Montana Health Journal spring 2017 by Montana Living

Montana

Health Journal T H E M AG A Z I N E O F C O M M U N IT Y W E L L N E S S

striking

a chord H ow m u s ic c a n h e lp h e al t h e s o u l

ALLERGY FREE

How immunotherapy brings relief to allergy sufferers

FLOAT AWAY

Float therapy centers on the rise

EQUINE FRIENDS

The emotional benefits of horses

STROKE SURVIVOR A woman battles back from debilitating series of strokes M O N TA NA L I V I N G. C O M

SPRING 2017

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CONTENTS: WINTER/SPRING 2017

FEATURES FINDING RELIEF FROM ALLERGY 13 How immunotherapy can help allergy sufferers YOGA IN THE WILDERNESS 22 A Helena retreat brings peace and calm STRIKING A CHORD 28 Bringing music therapy into mainstream

DEPARTMENTS PERSONAL JOURNAL 18 A musicianâ&#x20AC;&#x2122;s journey through brain illness HEALTH TRENDS 25 Benefits of float therapy, plus a look at equine-assisted therapy (p. 35) OUTDOOR REPORT Tips on proper boot fitting

ALTERNATIVE HEALTH 38 Missoula hypnotherapist Clark Patton talks about his work HEALTHY COMMUNITIES 41 Halt Cancer at X provides needed financial support HEALTHCARE PROFILE 43 Massage therapist Tammatha Ann takes diverse approach STATE OF HEALTH 44 Montana children make progress in well-being

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NOTE TO READERS: The contents of Montana Health Journal are for informational purposes only. The content of Montana Health Journal 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, healthcare providers, products, procedures, opinions, or other information that may be mentioned in this magazine or on its website, montanaliving.com. 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. M O N TA N A L I V I N G . C O M

SPRING 2017 MONTANA HEALTH JOURNAL

Health Matters News for a healthy Montana COMMUNITY

New homes for seniors Major new project under way at Immanuel Lutheran in Kalispell KALISPELL – Immanuel Lutheran Communities has broken ground on a $45 million, multi-phase, five-year expansion at Buffalo Hill Terrace in Kalispell. The first phase of construction adds a new therapy gym and 32 guest suites for a total of 48 guest suites at The Retreat at Buffalo Hill, a center designed for short-term rehabilitation and post-acute care. The expansion will include accommodations for postacute patients transitioning from hospital care before returning home. The expansion at Buffalo Hill Terrace began last summer with construction of The Lodge, an assisted-living memory-support neighborhood. The new Lodge will include

24 private residences and continues Immanuel Lutheran’s tradition of serving those with Alzheimer’s and other related dementias – a need that is expected to nearly triple in the next 35 years. In 1976, Immanuel Lutheran Communities was one of the first organizations in the country to open a dedicated living environment for people with Alzheimer’s disease.

Construction on the new phase is expected to be completed in the summer of 2017. •

RESEARCH

Montana man helps develop lung-cancer testing device BY MARSHALL SWEARINGEN

BOZEMAN - Montana State University alumnus Joseph Azzarelli has won a prestigious business plan competition with a noninvasive, low-cost lung cancer screening technology. The CARD is a postage stamp-sized sensor capable of detecting gases that indicate the presence of lung cancer. Similar to a breathalyzer, the lung cancer-specific Chemically Actuated Resonant Device measures the quantity of those gases when a patient blows on it. Azzarelli took a leading

role in developing a lowcost interface that allows the detection results to be

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easily read by a smart phone or other mobile device. Azzarelli earned a

bachelor’s degree in chemistry from MSU in 2010. Azzarelli and the team won by describing how single-use CARD devices could be manufactured for less than $1 each and produce results 10 times more accurate than CT scanning, an expensive process used for cancer screening. "Thinking about how to commercialize technologies in a way that is meaningful, has proven extremely fulfilling for me,” he said. “I am thankful for the many mentors and friends who have helped.” •

Healthier TEENS Montana launches teen vaccination program The Montana Immunization Program and its partners have launched a multi-year campaign called MT TeenVax that aims to promote teen vaccinations. This campaign will focus on increasing awareness about teen vaccines by providing resources and information to healthcare professionals, parents, and teens. “Montana continues to improve coverage levels for adolescent vaccines, and we’re hoping this program will help us improve even more,” Bekki Wehner, Department of Public Health and Human Services Immunization Program Manager, said. “The MT TeenVax campaign will help highlight the importance of adolescent vaccines statewide.” The recommended vaccines for teens are tetanus, diphtheria, pertussis (Tdap), the human papillomavirus (HPV) series, and the start of the meningococcal (MCV4). These vaccines are routinely administered at age 11-12 years and catch up for those age 13 years and older who missed vaccination. The influenza vaccine is recommended every year, Wehner said. “These vaccines are a safe and an effective way to help teens start a healthy adulthood,” Wehner said. For more information about adolescent vaccines go to www.immunization.mt.gov.

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Health Journal SPRING 2017

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a chord

H ow m u s i c t he r a py h ea l s t h e s o ul

ALLERGY FREE Immunotherapy brings relief to these allergy sufferers

FLOAT AWAY

Float therapy centers on the rise

EQUINE THERAPY The benefits of equine therapy

STROKE SURVIVOR

A woman battles back from debilitating series of strokes MONTANALIVING.COM

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PERSONAL JOURNAL

Learning Life all Over Whitefish woman battles back from series of severe strokes

BY DAVID REESE, MONTANA HEALTH JOURNAL

The headaches she was getting were bad, but Leslie Leroux had gotten used to them. ese headaches were diﬀerent, though. “ey were mega headaches," Leroux said. Four years ago, Leroux, a native of Paris, was a successful business person operating a boutique in Whitefish for her fashion company, Ethos Paris.

Whitefish resident Leslie Leroux survived eight strokes and had to re-learn how to walk and talk.

After about a week of painful headaches and unable to get out of bed, she called 911 and was taken to the hospital. After being releaesed, her family came home to find Leslie largely unable to explain what was happening. Her husband took her back to the hospital. What they found inside Leslie was a bacterial heart condition that had been sending showers of bacteria into her brain — in eﬀect, causing eight separate strokes.

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Leroux had what is known as ongoing diﬀuse embolic shower, according to Kalispell vascular neurologist Kurt Lindsay, M.D. Lindsay is the medical director for the stroke program at Kalispell Regional Medical Center. In embolic showers, the areas of stroke caused by restricted blood flow are usually small, Lindsay said. But recovery takes a long time and the degree of recovery can vary. “Leslie was young and healthy, had a great medical team, and worked very hard to get back to where she is now,” he said. Leroux underwent open-heart surgery at Kalispell Regional. But her condition was in peril. She could not speak or walk. Before the strokes, Leroux had been a vibrant, healthy woman. So she persevered, and taught herself how to re-learn reading, walking and talking; she did every possible brain-training exercise she could find, and after a few months she was able to walk to the end of her driveway. She regained her health on her own in a year, with a dogged perseverance and independence she is known for. But it was that independence that also may have caused her problems in the first place. If she had not waited so long to seek medical attention when she was having headaches, the bacterial heart infection might not have gotten so severe. "I was having incredible pain in my brain, and I thought it would never cease," she said. "I had been having migraines, but these were mega headaches. It literally felt like I was dying." While she was in the Kalispell hospital, she remembers feeling as if she was entering a calm, peaceful world, one without pain. “I felt I was being pulled into another reality, another world,” she said. “at was incredible, wonderful. It was an unreal place of bliss.” en she began to realize, deep inside, that her body wanted to heal. Her sister, who had arrived from France, whispered in her ear and Leslie awakened, opened her eyes and found herself surrounded by family. "I realized then I had another chance," she said. "From that point I was really driven to get well again." “I always took pride in my intellect,” Leroux said. “I found it very hard to accept my condition—I not only could not speak properly, I couldn’t read, I could not make sense of words on the page.”

When she had been in the emergency room, she wasn’t very responsive and was sleepy. She showed confusion, facial droop and was not able to walk or speak — all classic signs of stroke. “I couldn’t really talk. I couldn’t express myself and I was very bothered and hurt by the way people were acting towards me,” Leroux said. “ey didn’t know I was still in there, still with the power to think, even though I couldn't do much else." Leslie explains that she holds a deep belief that a body, on a very basic cellular level, wants to survive and repair itself. She believed she could recover. After months of retraining her brain, finally she began to be able to talk more fluidly and express herself. Leroux learned from her experience to appreciate the simple gifts of life — like just waking up to another day. “I really see the world diﬀerently now," she said. “I feel lighter, and thankful every morning I am alive.” She said she didn't think stroke could happen to her. “I was almost obsessively healthy, with an all-organic, vegetarian diet,” Leroux said. “But nothing guarantees your health, and no extreme is good.” She now says, “Pay attention to your body and when it feels wrong, do something about it. Don’t be prideful; be willing to seek help. I should have called for help earlier instead of staying in pain for days.” Leroux is, literally, a changed person after the stroke. She said one of the things she lost was all her baggage — all the regrets, grudges or peeves that humans may accumulate in their lives. “Negativity is gone, and I feel lighter and freer without it,” she said. “I wake up every

‘I'll never be 100 percent again, but I'll be something else.’ — LESLIE LEROUX morning and know we all have such an amazing beautiful life. I'll never be 100 percent again, but I'll be something else.” Stroke is a leading cause of long-term adult disability in the United States. Stroke survivors often have lingering problems with speech, balance, mental functions or emotions — depending on what part of the brain is aﬀected. Multiple areas of Leroux's brain were damaged by her strokes. Dr. Lindsay said cardiac disorders like the one Leroux had are one of the most common causes of stroke, and he recommends all stroke patients have a thorough cardiac evaluation to rule out any abnormal heart rhythm or structural abnormality. LINdsaY and LeROUX spoke at a program last fall called “Faces of Stroke.” Jason Gleason, who lost his wife to a stroke, leads the Faces of Stroke program around Montana. e program helps to educate people about stroke awareness. Gleason told the story of how he lost his wife unexpectedly one day in 2011. Gleason had said goodbye to his wife, Heather, one morning when he went to work at a Great Falls emergency room. en he heard the police scanner report the address of their home. His wife was having a stroke. In half an hour she was being wheeled into the emergency room where Jason worked. Two days later she was declared brain dead. She lived only 29 more days. Heather Gleason had suﬀered what is called a locked-in stroke —

REMOTE

ACCESS Telemedicine program brings help to rural areas TELEMEDICINE is stretching its wings at Kalispell Regional Healthcare and partnering hospitals. When a 32-week-old baby was born at Ronan’s St. Luke Community Healthcare at 3 pounds, 3 ounces, the baby arrived to the world in distress. But, thanks to a telemedicine network that was established initially for stroke care between the two hospitals, the tiny girl ended up in very good hands. A.L.E.R.T. Helicopter Flight Nurse Doris Yeatts, RN, said the mom still was in labor when the call requesting transport came in from Ronan. She, EMT Laurel Smart and pilot Matt Weller began preparations for the flight. As they were leaving, Neonatologist Mark Kaneta, MD, floated the idea of using the InTouch Health technology. “I said, ‘Yes, please,’” Doris recalled, “and we headed out.” When they touched down in Ronan, St. Luke’s medical team already had connected their end of the telemedicine equipment. Dr. Kaneta and Neonatal Intensive Care Unit Clinical Specialist Mindy Fuzesy signed in from Kalispell and the dual sites began communicating verbally and visually. The premature, hypotensive and hypoglycemic girl needed a dose of dextrose for her low blood glucose, and she needed a normal saline dose. As Laurel prepped all the supplies, Doris calculated dosages and began administering the life-saving medicines. At the same time, Mindy calculated the dosages and Dr. Kaneta assessed the infant via video link, viewing each procedure in real time. Because Doris didn’t have to stop and report results to Dr. Kaneta at each step, treatment was much swifter. “I could see immediately what to do and whether it worked,” Dr. Kaneta said. Right through the minutes that Doris and Laurel packaged the infant for transport back to the Kalispell neonatal intensive care unit, Doris felt solid support. The mother’s physician in Ronan called Dr. Kaneta the next day to say how much he liked the interaction. KRMC’s referral hospitals in Libby, Ronan, Cut Bank and Whitefish have access to this teleneonatology service because of federal grant funding for the equipment. The same grant that funded KRMC’s InTouch start-up technology also covered the cost of these hospitals’ equipment. Over the past few years, two initiatives have helped pave the way for telemedicine in northwest Montana. The Federal Communications Commission awarded $13.6 million to fund the Health Information Exchange of Montana, which established an advanced fiber-optic network between KRMC and remote sites. The U.S. Department of Agriculture’s Tele-Stroke grant funded robotic equipment that allows Kalispell physicians to evaluate patients in real time in rural communities. Most recently, KRMC was awarded a $373,658 grant from the USDA Rural Development Distance Learning and Telemedicine Program to provide reliable telecommunications connectivity for four additional rural facilities. To learn more about telemedicine at Kalispell Regional Healthcare, call (406) 751-3067.

SEE STROKE ON PAGE 27

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SPRING 2017 MONTANA HEALTH JOURNAL

Dr. David Healy is an allergy specialist and ear, nose and throat surgeon in Kalispell who works with allergy immunotherapy. DAVID REESE PHOTO

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New ways for allergy

RELIEF How immunotherapy helps allergy sufferers

BY DAVID REESE/MONTANA HEALTH JOURNAL

arlene Schottle doesn’t have to shy away from being active in the outdoors any more. irty years ago was a diﬀerent story for her, though. Back then, Schottle had a severe allergy to celery. For years she battled headaches, diﬃculty breathing and swelling in her eyes and hands due to her food and many environmental allergies. Over the years, Schottle learned to manage her allergy symptoms by avoiding the allergens that caused her health problems. When she moved to the Flathead Valley in 2004, she started getting symptoms again — some of them severe. Schottle had been on a regimen of antihistamines to control the allergy symptoms, but her primary-care physician advised her that long term antihistamine use was not good for her body; so she went to Glacier ear, Nose and roat in Kalispell for allergy testing and subsequently began immunotherapy. She found the entire process significantly more comfortable than her initial experience. Immunotherapy gradually exposed her body to the allergens that caused her so many problems. Little by little her body began to build up immunity. “I feel so much better,” she said. Schottle received three shots a week over the course of three years while in the Allergy program at Glacier Ear, Nose and roat. When Schottle began to feel some minor allergy symptoms about a year ago, she attempted to self-manage the symptoms with antihistamine medications; but decided to schedule updated allergy testing at Glacier Ear, Nose and roat, where they identified seven new allergies. She began weekly immunotherapy shots and now she’s back enjoying

the outdoor activities that she loves, like boating and hiking. “ey treat what it is you’re allergic to, and they helped educate me on the other things that I need to avoid,” she said. “If you do that, you can have some pretty successful outcomes.” She said antihistamines made her groggy, and years of allergy suﬀering caused her to develop severe nasal blockage, which surgery helped to alleviate. She’s glad she took the advice of her physician to undergo immunotherapy under the guidance of Dr. David Healy at Glacier Ear, Nose and roat. “It has had a really positive impact on my life,” she said. “My body knows how to take care of itself now.” One benefit of immunotherapy has been the positive impact on the quality of her sleep, Schottle said. Healy, an otolaryngologist, and a fellow of the American Academy of Otolaryngic Allergy, said allergies are an overreaction of the body to otherwise nontoxic environmental stimulants. Allergy, he said, is the human body’s immune reaction to an environmental stimulant that should otherwise be benign. Allergens can be food-related or environmental, such as pollen, mold, animal dander or dust. Allergens often impact the nose and lungs. “e allergic response is theorized to combat things that our bodies no longer need to combat, like a parasitic infection,” Healy said. In other words, human bodies are mistaking everyday allergens like grass or hay for something much worse. Healy postulates that humans are not being exposed to common infections as much as in past decades. He calls this the “hygiene hypothesis.” “Our environment is so clean. Our bodies are no longer exposed to the infectious agents they once were," Healy said. continued next page >>>

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SPRING 2017 MONTANA HEALTH JOURNAL

By trying to stay extremely clean, humans may be putting their bodies at risk to developing a heightened allergic response, Healy said. abies in today’s American culture, Healy said, are given antibacterial products and are living in a highly sterilized environment. “ey simply don’t have these exposures” to allergens, he said. Healy said he’s seeing an “epidemic of allergic conditions.” Accurate evaluation is important for allergy suﬀerers. “If you don’t know what you’re allergic to, you won’t know how to avoid those allergens,” Healy said. ere are three ways to treat allergies: • Avoidance of the allergens; • Medicines to treat the symptoms; • Immunotherapy — training your body to not have an allergic reaction to common allergens. Human bodies are born a blank slate on how they will react to allergens. As human bodies’ immune systems are exposed to the world, the immune system learns to recognize its own body and what it needs to react against, Healy said. e allergic response is one form of the

14 MONTANA HEALTH JOURNAL SPRING 2017

‘e sinus is kind of like a black box. It takes work to get to the bottom of what a person is suﬀering from.’ — DR. DAVID HEALy immune response, and it’s not always a helpful way for the body to react, Healy said. Immunotherapy introduces allergens to the body in a methodical fashion that allows a more appropriate immune response which allows the body to grow stronger. Health trends often follow popular culture, and there seems to be a predominance of people who are allergic to something. Healy has seen patients come to his oﬃce looking for help, and they are allergic to something specific though it's not always what they think it is. rough the science of immunotherapy, he's been able to find the exact cause of their allergy. “It is important for us to stay scientifically grounded in our testing and treatment of allergies," Healy said. "We rely

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

on evidence-based medicine. Patients that complete their immunotherapy regimen are able to live a much better life, and they are free of the allergy that once limited their lifestyle.” Our immune systems are constantly changing. As we age they tend to weaken, but that also means that the older human body typically doesn’t react as strongly to allergies, Healy said. However, older adults can develop rhinitis or chronic asthma, even though they didn’t have these conditions as children. rough immunotherapy, people now have the opportunity to help their bodies grow stronger against common allergens; in eﬀect, possibly preventing immune responses such as asthma, according to Healy, a former Navy physician.

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Healy did a fellowship in rhinology at Harvard and is an ear, nose and throat surgeon. He said he finds allergy is often the culprit of underlying medical ailments. “We used to favor surgery as the best option for many patients, but we didn’t always understand the underlying process,” he said. “In order for me to be a good surgeon, I need to understand all the medical aspects I treat. Our understanding of allergy and immunology continues to expand.” People often arrive at his clinic with chronic nasal or sinus complaints. rough a methodical process the clinic is able to narrow down the cause of the patient’s allergy. “e sinus is kind of like a black box,” Healy said. “It takes work to get to the bottom of what a person is suﬀering from.” WhaT Is aLLeRGY? e basic understanding of chronic inflammatory conditions is changing, Healy said. Chronic sinusitis was once regarded as a chronic bacterial infection, and would be treated with antibiotics. "In most cases it is not," Healy said. "Our understanding now is that it's a chronic inflammatory condition, more like asthma." ese symptoms are now often treated with anti-inflammatory drugs, rather than antibiotics. While Healy takes a scientific approach to immunotherapy, the process is based in human healing. "It's wonderful to clarify what people are suﬀering from," Healy said. "Helping people understand is immensely important, and I enjoy that aspect of my work. Changing their quality of life is meaningful to me as a physician.” •

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Oh, NUTS! How a family battled peanut allergies ONE KALISPELL family has learned how to adapt to their daughter's severe food allergy, and they used immunotherapy to increase their daughter's resistance to histamines. Even a handprint of someone who has eaten a peanut butter sandwich can send Jadyn Schussler to the emergency room. Schussler, 13, has an over-reactive immune disorder that makes her body extremely sensitive to allergens, especially peanut butter. But with the help of immunotherapy at Glacier Ear, Nose and Throat, Jadyn is slowing becoming more immune to everyday allergens. Her mother, Sarah Schussler, remembers when Jadyn was a young girl and Jadyn would aggressively scratch her skin from allergic reactions that caused severe eczema. Her family tried light therapy to help reduce their daughter’s eczema, and for a while they thought they had Jadyn's allergies under control. Her parents had concerns about light therapy, because they had to balance whether Jadyn would get an infection from the open sores on her skin, or if light therapy might lead to skin cancer, Sarah said. Then, three years ago, Jadyn ate a peanut butter sandwich. She went into shock and was taken to the Kalispell emergency room. After that incident, Jadyn's parents took a more aggressive approach to controlling her allergic reactions, and began immunotherapy at Glacier Ear, Nose and Throat. Jadyn started a four-year immunotherapy regimen two years ago, receiving two shots per session. While the immunotherapy regimen does not help with food allergies, Jadyn is able to slowly train her body to not overreact to other allergens that she might be exposed to. Jadyn's food allergy was so bad that her parents had to change schools when Jadyn was in seventh grade. If Jadyn so much as touched a water fountain that someone with peanut butter on their hands had touched, it could send her body into shock. “She couldn't even walk into the school without being scared," her mother said. "She was just this tiny, scared kid.” The allergic reactions and the histamine response would cause her throat to swell, and put pressure in her chest, Sarah said. Jadyn's parents asked the school to not serve nuts, but they would not change their policy. So the family changed schools. Jadyn’s new school, near Kalispell, was more than willing to take her as a student, and the school adopted a policy where other students must eat their peanut butter sandwiches or candy bars in separate lunch rooms. "She's learned a lot," Sarah said. "She knows how to keep herself safe. She's been sick forever, but now that she's older, she's learned to stick up for herself." Now, if Jadyn gets a severe allergic reaction, she has an Epi-Pen to fight any severe histamine response. Jadyn's parents don't have to worry about their daughter as much, and they're glad the skin-scratching is over. "She's lucky. She looks beautiful and my little girl just made the cheer team at her high school," her mother said. "It's amazing, because it's something I never would have seen for her." — David Reese

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PERSONAL JOURNAL

The right notes Electronic device brings back musical life for musician Reid Merley

BY MARTI EBBERT KURTH

t the start of every orchestra concert when the concertmaster cues the principal oboe player to blow the note “A,” that pitch becomes the standard the orchestra tunes to. For Glacier Symphony principal oboist, Reid Merley, being in perfect control of that note, and the thousands that follow it, has been a skillful combination of his breathing, muscle tone and nervous system for over 46 years, ever since he first began playing the oboe at age 11.

frequently is called upon to play, into position and began to blow into them. e shaking came seemingly out of nowhere, with no other symptoms such as pain or headache to precede it. Merley says until that day the tremor had never happened while he was in a concert situation and he was extremely upset at its appearance. At the time, Parmater and Merley were living together in Wyoming where she was executive director of the Wyoming Symphony. e symphony conductor suggested he see a neurologist, who diagnosed it as an essential tremor and

But one day in 2007, when Merley and fellow oboist, Sherry Parmater, were rehearsing, Parmater noticed that Merley was having trouble holding his instrument still. “I was shocked,” she said. “I looked over and his hand was shaking and I thought ‘What is that?’ e next day we were playing the concert and he was playing a flute and he couldn’t keep the flute to his mouth. I had never seen anything like it until that day. His arms were suddenly shaking a lot.” It was on that day that a mysterious tremor began to exhibit itself, appearing only when Merley brought his oboe, or any of the other wind instruments that he

prescribed DAVID REESE PHOTO anti-tremor medications to control it. But the medications didn’t help much, Merley said. About a year later, Parmater visited a bookstore around the corner from her symphony oﬃce. e bookstore owner knew she was a musician and told her about a new book she had just gotten in called “Musicophilia: Tales of Music and the Brain,” by Dr. Oliver Sacks. Parmater sat down with the book and had an “aha” moment when she came to the chapter describing musicians who would shake when they

Reid Merley, center, plays oboe for the Glacier Symphony and Chorale.

18 MONTANA HEALTH JOURNAL SPRING 2017

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CONTINUED ON PAGE 20

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Reid Merley of the Glacier Symphony fought an unsusual neurological disorder.

were playing. In about 2006 medical researchers had discovered a condition they call Musician’s Focal Dystonia, meaning the tremor happens only when musicians are in position and playing their instruments. arly on, treatment for the malady was limited to antitremor drugs and possibly cutting muscles and nerves to reroute the impulses. But Merley was reluctant to go down that path. e couple moved back to Kalispell, and Merley, an Army veteran who had played the oboe, tenor drum and piccolo with the 6th U.S. Army Band in the 1970s, convinced the local Veterans hospital to help him get treatment at the hospital in Helena. He had some relief with anti-tremor drugs — enough that he could continue to play his oboe again with the Glacier Symphony in 2009. However, in summer of 2010 when he was scheduled to solo with the Festival Amadeus orchestra, he had to bow out. “I was rehearsing with the quartet for my evening concert and I couldn’t keep my oboe still,” Merley said. “Reluctantly I had to cancel my performance.” e musician, a 1983 graduate of the San Francisco Conservatory of Music, who later played eight years with the Master Sinfonia Chamber Orchestra, stopped playing his instrument completely. He thought his music career was over. “I was ready to put it on the back burner,” Merley said. Parmater wouldn’t give up, though, and she kept encouraging Merley to explore new avenues of treatment. In 2011 he went to the Veterans Hospital in Portland, Oregon, to a newly opened movement disorder unit. e doctors experimented with several new drugs, including injecting Botox into his arms, none of which stopped the tremors, he said. Parmater remembers her frustration with the treatment. “He went through a huge amount of trial and error and nothing really helped,” she said. “I just knew from reading Musicophilia that he had Musician’s Focal Dystonia, which is centered in the brain. But they kept insisting it was a nerve disorder.”

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HEALTH DESTINATIONS

The Feathered Pipe Ranch near Helena provides remote solitude, peace and yoga

BY ANDY VANTREASE FOR MONTANA HEALTH JOURNAL

Feathered Pipe Ranch near Helena is a yoga retreat healing center known for world-renowned teachers and quiet time filled with the sights and sounds of nature.

eep in the lodgepole pines and birch trees near Helena, Montana, people wake to sunlight beaming through the clear dome of a custom-built yurt. ey walk gravel paths to morning meditation, eat breakfast in silence, practice yoga twice a day, drink tea and listen to stories by the campfire, and close out the night with a sauna, hot tub or massage session. is is a typical retreat schedule at the Feathered Pipe Ranch, a healing center known for world-renowned teachers and quiet time filled with the sights and sounds of nature. Baxter Bell, an Oakland-based yoga instructor, medical acupuncturist and former family physician, has been visiting the Feathered Pipe Ranch for 16 years, beginning as a student and growing his practice and experience to that of a seasoned retreat leader. Bell first visited the ranch for a retreat guided by Judith Hanson Lasater, a veteran yoga instructor who has been teaching at the ranch since it opened in 1975. At the time, he had an idea brewing – to leave his family medicine practice of 11 years and start studying yoga full time. e ranch allowed him space to quiet his mind and ruminate on this exciting, yet fearful idea, without outside distractions or influences. “is was the biggest decision I’d ever had to make, even more than my decision to go into medicine because I had thought about that my whole life growing up, and I was on that educational path for so long,” Bell says. “is was taking a left turn and heading oﬀ into the woods without a clear map. yet, I was met with such acceptance and support here, it gave me the confidence to fulfill the idea.” e Feathered Pipe Ranch founder, India Supera, took Bell under her wing for several years after his initial visit. As Bell reflects on their friendship over the years, he describes Supera as a grandmother CONTINUED ON PAGE 33 M O N TA N A L I V I N G . C O M

SPRING 2017 MONTANA HEALTH JOURNAL

A woman floats at the Cloud Niine float center in Kalispell. David Reese photo. 24 MONTANA HEALTH JOURNAL SPRING 2017

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

HEALTHCARE TRENDS

Floating Away Float therapy becomes a popular way to relieve stress

BY DAVID REESE/MONTANA HEALTH JOURNAL

randon Schmaus took a good idea, and armed with a freshly minted business degree started Cloud 9, a collaborative health and healing center in Kalispell. Schmaus had started out with a simple business plan to do a float center, a place where he could install a float tank, or sensory-deprivation pool. His idea grew from there to include two float tanks plus the added benefits of having other healthcare professionals in the same building. He assembled a team of professionals including chiropractor Todd Schleusner, massage therapist Stephanie Krause, midwife Honey Newton, naturopathic physician Joe Holcomb, and naturopathic doctor Paul Raish, licensed primary-care physician. While the float tanks are not the centerpiece of the healthcare oﬀerings at Cloud 9, they may be one of the most unusual. e tanks are basically meditation and relaxation centers. ey allow you to float buoyantly in 93-degree water that is infused with minerals. A solution of epsom salt (magnesium sulfate) increases water density, allowing the human body to float. Users float face-up in a relaxed position, with the face above the water and the ears submerged. is reduces the user's hearing, particularly when using earplugs as protection against the salt water. e density of the water prevents upi from rolling over, even if asleep. you float on the water naturally in zero gravity, without any flotation device, allowing your body to move, stretch and relax in a warm, darkened chamber. Schmaus says one hour of flotation therapy may provide your body an equivalent amount of relaxation as five hours of sleep. (It does not replace sleep, however, Schmaus says.) Within minutes of floating in the tank you begin to focus on your breath, or another meditative calling you choose. Music plays softly, if you wish, on the speakers inside the float chamber. Soon you are drifting away to another place, far from any distractions. Schmaus was raised in a health-conscious family in Kalispell. So when he graduated from Western Montana College in Dillon, Schmaus was eager to put his business degree to work, and in a way that would reflect a healthy lifestyle. “I took it and ran with it,” he said. “is is bigger >>>

Preparing to enter a float chamber at the Cloud Niine float center in Kalispell. David Reese photo. M O N TA N A L I V I N G . C O M

SPRING 2017 MONTANA HEALTH JOURNAL

than my dream.â&#x20AC;? Schmaus also installed an infrared sauna so clients can dial in a deepheating therapy. Float centers are becoming more popular â&#x20AC;&#x201D; as a way to destress, relax and meditate. Cloud 9 is one of two float centers in the Flathead Valley, with the Iso Float center in Whitefish oďŹ&#x20AC;ering flotation therapy also. IsOLaTION TaNKs were first developed in 1954 by John C. Lilly, a medical practitioner and neuropsychiatrist. During his training In neurophysiology, Lilly wondered what keeps the brain going and the origin of its energy sources. One hypothesis was that the energy sources are biological and internal and do not depend upon the outside environment. It was thought that if all stimuli are cut oďŹ&#x20AC; to the brain then the brain would go to sleep. Lilly decided to test this hypothesis and created an environment that isolated an individual from external stimulation. From there, he studied the origin of consciousness and its relation to the brain. Peter Suedfeld and Roderick Borrie of the University of British Columbia began experimenting on the therapeutic benefits of isolation tanks in the late 1970s.

WheN TheY were first developed, isolation tanks were uncomfortable. Users were entirely submerged in the tank, which required them to wear a breathing apparatus and tight clothing. Users complained that the discomfort from the mask and clothing distracted from the isolation experience and that complete submersion led to fear of drowning.

A woman floats at the Cloud Niine float center in Kalispell. A highly concentrated solution of magnesium sulfate (Epsom salts) allows the body to float on water. David Reese photo.

Schmaus says professional athletes and business professionals use flotation tanks to help them visualize goals or just relax. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s do-it-yourself therapy,â&#x20AC;? Schmaus said.

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STROKE/FROM PAGE 11

her brain was in perfect condition but she couldn't move anything, Jason said. For the 29 days that Heather remained alive, Jason and his sons made sure every day was special for her, as a wife, mother and friend. e boys did lots of little things for their mom, like bringing flavored lip gloss to her so she could taste her favorite flavors.

he family was the other victim of the stroke. Hospice care was instrumental in the family's care, he said. “ey were the Keebler elves of love and gooshiness,” he said. Gleason said it's crucial that stroke victims receive tissue plasminogen activator, or TPA, during a stroke event. e drug, which is sold as alteplase, works to break down clots in blood vessels. e drug costs around $3,000 per dose, according to Nichole Perisho, the coordinator of the stroke program at Kalispell Regional Medical Center. Heather Gleason's dose of TPA wasn't administered until 233 minutes after her son called 911, Jason Gleason said. He said TPA needs to be given to the victim in under 60 minutes. Nearly 2 million brain cells die every minute during a stroke, Gleason said. at means early activation of emergency medical services during a stroke is important, Gleason said. He commented that Benefis Healthcare in Great Falls is averaging under 30 minutes for TPA administration to stroke victims. Self-diagnosis is crucial to understanding signs of stroke, Dr. Lyndsay said, especially among men, who may tend to “just sleep it oﬀ.” Lyndsay, Montana's only vascular neurologist, is the director of the telestroke program at Kalispell Regional Medical center that helps bring professional expertise to rural areas of Montana that don't have stroke care. Using a robot in the Kalispell Regional Medical Center that is connected via Internet to eight Montana communities, Lyndsay is able to communicate live with healthcare professionals and their stroke victims. Telestroke serves emergency rooms in Whitefish, Libby, Ronan, Plains, Cut Bank, Conrad, Shelby and Chester. e technology is also used for neonatal care in those communities. With the telestroke program, the stroke victim undergoes a CT scan of their head, and neurologist in Kalispell is able to assess the patient live via technology interface. en, if the patient is transferred

to Kalispell, the neurologist is already wellinformed on the case, according to Perisho, at Kalispell Regional. e technology and expertise allow people in remote areas of Montana to receive professional care in time of a stroke, Perisho said. “If I lived on the Hi-Line, I'd feel confident in the level of care,” she said. Perisho became committed to stroke healthcare after working at Craig Hospital in Denver. She witnessed how a professional photographer struggled to regain his speech and mobility after he suﬀered a stroke. en, when she met Dr. Lindsay and saw his dedication to stroke patients, Perisho joined the Montana stroke Working Group. “All Montanans should have access to this level of expertise and stroke care,” Perisho said. Community awareness of stroke — and the professional expertise available — are keys to reducing stroke mortality and disability, Perisho said. e Montana Department of Health and Human Services began a stroke-awareness program in 2014, and with Kalispell Regional Medical Center's telestroke program, more communities are learning about stroke. “Stroke awareness is gaining a lot of ground,” she said. “Community awareness is key, and it has to be non-stop.” With increased community awareness, Perisho said KRMC in the last year tripled the number of emergency room visits with stroke victims. caRLa WILLIaMs recognized the sign of a stroke when she was having one. She had a stroke scare while washing dishes. Her left hand remained clenched, and her lip went numb for just a few seconds. Her husband, who works for a volunteer fire department, was able to perform a few verbal tests with her, to see if she was having a stroke. While she passed the test, she still felt uncomfortable. She went to the emergency room in Kalispell, where she was administered TPA. Jason Gleason now takes his message of stroke awareness around Montana. He gives a presentation of stroke education that is part stand-up comedy, part personal testimony with a slideshow of him and his family before, during and after his wife's stroke. e combination rivets the audiences, although for him to relive the death of his wife “is like ripping open scabs every time I tell it.” He remembers his wife's final words as he left for work that morning in 2011: “I love you.” On the Web: montanastroke.org; jasongleason.com

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Music therapist Kirsten Wells works with a group of residents at Lakeview Care Center in Bigfork. (David Reese photo)

Striking a

CHORD

How music therapy works in memory, emotional care settings

28 MONTANA HEALTH JOURNAL SPRING 2017

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BY DAVID REESE/MONTANA HEALTH JOURNAL

he small group of residents at Lakeview Care Center sat in a circle around Kirsten Wells as she strummed a familiar melody on her guitar. î&#x20AC;&#x201A;e residents sang to their heartsâ&#x20AC;&#x2122; delight a song from the 1940s that talked about love and marriage. Most of the residents joined in, except for a couple of men who sat quietly, observing the others. But when it came time to sing a song about cars, the two men who had held out before were now fully part of the group music experience. After singing the song, the entire group of people in the memory-care wing of the care center laughed and chatted about what the songs meant to them, with Wells leading the discussion. î&#x20AC;&#x201A;is may sound like an afternoon music session at a nursing home, but it was music therapy. Music therapy is not musical performance with an audience. Music therapy is the planned and structured use of musical experiences to increase emotional expression, life review, socialization and memory exercise, and that's what was happening at Lakeview

Care Center that day. Wells is a board-certified music therapist who provides individual and group music therapy in the Flathead Valley. She and her husband, Garth, moved to the Flathead area in 2015 from Denver and sheâ&#x20AC;&#x2122;s been busy building a music therapy practice ever since. Wells knew early in her life that music therapy was the path she wanted to take. As a junior in high school in Billings, Montana, Wells discovered music therapy when her mother clipped out an article

from the local newspaper. Wells wrote an essay about music therapy in high school, and she forged an education and a career around music therapy. â&#x20AC;&#x153;I never looked back, and I never turned back after that,â&#x20AC;? she said. â&#x20AC;&#x153;I just did it. I wanted to stay in the music field, but I didnâ&#x20AC;&#x2122;t want the lifestyle as a performer, and I wasnâ&#x20AC;&#x2122;t drawn to teaching. I wanted to be of service.â&#x20AC;? Wells attended a four-year college for music therapy, and worked fulltime professionally in Denver as a music >>>

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therapist before moving to Montana. She is one of about 12 board certified music therapists in Montana. She has worked in music therapy with children with disabilities to adults with dementia — from pediatrics to hospice care. With so few music therapists in Montana, getting the practice into schools, nursing homes and hospitals is taking time, Wells said, since it is generally not covered by insurance. But there is momentum. Healthcare administrators are seeing the benefits of group music therapy, and families are using music therapy for their loved ones. Wells is on the frontier of a business model that has not been fully tried in Montana. “I want to provide music therapy to an area that hasn’t had music therapy available,” she said. “I’m looking forward to showing the medical community how music therapy can be utilized.”

ELLS REMEMBERS working with one man in a care facility. For over a year the man sat detached from the group, smiling pleasantly as Wells led the music therapy sessions. en she sang “Make the World Go Away,” the Eddy Arnold song from 1966. “at song was the switch,” Wells said. She remembers another example of how music improved a stroke victim’s verbal communication. e woman had never been able to speak after her stroke, “She’d never been able to tell her husband that she loved him,” Wells said. Using what is called melodic intonation therapy, where a simple phrase like “I love you” is combined with a music melody, Wells helped the woman re-learn how to say those three words to her husband. at same kind of music therapy was used with Gabrielle Giﬀords, the Arizona congresswoman who was injured in a shooting several years ago, Wells said. Wells often works in conjunction with other care team members, such as speech therapists and teachers. “I have the same goals as everyone else, I just use music as the modality,” Wells said. When working with older clients, the therapeutic approach tends to be broader and less structured, while working with younger people involves setting very specific outcomes with the care team, Wells said. Music therapy works well with neonatal intensive care, early intervention, children with diabetes, at-risk youth, adults with disabilities, traumatic brain injury, dementia, hospice, mental health, and other situations, Wells said. 30 MONTANA HEALTH JOURNAL SPRING 2017

Kirsten Wells is a board certified music therapist. (David Reese photo)

e field is growing more clinical, which will help get music therapy into mainstream healthcare treatment. “We have to have proof something is doing what it says it’s going to do,” Wells said. Often there is a misconception about what music therapy does. A certified music practitioner is allowed to play music for a patient, but the practice is not outcomebased, Wells said, while music therapy is. “ere’s a big diﬀerence,” she said. Funding is often an issue in getting music therapy into a reimbursed, insurance-covered, organizational setting. Wells currently does music therapy in group settings around the Flathead Valley, including the Montana Veterans Home in Columbia Falls and e Springs in Whitefish. Group sessions help bring the cost per patient down. A medical referral from a physician can also help persuade insurance companies to cover it, but that takes quite a bit of background work and is

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

often not worth it financially, Wells said. However, that process may be exactly what is needed. “It’s a lot of work, but it’s where Montana and the nation need to go with it until insurance companies recognize us,” she said. ther states are finding success in getting music therapy reimbursed, Wells said, but with only about 13 board certified music therapists in Montana, Montana is a long way from having music therapy considered for reimbursement at the legislative level. “It’s going to be a hard push,” Wells said. Music therapists are trained to know what music is appropriate and when it should be used, and the situations that can arise during therapy, Wells said. “you have to know how to recognize the diﬀerent situations. Sometimes my sessions are mostly talking. Sometimes the music is emotional support. Every day is diﬀerent.” A bachelor's degree and board

certification are basic requirements for music therapy accreditation. î&#x20AC;&#x201A;e training for a music therapy certification is often a music degree with a music therapy emphasis or bachelor of science degree in music therapy. Music therapists must become recertified every five years. In other areas of the country, institutions such as jail, school districts and assisted living facilities incorporate music therapy into their systems, Wells said. â&#x20AC;&#x153;Montana is behind the times,â&#x20AC;? she said. Despite not having music therapy covered by insurance in Montana, Wells is pushing on with her own music therapy practice in the Flathead Valley, one group session, one family at a time, showing the public â&#x20AC;&#x201D; and the healthcare community â&#x20AC;&#x201D; how important this therapy is. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s a viable profession and a needed service,â&#x20AC;? Wells said. â&#x20AC;&#x153;I get the joy of making people happy. When you get to see someone do something they havenâ&#x20AC;&#x2122;t done in years, like talking or singing, itâ&#x20AC;&#x2122;s some of the best feelings to see them get to that point.â&#x20AC;? Lakeview Care Center, an assistedliving home in Bigfork, Montana, brought in music therapy in spring of 2016, and uses Wells as their music therapist. Karyn

Jones, director of activities at Lakeview, said the therapy sessions help bring people out of their sometimes isolated environments, and helps keep patients' minds sharp. â&#x20AC;&#x153;î&#x20AC;&#x201A;ey might not know their loved ones anymore, but they remember that song,â&#x20AC;? Jones said. Music is a keen motivator. When you see people running, they are usually listening to music. Music can help you run faster, stay motivated and on pace, Wells said. â&#x20AC;&#x153;Music often motivates us to do what we don't want to do,â&#x20AC;? she said. For patients with dementia, music is often the last part of their memory to fade away, she said.

ENNA JUSTICE is a board certified music therapist who provides services mainly in the hospice setting. Trained music therapists are skilled in verbal counseling. Music therapy is not just playing a guitar or tambourine in a group setting. During individual therapy sessions, the music is matched to the patient's physical state, Justice said. î&#x20AC;&#x201A;is practice is known as the isorhythmic principle. î&#x20AC;&#x201A;e style of music is matched to their emotional state; this is known as the isomoodic principle.

Music has the potential in therapy to help re-orient a patient back to a safe place, so that dialogue may take place, Justice said. â&#x20AC;&#x153;Music is the door, or the key,â&#x20AC;? Justice, who has a master's degree in music therapy, said. â&#x20AC;&#x153;Sometimes it's just the key to get me into the dialogue that needs to follow.â&#x20AC;? At a session at Lakeview Care Center, Wells started by checking in with each of the dozen or so people, then having them join her in songs that were appropriate for the age group â&#x20AC;&#x201D; most of whom were over 75 years old. î&#x20AC;&#x201A;e songs they shared, like â&#x20AC;&#x153;Abadaba Honeymoonâ&#x20AC;? and â&#x20AC;&#x153;Making Whoopie,â&#x20AC;? helped lead to conversations about each of the peoples' lives. One man in the group was reluctant to join in the conversations, until Wells brought out the song â&#x20AC;&#x153;My Merry Oldsmobile.â&#x20AC;? î&#x20AC;&#x201A;at opened the man up to join the conversation, and he shared a story about how as a child he drove a Model T sitting on his dadâ&#x20AC;&#x2122;s lap. î&#x20AC;&#x201A;e session ended with â&#x20AC;&#x153;Happy Trails to You.â&#x20AC;? On the web: flatheadmusictherapy.com

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FROM PAGE 23

figure. “She’s incredibly nurturing and really believed in me,” Bell said. “I was at the ranch one year as a student, and she asked the lead instructor if she would mind if I co-taught with her.” fter 45 minutes of discussion on shoulder alignment and safety, during one class Bell instructed his class of 14 students to stand up and get their blood flowing. He has a comical analogy for most wrist stretches – propeller hands, hypnotist hands, concert director hands, and he believes that small, simple movements every hour throughout the day may improve aches and pains. e retreat guests ranged from 30 to 70 years old and came from all over the country. One couple from Florida – Margit, a yoga and tennis instructor, and Brian, a software support manager – were celebrating Margit’s 40th birthday. What started as a week of uncertainty for Brian, having no prior experience with yoga, culminated in a wealth of knowledge and relaxation. “Going into it I figured I would have to cheat oﬀ my neighbors with every pose, but the instruction was so clear, and it was such a laid back atmosphere,” Brian said. “roughout the week, they emphasized that each of us will have diﬀerences and encouraged us to have fun, rather than worry about doing every pose correctly.” On recent retreats, Bell has had Melina Meza by his side as a nutritionist, Ayurvedic health educator, yoga instructor and photographer. Meza, who moved from Seattle to Oakland to grow her career in the Bay area, pioneered Seasonal Vinyasa, an innovative, multi-disciplined approach to wellbeing. Last year was Meza’s third year coteaching e Whole Enchilada, a week-long retreat at the Feathered Pipe Ranch that was designed to highlight Bell's and her experience in yoga, Ayurvedic lifestyle, nutrition and medicine. Since 1975, Supera has built Feathered Pipe Ranch into a place where people can come to get quiet and be inspired by the natural world. When she inherited the land from her late friend Jerry Duncan, Supera was hesitant to keep it, as she was only 24 years old and had not yet finished her world travels. She returned to the ashram in India where she had spent the previous four years, and asked her guru, Sai Baba, what she should do with the ranch. “He told me, ‘ere are too many followers in

With help from a core group of intellectuals, artists, yoga teachers, and other kindred spirits, Feathered Pipe Ranch near Helena became one of the most sought after retreats centers in America. As yoga grew in popularity, the group established the California Yoga Teachers Association.

this world. Go back and make this a place for leaders,’” she recalls. With help from a core group of intellectuals, artists, yoga teachers, and other kindred spirits, Feathered Pipe Ranch became one of the most sought after retreats centers in America. As yoga grew in popularity, the group established the California yoga Teachers Association, as well as the Institute for yoga Teacher Education. e institute became the Iyengar Institute, which continues to operate today as the Iyengar yoga Institute of San Francisco. e California yoga Teachers Association then founded the widely recognized yoga Journal. Bell and Meza will teach together at the

Feathered Pipe Ranch in summer 2017 to teach guests to align their routines with nature, move in a way that’s safe for their bodies and listen to their inner voices. “e Feathered Pipe feels like a home,” Meza said as she glanced around the room. “Whether it’s the games, the books, the way things aren’t overly formal and detailed, this is a place where people live year round. It has a lot of love and a lot of character. is is a home to many.” About Andy Vantrease: Andy Vantrease contributes to several platforms in the health, wellness and marketing industries, including Truly Yoga and Harvest Market Natural Foods.

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SPRING 2017 MONTANA HEALTH JOURNAL

Musician finds a way to play again FROM PAGE 20

Reid Merley plays oboe for the Glacier Symphony and Chorale

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breakthrough came for Merley when he was referred to Kalispell neurosurgeon Dr. Benny Brandvold. During the exam, Merley and Parmater told him how the tremors only happened when he tried to play his oboe, and the doctor agreed that his symptoms were caused by a malfunction in his brain and not from prior neck injuries. Brandvold wrote a letter to the Veterans Administration with his diagnosis. In 2012 Merley went back to the Portland veterans hospital to be evaluated for surgery. He met with neurosurgeons Dr. Justin Cetas and Dr. Nathaniel Whitney. Both doctors were experienced with deep brain stimulation surgery on Parkinson’s patients, a procedure where electrodes are implanted in the brain producing electrical stimulus to regulate abnormal impulses. A pacemaker-like device is placed under the skin in the upper chest and attached to a wire that travels under the skin connecting to the electrodes in the brain. But neither surgeon had ever performed this procedure before on a person with Musician’s Focal Dystonia. It diﬀers in that the brain over-fires in a specific location, similar to a circuit that has worn out from years of repetitive action, such as bowing a violin or holding the mouth precisely to create the perfect note. In Merley's case the surgeons would need to identify the exact target location where his brain was overfiring, causing his hands and arms to shake when he played his instrument. e only way to find that spot was for him to be awake and playing his instrument as they probed his brain. Sherry accompanied Reid for the first hours of the presurgery where a cage was screwed onto his skull so that his brain could be accurately targeted. During surgery after they exposed his brain, they called for Parmater's oboe, a plastic instrument that could be sterilized, handing it to Merley to play in order to reproduce his tremor. Now, Merley turns on the stimulator only when he is going to play. He says the sensation is not uncomfortable. “When I turn on the machine I feel it in my body,” he said. “I stop breathing for a moment and I get an electric buzz on my right side.” •

HEALTHCARE TRENDS

The help of a horse Brenda Westwood and her horses provide unique insight to the human condition

BY DAVID REESE/MONTANA HEALTH JOURNAL

t just over 1,000 pounds, Starry can seem a bit intimidating. But don’t let his long face and sweeping tail scare you; Starry, a quarter-horse gelding, is gentle as a lamb. He takes easily to people, and will sometimes nudge you with his long snout. It’s what Starry does that helps Brenda Westwood open a conversation about yourself. With a partner in Starry, the woman and the horse work together to open conversations with people in the safe, nurturing environment of a horse arena. Westwood describes this as “equine gestalt therapy,” and the practice can be a useful component to someone's personal exploration of self. “No one is broken,” Westwood said in an interview at her arena near Kalispell. “e answers lie within us, and the horses bring something to the surface that might be buried, whether it was yesterday, or from our childhood, that is not serving us well. We all have stories. Some are great; some are not so great. e horses and I uncover that, so you can leave it in the dirt. Gestalt helps people finish their business.” At a session last summer, Westwood and about five people sat in chairs in a circle on the dirt floor of the horse arena. Westwood opened a conversation with the people, who responded in varying degrees of openness. Some wanted to talk; others were reluctant. en, Westwood had each of the people enter the ring with Starry, the big, friendly horse. e people walked next to Starry, while Westwood remained outside the arena. Westwood asked questions of the people as they walked through the dirt along with the horse. She watched how Starry responded to the people, and she listened to the peoples' answers. e clinics are not horsemanship, nor are they clinical therapy. is is equineassisted learning. e horses react to how we hold our energy, and Westwood works >>>

Brenda Westwood, above, stands with Starry, a 17-year-old gelding at her arena in Kalispell. (David Reese photo) At left, Starry nudges a participant in one of Westwood’s sessions.

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DAVID REESE PHOTO

Brenda Westwood, above, with her horse, Starry. At top right, woman walks with Starry in a session at Westwood’s arena, while another woman, at right, shares moment with a horse.

to interpret these reactions and create a dialogue about them with the client. “e horses are a coach, and I'm a coach,” Westwood said. “ey guide a lot of the session.” Sessions last 60 to 90 minutes. Some clients attend her sessions with their own therapist. Westwood opened her equine program in 2012 after researching her goals in life. Asked to do a paper for a class at Flathead Valley Community College on her ideal life, Westwood designed this career path. “e things I love spoke to me, and those were horses and nature,” she said. “I wanted to do emotional and spiritual work, and this has been my dream.” She completed a two-year certification program through “Touched by a Horse.” Westwood also puts on sessions called “Grit with Grace.” ese are how-to workshops — one hour a week for six weeks — designed to teach people about household tasks or farm work, such as how to run a chainsaw, fix a sink or change a tire. e workshops help people learn resilience and self-reliance, she said. She runs the Grit workshops along with a Gestalt session with the horses in the arena. “I want to help people find their inspiration and confidence to go forward,” Westwood said. “I try to help people get connected to who they are, not who other people or society say they are.” During a session with one person, Starry moved in close to give the woman a nudge with his big, long muzzle. Starry was recognizing how the woman was speaking her truth. “He's very good at this work,” Westwood said. “He's like an equine truth detector.” • 36 MONTANA HEALTH JOURNAL SPRING 2017

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‘I try to help people get connected to who they are, not who other people or society say they are.’ — BRENDA WESTWOOD

OUTDOOR REPORT

The right stuff Choosing the right outdoors shoes for the active lifestyle

our feet are probably the most important aspect of your Montana field campaign, and a well-fittted boot is going to help you avoid injury in a

PHOTO by DAVID REESE

couple of ways. Here are some tips from Kalispell podiatric physician Eric Ploot on how to keep your feet healthy when enjoying the Montana backcountry. Dr. Ploot, an avid hiker and hunter, prefers a sturdy, over-built boot for backcountry hiking and hunting, where you are oﬀ trail most of the time. Ploot says to choose a boot that has good drying capacity, especially for Montana's warmer fall hunting seasons. Moisture is your feet's enemy, so he recommends carrying extra socks to change into during the day. "at's going to make a big

diﬀerence, bringing those extra socks," he said. "Moisture inside the boot is only going to make blistering worse." Insulated boots also cause sweating, another enemy of feet,

injury and allowed them to get him out of the backcountry without further injury. "When you start to treat the injury in the field, you're much better off," Ploot said. "If you limp your way home for five miles, you're just going to injure your foot structure further." Be sure to bring blister treatment, such as Moleskin, Ploot said. Use it with new boots at the first sign of a hot spot and on the first few hikes of the year. If you are hurting when you get home, see a doctor, Ploot said. Some injuries are deep inside the foot and take a trained physician to detect how to treat them. Ploot said a Proper-fitting boots, such as these wider boot is more from Garmont, will give you miles of important than a pleasure in the Montana backcountry. tall boot, when hiking on moderate terrrain, Ploot said. but for extreme off-trail use, a taller, you'll get fewer blisters, but cheap over the ankle boot is recommended. footwear could also lead to injury If you tend to have tight Achilles, from a fall, Ploot said. "Clip your get some doctor-recommended toenails to make sure the boots fit stretches that will help loosen up this properly," he said. important tendon. is tendon is Ploot said it's a good idea to bring able to support and propel your an elastic wrap, in case of ankle body's weight and is super strong — sprain, which is an inversion of the and super important. "you'd be hard ankle. "People can do a host of pressed to find a muscle tendon in different things to their ankle, from a the human body that is stronger," sprain to a break, but it's often not Ploot said. just one single structure in the foot e weekend warrior carrying a that is injured," he said. When his heavy backpack is prone to injury, son sprained an ankle in Glacier Ploot said, so prepare your body in National Park, far from their vehicle, advance of hiking and hunting the ankle wrap helped stabilize the season. • M O N TA N A L I V I N G . C O M

SPRING 2017 MONTANA HEALTH JOURNAL

ALTERNATIVE THERAPIES

Calming the mind A Missoula hypnotherapist discusses ways inward

BY THERESE WOOD/MONTANA HEALTH JOURNAL

n his small office in downtown Missoula, Clark Patton has created a sanctuary for his clients to experience clinical hypnotherapy. e serenity of the space emanates not only from the plants, soft lights and ethereal art in the room, but also from the gentle, grounded presence of Patton. Patton began his interest in psychological therapies at the intersection of nature studies and psychology. He learned nature tracking and survival skills under wilderness tracker Tom Brown, author of e Tracker, and later with Bill McConnell, a Bozeman outdoorsman who created the school Clark Patton for Philosophy Awareness Survival Tracking. Patton noticed the same brain wave functions that create a wider field of awareness inherent to wilderness awareness could have healing effects on human psychology when the brain is attuned to this wave state. e skills Patton learned in these studies put him on a track to become a facilitator in wilderness therapy and he worked with teens who could not be helped through regular therapy. Patton’s keen attention to successfully navigating states of consciousness in the natural world, and now through hypnotherapy, allows him to help clients manage the jungles of their own minds so they can not only survive and get by, but also thrive. Patton describes that the use of hypnotherapy is to create dexterity of mind, which is the ability to easily shift between the analytical and trance states. In a society that teaches us to overtrain the intellect, it often comes as a surprise that the logical part of our mind can actually block awareness and even create suffering, he says. According to Patton, deeper levels of trance are actually 38 MONTANA HEALTH JOURNAL SPRING 2017

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more focused, use less energy, and allow a person to take in greater amounts of information. When a person habitually experiences fight or flight mode, or stress, it is diﬃcult for them to access these deeper levels of consciousness and it can create a myriad of problems, Patton says. In the wilderness, however, it is very natural to have this dexterity of mind, Patton says. Indigenous people spend their entire lives in the natural world and their behaviors are designed to be highly adaptable, he says. “If we encounter hardship, or an obstacle in life, we don’t necessarily need years of therapy to overcome it. It’s possible to create profound change in a surprisingly short period of time,” Patton says. e conscious intellectual mind works in a linear, logical way, he says, while the subconscious is the collection of all our memories, experiences, behaviors, automatic responses, imagination and creativity. is part of the mind does not work through logic, but instead through association. An example of this is smokers who logically know they should stop smoking but are unable to quit despite their intellectual understanding, Patton says. “e downfall of traditional talk-therapy is that it tries to solve an illogical, associative problem with logic and linear reasoning. Often it only scratches the surface of the problem,” Patton says. Unlike wild animals, modern humans can hold on to event stress states for long amounts of time; hours, days, weeks, and sometimes years by recreating the events or the overall feeling of the events over and over again, Patton says. As Patton guides his clients into deeper levels of consciousness, he says many profound shifts can spontaneously occur for them. Hypnotherapy uses hypnosis as a tool combined with analysis techniques to create long-lasting change, according to Patton. Hypnotherapy is diﬀerent than hypnosis because it addresses the underlying root cause of an issue and, rather than using suggestion, it engages a state of consent so that the mind can navigate toward what is best for the individual. Patton sees a client usually one to four times. He says he has witnessed his clients go from using multiple prescription drugs for depression and anxiety for many years, to no drugs and no symptoms after only a few sessions. Similarly, addictions like smoking or even obsessive behaviors that have persisted for decades may, for some people, become a thing of the past, according to Patton, who says he has seen positive emotional changes in his clients. “It’s one of the most far-reaching healing tools I know of,” Patton says.

MEDICAL RESEARCH

A spore solution? Study shows relief for cancer patients using psychedelic mushrooms JOHNS HOPKINS RESEARCHERS reported that people suffering cancer-related anxiety or depression found considerable relief for up to six months from a single large dose of psilocybin — the active compound in hallucinogenic mushrooms. The researchers cautioned that the drug was given in tightly controlled conditions in the presence of two clinically trained monitors and said they do not recommend use of the compound outside of a research or patient care setting. The Johns Hopkins team released its study results, involving 51 adult patients, concurrently with researchers from New York University Langone Medical Center, who conducted a similarly designed study on 29 participants. Both studies are published in the Journal of Psychopharmacology. The Johns Hopkins group reported that psilocybin decreased clinician- and patient-rated depressed mood, anxiety and death anxiety, and increased quality of life, life meaning and optimism. Six months after the final treatment, about 80 percent of participants continued to show clinically significant decreases in depressed mood and anxiety, with about 60 percent showing symptom remission into the normal range. Eighty-three percent reported increases in well-being or life satisfaction. Some 67 percent of participants reported the experience as one of the top five meaningful experiences in their lives, and about 70 percent reported the experience as one of the top five spiritually significant lifetime events. Roland Griffiths, Ph.D., professor of behavioral biology in the Departments of Psychiatry and Behavioral Sciences and of Neuroscience at the Johns Hopkins University School of Medicine, notes that traditional psychotherapy offered to people with cancer, including behavioral therapy and antidepressants, can take weeks or even months and may have addictive and other troubling side effects. "A life-threatening cancer diagnosis can be psychologically challenging, with anxiety and depression as very common symptoms," says Griffiths. "People with this kind of existential anxiety often feel hopeless and are worried about the meaning of life and what happens upon death." •

Esther Barnes, DPM Robert Clase, DPM Diabetic Foot Care Treatment of Foot & Ankle Athletic injuries Custom Foot Orthotics Step Ahead Foot & Ankle Clinic, PC

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SPRING 2017 MONTANA HEALTH JOURNAL

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COMMUNITY JOURNAL

Sarah Broussard rides a horse during the Event at Rebecca Farm in Kalispell. The Event’s Halt at X program has become a major donor to cancer survivors in northwest Montana. (Noah Clayton photo)

A Community of Support Equestrian program supports multiple cancer organizations

he Event at Rebecca Farm remains one of Montana's leading fundraiser for cancer patients. e Event is a three-day equestrian competition at Rebecca Farm in Kalispell. As part of the event, Halt Cancer at X is a local initiative that funds breast cancer research and support services. Funds for this year were raised at e 2016 Event at Rebecca Farm. All grant applications submitted, totaling approximately $60,000, were fully funded. Created in memory of e Event at Rebecca Farm’s founder, Rebecca Broussard, her daughter, Sarah Broussard, launched Halt Cancer at X in 2012. e initiative’s name comes from dressage — where the first movement requires horse and

rider to halt at X, a station marked in the arena. To date, Halt Cancer at X has contributed more than $325,000 to national cancer research and local support services for cancer. Local groups that benefited last year include Flathead Cancer Aid Services, Cancer Support Community Kalispell, and the Flathead Valley Cancer Chicks. First time recipient, Save a Sister, was awarded the largest grant at $24,000. e Save a Sister initiative is a collaboration among Kalispell Regional Healthcare, North Valley Hospital and the Flathead City-County Health Department. Founded in 2008, Save a Sister improves women's access to screening mammography, educates M O N TA N A L I V I N G . C O M

SPRING 2017 MONTANA HEALTH JOURNAL

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The S Spir pirit of of W Weelcov With hospital stay stays getting shorter and a growing number of patients requiring complex medical care, finding the right place to recover is more important than ever. Heritage Place and Lake View Healthcare Communities in the Flathead Valley are ffo ocused on short-term care and ha havve transitioned close to 150 patients home in the last year. “For our patients, we know the primary destination is home. We ha havve the professionals and specialized services to assist in achieving that goal, al,”” says Brent Smith, administrator at Heritage Place Healthcare Community. Both Heritage and Lake View hav have wings dedicated to transitional care with private rooms and private bathrooms. “This can be a real comf mfo ort to patients during this difficult time and you just won’t find these kind of amenities at a lot of other places in the area,” sa sayys Emily Hutchins, RN, T Trransition Coordinator. Therapy is crucial in accelerating the recovery process for many complex conditions and physical, occupational and speech therapy is av available seven day days a week at both communities. In addition to skilled therapists, the clinical transitional care team includes nurse practitioners, RN transition coordinators, licensed nurses, certified nursing assistants, dieticians and case managers. The teams are led by Medical Directors and other physicians who make rounds and manage the needs of patients on a daily basis. Besides quality medical care, the associates strive to exceed customer expectations. “We call it ‘The Spirit of Welcov’ and it’s our commitment to making a diffe difference every day,” sayys Lake View administrator Tyna sa Tyna Smith. “During your your sta stayy we want you to fe feel comf mfo ortable, supported and confident in your care.”

Lake View Healthcare Community 1050 Grand Drive Bigfork 59911 406.837.5041

Heritage Place Healthcare Community 171 Heritage Wa Way Kalispell 59901 406.755.0800 42 MONTANA HEALTH JOURNAL SPRING 2017

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Sarah Broussard, center, presents a $21,000 check to the Cancer Support Community of Kalispell. Cancer Support Community of Kalispell provides a full range of support services for youth and adults affected by cancer. (David Reese photo)

the community, and promotes breast cancer awareness. e $24,000 grant will allow Save a Sister to establish a screening and support program for women at high-risk of developing breast cancer. Cancer Support Community of Kalispell was awarded $21,000. Cancer Support Community of Kalispell provides a full range of support services for youth and adults affected by cancer. ese services include healthy excursions, cooking and nutrition classes, education, professionally led support groups and more. Last year, the organization built the Halt Cancer at X Kitchen, which hosts cooking classes and provides a welcome space for those affected by cancer to seek support and learn about food and nutrition. Cancer Support Community of Kalispell will use funds to expand the current services they offer. e organization will also use funds to begin implementing horse-healing workshops, family-oriented camping opportunities, and a weekend retreat for cancer survivors. A third recipient, Flathead Cancer Aid Services, a nonprofit organization that provides financial assistance to cancer patients, was awarded two grants totaling $10,000. One grant will help fund daily living expenses for breast cancer patients. e other will provide financial assistance for healthy nutritional food and supplements to those affected by cancer. Flathead Valley Cancer Chicks received a grant of $3,000 to help expand their annual, overnight local wellness retreat for cancer survivors. A portion of the funds will also be used for publicity outreach. Halt Cancer at X’s primary focus is breast cancer, but in the Flathead Valley, with its unparalleled setting and closeknit community of medical services, funds for breast cancer often serve a dual role by providing resources to those with other forms of cancer. By the close of 2016, Halt Cancer at X will have contributed almost $140,000 to benefit local community programs. e Event at Rebecca Farm, presented by Montana Equestrian Events, is held every July in Kalispell, Montana. e largest equestrian triathlon in the United States, e Event is also considered to have some of the world’s finest scenery. Each year it draws hundreds of riders of all levels, from amateur to Olympians. •

HEALTH PROFILE

Magic touch Massage therapist combines several modalities to create a unique approach BY THERESE WOOD/MONTANA HEALTH JOURNAL

assage therapist Tammitha Ann was always told she had a gift for healing with touch. She knew it was true, but as a teenager the requests from those in her circle of friends and family became overwhelming, and she turned away from it, thinking that she never wanted to be asked to do another massage. After a long hiatus, Ann became serious about her gift again, and wanting a better life with her son she decided to go to massage school. Transitioning to becoming a professional massage therapist unlocked the deeper gifts that she had for body work, and making it a career brought back her original love for this healing art. Today, she has a thriving massage business in downtown Kalispell, Pure Magic Massage. Some of her devoted clients have been with her for over 12 years. Ann invests time getting to know her clients so she can work with all the life situations that are unique to each of them. “I know my clients”, she says. “Each person’s body is like a story of the things they have been through, or are currently going through.” In each session she tunes into what the body is holding on to and what the body is asking for. e work on her table is like a dialogue that she is having with the body, and she often gently talks to the muscles and limbs with encouragements that produce what seem like breakthroughs in stuck or congested areas. Having trained in several massage therapies, including Trager, positional release, passive range of motion, Reiki, deep tissue and ai, she blends a mix of techniques that create her own style. Her work became so well known in the community that she was asked to work at the Montana Center for Pain Management where she operated for a year and half until she returned back to her own practice downtown. Balance of physical and energetic aspects is what Ann works toward in her

Tammitha Ann is a massage therapiis in Kalispell.

sessions. Using her own intuition and ability to feel the most subtle changes as she works on the body, she has made an art of her bodywork.

She refers to our bodies as temples. “We need to tune into our own bodies and listen to what they need,” she said, “and massage is a great guide for us to do that.”

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SPRING 2017 MONTANA HEALTH JOURNAL

THE STATE OF HEALTH

Healthier kids MONTANA HEALTH JOURNAL

ontana has seen a big improvement in state rankings of child well-being, moving up six positions from 30th to 24th in the United States. at’s according to the 2016 KIDS COUNT Data Book from the Annie E. Casey Foundation, which focuses on key trends in child well-being in the postrecession years. e data book measures

Some increases in rank, as well as decreases, are not limited to how Montana is doing, but may be due to another state moving up or falling back, Dillon said. Recent data shows that teens in the United States are making gains in education and health indicators, despite growing up in the midst of the economic downturn, a trend found in Montana and nationwide. e report also reveals trends in the persistence of children living in poverty, a

child well-being in four domains: economic well-being, education, health, and family and community. “is positive change in rankings reflects some real improvements for children in our state,” ale Dillon, director of Montana KIDS COUNT, said.

finding that highlights the need for policies that advance two-generation solutions to provide opportunities for all children and families, Dillon said. In the area of overall health, Montana ranked 39th, the state’s best ranking since the Casey Foundation started its tracking.

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Driving this improvement are positive trends in three of the four health indicators the data book has documented since 2009. Since 2010, the number of Montana children and teens who lost their lives is down 35 percent, improving the state’s ranking from 50 to 38. As a result, Montana continues its efforts to increase seat belt use among all age groups and implement prevention programs that focus on suicide, as well as drug and alcohol abuse. Mirroring national trends, Montana continues to see reduced rates of uninsured children. State and federal programs have worked to move the uninsured rate from 12 percent of Montana children in 2010, to 8 percent in 2014. Nationally, about 6 percent of children do not have health insurance. During the 2010-11 school year, 10 percent of Montana teens ages 12 to 17 reported abusing alcohol or drugs. Each subsequent year, Montana has shown improvement in reduction of percent of users and national ranking, with the user rate dropping to 6 percent in 2013-14 and ranking decreasing from 50 to 35. “Given everything we know about how drugs and alcohol impact the developing brain, this is encouraging news,” Dillon said. Montana’s rank of 24th in the education domain results from higherthan-average graduation rates of 85 percent, tempered by low investment in high-quality early childhood education, according to Dillon. Montana’s lack of universal pre-Kindergarten education is leaving approximately 15,000 Montana 3and 4-year-olds without access to highquality early education, which strongly affects their school readiness and future chances at success, he said. In the family and community domain, Montana ranked 15th, based on indicators that trend in multiple directions. e teen birth rate continues its dramatic decline, nationally and in Montana, reaching a new, all-time low of 26 per 1,000 women ages 15-19, although the United States remains the highest among affluent countries. As

DAVID REESE PHOTO

Report shows Montana makes gains in overall child well-being

for the number of children living in high poverty areas, Montana’s trend has been at 7 percent during the past few years. In the domain of economic well-being, Montana ranked 19th with levels of persistent poverty that follow national trends. Between 2009 and 2014, Montana children living in poverty went from 20 to 19 percent, or approximately 41,000

children. While there has been little change in the percentage of children in poverty, Montana’s rank has improved from 27 to 22, the result of other states falling further behind, causing Montana to move up. On the Web: www.datacenter.kidscount.org

BY THE NUMBERS Statistics on Montana families

CHILD AND ADULT POPULATIONS Less than age 18

Data Type

2013

2014

2015

Number Percent

223,972 22%

225,205 22%

226,420 22%

Number Percent Number

790,430 78% 1,014,402

798,047 78% 1,023,252

806,529 78% 1,032,949

2008 $43,948

2014 $46,608

2015 $47,169

2013 11,000 5%

2014 11,000 5%

Age 18 and over

TOTAL POPULATION

PER CAPITA INCOME

CHILDREN WITH AT LEAST ONE UNEMPLOYED PARENT Data Type Number Percent

2015 9,000 4%

LOW-INCOME WORKING FAMILIES WITH CHILDREN*

Data Type Number Percent

2013 28,000 24%

FEMALE HEADS OF HOUSEHOLD RECEIVING CHILD SUPPORT Data Type 2012 Number 8,000 Percent 40%

2014 26,000 24%

2015 23,000 21%

2013 7,000 38%

2014 7,000 36%

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* Definitions: The share of families that met three criteria: (1) the family income was less than twice the federal poverty level; (2) at least one parent worked 50 or more weeks during the previous year; (3) there was at least one "own child" under age 18 in the family. ** Families headed by an unmarried women (living with one or more of her own children under age 18) receiving child support payments during the previous calendar year. Source: Population Division, U.S. Census Bureau; Kids Count

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

SPRING 2017 MONTANA HEALTH JOURNAL

PICTURE OF HEALTH

46 MONTANA HEALTH JOURNAL SPRING 2017

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

Permaculture gardener Kelly Ware stands in the Crossroads Community Garden in Bigfork. (David Reese photo)

Monte Dolack, Placid Lake Sunset - Dog is My Co-pilot, 2012

Painting s, Prints, Fine Art Po ste rs Visit the Monte Dolack Gallery at dolack.com to view the artwork of Monte Dolack and Mary Beth Percival P.O. Box 8927 â&#x20AC;˘ Missoula, Montana, 59807 â&#x20AC;˘ 80 0 . 8 2 5 . 7 6 1 3