Methow Valley
Health & Wellness 2018 – 19
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advocating for yourself
Guardian Angels give care & support Physical therapy’s role in healing
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Health & Wellness 2018 – 19
Don Nelson, publisher/editor Darla Hussey, design LaShelle Easton, design Sheila Ward, advertising Tera Evans, office manager
CONTRIBUTORS Ashley Lodato Sandra Strieby
A publication of the Methow Valley News P.O. Box 97, Twisp, WA 98856 509.997.7011 • 509.997.3277 fax editor@methowvalleynews.com www.methowvalleynews.com Find us on Facebook
Editor’s note
Your role in your health There’s nothing like personal experience to drive home the value of collaborative health care. Through several medical challenges including cancer, I learned to become a persistent (but polite) advocate for my own care. I also had some supportive help along the way, which may be more necessary for some than others. Your health care providers are the ones you ultimately count on for the best treatment options, but you can be an effective partner in the process. You will find some great ideas on how to do that in Sandra Strieby’s story on page 12 of Methow Valley Health & Wellness 2018-19. I can also attest to the restorative powers of physical therapy, which is often a vital component of the healing process. Ashley Lodato’s story on page 8 explains how to incorporate PT into your recovery regimen. Many of us may never need the extraordinary personal care provided by the Methow Valley’s own Guardian Angels program (see story, page 4), but for those who do it can be a godsend. Wellness is an all-encompassing concept, and what the Guardian Angels do is just one aspect – and a community-based one at that. We are fortunate to have an array of health care choices in the valley or nearby. You’ll find many of them as advertisers in Methow Valley Health & Wellness 2018-19, which makes the publication a year-round resource.
C over photo by D onni R eddington
Ta b l e o f Co n t e n t s Angels among us
4 Active healing
8 Be your own best advocate
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Jerry Young has found a true guardian angel in the form of Karen Evans (standing). Peanut, the dog (inset, right), is an important part of the Young family. Photos by A shley L odato
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Angels among us Methow Valley Guardian Angels provide care and support for the elderly By A sh l e y L odat o
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wo years ago Jerry and Lillis Young, then both in their mid-80s, packed up their lives in California, drove to the Methow Valley, moved into a rental house, and quietly began the next chapter of their lives in a place they had only visited once and where they knew hardly a soul. “We were called to move here,” says Jerry, one finger pointing upwards. “God told me to move to this place hidden away from the world. It’s a sort of Promised Land.” But with limited financial resources, some health issues, the inevitable trials of old age, and no adult children in the vicinity, the Youngs found themselves in need of more than just the hope of milk and honey. It was fitting, then, that assistance came in the form of an
angel — that is, a guardian angel from the Methow Valley Guardian Angels (MVGA) program. Formed by Glenn Schmekel in 2002 as an extension of the Methow Valley’s food bank, The Cove, the MVGA seeks to “improve the care and support of the elderly and persons with chronic illnesses or disabilities in our community, through personal contact by a special friend — a guardian angel.” The MVGA “matches volunteers to those people in our community who want to remain in their home, but are at risk of becoming socially or physically isolated.” Guardian angels nurture a caring relationship with a client and may help with things like transportation, errands, and shopping. The main purpose of the connection, however, is companionship. When MVGA administrator Eunice Marchbank reached out to Winthrop resident Karen Evans soliciting help for the Youngs, Karen was quick to answer that call. “I like to help people,” says Karen of her motivation to volunteer with MVGA. She
adds, “And I just can’t sit still.” No surprise, since she was a physical education teacher for 30 years, and at age 75 still volunteers at the public school. Developing relationship Karen’s relationship with the Youngs began with driving Jerry to medical appointments in Omak and Wenatchee, but soon developed into something more substantial: shopping trips, weekly visits, lunches out, trips to the Methow Valley Senior Center in Twisp. “I care about them,” Karen says simply. About their relationship with Karen, the Youngs mince no words. “She deserves a halo,” says Jerry, adding that when he first met Karen, he liked her immediately. “I told her, ‘I would love for you to be my guardian angel.’“ With all this talk of angels, one might imagine the MVGA to be a faith-based organization. Although its inception as a Faith in Action program is a nod to its faith-based roots, there is no formal focus or expectation that religion plays a role in the services
offered. Karen is not particularly religious, but a relationship with God is the defining element of both Jerry and Lillis’s characters. But “religion doesn’t matter,” says Jerry, who is a retired Baptist minister and former practicing Pentecostal. “Karen is a good person, she really is. It doesn’t matter that she doesn’t go to church.” He adds, “People who let their religious principles dictate who they associate with, they miss out on things.” Jerry was raised in Los Angeles, California, graduated from Life Bible College in 1950, and enlisted in the U.S. Air Force in 1952, eventually being posted as a chaplain service specialist at the former Harlingen Air Force Base in Texas’s Rio Grande Valley. After marrying Lillis in 1957 (and again in 2000, after being divorced from her for 12 years — but that’s another story), Jerry worked as a public school teacher in Modesto, California. California background California looms large in the Youngs’ background. They were both born and brought up there, raised their own two daughters there, and lived comfortably in Clearlake, California, until God called them to abandon all that was familiar and move to the Methow Valley. The call came in the form of
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Remarkably, he didn’t die, and moved back home, where he has been ever since. Hospice provided temporary housekeeping assistance, but the final hospice visit occurred in late July. The equation is simple but painful: Jerry’s death is not imminent, so his veteran’s health care no longer covers hospice services. But at 88 and 87, the Youngs are increasingly uncomfortable with some of the activities required for independent Methow living: shoveling walkways, driving, maintaining their household. Whether she was sent from God or from her own innate sense of compassion for humanity, Karen Evans truly has been a godsend for the Youngs. Still, she knows that down the line what she and MVGA can offer will not be enough. “And then what?” she thinks aloud. For now, however, Jerry is not concerned. “I leave it to the man upstairs,” he says, pointing upwards again. “The Lord will open the door.”
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Karen Evans (right) and Lillis Young have become fast friends. Photo by A shley L odato
what Lillis calls “written prophecy.” About a decade ago, Jerry says, “I knew I should start writing daily. So I began writing prophetically, speaking with God and writing down what he tells me.” Those writings now fill 29 spiral-bound notebooks. Jerry conducts his personal communication with God in the wee hours (“between midnight and 3 a.m.,” he says), but also enjoys more conventional hours of spirituality through weekly attendance at Friendship Alliance Church in Winthrop. It is through the church that the Youngs were able to identify resources that would help them continue to live independently in the Methow Valley: MVGA, Room One’s Lookout Coalition, and hospice services. “We’ve been lucky,” Jerry says. “Programs here have helped out with different things.” Hospice entered the Youngs’ lives in 2017, when Jerry was in Brewster, “waiting to die.” He had been given 4 to 6 months to live.
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Lots of services For a tiny community, the Methow Valley seems rife with social services. Indeed, Karen points out that “This area has more going on for seniors than many other places.” Room One offers health, aging, food, and other support services. The Cove provides food, as well as a place to honor and respect others at difficult times in life. MVGA offers support for elderly and ill clients. The Lookout Coalition serves clients through medical house calls. Methow At Home is a membership-based community that connects volunteers with members in need of various services, including driving, yard work and housekeeping. The Senior Center, churches and civic groups offer various forms of assistance. And the neighborly ethic is quite robust in the valley. Still, the Methow Valley is a difficult place to live independently once age and health take their tolls. The MVGA program seeks to alleviate some of the stress
associated with being elderly and infirm and supports residents in maintaining independent living. But volunteering as an angel is not a one-way street, says Karen. “I get a lot of personal satisfaction out of this. I want to do this for other people.”And, Karen says, illuminating the motivation that fuels altruistic work like that of the Methow Valley Guardian Angles, “I care about people. I want to help make their lives better.” Methow Valley Guardian Angels participate in orientations and trainings and submit to a background check before being matched with clients. Both client and volunteer needs and interests are taken into consideration when matches are being made. If you know of someone who has need of the services of MVGA, or if you would like to volunteer for MVGA, contact Eunice Marchbank for more information at (509) 9962569 or emarchbank@methownet. com; or visit www.thecovecares. com. ◆
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Active healing Physical therapy aids recovery and fosters longterm fitness By A sh l e y L odat o
“If you can’t do something physical that you want to be doing,” says Jenna Kokes, co-owner of Winthrop Physical Therapy & Fitness, “it’s quite likely that you need physical therapy.” Perhaps you have a recent injury — a tear, a sprain, a strain, a tweak, a twinge or a pinch. Perhaps you’ve been nursing a nagging pain for weeks, months or years. Perhaps you suffer from chronic low back, or shoulder, or knee pain. Whatever the situation, if you’re unable to do the activities you like to do without pain — whether they be running or hiking or sitting — physical therapy will probably be part of the solution. Physical therapy (PT) is a component of orthopedic medicine, says Kokes. “It’s an evidence-based treatment of muscle and skeletal pain,” she says. Through observation, evaluation, manual manipulation, corrections of positioning and technique,
and a series of exercises designed to boost strength, range of motion, and flexibility, licensed therapists empower patients to take control of their health and healing. Physical therapist Andrew Nelson of Altius Physical Therapy in Winthrop notes that the practice of PT came out of World War II, when so many men suffered serious injuries. “It was considered ‘restorative therapy,’” says Nelson, “to help these men recover from debilitating trauma.” Now considered mainstream treatment, PT still helps patients recover from debilitating injuries, but it can also help those trying to navigate the seemingly inevitable aches and pains that come with aging. “Getting old does not have to mean getting weak,” cautions Kokes. Nelson echoes Kokes, unwilling to subscribe to the notion that aging means resigning oneself to pain, stiffness or reduced physical activity. “Humans are bipeds [an animal that moves on two rear legs],” he
says. “We’re meant to walk with strength our whole lives; it’s what we are designed to do.” Many age-related conditions, says Nelson, can be prevented through exercise, gait mechanics, and awareness of one’s biomechanics. So true, agrees Kokes, noting that good PT is focused on getting at the root of what is causing pain and changing those factors through biomechanics. Kokes adds that if you can’t prevent a chronic condition or acute injury, your next best bet is to seek immediate treatment when you start feeling muscle or skeletal pain. “The longer you wait to get treatment,” she says, “the longer it will take you to heal.” Basic concepts Both Nelson and Kokes advise those who are injured or in pain to follow some basic instructions: • Stop doing what you were doing when you got hurt. You need to let the tissue recover. • Seek the help of a physical therapist. • Remain active but do
something different than the activity that caused the injury. (Don’t take to your bed. Kokes calls it “relative rest,” saying “our bodies are meant to move. If you can’t hike, then bike or walk.”) Activity is a vital component of PT. • Discipline yourself to follow the exercise program your physical therapist gives you. Going to PT every once in a while is far more effective when paired with regular strength and conditioning at home. • Take responsibility for your own healing. You are in control of your treatment. This client empowerment, says Nelson, is a critical component to successful PT. “We give people the tools of their own observation, what works and what doesn’t,” he says. “When PT is done well, the responsibility is on the patient’s shoulders.” Kokes agrees. “If patients are in control of their own health and are motivated to resume doing what they want to be doing, PT is very effective,” she says. “Our goal is to help you feel better and stay better, and you can do this on your own.” Both Kokes and Nelson have significant personal experience with injuries and how PT can be the road to recovery. Kokes, a former soccer player, has had four ACL (anterior cruciate ligament) surgeries on her knee. “Not all my surgeries were good,” she says, “and I was in and out of PT, and then finally
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Pete [Dickinson, from whom Kokes and her husband bought Winthrop Physical Therapy & Fitness in 2014] was able to help me so much. He’s the best.” After that experience, Kokes abandoned her planned educational path of equine science and entered PT school instead. Also a former soccer player, Nelson used PT to recover from sports injuries and after working for the Seattle Sounders, ventured into PT school, where he became fascinated by the biomechanics of the human body. Nelson used to watch his reflection in plate glass windows as he ran through the streets of downtown Tacoma. “I wondered if I was running the way I should be,” he says, “and I experimented with different techniques.” Then Nelson took a 40-foot fall while rock climbing. “Groundfall,” he says. “I was in a trauma unit for two weeks and spent three months in a wheelchair.” Among other bones, Nelson broke his back, his leg and his
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ankle. Seemingly miraculously, not only did he not die, but he eventually resumed running and today maintains an enviably active lifestyle of running, hiking, biking and skiing. “I was able to test my PT theories on myself after that fall,” he says. Active community In a community like the Methow Valley where so many people are so active, PT is particularly effective, says Kokes. “The people in this valley are so motivated and exercise-driven,” she says. “The health in this valley is quite high. Not many smoke. Obesity rates are low. There’s a commitment to fitness.” Often the hard part around here, says Kokes, is teaching people how to rest injuries and focus on recovery. “We’re in an ideal place to prevent and cure chronic pain caused by injury or incorrect movement,” Nelson agrees. “The outdoors around us is a giant gym. Twothirds of the American population is sedentary. That creates huge health issues, joint issues. But that’s probably only about one-third in the Methow Valley, so we’re just a healthier population simply by being more active.” Kokes believes that the combination PT clinic and gym at Winthrop Physical Therapy & Fitness is ideal for the Methow Valley. “I hadn’t really seen that approach in other places I worked,” she says. “It’s pretty unique, but it’s perfect for this area. You see patients on both sides of the building — getting treatment and then working out.
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One supports the other. It’s all part of sustaining this active lifestyle that so many around here seek.” Although PT is often a complementary treatment to primary care — such as recovering from a broken bone or joint replacement — it can be stand-alone treatment. Is activity causing you pain? Call a physical therapist. Seeking PT does not require a referral from a physician. PT operates without medication or surgery, instead focusing on the biomechanics and ergonomics of the human body and the underlying causes of pain. And there are no hazardous side effects, although Kokes cautions, “You may be sore at first, and you’ll also be stronger.” PT is also quite affordable, which is welcome news in a society of rising premiums and increasingly high deductibles. Both Winthrop Physical Therapy & Fitness and Altius Physical Therapy offer cash discounts for patients who choose to bypass their catastrophic insurance plans. While those new to PT might consider it something to dread, both Kokes and Nelson use the word “fun” to describe the process. “Patients around here are so motivated to get better,” says Kokes, “that it’s very rewarding to treat them. And people are so surprised by how much they learn here. It’s really fun to see.” Nelson even uses the word “hip,” adding “You’ve got all these great exercises to do, neat equipment, and you’re bounding around.” They do make it sound positively, well — fun. ◆
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Be your own best advocate Essential skills for navigating the healthcare system B y Sa n d r a S t r i e b y
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act of life: sooner or later just about everyone lands in the exam room. The good news is, you can stay in the driver’s seat even while you’re perched on a table covered with crinkly paper. Getting and staying healthy in the 21st century requires us to be full partners in our own health care. This article is about how to do that by preparing, speaking up, and being proactive about both everyday health and special challenges.
Local resources • The Lookout Coalition provides medical and socialservice support to people who are aging or facing difficult health challenges. Contact the coalition through Room One at (509) 997-2050 or info@ roomone.org. • Methow At Home volunteers may be able to accompany members on health care visits. (509) 996-5844 or manager@methowathome.org. • Room One can help with advocacy on a range of issues. (509) 997-2050 or info@ roomone.org. • Search “be your own health care advocate” online. Ask your provider which sources are trustworthy. Government sites and others run by established institutions may be most reliable
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Why advocate for yourself? Shared decision-making has become the norm. “Fifty years ago, the doctor had all the knowledge and told you what to do. In current times we’re partners with our health care providers and we make decisions together about our health care,” says Dr. Raleigh Bowden, a retired physician and founder of the Lookout Coalition. Your needs are important, and if you don’t make those needs known, they may not be met. Prepare for your visit To get the most out of an office visit, be prepared. Start by scheduling enough time. Most office visits last 15 minutes, but you can ask for a 30-minute appointment if you think your situation requires it. It’s ideal to focus on one main concern during your visit. If you’d like to discuss more than one thing, be realistic about how much can be covered. Prioritize topics and write down questions. Think about what you want from the visit. The answer to a question? A prescription refill? Information about new symptoms? Let your provider know what’s important to you so you can make a plan to use your time together efficiently. Be prepared to talk about the background of your problem. “One of the gifts you can give your health care provider is a thoughtful history,” says Dr. Elizabeth Weiss, also a retired physician and Methow At Home’s board president. Research your symptoms, if you like — just remember that not all sources are reliable. Dr. Allison Fitzgerald, a physician at Family Health Centers (FHC) in Twisp, says, “The best way to advocate for yourself is to seek information. But be really careful, and discriminating, about your sources.” Be ready to talk about any concerns, especially something that’s scaring you. Practice with a
close friend or family member, if you think that will help, or prepare a written script for yourself. You may also want to bring someone with you — for support as well as to take notes and ask questions.
forget that your needs are what’s important in that relationship.” Even with a trusted provider, you may need to ask for the kind of attention you need. Having the confidence to ask your provider to
“Most physicians, nurses, health care providers of all sorts care deeply about doing the right thing for their patients, or for the people they serve. There are many pressures on them, to move quickly and to focus on the things that they know best. But that doesn’t mean that they don’t want and hope to help you make the best decisions for you.” Dr. Elizabeth Weiss, Methow At Home
Speak up for yourself Once you’re in the exam room, be honest and tell your provider the whole story. Talk about any fears. And be frank about whatever concerns you have, including financial ones. Providers can often find creative ways to contain health care costs. Finding a provider you trust can make speaking up easier. Dr. Chris Hogness practiced at the Country Clinic in Winthrop (now the Methow Valley Clinic) for eight years; now he treats patients at Central Washington Hospital in Wenatchee. He says, “It’s crucial that you have confidence that your primary-care provider is looking out for your best interests.” Keep looking until you find someone you feel comfortable with, he recommends. Adds Weiss, “Never
meet your needs is one key to receiving good care, says Bowden. If you don’t feel heard, she suggests saying, “I have a concern I want to talk to you about today … are you able to listen for a few minutes?” Combining courtesy and respect with assertiveness will also pave the way for effective communication. Bowden recommends “trying to listen to the doctor the way [you’d] want to be listened to. It’s not a one-way street.” Once your dialog is underway, ask questions about anything you don’t understand. Feel free to ask your provider to use plain language, slow down, draw a picture — anything that will help you get the message. Take notes so you’ll remember important points. If the provider’s recommendations don’t work for you, say so. M e t h o w Va l l e y
Let the provider know what you think you can do, and ask for help creating a plan that you will be able to follow. “You have to start somewhere,” says Fitzgerald. “What’s going to help you do that?”
Finally, before you leave, make sure you know how to follow up with your provider. If you think you may have questions, ask how to get them answered. Email? Telephone? A letter? A follow-up appointment?
Special considerations for difficult situations Some situations present special challenges. In the hospital, you generally won’t know your providers. Speak up if you don’t think you’re
getting through to your provider, says Hogness — “Be very explicit about it.” If you still feel the hospital provider doesn’t understand your concern, ask your primarycare provider to talk with him or her.
Quick Tips – When Talking with Your Doctor The single most important way you can stay healthy is to be an active member of your own health care team. One way to get high-quality health care is to find and use information and take an active role in all of the decisions made about your care. Research has shown that patients who have good relationships with their doctors tend to be more satisfied with their care—and to have better results. Here are some tips to help you and your doctor become partners in improving your health care.
GIVE INFORMATION. DON'T WAIT TO BE ASKED!
• You know important things about your symptoms and your health history. Tell your doctor what you think he or she needs to know. • It is important to tell your doctor personal information—even if it makes you feel embarrassed or uncomfortable. • Bring a "health history" list with you, and keep it up to date. You might want to make a copy of the form for each member of your family. • Always bring any medicines you are taking, or a list of those medicines (include when and how often you take them) and what strength. Talk about any allergies or reactions you have had to your medicines. • Tell your doctor about any herbal prod-
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ucts you use or alternative medicines or treatments you receive. • Bring other medical information, such as x-ray films, test results, and medical records.
Get Information
• Ask questions. If you don't, your doctor may think you understand everything that was said. • Write down your questions before your visit. List the most important ones first to make sure they get asked and answered. • You might want to bring someone along to help you ask questions. This person can also help you understand and/or remember the answers. • Ask your doctor to draw pictures if that might help to explain something.
Take notes
• Some doctors do not mind if you bring a tape recorder to help you remember things. But always ask first. • Let your doctor know if you need more time. If there is not time that day, perhaps you can speak to a nurse or physician assistant on staff. Or, ask if you can call later to speak with someone. • Ask if your doctor has washed his or her hands before starting to examine
Take Information Home
• Ask for written instructions. • Your doctor also may have brochures and audio tapes and videotapes that can help you. If not, ask how you can get such materials.
Once You Leave the Doctor's Office, Follow Up
• If you have questions, call. • If your symptoms get worse, or if you have problems with your medicine, call. • If you had tests and do not hear from your doctor, call for your test results. • If your doctor said you need to have certain tests, make appointments at the lab or other offices to get them done. • If your doctor said you should see a specialist, make an appointment.
Information courtesy of the Association for Healthcare Research and Quality, U.S. Department of Health and Human Services
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“Fifty years ago, the doctor had all the knowledge and told you what to do. In current times we’re partners with our health care providers and we make decisions together about our health care.”
In your daily life Part of being your own advocate is being proactive about your health. If you’re having a problem, don’t wait to seek care. Keep your medication regimen up to date.
Talk with your provider if your medications don’t seem to be helping. Before starting a new medication, ask your provider to check for drug interactions with any existing medication. Keep records; use a journal to track health problems and solutions. Know your medications if you can — carrying a list with the name, purpose, and dosage of each one will make sure that information is available any time you need it. Recognize that some health conditions take time — and multiple office visits — to address. Know that past experiences can affect your health. “You don’t have to let those past experiences define you … having mentors and having support [can help to] overcome some of those past events,” says Fitzgerald. You can ask your providers to help you make good choices moving forward. Think about emergency and end-of-life choices.
Consider what’s really important to you, and be ready for difficult situations. Finally, remember that your well-being is important to your providers — they are there to support your good health. “Most physicians, nurses, health care providers of all sorts care deeply about doing the right thing for their patients, or for the people they serve,” says Weiss. “There are many pressures on them, to move quickly and to focus on the things that they know best. But that doesn’t mean that they don’t want and hope to help you make the best decisions for you.” Being your own advocate is a way to make the most of each provider’s time and skills so you can get the best possible care. ◆ Interested in learning more about health advocacy? Watch for information about a community presentation sometime in the next few months.
OF A DIFFERENT COL E S OR
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Dr. Raleigh Bowden, Lookout Coalition
Chronic conditions may require long-term commitment, and support can be extra important. FHC uses group visits “to help patients advocate for themselves and work with others with similar issues,” says Fitzgerald. “It’s a way for patients to learn how to take better care of themselves.” If English is not your first language, let the receptionist know when you make your appointment so translation can be arranged. Some local practitioners speak Spanish. Translators for many languages are available via computer. You may wish to ask a family member who is fluent in English and knows about your condition and medications to go with you to the exam.
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Dental Care/Orthodontics Family Health Centers . . . . . . . 10 Merlin Ekvall, DDS, MS . . . . . . . . 3
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Aging & Adult Care . . . . . . . . . . 7 Frontier Home Health & Hospice . 11
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Yoga Agni Yoga . . . . . . . . . . . . . . . . 7 15
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Dr. Sierra Breitbeil, ND Naturopathic Physican 996-3970 • drsierra.com Sharon Cohen, MFA, RYT Mindfulness-Based Stress Reduction 449-2594 • mindfulmethow.com Sue Peterson, MS, LMHC Licensed Mental Health Counselor 341-4487 • suepetersonms.com Jason Rumohr, CHP, LMT Certified Hellerwork Practitioner 341-4050 • jasonrumohr.com Kate MacDonald, PhD, RN Licensed Psychologist 425-283-9594 • drkatemacdonald@icloud.com
