Oregon Healthy Living February 2019 by Rosebud Media

FEBRUARY 2019 | VOL. 12 â&#x20AC;&#x201D; ISSUE 2

Fresh and flavorful

CITRUS POWER

PLUS Tasty Year of the Pig recipes Connecting through massage Normal vs. abnormal periods

O regon H ealthy L iving . com

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Healthy Food 4 Less Ethnic Produce Newly Expanded! From the World, to Food 4 Less, to you, we have hundreds of exotic and unusual produce items found in many cultures around the world. Food 4 Less has always carried a large selection of Hispanic produce items. But now, we have expanded to carry extensive Asian, Mediterranean, and Indian vegetable and fruit items. From Jackfruit to Durian and Thai guavas, to five varieties of bananas, we have the largest selection of ethnic fruits in Southern Oregon. Our Asian and Mediterranean vegetable section features bitter melon, long beans, Chinese eggplant, okra, lo bok, gai lan, yu choy, ong choy, taro root, lemongrass, and Persian cucumbers to name a few. If there is something you are looking for, we have the suppliers who can find what you need.

2230 Biddle Rd. • Medford www.shermsmarkets.com

Bitter Melon Stir Fry with Pork

Buy these ingredients at Food 4 Less

Ingredients • 1 pound bitter melon • 1/2 pound lean pork • 2 t finely chopped garlic • 1-1/2 t light soy sauce • 2 t granulated sugar

Directions Bring a large pot of water to a boil. Cut the ends off bitter melon and cut in half lengthwise (do not peel). Remove seeds and pith with a small spoon. Cut melon diagonally into 1/4-inch slices. Place in boiling water and parboil until just tender, about 2 to 3 minutes, drain. Cut pork across the grain into 1/8”-thick slices 1-1/2” to 2” long. Place in a bowl and add soy sauce, 2 teaspoons rice wine or sherry, pepper, and cornstarch, stirring to combine. Let pork marinate while preparing the other ingredients. In a small bowl, combine chicken broth and 1 tablespoon sherry. In another small bowl, dissolve the cornstarch in 1 tablespoon water. Rinse the black beans to remove excess salt. Mash beans with the side of a cleaver or knife. Stir together the beans and chopped garlic with a small amount of water. Heat 1

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• Pinch of freshly ground black pepper (or white pepper)

• 1-1/4 t cornstarch (plus, 2 teaspoons cornstarch dissolved in 1 tablespoon water) • 1/2 c chicken broth • 1 T Chinese slated black beans • 1 to 2 T vegetable oil (or peanut oil, as needed) • 1/4 t Asian sesame oil • Optional: salt and pepper (to taste)

tablespoon oil in a preheated wok. When oil is hot, add bean and garlic mixture. Cook, stirring for about 15 seconds until aromatic, then add the pork. Stir fry 2 to 3 minutes, until pork turns white and is nearly cooked. Remove pork from pan. Heat 1 to 2 teaspoons oil in the wok, as needed. When oil is hot, add the bitter melon. Stir fry for a minute, then pour in the chicken broth mixture. Add pork back in the pan, stirring to mix everything together. Cover and simmer for 2 minutes. Re-stir the cornstarch/water mixture. Push the other ingredients to the sides of the wok and add it to the chicken broth in the middle of the wok, stirring to thicken. Stir everything together, stir in the sesame oil, and season with salt or pepper if desired. Serve hot and enjoy!

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Table of Contents

FEBRUARY 2019 | VOLUME 12 — ISSUE 2

FOOD

Pig and Prosperity: Recipes for the lunar year

SPECIAL

COVER STORY

Kumquats, Pummelos and More? All about citrus

Try Kindness: Create random acts

PETS

Kitties and Kidneys: Early diagnosis important

HEALTH

PAMPER

No Flow/ Overflow: Irregular and heavy periods

Side By Side Massage for couples

Medford Foot & Ankle Clinic, P.C. Complete Foot & Ankle Care

Love Your Feet!

• Wound Care • Laser Technology • Trauma Surgery • Reconstruction • Diagnostic Ultrasound • Digital X-Ray • Orthotics • Heel Pain • Pediatric Foot and Ankle Care

MOST ADVANCED TECHNOLOGY IN SOUTHERN OREGON Jeffery D. Zimmer, DPM

Michael A. DeKorte, DPM, FACFAS

713 Golf View Drive, Medford • 541-770-1225 • www.medfordfoot.com

MF-00103319

Rick E. McClure, DPM, FACFAS

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On the cover

The editor’s desk When she was little, my daughter learned that you can eat a kumquat rind and all, so wanted to try one. We went to the store and bought a handful as an experiment. Otherwise, we haven’t been very adventurous on the citrus front, but now I’m curious to try new varieties. If you are a cat owner, please learn about kidney disease in felines. Our beloved kitty boy developed it, and I wish we had caught it sooner. Next month we’ll learn about K9 reading buddies and foam rollers.

Jeff Lisac of Medford has worked at Sherm’s Food 4 Less for 15 years, three as the produce manager. Lisac recently shed 30 pounds, in large part by taking his work home with him. “I try to have a salad every night,” he said. “Recently, we had ahi tuna and oyster mushrooms, Japanese sweet potatoes and broccolini for dinner. I’ve noticed more customers lately wanting to eat by CITRUS POWER color and looking for suggestions so they can get a wider assortment of nutrients.” FEBRUARY 2019 | VOL. 12 — ISSUE 2

Fresh and flavorful

PLUS

Tasty Year of the Pig recipes

Connecting through massage

Normal vs. abnormal periods

crose@rosebudmedia.com

STAFF

Photo by Dustin Peters

O regOn H ealtHy l iving . cOm

Join the list...

EDITOR: Cheryl P. Rose VICE PRESIDENT OF SALES: Gail Whiting DESIGN & PRODUCTION: Paul Bunch, Dustin Peters

Admire Aesthetics............................. pg. 25

Northridge Center............................ pg. 8

CONTRIBUTING WRITERS: Tessa DeLine Rebecca Scott Micah Leigh Cindy Wilson Sarah Lemon

Ashland Food Cooperative............... pg. 7

The Noyce Clinic.............................. pg. 16

Grins4Kidz....................................... pg. 4

Oregon Retina Center...................... pg. 9

Hyperbaric Oxygen Treatment Ctr.... pg. 29

Pioneer Village................................. pg. 17

CONTRIBUTING PHOTOGRAPHERS Tessa DeLine Dustin Peters

Illumined Body................................. pg. 21

Retina Care Center........................... pg. 23

Medford Food Co-op....................... pg. 13

Rosa Transformational Health........... pg. 15

Medford Foot & Ankle...................... pg. 3

Sherm’s Food 4 Less......................... pg. 2

Medicap Pharmacy.......................... pg. 10

Superior Athletic Club....................... pg. 26

Mail Tribune • Ashland Tidings

Oregon Healthy Living Magazine is published by the Rosebud Media Advertising Department, 111 N. Fir St., Medford, OR 97501. General information: 541.776.4422 Submissions and feedback: crose@rosebudmedia.com

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Big year for Pig

FOOD

Pork symbolizes prosperity in new lunar year HAWAIIAN KALUA PORK

PHOTOS AND RECIPES BY TESSA DELINE

n the Chinese zodiac, 2019 is the Year of the Pig, which began Feb. 5. Though Chinese astrology predicts the Year of the Pig to bring good fortune and luck, we think it also brings good eating! Choose lean cuts to benefit from the protein, vitamins and nutrients in pork, avoiding the fattier cuts or rendering the fat off before including in the meal. Try these flavorful recipes to change up your usual dishes this winter.

Make this simple three ingredient dish using your slow cooker! It’s an easy weekday or weekend main dish when you don’t have time to cook. Put the pork shoulder in the slow cooker before going to work and come home to a delicious main dish. Serve Hawaiian Kalua pork alongside your favorite Hawaiian side dishes. Any leftovers can be repurposed as a filling for tacos, burritos or even pulled pork sliders. The possibilities are endless! INGREDIENTS: 5-6 pounds pork shoulder (Boston butt, blade in) 1 tablespoon liquid smoke 1 tablespoon Hawaiian sea salt (or substitute kosher salt)

DIRECTIONS:

Use slow cooker liners for easy cleanup!

Lightly grease slow cooker with nonstick spray. Place the pork shoulder in a slow cooker and pierce lightly with fork. Pour liquid smoke evenly over the pork and then sprinkle the salt. Depending on your timeframe, cook on low for 8-10 hours or 5-6 hours on high. Pork is done when it is fork tender. Remove lid, pull apart pork with two forks and remove the bone. Servings: 10-12

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FOOD

PORK SATAY

Pork satay is a popular street food or snack in Indonesia and throughout Southeast Asia. It is often served with drizzled peanut sauce or for dipping on the side. You can make Indonesian pork satay on your stovetop using a grill pan or on your backyard barbecue. You can find the Indonesian soy sauce (ketjap manis) and bamboo skewers in the Asian section of well-stocked grocery stores, Asian markets or online. Be sure to soak your bamboo skewers in water for at least two hours or preferably overnight to prevent burning. INGREDIENTS: 2 pounds pork tenderloin 1 tablespoon ketjap manis – medium sweet (Indonesian soy sauce) 2 teaspoon minced garlic or garlic paste 1 1/2 teaspoon ground coriander 1 teaspoon salt ½ teaspoon turmeric 20 bamboo skewers Canola oil for grill

B yeai r fg or Pig

DIRECTIONS: Prepare the pork tenderloin by removing the tough silver skin from the meat and discard. Slice the tenderloin and cut into bite-sized pieces. Place all ingredients (except skewers) in a plastic zipper bag, mix well, and refrigerate for at least two hours or overnight. The longer the pork marinates, the more flavorful it becomes. When ready to cook, prepare your grill for medium-high heat and brush lightly with canola oil. Thread pork onto skewers. Place skewers on grill, turning often, until lightly charred (or to your liking), about 5-7 minutes. Servings: 20 skewers

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FOOD

EASY NO-COOK PEANUT SAUCE INGREDIENTS: ½ cup creamy peanut butter ½ cup water (or to desired consistency) 1 tablespoon low-sodium soy sauce 1 tablespoon ginger, minced 1 teaspoon garlic, minced 1 teaspoon brown sugar 1 teaspoon lime juice

DIRECTIONS: Whisk all ingredients in a bowl. Serve drizzled over satay skewers, rice, cucumbers or even salad. Best when used immediately. Refrigerate any leftovers. Bring to room temperature before serving. Servings: 1 cup

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FOOD BLUEBERRY-BALSAMIC PORK TENDERLOIN

Pork tenderloin is one of the healthiest cuts of pork because it is lean, low in fat and a great source of protein. This easy-to-make, stovetop-to-oven dish is perfect for busy weeknights and elegant enough for a weekend dinner. Be sure to have an instant-read or digital thermometer on hand before attempting this dish.

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INGREDIENTS: 1 pork tenderloin (1 pound) ¼ teaspoon salt ¼ teaspoon fresh-cracked pepper 1 tablespoon olive oil ½ cup balsamic vinegar ½ cup brown sugar ½ cup fresh blueberries, chopped

B yeai r fg or Pig

DIRECTIONS:

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Preheat oven to 425 F. Sprinkle salt and pepper on pork tenderloin. In a large ovenproof pan, heat olive oil over mediumhigh heat. Brown tenderloin on all sides. Remove tenderloin from pan. Remove pan from heat, add balsamic vinegar and blueberries. Stirring to loosen bits from bottom of the pan, add brown sugar. Return pork to pan, turning to coat in the sauce. Bake 8-10 minutes or until a thermometer reads 145 F, turning occasionally. Place tenderloin on a serving platter and lightly cover with foil. Pork will continue to cook once removed from oven. Let rest 5 minutes before slicing. Pour desired amount of sauce over pork before serving. Servings: 2–3

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FOOD

PULLED PORK TACOS

This is a perfect use for leftover Hawaiian Kalua pork. It’s super-simple to make with ingredients found at your local grocery store. INGREDIENTS: 2 cups Hawaiian Kalua pork or pulled pork (warmed) 8 tortillas (flour or corn) 1½ cups purple cabbage, shredded Be creative with Pico de gallo (recipe on p. 10) your garnishes! Use 8 lime wedges shredded lettuce, carrots, 2 radishes, thinly sliced low-fat sour cream or ½ jalapeno pepper, thinly sliced scallions.

DIRECTIONS: Heat tortillas on a hot, dry skillet or comal pan until warm and pliable. Add pulled pork and garnish with the cabbage, pico de gallo, radishes and jalapeno. Squeeze the lime wedges on the tacos for a burst of flavor. Servings: 8 tacos

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FOOD

PICO DE GALLO INGREDIENTS: 5–6 roma tomatoes, chopped ½ red onion, finely chopped 3 ½ tablespoons fresh cilantro, chopped ½ jalapeno, seeded and finely chopped 1 tablespoon lime juice Salt to taste

B yeai r fg or Pig

DIRECTIONS: Add all ingredients to a bowl. Mix well. Serve with tacos, chips, eggs or burritos. Best when used immediately. Keeps up to 24 hours in the refrigerator. Servings: 2-3 cups

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FOOD

lthful, flavorful a e H citr us fr

in ine sh ts ui

Here comes the

winter

sun

older climates’ pears and apples pale in winter to fruits that practically radiate warmth and sunshine.



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FOOD TEXT BY SARAH LEMON

PHOTOGRAPHY BY DUSTIN PETERS

Citrus fruits brighten basic flavors and lighten the season’s heavier foods. From deep green to nearly red and every color in between, the citrus rainbow bestows loads of vitamin C, antioxidants and fiber to counteract calorie cravings. Bursting with natural sugar, citrus also can fulfill the urge for sweets. And Jeff Lisac, produce manager at Medford’s Food 4 Less, has good news for shoppers with a sweet tooth: “Citrus is getting sweeter and sweeter.” Coming on by Thanksgiving, citrus season is in full swing by Christmas. But the holidays’ conclusion doesn’t end the citrus celebration. Many varieties — whether smaller than a golf ball or bigger than a softball — persist through March and even improve in appearance, texture and taste. “Color is important,” says Lisac, explaining that citrus fruits that soak up more sunshine are more vibrantly hued and also sweeter. Aroma, he says, isn’t always a reliable indicator of quality citrus. “Some citrus doesn’t smell at all, but it’s as sweet as sugar,” he says. Among those, as the name confirms, is sweet lime, a relative newcomer to the United States and the Food 4 Less inventory. More closely resembling a large, round lemon, sweet limes won’t offer that classic tart note in cocktails or guacamole. But they’re a worthwhile addition to fruit salads. “You can eat them just like an orange — they’re that sweet,” says Lisac. The produce manager reserves most of his affection for oranges, specifically the Cara Cara variety. With hints of cranberry and cherry, these bright-orange hybrids are prized for their low acidity and lack of seeds, eclipsed only by their striking salmon-pink flesh.

Jeff Lisac of Food 4 Less in Medford says his favorites are clementines and Rio Star grapefruit.

Many varieties — whether smaller than a golf ball or bigger than a softball — persist through March and even improve in appearance, texture and taste.

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FOOD “You cut ’em open, and you think ‘I bought a grapefruit.’” Related to grapefruits, pummelos are the largest of all citrus fruits, sometimes growing to the size of volleyballs. “They’re giant,” says Lisac. “They’re huge!” Much of a pummelo’s girth can be attributed to inches-thick skin with pillowy pith. But cooks who persist in prizing pummelo segments from their protective layers can look forward to pairing the Southeast Asian staple with a wide variety of spices and aromatics for sweet-savory dishes. A popular purchase for Lunar New Year, says Lisac, the pummelo signifies good luck in Asian cultures. Plenty of less exotic citrus varieties take pride of place among chefs. Widespread among gardens and patio pots in California, the Meyer lemon was elevated in fine dining over the past couple of decades. Head chef and café manager at Medford Food Co-op Benjamin O’Neill says the Meyer variety is “like a lemon should be.” The sweet-tart, faintly floral flavor goes with just about anything, says O’Neill, and enjoying Meyer lemons is as simple as squeezing them into water. Even freshly squeezed juice from common lemon varieties — usually Lisbon or Eureka — improves any dish, says O’Neill. One lemon yields about 1 tablespoon of zest and 2 to 3 tablespoons of juice. Lemon juice and zest wake up the palate in the way that many cooks associate with salt. So, reaching for citrus rather than the salt shaker is a savvy strategy to reduce sodium intake. “You just taste freshness,” says O’Neill. “Name something it doesn’t go with.”

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SPOTLIGHT ON CITRUS

Cara Cara oranges:

Also known as pink navel or red navel oranges, these are believed to be a natural mutation found in Venezuela. They were introduced to the United States in the early 1980s. Their ideal balance of sweetness and acidity makes Cara Cara suitable for fresh eating, juices, jams, sauces and baking. Use them in savory or sweet preparations, paired with avocados, lettuces, nuts, bacon, other citruses, tropical fruits, fresh herbs, strong and aged cheeses, grains, seafood and poultry. Branded by Sunkist as the â&#x20AC;&#x153;Power Orangeâ&#x20AC;? for its higher levels of nutrients compared with other varieties, Cara Cara is a good source of vitamin A and C, potassium and lycopene, which gives them their pink color.

Kumquats:

Unlike other citruses, the entire kumquat fruit is edible, despite a few seeds. The peel is where the true citrus aroma and flavor lies while the flesh offers a bold and juicy, tart contrast. Slice kumquats into coins and cook with sugar and water until candied, then use to top pound cake or ice cream. Add sliced kumquats to pomegranate juice, sparkling wine and club soda for punch. Chop kumquats and mix with diced avocado, red onion, cilantro and lime for a fresh salsa. Native to China, kumquats have a long culinary history throughout Asia, where they often are preserved as jams or in salt, added to teas and used as ornamental bonsai trees. The fruit arrived in the United States in the late 1880s.

Meyer lemons:

Smaller, smoother, rounder and with a thinner rind than a common lemon, Meyer lemons are known for their deep, brilliant yellow color and heady aroma. Their pulp is low in acid, aromatic, floral and sweet. Re-popularized by chefs in the late 1990s, they have a wide variety of culinary uses. Thinly slice them and add to pizza. Zest them into baked goods and juice them and combine with water and simple syrup for lemonade. They are believed to be a natural hybrid of a lemon and either a mandarin or a sweet orange that was brought to the United States from China in 1908.

Oregon Healthy Living â&#x20AC;˘ February 10, 2019

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FOOD

Pummelo:

This fruit has an exceedingly thick peel with a cotton-textured pith and skin that is green when young but becomes brilliant yellow as it matures. Although easily removed, the peel can grow up to 5 inches deep. Every bit of the heavy pith and membrane must be removed to make this giant gem edible. Cut off the ends; score the skin; peel away pith and rind. Separate the segments, pulling or cutting off the membrane. The pummelo’s pulpy segmented flesh ranges in color tones from pale to rich rose pink to translucent yellow; it can be served like grapefruit sections. Native to Southeast Asia, this staple food of Vietnam is excellent paired with seafood, coconut, papaya, peanuts, chilies, garlic and other Asian spices.

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FOOD

Satsuma mandarins:

These are considered the sweetest of all citrus varieties, though they do offer some acidity. Sometimes called tangerines, they are native to Japan, dating to the 14th century. Satsumas are thought to be a natural mutation discovered growing on a tree that was likely brought to Japan from China. This is the leading commercial citrus variety grown in the Gulf Coast region of the United States, although Japan is still the world’s largest producer. Satsumas can be added to green salads or used in baked, frozen or fresh dessert applications. Use the juice for cocktails or smoothies, or blend with other citrus juices. Satsumas pair well with sweet and spicy flavors like soy, ginger, garlic, vanilla, honey and olive oil.

Sweet limes:

Don’t squeeze these for Margaritas. Barely tart, the flesh of this fruit offers a sweet flavor with mild honey notes. They can be juiced for use in dressings, marinades and beverages, or preserved as pickles, chutneys and marmalades. Their flavor pairs well with meats, poultry and seafood, and they also can be used in desserts or as garnishes. Sweet limes are particularly popular in India, where Ayurvedic medicine cites their cooling properties. This natural hybrid is believed to have originated in India, and they did not arrive in the United States until 1904. Source: www.specialtyproduce.com

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Schedule your visit today and discover the many ways we can support you in a healthy, and fulﬁlling lifestyle!

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for your healthy

LIFESTYLE

We believe that a the secret to a great senior living community, is to support our residents in living the lifestyle that ﬁts their needs and desires! Our residents enjoy enriching activities, delicious fresh-foods, and most importantly, caring and passionate team members. Schedule your visit today, or stop in for one of our upcoming healthy living events!

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Pioneer Village’s free seminar on Blood Pressure by Accent Care on Thurs. Feb. 28, 2019 at 3 PM

Farmington Square’s free “Sit & Be Fit” exercise class designed for seniors with a dementia diagnosis. Every Saturday at 11 AM!

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SPECIAL

START

1. Reac h to a frie out nd you haven’t spoken to in a while.

February

2. Say “good morning” to someone you don’t know.

the 3. Hold en for door op . someone

ve 28. Lea nal inspiratio s in message r y libra random books.

Rando m

ster a 27. Fo t is up pet tha r ption o for ado od to fo donate mal an ani shelter.

acts of kindness

26. National Tell a Fairy Tale Da —Volunte y er to read at a local sch ool or library . Go dress ed in costume. 25. Buy items from children who are having school fundraisers.

24. Leave positive messages on sticky notes on restroom mirrors.

Making the world a better place, on TEXT BY MICAH LEIGH

23. Pay since a re comp limen t to some one.

22 Put . ou bird t feed ers.

CARTOONS BY PAUL BUNCH

21. Leave water and a thank-you note for your US PS, Fed-Ex, UPS driv er.

k up 20. Pic erever litter wh it. you find

Oregon Healthy Living • February 10, 2019

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4. National Homemade Soup Day — Make a batch and share with someone who is lonely.

5. Offe someon r to let e go ah ead of you in line.

our way y a t u are P 6. people n e h w m phone . Talk to the d n arou . instead

7. Natio nal Send Card to a a Friend D a y —Take th e time to handwrit e a note !

8. Return a shopping cart. 9. W ri letters te t soldie o Chec rs. k ou www t opera . tion gratit ude.c om.

10. Giv e someon e a hug

Random Acts of Kindness Week (RAK) is Feb. 9-15, 2019, but you can practice kindness every day. The first RAK week was observed in 1995 as an opportunity for people around the world to unite in kindness. Now more than ever, we could all appreciate a culture of kindness. Here are some ideas about how you can create a kinder world. As you bring happiness to others, you may be surprised to find a new happiness in your own heart.

11. Buy flowers to hand out on the street.

ve a 12. Lea u thank-yo a note on long napkin a p for with a ti ver. your ser

k up erever nd it.

17. Take r the fo s it k e k a the time 18. M cks with so ff tu S . ss to really homele ok hand sani- lis , o le tt b o b r a te ten to ift a wa 19. G eone bars, tooth- som la o n ra g r, m eone. tize to so shes. ru k b th n o i to h t d e e-fill ou who y joy it. past n e NATIONAL would

AL K IND

16. Natio nal Do a Grouch a Favor Da y —We all know at least one. Do something nice for th at person .

13. Plant a tree.

14. Valentine’s Day —Pass ou SS t Valentine cards at a nursin ay g 15. S ng i h o h t m e e . som ging ura enco cial on so . a medi

N AT I O N

EEK

ce, one small gesture at a time

KINDNESS DAY

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PETS

The Silent Prowl of Feline Kidney Disease

Most cats will suffer some degree of kidney disease in their lifetimes TEXT BY CINDY QUICK WILSON

elines are known for their endearingly capricious behavior, but lately Fluffy just hasn’t been her usual frisky self. She’s indifferent to food but seems unusually thirsty, has lost some weight, and spends extra time in the litter box. The signs may be subtle at first, but these could be indications that Fluffy is already in the advanced stages of kidney disease.

Some breeds of cats, like the Maine coon, Abyssinian, Persian, Siamese, Russian Blue and Burmese are genetically much more prone to kidney disease.

Oregon Healthy Living • February 10, 2019

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PETS The sneak attack

Though kidney disease affects as many as one in three cats, Dr. Gail Colbern, an Ashland veterinarian with Bear Creek Animal Clinic, says you may not know it because kidney disease in cats is very sneaky. “Early on, there are few clinical signs, which is a problem because by the time the symptoms are evident, the disease can be quite advanced.” Signs of kidney failure may include increased thirst and urination, leaking urine (especially at night), vomiting, diarrhea, lack of appetite, weight loss, depression, anemia and overall weakness. Generally speaking, Colbern says, “This is a degenerative disease common to older animals. There are specific factors that can cause a younger animal to have kidney disease, but those are caused by specific conditions.” Kidneys perform some of the body’s most critical functions, explains Dr. Diane Wittenberg, veterinarian with Allen Creek Veterinary Hospital in Grants Pass. “They filter wastes and toxins from the system through

urination. When kidney function is impaired, these wastes remain in the cat’s body, and that toxicity can cause them to feel sick with uremic gastritis, a condition that causes inflammation of the stomach and digestive upset, and because of that they may lose their appetite or start vomiting. In that case, we may need to keep them on intravenous fluids or flush their kidneys.”

Difficult to diagnose

“That’s the difficulty with kidney disease,” Colbern continues. “Even in looking at the usual laboratory parameters, the BUN (blood urea nitrogen) and the creatinine levels that we normally test in the blood, we don’t see changes in those until the animal has already lost 90 percent of their kidney function. Even as the kidneys start to deteriorate and lose their efficiency, it’s difficult to detect that until it’s fairly advanced. And because renal tissue cannot regenerate itself once it is damaged beyond repair, it is gone forever.” Renal or kidney disease falls into two categories,

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PETS Colbern says: acute and chronic. “Acute is what you’d see in the case of toxicity or some kind of medical crisis that happens with that animal that makes the kidneys not work. It could be from ingesting a chemical poison like antifreeze, a kidney infection or physical trauma to the kidney area. Chronic renal disease happens more slowly, with a gradual loss of kidney function.” Although advancing age is the most common factor, Wittenberg adds that there are other possibilities. “Some kitties are born with polycystic kidney disease or genetic abnormalities. And some breeds of cats, like the Maine coon, Abyssinian, Persian, Siamese, Russian Blue and Burmese are genetically much more prone to kidney disease, so one hopes responsible breeders are screening for that.”

Care and feeding of kidneys

If you’re recognizing these symptoms of kidney disease, Wittenberg stresses that it’s important to get your veterinarian’s diagnosis. “There are other diseases that have similar symptoms, such as hyperthyroidism and diabetes, so your vet will want to do some blood work and urinalysis to identify exactly what you’re dealing with. There may even be more than one disease going on at the same time. To make assumptions and start them on a kidney diet without knowing exactly what’s wrong, you can do more harm than good.” Once diagnosed, Colbern says, “It’s likely your veterinarian will recommend a change to a kidneyformulated food because regular formula cat food

that is high in protein will be very hard on the kidneys. Since cats are extremely finicky about what they eat, this change can sometimes be challenging.” Adequate hydration is also very important, Wittenberg says, so always provide access to a couple of sources of water at home. “Since most cats like to drink away from where the food is, place one water bowl near the food dish and one away from the feeding area.”

Can we prevent kitty kidney disease?

Wittenberg says that although we can’t prevent feline kidney disease, early detection can improve your kitty’s chance for a longer, healthier life. “By the time renal failure is diagnosed, they’ve already lost a significant percentage of their normal kidney function, but with proper care, sometimes these kitties can live for years with kidney disease. A lot depends on their care and quality of life at home.” Colbern stresses that it’s important to work with your veterinarian. “They can run laboratory tests, including the new SDMA test, which measures the level of symmetric dimethylarginine. That can help us detect changes in kidney function at an earlier stage. They look at the BUN and the creatinine, the specific gravity of the urine. Those are all primary parameters that indicate that the kidneys are not functioning as they should. So, while we can’t stop this disease or reverse the damage, the earlier we can diagnose and begin treatment, the better the chances are for a longer life.”

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WHY DO CATS HAVE SO MANY URINARY PROBLEMS? We asked Dr. Gail Colbern of Bear Creek Animal Clinic in Ashland to respond:

Stress “Kitties often have what is called interstitial cystitis, also termed idiopathic cystitis. We have identified it as a stress-related disease, meaning that emotional and behavioral upsets can have a negative affect on urinary conditions. The first thing we look for is the stress level for this animal. It may be from moving from one house to another, having multiple cats in the house or having cats that don’t get along. We have found that pheromones for kitties have a relaxing effect. One of the most common products we use for that is called Feliway, which reduces stress for cats.”

Diet “A high protein diet is what leads to kidney disease and can also promote crystals in the urine. Dry cat food in and of itself is not the culprit in urinary problems. It’s more that cats generally don’t drink enough water with it and ideally, the bladder wants to be flushed out. Dry cat food is better for reducing tartar on the teeth, but it obviously has a lot less moisture than wet or canned food, which provides a higher level of moisture. That makes it a better choice for cats with renal or urinary issues.”

Dehydration “An adequate intake of water is necessary to flush out toxins from the kidneys, especially when it comes to kidney disease. We’ve found that cats will drink a lot more water if it moves than when the water is still. For instance, cats are more likely to drink from a faucet left on a slow drip. Another possibility is a fountain that recirculates and moves the water around.”

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HEALTH

When you shouldn’t just go with the flow Erratic or heavy periods raise questions TEXT BY CHERYL P. ROSE

ven though half the human race experiences them, there can still be a lot of confusion about periods, or menstruation, and what is and is not “normal.” Depending on your frame of reference, you may be assuming your experience is typical when it isn’t. “When your period is interrupting normal, daily life —like missing school or not participating in sports or activities—that requires some evaluation, and potentially, intervention,” said Dr. Kristina Haley, a pediatric hematology/oncology specialist and co-director of the OHSU Spots, Dots and Clots clinic in Portland.

What is normal? Girls typically have menarche, the first occurrence of menstruation, around age 12. For the first two years, there often isn’t a pattern to the cycle or the flow. “It’s very normal to have irregular cycles the first couple of years,” said Dr. Maureen Baldwin, an OB-GYN specialist and co-director of the OHSU Spots, Dots and Clots clinic in Portland. “Missing up to a few menstrual cycles a year is within normal for any age group, but especially with teens. It doesn’t need evaluation—unless they are having sex and

could be pregnant.” After those early years, periods usually become more predictable, Haley said, though it can take up to six years to settle into a consistent pattern. Blood flow typically lasts four to five days and repeats about once a month. Each woman’s cycle, or the number of days from when one period starts until the next one starts, can vary. The average is 28 days. Tracking the calendar is easy, but it can be harder to determine if the amount of blood is normal. Baldwin said there is research about the average milliliters of blood, but who is going to weigh their pads to check that each month? Instead, she simply asks if patients feel their flow is heavy, because a study proved a woman’s perception of this is often correct.

What is abnormal?

Baldwin rates heavy and prolonged periods as the most important signs for medical evaluation. “Periods that last more than seven days are a red flag, regardless of age,” she said. Haley added that soaking through pads very quickly or needing to double-up on protection is unusually heavy for any age group as well. Heavy and/or prolonged periods can lead to an iron deficiency or anemia, which can cause fatigue and challenge a girl’s ability to participate in sports or perform in school. With irregular periods, Baldwin said counting the cycle correctly is important and often misunderstood by

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HEALTH women. A few days either way of the expected cycle date isn’t relevant, but having randomly occurring periods (for example, 14 days after the last one and then 40 days before the next one), warrants evaluation. “With young girls, irregularity is common, but if it’s been more than a couple of years of irregularity, they should get an evaluation by a health care provider,” Baldwin said. Another concern for young girls is failing to start a period. Baldwin said if a girl has reached 16 years old without a period, this is another reason to check in with a provider. “The first evaluation is a discussion and possibly a blood test,” Baldwin said. “We then start with attempting treatment, which is nearly always successful. If that doesn’t work, we might do a pelvic ultrasound next to rule out structural problems or ovarian cysts.”

Symptom of a bleeding disorder?

In general, about 20 percent of females with heavy menstrual bleeding have an underlying bleeding disorder. Close to 40 percent of the adolescent patients who come

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to the OHSU Spots, Dots and Clots Clinic for help with heavy periods test positive for a bleeding disorder. There are several kinds of bleeding disorders, which relate to how the blood clots. In her pediatric practice, Haley typically sees patients with congenital or inherited blood disorders. In girls, heavy periods can be a sign that the blood isn’t clotting properly. “it’s not uncommon for us to see an adolescent with a blood disorder, and then we find the mom also has heavy periods, so we refer her to an adult hematologist,” Haley said. “They’ll say, ‘I always had periods that lasted 10 days, but so does everyone else in my family, so I thought it was normal.’” Bleeding disorders, if mild, may not be obvious unless there is a bleeding challenge, like an injury, Haley said. However, with girls, every month presents a bleeding challenge, so heavy flow can be a sign for further investigation. A blood test can help determine if a disorder is present. “It’s important to know that abnormal periods don’t necessarily mean there is a bleeding disorder,” Haley said. “In 2006, the American College of Obstetricians and

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HEALTH Gynecologists and the American Academy of Pediatrics recommended that health care providers start using the menstrual cycle as a sort of vital sign. Screening for a bleeding disorder should be part of the evaluation for heavy menstrual bleeding.”

Finding a manageable solution

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Baldwin offers several solutions to patients who struggle with heavy menses or irregularity. “I start by asking the patient what is the most important thing for her— predictability or lots less?” Baldwin said. “With the heavy bleeders, they usually pick a lot less. Most teens want to know when they will bleed.” One option for treatment is tranexamic acid, a nonhormonal method of management. Baldwin said the patient takes six pills a day for five days while having her period. The pills help to decrease period bleeding by 30-40 percent. Not all insurance providers cover this method, Baldwin cautioned. Another option is a combination of estrogen and progestin hormones that provide regularity, predictability and decrease period bleeding by 50-60 percent for most women, Baldwin described. A third choice, she added, is progestin-only medications, which can decrease period bleeding by as much as 80-90 percent and have fewer contraindications for women with other medical problems. For young girls, Baldwin said doctors avoid using estrogen medicines for the first year after menarche to allow for complete bone fusion. However, there is no minimum age after periods start for placing an intrauterine device, she noted. The results of a survey commissioned in Britain recently revealed that 44 percent of girls worldwide do not know what is happening to them the first time they have their periods. Fifty percent of the girls surveyed were too shy to tell anyone else about starting their period. “Women don’t always talk about their periods and they don’t know how their experience compares to others, so it’s important for providers to ask questions,” Haley said.

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The teen years are full of awkward experiences for everyone, but females get the added embarrassment factor of the unexpected or heavy period causing blood stains through clothes. The humiliation factor can be high and horrifying to a young girl, even if no one notices or teases. At the OHSU Spots, Dots and Clots Clinic, the physicians noted many of their patients were missing school, leaving early or taking online classes because of their menstrual flow. “One reason seems to be that girls often don’t have adequate access and time for bathroom breaks to change pads at school,” Haley said. “We write notes to schools and help girls think about how to be prepared so they don’t have to go home.” Parents can help their daughters by assembling a period pack to keep at school, Baldwin suggested. Stock a small travel bag with pads, pantyliners, baby wipes and extra underwear. Keep a pair of black leggings and an extra sweatshirt that can be tied around the waist in the locker. “Many of these girls don’t have a medical problem; they have a period,” she said. “If a girl is missing school due to pain or bleeding that is prolonged or perceived as heavy, let’s evaluate her.”

541-779-7640 Oregon Healthy Living • February 10, 2019

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PAMPER

A Massage For

Two

How a couple’s your heal massage may improve th and relationsh ip TEXT BY REBECCA SCOTT

couple’s massage is a time to relax, unwind, enhance your relationship with a friend or loved one and improve your overall health, according to industry experts. Local massage professionals agree that people share a special bond during a couple’s massage because it is such a unique experience. What to expect from your massage

A couple’s massage shares many similarities to a regular massage session, with a few notable differences, says JoAnn Lewis, the director and owner of Family Massage Education Center in Ashland. “Massage helps restore the body and mind, and decreases stress levels,” she explains. During the session, she says couples go into the same room with massage tables placed side-by-side or facing each other to create an intimate experience. However, couples’ massages are not only for romantic partners, according to Joanne DeRoo, owner of the Blue Giraffe Spa in Ashland. She says side-by-

side massages are great for friends, spouses and family members, and are a nice way to connect with someone in silence. “We’re always talking, and massage allows us to have a deeper connection without a lot of verbal communication,” she explains. Similar to other massage treatments, DeRoo says you can choose whether you want a male or female masseuse, the length of the massage, the technique used and if you desire any aromatherapy. If you’ve never had a massage before, she advises you to come in with a receptive attitude. “Be open-minded and give feedback throughout the treatment so you have a positive experience,” she says. Additionally,

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PAMPER

“Massage helps restore the body and mind, and decreases stress levels.” —JoAnn Lewis, Family Massage Education Center, Ashland

she explains that a key component of a couple’s massage, or any massage, is communication with the masseuse. “Speak up and let the masseuse know what your comfort level is and what you do or do not want,” she says.

Benefits of massage

A couple’s massage focuses on connectivity, closeness and intimacy, according to Lewis. “It is a unique way to spend time with your partner, a family member or friend,” she explains. She also says it’s a great way to pamper yourself. Sharing a couple’s massage is a wonderful gift in a time where we don’t take care of ourselves as well as we should, she says. As with other massage treatments, Lewis explains there are many benefits to a couple’s massage. “You cannot move your own body in the multiple ways that massage can,” she says, noting that massage can relieve muscle aches, aide digestion and help with hormonal and emotional balance. In addition to a typical couple’s massage, she explains you could also attend classes which teach couples how to massage each other. “You learn a simple massage routine which helps you connect on a more intimate level and understand each other’s bodies,” she says.

Bonding through massage

Lewis and DeRoo agree that a couple’s massage is a meaningful experience which creates a strong bond between two people. DeRoo explains that a sideby-side massage is a special gift of “we time” for people with busy lives. “When you work 40 hours a week, volunteer or are just very busy, it’s nice to give the gift of ‘we time,’” she says.

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PAMPER PROPER MASSAGE ETIQUETTE If you are planning a couple’s massage for the first time, experts suggest you follow these steps before and during your treatment. 1. Arrive early: A massage is meant to reduce stress and running late only increases feelings of anxiety. Arrive 30 minutes before your treatment so you can enjoy any extra amenities the spa may offer, such as a relaxation lounge. 2. Plan together: Choose a treatment which is relaxing for both of you and doesn’t leave you sore or hurting the next day. Discuss ahead of time what type of massage you want and if you would like aromatherapy or other services. 3. Don’t worry: Be present and enjoy the moment. Focus on your experience and don’t let outside thoughts distract you.

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MAR FEB events calendar JAN 10 14 DEC NOV OCT SEP 11 14 AUG JUL JUN MAY APR TH

COFFEE AND CREDIT 10-11 A.M. REMIX, 1602 ASHLAND STREET, ASHLAND CONTACT INFO: www.roguecu.org/learn/availableclasses A free seminar to learn tips about how to raise your credit score, what to look at in a credit report and the huge impact credit has on your financial life. Hosted by Rogue Credit Union.

BELLY-CHEST PATTERN BREATHING 6-8 P.M. ASHLAND FOOD CO-OP CLASSROOM, 300 PIONEER ST., ASHLAND CONTACT INFO: 541.482.2237 Instructor Kelly Martin, a physical therapist with Connected Physical Therapy in Medford, leads a free class in how breathing impacts you from your heels to your skull. Learn how using the diaphragm can change the alignment of the pelvis, spine and ribcage, which influence joints and muscles.

GET LISTED!

NATIONAL DONOR DAY CONTACT INFO: www.donatelifenw.org/register-now Almost 115,000 people in the United States are currently on the waiting list for a lifesaving organ transplant, according to the American Transplant Foundation. On average, 20 people die every day from the lack of available organs for transplant. Sign up to become an organ donor at the Department of Motor Vehicles or by mail.

WINTER GROWERS MARKET 8:30 A.M.-1:30 P.M. FRY FAMILY FARM STORE, 2184 ROSS LANE, MEDFORD CONTACT INFO: rvgrowersmarket.com The Rogue Valley Growers & Crafters Market is open every Thursday this month at Fry Family Farms with indoor comfort. Winter Market vendors will feature fresh and seasonal produce, hand-crafted gifts and artisan food selections.

DO YOU HAVE AN EVENT YOU’D LIKE TO PROMOTE ON OUR EVENTS CALENDAR?

Simply email crose@rosebudmedia.com and include the following information: Event title, date, time, location, contact information and a brief description including any required fees. Please note: Event information must be received at least 60 days in advance to be considered for publication in Oregon Healthy Living.

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21ST 26TH

16TH FAMILY ART CLASSES 10:30 A.M.-NOON ASHLAND ART CENTER, 357 E. MAIN ST., ASHLAND CONTACT INFO: 541.482.2772, www. ashlandartcenter.org Drop-in and free art exploration for children and families (including free materials) every Saturday morning. Creative projects change weekly.

BAVARIAN NIGHT AT MOUNT ASHLAND 4–9 P.M. MT. ASHLAND SKI AREA, 11 MT. ASHLAND SKI ROAD, ASHLAND CONTACT INFO: www.mtashland.com/ event/bavarian-night An annual fundraiser for the Mount Ashland Ski Patrol, a rescue and first aid organization. All proceeds from Twilight Skiing tickets on Bavarian Night will support the ski patrol. Events include raffles, live music and a massive fireworks show.

16TH

USING ELECTRIC MULTICOOKERS 6-8:30 P.M. JOSEPHINE COUNTY EXTENSION, 215 RINGUETTE ST., GRANTS PASS CONTACT INFO: josephine.extension@ oregonstate.edu Have you gotten the hottest new kitchen gadget, the electric multicooker? Is it still sitting in the box? If so, this class is for you! Dive right in and learn recipes and try different items made in the multi-cooker. Class fee $10.

23RD

ROGUE RIVER HALF MARATHON/ ALYSSA WATSON MEMORIAL 5K 10 A.M.-NOON FLEMING PARK, 8880 ROGUE RIVER HWY., ROGUE RIVER Out and back on Rogue River Greenway bike path. Fees vary by registration date and race. Register online at https://runsignup.com/Race/OR/RogueRiver/RogueRiverHalfMarathon5k.

INTERNATIONAL & ADVENTURE TRAVEL BASICS 16:30-8 P.M. REI, 85 ROSSANLEY DR., MEDFORD CONTACT INFO: www.rei.com/event Thinking about an exciting adventure abroad? Curious about what planning the trip might entail? Come to a free class to learn the nuances of an international adventure trip, such as pre-planning and preparation, logistics, equipment and apparel, adventure travel activities and available resources.

26TH JUST SAY NO TO DISEASE 6-7 P.M. ROGUE VALLEY FAMILY YMCA, 522 WEST 6TH ST., MEDFORD CONTACT INFO: wellness@rvymca.org A free nutrition class to learn how to make better food choices for you and your family. The YMCA provides a healthy snack during the class.

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Take a behind-the-scenes look with Ryan Pfeil as he interviews other reporters on what went into their stories and videos, and how they were able to pull it all together.

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