NOVEMBER 2017 | VOL. 10 — ISSUE 11
CORE CONTROL
Picking a Pilates method PLUS
Earthly flavors: Edible local mushrooms Could you be prediabetic?
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Table of Contents
NOVEMBER 2017 | VOLUME 10 — ISSUE 11
FITNESS
COVER STORY
Core Lessons: Mat vs. Reformer Pilates
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HEALTH
Blood Sugar Alert: Prediabetes prevention
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FOOD
STYLE
Bright Smiles: Tooth whitening
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Fun with Fungi: Fresh mushrooms
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SPECIAL
Document Decisions: Necessary at all ages
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On the cover
The editor’s desk
At the first Pilates class I ever attended, I got frustrated with the full-body roll up. You’re laying on the floor, arms extended above your head and you need to curl up and touch your toes – without your lower body coming off the floor! What? But my patient instructor showed me the secret, and I soon felt confident. That class was a mix of age and genders, because Pilates works so well across the spectrum of ability. Meanwhile, holiday season has arrived again. Next month we have some suggestions for gift giving, food safety and even chiropractic tips for your pet. Happy Thanksgiving!
David Zauher of Grants Pass, a youth athletic trainer, has some past neck and back injuries. He recently started Pilates classes at Club Northwest to strengthen his core and improve his posture as a way to address those injuries and prevent future ones. Zauher believes that adding CORE CONTROL Pilates to his fitness Picking a Pilates method routine has helped to lengthen and balance his muscles, and has improved his flexibility. Photo by David Gibb Photography. NOVEMBER 2017 | VOL. 10 — ISSUE 11
PLUS
Earthly flavors: Edible local mushrooms Could you be prediabetic?
O regOn H ealtHy l iving . cOm
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crose@mailtribune.com
STAFF
EDITOR: Cheryl P. Rose VICE PRESIDENT OF SALES: Gail Whiting DESIGN & PRODUCTION: Paul Bunch, Sasha Kincaid, John Sullivan CONTRIBUTING WRITERS: Melissa Haskin Sarah Lemon Rebecca Scott Cindy Quick Wilson CONTRIBUTING PHOTOGRAPHER: David Gibb
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Join the list... Ashland Food Co-op ....................... pg. 19 Ashland Forest Resiliency Stewardship Project........................ pg. 15 Core Physical Therapy
Oral and Maxillofacial Surgery........ pg. 7 Oregon Retina Center...................... pg. 24 Pacific Source................................... pg. 6 Retina Care Center........................... pg. 10
& Training..................................... pg. 17
Rogue Scuba.................................... pg. 11
Good Medicine Acupuncture............ pg. 13
Rosa Transformational Health........... pg. 28
Linstrom Family Dental...................... pg. 3
Sherm’s Food 4 Less......................... pg. 21
Medford Dermatology...................... pg. 17
Shire Pharmaceuticals....................... pg. 14
Medford Food Co-op....................... pg. 13
Southern Oregon Foot & Ankle........ pg. 9
Medford Foot & Ankle...................... pg. 2
Superior Athletic Club....................... pg. 9
Medicap Pharmacy.......................... pg. 22 Northridge Center............................ pg. 4
Oregon Healthy Living Magazine is published by the Rosebud Multimedia Advertising Department, 111 N. Fir St., Medford, OR 97501. General information: 541.776.4422 Submissions and feedback: crose@mailtribune.com
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Norton Lumber................................. pg. 4
....and reach your next customer with Oregon Healthy Living!
To advertise contact Niche Marketing Specialist Athena Fliegel at 541.776.4385 or afliegel@mailtribune.com
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HEALTH
A Silent Warning TEXT BY CINDY QUICK WILSON
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rediabetes is an indicator that you are on the path to diabetes. It occurs when your body is unable to make enough insulin after eating or does not respond to insulin properly. And it can be sneaky: you may function day to day without knowing that your body is losing the struggle to regulate normal glucose levels. By the time you notice symptoms of the disease, you may have already progressed into Type 2 diabetes. The Centers for Disease Control estimate that 86 million people (about one out of every three) have prediabetes, and nine out of 10 of them don’t know it.
Prediabetes has few symptoms but can signal the need for lifestyle changes “When your blood sugar is higher than normal but not high enough to be diagnosed with Type 2 diabetes, that’s when you are considered to be prediabetic,” explains Kim Waller.“Or you might also hear the term borderline diabetic.” Waller is a physician assistant and certified diabetic educator with Primary Health in Grants Pass. “High blood sugar occurs when the pancreas doesn’t make enough insulin, or the cells become resistant to the action of insulin, or both,” she says. The exact cause for prediabetes is unknown.
But I feel fine There can be many variables with symptoms and timelines between prediabetes and being diagnosed with Type 2 diabetes, Waller says. “Some people may have no symptoms at all. But other patients might develop patches of darkened skin that becomes thicker than normal, called acanthosis nigricans. It’s often seen on the neck and around wrists or finger joints. Some patients will complain of blurred vision, because when your blood sugar is higher, the lenses in your eyes tend to swell. Others might be very fatigued and notice increased thirst, hunger, urination and slow-healing wounds.” Often by the time someone is diagnosed with Type 2 diabetes, Waller says they’ve probably been a diabetic for a few years, so they may not have even noticed being a prediabetic.
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HEALTH continued from page 5
How do I know?
“Diabetes can be delayed, controlled or prevented if properly treated with lifestyle changes.”
Diagnostic measures usually include three simple blood tests: a fasting plasma glucose test, an oral glucose tolerance test and a hemoglobin A1C test, which shows an average of blood sugar levels over two to three months. Sue Amidon, RN, CDC, “When your fasting blood sugar level diabetes program manager, Asante, Medford and Grants Pass is above 100 to 125, that’s when we’d call it prediabetes,” says Waller. “Two hours after eating, if your reading is between 140 and 200, that indicates prediabetes. If you get two fasting readings above 125, that could also mean a diagnosis of diabetes. When the A1C test results hit 5.7 percent, I’ll start full-on treatment because I’m trying to prevent the individual from going into Type 2 diabetes.”
Am I at risk? Though symptoms may not be obvious, there are some important clues as to predisposition. Sue Amidon, a registered nurse and diabetes program manager with Asante in Medford and Grants Pass, says certain groups are considered higher risk for developing diabetes. For example, age can be a factor. “We see diabetes most commonly in patients 45 years or older,” Amidon says. “Family history can be another indicator because the risk
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goes up for people whose parents or siblings have diabetes.” Amidon, a certified diabetes educator, says other higher risk groups include African-Americans, Hispanic/Latinos, American Indians or Pacific Islanders, as well as anyone with high blood pressure or low HDL cholesterol and/or high triglycerides. Also women who have had diabetes during pregnancy or have been diagnosed with polycystic ovarian syndrome (PCOS).
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HEALTH If there is a positive note, it is that some of the most dangerous risk factors – diet, obesity and sedentary lifestyles – can be managed. Amidon says diabetes can be delayed, controlled or prevented if properly treated with lifestyle changes. “Exercising 150 minutes a week and weight loss, as little as 5 to 7 percent, can reduce diabetes development by 58 percent.”
Can children be at risk? Yes, they can, responds Amidon, “Kids are not routinely screened unless their provider feels it is necessary. If you are overweight and have at least one other risk factor for diabetes, ask your children’s pediatrician about getting them tested.” She stresses that the best solution is prevention with a healthy diet and adequate exercise. “It’s important to teach your kids healthy eating behaviors at an early age and to balance their screen time with physical activity.”
Prevention is worth a pound of…fat “I have seen patients with both kinds of diabetes return to normal with lifestyle changes,” Waller states. “Weight control is huge. Even losing five to 10 percent of your body weight can make a difference.” Waller recommends cardio exercise every day and adhering to a healthy diet with lean protein, vegetables and whole grains. Omit starchy carbs, limit portion sizes and some sugars. “Just walking around during the day is not enough,” she says. “It has to be intentional exercise. I’ve seen people reduce and even eliminate medicine altogether. That’s why I’m always telling my patients, ‘Close your mouth and move your feet!’”
The Center for Disease Control estimates that 86 million people (about one out of every three) have prediabetes, and nine out of 10 of them don’t know it.
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FITNESS
Can Pilates Mat Users Be Reformed? David Zauher demonstrates the Pilates Reformer at Club Northwest. Photo by David Gibb.
Mat or machine, Pilates practitioners achieve core strength, flexibility and balance 8
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FITNESS
TEXT BY CINDY QUICK WILSON
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efore its exposure to today’s fitnessminded masses, the Pilates Method had quietly produced many a sleek silhouette for jet-setting, Hollywood types and high society dames. Through the years, dedicated followers have brought it to the forefront as a favorite workout method in studios, gyms and living rooms across the country. Pilates exercises are done either on a mat on the floor or on an exercise apparatus called a Reformer. Both methods achieve similar results, but the workouts are decidedly dissimilar. “Both mat and Reformer Pilates offer the types of exercises that promote a strong core, strong stabilizer muscles and proper placement of the spine,” explains Amanda Valle, trainer and fitness coordinator with Club Northwest in Grants Pass. Valle teaches Reformer classes and often incorporates Pilates exercises into her personal training routines. The wide appeal of Pilates is that all exercises are designed with modifications that make it safe and challenging for people at any level of fitness. Favored by athletes and dancers, it is adaptable for seniors or others at various stages of physical rehabilitation. Enthusiasts become stronger, leaner and more able to move with grace and ease. “Both Reformer and mat exercises are extremely effective in teaching body awareness and integrating our neuromuscular system,” explains Marie Quinn, a certified Pilates instructor. “Mat work utilizes body resistance and challenges balance, core strength and stability. Reformer
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FITNESS continued from page 9 routines offer a more varied total body workout, stabilization and stretching while performing abdominal exercises.” Quinn, co-owner of Verve Pilates + Fitness Studio in Medford, began practicing Pilates in 2007 to address her own chronic pain and mobility issues. Introduced first to the Reformer, she got back on a bike in weeks and was running 5K events within months. She says incorporating mat classes into her routine enhanced core strength and stability, improving her balance and mobility.
Going to the mat
For beginners, the first experience with Pilates is often the mat exercises, says Quinn. “These classes are usually done in larger groups using just body weight for resistance,” she explains. “The emphasis is on smooth movements through muscle control, deep breathing and good posture.” Mat Pilates is a smaller part of the entire range of Pilates exercises, using about 50 different moves.
“The theories and practices of Pilates, whether mat or Reformer, offer a healthy base for functional movement, which makes it a great investment in wellness for everyone.” Amanda Valle, trainer and fitness coordinator, Club Northwest, Grants Pass
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FITNESS The workout is fast-paced and good for burning calories. Though arms and legs are involved, the primary focus is on core muscles and core strength, which Quinn says is important for back and spine support, improving posture and reducing the risk of injury. Quinn points out that, “Once properly instructed, you can perform Pilates mat exercises anywhere, while the availability of Reformers is more limited. We encourage clients to perform mat exercises daily and we even design routines to be followed when they are unable to make it to classes regularly.”
Reformer routines
Photo by David Gibb
To the uninitiated, the Pilates-designed Reformer looks like an apparatus used for medieval torture. And for anyone who doesn’t enjoy a challenging full-body workout, that idea may be apropos. But for dedicated Pilates practitioners, it’s an effective method for attaining optimum results. “The Reformer uses springs for assistance and resistance,” Quinn says, “which is useful for beginners to initiate correct muscle engagement, while providing progressions into more advanced movements within the exercise routines. The Reformer also offers modifications and assistance for anyone working with physical limitations.”
The Pilates Reformer resembles a wooden bed frame, rigged with cables, springs, straps and a sliding seat. It allows for all the moves typical to a mat workout while sitting, lying or even standing. The level of resistance is adjustable and adapts well to a range of abilities, which can allow people with injuries or limited range of motion to practice modified Pilates exercises safely. “The Reformer includes more hip and leg resistance training,” adds Valle, “and the rehab reformer is built higher off the ground, like a therapy table, making it easier for people who have difficulties getting down and up off the floor.”
Personal preference
Both methods of Pilates have value, Quinn says, so it comes down to personal preference. “Pilates classes, whether mat or Reformer, should have a decent flow,” she says, “leading your body through all ranges of motion including flexion, extension and rotation. An accredited Pilates instructor with skills in observation and concise cueing is very important to the safety and effectiveness of Pilates classes.” Valle agrees. “The theories and practices of Pilates, whether mat or Reformer, offer a solid, healthy base for functional movement, which makes it a great investment in wellness for everyone – and it’s never too late to start,” she says.
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FITNESS Fitness results: Not surprisingly, some people swear by their mat Pilates workout, while others are committed to the Reformer. Both provide benefits in terms of greater flexibility, improved body awareness and enhanced core strength.
Exercise variety: Traditional mat Pilates consists of about 50 exercises, while there are more than 250 on the Reformer, which keeps boredom at bay.
Portability and expense: A mat Pilates workout is doable anywhere there’s enough room to spread a mat. A Reformer workout requires the machine, which takes up quite a bit of space and isn’t especially portable. Reformer class fees can be higher to cover the cost of the apparatus. Usability: You’re more likely to need guidance from a certified Pilates instructor to learn how to properly use the Reformer. Expert guidance on the mat is an advantage, but you can use a video or online streaming. Mat Pilates also lends itself more readily to a class environment whereas small group or one-on-one training is best for the Reformer. The more individualized attention and equipment required for the Reformer usually means a higher fee for comprehensive training. continued on page 14
Mat versus Reformer
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FITNESS
er
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FITNESS continued from page 12
The Pilates (R)Evolution The Pilates Method of exercise was originally developed by German-born Joseph Pilates in the 1920s as a rehabilitation program for prisoners of war. Designed as a full body workout, it emphasizes core strength, flexibility and body awareness to achieve balanced physical development. In recent years, science has validated Pilates’ teachings and its popularity has exploded with devotees who desire the sculpted look of long, lean muscles. In addition to the aesthetic benefits, regular total-body workouts can ease back pain, improve bone density and boost heart rate. As the originator of both mat and Reformer method, Pilates could not have imagined the long-lasting success of his efforts into the 21st century.
Pilates plus benefits Pilates offers more than just a lean, well-toned body. It promotes weight loss, improves posture and helps prevent injuries. This full-body workout can stand alone or be used as a plateau-busting change to regular cross-training, weightlifting and cardio fitness routines.
Builds cardiovascular endurance: High intensity, moving between exercises quickly and decreasing resting time increases stamina.
Strengthens core: Pilates targets deep abdominal muscles like the transverse abdominis as well as superficial ones like the rectus abdominis muscles that form that desirable six-pack.
Eases back pain: Pilates strengthens the core to support the back, teaches proper alignment and provides gentle stretching for tight back muscles due to misalignment and overuse.
Improves bone density: Bone responds to resistance and weight-bearing exercises through use of apparatus springs and resistance bands.
Increases flexibility: Pilates sessions move the spine from flexion to extension, internal rotation to external rotation and side bending, allowing an increased range of motion throughout the body.
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Controlled burns are “an ounce of prevention”
PAID ADVERTISEMENT
Controlled burns reduce fire danger to firefighters, residents, homes, and nature, and release a fraction of the smoke that severe summer wildfires do.
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evere wildfire is a real and growing threat to communities around the West, where lives, homes, and businesses were lost again this summer. Here in the Rogue Valley, we suffered through seven weeks of smoky air, health effects, canceled activities and modified summer plans.
Our summer of smoke raises the questions: What brought our forests to their current unhealthy conditions and what can we do to prevent future catastrophic fires?
Two sides of fire
For centuries, frequent mild fires shaped, cleared and maintained our forests, explains Dr. Kerry Metlen, a forest ecologist with The Nature Conservancy. “Though well-intentioned, attempting to put out all fires created unnaturally dense forests that put our water, air and communities at higher risk from abnormally severe wildfire,” he said. “Add this factor to increasing construction in wildfire-prone areas, loss of older forests, a warming climate and lack of preparation by residents, and fire impacts and smoke get worse.”
Use good fire to fight bad fire
An essential part of the solution to severe summer wildfires and suffocating smoke is more controlled burning during spring and fall, Metlen explains. Scientific studies show that fuel reduction followed by controlled burns are most effective at reducing wildfire impacts, while making firefighting safer. “Wildfires burn more fuel per acre and emit significantly more smoke than controlled burns. The recorded smoke concentration, duration and cumulative impacts on people from wildfire vastly exceeds smoke from planned, controlled
burning,” said Rick Graw, a U.S. Forest Service Regional Air Quality Program Manager, who compiles smoke data from Oregon and Washington each year. Fire is being put to work for community benefit in many locations in the mild seasons. According to Chris Chambers, Ashland Fire & Rescue Forest Division Chief, professional teams safely use controlled burns to reduce the potential for severe summer wildfires. “Reducing fire danger by cutting small trees and brush, followed by planned, controlled burns during favorable weather, we get to choose how the fire behaves and where the majority of the smoke goes,” says Chambers. “Fuel reduction and controlled burns set the stage for a safer community and fire resilient landscapes.” FIND OUT MORE: Partners on the Ashland sofrc.org Forest fireadapted.org/ Resiliency ashandwatershed.org Project and other forest managers all work within Oregon State regulations and procedures to minimize smoke impacts on communities, while accomplishing good for the long term. So when you see controlled burns during the cool time of year, know that people are working for healthier forests and community today and for future generations.
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Something to Smile About
STYLE Teeth whitening is more popular than ever, but is it right for you? more, even in a dentist’s office. Plus, not all dark TEXT BY MELISSA HASKIN
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n America, teeth whitening is a booming business. Even toothpaste wants in on the action — just take a look at the growing number of pastes that promise brighter smiles.
Dr. Trevor Peterson of Premier Care Dental says, “The demand for bright, white and straight teeth has never been greater.” Peterson works out of Premier Care Dental’s Medford and Ashland offices. He says almost every new patient he has asks about how to get a whiter smile. Those who have not had their teeth whitened before may wonder: How much does it cost? How long will the results last? And, how does it work? We asked Dr. Peterson and one other local dentist, Dr. John Linstrom, all about teeth whitening and why they think people should see a dentist instead of picking up something from the store.
The case for in-office care
With whitening products galore available at most every grocery store and drugstore, is there a reason to visit a dentist for whitening? One reason is the immediacy a dentist can offer, says Peterson. “Results can be reached much quicker with professional whitening versus store-bought,” he says. In addition, accuracy can be much better, says Linstrom, who owns Linstrom Family Dental practice in Medford. “A dentist can make a custom, take-home tray that accurately covers your teeth and protects your gums, whereas the over-thecounter strips are one-size-fits-all and only whiten where the strip covers.” Another reason to stop by the white coats before deciding on a whitening plan? Whitening products typically don’t work on fillings, crowns, veneers and
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spots are stains you can get rid of with whitening, says Peterson. “Cavities can also appear as dark areas on a tooth that can’t be bleached, but need to be removed and filled.” Whitening without dealing with these issues can result in patchy coloring, drawing attention to things like fillings that keep their original color.
The tooth treatment
People who visit a dentist for teeth whitening can usually elect to either have an in-office procedure or can ask their dentist to custom-make inserts to take home for later use. The current price range for inoffice whitening is somewhere between $350-$650, according to Peterson. Linstrom says the cost of inoffice whitening can be double the cost of take-home trays. Peterson agrees, saying that in his experience, the take-home trays may run $150-$400. With either method, a patient can expect an out-of-pocket expense. Peterson says, “I have yet to see an insurance company willing to cover it.” Those who choose to undergo in-office care can expect to spend 30-90 minutes at their dentist’s office per whitening session. Most whitening can be done
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in a single dentist visit, but sometimes it may take several sessions to get teeth as ivory as desired. Typically, a dentist will insert cheek retractors, apply a protective agent to the gums, and then apply a hydrogen peroxide gel to the teeth, allowing the gel 15-30 minutes to work. Then, the gel will be washed off. This may be repeated several times. For those opting for the take-home option, a trip to the dentist is still necessary. During the visit, the dentist will take an impression of the patient’s teeth to make a customfitted tray to send home with the patient. The patient will use this tray combined with a gel for at-home whitening. Linstrom says patients typically wear the tray once a day for two weeks or so until they reach their desired shade.
Radiant results
Effects of both methods should last about one to three years, says Linstrom. How long the results last can vary depending on a person’s eating and personal habits. Beverages such as juice or wine, as well as cigarette smoking, can stain teeth, undoing the effects of whitening, especially the first week after treatment. As for how drastic the effects can be, Linstrom and Peterson say that people can expect their teeth to be several shades lighter. In extreme cases, Peterson says, teeth can be whitened up to eight shades (imagine light antique yellow to pearly white). Speaking of drastic changes, remember the episode of “Friends” where Ross turned his teeth so white that they were practically glow-in-the-dark? This is another reason to see a doctor before whitening, even if you want to try something from the grocery store. There is something called “too much” and a dentist can help a patient pick the right shade.
BLACK TEETH
FOR WHITE SMILES
One recent trend in teeth whitening is using activated charcoal tooth powders, which often claim to be a natural alternative for removing toxins, stains and plaque from teeth. Dr. Trevor Peterson of Premier Care Dental isn’t sure if he can get behind these claims since there are no studies testing the products yet. However, he says, “after a cleaning at the dental office, the hygienist will often use a fine powder abrasive to polish off stains. This powder can likely provide a similar effect of removing surface stains.” He cautions that it is still a good idea to use a fluoride toothpaste to protect against cavities. He says he’d personally like to see more proof before he could recommend it to patients. Some people have been DIY-ing this trend by rubbing activated charcoal (mixed with water usually) directly onto their teeth. Peterson says he would recommend those who choose this option do so sparingly “to avoid permanent loss of enamel that can come from overuse of abrasive pastes.”
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FOOD
d e F g u a n r gus o F
Pacific Golden Chanterelle (C. formosus) – designated Oregon’s state mushroom
TEXT BY SARAH LEMON
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Southern Oregon’s wild, edible mushrooms span all seasons
early every month, some species of mushroom materializes in Oregon’s fields and forests.
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So Mushrooms All Year was a fitting moniker for Louis Jeandin’s business as a fungus forager. “Mushrooms, to me, are the testimony of the seasons,” says Jeandin, a native of Savoie, France. “With the season changing, you have something different.” Fall’s chanterelles, spring’s morels and other edible, wild mushrooms were far from the farmers markets’ hottest commodities when Jeandin first displayed them in the plastic pint baskets usually reserved for berries. More than 15 years later, Mushrooms All Year is hard-pressed to keep up with demand. “Mushroom is a main course,” says Jeandin. “It’s a signature.” The signature species of Southern Oregon — parasol-shaped chanterelles and honeycombed morels — are truly wild, the fruits of ideal sunlight, temperature, moisture and growing medium. Plucked from the natural landscapes, these and lobster, hedgehog, black trumpet, porcini, matsutake and truffles all evade efforts at cultivation. Grown year-round, often indoors, cremini, shiitake, oyster and enoki
are not “wild,” although restaurants and food labels may misappropriate the term. The Pacific Northwest’s widest variety of wild mushrooms spans the fall and winter, when prolific chanterelles can be prised from misty forests or scored at supermarkets. Among the most affordable mushrooms, says Jeandin, chanterelles also stay fresh, refrigerated in a paper bag, for at least a week. That long shelf life allows Jeandin and other foragers to ship them around the country, even the world. “The mushroom is global,” he says. Popular with vegetarians as a meat substitute, mushrooms also can constitute a light entrée, says Jeandin. The savory flavor is intense enough, however, that just a few mushrooms can elevate a dish above the ordinary. If cooks use them wisely, mushrooms can fit into just about anyone’s grocery budget, he says. The chanterelle, in particular, is highly versatile, he adds. “It’s a meaty and buttery mushroom, and it goes well with just about anything.” Jeandin recommends simple preparations
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STYLE FOOD that let the mushroom shine. An omelet with sauteed shallot or pasta with cream sauce both are straightforward enough for cooks of all skill levels. Whether served as an appetizer or alongside an abundant salad, chanterelle crostini garners rave reviews, says Jeandin, who features the recipe on his website and hands it out at farmers markets. Select grocers, including local food co-ops, stock wild mushrooms when the supply is high. About $20 per pound for chanterelles is a typical price, as high as $30 per pound for morels, says Mike Potts, who occasionally sells his surplus fungus at Talent’s Downtowne Coffee House. An expert in mushroom identification, Potts says he spends far more time photographing the region’s wild mushrooms and hosting hikes for would-be foragers. “It’s really hard work to go out all day and pick mushrooms,” he says. That doesn’t discourage mushroom enthusiasts from filling up Potts’ workshops offered through Siskiyou Field Institute in Selma. Ashland’s Northwest Nature
If cooks use them wisely, mushrooms can fit into just about anyone’s grocery budget
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FOOD White chanterelle (cantharellus subalbidus )
Shop is another clearinghouse for mushroom events, acquainting novice foragers with the habitats that wild fungus favor. Guided hikes typically take participants to higher elevations — spots in both the Siskiyou and Cascade mountains. Some mushroom species are associated with certain trees: lion’s mane with oak trees, for example. Lobster mushrooms are found nearer to the coast. Oregon’s own truffles, a gourmet’s delight, pop up around and underneath the roots of fir trees. “It’s very easy to get lost in the forest,” says Potts. “Stay near the road. Use a compass or a GPS.” Permits are free to pick wild mushrooms on public lands, available through the corresponding agency. The only gear needed is a basket, knife and small paintbrush or food-basting brush to clean the mushrooms, which should only be washed right before cooking. “Mushrooms are like 90 percent water,” says Potts. Studies have shown that cutting a mushroom at the base, rather than pulling it up, has no effect on a mushroom’s mycelium structure under the soil, says Potts. But he still prefers to cut mushrooms for the sake of keeping them clean. If in doubt about whether a mushroom is safe to eat, the public Facebook group Pacific Northwest Mushroom Identification and Information Forum provides the quickest and most accurate verification, says Potts, who is a member. Simply post a photo of the fungus and ask for its identification, he says. “It will not get ID’d wrong.”
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Photo by Nancy McClain
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CHANTERELLE CROSTINI
INGREDIENTS: 2 tablespoons butter 1/4 yellow onion, peeled and chopped Salt and pepper, to taste 1/2 pound fresh chanterelle mushrooms, cleaned and sliced 1 garlic clove, peeled and chopped 1/2 glass dry white wine 1 teaspoon fresh tarragon, chopped Toasted baguette, for serving DIRECTIONS: In a large pan, melt the butter on medium-high heat. Add the chopped onion and a pinch of the salt and pepper; sauté for 2 minutes. Add the mushrooms and garlic; sauté, stirring, for 5 minutes; season with a bit more salt and pepper. Add the white wine and allow to reduce for 1 minute. Finish with the chopped tarragon. Spoon mushrooms onto the toasted baguette, sliced on the bias ½-inch thick. Serves about 2 pieces per person as hors d’oeuvres. Servings: 4
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FOOD
Holiday Wild Mushroom Dressing Ingredients:
1/4 pound ground pork sausage 1/2 yellow onion, peeled and chopped Salt and pepper, to taste (remember, sausage already is salted) 1/2 cup celery, diced 1/2 pound fresh chanterelle mushrooms, cleaned and sliced (or 2 ounces dried porcini or morels, reconstituted) 2 garlic cloves, peeled and chopped 2 bay leaves 1 cup dry white wine 1 cup Granny Smith apples, peeled and diced 1 teaspoon fresh parsley (or herb of choice), chopped 1 cup croutons 1/2 cup chestnuts, poached, peeled and roughly chopped (optional)
Directions:
Preheat a heavy-bottomed skillet on high heat and sauté the sausage, stirring, for 2 minutes; strain and discard excess fat, if needed, Add the chopped onion to pan, plus a pinch of the salt and pepper; sauté, stirring, for 2 minutes. Add the chopped celery and sauté, stirring, for 1 minute. Add the mushrooms with a pinch of salt and pepper, the garlic and bay leaves; sauté, stirring, for 5 minutes. Add the wine and allow to reduce, stirring, for 2 minutes. Add the diced apple, parsley, croutons and chestnuts, if using. Gently stir and cook for 2 or 3 minutes. Dressing may be transferred to a baking dish and finished in a 350-degree oven until top is dry and toasted, if desired. Servings: 4 Photo by Mike Potts
Recipes courtesy of Louis Jeandin, www.mushroomsallyear.com
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Oregon Healthy Living • November 6, 2017
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SPECIAL
Protect Your Health Care Preferences An advance directive speaks when you cannot
TEXT BY REBECCA SCOTT
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roper medical care is part of everyday life. People go for annual check-ups or get flu shots. However, it is important to have the proper documentation ready if there comes a time when you cannot speak for yourself regarding your medical preferences. To ensure your medical wishes are enforced if you are incapacitated, experts suggest having an advance directive. Early preparation is key
“An advance directive is a legal document that you can complete on your own without the help of an attorney,” says Diane Kosmatka, palliative care manager at Providence Medford Medical Center. Each state has its own advance directive. “The recognized directive in Oregon is the Oregon Health Decisions document,” Kosmatka says. “Whether you’re 18 or 80, you should have an advance directive.” Adie Goldberg, a psychiatric social worker with Rogue Regional Medical Center, concurs. Whether you have a progressive illness or get in an accident, she explains the directive enforces your medical wishes, such as if you want life support. One scenario included on an advance directive is if you are close to death and life support would be used to postpone the moment of death, says Kosmatka. She explains you can choose to receive tube feeding, tube feeding as your doctor recommends or no tube feeding at all. “If you don’t have
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an advance directive, your family may request tube feeding even though you never wanted that,” she says. Kosmatka says the documentation is especially important if you are over 65 years old or on Medicare, because it shares what medical and nursing care you want, and where you want to receive care. However, that’s only one piece of the puzzle, according to Goldberg. “You also need a health care representative who knows your preferences,” she says.
Starting the conversation
Many factors go into choosing your health care representative—the person authorized to make medical decisions on your behalf in accordance with your advance directive. “If you have no living relatives, choose someone younger or healthier than you,” Kosmatka says. “Pick someone you trust, whether it’s a niece, nephew, neighbor or friend from church.” As a cautionary example, she says it does not help if an elderly couple chooses each other as a representative, and then one passes away, leaving the other without a representative. Goldberg says it is important to be mindful of who you choose as your representative. “Even if your representative has their own values, make sure they act in your best interest,” she said. According to Kosmatka, if you are incapacitated, the advance directive gives authority to the health care representative. While the advance directive includes your medical preferences, it’s important to talk with your representative and family beforehand. “You should have a
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SPECIAL
“I have worked with families who wished they knew what the person wanted. An advance directive will speak for you and support your decisions,” Diane Kosmatka, palliative care manager, Providence Medford Medical Center continued from page 23 conversation and explain what you want before an emergency happens,” she says.
Have your information available
You may want to keep an advance directive in a protected place, but you should have a copy available in case of an emergency. “Put it in the glove compartment of your car, or leave a note in your wallet of where to find your advance directive. This is especially important if you go to the ER,” explains Goldberg. She advises to send copies to your primary care doctor, family and representative. “You can also fax your advance directive to local hospitals,” she says.
Give yourself a voice
Advance directives contain personal decisions about your medical preferences. “Many people want to defer medical decisions to their doctors, but I don’t recommend that,” says Goldberg. She
says it’s better to have a health care representative advocate for you and be your voice when you cannot speak for yourself. Kosmatka says people without an advance directive fail to recognize that in the medical world, the default is to do everything to save you, unless you specify otherwise. She says whoever you choose as a representative would not have the authority to intervene on your behalf if he or she were not listed on your advance directive. Additionally, she says Oregon’s law allows one person to be your representative and another to be an alternate if the first person isn’t available. “You can also indicate if there’s someone you don’t want to make decisions for you,” she explains. Whatever you decide to include in your advance directive, start the conversation early. “I have worked with families who wished they knew what the person wanted. An advance directive will speak for you and support your decisions,” Kosmatka says.
WHEN TO CHANGE YOUR ADVANCE DIRECTIVE According to Kosmatka and Goldberg, advance directives do not expire. However, they recommend revisiting the document every four to five years. “Advance directives are valid throughout life, but they should be refreshed as your life and medical conditions change,” says Kosmatka. There are several reasons to change your advance directive, including: • Medical preferences have changed • Appointing a new health care representative • Medical conditions have changed
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November 6, 2017 • Oregon Healthy Living 25
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NOVEMBER
Events Calendar
GET 9th LISTED! DO YOU HAVE AN EVENT YOU’D LIKE TO PROMOTE ON OUR EVENTS CALENDAR?
Please email crose@mailtribune.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. We’re currently accepting submissions for event dates between January 9 & 31, 2018. 26
HOLIDAY SAFETY TIPS 6 P.M. • SANTO COMMUNITY CENTER, 701 N. COLUMBUS AVE., MEDFORD CONTACT INFO: 541.774.2400, PLAYMEDFORD.COM Learn safety tips for shopping to protect your wallet, credit cards and purchases. $12 for residents of Jackson County, $17 for nonresidents.
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PIONEER RUN 8:30-11:30 A.M. • PHOENIX HIGH SCHOOL, 745 N ROSE ST., PHOENIX CONTACT INFO: WWW.FACEBOOK.COM/ EVENTS/289772451490336 Two runs, a 5k and 9-mile, start and finish at the high school. Proceeds benefit the Phoenix High School Track team. Registration fees are $7 for youth under 18 and $20 for adults.
SKIP THE HOLIDAY BLUES 10:30 A.M. • MEDFORD SENIOR CENTER, 510 EAST MAIN ST. CONTACT INFO: 541.772.2273, INFO@ MEDFORDSENIORCENTER. ORG A free session focused on creating enjoyable experiences with family and friends.
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THE GREAT AMERICAN SMOKEOUT An annual, nationwide event of the American Cancer Society to encourage smokers to use this date to quit.
Oregon Healthy Living • November 6, 2017
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11/6/2017 11:28:51 AM
NOVEMBER
Events Calendar
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CASA VOLUNTEER ORIENTATION NOON–1 P.M. • CASA OF JACKSON COUNTY, 613 MARKET ST., MEDFORD CONTACT INFO: WENONOA SPIVAK, 541.734.2272, WWW.JACKSONCOUNTYCASA.ORG Every Thursday, CASA of Jackson County invites people interested in becoming a CASA (Court-Appointed Special Advocate) to an orientation to learn more about the role of working with the more than 800 children in foster care in Jackson County. The session is free and no reservation or volunteer commitment is necessary. There are more than 300 children on the waiting list for an advocate.
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SOUTHERN OREGON HOLIDAY EXPO 2017 10 A.M.-6 P.M. CENTRAL MEDFORD HIGH SCHOOL GYMNASIUM 815 S OAKDALE AVE, MEDFORD CONTACT INFO: 541-776-4385, afliegel@mailtribune.com Holiday shopping at 50 vendor booths, fun family activities, food and drinks, free pictures with Santa, Kids Zone and more! Free admission with donation of new, unwrapped toy, to benefit CASA of Jackson County.
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FIRST FROST 2 P.M.-10 P.M. 95 WINBURN WAY, ASHLAND CONTACT INFO: ASHLANDPARKSANDREC.ORG, 541.488.5340 Celebrate the opening of ice skating season at the Ashland Rotary Centennial Ice Rink. Sponsored by Ashland Parks and Recreation.
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MUSHROOMS AT ROGUE RIVER PRESERVE 10 A.M.-2 P.M. • ROGUE RIVER PRESERVE, EAGLE POINT CONTACT INFO: 541.482.3069, INFO@LANDCONSERVE.ORG Restricted to 15 registered participants. Guide Mike Potts will lead the group through the preserve area to identify both edible and toxic mushroom varieties. Sponsored by the Southern Land Conservancy.
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BRAIN BOOKS DISCUSSION GROUP 1:30-3:30 P.M. • ASHLAND BRANCH LIBRARY, GUANAJUATO ROOM, 410 SISKIYOU BLVD. CONTACT INFO: 541.774.6996, JCLS.ORG. This month’s book for discussion is “Immunity to Change: How to Overcome it and Unlock the Potential in Yourself and Your Organization” by Robert Kegan and Lisa Laskow Laney. Sponsored by the Friends of the Ashland Public Library.
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SOUTHERN OREGON TURKEY TROT 8-11 A.M. • JACKSON COUNTY EXPO FAIRGROUNDS, CENTRAL POINT CONTACT INFO: WWW.SORUNNERS.ORG/ TURKEYTROT Justify a big splurge on holiday trimmings by starting the morning with a run or walk. Ages 5 and under can participate in a dash and everyone else can join with the 2-mile or the 8-mile events.
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ROGUE WINTERFEST • 2101 NE SPALDING AVE., GRANTS PASS CONTACT INFO: WWW.ROGUEWINTERFEST.COM An annual holiday festival hosted by Evergreen Federal Bank to benefit the local mental health organizations Family Solutions, Kairos and Options for Southern Oregon. The event kicks off with a gala and grand auction with several follow up events throughout the weekend.
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11/6/2017 11:29:08 AM