Inhealth 10/3/2016 by The Inlander

Hospital How To’s 15 | Little Farms, Big Markets 35 | Michael Gurian 42

HEALTHY LIVING IN THE INLAND NORTHWEST • FREE

WOMEN’S HEALTH

Strategies to beat

INSOMNIA

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? OCTOBER - NOVEMBER, 2016

SPECIAL SUPPLEMENT TO THE INLANDER

9/22/16 10:30 AM

“M

y school-age daughter and I both have ADHD. We had each been to many different providers in both Seattle and Spokane, but none of them seemed to understand the nuances of female ADHD...and none of them helped. When we finally found Dr. Beck, it was such a relief. After years of searching, he has been by far the most effective provider I have met – and, on top of the great ADHD care, the Winston Center also addresses learning disabilities. My daughter, who struggles with dyslexia, is making fantastic progress with the help of a learning specialist at the center. She also sees an in-house psychologist, who is helping her manage all the frustrations that come with being a kid with ADHD and dyslexia. All in all, we couldn’t be happier with the Winston Center and recommend it highly.”

509-321-4521 • winstoncenter.com

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Life-changing EDUCATION AND RESEARCH

Health

SPOKANE • EASTERN WASHINGTON • NORTH IDAHO also at inlander.com/inhealth 1227 W. Summit Parkway, Spokane, Wash. 99201 PHONE: 509-325-0634

EDITOR Anne McGregor

annem@inlander.com

MANAGING EDITOR Jacob H. Fries CALENDAR EDITOR Chey Scott COPY EDITOR Michael Mahoney CONTRIBUTORS Kristen Black, Mac Booey, Wilson Criscione, Laura Johnson, Young Kwak, Linda Hagen Miller, Dan Nailen, Taryn Phaneuf, Carrie Scozzaro, Jake Thomas, Matt Thompson, Daniel Walters, Matt Weigand, John H. White PRODUCTION MANAGER Wayne Hunt ADVERTISING DIRECTOR Kristi Gotzian DIRECTOR OF MARKETING Kristina Elverum ADVERTISING SALES Autumn Adrian, Mary Bookey, Gail Golden, Janet Pier, Claire Price, Carolyn Padgham-Walker, Wanda Tashoff, Emily Walden SALES COORDINATION Kati Bronson, Camryn Barker DESIGN AND PRODUCTION Tom Stover, Derrick King, Alissia Blackwood Mead, Jessie Hynes DISTRIBUTION MANAGER Justin Hynes BUSINESS MANAGER Dee Ann Cook

Helping to slow disease progression.

CREDIT MANAGER Kristin Wagner

Making health care more accessible.

PUBLISHER Ted S. McGregor Jr.

Advancing solutions that reduce costs.

GENERAL MANAGER Jeremy McGregor

InHealth is published every other month and is available free at more than 500 locations across the Inland Northwest. One copy free per reader. Subscriptions are available at $2.50 per issue: call x213. Reaching Us: Editorial: x261; Circulation: x226; Advertising: x215. COPYRIGHT All contents copyrighted © Inland Publications, Inc. 2016. InHealth is locally owned and has been published since 2004.

spokane.wsu.edu SUPPLEMENT TO THE INLANDER

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INSIDE OCTOBER - NOVEMBER, 2016

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CHECK-IN PILL BOX

EpiPen Evolution 11 DR. MATT 10 / HEALTHY PLANET 10 / SUPERFOOD 12

NEWS THE EMPOWERED PATIENT

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FROM THE EDITOR

We treat all of you.

Do you have a story idea? Share it with Editor Anne McGregor at annem@inlander.com.

Taking Control

Whether you’re nine days old or ninety-nine years young, our network of clinics provides comprehensive medical, dental and social services for all members of your family.

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friend recently told me, “There are no minor surgeries.” She’s actually a surgeon, so I took her seriously. All surgery carries benefits as well as risks, not just from the procedure but also from the potential for the humans involved in the complex process to make mistakes. The Affordable Care Act included incentives for hospitals to improve patient safety, and so far those efforts seem to be paying off. The Department of Health and Human Services announced in September that “hospital acquired conditions” (HACs) declined 17 percent from 2010 to 2014, with patients experiencing 2.1 million fewer HACs, saving 87,000 lives and $20 billion. While hospitals are ramping up efforts to reduce medical errors, patients are increasingly expected to become active participants in their own care. Choosing a surgeon and hospital, weighing treatment options and continuously monitoring what goes on with your care during a hospital stay are big responsibilities. In the second installment of “The Empowered Patient” series (page 15), reporter Wilson Criscione talks with experts about what you should do before, during and after surgery to ensure the best possible outcome — and how you can enlist others to advocate for you. To your health!

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3D mammography. Clearer images. Greater accuracy. Earlier detection. Mammo Events at the Rockwood Breast Health Center. October is Breast Cancer Awareness Month. In our ongoing effort to promote early detection of invasive cancer, the Rockwood Breast Health Center will host extended mammography hours on October 3, 11, 19 and 27 from 5pm - 7pm. Mammo Night, October 19 from 5pm to 7pm: Grab your girlfriends, call to schedule your next mammogram and enjoy light refreshments, educational materials and a massage! Join us at the Rockwood Breast Health Center, 12410 E. Sinto Ave. Call to schedule today. We look forward to seeing you there!

ď&#x201A;&#x2020; To schedule your 3D screening mammogram, call the Rockwood Breast Health Center at 509-755-5801.

12410 E. Sinto Avenue, Suite 105 Spokane Valley, WA 99216

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CHECK-IN

Spokane Riverkeeper Jerry White in the Spokane River near Peaceful Valley. YOUNG KWAK PHOTO

CHARITY CORNER

A Toast to the River

STAY CONNECTED Email InHealth Editor Anne McGregor at annem@inlander.com. The conversation continues on the Inlander Facebook page, and stay in touch with us at Inlander.com/InHealth.

he health of a community is expressly tied to the health of its environment, which makes protecting our regional treasure — the Spokane River — an important priority. For its milestone 10th year, the Spokane Riverkeeper benefit “Dirty Martinis for Clean Water” again seeks to raise funds for projects that keep the river’s waters running clear and clean, including efforts to educate all ages on its major ecological role in the region. Funds raised at the annual event through auctions, ticket sales and raffles are used for water quality monitoring projects, outreach programs for kids and the new River Partner program for local businesses, says Spokane Riverkeeper Jerry White. “The other piece that we’re really starting to get into is trying to protect the river and tributaries

from forms of pollution that are basically runoff from fields and streets, and educating people about that kind of pollution — the kind you can’t just point to a pipe to see,” White says. This year’s event — which offers live entertainment, adult beverages (martinis included) and appetizers — also includes the presentation of the Mike Chappell River Hero Award, which recognizes an individual for their contributions to Spokane River conservation. The award is named after the late environmental lawyer, whom White says left a legacy here by helping establish legal protections for our region’s iconic waterway. — CHEY SCOTT Dirty Martinis for Clean Water • Fri, Nov. 4, from 5-8 pm • $45/advance; $50/door • 21+ • Hamilton Studio • 1427 W. Dean • cforjustice.org • 464-7614 OCTOBER-NOVEMBER, 2016

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CHECK-IN HEALTHY PLANET

Garden Dreams

nland Northwest yards and gardens are enjoying a well-deserved rest until spring, but plant lovers can already start planning next year’s bounty and beauty. Each year, Spokane’s Master Gardener Program clinics help local residents choose and care for plants, all the while promoting sustainable soil and water practices, and working to minimize the use of pesticides. For the Master Gardener Foundation Fall Banquet, which benefits the clinic, internationally recognized plant collector Dan Hinkley will share stories of his work. “He goes up mountains and finds places that people don’t go, and collects seeds from

interesting plants,” says the Foundation’s Jan Shellenberger. Described as a modern-day David Douglas, Hinkley was awarded the Veitch Memorial Medal from the Royal Horticultural Society of Great Britain in 2007 for “outstanding contribution to advancing the science and practice of horticulture.” — ANNE McGREGOR Fall Banquet including book signing, silent auction, dinner and keynote presentation by Dan Hinkley • Thu, Oct. 27, from 4 to 8:30 pm • $40 per person • The Lincoln Center • 1316 N. Lincoln • Tickets at MGFSC.org or Brown Paper Bag Tickets at 800-838-3006

ASK DR. MATT

Pesky Little Critters

Matt Thompson is a pediatrician at Spokane’s Kids Clinic.

ice are a great scourge of modern society. I know of no upside to lice, other than they are a great vehicle for humility. Lice can affect any age, gender or socioeconomic class — although they are a bit more common in girls. It is believed the lice prefer clean hair. (I suspect that is why my kids have never had them.) Prevention can be tough. I am aware of a few studies that have looked at melaleuca oil (tea tree oil) with or without lavender oil, with some reasonable results to suggest a bit of prevention. However, I know of no specific product out there intended to prevent infestation. Also, some experts suggest, without much rigorous evidence, that tea tree oil and lavender oil may hasten pubertal changes — so take your pick: lice or teenagers. Knowing the life cycle of lice helps to understand the reasoning behind the timing of treatment. An adult louse can live about 24 hours without feeding on blood, surviving slightly longer in warm weather. If it doesn’t feed, it dies. Paralyze it and it can’t

feed. The lice shampoos paralyze arthropods like lice (not humans — we have a blood brain barrier). It’s all about timing. It takes 2 to 3 days after mating for an adult lice to lay eggs (nits); It takes 7 to 12 days for the eggs to hatch; it takes 9 to 12 days for juvenile nymphs to mature to reproductive age. So the first treatment is designed to kill all the crawling lice. By applying a second treatment after 10 days, all the original nits should have hatched, and still be 9 to 12 days away from being able to lay eggs. Therefore, re-treating 10 days after the first treatment is the recommendation, all the while being careful about not sharing hats, combs, etc. Then repeat home hygiene measures after the second treatment, and all should be well. Over-the-counter options like Nix or RID are the way to start. There are some resistant strains of lice emerging in the southeast United States, so failure is possible, but it usually seems like suboptimal timing and technique are to blame in cases of reinfestation. There are some prescription products available, but most insurance plans want to see over-the-counter failure twice before they will pay for those. — MATT THOMPSON

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PILL BOX

EpiPen Evolution My child has allergic reactions to nuts, and if that happens I have to treat him with an EpiPen. Several years ago this medication cost about $50, but today I pay $600 for a pack of two. Why has the price increased so much?

piPen is a device that delivers an injection of a medication called epinephrine (aka adrenaline) that is used to treat severe allergic reactions. The molecule that comprises the medication is simple and cheap and the device is moderately simple; in fact, one medical technology expert estimated that the actual cost is about $20 per pen. It doesn’t take an economist to understand that the profit margin for the manufacturer in this case is not defensible. Still, the cost of FDA approval and producing the product is considerable. Because of this, several manufacturers elected to not keep their products on the market. Over time this created a vacuum that was filled by one company, John R. White chairs Mylan Pharmaceuticals. WSU-Spokane’s Unfortunately, they have Department of escalated the price over Pharmacotherapy. several years. Today it costs

A September study by the Kaiser Foundation found that Medicare Part D spending on EpiPens increased 1100 percent between 2007 and 2014 — growing from $7 million to $87.9 million.

as much as $600 for a pack of two pens. This is a considerable and unacceptable consumer expense. This medication has to be replaced periodically due to expiration, and most people need several of them in order to keep them at multiple locations, so some may be shelling out a couple of thousand dollars or more to keep their kids safe from allergic reactions. Fortunately for the consumer, this monopoly is finally getting a great deal of attention. Recently the Antitrust Subcommittee of the Senate Judiciary Committee called for the Federal Trade Commission to investigate the situation. Additionally, it appears that a burgeoning class-action suit is going to be launched against the manufacturer. Mylan will have to respond to questions from many directions and may rethink their pricing scheme. Also, given the landscape, other companies are likely to jump back into the EpiPen arena which will push the cost of the pens down. This may however take as much as a couple of years. — JOHN R. WHITE

In August, the West Virginia Attorney General’s office issued a subpoena to Mylan as part of an anti-trust probe. In September, the AG launched an investigation into Mylan’s failure to comply. Mylan Pharmaceuticals is headquartered in Morgantown, and CEO Heather Bresch is the daughter of West Virginia Sen. Joe Manchin.

Mylan Pharmaceuticals plans to offer additional rebates and make available a $300 generic form of the EpiPen.

For $300 per pen, you might at least expect a device that’s easy to use during the chaos of a medical emergency. But a report by ProPublica showed the EpiPen’s counterintuitive design (the “lid” of the “pen” covers the injector button rather than the needle) led to more than 30 percent of users incorrectly discharging the contents of the injector, often into their own hands.

Be Smart Around Lead, Play Clean! Lead and other metals are found f und in the soil along the Coeur d’Alene fo d’A ’ lene River, ’A r r, its South Fork, and the Chain Lakes. • Wash W sh hands and face Wa f ce before fa befo f re eating. fo • Bring water for f r all personal use. Don’t use �iltered fo � ltered river water. �i r r. • Eat on a table or blanket in grassy areas. • Limit children’s hand-to-mouth contact. • Remove dirt on clothes, toys, pets, and equipment before befo f re leaving. fo Know your child’s blood lead level through simple blood testing Panhandle Health District: (208) 783-0707 Know how to reduce your child’s exposure to lead in soil Idaho DEQ: www.deq.idaho.gov/PlayClean

• Recreate in designated

areas and stay on trails.

• Wear dust covering over mouth and nose when riding off-road trails.

• Follow �ish consumption

advisories. It is best to eat �illets only.

• Do not harvest edible plants from �loodplain areas. OCTOBER-NOVEMBER, 2016

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CHECK-IN SUPERFOOD

Cranberry Creativity ATTRIBUTES: Native to North America and harvested in September and October, cranberries contain high levels of vitamins C and E, an abundant dose of potent antioxidants and plenty of fiber. SUPER POWERS: Research on cranberries has found benefits, including slowing tumor growth in prostate, liver, breast, ovarian and colon cancer. Eating cranberries is also good for teeth and gums, inhibiting the growth of bacteria in the mouth. And cranberries may protect against cardiovascular disease. WEAKNESSES: Although cranberry capsules do help with urinary tract infections, there’s just not enough oomph in cranberry juice to have any effect. Be careful consuming cranberries if you take blood thinning medication or have a history of kidney stones. HOW TO USE THEM: Steer clear of cranberry sauces and juices loaded with added sugar. To bring out their natural sweetness, try this Bon Appétit recipe for roasted cranberries. Toss 2 cups cranberries with 2 teaspoons olive oil, 2 teaspoons chopped fresh thyme, and 1 tablespoon sugar. Roast in 400-degree oven until softened and slightly caramelized. Use as an accompaniment to roast pork, or add to rice pilaf. — ANNE McGREGOR

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BRAIN EXERCISE

Sudoku

RATINGS: Gentle (left), Tough (right) To complete Sudoku, fill the board by entering numbers 1 to 9 such that each row, column and 3x3 box contains every number uniquely.

2 4

Answers to all puzzles on page 44

PUZZLES BY JEFF WIDDERICH & ANDREW STUART www.syndicatedpuzzles.com

2 4

9 5

1 9 7 1 6

5 3

8 3

3 5

Codewords

Each letter has been replaced by with a number. Using the starter clues, work out the words that must go in each cell on the codeword grid. Some well-known phrases and names may also be found. For a three-letter clue, turn to page 21. 9

19 19

23 3

15 25

26 10

26 4

10 22

B J

6 3

10 10

5 5

25 21

20 13

6 13

13 24

17 1

B J

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

1 2

2 4 2 7 5 5 1 2 4 3 1 8 3 6 8

9 6 2

5 4 1 9

Str8ts

RATING: Moderate Like Sudoku, no single number can repeat in any row or column. But rows and columns are divided by black squares into compartments. These need to be filled in with numbers that complete a ‘straight’ — a set of numbers with no gaps but can be in any order. Clues in black cells remove that number as an option in that row and column, and are not part of any straight. Glance at the solution above to see how ‘straights’ are formed.

5 2 8 3 2 1 6 7 9 4 4 3 3 7 6

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NEWS

THE EMPOWERED PATIENT

Are You Ready? Surgery is a challenge, so prepare yourself BY WILSON CRISCIONE

f April Box hadn’t insisted on asking questions, she might never have walked again. Box has a congenital disorder that affected her ability to walk, even as a kid. She had her first reconstructive hip surgery in 1988, then another surgery a year after that. After a hip replacement in the early 1990s, her doctor told her she would never walk without crutches. She just wouldn’t accept that. She sought out opinions of other doctors, and they eventually discovered why she couldn’t walk: her pubic bone was dislocated. After figuring out the problem, she was able to walk again shortly after. She’s had two more hip replacement surgeries since — the most recent in 2013 — and Box says she has finally resolved her issues.

If she’s learned one thing along the way, it’s how to advocate for herself as a patient to ensure she has the best possible health care outcome. Now she works with other Spokane patients as a professional advocate, helping them achieve success when they go in for their own surgeries. “You’re a consumer,” she says. “It’s one of the harder areas in our life to think of ourselves as consumers, because we just kind of take it as we see it, because insurance says go see this person, they’re in a position of authority. So you have to push back on that a bit and [advocate for] your own wishes and desires.” Medical care, by nature, is imperfect, says Richard Cook, an anesthesiologist and research scientist studying patient safety at Ohio State University. New treatments and

new surgical procedures are always being developed, meaning that improving patient safety is a moving target. “We try and reach as far as we possibly can and get the best results for people we can, knowing we are going to fail, knowing we are not going to have good results for some people,” Cook says. “That’s not reassuring for the patient.” The data show there’s plenty of room for improvement. As many as one in 10 patients may be injured by medical providers who are supposed to be helping them, Cook notes. Hundreds of thousands of people in the U.S. acquire infections during treatment in a health care facility each year, and tens of thousands of people die from ...continued on next page OCTOBER-NOVEMBER, 2016

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NEWS

Patient advocate April Box: Health care is “one of the harder areas in our life to think of ourselves as consumers.” YOUNG KWAK PHOTO

“ARE YOU READY?,” CONTINUED... those infections, according to the Centers for Disease Control and Prevention. Additionally, 400,000 people experience an error in medication each year at a hospital, according to a report from the Institute of Medicine. Robin Shapiro, co-founder and president of Washington-based Allied Health Advocates, encourages people to not be patients, but active participants in their health care. “I think an informed consumer is the best consumer of anything,” she says. “And nowhere is that more important than our health.” In many cases, both patient advocates and health care professionals say hospital mistakes may be prevented if patients know the right questions to ask, aren’t afraid to advocate for themselves, and have someone at their side to help out.

HEALING ADVICE

Although no one wants to exaggerate an illness or run up a big bill, Cook says it is better to get to the hospital before you are critically ill, if possible. Once at the hospital, he says, patients need to ask questions and make sure they understand what is going on; the American College of Surgeons (facs.org) has a detailed questionnaire you can refer to, and Cook advises people to be as honest and complete as possible about all the medications and substances they’re taking. There’s an added benefit to patients if their regular doctor takes part in their care. You can research your hospital ahead of time, too. Word of mouth can be helpful, but there are more vigorous assessments available as well. The Leapfrog Group (leapfroggroup.org) is a national nonprofit whose volunteer expert panelists produce a Hospital Safety Score each year. More than 2,500 hospitals received letter grades in

2016, including the hospitals of the Inland Northwest. And Medicare just released its own star-based hospital ratings in July (hospitalsafety.org). If you are going in for surgery, Shapiro recommends taking time to choose a surgeon. Ask the surgeon how often they perform the surgery. Generally, the more times a surgeon does a procedure, the more proficient he or she becomes at it. Surgical errors can range from a dangerous object left in a patient’s body to a relatively harmless accidental cut. Ask about the surgeon’s complication rate for the surgery you are undergoing. The public interest journalism group ProPublica calculated complication rates for eight common surgeries and published those results in July 2015. Patients or prospective patients can search ProPublica’s “Surgeon Scorecard” database online at projects.propublica.org/surgeons. Though each surgery is different, Shapiro says a few safety tips apply to most medical procedures or hospital stays. Stay alert about the medications you are being given. If you’re hooked up to an IV, Shapiro says you should ask the nurse to remind you what’s going in the bag and write it down. Be on the lookout for the potential of acquiring an infection; make sure anybody coming into the room has washed their hands. And it never hurts to have another set of eyes and ears. Ideally, someone should stay with you, especially overnight to make sure an accidental fall doesn’t occur. Shapiro of Allied Health Advocates says it’s important to remember that health advocacy is not about confronting the people treating you. Instead, it’s about being curious and making sure you have the information you need. Don’t confront the doctor with a problem. Instead, ask them for more explanation, she says. “We teach how to ask questions in a ...continued on next page

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A BETTER WAY?

heryl Jacobs is a Seattle physician who has been practicing for about 20 years. Recently, she became frustrated that she didn’t have time to develop relationships with patients like she used to. Patient relationships, she says, lead to better diagnoses and to finding root causes of medical issues. Jacobs became the second physician to join a clinic in Seattle that works with seniors. The clinic is run by Iora Health, a Boston-based, for-profit company that operates various clinics across the country. It’s a single-payer system that Jacobs says allows for team-based care for patients that includes social workers and health coaches. She says she can “honestly say” they are doing better care — a decrease in emergency room utilization, a decline in hospitalizations — because they can devote more time to patients and because it’s less driven by productivity. “The difference is people feel like we are their advocate,” she says. “In the regular system, people are having to be their own advocate and navigate on their own.” — WILSON CRISCIONE

“ARE YOU READY?,” CONTINUED... way that’s helpful and productive,” she says. Leaving the hospital for home is a vulnerable time for patients. Hospitals face incentives to discharge patients quickly, but if you feel you aren’t ready to leave, ask to speak with your doctor. Medicare patients have specific rights when it comes to discharge, and the hospital is required to explain those rights. But be aware of what your doctor already knows: sticking around the hospital too long also has its dangers. “Hospitals are complex systems with human moving parts, so with every interface you have a human that can make an error, and there are sick people in hospitals that have diseases you don’t need to be exposed to,” says Dale Reisner, medical director responsible for Seattle’s Swedish Health Services OB/GYN quality and safety. When patients are getting ready to be discharged, Shapiro says they should make sure they do four things: manage their medicine, keep their own health record, follow up with a doctor appointment and understand warning flags of a worsening condition.

“Your doctor or surgeon is really a partner in care, and it’s not a ‘me vs. you’ scenario,” she says. “The doctor is a professional, but nobody is more informed about an individual than that particular individual.”

LEARNING FROM EXPERIENCE

Few people understand that more than Io Dolka, a founding board member of the Washington State Health Advocacy Association and patient advocacy organization GreyZone. As a patient, Dolka experienced errors in surgeries to remove brain tumors twice within a span of five years. In 2010, following the first surgery, she had to go back to the hospital because of a complication that dropped her blood sodium level down to a dangerous level. Protocols were in place, but the signs that could have predicted the issue went unnoticed. Following the second surgery to remove a separate benign tumor, Dolka found out she had a specific condition that could lead her to experience a severe, life-threatening allergic reaction if given blood. Except that nobody ever told her about it, and she had to find it on her own. “If it wasn’t for me looking for it, this

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would have slipped through the cracks,” Dolka says. For Dolka, these experiences illustrate the fact that medicine is an error-prone art and science, and that some errors are harder to avoid than others. While more vigilance could have caught the drop in so-

“I think an informed consumer is the best consumer of anything.” dium levels, Dolka says it “went from point A to point B so fast” that it would have been difficult. But the second error — not notifying her about a condition that could have put her in danger — was something that the medical team is fully responsible for, Dolka says. Either way, she says it’s better if patients are active in their own care. “We all, as patients, need to know that no matter what you do, mistakes will happen,” Dolka says. “All you can do is be extremely prepared for it.” n

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NEWS ALT MEDICINE

Taking a Complement A group of health care providers in Spokane hopes therapies outside the American norm can enter the mainstream BY JAKE THOMAS

rowing up in northeast India, Renu Sinha recalls her family using therapies from Western and Eastern traditions to stay healthy. They would meditate and practice yoga, and she recalls getting ayurvedic treatment, an ancient Indian healing system. When she was sick, her mother would give her ginger tea sprinkled with turmeric, a spice long used in Asian cuisine that’s recently been recognized for its range of health benefits. After moving to the U.S. and graduating from medical school, Sinha took a job teaching at the University of Arizona’s College of Medicine. There, she says, therapies from various traditions were similarly blended. Andrew Weil, a physician who has popularized complementary and alternative treatments, is on the faculty. But when she moved to Spokane, where she works a surgeon specializing in thyroid surgery, she says she didn’t find the same acceptance of nontraditional medicine. Now Sinha, and a group of like-minded health care providers, are hoping to change the culture of medical care in Spokane. Specifically, Sinha wants nontraditional therapies, including Tai Chi, acupuncture, special diets, chiropractic and other unconventional treatments to become as mainstream in Spokane as X-rays and prescriptions. “If we educate and break down

barriers, we can improve access and opportunities for wellness, and improve discussions between health care providers on how we can integrate traditional and nontraditional approaches,” says Sinha. Since June, the group of health care professionals (about half are medical doctors) called “Healing Spokane” has been meeting nearly every month to exchange ideas and strategies on how to make better use of nontraditional therapies. They’re also planning on holding forums intended to educate the public on the benefits of

nontraditional therapies for common ailments; the first was a back pain forum in September. Sinha says that research is increasingly confirming the effectiveness of many treatments that were once dismissed by mainstream medicine. For instance, she points to research published in medical journals showing that acupuncture, yoga, Tai Chi, massage therapy and relaxation techniques have the potential to help treat and manage pain. She also says that some of the these treatments are being embraced by the Duke University School of Medicine and the Mayo Clinic. They’re also being embraced by patients. In 2012, the National Health Interview Survey found that 59 million Americans spent $30 billion on alternative care. However, despite growing evidence and a clear interest from patients, there are barriers to making these treatments more widely accepted in places like Spokane. “We’re a pill-popping society,” says Catherine Anne Lee, a rheumatologist involved with Healing Spokane, who became interested in complementary medicines after her patients kept seeking them. Patients and medical professionals, she says, are accustomed to looking for quick fixes for ailments. But taking medications or having an invasive surgery can carry side effects, says Lee, and a lifestyle change that

Rheumatologist Sherry Wu is also trained in traditional Chinese medicine. YOUNG KWAK PHOTO

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incorporates treatments such as massage grew up in China, decided to go back to therapy and chiropractic work can lead to school for a master’s in traditional Chinese lasting health. medicine after getting her medical doctor“I think medications can only take you ate. Now, Wu, who is also involved with so far,” says Lee, who notes she’s had paHealing Spokane, offers acupuncture to tients who switch to low-sugar, low-glucose help patients with pain relief. But she says or anti-inflammatory diets, and it’s made a that for many members of the public, nonsignificant difference in their health. traditional treatments still seem “mysterious Lee says that one obstacle to having or odd.” complementary therapies Lee says Healing Spoused more widely is that inkane provides an opportusurance plans differ in terms nity for simply meeting with from the puzzle on page 13 of what types of treatments other health care profesthey’ll cover. And, she says, sionals who have a similar 1 = U; 9 = L; 25 = S if patients have to pay out philosophy, noting it is helpof pocket for an additional complementary ful for them to swap ideas. She says they all treatment, they might just skip it. have a goal of maintaining patients’ health Lee and Sinha, both specialists, say and doing more than just responding to they have more time to discuss alternative diseases, which she says have become the or complementary therapies with their focus of traditional Western medicine. patients. They point out that primary care In the future, Sinha says she hopes to doctors are typically pressed for time and get nonprofit status for Healing Spokane aren’t able to talk with patients about holisand further expand its outreach efforts to tic approaches to their health that include the city’s medical community and local diet changes, stressors and therapies that patients. She thinks the message will evenmight be helpful. tually take hold in Spokane the same way it “You can’t do that in 10 minutes,” says has in other communities. Lee. After all, she says, “We’re not talking Sherry Wu, a local physician who about crazy stuff.” 

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FOCUS WOMEN’S HEALTH

Secrets to Getting Some Shut–Eye More and more women are struggling to sleep; here are four ways to drift off to better health BY ANNE McGREGOR

wakening at 3:30 am is never a welcome event. Neither is watching the clock creep inexorably toward dawn as you wait to fall asleep. That’s the struggle faced by almost 30 percent of women in a 2007 National Sleep Foundation study, who reported getting a good night’s sleep only a few times each month, while 50 percent had trouble sleeping almost every single night. Ariana Huffington declared that Americans are in a “sleep deprivation crisis,” and penned The Sleep Revolution, offering her plan to both understand and improve sleep, with techniques including banning electronics from the bedroom, daily yoga and a gratitude journal. In fact, there’s no shortage of advice on how to get some sleep. Melatonin supplements, meditation apps, personal sleep trackers, “cool” pillows and sheets, sleep clinics and prescription sleep aids all have their proponents in the “sleep optimization” industry, which is expected to reach $76 billion by 2019. The intense interest in sleep is in part because we feel so crummy when we don’t sleep well, but also because new research highlights the surprisingly broad risks associated with a lack of sleep, including obesity, diabetes, heart disease, memory loss and a lower life expectancy, as well as impaired function at work and while driving. If you’ve paid attention to your “sleep hygiene” (see “Sleep Basics), and ruled out conditions like sleep apnea, read on to learn about four strategies that may just help you get some sleep.

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SCREENS TO THE RESCUE

While exposure to screens in the hour or two leading up to bedtime is not a good idea, there are innovative sleep programs offered via a computer or smartphone. Cognitive Behavioral Therapy for Insomnia is considered the “gold standard of treatment” for insomnia. In one-on-one counseling led by a psychologist trained in the program, patients learn to address the many components of life and body that influence sleep — from relaxation to creating a good sleep environment to adhering

SLEEP BASICS  Don’t drink coffee after lunch.

 Don’t rely on alcohol to get to sleep.  Get regular exercise; earlier in the day is better.  Be consistent about the time you get up; don’t get up and start your day at 3 am.  Use your bed only for sleep and intimacy.  “Reading a good old-fashioned paper book with an incandescent lamp is the best way to allow yourself to get sleepy.” — MICHAEL SCHWARTZ, Certified Clinical Sleep Educator to regular bedtime and more. Dr. Gregg D. Jacobs details the program based on CBT that he’s used to treat more than 10,000 patients over 25 years in his best-selling book, Say Good Night to Insomnia ($18). Jacobs’ program is now accessible in an interactive online format for $35 for lifetime use. The “Conquering Insomnia” program is generally five weeks long, though it can be completed at a subscriber’s own pace. Each module focuses on different aspects of sleep, beginning with a comprehensive assessment of insomnia and progressing

through various techniques and lifestyle adjustments. Each week, users can complete a sleep diary and send it to Jacobs to receive feedback. For those who think a five-week program Michael Schwartz sounds a little long, there is a shorter-acting option. It also starts with an assessment of your insomnia. “Most people with insomnia feel like they don’t have as much sleep as they actually do,” says Oregon-based sleep educator Michael Schwartz. In fact, 80 percent of people awakened during Stage 1 sleep will deny they were asleep. That lack of awareness can mean that people with insomnia lose confidence in their ability to sleep. Australian sleep researchers designed a regimen to help the “sleepless” practice recognizing sleep, and thus regain confidence. The lab-based program required participants to attempt to fall asleep, whereupon they were awakened, quizzed about their perceived sleep state, given the correct information, told to walk around, then get back into bed and try to fall asleep again, repeating the whole regimen for 24 long hours. “[The researchers] basically concluded this looks pretty good, as good as the best cognitive behavioral therapy,” says Schwartz. “But you need a lab to do it. I said, ‘Hmmmm… maybe not. I think I can do this with a smartphone.’” Schwartz’s app is called Sleep on Cue ($20 for iPhone; coming soon for Android), and it works like this: Users put an earbud in one ear, hold a smartphone in their hand, and climb into bed. Very faint tones will be presented and the user gives the phone a shake to let it know he or she is still awake. When the user quits responding to tones, (the start of Stage 2 sleep), the phone will vibrate to awaken him or her, and offer a query on whether the person believed they were

asleep, along with immediate feedback on the correct answer. The user then gets out of bed, walks around, and starts the next cycle. Schwartz says it’s best to train after a poor night’s sleep, but a two-hour session of practicing is sufficient, then it’s off to bed for the night. About 10 sessions are needed to see results. Schwartz says his app is now being studied by the Australian researchers. Developing and practicing a more accurate awareness of sleep seems to train people to put themselves to sleep — like practicing sleeping. “It gets into learning theory,” Schwartz says. ”We are not exactly sure how people do that. You ask someone who is a good sleeper, ‘How do you do that?’ They don’t know.” ...continued on page 26

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SCREENS TO FOCUS: WOMEN’S HEALTH

ESSENTIAL OILS

“Essential oils are extremely complex, but also very simple,” says Jimm Harrison, the author of Aromatherapy: Therapeutic Use of Essential Oils for Esthetics and an instructor at Seattle’s Bastyr University. Oils can work in a physical sense, like pharmaceuticals, or they can work on an emotional level. Noting that insomnia is highly individual and that sometimes poor sleep has a physical cause such as poor digestion or inflammation, Harrison says there are three oils or scents that can generally be helpful, particularly with the mental component of going to sleep. Lavender helps to calm the central nervous system — responsible for the clenched, tight muscles and pinched breathing that can impair the ability to relax and go to sleep. A 2015 study showed a chest patch with lavender oil used for five days helped participants sleep better than those without a patch, and the effect lasted two weeks after the patch was removed.

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S TO THE RESCUE Harrison suggests putting a drop of lavender oil on your pillow, or better yet, combining a couple of drops of essential oils into a teaspoon of vegetable oil and massaging it on. He notes, “The massage itself is a way of putting the person into relaxation.” But relaxation alone may not do the trick. For many, sleep is blocked by racing thoughts that Harrison calls “monkey mind.” This self-talk ignites the body’s “fight or flight” response, which is moderated by the autonomic nervous system. To calm down the autonomic nervous system, Harrison recommends adding fennel (or anise seed) and frankincense to your oil mix. Harrison says most oils purchased at local stores will work, noting he prefers high quality in oils, similar to how connoisseurs prefer high quality wines. For those who aren’t interested in creating their own blends, Harrison offers his “Serious Insomnia” blend ($44 for 5 ml; jimmharrison. com), based on those three oils and including other components based on his 30 years of experience: “I try to be as full spectrum, as holistic, as possible.” ...continued on next page

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FOCUS: WOMEN’S HEALTH

SLEEP WITH ME PODCAST

“The idea is to get people’s attention, but not hold it,” says Drew Ackerman, aka Dearest Scooter, about his thriceweekly Sleep with Me podcast. Ackerman describes the yarns he spins as “goofy bedtime stories that are a little bit silly and a lot pointless,” but listener comments are effusive in their praise: “Better than any sleep aid.” “It’s magic.” “Scooter, you have quite literally improved the quality of my life.” “Make no mistake, this isn’t random rambling — these podcasts are crafted and created deliberately and thoughtfully to help you get to sleep.” Podcasts run about an hour. A recent sderies of “superdull” episodes included “Fall Asleep to Superheroes in the Pitch Dark” and “The Peace of Mosquito Nets.” Ackerman says some listeners are asleep within 10 minutes, most seem to report checking out about halfway through, and

some let the podcasts run all night. Listening to Ackerman’s low and somewhat monotonal voice seems to be helpful both for people who have trouble initially falling asleep and those who wake up and can’t get back to sleep. “What I’ve been shocked by is how little I knew about what causes sleeplessness. A lot of my sleeplessness is due to anxiety or overthinking,” says Ackerman, who got the idea to do a podcast from his habit of falling asleep by listening to a Sunday night radio show as a teen anxious about returning to high school on Mondays. “But there’s a huge portion of people dealing with chronic pain, trauma, PTSD or serious health issues” who find help from his podcast. Ackerman, who lives in Alameda, California, says that although the stories are meant to be kind of pointless, “It is pretty all-consuming” to create the podcast three

times a week. It’s a responsibility he takes seriously, working to steer clear of topics that might be disturbing to listeners such as violence or politics, or even discussion of things like snakes and spiders or money: “People are giving up a level of their control to me, and I try my best not to damage it.” Despite the success of the nearly threeyear-old podcast, he admits he still works to silence his inner critic. “Even when I’m recording, the critic will be going, ‘This is going horrible.’ I’ll go, ‘wait a second, we are making a podcast to make people fall asleep.’”

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MARIJUANA AND SLEEP

Research on marijuana and sleep is provocative, but still in its early stages. Studies have suggested that THC may make it easier to fall asleep, and stay asleep longer. It seems to change the sleep cycle, leading to increased time spent in deep slumber (Stage 4) sleep, but decreased time spent in dream-rich REM sleep. Especially interesting is the potential for THC to reduce the disordered breathing patterns associated with sleep apnea. While sleep issues are not a “qualifying condition” for medical marijuana in Washington, Tracy Sirrine of the Holistic Wellness Center in Spokane Valley says that many of her clients inquire about sleeping better with

marijuana. She has some advice: start small. “Over-ingesting can cause you to have a panic attack. That is one of the worst things that can happen.” To get a more precise dose, Sirrine says edibles, tinctures or under-thetongue lozenges are a good option. “Those have a very small amount of THC,” she reiterates, “It is very important for a new user to start small. I would go for something with about 10 mg or less of THC per dose.” Sirrine says Kronic Tonic ($40) is popular. “It has some CBD and would be a good product to start with if you are looking to sleep,” Sirrine says. In general, indica products are better for sleeping than sativa products, which can actually energize people, she says. Sirrine recommends always asking to make sure that the product has been tested for pesticides and contaminants. 

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FOCUS: WOMEN’S HEALTH

Jennifer Myers suffered for years with symptoms of polycystic ovarian syndrome. MAC BOOEY PHOTO

Mystery Solved

How an ovarian disorder may affect fertility and more BY LINDA HAGEN MILLER

hen 15-year-old Willow passed out on the bathroom floor, her mother rushed her to the emergency room. Acutely aware that Willow had been experiencing extremely heavy periods, she advised the ER staff. “We weren’t taken very seriously until the labs came back and the staff realized she was two points below the level requiring a blood transfusion,” Willow’s mother says. Willow has polycystic ovarian syndrome (PCOS), a complex endocrine disorder that causes small cysts to form on a woman’s ovaries. The cysts themselves are not harmful but cause hormonal upheaval, leading to an excess of male hormones (androgens), and resulting in cascade of difficulties, ranging from heavy or nonexistent periods and difficulty getting pregnant to increased risk of obesity, diabetes and high blood pressure and acne, excessive hair on the face or body, and thinning hair on the scalp. Approximately one in 10 women in the United States have PCOS, and about

200,000 new cases are diagnosed each year, yet it continues to remain under the radar. “None of my doctors ever diagnosed me with PCOS,” says 31-year old Melanie Hewitt, “even though I never had a regular menses, ever. I also had really bad acne, thick hair on my chin and abdomen. My mother did a lot of research, and she was the one who first suggested it was PCOS.” “When I was a teenager, doctors weren’t too concerned with my irregular periods, and the only option they offered was to put me on birth control,” says 35-year-old Jennifer Myers, “but I couldn’t find one that didn’t make me super nauseous. When I was 18 and just graduated high school, my period quit for a year and that prompted me to go see a gynecologist. At one point when I was 25 years old, an ER doctor prescribed a high dose of progesterone to help stop an incredibly painful and overly heavy flow period.” R. Steven Brisbois, MD, calls PCOS the “silent impactor.” He has been involved with women’s reproductive issues for the past 37 years and is currently Medical Di-

rector for Women’s Services for Providence and Medical Director of the Providence Center for Gynecology, Robotics and Minimally Invasive Surgery. “Women have burst into tears in my office out of relief when I tell them they have polycystic ovarian syndrome,” says Brisbois. “They are just so relieved to be able to put a name to what is going on in their bodies, and to find out what can be done to control PCOS symptoms.” Shame, guilt and depression are often PCOS’ nagging companions, and women wonder what they could do differently, as well as how they will cope with the outward and inward malady that is PCOS. “PCOS probably does not cause depression, but when a woman feels bad about her looks and cannot get pregnant no matter what she does, she’s probably going to feel helpless and sad,” Brisbois says. Hewitt says not being able to get pregnant and not feeling beautiful because of acne and body hair were the worst parts of PCOS. She has taken birth control pills in the past and was able to conceive two healthy children without medical help. When Myers got married, she tried unsuccessfully to get pregnant. Her doctor did not give her the option of hormone therapy, and she was not able to conceive. She has since divorced, but the anguish of not being able to have a child is still with her: “When I was married and wanted to become pregnant, I just couldn’t, and I wanted to have children more than anything.” Threading the hormonal needle that is PCOS can be complicated, stressful and disheartening, but a knowledgeable physician can help control symptoms and, ultimately, fertility. “I explain to women, you will have this for the rest of your life, and it needs to be monitored,” Brisbois says. “It is what it is, but it is not the end of the world. We can control PCOS with medications, and you will be able to have a baby.” 

TREATMENT OPTIONS METFORMIN: An insulin-modulating drug commonly used in the treatment of diabetes. BIRTH CONTROL PILLS: Protect uterine lining and suppress the ovaries from making male hormones. SPIRONOLACTONE: A diuretic that decreases testosterone production.

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Class

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FOCUS: WOMEN’S HEALTH

With Eyes Wide Open A permanent solution to having to “put on your face” every day BY LINDA HAGEN MILLER

“B

ecause I don’t like looking like a hairless Chihuahua!” Tina Nadain exclaims when asked why she decided to have permanent makeup applied to her very pale eyebrows. “Because I want to look as good as I can, for as long as I can,” says 60-year-old Susan MacRae as she towels off after a Zumba class. No longer a celebrity craze, permanent makeup (sometimes called cosmetic tattooing) has gone mainstream. The Society of Permanent Makeup Professionals reports that the number of trained artists has increased tenfold in the past three years. More than a dozen hair or nail salons, dermatologists and aestheticians offer permanent makeup in the Spokane/Coeur d’Alene area. Alicia Seyhanli, owner of Alicia Seyhanli Permanent Cosmetics in the Garland District, can attest to the trend and reports that her clientele has grown steadily in the last decade. She sees women of all ages, and even a few men.

Why permanent makeup?

Alicia Seyhanli uses permanent makeup to enhance bone structure and natural coloring. KRISTEN BLACK PHOTO

Because it’s a boon to people with alopecia or vision issues like macular degeneration, those who cannot wear cosmetics because of allergies, post-chemo patients, and women with dexterity issues such as arthritis, Parkinson’s disease, multiple sclerosis and strokes. Women without physical issues say they arrive at the permanent makeup decision for a variety of reasons. Some want to darken naturally light features or emphasize their eyes or lips; athletes appreciate not sweating off their eyeliner; busy women say it’s a big time-saver. “When a person feels they look good, they have more confidence and a more positive attitude,” says Olga Yurkova, a permanent makeup artist who owns Faces

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SAVE THE DATE & Toes in Spokane. “And isn’t that a good thing?” Prices vary. Brows cost from $300 to $450, eyeliner and lip liner are $440 and full lip color runs $500 and up.

Is it really a tattoo?

Not quite. Tattoo ink goes into the third layer of skin, while permanent makeup reaches the second. Colored pigment is applied to the skin with a traditional tattoo coil machine, pen or rotary machine, or handheld micro blades. And yes, it hurts. The cosmetic makeup artist will apply a topical anesthetic which dulls the pain, but clients report mild to major discomfort. Eyebrows are the least painful; eyeliner and lip liner color are more uncomfortable.

CHOOSING A PERMANENT COSMETIC ARTIST  Start with friends’ recommendations and look at the artist’s before and after client photos.  Make sure the artist has a business license.  Make an appointment for a free consultation (if this is not a possibility, you can keep looking).  Ask the artist about their training, number of procedures they’ve done and years of experience.  The salon space should be free of contaminants like nail dust, aerosols or other chemicals.

Is permanent makeup forever?

Not really. Permanent makeup will not wash off but will fade over time, so periodic refreshing is needed. This isn’t all bad, though. As your face and hair coloring change with age, you may find that what worked several years ago is too strong a statement today. Styles change as well. Remember the silent movie stars who plucked their brows to pencil-thin lines, or Elizabeth Taylor’s dark brows and heavy liner? The bold look is in now, but who knows what the next decade holds.

BER 14 FRIDAY, OCTO

What can go wrong?

Botched jobs, allergic reactions, buyer’s remorse and infections are all possible. Expect to fill out a medical profile so the cosmetic artist can determine if you have issues that would cause problems. “Make sure you and the artist are communicating about what you want,” says Yurkova. “Look at photos of the artist’s work. If you are not comfortable with that person, find someone else.” A permanent cosmetic artist learns the trade through seminars or studies under someone with several years of experience. At this time, there are no schools or courses devoted to the practice. Washington state licenses permanent cosmetic artists and requires them to have a blood-borne pathogens certificate. Idaho does not regulate permanent makeup or tattoo artists, so it is important to do your homework and and find a skilled professional who been trained in applying permanent cosmetic makeup. “A good cosmetic artist knows how to consider the person’s bone structure and natural coloring,” says Seyhanli. “They will use quality pigments, match the pigments and style to the individual’s face and they won’t go overboard. It’s art, really.” 

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LIVING

FOOD

Small Farms Face Growing Pains BY TARYN PHANEUF

hen the person who grows, picks and packs your food is the smiling farmer on the other end of a handshake at the weekly market, it’s easy to feel sheltered from food recalls and nationwide outbreaks of listeria or salmonella. After all, that’s what so many people love about small farms and local food: It’s personal, Sunset over with a side order of trustworthiness. “People trust our food a bit more because Cloudview Ecofarms they’re more connected to our food than they are in Royal City. if they buy a cantaloupe from Safeway,” says Gabriela Amador of Cloudview Ecofarms in Royal City. “We have a different relationship with our customers.” People promote buying locally grown food for

a lot of reasons, and whether it’s based on philosophy, proximity or economics, the appeal is expanding beyond the weekly market. Farm-to-wherever isn’t a new concept, but it’s quickly becoming a more significant one for many farmers, giving the likes of Cloudview more options for the thousands of pounds of carrots harvested in early September. But as farmers move into markets dominated by food grown and shipped all over the world, they must grapple with consumer demands for more information, including creeping concerns about food safety. Expanding the reach of local food has brought new questions: Is this going to be safe? How will I know? ...continued on next page

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LIVING “SMALL FARMS FACE GROWING PAINS,” CONT... Answering these questions becomes more difficult for farmers accustomed to face time with the people who eat the food they grow. Schools, especially, have set a gatekeeper — an annual audit through a voluntary U.S. Department of Agriculture program to certify that a farm uses safe practices, from planting to harvesting and storing. Good Agricultural Practices, or GAP, is similar to organic certification or other labels that give a school or grocery shoppers an idea of how the food was produced, says Joel Williamson of LINC Foods, a Spokane cooperative that sells locally grown food to schools, restaurants and grocery stores. “Once you get beyond an arm’s reach, organic certification becomes important. All our farmers are doing those things, but they’re not certified because their customers are a handshake away,” Williamson says. “GAP certification is the same. No farmer wants to hurt anyone — they don’t want to do unsafe things. GAP is a way to communicate clearly that they’re doing these things, and they’re being audited.”

Cloudview Ecofarms works to meet full GAP standards. Similar to those other programs, the cost of meeting the standards can disqualify a lot of small farms. Seeing GAP’s rising importance, the Washington State Department of Agriculture and LINC Foods have been working with farmers to adapt food safety protocols to a small operation. “The reason they’re doing what they do is they want to grow wonderful food to feed people in their communities,” says

PHOTO COURTESY OF CLOUDVIEW ECOFARMS

Laura Raymond, who works with small farms and the farm-to-school program at the WSDA. “That’s why they’re farming the way they’re farming. They’re running a farm business, but there’s a real personal motivation behind that of wanting to contribute to their communities. From that perspective, farms are always interested in learning ways they can do that better.” ...continued on next page

VOLUNTEERS NEEDED The Spokane County Superior Court Guardianship Monitoring Program recruits and trains volunteers to assist in monitoring guardianship cases. Volunteers are needed as Financial Auditors and Court Visitors to serve as the eyes and ears of the court to help detect or prevent abuse, neglect, and exploitation of incapacitated persons. Volunteers must be 21 years of age or older. Training and supervision are provided. FINANCIAL AUDITORS The Financial Auditors review court-ordered accountings of the incapacitated person’s finances, submitted to the court by the guardian, to ensure that the incapacitated person’s finances are being handled properly and in their best interest. COURT VISITORS The Court Visitors visit the incapacitated persons, guardians, and any other caregivers to ensure that the incapacitated person’s needs are being met and adequate care is being provided. This monitoring function enables the court to have first-hand information about persons under guardianship. SPOKANE COUNTY SUPERIOR COURT Guardianship Monitoring Program 1116 W. Broadway, Suite 200 Spokane WA 99260

JJ or ANA Phone: 509-477-2622 Fax: 509-477-5195 Email: gmp@spokanecounty.org

The Inlander’s Top 5 events for the weekend - delivered to your inbox every Friday SIGN UP AT INLANDER.COM/NEWSLETTER

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LOCAL FOOD EXPOSITION

ant a lesson in food safety? Or maybe a crash course on kombucha? The Spokane Conservation District’s Farm & Food Expo on Nov. 5 could provide both. The all-day event at Spokane Community College will feature a master class with Joel Salatin, an author, farmer and teacher who’s known for his outspoken opinions on raising animals and crops sustainably. Salatin will address the entire Expo during a keynote lecture in the evening at Gonzaga University. There’s something for everyone at the Expo, says Erica Johnson, the SCD’s outreach specialist. The list of more than 90 courses includes business necessities, including an overview of the Food Safety Modernization Act and the U.S. Department of Agriculture’s Good Agricultural Practices standards, as well as marketing, agriculture education, and water law. It also includes the likes of cooking methods for meat cuts, how to choose poultry breeds, and beekeeping for foodies, preppers and homesteaders.

“It’s a mix of what [farmers] want to take and what they should take,” Johnson says. The SCD works with landowners throughout Spokane County to manage Joel Salatin and protect natural resources. Keeping land in production through farming and out of development is part of how they do that. — TARYN PHANEUF Tickets for the event are $100. The all-day Salatin track is an additional $75. Just going to hear Salatin speak costs $45. The Expo also has student rates. Registration is available online at sccd.org/departments/ small-acreage/farm-food-expo/farm-foodexpo-registration.

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LIVING to a produce farm, Raymond says. The rules are complex and offer some exemptions to different farms, but it demonstrates that attention to food safety isn’t a passing fad. “It is going to be a learning process. … We’re helping everyone understand there’s going to be a new normal for what farms are expected to respond to. You may start to get questions about food safety you want to be able to answer,” she says. “There is a changing landscape around food safety right now, and we want to make sure farms are prepared, so they can continue to sell to the markets they want to sell to.”

MIND THE GAP Joe Piver of Tolstoy Farms sells local lettuce at the Spokane Farmers Market.

“SMALL FARMS FACE GROWING PAINS,” CONT...

HOW WE GOT HERE

When it comes to food safety in the U.S., we owe a lot to a novel. The Jungle, written by Upton Sinclair in 1906, revealed some of the horrors of the meat-packing industry and inspired President Theodore Roosevelt to push for the first federal laws to scrutinize ingredients and regulate the food industry. Eventually, those laws gave us the U.S. Food and Drug Administration and the Food Safety and Inspection Service — two agencies that greenlight the food we buy. Despite oversight, food-related illness outbreaks are a fixture on the news. Right now, the FDA and Centers for Disease Control are investigating outbreaks linked to frozen strawberries, raw scallops, flour, alfalfa sprouts and frozen vegetables. Many recalls of vegetables are traced back to crops grown in other countries, like Mexico, but in 2006, California-grown baby spinach contaminated with E. coli

MATT WEIGAND PHOTO

killed five people and sickened 205 others. In 2009, in one of the biggest food recalls in U.S. history, nine people died and hundreds were sickened in nearly every state because of a salmonella outbreak. The recall included 2,100 products from more than 200 companies, all of which came from a contaminated Peanut Corporation of America plant in Georgia. The company’s owner was sentenced to 28 years in prison after a jury convicted him of 71 criminal counts, including conspiracy, obstruction of justice and introduction of adulterated food. The case served as the impetus for sweeping food safety legislation known as the Food Safety Modernization Act, which passed in 2011. FSMA shifts the FDA’s attention from reacting to food-related illness outbreaks to preventing them. The FDA has been writing and working to implement rules for the past five years, which includes regulations for fruit and vegetable growers on small farms. FSMA is the first federal law to apply

Though GAP is a voluntary, industry-driven program separate from FSMA, it has a similar aim: Prevention. And that makes sense to farmers at Cloudview, who primarily pursued GAP certification to qualify for a USDA program that lets Washington schools spend more federal dollars on local produce, as long as they buy from farms that have been audited. “Schools want a little more in terms of food safety,” Amador says. “You’re feeding children — you want to make sure your farmer is doing whatever they can to make sure the food is safe.” Even with the prospect of more business, the task of preparing for the audit looked daunting, she says. She started by implementing a handwashing station and establishing protocols for sanitizing the bins they use to harvest crops. Raymond says farmers already manage all kinds of risk on their farms all the time, but GAP offers a particular lens to look through, focusing on reducing contamination from water, animal and human sources. “A lot of it is really common sense, but it’s sometimes common sense that you may

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not be as focused or thoughtful about unless you’re preparing for an audit,” she says. Those who work with farmers interested in GAP say they often already have the right protocols in place, but don’t document it, which is a key step in passing the audit. Through a series of farm visits and workshops, LINC has helped farmers become more acquainted with the process and helped them prepare for an audit if it makes sense for their business. “If you haven’t had to do these things before, it’s definitely a new set of things that you need to add to your operation,” Williamson says. But “it can become a habit. It can become easy.” The cost remains a barrier. Farmers have to pay for an auditor to travel from their office to the farm, conduct the audit, and drive home. But without any auditors on this side of the state, the farmer is stuck paying for the hours-long drive back and forth from Wenatchee. The total cost of the annual bill can eat up an entire marketing budget, Williamson says. But it opens a door to selling more food, so for some it’s worth it, he adds. Since starting seven years ago, Cloudview relied on selling to individuals at markets or through selling shares in each season’s harvest. But that model doesn’t fit them as well anymore, Amador says. They’re simply located too far from the closest towns to make so many deliveries. Instead, they’re turning their focus to schools, stores and restaurants. That made GAP a necessity. “Hearing about GAP, it seemed like way too much work. It didn’t sound attainable for a small farm to be GAPcertified, because we had so many crops to keep track of,” Amador says. But she was actually surprised. “It isn’t as difficult as it seems, and it opens up a huge market for a farm — even a small farm.” n

Local partnerships providing hope. As a community, we are working together to fight cancer. The Community Cancer Fund is proud to partner with the Ronald McDonald House Charities of Spokane to provide a “home away from home” experience for families traveling to our region seeking superior cancer care for their children. In the past year, the Community Cancer Fund provided funding to completely renovate six apartments on the local Shriner’s Hospital campus to provide overflow capacity for Ronald McDonald House families impacted by cancer. These new accommodations will allow the Ronald McDonald House to decrease their average nightly waitlist by 33%. The Community Cancer Fund works through organizations in our region to financially assist cancer patients and their families in various aspects of their journey. Our partnerships ensure no one Learn more: will fight cancer alone.

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LIVING mented pickles, she dove into research and experimentation. Griffin has since taught numerous classes, including through Pilgrim’s Market, which carries her Cultured Mama line of fermented sauerkrauts, veggies and cashewbased probiotic dips.

Cole Ina Merlo Griffin is a fermentation guru in Coeur d’Alene.

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COOKING

Kitchen Culture Fermenting preserves the harvest and promotes wellness BY CARRIE SCOZZARO

ermentation is nothing new; it’s been employed in food and beverage production for centuries — used to make bread and cheese, preserve fruits and vegetables, and craft wine and beer, it’s an art form dating back 9,000 years. What is new, though, is the focus on fermentation for its health benefits, especially aiding in digestion. “The human GI tract contains over 70 percent of the body’s entire immune system,” says Natalie Colla, a licensed, registered dietitian with Panhandle Health District, “and when this becomes compromised, all kinds of chronic diseases and infections can occur.” A healthy gut, she says, can “play a

role in regulating obesity, diabetes, heart disease, allergies and more.” We know the benefits of consuming fiber-rich “prebiotic” foods, especially whole grains, legumes and certain vegetables. But our digestive systems can also benefit from probiotics: living bacteria and yeasts abundant in fermented foods like yogurt, miso (cultured soybean) and kombucha. Cole Ina Merlo Griffin of Coeur d’Alene discovered fermentation four years ago as a new mother in search of a local Community Supported Agriculture program. She met a farmer, also a young mother, who introduced her to fermenting as a way of preserving the harvest. Griffin was so intrigued with the farmer’s fer-

hen fermenting, it’s important to know what fermentation is and is not. Both pickling and fermenting preserve food in liquid, resulting in a tart-tangy flavor. Pickling uses acid, such as vinegar, to kill spoilage-causing and dangerous bacteria; heat does the job in home canning. Both processes also kill good bacteria, found to be increasingly vital to gut health. Chemically speaking, fermentation is the metabolic conversion of carbohydrates — sugar in fruit, for example — into either ethanol or lactic acid. We might associate ethanol with biofuel, but it’s really an alcoholic by-product, such as when yeast “eats” sugar in making wine, bread and kombucha. In lacto-fermentation, lactobacillus bacteria convert starches and sugars into lactic acid, essentially pre-digesting them. (That’s why some lactose-intolerant people can eat yogurt, but not milk.) The process lends tang to dairy products like buttermilk, sour cream, some cheeses, and kefir, a cultured milk beverage originating in the RussoGeorgian Caucasus region. It also turns vegetables such as cabbage into sauerkraut or Korean kimchi. In her classes, such as Inland Northwest Food Network’s recent Seasonal Kitchen class, Griffin covers technique and nutrition. For example, fermented foods can be denser in vitamins, especially B and C, than their raw counterparts. She also talks about materials like the sea salt she favors for creating her essential brine, because processed salt isn’t suitable for fermenting. But what about food safety? “Properly fermented vegetables can be safer than raw,” says Anna Kestell, Washington State University Extension’s Food Preservation/Safety Education Coordinator, echoing the oft-quoted words of United States Department of Agriculture microbiologist Fred Breidt. The issue isn’t fermentation, she says, but rather storing the food properly. Fermented foods stored in a refrigerator or a 40-degree Fahrenheit root cellar should last long enough to make it through many meals. “And that’s why it’s been around since the dawn of time,” says Kestell. 

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RECIPE

50 TAPS

Probiotic-Rich Garlic Carrot Coins Coeur d’Alene mom Cole Ina’s two young children enjoy the Happy Bellies Pea Salad she makes with these carrot coins (pictured above), which will brighten up the flavor of any salad or sandwich and add gut-friendly bacteria. SUPPLIES Clean, wide-mouth quart Mason jar with lid Coffee filter, tea towel or cloth napkin, rubber band, marker Weight: Empty jam jar or glass/ceramic weight (available at kitchen specialty stores) INGREDIENTS 2 tablespoons sea salt (do not use processed or iodized salt) Large handful organic carrots, washed but not scrubbed or peeled 1 to 4 garlic cloves, peeled Outer leaf of cabbage (grape leaf or raspberry leaf also would work) Optional seasonings: chili flakes, dill, rosemary DIRECTIONS: 1. Wash jar and weight in warm, soapy water (do not use scented or antimicrobial soap), rinse well, and let air dry. 2. Put garlic in bottom of the wide mouth jar. Add other seasonings as desired. 3. Slice carrots into quarter-inch-thick coins, excluding ends. 4. Fill jar to the “shoulder” with sliced carrots, packing down gently. 5. Rinse outer cabbage leaf in cold running water and “tuck” cabbage leaf into jar. This covers and secures the carrots from floating up out of your brine where they’d be exposed to air. 6. To make 2 percent brine, dissolve sea salt in a little bit of warm water, then add cool water to make 1 quart.

7. Pour half of your brine into the jar with the carrots and garlic, until everything is covered. Keep the remaining brine for refilling brine level as needed throughout fermentation. 8. Place weight onto the cabbage and push down (if using empty jam jar, fill with brine to weigh it down). 9. Cover jar with a coffee filter, tea towel or cloth napkin and secure with rubber band. Record the date (on the coffee filter or the jar). 10. Put fermentation jar in area where you can easily check on it, yet out of direct sunlight. 11. Check brine level, adding more as needed. None of the plant material should be exposed to air. You should see bubbles forming at the top of the jar. 12. After five days, use clean utensil to check whether carrot is tangy enough for you. If not, carefully repack carrots, cabbage and weight as you did before. 13. Once fermented, put lid on jar and store in refrigerator.

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Happy Bellies Pea Salad INGREDIENTS 4 cups peas (defrost if using frozen peas) 2 cups fermented carrot coins, chopped Small handful of mint, julienned Half a small red onion, sliced very thin ¼ cup avocado mayonnaise (or regular mayo) ¼ cup brine from carrot coins 1 to 2 cloves of garlic from fermented carrot coins, pressed Black pepper, to taste DIRECTIONS: Mix peas, chopped carrots, cut mint and sliced onions in large bowl Mix mayo, brine, pressed garlic and black pepper in a small bowl Combine and serve as is or with salad greens n

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LIVING

Spokane’s Michael Gurian will present at the Young Child Expo.

KRISTEN BLACK PHOTO

PARENTING

Boys vs. Girls Research is confirming Michael Gurian’s views on education BY DANIEL WALTERS

or decades, Michael Gurian — local author, counselor and consultant — has pushed a radical idea: Boys and girls are different. Not only that, but he argues that many of these differences are inherent, part of biology and neurology, not just upbringing

and the surrounding culture. A former Gonzaga and Eastern Washington University professor, Gurian has written 28 books — most of them focused on the radically different learning styles — summarizing the vast reams of neurological research on this topic. He founded the Gu-

rian Institute, an organization that trains thousands of teachers, therapists, parents and other professionals to understand and react to gender differences. And by now, he feels his larger conclusions are so clearly supported by the scientific research, that there’s not really much of a debate: Of course, innate gender differences play a massive role in how boys and girls — and men and women — learn and work, Gurian says. “I’d say 99 percent of neuroscientists who study gender and use scans say exactly what I say,” Gurian says. “Remember, it’s only a few people who are having an argument in the media, and keeping this argument alive. The scientists have moved on.” For example, the typical female brain processes words on both the left and the right side of the brain, he says, while the typical male brain only processes words on one side. And that, he says, has remained true across different cultures and different upbringings. That’s true in the United States of America, he says. And that was true, despite the wildly different culture, in Turkey, where Gurian taught at Ankara University. “They’re transcultural,” Gurian says about these differences. “Culture doesn’t matter to the ‘x’ and the ‘y’ [chromosomes].” Some biological differences are wellknown: Boys have more testosterone and girls have more estrogen. But it goes beyond that: Studies have shown that the genome itself creates differences. The Y-chromosome, for example, gives males genes that are absent in females. Brain scans also show similar differences in transgender subjects, Gurian says. A transgender man may have a female body — but the brain scan will show he has a more archetypally male mind. Boys, broadly speaking, tend to naturally excel in spatial reasoning, while girls often naturally excel in reading, writing and speaking. Gurian believes that’s one reason so many boys struggle with school — with dramatically higher rates of dropouts, discipline and failures. He believes that’s part of the reason college attendance has been skewing heavily female: The American educational system fails to adapt to the strengths and weaknesses of the male brain in particular, he says. “It’s sit still, do your worksheets, use your words. That’s why most of our school failures are male,” Gurian says. “We’ve left these millions of guys, who

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v vv

can’t get an education. Who don’t go to college. Who, when they go to college, they drop out, because college is so not for them. And they don’t have a vocational track.” The training Gurian gives teachers focuses on finding new strategies to address these gender differences. Female students can be given exercises with manipulables to improve their spatial reasoning, for example. And instead of punishing boys when they fidget, Gurian suggests giving them given standing desks to work off that nervous energy, or letting them draw before they write. At times, however, Gurian’s arguments — in particular his support for single-sex schools — have led to ginned-up opposition from those who see his ideas as old-fashioned sexism dressed up in lab coats. “The proponents of these theories use lots of language about brain structures and hormones that sounds scientific, but in the end, they are simply arguing that the old stereotypes about what boys are good at and what girls are good at are accurate,” the American Civil Liberties Union writes on a “Women’s Rights Project” pamphlet that specifically calls out Gurian. Gurian dismisses much of this genre of criticism as political instead of scientific. “These are folks who really think that you shouldn’t look at the brain, and that somehow if you look at the brain you’re all going to turn into bad people,” Gurian says, chuckling. “But most people in the field are looking in the brain. And we don’t go back. We know we can track directly the outcome of kids with the way their brains work.” Showing that research, he says, is particularly persuasive. “Once we show the brain scans, people say, ‘Holy moly, why is that not being taught in college?’” And not just in college. Gurian’s vision goes a lot further than that. He wants to see a full-scale cultural transformation using these ideas, from teachers and therapists to — well, basically everyone. “The cops get trained in it, right? The judges get trained in it. … It has to be a kind of systemic change,” Gurian says. “It saves lives. You literally save people’s education and you save their lives.” n Michael Gurian will be a keynote speaker at the Young Child Expo & Conference, on Thursday, Oct. 20, at 8:30 am at the Spokane DoubleTree, 322 N. Spokane Falls Ct. See more at youngchildexpo.com.

INTREPID There’s a fearless spirit about us INLANDERS. It’s unmistakable. Maybe it’s because we have come of age adjacent to the unforgiving wilds of the middle of nowhere. Or because our secluded little spot on the map affords us the luxury of testing the waters early and often.

Regardless of origin, that intrepid spirit is one of the many things that makes us Inlanders. And we deserve publications with that same courageous character. Because at the end of the day, the only thing we’re afraid of is the status quo.

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LIVING OCTOBER - NOVEMBER EVENTS BLOOD DONATION | Give blood at the Inland Northwest Blood Center, which requires up to 200 donors each day to ensure that the blood bank is adequately stocked. Donors can schedule an appointment online or donate during walkin hours. Spokane office: Mon, Fri-Sun from 7 am-3 pm; TueThu, 11 am-6 pm. Coeur d’Alene office: Mon, Fri, Sat, from 7 am-3 pm; Tue-Thu, 11 am-6 pm. inbcsaves.org (423-0151) BODIES HUMAN: ANATOMY IN MOTION | Mobius’ blockbuster science exhibit includes six whole bodies, more than 100 individual organs, and transparent body slices that have been preserved through plastination, a technique that replaces bodily fluids with reactive plastics. Exhibit runs through Dec. 31; open Tue-Sat, 10 am-5 pm; Sun, 11 am-5 pm. (Recommended for ages 10+.) $15 admission. Mobius Science Center, 331 N. Post. mobiusspokane.org (321-7137) CAR SEAT INSPECTIONS | On-site technicians will make sure families’ car seats are safely installed, offer safety tips and discuss passenger safety laws. Appointments available on Oct. 5, 12, 19 and 26; Nov. 2, 9, 16 and 30; Dec. 7 and 14. Free. Sacred Heart Children’s Hospital, parking garage, Seventh and Division. (844-1854)

INBODY 570 TESTS | INHS Community Wellness has a machine available that provides a complete analysis, including weight, body mass index, body fat mass, basal metabolic rate and more. Appointments available on Oct. 6 and 18 and Nov. 2, 17 and 29. $20/test. INHS Community Wellness Center, 501 N. Riverpoint Blvd., Suite 245. wellness.inhs.org PEOPLE WHO CARE | Transitions for Women’s annual benefit breakfast and luncheon event, supporting the organization’s programs to aid local women and children overcoming poverty and homelessness. Thu, Oct. 6. Breakfast from 7:308:30 am, lunch from noon-1 pm. Red Lion Hotel at the Park, 303 W. North River Dr. help4women.org (328-6702) YWCA WOMEN OF ACHIEVEMENT IMPACT LUNCHEON | Over the past 34 years, the annual luncheon has evolved into YWCA of Spokane’s largest fundraising events, and is one of the most prestigious award recognition events for women. This year’s keynote is actress and humanitarian Ashley Judd. Proceeds support YWCA of Spokane’s programs and services aiding domestic violence victims and their children. Fri, Oct. 7, at 11:30 am. $125/person. Spokane Convention Center, 334 W. Spokane Falls Blvd. ywcaspokane.org (326-1190)

CARDBOARD BOX CITY | Family Promise of North Idaho hosts its 9th annual family-friendly fundraiser and homeless awareness event. Participants can enjoy fire pits and s’mores, and continental breakfast on Saturday. Overnight event starts on Fri, Oct. 7, at 6 pm; ends Oct. 8, at 6 am. Community United Methodist Church, 1470 W. Hanley Ave., CdA. (208-777-4190) TEAM HOPE WALK | Help eradicate Huntington’s disease by participating in the 5K or 10K walk/run. All proceeds support the fight to improve the lives of people affected by Huntington’s. Sat, Oct. 8, at 10 am. $25/person. Riverfront Park, Spokane. hdsa.org/thwspokane (208-596-1368) MOBIUS ANNUAL GALA | An evening of celebration, including food, libations and a live auction. Guests can also experience the ongoing “Bodies Human” exhibit in the science center’s new location. Sat, Oct. 8, at 6:30 pm. $75/person. Mobius Science Center, 331 N. Post. mobiusspokane.org (321-7137) NW LYME PATIENT WORKSHOP | The workshop’s theme is “Unraveling the mystery of Lyme disease” and offers insight, support and resources for people living with the illness. Presenters include experts, patients and laypeople. Sat, Oct. 8, from 10 am-4 pm. $5-$15. Gonzaga University, 502 E. Boone. nwlymepatientworkshop.com (206-962-9439) CIRCLE OF HOPE | The annual benefit breakfast shares and supports the mission and programs of the Spokane Guilds’ School. Thu, Oct. 9, from 7:30-8:30 am. Davenport Grand Hotel, 333 W. Spokane Falls Blvd. guildschool.org (326-1651)

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also a contributing editor for The Atlantic and a columnist for the Washington Post. Tue, Oct. 11, at 7:30 am. $60/person. Spokane Convention Center, 334 W. Spokane Falls Blvd. whitworth.edu (777-3449)

CHARITY CORNER

BEYOND PINK | The seventh annual “Designer Bra Fashion Show” and silent auction hosted by the local nonprofit raises funds to help local women have access to thermography, a tool used to detect breast cancer used in conjunction with mammography. Sat, Oct. 14. $50/person. Spokane Convention Center, 334 W. Spokane Falls Blvd. beyondpink.net

Get Fancy for the Kids escribed by organizers as “a prom night for grown-ups,” the mission of the Pumpkin Ball fundraiser gala goes much deeper. Heading into its 13th evening this year, the event has become an annual season highlight for attendees, who get dressed up in tuxes and sparkly gowns to enjoy a festive atmosphere of food, auctions and fun, all to support local kids. Since the first Pumpkin Ball in 2004, the event has raised more than $1.8 million to support the programs and services of the Sacred Heart Children’s Hospital and the Vanessa Behan Crisis Nursery. “The Pumpkin Ball is fairly unique in that it benefits two charities,” says event director Sara Hale. “When it started, the partnership made a lot of sense because the goal of the Nursery is to keep kids safe, and the goal of the hospital is to keep them healthy.” One of Hale’s favorite highlights of the event — which is not a costume ball, despite its timing — is the annual pumpkin carving competition, which pits teams of Sacred Heart doctors against local community leaders. Hale says that each year, Pumpkin Ball beneficiaries share stories of their patients and clients; this year’s event will introduce attendees to a Spokane

BABYSITTING BASICS | Youth ages 10 to 15 can learn skills to be safe and successful babysitters in this course covering how to care for infants, CPR and first aid, personal safety, discipline issues and more. Sat, Oct. 15, at 9 am. $40. St. Luke’s Rehabilitation Institute, 711 S. Cowley. wellness.inhs.org SPOKANE TRIVIA CHAMPIONSHIP | The annual competition benefits the Spokane Public Library’s STEM programs; and is open to three-person corporate or individual teams from the community. Emceed by Mark Robbins and Kevin Benson. Wed, Oct. 19, at 7 pm. Bing Crosby Theater, 901 W. Sprague. spokanelibraryfoundation.org CATHOLIC CHARITIES VOLUNTEER INFO SESSION | Learn about the opportunities to volunteer with Catholic Charities’ many programs serving at-risk populations in the Inland Northwest. Sessions on Oct. 19, from 12:15-1 pm and Nov. 15, from 10-11 am. At Catholic Charities Family Service Center, 12 E. Fifth Ave. RSVP to 358-4270. HONORING CHOICES | A class is designed to help people through the process of advance-care planning; helping participants reflect upon, understand and have conversations about their goals, values and beliefs for future health care. Thu, Oct. 20, at 3 pm. Free. INHS Community Wellness Center, 501 N. Riverpoint Blvd., Suite 245. wellness.inhs.org BISHOP’S BRUNCH | Catholic Charities of Spokane hosts its 30th annual fundraiser breakfast to support and share the mission of the House of Charity. Sun, Oct. 23, from 10 am-1 pm. $10/person; $30/family. House of Charity, 32 W. Pacific Ave. catholiccharitiesspokane.org/events

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NATIONAL VETERANS DAY RUN | The fourth annual race offers a 11K, 5K and a 1-mile family and supporter walk/run. Sat, Nov. 12, at 7:11 am. $5-$35. Starts and finishes at Riverfront Park. veteransdayrun.com SPOKANE HUMANE SOCIETY FURR BALL | The 16th annual fundraiser gala includes a reception, dinner, live auction of decorated Christmas trees, a silent auction, parade of adoptable pets and live music and dancing. Sat, Nov. 19, at 6 pm. $125/person. Davenport Grand Hotel, 333 W. Spokane Falls Blvd. spokanehumanesociety.org JINGLE BELL RUN | This annual event is a fundraiser run for the Arthritis Foundation, with holiday-themed costumes strongly encouraged. Sat, Dec. 3, at 8 am. Riverfront Park, Northbank Shelter. kintera.org (263-0193) n

EPICUREAN DELIGHT | The annual fundraiser gala benefits the Blood Center Foundation and the Inland Northwest Blood Center. Event includes 30 local wineries and breweries, and more than 30 local restaurants showcasing and sampling their menus. Fri, Nov. 11, at 5:30 pm. $175/person. Spokane Convention Center, 334 W. Spokane Falls Blvd. bloodcenterfoundation.com/epicurean-delight

MONSTER DASH FUN RUN | The annual Halloween-themed fun run, hosted by the Spokane Swifts running club. Sun, Oct. 30, registration at 8:30 am, adult 5K at 10 am, kids race at 11 am. $5-$15. Manito Park, 1800 S. Grand Blvd. bit.ly/2czWCeY

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The Pumpkin Ball • Sat, Oct. 22, at 5:30 pm • $150/ person; $1,200-$2,000/table of eight • Spokane Convention Center • 334 W. Spokane Falls Blvd. • thepumpkinball.org • 994-4146

SUGAR RUSH SPOKANE | The third annual 5K or 10K fun run/ walk benefits Inland Northwest Baby, and participants can enjoy a cup of hot cocoa and chocolate treats at the finish line. Sat, Nov. 5, at 8:30 am. Gonzaga Law School, 721 N. Cincinnati. bit.ly/2cmcFt9

GHOST BALL | An evening benefiting Elevations Therapy Foundation, featuring food, drinks, music, dancing, a silent auction and more. Elevations provides therapy resources to children in the local community. Ages 21+. Sat, Oct. 29, 7 pm. $50/person. Riverside Place, 1108 W. Riverside. ghostball.org

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family whose triplets’ lives were saved at Sacred Heart’s neonatal intensive care unit (NICU). “It’s really moving, and inspires people to know the money they are giving that night is going to help families like that,” Hale says. Pumpkin Ball funds raised for the hospital are being directed to improvements in the NICU, while money going to the nonprofit crisis nursery will fund regular operating costs, so it can care for more children when local families face times of crisis. — CHEY SCOTT

FALL LEAF RAKING BLITZ | Members of the community are invited to come out and help rake leaves for low-income and disabled adults in the Spokane area, during this event hosted by Catholic Charities Spokane. Sat, Nov. 5, from 8 am-1 pm. Meet at St. Aloysius Church, 330 E. Boone. Register at 4596172. catholiccharitiesspokane.org

NORTH IDAHO LIFE MASQUERADE BALL | The Halloween masquerade ball and costume party benefits Children’s Village in Coeur d’Alene, and includes a champagne reception, baroque music, a plated dinner, and more. Sat, Oct. 29, at 4 pm. $150-$175/person. Greyhound Park & Event Center, 5100 Riverbend Ave., Post Falls. cdamasquerade.com

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The calendar is a free service, on a space-available basis. Mark as “InHealth Calendar” and include the time, date, address, cost and a contact phone number. Mail: 1227 W. Summit Pkwy, Spokane, WA 99201; or Email: calendar@inlander.com.

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LIVING

Scott Ingersoll (left) and Miles Martin at the Sacred Heart Children’s Hospital.

KRISTEN BLACK PHOTO

PEOPLE

Healing Songs Local musicians bring music to kids who need it most BY DAN NAILEN

s concert venues go, Rachel and Gracie’s Playhouse is a lot brighter than the typical nightclub. The walls are splashed with original watercolors; the floors are a downright garish combination of light green and ocean blue. The electrified hues fit right in with the playhouse’s surroundings inside the inpatient unit of Sacred Heart Children’s Hospital. Every wall, window and sign seems an effort to sunny up the place where kids can spend days on end dealing with serious illnesses. Today there’s an added attraction in the playroom, as Spokane musicians Scott Ingersoll and Miles Martin set up equipment for a 90-minute concert heavy on Disney tunes and pop hits. They’ll follow up by going door-to-door to rooms where the kids might be too ill or too shy to leave, but still appreciate a rousing acoustic take of “Itsy Bitsy Spider” or Pharrell Williams’ “Happy.”

In the playhouse, patients are free to come and go, along with their parents and hospital personnel, so the crowd can be upward of a dozen, or just a few. Right now, it’s just a little girl from Post Falls. “Are you a Taylor Swift girl?” Ingersoll asks. She shakes her head no. “Hmmmm… do you like Frozen?” A nodded affirmation and a smile. And with that, Ingersoll and Martin launch into what will be three different runs through “Let It Go” over the next three hours, encouraging kids to shake a maraca or tambourine. Nurses working at the station outside the room quietly sing along.

he musicians work for the Songs for Kids Foundation, a national nonprofit formed in 2007 in Atlanta by musician Josh Rifkind to bring music

into the lives of kids suffering from serious illness. Since its formation, it’s grown to include chapters in Los Angeles and Orange County, California, as well as Charlotte, North Carolina. Ingersoll launched the Spokane chapter when he moved to Washington after working for Songs for Kids in L.A. After several months getting to know his new town, he recruited some fellow musicians and got a weekly program started at Sacred Heart. Ingersoll grew up in a musical family and has spent a lot of time arranging music for churches and working with kids before he met Rifkind through a mutual friend. “We talked for a couple of hours and he explained what the foundation was, and I was just so on board with the mission of what they were trying to do,” says Ingersoll. Practically speaking, Ingersoll and his fellow musicians have to develop the ability to play and sing songs they might not be familiar with on a moment’s notice; no one wants to disappoint a child with a Katy Perry request. There’s a big Songs for Kids book full of classics — “Twinkle, Twinkle, Little Star,” “The Wheels on the Bus” — and always growing. “We try to keep up as best we can,” says Ingersoll, who performs as Scott Ryan and in local bands including Water Monster; Martin plays in Friends of Mine. “If we get a request and it’s something I can look up and get lyrics, we can pick our way through part of it. We try to stay up with as much of the Top 40 stuff as we can. That goes a long way, especially when you’re playing bedsides and trying to cheer someone up. To be able to play some of their favorite artist, if not their favorite song, you can get them to smile a little bit.”

n this day, there are a lot of smiles as Ingersoll and Martin deliver everything from “La Bamba” to “Old McDonald,” Taylor Swift to The Beatles. A “Beat It”/”Uptown Funk” mashup played at the nurse’s station had people up and down the hall leaving their rooms to join the party. “That’s a first,” Martin says. “It’s a meaningful gig,” Ingersoll says. Being able to play music and doing something that’s meaningful — that’s kind of rare.”  The Songs for Kids Spokane chapter recently lost several thousands of dollars’ worth of equipment in a theft. To help replace equipment for their hospital visits, go to GoFundMe.com’s “Songs for Kids Spokane Sound Gear” page to donate: gofundme.com/2duz5bw

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Together we’re doing great things. A new therapeutic garden at Providence Adult Day Health will help patients challenged by disease, dementia, injuries or the frailties of aging exercise their mind, body and spirit. And it’s all possible because of generous gifts to Providence Health Care Foundation. In 2015, Providence Health Care Foundation awarded $5.8 million in grants to our hospitals in Spokane and Stevens counties. We support everything from building upgrades to art supplies. Ultrasound machines to family support groups. It’s not too late to help. Visit phc.org/giving for more information and to donate to the therapy garden at Providence Adult Day Health.

Thank you. The 13th Annual Pumpkin Ball ~ A Magical Evening Benefiting:

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