to educate themselves and read the department’s website (www.doh.wa.gov/hsqa/medical-marijuana). Dispensaries are cooperative stores that may offer dried medicine by the ounce and candies, cookies, lotions and oils, according to a medical marijuana advocate in the Seattle area named Todd, who declined to give his last name. “Technically, it is illegal to sell. Like a true cooperative, you put something in and get something out,” he said. You must have a qualifying card to get in the door. The lack of a legal source of usable marijuana or seeds to start homegrown plants remains a barrier for patient access to medical marijuana, according to the 2008 Health Department report on patient access. The disagreement between federal and state laws blocks the development of a legal distribution system and “legal ambiguity puts patients, caregivers, law enforcement and the judicial system in the difficult position of figuring out which activities are protected.” The law does not allow smoking medical marijuana in any public place or engaging in its use while driving on public roads. Workplaces, schools and correctional facilities are not required to accommodate a patient’s medical use of marijuana. Photo by Sue Misao
Health and Wellness 2010/11
Page 13
Home birth: the right choice for some
U
ntil the early 1900s, the term “home birth” was redundant; most births took place at home. By the 1950s, however, most births took place in a hospital – attended by physicians, accompanied by pharmacological pain relief, and frequently resulting in medical interventions, including induced labor, episiotomies, and instrumental or Caesarean delivery. The creation of the insurance industry, coupled with aggressive promotion of hospital births, created a climate that effectively eliminated midwives and home births. But in recent years, as the rate of Caesarean section births in this country has skyrocketed (from about five percent in 1965 to about 30 percent in 2009), many more low-risk women are choosing midwife-assisted home birth in hopes of preventing the invasive or premature interventions that increasingly accompany hospital births. The American Congress of Obstetricians and Gynecologists (ACOG) opposes home births, believing that women who deliver babies without physicians and hospital (or birth center) resources close at hand are taking unnecessary risks. Yet the American College of NurseMidwives (ACNM) supports home births for women with uncomplicated pregnancies. Both organizations use the same data to support their positions, but with different interpretations. ACOG cites risk statistics that include all out-of-hospital births (including unplanned home/car/etc. births, unassisted births, and births assisted by unqualified attendants), while ACNM defines planned home birth as “the care of selected pregnant women by qualified providers within a system that provides for hospitalization when necessary.” Within this context, home births are statistically as safe as hospital births and result in far fewer interventions. Some home birth mothers seek to avoid hospital interventions, but other women simply believe the birth experience will be more satisfying at home. Twisp mother Heidi Bard delivered her first child without complication at an area hospital attended by her then-practicing midwife. “The birth was routine,” she said, “but the post-partum experi-
By Ashley Lodato
Photo courtesy of Sandy Szalay
If possible, at home with the family is a nice place to be born. ence was terrible.” Hospital staff came in every hour to check the vital signs of mom and baby, to bathe the baby, and to change diapers. “By the next morning,” says Heidi, “we hadn’t slept for more than 45 minutes. I said to my husband, ‘We’ve got to get out of here.’” When Heidi was expecting her second child, she immediately opted for home birth. Like her first birth, Heidi’s second delivery was routine. But un-
like her first post-partum experience, Heidi’s second recovery was tranquil and unscheduled. “We didn’t even leave the house for two weeks,” laughs Heidi, “and my baby got a gradual, gentle introduction to the world.” “Home births make sense for lowrisk women,” says Blue Bradley, who is the Methow Valley’s only practicing Certified Nurse Midwife (CNM), and only one of four CNMs in Washington state doing home births. “Women have more power and control in their own homes and they are less likely to experience interventions than in a hospital birth. “As an out-of-hospital midwife, I continually evaluate all my clients for risk factors all through pregnancy and labor,” continues Bradley. “If at any point they develop a risk factor, they become ineligible for home birth.” Bradley closely follows standards that make a woman ineligible for home birth, such as cardiac disease, seizures, twins, or previous Caesarean delivery. Mazama mom Katharine Bill planned to deliver her first child at a hospital, but as she learned more about the statistics for positive outcomes for home births and high intervention rates
at hospitals, she reconsidered. “We had a high level of trust in Blue, and knew that she had the experience and tools to address nearly any complication that might arise,” says Katharine. “I also felt that I would cope with the pain best in a familiar, private place.” A late pregnancy ultrasound confirmed that all signs indicated a normal, healthy baby, which gave Katharine the confidence to proceed with a home birth. The birth was routine and Katharine felt lucky to have been able to welcome the baby “in a private, peaceful way.” Home birth isn’t for everyone, however, Bradley acknowledges, particularly in the Methow Valley, where hospital transport times can be as long as an hour. Most midwives use a 30- or 60-minute maximum transfer time as a guideline, but for the rare woman who requires a mid-labor transfer, those 30 or 60 minutes in the car can be grueling. The most important thing, says Bradley as she echoes the position of midwives around the country, is that a woman experiences childbirth in a way that respects the safety and dignity of both mother and baby.
Page 14
Health and Wellness 2010/11
Hospitals target infections By Sally Gracie
A
plary rates of hand hygiene. fter breaking her ankle in a “Hand washing and the use of hand car accident, my friend had cleaner is the best way hospitals can emergency surgery. She was decrease the risk of HAIs,” said Central released from the hospital Washington Hospital’s Tracey Kasnic, and went home to mend. vice president of patient care services. Shortly after, when she was The Wenatchee hospital also participates diagnosed with Methicillin-resistant S. in the WSHA’s Safe Hands initiative aureus (MRSA), she had to return to the and has implemented best practices to hospital, where she was isolated until eliminate surgical site, ventilator and the staphylococcus rash on her ankle central line infections. was treated successfully. Progress has been made since 2005, My friend may have been a MRSA when Washington hospitals began colcarrier, or she may have acquired the laboration to reduce HAIs. At a leaderinfection in the community. In any case, ship meeting in Washington, D.C. in she did have to return to the hospital, 2008, healthcare administration profesand the cost to her recovery and to her sionals agreed that “Chasing Zero” HAIs health insurance and the hospital were must become reality. Today, WSHA has significant. raised the bar by creating the WashingAccording to a 2009 Centers for ton Hospitals In Safe Hands Initiative Disease Control and Prevention study, to accelerate the effort by eliminating the overall, direct annual medical costs HAIs by 2012. The boards of member of hospital-associated infections (HAIs) hospitals must approve the infection in the United States were as high as $45 billion annually for inpatient services Photo by Sue Misao elimination goal and sign a pledge of during the years 2001 through 2007. Don’t be afraid to ask your doctor if he washed his hands before participation. WSHA will evaluate their success or failure. The good news is that our hospitals, handling you. Our hospitals are working to adopt locally and nationally, are on the job to the best medical practices that will reduce and eliminate HAIs for good – and the costs they add to rates have followed. “Millions [of dollars] have been saved”, says eliminate HAIs. When you prepare to go to the our healthcare – and our family doctors are ready to answer our questions about infection before we Wagner, as concerted efforts have been made to hospital for surgery, you must also take an active reduce infections. role in infection prevention. Ask your surgeon or are admitted to the hospital. All member hospitals have adopted the Safe contact WSHA about HAIs in the hospital where Washington state is a leader in adopting those “Best Practices” protocols in hospitals that will Surgery Checklist, including Mid-Valley Hospital your surgery will be performed. Methow Valley Family Practice’s Joe Jensen eliminate HAIs, according to Carol Wagner, vice in Omak, Okanogan-Douglas District Hospital president for patient safety at the Washington State in Brewster and Central Washington Hospital in told me that he may or may not play a role in preWenatchee. op evaluations as those are generally done by the Hospital Association (WSHA). In 2005, WSHA launched the first statewide surgeon. When he does participate, he works with Member hospitals are targeting the most common HAIs: surgical, central line infections, ventilator effort in the nation to improve hand hygiene in his patient “to examine risks and make sure they’re member hospitals. One key strategy for this initiative stable medically” before they go for surgery. He infections and urinary tract infections. Washington hospitals were the first to adopt was to “make it easy for the staff.” Hand sanitizer routinely would look for infections. If the surgery the Safe Surgery Checklist in 2008. According to dispensers have been placed outside patient rooms is elective, he would help the patient take care of Wagner, “The Surgical Checklist improves com- and throughout all areas of the hospital. Your doctor, problems ahead of time. Chris Hogness is a family practice doctor and munication among members of the surgical team nurse or orderly, will not think you rude if you ask while insuring the key steps to keep patients safe them if they have washed their hands before they internist at The Country Clinic in Winthrop. Dr. are completed.” Studies have shown that where enter your hospital room. According to Wagner, Hogness told me that he “co-manages” his patients the surgical safety checklist has been introduced, the simple task of hand washing has resulted in a with surgeons before surgery and at the hospital. marked improvements in surgical outcomes, reduc- 25-percent reduction in HAIs. The “Best Hands on Like Dr. Jensen, he actively addresses such risk faction of complications after surgery and lower death Care” is awarded by WSHA to hospitals for exem- tors as smoking, blood glucose control in diabetics, and cardiovascular issues. He also advises patients to ask caregivers if they have washed their hands. Our primary care doctors in the Methow Valley are well-informed about HAIs, and are ready to advise us when our specialist says we need surgery. Our surgeons should expect to be asked about their “infection rates.” Hospitals in our region are actively working to eliminate HAIs, but you may want to check your hospital’s record before you schedule your surgery.
Health and Wellness 2010/11
Page 15
Directory of advertisers
Acupuncture Methow Valley Wellness Center ................6, 9
Adult Care Harmony House Health Care .........................14
Assisted Living Centers Emmanuel Rocking Chair Ranch .....................................9
Counseling
Hospitals
James Donaldson.....................13 Okanogan Douglas Hospital ...7 Ann Douglas ............................. 5 Mid-Valley Hospital ................ 3
Dentistry/Orthodontics
Human Resources
Pharmacies Family Health Centers............. 6 Ulrich’s Valley Pharmacy ........ 5
Psychotherapy
Merlin Ekvall, DDS, MS ...........8 Room One.................................. 2 James Donaldson.................... 13 Family Health Centers............. 6 The Support Center.................10 Steven Harrop, DDS ................ 5 Physical Therapists Sawtooth Dental Care .............11 Laundromats/Showers Winthrop Physical Therapy .... 8 The Washworks ........................ 5
Emergency Services
Aero Methow Rescue..............10
Ayurvedic Practitioners
Medical Clinics
Pregnancy/Birth Control Okanogan Family Planning ...10
The Country Clinic................... 9 Eye & Ear Clinic ....................... 8 Methow Valley Fitness Centers Retail/Gifts Wellness Center ............... 6, 9 Winthrop Physical Therapy .... 8 Family Health Centers............. 6 Spirals .......................................13 Main Street Moksha Studio .........................10 Ulrich’s Valley Pharmacy ........ 5 Health Associates ................ 9 Health Food Stores Bakeries Glover Street Market................ 2 Omak Clinic .............................16 Schools Cinnamon Twisp .......................9 Little Star Montessori ............ 10
Hearing Aids & Services
Midwifery
Bodywork Eye & Ear Clinic ....................... 8 North Glover Teeth Whitening Services Healing Center..................... 2 Merlin Ekvall, DDS, MS ...........8 Circle M Massage .................... 6 Micron Audiology .................... 4 Green Lotus Massage .............. 2 Kara’s Smile Lab ........................2 Methow Valley Naturopathy Herbalists Steven Harrop, DDS ................ 5 Wellness Center ............... 6, 9 Horse of a Different Color....... 6 Methow Valley Sawtooth Dental Care .............11 North Glover Wellness Center ............... 6, 9 Healing Center..................... 2 Home Care Suppliers Yoga Spirals .......................................13 Okanogan Douglas Hospital ... 7 Optometrists Moksha Studio ........................ 10 Ulrich’s Valley Pharmacy ........ 5 Eye & Ear Clinic ....................... 8 Winthrop Physical Therapy .... 8 Cardiopulmonary Webster Furniture .................... 2 Dr. Milt Herman ..................... 13 Rehabilitation
Okanogan Douglas Hospital ... 7
1985
2010 [ celebrating
25 YEARS together ]
Ever since the beginning of Omak’s Family Medical Center in 1958, the clinic has experienced a lot of change, including the merge with Wenatchee Valley Medical Center (WVMC) in 1985. One thing that has not changed is the strong commitment we have to the communities of Okanogan County. You are our friends, family and neighbors and we want to make sure you are receiving quality health care in a friendly and caring atmosphere close to home. With our association with WVMC, we have been able to host 33 different physicians and mid-levels representing 15 different specialty depar tments in Omak so that our patients do not have to travel to Wenatchee for their specialty visits. We’re proud of our association with WVMC and we’re honored to ser ve your medical needs together.