Inhealth 12/4/2017 by The Inlander

Rural Health Care

| How Much Homework Is Too Much?

| Keeping the Slopes Safe

HEALTHY LIVING IN THE INLAND NORTHWEST

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Health 3

Meet a WSU Spokane Scientist Dr. Graves’ research dispels the myth that pediatric concussions are a low-cost, short-term problem. Her work in brain injuries contributes to the knowledge and discussion about youth sports and safety. Learn more at spokane.wsu.edu

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 ART DIRECTOR Ali Blackwood CALENDAR EDITOR Chey Scott COPY EDITOR Michael Mahoney CONTRIBUTORS E.J. Iannelli, Jacob Jones, Young Kwak, Robert Maurer, Carrie Scozzaro, Matt Thompson, John R. White, Samantha Wohlfeil PRODUCTION MANAGER Wayne Hunt ADVERTISING DIRECTOR Kristi Gotzian DIRECTOR OF MARKETING Kristina Elverum ADVERTISING SALES Autumn Adrian, Mary Bookey, Jeanne Inman, Susan Mendenhall, Claire Price, Carolyn Padgham-Walker, Wanda Tashoff, Emily Walden EVENTS & PROMOTIONS Emily Guidinger Hunt SALES COORDINATION Andrea Tobar, Sarah Wellenbrock DESIGN AND PRODUCTION Tom Stover, Derrick King, Jessie Hynes DISTRIBUTION MANAGER Justin Hynes BUSINESS MANAGER Dee Ann Cook CREDIT MANAGER Kristin Wagner PUBLISHER Ted S. McGregor Jr. GENERAL MANAGER Jeremy McGregor

Janessa Graves, PhD, MPH #SpokaneCougs

Pediatric Injury Specialist | Nursing Research

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. 2017. InHealth is locally owned and has been published since 2004.

SUPPLEMENT TO THE INLANDER

4 Health DECEMBER 2017 - JANUARY 2018

INSIDE

Every Woman Can

DECEMBER, 2017 - JANUARY, 2018

ON THE COVER | ALI BLACKWOOD ILLUSTRATION AND DESIGN

“Fight Like a Girl”

CHECK-IN I’ll take on this world

DEVELOPMENT

Health Connections 9

I’ll stand and be strong

SUPERFOOD 11 / ASK DR. MATT 12 / PUZZLES 13

I’ll never give up

NEWS

I will conquer with love

RURAL HEALTH CARE

Pinched for Resources 15 HOSPITAL MAP 16 / PERSONALIZED CARE 19

And I’ll fight

Like a girl.*

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FITNESS

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EveryWomanCan.org *Osmunson, Kristy and Shepard, Kelley, along with Regan, Bob. “Fight Like a Girl.” On Fight Like a Girl, Curb Records, 2009.

DECEMBER 2017 - JANUARY 2018

Health 5

FROM THE EDITOR

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

Minimize the Messes

W Providing a community when it’s needed most. Local Collaborative Innovative Dynamic

6 Health DECEMBER 2017 - JANUARY 2018

ith the holidays and a brandnew year right around the corner, it’s time to get creative. This issue of InHealth is bursting with ideas on moving beyond habits that may have served us well in the past, but could use a little freshening up. For our cover story, I had the pleasure of asking local experts for their advice on tackling some of the common causes of our discontent. If frustration over a messy house, messy family relations or an endless to-do list have troubled you, read on. Meanwhile, our health care system seems to be a perpetual and constantly changing puzzle for those of us on the care-receiving side. For those on the front lines, the challenge is more immediate. The situation in rural areas is especially tenuous, and Samantha Wohlfeil looks at how the isolated hospitals scattered over the Inland Northwest — facilities critically important not only to health care, but also to local economies — are finding innovative ways to succeed in an unpredictable medical marketplace. On a much lighter note, I know you’ll enjoy learning about all the seemingly incongruous activities — drinking and sleeping, for example — that are being combined with yoga. It’s all in service of a good workout — and the healthy pleasure of spending time with others.  To your health!

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CHECK-IN

The Gateway Bridge is expected to open in September 2018. The Catalyst project (inset) aims to bring more health care businesses to the University District. CITY OF SPOKANE AND AVISTA RENDERINGS

DEVELOPMENT

Health Connections

owntown Spokane’s University District, home of Washington State University’s medical school and the medical education partnership between the University of Washington and Gonzaga University, is starting to throw off sparks of development, both public and private. Today, you can see the footings go up for the University District Gateway Bridge, which will give cyclists and pedestrians a way to cross the railroad tracks that divide Sprague Avenue from the University District when it opens in September of 2018. Avista’s recently announced Catalyst project,

to be located on the south side of the pedestrian bridge, is starting to take shape, too. “All summer, we just cleaned up the site,” says Latisha Hill, Avista Development’s senior vice president. Once the site is ready and permits are in place, the plan is to build at least 140,000 square feet of space on about five acres located just a quick ride from campus. Some could be office, some could be high-tech lab space. Hill says Avista plans to consult closely with the local med schools to address their needs and hopefully give spin-off businesses a future home. “We just call it the business of health,” she says, “and there are lots of components to that. So we don’t want to pigeonhole it at this point.” Meanwhile, local developers are watching as

the University District Public Development Authority (spokaneudistrict.org) guides what it calls Spokane’s “burgeoning health sciences ecosystem” into the future. The new span connecting up to Sprague is expected to grow that footprint even more. It is, in the words of Spokane Mayor David Condon, “the perfect next step” for the University District. — TED S. McGREGOR, JR.

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.

DECEMBER 2017 - JANUARY 2018

Health 9

CHECK-IN PILL BOX

Gut Check I have been reading a lot lately about the gastrointestinal microbiome and its link to health. Are there medications that have damaging effects on the microbiome?

he billions of microorganisms that live in our gastrointestinal tract have been getting a great deal of attention lately in the scientific and medical community. While there’s been the suggestion from researchers that our John R. White chairs individual gastrointestinal WSU Spokane’s microbiomes (the types Department of and numbers of organisms Pharmacotherapy. that live in our gut) and alterations in the microbiome may be linked to dementia, depression, obesity, autism, diabetes and other issues, the exact nature of these potential associations is still being worked out. At this point we can say that our gastrointestinal microbiomes are very important for good health, but the particulars are still up for debate. The primary types of medication that can have damaging or altering effects on the microbiome are broad-spectrum antibiotics. It goes without saying that antibiotics should only be taken in certain situations where they are absolutely indicated. Maintenance of a healthy microbiome is simply another factor that we should add to our list of reasons for not overusing antibiotics. In cases where they are needed, changes to the microbiome that result will likely resolve in the weeks to months after antibiotic exposure. Other medications, such as ones that alter the acidity of the gastrointestinal tract, may also alter the microbiome. — JOHN R. WHITE

FITNESS

Join in the Movement

ew Year’s resolutions beware: the annual Spokane Health and Fitness Expo is back, just days after January 1, to offer plenty of activities that’ll entice anyone out there to actually stick to a new fitness regimen. It’s also an event for which the athleisure wear trend is totally acceptable and encouraged, since there are plenty of reasons to get sweaty during fitness classes and other demos to test out new-to-you forms of exercise, including a climbing wall, barre, yoga and even martial arts. Entry to the two-day event includes access to all of these demos and a packed schedule of classes (check for the complete schedule online) offered throughout the weekend, along with seminars and an exhibitor fair. Among many other reasons to brave the cold and head to the Expo are a pickleball tourney, rollerderby triple-header (featuring Spokane-area teams vs. regional rivals), a Brazilian Jiu Jitsu tournament and an all-female CrossFit competition. If attending this annual new year event doesn’t inspire you to get your butt off the couch and move around a little, we’re not sure what would. — CHEY SCOTT Spokane Health & Fitness Expo • Sat, Jan. 6 from 10 am-6 pm; Sun, Jan. 7 from 10 am-4 pm • $8/adults, $5/ages 6-12 (cash only, good all weekend) • Spokane County Fair & Expo Center • 404 N. Havana • spokanehealthfitexpo.com

Physiatry: • Jamie Lewis, BC PM&R, Pain Medicine • Howard Grattan, BC PM&R, Pain Medicine Anesthesiology: • Ghassan Nemri, BC Anesthesiology, Pain Medicine Psychology: • Patricia Fernandez, PsyD • Megan Russell, PsyD

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Physical Therapy: • David Springer, PT Services: • Rehabilitation • Interventional Pain Management • Psychological Pain Management South Location: 2607 S. Southeast Blvd, BLDG A, Ste. 100

Nurse Practitioners: • Xiang “Shawn” Jing, ARNP, MSN • Susan Steadman, ARNP, MSN • Megan Wildes, DNP, FNP-BC Physician Assistant: • Johanna Golke, PA Research Center: Engaged in research aimed to increase the scope of treatment options readily available to those suffering from chronic pain. Two Certified AAAASF Procedure Centers • Pharmacological Pain Management • EMG/NCS Testing • Both traditional and emerging treatment options North Location: 5901 N. Lidgerwood St., Ste. 218

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SUPERFOOD

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Winning With Walnuts ATTRIBUTES: Walnuts’ healthy combination of fat, protein and fiber in a small package makes them a satisfying snack, and a good replacement for sugary or salty treats. One ounce of walnuts provides almost half your daily recommended allowance of manganese, 4 grams of protein, 2 grams of fiber and 2.5 grams of omega-3 alpha-linolenic acid (ALA). SUPERPOWERS: Research indicates that consuming tree nuts, including walnuts, may help reduce the risk of heart disease and some types of cancer, and may also help stave off type 2 diabetes and keep the brain healthy. Despite the fact that nuts are “energy dense,” the National Health and Nutrition Examination Survey showed that those who ate at least a quarter-ounce of tree nuts per day had a lower weight, body mass index and waist circumference that those who didn’t eat nuts.

WEAKNESSES: Walnuts contain a high percentage of fat, and they can turn rancid if they’re stored in humid, warm conditions. Store in the shell for several months or store shelled nuts in the refrigerator for up to six months. HOW TO USE IT: Legendary Moosewood Cookbook author Mollie Katzen’s Favorite Walnut Recipes — all 70 of them— are available in a free downloadable cookbook online at walnuts.org under the “How To” tab. Here’s her Walnut Pesto: Blend 3 packed cups fresh basil and three large cloves of garlic in food processor. Add ⅓ cup lightly toasted walnuts and blend until finely ground. Keep machine running and drizzle in ⅓ cup extra virgin olive oil. When mixture is smooth, transfer to a bowl, stir in ⅓ cup grated Parmesan and season to taste with salt and pepper. — ANNE McGREGOR

LIFE COACHING

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Offering Hope

A Simple Path to Fitness

n the one hand, fitness is quite simple: eat nutritious food and exercise regularly, On the other hand, taking care of our health takes more time and energy than many of us have to spare. As Mark Twain wrote, “The only way to keep your health, is to eat what you don’t want, drink what you don’t like, and do what you’d rather not.” But there is good news: A growing body of research reveals some surprising insights. Small — very small — amounts of exercise have powerful effects on the body. A study of more than 400,000 adults found that exercising for 15 minutes a day led to three more years of life. Losing one pound a year for four years, and keeping the four pounds off, reduced the risk of high blood pressure by 25 Robert Maurer is a percent. The Mayo Clinic found that lean, fit people moved more during the day: Spokane psychologist, pacing, parking farther away from the store, standing rather than sitting. As a consultant and author result, they burned about 350 calories more each day. Standing from a sitting of “One Small Step Can position doubles our metabolic rate; a short walk doubles the burn rate again. Change Your Life.” So in our 70mm Dolby, supersized, extreme makeover culture, it’s hard to believe that small amounts of movement can lead to big results. Of course, more is better, but small efforts throughout the day build habits and help us to rediscover the pleasure of moving our bodies. Remember our favorite part of school growing up? Recess! We can rediscover that joy, a few minutes at a time. — ROBERT MAURER

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Health 11

CHECK-IN ASK DR. MATT

Safe and Secure

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

’m sure most of you reading this have either been in the McCarthey Athletic Center or have at least watched a Gonzaga game on TV. Imagine standing at midcourt, looking all around the arena: Now imagine that all the faces you see are young, with about twice as many males as females. As you look around 360 degrees, there is no dancing, no clapping, no cheering, no music. This is not a celebration of sport. There is no joy. This is a funeral. Imagine the arena is filled with those, ages 15-24, who died in 2014 from a firearm injury; tomorrow, you could fill it with 6,000 more adolescents and young adults, those who died

Suicide is the second-leading cause of death in young adults between ages 15 and 24. Firearms are the leading cause of death in these suicides. from guns in 2015, then 2016, then this year. This is not about the Second Amendment, bump stocks, high-capacity magazines, waiting periods to buy firearms, gun shows or online purchases of gun parts. This is about risk reduction, about safe storage of firearms and ammunition, for a very practical reason: Secure storage saves lives. As part of the standard questionnaire we give parents visiting my office, we ask if there are firearms in the home; if so, are they unloaded and securely stored? I’m always surprised at the range, and lack of, responses. This question is very important, because the reality is (according to 2014 data from the Centers for Disease Control and Prevention) firearms are annually involved in the deaths of more than 6,000 children and young adults between the ages of 15

and 24 in the U.S. In this group, around 200 deaths a year are due to the accidental discharge of a firearm, about 3,500 are homicides, and the remaining 2,300 are due to suicide. Although all causes of death are important, I want to focus on to focus on suicides that occur between ages 15 and 24. In the U.S. in 2014, more than 5,000 15-to-24-year-olds took their own lives. That amounts to an average of 14 kids a day, and six of those 14 used a gun to kill themselves. Sadly, the number of suicides in this age group has risen steadily over the past 20 years. Suicidality is most often a time-limited crisis, with the great majority of individuals surviving the crisis. But when suicide attempts are made, they are often made impulsively; lethality becomes very relevant. Suicide attempts using a firearm are approximately 90 percent successful. Fatality from poisoning? Approximately 2 percent. For those who survive a suicide attempt, nine out of 10 never go on to commit suicide. Of a population of individuals who survived a nearlethal attempted suicide, the time between the decision to attempt suicide, and the attempt itself, was less than five minutes for 24 percent, less than an hour for 71 percent. There is robust data that the risk of dying from suicide is much higher if there is a firearm in a household, and up to 30 times more likely for kids with no history of mental health problems if a gun is stored unlocked and loaded. One study suggested that keeping firearms locked away and unloaded can reduce the likelihood of suicide by a gun by more than 70 percent. When a household has a child or young adult 10 and older, firearms and ammunition should be completely removed from that house; it should just be another measure of childproofing a house. If one chooses to possess firearms in the home during this period of elevated risk of suicide using a firearm, store them securely, with ammunition stored separately. There are numerous methods to do this: individual gun locks, gun boxes and safes that have key, code or biometric locks. Under the mattress? In the back of the closet? On top of a shelf in the garage? Not safe. To reiterate, I am not taking issue with the Second Amendment; I want to just educate regarding risk, as it exists. Suicide is the second-leading cause of death in young adults between ages 15 and 24. Firearms are the leading cause of death in these suicides. n

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12 Health DECEMBER 2017 - JANUARY 2018

BRAIN EXERCISE

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

Sudoku

RATINGS: Tough (left), Killer (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.

Answers to all puzzles on page 40

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

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 17. 16

6 8

1 9

3 16

11 24

4 24

9 11

4 21

D D

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 4

9 5

5 8

2 5 1

7 6

21 2

1 to 25

8 10 11

13 17 16 13 12 11 12

To solve 1 to 25, move the 15 18 15 14 9 10 numbers from the outer 20 19 20 21 8 7 ring onto the board in the 24 2 1 22 6 24 directions of the arrows. The 23 3 4 5 23 25 number must appear on the line — up, down or diagonal 9 17 16 14 6 7 — that the arrow indicates. As you place them, they must snake together vertically, horizontally or diagonally so they link in sequence from 1 to 25. We started you out with a number to work from. A solved puzzle will look like the one above. There is only one solution.

19 21 24 4

18 19 22 3 25

9 16

13 3

2 22 20 12 7 14 10

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Health 13

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NEWS

Lincoln Hospital CFO Tim O’Connell says closing the Davenport hospital’s long-term care services in 2012 has had a “big impact.” YOUNG KWAK PHOTOS RURAL HEALTH CARE

Pinched for Resources Rural hospitals in Washington state are shaking things up as they face an increasingly difficult financial environment BY SAMANTHA WOHLFEIL

ith the sun shining, fresh snow on the mountain, and skis cutting through the fresh powder, the morning couldn’t be better. But then: an ache, shortness of breath, and lightheadedness. Is this a heart attack? From this elevation, where is the closest hospital? For skiers at the Bluewood ski hill, it’s Dayton General, about an hour east of the Tri-Cities, where a cardiac center can help heart patients and stabilize them if they need to be transferred. But like many rural hospitals, Dayton’s,

which is run by the Columbia County Health System, has struggled to remain financially viable. “When people have accidents, they have this expectation with the 911 system there’s a hospital nearby,” says Shane McGuire, CEO of Columbia County Health System. “I’m fearful that we’re close to that not being a reality.” The threat of closure is a big deal when the next closest hospital can be more than an hour away. With medical emergencies like a stroke or heart attack, every minute it takes to get to care counts when it comes to

saving heart and brain tissue. With the Affordable Care Act, much of the national health care conversation in recent years has centered on access to insurance. But even as more people are getting coverage to help pay for care, the providers they need nearby aren’t a sure thing. Over the past decade, more than 80 rural hospitals around the country have had to close their doors because they couldn’t make things pencil out. Many others are at risk. The good news: Washington state is working to prevent the loss of rural access ...continued on next page

DECEMBER 2017 - JANUARY 2018

Health 15

NEWS

WASHINGTON HOSPITALS WSHA Member Hospitals

www.wsha.org

WHATCOM

BELLINGHAM PeaceHealth St. Joseph Medical Center

SAN JUAN

SKAGIT

FRIDAY HARBOR PeaceHealth Peace Island Medical Center

ANACORTES Island Hospital

CLALLAM

PORT ANGELES Olympic Medical Center

SEDRO-WOOLLEY PeaceHealth United General Medical Center MT. VERNON Skagit Valley Hospital

ISLAND

COUPEVILLE WhidbeyHealth

OMAK Mid-Valley Hospital

EVERETT S N O H O M I S H Providence Regional Medical Center Everett

REPUBLIC Ferry County Memorial Hospital

STEVENS FERRY

PEND

OREILLE COLVILLE Providence Mount Carmel Hospital

CHEWELAH Providence St. Joseph’s Hospital

ARLINGTON Cascade Valley Hospital & Clinics

BREWSTER Three Rivers Hospital

MARYSVILLE Smokey Point Behavioral Health

PORT TOWNSEND Jefferson Healthcare

TONASKET North Valley Hospital

OKANOGAN

NEWPORT Newport Hospital & Health Services

CHELAN

SPOKANE FORKS GRAND COULEE CHELAN Forks Community Hospital Coulee Medical Center Lake Chelan Community BURIEN MONROE EDMONDS SPOKANE VALLEY SEATTLE Hospital & Clinics Highline EvergreenHealth Monroe Swedish Edmonds MultiCare Valley Hospital Kindred Hospital Seattle – Medical Center JEFFERSON DAVENPORT KIRKLAND Northgate & First Hill Lincoln Hospital Regional DOUGLAS u Fairfax Behavioral Health Hospital for Navos SPOKANE & MEDICAL LAKE EvergreenHealth LEAVENWORTH uSEATTLE See list Respiratory & Seattle Cancer Care Alliance BELLEVUE Cascade Medical Center See list Complex Care K I T S A P Seattle Children’s K I N G Overlake Medical Center MultiCare Deaconess Hospital ISSAQUAH — Swedish/Issaquah Swedish Ballard BREMERTON BURIEN WENATCHEE RENTON — UW Medicine/Valley Medical Center ODESSA Eastern State Hospital Harrison Medical Center Swedish Cherry Hill See list Confluence Health/Wenatchee Odessa Memorial Healthcare Center Providence Holy Family Hospital TUKWILA — Cascade Behavioral Health Naval Hospital Valley Hospital EPHRATA Swedish First Hill Providence Sacred Heart FEDERAL WAY Columbia Basin Hospital SNOQUALMIE UW Medicine/Harborview LINCOLN St. Francis Hospital GIG HARBOR Medical Center & Children’s MASON Snoqualmie Valley Hospital District GRAYS Medical Center St. Anthony Hospital Confluence Health/ AUBURN Hospital QUINCY UW Medicine/Northwest u HARBOR Central Washington MultiCare Auburn Medical Center Shriners Hospitals for Children — SHELTON Quincy Valley Medical Center TACOMA & Hospital & Medical Center Hospital Mason General Hospital Spokane ENUMCLAW LAKEWOOD RITZVILLE UW Medicine/University of & Family of Clinics St. Elizabeth Hospital St. Luke’s Rehabilitation Institute G R A N T See list East Adams Rural Hospital Washington Medical Center K I T T I T A S PUYALLUP ELMA MOSES LAKE VA Puget Sound Health Care OLYMPIA MultiCare Good Samaritan Hospital Summit Pacific Samaritan Healthcare Providence St. Peter Hospital System COLFAX Medical Center ELLENSBURG ADAMS Capital Medical Center Virginia Mason Medical Center Whitman Hospital & Medical Center Kittitas Valley Healthcare ABERDEEN OTHELLO Grays Harbor Community Hospital PIERCE WHITMAN Othello Community Hospital THURSTON PULLMAN YAKIMA Pullman Regional Hospital CENTRALIA Providence Centralia Hospital LEWIS

SOUTH BEND Willapa Harbor Hospital ILWACO Ocean Beach Hospital & Medical Clinics

MORTON Morton General Hospital

PACIFIC

YAKIMA Virginia Mason Memorial Hospital Astria Regional Medical Center TOPPENISH Astria Toppenish Hospital

WAHKIAKUM

LONGVIEW PeaceHealth St. John Medical Center

TACOMA & LAKEWOOD Madigan Army Medical Center MultiCare Allenmore Hospital MultiCare Mary Bridge Children’s Hospital MultiCare Tacoma General Hospital St. Clare Hospital, Lakewood St. Joseph Medical Center Western State Hospital, Lakewood

COWLITZ

SUNNYSIDE Astria Sunnyside Hospital

SKAMANIA KLICKITAT

CLARK

VANCOUVER Legacy Salmon Creek Medical Center PeaceHealth Southwest Medical Center

WHITE SALMON Skyline Hospital

FRANKLIN

POMEROY Garﬁeld County Public Hospital District GARFIELD RICHLAND Kadlec Regional Medical Center DAYTON Lourdes Counseling Center PASCO Columbia County CLARKSTON Lourdes Medical Center Health System Tri-State Memorial Hospital

BENTON

KENNEWICK Trios Health PROSSER PMH Medical Center

WALLA WALLA

COLUMBIA

WALLA WALLA Providence St. Mary Medical Center

ASOTIN

GOLDENDALE Klickitat Valley Health Private Not-for-Profit For-Profit Public Hospital District Federal/State

999 Third Avenue, Suite 1400 | Seattle, WA 98104 | (206) 281-7211 Date last revised: 10/2017

“PINCHED FOR RESOURCES,” CONTINUED... to doctors and health care providers. While the hospital association and state are working with some of the most vulnerable facilities to try a new payment method that could provide more stability, many of the hospitals are also changing the way they operate to remain as viable as possible.

NUMBERS GAME

While the Medicaid expansion allowed more people to be eligible for coverage, those in rural areas tend to be older and sicker, and more likely on Medicare, so the financial change wasn’t that significant for hospitals like the one in Dayton. Patients in rural areas are also less likely to have

In Washington, rural health is especially of concern east of the Cascades: While 16 percent of state residents lived in rural areas as of 2010, Eastern Washington counties were often 60, 70, 80 and even 100 percent rural, according to the state Department of Health. commercial insurance through an employer, and at the root of the financial struggle is the fact that often there just aren’t that many patients on a daily basis. “The fact is, hospitals need volume. We are volume-driven businesses,” says Mo Sheldon, CEO of Odessa Memorial Healthcare Center. “That’s the reality in today’s environment, and small communities often don’t have the volume to generate enough business to make a hospital viable without tax support.”

“When we worry about rural hospitals, it’s not just the emergency care, it’s the whole spectrum.” — MARY KAY CLUNIES-ROSS

16 Health DECEMBER 2017 - JANUARY 2018

The smallest rural hospitals may only have a single patient staying overnight every other night, but importantly, they may provide clinic services to 100 people a day, as they care for most of the people who live in the area, says Mary Kay Clunies-Ross, a spokeswoman for the Washington State Hospital Association. “When they falter, it puts at risk not just the hospital, which is important when you’re in dire straits, but also all the preventive care and maintenance care the community relies on,” she says. “So when we worry about rural hospitals, it’s not just the emergency care, it’s the whole spectrum.” Hospitals like the ones in Odessa and Dayton are known as Critical Access Hospitals. They provide 25 or fewer inpatient beds, and are at least 35 miles from the nearest hospital. Some are managed and partly funded by taxpayers through a public health district, but while their residents’ support helps, elements of these smaller health care systems aren’t sustainable as they run now. That’s led to some difficult decisions. For example, in Davenport, Lincoln Hospital administrators had to make the decision to shutter their long-term care

services at the hospital in 2012. “That is a service that is incredibly needed, but very hard to offer. There’s a lot of cost,” says Tim O’Connell, Lincoln Hospital’s chief financial officer. “It was a big impact to our community.” Now, people from the community of about 1,800 have to move farther away from their families if they need round-theclock care as they age. Where possible, Lincoln Hospital is continuing to help those neighbors, O’Connell says, providing relief services as needed to families who have a loved one receiving hospice care at home, and connecting them with other services as they can.

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FINDING A NICHE

Some rural hospitals are figuring out ways to innovate around those financial landmines where they can. Lincoln can’t keep specialists on staff, but the facility is home to a robot that can move around the facility, enabling specialists in other parts of the state to videoconference in with doctors and patients and provide them with specialized diagnoses without the need to leave Davenport. Meanwhile, farther south in Dayton, after the daily average number of patients dipped too low, that facility started accepting people who might have been denied admission in the past — those who need continued care and specialized nursing or physical therapy. “I think that part of the challenge of rural health care is: Can you find a niche, outside of the standard competitive nature of larger health systems, who are constantly one-upping with diagnostic equipment, or cardiac surgeons?” says McGuire, the Columbia County Health System CEO. For Dayton, the niche has been taking on more bariatric (obese) patients, or intravenous drug users with infections that might require long-term care as they transition out of larger hospitals, from the puzzle on page 13 McGuire says. 8 = B; 9 = E; 21 = K Some hospitals review requests for those patients and deny their stay, because they may be harder to work with than the nice 78-yearold lady who just had a hip replaced, McGuire says. “Before we started down this road, we used to be like everybody else. We’d get these calls and say, ‘Oh my gosh, this ...continued on next page

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Health 17

NEWS “PINCHED FOR RESOURCES,” CONTINUED... could be a really difficult patient, maybe we shouldn’t take them,’” he says. “But in 2015 our average daily patients was 2.4 patients. You can’t sustain a service on 2.4 patients. We have 13 to 14 rooms in our acute wing, and you’re paying to heat it and light it and staff it. That’s when we started saying yes.” Now, they’ve had patients from as far away as Aberdeen, on the Olympic Peninsula. Not only are they helping the patients, but the nurses are keeping up on skills and are happier because they have patients to care for, he says. “We’ve been taking these more challenging patients and wrapping services around them to see if we can meaningfully bring them back to health,” McGuire says. “I think we’ve been surprised at the outcomes.”

THE STABILITY FIX

At the state level, Washington lawmakers agreed to see if they could change the future for rural hospitals by creating the Washington Rural Health Access Preservation project (known as WRHAP;

pronounced “wrap”), which will test if a different way of making Medicaid payments can help stop the hemorrhaging of small hospitals’ budgets. Not all hospitals will participate — Davenport is not part of the pilot program — but a core group of 14 struggling facilities are in the initial project. “We don’t want to be talking about how Dayton and Odessa lost their hospital, and how do we respond to that,” says Jacqueline Barton True, director of rural health programs for the Washington State Hospital Association, which is partnering with the state Department of Health and Healthier Washington, a program of the Washington State Health Care Authority, to run the rural pilot program. It turns out that part of what’s putting hospitals like Dayton’s at risk has less to do with the expensive emergency department than once thought. State officials and politicians often point to empty inpatient beds that see only a small number of patients as the factor causing rural hospitals around the country to have money troubles, says Harold Miller, an expert on health care reform

who is helping lead the rural pilot program. Miller is president and CEO of the Center for Healthcare Quality and Payment Reform, a national policy center that puts out informational reports meant to help everyone from the government to hospital associations. And while it’s true that there are set costs to run an emergency department, and fewer patients means less income to cover those costs, the real issue for many rural health districts is actually the loss at their primary care clinics. “For most, it was their clinics that were losing the money,” Miller says. “Medicaid was one of the biggest underpayers for that.” With Medicaid, rural clinics are eventually paid for every patient they see, but it’s through a complicated, multi-step process that can take more than a year to fully reimburse them for the cost of care. To fix that, the pilot program will allow the state to pay for services under a different logic than currently used. Rather than pay the hospitals a big bill every time a Medicaid patient comes to the ER, the program will test paying the

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PERSONALIZED CARE

ersonalized care is somewhat of a health care buzzword lately, says Carey Guhlke-Falk, a spokeswoman for Lincoln Hospital. But in rural communities like Davenport, the nurses, doctors, and health care professionals on staff often know their patients very well. “This really is personalized care,” Guhlke-Falk says. “These are our neighbors.” Steve Beckstrom, a nurse anesthetist at Lincoln Hospital, says he knows about 90 percent of the people he sees come through the hospital. “You know they’re going to go feed cows, or birth a calf in a Steve Beckstrom says, “It’s a face. week,” Beckstrom says. “It’s a face. It’s a person.” It’s a person.” YOUNG KWAK PHOTO — SAMANTHA WOHLFEIL hospitals a set monthly amount for every Medicaid patient in that hospital’s district. If and when someone comes in to use the facility, a much smaller rate than what insurers pay currently would be charged. A similar model may be applied to primary care clinics, where patients would enroll and pay a regular fee, then not pay when they come in, unless they get some

specialized services. Focusing on changing payments across the board becomes important, Miller says, because if making primary care better — and hopefully keeping people healthier — hurts the number of emergency room or hospital visits, it can create a shortfall there. “What we kind of discovered through all this was this incredible interconnection

between all the services, and it’s a domino effect,” Miller says. “You can’t just fix one thing. Everything has a cascading effect on other things.” While making regular payments whether you use the hospital or not may seem illogical at first, Miller says, it’s easy to make a comparison to other services. “The benefit is having [the hospital] there, but we pay on a per-visit basis,” he says of the way things work now. “It’d be equivalent to paying your fire department based on the number of fires they have.” Hospitals are a service that people want around when needed, so paying for them regularly, even if you aren’t using them at that moment, makes sense for the community, and will help the hospitals more reliably plan their budgets, he says. Eventually, the fixes could be scaled to larger hospitals. “These hospitals need this help maybe more severely than others do, but the kinds of things we’re talking about putting in place here are not some special fixes, only for desperate rural hospitals,” Miller says. “They actually would apply a lot to other hospitals.” n

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Health 19

FOCUS: FITNESS

yoga plus Modern add-ons lure newbies to the ancient practice of yoga BY CARRIE SCOZZARO

aybe you’re curious about yoga, but a little intimidated by the quiet atmosphere and 360-degree exposure of your body as you attempt to do unfamiliar poses. Maybe a whimsical pairing of yoga with something more familiar would offer an appealing and approachable introduction to the practice. Enter mimoga — yoga with mimosas. Or how about boga, aka beer yoga? Maybe yoga with an animal partner sounds intriguing. All of those options, and more, are available right here in the Inland Northwest.

20 Health DECEMBER 2017 - JANUARY 2018

Despite the slight silliness, these types of classes often provide a fairly vigorous workout, and can help introduce newbies to the world of benefits that yoga offers. Several new students at South Perry Yoga, notes co-founder and instructor Shawn Brow, first tried beer yoga elsewhere, then signed on at South Perry for more in-depth pursuit of traditional yoga. One popular combination is yoga with a beverage. Badass Backyard Brewing offers boga on Sundays from 12:30 to 1:30 pm at their Spokane Valley location. (A Coeur d’Alene location is in the

works.) “Some of our customers report a relaxed atmosphere where they feel more comfortable, as opposed to a traditional yoga class,” says owner and brewer Charlene Honcik, “and most importantly, the majority like the experience of something familiar done in a new and exciting way.” Badass teams up with Mellow Monkey Yoga Studio’s Sara Murphy for the class. Murphy says she has fun with the poses, encouraging students to bend their arm and bring their drink closer to their mouth. In Sandpoint, MickDuff’s Beer Hall

Instructor Sara Murphy (center) leads a Boga class at Badass Backyard Brewing for Eve LaRue (lower left) and Shelley Lane (above), sipping a blend of Not Your Average Blonde and Darling Diva Razz Wheat beer. YOUNG KWAK PHOTOS offers Saturday beer and yoga, where a beer (or root beer) is the reward for an hour of Vinyasa flow. Yoga also pairs nicely with wine and champagne. Townshend Cellars has done several mimoga events at their Green Bluff tasting room, featuring fresh orange juice and their non-vintage Brut. Nectar has teamed up with Seattle-based yogi Taylor Apfelbaum, originally from Spokane, to offer Sips and Serenity, in which she balances meditative yin yoga and the more active Vinyasa flow style.

or a party-like atmosphere, check out the Union Studios, initially billed in Spokane as a hip-hop yoga and spinning studio when young entrepreneurs Nick Murto and Tyler Lafferty launched the first of two locations in 2014. The music is pumping and the black lights are on for an out-of-this-world yoga workout combining cardio and faster-paced Vinyasa flow. “You definitely work up a sweat because it’s warmer in [the studio] and you’re moving a little bit quicker,” says

the Union’s Elissa Wert, noting they’ve recently added a slower, more traditionalstyle class for beginners. If you’re interested in a restful experience, consider Yoga Nidra, which is a kind of semi-wakefulness or lucid sleep state achieved by focusing on breath, the body, emotion, energy and other aspects of self. During Yoga Nidra, participants lie face-up on the floor, guided by the yogi into deeper and deeper levels of relaxation through voice prompts, chanting, and even sound, ...continued on page 24 DECEMBER 2017 - JANUARY 2018

Health 21

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Health 23

FOCUS: FITNESS tional classes, all of which sold out quickly.) “What I really noticed, and the research lent to this experience,” says Sampson, “is that the yoga part is important, but it’s about the animal connection.” The diminutive Nigerian goats naturally jump on things, so as people are lying either on their back or stomach, the playful, lightweight goats are likely to jump onto them. They also get habituA baby goat perches on an attendee’s back at FatGirl Yoga. HAPPY HEART HOMESTEAD PHOTO ated to people and can be picked up, as well as given a “YOGA PLUS,” CONTINUED... good scratch behind the ears. such as ambient music, as well as gongs, Sampson is looking forward to bringing rattles, chimes and singing bowls. goats into the studio again, most likely in Usually made of brass or bronze, Himaearly spring, when the next generation of layan or Tibetan Singing Bowls are actually kids are born and old enough to travel. upside-down bells played by striking or t’s never too early to introduce actual stroking the rim of the bowl with a special human kids to the idea of yoga. There mallet, resulting in different harmonics and are a number of programs all around specific vibrations that resonate through the Spokane, including Beyoutiful Hot Yoga’s body. Homegrown Kids program, which offers “It’s like having the best night’s sleep classes for toddlers on up to eighth grade you’ve ever had,” says practitioner Lisa (13- and 14-year olds). Koep. “You wake up feeling relaxed and “We have offered adult hot yoga classes refreshed… with a sense of pure joy with [in a heated room] for almost five years and around you.” now, and many of our clients have asked South Perry Yoga, YogaJoy North about kids’ classes and/or classes they can and Harmony Yoga all offer Yoga Nidra attend with their kids,” says studio owner sessions. Check out Dream Time Sound Mimi Vimont, who also teaches many of Healing Meditations, which holds sessions the classes. “Other clients voiced that they at Spokane Yoga Shala, as well as Dharma were unable to participate in our classes Sound Yoga for sessions combining yoga, due to lack of childcare. Instead of offering sound healing and meditation. traditional childcare, we wanted to offer If you’re looking for an experience that something more to our youth. Yoga!” is relaxing and fun without the alcohol, The classes are modified according to consider yoga with animals. At FatGirl age grouping: 18 months to 3 years, 3 to Yoga, owner Stacey Sampson worked with 5 years, kindergarten-age to fourth grade, Happy Heart Homestead in Deer Park, and fifth to eighth grade, as well as family introducing baby goats to her regular yoga classes. Kids’ and parents’ classes line up so classes last spring. adults can drop off potty-trained kids 3 and “People who came to the classes were older to take their own class. just enamored of them,” says Sampson, Through yoga-themed games, dancwho researched animal-assisted therapy ing and singing, kids not only learn body prior to offering the class this past summer. awareness, but Vimont says the practice (It was so popular she offered four addi-

24 Health DECEMBER 2017 - JANUARY 2018

helps them develop skills to manage stress, build concentration and “increase confidence and positive self-image [and] feel part of a healthy, noncompetitive group.” Yoga enthusiasts seem quick to embrace new opportunities and within a week of the grand opening of the Ice Ribbon at Riverfront Park, Yoga on Ice classes will debut. A complimentary ice yoga session will be offered every Tuesday from 5:30 to 6:30. Participants need to dress warmly, bring their own mats and arrive in time to fill out waiver forms before class starts. Enjoy a hot beverage and specials from event sponsor Athleta after each class. (No class on December 26.) n

CLASSES TO TRY BADASS BACKYARD BREWING 1415 N. Argonne, Spokane Valley badassbackyardbeer.com MICKDUFF’S BEER HALL 312 N. First, Sandpoint mickduffs.com TOWNSHEND CELLARS 8022 E. Greenbluff Rd., Colbert townshendcellar.com THE UNION STUDIOS 121 W. Pacific, Spokane 7704 N. Division, Spokane thisistheunion.com SOUTH PERRY YOGA 915 S. Perry, Spokane southperryyoga.com YOGA JOY NORTH 12501 N. Division, Spokane yogajoynorth.com HARMONY YOGA 1717 W. 6th, Spokane harmonyoga.com SPOKANE YOGA SHALA 731 S. Garfield, Spokane spokaneyogashala.com FATGIRL YOGA 1512 N. Monroe, Spokane fatgirlyogaspokane.com

benefits package The practice of yoga offers far more than increased strength and flexibility BY CARRIE SCOZZARO

ichard Semler describes himself as an active guy — he enjoys fly fishing, golfing and photography — but four years ago, he had to do something about his recurring back injury. Back surgery was an option, but he opted for yoga. “It helped me do a better job protecting myself, bending properly,” says Semler, who says he was following the advice of his daughter… and his doctor. Research shows that the practice of yoga offers significant health benefits for cardiovascular disease, cancer, diabetes and respiratory disease — afflictions that are now the leading causes of death worldwide. The authors of a 2017 study on medical yoga therapy noted “Some healthcare providers are responding to these positive findings — as well as the growing patient demand for an alternative approach to wellness that is natural, low-tech, relatively inexpensive and generally very safe — by incorporating medical yoga into their practices.” Specifically, they report that yoga is beneficial in “helping to regulate blood glucose levels and keeping the cardiovascular system healthy. It also has been shown to have important psychological benefits, as the practice of yoga can help to increase alertness and positive feelings, and decrease negative feelings of aggressiveness.” A 2011 study found that yoga can be effective in reducing symptoms of depression and anxiety, and may be a helpful complement in treatment of other psychiatric disorders. Those benefits have resulted in a boom in the training of yoga therapists. From just five training programs affiliated with the International Association of Yoga Therapists in 2003, there are now 130, with most graduates working in

health care settings. Shawn Brow is one of those graduates; her dual background in nursing and yoga is extensive. “For the Western world to embrace [yoga] more, there has to be research,” says Brow, who’s also a Certified Registered Nurse Anesthetist with nearly 30 years in health care. In 2006, Brow and physical therapist Sandra Nolting founded South Perry Yoga, and in 2009, they partnered with Washington State University and the University of Washington medical schools, offering first- and second-year students a nonclinical site at which to explore yoga’s benefits for both their future patients and themselves. (South Perry Yoga has only worked with WSU’s Elson S. Floyd College of Medicine since the 2016 medical-school partnership split.) Providing a vehicle for stress relief to medical students is essential, says Brow, who notes that local doctors also continue to refer patients to the studio, which offers private consultation to people with specific health needs. After consulting with Nolting, Richard Semler and his wife Ginny — she was overweight, with a longstanding knee problem — took the beginner class at South Perry Yoga for about a year. In addition to learning basic poses, or asanas, they learned about yoga history and philosophy and the importance of breath and breathing. The yoga training became a catalyst for the Semlers, both in their 70s, who went on to revamp their exercise regimen and diet, walking more and eating better. While it’s possible to continue some of the work they’ve started at home, they’re committed to the weekly yoga sessions, says Semler. “It’s like a whole package,” he says, with yoga as the cornerstone. “We also enjoy the fellowship.” n DECEMBER 2017 - JANUARY 2018

Health 25

LIVING

STOP HIDING FROM STRESS STORY BY ANNE McGREGOR | ILLUSTRATIONS BY ALI BLACKWOOD

he holidays and new year can bring up all kinds of stress — from trying to meet heightened expectations, to worries over money, regret over missed opportunities, or even a general discomfort over “who and where we are and where and who we want to be in the next year.” says Gonzaga University leadership program faculty member and life coach Christina Geithner. “The stress response is a natural response of living things when the challenge at hand exceeds our resources and capacities,” says Geithner, who notes that stress can take a lot of forms. Still, despite the broad array of responses — from physical symptoms like sweaty palms, a pounding heart, or churning stomach to emotional responses like fear, anger or even excitement and astonishment — many of us are so accustomed to being under siege that we don’t even realize the toll it is taking on our bodies. “What works to reduce stress is to notice when you are stressed, acknowledging your experience and practicing pausing and choosing a more useful response in the moment,” says Geithner. Read on for practical ways to tackle some of our most common stressinducing situations.

26 Health DECEMBER 2017 - JANUARY 2018

I’M GRUMPY! Here’s the deal. We’re inherently a negative bunch. That’s because the brain is wired to react to danger, in the process devoting more attention to avoiding threats (i.e., negative things) than it does to basking in warm and fuzzy feelings. It’s called a “negativity bias” and sometimes you’re going to need to tame it. If you’re feeling out of sorts, a quick inventory of what is, in fact, going well may be just the ticket. Geithner calls it an “appreciative inquiry.” “As the saying goes, ‘Where our attention goes, energy flows.’” She recommends spending a few minutes each day keeping a gratitude journal, or even just making a mental note of the things we are grateful for: “Gratitude is one of the keys to resilience — the capacity to bounce back or recover from life’s challenges. When we take time to be grateful for the people, circumstances, and things in our lives, our quality of life is improved. It’s that simple!” Another way to climb out of a bad mood is to reframe seemingly negative events. For example, Geithner tells of being stuck in a traffic jam that might have meant missing an important event. Instead of focusing on the frustration, she and her husband turned their attention to being grateful

they weren’t involved in the accident that caused the slowdown, and then “enjoyed the sunshine and changing colors on an extraordinarily beautiful fall day.” Your physical state can also have a dramatic impact on your mental state. It’s well known that exercise helps improve mood, but short of that, simply smiling can help you feel happier. Research shows that the act of smiling changes the chemistry in your brain, and just doing it will take some of the edge off that innate negativity bias. And finally, consider steering clear of social media. A 2016 study showed that the more social media platforms a person engaged with, the more likely they were to experience symptoms of depression and anxiety. In particular, negative online experiences — including “gaffes, unwanted contacts or cyberbullying” — increased the risk for depression. Notably, more than 80 percent of study participants reported at least one negative experience on Facebook, while 60 percent had four or more. Noticing that you’re feeling stressed and taking steps to change how you react is a skill. “Like most skills, it takes intention and practice. And it’s doable,” says Geithner.

THESE PEOPLE ARE DRIVING ME CRAZY! Ah! The anticipation! Meaningful time with family and friends is what the holidays are all about. There’s finally an opportunity to spend more extended time together. What could be better? Unfortunately, things can get rocky for all kinds of reasons: conversations that drift into uncomfortable territory or the crash of reality against heightened expectations. Social media can reinforce the impression that your together-time experience is falling far short of the joyous photos shared by others. The first step to enjoying the company of family and friends is actually a solitary one: You have to prioritize your own needs. “Taking care of yourself helps you be more present, available and better equipped to deal with or help meet someone else’s needs,” says Geithner. That can mean something as simple as getting some exercise, or having a snack before leaving home so you’re not “hangry” when you arrive at a gathering. If frustration, irritation or anger begin to mount while you are interacting with others, “pause and zoom out: literally or figuratively step out of the situation for a moment and take the

10,000-foot view of what is happening,” says Geithner. Then ask yourself, “What is most important here?” Guess what? You’re not going to change other people. What you do control is how you react. It’s easy, and quite common, to view others in terms of how they relate to your needs and desires — perhaps they are a “thorn in your side, an obstacle in your way or critical to your success.” says Geithner. Instead, try to consider the person as “a complete and beautifully imperfect human being — like yourself.” Recognize that for the most part, people have good intentions, are most likely fighting battles you aren’t even aware of, and generally are doing the best they can to make sense out of the messiness of life. In short, show compassion and be prepared in advance not to take things personally. If you find you’re still getting angry or frustrated, a quick break to another room or a short walk can help soothe your feelings. Consider reaching out to a supportive friend, or if things seem destined to spiral downward, give yourself permission to prioritize your own well-being and head home. ...continued on next page

DECEMBER 2017 - JANUARY 2018

Health 27

LIVING ARRRRGH! I ATE TOO MUCH… AGAIN! Food undeniably plays an important role in celebrations — there are often foods that are only available at certain times of the year, and family favorites that bring back happy memories. Korrin Fotheringham, a Registered Dietitian Nutritionist and owner of Spokane’s Northwood Nutrition, says it is important not to feel deprived: “We should enjoy those foods and enjoy them with those we love.” Food is not just about eating; the whole experience can be savored. For example, rather than just sitting down to eat, consider taking part in the ritual of preparing food and spending time talking about family history related to the food; in short, doing things that help to “nourish our bodies, but also our souls,” she says, can create a richer experience outside the simple act of eating. Taking an active role in

making sure there are some healthy choices to round out a festive plate can be also helpful. “Is there anything green on the table?” Fotheringham asks. If not, take charge of making sure there is. “One favorite that I like to share is Brussels sprouts with crisp bacon and maple syrup.” She also recommends a Honeycrisp apple and kale salad as a nice addition to any celebratory table. When it’s time to eat, it’s important to approach the buffet line with a sense

of awareness. “It is very much about balance and giving ourselves permission to enjoy these foods that may not come around very often,” says Fotheringham. “That may look like taking little bites of everything. After you’re done with that, be cognizant of checking in and seeing if you are still hungry.” What about the pressure to “Just try some!” that excited cooks can exert? She notes it’s OK to say “No, thank you” or “Maybe later” if there’s pressure to eat something you don’t particularly want or just aren’t hungry for. Though most people have the ability to regulate their own hunger and rely on their own hunger cues, Fotheringham cautions that overeating until you are uncomfortably full multiple times can be a problem, because it “could set your body up to wanting to feel more full than it needs to be.”

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28 Health DECEMBER 2017 - JANUARY 2018

MY HOUSE IS A MESS! “You worry about the area where everybody is going to be,” says Cindy Vanhoff, a Spokane Valley professional organizer and owner of reclaimed spaces. “The bathroom or the kitchen. Just box up the stuff that is your everyday nemesis. But then after the party or after the people come When you’re planning to declutter, start in the most over, you have to deal used space. It’s the most rewarding, because you can with it.” see it. But keep in mind that you’ll need to give yourself two-andWhile your home a-half times longer than you think it will take. “We often don’t give doesn’t have to be “party ready” at all times, Vanourselves enough time to complete a task,” says Vanhoff. “Stop, take hoff says there are some a breath and work your way around the room. Start in one place and habits that can make spiffhang out in that place before moving on.” ing the place up a snap: “Hey, we’re in the neighborhood and thought we’d stop by!” Those heartstopping words are often followed by a perimeter scan: What can be done in the next 10 minutes to spruce the place up?

number one is the Ten Minute Tidy. “Everybody in the family spends 10 minutes each night tidying up the house. The key to staying clutter-free is maintenance every day. Every day. Is that reality? No, because we get busy, but if you do it every day that you can, even if you do it four times a week, that’s more than zero, right?” A Ten Minute Tidy is most effective when there is underlying structure. “In order to truly be organized, there needs to be a place for everything, and everything in its place. My mom used to tell me that and I hated it, but it is so true,” Vanhoff says. A trouble spot for many clients is what to do with mail. Here are some tips: First, get off mailing lists. Put unwanted mail immediately into the recycling bin. Have a separate basket for shredding and filing. “Clutter is just postponed decisions,” says Vanhoff. “We’re in such a hurry, we think, ‘I’ll just set it here for now.’ ‘For now’ are two words that should not be in our vocabulary, because oftentimes it is there ...continued on next page

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LIVING “MY HOUSE IS A MESS!,” CONTINUED... ‘for now’ for a long time.” In addition to the Ten Minute Tidy, Vanhoff recommends the Two Minute Rule: “If it takes two minutes or less to do it, just do it… If you ever time yourself, you can do a lot in two minutes. And if you can do that 90 percent of the time, you are going to be decluttered.” So put the clothes in the hamper, go ahead and put that dirty dish right into the dishwasher — no need for a stop in the sink. One cause of clutter is simply having too much stuff. Struggling with what to hang onto? Here’s some tough news: “My kids are in their 30s, and I really don’t think they are interested in much of our stuff,” Vanhoff says. “And most people under 40 I would say are not interested in their parents’ things.” And finally, Vanhoff says it’s important not to feel too bad about less-than-perfect homes. “People need to realize too that you go into someone’s home and it looks gorgeous, but you don’t know that they didn’t just stuff everything in a box and put it in the office,” she says from experience. “You don’t know what their closets look like. Sometimes we compare ourselves and we don’t know what is hidden behind closed doors.” she says, laughing.

I HAVE TOO MUCH TO DO! Overwhelmed by too many tasks and not enough time? Here’s a step-by-step guide to finding calm.

WRITE IT ALL DOWN

“I always use a time map,” says Cindy Vanhoff, professional organizer and owner of reclaimed spaces in Spokane Valley. “It is basically your week on a piece of paper, by the hour. Fill it with your have-to-dos, and then fill in the things that you want to do. You don’t fill it up 100 percent. You need to always have free time.” Don’t forget to include things you need to do to take care of yourself: time for exercise, journaling or meditating, says Gonzaga University leadership program faculty member and life coach Christina Geithner.

PRIORITIZE

You can’t do it all. Geithner recommends considering the following questions: Which project is most important for me to give my attention and energy to right now — for today? For this week? For this month? What action will make the biggest difference in the quality of this day or will help move things forward? “Keep the action list short,” she says. “One to three to-do’s that will make a significant difference.”

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30 Health DECEMBER 2017 - JANUARY 2018

SHARE THE LOAD

“My motto is finding the time to do the things you love with those you love,” says Vanhoff. That can mean delegating tasks: “What can you give your kids to do or to your partner?” Set up carpools for kids, and, “if you can afford it at all,” consider hiring help for household duties. We usually put off doing what we don’t particularly like to do.

ANALYZE THE SITUATION

Talking about your feelings of frustration over too much to do can be helpful. Just getting a second set of eyes on the problem may reveal solutions. “We have a-ha! moments when we are talking with somebody,” Vanhoff notes. Sometimes in really thinking about a to-do list, you’ll realize there are things you just need to accept as they are. “We can pick our battles, and some choices only require that we shift our attention and perspective,” says Geithner.

LET IT GO

Vanhoff says she used to try to do it all, but that’s changed: “Just being in my business and watching people, I see how not having enough time is overwhelming.” Instead of letting your to-do list rule your life, she says it’s important to take a step back and think about what you want to do. “If something has been on your to-do list for a year, do you really need to do it?” she asks. Even with your hour-by-hour weekly plan in place, life happens. A kid needs to visit the urgent care. Things just don’t get done. “And you have to be OK with that,” Vanhoff says. “Give yourself a little grace!” Geithner echoes that thought. “Realizing we can’t do everything, be everything to everyone, or be perfect goes a long way to reducing stress and increasing contentment.” And that’s a good thing, she adds. “If we could do everything, be everything to everyone, and be perfect, life would be boring and without rich opportunities for learning and development.” n

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LIVING

FOOD

As a family business, Shaver Farms relies on the varied talents of co-owners Lori Mayfield (second from left) and Charlene Shaver, as well as Shaver’s sons Matthew (left) and Tom. YOUNG KWAK PHOTOS

Wild About Berries

Huckleberries shine in the creative flavor combinations of a North Idaho food business BY CARRIE SCOZZARO

erendipity and family have both played a part in the sweet — and savory — success of Wildbeary, a North Idaho-based food products business making sweet and savory spreads, rubs and other flavorful concoctions with huckleberries. Charlene Shaver, a retired teacher, was impressed with Wildbeary Huckleberry Products, which was the name of the company from 2001-13, when Kris and Bob

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McIlvenna ran it out of their 315 Martini & Tapas and Greenbriar Inn bed and breakfast in Coeur d’Alene. Shaver approached Kris McIlvenna, who said there was no room at the inn for her at Wildbeary, yet eventually hired her to serve some shifts at the 315. When McIlvenna’s steady expansion of huckleberry-based products prompted the need for a production manager at Wildbeary, Shaver was in the right place at

the right time. She jumped in, purchasing the company six years later with her sister, Lori Mayfield. Wildbeary has continued to expand in products and staffing. Shaver’s son Tom, an ergonomic engineer, invents new flavor profiles and products, while son Matthew draws upon his career in retail produce to assist Charlene on the production side. Mayfield and her husband Joe focus on

sales, graphic design and marketing. “Everybody has their own gifts to give something to this company,” says Charlene, who remembers picking huckleberries as a child with her parents in western Washington’s Kent Valley. Her mother, she says, made jam using a simple, traditional recipe — fruit, cane sugar, lemon juice and pectin — that they still follow. Time-tested recipes, natural (nonGMO) ingredients, locally sourced: that’s Wildbeary, says the Shaver clan. Better-quality fruit means a better product requiring less sugar, says Charlene, who notes that they purchase all cultivated fruit from throughout Oregon’s Willamette Valley. Because fruit flavor can vary depending on both variety and where it’s grown, Wildbeary uses only North Idaho purple huckleberries, as opposed to the coastal variety, which is typically redder and more tart than its mountainous cousin. Wildbeary relies on two North Idaho families with a 30-year history of handpicking to provide them with berries for their spreads, pie filling, syrup, vinaigrette, baking mixes and rubs. Last year they used roughly 6,500 pounds, or 1,300 gallons of berries. Some products require the berry juice; others, such as Wildbeary’s spice rubs, require the whole berry. Whole berries are dehydrated for more than 20 hours, explains Tom, resulting in a two-thirds reduction of the berry’s size. The berries are then puréed and mixed with select spices to create rubs — including Huckleberry Mole with cinnamon, coffee and chocolate or the Huckleberry Cajun rub, which can also be used in a dip (see recipe). Still other products resulted from conversations with customers, says Tom. Huckleberry Habanero jelly, for example, is a kicked-up version of their regular pepper jelly, while their simple spreads seem to resonate best with farmer’s market crowds. Wildbeary sells its products wholesale throughout Idaho, Montana, Washington, Oregon and Alaska, and they’re carried in local stores, including Yoke’s, Super 1 and My Fresh Basket. Their creations are also available seasonally at the Kootenai County Farmers’ Markets. Online, they’re available via shaverfarms.com. Shaver Farms, explains Charlene, doesn’t exist… yet. It’s a dream of hers, to create a teaching farm with the purpose of educating others about food and farming. Maybe it would even include an expanded Wildbeary production facility, as America’s taste for huckleberries continues to grow. n

RECIPES

Huckleberry Cajun Dip

In addition to helping tenderize meat and infuse flavor, Wildbeary rubs can be incorporated into other recipes like this one, which marries heat and sweet for a dip that goes beautifully with crackers, veggies or even shrimp. ¾ cup sour cream* ½ cup mayonnaise* ¼ cup chopped parsley ¼ cup chopped chives ½ tablespoon minced garlic ¼ teaspoon each salt and pepper, to taste 1-2 tablespoons Wildbeary Huckleberry Cajun Rub * substitute with vegan and/or lower-fat products as needed Mix ingredients in small bowl, combining well. Cover and chill for at least one hour to let flavors develop.

Fast and Easy Winter Salad

Next time you’re craving strawberry-and-spinach salad, try this combination instead, which still gives you the sweetness of fruit, brightness of greens, and crunchy nuts and apples, as well as the tang of cheese. 8 ounces mixed field greens, washed and dried 2 apples, matchbook sliced (Granny Smith, McIntosh, etc.) ¼ cup candied pecans or walnuts ¼ cup blue or feta cheese, crumbled Black pepper, to taste Wildbeary Huckleberry Poppyseed Vinaigrette Combine first four ingredients in a large bowl. Toss with enough vinaigrette to coat greens; season with black pepper.

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LIVING

ALT MEDICINE

A Blanket Cure? Weighted blankets may be comforting, but objective research into their effectiveness is lacking BY E.J. IANNELLI

e all enjoy a good hug every now and then, and that’s the basic premise behind weighted blankets. It might also account for the surge in their popularity in recent years, which has given rise to an expanding cottage industry and a community of enthusiasts who tout their calming benefits. Weighted blankets are precisely what their name suggests: a body-length covering made of fleece, chenille or other soft material that’s been given extra heft by integrating artificial beads, or even dried foodstuffs

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like beans or rice. They evolved out of the weighted vests that have been used in occupational therapy since the 1980s, usually on children with sensory processing disorders and other conditions that caused restlessness, hypersensitivity and anxiety. Therapists and parents observed that the weighted vests have a tranquilizing effect — not all that different from the relaxation you might feel when the dental assistant drapes a lead X-ray vest over your chest. In time, weighted blankets started being applied in other environments. Angie

Bevacqua first came across them while working in a Spokane-area preschool. “They were using weighted blankets with kids who have autism and special needs, and were having a hard time settling down. I saw firsthand how they really calmed kids down and just relaxed them, and it intrigued me. So I did a little research, because with my niece having special needs, I thought maybe that could help her,” she says. Bevacqua found plenty of testimonials about the therapeutic efficacy of weighted

blankets, and became increasingly convinced that they might be a good, non-medicinal way to mitigate some of the disquieting effects of her niece’s cerebral palsy, epilepsy and sensory processing disorder. But she also found “they were really expensive — hundreds of dollars per blanket” and resolved to make her own. That was in 2014. Within two years, she was fielding more and more blanket requests and found herself moonlighting under the name Weighted Joy. Her handmade products now range from lap pads to adult-sized blankets, each of which is made to order and uses washable polypropylene beads for weight. Bevacqua follows a common — though not universal — formula of weighting the blanket to roughly 10 percent of the individual’s body weight. “They can be for anyone and everyone,” she says, likening their effect to swaddling a baby. “It really helps with a lot of different needs. That weight on you, it releases your body’s natural serotonin and melatonin. It just kind of relaxes you naturally with that deep pressure.” Purported benefits like those have attracted increasing interest from researchers like Dr. Bryan Gee, an associate

professor and program director in the Occupational Therapy department at Idaho State University. His own research group conducted a pilot study on individual patients’ response to weighted blankets, and the results were published last December in the International Journal of Therapy and Rehabilitation under the title “Exploring the Efficacy of Weighted Blankets with Children with Autism Spectrum Disorders and Sleep Disturbances.” What they found is that the therapeutic effect of weighted blankets “really depends on the profile of the patient,” he says. “The more severe their sensory processing deficits are, the more they’re responding and getting between 20 and 40 more minutes of sleep per night. We also see a change in their morning behavior as well.” By way of contrast, Gee references an earlier study led by Dr. Paul Gringras, head of the Children’s Sleep Medicine Unit at Evelina London Children’s Hospital in England. Those results, published in the journal Pediatrics in 2014, found no discernible difference in therapeutic value between weighted and ordinary blankets, even though Gee says that some patients in that study did express a preference for the

weighted blanket: “That’s probably where most people are coming from, whether it be clinicians or clients, is the anecdotal range. In my professional opinion, this type of intervention is being applied to everybody without really understanding why they might need it, and what it’s really targeting from a neurological or behavioral standpoint. We have to be a lot more judicious in how we’re prescribing things.” Gee warns of possible suffocation from weighted blankets, and cites changes to diet and routine as potentially safer, more universal methods of achieving relaxation. However, until more is known, possibly through studies that Gee himself is conducting on further pediatric groups, he says that there’s “minimal to no risk” for healthy adults who want to experiment with sensibly weighted blankets. “Are they effective? It’s way too early to tell. With anything that’s new, it’s always best to be cautious, cautious, cautious, and it’s OK to ask questions of manufacturers and get feedback from other professionals. But the other side of the coin is that it may be that silver bullet for some folks. It may be what really helps them.” n

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LIVING

PARENTING

Homework Woes What’s the right amount of afterschool work for kids? BY E.J. IANNELLI

cross the decades, homework has never been especially popular with students. That’s something we can all agree on. As it turns out, homework isn’t always a hit with parents, either, especially when watching their children — sometimes as early as kindergarten — wrestle with a backbreaking afterschool workload. That’s led some of them to question not only the amount of homework that’s being assigned, but the necessity of homework in general. Researchers have followed suit. In 2006, Duke University psychology professor Harris Cooper conducted a meta-analysis of scientific studies on homework published between 1987 and 2003. He found a stronger correlation between homework and student achievement for middle- and high-schoolers than for grade-schoolers, but

36 Health DECEMBER 2017 - JANUARY 2018

in the end, the only definitive conclusion was that more research was needed. Cooper’s study was one of a number of factors that prompted educators to rethink the dominant pro-homework mindset, which arose during the late-1950s Space Race and the ensuing drive to boost America’s academic performance. Both the National Education Association and the National Parent Teacher Association have since adopted the “10-minute rule” — that is, 10 minutes’ worth of homework per grade level per night. Yet wider trends didn’t always align with that standard. A 2015 study published in the American Journal of Family Therapy found that children were receiving up to three times more homework than was recommended. In homes where parents lacked college degrees, conflicts over that level of

homework were 200 percent more likely to happen. Nor were families with higher levels of education immune to homeworkrelated strife. Tami McCracken says her moment of reckoning came several years ago when her youngest child started returning from elementary school with the same homework packets as her eldest, even though they were one grade apart: “I was just seeing mass-produced, photocopied worksheets. Those packets of homework were created in advance and they weren’t formative.” And that only meant “arguing, crying and struggling” as she forced her children to complete their worksheets for the sake of completing them. “It didn’t feel quite right to me,” she says, so she started searching online for studies that supported the efficacy of homework. But that information-gathering process only bolstered her “initial gut feeling” that homework is more task-oriented than truly educational: “I haven’t come across any evidence that suggests doing homework prior to grade six is effective in terms of increasing [students’] learning.” In time, McCracken came to disagree with assigning any kind of homework for

elementary students, beyond supplementary reading and flash cards. She also placed time limits on her children’s homework — no more than, say, 20 or 30 minutes per night — when they reached middle school. To her, it seemed far more worthwhile to give her children “authentic responsibilities” like setting the table or tidying, or “meaningful” extracurricular activities like drawing or music instead. For at-risk students who might have less parental guidance, she thinks that homework causes “stress and anxiety” that can make a precarious home life worse.

t’s worth noting that McCracken didn’t arrive at those opinions from a parent’s perspective alone. She comes from a family of education professionals, and currently works as an assistant principal at North Central High School in Spokane. Her own children, now close to graduating from high school, don’t seem to have been adversely affected by McCracken’s stance on homework. She describes them as “well-rounded, excellent students” with “interests that are unique to them as individuals.” But does all homework amount to mere

busywork? Kristy Masteller, a fifth-grade teacher in District 81’s Odyssey program for advanced learners, says that purposeful homework can serve as a good reinforcement tool for the student and a feedback mechanism for the teacher. “To me, homework is mandatory,” she says, “because in Odyssey we’re moving pretty fast. When, like today, we’re working on prime factorization, if the only time [the students] see it was for that 25-minute introductory lesson and 25 minutes where they practiced on their own in class, no matter how bright they are, they’re not going to remember that in two weeks when we have a test on it.” She likens homework to playing a video game. “There’s a part when you introduce a subject, where you practice it, and then you become the master of it. We want to go toward mastery.” For Masteller, checking the students’ homework from the previous night is also a good gauge of how well each student grasps the subject independently. Or how much their parents helped. “If I’m not getting some kind of feedback,” she says, “I’m not able to guide my

instruction. But I try not to give 50 problems when 15 will tell me if you know it.” What Masteller and McCracken both emphasize is that needs vary by student and family. Masteller, who has taught at a range of private and public schools, including those with students from challenging home environments, says that teachers constantly have to tailor the level of homework to their class to avoid homework becoming more punitive than beneficial. With occasional exceptions, she tends to follow District 81’s guidance, which parallels the national guidance. And if, despite the “10-minute rule,” a parent still feels their child is overwhelmed by homework? Both Masteller and McCracken agree here, too: Have an honest, respectful sit-down with the student’s teacher. It could be that the teacher really is assigning too much homework, or it could be that the student needs help developing better work habits. “Each family is going to have to come to that decision on their own,” says McCracken. “What I’d want to caution parents about is to really think deeply about what the right decision for their family is, and then feel confident in their decision.” n

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Savor the dates FEBRUARY 22 - MARCH 3

Benefitting

LIVING DECEMBER-JANUARY EVENTS DONATE BLOOD | 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 walk-in hours at the Spokane, North Spokane, Spokane Valley, Coeur d’Alene, Lewiston, Moscow, Pullman and Moses Lake collection centers. Hours and addresses at inbcsaves.org.

INBODY 570 TESTS | INHS Community Wellness has a machine available to the public which provides a complete picture of body composition, including weight, body mass index, body fat mass, basal metabolic rate and more. Appointments available on Dec. 7, 14, 20 and Jan. 3, 9, 19, and 24. $20/test. INHS Community Wellness Center, 501 N. Riverpoint Blvd., Suite 245. wellness.inhs.org

SECOND HARVEST FOOD SORTING | Join other volunteers to sort and pack produce and other bulk food items for delivery to emergency food outlets. Ages 14+. Shift dates and times vary; sign up at inland. volunteerhub.com/events. Second Harvest Food Bank, 1234 E. Front (252-6267)

CELEBRATE THE SEASON | An event to raise awareness and support for local Salvation Army programs to help our community’s most vulnerable children and families. $75/person; $750/table of 10. Fri, Dec. 8 from noon-1 pm. Northern Quest, 100 N. Hayford Rd., Airway Heights. spokane.salvationarmy.org (329-2721)

UNION GOSPEL MISSION VOLUNTEER ORIENTATION | Learn about volunteer opportunities and services offered through the local homeless ministry. Sessions in Spokane are held the second and fourth Tuesdays of the month at 6 pm, and in CdA on the second Tuesday of the month at 6 pm, and the fourth Tuesday of the month at 10 am. uniongospelmission.org/events (535-8510 x 2 or 208-665-4673) TREE OF SHARING | Community members can help provide holiday gifts to Spokane’s often-forgotten residents. Pick up gift tags at Tree of Sharing tables located at River Park Square, NorthTown and Spokane Valley malls. Collection runs through Dec. 17; all tables are open during regular mall hours. treeofsharing.org (808-4919) SANTA EXPRESS | The annual holiday store offers items at allowance-friendly prices (50 cents to $8) for area children (ages 4-12) to purchase for their friends and family, with proceeds supporting the Vanessa Behan Crisis Nursery. Open through Dec. 23 during mall hours. River Park Square, 808 W. Main (2nd level). santaexpress.org 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 Dec. 4-7, Dec. 11-14 and Dec. 18-21. Free. Before your appointment, email Renee.Witmer@providence.org with your child’s age, weight, height, your vehicle year and model, and the reason for your inspection. At the Providence Heart Institute Receiving area on Seventh Avenue between Browne and Division. (844-1854) HEALTH CARE FOR ALL | Healthcare for All Washington hosts a video lecture on Single Payer Health Insurance. The lecture covers the broad implications of a single-payer system, and the ways in which employers and employees would benefit. Free. Mon, Dec. 4 from 6:30-7:30 pm. Shadle Library, 2111 W. Wellesley. (747-0659) ADVANCE CARE PLANNING | A session covering how to complete an advance directing in the event that an illness or injury leaves you unable to speak for yourself, and direct your care. Tue, Dec. 5 from 11:30 am-noon. Sacred Heart Medical Center, 101 W. Eighth Ave. (in the 6 North Day Room). washington.providence.org (474-2296)

CHRIST KITCHEN GINGERBREAD BUILDOFF | The annual gingerbread house buildoff features teams competing to build the most elaborate gingerbread house, as voted by the public. Families and kids can also make their own gingerbread houses ($7), take photos with the Gingerbread Man and watch the houses being constructed. Sun, Dec. 10 from 10 am-4 pm. Free to watch. Davenport Grand Hotel, 333 W. Spokane Falls Blvd. christkitchen.org (325-4343) BLESSINGS UNDER THE BRIDGE WINTER EVENT | The local nonprofit hosts its 11th annual event to serve the community’s homeless population, offering a free hot brunch, hot drinks, holiday treats, distributions of winter clothing, blankets and gifts. Sat, Dec. 16 from noon-3 pm. At Fourth Avenue and McClellan Street. To serve, sponsor, bake or give during this annual event visit the organization’s website or email butbvolunteer@gmail.com. butb.org MEDICARE 101 | A class designed to help attendees understand options in the Medicare program in order to make informed choices about enrollment and coverage. Tue, Dec. 26 from 1-3 pm. $5 donation. Kroc Center, 1765 W. Golf Course Rd., CdA. kroccda.org (208-667-1865) PLANNING MEALS FOR NUTRITION & SAVINGS | A session covering tips and tricks to plan ahead for your meals and grocery shopping, while helping you stick to healthy choices and avoid impulse buys. Educators from Second Harvest also share how to menu-plan for nutritious meals and how to find quality, affordable food. Free. Offered Jan. 10 (South Hill); Jan. 17 (Downtown), Jan. 24 (East Side) and Jan. 29 (Shadle); all sessions begin at 4 pm. spokanelibrary.org 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. Offered Sat, Jan. 13 and Sat, March 17 at 9 am. $45. St. Luke’s Rehabilitation Institute, 711 S. Cowley. wellness.inhs.org NORTHWEST FEST & SALMON FEAST Family Promise of North Idaho’s 11th annual dinner begins at 5:30 pm with silent auction items, followed by a catered dinner of salmon, chicken, side dishes and more.

The 1965 film version of Cactus Flower starred Ingrid Bergman, Walter Matthau and Goldie Hawn.

CHARITY CORNER

Stage for Schools

pend a night at the theater to help local students stay in school as the Spokane Civic Theatre hosts a benefit performance of the farcical romance Cactus Flower in support of Communities in Schools of Spokane County. With a mission to aid local youth at risk of dropping out of the public education system, Communities in Schools last year helped more than 6,800 students stay on track toward high school graduation and a bright future. By bringing resources and volunteers into local schools, CIS not only aids individual students at risk of dropping out, but also provides schoolwide programs to address issues like bullying, along with offering afterschool enrichment programs for all students. The upcoming benefit production of Cactus Flower, the Civic’s first main stage show of 2018, includes a pre-show auction and cocktail hour. For those not familiar with this classic comedy, it premiered on Broadway in 1965 with an original cast that included top names such as Lauren Bacall, Barry Nelson and Brenda Vaccaro. Cactus Flower was also adapted into a 1969 romantic comedy starring Ingrid Bergman, Walter Matthau and Goldie Hawn, who won an Academy Award for Best Supporting Actress for her performance. Without giving away too much of the plot, its essence is a dramatic love triangle filled with misconceptions and plenty of humor. — CHEY SCOTT

CISSC Benefit: Cactus Flower • Sat, Jan. 13 at 6 pm • $40 • Spokane Civic Theatre • 1020 N. Howard • Tickets: bit.ly/2hzleI7 • spokane.ciswa.org $50. Fri, Jan. 26 at 5:30 pm. Coeur d’Alene Eagles, 209 Sherman Ave. familypromiseni.org (208-777-4190) LEADERSHIP LIGHTS THE WAY GALA | The annual gala celebrates local community leaders, and raises funds to support scholarships for local youth and adult programs. Evening includes a champagne reception, gourmet dinner, auctions, networking opportunities, award presentations and more. Sat, Jan. 27 at 6 pm. $75/ person; $750/table of ten. Northern Quest

Resort & Casino, 100 N. Hayford Rd., Airway Heights. leadershipspokane.org TASTE SPOKANE | The annual event benefiting the Wishing Star Foundation hosts local food and drink purveyors, sharing samples. Proceeds help Wishing Star grant wishes to area children with life-threatening conditions, and to support their families. $65. Fri, Feb. 16, from 7-10 pm. Northern Quest Resort & Casino, 100 N. Hayford Rd., Airway Heights. wishingstar.org (744-3411) n DECEMBER 2017 - JANUARY 2018

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LIVING medical care. All types of people — doctors, sales reps, students and retirees — dedicate their winters to serving on the slopes. Patrollers must clear runs, mitigate safety hazards, search for stray guests and respond to approximately 250 emergency “codes” each year at the Mt. Spokane Ski and Snowboard Park. A medical auxiliary group also staffs the patrol headquarters and nursing station.

Mt. Spokane Ski Patrol members respond to about 250 calls for help on the slopes each year.

MT. SPOKANE SKI PATROL PHOTO

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Sliding to the Rescue Mt. Spokane Ski Patrol has conducted mountain rescues for 80 years BY JACOB JONES

hen Ryan Berk’s grandfather first joined the Mt. Spokane Ski Patrol around 1950, rescuers scoured the frozen slopes without the help of cellphones, helicopter support or Gore-Tex. Story has it that Gordon Berk skied his first patrol shift in exchange for a free meal. He would spend the following decades saving stranded powder hounds and training up recruits. In 1969, the National Ski Patrol named him Outstanding

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Patroller of the season. “They skied on wooden skis with leather boots,” Ryan Berk says. “Things have changed, (but) the core mission really hasn’t.” Following after his grandfather and father, Ryan Berk, 32, grew up on the mountain as a third-generation patroller in one of the nation’s largest and oldest all-volunteer ski patrol organizations. Formed shortly after the creation of the National Ski Patrol in 1938, the Mt. Spokane Ski Patrol has kept

local recreationists safe for 80 years. This next season may be a big one, as the patrol looks to grow its ranks to cover a new chairlift, additional runs and extra guests. “It’s a lot of work,” Berk says of the patrol. “You really have to love skiing. You really have to love helping people.” Director Randy Foiles, who has spent more than 35 years with the MSSP, says the patrol’s 140 volunteers complete weeks of training in ski technique and

ver its eight decades of service, patrollers have watched the resort grow, celebrated unlikely rescues and sometimes met their future spouses. They have also seen the lodge burn, combed plane wreckage for survivors and anguished over the people they couldn’t save. Foiles says patrol work has become both more demanding and more rewarding in recent years. Certification has become much more sophisticated with the introduction of new medical equipment, performance ski gear and GPS technology. “The training is a lot more intense,” he says of the now more than 120-hour certification process. Volunteers also help raise money to pay for all of the patrol’s uniforms, radios, medical supplies, rescue toboggans and other equipment. In the mid-1960s, the patrol launched its annual ski swap event to help fund its operations. And in 1992, it opened a new headquarters. “It was a labor of love,” says Larry Briney, a patroller for 31 years. “It’s like a piece of furniture.” The 6,500-square-foot chalet rose out of largely donated materials and thousands of volunteer hours of construction work, with former patrol director Craig Lee serving as structural engineer. It houses medical facilities, dining areas, gear storage and training space. Briney notes guests often mistake the facility for the resort’s main lodge.

“It’s unbelievable,” he says. Next spring, the patrol expects to make its largest recruitment effort in years as the Mt. Spokane Ski and Snowboard Park opens a half-dozen new runs on the mountain’s northwest side. The controversial expansion will add nearly 80 acres of trail to the patrol’s responsibilities. Foiles says they will probably need to bring on 10 new patrol members to cover the extra areas and shifts. The patrol will conduct a day of on-the-hill ski testing and interviews in February. “This is kind of an important recruiting year,” he says.

hile serving on patrol requires great commitment, Foiles says volunteers receive free season passes, access to the patrol building and advanced mountain skills training. After their first year, members also get free passes for family members. But it’s the camaraderie, professionalism and satisfaction that keep people dedicated year after year. Foiles says few things feel better than working as a team to save lives. “I’m not doing it for the free pass anymore, that’s pretty obvious,” he says with a laugh. “My best friends are on the ski patrol. … It’s such a good organization to be involved with.” Briney notes that Mt. Spokane mostly serves locals, so the ski patrol gets to watch out for its own community. They spend long nights searching for lost kids in icy weather. They revive old men who suffer heart attacks on the chairlift. And they sometimes respond too late. “There are accidents over the years that you really never forget,” he says. “It gets into your soul.” Ryan Berk’s father Al says he grew up serving as a mock victim for his father’s training sessions and the ski patrol became an extended family. They can lean on one another, mourn together and push each other toward that same shared mission passed down through the decades. “Our job is to be there and make sure people get taken care of,” Al Berk says. “It’s there to serve the public.” “Hopefully we’ll have a fourth generation here soon,” he adds. Ryan Berk’s 3-year-old son strapped into skis for the first time last year and loved it. “I’m not the type to push him into it,” Ryan Berk says, “but … I’d be over the moon if that was something he wanted to do too.” n

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