Pulse Magazine - Fall/Winter 2012 by Western Communications, Inc.

FALL/WINTER2012

H I G H

D E S E R T •

Breaking barriers: Interpreters helpdoctors andpatients

Kids and sleep: Deprivation is more harmful than youthink Healthy fat: What to(eep in

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Healthy Living in Central Oregon •

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Bend Urology'sAccessClinic (on the 2nd floor of our building in Bend) now offers same-day appointments,

Bend Urologyprovidesstate-of-the-art diagnosis, plus the best treatment and care ofurological conditions for the men, womenand children living throughout central and eastern Oregon.

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providing those with an urgent or

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emergent urologic problem timely consultation and treatment.

Our growing team of board-certified

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With office locations in Bend and Redmond, outreach

partners in their care, and strives to

make educationa key component

clinics in John Dayand Burns, plus our comprehensive and user-friendly website, bendurologycom,our goal

of the services it provides. Highly

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trained physician assistants, nurses and support staff

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all contribute greatly to the high standards ofquality I

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our patients' urologic health

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These high s tandards also

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Call us at 541 382 6447 for an

w hen dealing with al l

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staff will evaluate your situation

urologicalconditions may be accompanied by levels

over the phone, and, if necessary,

of sensitivity or social discomfort.

get you in to the clinic asap.

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MY URGENT CARE MOMEN T As an Urgent Care physician at Bend Memorial Clinic, I care for thousands of patients and their Urgent Care moments every year. With the ability to treat a wide variety of injury and illness and the convenience of imaging and laboratory services on site, we are ready for your Urgent Care Moment — whatever that might be. And because you never know when you might have an Urgent Care moment, our clinics are open seven days a week. Our Eastside clinic is also open holidays. As always, walk-ins are welcome and no appointment is n ecessary. We accept most insurances as well as self-pay patients. I Y

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H I G H •

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D E S E R T

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There is a difference in Cataract Surgery

Healthy Living in Central Oregon

FALL / WINTER 2012 VOLUME 4, NO. 4

If you are feeling that your vision is not as clear as it could be, you may have cataracts. At lnfocus Eye Care, we offer modern cataract

How to reach us

surgery with several different lens options that may help you to see

Julie JohnsonlEditor 541-383-0308 or jjohnson@bendbulletin.com

near, far, and possibly in between. If you are interested in reducing

Sheila Timony Associate l editor 541-383-0355 or stimonyCIbendbulletin.com

your dependency on glasses please see us at lnfocus, and explore all your options.

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vlBlon

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• Design / Production Greg Cross Tim Gallivan • PhotograPhy Ryan Brennecke Rob Kerr Andy Tullis

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• Reporting Anne Aurand 541-383-0304oraaurand@bendbulletin.com Beau Eastes 541-383-0305 or beastes@bendbulletin.com Elise Gross 541-383-0305 or egross@bendbulletin.com Heidi Hagemeier 541-617-7828 or hhagemeierCIbendbulletin.com Markian Hawryluk 541-617-7814or mhawrylukCIbendbulletin.com

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AndyZeigert Pete Erickson Joe Klein

• Corrections High Desert Pulse's primary concern is that all stories areaccurate. Ifyou know ofan error in a story, call usat 541-383-0308or email pulseCIbendbulletin.com. • Advertising Jay Brandt, Advertising director 541-383-0370 or jbrandtCIbendbulletin.com

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Qkt On the Weh: www.bendbulletin.com/pulse

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ABBulletinpaymentsareacceptedatthedropboxatCityllallCheckpay ments may be converted to an electronic funds transfer,TheBukeun, LISPS aSS2 520is published daily by Western Communications Inc,1777 SW Chan dler Ave, Bend,OR 97702.Periodicals postage paid at Bend, OR.Postmaster. Send addresschanges to The Bulletin orculauon department, PO.Box 6020, Bend, OR 9770B.The Bulleun retains ownership and copynght protecuon of all staff prepared newscopy advertising copyand newsorad illustrations. They maynor be reproduced wirhoutexpliot pnorapproval. Published:11/12/2012

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GREAT MEOICINE

Contents ~ HIGHDEsERT PULsE

COVER STORY CANCER 10 PROSTATE Sometimes the cure is worse than the disease.

16 '-.

FEATURE AND SLEEP Whether it's stress or too much time on the iPad, 20 KIDS kids aren't getting enough sleep, and it matters.

DEPARTMENTS What's new since we last reported. 8 UPDATES THE JOB: MEDICAL INTERPRETER 16 ON Bridging the gap between doctors and patients who don't share a language.

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DOES HE DO IT?: ERIC KING 24 HOW How Bend's city manager finds time for fitness. THIS: TASTE 27 PICTURE How does the brain know what the tongue is touching? GEAR: LONG JOHNS 28 GET A side-by-side look at the most common materials. EATING' GOOD FAT 30 HEALTHY Keep your pantry stocked with these flavor-packed healthy fats. READY' INDOOR RACKET SPORTS 36 GET From pickleball to badminton, the ball's in your court. SMITH ROCK 39 SNAPSHOT: Our local climbers' paradise. HEREDITY 101 40 TIPS' From dimples to tongue rolling, a look at genetics. OF KNOWLEDGE: POP QUIZ 53 BODY How well do you know running injuries? VOICE: APERSONAL ESSAY 54 ONE Learning to love ADHD.

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COVER DESIGN: ANDYZEIGERT CONTENTS IMAGES, FROMTOP:RYAN BRENNECKE, ROBKERR, ROB KERR,ANDYZEIGERT

HIGH DESERT PULSE • FALL/ WINTER 2012

•

A A TIPS M

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UpdateSINEwsiNcE wE LAsTREPDRTED New study quantifies risk of injury in young athletes In High Desert Pulse's Fall/Winter 20tt cover storp, "whenioonesport

too much? Overtraining and the single-sport kid," we looked at many facets of today's competitive young athletes. The trend in single-sport spe

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cialization has drawn much criticism

from sports medicine researchers, na tional policy leaders and parents, who are concerned about the physical and mental ramifications of too much train

ing in a single sport. Primary among concerns is a growing rate of overuse injuries. Since then, another study has quantified that idea."Coaching Our

ten young athletes need to drink fluids per hour of play. Children need to drink fluids every 15 to 20 minutes during physical activity to avoid dehydration. About 92percent ofparents say they depend on coaches to keep their kids safe. However, nearly half of all coaches indicated that they have felt pressure, either from parents or children, to play an injured child in a game, according to the report. And three out of 10 kids think that good players should keep playing even when they're hurt, unless a coach or adult makes them stop. Further, only two out of five parents knew how much sports safe ty training their child's coach had received, and even well-trained coaches said they would like more training, specifically on prevent ing concussions and heat illness.

Researchers' understanding of ketamine mechanism grows

Researchers are continually looking HI G H n s d r survey commissioned by Safe Kids Worldwide, a network of orga for better ways to treat debilitating major nizations whose mission is to improve child safey, said one in three depression. High Desert Pulse discussed children who play team sports sustain injuries severe enough to re a number of cutting-edge brain stimula h IH quire medical treatment. tion therapies and experimental drugs in "Beyond Researchers surveyed hundreds of coaches,parents and children the Summer/Fall 2012 article, earlier this year and concluded that nine out of 10 parents under antidepressants; Working with new FroiiCt@:-&4ilhg INlijQoit ioodhil. estimate the amount of time kids should take off from playing any therapies to stimulate the brain." %588Kh Isitcoiolh one sport during the year to protect them from overuse, overtrain One new promising drug is called ing and burnout. According to the American Academy of Pediatrics ketamine,which has been used as a and the American Orthopaedic Society for Sports Medicine, children recreational street drug but is FDA-ap should take two to three months away from a specific sport every proved as an anesthetic. Unlike standard antidepressants, it almost year. Young athletes are also encouraged to take at least one day off immediately alleviates symptoms of depression, and under physi each week from the activity. cian supervision, has been used as a rescue treatment for severe Additionally, about four out of 10 parents underestimate how of cases that haven't responded to other treatments. Kids to Fewer Injuries: A Report on Youth Sports Safety," a national

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FALL/WINTER 2012• HIGH DESERTPULSE

OS IC

Ketamine affects the glutamate neurotransmitter system.

(Conventional antidepressants work on the serotonin, dopa mine andnorephinephrine neurotransmitters.) Researchers are currently involved in many studies to further understand how the drug works. Scientists at the National Insti

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tutes of Mental Healthare studying brainwave imaging andother biologicalmarkers to identify which depressed patients wouldre spond to thedrug. "Themorepreciselyweunderstandhowthismechanismworks, the more narrowlytreatmentcanbe targeted toachieve rapid an tidepressant effects and avoid undesirable side effects," said Dr. Carlos Zarate ofthe NIH's Nationallnstitute of MentalHealth.

"We are investigating ketamine in multiple ways — studying genes, geneexpression, synapses, cells, circuits, and symptoms with neuroimaging, genetics, electrophysiological measures and other techniques," said Zarate."These studies holdhope for predicting the likelihood of response and for gaining insights

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into mechanisms ofaction." Zarate and his international colleagues said that intravenous

ketamine may prove useful for acutely suicidal patients. They said it may also offer an alternative to electroconvulsive thera py, a highly effective treatment for severe depression, but one with concerning cognitive side effects. Another recent study published in the journal of the Inter national Society for ECT and Neurostimulation said the use of

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ketamine did not improve a patient's response to ECT. Prior to

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ECT, a small number of patients were given a low dose of ket amine in addition to another, standard, pre-treatment anesthe

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sia. The ketamine patients did not have faster antidepressant effects from ECT than patients not given ketamine. Research ers suggested that ketamine's interactions with other anesthe

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Cover story( pRosTATE cANcER •

•

Prostatecancer survivor Mark Quon shares a hug with his daughter, Presley a Summit High Schoolvarsitysoccer player, following a matchin Redmondin October.

BY MARKIAN HAWRYLUK •PHOTOS BY ROB KERR

ary Wirth just wanted the cancer out of his body. Mark Quon knew he had to treat his cancer, but worried about the side effects. And Mark, a practicing dentist in Oregon who asked that his last

name be withheld, wasn't sure his cancer needed to be treated at all. One disease, three men, three different choices. This year some 200,000 men in the United States will be in a simi lar situation, facing one of the most difficult decisions in health care. Diagnosed with prostate cancer, they'll be asked to choose from a range of treatments, each with its own unique side effects, but none

much better than anything else, and the side effects of treatment af fect people's lifestyle, their quality of life, so much." Prostate cancer is a cancer like no other. It is the most common

cancer affecting men, but in most cases, it is a slow-growing cancer, confounding research efforts and raising the question of whether it should be treated at all. Autopsies confirm that about half of all men have some prostate cancer in their bodies at the time of their death, yet only 3 percent

of men will actually die from prostate cancer. In fact, prostate cancer patients are more likely to die of heart disease than of their cancer. Still, men do die of prostate cancer and many die young. While doctors have tests and algorithms that can help predict the risk, any better than the others at curing cancer. none can definitely say whether a given man's prostate cancer will "If you have one great option, it makes the conversation really sit meekly in the background or aggressively threaten a man's life. simple. But since we have all these other options, it really makes the As a result men face a very individualized, intensely personal deci decision difficult," said Dr. Andrew Neeb, a urologist with Urology sion that more often than not is based on personal values and pref Specialists of Oregon, in Bend."There's not one single thing that is erences rather than pure medicine.

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FALL/WINTER2012• HIGH DESERTPULSE

Gary Wirth, athis homein Bendin October wasdiagnosed with prostate cancer. Henow volunteers with the Cancer Hope Network.

Location makes treatment difficult Prostate cancer starts in the prostate gland, a walnut-sized struc

ture that is part of a man's reproductive system. The prostate wraps around the urethra, the tube that drains urine from the bladder, and sits just across from the rectum. Its location is what makes treat ment options difficult, says Dr. Brian O'Hollaren, a urologist with

Bend Urology. "It's a tough decision because the prostate is surrounded by so many sensitive tissues," he said."The urinary sphincter is so close, the nerves for erection are close, the bladder neck is close, and the urethral orifices are close. And any treatment for prostate cancer can affect one or more of those structures." Surgery, for example, involves removing the entire prostate gland and possibly some of the surrounding tissue. That can damage the

CANCEk lj

nerves that control erectile function or the muscles that ensure uri

nary continence. Because the urethra travels through the prostate, the tube must be severed and reattached during surgery, leading to the possibility of partial or full incontinence. If radiation is not tar

geted precisely to the prostate, it can damage the adjacent bladder

XETWORK

or rectum tissue.

If not for these side effects, the decision to treat would be easy. The benefits would far outweigh the risks. But with the potential for life-altering side effects, the decision to treat or not to treat becomes

paramount. "The most important thing for patients to know is that prostate

cancer does exist in two forms, a fairly slow-growing form that needs to be followed closely, and an aggressive form that needs to be treated immediately," O'Hollaren said. Urologists, who are generally the doctors who help patients navi gate their options, use a blood test called the prostate specific anti gen or PSA test to screen for prostate cancer and to measure how aggressive that cancer is. When scores are low and aren't increasing rapidly, it's a clue the cancer might not be growing very quickly. Biopsies of the prostate area visualcheck ofthe cancer,and doctorscan use theappearance of the samples to create a Cleason score, a grade of how far that cancer has progressed. Those tests give hard numbers that can be plugged into a formula — combined with a patient's life expectancy and health status — to narrow the options.

Need for treatment For older men in the last few years of life, prostate cancer may not kill them, but the side effects of treatment could very well reduce the quality of life for their remaining years. There's little payoff to treatment in such cases. But even in men expected to live for a de cade or more, there might never be a need to treat. "It's very obvious that most cancers need to get treated," said Dr. Tomasz Beer, deputy director of the Knight Cancer Institute at Or egon Health 8 Science University in Portland. "But with prostate can

cer, we know very well that many men with the disease might live out their full lives without being bothered by the cancer. And yet, it's very difficult to give any individual man a full confidence in that." Prostate cancer may be one of the few diseases with which doc tors and patients have the luxury of time. They can take a step back and evaluate the situation instead of rushing into treatment. "It's not a strategy to give up on treatment," Beer said. "It's a strat

If the cancer has already spread beyond the prostate gland, treat ment decisions are simpler. Strategies such as surgery, cryotherapy (freezing) or implantation of radioactive seeds, known as brachy therapy, fall off the table; none of those can be expected to eliminate cancer beyond the prostate. But with localized prostate cancer, virtually all of the options re main the table, including waiting to see whether the cancer needs to

egy to monitor the disease and treat later."

be treated at all.

dence to say that if we follow you closely, you haven't lost anything

HIGH DESERT PULSE • FALL I WINTER2012

Known as watchful waiting or active surveillance, this protocol calls for patients to come back for regular testing, possibly even ad ditional biopsies, to determine whether the cancer is growing and how quickly. "Basically we are going to follow you really closely," said Dr. Russ Omizo, a radiation oncologist with St. Charles Bend. "And there's evi

Page11

Coverstory(PROSTATECANCER

"I was ready for the surgery, I was scheduled," he said."All they have to do is tell somebody you have cancer and you want it out."

if your cancer starts getting more aggressive."

Getting it Out

But the more he talked to other men with prostate cancer, the

more he questioned whether he truly needed surgery. What would procedures and necessary care every day. He regularly tells his pa affect him more, he reasoned, the cancer or the potential side ef tients what dental work should be done immediately and what can fects of surgery? At his age, Mark would have had to live with any wait. But when he was diagnosed with prostate cancer last year, his sideeffectsfordecades. "Definitely, the incontinence would be terrible, and definitely the initial thought was to act quickly. As a dentist, Mark, 60, deals with the distinction between elective

Prostate eancer treatment options TREATMENT

DESCRIPTION

ELIGIBLE PATIENTS

DURATION

SURVIVAL RATES

POTENTIAL SIDE EFFECTS

I Radical ~ go rger y removing the prosBest suited for patients prostatectomy ta te gland, surrounding tis whose cancer is confined to %ue and the seminal g ands. the prostate g and, may be Usually done through a better for younger patients single incision in the abdo for whom surgery is not as pen, but can also be done risky. through multip e small inci gions. nvolves cutting and reattaching the urethra. Radiation, External Beam

Uses r adiation from a ma chine targeted at the prostate gland to kill cancer ce s.

Length of the surgery, hospita stay and recovery time differ depending on the specific surgical tech nique used and the

Effective for patients with lo calized cancer, better option minutes a day for for older patients for whom about 6 to 8 weeks. surgery is risky, recommend ed option for patients whose cancer has spread.

I R

Radiation, 4s~ %le to i~lant g MoFeffectivlin y u Brachytherapy gadioactive seeds in the g patients in good health with prostate gland to kill cancer localized prostate cancer. ce s with radiation.

Cryotherapy

Uses needles to apply frozen gas to the prostate, freezing and destroying cancer cells.

Best for patients in the early stages of prostate cancer with low riskfor cancer splead.

Protdu~u ually lasts 1-2 hours, with an overnight hospital stay possible; Patients can resume normal activity within a gouple ofdays

Multiple studies ~ Impotence, confirm recurrence incontinence. free success rates of greater than 90 percent in individuals with localized prostate cancer.

Short and long term studies have found fatigue, skin irritation, survival rates of great incontinence, diffi er than 85 percent. culty urinating.

si • MultipleWsudies have found recurrence-free survival rates of 73 to 93 percent.

Procedure usually Limited data on long lasts about two hours term survival rates. with an overnight hospital stay possible.

• •

R .R . R

Bleeding, inconti nence, impotence, mi gration of seeds to the bladder or urethra.

Moderate pelvic pain, blood in urine, scrotal swelling, mild urinary urgency, impotence.

•

Hormone therapy

wlocks testosterone produc ion to slow tumor growth, apy for patients undergoing gadministered by shots or other treatments. pills.

Treatment time can vary, often patients will cycle on and off hormones every six months.

Delaying treatment in favor Bestfor patients with slow of active surveillance of the growing cancers and older progression ofthe cancer. patients with a life expec tancy ofless than 10 years.

Regular doctor visits every three to six months for PSA tests and digita rectal exams.

Watchful waiting

. R.

Constipation, diarrhea, on combining hor nausea, swelling of mone therapy with breasts, decreased sex other treatments, drive, hot flashes, loss limited data is available of muscle mass. on using hormone gerapy alone. Studies show no differ ence in survival rates for men with slow growing cancers com pared with surgery.

Potential for cancer to grow faster than expected, emotional stress of living with cancer.

Source; Bulletin staffresearch

Page12

FALL/WINTER2012• HIGH DESERTPULSE

impotence," he said. "It's not just a little deal. It's a big deal."

More than a year after his diagnosis, he has no immediate plans to

Seminal vesicle

treat his prostate cancer.

"I'm going to continue to do active surveillance," he said. "If PSA levels went off the chart or I had another biopsy and it was growing a lot, I would definitely do something." The risk of watchful waiting is that the cancer may grow more quickly than expected in between those regular tests, and if the can cer spreads beyond the prostate during that time frame, it becomes more difficult to treat.

Bladder

Pubic bone

—

Rectu m

"That's what makes prostate cancer so hard to treat," Omizo said. Cowper's gland Urethra "One personcan have the exactsame Gleason score or PSA as the next, and one might progress and one might not." Prostate gland Source WebMD One of the more significant prostate cancer studies conducted to date was a randomized controlled trial in Sweden, in which men di GREG CRQSS agnosed with localized prostate cancer were randomly assigned ei ther to surgery or watchful waiting. After 15 years, nearly15 percent of men in the surgery group died of prostate cancer, compared with sented with the evidence of how effective active surveillance is, then nearly 21 percent of men in the watchful waiting group. many of them change their minds." But the study comes with several important caveats. For one, The sole side effect of watchful waiting is perhaps the emotional when only men over the age of 65 were considered, there was little toll of living with an unaddressed cancer. Men who opt for treatment difference in survival rates between the two groups. And the Swed havethechance to say they had cancer.Those who choose watchful ish study, which was started two decades ago, included few men waiting must stick to the present tense. "You have to come to grips with it. You do have cancer," Mark said. whose cancer was discovered by PSA testing. The vast majority had "You have to know that's in your body." tumors that could be felt by the physician in a rectal exam. Their cancers were much further along than most men diagnosed with Mark deals with the uncertainty by taking control of what he can. prostate cancer today. He eats more omega 3 fats and cruciferous vegetables that some In contrast, in 1995 researchers at the University of Toronto start studies suggest could have a cancer-fighting effect. He started to ex ed following 450 patients undergoing watchful waiting. While the ercise more and lose weight. "Good diet and exercise is way more important for me now than group hasn't been followed as long as those in the Swedish study, initial results with a mean follow-up time of nearly 7 years show a it was before I found out I had cancer," he said. "I'm 60 years old and much different picture. the clock is ticking. I can die of heart disease or diabetes." Only 3 percent of the men in the study had died of prostate cancer Watching and waiting within 10 years, compared to death rates of 8 percent in the Swedish watchful waiting group and 5 percent in the Swedish surgery group. For Mark, all of the treatment options remain on the table. He's In fact, of the 450 men being followed, only five have died of pros leaning toward radiation if tests show the cancer is starting to grow tate cancer. In all five cases, their test results indicated their cancer more quickly. He's also hopeful that new technologies will be devel had started to grow and doctors urged all five to proceed with treat oped that will offer high cure rates with lower risks of side effects. ment. Two of the five declined treatment. More than 90 percent of prostate cancer patients have localized Combining the results of six studies tracking men on watchful cancer, and if localized cancer needs to be treated, surgery, radiation, waiting, about a third of all patients saw their cancer progress to and cryotherapy are all viable options. And that's where the decision the point that doctors recommended treatment. Of the more than really gets difficult. There have never been any head-to-head tests of 2,000 patients being followed, including 200 who have lived more surgery versus radiation, the most common treatment options. than 10 years after diagnosis, the death rate from prostate cancer is That leaves men trying to choose between quality of life and lon a mere 0.3 percent. gevity, even though it is unclear what the outcome will be on either But perhaps more importantly, the death rate among men who side of the equation. started with watchful waiting isn't any higher than among men who Many will ask their doctor what treatment he would choose for choose to have surgery or radiation right away. Even those men who himself or a family member. But physicians stress there is no way for eventually required treatment avoided two, five, maybe 10 years of them to make an objective decision. The treatment decision must be living with the side effects. based on the patient's own preferences. "It's generally thought that the treatments are equivalent, the side "Some men want definitive treatment and generally those are patients who have seen others close to them suffer the ravages of effects are different," Omizo said. "So most of the time, the patient prostate cancer. That's understandable," O'Hollaren said. "When pre will have to choose based on what they feel they can tolerate."

HIGH DESERT PULSE • FALL/WINTER 2012

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Coverstory(PROSTATECANCER

Percentage of men experieneing side effeets from prostate treatment A study considering the quality oflife after prostate cancer treatments found that the prevalence of side effects differed according to the type of treatment, but symptoms tended to get better over time. • Baseline• 2 months 6 m onths • 12 months• 24 months

Surgery 60

II Urinary

function

Bowel

function

Sexual function

External-beam radiation

One study found that among patients choosing surgery, nearly two-thirds will have sexual function issues after treatment, one third will have urinary function issues and 3 percent will have bowel issues. Patients un dergoing radiation, on the other hand, are more likely to face bowel function issues (16 percent) or urinary function issues (30 percent), but less likely to face sexual side ef fects (28 percent).

the first month, his recovery was normal. But the surgery had damaged the wall be tween his bladder and his rectum, creating

patients is, we're in a situation where you're

cancer treatment strike at the very heart of

an opening between the two. For the next nine months, he had to wear a catheter,

sometimes two, until doctors could repair the damage. His urethra, the tube carrying urine away from the bladder, constricted where it had been reconnected after the prostatewas removed, and Quon under But the study found that the side effects went a second surgery to fix it. "I just couldn't believe this was happen generally improved over time. "The reality is very few people die from ing to me," he said. "It was such a quality localized prostate cancer within the first of life changing time. The last nine months five years of diagnosis, so you get all your have been a nightmare." side effects up front and your benefits are Even walking was difficult. One day, 10 years from now, 15 years from now, 20 Quon set out for a walk in the Old Mill ois years from now," Beer said. "Treatment for trict with his wife. He never made it out of prostate cancer has to be viewed as a very the parking lot. Three surgeries later, he is long-term investment and you know the finally cautiously optimistic that the entire way we treat long-term investments in life in episode is behind him. "I'm still in a little bit of shock and de general." That leaves men having to decide how to nial that it worked, but as the weeks pass weigh the immediate impact of erectile func I'm feeling more and more confident that tion or bladder control issues against a cancer it's good," he said. "Boy when those cath that could kill them in 10 or 15 years. And no eters came out, it was like I was a new man doctor can tell them for sure how bad their again. I went from feeling like I was 70 side effects or how risky their cancer will be. years old in a 54-year-old body to feeling "It's a very qualitative personal choice, and like I was 45.u the positive spin that I try to put on that for For many men the side effects of prostate not going to make a wrong decision," Beer what it means to them to be a man. Erectile sald. function or bladder control are often valued on par with prolonging their lives.

Side effects

Urinary

function

Bowel

function

Sexual

function

Brachytherapy

Quon, 54,of Bend, was diagnosed with prostate cancer in 2011. He had undergone five biopsies over the past nine years once doctors found an enlarged prostate when he was 45. Because of his young age, doc tors recommended nerve-sparing surgery, a technique to remove the prostate while minimizing the risk oferectile dysfunction. u

My primary thought in my mind was I

want to get this out. I want the least chance

Urinary function

Bowel function

Sexual function

Source: Bulletin staff research

GREG CROSS

Page 14

of it being in there and then spreading to something else," he said. "My second con cern was the nerve sparing." The last thing Quon — an avid tennis player, a performing musician, a husband and father — wanted was to endure in continence or erectile dysfunction. The doctors felt his surgery went well and for

But not all men.

"I have patients who come in and they're 60 years old, 70 years old, they say, 'You know what, I've had a great sex life, but that's not important to me any longer. I

want to cure this cancer,'" Neeb said.

Age can make a difference Wirth, of Bend, was 64 when his prostate

cancer was diagnosed in 2010. His doctor felt the lump on his prostate during an exam before a back operation. His doctors laid out his options for treatment, including ra

diation, brachytherapy and surgery. It didn't take long for Wirth to decide. "No, I want it removed," he told the doc tor. "I really don't want to hesitate."

Wirth said his primary concern was get ting the cancer out ofhis body. He settled on

FALL/WINTER2012• HIGH DESERTPULSE

"There are some people who have really surgery but asked to speak to other patients high-risk cancers that I really worry about who had undergone the procedure. "They told me things would happen, but who say, 'I want to just watch this. I don't really my mind was set on the surgery, just want to do any active treatment right now,' to get it done," he said. "I didn't want to be because they're so afraid of what will hap worried about anything else other than get pen to their erectile function," Neeb said. "It's ting rid of this cancer. And then afterward, a scary time for these guys." It's a stark contrast to other types of can things have changed, but it's not a big con

aspect of their lives." Beer sees many patients even with low

cern to me." Wirth and his wife now volunteer to drive

and advocate with the Prostate Cancer Foun

cers where immediate treatment is rarely

questioned. A cancer diagnosis often has other patients to their chemotherapy ap patients rushing into surgery or radiation or pointments, and on occasion, talk with those chemotherapy, the side effects be damned. patients about their fears about treatment. Some women opt for double mastecto Some are dead set against surgery. Others mies when diagnosed with a precancerous want the cancer out as quickly as possible. growth in their milk ducts. Yet many men "Each has their own little thing they're aren't scared as much by the C word as they concerned about," he said. are by the risk of erectile dysfunction or loss of bladder control. Fearofchange "That might be a unique feature of the Concerns about side effects are so strong, male psyche," Beer said. "I know guys who however, that some patients decline life-sav say 'if I can't have an erection, I don't want ing treatments for fear of incontinence or to live.' It's out there. There are a lot of guys erectile dysfunction. out there who feel that strongly about that

•

risk prostate cancer who just want the can cer out. And it's often hard to get them to

even consider watchful waiting. "But there's also quite a few men who are very focused on the side effects," Beer said. Dan Zenka, a prostate cancer survivor dation, said men often have misconceptions abouthow bad the sideeffectscan bebased on what they've experienced with older fam ily members. "What a lot of men don't realize is that out

comes in terms of erectile dysfunction and incontinence are so much better than they were 10 years ago," he said. Surgeons are able in many cases to per form nerve-sparing surgery that protects the nerves controlling erectile function. Ra

diation oncologists are using image-guided radiation that allows them to determine the Continued on Page 52

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Bend Spine R Pain Specialists S

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Theodore Ford, MD Board Certified Anesthesiologist Board Certified Pain Specialist Non-surgical Pain Management

(541) 647-1645 0

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2041 NE Williamson Court, Suite B, Bend www.BendSpineandPain.com Page15

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FALL/WINTER2012•HIGH DESERT PULSE

On thejob ~ MEDIcALINTERP RETER

'Spanish for"where does it hurt?"

When doctors and patients don't speak the same language, they rely on medical interpreters interpretation services, mostly for Spanish pain. speakers. For Spanish and American Sign At conferences, Durham said he hasheard ennie Davis feels she's succeeding in her Language, the health system uses in-person of errors made in other emergency rooms job when her presence fades into the interpreters contracted through Bridges to due to the wrong pronunciation of a word background. Communication. or the wrong adjective used. He said that's In those moments, in hospitals and clinics Occasionally a patient needs interpreta why evenifa caregiver knows some of the and small offices, the caregiver and patient tion in another language. For instance, the language, an interpreter is crucial. "I can't tell you enough, they're priceless," look directly at each other. They speak and St. Charles system in August encountered listen to each other even though they don't the need for interpretation in Mandarin, he said. "People can be talking quickly and necessaril y sharea common language. Cantonese and Korean. When there is diffi they understand and can translate perfectly. And regardless of the situation — from culty identifying a language on the fly, Rob And this could be a matter of life and death routine checkup to health crisis — the pa inson said the hospitals keep a poster with a if we get it wrong." tient receives the best care possible, in part variety of languages written on it so patients Davis and other interpreters say there because of Davis' help. can point out theirs. is more to the job than fluency in another "You're their voice," she said."You're their In those instances, St. Charles uses a language. "You need to be trained to be a profes only voice." phone-in interpretation service. Another Davis, a certified health care interpreter option, used by Mountain View Hospital in sional interpreter," said Roxana Ocaranza who works for both Volunteers in Medicine Madras, is interpretation through a Skype Ermisch, who in 2005 helped found Bridges and local interpretation service Bridges to like computer video service. to Communication. "You have to understand Communication, acts as the link between And interpreters — whether in-person terminology, ethics, cultural differences and providers and patients. It's a profession that or over the phone or computer — must be have a commitment to being a neutral per those in health care say is critical to doing available 24/7. Their services are regularly son between the doctor and the patient." their work. needed in emergency rooms and the birth In fact, Davis, who interprets in Spanish, "I think that's one of the things we try to en ing centers. said the patients she helps regularly know force with our caregivers: We absolutely need Darin Durham, St. Charles' emergency some English and often are quite good in it. an interpreter present," said Debbie Robin department director and a registered nurse, Yet fluency is a spectrum, and because health son, who oversees interpretation services for said emergency room staff rely on interpret care is both complex and important, some the St. Charles Health System. "Diagnoses, ers to accurately convey details of the prob people prefer the help ofan interpreter. "Health problems can be nerve-wracking," discharge plans ... these kinds of conversa lem, how long it's been going on and what tions are critical to the success of a patient." medical history might be relevant. The ques she said. "Sometimes people are in tense sit Robinson said rarely a day goes by in tions can be nuanced, especially about the uations and they can't understand 100 per the St. Charles system without a need for location of the pain or the acuteness of the centofwhat'sgoing on.And they should." BY HEIDI HAGEMEIER

HIGH DESERT PULSE • FALL/ WINTER 2012

Page 17

On thejob(MEDICAL INTERPRETER

Medium for communication Interpretation seems a fitting field for

some. It did for Mari Lu Pedraza, an inter preter for Madras Medical Croup. Pedraza's first language is Spanish. She learned English early on from siblings and in school. She started working in health care related jobs after high school and then went on to get her interpreter certification.

Others must work to become fluent later in life. Bend-based American Sign Language interpreter Tamara Catalano, who isn't deaf, studied the language for years before com

terpreters are ready to handle their role as a medium for communication. "It becomes very important for every one toknow where you stand,"Davis said. "You're not a provider, you're not a friend, you're not a family member. You're com pletely unbiased." Historically, language interpretation has more frequently been handled by relatives or friends. Even though relatives might be fluent in both languages, Ocaranza-Ermisch said, the relationships might change what is said — and what's left unsaid.

waiting rooms with paperwork but they avoid chitchat, as they don't want the pa

tient to share anything that isn't going to be said in front of a caregiver. Once called back, they stay outside of ex amination rooms until caregivers enter. If a doctor, nurse or other staff member exits, so does the interpreter. They try to stand slightly behind the health care provider to make the situation

less like a triangle and more like direct com munication. They speak in first person for the same reason. If the patient is lying on an exam table,

The relationship with an interpreter, on

the other hand, is a more formal one. Sever Locally, Central Oregon Community Col al interpreters described how an interaction lege has offered a Spanish health care inter generally unfolds: If it's a set appointment, pretation certification, which takes about six interpreters will try to research possible vo months to complete. It includes classroom cabulary that will be needed beforehand. time, language labs and a practicum. A team They will not necessarily know the details is revamping the certification right now and of the case in advance, but the doctor's spe plans to offer it again next year. cialty or type of clinic offer clues. pleting an interpretation program.

Upon completion of the certification, in

the interpreters stand behind the head. In

the case of ASL, interpreters stand close to the head of the patient but turn their backs

to the rest of the body. While it all sounds structured, in reality in terpreting is regularly more nuanced.

More than words

The interpreters might help patients in

The situations interpreters end up in are

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FALL/WINTER2012• HIGH DESERTPULSE

as varied as those experienced by health care providers. Davis said her days range from cardiol ogist's offices to chemotherapy treatments to emergencies. It can be difficult to know how long she will be working at times, particularly in t h e s pur-of-the-moment

about them," she said. Pedraza said she includes everything in an exchange,from tone to volume to con tent, even when the content is angry or rude

or sad. Sometimes emphasis is important too, such as when a patient is identifying de grees of pain during an examination. "We really have to portray the emotion so situations. In these varied scenarios, interpretation the doctor can understand the feeling there," requires more than just understanding the she said. WOI'ds. For the deaf community, Catalano said, "Our job is to say every little thing," Davis body language is particularly significant, as said. "So if the doctor presses on the abdo is the emphasis given to the sign and where men and the patient moans the Spanish it's placed in space. "Facial expression is super important," equivalent of 'Ow,' we moan 'Ow.' If they are having a baby and say anything in those she said. She also tries to match her verbal yells, that has to be interpreted." translations to the age of her deaf patients. That even goes for chatter between If it's a 7-year-old, she uses the same simple caregivers, Davis said. A woman in labor language of a child. should know what the two nurses said to Explaining cultural expectations and be each other, even if it was about when to liefs is also a key part of keeping communi eat dinner. cation flowing. "They should understand what is and isn't For instance, Ocaranza-Ermisch said, care

givers are at times confused when a Hispan ic woman in labor doesn't want ice chips or water. Yet the belief in many Latin American countries is that women need to retain heat

during childbirth, so they prefer hot drinks and broth soups. Occasionally, an interpreter must engage in what Ocaranza-Ermisch called "limited

advocacy" when it's clear that the two sides aren't understanding each other. Davis said she usually approaches these situations by stopping the dialogue and ask ing the last party speaking to repeat what was said. If that doesn't help everyone get on the same page, she will ask people to elaborate on their points. But she isn't interjecting her understand

ing — she's helping two people reach their own. Because ultimately, decisions should be made between caregiver and patient. "We wouldn't want a medical error to hap pen," Pedraza said, "just because one person doesn't understand."•

Comp ete Hea th 8 We ness • High Cholesterol

• Coag Clinic

• High Blood Pressure

• Adult 8 Child Wellness Physicals

• Heart Disease

• Women's Health

• Stress Testing

• Arthritis

• Diabetes Dr. Celso Gangan

• School 8 Employment Physicals

• Lung Disease

Dr. Derelr p erek Palmer

• Acute illness Treatment Lorl McMllllan FNP

REDMOND MEDICAL CLINIC I541I 323-4545 1245 N W HIGH DESERT PULSE • FALL/WINTER 2012

4 t h S t r eet • Su i t e 2 0 1 • R e d m o n d, O R Page 19

New research ~KIDsANDsLEEp

After a volunteer shift at St. Charles Bend endingjust after 9 p.m., Aedin Wright, 17,works on her biology homework on her laptop at around 10 p.m. in her room at home. She getsupat6:15a m. tostart thenext day.

Page 20

Studies show that disrupting youths'sleep can lead to obesity and poor academic performance BY ANNE AURAND • PHOTOS BY ROB KERR

uring the school year, Aedin Wright, a busyand ambitious 17-year-old senior, rarely gets a de cent night's sleep, and it's wearing her down. Last summer, Kayla McCarthy, 4, couldn't sleep due to fear or anxiety that didn't calm down until she

moved into her sister's room and her mother doubled up on bath and story time before bed. Like many of today's youth, these local kids are overstimulated, over-scheduled and anxious, and it's interfering with their sleep. From preschool through high school, kids are falling short of national sleep recommendations. Studies have tried to quantify the problem, report ing figures such as: 10 percent of young children have periodic sleeping problems, 10 percent of adolescents have insomnia, and 62 percent ofhigh schoolers sleep less than eight hours nightly. The most visible side effects include kids dozing in class, spacing out, acting moody — what's often writ ten off as typical adolescent behavior. But there can be far more serious consequences. "Short sleep and poor quality sleep impact every as pect of children's and adolescents' well-being and day time functioning," according to a 2011 study published in the journal Sleep Medicine. Inadequate sleep is linked to obesity and metabolic problems in children. It's associated with behavioral problems, emotional instability and mental illness, ac

HIGH DESERTPULSE• FALL/ WINTER 2012

cording to Sleep Medicine. It damages academic per formance and increases the risk of car accidents and even sports injuries. "It's a huge topic of research these days," said Dr. Da vid Dedrick, a sleep specialist at St. Charles Health Sys tem. "Fundamentally, as a society we're sleeping less than ever before. Initially it was adults. It's spilling over to children, even small children." Over the past century, kids' nightly sleep time has shrunk at a rate of about .73 minutes per year, accord ing to a study in the February 2012 issue of Pediatrics. "Inadequatesleep was seen asa consequence ofmod ern life, associated with technologies of the time," ac cording to the study. Once upon a time, people's work days were limited by natural light. Electricity has ex panded our hours of productivity. Technology is still a factor that is disrupting sleep wake cycles. Add to that the prevalence of anxieties, caffeine and sugar, and "it's a perfect cocktail for not being able to sleep well," Dedrick said. "It's bothersome how much less we're sleeping," De drick said. "On thesurface,look how much more ef ficient we are, that's great. But the other side, look how

unhealthy we are for Cod's sake."

Obesity "The less you sleep, the fatter you are," said Dedrick. For every hour of habitually lost sleep, the odds of obesity increase 80 percent, according to a 2002 study published in the American Journal of Human Biology.

Page 21

New research( KIDS AND SLEEP

In more general terms, a comprehensive review of 29 epidemiological studies about the relationship between sleep and obesity said short sleep and late bedtimes are as sociated with an increased risk for being or becoming overweight or obese. Sleep restriction decreases the secretion of the hormone leptin and increases the hormone ghrelin, both of which are associ ated with increased hunger, appetite, moti vation to eat and food intake, authors of the report wrote.

Sleep loss also elevates a hormone called cortisol, which stimulates production of fat. One study highlighted in the review said when sleep is limited, children increase their caloric intake from snacks and meals. Another specifically linked shortened sleep with more consumption of pizza, pasta and refined sugars. One study suggested that sleep deprivation could lead to decreased physical activities, which could promote weight gain. Health problems can be more compli cated than a couple of extra pounds. Sleep deprivation affects the hormones. It can create metabolic abnormalities, including higher insulin resistance, which can lead to Type 2 diabetes. A study of young adults published in the April 2012 issue of the jour nal Science Translational Medicine discussed a controlled laboratory experiment in which researchers restricted and upset the sleeping patterns of healthy adults. The sleep disturbances resulted in decreased resting metabolic rates,

Tips for improving sleep The pillars of good sleep for youth are: Schedules:Create a bedtime schedule and stick to it. This helps to regulate various body cycles that effect sleep, metabolism, diet, and hormones. This requires a person to have a regu ar bedtime and waking time, even on weekends. Routines: Bedtime wind-down routines should start about a halfhour before bedtime. These should include comforting activities such as baths, stories or stretching and should not include heavy emotional conversations, TV, video games, active or aerobic exercise or caffeine. Also avoid too much liquid, food or sugar in the evening.

to bed. "If a student sacrifices sleep to study more than usual, he or she will have more trouble understanding material taught in class and be more likely to struggle on an assign ment or test the following day," the study's

Bedrooms:The bedroom should be cool and comfortable with sufficient air circulation. It should be dark, quiet, and not include television viewing. Daytime habits: Expose a child to sun ight first thing in the morning. Don't use the bed room for punishment or time out. Monitor and limit exposure to television, Internet or video gaming. Limit vio ent, disturbing, or confusing images, which can be responsible for many sleep disturbances, such as nightmares. Con front bullying or other stressful or emotional issues such as death or divorce in your child's life. Theses troubles can affect a child's sleep. Discuss your child's medicines with a pediatri cian. Some interfere with restful sleep. Source:Tom Jackson,anldyllwild,calif., basedpsychiatristwho specializes >n sleepdisorders and anx>ety.

enlarged tonsils and adenoids for years. In 2007, they discovered that children who snored nightly scored lower on vocabulary tests. University of Virginia pulmonologist

and sleep lab director Dr. Paul Suratt said the vocabulary score differences associated with authors wrote. It's possible, they wrote, that nightly snoring are the same as IQ dissimilari if students weren't generally sleep deprived ties attributed to lead exposure, which can re already, they might be less sensitive to an duce a child's IQ by more than seven points. occasional daily variation in schedule. Manipulating children's sleep is not a com Disruption to sleep quality can have the mon or generally well-accepted practice for same effect. Poor quality sleep could stem the sake of clinical research. But one three from a number of issues, including restless week experiment in 2005 actually did restrict leg syndrome, which is character sleep for 74 children, and their teachers were ized by unpleasant sensations in asked to rate their performance during the the legs, or sleep apnea, when the period of study. Children in first and second airway gets blocked or narrowed grade were restricted to eight hours of sleep which can t ranslate into w eight and breathing pauses during sleep. per night for one week. Third graders and gain, and increased glucose con Physicians are paying more at older were restricted to six and a half hours centrations after eating, which can tention to obstructive sleep apnea per night for one week. Teachers reported ~ \ increase the risk of diabetes. because it's fairly common and it that the sleep-deprived children had more edrick is as s ociated with other cardiovas academic difficulty and attention problems. Academics cular health problems, said Dr. Jen The authors suggested that insufficient sleep When a student struggles stay awake in nifer Warton, a pediatrician at 6end Memo could be a source ofattention problems, such class, it's bound to hurt academic perfor rial Clinic. Sleep apnea is more prevalent in as those in children with attention deficit hy mance.This assumption has been backed obese kids. It can be diagnosed through a peractivity disorder. Kids between age 5 and by research. sleep study, or sometimes just an exam of 12 need 10 to 11 hours of sleep nightly. A recent study in the journal Child Devel the tonsils and adenoids. Once diagnosed, ADHD opmentconsidered a common studyingsce there are solutions. In the case of obesity, nario: pulling all-nighters prior to a test. The losing weight usually helps. If it's from en Research has still not clarified the links be report found that extra studying and its as larged tonsils and adenoids, those can be tween sleep and ADHD. An analysis of litera sociated loss of sleep resulted in worse aca surgically removed. ture said the link between sleep problems demic performance, and suggested that the University of Virginia researchers have and ADHD is far fromclear. students might fare better if they just went studied sleep disturbances in children with Dedrick doesn't believe sleep shortages

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FALL/WINTER2012• HIGH DESERTPULSE

How much sleep do kids need each day?

before bed. Research has shown that viewing back-lit communication devices can cause melatonin levels to drop, making it much harder to fall asleep. Melatonin is a hormone that creates the feeling of sleepiness.

Newborn

(1-2 months)

Toddler Infant

Preschool

(1-3 years)

(3-11months)

(3-5 years)

"Light signals the brain that it's daytime

School-age (5-12years3

Teenage

(13-18years) aL

and we should be awake and alert, looking for food. At night time, we're supposed to be in the cave asleep. Light is an evolution ary signal," Dedrick said. But we're getting light exposure at times we should not, and it throws off one's hormonal rhythm. Aedin Wright, the Summit High School

senior, says she knows this, but avoiding her laptop late at night is unrealistic. That's how 0.5 to 18 ours on an irregular schedu e; inc udes naps

9to12 ours each night; additional naps needed

Source: National Sleep Foundation

12to14 hours; around 18 months of age, nap times decrease

homework is done. She's working harder 11 to 13 ours each night; most stop napping fter age 5

than ever this year in hopes of getting into

10to11 ours each night

8.5 to 9.5 ours each night ANDYZEIGERT

cause actual ADHD, but create symptoms tion robs the brain's ability to memorize the that mimic it. good things, and leaves a brain biased to "(Sleep deprivation) makes kids inattentive ward the negative. and distracted. Sleep-deprived children are Sleep deprivation also leads to impulsivity hard to be around. They're temperamental, and errors in judgment, Dedrick said. Citing can't focus. They get tired, have crying fits, studies on adults again, Dedrick used this more aggressive behavior," he said. That example: Sleep-deprived gamblers don't might be falsely labeled as ADHD. see a five in six chance of losing, they see a A misdiagnosis ofthis nature could lead to one in six chance of winning. "Vegas is built inappropriately medicating a kid who really around sleep deprivation," he said. just needs better sleeping habits. A doctor Teenagers don't frequent the casinos, but might prescribe amphetamines for ADHD, they gamble every day with drugs, sex and which will "further rev up the adrenaline sys dangerous driving. Suicide is a scary and se tem," Dedrick said. "The brain doesn't want vere example of what could go wrong in the (increased stimulation), it wants sleep." eye of a perfect storm of negativity, impul sivity and bad judgement. Perception and judgement "Those intensely emotional days of teen "The other thing, a little esoteric but al agership are some of the most dangerous most more alarming, is the effects on our times," Dedrick said. mood," Dedrick said. "What happens, in a Whyyouth aren't sleeping nutshell, is, a good night of sleep makes the world rose-colored. 6ut a bad night is like Many factors could be responsible for dis dark glasses." rupting youths' sleep. "The biggest new one is excessive light Researchon adults has shown that much of memory formation happens during sleep. exposure prior to bed and late at night," De Our brains are wired so that we process bad drick said. Kids, especially teens, are up late memories first. Then the brain can lay down texting or looking at electronic screens such the good stuff, Dedrick said. Sleep depriva as laptops, televisions and iPads in the hours

HIGH DESERT PULSE • FALL/ WINTER 2012

the Robert D. Clark Honors College at the University of Oregon, where she wants to study medicine. She's not going to skip her homework or damage her 3.8 CPA. She said she rarely gets a decent night's sleep. On school nights, by the time she's done with school, running with the cross country

team, showering, eating and homework, it's about 10:30 p.m. Sometimes, Wright can't

fall asleep until midnight. Often her mind will chatter: "I need to do this, and this, and this,"

forhours.Then,she wakes up at6:15 a.m .to make her flrst class at 7:45 a.m.

According to the National Sleep Founda tion, Wright's age group needs 8.5 to 9.5 hours of sleep nightly. When she sleeps less than eight hours a night, Wright feels cranky and stressed. She catches more colds. She eats more when she's tired. She struggles to concentrate at school. "I have definitely fallen asleep in class," Wright said. "The feeling I hate the most is

when I can't concentrate or focus, because all my willpower is focused on staying awake." Dedrick recalled a story about a sleep study with a 16-year-old insomniac whose concerned parents brought him into the sleep clinic. "The kidhad snuck a cellphone in and buried under the covers. We could tell he was texting by the brain waves we were monitor

ing. We told him and his parents, 'Nothing's wrong with you. You just need to get off your phone,"' Dedrick said. Continued on Page34

Page23

HDI/I/doeshedoit? ~ REN0cITYMANAGER ERIcKING

Bend City Manager Eric King's newfound fitness regimen helps keep him slim, strong and less stressed BY ANNE AURAND

t 5:15 p.m. on a Tuesday, Eric King zipped into the Athletic Club of Bend parking lot in his Volvo 5UV, straight

from Bend City Hall and still dressed in slacks and a button-down business shirt. The city manager flung his gym bag over his shoulÂ der and charged toward the locker room. Work was still on his mind: The following day he would be orchestrating a meeting between local higher education leaders and state legislators from out of town. Two days later he was scheduled to fly to New Zealand for a two-weekjob exchange. He needed a good workout to rinse his stressed mind, the way a shower can clean his body. By 5:30 p.m. hewasclutching hand weights and lunging from side to side at the direction of a fitness class instructor and to the beat

RYAN BRENNECKE

Page 24

of the loud and appropriate pop lyric: "What doesn't kill you makes you stronger." The strenuous workout went from ab crunches

FALL/WINTER2012â&#x20AC;˘ HIGH DESERTPULSE

Atrightandon the previous page, EricKing works outduring astrength training class at the Athletic Club ofBend. RYAN BRENNECKE

to deep squats to shoulder-strengthening weightlifting. King bared his teeth. Sweat

stains spread across his gray T-shirt. After an hour of this, his mind had stopped spiraling with worry. He could remember the bigger purpose of the following day's meeting, and felt more relaxed about it. He looked forward to the cool places he would go runningonce he gotto New Zealand. Intense workouts, which he's started do ing regularly over the past year, have helped King handle his all-consuming job. "I'm more efficient and focused at work, although there's no data to back that up," he said with a smile. "I'm sleeping better and able to cope with stress." He also has a smaller waist and more de fined muscles. Over the past year and a half, he's lost more than 20 pounds.

Life over fitness King, born and raised in Madison, Wis., was academic, responsible, hard-working. He at one point thought he might be an

architect, but later studied economics and sociology at the University of Wisconsin. He earned a master's degree in urban and regional planning at Portland State Univer

sity and worked for the city of Portland for almost adecade before becoming Bend's assistant city manager in 2007. When he

landed the job as the city's top executive at age 33 in2008, he was the youngest city manager known to Bend. Crowing up, King was a string bean who actually wanted to gain weight. But then he hit his 30s, and his metabolism

changed. He and his wife, Martha Ketsdever, had two kids, a game-changer that cut into his

backpacking and bike riding. "It took me a while to recover from those

early stages of parenting where you strug gle to find an appropriate life balance," he said. "This was compounded by the fact that I came into a high-profile, stressful job dur ing one of the worst economic times in Bend

HIGH DESERT PULSE • FALL I WINTER2012

Howdoeshedoit?(ERICKING Hnu

and had to devote a lot of energy to my role as city manager. Health and fitness definite ly took a back seat to these challenges and I don't think I had a strong enough founda tion, a core fitness regime, to help me man age the stresses in my life." King said he worked out from time to time,

but not in a strenuous or focused way. Mostly he went to the gym to fulfill his need for some "alone time," he said. He spent increasing amounts of time decompressing in the steam room, he said, like he was going to a spa. "I think I exercised at this minimal level to justify eating anything I wanted, which tend

ed to work in my 20s. However, I learned by gaining weight, albeit at a very slow pace, that I need to change my diet and exercise regularly to stay fit. I also needed to get away from my Midwestern comfort food diet that included a lot of dairy and foods that were salty and high in fat — ice cream, french fries, pasta, etc." In 2011, at 5 feet Il-inches, he peaked at 192 pounds.

Getting in shape

Paleo-style eating, advocating a diet of meat, nuts, fruits and vegetables. "I've gone a little Paleo," he said. "Not su per intense or anything. Less bread is how I've interpreted it. No bun on the burger." In

stead of cereal and milk for breakfast, he's '„"k"j~+~j~'A ~ 4 4(4~

more apt to eat nuts and fruit. He keeps trail

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mix handy to curb hunger pangs through out the day. His biggest problem, food-wise, has been lunch. Ketsdever cooks healthy food at home, but when he's on a lunch break down town, it's tempting to grab a burger and fries at a nearby pub, he said. He 's now more apt to order "Paleo-like" options, such as a steak salad, carne asada or a chicken Ceaser salad.

JOE KLINE

Bend City Manager Eric King exercises about five times a week and has started eating healthier."I'vegone a lit tle Paleo,"King said.

"I don't count calories, but I look at them,"

he said. For example, he will compare calo break or after work. Interval-style strength ries between various brands of snack bars classes happen Tuesdays and Thursdays before choosing which one to eat. "Did you know margaritas have up to 700 after work, or on Saturdays. Every now and then he slips into the gym for some freestyle calories!" he said, his eyes growing large. In weightlifting. stead of margaritas, he chooses clear liquids Despite his planning and organizational now, such as a gin and tonic a couple oftimes skills, he said, he's notorious for underesti a week, or the occasional beer, he said.

mating the time it takes to go somewhere, or to complete a task. He often tries to cram years ago, when an executive coach he was too much in a short period of time. But he

Weight loss

His trajectory started shifting about two

working with told him he looked stressed. doesn't feel like he's sacrificing work time or That bugged him. family time to accommodate his exercise, he In spring of 2011, Ketsdever suggested he said. He does have to deal with email more at join her for a strength training class at the Ath home after the kids go to bed, he said. And, letic Club of Bend. He started going with her, Ketsdever, who works as an account manag and it felt great. Sometimes he and Ketsde er for an educational software company, said ver put their kids in childcare at the club and the family has adjusted to eating dinner later worked out together. Sometimes they would some nights, if they all want to eat together. get a sitter at home so they could go out after King said he maximizes weekend time the class for a drink or dinner and call it a date. with his two young kids. He builds Legos In the fall of 2011, he joined a CrossFit with hisson on weekend mornings. The gym, where he said he learned a lot about family often goes to the pool or a park, weightlifting and started seeing real changes and, with some regularity, they travel to the in his body. The success was motivating, and coast, Portland or Seattle. They go to church, made exercise a priority. He dabbled in road but somewhat inconsistently, he said. He's not always uber productive though. bikingwhen the weather was good. He's been running. He is known to watch some TV. "I really like Now, he exercises about five times a week. the 'Mad Men' series and love historical doc He doesn't have a rigid repertoire but he ar umentaries," he said. "... On occasion we will ranges his work schedule to fit it in. Because watch some random reality TV shows." he's the boss, he has the power to make it Eating better possible. "Meeting's over," he'll say."I gotta go." He's a planner, and highly organized, Somewhere during his transformation into and he knows byheart his menu of avail more ofa fitness guy, he started eating better. able workouts. Running can fit in on a lunch The CrossFit gym he had joined promoted

Page 26

By last summer, his weight had dropped to 170 pounds. Weightloss wasn'ta huge goal when he started. A self-proclaimed Type A personal ity, he said, "it was more about me being in control of my health." But as he lost weight and built muscle, people noticed and told him he looked good. "It was nice to have people recognize that," he said. King doesn't plan to or need to lose any more weight, but he's setting new goals: .. continuing to challenge myself in be ing more fit and perhaps getting to a place where I may want to compete in some type of enduranceevent down the road,"hesaid. Those who spend time with King have noticed a change, and not just in his clothes size. "He's lost weight and is a lot happier about himself and his appearance," said Ketsdever. "Working as many hours as Eric does, it "

takes quite a commitment to get into and

keep in shape, but the payoff makes it well worth it," said Justin Finestone, the city's com munications director . "It's easy to tell he has

more energy."•

FALL/WINTER 2012• HIGH DESERTPULSE

Picturethis ~~AS~E

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Taste vs.flavor

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Taste is the chemical sense that distinguish

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The common map of tastes on the tongue, devel oped in 1901, is misleading. The regions indicate

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where taste sensation was thought to be strongest,

not where it was exclusively. New research has shown that taste can be perceived anywhere on the tongue.

Flavor is the mental interpretation of taste, smell, texture and temperature. Even the burn

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ing pain of spicy foods factors into the brain's perception of flavor. Sensations of taste and smell become percep tions of flavor when they reach the brain.

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Taste provided clues to our ancestors about the nu

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Fun fact:Children tend to be more taste-sensitive than their parents.

One taste bud comprises about 50 taste receptor cells, organized into papillae. Chemicals from food mix with saliva and enter the taste pore, interacting with the microvilli. This stimulates the sensation of taste.

The gustatory impulse then travels to the brain's ce rebral cortex, where it is interpreted. Taste pore Foodmolemlee • Sensorycortex ~

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HIGH DESERT PULSE • FALL I WINTER2012

Gustatorysensors

oo © Taste anddesire Our brain associates flavor with the mouth, even though smell provides a larger component. The brain uses signals from the taste buds and olfactory sensors to determine what something is and whether it is de sirable. But emotional centers also help us determine if something is desirable. Source:HowstuffWorks.com, Tastescience.com

ANDYZEIISERT

Page 27

•

• •

Wool While wool can be scratchy on the skin, Merino wool is made of soft, natural fibers. Wool is stain- and wrinkle-resistant, and is usually machine-washable. Brands:Patagonia, Icebreaker, Smartwool Temperature regulation:Great — Warmer than synthetic fabric but still comfortable for milder temperatures. Moisture wicking: Great — Can absorb up to 35 percent ofits own weight in liquid, then Page 28

•

Silk gradually release it through evaporation. Drytime: Good — While it takes longer to dry than synthetic fabric, wool often feels dry on the skin due to water-repellent outer fibers. Odor resistance:Great — Unlike silk and syntheticfabric, wool is antibacterial and can be worn several times before odor builds up. Cost: Expensive — From S50-5100 per garment.

Treated silk — chemically modified to improve wicking — is best for physical activity. Silk is a smooth natural fiber, and some types require hand-washing. Brands:REI, Terramar, Eddie Bauer, WinterSilks Temperature regulation:Good — A great insulator in cold conditions, but is sometimes too warm for vigorous physical activity. deal for snowsports and when sedentary.

HIGH DESERT PULSE

' ' •

•

' • •

•

• •

•

Synthetics Moisture wicking:Good — Treated silk transports moisture awayfrom the skin, but un treated silk absorbs and retains moisture. Drytime: Fair — Absorbs some moisture, meaning it takes longer to drythan woo or synthetic fabric. Odor resistance:Fair — Launder garments after each use to keep them sme ing fresh. Cost: Fair — From $40-560 per garment.

FALL/ WINTER 2012

Polyester and polyester blends are the main type of synthetic fabric, while some include spandex to increase stretch. Synthetic fabric is wrinkle-resistant and machine-washable, but can be prone to stains. Brands:Nike (Dri-FIT), Under Armour, Patago nia (Capilene), The North Face Temperature regulation:Good — Perfect for warmer conditions but can sometimes cause chills if a breeze hits before the fabric has dried. Moisture wicking:Great — Moves mois

ture away from skin, speeding evaporation by spreading moisture over a large surface area of the garment. Ideal for running or other high-in tensity physical activities. Drytime: Great — Dries faster than any other type of base layer. Odor resistance:Poor — Over time, synthet ic fabric collects odor-causing bacteria. Launder after each use. Cost: Moderate — From 530-550 per garment. Page29

Healthyeating ~FATs

Select the right fats to enjoy without risking your health BY ANNE AURAND • PHOTOS BY ROB KERR

at," for quite some time, was synonymous with "bad." 6ut science has debunked the idea that banning fat is the key to weight loss and better health — wonderful news for people who appreciate the tastes and textures attributed to fats.

Fats are no longer deemed entirely villainous. There are good fats and bad fats, saturated and unsaturated, solids and liquids, substitutes and spreads. But this can become confusing. What'sa consumer to do? With the help of two local dietitians, we highlight the

healthiest products to keep in your cupboard, illustrate some easy options for putting good fats on your plate, and intersperse some fat facts to put it all in perspective.

Dietitian and chef Garrett Berdan suggests using whole foods such as avocados to add texture, flavor and healthy fats to meals.

T hanks to y o u , w e h a v e a d d e d n ew avail ab i l it y fo r w a l k i n a ppo i n t m e n t s , o n l i n e a b i l i t y t o

r egister as a ne w p a t i e nt , an d n ew w ay s t o a c c es s y o u r h e a l t h c are team an y t i me , a n y w h e r e .

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H ea l t h C a r e FALL/WINTER2012• HIGH DESERTPULSE

Fats 101

Complexity of fats

Saturatedfat

Fats are generally categorized as either saturated or unsaturated, but most are made up ofa combination offatty acids. This graph illustrates the proportion of various fatty acids in a number of common fats and oils.

•Generally considered "bad" fats. •Primarily from animal products. Think; butter, cheese, meat. •Solid at room temperature. What they do •Increase "bad" or LDL cholesterol,

which is associated with higher rates of heart disease, and risk of colon and prostate cancer. Exceptions •Coconut and palm oils are plant sources ofsaturated fats that can in crease "good" or HDL cholesterol.

• Saturated fat• Monounsaturated fat•

Po lyunsaturated fat

Fatty acid composition (percentage of total) 1 0% 20

90 100 %

Coconut oil Palm kernel oil Butter B ffat

Unsaturatedfat (can be monounsaturated and polyunsaturated) • Generally considered "good" fats. • Typically from plants. • Liquid at room temperature. Think: o ive oil, peanut oil, canola oil. What they do • Lower "badwor LDL cholesterol. • Polyunsaturated fats, which include corn, flaxseed, safflower, sunflower, cottonseed, soybean, and sesame oils,

Palm oil

fatS

contain essential fatty acids necessary for the health ofcell membranes, vi sion, brain cells and other parts ofthe nervous system. Polyunsaturated fats can be either omega-3, which reduce risks for heart disease and chronic inflammation, or omega-6. Exceptions • Fish, an animal product, con tains unsaturated fats, especially polyunsaturated.

Pork fat (lard) Chicken fat Shortening Stick margarine Cottonseed oil Soft margarine Peanut oil Soybean oil

Trans fats •"Bad" fats, to be avoided. •Are partially hydrogenated vegeta ble oils, an unsaturated fat that gets processed into something more like a saturated fat. •Prevalent in processed cookies and

Olive oil

ojjS

crackers and in firmer margarines. What they do • ncrease "bad" cholestero, decrease "good" cholesterol and are associ

Corn oil Sunflower oil Canola oil

ated with increased risk ofcardiovas cular disease.

Saffjower oil

Source: Julie Hood Gonsalves, a registered dietitian and associate professor of health at Central Oregon Community College.

GREGCROSS

Source: U.S.D.A. Dietary Guidelines for Americans, 2010

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Healthy eating(FATS

Best fats to keep in your cupboard Canola oil For: Baking, sauteing. Its mild flavor goes with most foods. •It has high levels ofhealthy omega-3 fatty acids and monounsaturated fatty acids.

Oliveoil For:Sauteing, when olive flavor is desired. •It has high levels ofhealthy monounsaturated fatty acids.

Butter For:Adding a rich, unique flavor, where butter flavor or solid fats are needed. •It does not have unhealthy trans fat. But use sparingly, because it has high levels of saturated fats. Tip: Llse part butter and part canola oil in recipes re quiring butter flavor or solid fat.

Berdan adds a salmon fi let to a salad prepared with avocado, almonds and a vinaigrette dressing with olive oil, mint and shallots. The combina tian ofingredients offers healthy fats and plenty offlavor.

Each oil has a different smoke point. Lookfor oil labels that suggest uses, such as sauteing (medium heat), stir-frying (high heat), or salad dressings (no heat). • Margarines:Firmer-consistency stick margarines, often substituted for but Ifyou fry, brown or sear at high temperatures, try more refined oils such as ter in cooking, have the most trans fats. Softer, spreadable margarines have corn, safflower or peanut oil, which have a higher smoke point. a higher proportion ofhealthier, unsaturated fats than butter. However, they • Aii fats are calorie dense.Fat has 9 calories per gram, compared with car have some saturated fats and/or trans fats in them. bohydrates which have 4 ca ories per gram, and proteins, which have 4 calo • Smoke point:The smoke point is the temperature at which an oil breaks ries per gram. Eating too much fat, even good fat, is associated with obesity. down. In addition to degrading its smell and flavor, it creates a chemical trans Obesity is associated with some forms ofcancer, especially breast and colon formation that releases free radicals in the oil. Free radicals are molecules that cancer. Eat good, unsaturated fats in moderation, and emphasize polyunsatu steal electrons from cells, creating cellular damage in our bodies. rated fats, said Gonsalves."We don't need much to maintain a healthy body."

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FALL/WINTER2012• HIGH DESERTPULSE

Best fats for your table Healthy fats from whole foods are tastier than those from oils because you get great flavor and texture, said Garrett Berdan, a registered dietitian and a chefin Bend. Berdan suggests easy ways to put the right fats on your plate:

l•

• l

(

•

• Nutsand seeds contain unsaturated fats and add a satisfying crunch and flavor to any meal or snack, including breakfast cereals, homemade granola, trail mix and salads. Toast nuts in the oven to enhance the crunch and flavor. Spread nuts in a single layer on a baking sheet and bake in a preheated 325 degree oven until lightly toasted and aromatic. The time will vary depending on the size and type of nut. • Avocados, rich in monounsaturated fats, aren't just for dipping tortilla chips. When spread on a sandwich, avocado offers creamy richness like but ter, but with fewer calories and no saturated fat. Or, add an avocado when blending fruit or berries for a richer, creamier smoothie. • Fish — especially salmon, trout, herring, albacore tuna and sardines — are rich in omega-3 fat. Baking, broiling or grilling fish seasoned with salt, pepper and fresh herbs is a fast and easy way to get the best flavor with the fewest calories. Avoid deep-frying or dousing in rich sauces. Another option: Place fish in a lightly oiled baking pan and drizzle a spoonful of pesto, teriyaki sauce or a miso-based dressing over the top before cooking.

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HIGH DESERT PULSE • FALL/ WINTER 2012

Page 33

Feature(KIDS AND SLEEP

Jen McCarthy reads to her daughter Kayla to help her get to sleep on a school nightin September. Kayla sleeps bet ter when she's on a pull-out bed near her sister Payton, 8,instead ofalonein her own room.

he finds himself staring off into space, or making social mistakes such as calling people the wrong name. the topics of dating, friendships or other potentially stressful issues. Some school districts have experimented with pushing back And that won't help teens sleep because it keeps their minds swirling in morning start times. A well-known case in Minnesota showed an in emotional activity at a time when they should be calming down. crease in SAT scores for the top 10 percent of students a year after school start time moved from 7:25 a.m. to 8:30 a.m. After a school School start times district in Kentucky delayed its start time an hour, teenage car acci Research backs a notion that Wright said she knows firsthand. dents reduced about 16 percent at the same time that the rest of the There's a disconnect between high school start times and teenage state saw an increase in accidents. sleep cycles. Anxiety Through puberty and the teen years, sleep-inducing melatonin is heaviest from about 11 p.m. to about 8 a.m. It's therefore some Nighttime fears are common in preschool and early school years, what biologically dictated that most teens can't easily fall asleep according to a 2011 study in Sleep Medicine, and children with such much before 11 p.m., and their brains want to stay in sleep mode fears have more disrupted sleep. Poor sleep quality can compromise until about 8 a.m. a child's psychological well-being, the study said. Like Wright, C.J. Fraley, a 17-year-old at Bend High School, has Any number of anxieties can keep kids awake at night, said Dr. more to do than he has time for, and it's often sleep that gets short Kyle Johnson, an associate professor of psychiatry and pediatrics changed. He runs cross country and takes online classes through and co-director of Oregon Health 8 Science University's sleep dis Massachusetts Institute of Technology in addition to his regular orders program. He can't say whether anxiety disorders in kids are school load. He said he sleeps 6.5 to 7.5 hours per night during the more prevalent now than some years ago, or just better recognized. school year. "Mainly it's my workload that prevents me from sleep Cognitive behavioral therapy can help these anxieties and therefore ing more, but I have trouble getting to sleep until later and by then improve sleep, he said. Four-year-old Kayla McCarthy, of Bend, struggles to sleep enough. school is relatively close on the horizon," Fraley said. He can generally function on little sleep, he said, but sometimes On bad nights she sleeps less than seven hours. The National Sleep Continued from Page23 Dedrick also said that late-night digital communications often involve

Page 34

FALL/WINTER2012• HIGH DESERTPULSE

Resourees for families St. Charles Sleep Center: www.scmc.org/services/sleep/index.html Doernbecher Children's Hospital, Oregon Health and Science University: wwwohsu.edu/xd/health/services/doernbecher/pro grams-services/sleep-medicine.cfm?=home+by+spec+sleepmedicine

Foundation says she needs 11 to 13 hours a night. Her mother, Jen McCarthy, believes it has to do with some fear or anxiety. "Fear of the dark or maybe just age-appropriate fears," speculated McCarthy. Cetting too little sleep aggravates her temper and changes her behavior and her personality for the worse. "It has become a huge ordeal," said McCarthy."It's hard on the whole family." Last summer, it took forever for Kayla to fall asleep at night, and it required a parent to lay down with her. Then, Kayla would wake four or fives times a night. McCarthy has tried all sorts of parenting approaches and com forting tools — blankets, toys, flashlights. What appeared to be helping in early October, as the routine of the school year settled in, was having Kayla share a room with her older sister and boost ing up a structured, lengthy, relaxing bedtime routine. Kayla was more apt to sleep in the company of her sister, after a bath and a good dose of story time.

You would give anythin g for your family.

G ive th e m . l ess radi a t i o n a nd more peace of mi n d .

Solutions Sleep problems often can be resolved by improving what's known as "sleep hygiene" — all the habits and practices that play into having quality sleep — said Warton from BMC. 6y this she means: Establish a regular bedtime, and make sure it's early enough. Limit screen time in the evenings. Don't expose kids to

violent TV or disturbing news, even from afar. "Some kids are more anxious. They'll tune in. They'll be awake at night, scared of earthquakes or stuff like that. That fear translates into sleep problems," Warton said. Don't allow sugary or caffeinated beverages after school. Johnson, from OHSU, said it's also crucial that parents model good habits, and emphasize that sleep is as important as diet and exercise in managing health. "Kids are very good at detecting hypocrisy. If parents use the iPad in bed, (children) are going to wonder why they can't," John son said. Johnson added that letting kids try to catch up on sleep on weekends creates a bad cycle."It gets their circadian rhythm off. It can, I think, lead a kid to be on the wrong foot starting the

week out," he said. Dedrick said the solution lies in our cultural attitudes about

•

-• e

•

sleep, and getting around that cultural perception is going to be tough. "From a cultural standpoint, sleep is viewed as a flexible com modity: You can use it or not. It doesn't have a tremendous amount

of bearing," Dedrick said. "I think more and more good evidence is pointing that it's not flexible. It's a vital nutrient that our bodies

need on a regular basis."•

HIGH DESERT PULSE • FALL/ WINTER 2012

• I

•

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Getready ~RAcKETspoRT s

Now is a perfect time in Bend to learn an indoor sport BY BEAU EASTES • PHOTOS BY ROB KERR

entral Oregon has long been a hot bed for winter sports enthusiasts but what if you don't like the snow?

You're in luck. Bend and the surround ing areas also boast multiple indoor racket sport options for athletes who would prefer to avoid wearing thermals for a winter work out. Tennis, racquetball, pickleball, table ten nis, badminton and even squash are offered at indoor facilities in Bend, Redmond and

Shoppe in Bend with business partner Sa brina Fefferman. "The sport is catching on like wildfire," said Palcic, 41, herself a recent convert after playing tennis for the past 12 years. Typically staged on tennis courts or bas ketball floors, pickleball is played on a sur face that is 20 feet wide and 44 feet long, the same size as a badminton court. Players volley a whiffle ball with a paddle made of

wood or a composite material, using a scor ing system similar to tennis and table tennis.

"I was decent at racquetball, I played some tennis, quite a bit of squash, and badminton whenever I could find a competitive game," said A.J. Fraites, president of the Bend Pickle ball Club. "All those sports seem to transfer

Finding your sport

Sunriver during the winter months. "It's a very low-cost activity to get into and

you only need one other person to play," said Kevin Collier, a Bend Park & Recreation District sports program coordinator and the Bend High School girls tennis coach."Racket

sports aren't team sports where you have to have nine or 10 other people to play.... And it's something you can pick up at any age. You gotoany ofthe clubsaround here and there's people well into their 80s and still having a great time playing. That's true for tennis and all racket sports."

Pickleball explosion While tennis players have the most in door options in the High Desert — the Ath

letic Club of Bend, Bend Golf and Country Club, Eagle Crest Resort and Sunriver's Sage Spring Spa all have indoor tennis courts pickleball appears to be the sport with the most growth in the region, according to Lisa Palcic, who owns and operates the Racquet

Page 36

I~ Picklebalb Played with a wood or compos ite paddleand a hard, plastic whiffle ball on a surface approximately one-third the size ofa tennis court, pickleball isvery similar to tennis, but with a slower-moving ball and less ground to cover. Ideal racket sportfor mixing different ability levels.

8 '' V.5

Racquetbalb One of the few racket sports with out a net, racquet ball is played in a 40 foot-long, 20-foot-wide indoor cube. There is no out ofbounds in the U.S. version of the sport, with the key to the game being players'abilityto contro the center ofthe court.

HIGH DESERT

Mike Soto, nght, gets ready to unleash a forehand servein a racquetballgame with Roberto Cardenas at Fitness 1440in Bend in September.

OVNLOP 2 QIAN D

i RI X

I Tennis:The racket sport with the largest court, players com pete on a surface 78 feet long and 27 feet wide, hitting a ball over a net that mea sures 36 inches high in the center. Mobility and agility are crucial with the spacious playing surface.

PULSE• FALL/WINTER 2012

s, Squash:Similar to racquetball, but played with a smaller,faster ball. Squash also hasseveral out-of-bounds areasat the top and bottom of its courts'walls, unlike racquetball.

Badminton: Different from other racket sports in that a shuttlecock, instead ofa ball, is volleyed between players. Badmintoncom petitors also use lighter racquets than those in tennis or racquetball. The playing surface is about one-third the size ofa tennis court.

Page 37

Get ready(RACKETSPORTS

into pickleball. It brings any and all of those skills into this one game." Seniors in particular are flocking to pickle ball, according to Fraites. "It's more ofa strategy game than a power game," said Fraites, 67, who took up pickle ball six years ago."In the geezer-jock set

mend at the very minimum working with a veteran of the sport before getting started. "In all those sports, it's really important to

folks over 50 — that still want a competitive,

Group clinics are offered throughout the winter for almost all of Central Oregon's in door racket activities, and some sports, such as pickleball, have "ambassadors" on hand at venueshelping expand the game. "It all depends on your budget and how

athletic (experience), it's the game of choice. It's a short court and the ball moves relative

ly slowly. You can still use all the spins, cuts and strange shots if you want, but it's on a court one-fourth the size of a tennis court."

Indoor racket sport options in Central Oregon Bend

get some kind of proper instruction," Palcic •Athletic Club ofBend,wwwathleticclubofbend said. "When you're starting out, you tend to .com — Tennis, racquetball, squash, pickleball, form bad habits. It's so much harder to break badminton that habit if you're doing it for a while."

The sport is hardly limited to older play into the sport you want to get," Palcic said. ers, though. With the compact court and "But even people who are just playing for a ball that doesn't take off like its tennis or fun need some proper instruction so they're squash counterpart, pickleball is great for doing everything right from the start." incorporating players of all abilities. Just as important as learning the basic "With pickleball, you can mix levels a lot fundamentals of a new racket sport is warm easier than other sports," Palcic said."In ten ing up properly, said Bend physical therapist nis, it's really tough for a beginner to be paired Mandon Welch. "To minimize risk to injury, warm up ad with someone outside their skill level. Pickle ball's pretty fun with whoeveryou're playing. equately, whether that's running or a brisk "It's a great family sport," she added. "My walk," said Welch, of Rebound Physical Ther kids are tennis players, but we're not all at apy. "Get the blood flowing. Also, before you the same skill level. We can all go out and start hitting overhead serves, work on your play pickleball, though, and be somewhat ground strokes and loosen up your joints. If you're playing at a health club, get on the competitive if we want to be." Palcic and Fefferman are seeing pickle arm bike for a little bit." ball's surge in popularity first hand. Three Knees and ankles can also be problem years ago the two business partners didn't spots for racket sport athletes, according to have a single pickleball paddle or net in their Welch, himself an accomplished triathlete store. Now the sport is responsible for al who has been known to dabble in pickleball. "When you're playing tennis or any of the most a third of their sales. "Pickleball's been really, really huge for us those racket sports, it's not like jogging," since it's taken off," Palcic said. "It's definitely Welch said."You're not moving in the same our second-strongest sport in terms of sales line. It's more lateral movement, so you need (after tennis).... It's transforming places in more hip strength and hip control. Doing 20 Arizona, in Palm Desert (Calif.), St. George or so partial body-weight squats — not real (Utah). Those places (with large number of deep, keep the knees at about a 45 degree retirees) are changing a lot of their tennis angle — should get you good and loose and courts into pickleball courts." make the body more reactive." In Central Oregon, the Athletic Club of Welch emphasized that racket sport ath Bend, Eagle Crest Resort and Sunriver's Sage letes should also be sure to stretch after Springs Spa all devote indoor space to pick their workout when more blood is flowing leball this time of year, and the Bend Pickle to their soft tissue areas. ball Club will host drop-in games at the Bend Cost and benefits Senior Center and the Boys and Girls Clubs of Central Oregon's downtown Bend branch. Unlike some w i nter a ctivities, racket

•Bend Golfand Country Club, www.bendgolfclub.com — Tennis, racquetball •Fitnessl440, www.fitness1440.com/bend — Racquetball •Bend Table Tennis Club, www.bendtabletennis.com — Table tennis at the Boys and GirlsC ubs of Central Oregon (down town Bend site) •Bend Pickleball Club, wwworegonhighdesertpickleball.blogspot.com — Pickleball at the Bend Senior Center and the Boys and GirlsC ubs of Central Oregon (down town Bend site) Redmond •Eagle CrestResort, www.eaglecrestfamilyfun.com, wwweagle-crestcom — Tennis, racquetball, pickleball • Redmond Activity Center,www.raprd.org — Racquetball Sunriver SunriverResort's SageSprings Spa,www.sunriver resort.com — Tennis, pickleball

with entry-level performance models start ing around $100, but The Racquet Shoppe sells high-quality used rackets for as low as $50. Reputable pickleball paddles and bad minton rackets also start around $50. Balls — and birdies for badminton — typically run under $4, and squash and racquetball goggles or glasses start at $10. Whatever racket — or rackets — you choose,the benefitsofchasing down a shut tlecock or fighting offa mean top-spin serve go far beyond a healthy heart and well-de fined legs, Palcic said. "With any racket sport, I think one thing

people don't realize is the sense of com munity you get with it," Palcic said. "You're sports require minimal startup costs. Get out there and it's exciting and great for your Starting out yourself a racket and some balls and you're body, but it's also about the friendships and Whatever racket sport you're thinking ready to go. Tennis and racquetball rack getting out and about. Having those kind of about taking up, area instructors recom ets are the most expensive of the bunch, activities are really imperative." •

Page 38

FALL/WINTER2012• HIGH DESERTPULSE

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Some traits are the expression of a single gene; others are more complicated BY HEIDI HAGEMEIER

t's the stuff of cocktail-party chatter and baseball bleachers ban ter: How is it that two relatively short parents gave birth to a gi

ant? Or why do two brown-haired parents produce a redheaded child? It all stems back to genetics. The answers to some of these ques tions are exceedingly complex. Hair color, for instance, is deter mined by an array of genes. Other traits appear to be linked to the interplay of just one gene pair. Think back to high school biology, when you first learned about Cregor Mendel and his pea plants. Here are the basics: Half of every person's genes come from the father and half from the mother. Thus every person hastwo copiesofeach gene. Chance determines a person's overall genetic makeup. For every gene pair, either one of the mother's two copies and the father's two copiesmight be passed on, so each possiblecombination hasaone in-four chance of occurring. Yet there are certain rules in genetics, as well. One is that one gene might be what is called dominant, suppressing the expression of the other gene, which is called recessive. It's true that today we know more than ever before about genet ics. The exploration of the human genome is still young, however, and queries right now are focused on discoveries that could be life saving, said Barbara Pettersen, a Bend genetic counselor. Therefore, some of the questions asked most by people in casual banter — like why is my daughter is a redhead — are the ones that are least researched and possibly still unanswered. "There's not a lot of research money going into these things," Pet tersen said. "The questions that are being looked at are ones that might cure diseases or lead to pharmaceuticals." In fact, she said, some of our knowledge about certain human traits comes largely from observing families for generations.•

Page 40

Expressing dominant and reeessive genes A dominant gene will be expressed if the child inherits even one copy from a parent. A recessive gene will only be expressed if the child inherits a copy from each parent. In the example below, the father carries a dominantQe gene and a recessiveO gene. The mother carries two copies of the recessive

O gene.

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FALL/WINTER2012• HIGH DESERTPULSE

So what are some common inherited traits? Simple geneties Some traits are believed to stem from just one gene pair. However, a gene can be dominant and still not common in the human population: The gene might have emerged recently. Also, the dominant trait might not confer a significant benefit over the recessive trait, meaning people with that dominant trait don't necessarily survive better or have more children than the general popu ation. Thus, its spread is slow. V Clasping hands together. Clasp your hands together, fingers intertwined. The left thumb on . topoftherightisthe i trait,Theright thumb on top is

Dimples. ~i • Webbing between the second and third toe.

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Ear wax. Wet ear wax is~i • ~ D ry, pow der-like ear wax is recessive. Dry ear wax is more common in Asian populations. Freckles. ~i •

Ability to roll tongue. ~s • Double-jointed thumbs. ~i • Inability to smell freesia flowers. II

Ear wiggling. ~i • ~ More m en appear to carry the trait than women. Cleft chin. ~i • Lactose intolerance. ~

Sixth finger. ~i • ~ This c haracteristic is more often found in the African-American popu lation. Doctors usually remove the additional digit right after birth.

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Light-sensitive sneezing. ~i •

Complex geneties Baldness.There's a reason men go bald more often than women: Women do carry the gene, but estrogen masks it. So the adage to look to the mother's father to know if her son wi I be bald is correct. If the mother carries her dad's gene, the answer very well might be yes. Men can also in herit the gene from their bald fathers. Eye color.There are at least three genes, and pos sib y more, involved in eye color. What is known is that brown is the most . col o r and blue is the most . Green is recessive to brown but dominant over blue. Yet geneticists at this point can't explain hazel or gray eyes. •

Hair follicle shape (crosscut view):

•

V Curly vs. straight hair.The amount of curl in hair is determined bythe shape ofthe follicle, and the shape of the follicle is due to genetics. The straightest hair comes from circular follicles, while the tightest curls, as seen in African popula tions, come from follicles like a slit. Follicles can be all sorts of shapes between the two extremes of circu ar and slit, and one person can have multiple shapes on the head. Genetically, follicles for cur y hair are~s~ I over straight.

HIGH DESERT PULSE • FALL/ WINTER 2012

• Straight

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Height. There's nothing simple about this one: It's determined through a combination of genes and environmental factors, such as nutrition. Hair color. Hair color is determined by cells called melanocytes, which produce melanin. Melano cytes produce different hues of melanin based on our genes, and at least two pairs of genes contribute to the shades. The varying genes act in concert to create the wide array of hair colors seen in humanity. Black is the most~s • ~ I while red is the mostg Each parent carries several different genes relating to hair color,thus explaining why one person can have varied hair colors or why two brown-haired adults can birth a red-headed child. Only 4 percent of humans are believed to carry the red hair gene.

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Page41

AOVERTtstNGSUPPLEMENT

2 012 C E N T RA L O R E G O N

Your

S o u r c e f o r Lo c a l H e a l t h Se r v i c e s a n d Ex p e r t M e d i c a l P r o f e s s i o n a l s To list your medical office andlor physicians in the PULSEIConnections Medical Directory contact...

Lorra in e

S t a r o d u b , A c c o u n t E x e c u t i v e ( H e a l t h 8c M e d i c a l) • 5 4 1 . 6 1 7 .7855 •

s•

•

119 N RopeStreet • Sisters

541-588-G119

www. a bsoluteserenity.info

ADULT FOSTKR CARE

Absolute Serenity Adult Foster Care

AESTHETIC SERVICES

DermaSpa atBend Dermatology

2705 NE Conners Drive• Bend

541-330-9139

ALLERGY &ASTHMA

Bend Memorial Clinic

Locations in Bend StRedmond

541-382-4900

www .bendmemorialclinic.com

www. b rookdaleliving.com

www.bendderm.com

1099 NE Watt Way • Bend

541-385-4717

ASSISTED LIVING

Brookside Place

3550SW CanalBlvd • Redmond

541-504-1600

BEHAVIORAL HEALTH

St. Charles Behavioral Health

2542 NE Courtney Drive• Bend

541-706-7730

www . stcharleshealthcare.org

CANCER CARE

St. Charles Cancer Center

Locations in Bend StRedmond

541-70G-5800

www. stcharleshealthcare.org

CARDIOLOGY

Bend Memorial Clinic

Locations in Bend StRedmond

541-382-4900

ww w .bendmemorialclinic.com

CARDIOLOGY

The Heart Center

2500 NE Neff Road• Bend

541-706-6900

ww w .heartcentercardiology.com

2500 NE Neff Road• Bend

541-388-1G3G

www. stcharleshealthcare.org

2600 NE Neff Road• Bend

541-382-4900

ww w .bendmemorialclinic.com

ALZHEIMERS &DEMENTIA CARE Clare Bridge Brookdale Senior Living

CARDIOTHORACIC SURGERY St. Charles Cardiothoracic Surgery

COSMETIC SERVICES

Bend Memorial Clinic

COUNSELING & WELLNESS

J u n i per Mountain Counsding gt Wdlness

DKRMATOLOGY (MOHS) ENDOCRINOLOGY

ENDOCRINOLOGY

www.ccliving.com

334 NE Irving Ave, Ste 102 • Bend

541-G17-0377

ww w junipermountaincounseling.com

Sisters Denture Spedalties

161 E Cascade • Sisters

541-549-0929

www. r aordenturecenter.com

Bend Dermatology Clinic

2747 NE Conners Drive• Bend

541-382-5712

Bend Memorial Clinic

2600 NE Neff Road• Bend

541-382-4900

www .bendmemorialclinic.com

www.bendderm.com

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www .bendmemorialclinic.com

Kndocrinology ServicesNW

929 SWSimpson Ave,Ste 220 •Bend

541-317-5GOO

Locations in Bend, Redmond StSisters

541-382-4900

ww w .bendmemorialclinic.com

2965 NE ConnersAve,Suite 127 • Bend

n/a

PAMILY MEDICINE

Bend Memorial Clinic

PAMILY MEDICINE

St. Charles Family Care in Bend

541-70G-4800

www .stcharleshealthcare.org

FAMILY MEDICINK

St. Charles Family Care in PrinevrIIe

1103 NE ElmStreet • Prineville

541-447-G2G3

www. stcharleshealthcare.org

PAMILY MEDICINK

St. Charles Family Care in Redmond

211 NW LarchAvenue• Redmond

541-548-2164

www. s tcharleshealthcare.org

FAMILY MEDICINE

St. Charles Family Care in Sisters

61 5 Arrowleaf Trail• Sisters

541-549-1318

www. s tcharleshealthcare.org

FAMILY PRACTICE

High Lakes Health Care

Locations in Bend StSisters

541-385 7741 t

GASTROENTEROLOGY

Bend Memorial Clinic

GENERAL DENTISTRY

Coombe and Jones Dentistry

GENERAL SURGERY

Surgical Assodates of the Cascades

GENE RALSURGERY,BARIAYRICSI VEINCARE Advanced Spedalty Care

.I IE EI II E I « .

1501 NE Medical Center Drive• Bend

541-382-4900

ww w .bendmemorialclinic.com www.c o ombe-jones.com

774 SWRimrock Way• Redmond

541-923-7633

1245 NW 4th Street, Ste 101 • Redmond

541-548-77G1

2084 NE Professional Court• Bend

541-322-5753

1245 NW 4th Street, Ste 101 • Redmond

541-548-7761

www.cosurgery.com

www .advancedspecialtycare.com www.cosurgery.com

GENERALSURGERY Rr OBESITY CARE

Cascade Obesity and General Surgery

HOME HEALTH SERVICES

St. C h arles Home Health Services

2500 NE Neff Road• Bend

541-70G-779G

www. stcharleshealthcare.org

HOSPICE/HOME HEALTH

Hospiceof Redmond

732 SW 23rd St• Redmond

541-548-7483

www.r edmondhospice.org

HOSPICE/HOME HEALEH

2075 NE Wyatt Ct.• Bend

541-382-5882

www.partnersbend.org

Mountain View Hospital

470 NE "A" Street• Madras

541-475-3882

www.mvhd.org

HOSPITAL

Pioneer Memorial Hospital

1201 NE Elm St• Prineville

541-447-G254

www. stcharleshealthcare.org

HOSPITAL

St. Charles Bend

2500 NE Neff Road• Bend

541-382-4321

www. stcharleshealthcare.org www . stcharleshealthcare.org

HOSPITAL

I C

HOSPITAL

St. Charles Redmond

1253 NE Canal Blvd• Redmond

541-548-8131

HOSPITALIST

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www .bendmemorialclinic.com

1501 NE Medical Center Drive• Bend

541-382-4900

ww w .bendmemorialclinic.com

locations in Bend AtRedmond

541-382-4900

www .bendmemorialclinic.com

2600 NE Neff Road• Bend

541-70G-3700

www . stcharleshealthcare.org

1501 NEMedical Center Drive • Bend

541-382-4900

ww w .bendmemorialclinic.com

916 SW 17th St, Ste202 • Redmond

541-504-0250 ~ www.centerforintegratedmed.com

HYBERBARICOXYGENTHERAPY Bend Memorial Clinic IMAGING SERVICES

Bend Memorial Clinic

IMMEDIATE CARE

St. Charles Immediate Care

INPECTIOUS DISKASK

Bend Memorial Clinic

INTKGRATKD MKDICINK

~ Center for Integrated Medicine

2 012 CE N T RA L O R E G O N •

INTERNAL MEDICINE

DVERTISINGSUPPLEMENT

M E D I CA L D I RECTORY E

Send Memorial Clinic

INTERNAL MKDICINK

High Lakes Health Care Upper Mill

INTERNAL MEDICINE

Internal Medicine Assodates of Redmond

INTERNAL MEDICINE

Redmond Medical Clinic

LASIK MEDICAL CLINIC

Bend Eastside gh Westside

541-382-4900

ww w .bendmemorialclinic.com

929 SW Simpson Ave• Bend

541-389-7741

www .highlakeshealthcare.com

236 NW Kingwood Ave• Redmond

541-548-7134

www.imredmond.com

1245 NW 4th Street, Ste201 • Redmond

541-323-4545

n/a

Send Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www .bendmemorialclinic.com

Bend Memorial Clinic

1080 SWMt. Bachelor Dr • Bend (West)

541-382-4900

ww w .bendmemorialclinic.com

MEDICAL CLINIC

Bend Memorial Clinic

1501 NEMedical Center Dr • Bend(East) 541-382-4900

www .bendmemorialclinic.com

MEDICAL CLINIC

Send Memorial Clinic

231 East CascadesAve• Sisters

541-382-4900

ww w .bendmemorialclinic.com

MEDICAL CLINIC

Send Memorial Clinic

865 SWVeteransWay• Redmond

541-382-4900

www .bendmemorialclinic.com

NEPHROLOGY

Bend Memorial Clinic

Locations in Bend,Redmond ghSisters

541-382-4900

www .bendmemorialclinic.com

NEUROLOGY

Bend Memorial Clinic

150i NE Medical Center Drive• Bend

541-382-4900

ww w .bendmemorialclinic.com

Locations in Bend gh Redmond

541-382-3344

www. t hecenteroregon.com

Locations in Bend,Redmond thSisters

541-382-4900

ww w .bendmemorialclinic.com

2400 NE Neff Road, Ste A• Bend

541-389-3300

w ww.eastcascadewomensgroup.com

213 NW Larch Ave,Suite B• Redmond

541-52G-GG35

www .stcharleshealthcare.org

Locations in Bend gh Redmond

541-382-4900

www .bendmemorialclinic.com

Locations in Bend ga Redmond

541-382-3344

www. t hecenteroregon.com

NEUROSURGERY

The Center: Orthopedic tf Neufosufgical Care A Research

Bend Memorial Clinic

NUTRITION

OBSTETRICS StGYNECOLOGY E ast Cascade Women's Group, P.C.

OOEYEYEICE 8GYNECOLOGY OCCUPATIONAL MEDICINE OCCUPATIONAL MEDICINE

Ot . Ch I OO/CYN —d 8d Send Memorial Clinic The C e nter: Orthopedic A Neufosufgical CareAResearch

ONCOLOGY - MEDICAL

Bend Memorial Clinic

Locations in Bend ga Redmond

541-382-4900

ww w .bendmemorialclinic.com

OPHTHALMOLOGY

Send Memorial Clinic

Locations in Bend gh Redmond

541-382-4900

www .bendmemorialclinic.com

OPTOMKTRY

Send Memorial Clinic

Locations in Bend gtRedmond

541-382-4900

ww w .bendmemorialclinic.com

Desert Orthopedics

Locations in Bend ga Redmond

541-388-2333

www . desertorthopedics.com

Locations in Bend /hRedmond

541-382-3344

www. t hecenteroregon.com

2200 NENeffRoad,Suite 302 • Bend

541-388-3978

w wwdeschutesosteoporosiscentercom

2500 NE Neff Road• Bend

541-70G-5880

www .stcharleshealthcare.org

1230 NE 3rd Street, Suite A-174• Bend

544-389-8800

ORTHOPEDICS

The Center: Orthopedic tf NeurosurgicalCaregfResearch

Deschutes Osteoporosis Center

PALLIATIVE CARE

St. Charles Advanced Illness Management

PEDIATRIC DENTISTRY

Dentistry For Kidz

PEDIATRICDENTISTRY

Deschutes Pediatric Dentistry

1475 SWChandler Ave, Ste 202• Bend

541-389-3073

PKDIATRICS

Send Memorial Clinic

1080 SWMt. Bachelor Dr • Bend (West)

541-382-4900

ww w .bendmemorialclinic.com

PEDIATRICS

St. Charles Family Care

211 NW LarchAvenue• Redmond

541-548-2164

www . stcharleshealthcare.org

2065 NEWilliamson Court, Suite B• Bend

541-382-0287

Locations in Bend gh Redmond

541-388-2333

www . desertorthopedics.com

Locations in Bend ga Redmond

541-382-3344

www. t hecenteroregon.com

1501 NE Medical Center Drive• Bend

541-382-4900

www .bendmemorialclinic.com

2275 NE Doctors Dr,¹3 A336SWCyber Dr,Ste107

541-382-5500

w w w.alpinephysicaltherapy.com

PHARMACY

PHYSICAL MEDICINE

N/ C t

Desert Orthopedics The Center: Orthopedic A NeurosurgicalCareAResearch

PHYSICAL MEDICINE/REHABILITATIO

Be nd Memorial Clinic

PHYSICAL THERAPY

Alpine PhysicalTherapy gt Spine Care

PHYSICAL THERAPY

Healing Bridge Physical Therapy

PODIATRY

Cascade Foot Clinic

PULMONOLOGY

Bend Memorial Clinic

PULMONOLOGY

St. Charles Pulmonary Clinic

RADIOLOGY

Central Oregon Radiology Assodates, P.C.

REHABILITATION

St. Charles Rehabilitation Center

RHEUMATOLOGY

Send Memorial Clinic

RHKUMATOLOGY

Deschutes Rheumatology

SLEEP MEDICINE

. I t ' t tf f

hid.

www. d eschuteskids.com

www.homecareiv.com

www.healingbridge.com

404 NE PennAvenue • Bend

541-318-7041

Offices in Bend, Redmond th Prineville

541-388-2881

Locations in Bend /hRedmond

541-382-4900

/ ww w .bendmemorialclinic.com

Locations in Bend gh Redmond

541-70G-7715

1460 NE Medical Center Dr• Bend

541-382-9383

www . stcharlesbealthcare.org

Locations in Bend ga Redmond

541-70G-7725

www .stcharleshealthcare.org ww w .bendmemorialclinic.com

www.corapc.com

Locations in Bend gh Redmond

541-382-4900

2200 NENeffRoad,Suite 302 • Bend

541-388-3978

Bend Memorial Clinic

Locations in Bend ga Redmond

541-382-4900

SLEEP MEDICINE

St. Charles Sleep Center

Locations in Bend /hRedmond

541-706-6905

www .stcharleshealthcare.org

SURGICAL SPKCIALIST

Send Memorial Clinic

Locations in Bend gh Redmond

541-382-4900

www .bendmemorialclinic.com

URGENT CARE

Bend Memorial Clinic

I h t h I) 9 thd -dg 541-382-4900

ww w .bendmemorialclinic.com

UROLOGY

Bend Urology Associates

1'. • I . I f f

2090 NE Wyatt Court• Bend

541-382-G447

Locations in Bend gh Redmond

541-322-5753

/ www .bendmemorialclinic.com

www.bendurology.com

UROLOGY

Urology Specialists of Oregon

VASCULAR SURGERY

Send Memorial Clinic

1501 NE Medical Center Drive• Bend

• f .p dt 18 p. J http// 541-382-4900 www .bendmemorialclinic.com

VEIN SPECIALISTS

Inovia Vein Spedalty Center

2200 NE Neff Road, Ste 204• Bend

541-382-8346

VEIN SPECIALISTS

Bend Memorial Clinic

150i NE Medical Center Drive• Bend

541-382-4900

www.bendvein.com ww w .bendmemorialclinic.com

2 012 CE N T RA L O R E G O N •

•

M E D I CA L D I RECTORY •

•

DVERTISINGSUPPLEMENT

ADAM WILLIAMS, MD

Send Memorial Clinic

Bend Eastsidegt Redmond

541-3 8 2-4900

STEPHEN ARCHER, MF, FACS

Ad vanced Specialty Care

2084 NE Professional Court• Bend 5 4

PHILIP B.ANDERSON, MD

St. Charles Sehavioral Health

2542 NE Courtney Dr • Bend

KAREN CAMPBELL, PhD

St. Charles Sehavioral Health

RYAN C. DIX, PsyD

St. Charles Family Care

BRIAN T. EVANS, PsyD

ww w .bendmemorialclinic.com

1- 3 2 2-5753 w ww . advancedspecialtycare.com

541-706-7730

www.stcharleshealthcare.org

2542 NE Courtney Dr• Bend

541-706-7730

www.stcharleshealthcare.org

1103 NE Elm Street, Ste C• Prineville

541-447-G2G3

www.stcharleshealthcare.org

St. Charles Sehavioral Health

2542 NE Courtney Dr • Bend

541-706-7730

www.stcharleshealthcare.org

KUGKNK KRANZ, PhD

St. Charles Sehavioral Health

2542 NE Courtney Dr• Bend

541-706-7730

www.stcharleshealthcare.org

SONDRA MARSHALL, PhD

St. Charles Behavioral Health

2542 NE Courtney Dr • Bend

541-706-7730

www.stcharleshealthcare.org

NATHAN OSBORN, MD

St. Charles Sehavioral Health

2542 NE Courtney Dr • Bend

541-706-7730

www.stcharleshealthcare.org

MIKALA SACCOMAN, PhD

St. Charles Behavioral Health

2542 NE Courtney Dr • Bend

541-706-7730

www.stcharleshealthcare.org

LEAH SCHOCK, PILD

St. Charles Sehavioral Health

2542 NE Courtney Dr • Bend

541-706-7730

www.stcharleshealthcare.org

RKBKCCA SCRAFFORD, PsyD

St. Charles Sehavioral Health

2542 NE Courtney Dr • Bend

541-706-7730

www.stcharleshealthcare.org

KIMBERLY SWANSON, PhD

St. Charles Sehavioral Health

2542 NE Courtney Dr • Bend

541-706-7730

www.stcharleshealthcare.org

s •

•

CATHERINE BLACK, PA-C

Bend Memorial Clinic

f 1501 NE Medical Center Drive• Bend

541-382-4900

ww w .bendmemorialclinic.com

JEAN BROWN, PA-C

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

RICK KOCH, MD

Send Memorial Clinic

Bend Eastside 8r Redmond

541-382-4900

www.bendmemorialclinic.com

GAVIN L.NOBLE, MD

Bend Memorial Clinic

Bend Eastside gt Redmond

541-382-4900

www.bendmemorialclinic.com

STEPHANIE SCOTT, PA-C

Send Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

JASON WKST, MD

Send Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

s s

JOHN D. BLIZZARD, MD

St. Charles Cardiothoradc Surgery

2500 NE Neff Road• Bend

541-388-163G

www.stcharleshealthcare.org

DARIN CLEMKNT, PA-C

St. Charles Cardiothoradc Surgery

2500 NE Neff Road• Bend

541-388-1636

www.stcharleshealthcare.org

CARL E. MILLER, PA-C

St. Charles Cardiothoradc Surgery

2500 NE Neff Road• Bend

541-388-1636

www.stcharleshealthcare.org

ANGKLO A.VLESSIS, MD

St.Charles Cardiothoracic Surgery

2500 NE Neff Road• Bend

541-388-1636

www.stcharleshealthcare.org

TIMOTHY J. ZERGER, PA-C

St. Charles Cardiothoradc Surgery

2500 NE Neff Road• Bend

541-388-163G

www.stcharleshealthcare.org

JASON M. KREMER,DC,CCSP, CSCS Wellness Doctor

1345 NWWallSt, Ste202• Bend 5 4

1- 3 18-1000 w ww. bendwellnessdoctor.com

MICHAEL R. HALL, DDS

Central Oregon Dental Center

BRADLKY E. JOHNSON, DMD ' s s s

Contemporary Family Dentistry

ALYSSA ABBKY, PA-C

Send Memorial Clinic

2G00 NE Neff Road• Bend

541-382-4900

www .bendmemorialclinic.com

ANGELA COVINGTON, MD

Bend Memorial Clinic

2600 NE Neff Road• Bend

541-382-4900

www .bendmemorialclinic.com

MARK HALL, MD

CentralOregon Dermatology

JAMKS M. HOESLY, MD

Send Memorial Clinic

1563 NW Newport Ave• Bend 5

41-3 8 9 -0300 w

1016 NW Newport Ave• Bend 5

41-3 8 9 -1107 w w wcontemporaryfamilydentistrycom

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388 SW Bluff Dr• Bend

541-G78-0020 wwwcentraloregondermatologycom

2600 NE Neff Road• Bend

541-382-4900

ww w .bendmemorialclinic.com

GERALD E. PETERS, MD, DS (Mohs) Bend Memorial Clinic

2600 NE Neff Road• Bend

541-382-4900

ww w .bendmemorialclinic.com

ANN M. REITAN, PA-C (Mohs)

2600 NE Neff Road• Bend

541-382-4900

www .bendmemorialclinic.com

Send Memorial Clinic

s s

MARY F. CARROLL, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900 w

RICK N. GOLDSTEIN, MD

Send Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

TONYA KOOPMAN, MSN,FNP-BC

Bend MemorialliC nic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

PATRICK MCCARTHY, MD

Endocrinology ServicesNW

929 SWSimpson Ave,Ste 220 • Bend

541-317-5GOO

n/a

TRAVIS MONCHAMP, MD

Kndocrinology Services NW

929 SW Simpson Ave, Ste220 • Bend

541-317-5600

n/a

(

ww . bendmemorialclinic.com

2 012 CE N T RA L O R E G O N

M E D I CA L D I RECTORY

DVERTISINGSUPPLEMENT

CAREY ALLEN, MD

St. Charles Family Care

1103 NE Elm Street• Prineville

541-447-G2G3

www.stcharleshealthcare.org

HEIDI ALLEN, MD

St. Charles Family Care

1103 NE Elm Street• Prineville

541-447-G2G3

www.stcharleshealthcare.org

211 NW Larch Avenue• Redmond

541-548-2164

KATHLEEN C. ANTOLAK, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

SADIE ARRINGTON, MD

Bend Memorial Clinic

865 SWVeterans Way• Redmond

541-382-4900

www.bendmemorialclinic.com

30SEPH BACHTOLD, DO

St. Charles Family Care

G15 ArrowleafTrail • Sisters

541-549-1318

www.stcharleshealthcare.org

EDWARD BIGLER, MD

High Lakes Health CareUpper Mill

929 SW Simpson Avenue• Bend

541-389-7741

www.highlakeshealthcare.com

3EFFREY P.BOGGESS, MD

Bend Memorial Clinic

1080 SW Mt. Bachelor Drive• Bend

541-382-4900

www.bendmemorialclinic.com

BRANDON W. BRASHER, PA-C

St. Charles Family Care

1103 NE Elm Street• Prineville

541-447-G2G3

www.stcharleshealthcare.org

SHANNON K. BRASHKR, PA-C

St. Charles Family Care

1103 NE Elm Street• Prineville

541-447-G2G3

www.stcharleshealthcare.org

MEGHAN BRECKE, DO

St. Charles Family Care

2965 NE ConnersAve, Suite 127 • Bend

541-70G-4800

www.stcharlesheaithcare.org

NANCY BRENNAN, DO

St. Charles Family Care

2965 NE ConnersAve, Suite 127 • Bend

541-70G-4800

www.stcharleshealthcare.org

WILLIAM C.CLARIDGE, MD

St. Charles Family Care

211 NW Larch Avenue• Redmond

541-548-2164

www.stcharleshealthcare.org

MATTHKW CLAUSEN, MD

St. Charles Family Care

2965 NE ConnersAve, Suite 127 • Bend

541-70G-4800

www.stcharleshealthcare.org

LINDA C. CRASKA, MD

St. Charles Family Care

1103 NE Elm Street• Prineville

541-447-G2G3

www.stcharleshealthcare.org

AUDREY DAVEY, MD

Send Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

AMY DELOUGHREY, PA-C

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

3AMES K. DKTWILER, MD

St. Charles Family Care

211 NW Larch Avenue• Redmond

541-548-2164

www.stcharleshealthcare.org

MAY S. FAN, MD

Send Memorial Clinic

231 East Cascades Avenue• Sisters

541-382-4900

ww w .bendmemorialclinic.com

929 SW Simpson Avenue• Bend

541-389-7741

www.highlakeshealthcare.com

THOMAS L. ALLUMBAUGH, MD St. Charles Family Care

3AMIE FREEMAN, PA-C

High Lakes Health Care Upper Mill

MARK GONSKY, DO

St. Charles Family Care

STEVEN GREER, MD

St. Charles Family Care

61 5 ArrowleafTrail • Sisters

541-549-1318

ALAN C. HILLKS, MD

Bend Memorial Clinic

Redmond gt Sisters

541-382-4900

PAMKLA 3. IRBY, MD

St. Charles Family Care

211 NW Larch Avenue• Redmond

541-548-2164

www.stcharleshealthcare.org

MAGGIE 3. KING, MD

St. Charles Family Care

1103 NE Elm Street• Prineville

541-447-G2G3

www.stcharleshealthcare.org www.stcharleshealthcare.org

2965 NE ConnersAve, Suite 127 • Bend 541-70G-4800

www.stcharleshealthcare.org www.stcharleshealthcare.org

ww w .bendmemorialclinic.com

PETER LEAVITT, MD

St. Charles Family Care

2965 NE Conners Ave,Suite 127 • Bend

541-70G-4800

CHARLOTTE LIN, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

STEVE MANN, DO

High Lakes Health Care UpperMill

~ 929 SW Simpson Avenue• Bend

541-389-7741

www.highlakesheal thcare.com

30E T.MC COOK, MD

St. Charles Family Care

211 NW Larch Avenue• Redmond

541-548-2164

www.stcharleshealthcare.org

1245 NW 4th Street, Ste 201• Redmond

541-323-4545

n/a

354 W Adams Avenue• Sisters

541-549-9G09

www.highlakeshealthcare.com

354 W Adams Avenue• Sisters

541-549-9609

www.highlakeshealthcare.com

929 SW Simpson Avenue• Bend

541-389-7741

www.highlakeshealthcare.com

211 NW Larch Avenue• Redmond

541-548-2164

www.stcharleshealthcare.org

211 NW Larch Avenue• Redmond

541-548-2164

www.stcharleshealthcare.org

LORI MCMILLIAN, FNP

EDEN MILLER, DO

High Lakes Health Care Sisters

KKVIN MILLKR, DO High Lakes Health Care Upper Mill

3ESSICA MORGAN, MD DANIEL 3. MURPHY, MD

SHERYL L. NORRIS, MD

St. Charles Family Care

AUBRKY PKRKINS, FNP

High Lakes Health Care East

1247 NE Medical Center Drive• Bend

541-318-4249

www.highlakeshealthcare.com

3ANEY PURVIS, MD

Send Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

KEVIN REUTER, MD

High Lakes Health Care East

1247 NE Medical Center Drive• Bend

541-318-4249

www.highlakesheal thcare.com

DANA M. RHODE, DO

Bend Memorial Clinic

1080 SW Mt. Bachelor Drive• Bend

541-382-4900

www.bendmemorialclinic.com

HANS G. RUSSELL, MD

Bend Memorial Clinic

Bend Eastside gr Westside

541-382-4900

www.bendmemorialclinic.com

KRIC 3. SCHNKIDKR, MD

Send Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

CINDY SHUMAN, PA-C

Send Memorial Clinic

1080 SW Mt. Bachelor Drive• Bend

541-382-4900

www.bendmemorialclinic.com

~ 1247 NE Medical Center Drive• Bend

541-318-4249

www.highlakeshealthcare.com

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

3ENNIFER SURBER, MD

High Lakes Health Care East

EDWARD M. TARBET, MD

Bend Memorial Clinic

2 012 CE N T RA L O R E G O N

M E D I CA L D I RECTORY

JOHN D. TKLLKR, MD

Bend Memorial Clinic

NATHAN R. THOMPSON, MD

St. Charles Family Care

LISA URI, MD

High Lakes Health Care Upper Mill

MARK A. VALENTI, MD

St. Charles Family Care

THOMAS A. WARLICK, MD BILL WIGNALL, MD

BRUCE N. WILLIAMS, MD

St. Charles Family Care

DAVID KELLY, MD

High Lakes Health Care UpperMill •

DVERTISINGSUPPLEMENT

~ 1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

211 NW Larch Avenue• Redmond

541-548-2164

www.stcharleshealthcare.org

929 SW Simpson Avenue• Bend

541-389-7741

www.highlakeshealthcare.com

211 NW Larch Avenue• Redmond

541-548-2164

www.stcharleshealthcare.org

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

High Lakes Health Care East

1247 NE Medical Center Drive• Bend

541-318-4249

www.highlakeshealthcare.com

1103 NE Elm Street• Prinevilie

541-447-G2G3

www.stcharleshealthcare.org

929 SW Simpson Avenue• Bend 5 4

1- 3 89-7741

www.highlakeshealthcare.com

•

RICHARD H. BOCHNER, MD

NE Medical Center Drive• Bend 541-382-4900

Send Memorial Clinic

ww w .bendmemorialclinic.com

ELLEN BORLAND, MS, RN, CFNP Bend Memorial Clinic

1501NE Medical Center Drive• Bend

541-382-4900

www .bendmemorialclinic.com

ARTHUR S. CANTOR, MD

Send Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

HEIDI CRUISE, PA-C, MS

Send Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

LANCE PERRIN, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

SIDNEY E. HENDERSON III, MD

Send Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900

www.bendmemorialclinic.com

SANDRA K. HOLLOWAY, MD

Send Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900

www.bendmemorialclinic.com

MATTHEW WEED, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900 w

CHRISTY ENGLAND, PA-C

Advanced Specialty Care

2084 NE Professional Court• Bend

541-322-5753

www.advancedspecialtycare.com

NICOLLE O'NKI, PA-C

Advanced Spedalty Care

2084 NE Professional Court• Bend

541-322-5753

www.advancedspecialtycare.com

NGOCTHUY HUGHES, DO, PC

Ca s cade Obesity and General Surgery

1245 NW 4th Street, Ste 101 • Redmond 541-548-77G1

JOHN R. ALLEN, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

LAURIE D'AVIGNON, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

GINGER L.DATTILO, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

MATTHEW DAVEY, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

BENJAMIN ENGLAND, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

MICHAKL GOLOB,PA-C

Send Memorial Clinic

NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

ADRIAN KRUEGER, PA-C

Bend Memorial Clinic

1501NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

SUZANN KRUSE, PA-C

Bend Memorial Clinic

541-382-4900

www.bendmemorialclinic.com

PHONG NGO, MD

Send Memorial Clinic

J 1501NE Medical Center Drive• Bend T 1501NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

DEONA J. WILLIS, PNP-C

Bend Memorial Clinic

1501NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

LAURIK D'AVIGNON, MD

Send Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900

www.bendmemorialclinic.com

JON LUTZ, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900 w

REBECCA SHERER, MD

St. Charles Infectious Disease

2965 Conners Ave, Ste 127• Bend 5 4 1 - 7 0G-4878 w

ww . bendmemorialclinic.com

www.cosurgery.com

ww. bendmemorialclinic.com ww. s tcharleshealthcare.org

JKNKSS CHRISTKNSKN, MD

High Lakes Health Care UpperMill

JOHN CORSO, MD

High Lakes Health Care Upper Mill

CELSO A.GANGAN, MD

Redmond Medical Clinic

MICHAKL N. HARRIS, MD

Send Memorial Clinic

ANNE KILLINGBECK, MD

Internal Medidne Assodates of Redmond

ANITA D.KOLISCH, MD

Bend Memorial Clinic

929 SW Simpson Avenue• Bend

541-389-7741

www .highlakeshealthcare.com

~ 929 SW Simpson Avenue• Bend

541-389-7741

www.highlakesheal thcare.com

24 5 NW 4th Street, Ste •201 Redmond

541-323-4545

n/a

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

236 NW Kingwood Ave• Redmond

541-548-7134

www.imredmond.com

Beud Eastside 8 Redmond

541-382-4900

www.bendmemorialclinic.com

2 012 CE N T RA L O R E G O N

DVERTISINGSUPPLEMENT

M E D I CA L D I RECTORY

MATTHEW R. LASALA, MD

Ben d Memorial Clinic

MADELINE LEMEE, MD

High Lakes Health Care Upper Mill

MARYMAMPRRDI, MD

BlghLM B Mlhe Upp MM

1501 NE Medical Center Drive• Bend 541-382-4900 w 929 SW Simpson Avenue• Bend 5 4

929SWB p

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Ilh

KAREN L. OPPENHKIMKR, MD Bend Memorial Clinic

1080 SW Mt. Bachelor Drive• Bend

541-382-4900

H. DEREK PALMER, MD

Redmond Medical Clinic

1245 NW 4th Street, Ste 201• Redmond

541-323-4545

A. WADK PARKKR, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900

www.bendmemorialclinic.com

MATTHEW REED, PA-C

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900

www.bendmemorialclinic.com

M. SKAN ROGERS, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900

www.bendmemorialclinic.com

DAN SULLIVAN, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900

www.bendmemorialclinic.com

www .bendmemorialclinic.com

n/a

' s s

CAROL A. CRAIG, NNP

St. Charles Medical Group - Neonatology

2500 N E Neff Road • Bend

541-382-4321

www.stcharleshealthcare.org

JOHN 0. EVERED, MD

St. Charles Medical Group Neonatology

2500 NE Neff Road• Bend

541-382-4321

www.stcharleshealthcare.org

SARAH K.JAMES, NNP

St. Charles Medical Group Neonatology

2500 NE Neff Road• Bend

541-382-4321

www.stcharleshealthcare.org

JAMKS MCGUIRK, MD

St. Charles Medical Group Neonatology

2500 NE Neff Road• Bend

541-382-4321

www.stcharleshealthcare.org

PREDERICK J. RUBNER, MD

S t . Charles Medical Group Neonatology

2500 NE Neff Road• Bend

541-382-4321

www.stcharleshealthcare.org

Be n d Memorial Clinic

Bend Eastside tit Redmond

541-382-4900

www .bendmemorialclinic.com

RUSSKLL K. MASSINE, MD, FACP Bend Memorial Clinic

Bend Eastside SaRedmond

541-382-4900

www.bendmemorialclinic.com

ROBERT V. PINNICK, MD

Bend Memorial Clinic

Bend Eastside St Redmond

541-382-4900

www .bendmemorialclinic.com

Bend Memorial Clinic

Bend Eastside SaRedmond

541-382-4900

ww w .bendmemorialclinic.com

PRANCENA ABENDROTH, MD Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www .bendmemorialclinic.com

CRAIGAN GRIPPIN, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www .bendmemorialclinic.com

RICHARD KOLLER, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www .bendmemorialclinic.com

The Center: Orthopedic tt Neurosurgical Carett Resa erch Locations in Bend tk Redmond

541-3 8 2 - 3344

www.t h ecenteroregon.com

The Center: Orthopedic gt Neurosurgical CareStResearch Locations in Bend tia Redmond

541-3 8 2 - 3344

www.t h ecenteroregon.com

Bend Eastside tit Redmond

541-382-4900

www .bendmemorialclinic.com

213 NW Larch Ave, Ste A• Redmond

541-52G-G635

www.stcharleshealthcare.org

929 SW Simpson Avenue• Bend

541-389-7741

www.highlakeshealthcare.com

•

MICHAEL E. PELDMAN, MD

MOLLY TILLKY,MD •

•

RAY TIEN, MD BRAD WARD, MD

ANNIE WILLIAMSON, RD, LD B end Memorial Clinic

WILLIAM H. BARSTOW, MD

St. Charles OB/GYN

JANK BIRSCHBACH, MD

High Lakes Health Care Upper Mill

ANN BRIDGET BIRD,MD

St. Charles OB/GYN

213 NW Larch Ave, Ste A• Redmond

541-52G-GG35

www.stcharleshealthcare.org

BRENDA HINMAN, DO

St. Charles OB/GYN

213 NW Larch Ave, Ste A• Redmond

541-52G-G635

www.stcharleshealthcare.org

ALISON LYNCH-MILLKR, MD

High Lakes Health Care Upper Mill

929 SW Simpson Avenue• Bend

541-389-7741

www.highlakeshealthcare.com

213 NW Larch Ave, Ste A• Redmond

541-52G-G635

www.stcharleshealthcare.org

~ 213 NW Larch Ave, Ste A• Redmond

541-52G-G635

www.stcharleshealthcare.org

St. Charles OB/GYN

AMY B. MCELROY,PNP

~ St. Charles OB/GYN

BARBARANEWMAN, MD

JAMES NELSON, MD LARRY PAULSON, MD s

s s

The Center: Orthopedic gtNeurosurgical CaregtResearch

Locations in Bend St Redmond

541-3 8 2 -3344

www.thecenteroregon.com

The Center: Orthopedic tt NeurosurgicalCareGResearch

Locations in Bend tia Redmond

541-3 8 2 -3344

www.thecenteroregon.com

Locations in Bend St Redmond

541 - 70G-5800

www . stcharleshealthcare.org

ROB BOONK, MD

St. Charles Cancer Center

THEODORE A. BRAICH, MD

Bend Memorial Clinic

CORA CALOMENI, MD

St. Charles Cancer Center

Bend Eastside tia Redmond Locations in Bend tia Redmond

541-382-4900

ww w .bendmemorialclinic.com

541 - 70G-5800 ~ w w w.stcharleshealthcare.org

2 012 CE N T RA L O R E G O N •

•

M E D I CA L D I RECTORY

DVERTISINGSUPPLEMENT

•

SUSIK DOKDYNS, FNP

St. Charles Cancer Center

Locations in Bend St Redmond

541-70G-5800

www.stcharleshealthcare.org

STEVE KORNPELD, MD

St. Charles Cancer Center

Locations in Bend gt Redmond

541-70G-5800

www.stcharleshealthcare.org

BILL MARTIN, MD

St. Charles Cancer Center

Locations in Bend ga Redmond

541-70G-5800

www.stcharleshealthcare.org

LAURIE RICE, ACNP

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

Bend Eastside gt Redmond

541-382-4900

www.bendmemorialclinic.com

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

WILLIAM SCHMIDT, MD HKATHKR WKST, MD s

a '

a s

Bend Memorial Clinic

LINYEE CHANG, MD

St. Charles Cancer Center

2500 NE Neff Road• Bend 5

41-70 G -7733 w

ww. s tcharleshealthcare.org

TOM COMKRFORD, MD

St. Charles Cancer Center

2500 NE Neff Road• Bend 5

41-70 G -7733 w

ww. s tcharleshealthcare.org

RUSS OMIZO, MD

St. Charles Cancer Center

2500 NE Neff Road• Bend 5

41-70 G -7733 w

ww. s tcharleshealthcare.org

•

Bend Eastside, Westside gaRedmond

541-382-4900

ww w .bendmemorialclinic.com

THOMASD. PITZSIMMONS,MD,MPH Bend Memorial Clinic

Bend Eastside, Westside ga Redmond

541-382-4900

www .bendmemorialclinic.com

ROBERT C.MATHKWS, MD

Bend M emorial Clinic

Bend Eastside, Westside ga Redmond

541-382-4900

www .bendmemorialclinic.com

SCOTT T. O'CONNER, MD

Bend Memorial Clinic

Bend Eastside, Westside gaRedmond

541-382-4900

www .bendmemorialclinic.com

DARCY C. BALCKR, OD

Bend Memorial Clinic

Bend Eastside ga Westside

541-382-4900

www .bendmemorialclinic.com

LORISSA M. HEMMER, OD

Bend M emorial Clinic

Bend Eastside ga Westside

541-382-4900

www .bendmemorialclinic.com

BRIAN P.DESMOND, MD

Bend Memorial Clinic

•

KEITH E. KRUEGER,DMD, PC Keith K. Krueger, DMD, PC s'

1475 SWChandler, Ste 101• Bend 54 1 - 617-3993 w

ww.d r keithkrueger.com

a Locations in Bend St Redmond

541-388-2333

www.desertorthopedics.com

Locations in Bend gt Redmond

541-382-3344

www.thecenteroregon.com

Locations in Bend ga Redmond

541-382-3344

www.thecenteroregon.com

The Center: Orthopedic A NeurosurgicalCareA Research

Locations in Bend ga Redmond

541-382-3344

www.thecenteroregon.com

KNUTE BUKHLKR, MD

The Center: Orthopedic@NeurosurgicalCareaResearch

Locations in Bend St Redmond

541-382-3344

www.thecenteroregon.com

MICHAEL CARAVELLI, MD

The C e nter:Orthopedic S Neurosurgical Carea Research

Locations in Bend gt Redmond

541-382-3344

www.thecenteroregon.com

Locations in Bend th Redmond

541-388-2333

www.desertorthopedics.com

Locations in Bend Sa Redmond

541-382-3344

www.thecenteroregon.com

Locations in Bend gt Redmond

541-388-2333

www.desertortbopedics.com

AARON ASKKW, MD ANTHONY HINZ, MD SEFFREY P. HOLMBOE,MD

JOKL MOORK, MD s'

JAMKS HALL, MD

ROBERT SHANNON, MD • '

The Center: Orthopedic ra Neurosurgical Carea Research

The Center: Orthopedic tt NeurosurgicalCarea Rese arch

ERIN FINTER, MD

• '

Desert Orthopedics

Desert Orthopedics The Center: Orthopedic rs NeurosurgicalCareA Research

Desert Orthopedics a

I Desert Orthopedics

I 1303 NE Cushing Dr, Ste 100• Bend

GREG HA, MD

Desert Orthopedics

1303 NE Cushing Dr, Ste 100• Bend

54 1 -388-2333

www.desertorthopedics.com

KATHLEEN MOORE, MD

Desert Orthopedics

1303 NE Cushing Dr, Ste 100• Bend

54 1 -388-2333

www.desertorthopedics.com

541-382-3344

www.thecenteroregon.com

1315 NW 4th Street• Redmond

541-388-2333

www.desertorthopedics.com

MICHAKL RYAN, MD s'

• '

54 1 -388-2333 I w ww .desertorthopedics.com

TIMOTHY BOLLOM, MD BRETT GINGOLD, MD

The Center: Orthopedic A Neurosurgical CareAResearch Locations in Bend St Redmond

Desert Orthopedics

SCOTT T. JACOBSON, MD

The Center: Orthopedic t'Neurosurgi a cal CareA Research

Locations in Bend ga Redmond

541-382-3344

www.thecenteroregon.com

BLAKE NONWEILER, MD

The Center: Orthopedic A NeurosurgicalCarea Research

Locations in Bend ga Redmond

541-382-3344

www.thecenteroregon.com

54 1 - 388-2333

www.desertorthopedics.com

CARA WALTHKR, MD I '

Desert Orthopedics

1303 NE Cushing Dr, Ste 100• Bend

MICHAEL COE, MD

The Center: Orthopedic tt Neurosurgical Carea Research Locations in Bend th Redmond ~

54 1 - 382-3344 ~ w ww . thecenteroregon.com

2 012 CE N T RA L O R E G O N • '

• '

SOMA LILLY, MD 3AMES VERHEYDEN, MD ' '

DVERTISINGSUPPLEMENT

KKNNKTH HANINGTON, MD

•

M E D I CA L D I RECTORY

•

541-388-2333

www . desertorthopedics.com

The Center: Orthopedic St Neurosurgicai CaregtResearch Locations in Bend gt Redmond

Locations in Bend At Redmond

541-382-3344

www. t hecenteroregon.com

The Ce n t er: OrthopedicNeurosurgi st cai CaregtResearch Locations in Bend gt Redmond

541-382-3344

www. t hecenteroregon.com

Dese rt Orthopedics

MOLLY OMIZO, MD

Deschutes Osteoporosis Center

LISA LKWIS, MD

Partners in Care

RICHARD 3. MAUNDER, MD

St. C harles Advanced Illness Management

2500 NE Neff Road • Bend 5

LAURA K. MAVITY, MD

St. Charles Advanced Illness Management

2500 NE Neff Road • Bend

STKPHANIK CHRISTENSEN, DMD Deschutes Pediatric Dentistry STEVE CHRISTENSEN, DMD

Deschutes Pediatric Dentistry

R DEAN NYQUIST, DMD

Dentistry for Kidz

KATHERINE BAUMANN, MD

Bend Memorial Clinic

KATE L. BROADMAN, MD

Bend Memorial Clinic

RICK G. CUDDIHY, MD

Send Memorial Clinic

2200 NE Neff Road, Suite 302• Bend 5 4 1 - 3 88-3978 w w wdeschutesosteoporosiscentercom

2075 NEWyatt Ct • Bend 5

J J

41-3 8 2 - 5882 41-70 G -5885 w 541-70G-5885

1475 SW Chandler Ave, Ste• Bend 5 4 1 - 389-3073 w

www.partnersbend.org ww. s tcharleshealthcare.org

www.stcharleshealthcare.org

ww.d e schuteskids.com

1475 SW Chandler Ave, Ste• Bend 5 4 1 - 3 89-3073 w

ww.d e schuteskids.com

1230 NE Third St, Ste A-174• Bend 5 4 1 - 389-G600 w

ww.d entistryforkidz.com

1080 SW Mt. Bachelor Drive• Bend

541-382-4900

www.bendmemorialclinic.com

1080 SW Mt. Bachelor Drive• Bend

541-382-4900

www.bendmemorialclinic.com

1080 SW Mt. Bachelor Drive• Bend

541-382-4900

www.bendmemorialclinic.com www.stcharleshealthcare.org

THOMAS N. ERNST, MD

St. Charles Family Care

2ii NW Larch Ave• Redmond

541-548-2164

KATHRYN LEIN, CPNP

Bend Memorial Clinic

1080 SW Mt. Bachelor Drive• Bend

541-382-4900

www.bendmemorialclinic.com

MICHKLLE MILLS, MD

Bend Memorial Clinic

1080 SW Mt. Bachelor Drive• Bend

541-382-4900

www.bendmemorialclinic.com

MARGARKT 3. PHILP, MD

St. Charles Family Care

211 NW Larch Ave• Redmond

541-548-2164

www.stcharleshealthcare.org

JB WARTON, DO

Send Memorial Clinic

1080 SW Mt. Bachelor Drive• Bend

541-382-4900

www.bendmemorialclinic.com

ROBERT ANDREWS, MD

Desert Orthopedics

Locations in Bend ga Redmond

541-388-2333

www.desertorthopedics.com

LINDA CARROLL, MD

High Lakes Health Care Upper Mill

929 SW Simpson Avenue• Bend

541-389-7741

www.highlakesheal thcare.com

L o cations in Bend ga Redmond

541-382-3344

www.thecenteroregon.com

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

TIM HILL, MD NANCY H. MALONEY, MD

J J

The Center: Orthopedic St Neutosutgical Care gtResearch

Bend Memorial Clinic

3AMES NELSON, MD

The Center: Orthopedic gtNeurosurgicai CaregtResearch

Locationsin Bend gt Redmond

541-382-3344

www.thecenteroregon.com

LARRY PAULSON, MD

The Center: Orthopedic A NeurosurgicaiCareA Research

Locationsin Bend At Redmond

541-382-3344

www.thecenteroregon.com

DAVID STEWART, MD

The Center: Orthopedic tt NeurosurgicalCarett Research

Locationsin Bend gt Redmond

541-382-3344

www.thecenteroregon.com

Locationsin Bend gt Redmond

541-388-2333

www.desertorthopedics.com

The Center: Orthopedic gt Neurosurgicai Care StResearch

Locationsin Bend gt Redmond

541-382-3344

www.thecenteroregon.com

The Center: Orthopedic A NeurosurgicaiCareAResearch

Locationsin Bend gt Redmond

541-382-3344

www.thecenteroregon.com

JON SWIFT, DO

VIVIANE UGALDE, MD MARC WAGNER, MD

Desert Orthopedics

DEAN NAKADATE, DPM

Deschutes Footgt Ankle

BROOKE HALL, MD

St. Charles Preoperative Medidne

2500 NE Neff Road• Bend 5

JONATHON BRKWER, DO

Send Memorial Clinic

Bend Eastside gaRedmond

JAMIE DAVID CONKLIN, MD

St. Charles Pulmonary Clinic

929 SW Simpson Ave, Ste 220• Bend 541 -317-5GOO w ww.deschutesfootandankle.com

41-70 G -2949 w

ww. s tcharleshealthcare.org

s s 541-382-4900

www .bendmemorialclinic.com

Locations in Bend gt Redmond

541-70G-7715

www.stcharleshealthcare.org www.bendmemorialclinic.com

LOUIS D'AVIGNON, MD

Bend Memorial Clinic

Bend Eastside gt Redmond

541-382-4900

KRIC S. DILDINK, PA-C

St. Charles Pulmonary Clinic

Locations in Bend ga Redmond

541-70G-7715

www.stcharleshealthcare.org

ROD L.KLLIOT-MULLKNS, DO

St. Charles Pulmonary Clinic

Locations in Bend gt Redmond

541-70G-7715

www.stcharleshealthcare.org

KEITH W. HARLESS, MD

St. Charles Pulmonary Clinic

Locations in Bend ga Redmond

541-70G-7715

www.stcharleshealthcare.org

2 012 CE N T RA L O R E G O N t

M E D I CA L D I RECTORY

DVERTISINGSUPPLEMENT

s s

Locations in Bend gt Redmond

541-70G-7715

www . stcharleshealthcare.org

Bend Memorial Clinic

Bend Eastside gt Redmond

541-382-4900

www .bendmemorialclinic.com

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www .bendmemorialclinic.com

541-70G-7715

www . stcharleshealthcare.org

MATT HEGEWALD, MD

St. Charles Pulmonary Clinic

T. CHRISTOPHER KELLEY, DO JONATHON MCPADYEN, NP

KEVIN SHERER, MD

St. Charles Pulmonary Clinic

NOREEN C. MILLER, FNP

St. Charles Rehabilitation Center

2500 NE Neff Road• Bend 5

GREG BORSTAD, MD

Bend Memorial Clinic

Bend Eastside gt Redmond

541-382-4900

DAN FOHRMAN, MD

Deschutes Rheumatology

2200 NENeffRoad,Suite 302 • Bend

541-388-3978

n/a

TIANNA WELCH, PA

DeschutesRheumatology

2200 NENeffRoad,Suite 302 • Bend

541-388-3978

n/a

JONATHON BREWER, DO

Bend Memorial Clinic Sleep Disorders Center

Bend Eastside gt Redmond

541-382-4900

www.bendmemorialclinic.com

ARTHUR K. CONRAD, MD

St. Charles Sleep Center - Bend

Locations in Bend gt Redmond

541-70G-G905

www.stcharleshealthcare.org

DAVID L. DEDRICK, MD

St. Charles Sleep Center - Bend

Locations in Bend gt Redmond

541-70G-G905

www.stcharleshealthcare.org

T. CHRISTOPHER KELLEY, DO

Bend Memorial Clinic Sleep Disorders Center

Bend Eastside gt Redmond

541-382-4900

www.bendmemorialclinic.com

DAVID HERRIN, DC

Locations in Bend gt Redmond

41-70 G -7725 w

ww. s tcharleshealthcare.org

ww w .bendmemorialclinic.com

Redmond Wellnessgt Chiropractic

1655 SW Highland Ave,Ste 6 • Redmond 541-923-2019

www.drherrin.com

TIMOTHY L. BEARD, MD, FACS Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

DARA H. CHRISANTTE, MD

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

GARY J. PREI, MD, FACS

Bend Memorial Clinic

Bend Eastside gt Redmond

541-382-4900

www.bendmemorialclinic.com

JACK W. HARTLEY, MD, FACS

Surgical Associates of the Cascades

1245 NW 4th Street, ¹101• Redmond

541-548-77G1

www.cosurgery.com

www.bendmemorialclinic.com

DARREN M. KOWALSKI, MD, FACS Bend Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900

JOHN C. LAND, MD, FACS

Surgical Associates of the Cascades

1245 NW 4th Street, ¹101• Redmond

541-548-7761

www.cosurgery.com

ANDREW SARGENT, PA-C, MS

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

GEORGE T. TSAI, MD, FACS

Surgical Assodates of the Cascades

1245 NW 4th Street, ¹101• Redmond

541-548-7761

www.cosurgery.com

JENNIFER TURK, PA-C

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend

541-382-4900

www.bendmemorialclinic.com

JEANNE WADSWORTH,PA-C, MS

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900

www.bendmemorialclinic.com

ERIN WALLING, MD, PACS

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900

www.bendmemorialclinic.com

JEFF CABA, PA-C

Bend Memorial Clinic

Bend Eastside, Westside gt Redmond 5 4 1-382-4900

www .bendmemorialclinic.com

ANN CLEMENS, MD

Bend Memorial Clinic

Bend Eastside, Westside gt Redmond

541-382-4900

www .bendmemorialclinic.com

TERESA COUSINEAU, PA-C

Bend Memorial Clinic

Bend Eastside, Westside gt Redmond

541-382-4900

www.bendmemorialclinic.com

2G00 NE Neff Road• Bend

541-70G-3700

www.stcharleshealthcare.org

DANETTE ELLIOT-MULLENS, DO St. Charles Immediate Care

J. RANDALL JACOBS, MD

Bend Memorial Clinic

Bend Eastside, Westside gt Redmond

541-382-4900

www.bendmemorialclinic.com

AMEE KOCH, PA-C

Bend Memorial Clinic

Bend Eastside, Westside gt Redmond

541-382-4900

www.bendmemorialclinic.com

JIM MCCAULEY, MD

Bend Memorial Clinic

Bend Eastside, Westside gt Redmond

541-382-4900

www.bendmemorialclinic.com www.bendmemorialclinic.com

TERRACE MUCHA, MD

Bend Memorial Clinic

Bend Eastside, Westside & Redmond

541-382-4900

JAY O'BRIEN, PA-C

Bend Memorial Clinic

Bend Eastside, Westside gt Redmond

541-382-4900

www.bendmemorialclinic.com

CASEYOSBORNE-RODHOUSE, PA-C

Bend Memorial Clinic

Bend Eastside, Westside gt Redmon

541-382-4900

www.bendmemorialclinic.com

LAURIE D. PONTE, MD

Bend Memorial Clinic

Bend Eastside, Westside gt Redmond

541-382-4900

www.bendmemorialclinic.com

PATRICK L. SIMNING, MD

Bend Memorial Clinic

Bend Eastside, Westside gt Redmond

541-382-4900

www.bendmemorialclinic.com

SEAN SUTTLE, PA-C

Bend Memorial Clinic

Bend Eastside, Westside gt Redmond 541-382-4900

ww w .bendmemorialclinic.com

2012 CE N T RA L O R E G O N

DVERTISINGSUPPLEMENT

M E D I C A L D I R E C T O RY '

THOMAS H. WKNDKL, MD

Bend Memorial Clinic

Bend Eastside, Westside 8t Redmond 5 4 1-382-4900

www .bendmemorialclinic.com

BRENT C. WESENBERG, MD

Be n d Memorial Clinic

Bend Eastside, Westside gt Redmond 5 4 1-382-4900

www .bendmemorialclinic.com

•

MEREDITH BAKER, MD

Bend Urology Associates

2090 NE Wyatt Court• Bend

541-382-6447

www.bendurology.com

MICHAEL BOILKAU, MD

Bend Urology Assodates

2090 NE Wyatt Court• Bend

541-382-6447

www.bendurology.com

JACK BREWER, MD

Bend Urology Associates

2090 NE Wyatt Court• Bend

541-382-6447

www.bendurology.com

ANDREW NEEB, MD

Urology Specialists of Oregon

2084 NE Professional Court• Bend

541-322-5753

h t t p: //usof or.praxismedicalgroup.com

BRIAN O'HOLLAREN, MD

Bend Urology Associates

2090 NE Wyatt Court• Bend

541-382-6447

www.bendurology.com

ERIC SHREVE, MD

Bend Urology Associates

2090 NE Wyatt Court• Bend

541-382-6447

www.bendurology.com

NORA TAKLA, MD

Bend Urology Associates

2090 NE Wyatt Court• Bend

541-382-6447

www.bendurology.com

ROD BUZZAS, MD

Advanced Specialty Care

2084 NE Professional Court• Bend

541-322-5753

EDWARD M. BOYLE,JR., MD, FACS

Inovia Vein Specialty Center

w w w.advancedspecialtycare.com www.bendvein.com

2200 NE NeffRoad, Ste 204 • Bend 541-382-834G

ANDRKW JONKS, MD,FACS I n ovia Vein Specialty Center

www.bendvein.com

2200 NE Neff Road,Ste 204 • Bend 541-382-834G

Bend Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900 w

ww. bendmemorialclinic.com

JOSKPH COLELLA, MD, FACS B end Memorial Clinic

1501 NE Medical Center Drive• Bend 541-382-4900 w

ww. bendmemorialclinic.com

DARREN KOWALSKI, MD

P AID A D V E R T I S I N G S U P P L E M E N T

To be included in the next issue ofthe PULSE/Connections Medical Directory, contact:

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LOCAL SERVICE - LOCAL KNOWLEDGE

Coverstory(PROSTATECANCER

make-up of the different types of prostate exact location of the prostate and avoid ad cancer and may someday be able to better jacent tissue. Many surgeons are now using predict which ones need to be treated. Scien robotic surgery that can remove the prostate tists at OHSU are studying targeted therapies through smaller openings with less recovery that can stop the growth of prostate cancer ContinuedfromPage15

time.

tumors by starving them or by stimulating

"The surgical techniques have improved greatly," O'Hollaren said."Total urinary incon tinence after radical prostatectomy is now something that is rare. Impotence is some thing that definitely exists as a side effect of

the body's immune system. Yet, some of the most basic prostate can cer research has never been done. There has yet to be a single randomized trial compar ing surgery and radiation outcomes. In part that's because researchers feel it would be

treatment but it's definitely decreased from

prior years. Radiation is now more accurate, with less scatter and few side effects to sur rounding tissue. Cryotherapy has evolved tremendously over the past 10 years and the side effects are minimized greatly." Meanwhile, medical research into pros tate cancer treatments is rapidly progress ing. New technologies are being developed that aim to further reduce the side effects of treatment while still providing high cure rates. Researchers are studying the genetic

difficult to convince patients to let random

chance decide something as big as surgery or radiation.

But even that study shows how dif ficult prostate cancer research can be. Because the cancer grows so slowly, researchers must track outcomes for decades to determine the true impact of treatment. And by t hat t ime, the

patients have changed, the diagnostic tools have changed and the treatments have changed. "What happensistechnology chang es so rapidly," Omizo said. "As soon as somethingbecomes standardized, technology's changed and soon you're comparing apples to oranges again." But that leaves even the most basic

"The one head-to-head study that's been done is the Scandinavian study that com pared watchful waiting to surgery, which if you think about it, is an amazing accom plishment," Beer said. "Seven hundred men willing to let a coin flip decide between ma jor surgery and leaving their cancer untreat ed is sort of staggering."

questions unanswered. Doctors find themselves in a no-win situation in try

ing to help patients. If they recommend a treatment, they get accused of push ing their own bias, surgeons toward surgery, radiation oncologists toward radiation. If they bend over backward to be impartial and not push any treat ment, patients can feel they're being abandoned to make their own decision with no help from their doctor.

"Prostate cancer is the grayest part of medicine at a lot of different levels. Who should bescreened? Ifyou get screened,what should you do?" Omizo said. "It's problematic for clinicians and I think it's problematic for patients.

W hen patients come away confused, it's because nobody has the right answer." At OHSU, prostate cancer treatment

Can you spot the person with varicose veins? Varicose and spider veins are very common, affecting over 40% of adults. They can be painful, itchy, and interfere with work, exercise, and life in general. Ifyou have these symptoms we can help. • Prominent or bulging veins • Discomfort or restless legs • Pain and swelling in legs, ankles or feet • Leg fatigueor heavy sensation • Skin discoloration around the ankles • Itching along leg veins Treat your varicose veins now for healthy legs next summer. Trust our experts and learn about the latest in minimally invasive procedures perFormed in our office.

i n o v V EI N

S P E C I A LT Y

i a C EN TE R

specialists are trying to overcome those issues with a group approach. Newly diagnosed patients can meet with a urologist, a radiation oncologist and a medical oncologist in a single day. The experts can discuss the patient's con dition, review his tests and pathology reports, and give their combined rec ommendation on the best treatment option.

"We keep each other honest when you approach it as a team," Beer said. "I wouldn't say all biases fall away. That never happens in any subject. But I would say the biasesare subsumed, are very much reduced, and really there's a bitof a check and balance on every body, which I think works out well." •

2200 NE Neff Road, Suite, 204 (in The Center) l bendvein.com l 541-382-VEIN (8346) Andrew Jones,MD, FACS I Edward Boyle,MD, FACS I Board Certified Surgeons

Page52

Body ofknowledge ~POPQUlz

etrut a out runnin inuries GREG CROSS

BY ELISE GROSS

potting the symptoms of common running injuries early on is crucial in preventing a full-blown injury that can thwart your training and racing plans. A base knowledge of proper run ning footwear and treatment can also reduce your risk of injury and keep you running happy. Are you injury prevention savvy? Take this

Where is the largest tendon in the body located? A. Neck B. Ankle C.Back D. Shoulder

quiz to find out.

When is the best time to stretch your muscles? A. 6efore a run B. During a run C. After a run D. None of the above

Tenderness and/or pain down the front of the shin is just an annoyance novice runners often experience that will go away if they continue running.True or false?

What is the most common runner's injury? A. Shin splints B. Achilles tendonitis C. Plantar fasciitis

D. Runner's knee How often should you replace your running shoes? A. Every 200 miles B.Every 300-500 miles C.Every 600-800 miles D. When the shoes fall apart

What is the best type of running shoe footbed for plantar fasciitis? A. A soft footbed B. Whatever footbed came with the shoe C. A rigid footbed with arch support D. None of the above Sore muscles the day or two after a run are caused by: A. Tiny muscle tears B. Overheating C. Not drinking enough water D. Lactic acid buildup Asprainis aninjury to a: A. Tendon B. Muscle C. Ligament D. 6one

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ue41 Jalse) uar a lno JeaM IIiM weog igos-Jadns Jo uoiqsn3 Iewiuiw qiiM saoqs 'Ieiauab u) AJn(u) ol a)qpda3sns aiow noA bu)neaI 'uMop 3IeaJq saoqs buIuunJ u) peail pue uoIqsn3 aqi 'awp JanO a)nJ poo6 e si saIiw pps-ppE AJana saoqs buiuunJ JnoA bu)3E)da)I b Ir .aaus) S,Jauun»uanaJd d)aq I)e ue3 JeaMioog Jadoid buueaM pue 'Apsualu) pue abea)iw 6uiseaJ3ui AIMoIs 'unJ e aJogaq dn bu)wJPNI aau3I aql ol ssails paleadaJ 4»M aspiaxa buueaq-lqbiaM e — 5uiuunJ ol uowwo3 si AJn('ui Io adAl 514J de3aau3) a41 Jeau uied buisne3 'abe)pie3 paleluii Aq pasne3 si aau3) S,Jauun)I Q Z IeuoIssagoJd Ie3ipaw e woJ) a3inpe 3)aas 'AJnt'ui Aue 44M SV.sapsnw uiqs a41 uaqlbuails ol saspiaxa bu)wJoyad ue3 se 'd)a4 uea uopewweoui a3npaJ ol suiqs aql bupI (aiols bu)uunJ Al)epads Jo IPUOIssagoJd Ie3Ipaw e woJj a3)npe3)aas 'uosiad 43ea JOI saiien JeaMJDOI145u aql) JeaMJOOI Jadoidwi Jo /pue sa3eynsuanaun uo buiuunJ ' iaaI leg Aq pasne3 aq osIe ue31nq 'AJnrui asniano ueA)uowwo3 aie AaqJ uopewwe)ju) apsnw uiqs go woldwAs e uaigo aie 'awoipuAs ssails Ieiqp se UMous) os)e 'slui)ds uiqs .as)edZ AJnt'ui oi auoid aiow aie sapsnw p)o3ie41Moqs saipnis pueqaJOIaq sainuiw pI isea) ie JOI dn UiieM '6uiuunJ aJO)aq 431aas Apqbi) ol qsiM op noA)I dn pawieM aie sapsnw uaqM 'unJ e Jalpy 431aas ol awp lsaq aqJ AJnlui jo 3)su JnoA sa3npaJ inosIJOM e aJogaq bu)43iaJJS le41)ooJd ou si aJaqj .D I,

Sources: National lnsituteof Arthritis and Muscoloskeletal and Skin Diseases, WehMD and Runner's World Magazine

HIGH DESERT PULSE • FALL/WINTER 2612

Page 53

One voice ~ ApERsoNALEssAY

earnin to ove detailing each turn, the night before. Spontaneous weekend surf trips to the Oregon Coast and late-night cross-country ski sessions, hen people learn that my husband, Tim, has attention however, all seem to fall into place with little or no planning. deficit hyperactivity disorder, they are often sympathetic In August 2011, Tim and I got married and moved to Bend. I wast toward me. ed no time organizing the house: I carefully arranged a tray for our "That must be hard for you ... I'm sorry ... Are you happy?" keys on the entry table, put up a calendar on the fridge detailing our These responses are always empathetic, if not merited. ADHD, schedules, and filed every paper we owned religiously. characterized by inattention, impulsivity and hyperactivity, can put But after three years of dating, Tim's free spirit still made me ner a strain on relationships. The divorce rate is vous. Ordering the house in a systematic nearly double for those with ADHD. way seemed to help. But doctor's appoint Experts suggest that at least 4 percent of ments are occasionally still forgotten, keys adults have the disorder. Tim, who was first are still misplaced. diagnosed as ayoung boy, is partofthe esti Working full-time can be hard for Tim, an mated half of those who never fully outgrow aide supervisor at a physical therapy clinic. childhood ADHD. He struggles with the logistics of scheduling BY ELISE GROSS

For Tim, 23, ADHD medication helps sig

aides and getting to work on time.

nificantly, but is not a cure-all. One of Tim's biggest struggles is with executive function

Some days are harder than others. It is frustrating when I have to say Tim's name

ing — planning, paying attention to details,

three times to get his attention. And it's not

and managing time and space. Naturally, I want to help Tim as much as possible. During our engagement, I sought advice from Tim's aunt, Diane, whose hus band ofmore than 25 years,Steve,also has

always fun to be in charge of cleaning the house, paying bills and budgeting — things that are stressful for someone with ADHD.

Tim is gracious about my help, but I am incredibly thankful for his. Despite dealing with the challenges of ADHD, our first year of marriage has been transformative for me. I have learned to value the positive, unique

ADHD. At the time, Tim and I were in our last

semester of college in San Diego. Diane and I sat around the kitchen table,

wrapping our hands around our coffee mugs in their Irvine, Calif., home. "How do you help Steve manage his ADHD?" I asked.

ROB KERR

Ti mand Elise Gross

Diane'ssuggestions were some of the bestIhad heard.She advised me to sched ule meetings with Tim when discussing stressful things like financ es. She told me to be patient when Tim forgot to pick up milk on the way home from work. Diane leaned forward in her chair. "Honestly, it's been wonderful," she said softly. "My life was so boring before I met Steve." I could relate. When I first met Tim as a college freshman, his spon taneity frightened me. I am the type of person who buys my plane ticket a year in advance, who organizes the junk drawer for fun. Tim, onthe hand,does notplan.He schemes. Ihave often come home to find him leaning over a trail map spread out on the kitchen island, brows furrowed, calculating his next grand adventure. While my plans are made days — if not weeks — in advance, Tim's are not. He carefully maps out 20-mile mountain biking expeditions,

Page 54

traits of ADHD that Tim possesses.

While Tim often jumps from one subject to the next in conversation, he offers cre ative, intuitive solutions to life's everyday

problems. Fine wining and dining is outside of our budget, but Tim brews beer and kombucha (fermented tea) at homeand whips up sushiand coconut crepes. He is also enthusiastic, adventurous and full of energy. Every day, Tim bikes 12 miles to work round-trip. Weekends usually consist of at least two sports per day. Tim's active, laid-back lifestyle has pushed me both mentally and physically. This year, for the first time in a decade, I stopped writing in a per sonal planner. I took up mountain biking and snowboarding, two things I had always been afraid to try. And I stopped worrying about my to-do list and began to let dirty dishes and clothes pile up. Finding a balance between organization and relaxation, planning and spontaneity is a continual process. But Tim's creative perspective on the world has helped me prioritize better than any planner ever could.•

FALL/ WINTER 2012• HIGH DESERTPULSE

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