Oregon Healthy Living - January 2016

JANUARY 2016 | VOL. 9 — ISSUE 1

PAIN PACKS

A PUNCH Over 25 million American adults experience daily chronic pain

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PLUS

O regOn H ealtHy l iving . cOm

Finding Pain Relief: Movement and mindfulness Natural therapeutic modalities Cognitive approaches

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Table of Contents JANUARY 2016 | VOLUME 9, ISSUE 1

NATURAL

HEALTH

Chronic Pain: Skills instead of pills

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Precision Surgery: A robotic assist

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What Works For You: Non-pharma pain therapies

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FITNESS

Movement Matters: Gentle options for pain sufferers

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FOOD

MIND

Golden Spice: Flavorful turmeric

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Attitude and Acceptance: Rebooting pain associations

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CALENDAR

Local Events Calendar: Find out what’s happening in your community

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ADVERTISER INDEX

The editor’s desk Chronic pain sucks the joy and hope out of the sufferers and caretakers, leading to alarming statistics for suicide and accidental overdoses. Physicians across the country are realizing that skills rather than pills are the way forward.

We’ve dedicated this issue to highlighting some of the current thinking on coping with pain. For a great summary, search YouTube for a short video called “Understanding Pain in 5 Minutes.”

Ashland Food Co-op .............. 13 Katzen Orthodontics.................. 4 Medford Dermatology............... 7 Medford Food Co-op.............. 11 Medicap Pharmacy................. 11

crose@mailtribune.com

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

Photographers

Providence Medford Medical Center....................3, 24 Sherm’s Food 4 Less.................. 2 Shop’n Kart............................. 21 Southern Oregon

Denise Baratta

Tessa DeLine

STAFF EDITOR: Cheryl P. Rose

ADVERTISING DIRECTOR: Dena DeRose DESIGN & PRODUCTION: Bret Jackson CONTRIBUTING PHOTOGRAPHERS: Denise Baratta, Tessa DeLine

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David Gibb CONTRIBUTING WRITERS: Cathleen Cole Rebecca Scott Cindy Quick Wilson

Foot & Ankle........................... 23 Oregon Healthy Living Magazine is published by the Southern Oregon Media Group Advertising Department, 111 N. Fir St., Medford, OR 97501. General information: 541.776.4411 To advertise: 541.776.4422 Submissions and feedback: crose@mailtribune.com

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FIT BIT

Information courtesy of Advanced Pain Management APMhealth.com

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HEALTH

Pain, Pain,

Go Away Chronic pain sufferers are learning coping skills to ease their pain while reducing their use of medication TEXT BY CATHLEEN COLE

I

n 2003, Michelle Marikos was a college student enjoying a party at her sorority house with other people on a second-story balcony. One of her sorority sisters had been drinking too much and pushed Marikos, who grabbed onto a young man for balance. It didn’t help. Both of them toppled over the railing with the man falling on top of her when they landed.

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HEALTH

“I still have chronic pain, but my perspective of it is different. Acceptance is a real key. I felt myself coming back slowly. I was going forward. I wasn’t going back.”

— Michelle Marikos

Pain, frustration and depression

Marikos fractured two cervical (neck) discs and crushed one in the fall. She’d never experienced that kind of excruciating pain before. Her doctors started her on heavy doses of opioid pain medication, and she eventually returned to Medford to live with her mother. She stayed on painkillers for 10 years. “I could be mobile, but I couldn’t think straight,” she remembers. “I was debilitated. I didn’t have any quality of life.”

During those first 10 years after her fall, she says, she was contantly trying to find a cure for her condition to stop the pain. She tried nerve blocks and cortisone shots. She even had surgery to fuse a cadaver bone to stabilize her disintegrating discs. It didn’t work. It was a sad cycle of finding a new potential cure, trying it, having it fail and then spiraling into depression. “In all reality, there is no cure for chronic pain,” she says.

Skills instead of pills

In 2013, Marikos went to her doctor in complete desperation saying, “I can’t do this anymore. Get me out of this.” The Mayo Clinic in Rochester, Minn., was her next destination for an operation to fuse all her neck vertabrae, which would cause her to lose up to 90 percent movement in her neck. But the Mayo Clinic doctors told her that before they could do the surgery, she had to wean herself off the massive doses of pain medication she was on. To do that, she went through the clinic’s 21-day pain rehabilitation program.

The program was a combination of occupational therapy, physical therapy, cognitive behavioral therapy and education.

She learned how chronic pain works and what the opioid

After many years of being sidelined, Michelle Marikos was able to return to the slopes at Mt. Ashland with her mother, Lynda. painkillers do to your body. The more she learned about pain, the more it made sense to her. Meanwhile, she was tapering off her strong medication while learning skills to help her ease the pain.

Midway through the program, Marikos realized she couldn’t go back on the opioid painkillers. “I can’t go back to being a zombie,” she says. “I was so numbed that I didn’t laugh; I didn’t joke; I didn’t smile.”

continued on page 8

Chronic Pain: Pain that persists or progresses over a long period of time and is often resistant to medical treatment.

Acute Pain: Pain that arises suddenly from a specific injury and is usually treatable.

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HEALTH

“Psychotherapies are statistically more effective and safer than opioids for treating complex, chronic, non-cancer pain.”

— Dr. Jim Shames Photo by Mandy Valencia

continued from page 7 After finishing the program, Marikos decided not to have the surgery. “I could live with the pain,” she realized. “I still have chronic pain, but my perspective of it is different.

Acceptance is a real key. I felt myself coming back slowly. I was going forward. I wasn’t going back.”

Now Marikos, who only takes ibuprofen for pain when she feels she needs it, is a peer support specialist with the Medford branch of Oregon Pain Advisors. “I really connect with people going through this,” she confirms.

The Peer-to-Peer Support Group for Persistent Pain helps people who can’t take pain medications and others who are trying to wean themselves off large doses of opioid painkillers.

Like all peer support groups, it shows attendees that they aren’t alone. “Pain is so isolating,” Marikos says. “There is no cure for chronic pain. That’s horrible, but there are things you can do about it.”

The medical community’s changing views

Jim Shames, medical director of Jackson County Health and Human Services in Medford, says opioid drugs are generally not considered the best treatment for chronic pain. The painkillers are not effective for most conditions, and the risks

(including addiction) outweigh the benefits.

Physicians are realizing now that prescribing painkillers for long-term use is not working and are recommending other strategies to cope with chronic pain. “Doctors are definitely getting the message,” Shames says.

Psychotherapies are statistically more effective and safer than opioids for treating complex, chronic, non-cancer pain, Shames confirms. Psychological perceptions can lessen or amplify pain.

The medical community is setting new guidelines in how to treat chronic pain, according to Shames. This includes screening individuals prior to prescribing opioid drugs, keeping the doses low and monitoring the patients better. Are they taking the pain medication as prescribed? Are they going to more than one doctor for painkillers?

Shames and his fellow physicians don’t want to get rid of opioid drugs entirely. They are good for acute pain on a short-term basis. “Don’t throw the baby out with the bath water,” he advises. But he believes opioid pain medications are still being overprescribed for chronic pain. “Sometimes, as providers, we prescribe too much medicine for too long,” he says. “We have to prescribe responsibly.”

5TH ANNUAL THOUGHTFUL APPROACH TO CHRONIC PAIN CONFERENCE

Oregon Pain Guidance is hosting this conference May 20-21, 2016 at the Smullin Education Center in Medford for physicians and professionals in multidisciplinary primary care, occupational health, behavioral health and pain management. Author Sam Quinones will discuss his book, “Dreamland,” as part of a community reading event.

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HEALTH

DON’T SUFFER ALONE American Chronic Pain Association This association facilitates peer support and education for individuals with chronic pain and their families so that these individuals can live more fully in spite of their pain.

It offers information on conditions, medications, treatments, pain-management tools and pain awareness. For more information, go to theacpa.org.

Breaking Free of Chronic Pain This program offers classes that teach tools and techniques for self-care and pain management. The program helps participants restore well-being when injured or in pain and provides information about the effects of chronic pain on the health of the body, mind, emotions, stress and energy levels. For more information, go to breakingfreeofchronicpain. com, call 541.210.1952 or e-mail breakingfreeofchronicpain@gmail.com.

Living Well with Chronic Conditions in Southern Oregon This is a workshop series that shows pain sufferers how to take small, manageable steps toward healthier living and improve their ability to manage day-to-day activities.

Workshops are ongoing and registration is required. For information, go to sohealthyoregon.org, call 541.864.9611 or e-mail livingwell@rvcog.org.

Oregon Pain Advisors This group provides a range of solutions focused on advancing the treatment of persistent pain. It provides advisory services and program implementation for medical providers, local jurisdictions, insurers and allied health organizations. Through its Pain Resiliency Program, pain sufferers can increase their quality of life, learn stress reduction techniques and restore function through movement training. Oregon Pain Advisors also organizes a weekly Peer-toPeer Support Group for Persistent Pain. For more information, go to painadvisors.com or contact Michelle Marikos at 541.774.3855 or admin@painadvisors.com.

Oregon Pain Guidance This is a group of healthcare providers from Jackson and Josephine Counties in Southern Oregon who are working together on standardizing community guidelines and best practices for treating patients with chronic pain. An improved quality of life for people with chronic pain can be achieved when patients and their families work closely with their healthcare providers. Go to oregonpainguidance.com for educational information, news, community resources and upcoming events for both the public and healthcare providers.

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NATURAL

Laura Winslow teaches simple yoga, tai chi and other techniques for relieving chronic pain.

Natural Healing Strategies

Non-pharmaceutical therapies for pain relief TEXT BY REBECCA SCOTT • PHOTOS BY BOB PENNELL

C

ommon pain treatments include medication or surgery. For some, neither is an acceptable option. So where do you turn for relief?

The mind is a powerful tool you can use to fight pain. “The more you train yourself to associate positive stimuli with painful movement, you’ll slowly start to feel differently,” says

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Brian Saling, manager of outpatient rehabilitation services at Providence Medford Medical Center. “The best thing for helping chronic pain is self-awareness.”

Relying solely on medications can lead to complications.

“Covering up pain symptoms with medication can be dangerous,” says Laura Winslow, a certified yoga therapist and founder of Integrative Healing and Recovery Programs.

“Medication masks the true level of pain. People aren’t aware of how they stress their body, which can lead to more pain or injury.”

For those who make the choice not to pop pills, several nonpharmaceutical therapies exist which effectively treat pain.

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NATURAL Let’s get physical

Physical therapy is primarily exercisebased and used to normalize tissue functions. It’s a good option for people suffering from muscular-skeletal issues, such as back pain. “Each therapy session is unique,” explains Saling. “Treatment is different for a patient recovering from surgery versus someone with an injury.”

In addition to sessions with a physical therapist, there is always an at-home component. According to Saling, this reinforces what is done in the one-onone meetings. As with any therapy, cost and coverage are important considerations. “Most insurance companies cover physical therapy to some extent,” explains Saling.

Adjusting to the situation

Chiropractic therapy typically involves hands-on spinal manipulation.

It’s used as a pain relief alternative for muscles, joints and bones, but works best for back pain. The principle is that proper alignment should enable the body to heal itself without surgery or medication. Chiropractic care also aims to prevent further injury.

A trained chiropractor takes a complete medical history and performs an exam before administering any therapy. Most insurance plans cover chiropractic care for acute conditions.

Acupuncture doesn’t needle you

Acupuncturists insert thin needles into the skin at specific points around the body. Virtually painless when administered by a professional, inserting the needles is believed to correct imbalances in the flow of energy in the body. Disturbances in this energy can lead to illness or other dysfunctions.

Acupuncture affects several biological systems, including activating antiinflammatory chemicals which treat pain. Until you start to see benefits, plan on weekly sessions. Acupuncture treatments run anywhere from $65 to $125 per session. Most private insurers do not cover acupuncture, and neither does Medicare or Medicaid.

Relaxing with massage

Therapeutic massage uses an array of different modalities to enhance the body’s natural restorative functioning.

Similar to other therapies, massage relaxes tight muscles. “Relaxation techniques are liked best by many

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NATURAL

continued from page 11 patients,” says Winslow. “It’s about finding ways to release tension in the body and loosen chronically tight muscles.”

Practitioners use a light or firm touch to release tension, increase circulation and impart a sense of peace and calm. There are several types of therapeutic massage available, including deep tissue and reflexology. Overall, fibromyalgia and arthritis are the two main pain problems positively impacted by massage.

Managing all aspects of stress

Stress worsens pain. Stress management teaches healthier ways to cope with stress, helps reduce its harmful effects and prevent it from getting out of control. Learning better coping mechanisms, and understanding the relationship between pain and stress, can lead to reductions in both and a better quality life. “Chronic pain affects us physically, mentally and emotionally,” explains Winslow. “It’s important to address all those levels where chronic pain affects your quality of life.”

A good night’s rest

How many nights of sleep have you skipped, thinking it was no big deal? Lack of restorative sleep deprives your body of its repair time and heightens pain conditions.

Many patients with chronic pain also suffer from insomnia or other sleep disorders. Chronic pain disrupts sleep, which in turn aggravates pain.

People with pain issues have trouble falling and staying asleep. This nonrestorative sleep pattern can cause lethargy, fatigue and worsen pain.

Pain and sleep problems should be treated together. To increase nightly restorative sleep, don’t nap during the day, limit caffeine and alcohol and reduce stress through other alternative therapies. Before changing your sleep patterns or habits, always consult with a physician and create a comprehensive plan together.

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Finding the right balance

A wide array of alternative pain therapies exist. Pills aren’t the only option. “Take the least invasive steps first,” advises Saling. “Educate yourself about pain. Don’t put your body through undue risks.”

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MAKOplasty Lends a Helping “Hand”

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TEXT BY CINDY QUICK WILSON

t’s all about precision, with the assistance of a new robotic technology that improves longterm results for joint replacement surgery.

“Providence now has a MAKO robot we use for both knee and hip replacements,” says Todd Clevenger, orthopedic surgeon with Southern Oregon Orthopedics.

MAKO Surgical Corp. is a Florida-based company that has developed a robotic-assisted way of performing joint replacements. “Plasty” refers to the molding or shaping of a defect to restore form and function to a body part, typical of knee and hip replacements. “Robotic-assisted surgery allows for better planning and tracking as the surgery takes place,” Clevenger explains.

The advantages are the long-term success of joint replacement implants due to improved alignment and placement, and the preservation of healthy bone at the site.

Using a partial knee replacement as an example, Clevenger says, “You’d map out the knee electronically. Using computerized tracking technology, the sensors tell you exactly where the

HEALTH knee is and that information goes to the robot which allows you to remove bone precisely, down to a half of a millimeter. All of the soft tissue is still prepared in the traditional way with the surgeon cutting the skin and opening the capsule of the knee joint, but the removal of the bone, which is the trickiest part of any joint replacement, is guided by the robot. The robot has no power of it’s own, but does keep the surgeon from straying and removing bone he didn’t plan on removing.” For the patient, the experience is the same, Clevenger says, other than a little extra planning and time to set up the robot.

In his practice at Southern Oregon Orthopedics, Yaser Metwally, agrees, “Precision is the key.” As a surgeon who specializes in hip replacements, he says, “Obtaining a CT scan to plan the surgery allows for precise execution of that plan and the exact placement of the implants, which helps to ensure their survival over time. This technology is especially useful for those needing total hip replacements who have unusual anatomy.”

Although this robotic-assisted method will not change traditional replacement procedures, it will help greatly with the more challenging cases, Metwally says. “MAKO is more about the longterm results, not the short-term gain.”

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FITNESS

Making a Move to

Pain Control Movement therapies moderate pain, improve attitude and enhance functional fitness TEXT BY CINDY QUICK WILSON • PHOTOS BY DENISE BARATTA

W

hen movement causes pain, exercise can be a daunting thought, but experts agree that under most circumstances, inactivity can lead to a reduction in flexibility, loss in range of motion and a decline in muscle tone and strength. Many chronic pain sufferers find relief mentally, physically and emotionally through participation in movement therapy which can include yoga, tai chi, qigong and aquatic exercise. As traditionally trained physicians learn more about the healing power of the bodymind connection, they are increasingly likely to recommend movement therapy to patients who wish to reduce or eliminate the need for drugs to control their pain.

Instructor Natalie Stawsky demonstrates a yoga pose.

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FITNESS

Movement and mindfulness

“We live in a culture that is not bodyoriented, so it’s learning about not reacting to a memory of pain, and about how much control we have over our bodies if we can claim it.”

Natalie Stawsky has been teaching yoga for a decade, but since her move to Ashland in 2008, her role as a yoga instructor has expanded. “Many of my yoga students seemed to have chronic pain, so the transition was based on what I was seeing and the needs of the population.”

She has developed an 8-week class she calls “pain school.” “I work with people who have issues like cancer, injuries, osteoporosis and arthritis, or may be recovering from surgery. Every case is different.”

Understanding the power of the mindbody connection, she began teaching movement therapy and mindfulness techniques. “A movement therapist uses — Natalie yoga, qigong and other simple exercises to encourage self-healing. I also realized that pain could be alleviated by improving posture and teaching people how to sit down or stand up or get out of bed in a way that doesn’t cause more problems.”

The mindfulness concept, she explains, is learning to be aware of the story we tell ourselves about our pain—how

Natalie Stawsky, far left, leads a gentle yoga class at Hidden Springs Wellness Center in Ashland.

much of it is real pain and how much is more the fear and anticipation of pain. “We live in a culture that is not body-oriented, so it’s learning about not reacting to a memory of pain, and about how much control we have over our bodies if we can claim it. Yes, there may be a sensation of pain, but there is also the sensation of joy and we can learn how not to give the pain so much energy.”

Working with an array of healing talents, Stawsky says she has many toolboxes from which to design individualized therapies. “I use breathing exercises, meditation and music. I always start from a place of relaxation which helps to calm the nervous system.”

Many participants feel hopeless and Stawsky alone when they first come to class, she says. “We do have some therapies that are one-on-one, but being in a community with other people is most healing.

I have people who start out with level eight pain and after eight weeks, they are a level two. The transformations I see are amazing and very powerful.”

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FITNESS

Water Wellness class at RVYMCA is designed for people who have MS, Fibromyalgia, or post –operation rehabilitation needs.

The focus of this class is range of motion and balance exercises.

Photo by Jeni Beck.

Aquatic Therapy

Water has long been valued for its therapeutic properties.

From the healing effects of mineral hot springs to its use as an exercise and conditioning aid for athletes, water’s natural characteristics provide a range of benefits.

Water therapy is an appealing choice for many who suffer from chronic pain, says Holly Hawley, aquatics director at the Rogue Valley YMCA. During her 18 years as a fitness instructor, she has witnessed the advantages of both physical conditioning and pain relief in her participants.

“Most of our aquatic classes are for the general population, but we offer two that are specialized,” she says. “Therapeutic Mobility is taught twice a week by a certified arthritis instructor. It takes place in a smaller pool with warmer water which helps with joint manipulation.” The second class, Water Wellness, is a functional fitness class that was originally designed for those with multiple sclerosis, but soon grew to address a wider variety of needs.

Aquatic exertion requires the respiratory muscles to work harder, which causes them to become more toned even without movement. Hawley says, “People don’t realize that water creates a lot of resistance, so it’s not that easy to displace all that water every time they change a direction. In essence, they are lifting weights and they don’t even know it.”

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Hawley adds that for people who have a level of pain that makes ordinary life tasks difficult, such as getting out of bed, doing errands or grocery shopping, water therapy makes it possible for them to do the things that everyone else takes for granted. “People tell me their pain improves dramatically,” she said. “I have people who have been on drugs for chronic pain who are able to stop or reduce their medication.”

Completely sold on water as therapy and the results she has seen, Hawley admits, “I walk and run and lift weights, but when my body hurts, water is what always makes me feel better.”

Tai Chi and Qigong

With ancient ties to Chinese medicine, philosophy and martial arts, practitioners of tai chi and qigong (pronounced “chi gong”) use a wide range of slow-motion, flowing movements to improve balance, strength, flexibility and coordination. “In terms of pain therapy, I believe that both qigong and tai chi act similarly in their approach,” explains Adam Holtey, owner of Community Acupuncture and Natural Health in Ashland. “Both are based in movements of the body that coordinate with a particular focus of the mind and a specific breathing pattern. Many qigong forms can help re-align and decompress the spine, and improve circulation of blood and oxygen to all areas of the body, including the

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FITNESS

Adam Holtey leads students in the healing movements of qigong and tai chi at Southern Oregon University in Ashland. internal organs. Aside from the physical practices, qigong can help to calm the mind and reduce stress and anxiety, which are often an underlying cause of pain.”

At his studio, he has combined several healing therapies for his clients who seek relief from a variety of complaints including back pain, sciatica, arthritis and headaches. Many others, he says, come to address mental and emotional concerns such as anxiety, stress, insomnia, poor digestion and low energy.

Although the results may not be as dramatic as with pain medication, Holtey says the overall benefits can produce lifelong positive changes in mental and physical health. “People often see results after the first class,” he says. “They usually leave feeling more centered, relaxed and peacefully energized.

More significant and long-lasting changes take more time.”

Fifteen years ago, Holtey became involved with Dahn Hak, a Korean discipline, primarily consisting of qigong principles and exercises, first as a student and then as an instructor. “It’s unfortunate that people only turn to mind-body modalities such as qigong, meditation or tai chi as a last result, after they’ve already been on pain pills,” he says. “In my opinion, this is the cheapest and most rewarding way to stay healthy and pain free, and should be practiced much more commonly as a preventative health measure, both for physical and mental health.”

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FOOD

Pain Relief in Your

Spice Rack

Turmeric’s beneficial antiinflammatory properties

TEXT BY REBECCA SCOTT • PHOTOS BY TESSA DELINE

T

urmeric brings to mind the warm aroma and flavors of curry, but its uses reach far beyond cooking. Other cultures have long used this colorful spice to help treat myriad ailments because of turmeric’s anti-inflammatory qualities. These properties make it a natural resource for people with pain issues.

“Turmeric and its primary compound, curcumin, work with inflammation in the same way as over-the-counter medication does, but without the side effects,” explains Tyler Giles, general manager of HealthWay Nutrition Center.

“There is adequate information to show turmeric helps with inflammation.”

Often traditional medications carry a laundry list of side effects. As more people crave natural alternatives to pharmaceutical pills, turmeric fits the bill. “A key attribute of turmeric is that it’s safe to use,” notes Giles. “However, you can take too much of anything – even water. Just because an ingredient is safe and natural doesn’t mean you should take too much. As with adding any supplement, it’s important to talk with your physician first.”

Whether you take turmeric as part of a regular regimen of vitamins or to treat pain, research its benefits, risks and how it affects inflammation in the body first. “Inflammation isn’t inherently bad,” explains Giles. Without inflammation, pathogens like bacteria could harm or potentially kill us.

“However, chronic inflammation can directly, or indirectly, cause some diseases.”

Medford resident Jessica Cempa has found relief from debilitating pain by using turmeric. “After several bouts of strep throat, my immune system started attacking my joints, which became extremely inflamed,” she says. “Medication didn’t help, and I was told I’d need chemotherapy drugs to treat the inflammation. Another doctor prescribed a handful

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of vitamins, which included turmeric supplments. It helped my pain, and after a month I was off all other medications.

Something as simple as a spice helped me in ways modern medicine could not.”

Turmeric’s potent anti-inflammatory qualities affect a variety of systems in the body, but the delivery of these compounds changes its level of effectiveness. “The amount of turmeric in food is so low it’s difficult to get any benefits,” Cempa finds.

“A supplement is preferable because it’s a concentrated dose.”

While some people take turmeric to treat pain, others use it more casually. “Capsules are very good for those without a serious illness,” says Giles. “Since curcumin absorbs at a low rate, patients seeking meaningful therapeutic action with turmeric should look into enhanced absorption products. The one thing you should avoid is tea made from turmeric because it’s ineffective at delivering curcumin into the body.”

Despite its many benefits, turmeric may not be the right supplement for everyone. “Turmeric is good for the average person, but it can have a slight blood-thinning effect, so it’s not a good supplement for someone on blood thinners,” says Giles. People with diabetes or low blood sugar should also remain cautious about taking turmeric. “Curcumin might decrease blood sugar in diabetics.”

According to Giles, there are many alternative herbal antiinflammatories if someone can’t ingest large amounts of turmeric. “Ginger is botanically related to turmeric and helps with inflammation,” he notes.

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FOOD

YELLOW SPLIT PEA WITH TURMERIC Ingredients: 2 cups dried yellow split peas 2 quarts vegetable stock 1 cup onion, chopped 1 cup celery, chopped 2 teaspoons ground coriander 1 teaspoons ground cumin 1 teaspoon ground turmeric 1 teaspoon garlic paste 1/4 teaspoon white pepper 1 bay leaf Salt to taste Fresh-snipped chives and pinches of paprika for garnish (optional) Directions: Add all ingredients (except salt and garnishes) to a large pot with a lid. Cook on medium-low, stirring occasionally for about an hour or until the split peas are tender. Remove bay leaf from soup and blend soup with a hand-blender until smooth. Taste and correct seasonings.

Garnish with fresh-snipped chives and paprika. Makes about 6 to 8 servings.

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COCONUT TURMERIC RICE Ingredients: 2 cups jasmine rice, washed 1/2 medium onion, chopped fine 1 3/4 cups water (or more as needed) 1 – 14-ounce can coconut milk 2 teaspoons canola oil 2 teaspoons ground turmeric 1 teaspoon ground coriander 3/4 teaspoon salt Directions: In a heavy-bottomed pot with a tight-fitting lid over medium-heat, cook the onion and canola oil until onion is translucent (about 5 to 7 minutes). Add remaining ingredients, stir and then bring to a boil.

Stir once again, immediately turn heat down to the lowest setting, cover with the lid, and cook about 20 to 30 minutes or until all the liquid has been absorbed and the rice is tender. Fluff with fork, remove from heat and let sit for 10 minutes before serving. Makes about 10 cups cooked rice.

GRILLED THAI TURMERIC CHICKEN Ingredients: 2 pounds boneless/skinless chicken thighs 5 teaspoons garlic paste 2 tablespoons brown sugar 1 1/2 tablespoons fish sauce 1 1/2 tablespoons light soy sauce 2 teaspoons ground turmeric 2 teaspoons ground coriander 1/4 teaspoon ground white pepper Garnish with fresh cilantro sprigs Directions: Add all ingredients in a covered container and refrigerate the chicken mixture at least 4 hours or overnight. Toss the chicken on a medium-hot barbecue grill or grill pan and discard the marinade. Be watchful of the chicken, turning occasionally, being careful not to burn. Cook until the juices run clear or the internal temperature of the chicken reaches 170 degrees. Makes 8 servings.

All recipes courtesy of Tessa DeLine of the Feral Kitchen, feralkitchen.com

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MIND

Your Brain &

PAIN

It still hurts, even if it’s “all in your head”

TEXT BY CATHLEEN COLE

T

he traffic light turns green and you start to drive your car into the intersection when a speeding truck runs the red light. You slam on your brakes, avoiding a collision by just inches. The truck didn’t hit you, but your hands are shaking and your heart is pounding. Why?

Pain education and support

You don’t have to have a physical stimulus to create a physical effect in your body. Being frightened or anxious, even if nothing physically touched you, can elicit heavy breathing, a racing heart and sweating. Thinking of a situation that angers you can increase your blood pressure. Feeling the emotions of fear or anger can set off a fight or flight response that is very physical in nature. Pain works this way, coming from emotional or physical stimuli. Pain is the output from the brain, whether the cause is physical (a burned hand) or mental (a perceived threat). Think of phantom limb pain – when a person feels (perceives) pain in a limb that was amputated. The physical stimulus is gone, yet the brain is interpreting pain.

“Emotions are felt in the body,” says Mark Altenhofen, CEO of Oregon Pain Advisors based in Portland with programs statewide. His organization provides a range of solutions focused on advancing the treatment of persistent pain through its Pain Resiliency Program and Peer-to-Peer Support Group for Persistent Pain that are run by behavioral health professionals. “These professionals are specifically trained in pain treatment and the challenges that

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come with it,” he says. “There’s a lot of sadness and frustration that comes with pain.”

The 8-week program includes educational, group and movement components. The educational component, or “pain school,” teaches chronic pain sufferers how pain works in the body, how stress can exacerbate pain and skills to use to relax.

People with chronic pain often isolate themselves, and this program gives them the chance to connect with others going through the same situations. Because their bodies hurt, people dealing with persistent pain often become afraid to move. The program gets them moving again.

The free Peer-to-Peer Support Group for Persistent Pain helps people with chronic pain realize they’re not alone. “It’s unique in that it’s combined as an extra support resource,” Altenhofen says. “There’s a nice group communication aspect.”

Easing the pain without drugs

Kristen Lorange, a licensed professional counselor with Pain Specialists of Southern Oregon in Medford, has patients suffering from chronic pain along with anxiety, depression, grief and post-traumatic stress. She explains the psychotherapy frontrunners in treating chronic pain and uses whichever therapy works best for an individual patient.

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MIND A graduating group from the Pain Resiliency Program in Medford

“There are things that you can do to better control and cope with the pain. You can move from a place of helplessness and hopelessness to empowerment and fulfillment.”

— Kristen Lorange, counselor with Pain Specialists of Southern Oregon in Medford Cognitive behavioral therapy

Cognitive behavioral therapy is a type of psychotherapy in which negative thoughts are challenged in order to change unwanted behaviors or treat mood disorders such as depression.

Lorange has patients keep a record of their thoughts and determine if they are helpful or unhelpful. For example, a patient might be depressed and feeling hopeless because on any given day she is able to get dressed and make her family breakfast, but she spends the rest of the day on the couch.

Stop disqualifying the positive, Lorange notes. The patient got out of bed, got dressed and made her family breakfast. Those are huge achievements for someone suffering from chronic pain.

Mindfulness-based stress reduction

The catch-phrase of this therapy is, “You can’t stop the waves, but you can learn to surf.”

It’s very grounding and calming, Lorange confirms, explaining that it is “paying attention in a particular way on purpose to the present moment without judgment.” For example, people can focus on their breathing, how it feels going in and out of their bodies. People suffering with chronic pain are often stuck in the past or anxious worrying about the future. Pain can get worse with anxiety about the future. It can be very hard to stay in the present moment. “But the present moment is all we really have now,” Lorange says.

Neuroplasticity

This therapy deals with the brain’s ability to reorganize itself by forming new neural connections throughout life.

Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their

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activities in response to new situations or to changes in their environment. “It’s the ability of your brain to change and adapt,” Lorange says. “Pain is interpreted by your brain.”

The brain learns pain as a protective measure. When pain becomes chronic, the brain is not doing its protective job.

“You can rewire your brain to feel less pain,” she says. People can retrain the brain to redirect to something other than the pain – a counter stimulation. These skills help people take back control of their lives, affecting a positive change on their pain.

Acceptance and commitment therapy

According to this therapy, acceptance is a necessary ingredient for positive change. Patients have to accept their situation before positive growth and change can occur.

Commitment is based on their personal values and priorities.

For example, a patient might say, “I only have so much energy today. I will use it to take care of my children. The house cleaning and errands will have to wait.”

Lorange uses the analogy of life as a bus. Pain is a passenger on the bus. You want him to get off the bus, but he won’t.

He’s staying. The more you try to get him off the bus, the more he fights back. You stop the bus and try to throw Pain off. The other nice passengers are kept waiting while you’re arguing with Pain. Don’t stop the bus for Pain. Focus on the nice passengers and keep driving the bus.

Hope for chronic pain sufferers

“There is hope,” Lorange says. “There are things that you can do to better control and cope with the pain. You can move from a place of helplessness and hopelessness to empowerment and fulfillment. It is possible.”

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JANUARY

EVENTS CALENDAR

NOW THROUGH FEBRUARY

ASHLAND ICE RINK VARIOUS HOURS • ASHLAND ROTARY CENTENNIAL ICE RINK, 95 WINBURN WAY, ASHLAND CONTACT INFO: 541.488.9189 It’s that time of year again, so lace up your skates and hit the ice! The Ashland Rotary Centennial Ice Rink will be operational through February 28, 2016.Contact the rink for more information on prices, schedules, lessons, family and adapted programming, and hockey.

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FROSTBITE RUN 12 PM • TALENT MIDDLE SCHOOL; 102 CHRISTIAN AVE., TALENT CONTACT INFO: sorfrostbiterun@gmail.com Packet pickup on day of race: 11 a.m.–12 p.m. Race start times: 10K at 12 p.m.; 5K at 12:30 p.m. Indoor race for the 5-year age division with ribbons for first, second and third. Refreshments available before and after run. Advance registration is $15 for Southern Oregon Running members or $20 for non-members.

Day-of-race entries for everyone over 14 l will be $25.

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2016 MASTER GARDENER PROGRAM BEGINNING JANUARY 14 • JOSEPHINE COUNTY EXTENSION, 215 RINGUETTE ST., GRANTS PASS CONTACT INFO: extension.oregonstate.edu/josephine/ Offered once a year in Josephine County, OSU Extension Service provides ten weeks of classes to become a master gardener.

Students should attend an orientation in advance and be willing to commit to 70 hours of volunteer gardening service over 10 months. The course costs $150, which covers class fees, textbook and materials. Classes meet on Thursdays from 8:30 a.m.-4 p.m. and on two Saturday mornings, January 23 and February 20.

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SALSA SOCIAL DANCE WORKSHOPS 6 P.M. BEGINNERS, 7 P.M. INTERMEDIATE, 8 P.M. OPEN • PIONEER HALL, 340 S PIONEER ST., ASHLAND CONTACT INFO: 541.488.5340 Requested $5 donation, all ages welcome, no preregistration required

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JANUARY

EVENTS CALENDAR

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NATURAL HEALTH - ESSENTIAL OILS 6 P.M. TO 7 P.M. • COMPUTER CLASSROOM, CENTRAL POINT POLICE DEPT., 155 S. 2ND STREET (2ND FLOOR) CONTACT INFO: www.centralpointoregon.gov/parksrec This is a beginning level class for people learning to manage their health naturally. The focus will be on what essential oils are, how they can be used, and the health benefits of the top ten most used oils. Cost is $5.

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ROGUE VALLEY HEALTH FAIR 9 A.M. TO 4 P.M. • MEDFORD ARMORY, 1701 S PACIFIC HWY, MEDFORD CONTACT INFO: roguevalleyhealth.com Kick-off 2016 with healthy ideas from local experts for optimum health and see how you can be your very best! The workshops encompass varying topics including nutrition, sleep, osteoporosis, weight-loss through nutrition, and lifestyle changes for better health.

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HYPNOBIRTHING CLASS SATURDAYS FROM 10 A.M. TO 12:30 P.M. • 258 A ST., SUITE 1-102, ASHLAND CONTACT INFO: ashlandsourcecenter.com/events The HypnoBirthing Series class is a comprehensive childbirth education series offering techniques to help you prepare for a calm, natural birth. The class starts January 23 and runs through February 27.

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TALKING TO TEENS ABOUT MONEY 6 P.M. TO 7:30 P.M. • CONSUMER CREDIT COUNSELING SERVICE OF SOUTHERN OREGON, COUNCIL CHAMBERS 820 CRATER LAKE AVE., # 202, MEDFORD CONTACT INFO: 541.779.2273 This class covers setting financial priorities, the realities of a paycheck, the basics of budgeting and more. Bring your teen(s) and enjoy learning as a family! Each person attending will receive a workbook.

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