Montana Health Journal Fall 2013 by Montana Living

NATURAL HEALING: BETTER HEALTH THROUGH HERBAL TINCTURES I QUIT: HOW ONE WOMAN KICKED THE HABIT OF SMOKING

Montana

Health Journal TA K E G O O D C A R E O F YO U R S E L F.

THE

Art of Life How art therapy heals lives

FRONT LINES

Dr. Loren Vranish and his 40 years in primary care medicine

THE DIABETES DILEMMA Montanans work to prevent and manage a diabetes crisis

BARE MINIMUM The pros and cons of minimalist running

MONTANALI V ING.COM

Art therapist Allyson Norwood Bush

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PICTURE OF HEALTH

Dirk Gillette hikes Big Mountain in Whitefish. Gillette is a physicianâ&#x20AC;&#x2122;s assistant at Family Health Care in Kalispell, Mont. Photo courtesy of Gordy Stafford/Mountain Life Photography

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Montana

Health Journal

Health

community wellness eXpo june 15, 2013 kalispell, montana

HealthX is a community wellness expo featuring montanaâ&#x20AC;&#x2122;s leading healthcare providers. HealthX seminars and displays include: Personal Wellness Healthcare Screenings Diabetes Care Weight Loss Healthcare Reform Pain Management Heart Health Dental Health Alternative Healing Physical Therapy Stroke Awareness Elder Care Assisted Living Facilities Chiropractic Mental Health and Counseling Allergy-free Cooking Sleep Therapy CPR Education Chemical Dependency Community Organizations

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EDITOR’S NOTE

Last call Knowing when it’s time to move on from unhealthy habits sometimes takes a while

Ruth Lang aLmost comes to tears when she talks about smoking. Lang, who quit smoking after puﬃng for more than 50 years, feels so good about not having to be chained to chain smoking any longer, that she literally shouts with joy to the heavens. “It’s crazy. It makes me want to cry,”

Melissa Lang, left, and her mother, Ruth Lang, stand by their bikes in Kalispell’s Lawrence Park.

she told me during an interview on a sunny day in Kalispell’s Lawrence Park. Raising her eyes to heaven, her voice shaking, she said, “I did it. I did it.” Ruth smoked constantly while raising her two daughters. she’d even let a ciggy dangle from her mouth while bottle feeding her daughters. “my cardiologist said I

had to quit, but I never did. I always thought cancer and other diseases happened to other people. next to having my two girls, this is the biggest milestone of my life. at’s why I’d never go back to smoking. I’d disappoint too many people.” at some point in our lives we all have to confront our health issues — and what we are going to do about them. Elaine Ryan, who is featured in our story about diabetes, faced a similar challenge. Knowing she was severely overweight and at risk for diabetes, she changed her life; she lost over 100 pounds changed her diet and is now on the way to a lifetime of wellness. With america facing an epidemic of obesity, it’s time many of us come to terms with our own health issues. e days of over indulging, over consuming and over eating need to change, and they need to change soon. We talk about the great fiscal cliﬀ that our country faces. at’s the least of our worries if we don’t confront the fat cliﬀ — that creeping, ever-growing bulge that I fear will threaten to obliterate the gains our country has made in most areas of social health, welfare, industrialization and society. at’s one of the reasons I’m so passionate about publishing montana health Journal. Perhaps in my way I can direct information to people and help them live a healthier life. Like Ruth Lang, who came to grips with her smoking habit on her own and after 50some years, I wonder what else we as a society could accomplish if we look at ourselves honestly. Ruth did. Elaine Ryan did. and they are some of the happiest people in the world, for taking charge of their health. — David Reese, editor editor@montanaliving.com

EDITORIAL POLICY: The contents of Montana Health Journal are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Montana Health Journal does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned in this magazine or on its website. Relying on any information provided by Montana Health Journal is solely at your own risk. Always seek the advice of a physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you may have read in Montana Health Journal. If you think you may have a medical emergency, call your doctor or 911 immediately. 6 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

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Montana

Health Journal CONTENTS Volume 3, No. 1 2012-13

FEATURES THE ART OF LIFE How art therapy is used to heal lives

FRONT LINES 23 40 years in the life a primary-care physician BRIGHTER FUTURE 29 Montana health professionals confront a diabetes crisis

DEPARTMENTS

PERSONAL JOURNAL 17 How Ruth Lang stopped smoking after 55 years EXERCISE FOR HEALTH 18 The pros and cons of minimalist running BODY WORK How a personal trainer can benefit you

HEALTH TRENDS 38 Portable dialysis system gives a diabetes patient freedom BUSINESS OF HEALTH 46 Kalispell business takes herbal remedies to new level PHYSICAL THERAPY 53 How physical therapy can help alleviate head, jaw and face pain CHIROPORACTIC CARE 55 Starting chiropractic at a young age helps establish healthy patterns HOME AND GARDEN 57 Tips on establishing your indoor garden paradise

Montana

Health Journal

Montana Health Journal is published by NewWest Communications LLC, 52 Buffalo Hill Drive, Kalispell MT 59901 EDITOR David M. Reese E-mail: editor@montanaliving.com

ADVERTISING MANAGER Therese Wood E-mail: adsales@montanaliving.com

CONTRIBUTING PHOTOGRAPHER Brenda Ahearn/brendaahearn.com ONLINE: montanaliving.com All contents Â© 2013 ON THE COVER: Kalispell art therapist Allyson Norwood Bush sits next to a painting done by one of her art therapy clients. Brenda Ahearn photo

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HEALTH MATTERS

Country doctors Report shows rural Montanans have less acccess to quality health care thE CEntER foR RuRaL affaIRs recently released a policy report showing that people in less populated montana counties have a much higher rate of being uninsured. according to the report, montana’s rural counties have lower health insurance coverage rates than more urban counties for residents under 65. and as county populations decrease, uninsured rates increase. of montana’s 46 rural counties, 28 have an uninsured rate at or above 25 percent. Rural montanans face more structural barriers to adequate health insurance coverage than their urban counterparts, said steph Larsen, Center for Rural aﬀairs assistant director of organizing in missoula. “With an economic foundation of small businesses, selfemployment, and low wages, rural communities are not well served by a health insurance system that relies on employer-based coverage,” she said. many families are forced to purchase from the individual insurance market where they all too often wind up underinsured, with coverage that costs too much and provides too little, Larsen noted. ose who cannot aﬀord the significantly more expensive individual packages must go without or rely on public insurance, Larsen added. and in DAVE REESE PHOTO

Restoring life’s quality. Introducing the

Neuroscience & Spine Institute Kalispell Regional Medical Center is pleased to introduce the Neuroscience & Spine Institute, a collection of services and specialists in neurological medicine that is committed to excellence in education, treatment, research and care of patients with neurological disorders and injuries.

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montana’s most rural counties the roughly 25 percent of residents without health insurance impose a significant burden on those with health insurance, on local health care providers, and on their community in general. e Center for Rural affairs report also points out that significantly higher uninsured rates in rural montana affect the health status of rural individuals and families and rural communities. Research finds that people in rural areas receive fewer necessary health care services and less preventive care, leading to more expensive health care. e result is a worsening of health status and an increase in chronic conditions, according to the Center for Rural affairs. a community’s economic development, community cohesiveness, and health care infrastructure are all threatened by a lack of affordable health insurance that results in more families without health insurance or less than adequate insurance, Larsen said. “We all pay for the skyrocketing costs of health insurance as the insured and health care providers in rural montana face increasing economic pressure from the costs of health care services to the uninsured or underinsured that are not paid by insurance or any other source.” Larsen said montana political leaders could reduce the uninsured rate by almost half. one way to do that is by having the montana Legislature decide whether to participate in the medicaid initiative created by the affordable Care act. is would provide healthcare coverage to low-income, working adults that could help as many as 60,000 uninsured montanans and 39,600 rural montanans obtain health care coverage. A full copy of the report can be viewed and downloaded at: http://files.cfra.org/pdf/MT-Health-Insurance-Coverage.pdf

Adopt. Donate. Volunteer. Three great ways to help pets at the Humane Society of Northwest Montana! Humane Society of Northwest Montana Home of the Charlotte Edkins Animal Adoption Center 100 Adopt A Pet Way, Kalispell, MT 59901 U.S. 93 between Kalispell and Whitefish - Open: Tues – Sat, 11a.m. – 5p.m. 406-752-7297 • www.humanesocietypets.com

To establish a legacy of lifetime care, consider making a lasting gift to one of our endowment funds established with the Flathead Community Foundation, the Montana Community Foundation or the Whitefish Community Foundation.

M O N TA N A L I V I N G . C O M

VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

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DAVE REESE PHOTO

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M O N TA N A L I V I N G . C O M JIM MANN PHOTOS

CHAI ME A fresh look at chais and cocoas 5 Sparrows is a Kalispell-based purveyor of the first-ever line of sugar Free, stevia-sweetened products line, including White Chocolate Cocoa, Chocolate Cocoa, Monumental Spiced Chai and Vanilla Snow Ghost Frappe. The products are sold throughout Montana at cafes and coffee shops, health food grocers, restaurants and wholesale distributors places like Sykes, Montana Coffee Traders, Rising Sun Bistro, Colter Coffee, Witheyâ&#x20AC;&#x2122;s Health Foods, and various coffee shops in Great Falls and Missoula. The mixes are handcrafted at the companyâ&#x20AC;&#x2122;s facility in Kalispell. 5sparrowsbrand.com

5Sparrows owner/founder Melanie Nelson

MERISSA LAMBERT PHOTO M O N TA N A L I V I N G . C O M

VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

Allyson Norwood Bush displays a painting at her office in Kalispell. Bush is the founder of Flathead Valley Art Therapy, and a member of the Montana Art Therapy Association. Brenda Ahearn photo 12 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

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A young child works on artwork at Flathead Valley Art Therapy in Kalispell.

the art of

LIFE How art therapy is used to heal people’s lives

BY DAVID REESE MONTANA HEALTH JOURNAL

RIght autumn sun stREams Into aLLyson noRWood Bush’s aRt studIo In a BRICK BuILdIng In KaLIsPELL. a PaIntIng on an EasEL dEPICts a LaRgE tREE, WIth a soLItaRy ELK standIng BEnEath It. shELvEs on thE othER sIdE of thE studIo aRE LInEd WIth smaLL CLay CaRICatuREs, masKs and othER aRtWoRK. a smaLL, WoodEn taBLE sIts In thE CEntER of thE Room, WIth tWo ChaIRs aRound It. hERE, In thIs BRIght studIo, Bush doEs hER WoRK as an aRt thERaPIst. hERE, Bush hELPs CLIEnts CREatE PEaCE In thEIR LIvEs — By CREatIng aRt. >>>

M O N TA N A L I V I N G . C O M

VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

Art therapist Allyson Norwood Bush works with a client at her studio in Kalispell. Brenda Ahearn photo

Samples of client artwork. Photos courtesy of Allyson Norwood Bush

Old Man, by Allyson Norwood Bush

rt has always been a window to the soul. Creating art in a nurturing, safe environment in a clinical therapy setting is a way for Bush to help clients through a wide range of emotional challenges. It might be a simple sketch on piece of paper. or a series of cartoons, or a papier mache mask. Whatever the medium the client and she choose, the process of creating art begins the conversation between the client and Bush, the art therapist. art therapy involves two concepts: that the creative process 14 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

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itself is therapeutic for the person practicing it; and the products of making art are helpful in communicating ideas between the client, self, therapist and others. art therapy is not new in clinical settings, but it is fairly new in montana, where the montana art î&#x20AC;&#x201A;erapy association has recently taken root. norwood Bush is one of a few registered art therapists in montana. she earned a masterâ&#x20AC;&#x2122;s degree in art therapy from new york university in 1997. art often delves into the unconscious, tapping into

psychoanalytic theory. “ere is so much that comes out in the artwork and the relationship to the artwork itself,” Bush said. “It’s like there are three people in the room.” art therapy is especially useful in situations with young children, who might otherwise not be able to verbally portray feelings. art therapy is a way for a client and the therapist to create a metaphor for self, a token that is separate — yet accessible — for a conversation of the self. is helps the art therapist to increase flexibility in therapy, decrease rigidity, and allow the client to take chances and explore their outside world and their relationship to it. Bush says there is a great distinction between a registered art therapist and a therapist who might use art in clinical practice. e use of art can be a powerful tool in therapy, unlocking places in a client’s unconscious that an untrained therapist might not be adept at handling. Registered art therapists are master’s prepared artists and therapists who undergo years of training and supervision specific to their field. If therapists want to oﬀer art making in their practice that’s ok, she said. It’s also important that the therapist actually be an artist, she said. “art bypasses the verbal censors,” Bush said. “It gets to the heart of the matter very quickly. It’s much easier to see yourself in the art, because it’s a visual, living record of the session.” With this kind of power inherent in art therapy, there has to be an ethical side to using art as therapy. “It’s a fast track of getting to the core issues, if a person is willing,” Bush added. “But it can also uncover a lot of pathology that the person might want to avoid.” art therapy is also indicated for use with people who have post-traumatic stress disorder, depression and anxiety, Bush said. In addition to the final product of the art and the conversation it endows, the process, itself, of creating art can be therapeutic. “often a therapy session might involve just me watching a client make art,” she said. often it may be a time for a client to relax and reflect, perhaps the only time allowed during a hectic week. one client, for instance, began by drawing the hands of a clock. is led to what Bush said was a surprising discussion of how the client was fearful of growing older. “It was surprising because the client was not consciously thinking of growing older when drawing, but only afterward, when

A client works on art at Allyson Norwood Bush’s Kalispell studio.

Founders of the Montana Art Therapy Association are, from left, Sally Hand, Bozeman; Allyson Norwood Bush, Kalispell; Kim Brown Campbell, Missoula; Lisa Pohlman, Whitefish; Rachel Long, Billings; Sabrina Husain Bajakian, Bozeman; Melody Rice, Butte. Not pictured: Stephen Thomas

‘art bypasses the verbal censors ... it gets to the heart of the matter very quickly. It’s much easier to point something out in art, because it’s a visual, living record of the session.’ — Kalispell art therapist allyson norwood Bush M O N TA N A L I V I N G . C O M

VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

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addressing her art, found that this issue was a central theme in her life that was causing some anxiety,” Bush said. “my goal is to help people make sense of their lives.” ere may be clinical analysis in the art process, but there is no judgment of the quality or the method of creating the art. “e art is what the client says it is,” she said. “I allow the client to come to their own conclusions.” Bush said art therapy is useful for adults, but it’s often indicated for children. unless they identify as artists, people often stop doing artwork around the age of 14, she said. But art-making is a very useful, therapeutic tool because art helps people come up with a new ending to a story in a way you can’t do when you’re verbally trying to control the ending, she said. for example, one of her clients spent months working on a project to create a blanket and a model of a small child. e process and the art helped nurture a conversation between Bush and her client to help the client resolve issues about his childhood. e process was therapeutic in that the soft fleece patchwork blanket required daily, repetitive movement and attention to the fine detail of sewing pieces together. e child seemed to need this grounding to feel safe in his body and to learn to be present in the moment. e artwork of a baby he created then had a warm, nurturing environment and thus he metaphorically began to care for and nurture the baby in himself. “We couldn’t have ever talked about that,” she said. “It was way too big. sometimes there are no words.” While art therapy is relatively new in montana, it’s catching on. “What’s art therapy?’ is a common question I get,” Bush said. Kalispell Regional medical Center recently launched a program using art therapy for patients in cancer treatment, which will begin in march 2013. some public and healthcare institutions in montana are getting used to this movement in clinical therapy. ere are no training programs in montana for art therapy, and Bush said she’s hoping to change that. “When it comes to the arts,” she said, “people sometimes feel skeptical about their use in our lives.” ere are currently seven registered art therapists in montana, and they are the founding members of the montana art erapy association. art therapy, like other counseling modalities, is relationship based. Everything happens within the context of a trusting, honest rapport. “I really like that, as opposed to being silent and observant,” Bush said. as an artist, being an art therapist combines two of her passions in life: art and helping others. “I have the perfect job,” Bush said. “all of my best experiences in life are in art.” on the Web: flathead valley art erapy: flatheadvalleyarttherapy.com

Did You Know?

AN ANALYSIS of nearly 30 studies including more than 300,000 patients finds that depression is associated with a significantly increased risk of developing stroke and dying from stroke, according to an article in the Journal of the American Medical Association. Stroke is a leading cause of death and permanent disability, with significant economic losses due to functional impairments, the Journal said. The lifetime incidence of depression has been estimated at more than 16 percent in the general population, according to JAMA. •

PERSONAL JOURNAL

She quit How one woman kicked the smoking habit

t’s an old habit. Ruth Lang sometimes still pauses momentarily when she leaves her house or car. It goes like this: she begins to reach for her purse, to check for cigarettes and a lighter, a habit she’s developed over five decades of smoking. en she remembers: she doesn’t smoke any more. Lang, 67, is a success story for quitting smoking. after smoking for nearly 55 years, she was able to quit the habit and she’s never looked back. “I always enjoyed smoking, and never once did I try to quit,” she said. “I never thought I could get it done. smoking was a part of me.” Lang finally decided enough was enough, and with the help of dr. Elizabeth White, a Whitefish physician, Lang was prescribed with the drug Chantix, a smoking-cessation drug. “It blows me away how that drug totally stopped me from smoking,” Lang said. after a month on Chantix, Lang took all her cigarettes and smoking paraphernalia and tossed them in the garbage. “I would think about smoking, but the thought of it would totally go away,” she said. “It was the strangest thing.” now Lang, whose voice, sometimes raspy, has remnants of 55 years of smoking, has started cycling with her family and rides up to 30 miles a week. “I can’t believe the diﬀerence it’s made without smoking,” she said. “It’s just been wonderful. “When you accomplish something like I did, it makes you want to shout it out to the world.” In addition to the many health benefits of not smoking, she has one other side benefit: she never has to worry about leaving her house without cigs. “I can grab my purse, and go outside and I don’t have to Ruth Lang used the drug Chantix to help stop smoking. wonder ‘do I have a lighter and cigarettes?’” according to the food and drug adBased on fda’s assessment of currently available data, the agency ministration, healthcare professionals and patients should con- continues to believe that the drug’s benefits outweigh the risks. tinue to follow the recommendations in the physician label and e fda says some patients have experienced changes in bethe patient medication guide of Chantix, and to monitor for neu- havior, hostility, agitation, depressed mood, and suicidal thoughts ropsychiatric symptoms when prescribing or using Chantix. or actions while using Chantix to help them quit smoking. • M O N TA N A L I V I N G . C O M

VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

Avid runner Kevin Allen-Schmid wears Merrell minimalist shoes. Dave Reese photo 18 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

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EXERCISE FOR HEALTH

Bare minimum The pros and cons of minimalist running By davId REEsE montana hEaLth JouRnaL Physical therapist Brian miller has been a runner most of his adult life. so when the book “Born to Run” came out a few years ago, miller naturally picked it up. and it’s changed the way he runs. e book, from author Christopher mcdougall, explores how a tribe in mexico is able to run using very little or no shoe support. e book has led to a boom in what’s called “minimalist running” a term that describes running barefoot or with “barefoot style” shoes. But minimalist or barefoot running is not for everyone, and miller quickly learned that when he starting using the five finger shoes three years ago. “When I first tried it, I thought ‘Wow, my feet need to get used to this,’” miller said. minimalist running mimics the way our feet performed hundreds of years ago. Proponents of minimalist running say that as hunter-gatherer people our feet adapted over hundreds of years to use the forefoot and midfoot to run and chase game. “It forces people into better running form,” miller said. When nike introduced the waffle-soled shoe in the 1970s, that changed everything. e shoes allowed couch-potatoes to start “jogging” and while it did encourage physical fitness, the highly cushioned shoes encouraged people to run the wrong way, landing hard on the heels and pushing off on the toes. “It created a monster,” miller said. “But there was good logic behind it. e shoes did help people get off the couch and into running.” however, the shoes also tended to create injuries from pronation of the foot, as well as back, knee and hip injuries, miller said. KaLIsPELL PodIatRIst Esther Barnes says she realizes the benefits of minimalist running — and sees its drawbacks. “as a foot doctor I have seen injuries when it’s not done right,” she said. “I’m not against it, but people need to be cautious, careful and slow, and under the supervision of a professional. People can run barefoot successfully and injury free, but it’s not going to be overnight. It’s a process.” In fact, Barnes is trying it, by using a less structured shoe. Barnes recommends that anyone considering minimalist running should have their feet examined, so that they don’t worsen existing conditions like plantar fasciitis or achilles tendon

Brian Miller demonstrates minimalist running with Merrell Five Finger shoes. M O N TA N A L I V I N G . C O M

VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

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issues, if they have a foot type that predisposes them. ese issues can sometimes be prevented with appropriate stretching and exercises, she said. Barnes said she agrees that the theory behind minimalist running is accurate: it creates a varied running gait and better running form. a shorter running gait creates less stress on the body’s joints. however, this is something that could be accomplished with any style of shoe. “People focus on the shoe instead of the change in running gait,” Barnes said. “you don’t need a fancy minimalist shoe to do that.” But just moving to a shorter stride and placing more stress on the front of the foot can have its harmful effects as well, according to Barnes. When running in minimalist style it can put additional strain on achilles tendons, hamstrings, and even lead to stress fractures, Barnes said. “ere needs to be a balance,” she said. “It’s not for everybody.” Classic heel-strike running causes disproportionate strain on heels, ankles, knees, hips and backs, while minimalist running demands shorter strides, and striking the foot on the front or midsection. is, in turn, allows our forefeet and midfeet, which are better shock absorbers, to bear and mitigate the stresses instead of our heels, knees and hips, Barnes said. While the minimalist style of running is a great strengthening method, miller says people considering minimalist running should consult a healthcare professional such as a physical therapist or podiatrist before attempting it. “you have to do it carefully and systematically,” he said. ere are now several styles of minimalist shoes to choose from, all the way from the five fingers style to flat-soled minimalist shoes. miller runs with five fingers shoes two to three times a week and the rest of the time he uses a flat-soled shoe that offers him good foot protection while giving him some of the benefits of minimalist-shoe running. for people with arthritis or other foot conditions, minimalist running is likely not for them, according to miller, who leads running clinics. he saw how harmful minimalist running was on a person —a former marathon runner — who was in a great shape, but whose feet were used to different shoes and a different running style. e woman damaged her arches quickly after beginning the minimalist running style. “It’s all about moderation,” he said. now that he’s had a few years to train in the minimalist style, miller says he runs faster now than he ever has. “I always thought running was just running, but with better form I’m faster now than I was in high school,” he said. Kalispell podiatrist Esther Barnes, dPm, says she does a lot of shoe education for people concerned about their feet. here are some of her tips: Choose the right size. have your feet measured. toenail injury is a common injury from wearing shoes or boots too small. “feet change and people don’t realize that,” she said. “ey’ve been a size eight all their life and that’s what they buy.” Poor-fitting shoes can also cause heel pain, achilles tendinitis, foot numbness and plantar fasciitis, she said. “It doesn’t matter if you spend $100 on a shoe that is a size too small.” doing foot stretches can help avoid some injuries. to loosen your toes, Barnes recommends putting a rolled-up towel on the floor and trying to grip it with your toes. •

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By DAVE REESE VOL. 3 NO. 1 2013

M O N TA N A L I V I N G . C O M

MONTANA HEALTH JOURNAL

Dr. Loren Vranish sits in an examination room at Family Health Care in Kalispell. 22 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

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PRIMARY CARE

FRONT Lines 40 years in the life of a primary-care physician BY DAVID REESE MONTANA HEALTH JOURNAL

It’s mIdmornIng at FamIly HealtH Care In KalIspell. tHe waItIng room Is empty, and tHe reCeptIonIsts Can be Heard CHattIng among tHemselves and maKIng small talK. tHen tHe rusH HIts and wItHIn 10 mInutes tHe waItIng room Is Full. aFter 40 years oF praCtICIng medICIne, dr. loren vranIsH stIll loves tHIs ebb and Flow oF HIs worK as a prImary-Care pHysICIan at FamIly HealtH Care.

s the waiting room begins to bustle, vranish emerges from his exam room with a female patient, holding her elbow just slightly and talking in a reassuring tone about when she should come in for another visit. vranish began his career in medicine during the vietnam war, then worked in family practice in Browning before starting family health Care 40 years ago. With over four decades of serving patients at family health Care, vranish has had the opportunity to witness families’ entire lifecycles — from birth to death and most everything in between. “at’s been a great gift to me,” he said. he sees his oﬃce as a safe haven where people can completely let go and trust him — a key component of the patient/physician relationship. e relationship between patient and physician is an intimate one. Patients must be vulnerable and open in order for the act of care giving to be nurtured along its gentle path. sometimes all a patient needs is a little time,

empathy and caring. “most people appreciate being seen, heard and validated,” he said. “a big part of healing is feeling comfortable with a provider, and turning some control of the illness to another person.” While that relationship has stayed constant, much has changed during his career. for instance, 40 years ago there were very few options available for hypertension, cholesterol, bypass surgeries or orthopedic hip or knee replacements. “e quality of life of patients has improved a lot over the last 40 years,” vranish said. “ere’s been a great improvement in treatment for patients.” a physician develops a keen sense of instinct. In his long career, vranish has been able to practice the art of medicine and hone his instincts. “I’ve been able to follow diseases for 40 years,” he said. “after that long you kind of know what’s going to happen. It’s like being an actuary. you’re able to see what’s coming down the line.” vranish now enjoys focusing on preventive care. >>>

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Front Lines “you know which problems will cause complications and you know what measures to take,” he said. vranish is never quick to judge someone. In fact he has had to treat a person charged with murder. vranish founded family health Care with the intention of giving the best care. since the practice’s founding, it merged with Kalispell Regional medical Center in 2010. e acquisition by the hospital represents a continuing trend of healthcare consolidation. is has given vranish and the other professionals in his practice more time to devote to the patients. “Physicians want to take care of people,” he said. “We don’t want to be burdened by whether or not people can pay.” e primary care physician is a vital part of today’s healthcare landscape. ey determine the path that a patient will take in their personal-care journey. vranish sees this as a great privilege — and responsibility. “In primary care you really have to be a detective; narrow down and investigate an illness’s cause,” he said. “What we do aﬀects the whole chain of care.” healthcare is changing with the arrival of the aﬀordable Care act. vranish said per-

sonal accountability and personal responsibility must take a greater role in america’s healthcare future. mid-level care givers will have to help carry the load in primary-care settings. vranish was the first physician in montana to hire physician-assistants, and he sees physician-assistants and nurse-practitioners as being key components of care. e system has to move away from oﬀering what he called “carte blanche” services that cater to insured people. ere simply won’t be enough services or providers to tackle the amount of care americans are going to need in the next 40 years. “to control costs we have to attack it (illness) on the preventive side, and learn how to ration care away from carte blanche,” he said. “We must learn how to balance the quality of care with aﬀordability. If it isn’t affordable, it isn’t any good.” hen vranish began his career in Kalispell there were only 25 physicians in Kalispell. now there are close to 200. more physicians are specialized in certain areas of healthcare, and this has led to a shortage of primary-care physicians. ere’s a good reason for that; work load and hours. a specialized physician doesn’t have to put in the long hours and take lower pay, having to do hospital rounds or serve in the emergency room, as vranish remembers

having to do in the early years. Even before the affordable Care act, the landscape of healthcare had been continually shifting. vranish adapted to this by opening one of the first urgent-care facilities in northwest montana. ere was good reason for that, too. urgent-care facilities help alleviate pressure on emergency rooms and give patients more opportunity get the right kind of care. “you have to move urgent care out of the emergency rooms,” vranish said. “at was pretty innovative at the time, to have primary care and urgent care together.” vranish has no intention of slowing down in his career, as he’s enjoyed every day of his work. he’s helped thousands of people in his years of being a physician. at’s no small achievement. on one busy day at his office, he ducked into an exam room for a photo shoot for this article and to reflect on his job. vranish is a big, gregarious man, but get him to slow down for one second and he can be quite contemplative. outside the exam room the hustle of the office could be heard. In here, in his private sanctuary, vranish became very still, with a wistful, faraway look in his eyes. “I can always look back and say I made the world a better place.” From his office on the second floor, urgent Care manager mark davis can hear

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the daily activity of what’s going on in the reception room downstairs. a steady stream of patients comes through the door of urgent Care clinic, with maladies from common colds to whooping cough. “Primary care is interesting, because you never know what’s coming through the door,” davis said. “you just never know, and you have to be prepared for whatever comes in.” as health care becomes more streamlined, with emphasis on results and accountability, primary care is often pointed to as one of the most important areas of solving america’s health care challenges. urgent Care, a division of family health Care, sees over 200 patients a day. often the patients are seen by a physician assistant, someone who is qualified to diagnose medical issues and write prescriptions. is gives family health or primary care physicians more time for their patients. and, davis’ oﬃce has three to four people who just handle phone calls. “We think that’s pretty important,” davis said. “We don’t want people to go to an emergency room for a sore throat. at’s not a wise use of dollars.” a challenge of being on the front line of health care is a changing level of illness

that primary-care oﬃces see. according to davis, the severity of illness of the patient his oﬃce sees is getting worse. Whether it’s because of the national economy or not, “It’s hard to say,” davis said. “We are seeing sicker people than we used to.”

an indication of that is the amount of intravenous treatments given in a particular day. Whether it’s for antibiotics or dehydration, “ose types of things indicate those folks are pretty sick,” davis said. Primary care is becoming more competi-

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VOL. 2 NO. 1 SPRING 2012 MONTANA HEALTH JOURNAL

tive. family health Care’s urgent Care was ing provider would get paid more for that care physicians. as more of them retire, once the only clinic of its kind in the flatclinic visit, since foot health is often an inthey’re not being replaced. “It’s going to be head valley. now there are several. dicator of diabetes. “most of us were doing a real problem in the future,” davis said. Consolidation of health care services by this any way, so it’s time we’re recognized Career burnout is also an issue, but large, nonprofit hospitals redavis said family health flects a growing trend to keep Care has a tight-knit staff ‘Primary care is interesting, because you never know people within a line of care, that helps each other with what’s coming through the door. You just never know, and and within an organization. tough decisions. “We buoy medical home is a new catch each other up,” he said. you have to be prepared.’ phrase that describes how and — Mark Davis, manager, Family Health Care, Kalispell one of the challenges of where a person is treated primary care is staffing. throughout their health care davis said it’s hard to find situation. Primary care is an important asfor the work we do,” davis said. “finally nurses with the right mix of training and pect of a medical home, since it’s often a people are recognizing primary care” as a experience to help staff his office. person’s first choice. “most of their needs cornerstone of quality care. Primary care Being on the front line of health care can be met here,” davis said, “and they can physicians are often cited as being the lowputs stress on primary-care providers. “Big keep most of their care in home.” It also est-paid providers, while they work the decisions have to be made here, but usually means people can be more proactive in hardest. is is starting to change with we have to err on the side of caution,” their own health care, davis said. healthcare reform. davis said. “medicine is still an art, espeInsurance is a driving force of health more and more, a visit to urgent Care is cially in primary care.” care. Companies dictate what kind of treat- a counseling session for the patient. It may When he arrives at work, davis never ments get paid for, and how much they’ll be the patient losing his job, their child knows which hat he’ll have to wear that pay. But this kind of system is also leading doing poorly in school, or the recession day. as a health care administrator, his job to more accountability in health care, davis forcing the family to move in with their might be to take care of finances, staffing, said. a pilot project between family health parents. “We’re doing more social work,” or building maintenance. davis gets a high Care and Blue Cross/Blue shield of mondavis said. “e basket of problems has amount of satisfaction with the work he tana is helping providers and patients be gotten bigger. Primary health providers are does. “I see people doing good, quality more accountable for personal health. mental health providers, plain and simple.” work,” he said. “We’re providing the kind of for instance, if a person at risk for diae challenge of “overworked and uncare we should be providing.” • betes is given a foot exam, the administerderpaid” has led to a shortage in primary-

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BODY WORK

Getting

personal

Personal trainers can help bring out the best in you

WHEN YOU’RE in a fight to lose weight, it helps to have someone on your side. And as a personal trainer, Troy Schultz gets behind people, next to them and in front them — whatever it takes to motivate them to achieve their personal fitness goals. Schultz, owner of M Team Fitness in Kalispell, is not afraid to tell people the truth about their situation and what it’s going to take to get them to lose that 10, 20 or 50 pounds. “Most people don’t realize how sick they are when they come in,” he said. “Until they’re feeling better they don’t know how ill they are. But your body is talking to you all the time.” As a weight and training coach, Schultz combines a lifestyle education with the right exercise program. “It’s a conscious, intentional effort on the part of the client,” he said. Personal trainers are not new. But the way they are being used is changing, perhaps as a reflection of Americans’ obesity and the way this is affecting diabetes, heart health and other personal issues. For instance, one of the cornerstones of a diabetes education at Community Medical Center in Missoula is for the client to lose at least seven percent of their body weight. How that is accomplished is up to the client, and often they turn to personal trainers to achieve the weight loss that will change their lives. “You have to ask yourself hard questions and find a professional who can help,” says Schultz, who has been a personal trainer for over 20 years. “I get them to create a goal that is tangible and owned by them,” he said. “Then, amazing things happen.” M Team Fitness uses a high-intensity cardio workout, combined with weight training based on the individual’s needs and abilities. His fitness center does not sell trendy energy drinks, vitamins or potions that will magically help someone achieve their fitness goals. His ethic is hard work, and eating the kind of food that “God made,” he said. He tells his clients, “If God made it, eat it. If man made it don’t touch it. You’ll take care of a lot of issues with that.” There is no shortcut to fitness, and Schultz said he thinks people are doing their bodies more harm by fluctuating their weight through dieting. “The damage that does to the body is unbelievable,” he said. Schultz said people want accountability in their fitness goals, and a trainer helps them achieve that. He starts with a 90-day program that usually gets people to lose the first 20 pounds. From there, the weight loss can get more difficult, but he’s there for the long haul. Clients sometimes lose focus after that first milestone is achieved, and that’s when a trainer is especially important, Schultz said. “It’s far easier to maintain, than it is to obtain, fitness,” he said. A trainer is often the last resort, after a person has tried some other fix, Schultz said. “Whether you’re with me or someone else, you need to figure out something to do,” he said. Schultz sometimes has to dig deep to find out what their motivation for fitness is. The price of a personal trainer varies. Schultz, who is from California, said Montanans sometimes balk at the price compared to what he’d charge in California. “Most people hurt a bit when they see the cost,” he said, “but I’ve got to get their attention and get them with a trainer. That’s valuable.” •

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VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

DIABETES SPECIAL REPORT

building a

brigHter future BY DAVID REESE MONTANA HEALTH JOURNAL

BY DAVID REESE MONTANA HEALTH JOURNAL

iracles sometimes come in small packages, and that’s how it was for Elaine Ryan.

Montana health professionals confront a looming diabetes crisis

M O N TA N A L I V I N G . C O M

In 2007 Ryan had overheard a coworker talking about a weight-loss program in missoula for people at risk for diabetes. e conversation got her attention. Ryan, 60, had lost her mother to chronic high blood pressure from being overweight. Ryan she knew she had to do something about her weight, which at that time was 237 pounds. Ryan was a textbook case for someone at risk for diabetes. she was overweight, her cholesterol was high, her blood sugar was high, and so was her blood pressure. she also had a family history of diabetes. two months after hearing about the program Ryan got a doctor’s referral and entered the first class of the diabetes Prevention Program at Community medical Center in missoula. e program is designed to help people who have diabetes or are at risk for diabetes live healthier by reducing their weight, adding exercise and modifying their diets. e program is one of several around montana designed to help prevent, diagnose and treat diabetes. since it was begun in that first class of february 2008, the program at Community hospital has helped over 450 people. “I just took to the program,” Ryan said. “to me, this was about opportunity. e 10 months I was in it, I just really took to it, like a duck to water. It expanded my horizons.” diabetes mellitus is a group of diseases characterized by high blood glucose levels that result from the body’s inability to produce or use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy for the body. ere are three types of diabetes. type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. In type 1 diabetes, the body does not produce insulin. type 2 diabetes is the most common form of diabetes. type 2 diabetes is caused by genetics, being overweight, and not getting enough exercise. >>> |

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disease, such as high blood pressure, high cholesterol, a history of diabetes or gestational diabetes. most people in the program report an average weight loss of 15 pounds, plus improvements of blood pressure, cholesterol, and fasting blood glucose levels, according to shirley schneiter, program director at Community medical Center. ccording to the Center for disease Control, there are 25.8 million people in the united states with diabetes, affecting 8.3 percent of the u.s. population. Eleven percent of america’s population who are 20 years old and above — roughly 79 million people — have pre diabetes or are at risk but undiagnosed for the disease. montana is seeing an increase in diagnosis of type 2 diabetes, which is caused, in part by being overweight. at’s why the focus of the wellness program at Community medical Center — and others around montana — is on diabetes prevention. e education effort is among 14 sites providing diabetes-education programs in montana. e programs are funded by a grant from the montana department of health and human services. Kalispell Regional medical Center, st. Patrick hospital in missoula and missoula City/County health department are some of the other institutions that offer diabetes-education programs. e increase in diabetes in montana and across the nation is due in large part to high-fat diets, large portion sizes, low exercise, and fast foods, according to schneiter. “all of these things contribute to being overweight,” she said. diabetes prevention is geared toward weight loss and increasing activity level. is decreases a body’s insulin resistance, so a body’s cells are more responsive to the insulin they are producing. is helps lower blood sugars, which reduces the risk of developing type 2 diabetes. “Weight and exercise are the two things that people can do to reduce their risk,” she said. EnnIfER tRouPE is a tireless advocate for diabetes education and prevention. troupe is a certified diabetes educator at Providence st. Patrick hospital in missoula, and helped start the diabetes clinic in Kalispell. diabetes is not what kills people, she said. It’s uncontrolled diabetes that causes problems and leads to dialysis, eye issues, neuropathy, amputations, wounds, emergency room visits and death. at’s

HEALTHY KIDS Healthy diets and exercise are keys to preventing Type II diabetes.Missoula Community Medical

[

Center’s Shirley Schneiter (below) is a crusader against diabetes

]

DAVID REESE

ver consumption of food and poor food choices, like sugary drinks, can also lead to type 2 diabetes. e third type of diabetes is gestational diabetes. during pregnancy – usually around the 24th to the 28th week – women can develop gestational diabetes. having gestational diabetes is also a risk factor for developing type 2 diabetes later in life. type 2 diabetes can usually be prevented, managed and treated, and that’s why programs at diabetes education centers around montana seek to reduce the increasing trends in diabetes diagnoses. e diabetes education programs are designed to educate people how to manage their diabetes and also to inform people who might be at risk for developing the disease. e 10-month program at Community medical Center in missoula helps people develop an exercise regimen, oﬀers classes on healthy eating, and helps people make 30 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

lifestyle changes to reduce their chances of heart disease or diabetes. to enter the program participants must have a doctor’s referral, be overweight and have at least one other risk factor for diabetes or heart M O N TA N A L I V I N G . C O M

Diabetes facts

[

JENNIFER TROUPE is a certified diabetes educator at Providence St. Patrick Hospital in Missoula.

]

Diabetes affects 8.3 percent of the U.S. population Of people ages 20 and over, 25.8 million have Type II diabetes. Seven million people are undiagnosed of the disease but are at risk. • 79 million American adults, 20 years or older, have prediabetes • 35 percent of U.S. adults 20 and over have prediabetes, including people age 65 and older. Symptoms of diabetes might be frequent urination, vision changes, fatigue, or involuntary weight loss. People with diabetes or at risk for diabetes should monitor blood sugar daily; get their blood pressure checked; get feet exams; get a hemoglobin A1C test, which gives a patient an idea of what average blood glucose has been over past two to three months. People at risk should also: • get an annual microalbumineria test for kidney problems • receive a dilated eye exam • have cholesterol levels tested annually • see their dental hygienist or dentist twice a year Source: Centers for Disease Control

why education, disease management and prevention are important, troupe said. uncontrolled diabetes can lead to other serious health conditions, namely heart disease. People with uncontrolled diabetes have a three- to four-times higher risk for a stroke than the general population, according to troupe.

iabetes is the seventh-leading cause of death now, but troupe said she sees that moving up to no. 1 in the near future unless americans make eﬀorts to control their weight. “We have a big challenge coming up,” she said. e cost to the u.s. health care system is huge. In 2007 $174 billion was spent in the united states on diabetes care, according to troupe. Caring for people with diabetes is one of the biggest expenses of st. Patrick hospital, troupe said. a diabetic patient may need care in the cardiac surgery center, or need emergency care from uncontrolled diabetes. troupe is adamant about people with diabetes working with a knowledgeable diabetes educator — preferably a physician with experience in diabetes management, along with a Certified diabetes Educator. she says diabetes educators provide a crucial service to patients, as well as primary-care physicians who are overwhelmed with daily patient loads. many primary-care doctors have less than 15 minutes to spend with a patient, and if someone has diabetes, 15 minutes is not enough time for a doctor to diagnose treatment, diet, medication or exercise

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regimens, she said. eople with diabetes need to see a certified diabetes educator,” she said. “e impact we have can really change their lives. ere are so many myths out there. We build lifelong relationships with clients, and help them manage their disease.” Colleen Karper works at Kalispell Regional medical Center to provide diabetes education. Because of the rural nature of northwest montana, KRmC’s focus is on outreach to communities like Libby and Browning. her Continually monitoring blood-sugar goal as a former levels is important for people with hemodialysis nurse is to keep diabetes. people with diabetes healthy — and prevent those with pre-diabetes from ever getting the disease. “my goal is to keep someone oﬀ a dialysis machine,” Karper said. “I just have a passion for helping people prevent and manage diabetes. With education you can help people make changes in their lives and live a healthier lifestyle.” troupe wants to bridge the gap between physicians and certified diabetes educators, and develop teamwork with a person’s primary-care doctor. “We are an extender of a physician practice with a person’s diabetes management, not a replacement,” troupe said. “our goal is to assist the physician in improving the diabetes care of their patient and help carry the load. Communication with physicians and a good relationships are keys to success.” another challenge to diabetes education is the lack of access to care in rural communities. People don’t want to leave their communities to get their care, and that’s especially diﬃcult when diabetes is prevalent on montana’s seven Indian reservations, troupe said. st. Patrick hospital is focusing on outreach to small communities in montana, such as drummond, superior and florence. ey also work in Polson, a part of the salish-Kootenai Indian Reservation, where about 25 percent of the population has diabetes, troupe said. hERE aLso nEEds to be a change in the way diabetes education is paid for by medicare and insurance companies. Currently, medicare pays for 10 hours the first year someone is diagnosed with diabetes for diabetes management and education with a certified diabetes educator. e counselor then gets paid for only three hours per year after that. montana-based insurance companies are mandated to pay $250 per year for diabetes self-management education, which is “barely enough to pay for ongoing consultation work with a diabetes educator,” troupe said. troupe has seen the inconsistencies in how diabetes is managed by health insurance companies. for instance, a private company won’t pay $60 for a client to visit her and get nutritional or dietary advice related to their diabetes; but the insurance companies will, on the other hand, pay $60,000

CONTINUED ON PAGE 34

32 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

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North Valley Hospital, Whitefish

Menâ&#x20AC;&#x2122;s HEALTH WEIGHT TRAINING AND EXERCISE LINKED TO LOWER RISK OF DIABETES Men who engage in weight training and aerobic exercise for at least 150 minutes a week have the greatest reduction in risk for Type II diabetes, according to a report published by Archives of Internal Medicine, a publication of the Journal of the American Medical Association. Researchers, who documented 2,278 new cases of Type 2 diabetes, suggest that engaging in weight training or aerobic exercise for at least 150 minutes per week was associated with a lower risk of Type 2 diabetes of 34 percent and 52 percent compared with men doing no weight training or no aerobic exercise respectively, according to the results. Men who adhered to the recommendations on aerobic exercise of 150 minutes per week and engaged in weight training at least 150 minutes per week had the greatest reduction in Type 2 diabetes risk, the study showed. In a separate study, researchers found conclusive evidence that exercise and physical activity help reduce the risk of death in people with Type 2 diabetes. Increased physical activity has long been considered a key element in diabetes management. Patients with diabetes are at higher risk for cardiovascular disease and premature death, so researchers note it is important to determine whether physical activity can produce similar beneficial effects in this high-risk population. Source: Journal of the American Medical Association

Men who engaged in weight training and aerobic exercise for at least 150 minutes a week had the greatest reduction in risk for diabetes.

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VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

surgery for that same patient to have a gastric-bypass surgery, an extreme form of weight loss control. “is just doesn’t make sense,” troupe said. accountable Care, an aspect of the aﬀordable Care act, could impact the way diabetes education is paid for, since a health care system could get penalized for not managing their diabetes patients to national standards. is could lead to a person with diabetes being referred to a more eﬀective provider or source, such as a certified diabetes counselor, troupe said. under accountable Care, a physician will, however, make more money per client visit if a person with diabetes meets national standards, such as a hemoglobin a1C level. Without government grants, the diabetes prevention classes will likely cease to exist, troupe said. “diabetes centers are always on the chopping block,” troupe said. “ey don’t make money at the front end, due to poor insurance. But diabetes education could help prevent a heart surgery, which would easily pay for two years of a certified diabetes educator’s salary in that one intervention.” getting tested for diabetes is hard enough for some people. and for those who find out they do have the disease, the

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results can be hard to live with. at’s why a certified diabetes educator is so important, troupe said. a diabetes counselor can help a person adapt to the life choices they must make when they find out they have the disease. “People go through a grieving process when they learn they have diabetes,” troupe said. “some accept it, some deny it. e deniers are the tough ones. you can’t push them too hard. If you’re taking insulin, it doesn’t mean you failed. and it’s not a death sentence.” By the year 2050, she said, roughly 30 percent of americans will have type 2 diabetes. “once you have type 2, you have it and it doesn’t go away. It’s like being pregnant. Either you are or you aren’t,” she said. Continually monitoring blood-sugar levels is important for people with diabetes, and simple tests can tell if a person has diabetes if they think they may be at risk. “don’t put your head in the sand — find out what your number is,” troupe said. signs

‘once you have type 2 diabetes, you have it and it doesn’t go away. It’s like being pregnant. Either you are or you aren’t.’

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of diabetes are blurred vision, extreme thirst, infections that won’t heal such as a prolonged urinary tract infections, or numbness and tingling in feet. diabetes has other effects aside from the disease. he stress of managing diabetes can also be difficult, and depression is often something that people with diabetes must cope with, troupe said. a person’s insulin needs change over time, so there’s a constant adjustment in a person’s life. is is another reason why a certified diabetes educator is helpful, troupe said. having diabetes in the teenage years can be difficult to manage, troupe said, because of the independent nature of this age group. Regardless of age, it’s important for people with diabetes to have partners or friends around them who are aware of their condition. at’s why schools are making more of an effort to know the signs of people with diabetes. Currently only a nurse or parent can give an insulin injection to someone with diabetes, and there’s not always a school nurse around if someone is experiencing drastic fluctuations in blood sugar. teachers need to be trained in how to help students with diabetes and how to educate students about the risks of the disease, according to troupe. one way schools can be proactive in diabetes management for students is to have a supply available of glucagon, a hormone that causes the liver to produce glucose and increase blood sugar. It’s often the first treatment that a paramedic — or a school nurse, for example — would administer to a person with diabetes suffering extremely low blood sugar. is simple, inexpensive treatment could save a child from an emergency-room visit, but not all schools choose to have glucogon available, troupe said. montana Is ContInuIng to see an increase in the diagnosis of type 2 diabetes, schneiter, of Community medical Center in missoula, said.

CONTINUED ON NEXT PAGE M O N TA N A L I V I N G . C O M

VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

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â&#x20AC;&#x153;î&#x20AC;&#x201A;atâ&#x20AC;&#x2122;s really a national trend and weâ&#x20AC;&#x2122;re seeing it in montana as well,â&#x20AC;? she said. â&#x20AC;&#x153;We see that percentage continue to climb, and thatâ&#x20AC;&#x2122;s why part of our program now consists of an eďŹ&#x20AC;ort toward diabetes prevention.â&#x20AC;? schneiter said the programs around montana are having a positive impact on detecting and treating diabetes. â&#x20AC;&#x153;for the amount of people weâ&#x20AC;&#x2122;ve worked with, itâ&#x20AC;&#x2122;s helping, considering that weâ&#x20AC;&#x2122;re doing this in 14 sites across the state,â&#x20AC;? she said. â&#x20AC;&#x153;montana is making a big eďŹ&#x20AC;ort to reduce the incidence of type 2 diabetes in the state, through these programs.â&#x20AC;? as troupe and schneiter can attest, diabetes is the biggest health issue facing america. â&#x20AC;&#x153;î&#x20AC;&#x201A;e increase in diagnoses of diabetes is result of more obesity and less activity,â&#x20AC;? schneiter said. Continuous contact with a physician or certified diabetes educators is crucial for people with diabetes or those at risk for the disease. î&#x20AC;&#x201A;atâ&#x20AC;&#x2122;s why itâ&#x20AC;&#x2122;s so important to attend a diabeteseducation program, schneiter said. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s a unique disease, in that people are really the self managers of their condition, along with guidance of medical providers,â&#x20AC;? she said. â&#x20AC;&#x153;People have to stay up on the education through their lives, because itâ&#x20AC;&#x2122;s a chronic condition that changes over time. What works today might not work two years from now. Itâ&#x20AC;&#x2122;s something that requires continuous care. and as we learn more about the treatment of diabetes itâ&#x20AC;&#x2122;s helpful to continue with education to stay up with the newest technology and information.â&#x20AC;? Even though there are 14 diabetes prevention centers and many more diabetes educators in montana that are helping people manage diabetes, this assistance might not last forever if healthcare providers and insurance companies donâ&#x20AC;&#x2122;t find a way to cover the costs of providing services. schneiter said itâ&#x20AC;&#x2122;s crucial that the centers demonstrate their eďŹ&#x20AC;ectiveness so that insurance companies will be able to reimburse for those services in the future. î&#x20AC;&#x201A;e needs for diabetes education and prevention are not going to go away. In fact theyâ&#x20AC;&#x2122;re only going to get worse. â&#x20AC;&#x153;I see it continuing to increase unless we make a serious eďŹ&#x20AC;ort at helping children maintain healthy lifestyles, and to help them learn to eat healthy and be active,â&#x20AC;? schneiter said. â&#x20AC;&#x153;a lot of diseases are aďŹ&#x20AC;ected by our behavior. diabetes is reflective of our lifestyle.â&#x20AC;? Reducing risk means changing diets that are high in fat and sugar, and increasing physical activity. â&#x20AC;&#x153;If people realize how their risk for diabetes increases with poor diet, theyâ&#x20AC;&#x2122;d make changes,â&#x20AC;? schneiter said. â&#x20AC;&#x153;Education is a key piece for people to understand, but itâ&#x20AC;&#x2122;s up to the person.â&#x20AC;?

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laine Ryan was one of those people who knew she had to do something â&#x20AC;&#x201D; about her weight and about her lifestyle. at 237 pounds, Ryan said oďŹ&#x192;ce desks and even toilet stalls seemed small to her. î&#x20AC;&#x201A;en she began the journey to lose weight and make healthier lifestyle choices at Community medical Centerâ&#x20AC;&#x2122;s diabetes and heart health education program. î&#x20AC;&#x201A;rough the program she began to take her weight loss seriously. she said she â&#x20AC;&#x153;really got intoâ&#x20AC;? the exercise part of the program, and was fastidious about what she ate. she writes in her food journal every day about what she eats, and how much, watching, in particular her fat consumption. â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;m not worried about carbs or protein,â&#x20AC;? she said. her exercise goal started out at a half hour a day, five days a week. she met the goal of taking oďŹ&#x20AC; seven percent of her body weight pretty easily, she said, but in order to keep oďŹ&#x20AC; the weight, she went further, taking advantage of programs at

missoula Women’s Club, walking miles on the treadmill. she lost 90 pounds in a 16 months. how did she get so big? “I didn’t say no to anything,” she said. “I just kept buying bigger clothes. I let myself get into some really sloppy habits of poor diet and little exercise.” Ryan has become an advocate of the importance of exercise, diet and, most importantly, the diabetes education centers. she has remained on bloodpressure medication on recommendation from her physician, but Ryan doesn’t have to take any cholesterol-reducing medications because she takes care of that herself. Ryan, a self-described cheerleader for weight loss and diabetes prevention, says people at risk for diabetes should not wait to get help. “don’t come up with any excuses; put your foot out and take that first step,” Ryan said, “and don’t beat yourself up if you slip back. It’s never too early and it’s never too late.” on the web: mtprevention.org Choosemyplate.gov

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VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

HEALTH TRENDS

Dialysis to go Portable systems allow dialysis patients to live a more mobile life

BY DAVID REESE MONTANA HEALTH JOURNAL

im smith was visiting friends in new Zealand when he discovered he might have diabetes. upon returning home to the states, smith got tested, and yes, he had developed type II diabetes.

Claire Smith, left, helps her husband, Jim Smith, undergo dialysis in their RV while on a trip to Kalispell.

smith, 64, has no function in either of his kidneys and relies on dialysis to perform his vital kidney functions. for millions of people on dialysis, they must sit in dialysis centers for several hours a week to be dialyzed. only a few weeks after he began dialysis in a clinic, smith knew that was not for him. so after a three-week training he was able to use a portable machine to dialyze at home with the help of his wife, Claire. on a trip to Kalispell to demonstrate the nxstage system, Claire and Jim walked into their Rv and sat down on the couch. on the floor near them sat a small aluminum box, about the size of a dorm-size refrigerator. en Claire went to work. she unpacked the 38 MONTANA HEALTH JOURNAL VOL 2 NO. 1 SPRING 2012

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silver box and began assembling the various hoses and tubes that she and Jim would use for his dialysis. minutes later Jim’s blood was coursing through the portable dialysis machine while he relaxed on the couch with a glass of juice. millions of people undergo dialysis treatments, mainly in dialysis centers and clinics, but portable dialysis now allows people to undergo their treatments at home or on the road, as Jim and Claire often do. for most patients, dialyis at home lasts two and a half to three hours and is done five to six days a week at a time that is convenient for the patient. Patients can do treatments on their own schedule in the comfort of their home or while traveling. flexibility and more frequent treatments are benefits of home dialysis, Claire, said. “It’s made a diﬀerence in our lives, not to be tied to someone else’s schedule,” she said. dialysis centers are often very busy, so scheduling is not as flexible as being able to do home dialysis, Jim said. not everyone who is on dialysis is able to home dialyze; among the restrictions is that a patient must have a caregiver along with them while they are dialyzing their blood. smith has been a diabetic for 20 years, but was able to delay dialysis by losing weight and exercising. he once weighed 330 pounds, but now tips the scales at 220. Jim says having the flexibility to dialyze at home allows him to dialyze more frequently, which helps him feel better. “more dialysis means I feel better, and people who dialyze more often tend to be healthier,” he said. Rather than the three times a week that patients dialyze at clinics, Jim is able to dialyze five to six times a week. e treatments take about three hours he said. “is acts more like a regular kidney,” he said. “I have more control and independence. I control how my dialysis happens, when it happens and what I have to do to stay healthy.” •

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FRESH FIRST A guide to local food and dining

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VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

FOOD AND DINING

Apple Barrel Country Market owners Dana Cordell, left, and David Cordell stand in their wine-tasting room at Glacier Sun Winery in Kalispell.

FRESH WINE COMES TO KALISPELL

n 1996 David Cordell had an idea: to bring the freshest fruits and vegetables to the Flathead Valley. Cordellâ&#x20AC;&#x2122;s idea became the Apple Barrel Country Market, a downhome-style country store that is packed with fruits, vegetables and more. Now after seeing the Apple Barrel become a successful hit with local customers, David and Dana Cordell are turning their attention to another flavorful, fresh product: wine. The Apple Barrel, on U.S. 2 near Glacier 44 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

Park International Airport, has launched Glacier Sun Winery, a small-batch winery that produces several styles of wines, from cheerful summer whites to a bold Cabernet Sauvignon, and many in between. The wines are created from Washington-state grapes. The Glacier Sun Riesling has a bubbly effervescence, almost like a sparkling wine, making it a perfect companion to summer dining or lighter fare. The Tempranillo is one of Glacier Sunâ&#x20AC;&#x2122;s most interesting wines. The Tempranillo brings an assertive flavor of M O N TA N A L I V I N G . C O M

FOOD AND DINING pinot noir with the laid-back feel of a merlot. It’s an easy-to-drink red wine with a bold flavor palette. One of the most popular wines is a Huckleberry/Rhubarb blend. While some flavored wines taste like a lollipop, this one from Glacier Sun Winery lets you search for the flavors in your mouth instead of overpowering you with a fruity explosion. As for a sweet wine, Glacier Sun has also produced a Chocolate/Raspberry Port, while the Flathead Valley Cherry wine has been a

huge hit with locals and visitors. The wines are available for sale at Glacier Sun Winery, where you can also sample them in their wellappointed tasting room. The air at the Apple Barrell is filled with the scents and aromas of fresh fruit and vegetables. Having a wine-tasting room adjacent to this casual, pleasing area was the perfect complement. “It’s just a feel-good place to come and relax,” David Cordell said. “We just thought a winery would be the perfect

complement to the Apple Barrell.” Dana agrees. “I love the subtleties of wine making,” she said. “It’s not just a science, there’s a creativity to it. It’s more of a feel thing. You don’t just follow recipes.” Apple Barrel Country Market & Glacier Sun Winery 3250 U.S. Highway 2 W., Kalispell MT 406-755-7753

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VOL. 2 NO. 1 SPRING 2012 MONTANA HEALTH JOURNAL

HEALTH BUSINESS

David P. Amrein is the owner of Mountain Meadow Herbs. DAVE REESE PHOTOS

Nature’s remedy Kalispell business takes natural healing to a new level

BY DAVID REESE MONTANA HEALTH JOURNAL

alking into the production area at mountain meadow herbs, the aromas hit you first.

e smells are at once familiar and strange, like a memory or a faraway land. ese wonderful aromas come from around the world, and have names like dong quai root, cat’s clawbark, false unicorn, and cornsilk herb. strange as the names may be, their healing properties have been around for centuries. here at mountain meadow herbs south of Kalispell, herbal remedies are being created, packaged and sold to thousands of customers all over the world. e company occupies a 23,000-square-foot warehouse and retail space on montana 82, between somers and Bigfork. a retail facility in the front of the shop is being created, with space for a restaurant. In the back of the facility the real magic takes place. tall shelves are lined with dark-brown jugs of prepared tinctures. at one end of the production 46 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

M O N TA N A L I V I N G . C O M

Manuel Lobo fills a beaker with infant immune booster at Mountain Meadow Herbs in Kalispell.

facility, a worker fills tiny bottles of tincture, while workers at the other end prepare boxes of the tinctures for shipping. some herbs are so delicate they are kept in a quarantine room before being used and over 220 herbs are used in the manufacture of the herbal tinctures at mountain meadow herbs. e manufacturing process resembles something between a cooking operation and a brewery. e dried herbs are cooked for two days in large, stainless steel vats, then allowed to simmer and cool before bottling. e cooked liquid of herbal recipes is blended with glycerin or alcohol as a preservative, then bottled and sold around the world. mountain meadow herbs creates over 50 herbal tinctures for a wide range of uses, for anti-inflammatory, arthritis, high blood pressure, even impotence and placenta release. founder Kathy garber knows firsthand how well herbal remedies can work. her son had kidney disease at a young age, so she set out to find a solution that would not require drugs. she began making herbal capsules for his treatment then made liquid herbal extracts. her son’s kidneys eventually returned to normal function. seeing how successful herbal remedies were, she created a business around them and started mountain meadow herbs in 2003. david P. amrein had been looking at buying a naturopathic business for several years and had scoured the country for the right business model and team. e swiss native came upon mountain meadow herbs in 2008 and purchased the business from garber, who has remained on staff. about 60 percent of mountain meadow herbs’ business is geared toward amish and mennonite communities. amish believe that true healing must come from god, and that herbs are a gift from god to humans. is is why they rely on natural remedies such as those sold by mountain meadow herbs. e company remains focused on its popular existing products and its commitment to the amish and mennonite communities, but it also researches and develops its own new herbal remedies and recipes, such as those for weight loss, cholesterol and eyesight problems. amrein is a lean, fit athlete who is a certified naturopath. he knows the value of the herbal remedies, having used them himself. But he also makes sure people know herbal remedies are not a quick fix. herbal remedies are made to support and enhance the body’s own immune systems, so they take more time to show effectiveness, he said. “your body is a machine, and the idea is to let the body take care of itself,” amrein said. People who use natural healing remedies tend to fall into two categories, amrein said. e first are people who simply don’t trust modern pharmaceuticals. e others are people who have tried drugs, and are hoping for something effective and natural. While much of mountain meadow herbs’ business is focused on helping amish and mennonite communities, amrein hopes to grow the market for his herbal remedies outside the religious community. at, however, is a delicate balance, as the amish and mennonite are a devoted, but skeptical, clientele. “you can’t be glossy, loud or self impressed,” he said. “at doesn’t work with them. you have to respect their values.” With 20 employees, the company is just the right size to be able to achieve its goals, amrein said. “I don’t want to create something anonymous and big,” he said. staying focused is important, as the market for natural remedies has expanded greatly in the last few years. “e market

A worker holds herbs used in creating tinctures at Mountain Meadow Herbs.

David P. Amrein stands outside Mountain Meadow Herbs in Somers, Mont.

has seen a lot of innovation,” he said. “to set yourself apart from what is there, is not as easy as it once was.” trust and experience are keys to building a customer base that relies on quality herbal products, amrein said. he’s also seeing traditional Western medicine embracing herbal remedies. Creating and selling natural remedies requires complying with food and drug administration guidelines. since the herbal tinctures are classified as a food, mountain meadow herbs cannot make medical claims. one of their tinctures that is used as an anti-diahreal can only be said to “balance the digestive system.” amrein lives in switzerland and travels between Europe and Kalispell. Coming out of college armed with an mBa, he knew he didn’t want to go into business with aspirations of being a banker and occupying a corner oﬃce. “I wanted to do something meaningful,” he said. “I had a great job oﬀer out of school but I would have been totally replaceable, and I wouldn’t have been trying to make the world better. e whole thing is very close to my heart. I’m in the business of making products that benefit people.” on the web: mountainmeadowherbs.com M O N TA N A L I V I N G . C O M

VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

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PHYSICAL THERAPY

Head start How physical therapy can help alleviate head, jaw and face pain

BY DAVE REESE MONTANA HEALTH JOURNAL

t must be the dry air from flying in an airplane, I thought. Whatever it was, it was making my nose dry and itchy. scott Ruta had a different idea. Ruta, a physical therapist in Whitefish, looked at my neck, not my nose, to figure out what was making it dry and itchy. Ruta is an advocate of using physical therapy to address a wide range of maladies, from headaches to facial pain, and yes, even a dry, stuffy nose. Ruta, owner of Whitefish erapy and sport Center, has begun using physical therapy techniques that pinpoint sources of pain. some people come to his office saying their headaches are due to menstrual cramps, diet or alcohol. during the interview for this story, Ruta was quick to start narrowing down the source of my problem and he smiled knowingly about my airplane anectdote. using a gentle pushing technique on my chin, we started to adjust my neck, head and spine position. Within a few minutes I began feeling some relief, as blood flow seemed to be increasing to my nasal passages. Ruta is using the techniques to help people with a wide range of medical issues. People who have had headaches for 30 years and he is treating them with good results, Ruta said. using a technique called centralization, Ruta traces the pain back to its source. en with a series of manipulations, he and the patient can begin to unlock the hidden causes of body pain. “In the first visit I can usually tell if a patient can be helped in one session, or one year,” he said. “some patients have had these symptoms for 20 or 30 years, and they don’t get better on their own … until you address the mechanical problem.” e process works well with headaches, and the severe kind of headaches known as migraines, he said. Physical therapy for physical pain is something that more people are trying, Ruta said, but he hopes that he can direct his treatments to the population that is most responsive to them: young adults and children. “ey respond so much better,” he said, “and it teaches parents what correct posture is.” •

Physical therapist Scott Ruta demonstrates techniques he uses to help patients alleviate pain.

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VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

PROMOTIONAL SEGMENT

StartingYoung Chiropractic at an early age can help establish healthy patterns in life

PHOTOS BY CRACKLE BINGHAM 54 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

M O N TA N A L I V I N G . C O M

nthony Lambert likes to get children off to a good start in life, and through chiropractic, he’s able to do just that. Lambert, a Missoula chiropractor, works with many families who see chiropractic healthcare as a way to treat colic, ear infections, bed wetting and other children’s illnesses. Lambert is trained in what’s known as the Webster technique. This technique is helpful in treating women in the final trimester of their pregnancies. This is a crucial time for women to help them prepare their pelvis and align their sacrum for the birth process, he said. “That’s the time I like to be involved, for mom and baby,” he said. For children, chiropractic is an effective treatment and often shows immediate results, Lambert, a father of three with his wife, Stephanie, said. “I wasn’t that interested in treating children until we starting having our own,” he said, “and I realized it’s easier to teach them when they’re young.” Lambert said he uses a light touch with children and his treatments are mainly soft-tissue manipulations. Lambert sees chiropractic being incorporated into a multi-displinary approach to health care, and more

Children BOE Chiropractic... the

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side effects Fewer ear infections, better sleep, stronger immune systems, relief for colic and other digestive disorders, as well as, overall health and well being.

healthcare professionals are turning to chiropractic for a variety of reasons, he said. “Medical doctors are starting to get it and understand it, that we can help with a lot of the work load of doctors by helping patients with musculoskeletal issues,” he said. Better research has also led to chiropractic care being incorporated into other forms of healthcare, according to Lambert, whose patients also use physical therapy and massage, when appropriate. Chiropractic helps to reduce stress and create balance in the spine and nervous system, Lambert said. “We help take care of the foundation, then let the natural healing of the body take over,” he said. That’s why chiropractic works so well for children, he said. “Their bodies are built to adapt and change,” Lambert said. “With adults you don’t see the drastic results you see with children.” ON THE WEB: ICPA4KIDS.ORG

Dr. Anthony Lambert specializes in dealing with prenatal care, pregnancy, and children.

406.541.WELL • www.lambertfc.com Now accepting Healthy MT Kids Plus insurance M O N TA N A L I V I N G . C O M

VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

A collaborative practice offering holistic, integrated healthcare options as unique as each individual we serve. Acupressure Aqua Chi Detox Foot Baths Ayurvedic Wellness Consulting BodyTalk Chiropractic Care Cranio-Sacral Therapy Family Medicine Homeopathy Hypnotherapy LEAP Therapy Massage Mental Health Counseling Neuro-Linguistic Programming Rosen Method Bodywork

825 West Kent Avenue, Missoula MT

406-721-0033 www.redwillowcenter.org 56 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

M O N TA N A L I V I N G . C O M

HOME AND GARDEN

Grow your own Tips on establishing your indoor garden paradise BY THERESE WOOD

rowing your own vegetables and herbs is a hobby for some and a way of life for others, but whatever your level of interest in growing food at home, it can be easily done year round with a moderate one time investment that can last for years. Everyone knows that plants need light, water and nutrients to grow, but the quality of those things is what makes the diďŹ&#x20AC;erence for a successful garden. Lighting is probably the single most important factor in creating an indoor growing environment, says matt î&#x20AC;&#x201A;rasher, certified master gardener and owner of Box of Rain organic garden center in Kalispell. Compact fluorescent lights that are designed especially for indoor plants are available in a variety of sizes that make it easy to design a space that doesnâ&#x20AC;&#x2122;t take up too much room. to begin creating the indoor garden, find an area in the house that is a somewhat unused or out of the way, where a wire metal rack can be placed. î&#x20AC;&#x201A;ese three- to five-foot metal racks can be purchased at your local hardware store. most have three to four shelves, and each shelf that will house pots will have two three-foot to four-foot lights. When the framework for the garden environment is ready, you can move on to the potting. Water drainage is also important, which is achieved by using a layer of stones or hydroton expanded clay pebbles in the bottom of the pots. an excellent potting soil is foxfarm or Roots organics. most potting soils have perlite â&#x20AC;&#x201C; small mineral beads that help with aeration and drainage. If the soil seems heavy it is a good idea to add extra perlite. If you are starting with seeds, you will want to use the small individual seed starter containers made of plastic or rockwool. another key to growing healthy indoor plants is the availability of nutrients. since the soil canâ&#x20AC;&#x2122;t replace the nutrients with dead plant matter over time, the potted plant must receive nutrients from an outside source of fertilizers. Liquid or powdered fertilizers that can be mixed with

water are an excellent way to deliver this nutrition to the soil. î&#x20AC;&#x201A;rasher recommends natureâ&#x20AC;&#x2122;s nectar liquid, down to Earth Powder, or his favorite, Bio Bizz liquid and their own in-store made compost tea. Compost tea from Box of Rain is a mixture of Earth tonic fertilizer, Earth Compound, Earth Kelp and molasses that is churned in î&#x20AC;&#x201A;e vortex Brewer which aerates it, providing the oxygen for the robust growth of microorganisms that are necessary to break down the soil nutrients to make them available to the plants. Here is a tally of the items needed and their approximate cost: Four shelf rack: $50 Lighting for a four shelf rack (using bottom shelf for storing plant care items): $240 Pots of various sizes: $6.50 (garden bags) to 25.00, or with geo pot raised beds $42 each shelf

Matt Thrasher, owner of Box of Rain in Kalispell.

Drainage stones or clay pebbles: $20 Potting soil:$15 - $30 Fertilizers: $10 -$20 Fan: $30

on the Web: www.msuextension.org

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VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

Montana

Health Journal Guide to Senior Living

Prestige Assisted Living MINUTES AWAY from Glacier National Park, Whitefish Mountain Ski Resort, Flathead Lake and snow-capped mountain peaks, Prestige Assisted Living Center in Kalispell is surrounded by the awesome beauty of nature. Conveniently located in a residential area just off Meridian and Highway 2 West, our community at Kalispell is close to grocery and other shopping, banking, medical and dental clinics, and the Kalispell Regional Medical Center. This pet-friendly community offers a choice of 44 studio, one- and two-bedroom apartments featuring a kitchenette with full-size refrigerator and microwave oven, barrier-free showers, individually controlled heat, and a 24-hour emergency call system. All of the firstfloor apartments feature private patios. Apartments with mountain views are also available. Prestige Assisted Living at Kalispell also offers a beauty salon, spa room, fitness gymnasium, private dining room, an activity room with a large screen television for viewing all your favorite shows and a central courtyard. Prestige Assisted Living 125 Glenwood Drive, Kalispell, Montana 59901 406.756.1818 Fax: 406.756.0583 www.prestigecare.com

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Your Y our Loved Loved Ones Ones Deserve Deser ve the t Best! At Prestige Assisted Living at Kalispell we know how im ones are to you! Our dedicated trained staďŹ&#x20AC; are re lifee to the fulles lif fullest!

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For more infor information please call 406-756-1818, for a visit, weâ&#x20AC;&#x2122;d love to see you! 1SFTUJHF 4FOJPS -JWJOH --$ PXOT BOE PQFSBUFT JOEFQFOE OBUJPOBMMZ SFDPHOJ[FE &YQSFTTJPOTÂ&#x2122; .FNPSZ $BSF DPNN

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Prestige Senior Living

M O N TA N A L I V I N G . C O M

Immanuel Lutheran Communities IT’S THE FULLEST, most convenient and most professional array of senior services in the Flathead Valley. With Residential Living, Assisted Living, Skilled Nursing, Rehabilitative Services and Memory Support integrated into a compassionate continuum, Immanuel Lutheran Communities offer everything in one place with a distinctive style that looks like hospitality and feels like friendship. Residential Living at Buffalo Hill Terrace: Maintain your active lifestyle from the comfort of your beautiful apartment home — with services and amenities that make everything easier. Assisted Living at Buffalo Hill Terrace: With a little bit of help, remain as independent as possible. Rehab to Home at Immanuel Lutheran: Catch your breath after surgery or an accident. First-rate professional care and old-fashioned kindness are provided with newly renovated private rooms and the friendliest staff around. Long-term Skilled Nursing at Immanuel Lutheran Home: The professional attention you expect, with a loving kindness that makes such a remarkable difference. Memory Support at Bratsberg Dementia Care: For residents with age-related dementia and Alzheimer's, our specialized and caring community is determined to make each day a good day. CHOICES, CARE AND INTEGRITY — they’re what so many have come to expect from Immanuel Lutheran Communities.

A better way to get better. The Retreat at Buffalo Hill delivers concierge-like personalized service in a resort-like setting. When you can’t go straight home after surgery or an accident, your ideal getaway is The Retreat. You’ll find an exceptionally comfortable environment, flexible dining, private suites, state-of-the-art therapies – and straight-from-the-heart care. So catch your breath and mend yourself at The Retreat at Buffalo Hill. It’s a better way to get better.

25 Claremont Street Kalispell, MT 59901 (406) 752-6953 www.ilcorp.org

Immanuel Lutheran Communities 185 Crestline Avenue, Kalispell, MT 59901 406-752-9622 •www.ilcorp.org

M O N TA N A L I V I N G . C O M

VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

Montana

Health Journal Guide to Senior Living

Join our Families in Kalispell You can make Valley View Senior care, a certified senior care house, your home with beautiful views of the Flathead Valley. Valley View Senior Care offers 24-hour personalized senior care provided at lower costs than most assisted-living facilities.

We offer nutritious, home-cooked meals with healthy food that allows us to accommodate special dietary needs. We are young seniors ourselves and will help you socialize, since your mental health is as important to us as your physical well being.

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We treat our residents like family, in the updated home where we raised our own for more than 30 years, simply because it’s the way we would want to be treated ourselves. Westside Care Home in Kalispell offers a beautifully remodeled home with a true family atmosphere. Scott and June Huckeba are licensed for four elder residents in the home where they are raising their two young boys. June is a registered nurse with 10 years of experience in nursing care. This couple is passionate about providing quality, loving care to an aging generation. Come and see if this could be the perfect place for your loved one in need of assisted living. Valley View Senor Care 406-756-2282 valleyviewseniorcare.com

60 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

M O N TA N A L I V I N G . C O M

Live the Wel-Life As we celebrate our senior years, our bodies resist a bit and tasks that might have been routine become more challenging. Assisted living level of care may be the right fit for many seniors, in fact a large number of our retired tenants thrive in the environment that assisted living offers. What are some of the benefits of our Wel-Life care? Independence: With the help of our professional care team, the reliance upon family members and friends to help with daily routine tasks are minimized and handled by our professionally trained personal service care team. Safety: This feature includes having personal service attendants available if assistance is needed; as well as reminders regarding medication times and administration. Safety is of high priority at Wel-life. Each room is equipped with a call system to notify our care team if any assistance is needed. Companionship: Having people around to share, love and laugh with is an important priority. We offer a number of social gatherings for all of our community members to keep each person as socially active as possible. Activities: A big part of assisted living is the activities. Activities are not only intended to keep community members active, they also serve as a way for tenants to participate as they choose. Our activities are not only fun but they are also a way for our tenants to get to know one another and become familiar and comfortable with our community. Peace of mind for you and your family. At WEL-Life at Kalispell, we have someone on duty every hour of the day. We also have a Registered Nurse on-call for any emergency situations. Come Live the WEL-Life!

WEL-Life Kalispell 156 Three Mile Dr, Kalispell · (406) 756-8688 wlkalispell.com

Foster Care at Quality of Life If you have an aging loved one who needs daily help, but you don’t want them to go into a nursing home, adult foster care is a quality alternative. Adult foster care homes provide a home-style environment with a small group of seniors and around the clock care. Laura Schlieper, administrator of Quality of Life Adult Foster Care in Kalispell, is a licensed nurse and has worked with the elderly for 30 years. “I find it so rewarding to care for these precious aging individuals,” she says. Quality of Life Home can also fulfill special needs for those suffering from Alzheimer’s, as well as third party assistance on site from physical therapists, comfort care (to eliminate doctor office visits), and hospice. Quality of Life can also accept Medicare and insurance. Adult foster homes are residential homes that provide their residents with a trained caregiver who cooks their daily meals and accommodates special diets, assists with bathing, medications, and other individual needs. Residents truly feel a sense of home and personal connection in this setting and are provided with transportation to doctor’s appointments and outings. Family members can come and go for visits as they wish, secure in the knowledge that their loved one is getting the attention and care they need. An adult aoster care home can provide more individualized care and costs almost half as much as most nursing homes. It is worth a visit to Quality of Life Home to see if this is the senior care difference you are looking for. Quality of Life Adult Foster Care 409 Parkway Dr., Kalispell, MT. 59901 (406) 756-2273 M O N TA N A L I V I N G . C O M

VOL. 3 NO. 1 2013 MONTANA HEALTH JOURNAL

PICTURE OF HEALTH

Heidi Fehlhaber takes in the spring sunshine on Whitefish Lake. Dave Reese photo 62 MONTANA HEALTH JOURNAL VOL 3 NO. 1 2013

M O N TA N A L I V I N G . C O M

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