Alaska
PULSE
April 2020 Vol. 1, No. 4
MONTHLY
Asha’s story Singer follows Nashville ambitions in a story of resilience and healing Fairbanks couple shapes up in a big way
Health Sense: Dr. Lee Ann Gee on depression
Healy school sprouts health professionals
Dental health aide therapists serve rural Alaska
Nurse of the Year honoree helps those with HIV
Walter P., succeeding with mental health services
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Helping Alaskans to live a healthy and satisfying life in the Last Frontier by hearing from their fellow Alaskans, from Alaska health experts and by sharing their own stories.
April 2020 Vol. 1, No. 4
Alaska People
About Alaska Pulse Alaska Pulse is a monthly magazine focusing on health in the Far North and distributed around Fairbanks and Anchorage. We’ll share stories from around the state about how people stay healthy. Learn from experts in different medical fields on ways to improve, or maybe just maintain, your health. We’ll hear personal stories about people’s triumphs over different health adversities. Alaska Pulse is a community publication, so every issue is sure to hold a variety of perspectives.
Alaska Pulse is a publication of the Fairbanks Daily News-Miner LLC. 200 N. Cushman St. Fairbanks AK 99707
Fairbanks couple goes the extra mile to get fit. By David James Page 4
MOVE program helps military veterans achieve their weight goals. By Katie Yearly Page 18
Publisher Richard E. Harris Editor Rod Boyce editor@AlaskaPulse.com 459-7585 Advertising
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Flora Deacon helps rural Alaska residents learn how to prepare healthy meals.
Health professionals sprout from Healy school.
Asha Ashley Smith’s story of resilience and healing.
By Kris Capps Page 14
By Kris Capps Page 20
By Aliza Sherman Page 32
Alaska dental program helps patients in far-flung communities.
Nurse of the year honoree helps those with HIV.
Persistence pays off for Walter, with help from mental health services.
By Aliza Sherman Page 31
Page 38
By Sean McDermott Page 28
FEATURES HEALTH SENSE: Nicolas Bradley on running ...............................................................................................10 Chef Solus veggie crossword puzzle .............................................................................................................11 Health Sense: Heidi Hedberg on preparing for COVID-19...............................................................12 Health Sense: Tiffany Hall on the sober-curious movement.........................................................19 Health Sense: Dr. Lee Ann Gee on depression......................................................................................26 Health Sense: Dr. Timothy Ballard on VA ambulance changes......................................................30 Southcentral Foundation at Fur Rondy; Go Red........................................................................................36 Health Sense: Tim Parker on benefits of health trust ......................................................................37 For kids: Easter word search..............................................................................................................................39
AlaskaPulse.com — April 2020 3
From couch potato to Ironman
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ALASKA PULSE MONTHLY — April 2020 — AlaskaPulse.com
Above, Shawn and Jessica Armstrong before they started their journey to fitness. At left, fatbiking is a winter favorite for the couple. Photos courtesy of the Armstrongs
Couple goes the extra mile to get fit By David James
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hawn Armstrong remembers the day in 2011 he realized he needed to do something about the poor physical shape he had fallen into. “We had a digital scale in our bathroom and I stepped on it,” he said. “It didn’t give me back a weight, it said error overload.” The scale could only measure up to 365 pounds, and he was well beyond that point. His wife, Jessica, was also struggling with weight issues, having surpassed 200 pounds. Most people in their situation would, at best, try dieting and increasing their daily physical activities a bit, hoping to slim down. The Armstrongs decided the way to get into better shape was to
work toward an objective that even few healthy people consider. The couple had just watched an Ironman event on television, “and he said we should do it,” Jessica remembered. The Armstrongs, both of whom work for the University of Alaska Fairbanks, had never been interested in exercise, much less attempting one of the most brutal endurance sporting events to be found. Ironman competitions begin with a 2.4-mile swim. This is followed by a 112-mile bicycle race. And then entrants run a full 26.2-mile marathon. And they are required to complete all three parts of the race in 17 hours total, with time cutoffs that must be met along the way. Jessica, 34 at the time, had never been a runner. Shawn, then 38, didn’t know
how to swim. They were both obese. Some people thought they were crazy to even dream about it. When Shawn went to buy running shoes at a local retailer and mentioned his plans, the clerk told him, “You’ll never do that. Go out and go walking and just do that.” Armstrong took that as a challenge. He said to himself, “OK, it’s on now.” The Armstrongs recognized that they had set a lofty goal for themselves, but they were realistic about the time it would take to accomplish it. Shawn wanted to finish an Ironman before his 40th birthday, which meant he needed to aim for the 2014 season. That gave them both a couple of years to work up to it. Running would be a big factor in their plans.
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The first step
It wasn’t easy getting started. Shawn said at first he couldn’t run a full 100 yards, but the couple set short-term goals that they could achieve before pushing themselves to the next level. “Part of it was little milestones,” Jessica said. “OK, I did a mile today, that’s pretty awesome.” In the summer of 2012, the Armstrongs entered first a 5K running race and then a 10K. Jessica went much further, running the Santa Claus Half Marathon in North Pole. “It was surprisingly hard. I wasn’t good at pacing yet. But you learn a lot each race.” The couple ended the year with a trip to Hawaii, where they ran an 8K. Then, as 2013 arrived, they looked toward the next step. “The goal for that one was finishing the Equinox Marathon,” Shawn said. The Equinox, held in Fairbanks every September, is Alaska’s oldest marathon and generally considered the most challenging in the state. It includes a 4-mile climb up Ester Dome, an out and back that goes partway down the other side of the Dome and then back up, and a steep and treacherous descent straight down off the top of the Dome called the Alder Chute. To complicate matters, the course was hit with snowfall that year. “The out and back was ice by the time we got there,” Shawn said. “People had bloody hands, bloody arms, bloody legs, Continued on Page 8
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ALASKA PULSE MONTHLY — April 2020 — AlaskaPulse.com
Top, the field takes off for the 2013 Equinox Marathon on the University of Alaska Fairbanks campus. Above, Jessica and Shawn Armstrong at the end of the 2013 Equinox Marathon. Left, the couple before Boulder Ironman in 2015
Eric Engman photo
Advice for beginning runners
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sked what advice they would give to others who are thinking of attempting an endurance athletic event, the Armstrongs and some other experts offered some tips. Shawn Armstrong said, “Have three goals. One is having your long-term goal. Ultimately, what do you want to do? Second, what’s that first short-term goal that you can achieve to get you started with some idea of success? And the third one is to be able to build intermediate goals off of that first one that get you to that ultimate end goal.” Stacy Fisk, Frosty Feet Running Company in Fairbanks owner and race director of the Equinox Marathon, advised starting slow. “Start with the run/walk method. You don’t have to go out to run one mile or two or three. You can do 30 seconds of a jog and 30 seconds walking. Or you can just walk for five minutes. It depends on the individual and how sedentary they might have been in the past, or if you’re coming back from an injury. Start slow and progress forward.” Jessica Armstrong emphasized that, “For me, trying to lose a bunch of weight, you have to remember, you didn’t put it on overnight, you aren’t going to lose it overnight. You have to
Jessica and Shawn Armstrong prepare for the Sourdough Triathlon in 2016.
be patient with yourself. That’s always hard for people who are trying to get fit. You want to be able to go fast right away, you want to be able to go distances right away. You have to work up to it.” The Armstrongs said joining local running and cycling groups are good ways to train in a social setting. They also took advantage of technology. Having never learned to swim as a child, Shawn turned to Total Immersion, an online course from which he was able to teach himself. For running, they used TrainingPeaks, a smartphone app that has a basic free version but can also connect runners to trainers who design programs tailored to their needs. Working with professionals isn’t a bad
idea. Check with your primary care physician if you have any medical concerns, and take advantage of available trainers. Nicolas Bradley, a certified physician assistant at Providence Express Care in Anchorage and former marathon runner, stressed that beginning runners should “Focus on programs that invest heavy into injury prevention.” Speaking from his experience, Shawn Armstrong concluded, “There’s going to be ups and downs, and the only thing you must do is keep moving forward. One step in front of the other. As long as you’re able to keep moving forward, that’s going to get you to the end goal.” —David James
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How to choose running shoes The first thing a runner needs is a pair of shoes, and getting the right pair for your cadence can make the difference between being able to train comfortably or getting hurt. It’s not just a matter of whether they feel comfortable at the shop or whether a particular shoe is on sale. The wrong shoes can result in injuries not just to feet but also to legs. Stacy Fisk, owner of the newly opened Frosty Feet Running Company in Fairbanks and race director of the Equinox Marathon, said the first thing a person needs to do is go to a running shop and talk with the salesperson. They will try to get as much information as possible to put customers into the proper shoe. The way they do this is to have the customer take what’s called a gait analysis. This is done on a treadmill that records an individual’s running style and allows the salesperson to look at what is happening from the person’s knee down. Fisk said they look to see “what your feet are doing. Are they collapsing in or out? Because we want to prevent injuries, not cause injuries.” For a beginning runner, Fisk added, “I would recommend something with a little support. You don’t want a whole lot to begin with because that can cause issues too. Like arch pain.” While getting the proper footwear is critical, the nice thing about running compared with many other sports is that it doesn’t require a lot of gear. “It’s relatively cheap,” Fisk said. “Just get a pair of shoes and head out your door.” —David James
Smiles at the end of the finish of the 2015 Boulder Ironman.
Continued from 6 just from falling on the rocks.” Despite the difficulties, both enjoyed taking part. “It was pretty incredible being part of something that big,” Jessica said. “So many people being out there doing the same thing is a cool community event.” The following year, with Shawn’s 40th birthday rapidly approaching, the Armstrongs signed up for the Coeur d’Alene, Idaho, Ironman, known to be a particularly grueling course. “It was, again, that community of racers,” Jessica said, “so many different skill levels, and you’re all about to have the best and worst day of your life.”
Success and setbacks
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For Jessica it was a bad day in Idaho. She failed to reach one of the checkpoints before the time cutoff and was disqualified. Shawn finished, however, achieving the goal he had set more then two years earlier. Jessica ran the Equinox again as a consolation. Both of them were eager to give it another go the following year. Jessica wanted to notch up a completion, while Shawn wanted to see if he truly could finish such events. “If you can do it once, it might be luck,” he said. “But if you do it twice, then you really pulled it off.” The two flew to Colorado to compete in the Boulder Ironman. This time it was Jessica’s year, and she enjoyed a strong finish. Shawn, though, discovered his cycling shoes had been damaged
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Ready for another race on the University of Alaska Fairbanks campus.
in the drop bag they were left in at the start of the bike ride. This led to difficulties riding and extreme foot pain that was compounded when he reached the marathon portion. Buoyed by a fellow competitor, he forced himself to the finish line anyway by taking it one mile at a time. “You find something within yourself,” he said. “I can do this. I can hit the next signpost, I can hit the next mile marker.” The following year they ran the Wenatchee, Washington, marathon, but Shawn scratched a mile from the finish. Nauseous and staggering, he was unable to go further. Perhaps there was a hidden health problem. In 2017, Shawn began training for the Alaska Man Extreme Triathlon, but an injury sidelined him on a doctor’s advice. The couple decided to give their bodies a rest. But they immediately ran into a problem that plagues extreme athletes who take a break. They kept eating like they were training and began to regain some of the weight they had lost. For Shawn it got worse. He found himself growing lethargic and unable
“You find something within yourself. I can do this. I can hit the next signpost, I can hit the next mile marker.”
— Shawn Armstrong
to keep weight off despite watching his diet. He assumed it was from lack of exercise. Then this past fall he suffered a minor heart attack. “I had this blockage in my heart,” he said, explaining why his body had been slowing down. “My heart wasn’t working well, so my metabolism wasn’t working well.” While the initial attack was mild, his heart shut down for two minutes while at Fairbanks Memorial Hospital, and he ended up being medevaced to Anchorage. While Jessica described Shawn’s heart stoppage as “The most terrible two minutes of my life,” Shawn was nonchalant. “It was scary for her. I was dead.” More importantly, he said that after having stents put in, “From two days afterward, I feel better than I have for the past two-and-a-half years.” Since the heart attack, Shawn has had
to limit himself to walking, but he plans on returning to running soon and hopes to complete the Breakup Triathlon in Fairbanks this spring and the 2020 Ironman in Lake Placid, New York, in late July. Jessica, who prefers cycling to running, intends to ride the KluaneChilkat bike race from Haines Junction to Haines this summer. Whatever the future brings, they both know that they’ve accomplished a lot on their journey from couch potatoes to endurance athletes. “The thing about triathlons is, once I finished my first race, they can never take that away from me,” Jessica said. “I’ll always be a triathlete. I’ll always be an Ironman, even if I’m not active right now. It’s something I’ve achieved.” David James is a freelance writer in Fairbanks. Comments about this story? Email editor@AlaskaPulse. com.
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HEALTH SENSE
Things to consider when running for the first time or if it has been a while By Nicolas Bradley
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f it’s been a long time since you’ve last had a good workout and you are looking to get started again, there’s a lot of things to consider to increase your chances of success and reduce the chance of being injured. First, consider establishing run or fitness goals for the summer or year. Are you running for weight loss, general health or to “check the box” of running in a race like a 5K or a half or full marathon? There are an abundance of run programs that can help guide your mileage based on your current fitness level and run goals. Start with the basics. Have your run gait looked at by a certified athletic trainer or professional at a local running shoe store who would be able to assess whether you are a natural runner or tend to over-pronate when landing. They can also provide shoe options, such as neutral shoes for natural runners or stability shoes for foot control. Begin, and continue throughout the run year, working on quadriceps strengthening and hip stability exercises. Quad and hip strength will help prevent runner’s knee and iliotibial (IT) band syndrome. A tight iliotibial band can 10
lead to swelling and pain around your knee. A simple internet search can provide you a wealth of hip and quadriceps exercise options. Injury can halt everything, so it’s best to build and maintain a strong running platform that will help you prevent injury. Once you are ready to run, take a few minutes to warm up and loosen up those “cold” muscles. Brisk walking, jogging in place, and jumping jacks are a few examples that will help prepare your muscles for the impact of running. Follow that up with some light stretching, emphasizing the hamstring, glute, calf and quadriceps areas. The more time spent warming up and preparing muscles for running, the greater likelihood of preventing injury. Run progression is also important with injury prevention and can help add mileage in a controlled fashion. There are several options to increase distance
ALASKA PULSE MONTHLY — April 2020 — AlaskaPulse.com
A simple internet search can provide you a wealth of hip and quadriceps exercise options. Injury can halt everything, so it’s best to build and maintain a strong running platform that will help you prevent injury. in a controlled fashion. One method is to start with timed walks, increasing speed and duration daily. Once you feel ready to run, alternate between walking and running until you feel more comfortable with just running. Another option is to run a comfortable distance pain-free for one week, then increase the next week’s run distance by no greater than 10%. For example, if you ran 3 pain-free miles the first week of running, increase your next run week distance to 3.3 miles. Continue this trend as it feels comfortable and good luck getting back into shape. Nicolas Bradley, MPAS, PA-C, is clinic provider at Providence Express Care-Alaska
Chef Solus Fruit and Veggies Crossword Puzzle
Across 4 The opposite of a sour potato 8 The outside of this melon looks like a web 12 Tomatoes, cucumbers and lettuce make a nice ___ 13 This vegetable looks like a mini tree 15 Dip the leaves in butter and enjoy the heart of an ___
Down 1 This is a fuzzy stone fruit 2 This is a side dish at Thanksgiving 3 A palm tree grows these 5 One popular big squash at Halloween 6 This tropical fruit has a big seed in the middle. 7 This looks like an orange but is smaller 9 Monkeys love them 10 Dip these into Ranch dressing 11 Dried grapes are called ___ 14 This vegetable has ears (think of cob)
Solution on page 39. More Nutrition Fun www.ChefSolus.com Copyright Š Nourish Interactive, All Rights Reserved
HEALTH SENSE
Prevention, preparedness are critical tools to combat the novel coronavirus By Heidi Hedberg
T
he novel coronavirus (COVID-19) is dominating the media because it’s new, which can create uncertainty and make you feel vulnerable. The number of cases, the areas affected by outbreaks, even what we know scientifically about this virus — all of this information is changing rapidly as we learn more about this novel virus. What is timeless, though, is the importance of preparing, remaining calm, and taking care of yourself and others. It is easy to feel overwhelmed or powerless when confronted with the uncertainties that come with a new disease like COVID-19, first discovered in China in December 2019 and now spreading rapidly across the globe. The good news, however, is we do know quite a bit already about this disease and are learning more every day. COVID-19 is a respiratory illness that can spread from person to person. Patients with the disease have mild to severe illness with symptoms of fever, cough, and shortness of breath. Many patients recover on their own while others require hospitalization and some die. There is currently no vaccine for this disease, so the best way to prevent infection is to limit your exposure to the virus that causes COVID-19. Some actions that we know help — and are easy to do — are the same simple, everyday preventive measures that prevent other respiratory illnesses like the flu and the common cold. • Wash your hands. We think of handwashing as an infection prevention tool that’s been around forever, but it was actually first pioneered by doctors in the mid-1800s. Today, it remains one of our simplest and most powerful defenses 12
against germs. Wash frequently with soap and warm water for 20 seconds, or use alcoholbased hand sanitizer if you don’t have soap and warm water. • Cover your coughs and sneezes with a tissue and throw away the tissue after use. If you don’t have a tissue, cough and sneeze into the inside of your elbow. • Try to avoid touching your face, mouth, nose and eyes, especially with unwashed hands. • Routinely clean frequently touched objects and surfaces, including toys, doorknobs, keyboards and phones with normal household cleaners. • Get a flu shot every year. Flu vaccine doesn’t protect against COVID-19, but keeping current with an annual flu shot and other routine vaccinations helps keep you and your family well. Ensuring that most Alaskans are vaccinated against the flu also helps protect our health care facilities from becoming overwhelmed as they respond to other health issues and emerging diseases like COVID-19. • Eat nutritious food, drink water, get enough sleep and physical exercise. • If you begin to feel ill, stay home, and call your health care provider. Here are some other key strategies that can help you prevent the spread of disease and prepare for public health emergencies: • If you’re sick and you need to see
ALASKA PULSE MONTHLY — April 2020 — AlaskaPulse.com
Whether preparing for a pandemic, an earthquake, wildfire or other disaster, Alaskans should have an emergency kit. Remember to include supplies like soap, hand sanitizer, and tissues. a health care provider, call ahead and make an appointment. This is especially important if you have a cough and fever. This will help the health care provider’s office take steps to keep other people from getting infected or exposed. • Whether preparing for a pandemic, an earthquake, wildfire or other disaster, Alaskans should have an emergency kit. Remember to include supplies like soap, hand sanitizer, and tissues. If you or a family member regularly take a prescription medication, talk to your health care provider and pharmacist about what is an appropriate amount to have in your emergency kit. Remember to include an appropriate amount of nonprescription drugs and other health supplies on hand, including fluids with electrolytes, cough and cold medicines, stomach remedies, pain relievers and vitamins. • For more information about emergency kits, please see this information from CDC — www.cdc.gov/cpr/prepareyourhealth/PersonalNeeds.htm — and this information from the Department
Coronavirus prevention There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19). The best way to prevent illness is to avoid being exposed to this virus.
Symptoms: For confirmed coronavirus cases, reported illnesses have ranged from mild symptoms to severe illness and death. Symptoms can include: • Fever • Cough • Shortness of breath • Headache
Prevention: • Avoid close contact with people who are sick. • Avoid touching your eyes, nose, and mouth.
Tribune News Service
of Homeland Security — www.ready. gov/pandemic • When preparing your family for the possibility of COVID-19 cases in Alaska, consider the following: 1. If you have children, begin planning for the possibility of school dismissals. If you can’t stay home with your children, could a neighbor or friend look after them? Ideally, children should be cared for in small groups. For more information visit the CDC website. 2. Talk with your employer about tele-working options and business continuity of operations plans 3. Get to know your neighbors and include their contact information in your plan. Public health officials may recommend that everyone in the household of an ill person stay home, not just the person who is sick. If this happens, can your neighbors shop for
you and leave items you might need on your doorstep? 4. Identify a room in your house to separate ill people from those who are healthy. Ideally, identify a bathroom that would only be used by those who are ill. 5. Especially if you live alone, talk to your friends and family about what you might need. If you do fall ill, keep in touch by phone with a friend or family member. • Stay informed. Follow updates from public health officials. • Do your part to fight fear, stigma and misinformation that can surface when people are anxious about a new disease and ensure you are getting and sharing verified information and doing your part to prepare your family and community for this new virus. Heidi Hedberg is the director of the Division of Public Health, Alaska Department of Health and Social Services.
• Stay home when you are sick. • Cover your cough or sneeze with a tissue, then throw the tissue in the trash. • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe. • Wash your hands often with soap and water for at least 20 seconds. • Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility). Source: CDC Graphic: Staff, TNS
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Using the land to fight diabetes Flora Deacon teaches Alaskans to cook with what nature gives By Kris Capps
Alaska Pulse Monthly
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lora Deacon has been cooking her entire life. Now, she teaches others how to cook for themselves using traditional foods to stay healthy and prevent the onset of diabetes. “I started believing that food is medicine,” she said. “As a Native person, we grew up with our traditional food. The store is outside your door.” 14
“You know what’s in your food,” she added. “You know the moose you harvested only ate plants from the area. The black bear only ate food from the same area.” In 2018, Flora began traveling to remote Alaska villages under the umbrella of the Bristol Bay Area Health Corp. in Dillingham. Her goal has always been to visit villages and teach her healthy style of cooking. “With teaching, you get to see students making life changes and becom-
ALASKA PULSE MONTHLY — April 2020 — AlaskaPulse.com
ing more interested in their food,” she said. “They start thinking about where their food comes from.”
Ingredients from the land
Flora brings everything she needs for the class — pots, pans, food. The community gets notified ahead of time, and sometimes villagers provide traditional food. But it’s not unusual for Flora to be outside picking many jars of berries to bring with her.
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Opposite page, on a recent trip to Dillingham, Flora Deacon helped Annie Andrew and John Wonhola learn healthy cooking. Above left, villagers learn to cook in a healthy way and then enjoy results of the class. Above, Flora became chef of the nutrition services department at the University of Alaska Fairbanks and designed her own interdisciplinary degree in rural nutrition. Photo courtesy Flora Deacon
“Anywhere from eight to 15 people show up, and they’re each set up at a station with a cutting board, knives and a recipe,” she said. “I go over the recipe with everyone before the cooking starts. I talk about why I chose that certain recipe and how important traditional food is.” The younger generation is accustomed to food that is highly seasoned, often with strong flavors, she said. The elders usually opt for a plain menu. Flora tries to accommodate both palates. “I make high bush cranberry ketchup, high-bush cranberry barbecue sauce,” Flora said. “Then I make my own taco seasoning.” She adapts every recipe, reducing the amount of sugar, salt and oil that gets used. Then she shows the class photos of ingredient labels on commercial products. “For the most part, the No. 1 ingredi-
ent in barbecue sauce is high fructose corn syrup,” she said. “After that, you get tomato paste and probably like 20 ingredients. The list is pretty long.” Her homemade barbecue sauce includes high bush cranberries, a bit of sugar, five or six different spices, and apple cider vinegar. She tries to make cooking as simple as possible, and the reactions are now predictable: “This is really good!” and “I’m really surprised.” Flora remembers a couple who took the class with their 7-year-old son in Pilot Point. They made meat loaf. When it was time to eat, the youngster ate that meat loaf without hesitation. “His mom pulled me to the side and whispered, ‘He never eats. He really likes the meat loaf because he knew what was going in it.’ “ Another villager took the class in Western Alaska and later ran into Flora
in Anchorage and told her, “Ever since you came, I only fix brown rice.” “After she said that, I wanted to jump up and down,” Flora said. Healthy eating can help prevent diabetes, Flora said. But getting people to try cooking in new ways is not always easy. “They’ve never really thought about cooking with the berries or going back to traditional food,” she said. “So we push both those things.” It can be daunting to change their way of cooking. People diagnosed with diabetes often have a hard time letting go of their routine diet. “It’s really scary when they’re told you can’t eat the way you’ve eaten the last 10 to 20 years,” she said. “So I’m there to hold their hand and say, ‘just try this.’” She starts with the essentials, teaching basic knife skills, like how to cut the vegetables.
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“It’s different from the way they’ve always cut them,” she said. “It just makes it safer, more efficient and makes better use of the vegetable.”
Always cooking
A
laska Pulse is a monthly magazine focusing on health in the Far North and distributed around Fairbanks and Anchorage. We’ll share stories from around the state about how people stay healthy. Learn from experts in different medical fields on ways to improve, or maybe just maintain your health. We’ll hear personal stories about people’s triumphs over different health adversities. Alaska Pulse is a community publication, so every issue is sure to hold a variety of different perspectives.
Contact editor Rod Boyce at editor@AlaskaPulse.com or 907-459-7585 to talk about it. Alaska Pulse is a publication of the Fairbanks Daily News-Miner. 200 North Cushman Street • Fairbanks AK, 99701
Flora lived in the remote village of Shageluk in Western Alaska until she was 9 years old, then moved 20 miles away to Grayling. She began high school at a Bureau of Indian Affairs school in Salem, Oregon. And that is where she discovered a whole new world of foods “It’s really scary when — along with other things. “I’d never seen a televithey’re told you sion before. I had never a car before,” she can’t eat the way you’ve driven said. “I was 13. They sent us from Grayling to Aniak eaten the last to Anchorage to Seattle, 10 to 20 years. So I’m then bused us from Seattle to Salem, Oregon. It was there to hold their hand like a five-hour drive.” To Flora, the campus and say, ‘just try this.’” with close to 900 students — Flora Deacon was overwhelming. For the first two weeks, she was homesick and cried every day. But she stuck it out, coming home every summer, then back to school every fall. “I never really went back to Grayling to live after that,” she said. She settled in Anchorage and now lives in Wasilla. It was when she was living in Dutch Harbor that her husband at the time saw an advertisement for the New England Culinary Institute in Vermont. She applied but was rejected because she had no professional experience. So she went to work as part-time baker at the Grand Aleutian Hotel in Dutch Harbor. The next time she applied to the New England Culinary Institute, she was accepted. That’s also where she met Laura Cole, owner/chef of 229 Parks Restaurant at Denali Park. Flora worked at 229 Parks Restaurant for several summers. Flora worked part of her internship at the Point Hope Senior Center, where her family lived. She also worked at the Kantishna Roadhouse during a busy summer season. “Ninety-four days straight, we became really close as a kitchen crew because we saw each other every day,” she said.
Serving up a healthy life
From that point on, she worked primarily to save money so she could return to culinary school. Her life became a series of seasonal jobs until she stumbled upon the nutrition services department at the University of Alaska Fairbanks. The program was based on Alaska food and nutrition for Alaska Natives. She became its chef. Every week, she created a daily menu that provided healthy food — less fat, salt and sugar. It was a menu filed with vegetables, grains and traditional foods. She received a culinary certificate from that program, which
opened the door to designing her own interdisciplinary degree in rural nutrition. “I never knew you could do such a thing,” she said. Plugging away at this new pursuit, she helped created a wellness calendar for the Alaska Native Tribal Health Consortium. She began traveling to villages to teach healthy cooking. She said she is living her dream. “I don’t feel like I’m working when I’m out there,” she said. “It just feels like I’m sort of on vacation, meeting new people every day.” It’s been a long road, but well worth the journey. “Time and time again, I would tell people what I want to do,” Flora said. She is now 61 years old and continues to get offers to work as a cook. “I know I can cook,” she said. “That’s not what I want to do.” As she tells students in the villages who show up for her culinary classes: “I don’t cook. You will.” Contact Alaska Pulse Monthly staff writer Kris Capps at 459-7546. Email her at kcapps@AlaskaPulse.com
Flora Deacon seasons salmon while on a visit to a village.
Mountain View Integrative is pleased to welcome Dr. Suzette Mailloux! Dr. Mailloux is accepting established and new patients of all ages! Naturopathic Primary Care Mental/Emotional Health – Depression, Anxiety, ADD Hormone Balancing • Digestive Health LENS Neurofeedback
mvintegrative.com (907)371-1777 AlaskaPulse.com — April 2020 — ALASKA PULSE MONTHLY
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Above, before and after of veteran Lisa Scroggs after losing 33 pounds using the VA’s MOVE program. At right, Lourdes Rivera lost 30 pounds.
Military veterans get on the MOVE to weight loss By Katie Yearley
Alaska Veterans Affairs Healthcare System
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ourdes Rivera smiles brightly as she walks into the office, excited for the interview. She has come to talk about VA Healthcare’s MOVE program, a weight management program that has helped her significantly over the past year. “I’ve lost 30 pounds, my next goal… is to go down 35 more pounds, which would put me at my Air Force weight,” she says. Going through the program, Rivera says accountability was the most important factor for her weight loss in the MOVE program. She joined the program with a friend who is a veteran in February 2019. They kept each other accountable as they made changes to their diet and exercise. After a while, the changes became evident in her health care visits. Rivera shows me a copy of her weight chart during the program. A strong dip appears as the months go on, showcasing her weight loss. “The provider started noticing the charts and was like, ‘What are you doing?’” she says. The MOVE program as a weight management program is individualized for each participant so results can be achieved at a rate that is healthy and attainable. The program encourages veterans to set realistic goals for themselves and to create plans to reach them. Deedee Brandeberry, dietitian, says the MOVE program relies on veterans planning their own health goals and how 18
ALASKA PULSE MONTHLY — April 2020 — AlaskaPulse.com
they can achieve them. She agrees that it’s the accountability that works so well with weight loss. The MOVE program can be approached in several ways, including a group setting and telephone lifestyle coaching. Veterans can even do a one-onone in person with a provider or through secure messaging. Another veteran, Lisa Scroggs, loves the MOVE program and what it has helped her achieve. When she started the program, she had no idea she was in danger of becoming diabetic because of her weight. Through the MOVE program, she was able to go from 188 pounds to 150 pounds. As we talk, Scroggs shows the worn notebook in which she has tracked her exercise and nutrition as well as the phone apps she uses with her Fitbit. Despite a back surgery, she stays active. She makes sure to find exercise time when she travels, using elliptical machines and walking 3 to 4 miles in a day to stay healthy. “It’s good, it’s great, but you’ve got to stay consistent with it,” she says. As the lead person on the MOVE program, Brandeberry says the best way to check out the program’s options is by coming to the free MOVE intro class on Wednesdays from 3 p.m. to 4 p.m. in Room 1A-221 at Anchorage’s VA Healthcare Clinic. If you have questions about the MOVE program, you can call 907-257-4720 or find more information at www.move. va.gov. Katie Yearley is a public affairs specialist at the Alaska Veterans Affairs Healthcare System office in Anchorage.
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HEALTH SENSE
Sobriety without stigma By Tiffany Hall
Recover Alaska
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stigma exists that sobriety is boring or antisocial, but that couldn’t be further from the truth. A growing number of Alaskans are deciding to live a sober lifestyle, which ranges from never drinking to intentionally drinking less, for reasons that range from choosing a healthier routine to spending less on extras. People are opting for fun and creative alcohol-free cocktails when out with friends and choosing to participate in alternative activities such as getting outdoors or catching up over a cup of coffee over the standard bar scene. Last month, in March, sobriety took center stage as Alaskans worked to break the stigma surrounding sobriety during Alaska’s Sobriety Awareness Month. Bars and restaurants across the state participated by featuring delicious alcohol-free beverages on menus. Sobriety Awareness Month leads nicely into Alcohol Awareness Month in April. While sobriety awareness is really about breaking the stigma around choosing not to drink or choosing to drink less, this month is about Alaskans reevaluating their relationships with alcohol. Recover Alaska, a nonprofit, helps people do this by providing a free online screening tool and listing many resources on their website. Results are confidential. Healthy living and intentional choices continue to drive a sober-curious movement across the country year-round. Nearly 40% of Alaska adults report not drinking, while thousands more are actively reducing their alcohol use through dry weekends and months or just skipping a drink now and then, according to the Alaska Department of Health and Social Services. While people increasingly think more about their alcohol use, so do bars and restaurants. Many are branching off from only having dusty bottles of O’Douls on hand to creating hand-crafted cocktails that are not only tasty but are completely buzz-free. For example, in Fairbanks, the Pump House has a mocktail menu with zero-proof cocktails they’re happy to shake up for you. First on the menu is On the Beach, a bubbly and tart drink made with fresh raspberries, orange and lime juices and topped with Sprite. The Reviver is on the fresher side, made
Non-alcohol mocktails are a popular option at many Alaska bars and restaurants.
with pineapple juice, ginger simple syrup and fresh mint. A third option for those looking for something tropical is the Cranpina which includes orange, pineapple, cranberry and grapefruit juices with coconut syrup. No alcohol-free drinks on the menu? Bartenders say when in doubt, just ask! Many are prepared to make an alcohol-free version of popular cocktails or have their own go-to drink that may not be on the menu. Many people who choose not to drink, or drink less, report experiencing better moods, sleeping better, better skin and many other benefits. So don’t let the misconceptions of the past surrounding sobriety deter you from ordering a buzz-free Old Fashioned on the rocks! Tiffany Hall is executive director of Recover Alaska, a multi-sector action group pursuing a solutions-based approach to reduce excessive alcohol use and harms across the state. Its vision is for Alaskans to live free from the consequences of alcohol misuse and be empowered to achieve their full potential.
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AlaskaPulse.com — April 2020 — ALASKA PULSE MONTHLY
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Krystopher Byfuglien graduated from Tri-Valley School in 2014. He is a paramedic in Texas, working on a master’s degree in biomedical science and planning on applying to medical school to become a doctor. Photo courtesy Tina Graham
Small school, big impact Healy sprouted many students who entered health professions By Kris Capps
Alaska Pulse Monthly
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hen Krystopher Byfuglien was a freshman at TriValley School in Healy, he thought he would probably pursue law as a career. Then he took an emergency trauma technician training intensive taught by the Tri-Valley Volunteer Fire Department. “I quickly found that medicine was much more rewarding,” he said. Today, he works as a paramedic in Texas, is about to earn a master’s degree in biomedical science and then intends to apply to medical school. He remembers exactly when he made that career choice. Shortly after completing the ETT course, he answered a
911 call that required him to do CPR in a real life situation for the first time. “I will never forget Rusty (Fire Chief Rusty Lasell) looking at me and telling me the only thing keeping the patient alive was me compressing the bag valve mask,” Byfuglien said. “By the time we reached Clear airstrip, I had worn a hole through my glove. “After that call, I knew my future was in medicine.” Those ETT classes generated a long list of students who went on to become physician assistants, emergency medical technicians, nurses, and paramedics. Two graduates became medical doctors. Others went on to positions at Fairbanks Memorial Hospital, Mary C. Demientieff Health Clinic in Nenana, Siddall Medical Clinic at Clear Air
Force Station, Canyon Clinic in the Denali area, Chief Andrew Isaac Health Center and more. And while they were still in high school, those new ETT graduates revitalized the Tri-Valley Volunteer Fire Department, bringing in new energy, fresh enthusiasm and many more volunteers.
Rob Graham: Helped get it started
Rob Graham helped implement that ETT collaboration with the school, just before he became the fire chief himself in 2014. He retired from that position last year to pursue a ministry in another
“Medics have an incredibly dynamic mission that is like no other. We are trained to do everything from flying on unarmed UH-60 Black Hawk helicopter into the teeth of battle to save the lives of wounded in war, to performing technical hoist rescues on injured hikers and hunters from the top of mountains here in Alaska.” — Mikana Halloran
Mikana Halloran graduated from Tri-Valley School in 2006. She is a full time critical care flight paramedic with the Alaska Army Guard. Photo courtesy Mikana Halloran
Rob Graham during a recent wildfire. Photo courtesy Rob Graham
Mikana Halloran also participates in medevacs throughout Alaska. Photo
Shelby Townsend is an EMT3, who started out learning ETT techniques in a high school class. She hopes to eventually become a K9 police officer. Here she is with Trooper, the dog she trains. Photo courtesy Shelby
courtesy Mikana Halloran
state. He’s a 1995 graduate of TriValley School. He started volunteering at the fire hall in 2004 because he saw a desperate need for volunteers. The clinic was not accepting some emergency calls, he said, so every call took a guaranteed five or six hours, driving the patient to Fairbanks. One day, he answered an emergency medical call and transported the victim to medical care as fast as possible. “I felt really helpless and told myself I never want to be in that position again,” he said. “So I took an EMT class.” When he responded to those calls, knowing what he was doing, he realized he cared more about people than their belongings. So he focused on emergency medicine instead of firefighting. He became the department’s EMS director. “We are showing up on somebody’s worst day of their life,” he said. He treats each person the way he would
want someone to treat his own mother or grandparents. “We always say we wish no harm on anyone, but if it does happen, we are glad we are on shift,” he added.
Mikana Halloran: Flight paramedic
Townsend
Some graduates chose the medical profession for personal reasons. Mikana Halloran graduated from TriValley School in 2006. She is a full time Army critical care flight paramedic in the Army National Guard, stationed in Anchorage. She was inspired to choose this career by her patriotic family and by current events, particularly 9/11. “I was an eighth grader in New York state when I watched in real time as 2,996 souls were lost to a violent act of terrorism,” she said. “The incredible acts of selfless service, bravery, and heroism of service members and first responders on that day and in the many
years following is what inspired me to join the medical field and become part of the DUSTOFF legacy.” DUSTOFF refers to the Army call sign for evacuating casualties from a combat zone. It’s an acronym that means Dedicated Unhesitating Service To Our Fighting Forces. “Medics have an incredibly dynamic mission that is like no other,” she said. “We are trained to do everything from flying on unarmed UH-60 Black Hawk helicopter (MEDEVAC) into the teeth of battle to save the lives of wounded in war, to performing technical hoist rescues on injured hikers and hunters from the top of mountains here in Alaska.” She has deployed to the Middle East, Germany and Mongolia.
“Being a firefighter/EMT has been the most rewarding job I have ever done. Having the knowledge and training to help people in their time of need is the reason I’m here.” — Shelby Townsend
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in North Carolina when another passenger needed medical assistance on my flight,” she said. “Thanks to my training, I was able to help a fellow passenger.”
Mylinda Cizmowski: Physician assistant
Graduates of the first ETT collaboration in 2012 between the fire department and the school ended up saving the volunteer fire department. Here they proudly pose with then EMS director Rob Graham. Three of them are still in careers involving emergency medicine. Photo courtesy Tri-Valley Volunteer Fire
Department
Shelby Townsend: EMT
Mylinda Cizmowski always wanted to work as a health care provider. Photo
courtesy Mylinda Cizmowski
Shelby Townsend signed up for that ETT class at Tri-Valley School when she was a junior, and she continued emergency medical training after graduating high school in 2013. “Being a firefighter/EMT has been the most rewarding job I have ever done,” she said. “Having the knowledge and training to help people in their time of need is the reason I’m here.” She became a certified ETT in 2012 and worked her way up to EMT3, Firefighter 2, and became a captain at TriValley Volunteer Fire Department. She’s in Fairbanks now, in between jobs, but hoping to continue work in the emergency medical/firefighting field and also to eventually make the switch to law enforcement and become a K9 police officer. The training comes in handy when you least expect it, she said. “I was flying to an EMS conference
As long as she can remember, Mylinda Cizmowski wanted to become a health care provider. Those goals changed from wanting to work as a doctor, then as a nurse, to eventually becoming a physician assistant. “I can’t remember the exact reason that I chose this profession,” the 2011 graduate of Tri-Valley School said.. “But it’s been a mixture of appreciating and respecting the work of John Winklemann in our small town of Healy, saving many people the highway miles and taking care of a lot of challenging cases right in my hometown.” Dr. John Winklemann was a longtime physician in the Healy community, still known affectionately as Dr. John. Cizmowski has always appreciated healthy living. Her grandfather died at the age of 51 of a heart attack. “Still today, 22 years later, I think of him almost daily,” she said. “No one should die in their 50s of a heart attack, no one in their 20s should lose their parents to a mostly preventable disease.” Today, her passion is preventive medicine. She loves teaching people about the healthy foods to put in their bodies, the daily exercise that protects their joints, muscles, heart, lungs, the routine screenings that find early disease and the vaccines that prevent disease. She is also passionate about mental health, screening for it, and always holding open and honest discussions about it. “One of my classmates in PA school took his own life during our first year, and shortly after, two others,” she said. “Three people in a matter of six months.” That is where she learned that no one knows the battles individuals are going through. “I am so fortunate and blessed to be in this role where I can have raw and
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honest conversations with patients and encourage them to take action in their own health,” she said. She works at the Coalition Health Center in Fairbanks.
Cora Braun: Physical therapist
Cora Braun graduated from Tri-Valley School in 2008 and is now a physical therapist, about to begin practice in the Denali area. During high school, she was an active participant in the after-school program Motion Sensors Dance Troupe, and that encouraged her interest in the human body and medical fields. After her mother received physical therapy from local Denali therapist Patty Sanders, her mother suggested she consider physical therapy as a career. “At first, I thought she just wanted some free therapy, but the more I thought about it, the more I thought it could be a cool fit,” she said. “So I decided to major in kinesiology and pre-physical therapy at Western Washington University, and the more class-
Cora Braun grew up on the outskirts of Healy and is now a physical therapist who will soon join Patty Sanders’ practice in the Denali area. Photo courtesy Tim Melanick
To learn more about advertising opportunities in the next issue of Alaska Pulse, please contact:
In the Fairbanks/Interior area, call Nita Hamlin at (907) 459-7560 or email national@AlaskaPulse.com
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Alaska Pulse is a publication of The Fairbanks Daily News-Miner. 200 North Cushman Street • Fairbanks AK, 99701
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ALASKA PULSE MONTHLY — April 2020 — AlaskaPulse.com
Former fire chief Rob Graham (left) was instrumental in starting the ETT collaboration between the Tri-Valley Volunteer Fire Department and Tri-Valley School. Now, current fire chief Brad Randall (right) spearheads the program. Photo courtesy Tri-Valley
Volunteer Fire Department
es I took, the more I liked it.”
You never know
And then there’s the story about high schooler Ben Brown, who recently got certified as an ETT at a class in his own neighborhood, at the McKinley Volunteer Fire Department. The first 911 call he responded to was for his own little sister, who had fainted. Byfuglien, the paramedic in Texas, had something similar happen on one of his first days of ETT training. In
the school hallway, a teacher collapsed, mid-conversation, reaching out to him as she fell to the floor. The lessons learned along this journey to a medical career are invaluable, he said. “I have watched countless medical professionals advocate fearlessly and relentlessly for their patients,” he said. “This has taught me the singular lesson that a health care providers’ job is first and foremost to care for their patient, and I have tried my best to emulate
their valiant efforts.” “Once I am a doctor,” he added. “I intend on serving rural and underserved communities like Healy. Working as an ETT and a volunteer with Tri-Valley Volunteer Fire Department showed me how rewarding it is to serve and be relied upon by your neighbors and what a positive impact you can have on your community when you are willing to serve.” Contact Alaska Pulse Monthly staff writer Kris Capps at 459-7546. Email her at kcapps@AlaskaPulse.com
AlaskaPulse.com — April 2020 — ALASKA PULSE MONTHLY
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HEALTH SENSE
What you need to know about depression – serious or not? By Dr. Lee Ann Gee
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epression affects approximately 10% of the U.S. population. Feeling sad or upset is a normal response to situations of loss, stress, illness, or other emotional occurrences. Major depression, however, is different and will last for long periods of time, interfering with a person’s health and daily life. If you or someone you know has been suffering from symptoms of depression, there are a few things that are important to know.
Recognizing depression
The signs and symptoms of depression can be variable. People who have been suffering from the disorder may not even realize that they have it. Intense feelings of sadness, hopelessness, worthlessness, or emptiness are the most well-known characteristics of depression. You might also experience a loss of enjoyment for activities or things that used to make you happy as well as a lack of motivation for performing daily tasks, increased irritability or anger outbursts, or trouble becoming aroused in an intimate way. It may be difficult to concentrate, remember things, or make decisions. Thoughts of self-harm, death, or suicide are also signs of severe depression. Your mental and physical health are very closely tied. During a depressive episode, there are physical symptoms you may notice such as low energy, sleeping too much or too little, appetite changes, indigestion and other digestive 26
problems, and weight loss or gain. Odd pains such as headaches, stomachaches, or backaches are also possible. You may find yourself crying nonstop, exhibiting purposeless physical actions such as handwringing or pacing, or slowing your speech and movements.
Depression is a real illness
One of the most important things to understand about depression is that it is a real disease with physiological connections. While the most obvious symptoms may be emotional, a major depressive disorder is not a passing emotional state. You can’t expect someone with depression to “snap out of it,” “be happy,” or “get over it.” Depression is essentially caused by an imbalance in brain chemistry. Neurons (brain cells) use several complex methods for communicating between each other and along nerves. One mechanism involves sending specific chemicals, called neurotransmitters, as messengers. The main neurotransmitters in emotional regulation are serotonin, norepinephrine, and dopamine. Though these have many functions, they are involved in controlling feelings of happiness,
ALASKA PULSE MONTHLY — April 2020 — AlaskaPulse.com
reward, pleasure, appetite, and energy. Changes in the balance or composition of these neurotransmitters can lead to conditions such as depression. What often happens in depression is too little serotonin is produced, or it is reabsorbed too fast. Some scientists now think this may be related to chronic low levels of inflammation in the brain or central nervous system.
Depression is treatable
There are many different treatment options available for managing depression, and the majority of patients who receive proper treatment will be able to overcome this condition. However, every person and every case is unique. This means that patients need to work closely with health care providers to develop treatment strategies that work. The first course of action is to make an appointment with your doctor. He or she may perform a physical and/or psychiatric evaluation to determine factors contributing to your illness. The most common and well-known treatments for depression are antidepressant medication and psychotherapy. For mild depression, psychotherapy or “talk therapy” is often adequate. This involves speaking with a licensed therapist, either alone or with family members or in a group. For moderate or severe depression, psychotherapy is best alongside antidepressant medication. Antidepressant medications work to restore a normal balance to the neurotransmitters in your brain, enabling normal emotional control and response.
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They are not stimulations and are not addictive. Research is continually uncovering information about the causes of depression. With it, newer treatments are being developed. One example is transcranial magnetic stimulation, or TMS, a non-invasive technique that sends magnetic pulses to stimulate specific regions of the brain. This therapy has been shown to be effective even for patients who are resistant to antidepressant medication.
Self-care and coping
There are a few things you can do on your own to help ease the symptoms of depression. Most have to do with taking care of your body. Good physical health is important for mental wellbeing. Regular exercise is especially helpful. Not only does exercise improve your physical health, it also boosts the production of endorphins, which elevate your mood. Eating a healthy diet with plenty of nutrients and low amounts of inflammatory foods is also good for your brain. Maintaining connections with friends
and family is important, too. Additionally, make sure you get plenty of sleep at night.
Emergency help is available
If you are ever thinking about committing suicide or harming yourself or others, it is critical that you stop and seek help immediately. Even if you don’t have time to make an appointment with a doctor, there are several ways to receive help at any time of day, any day of the year. Calling 911 is always an option, and there are several mental health hotlines available. You can also walk in to a hospital emergency room. • National Suicide Prevention Hotline: 1-800-273-TALK (8255) • Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline: 1-800-662-HELP (4357). Dr. Lee Ann Gee is a licensed and board certified general practice psychiatrist based at Achieve Medical/TMS Center of Alaska in Anchorage. She also practices in Fairbanks. For more information please visit info@tmscenterofalaska.com or call 833-872-5867.
AlaskaPulse.com — April 2020 — ALASKA PULSE MONTHLY
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Something to smile about An Alaska dental program reaches far-flung patients By Sean McDermott
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anette Ulak recalls her time working as a dental assistant in private practice and in the Air Force, when she was limited to helping dentists set up, or assisting during procedures. Today, however, she’s the one performing essential dental services, doing so for three Alaska Native communities. “The table has turned,” she said. Ulak is a 2018 graduate of the Alaska Janette Ulak Dental Therapist Education Program and is now a dental health aide therapist with the Yukon-Kuskokwim Health Corp. based in Hooper Bay. “I wanted to be here, helping my people.” The program that Ulak attended was designed to help tribal health programs and Alaska Native communities cope with a severe shortage of dentists and higher rates than national
Achieve
a more active pain-free lifestyle.
Education is an integral part of dental health aide therapist’s work. Stephanie Woods gives an oral health lesson to students at the local school. Courtesy of Stephanie Woods
averages of dental caries, or tooth decay. Some rural communities only had dentists visit for as few as several weeks a year. Tom Bornstein, who served as dental director for the Southeast Alaska Regional Health Consortium for 30 years, recalled seeing “little kids who by the time they were 3 or 4 had rampant caries.” To help combat these problems, the Alaska Native Tribal Health Consortium in 2003 sent six students to study dental therapy at Otago University in Dunedin, New Zealand. While dental therapy is still a relatively new concept in the United States, New Zealand started using dental nurses in elementary schools in 1921 after dental problems prevented military recruits from serving during World War I. Now, more than 50 countries have similar dental therapy programs, including Canada and Australia.
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The idea of having dental therapists practicing year-round in rural communities also represented a shift in focus toward preventive care. Bornstein, who played a pivotal role in initiating the dental therapy program, saw the idea as something that “could drastically impact the health of the folks that we were trying to serve,” he said. Nevertheless, the Alaska program met with some initial resistance from traditional dentistry, including a court case, led by The Alaska Society of Dentistry and the American Dental Association in 2006, which attempted to stop its graduates from practicing in the state. Stephanie Woods, a graduate of the first cohort in New Zealand who was listed in the lawsuit, remembered being “scrutinized quite a bit when we first started practicing.” But, she said, “We just did our jobs that we were trained to do.” The case settled out of court, and in 2007, Alaska Dental Therapy Education Program began to offer classes in
Above, 2019 Alaska Dental Therapy Education Program graduates Asiah Gonzalez and Kari Douglas practiced removing dental plaque in a training simulation. Top right, first year dental health aide therapist students in 2020 in the ADTEP clinic in Anchorage. Photos courtesy of ADTEP. Bottom right, Stephanie Woods gives an oral health lesson to students at the local school. Courtesy of Stephanie Woods
Anchorage and hands-on training in Bethel. Since then, the program has been widely lauded for its well-documented, positive impacts — a 2017 study of the Yukon-Kuskokwim region from the University of Washington found increased preventive care use and fewer tooth extractions, and a recent initiative near Bethel helped decrease tooth decay and cavities in young schoolchildren by more than 50%. In addition to helping Alaska communities, the dental therapist program has paved the way for therapists to work in a growing number of states in the Lower 48. Woods is now a dental health aide therapist working in Shungnak, in the Northwest Arctic Borough. She said there is much more of an understanding today that “we are just part of the team.” She has the support of regional supervising dentists and feels empowered to provide important dental care for her community. The first four students who completed their dental therapy studies in New Zealand are all still serving communities in Alaska. “Having this educational program here in Alaska has allowed people to pursue their dreams, then go back and
help their communities,” said Mary Williard, director of the dental therapist program. The program continues to grow. In the summer of 2019, the program had its largest graduating class ever, with 10 new dental therapists joining communities in Alaska and in the Lower 48. Program graduates now provide preventative care and education, teeth cleaning, fillings, X-rays, extractions, and more for over 40,000 residents in rural communities across the state. “We’re educating [students] to do work well. And they’re staying around and providing that care for a long time,” Williard said.
‘Love what I am doing’
Woods, the dental therapist in Shungnak, said there’s still a need for more dental aides therapists to serve rural communities but that the program has “made a huge, huge dent in getting people treatment and raising people’s awareness.” She and her dental assistant go to the school in Shungnak every day as part of a dental health program. The reward is having kids tell her they’re brushing their teeth and flossing now and, Woods said, to “hopefully make a positive
change in their life, in their health.” Educating parents and children about preventative care is also an important part of the job for Ulak, the dental therapist with the Yukon-Kuskokwim Health Corp. As a testament to her strong ties to her community, she explained, “patients want to come back and see me. People come to me for advice even when I am not at work.” “I absolutely love what I am doing,” she said. “I never ever thought I would be in this position.” Sean McDermott is a freelance writer in Fairbanks. Comments? Contact editor@AlaskaPulse.com
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HEALTH SENSE
VA changes ambulance travel reimbursement for some Alaska veterans By Dr. Timothy Ballard
Alaska VA Healthcare System
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ver the last several years, the Alaska VA Healthcare System has been authorizing and reimbursing ambulance transportation for all Alaska veterans regardless of their beneficiary travel eligibility in accordance with 38 USC III and 38 CFR part 70. An audit in 2019 revealed that this practice was in error. Therefore, effective immediately, we will no longer be authorized to approve or reimburse ground or air ambulance transportation for Alaska veterans who are not eligible for travel benefits in accordance to these laws. I apologize for this change. However, during my most recent town halls, I tried to explain that this had the potential of occurring soon. However, I did not realize that the VA Central Office decision would be finalized so quickly. As one of the least-resourced states for health care services, air ambulance transportation is an essential facet of emergency care coordination for many Alaskans. It is incredibly expensive. Therefore, I strongly recommend that all Alaska veterans — particularly those who do not qualify for travel benefits — immediately research their options for ground ambulance and/or air ambulance coverage to protect themselves from a potential financial catastrophe. If you have any questions about your eligibility for VA travel benefits, please call the beneficiary travel office at 907257-4738. To ensure widespread awareness of 30
this critical change in our operations, my staff will also send out emails and post this information via social media. In addition, we will also be contacting all Alaska hospitals and emergency departments to notify them of this critical update. If you are travel eligible, these are the items for which the VA will reimburse you:
Airfare and ferries
• Will reimburse up to the maximum government rate allowed for the most economical or medically required common carrier. • All common carrier methods of travel must be preapproved by the VA BENEtravel department.
Hotels
• Hotels must be preapproved by the VA BENEtravel department and are only reimbursed at up to 50% of the government employee rate. • If the veteran is inpatient, hotel is not reimbursable regardless of nonmedical attendant being present.
Taxi, UBER and Lyft
• Will reimburse if a date, start-
ALASKA PULSE MONTHLY — April 2020 — AlaskaPulse.com
ing location and ending location are annotated. Only reimbursable travel is between airports, hotels and appointments. No stops in between will be reimbursed. • The VA will not reimburse for extra trips, for example to meal locations, or trips from appointments to the hotel if you are flying out the same day • Will not reimburse for rental cars, fuel or tips of any kind. • Must be preapproved by BENEtravel department.
Meals
• Will reimburse up to the local per diem rate for the city you are scheduled for a medical appointment in. Each city has a different per diem rate, please contact BENEtravel for local per diem rates. Reimbursed at up to 50% of the government employee rate. • Receipts must be itemized, if receipts are not itemized there will be no reimbursement for that amount. All receipts must have a date legible for reimbursement. • Will only reimburse for food items; no tobacco, alcohol or medications • Will not reimburse for tips. Will reimburse for taxes and surcharges. • Must be preapproved by BENEtravel department.
Parking
• Can reimburse for parking fees associated with preapproved common carrier (flight) fees. Dr. Timothy Ballard is director of the Alaska VA Healthcare System.
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Nurse of the Year honoree helps those with HIV By Aliza Sherman
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he child of a Lutheran minister and a retired nurse, Thor Brendtro really wanted to do something meaningful from a young age and wanted to make a difference in people’s lives. His parents taught him that you should want to try to make this world a better place. Today, the 2019 Nurse of the Year awardee provides intensive medical case management for about 140 patients — referred to as customer owners at Southcentral Foundation – living with human immunodeficiency virus, or HIV. “It’s really hard to get some of the customer owners into care. I make sure their needs are met — safety, support, housing — and work with them on getting HIV medications onboard as soon as possible.” Brendtro explains that Southcentral Foundation takes a unique approach to health care, a “relationship-based approach” to HIV. Working as a case manager, his office is located in a primary care setting so he can easily see patients as they come in to see their primary care providers. “They call on me to come in if there are any concerns, and I consult with providers, making sure there are appropriate labs, health screenings, immunizations,” says Brendtro. “It really comes down to relationships with patients and providers. I leave messages about medical health records and see what’s going on if they haven’t been seen in a while and are overdue to follow up or not picking up their HIV meds. I leave messages and alerts in their health records to re-engage.” Twice a week, Brendtro is in clinic half the day seeing patients with their providers. The majority of his time is spent on the phone or with patients who drop into his office. Patients have access to his work cellphone and can contact him via text, and he calls them right back. Says Brendtro: “So many issues are related to stress and what’s going on in their lives.” Brendtro is the person patients can talk with to coordinate appointments and receive guidance. He encourages them to stay on their meds and helps coordinate follow-up appointments. He also checks up on the patients he knows are newly engaged in care to make sure they’re doing OK. If they need help with housing or food, he refers them to nonprofit organizations that can help, typically local AIDS organizations like Alaskan Aids Assistance Association. He even helps patients with their paperwork. To assist homeless patients, Brendtro spends time at Beans Cafe and Brother Francis Shelter where Anchorage’s homeless population gathers and receives services. He also meets with patients at the primary care clinic within Brother Francis that Southcentral Foundation co-manages with Providence Hospital to provide support.
“So many are lost to follow-up and lost to care. If they end up in the psychiatric ward, for example, public health will let us know they have a patient there in their care, and I make sure they are on the right meds and that their lab work is done,” Brendtro said. He also works with the Department of Corrections to access patients. Typically, Brendtro sees HIV patients every three months if they are having some challenges, or if not, every six months for follow-ups, labs, even dental referrals and optometry as HIV patients tend to have issues with their eyes and have the potential for getting oral infections. Brendtro says he is behind a desk phone a lot with a headset on at his computer, seeing who is due for follow-up, what kind of appointments they need, which specialists they are seeing and tests they’re undergoing. He says Southcentral Foundation has a large number of specialties under one roof, including Traditional Healing and Integrative Behavioral Health Counselors. Brendtro says he looks forward to going to work. “I know there are patients out there that I can have an influence on for the better. Ultimately, there are choices and lots of opportunities.” Brendtro is one caring person in patients’ lives who guides the way. The March of Dimes Nurse of the Year awards honor “extraordinary nurses” in local communities who “go above and beyond to deliver compassionate care.” Brendtro was one of several recipients in different categories in 2019. You can nominate a nurse when events are announced at nurseoftheyear.marchofdimes.org. Southcentral Foundation provides health and wellness services for Alaska Natives and American Indians in the Anchorage area, the Matanuska-Susitna Borough and nearby villages. It also supports residents of 55 rural villages in an area stretching 107,400 square miles across Southcentral Alaska, from the Canada border to the Aleutian Chain and Pribilof Islands.
AlaskaPulse.com — April 2020 — ALASKA PULSE MONTHLY
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t S a s s b
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Asha’s story
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Singer’s resilience pays off after devastating accidents derail career By Aliza Sherman
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n accident can change the course of one’s life. Asha Ashley Smith twice felt the impact of accidents, and her entire life changed. If you followed Asha, a dance instructor and country music singer/songwriter who spent a number of years living in Alaska, you would think she was living in a Lifetime television movie. 32
Her life from childhood through most of her adult years is vastly different from her life today at age 56. Asha’s story is one of resilience and healing through persistence, faith and finding a new way to live despite injury and illness.
Difficult early years
Before moving to Alaska the first of several times, Asha grew up on the Washington coast with an abusive father and a prescrip-
ALASKA PULSE MONTHLY — April 2020 — AlaskaPulse.com
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Top, a promo for Asha Ashley Smith’s first record, before accidents left her with serious health problems. Bottom, Asha four hours before trying to record her songs in Nashville Studio recently. She suffered asthma attacks on the plane and two severe ones in the motel room and needed breathing machines and emergency inhalers. Courtesy of Asha Ashley Smith
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From left, Asha, then about 12, hugs her younger siblings. 2. An outing in Alaska. 3. Asha holds her son and her sister’s young children. 4. Promo photo. Asha had a promising singing and dance career until another accident in 2000. Photos
courtesy of Asha Ashley Smith
tion drug-addicted, alcoholic mother. She was put into her first group home at 9 years old. Typical of the foster care system, reunification was a priority, and she was returned to her parents only to be removed again when she was 11. “At about 13, I became a ward of the court and became homeless when I was about 17 or 18,” Asha tries to recall, her memory foggy. She tried to be a parent to her two younger siblings while her mother was barely able to function through addiction but ended up responding to an ad for a job in Seattle thinking she could make it on her own. The ad for dancers wasn’t the kind of dancing she imagined. She took the next job she could find and pieced together barely enough money to put a roof over her head and send some back home to her mother and siblings. Around 1984 she saw an ad for a job in Alaska and took a chance. She headed north, ending up in Valdez and working that summer for Peter Pan Seafoods. After the season ended, she wound up in Anchorage and soon flew her sister up to live with her. While in Anchorage, she began dating a man she met at her apartment complex and soon found out she was pregnant. “Because of the condition of abuse I endured, everything I had been through, I was told I would never have children, but I was with child, and it was an absolute shock to my system,” Asha says. Around the same time, she realized the relationship was not working out, so she returned to Washington state to help her mother. Not only was she alone and pregnant but also trying to care for her mother and her siblings. She turned
to religion for support. “I didn’t have the support system of any family or anything,” Asha said. “Even when you’re getting a little older, struggling, wishing you could have one person you could rely on, I didn’t really have that. I really had no structure … I finally said ‘I need help’ and called upon a higher power to help me.” Asha found the support, stability and consistency she was seeking in the Church of Jesus Christ of Latter-day Saints and was baptized into the church when her son was around 5 years old. In 1991, Asha met her first husband, a blue-collar worker, and the couple welcomed a daughter in 1993.
Asha and her husband, Sterling.
Living with hidden damage
While still in Washington, Asha was in a vehicle accident in which another car ran a stop sign at 50 mph and struck hers. Asha, who was driving, leaned over and put arm in front of her mother, who was in the front passenger seat, to protect her from the impact. Both of her children were in the back seat. The other car slammed into hers on the driver’s side. Her mother, son and daughter all
came away with minor injuries. Asha, however, suffered damage to several of the vertebrae in her neck, although the extent of the damage was not clear at the time. She spent the next few years trying to manage the near-constant pain. In 1996, she and her then-husband moved back to Alaska. Her husband took a job on the North Slope, and the family bought a home in Wasilla. They would move away from and back to Alaska several more times, including living and working in Glennallen for a spell. “I always wanted to stay in Alaska. I
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“I always wanted to stay in Alaska. I always considered Alaska my home. It gets in your blood. You can’t ever get it out. Just the way it is. I’ve always felt like I was an Alaskan.” — singing. She won contest after contest and began performing at rodeos, casinos, fairs and clubs.
A frightening turn
Asha in front of the Grand Ole Opry during her 2019 trip to Nashville to record her new songs.
always considered Alaska my home. It gets in your blood. You can’t ever get it out. Just the way it is. I’ve always felt like I was an Alaskan,” says Asha, who currently lives in Idaho. Eventually, Asha and her family moved away for her husband’s job, buying a house in South Dakota where Asha began teaching dance classes — modern, jazz, and ballet — and taking online courses to become a certified nurse assistant. One day, she heard one of her young 34
dance students, an 8-year-old, singing and encouraged the girl to enter a local singing contest where the grand prize was a chance to sing at The Corn Palace, South Dakota’s equivalent to Nashville’s Grand Ole Opry. “The girl pointed to something on my office wall, my bucket list, and the first thing on the list was to sing in public, and she said ‘I’ll do it if you do it,’ so I did, and I won.” Asha suddenly found herself doing what she had only dreamed of for years
ALASKA PULSE MONTHLY — April 2020 — AlaskaPulse.com
She was offered a singing contract in Nashville and was considering it when she was involved in a second car accident, in South Dakota around 2000. The second accident seemed much less severe than the first. She was rearended and the other car wasn’t traveling very fast. Her condition following the impact, however, was extreme. “It knocked me out. I was taken by ambulance to the hospital. I could not move. I was screaming in so much pain,” Asha recounts. Over the next five years, she lived with intense pain — even after physical therapy and chiropractic care. Her health issues were compounded by severe asthma. And she had migraines that led to a diagnosis of glaucoma. Around 2008, Asha and her family relocated to Idaho, another move for her husband’s work. It wasn’t until she passed out in her garden that summer and ended up in the Idaho Neurosurgical Center that the extent of her neck damage was discovered. Doctors found two things: a hairline fracture in her neck that was most likely caused by the first car accident and a physical anomaly on the right side of her head limiting the blood flow to her brain.
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Jackson Brumley, who was road manager for Loretta Lynn,Merle Haggard and Buck Owens, was so impressed with Asha that he wanted to meet her even though he has long ago retired. When Asha and her friend joined Brumley at Starbucks in Nashville she asked “Why did you want to see me?” Brumley said “ I like your style, music and your voice.” Asha has several releases planned over the next year and a visit back home to see her son Spencer in Girdwood.
“I was told if I turned my head to the left, I would have a stroke and die,” she said. She was flown to Utah for surgery on her badly deteriorated neck vertebrae. Doctors rebuilt her neck with titanium rods and screws. During the surgery, her vocal cords needed to be moved and were inadvertently damaged. Her dreams of a singing career — and even her dance career — seemed finished. “I just had resigned myself when I came out of the surgery, and months went by where my sound was not the same — it’s still not the same — so I gave up,” says Asha, adding that she decided to focus more on songwriting since singing seemed out of the question. “Imagine everything you wanted and never thought possible being completely ripped out from underneath you.” About a year and a half after her surgery, Asha’s first husband walked out on the family and the couple divorced. Her son, by then, was living and working in Alaska. She and her daughter remained in Idaho for a year as her health continued to suffer and then relocated to Oregon to get away from the agricultural chemicals from the farmlands sur-
rounding her Idaho home.
A dream reborn
While in Oregon, Asha began online dating on a website for Latter-day Saints singles. She met her current husband, a medical lab scientist, through the site. Her husband played guitar on the side and shared Asha’s love of music. They married about a year later. He encouraged her to continue pursuing her songwriting and singing. While her vocal cords did heal, Asha’s vocal quality was permanently altered. High doses of albuterol for her asthma also made her singing voice shaky, but she continues to work through those challenges. “Sometimes, we think because we’re not the same or not at the same level or didn’t get what we wanted, we quit. We don’t necessarily pursue it because we can’t pursue it in the same way,” says Asha, who soon learned that pursuing a dream, even in the face of tremendous adversity, could pay off. Within the last year, Asha reached out to old contacts in Nashville, and the response was positive to both her song lyrics and her singing. Music business doors began to open for her again. Today, she is getting her songs in front
of artists such as Sheryl Crow and the Oak Ridge Boys. A song she co-wrote with her sisterin-law, “Gimme Something I Can Work With,” is getting airplay on several Nashville radio stations and is available on Spotify, Amazon Music, iTunes, Pandora and YouTube. Says Asha, “Sometimes you have to find a way. It may be a different way, but you can still work at it. I will never sound like I did before, but that doesn’t mean people won’t like what I have to offer now.” Aliza Sherman is a freelance writer in Anchorage. Comments about this story? Email editor@AlaskaPulse. com.
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Getting the message out at Fur Rondy Southcentral Foundation Health Education employees dressed as fruits and vegetables to encourage health and wellness during the 2020 Fur Rendezvous Parade in downtown Anchorage. Since 1935, Fur Rendezvous – known locally as Fur Rondy – has proudly repre-
Go Red Fairbanks’ 2020 Go Red for Women Luncheon took place on Feb. 21. Dozens of women donned their red outfits and learned about heart-healthy living, including a keynote speech from Kristen Brogan, at right, of On Target Living.
— Kyrie Long photos
sented the pioneering spirit of Alaskans. In addition to more than 20 official cultural and sporting activities, the Anchorage community hosts nearly 50 Rondy Round Town events, offering wacky winter fun for all ages.
Southcentral Foundation is an Alaska Native-owned, nonprofit health care organization serving nearly 65,000 Alaska Native and American Indian people living in Anchorage, Matanuska-Susitna Borough and 55 rural villages in the Anchorage Service Unit. Incorporated in 1982 under the tribal authority of Cook Inlet Region, Inc., Southcentral Foundation is the largest of the CIRI nonprofits, employing more than 2,500 people in more than 80 programs.
HEALTH SENSE
Trust helps keep lid on health costs By Tim Parker
I
t is about dollars and sense. The cost of care in Alaska is among the highest in the country any way you slice it, but there are efforts underway here to push the cost of care down, leading to more disposable income for Last Frontier residents and growing our economy. An innovative approach is being used by the Public Education Health Trust, or PEHT, and other health trusts in the 49th state, and the numbers tell a story. In the past three years PEHT has saved the state of Alaska nearly $156 million, approximately $52 million per year, through our ability to make quick adaptations and by negotiating lower rates for our plan holders. Being small and nimble allows PEHT to act quickly and take advantage of opportunities, as we are not burdened by a cumbersome RFP process. If a quality deal becomes available, we can act immediately. Other trusts such as the Pacific Health Coalition have also saved millions of dollars for their plan holders and the state. So who are we and how does it work? PEHT is a nonprofit organization that provides services for 28 individual insurance purchasers at school districts, associations, school boards and others that provide public education services. Using minimal staffing and overhead, we pool large and small districts together to combine purchasing power, reduce costs, and increase the availability of benefits. We are nimble and can move quickly, allowing us to be strong, flexible negotiators. The PEHT vision is simple: maximize member benefits with quality care at the least cost. We spend more than 95 cents of every dollar we take in on cov-
ered medical services. We spend under 5 cents on every dollar on administration. Because PEHT members, staff, and leadership determine coverage benefits, our member health insurance providers work in the member’s interest to deliver the lowest administrative cost, advocating during appeals of any claim decision and plan provision interpretation. Our trust pool puts assets to work for the sole benefit of plan participants. The trust and the plans in it are under the control of elected trustees. Each member of PEHT has a vote in who represents their concerns with their health care needs. We support local choice and local control in providing low costs options for health insurance. Another innovative example that PEHT and other trusts are using is BridgeHealth. This medical tourism organization provides access to centers of excellence for scheduled procedures at substantial savings. BridgeHealth responds to savings opportunities when they arise, negotiating direct contracts with hospitals, providers, and accommodation facilities. They provide significant savings when compared to the same services rendered in Alaska. A few more statistics will help underscore the good things happening in Alaska. PEHT represents 28 public education groups, covers 17,000 people, and offers eight medical plans. In recent years, roughly half of the time our plan costs have either
Overall, for five years PEHT’s plan cost increases have averaged just a 2.7% increase. The innovative cost containment measures at PEHT are saving more than $9,000 per plan member per year. That translates to money in Alaska’s economy. decreased or seen no increases. Overall, for five years PEHT’s plan cost increases have averaged just a 2.7% increase. The innovative cost containment measures at PEHT are saving more than $9,000 per plan member per year. That translates to money in Alaska’s economy. Other trusts are finding success as well. In fact, Fred Brown, executive director of another Alaska-based organization, the Pacific Health Coalition, was recently elected president of the National Labor Alliance of Health Care Coalitions. The NLA is a nonprofit national organization of management, health, and welfare coalitions representing more than 6 million members. He was elected in part because of the innovation and excellence of trusts in Alaska. While the nation continues to debate health care, in Alaska there are ongoing innovations that save dollars and make sense. Tim Parker is a high school English teacher from Fairbanks now serving as the chair of the Public Education Health Trust. Tim loves making student learning happen in his classroom, and he looks forward to being back in the classroom this fall.
AlaskaPulse.com — April 2020 — ALASKA PULSE MONTHLY
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Walter is thriving in his job with Holland America Princess.
For Walter, persistence pays Mental health services help him land a job — and success Anchorage Community Mental Health Services
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hen Walter P. started his summer 2019 job as a luggage handler for HAPYukon (Holland America Princess), he wasn’t sure he’d like working with customers. It had been six years since he’d had a job, and he was worried interacting with customers would make him anxious. But it turned out that he liked it – and he was good at it. His supervisors wrote that he was always helpful and willing to pitch in, and the tips from customers indicated they appreciated him too. He’s already been asked to come back. It took a while to find a job. Walter’s therapist at Anchorage Community Mental Health Services, Judy Sparks, suggested going back to work was the 38
next step in his recovery. Sparks has always believed that clients with serious mental illness need something to do, whether that’s volunteer or paid work or activities during the day, to bring some normalcy to their lives. When she first started working with Walter, he was closed off and didn’t communicate well. But after attending groups and working on coping skills, he was able to interact out in the community and learned to take the bus, and she thought he was ready. “He was really nervous, but he’s made awesome growth,” she said. Walter worked with the RISE vocational team to write a resume and build his confidence. Then he said, he “applied, applied, applied” but he wasn’t getting hired. Allen Erickson, the manager of Plato’s Closet, offered to do a mock interview with Walter and offer
ALASKA PULSE MONTHLY — April 2020 — AlaskaPulse.com
feedback. That helped Walter practice his answers to interview questions. But the biggest problem was the six-year gap on his resume. So he turned his focus to summer seasonal work so he’d have a more recent track record. When he was first hired by Holland America Princess, he had to learn to advocate for himself, with help from his vocational employment specialist. The first shift he was offered started so early in the morning, he couldn’t get a bus there. But after talking to his manager, he was moved to a late shift, where he thrived — sometimes independently handling all the luggage for large airport departures. Walter isn’t content to wait until summer to work again, so he’s looking into training opportunities to help him get more stable year-round work.
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Across 4 The opposite of a sour potato 8 The outside of this melon looks like a web 12 Tomatoes, cucumbers and lettuce make a nice ___ 13 This vegetable looks like a mini tree 15 Dip the leaves in butter and enjoy the heart of an ___
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Overcoming Infertility . . .
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