WINTER/SPRING 2013
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Exercise= medicine Low cost andwithout side effects, physical activity can cure
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Also inside: • Dress up yourtoast • Meet a hospital systems wizard • Get a grip on winter running
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PTSD: Veteransconfront thewounds ithin
ll SA FACT! Except for lung cancer, prostate cancer is responsible for more deaths than any other cancer.
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H I G H
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UPdates( NEw slNcE wE LAsTREPORTED
Healthy Living in Central Oregon
WINTER / SPRING 2013 VOLUME 5, NO. 1
How to reoch us Julie Johnson IEditor 541-383-0308 or jjohnson@bendbulletin.com Sheila TimonyIAssociate editor 541-383-0355 or stimony@bendbulletin.com • Reporting Anne Aurand 541-383-0304or aaurandCIbendbulletin.com Elise Gross 541-383-0351, egross@bendbulletin.com Heidi Hagemeier 541-617-7828, hhagemeierCtbendbulletin.com Zack Hall 541-617-0868, zhall@bendbulletin.com • Design / Production Greg Cross Lara Milton • Photography Ryan Brennecke Rob Kerr
David Wray Andy Zeigert Joe Kline Andy Tullis
• Advertising Jay Brandt, Advertising director 541-383-0370 or jbrandt@bendbulletin.com Lorraine Starodub, Accountexecutive 541-617-7855 or Istarodub@bendbulletin.com Otb On the Weh: www.bendbulletln.com/pulse
• Corrections High Desert Pulse's primary concern is that all stories are accurate. If you know of an error in a story,call us at 541-383-0308or email pulseOIbendbulletln.com.
The Bulletin
AR Bulletin paymentsareaccepted at thedrop boxat Cityllau Checkpayments may beconverted to an electronic funds transfer The Bulletin, USPS 11552520 is publrshed daily by Western Communicauons Inc.,1777 5W Chan dler Ave. Bend,OR97702 Penodicals postage paid at Bend.OR.Postmaster. Send addresschanges toTheBuueun arculauon department, PO.Box6020, Bend, OR 9770B The Bulletin retains ownershipand copynght protecuon of au staff preparednews «opy,adverusing copyand news or adilustrauons. They may nor bereproduced without expliat pnorapproval. Published 2/rt/2013
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Controversial treatment is effective against deadly C.diff infections The cover story of our Spring/Summer 2011 issue, "Cerm warfare," explored how bad bacteria and good bacteria
tional treatment and who want to avoid surn gery, he said in a news release. —ANNEAURAND
Study shows link between teen sleep habits, later diabetes
In our Fall/Winter =-,== 2012 issue of High b attle w i thin o u r Desert Pulse, we li~ i A i 4~e~hbodies, and somewrote a story, "How times, in a quest to staying up may be stay healthy, we wipe out both kinds with keeping kids down," Navigating antibiotics. that said youth and The story featured an experimental treat- teens don't sleep ment that used human feces to treat a pa- as much as they tient with a dangerous and highly conta- shouldand sleep shortages causean array of gious bacterial infection called Clostridium behavioral, emotional, mental and physical difficile, or C.diff. The treatment is thought problems. A new study builds on the evidence to re-establish normal intestinal flora, the that adequate sleep is a crucial component to healthy bacteria that stimulates the immune health, suggesting that if teens could get more system and aids the digestion and absorp- sleep, they could possibly prevent diabetes in tion of food. the future. Since our story ran, a Henry Ford HospiThe new study, which appeared in the tal study showed that using donated human journal Sleep, tracked the sleep duration and stool to treat the potentially deadly C.diff in- insulin resistance of 245 healthy high school fection cured 43 of 49 patients quickly and students. Results showed higher insulin rewith no complications up to three months sistance associated with shorter sleep duralater. The unconventional treatment is per- tion, independent of race, age, gender, waist formed either through a nasogastric tube circumference and body mass index. Insulin or colonoscopy. Of the 49 patients, 43 fully resistance increases the chance of developrecovered, four died of causes unrelated to ing Type 2 diabetes. "High levels of insulin resistance can lead C.diff, one had intestinal surgery and one had no improvement. to the development of diabetes," according C.diff causes intestinal problems and is to the study's lead author, Karen Matthews, linked to 14,000 deaths annually. C.diff infec- of the University of Pittsburgh Department tions are becoming more common and more of Psychiatry. "We found that if teens that severe in hospitalized children and the elderly, normally get six hours of sleep per night get in large part due to greater use of antibiotics. one extra hour of sleep, they would improve Dr. Mayur Ramesh, a Henry Ford Infec- insulin resistance by 9 percent." tious Diseases physician and senior author The American Academy of Sleep Medicine of the study, said the treatment has striking says most teens need at least nine hours of results. "This treatment is a viable option for sleep each night. —ANNEAURAND patients who are not responding to conven-
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Letters ~ READERs REsPDND
What about the proton accelerator7
in a hospital setting on an outpatient basis. I was treated 15 years ago with the proton
accelerator and my quality of life has never
PULSE.::.=.=:.==.
The article "What's the solution?" about treatment for prostate cancer in the re-
cent Pulse magazine of your paper (Fall/ Winter 2012) was informative, but failed
»19a m9 he maze
been altered. Robert Marckini has written a
Thanks so much for the concise, clearly written article on prostate cancer in the Fall/
book called "You Can Beat Prostate Cancer Winter High Desert Pulse. As a 69-year old and You Don't Need Surgery to Do It." prostate cancer survivor, I only wish I had the Proton accelerator is the modality men opportunity to have read your very informashould be aware of. tive article prior to my brachytherapy in January, 2008. I feel you laid out the complex— Weldon Hagen, Bend and overwhelming — treatment options and
to include the treatment that is least invasive,
ReporterMarkian Hawryluk responds: We opted againstincluding newer treatments such as protontherapy in our report on prostate canceroptionsbecauseofa lack ofdata about the effectiveness of proton therapy and its side effects. Prostate cancer experts are still debat-
the proton accelerator. Because of the unique characteristics of the proton particle (Bragg peak), the tumor can be more precisely targeted. Thus, less ing whether the high cost of the treatmentcollateral damage and fewer side effects, generally more than $50,000 per patient — is including impotence and incontinence. It is justified by the outcomes. Although Medicare's noninvasive, painless, without trauma and decision to pay for proton therapy is spurring requires no hospitalization. the opening of new proton therapy clinics, Loma Linda Hospital in Loma Linda, Calif., was availability of the treatmentis generally limited the flrst to utilize this groundbreaking treatment to larger urban centers and academic settings.
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their resulting side effects in an easy-to-understand manner. Had I known after reading your article what I did not fully understand then, I would most certainly have opted for the "watchful waiting" option rather than
have proceeded with treatment. I was overwhelmed by explanations of the competing surgical and radiation treatment options, par-
ticularly weighing the potential side effects of each treatment. I would have welcomed the "multidisciplinary" approach you reported as beingoffered atOHSU. — Tom Hartrich, Bend
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Opting for watchful waiting
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LOCAL SERVICE — LOCAL KNOWLEDGE
WINTER/SPRING 2013• HIGH DESERTPULSE
Contents ~ HIGHDEsERT PULsE
COVER STORY POST-TRAUMATIC STRESS DISORDER Back from battle, today's vets have new options for treating PTSD. But they have to seek help.
FEATURE AS MEDICINE How goodisit? Ifwecouldbottleit, 18 EXERCISE everyone would buy it.
DEPARTMENTS UPDATES
What's new since we last reported.
GEAR
LETTERS Response from our readers.
THE JOB' FACILITIES ENGINEER 14 ON Colclough and company keep the hospital ticking. FLY-FISHING 16 SNAPSHOT: Locals'winter fishing spot? The Crooked River. DOES SHE DO IT?: BECKY JOHNSON 24 HOW Playing hard works out for OSU-Cascades VP. READY: GOLFING 28 GET Get on course in Central Oregon. SHOE TRACTION 32 GEAR' Keeping up while winter running. SINUS CONGESTION 34 TIPS: Feeling the pressure? Get to knowyour nose. EATING' TOAST 37 HEALTHY Quick fix for a boring breakfast. OF KNOWLEDGE: POP QUIZ 53 BODY Test your mind's medical dictionary. VOICE: A PERSONAL ESSAY 54 ONE Eating green in the new year.
ET3KADY;-
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COVER DESIGN:GREG CROSS CONTENTS PHOTOS BYROBKERR
HIGH DESERT PULSE • WINTER/SPRING 2013
»ge 7
HE LTHY EATING
Cover story ~ PosTTRAUMATIc sTREssDlsoRDER
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An Army veteran who lost a leg while servingin Iraq and has post-traumaticstress disordergoes for a walk in Dexter, Maine, in 2011. While he has learned to live with the physical wounds of war, a role as a soldierin a movieis helping him cope with PTSD. TODD • EISLER/THENEWYORKTIMES
Page 8
he story of how war wounded Don Henderson's soul is a familiar one, told time and again by generations of veterans. During his seven months in action in Vietnam, the gentle, 18-
year-old California boy stepped into the role of Marine machine gunner, spraying bullets from his M-60 at the front of firefights. His best friend died in one of them. Then his time came, and enemy fire ripped through his chest. After recuperating, Henderson was honorably discharged. He re-
Home from lraq and Afghanistan, many soldiers are healing. But for more than a few, the war lives on. BY HEIDI HAGEMEIER
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turned to his parents' house, but he knew he wasn't the same. Footsteps from behind would cause him to slam his body flat against the wall, head turning left and right on full alert. Abackfiring truck triggered Pavlovian adrenaline surges. Nighttime paralyzed him. "When I came home in 1970," Henderson said, "I thought I was crazy." It was an assessment Henderson quickly learned to keep to himself.
"medicated vegetables" there.
In one attempt to get help soon after returning home, at a Veterans
or will to help them.
Administration hospital, he felt horrified by what he described as the
"If that's what these people do," he recalled thinking at the time
about the caregivers, "I'm never going to tell them." It became the hallmark of a generation: Soldiers at war in the jungle witnessed the unthinkable and struggled to deal with extraordinary events. Then they returned to a homeland that lacked the knowledge Some, like Henderson, now 62 and a Bend resident, buried their hurt
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As a mental-health diagnosis, post-traumatic stress disorder is unusual in that its trigger is external — an event or series of events leads to its development. A variety oftraumatizing experiences can bring on PTSD, from a car crash to a rape to childhood abuse. A classic cause for both soldiers and civilians is living in a combat zone. Fearing death can be enough, but wartime causes aren't limited to that, experts say. Working with the wounded, seeing a bestfriend die or searching the body of an enemy for maps — only to find a family photo that makes that enemy human — can all bring on PTSD. Most traumatized people initially have symptoms. Only some will develop PTSD, though it's not clear why. For many, PTSD emerges within three months of the trauma, but some can bury their pain onlyto have it become unbearable years later. Symptoms typically include frequent nightmares; being quickto anger; difficulty sleeping; recurring visions of the trauma; avoidance of places, objects or sensory elements, like sounds that are reminders of the trauma; emotional numbness; being emotionally distant from loved ones. PTSD is often intermingled with feelings of guilt or shame. Some develop compounding problems, such as depression or substance abuse issues.
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Sources: National Center for PTSD, U.S. Department of Veterans Affairs; Gary Hunter, Central Oregon Vet Center
Bend resident Don Henderson, a Vietnam veteran, has long struggled with PTSD, which he considers a chronic disease. ROB KERR
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Cover story(POSTTRALIMATIC STRESS DISORDER reproduce the sights, sounds and smells of thecombat zone so soldierscan become desensitized to their experiences. Dogs trained
specifically for those with PTSD serve as emotional-support animals. Yet there's a cloud to this silver lining.
One local expert had seen a soldier deployed as many as 14 times. Also, research suggests that what these troops have faced on the ground, particularly in Iraq, potentially increases the severity of PTSD.
The nature of the Afghanistan and Iraq conflicts have set up the potential for more harmful wounds than soldiers experienced in previous conflicts. Repeated deployments, as well as brain injuries from all-toocommon bomb explosi ons,can deepen the scars. Once out of combat, the longtime aver-
Improvised explosive devices, lEDs, were the weapons of choice for insurgents in Iraq. They arebombs thatcan be disguised as anything and set off remotely, making everyone and everything a threat. When soldiers return home, roadside trash can send them spinning. A discarded Walmart bag — white plastic sacks were sion to admitting weakness still runs deep. A used frequently early on — makes their hair mental health diagnosis is believed by many stand on end. to cripple careers. lEDs also increased the frequency of trauIt all contributes to a sobering fact: Suicide matic brain injury, which has been called is on the rise in the military. the signature injury of the past decade's The key to saving soldiers from decades conflicts. Even outside the immediate realm of burying their pain, mental health profes- of theblast,lEDs produce shock waves sionals say, will be persuading them to get that can rattle the brain within the skull, help. though outwardly the soldier may not have Patty Ciffin, a Bend psychologist who a scratch. regularly works with veterans, said she worExperts say brain injury symptoms, such ries that too few recently returned soldiers as diminished impulse control and violent have sought help so far, even though there mood swings, look a lot like those of PTSD. are more outlets available to them than ever Research suggests they also exacerbate before. each other; studies are showing that sol"I think the Iraqi vets think it's going to go diers diagnosed with PTSD recover more away," she said."I wish they knew it can go slowly from traumatic brain injuries than away faster." civilians. Henderson wishes there had been more Perhaps the most perverse intensifying helpavail able when he came home from contributor to PTSD numbers is that more war. Until a series of sad events brought soldiers are surviving injuries that would his pain rushing back in 1999 and he again have killed them in previous wars. In his sought help, he had never heard the term 2006 book "Wounded:From Vietnam to such as PTSD. Iraq," Dr. Ronald Glasser says the ratio of PTSD. Dr. Daniel Libby, clinic services director "On the battlefield, I lost a part of my hu- wounded service members to fatalities was for Starlight Program, a residential treatment manity," he said. "That was catastrophic. I 16 to I in lraq. For the Vietnam War, it was program for active-duty military in Stoningthink that is at the heart of why PTSD is so 2.6 to 1. ton, Conn., said the soldiers of the past depernici ous forpeople who have faced death For some, the internal pain becomes too cade have witnessed more than the public and taken life." much. realizes. "They really are heroes," he said. "If any A 2011 study in the journal Injury PrevenToday's conflicts tion found that the number of suicides in the of ushad any inkling of what these men The years of war in Iraq and Afghanistan U.S. Army doubled between 2004 and 2008. and women have endured in their lives ... introduced a whole new set of challenges. In one year, from 2007 to 2008, 255 active- it's amazing, the resilience. The fact that Unlike Vietnam, when the draft made for duty soldiers took their own lives. More than there aren't higher rates of suicide is amaza continuous pool of fresh troops, roughly two-thirds of them had been deployed in ac- ing. They're survivors and heroes to be 900,000 soldiers have been deployed re- tive combat. celebrated." peatedly to Iraq and Afghanistan, vastly In Oregon in 2010, suicide was the top Inside PTSD expanding their exposure to the brutality cause of death for veterans ages 18 to 24, of war. There is also often less time at home a state report says. It adds that there is a Researchers are trying to better underbetweendeployments. strong connection with mental health issues stand what happens in the brain of someone •
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Coverstory IPOSTTRAUMATIC STRESSDISORDER
experiencing PTSD. "The brain is really the final frontier," Hunter
Forte characterizes it as moving the place where the memories are stored. If a soldier can be desensitized to the memories, she said, they
said. "We don't fully understand it." The disorder is considered unusual. Unlike many no longer have the same ability to torture or to psychiatric diagnoses, experts say, PTSD can be erupt. linked to a single event. Libby said one of the latest terms connected Such differences are leading to a touch-up in its with PTSD is post-traumatic growth. The concept description in the latest edition of the "Diagnostic and Statistical Manual of Mental Disorders," the •
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book of standard criteria for mental disorders pub- growth. lished by the American Psychiatric Association and If the way these memories are stored can't be relied upon by doctors, insurance companies and transitioned, however, the veteran is subject to others in the health community. Due out in the them replaying like it was just yesterday. "No matter how loving and caring family and spring, it's expected to reclassify PTSD from an anxiety disorder to a new class dubbed "trauma friends are, that doesn't cure PTSD," Forte said. "Time doesn't heal PTSD. Logic doesn't heal PTSD. and stressor-related disorders." It's not stored somewhere the brain can make What is known is that PTSD isn't limited to soldiers. Rape victims, abused children, car crash sur- sense of it." vivors or anyone who has experienced a trauma are Building resilience all at risk of developing it. But the chaos of war provides an environment Who is more apt to develop PTSD and why is of
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ripe for it. That is because with PTSD, experts say, • •
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is that the memories can be integrated into a per-
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particular interest to the military to better prepare
it's as if the body's fight-or-flight switch never gets soldiers for deployments and for their return. turned off. The majority of people who go through har"The war is still alive in their bodies," said Karen rowing experiences don't develop PTSD. And it's Forte, a Bend psychotherapist who specializes in not predictable which experiences will trigger that treating trauma. overload in an individual. As Hunter puts it, each Scientists believe the brain sorts experiences person has a "too-much place." into unimportant bits to discard and those of sigResearch into families and twins suggests genetic nificance that might later merit recall. So the dinner influences might make for a greater likelihood of from a night last week quickly fades away, while developingPTSD when exposed to trauma. Some other interactions become stored as memories. of those genetic influences are the same ones asThey come tothe fore again as needed, some- sociated with other mental disorders as well as altimes in vivid detail. cohol and drug dependence. For some people, scientists believe, certain expeAlso, those who suffered difficult childhoods riences are powerful enough to overload the brain's or grew up in poverty, research shows, are more ability to synthesize and store them. Hunter said prone to developing PTSD after a crisis. stress-related hormones flood the body during the Elizabeth Leeberg, a Bend psychologist who speexperience and are believed to play a role. These cializes in helping veterans, likened piling trauma memories continue to overstimulate areas of the on top of trauma to physical injury. "It's like running a marathon on a sprained anbrain — called the amygdala and the hippocampus — associated with the adrenaline-pumping, quick- kle," she said. "You're going to get hurt." response instincts to mortal threats. When such The disorder doesn't necessarily last for everyfeelings and images aren't properly stored, they can one who experiences it, either. A study of rape vicrage to the surface in debilitating ways. tims with PTSD symptoms says that half recovered Some experts, like Forte, describe the trauma as from the trauma on their own. Those who were being stored in the neural system. She said when dis- still struggling after two months, however, were cussing trauma, people usuallyexperience a physical unlikely to get better without help. response in an area of their body, like a tightness in For the military, the hope is this research can their chest or a constriction in their throat. lead to strategies to incorporate into programs. The goal of PTSD treatments, then, isn't to erase Perhaps a mental armor can be built that deflects memories. Rather, it's to change their nature, from PTSD. For instance, research suggests that protecones that are emotionally charged and dangerous to tive factors within the military include good coheones that are less painful, or even filled with insight. sion and leadership in a unit.
Page 12
WINTER/SPRING 2013• HIGH DESERTPULSE
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• Bend Community-Based Outpatient
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Clinic —A U.S. Department of Veterans Affairs clinic. Offers mental health services. Can refer to others who take VA insurance. 541-647-5200 • Central Oregon Vet Center —Part of Veterans Affairs. Its services are confidential. Offers individual and family counseling, as well as support groups. 541-749-2112 • National Center for PTSD —Part of Veterans Affairs. It maintains links on its website, such as how to find a therapist, and an emergency hotline. www.ptsd.va.gov/public/ where-to-get-help.asp • PTSD Coachmobileapp — Designed by Veterans Affairs. Meant as an aid for managing PTSD, rather than a replacement for professional care. It helps tracksymptoms and gives links to support.
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«-"M@ + -c.f GaryHunter of the Central Oregon Vet Center hasbeen helping veterans with mental health issues formo rethan two decades. RYAN BRENNECKE
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About7to8percentofthe U.S. population will develop PTSDat some point in their lives, with about 5.2 million adults having PTSD during a given year.This is a small portion of those who have gone through a trauma.
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Women are more likely than men to develop PTSD.About 10 percent of women develop PTSD sometime in their lives compared with 5 percent ofmen.
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Veterans aretwice as likely as nonveterans to die by suicide. Approximately 27 percent of suicides in Oregon in 2010 occurred among veterans. Of those, 97 percent were male.
t's estimated that23 to 40 percent of service members and veterans in need of mental health services receive care. During 2010,438,091 veterans were treated for PTSD in the VA medical system.
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The Department of Defense and the Defense and Veteran's Brain Injury Center estimate that22 percent of combat wounds from Iraq and Afghanistan are brain injuries, compared with 12 percent in Vietnam.
Sources: NationalCenter for PTSD, US. Department of Veterans Affairs, Oregon Department of Veterans'Affairs, Committee on the Assessment ofongoing Efforts in the Treatment of PTSD 2012 report, Institute of Medicine
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ChuckColclough, a facilities maintenanceengineer standsin frontofbackupgenerators he helps maintain at St. Charles Bend. Stafflike Colclough makesure the hospital always has adequate power heat and water to keepit running like clockwork.
Ever wonder who keeps the lights on? Meet Chuck Colclough. all the most essential functions of the hospital — like life-support machines and surgeries in progress — continue without a hitch. It's a little-known, near-weekly dry run for disaster. Few people early every Wednesday at 6 a.m., Chuck Colclough monitors a digital display as power is cut off throughout the St. think much about it, unless something happens. Charles Bend medical complex. As Colclough said with a smile, "When Noah built the ark, it wasn't Already, staff has called operating rooms to make sure no proce- raining." dure is interrupted during this test. Then maintenance staffstationed Colclough is a facilities maintenance engineer, working in an area throughout the property flip switches to "emergency," signaling the of the hospital few outsiders ever see. The department is St. Charles three massive generators located in a distant building to roar to life. Facilities Services. The 2,200-horsepower generators reach full power within 10 secFacilities staff work on myriad tasks for the roughly 78-acre camonds of the electricity outage, providing enough juice to make sure pus. The main hospital building alone is 502,000 square feet. FaciliBY HEIDI HAGEMEIER
Page 14
WINTER/SPRING 2013• HIGH DESERTPULSE
ties staff members repair beds and replace light bulbs. They come Northeast 27th Street. up with ways to save energy and maintain the equipment that steril-
Computers in the generator control room instantly sense the out-
izes biohazardous waste. In a separate building added nine years age and automatically cue the generators. Although one generator ago, they work on and monitor boilers the size of RVs that heat wa- can power the entire campus, Colclough said they operate at least ter that in turn warms the hospital's buildings. two at a time in case one generator were to hiccup. Colclough has been at the hospital for 25 years. He says he doesn't Any patient-related room in the hospital has a special e-outlet have a business card — he jokes that his title is coffee pot coordi- linked to the emergency power system, Colclough said. Critical nator, retired. But he is among the staff that makes sure the basics areas, like operating rooms, all have e-power. The most essential — air, water, power and more — function like clockwork. equipment is always plugged into these outlets, while less critical It's a complicated endeavor in a hospital, which has specialized items are plugged into regular outlets. needs and grapples with health emergencies 24 hours a day. The system isn't meant to run the hospital at business-as-usual "It boils down to life safety," said Tom Newton, the hospital's facili- level. Coffee makers and administrative computers aren't plugged ties manager."We help provide a safe, healing environment for our into the e-outlets. Some lighting goes out. For a long outage, nonespatients and caregivers." sential services would be shelved. The generators usually run on natural gas but can also use diesel. Backups for the backups In preparation for a long-term outage, St. Charles Bend keeps up to There are backups for the backups at St. Charles Bend: three gen- 75,000 gallons of diesel on hand, enough to keep the hospital runerators, three boilers. That is because the most basic services go ning for about three weeks. Two 25,000-gallon tanks are allotted for center stage when something goes awry. the generators and one tank of the same size is for the boilers. One of the most recent, well-publicized emergency If need be, facilities staff could take services — the elevasituations was in October when Superstorm Sandy tors, for instance — off the system to conserve fuel. hit the East Coast. Many hospitals in the storm's path
Noah bUIttth eark,
switched to generators when the power went down. Others suddenly needed to evacuate as floodwater submerged their generators or other issues arose: New York It WOSn't /I University Langone Medical Center, a private hospital in New York City, moved more than 200 patients, including 20 infants from the neonatal intensive care unit, ac-
g. — (:huck
Becoming high-tech Over the course of Colclough's career, much of what Facilities Services does has become more and more high-tech. The heating, cooling and other hospital facility systems are now computerized, with temperatures an d humidity tracked down to the detail throughout the
cording to The Huffington Post. Brooklyn's Coney Island Hospital moved about 180 patients. Airflow systems within hospitals are another chief concern.
Colclough bu ildings. Identification numbers affixed to equipment signal to staff when it was last serviced and which items seem to continually break. Security cameras and the pneumatic tube Air systems in large buildings started receiving more attention in system are also tracked there. the late 1970s after more than 200 veterans attending an American When Colclough started, the manual way was the only way. SomeLegion meeting at a Philadelphia hotel became sick in the epony- times checking the heat required sticking a thermometer in a pipe. "When I started, there were no PCs," he said."The only computer mous outbreak of Legionnaires' disease, a virulent form of pneumonia. Eventually, investigators concluded that the bacterium was was a mainframe and it was for accounting." spreading through the hotel's air-conditioning system. Newton said St. Charles' utilities plant is one of the most modern Hospitals like St. Charles Bend go to great efforts to make sure air in the state, similar to the one at the Portland airport. is properly managed. Factors like these mean facilities jobs are specialized. Most require St. Charles Bend has isolation spaces that are called negative a year of hospital facilities experience, Colclough said. rooms, meaning air in that space cannot leak out into corridors or be Simple building maintenance comes with unique protocols in a recirculated. Those rooms are for containing an infectious disease, hospital, he added. Staff must go through an assessment process like tuberculosis. Other times, fresh air must be brought into a room for even routine work that might kick up some dust, particularly for but other air from the hospital must be kept out. A patient with a
infection control.
"Even if we want to take a ceiling tile out to do something," Colcompromisedimmune system might need such a space. All air is filtered on the way in, and some is filtered before it's sent clough said, "you can't just take a tile out in the (intensive care unit) to the outside, Colclough said. Twenty-nine air handlers manage the and let whatever come crashing down." flow of air in and out. Surgery rooms are the most critical, and any work requires that a "They all take different percentages of particles out of the air," he room be taken out of use, then thoroughly cleaned at the end. "It's a very different place for contractors," Colclough said."There said. "The air here is better than your air at home, I think."
Switching to e-power Segments of the St. Charles Bend property occasionally lose power, whether from a blip in the system or an incident like a car driving into a transformer. The longest outage in recent years, which was hospitalwide for four hours, occurred in 2012 because a bird flew into equipment at a power substation at the corner of Neff Road and
HIGH DESERT PULSE • WINTER/SPRING 2013
is no shutdown in this building. It never is turned off."
And just as there is no shutdown for many hospital employees, Colclough said facilities staff are present at every hour of the day to make sure it all keeps running around the clock. "There'sa huge amount of emergency planning and backup,"he said. "People can really know that in a crisis, St. Charles will be ready. We'll be here."•
Page15
SnaPshot[ FLY-FisHING PHOTO BY RYAN BRENNECKE
Tony Myers, of Portland, casts to rising rainbow trout while fishing the Crooked River below Bowman Damin late December. The Crooked River is a top winter fly-fishing destination in Central Oregon.
Page 16
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Breast cancer survivor Juani ta Vianelle,66, exercises on a recumbent bike at least 20minutes a day. "I'm happier have a better mindset. I know that exerciseis one ofthe main medicines, with diet, to keep this from coming back,"shesaid.
You can spend a fortune on medicine and risk the side effects. Or you can get up and move. BY ANNE AURAND • PHOTOS BY ROB KERR
Page 18
WINTER/SPRING 2013• HIGH DESERTPULSE
t took a heart attack and a stern warning from his doctors to make Bob Wren start exercising.
After surgeons unblocked his arteries with angioplasty and two stents and the immediate danger had passed, a fit-looking cardiologist told Wren he needed to exercise and lose 50 pounds. "I said, jokingly, 'You want me to look like you?"'Wren recalled. "He said back, and he wasn't joking, 'You can either lose 50 pounds or come see me again."' Now, Wren, 60, works out religiously. "You do it because you want to live," he said. "It is kind of a chore, but you know that you have to do it or more problems will develop." We'veknown fordecades that exercise keeps us healthy.But researchers are starting to figure out how it works, and they're discovering that exercise can act on the body the same way that some pharmaceuticals do. Doctors more and more are prescribing exercise as medicine to heal the body and, possibly, the nation's increasingly expensive health care system. Juanita Vianelle rides her recumbent bike daily, the way some people dutifully take their drugs. The 66-year-old Bend woman received her breast cancer diagnosis in an envelope following a mammogram in November of 2011. She had stage 2, grade 3 breast cancer. A biopsy determined it would be best treated with a lumpectomy and radiation rather than chemotherapy. On Jan. 10, 2012, surgeons removed two lymph nodes. In February, she began 33 radiation treatments.
Through it all, several doctors discussed her need to exercise, in order to stay healthy and keep her cancer from coming back. Ten days after radiation ended, Vianelle joined about 15 other cancer patients and survivors for a hike in the Badlands east of Bend.She had been scared to go, afraid she couldn't keep up. But she was surrounded by understanding and supportive people from St. Charles' DEFEAT program for cancer survivors, and she hiked six miles. Tears pool in her eyes when she recalls that day. The hike inspired her to take yoga and other exercise classes. "I'm happier, have a better mindset," she said."I know that exercise is one of the main medicines, with diet, to keep this from coming back."
Prescriptions for exercise Scientists such as Kerri Winters-Stone, an associate professor at Oregon Health 8 Science University in Portland, are researching the perfect prescriptions for exercise for cancer patients. She's trying to develop exercise programs for specific problems, such as bone health after cancer treatment. "I'm targeting the program so it best meets the needs of survivors," Winters-Stone said. "We are working toward continuing to
develop specific programs based on symptom profiling and side effect profiling." Does it really need to be so specific? "I run that fine line," she admitted. "Do we just want people to
HIGH DESERT PULSE â&#x20AC;˘ WINTER/SPRING 2013
Page 19
Heart attacksurvivor Bob Wren,60, has changed his dietand added exerciseas preventivemedicine to keep coronary artery disease atbay. Hehas lostmore than 30poundssince his lifestyle changed late last summer andis reducing theamountofmedication hehas to take.
FACT:For those with cardiovascular disease, exercise lowers angiotensin levels, just like blood pressure medication but without the side effects. And it has an effect similar to statins: it lowers"bad" cholesterol. Exercise also raises "good" cholesterol levels; no pill can. FACT:Exertion immediately reduces blood sugar levels and improves insulin sensitivity for about 24 hours, which can keep active individuals below the threshold of a diabetes diagnosis. FACT:Exercise significantly reduces risk of cancer recurrence and death for breast, colorectal, prostate and ovarian cancer survivors.
Feature(EXERCISEAS MEDICINE
How does it work?
be active? That's the first hurdle: Cet them willing to do some-
thing. As people recover and regain some confidence about doing exercise, let's get them toward the right program." Most physicians aren't equipped with the time, the tools or the
training to dispense such specific, effective prescriptions, Winters-Stone said, which is why research like hers could be helpful. At this point, prescribing specific exercise routines to cancer survivors is pretty uncommon, said Dr. Linyee Chang, an oncologist and the clinical director of St. Charles' Cancer Center of Care. It would be difficult to get physicians to uniformly agree on the perfect prescription, she said. Also, Chang said, in some cases, a person might be too sick to exercise, and prescribing it might create undue stress.
The move toward movement The American College of Sports Medicine and the American Medical Association launched an "Exercise is Medicine" initia-
tive in 2008 that called on physicians to discuss and prescribe exercise with all patients, to make it a staple of health care. The campaign is catching on, but slowly. It's not unlike how the anti -smoking campaign, which was seeded decades ago with sporadic research, sprouted with the support of medical and government groups and has grown into a mainstream movement. "The medical world is starting to embrace the idea, but it's like
turning around a giant ship," said Dr. Stephen Mann, medical director at High Lakes Health Care and president of the Central Oregon Independent Provider Practice Association in Bend. The exercise conversation is "integral to every visit" with his
patients, Mann said, though he doubts all primary care physicians do the same. A couple of studies have suggested that patients who get actual prescriptions to exercise are more likely to do something active, and another report said more doctors are advising exercise now than a decade ago. But Mann said exercise awareness needs to spread from a broader, societal context beyond just the doctor's office. "I think if our ultimate goal is patient health and the most potent intervention is regular exercise, it's a foundational part of
good medical care. It belongs in medicine, but it doesn't mean it shouldn't also be taught in nursery school through college," Mann said. While the idea that exercise is a component of medical care is reflected in federally driven health care reform, most agree it's still underutilized.
Sixty-six percent of the physicians who responded to a 2011 survey from the Institute of Lifestyle Medicine said they talked to
patients about exercise. They wrote prescriptions for exercise to only 26 percent of patients. Lack of time on the part of the doctor was the primary reason doctors didn't tackle the topic. Lack of compliance on the part of the patient was another top factor.
"You can guilt them or push them or tell them they'll die prematurely, but that's an ineffective way to change people's behavior,"
Page 20
Cardiovascular disease Heart disease is the leading cause of death in this country. Exercise is a means of preventing and treating it. The hormoneangiotensin causes our blood vessels to constrict, which raises blood pressure. Exercising lowers circulating leve s of angiotensin in our bodies, said Dr. Michael Widmer, a cardiologist at Heart Center Cardiology.ACE inhibitors, blood pressure drugs, have the same effect. But ACEinhibitors can a so have side effects including coughs, rashes, angioedema (swelling) or kidney problems, "all of which you don't get with exercise," Widmer said. Widmer said exercise is also one of the most potent ways to increasegood (HDL) cholesterol levels, which seems to protect against heart attack. Experts be Ieve HDL helps move excess cholesterol away from the arteries. It's difficult to increase good cholesterol levels with medications, Widmer said. Trials have studied howto do it but have been unsuccessful so far, he said. "But exercise does it." Exercise changes themetabolism of fat and cholesterol similar to the way thatstatins, an LDL (bad) cho esterol-lowering medicine, regulate the appropriate uptake ofcholesterol from the bloodstream by the liver. Researchers with the Harvard School of Public Health published a studythat said vigorous-intensity exercise decreases a man's chance ofa heart attack in part because ofwhat the exercise does to HDL (good) cholesterol levels. And, new research published in the American Heart Association's journal I-Iypertension said children of parents withhighblood pressurecan significantly reduce their risk of the disease with 150 minutes per week of brisk walking (or an equivalent activity). In the study, which observed more than 6,000 people, those who had a parent with high b ood pressure but were highly fit had a 34 percent lower riskof developing highblood pressure themselves compared with those with a low fitness leve who had the same parental history.
WINTER/SPRING 2013â&#x20AC;˘ HIGH DESERTPULSE
Let's examine exercise's effects on three big killers
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Type 2 diabetes
Cancerisconsideredthesecondleading causeof deathinthiscountry. Observational studies have suggested that physical activity after a diagnosis of breast, colorectal, prostate or ovarian cancer canreduce the riskof cancer recurrence and death. In breast cancer survivors, a comprehensive analysis of research, published in Cancer Journal for Clinicians, said that exercise was associated with a 34 percent lower risk of breast cancer deaths,a 41 percent lower riskof death from all causesand a 24 percent lower riskof breast cancer recurrence. Exercise might also be a preventive measure. Women who exercised at any level of intensity for10 to 19 hours per week during their reproductive years or postmenopausal years had a nearly 30 percent reduced risk of deve oping breast cancer, according to a 2012 study pub ished in Cancer, a peer-reviewed publication of the American Cancer Society. The study,
Type 2 diabetes, a metabolic disease with potentially serious complications, is a prevalent cause of death and has more than doubledinrecent decades. It's largely linked to lifestyle. Exercise can he p in its prevention or treatment, said Don Kain, a certified diabetes educator and registered dietitian at Oregon Health 8 Science University who has a master's degree in exercise physiology. Exercise can lower body weight andhelp manage blood glucose levels, he said. Type 2 diabetes means there's an insulin resistance problem. Insulin, a hormone, helps move blood sugar (glucose) into cel s, where it is stored and used for energy. With insulin resistance, insulin does not connect with insulin receptors at the cell level. Therefore b ood sugar doesn't move into other body cells and instead accumulates at dangerously high evels in the blood. But exertion — say, a 30-minute brisk walk —burns blood sugar immediately for energy, a short-term way to reduce b ood sugar. A contracting musc e, Kain said, pulls glucose into the muscle cells via pathways that don't require assistance from insulin. The muscles wil continue to use blood sugar up to an hour after exercise, Kain said.
which looked at 1,504 women with cancer and 1,555 women without cancer, also found that exercise seemed to preferentially reduce the risk of hormone receptor-positive breast cancer,the most common kind. How exactly exercise fights cancer is unclear. "There are so many laboratories trying to figure out how exercise works against cancer, especia ly in Europe, that I can't pick which of the many expla« nations is the most likely exp anation, said Dr. Archie Bleyer, a ocal oncologist and clinical research professor at Oregon Health & Science University. Bleyer said the idea thatexercise affects levelsof insulin, insulin growth factors and proteins in a way that protects against cancer and reverses the cancer process seems to be backed by good evidence. Dr. Linyee Chang, an oncologist at St. Charles' Cancer Center of Care, said researchers are trying to tease out other potential contributing factorssuch as obesity, hormones and inflammation to truly know how exercise works to reduce cancer. Researchers question whether those who exercise are just more ikely to also engage in other healthy behaviors.
HIGH DESERT PULSE • WINTER/SPRING 2013
Also, Kain said, physical fitnessimproves insulin sensitivity, meaning the sugar will generally move better from the blood into the muscle cells.«You go for your walk and you've got improved insulin sensitivity for about 24 hours." As with many medications, he said,"you've got to hit it again the next day« n a study known as the Diabetes Prevention Trial, researchers looked at 3,234 overweight or obese adults with blood sugar levels higher than normal but below the thresho d for diabetes diagnosis. Those who engaged in a 16-week exercise plan were far less likely to be diagnosed with Type 2 diabetes than those who took a blood sugar medication or those who took a placebo.
Page 21
Feature(EXERCISEAS MEDICINE
Askyour doctor Inactivity is killing us. nactivity is the fourth-leading cause ofdeath globt ally, according to the World Hea th Organization. It ifgetting contributes to chronic diseases and hea th complications inc uding obesity, heart disease, Type 2 diabetes, hyperoff the couch tension, cancer, depression, arthritis and osteoporosis,
is right for you
according to the American College of Sports Medicine. An antidote to those health problems is simple, the ACSM says: activity.
said Mann. "I look for the teachable moment when someone (they know) has died, or they are sick of being sick, and I say, 'Here's the thing you can do to change your health."' A truly teachable moment, he said, is more likely to happen when a patient is scared for his life.
The teachablemoment
"With chronic diseases, including heart disease, stroke and diabetes responsible for seven out of10 deaths, and with physical activityand exercise shown to help prevent and treat more than zI0 chronic conditions, hea thy lifesty es must be a part of the health care equation," said Janet Walberg Rankin, a professor in the Department of Human Nutrition, Foods, and Exercise and associate dean at Virginia Tech, and the ACSM board president.
times a week. These days, he's riding a stationary bike or using a Gazelle exercise machine at home in addition to cardiac rehab. He improved his diet. "I can't have sausage, eggs and bacon every day,"he said.He has lostabout 30 pounds. By mid-December, he had reduced his blood pressure medicines. His goal is to lose a total of 50 pounds and further reduce his medications.
Bridging the gap
Such wasthe case with Bob Wren. Wren's dad had a heart attack at 58. His grandfather died from one Juanita Vianelle was one of five middle-aged breast cancer surat 57. Wren had never been one to exercise, save for the occasional vivors to participate in a new program offered through St. Charles walk with his insisting wife. He was overweight and had called Transition to Health, which offers education, supbeen on blood pressure medication for a couple of years, port and exercise guidelines after cancer treatment. which, he said, "should have been a sign that something Chang, the oncologist, told the participants, who were was starting to happen." sitting in a rehab room surrounded by treadmills and exSomeone probably told him to exercise back when he ercise bikes, to aim for 150 minutes weekly of moderate started on those medications, he said, but it wasn't yet exercise (biking, canoeing, tennis, walking, catching and his teachable moment. throwing a ball) or 75 minutes weekly of vigorous exer"I figured I got enough exercise at work," he said. As cise (aerobic dancing, jumping rope, hiking uphill) in ada radiology technician at St. Charles Bend, he pushes dition to two weekly strength training sessions. chairs and beds around the hospital's halls. "I came home The recommendations fall short of a prescription, but tired." Dr. Michael Widmer Vi a nelle said the specificity was helpful and made exerIt was late summer 2012 when Wren started feeling cise sound reasonable, doable. what he described as intense heartburn. At St. Charles, cardiac or cancer patients like Wren and "It felt like someone was choking me," said Wren. "It concerned me Vianelle may get funneled into rehabilitation or support programs to enough to call my doctor." help them find their path to exercise. Getting this so-called heartburn checked out led to a stress But for less severe health problems, or in the name of preventive test which ultimately showed that cholesterol in his arteries was health care, there's often a gap between a doctor who says, "You blocking his heart from adequate blood and oxygen. Wren had should exercise," and the patient who doesn't know what to do. experienced a heart attack at some point recently, from the looks To bridge that gap, Mann, the physician from High Lakes Health of his heart damage, said Dr. Michael Widmer, a cardiologist at Care, long ago co-founded his own nonprofit organization called Heart Center Cardiology. HealthWise, where he can send patients to get exercise counseling "We restored things so his overall heart function was good," and training from a nurse and a fitness professional. Widmer said. "The immediate problem was addressed. But with Dr. Lisa Uri, a family practice physician at High Lakes Health Care, anyone with coronary artery disease, they have risks of problems said she tells every patient to exercise. She suggests patients hire going forward. That's where additional prevention becomes really a personal trainer, at least to start, to design an appropriate exerimportant." cise routine. She said in her experience, exercise has helped patients "Then we gave him the heart-to-heart," Widmer said. A team of with weight loss, anxiety, depression, high cholesterol and high medical professionals told Wren he had to improve his diet and blood sugar. exercise. The ACSM recently developed an Exercise is Medicine training "Bob saw the light," Widmer said. program to teach personal trainers how to safely and effectively The cardiologists sent Wren to cardiac rehabilitation at St. prescribe exercise for specific conditions â&#x20AC;&#x201D; cardiovascular disCharles Bend on a schedule that required him to exercise three ease,diabetes, cancer,chronic pain,depression and so on. The
Page 22
WINTER/SPRING 2013â&#x20AC;˘ HIGH DESERTPULSE
Leading risk factors for death, worldwide: • High blood pressure 12.8% of total deaths • Tobacco use8.7% of total deaths • Highblood glucose5.8% of total deaths • Physical inactivity 5.5% of total deaths • Overweight and obesity 4.8% of total deaths • High cholesterol 4.5% of total deaths
Exereising 150 minutes weekly ean: • Reducemortalityandtheriskof recurrent breastcancerbyabout50% • Lower the riskof coloncancerby about 60% • Reducethe riskof developing Alzheimer's diseasebyabout40%. • Reduceincidenceofheartdiseaseandhigh blood pressureby about40%. • Lower the riskof strokebyabout 27%.
Lowe r t heriskof developing Type2diabetes byabout58%. • Bet w iceaseffective intreating Type 2diabete sas standard insulin prescription and save 52,250 per person peryear when compared with the cost of stan dard drug treatment. • Decreasedepressionas effectivelyas Prozacor behavioral therapy.
Sources: The World Health Crrganization's Global Health Risks 2009report, American College of Sports Medicine, exerciseismedicine.org
credential is intended to provide a base of qualified professionals to whom physicians can confidently refer patients, according to an ACSM spokesman. Locally, a woman named Judy Shasek has been building what's called the Physical Activity Pharmacy (pa-pharmacy.com), a website intended to help connect doctors, patients and wellness professionals, such as those with the Exercise is Medicine credential. The website also uses social networks and games to try to keep reluctant exercisers connected, motivated and engaged.
Incentive for prevention Employer-subsidized wellness programs, still growing in American workplaces, provide incentives, camaraderie and accountability for employees. Such programs aim to encourage healthy lifestyles, in the name of disease prevention and, potentially, cost savings. For example, Bend Research Inc., a pharmaceutical designer and manufacturer, provides onsite workout facilities, pays half the cost of employees' gym memberships, provides fitness sessions with a personal trainer several times a week and sponsors Frisbee or soccer games on site. "Having healthy employees is very important to us,n said Bend Research President Jim Nightingale."Anecdotally, there are many benefits to fitness, including happiness, reduced stress, better camaraderie (and) working relationships and hopefully fewer claims to our self-funded insurance plan." Wellness programs can have a good return on investment, according to a 2012 report from the Centers for Disease Control and Prevention.
With the passage of the Affordable Care Act, worksite wellness programs will become part of the national strategy to address chronic diseases, which are predicted to cost the American health care system $4.2 trillion annually by 2023, according to the CDC report. The Affordable Care Act includes $200 million in grants for small businesses to help them develop wellness plans. Some insurance companies are also embracing exercise as medicine. "We're all aware that getting people moving will decrease health risks and decrease health care costs," said Vanessa Polvi, a wellness consultant for PacificSource Health Plans, a nonprofit community health plan serving the Pacific Northwest. Part of Polvi'sjob includes helping smaller businesses that can't afford their own wellness coordinator to design wellness programs.
HIGH DESERT PULSE • WINTER/SPRINta 2013
For people covered by a PacificSource insurance plan, there are financial perks for both exercise-based prevention and disease treatment. For example, members can be reimbursed for up to $150 a year for the cost of hospital-based wellness classes, which at St. Charles Bend include classes such as yoga, or "preventing osteoporosis with exercise." These reimbursements don't require a doctor's prescription. In the treatment of disease, some PacificSource plans cover up to 36 sessions of cardiac rehab exercise, if ordered by a physician. With the appropriate prescription, some exercise regimens can be covered for conditions such as Parkinson's, chronic obstructive pulmonary disease or heart disease, she said. Other examples of how insurance plans are jumping on board: LifeWise Health Plan of Oregon offers its members a discount on fitness club memberships and pays the entry fee for an organized running event in Portland for its members, said communications manager Deana Strunk. Medicare offers programs specifically for the elderly population, such as SilverSneakers, which covers a fitness center membership. Cigna, an international health insurance provider, says on its website that it will reimburse the cost of exer-
cise equipment and health club fees if prescribed by a doctor to treat an illness such as obesity or diabetes. If these embers of preventive care incentives ignite, it could make a huge difference in the nation's health and associated expenses. "If we slowed the growth rate of four diseases closely associated with obesity — Type 2 diabetes, hypertension, heart disease and stroke — by 5 percent by 2030, then the United States government
would save approximately $5.5 billion per year in combined Medicareand Medicaid spending on Americans ages 45 and above,"said Ashley Berrang, a spokeswoman for the Bipartisan Policy Center, in an email. A report from the center, a Washington, D.C., think tank,
suggested that fitness and physical activity are a means to that goal. "It's good medicine, it's sound science, and it's an economic necesn
sity according to a statement from Dr. Robert Sallis, with Kaiser Permanente Fontana Medical Center, who chairs the ACSM's Exercise is Medicine health initiative. "Chronic diseases account for 75 percent
of the nation's health care spending. Increased physical activity can play a powerful role in treating these problems and, even better, in preventing them from occurring in the first place. If the benefits of exercise could be captured in pill form, it would be the most widely prescribed drug in the world."•
Page23
How doesshedoit? ~ BEcKYJOH NsoN
OSU-Cascades VP uses exercise to stay at the top of her game BY HEIDI HAGEMEIER â&#x20AC;˘ PHOTOS BY ANDY TULLIS
Winning as a team
ong before the sun had risen on a December morning, Becky Johnson has spent a lifetime as an athlete. Johnson was sprinting on a stationary bike under the bright She grew up playing sports with her two older brothers in Wisconlights of Bend private exercise studio Body by Schliebe. sin and was on her high school basketball, softball and golf teams. She eyed a timer, legs furiously pumping until it hit 30 seconds. In basketball, she started as a center and later transitioned to point "Stop!" she called out. Then each person in the small class moved guard. to the next station as part of a 45-minute, grueling circuit session She showed enough talent in golf that an instructor said he called the Hurricane Warrior. thought she could have a professional career and offered to coach Johnson switched too: on to machines for crunches, pull-ups and her for free. It didn't appeal to her, although she has a love for golf. "My mother insisted that all of the kids learn to play golf," she said. presses. The circuit included squats with a kettlebell, squats while "It's a good thing to learn young, as the golf swing is not a natural teetering on a bench with a rubber top and squat-like, thigh-burning jumps back and forth between half balls called BOSUs. And she motion." regularly outdid those who are decades younger. Johnson went on to play basketball and golf for the University of Johnson, 57, logs long days as the leader of Oregon State Univer- Wisconsin-Madison, although she notes that Title IX had yet to bring sity-Cascades. Yet she always makes sure there is time to exercise. more girls into sports. She joined OSU-Cascades in late 2008, first as interim vice presiTim Schliebe, owner of Body by Schliebe, said it's clear Johnson dent and then permanently in that role. Since her arrival, the fledg- has been a strong competitor all her life. "She's solid," he said."She never gives up. She never quits. I've nevling institution has defeated an attempt by lawmakers to defund it, rapidly grown its enrollment and moved toward establishing itself er seen her say she can't do something. She always sees it through." as a four-year university. Indeed, Johnson has been known to jog an 18-hole golf course to Amid all this activity, however, Johnson said exercise remains part get in her exercise. of her daily routine. For the past two years she has gone to Body Johnson said she prefers the camaraderie of team sports to indiby Schliebe nearly every weekday morning, even to the spin classes vidual ones. It's one reason a career in golf didn't click, because so that she only half jokingly says she hates. much focus goes on the individual. "I like working together, I like the social competition," she said. For Johnson, working out is an essential component of being on " Winning as ateam isso m uch fun." top of her game. "I have always felt like I need to work out every day," she said. "PhysJohnson continued with team sports as her exercise outlet even ical activity is first on the agenda. No matter how busyyou are, you're after she moved on from UW-Madison, first to earning her doctorate not going to be as effective in your daily life if you don't work out." in agricultural economics at Michigan State University and then to a
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WINTER/SPRING 2013â&#x20AC;˘ HIGH DESERTPULSE
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Becky Johnson walks her2yearoldchocolateLab, Dallas, near her homein Broken Topin Bendin December On the rare occasion Johnsonmissesa workout, having Dallasensuresthatshe will getout:
career at Oregon State. She started there as an assistant professor in the College of Forestry, researching the economic value of resources like fish and wildlife and biodiversity. Later, as an associate dean, she led the development of OSU's strategic plan and oversaw academic and international programs. Throughout her nearly 25 years in Corvallis, Johnson was a regular in noontime pickup basketball games. Some players were faculty, a few were students and nearly all of them were men. It wasn't until she neared 50 that she turned to other ways to stay fit.
"I decided that (the other players) just kept getting younger and faster and bigger," she said, "and if I kept doing that I was going to get hurt."
She misses competitive sports, though. "There's no question that you can get more exercise without thinking about the fact that you're exercising, when you're playing a game versus doing cardio or weights," she said in an email."6asketball was the best because there was lots of sprinting. You didn't even realize how tired you were until there was a break."
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"She'ssolid. Shenevergives up.Sheneverquits. I'veneverseen hersayshecan tdosomething. Shealwaysseesit through." — Tim Schliebe, owner of studio Body by Schliebe
A good state of mind After the morning workout, Johnson usually heads home for a bit of calm. Her days can be long, at times stretching into the evenings with dinners and events.
Johnson had fallen for Central Oregon long before moving here to take the OSU-Cascades post. While living in Corvallis, she would regularly head east to hike, mountain bike and ski. One of her favorite activities is fly-fishing. She enjoys taking her one-person pontoon boat out on Hosmer Lake. "You feel like you're in paradise ..." she said."Who cares if you catch a fish?" Now that she lives here, she doesn't do as much of these sports as she would like. But because she's devoted to staying fit, she fosters the same thing in the workplace. Christine Coffin, communications director for OSU-Cascades, said staff members wedge their yoga classes into their workdays or zip down to the nearby Deschutes River Trail for a run. Johnson encourages it, Coffin said, as she believes physical activity leads to a good state of mind, which in turn gets the best results.
"It's not just that she works out and that she takes care of herself physically and mentally; she sets a good example and encourages her staff to take care of themselves, too," Coffin said. The devotion to a healthy lifestyle and exercise doesn't mean that Johnson goes without indulgences. She recalls growing up on Midwestern cooking, and credits her partner, Lori Elkins, for being the housecook and making healthy meals. "I love fast food," she said."Taco Bell, McDonald's every once in a while. Panda Express is my favorite."
Becky Johnson squats while balancing on a Vicore bench, which has a rubber dome top, during an early morning workoutat Bodyby Schliebein Bend.
But keeping the balance,Johnson said, is what is important. Even when it's hard to fit in exercise, her 2-year-old chocolate Lab, Dallas, still needs a walk. It makes the dog calmer, she said. "Maybe it's just like us," Johnson said. "The more you exercise her, the better she is." •
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BY ZACK HALL • PHOTOS BY ROB KERR •
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olf looks like such a simple game. •
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What is so difficult about putting a little white ball into a hole,
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anyway? Each summer the emerald-green grass of Central Oregon's golf courses — some of which are considered to be among the country's best — teems with golfers from around the Pacific Northwest and beyond. With all those golfers around, there must be something to the game. "Every course is a unique landscape to test your skills, and you can travel the world to see all these different natural landscapes that are offered," says Erik Nielsen, the longtime head professional at Bend Colf and Country Club. "It's a game that you can play whether you're 3 years old or 93yearsold.You can play the game by yourself, with your spouse, your friends, your family, and against either beginning or skilled competitors. Every experience on any golf course is different, and the quest for perfection is always in your mind. "There's also the integrity of the game — the learning of new skills, the adapting to good breaks and bad breaks, the honor in playing by the rules when you're the referee." Colf many not quite be as simple as it looks at first glance. A would-be golfer will be well-served
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to take the right steps to get started: tak-
ing lessons, getting in shape, wearing the right attire and investing in equipment.
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For those willing to take on the challenge, golf can provide a game that most anyone can play for a lifetime while enjoying the physical benefits and camaraderie that attract so many devotees to the sport.
Physical benefits This will come as little surprise: Playing a round of golf is nowhere near as strenuous as competing in a triathlon. But there are health benefits to playing the
game, particularly for golfers who forsake a powered golf cart and walk the course. A study released in 2009 by the Rose
Getready ~ GOLFING
Driver
Fairway woods H y b rids
Primarily used to tee off it is the longest and lowest-lofted club in a typical golf bag, which allows golfers to hit a ball a great distance.
Used to tee off or to hit longer shots from the fairway, these woods areeasier to control than a driver but can be hit a greater distancethan irons.
Center for Health and Sports Sciences in Denver said walking 18 holes while carrying a golf bag burns an average of 721 calories. Walking with a pushcart burns 718 calories. Colfers who choose to ride in a golf cart burn an average of 411 calories for an 18hole round, according to the same study. "Cranted you're not burning as many calories (as more strenuous activities), only because you're not consistently keeping the pace up, but it helps for sure to get your heart rate up," says Shannon Segerstrom, an expert in golf fitness as a Titleist Performance Institute-certified physical trainer, and owner of inMotion Training Studio in Bend. "A
Irons
A relatively new revelation in golf equipment, hybrids have higher lofts than woods and are typicaffy easier to hit than longer irons.
says. "In women, it's pure strength." She recommends first pinpointing what parts of the body need the most help. That can be done either through TPI's website, www.mytpi.com, or by a fitness instructor. But Segerstrom says upper-body stretching and basic exercises such asbridges and crunches will usually help a golfer. "It looks like golf should be so easy and basic, but it takes a lot of core strength, hip stability and balance," Segerstrom warns.
Where to start Beingingoodshape means nothingifyoudo not acquire the proper skills to play the game.
lot of our courses have hills, and that can reIt might be best to start slowly with group ally get your heart rate up." classes, suggests Bob Carza, director of in-
The higher the number on an iron, the higher the loft, the shorter distance and the higher a ball can be hit. Irons are the tools used to hit precise distances onto putting greens.
struction to a range of basic skills, from how to execute a golf swing to the difference between a driver and 5-wood. Some classes are designed to cater exclusively to women. "It's an inexpensive way to get your feet wet to find out if you like the game," says Garza. "It's less intimidating. Usually in the group
classes, people can look around and realize that others are struggling, too."
A well-designed group lesson usually includes some on-course instruction, during which students learn to actually play the game, withadvice on such basics as wher e on the course to tee up, how to make tee times, basic rules and etiquette, Garza says. "We get so enamored with hitting the ball
and swinging the club, that (beginning golfers) don't know how to play," Carza says. get in shape to both improve performance teaches such classes in cooperation with the "There is a huge difference between hitting and prevent injury, Segerstrom continues. Bend Park 5 Recreation District. a golfball and playing golf." Colf largely tests muscles above the hips, Group lessons are more affordable than Once a golfer has decided to commit to the and Segerstrom sees certain general defi- one-on-one instruction â&#x20AC;&#x201D; the Bend Park & Rec game, Carzarecommends seeking out oneciencies in many would-be golfers. clinic costs $55 in-district and $74 for out-of- on-one instruction through a PCA of America "In men, what I usually see is (a lack of) hip district residents. For that price, golfers are golf professional, who can be found at nearly flexibility and core strength," Segerstrom usually introduced through three days of in- every golf course in Central Oregon. As with any physical activity, it helps to
Page 30
struction at Lost Tracks Colf Club in Bend who
WINTER/SPRING 2013â&#x20AC;˘ HIGH DESERTPULSE
A golfer's glossary
Wedge A subset ofiron used close to a green or as a tool to dig outofa sandy bunker.
Putter Putters come in all sorts of shapesand sizes, but none have any loft. They are used primarily on the greens, and considering a putter is used to score the ball into a cup, it is the most often-used club.
Suchcustomized lessons can costbetween $50 and $75 per hour, but most pros offer a discount for buying a package of five or 10 lessons. Nielsen adds that students should figure on additional time for practice to reinforce the lessons. Such investment in time and money is
worth it, says Andy Heinly, a longtime area pro who co-owns retailer Pro Colf of Bend. "Start out with the basics so you have a good foundation to build on," Heinly says.
Equipment and attire Of course, being a golfer eventually requiresequipment. Choosing among an endless array of golf clubs can be a daunting task for the uninitiated. But for a golfer, there is little better than the
feel of a well-struck golf shot. That pure feel, though, can be dampened by inferior equipment that is either out of date or improperly fit
to a particular golfer, Heinly says. "Make sureyou have something in your hand that is going to reward you for a good, fundamental swing," Heinly says. "Equip-
HIGH DESERT PULSE • WINTER/SPRING 2013
ment is real important."
The Rules of Golf, which are released every four years by the United States Colf Association, prohibit golfers from carrying more than 14 clubs (fewer than 14 is legal) at any one time during a round of golf. Each set includes some basics, including a putter, a highly lofted wedge, a variety of irons and at least two woods, such as a driver and a 3-wood, for longer shots, particularly off the tee. But the exact makeup of the 14 clubs is up to the golfer. A box set of clubs — which will include every club a golfer needs and are often geared toward beginners — can take out some of the guesswork, Heinly says. Such sets can cost as little as $250 or as much as $1,000. And with even major manufacturers such as Adams Colf getting into the act, box sets have improved in quality in recent years and are more economical than a high-end set of custom clubs that can cost well into the thousands ofdollars, Heinly says. How much a novice should spend probContinued on Page 49
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Golfhas a language all its own. Here are some common terms used on the course: Round:A completed game of golf, typically done in nine or 18 holes. Fairway:The closely mowed area between tee and greens. Green:The area of smooth, short grass where a ho e is set. Rough: Longer grass that surrounds the fairway. Par:The number ofshots a highly skilled golfer is expected to comp ete a hole or round in. Golfholes typically are rated a par3,4 or 5. An18-ho e round usua ly has apar around 72, but it f uctuates from course to course. Birdie:One shot less than par on a given hole. Bogey: One shot more than par on a single hole. Eagle: Two less shots than par on a single hole. Mulligan: Common custom ofhitting a second ba I without penalty. Shot is against the rules of golf. Chip:A very short shot made in close to the putting green. Draw: A ball that curves slightly from right to left for right-handers and left to right for eft-handers. Fade: A ball that curves s ightly from left to right for right-handers and right to left for eft-handers. Hook: A ball that curves severelyfrom right to left for right-handers and left to right for left-handers. Slice:A ball that curves severely from left to right for right-handers and right to left for left-handers. Loft: The degree at which a golf face is set. The higher the loft, the shorter and higher a ball can be hit.
Dress to play Unlike most sports, golfusually comes with its own dress code, particularly at private clubs such as Bend Golfand Country Club and higher-end resort courses such as Crosswater Club in Sunriver or Pronghorn Club near Bend. Men shou d wear collared shirts with s eeves,slacks or Bermuda-style shorts. Women should wear a dress, skirt, slacks or mid-length shorts as well as a collared blouse. Common attire such as denim or gym shorts is usua y a no-no.
Gear( GETAGRIPONWINTERRUNNING mnaIIN -
Do-it-yourself screwed shoes
Due North Everyday Traction Aids Design:A rubber web with six carbide tungsten spikes on the bottom; fits over the sole of your shoe. Approximate cost:$15-$20 Bestfor: Ice and packed snow. Pros:Lightweight and removable. The carbide
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tungsten spikes are strong, sharp and easily replaceable. Cons:Not ideal for deep snow. Spikes wear down over time and must be replaced, and the device itself can be awkward to put on. Available at: FootZone, online.
Design: 7-10 sheet-metal screws are inserted into the sole ofyour running shoe using a power drill. Approximate cost: $4 for the screws. Bestfor: Ice and packed snow. Pros:The cheapest, least bulky option. And the screws can be removed at winter's end.
WINTER/SPRING 2013â&#x20AC;˘ HIGH DESERTPULSE
Yak Trax Pro Cons:You'll need a dedicated pair of shoes. While there are online tutoria s to help you screw shoes at home, stud placement can be tricky with some shoe models. Available at: Any hardware store. FootZone will insert screws for you free of charge.
Traction devices provide confidence for winter runners HIGH DESERT PULSE • WINTERI SPRING2013
Design: A rubber web with metal coils on the bottom; fits over the sole ofyour shoe and is secured with a strap over the top. Approximate cost:530 Bestfor: Softand packed snow. Pros: Removable, lightweight.
Cons:The coilscan beannoying on m ixedsurface trails of snow and dry conditions, and are not always stable on ice. Can be cumbersome to put on. Availableat: REI, FootZone, Fleet Feet Sports, online.
Some runners opt for pull-on products that use metal coils or spikes and fit snugly any runners choose to hop on a over shoes. A more economical, do-it-yourtreadmill indoors rather than brave self option is to "screw" your shoes, requirwinter running trails or roads. ing only a handful of sheet-metal screws and While running on snow and ice can be a power dnll. dangerous, traction devices for your shoes Take a look at three gripping options for that work like tire chains can drastically im- keeping you on your feet while you log your snow-covered miles.• prove grip and stability. BY ELISE GROSS• PHOTOS BY ROB KERR
Page33
TIPSi WHATTOKNOWABOUTYOURNOSE
Key to overcoming sinus pressure is knowing the cause BY ELISE GROSS
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ne of the many functions of the sinuses — the hollow cavities hidden in the bones around your nose — is to lighten the weight of the head. But when your nose is stuffed up and your temples are pounding, your sinuses may feel like a ton ofbricks. Sinus congestion can be caused by a number of culprits: allergies, viruses, bacteria. A common belief is that sinus congestion is caused by a buildup of mucus in the sinuses, but in reality, it is usually due to swelling of the nasal tissues. Normally, the sinuses produce mucus that drains through small openings into the nasal passages. The four sets of paired sinuses help humidify and filter the air we breathe. When the membranes lining the nasal passages become inflamed, air, pus and mucus can become trapped within the blocked sinuses. Sinuscongestioncan cause a constant,deep pain around thecheeks,eyesand nose, and sometimes ill-defined pain near the top of the head, according to Dr. Michael Villano, an otolaryngologist at Cascade ENT in Bend. It can also cause sinus pressure, nasal drainage, mild facial swelling and plugged ears, said Villano. Sinus congestion can range from irritating to severe, and can sometimes be caused by a bacterial infection. For those who struggle with repeated sinus infections, it can be a vicious cycle: Sinus and nasal membranes may thicken over time and slow in their drainage, which can cause a predisposition to future bacterial infection. While bacterial infections often require antibiotics, Villano
recommends waiting seven days before seeing a doctor for sinus pain and congestion. "More often than not it's a viral infection" and will
Frontal sn1Us
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The membranes that line the inside ofthe sinuses can become inflamed, trapping air, pus and mucus inside and causing painfui pressure.
Membranesof maxillarysinus
resolve on its own, said Villano.
Sphe noid sn1Us
In the meantime, there are several treat-
ments you can try at home to alleviate symptoms and pain. Be sure to read labels for drug facts and directions. Consult a doctor if you are unsure which over-the-counter remedy is best for you, particularly if you take other medications. •
WINTER/SPRING 2013• HIGH DESERTPULSE
How to fight back Antihistamines How they work: Ifyou suffer from allergies, you may find relief with antihistamines. When the body comes into contact with allergens such as pollen, smoke and mold, its immune cells respond by releasing a chemical called histamine. Histamine can cause swelling of the membranes in the nose and increase mucus production. Antihistamines prevent immune cells from producing histamine, and shrink blood vessels in the
nasal tissue to reduce swelling and promote sinus drainage. Best for:Treating sinus congestion caused by allergies. Pitfalls:Antihistamines such as Benadryl have a potential for sedation. Commondrugsandbrands: Diphenhydramine(Benadryl), clemastine (Tavist), loratadine (Claritin), cetirizine (Zyrtec). Approximate cost:$6-520 for 24-30 tab ets.
ALLERGY
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Nasal irrigation How it works: Sinus rinses flush out congested sinus passages using a saltwater solution. The user pours or sprays a mixture of salt and water into the nostril using a bulb syringe, a Neti Pot or a saline nasa spray. Vi ano said one can even use a turkey baster and an at-home mixture of1 teaspoon salt and '/2 teaspoon baking soda with 1 cup of distilled or filtered warm water.
Bestfor: Reducing sinus congestion by loosening or removing mucus and rinsing out debris, bacteria and allergens. Pitfalls: Shooting water up your nose is an unpleasant process, and perfecting the technique takes practice. Common products andbrands:Neti Pot, NeilMed Sinus Relief Kit (bulb syringe),Ocean Premium Saline Nasal Spray. Approximate cost:55-510 for devices or spray.
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s
Decongestant sprays and pills Howthey work: Help open blocked sinus cavities and relieve sinus congestion by reducing nasal inflammation and mucus production. In Oregon, medicines containing pseudoephedrine (such as Sudafed) are kept behind the pharmacist's counter and require a doctor's prescription. Bestfor: Reducing nasal inflammation to open sinus cavities and promote sinus drainage. Pitfalls: Do not use decongestant nasal sprays for more than
three consecutive days, as overuse can lead to further swelling ofthe nasal membranes, according to Villano. Decongestants can also make mucus thick and hard to drain, which can increase your likelihood ofan infection. Common drugs andbrands:Oxymetazoline (Afrin nasal spray), phenylephrine (Sudafed PE and Neo-Synephrine), pseudoephedrine (Sudafed). Approximate cost:55-58 for 18-24 tablets.
es nns >
Nasal Decongesfan: enn • HEEXRttIIRKIS
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Combination products How they work: Decongestants or antihistamines are often combined with over-the-counter pain meds. These products seekto relieve multiple symptoms ofcongestion (headache, nasal inflammation), which Villano calls the "shotgun approach." Bestfor: Relieving headaches and reducing nasal inflammation to open sinus cavities and promote sinus drainage.
as effective as Sudafed because it does not act on shrinking (nasal) tissues, but acts more globally," said Villano. Common drugs andbrands:Aspirin, ibuprofen (Advil), naproxen (Aleve). Approximate cost:52-512 for 100 tablets.
Pitfalls: Combination meds usually cost more than if each drug is purchased separately. Commondrugsandbrands: Acetaminophen pseudoephedrine (Tylenol Sinus), ibuprofen pseudoephedrine (Advil Cold and Sinus). Approximate cost:55-58 for 20-24 tablets.
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LIHnm eroed Hoeenels
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PHOTOS BY ROB KERR
Sources: American AcademyofOtolaryngology — Head and Neck Surgery, WebMD, www.mayoclinic.com and Dr. Michael Villano
HIGH DESERT PULSE • WINTERI SPRING2013
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Over-the-counter pain relievers How they work: Nonsteroidal anti-inflammatory drugs like ibuprofen reduce overall inflammation, while acetaminophen (Tylenol) does not. Both drugs, however, can alleviate headaches caused by sinus congestion. Bestfor: Relieving headaches. Pitfalls:A nonsteroidal anti-inflammatory drug "won't be
Nornoroyrey EEEHEW HIH
MAKIMDMSIHENGIN
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Home Health
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Healthy eating ~ DREsslNG UPABAslc BRE AKFAsT If toast is your breakfast staple, here are a few recipes to take you
ing your children before sending them off to school. These nutritious, quick-fix toast toppers were prepared reakfast is not only a healthy goal, it's an achiev- from suggestions by Lori 6rizee, a local dietitian and author able one. Even in the busiest of households, there's of "Healthy Choices, Healthy Children: A Guide to Raising always time for toast. If toast is on your family's Fit and Happy Kids." menu, consider stepping outside the butter-and-jam box Start with one slice of 100 percent whole grain toast. and adding some creative nutrition. Here are a handful of Choose a topping from these suggestions. Have a piece of three-minute breakfasts that you can feel good about feed- fruit on the side. • Lori Brizee BY ANNE AURAND • PHOTOS BY ROB KERR
ak
Super simple 2 tablespoons salted, natural ~ peanut butter
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2 tablespoons salted, natural peanut butter
'/*slicedbanana
2 teaspoons jam
345 calories 17 grams fat 3 grams saturated fat 251 mg sodium 40 grams carbohydrate 5 grams fiber 13 grams protein
323 calories 17 grams fat 3 grams saturated fat 251 mg sodium 35 grams carbohydrate 4 grams fiber 12 grams protein
2 tablespoons salted, natural almondbutter 2teaspoons blueberries Smashberriesinto the almond but ter to get them to stick to the toast. 304 calories 18 grams fat 1 gram saturated fat 170 mg sodium 27 grams carbohydrate 6 grams fiber 12 grams protein
HIGH DESERT PULSE • WINTER/SPRING 2013
'/4 cup 2 percent cottage cheese Add N teaspoon driedor I teaspoon fresh chopped chivesor a sliceoftomato, ifdesired. 150 calories 2 grams fat 1 gram saturated fat 6 mg cholesterol 356 mg sodium 21 grams carbohydrate 2 grams fiber 11 grams protein
Page 37
Healthy eatingJDRESSINGLIP A BASIC BREAKFAST
A wee bit of work Two poached eggs
C h e esy toast
Crack two whole eggs in a ceramic bowl filled halfway with hot water. Coverwithaplateand microwaveon high at least until whites aresolid, or up Totwo minuTes. Remove eggsfrom water. Toast bread while eggs arecooking; spread1teaspoon but teron bread. Top toast wi Th eggs. Salt and pepper to taste.
Broil 1Y~ ounces natural cheddar cheesegenerally two slices of pre-sliced brandson bread. For variation, add sliced tomato and chopped, fresh basiljust beforedonebroiling.
280 calories 15 grams fat 6 grams saturated fat 383 mg cholesterol 341 mg sodium (before adding salt) 20 grams carbohydrate 2 gramsfiber 17 grams protein
280 calories 16 grams fat 11 grams saturated fat 45 mg cholesterol 440 mg sodium 19 grams carbohydrate 2 grams fiber 13 grams protein
Eggpatty and cheese Whiponelargeeggwith 1tablespoon nonfat or 1percent milk. Addit to 1teaspoon oliveoilin a hot frying pan. Fold egg asit cooks, to thesize of a piece ofbread. Mei cheese on top ofsolid egg and slide onto toast. 310 calories 18 grams fat 8 grams saturated fat 217 mg cholesterol 369 mg sodium 20 grams carbohydrate 2 grams fiber 15 grams protein
For the carnivore Turkey leftovers
Ham and cheddar
Stack2 ounces roasted turkey and N cup turkey gravy on toast.
Broil 1ouncehamand 1ounce cheddar cheese on bread.
204calories 3 grams fat 49 mg cholesterol 542 mg sodium 22 grams carbohydrate 2 grams fiber 22 grams protein Note: Sodium varies in turkey and gravies. This assessment used home-roasted light meat turkey and Heinz g ravy.
240 calories 11 grams fat 6 grams saturated fat 44 mg cholesterol 654 mg sodium 19 grams carbohydrate 2 grams fiber 16 grams protein Note: This assessment used Hormel "Cure 81" ham, which is middle of the road for sodium.
Page 38
WINTER/SPRING 2013â&#x20AC;˘ HIGH DESERTPULSE
2 013 C E N T RA L O R E G O N
Your
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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 •
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•
1
•
A
•
•
119 N RopeStreet • Sisters
541-588-G119
www.a bsoluteserenity.info
DermaSpa atBend Dermatology
2705 NE Conners Drive• Bend
541-330-9139
www.bendderm.com
Bend Memorial Clinic
Locations in Bend &Redmond
541-382-4900
www.bendmemorialclinic.com
1099 NE WattWay• Bend
541-385-4717
www.brookdaleliving.com
3550SW CanalBlvd • Redmond
541-504-1600
www.ccliving.com
Bend &P Redmond
541-G47-2894
www.centraloregonaudiology.com
ADULT FOSTERCARE
Absolute Serenity Adult Foster Care
AESTHETIC SERVICES ALLKRGY &ASTHMA
ALZHEIMERS &DEMENTIA CARE Clare Bridge Brookdale Senior Living ASSISTED LIVING
BrooksidePlace
AUDIOLOGY
Central OregonAudiology & Hearing Aid Clinic
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 & Redmond
541-70G-5800
www.stcharleshealthcare.org
CARDIOLOGY
Bend Memorial Clinic
Locations in Bend &Redmond
541-382-4900
www.bendmemorialclinic.com w w w.heartcentercardiology.com www. s tcharleshealthcare.org
2500 NE Neff Road• Bend
541-706-6900
CARDIOTHORACIC SURGERY S t . Charles Cardiothoracic Surgery
2500 NE Neff Road• Bend
541-388-1636
COSMETIC SERVICES
Bend Memorial Clinic
2600 NE Neff Road• Bend
541-382-4900
ww w .bendmemorialclinic.com
COUNSELING & WELLNESS
J u n iper Mountain Counseling gt Wellness 334 NE Irving Ave,Ste 102• Bend
541-G17-0377
ww w junipermountaincounseling.com
DENTURISTS
Sisters Denture Specialties
I 61 E Cascade• Sisters
541-549-0929
www . raordenturecenter.com
DKRMATOLOGY
Bend Dermatology Clinic
2747 NE Conners Drive• Bend
541-382-5712
DERMATOLOGY (MOHS)
Bend Memorial Clinic
2600 NE Nef'f Road• Bend
541-382-4900
ww w .bendmemorialclinic.com
ENDOCRINOLOGY
Bend Memorial Clinic
150i NE Medical Center Drive• Bend
541-382-4900
www .bendmemorialclinic.com
The Heart Center
CARDIOLOGY
www.bendderm.com
Endocrtnology ServicesNW
929 SWSimpson Ave,Ste 220 •Bend
541-317-5600
FAMILY MEDICINE
Bend Memorial Clinic
Locations in Bend, Redmond fk Sisters
541-382-4900
ww w .bendmemorialclinic.com
FAMILY MEDICINE
St. Charles Family Care
2965 NE ConnersAve, Suite I27 • Bend
541-70G-4800
www. stcharleshealthcare.org
St. Charles Family Care
1103 NE ElmStreet • Prineville
541-447-G263
www. stcharleshealthcare.org
St. Charles Family Care
211 NW LarchAvenue• Redmond
541-548-2164
www. s tcharleshealthcare.org
615 Arrowleaf Trail• Sisters
PAMILY MEDICINK
PAMILY MEDICINE
St. Charles Family Care High Lakes Health Care
GASTROENTEROLOGY
Bend Memorial Clinic
GASTROENTEROLOGY
Gastroenterology of Central Oregon
GKNKRAL DKNTISTRY
Coombe and Jones Dentistry
GENE RALSURGERY,BARIATRICS&VEINCARE Advanced Spedalty Care GENERALSURGERY& BARIATRICS St. Charles Surgical Specialists HOME HEALTH SERVICES
HOSPICE/HOMEHEALPH
St. C h arles Home Health
Q
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Pf
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O
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n/a
541-549-1318
www. s tcharleshealthcare.org
Locations in Bend, Sisters &P Redmond
541-389-7741
ww w .highlakeshealthcare.com
1501 NE Medical Center Drive• Bend
541-382-4900
ww w .bendmemorialclinic.com
2450 Mary RosePlace,Ste210 • Bend
541-728-0535
www .gastrocentraloregon.com
774 SWRimrock Way• Redmond
541-923-7633
www.c oombe-jones.com
2084 NE Professional Court• Bend
541-322-5753
www .advancedspecialtycare.com
1245 NW 4th Street, Ste 101 • Redmond
541-548-77G1
www .stcharleshealthcare.org
2500 NE Neff Road• Bend
541-70G-7796
www.stcharleshealthcare.org
732 SW 23rd St• Redmond
541-548-7483
www.redmondhospice.org
HOSPICE/HOME HEALTH
Partners In Care
2075 NE Wyatt Ct.• Bend
541-382-5882
www.partnersbend.org
HOSPITAL
St. Charles Madras
470 NE "A" Street• Madras
541-70G-7796
www.stcharleshealthcare.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
HOSPITAL
St. Charles Redmond
1253 NE Canal Blvd• Redmond
541-70G-7796
www.stcharleshealthcare.org
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
Locations in Bend &Redmond
541-382-4900
www.bendmemorialclinic.com
2600 NE Nef'f Road• Bend
541-70G-3700
www.stcharleshealthcare.org
HOSPITALIST
T J
HYBERBARIC OXYGENTHERAPY Bend Memorial Clinic Bend Memorial Clinic
IMMEDIATE CARE
St. Charles Immediate Care
2 013 CE N T RA L O R E G O N
R
J INTEGRATKD MKDICINK
www.bendmemorialclinic.com
1501 NE Medical Center Drive• Bend
541-382-4900
St. Charles Infectious Disease
2965 NE ConnersAve., Suite 127sgend
541-70G-4878
www.stcharleshealthcare.org
Center for Integrated Medicine
91G SW17th St, Ste202 • Redmond
541-504-0250
www.centerforintegratedmed.com
Bend Eastside 8)Westside
541-382-4900
www.bendmemorialclinic.com
929 SW Simpson Ave• Bend
541-389-7741
www.highlakeshealthcare.com
High Lakes Health Care Upper Mill
23G NW Kingwood Ave • Redmond
541-548-7134
www.imredmond.com
1245 NW 4th Street, Ste 201 • Redmond
541-323-4545
n/a
Internal Medicine Associates of Redmond
J
a
Bend Memorial Clinic
Bend Memorial Clinic INTERNAL MEDICINE
DVERTISINGSUPPLEMENT
M E D I CA L D I RECTORY
Redmond Medical Clinic Bend Memorial Clinic
1501 NEMedical Center Drive • Bend
541-382-4900
www.bendmemorialclinic.com
MEDICAL CLINIC
Bend Memorial Clinic
1080 SWMt. Bachelor Dr • Bend (West)
541-382-4900
www.bendmemorialclinic.com
MEDICAL CLINIC
Bend Memorial Clinic
1501 NEMedical Center Dr • Bend(East) 541-382-4900
www.bendmemorialclinic.com
MEDICAL CLINIC
Bend Memorial Clinic
231 East CascadesAve• Sisters
541-382-4900
www.bendmemorialclinic.com
MEDICAL CLINIC
Bend Memorial Clinic
865 SWVeteransWay • Redmond
541-382-4900
www.bendmemorialclinic.com
NEPHROLOGY
Bend Memorial Clinic
Locations in Bend, Redmond 8)Sisters
541-382-4900
www.bendmemorialclinic.com
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
ca t ions in Bend 8) Redmond
541-382-3344
www.thecenteroregon.com
Locations in Bend,Redmond 8)Sisters
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 8)Redmond
541-382-4900
ww w .bendmemorialclinic.com
LASIK
NEUROLOGY NEUROSURGKRY NUTRITION
The Center: Orthopedic rs Neurosurgical Care¹) Research l o
Bend Memorial Clinic
OBSTETRICS 8)GYNECOLOGY E ast Cascade Women's Group, P.C.
OBSTETRICS 8) GYNECOLOGY St. Charles OB /CYN OCCUPATIONAL MEDICINE
Ben d Memorial Clinic
541-382-3344
www.t h ecenteroregon.com
ONCOLOGY - MEDICAL
Bend Memorial Clinic
locations in Bend 8)Redmond
541-382-4900
www .bendmemorialclinic.com
OPHTHALMOLOGY
Bend Memorial Clinic
locations in Bend 8)Redmond
541-382-4900
ww w .bendmemorialclinic.com
OPTOMETRY
Bend Memorial Clinic
Locations in Bend 8)Redmond
541-382-4900
www .bendmemorialclinic.com
Desert Orthopedics
Locations in Bend 8)Redmond
OCCUPATIONAL MEDICINE
ORTHOPEDICS ORTHOPEDICS
The C enter:Orthopedic s) Neurosurgical CareAResearch Lo c ations in Bend 8) Redmond
The Center: Orthopedic ¹) NeurosurgicalCareS)Research l o
541-388-2333
www. d esertorthopedics.com
ca t ions in Bend 8) Redmond
541-382-3344
www.t h ecenteroregon.com
2200 NENeffRoad,Suite 302 • Bend
541-388-3978
ww w.deschutesosteoporosiscenter.com
2500 NE Neff Road • Bend
541-70G-5880
www . stcharleshealthcare.org
OSTEOPOROSIS
Deschutes Osteoporosis Center
PALLIATIVK CARK
St. Charles Advanced Illness Management
PEDIATRIC DKNTISTRY
Dentistry For Kidz
1230 NE 3rd Street, Suite A-174• Bend
541-389-G600
www. d entistryforkidz.com
PEDIATRIC DENTISTRY
Deschutes Pediatric Dentistry
1475 SWChandler Ave, Ste202 • Bend
541-389-3073
www. d eschuteskids.com
PEDIATRICS
Bend Memorial Clinic
1080 SWMt. Bachelor Dr • Bend (West)
541-382-4900
ww w .bendmemorialclinic.com
PKDIATRICS
St. Charles Family Care
211 NW LarchAvenue• Redmond
541-548-2164
www . stcharleshealthcare.org
Locations in Bend 8)Redmond
PHYSICAL MKDICINK PHYSICAL MEDICINE
Desert Orthopedics The Center: Orthopedic g) Neurosurgical CareS)Research l o
PHYSICAL MEDICINE/REHABILITATION
Bend Memorial Clinic
PHYSICAL THERAPY
Alpine Physical Ilterapy tk Spine Care
PHYSICAL THERAPY
Healing Bridge Physical Therapy
PODIATRY
Cascade Foot Clinic
PULMONOLOGY PULMONOLOGY RADIOLOGY
Central Oregon Radiology Assoclates, P.C.
REHABILITATION
St. Charles Rehabilitation Center
RHEUMATOLOGY
Bend Memorial Clinic
RHKUMATOLOGY
Deschutes Rheumatology
SLEEP MKDICINE
541-388-2333
www. d esertorthopedics.com
ca t ions in Bend 8) Redmond
541-382-3344
www.t h ecenteroregon.com
1501 NE Medical Center Drive• Bend
541-382-4900
ww w .bendmemorialclinic.com
2275 NE Doctoi Dr,s¹3 I) 336SWCyber Dr,Stei07
541-382-5500
w w w.alpinephysicaltherapy.com
404 NE PennAvenue • Bend
541-318-7041
www.healingbridge.com
Offices in Bend,Redmond 8)Prineville
541-388-28G1
n/a
Bend Memorial Clinic
locations in Bend 8)Redmond
541-382-4900
ww w .bendmemorialclinic.com
St. Charles Pulmonary Clinic
locations in Bend 8)Redmond
541-70G-7715
www . stcharleshealthcare.org
14 6 0 NE Medical Center• Dr Bend
541-382-9383
locations in Bend 8)Redmond
541-70G-7725
www .stcharleshealthcare.org ww w .bendmemorialclinic.com
www.corapc.com
locations in Bend 8)Redmond
541-382-4900
2200 NENeffRoad,Suite 302 • Bend
541-388-3978
/
Bend Memorial Clinic
Locations in Bend 8)Redmond
541-382-4900
www.bendmemorialclinic.com
SLEEP MEDICINE
St. Charles Sleep Center
locations in Bend 8)Redmond
541-70G-G905
www.stcharleshealthcare.org
SURGICAL SPECIALIST
Bend Memorial Clinic
Locations in Bend 8)Redmond
541-382-4900
www.bendmemorialclinic.com
URGKNT CARE
Bend Memorial Clinic
541-382-4900
www.bendmemorialclinic.com
UROLOGY
Bend Urology Assocfates
541-382-G447
www.bendurology.com
r • Ir d)E rsw r)ssa ) Locations in Bend 8)Redmond
T
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2 013 CE N T RA L O R E G O N UROLOGY
DVERTISINGSUPPLEMENT
M E D I CA L D I RECTORY
Urology Spedalists of Oregon
locations in Bend gtRedmond
541-322-5753
h t tp: //usof or.praxismedicalgroup.com
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
VEIN SPECIALISTS
lnovia Vein Spedalty Center
2200 NE Neff Road, Ste 204• Bend
541-382-8346
www.bendvein.com
VEIN SPECIALISTS
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
VASCULAR SURGERY
•
•
ADAM WILLIAMS, MD
A
•
•
•
~ Bend Memorial Clinic
STEPHEN ARCHER,MF, FACS Advanced Specialty Care 1
•
A
A
Bend Eastside gt Redmond
( 541-382-4900 ( www.bendmemorialclinic.com
2084 NE Professional Court• Bend 5 4
1- 3 2 2-5753 w ww . advancedspecialtycare.com
1
I
PHILIP B. ANDERSON, MD
St. Charles Behavioral Health
2542 NE Courtney Dr • Bend
541-706-7730 ~
w w w.stcharleshealthcare.org
KAREN CAMPBELL, PhD
St. Charles Behavioral Health
2542 NE Courtney Dr • Bend
541-706-7730
www.stcharleshealthcare.org
RYAN C. DIX, PsyD
St. Charles Family Care
1103 NE Elm Street, Ste C• Prineville
541-447-G263
www.stcharleshealthcare.org
BRIAN T. EVANS, PsyD
St. Charles Behavioral Health
2542 NE Courtney Dr • Bend
541-706-7730
www.stcharleshealthcare.org
EUGENE KRANZ, PhD
St. Charles Behavioral 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 Behavioral 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
RKBKCCA SCRAFFORD, PsyD
St. Charles Behavioral Health
2542 NE Courtney Dr• Bend
541-706-7730
www.stcharleshealthcare.org
KIMBERLY SWANSON, PILD
St. Charles Behavioral Health
2542 NE Courtney Dr • Bend
541-706-7730
www.stcharleshealthcare.org
CATHKRINE BLACK, PA-C
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
3EAN BROWN, PA-C
Bend Memorial Clinic
1501 NE lvledical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
RICK KOCH, MD
Bend Memorial Clinic
Bend Eastside gt Redmond
541-382-4900
www.bendmemorialclinic.com
GAVIN L.NOBLK, MD
Bend Memorial Clinic
Bend Eastside gt Redmond
541-382-4900
www.bendmemorialclinic.com
STEPHANIE SCOTT, PA-C
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
3ASON WEST, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
I
I
I
30HN D. BLIZZARD, MD
St. Charles Cardiothoradc Surgery
2500 NE Neff Road• Bend
541-388-163G
www stcharleshealthcare.org
ANGELO A. VLESSIS, MD
St.Charles Cardiothoracic Surgery
2500 NE Neff Road• Bend
541-388-163G
www .stcharleshealthcare.org
30RDAN T. DOI, MSC, DC
NorthWest Crossing Chiropracticgt Health
62 8 NW York Dr, Ste. 104 • Bend
541-388-2429
THERESA M. RUBADUE, DC,CCSP NorthWest Crossing Chiropracticgt Health
62 8 NW York Dr, Ste. 104 • Bend
3ASON hLKRKMKR,DC,CCSF, CSCS
Wellness Doctor
1345 NW Wall St, Ste 202• Bend
541-318-1000
ww w .bendwellnessdoctor.com
MICHAEL R. HALL, DDS
Central Oregon Dental Center
1563 NW Newport Ave• Bend
541-389-0300
ww w.centraloregondentalcenter.net
Co n temporary Family Dentistry
101 6 NW Newport Ave• Bend
341-388-1107
BRADLKY K. 30HNSON,DMD •
www.nwxhealth.com
T
www.nwxhealth.com
541-388-2429
t
.
1 1 yyl
l l yp
•
ALYSSA ABBEY, PA-C
Bend Memorial Clinic
2600 NE Neff Road• Bend
541-382-4900
ANGKLA COVINGTON, MD
Bend Memorial Clinic
2600 NE Neff Road• Bend
541-382-4900
ww w .bendmemorialclinic.com
MARK HALL, MD
CentralOregon Dermatology
541-678-0020
w ww.centraloregondermatology.com
3AMES M. HOESLY, MD
Bend Memorial Clinic
2600 NE Neff Road• Bend
541-382-4900
www .bendmemorialclinic.com
GKRALD E. PKTKRS,MD, DS (Mohs)
Bend Memorial Clinic
2600 NE Neff Road• Bend
541-382-4900
ww w .bendmemorialclinic.com
ANN M. REITAN, PA-C (Mohs)
Bend Memorial Clinic
2600 NE Neff Road• Bend
541-382-4900
www .bendmemorialclinic.com
MARY F. CARROLL, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
ww w .bendmemorialclinic.com
RICK N.GOLDSTEIN, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www .bendmemorialclinic.com
TONYA KOOPMAN, MSN,FNP-BC
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
Endocrinology Services NW
929 SWSimpson Ave,Ste 220 • Bend
--- ---L
www .bendmemorialclinic.com
PATRICK MCCARTHY, MD TRAVIS MONCHAMP, MD
Endocrinology ServicesNW
929 SWSimpson Ave,Ste 220 • Bend
541-317-5GOO
I I
I
388 SW Bluff Dr• Bend
I
www .bendmemorialclinic.com
I
n/a
2 013 CE N T RA L O R E G O N CAREY ALLEN, MD
DVERTISINGSUPPLEMENT
M E D I CA L D I RECTORY 1103 NE Elm Street• Prineville
541-447-G2G3
www. stcharleshealthcare.org
St. Charles Family Care
1103 NE Elm Street• Prineville
541-447-G263
www. stcharleshealthcare.org
THOMAS L.ALLUMBAUGH, MD
St. Charles Family Care
211 NW Larch Avenue• Redmond
541-548-2164
www. s tcharleshealthcare.org
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 SW Veterans Way• Redmond
541-382-4900
www .bendmemorialclinic.com
30SEPH BACHTOLD, DO
St. Charles Family Care
630 Arrowleaf Trail • Sisters
541-549-1318
www. s tcharleshealthcare.org
KDWARD BIGLKR, MD
High Lakes Health Care Upper Mill
929 SW Simpson Avenue• Bend
541-389-7741
ww w .highlakeshealthcare.com
3EFFREY P.BOGGESS, MD
Bend Memorial Clinic
1080 SW Mt. Bachelor Drive• Bend
541-382-4900
ww w .bendmemorialclinic.com
BRANDON W. BRASHER, PA-C
St. Charles Family Care
1103 NE Elm Street• Prineville
541-447-G2G3
www. stcharleshealthcare.org
SHANNON K. BRASHER, PA-C
St. Charles Family Care
1103 NE Elm Street• Prineville
541-447-G263
www. s tcharleshealthcare.org
MEGHAN BRECKE, DO
St. Charles Family Care
2965 NE Conners Ave,Suite 127 • Bend
541-70G-4800
www . stcharleshealthcare.org
NANCY BRKNNAN, DO
St. Charles Family Care
2965 NE ConnersAve, Suite 127 • Bend
541-70G-4800
www. s tcharleshealthcare.org
WILLIAM C.CLARIDGE, MD
St. Charles Family Care
211 NW Larch Avenue• Redmond
541-548-2164
www. stcharleshealthcare.org
MATTHEW 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
Bend Memorial Clinic
541-382-4900
www .bendmemorialclinic.com
3AMES K. DETWILER, MD
St. Charles Family Care
211 NW Larch Avenue• Redmond
541-548-2164
www. s tcharleshealthcare.org
MAY S. FAN, MD
Bend Memorial Clinic
231 East Cascades Avenue• Sisters
541-382-4900
www .bendmemorialclinic.com
JAMIK FRKEMAN, PA-C
High Lakes Health Care Upper Mill
929 SW Simpson Avenue• Bend
541-389-7741
ww w .highlakeshealthcare.com www. stcharleshealthcare.org
HEIDI ALLEN, MD
St. Charles Family Care
T
1
T 1501 NE Medical Center Drive• Bend J
MARK GONSKY,DO
St. Charles Family Care
2965 NE ConnersAve, Suite 127 • Bend
541-70G-4800
STKVEN GREER, MD
St. Charles Family Care
630 Arrowleaf Trail • Sisters
541-549-1318
www. stcharleshealthcare.org
ALAN C. HILLES, MD
Bend Memorial Clinic
Redmond gr Sisters
541-382-4900
www .bendmemorialclinic.com
PAMELA 3. IRBY, MD
St. Charles Family Care
211 NW Larch Avenue• Redmond
541-548-2164
www . stcharleshealthcare.org
MAGGIK 3. KING, MD
St. Charles Family Care
1103 NE Elm Street• Prineville
541-447-G2G3
www. stcharleshealthcare.org
PETER LEAVITT, MD
St. Charles Family Care
2965 NE ConnersAve, Suite 127 • Bend
541-70G-4800
www. stcharleshealthcare.org
CHARLOTTE LIN, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
ww w .bendmemorialclinic.com
KAE LOVERINK, MD
High Lakes Health Care Redmond
1001 NW Canal Blvd• Redmond
541-504-7635
ww w .highlakeshealthcare.com
STEVE MANN, DO
High Lakes Health Care Upper Mill
929 SW Simpson Avenue• Bend
541-389-7741
www .highlakeshealthcare.com
JOE T.MC COOK, MD
St. Charles Family Care
211 NW Larch Avenue• Redmond
541-548-2164
www. s tcharleshealthcare.org
LORI MCMILLIAN, FNP
Redmond Medical Clinic
1245 NW 4th Street, Ste201 • Redmond
541-323-4545
KDKN MILLKR, DO
High Lakes Health Care Sisters
354 W Adams Avenue• Sisters
541-549-9609
ww w .highlakeshealthcare.com
KEVIN MILLER, DO
High Lakes Health Care Sisters
354 W Adams Avenue• Sisters
541-549-9609
ww w .highlakeshealthcare.com
JKSSICA MORGAN, MD
High Lakes Health Care Upper Mill
929 SW Simpson Avenue• Bend
541-389-7741
ww w .highlakeshealthcare.com
DANIEL 3. MURPHY, MD
St. Charles Family Care
211 NW Larch Avenue• Redmond
541-548-2164
www . stcharleshealthcare.org
SHERYL L. NORRIS, MD
St. Charles Family Care
211 NW Larch Avenue• Redmond
541-548-2164
www . stcharleshealthcare.org
AUBRKY PKRKINS, FNP
High Lakes Health Care East
1247 NE Medical Center Drive• Bend
541- hh
3ANEY PURVIS, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
ww w .bendmemorialclinic.com
KEVIN REUTER, MD
High Lakes Health Care East
1247 NE Medical Center Drive• Bend
541-318-4249
www.highlakes healthcare.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 gt Westside
541-382-4900
www.bendmemorialclinic.com
ERIC 3. SCHNEIDER, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
CINDY SHUMAN, PA-C
Bend Memorial Clinic
1080 SW Mt. Bachelor Drive• Bend
541-382-4900
www.bendmemorialclinic.com
KDWARD M. TARBET, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
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M E D I CA L D I RECTORY
JOHN D. TELLER, 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
DVERTISINGSUPPLEMENT
1501 NE Medical Center Drive• Bend
541-382-4900
211 NW Larch Avenue• Redmond
541-548-2164
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
BILL WIGNALL, MD
High Lakes Health Care East
1247 NE Medical Center Drive• Bend
541-318-4249
www.highlakesheal thcare.com
BRUCE N. WILLIAMS, MD
St. Charles Family Care
1103 NE Elm Street• Prineville
541-447-G2G3
www.stcharleshealthcare.org
DAVID KELLY, MD
High Lakes Health Care Upper Mill •
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929 SW Simpson Avenue• Bend 5 4
www .bendmemorialclinic.com www . stcharleshealthcare.org
1- 3 89-7741 w ww . highlakeshealthcare.com
•
RICHARD H. BOCHNER, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend 541-382-4900 w
ELLEN BORLAND, MS, RN, CFNP Bend Memorial Clinic
ww . bendmemorialclinic.com
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com www.bendmemorialclinic.com
ARTHUR S. CANTOR, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
HEIDI CRUISE, PA-C, MS
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
CHRISTINA HATARA, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
SIDNEY E. HENDERSON III, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
SANDRA K. HOLLOWAY, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
GLKNN KOTKKN, MD
Gastroenterology of Central Oregon
2450 Mary Rose Place, Ste 210• Bend
541-728-0535
www.gastrocentraloregon.com
MATTHEW WEED, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend 541-382-4900 w
CHRISTY ENGLAND, PA-C
Advanced Specialty Care
NICOLK O'NEIL,PA-C
Advanced Spedalty Care
NGOCTHUY HUGHES, DO, PC St. Charles Surgical Spedalists •
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2084 NE Professional Court• Bend 5 4
ww . bendmemorialclinic.com
1- 3 2 2-5753 w ww . advancedspecialtycare.com
2084 NE Professional Court• Bend 5 4 1 - 3 22-5753 w
1245 NW 4th Street, Ste 101 • Redmond 541-548-7761 w
w w .advancedspecialtycare.com
ww. stcharleshealthcare.org
•
JANE BIRSCHBACH, MD
High Lakes Health Care UpperMill
929 SW Simpson Avenue• Bend
SUSAN GORMAN, MD
High Lakes Health Care Redmond
1001 NW CanalBlvd.• Redm ond 541-504-7635
ALISON LYNCH-MILLER, MD
Hig hLakes Health Care Upper Mill
929 SW Simpson Avenue• Bend
JOHN R. ALLEN, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend 541-382-4900
www.bendmemorialclinic.com
LAURIK D'AVIGNON, 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 KNGLAND, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
MICHAEL GOLOB, PA-C
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
ADRIAN KRUEGER, PA-C
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
SUZANN KRUSK, PA-C
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
PHONG NGO, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
DKONA J. WILLIS, FNP-C
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
LAURIK D'AVIGNON, MD
Bend 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
www .bendmemorialclinic.com
RKBKCCA SHKRKR, MD
St. Charles Infectious Disease
29G5 Conners Ave, Ste 127• Bend
541-70G-4878
www . stcharleshealthcare.org
JKNKSS CHRISTKNSKN, MD
High Lakes Health Care UpperMill
929 SW Simpson Avenue• Bend 5 4
541-389-7741
541-389-7741
www.highlakeshealthcare.com www.highlakeshealthcare.com
www.highlakeshealthcare.com
1- 3 8 9-7741 w ww . highlakeshealthcare.com
2 013 CE N T RA L O R E G O N
M E D I CA L D I RECTORY 541-389-7741
DVERTISINGSUPPLEMENT
www .highlakeshealthcare.com
30HN CORSO, MD
High Lakes Health Care Upper Mill
CELSO A.GANGAN, MD
Redmond Medical Clinic
1245 NW4th Street, Ste 201• Redmond
541-323-4545
MICHAEL N. HARRIS, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
ANNK KILLINGBKCK, MD
Internal Medicine Associatesof Redmond
236 NW Kingwood Ave • Redmond
541-548-7134
ANITA D.KOLISCH, MD
Bend Memorial Clinic
Bend Eastside gaRedmond
541-382-4900
www .bendmemorialclinic.com
MATTHEW R. LASALA, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www .bendmemorialclinic.com
MADELINE LEMEE, MD
High Lakes Health Care Upper Mill
929 SW Simpson Avenue• Bend
541-389-7741
www.highlakesheal thcare.com
MARY MANFREDI, MD
High Lakes Health Care Upper Mill
929 SW Simpson Avenue• Bend
541-389-7741
www.highlakeshealthcare.com
KAREN L. OPPENHEIMER, MD
Bend Memorial Clinic
1080 SW Mt. Bachelor Drive• Bend
541-382-4900
www.bendmemorialclinic.com
H. DKREK PALMKR, MD
Redmond Medical Clinic
1245 NW 4th Street, Ste 201• Redmond
541-323-4545
n/a
A. WADE PARKER, 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 ROGKRS, MD
Bend Memorial Clinic
1501NE Medical Center Drive• Bend 541-382-4900 w
ww. bendmemorialclinic.com
DAN SULLIVAN, MD
Bend Memorial Clinic
1501NE Medical Center Drive• Bend 541-382-4900 w
ww. bendmemorialclinic.com
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CAROL A. CRAIG, NNP
St. Charles Medical Group - Neonatology
2500 NE Neff Road• Bend
541-382-4321
www. s tcharleshealthcare.org
30HN 0. EVERED, MD
St. Charles Medical Group Neonatology
2500 NE Neff Road• Bend
541-382-4321
www . stcharleshealthcare.org
SARAH E. 3AMES, NNP
St. Charles Medical Group Neonatology
2500 NE Neff Road• Bend
541-382-4321
www. s tcharleshealthcare.org
3AMKS MCGUIRK, MD
St. Charles Medical Group - Neonatology
2500 NE Neff Road• Bend
541-382-4321
www. s tcharleshealthcare.org
PREDERICK 3. RUBNER, MD
St. Charles Medical Group - Neonatology
2500 NE Neff Road• Bend
541-382-4321
www . stcharleshealthcare.org
Bend Memorial Clinic
Bend Eastside gaRedmond
541-382-4900
www .bendmemorialclinic.com
RUSSELL E. MASSINE, MD, FACP Bend Memorial Clinic
Bend Eastside th Redmond
541-382-4900
www .bendmemorialclinic.com
ROBERT V. PINNICK, MD
Bend Memorial Clinic
Bend Eastside th Redmond
541-382-4900
ww w .bendmemorialclinic.com
MOLLY TILLKY,MD
Bend Memorial Clinic
Bend Eastside gaRedmond
541-382-4900
www. bendmemorialclinic.com
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•
MICHAKL K. PKLDMAN, MD
PRANCENA ABENDROTH, MD B end Memorial Clinic
1501 NE Medical Center Drive• Bend 541-382-4900 w
ww. bendmemorialclinic.com
CRAIGAN GRIPPIN, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend 541-382-4900 w
ww. bendmemorialclinic.com
RICHARD KOLLER, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend 541-382-4900 w
ww. bendmemorialclinic.com
RAY TIKN, MD
The Center: Orthopedic rs Neurosurgical CareGResearch Locations in Bend St Redmond
541-3 8 2 - 3344
www.t h ecenteroregon.com
BRAD WARD, MD
The Center: Orthopedic rs Neurosurgical CareSResearch Locations in Bend th Redmond
541-3 8 2 - 3344
www.t h ecenteroregon.com
Bend Eastside gaRedmond
541-382-4900
www .bendmemorialclinic.com
ANNIK WILLIAMSON, RD, LD B end Memorial Clinic
WILLIAM H. BARSTOW, MD
St. Charles OB/GYN
213 NW Larch Ave, Ste A• Redmond
541-52G-GG35
ww w .stcharleshealthcare.org
ANN-BRIDGKT BIRD,MD
St. Charles OB/GYN
213 NW Larch Ave, Ste A• Redmond
541-52G-G635
www. s tcharleshealthcare.org
BRENDA HINMAN, DO
St. Charles OB /GYN
213 NW Larch Ave, Ste A• Redmond
54 1 -52G-G635
wwwst charleshealthcare.org
AMY B. MCELROY, PNP
St. Charles OB/GYN
213 NW Larch Ave, Ste A• Redmond
54 1 -52G-GG35
www. stcharleshealthcare.org
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3AMES NELSON, MD
The Center: Orthopedic S Neurosurgical CareSResearch Locations in Bend th Redmond
541-3 8 2 - 3344
www.t h ecenteroregon.com
LARRY PAULSON, MD
The Center: Orthopedic gt Neurosurgical Careg Research Locations in Bend th Redmond
541-3 8 2 - 3344
www.t h ecenteroregon.com
DVERTISINGSUPPLEMENT
2013 CENTRAL OREGON MEDICAL DIRECTORY •
•
•
541-70G-5800
www.stcharleshealthcare.org
Bend Eastside SaRedmond
541-382-4900
www.bendmemorialclinic.com
St. Charles Cancer Center
Locations in Bend tia Redmond
541-70G-5800
www.stcharleshealthcare.org
St. Charles Cancer Center
Locations in Bend tia Redmond
541-70G-5800
www.stcharleshealthcare.org
STEVE KORNPELD, MD
St. Charles Cancer Center
Locations in Bend tia Redmond
541-70G-5800
www.stcharleshealthcare.org
BILL MARTIN, MD
St. Charles Cancer Center
Locations in Bend ga Redmond
541-70G-5800
LAURIE RICE, ACNP
Bend Memorial Clinic
WILLIAM SCHMIDT, MD
Bend Memorial Clinic
HEATHER WEST, MD
Bend Memorial Clinic
ROB BOONE, MD
St. Charles Cancer Center
THEODORE A. BRAICH, MD
Ben d Memorial Clinic
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CORA CALOMENI, MD
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St. Charles Cancer Center
RUSS OMIZO, MD •
1501 NE Medical Center Drive• Bend 541-382-4900
Bend Eastside gaRedmond
541-382-4900
1501 NE Medical Center Drive• Bend 541-382-4900 w
www.stcharleshealthcare.org www.bendmemorialclinic.com www .bendmemorialclinic.com ww. bendmemorialclinic.com
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LINYEE CHANG, MD
•
Locations in Bend tia Redmond
•
St. Charles Cancer Center •
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2500 NE Neff Road• Bend
541-70G-7733
www . stcharleshealthcare.org
2500 NE Neff Road• Bend
541-70G-7733
www. stcharleshealthcare.org
•
MATTHEW N. SIMMONS I
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Urology Spedalist of Oregon
2084 NE Professional Ct• Bend
541- 3 2 2-5753 h t p//usofor.praxixmedi : calgroup.com
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Bend Eastside, Westside ga Redmond
541-382-4900
www .bendmemorialclinic.com
THOMASD. FITZSIMMONS,MD,MPH Bend Memorial Clinic
Bend Eastside, Westside gt Redmond
541-382-4900
www .bendmemorialclinic.com
ROBERTC. MATHEWS, MD
Bend M emorial Clinic
Bend Eastside, Westside ga Redmond
541-382-4900
www .bendmemorialclinic.com
SCOTTT. O'CONNKR, MD
Bend Memorial Clinic
Bend Eastside, Westside gt Redmond
541-382-4900
ww w .bendmemorialclinic.com
DARCY C. BALCER, OD
Bend Memorial Clinic
Bend Eastside gaWestside
541-382-4900
ww w .bendmemorialclinic.com
LORISSA M. HEMMER, OD
Ben d Memorial Clinic
Bend Eastside gt Westside
541-382-4900
www .bendmemorialclinic.com
BRIAN P.DESMOND, MD
Bend Memorial Clinic
I
KKITH E. KRUKGER,DMD, PC Keith E. Krueger, DMD, PC I '
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1475 SW Chandler, Ste 101• Bend 5 4 1 - 617-3993 w
ww.d r keithkrueger.com
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AARON ASKEW, MD
J J.
Locations in Bend tia Redmond
541-388-2333
www.desertorthopedics.com
Locations in Bend tia Redmond
541-382-3344
www.thecenteroregon.com
The Center: Orthopedic gtNeurosurgicai CaregtResearch
Locations in Bend tia Redmond
541-382-3344
www.thecenteroregon.com
The Center: Orthopedic gt Neurosurgical Care gt Research
Locations in Bend tia Redmond
541-382-3344
www.thecenteroregon.com
KNUTEBUEHLER, MD
The Center: OrthopedicttNeurosurgicaiCaregtResearch
Locations in Bend tia Redmond
541-382-3344
www.thecenteroregon.com
MICHAKL CARAVELLI, MD
The C e nter:Orthopedic a Neurosurgicai CaregtResearch
Locations in Bend tca Redmond
541-382-3344
www.thecenteroregon.com
Locations in Bend tia Redmond
541-388-2333
www.desertorthopedics.com
Locations in Bend tca Redmond
541-382-3344
www.thecenteroregon.com
Locations in Bend tia Redmond
541-388-2333
www.desertorthopedics.com
ANTHONY HINZ, MD 3KPFRKY P. HOLMBOE,MD
30EL MOORE, MD I '
The Center: Orthopedic gt Neurosurgical Care gt Research
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ERIN PINTER, MD JAMES HALL, MD
ROBERT SHANNON, MD I '
Desert Orthopedics
I '
Desert Orthopedics The Center: Orthopedic gtNeurosurgical CaregtResearch
Desert Orthopedics I
I
MICHAEL RYAN, MD
Desert Orthopedics
1303 NE Cushing Dr, Ste 100• Bend
54 1 -388-2333
www.desertorthopedics.com
GRKG HA, MD
Desert Orthopedics
1303 NE Cushing Dr, Ste 100• Bend
54 1 -388-2333
www. d esertorthopedics.com
KATHLEEN MOORE, MD
Desert Orthopedics
1303 NE Cushing Dr, Ste 100• Bend
54 1 -388-2333
www. d esertorthopedics.com
Locations in Bend tia Redmond
541-382-3344
www.thecenteroregon.com
1315 NW 4th Street• Redmond
541-388-2333
www.desertorthopedics.com
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TIMOTHY BOLLOM, MD BRKTT GINGOLD, MD
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The Center: Orthopedic gtNeurosurgicai CaregtResearch
Desert Orthopedics
2 013 CE N T RA L O R E G O N s'
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DVERTISINGSUPPLEMENT
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SCOTT T.JACOBSON, MD
The Center: Orthopedic tt NeurosurgicCare al GResearch Locations in Bend gt Redmond 5
41-3 8 2 - 3 344
www.thecenteroregon.com
BLAKE NONWEILER, MD
The Center: Orthopedic Neurosurgi gt cai CaregtResearch Locations in Bend gt Redmond 5
41-3 8 2 - 3 344
www.thecenteroregon.com
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CARA WALTHER, MD
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Desert Orthopedics
1303 NE Cushing Dr, Ste 100• Bend 54 1 -388-2333
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The Center: Orthopedic tt NeurosurgicalCaregtResearch
KENNETH HANINGTON, MD
Desert Orthopedics
Locations in Bend gs Redmond
541-382-3344
www.thecenteroregon.com
Locations in Bend Sa Redmond
541-388-2333
www.desertorthopedics.com www.thecenteroregon.com
www.thecenteroregon.com
SOMA LILLY, MD
The Center: Orthopedic tt NeurosurgicalCaregtResearch
Locations in Bend gt Redmond
541-382-3344
JAMES VERHEYDEN, MD
The Center: Orthopedic gtNeurosurgical CaregtResearch
Locations in Bend ga Redmond
541-382-3344
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MOLLY OMIZO, MD
Deschutes Osteoporosis Center
JENNIFER BLECHMAN, MD
St. Charles Advanced Illness Management
LISA LEWIS, MD
Partners in Care
RICHARD J. MAUNDER, MD LAURA K. MAVITY, MD a
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www.desertorthopedics.com
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2200 NE Neff Road,Suite 302• Bend 54 1 - 388-3978 w w wdeschutesosteoporosiscentercom
2500 NE Neff Road• Bend
541-70G-5885
www.stcharleshealthcare.org
2075 NE Wyatt Ct • Bend
541-382-5882
www.partnersbend.org
St . Charles Advanced Illness Management
2500 NE Neff Road• Bend
541-70G-5885
www.stcharleshealthcare.org
St. Charles Advanced Illness Management
2500 NE Neff Road• Bend
541-706-5885
www.stcharleshealthcare.org
I
STEPHANIE CHRISTENSEN, DMD Deschutes Pediatric Dentistry STEVE CHRISTENSEN, DMD
Desc h u tes Pediatric Dentistry
R DEAN NYQUIST, DMD
Dentistry for Kidz
KATHERINE BAUMANN, MD
Bend Memorial Clinic
KATE L. BROADMAN, MD
Send Memorial Clinic
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1475 SW Chandler Ave, Ste• Bend 5 4 1 - 389-3073 w
ww.d e schuteskids.com
1475 SW Chandler Ave, Ste• Bend 5 4 1 - 389-3073 w
ww.d e schuteskids.com
1230NEThirdSt,SteA-174 • Bend 5 4 1 - 389-6600 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 www.bendmemorialclinic.com
RICK G. CUDDIHY, MD
Bend Memorial Clinic
1080 SW Mt. Bachelor Drive• Bend
541-382-4900
THOMAS N. ERNST, MD
St. Charles Family Care
211 NW Larch Ave• Redmond
541-548-2164
www.stcharleshealthcare.org
KATHRYN LEIN, CPNP
Bend Memorial Clinic
1080 SW Mt. Bachelor Drive• Bend
541-382-4900
www.bendmemorialclinic.com
MICHELLE MILLS, MD
Send Memorial Clinic
1080 SW Mt. Bachelor Drive• Bend
541-382-4900
www.bendmemorialclinic.com
MARGARET J. PHILP, MD
St. Charles Family Care
211 NW Larch Ave• Redmond
541-548-2164
www.stcharleshealthcare.org
1080 SW Mt. Bachelor Drive• Bend
541-382-4900
www.bendmemorialclinic.com
Desert Orthopedics
Locations in Bend St Redmond
541-388-2333
www . desertorthopedics.com
High Lakes Health Care Upper Mill
929 SW Simpson Avenue• Bend
541-389-7741
ww w .highlakeshealthcare.com
JB WARTON, DO
ROBERT ANDREWS, MD
LINDA CARROLL, MD TIM HILL, MD
Bend Memorial Clinic
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The Center: Orthopedic gt Neurosurgical CaregtResearch Locations in Bend ga Redmond
www.thecenteroregon.com
541-382-4900
www.bendmemorialclinic.com
JAMES NELSON, MD
The Center: Orthopedic gt Neurosurgical CaregtResearch Locations in Bend gt Redmond
541-382-3344
www.thecenteroregon.com
LARRY PAULSON, MD
Ihe Center: Orthopedic tt Neurosurgicat CareAResearch Locations in Bend gt Redmond
541-382-3344
www.thecenteroregon.com
DAVID STEWART, MD
The Center: Orthopedic gt Neurosurgicai CaregtResearch Locations in Bend gt Redmond
541-382-3344
www.thecenteroregon.com
541-388-2333
www.desertorthopedics.com
The Center: Orthopedic gt Neurosurgical Carett Resea rch Locations in Bend gt Redmond
541-382-3344
www.thecenteroregon.com
The Center: Orthopedic tt Neurosurgicat CaregtResearch Locations in Bend Sa Redmond
541-382-3344
www.thecenteroregon.com
NANCY H. MALONEY, MD
JON SWIFT, DO VIVIANE UGALDE, MD MARC WAGNER, MD
Send Memorial Clinic
541-382-3344
Desert Orthopedics
DEAN NAKADATE, DPM
Deschutes Footgt Ankle
BROOKE HALL, MD
St. Charles Preoperative Medicine
1501 NE Medical Center Drive• Bend
Locations in Bend Sa Redmond
929 SW Simpson Ave, Ste 220• Bend 541 -317-5600 w
2500 NE Neff Road• Bend 5
41-70 G-2949 w
w w .deschutesfootandankle.com
ww. s tcharleshealthcare.org
DVERTISINGSUPPLEMENT
2013 CENTRAL OREGON MEDICAL DIRECTORY s
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JONATHON BRKWKR, DO
Bend Memorial Clinic
JAMIE DAVID CONKLIN, MD
St. Charles Pulmonary Clinic
LOUIS D'AVIGNON, MD
Bend Memorial Clinic
ERIC S. DILDINK, PA-C
Bend Eastside 8t Redmond
541-382-4900
www .bendmemorialclinic.com
Locations in Bend gt Redmond
541-70G-7715
www.stcharleshealthcare.org
Bend Eastside gt Redmond
541-382-4900
www.bendmemorialclinic.com
St. Charles Pulmonary Clinic
Locations in Bend gt 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
KKITH W. HARLKSS, MD
St. Charles Pulmonary Clinic
Locations in Bend gt Redmond
541-70G-7715
www.stcharleshealthcare.org
MATT HEGEWALD, MD
St. Charles Pulmonary Clinic
Locations in Bend gt Redmond
541-70G-7715
www.stcharleshealthcare.org
T. CHRISTOPHER KELLEY, DO
Bend Memorial Clinic
Bend Eastside gt Redmond
541-382-4900
www.bendmemorialclinic.com
JONATHON MCFADYKN, NP
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
Locations in Bend gt Redmond
541-70G-7715
KKVIN SHKRKR, MD
St. Charles Pulmonary Clinic
s
T
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
Deschutes Rheumatology
2200 NE Neff Road,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
Locations in Bend gt Redmond
541-706-6905
www . stcharleshealthcare.org
DAVID L. DEDRICK, MD
St. Charles Sleep Center
Locations in Bend gt Redmond
541-706-6905
www .stcharleshealthcare.org
Bend Eastside gt Redmond
541-382-4900
www .bendmemorialclinic.com
T. CHRISTOPHER KELLEY, DO I
s
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Bend Memorial Clinic Sleep Disorders Center •
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41-70 G -7725 w
www.stcharleshealthcare.org
ww. s tcharleshealthcare.org
ww w .bendmemorialclinic.com
I
i 1655 SWHighland Ave,Ste 6• Redmond
541-923-2019 i
DAVID HERRIN, DC
Redmond Wellnessgt Chiropractic
TIMOTHY L.BKARD, MD, FACS
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
DARA H. CHRISTANTE, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www .bendmemorialclinic.com
ww w .bendmemorialclinic.com
www.drherrin.com
ww w .bendmemorialclinic.com
GARY J. FREI, MD, FACS
Bend Memorial Clinic
Bend Eastside gt Redmond
541-382-4900
JACK W. HARTLEY, MD, FACS
St. Charles Surgical Specialists
1245 NW 4th Street, ¹101• Redmond
541-548-77G1
www .stcharleshealthcare.org
DARREN M.KOWALSKI, MD, FACS
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
ww w .bendmemorialclinic.com
JOHN C. LAND, MD, FACS
St. Charles Surgical Specialists
1245 NW4th Street, ¹101• Redmond
541-548-7761
www.stcharleshealthcare.org
ANDRKW SARGKNT, PA-C, MS
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www.bendmemorialclinic.com
GEORGE T. TSAI, MD, FACS
St. Charles Surgical Specialists
1245 NW 4th Street, ¹101• Redmond
541-548-7761
www.stcharleshealthcare.org
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
KRIN WALLING, MD, FACS
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend 541-382-4900 w
JEFF CABA, PA-C
Bend Memorial Clinic
Bend Eastside, Westside gt Redmond 541-382-4900
ww w .bendmemorialclinic.com
ANN CLEMENS, MD
Bend Memorial Clinic
Bend Eastside, Westside gt Redmon
541-382-4900
www.bendmemorialclinic.com
TERESA COUSINKAU, PA-C
Bend Memorial Clinic
Bend Eastside, Westside 8 Redmond
541-382-4900
www.bendmemorialclinic.com
2G00 NE Neff Road• Bend
541-70G-3700
www.stcharleshealthcare.org
DANETTK ELLIOT-MULLKNS, DO St. Charles Immediate Care
ww . bendmemorialclinic.com
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 8 Redmond
541-382-4900
JAY O'BRIEN, PA-C
Bend Memorial Clinic
Bend Eastside, Westside gt Redmond
541-382-4900
www.bendmemorialclinic.com
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Bend Memorial Clinic
Bend Eastside, Westside gt Redmond
541-382-4900
www.bendmemorialclinic.com
DVERTISINGSUPPLEMENT
2013 CENTRAL OREGON MEDICAL DIRECTORY LAURIE D. PONTE, MD
Bend Memorial Clinic
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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
www.bendmemorialclinic.com
THOMAS H. WENDEL, MD
Bend Memorial Clinic
Bend Eastside, Westside gt Redmond
541-382-4900
www.bendmemorialclinic.com
BRENT C. WESENBERG, MD
Bend Memorial Clinic
I Bend Eastside, Westside gt Redmond I 541-382-4900
www.bendmemorialclinic.com
MEREDITH BAKER, MD
Bend Urology Associates
2090 NE Wyatt Court• Bend
541-382-G447
www.bendurology.com
MICHEL BOILEAU, MD
Bend Urology Associates
2090 NE Wyatt Court• Bend
541-382-G447
www.bendurology.com
3ACK BREWER, MD
Bend Urology Associates
2090 NE Wyatt Court• Bend
541-382-G447
www.bendurology.com
ANDREW NEEB, MD
Urology Specialists of Oregon
2084 NE Professional Court• Bend
541-322-5753
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BRIAN O'HOLLAREN, MD
Bend Urology Associates
2090 NE Wyatt Court• Bend
541-382-G447
www.bendurology.com
ERIC SHREVE, MD
Bend Urology Associates
2090 NE Wyatt Court• Bend
541-382-G447
www.bendurology.com
MATTHEW N. SIMMONS, MD
U r o logy Specialists of Oregon
2084 NE Professional Court• Bend
541-322-5753
ht t p : or. //usof praxismedicalgroup.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,3R.,MD,EACS
InoviaVein Spedalty Center
2200 NE Neff Road, Ste 204• Bend
541-382-834G
www.bendvein.com
ANDREW 30NES, MD, FACS
Ino via Vein Spedalty Center
2200 NE Neff Road, Ste 204• Bend
541-382-834G
www.bendvein.com
DARREN KOWALSKI, MD
Bend Memorial Clinic
1501 NE Medical Center Drive• Bend
541-382-4900
www .advancedspecialtycare.com
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1501 NE Medical Center Drive• Bend 541-382-4900 w
30SEPH COLELLA, MD,PACS Bend Memorial Clinic
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Comp ete Hea th 8 We ness • High Cholesterol
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Continued from Page 31
ably depends on how committed the would-be golfer is to the sport. "Do yourself a favor and invest up front, because it's going to pay off in the long haul," Heinly says. "If you start dinking around with inferior equipment that doesn't fit you and doesn't reward
you, you're not going to like this game." Local retailers such as Pro Golf of Bend and pro shops at nearly every golf course have pros on site who can help find the best set, Heinly adds. $
Taking it to the course $
For beginners, picking the right golf course is important. Choosing forward tees (tees set closest to the hole) is a good way to make ordinarily tough golfcourses more playable for less skilled golfers. But in Central Oregon, which is no stranger to championship golf, courses such as Crosswater Club in Sunriver or Tetherow Golf Club in Bend could prove tough for a novice. Garza recommends less expensive, straightforward golfcourses suchas The Greens atRedmond or The Challenge Course at Eagle Crest Resort in Redmond, or the nine-hole Old Back Nine at
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Those courses are shorter in length than a typical regulation course and will help a budding golfer get comfortable. Garza also suggests playing at twilight or in early morning hours,when green fees tend to be less expensive and the courses are less crowded. Nielsen says picking a course nearest to home will get golfers out more often. "Don't be nervous about playing golf — be excited," Nielsen adds. "It's so rare to have access to something that can enrich you for a lifetime. You use it to strengthen your family bonds, develop important business relationships and initiate friendships that last
fordecades.Thegame ofgolfcan teachyou so much about yourself and helps to strengthen your character and integrity."•
WINTER/SPRING 2013• HIGH DESERTPULSE
Page 49
Call or appointments: 382-9383 John Stasst.n, MD — Cloe Shelton, MD —Ronald D. Hanson, MD Will Wheir, MD — James E.Johnson, MD — Patrick B. Brown, MD Jeffrey Drutman, MD - Traci Clautice-Engle, MD - Laurie A. Martin, MD Steven D. Kjokech, MD - Garrett Schroeder - Thomas E Koehler, MD Robert E. Hogan, MD - Stephen Shultz, MD - Paula Shultz, MD David R. Zulauf, MD — Steven J. Michel, MD
Cover story(POSTTRALIMATIC STRESS DISORDER Continued from Page 13
some discussion of the trauma, although it
count what is most painful to them. Hunter believes individual treatment strat-
them. It's about getting "unstuck."
need not delve into the details. Clients also
Another similar strategy, prolonged ex- egies should be handled with care. The Vet posure therapy, asks the veteran to discuss Center offers cognitive processing therapy the trauma until it's no longer so charged. It and other methods. It also holds group sesmight also involve homework, like listening sions that are more general conversations to tapes or facing one's fears. For instance, about feelings and life skills. an Iraq vet trained to scour roads for possible The variety is important, he said, as what lEDs might be asked to drive up and down works for one soldier might not for another. "Some guys can be retraumatized," Hunthighways to neutralize the experience. In roughly 60 sites around the country, er said. "And we've got to be really careful prolonged exposure therapy has gone from about that." the counselor's office to putting veterans Others maintain that it's unnecessary to into video-game style experiences called vir- make returned soldiers relive the details of tual-reality exposure. One, called Virtual Iraq, awful moments. started making headlines about five years Forte, who began practicing in 1977, spent ago. Wearing a head apparatus, veterans con- years engaging in cognitive behavior therafrontdesertscenes accompanied by sounds py with trauma victims. Then in the early like gunfire, incoming mortar rounds and 1990s, she encountered what was then a screams. A separate machine added smells new strategy called eye movement desensilike burning rubber, sweat and diesel fuel. tization and reprocessing, or EMDR. "It's more efficient and more effective than Empirical evidence suggests that such therapies work. But some therapists are cau- any other therapy I've ever used," she said. tious about continually making veterans reEMDR is a multistep process that involves
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ear, then the other. Or they hold vibrating
buzzers in each hand, the sensations going from one side to the other like a metronome. Or in the simplest version, a therapist uses fingers or holds an object like a pen and asks the client to watch it as it moves back and forth. It's called "bilateral stimulation." Scans
show that each side of the brain lights up correspondingly from left to right. It's similar to the rapid eye movement that
takes place during deep dream sleep, said Giffin, who also uses EMDR.While scientists don't quite know why it works, what it does, she said, is take the charge out of painful memories. Forte said EMDR even gets good results in clients who start out seeing it as a bit
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identify happy memories or images in which to ground themselves. Then, clients are asked to discuss in general terms the source of the trauma and the feelings that arise. Simultaneously, they wear headphones with a tone that sounds in one
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connection to healing. Libby,who has published a number of it," she said. PTSD-related research papers, noted that In addition to these treatment strategies, some newer approaches have more empiriveterans and caregivers are now trying oth- cal evidence supporting them than others. That's why he advocates for veterans using er ways to deal with the pain. One organization, the Washington, D.C.- yoga and mindfulness practices like meditabased Center for Mind-Body Medicine, is tion and focusing on breathing to manage piloting groups for returned soldiers in part- their PTSD. He also founded a nonprofit nership with Veterans Affairs in several loca- called the Veterans Yoga Project. "You're using your mind to focus on physitions across the country. The groups employ techniques like meditation, self-hypnosis and ological sensations, and that is I think the core guided imagery — using thoughts to guide skill or core practice for the treatment of PTSD," the imagination toward a relaxed state. he said. "It helps these men and women learn Judith Pedersen-Benn is on the center's how to become comfortable in their own skin. "By guiding consciousness, guiding your faculty and is herself a group facilitator. She said the groups aren't considered therapy attention inward," he added, "you're able to — there isn't a required discussion of past process through that and gain some meaevents and group leaders don't necessarily sure of control." have clinical degrees. Yet in limited research On a less formal level, Giffin, who also from a site in Louisiana, she said, partici- guides meditation groups and is a certified pantsreported a decrease of PTSD symp- yoga instructor, said she will at times incortoms of up to 90 percent. porate movement of the body into her work. Other efforts are adding techniques like During therapy sessions, she may ask a climeditation to traditional treatment strate- ent to move into a yoga pose and then disgies. A 2012 study assessing PTSD treat- cuss the feelings that come up. "I say, 'Let's try a position,"' she said. "I don't ments in the journal Psychiatry said 96 percent of Veterans Affairs treatment programs use the word 'yoga' if they seem allergic to it." had a complementary element, like yoga or Just as a smell, sound or object can trigger mindfulness practices. The majority of those a response of fear and panic, Ciffin said, a elements, it noted, focused on a mind-body body position can tell the brain that it is safe.
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She sometimes asks clients to lie on the floor with their legs up on the wall, forming a 90-degree angle. "You would never have your legs over your head if you were not safe," she said. "It's a neural signal." Even caninecompanionship is seen as a healing option. Leeberg said she has written veterans authorization letters so they
can beaccompanied in public places by an emotional-support dog, in a similar vein to a seeing-eyedog. Forsomeone with PTSD,a therapy dog can provide a real support system — mellow and loving, yet ever vigilant for signs of trouble. "Your dog has got your back," she said.
Seeking help Experts believe if treated early on, veterans canbe cured of PTSD. Butthey need to get the help. A 2012 Institute of Medicine report for the
Department ofDefense says that among those who served in Afghanistan and Iraq and tested positive for PTSD, only a bit more than half have received treatment.
Revealing PTSD-related symptoms can delay soldiers returning home as they are diverted to military health facilities. So they
aren't inclined to self-report. In one 2011 study of an Army brigade returning from Iraq, some soldiers filled out
Page 51
Cover story(POSTTRALIMATIC STRESS DISORDER both a regular post-deployment health assessment and an anonymous one. When compared, the positive responses for PTSD in the anonymous survey were double those in the official version. Also, a bias remains against seeking mental health help. Hunter said he sometimes M
LLLAQ MIDDLE EAST
Maps of conflict zones line the hallway at the Central Oregon Vet Center. Veterans can then point out where they served. RYAN BRENNECKE
D
will not even mention the phrase PTSD while working with veterans. Some in the
military are advocating for dropping the word "disorder," simply calling it post-traumatic stress or post-traumatic stress injury.
A good portion of a soldier's worry stems from a belief that getting help will damage a career in the military or one outside it, such as law enforcement. "There is a stigma against mental hurt, she said, and their loved ones — who health treatment," Libby said. "Having mental health treatment is a serious ob-
stacle to career goals."
now know what PTSD is — are more apt to push them toward treatment. "Their wives insist," she said. "It's one of the
portive community. Veterans groups, like Band of Brothers, are very active here. The Veterans Affairs clinic and the Vet Center pro-
vide outlets for services. It's now about persuading these soldiers to reasons they're getting help earlier." Moving on? Leeberg, who is also a Central Oregon Vet- reach out. "There's a choice now,D Forte said. "There's Henderson believes he will never be erans Outreach board member, said Central fully free from PTSD. The extent of his ex- Oregon veteransalso come home to a sup- a choice for healing."• periences in Vietnam and the years it was suppressed means he will manage it like a chronic illness. M War ravages the human soul," he said. "The woundsofwar may be physical,but there is always also a soul wound. It raises havoc with what it is to be human."
Through the years he has used various tools to keep it at bay. Exercise, he realizes now, played a critical role: One trigger to his downward spiral was being laid up after blowing out his knee. He also turned to faith. He became a pastor in 1977. Yet he believes telling people that Cod can heal all wounds is counterproductive, as it can prevent them
from seeking help they need. M
D
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I knew God forgave me, he said, but I
needed to forgive myself." Since 1999, when he was twice admitted to a Veterans Affairs hospital for inpatient
treatment, Henderson has also received outpatient counseling, written poetry and
talked openly about his experience. He said it's still painful, but it's a better existence be-
cause he now feels honest about his life. Leeberg believes veterans of the past decade are less likely to suffer in silence than previous generations. They are less likely to keep plowing ahead through the
Page 52
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1. Horripilation 2. Epistaxis 3. Xerostomia 4. Pruritus ani 5. Aphthous ulcer 6. Hallux valgus 7. Tinea pedis 8. Cerumen 9.Xerosis 10. Borborygmus 11.Eructation 12. Herpes labialis 13. Pityriasis capitis 14.Singultus 15. Sternutation 16.Sialorrhea 17.Oscitation 18. Ecchymosis 19. Lachrymation 20. Bulla 3 'OZ
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HIGHDESERTPULSEâ&#x20AC;˘ WINTER/SPRING 2013
Page 53
One voice ~ ApERsoNALEssAY
o o ies,wit asi eo
So I've been giving myself assignments in the past few months to try to incorporate more fruits and vegetables into my diet. It has been,shallwe say,a bumpy ride.
BY SHEILA G. MILLER
s I write this, I'm sitting at my desk eating cookies.
I'm not proud. I'm a 32-year-old woman with the palate of a 10-year-old boy. Here's the deal: I hate eating fruits and vegetables. Left entirely to my own devices, I would subsist on cheese, pasta, popcorn, potatoes and combinations thereof. I will eat bananas, but only because if I don't, my legs cramp when I go running. Vegetables? Unless they're covered in ranch dressing or have bacon bits on
j ~ i
ized that if I'm to avoid bankruptcy and massive weight gain, I probably need to
tiny camp grill right next to the burger I was cooking, then ate the burger and left most of the veggies. Last fall, I ordered a box of produce from a local co-op. It was horrifying. I ended up with four Asian pears, four Cravenstein apples, two tomatoes, two ears of corn, a dozen fingerling potatoes, and a pint of strawberries. Oh, and a big pile of leafy greens that, to be honest, I could not identify.
That's, seriously, more fruit and vegetables than I've had in my fridge at any one time since I moved to Bend six years ago.
start thinking about what goes into my
body. It's not pretty.
still fried.
At first I was overzealous. I tried to make smoothies, then left the
dirty blender in the sink for three days. I asked the Whole Foods people what kale looked like, bought a bunch of it, tried it, hated it, let it wilt. I grilled vegetables on my
them, I'm not particularly interested. But in the past few months, I've real-
Mostly it's beer and wine, and whatever foods are served where beer and wine are sold. Mac and cheese? Absolutely. Bacon cheeseburgers? I'll take two. Veggie tempura? Only because the girls at my table are vegetarian, and it's
ae
I didn't eat all of it. I tried. I gave away I'
the corn, because I can't even express how much I dislike corn (popcorn is different). I immediately cooked the potatoes; I put slices of the tomatoes into
grilled cheese sandwiches (this is major progress), and brought the apples to work. That's what I managed before it all went bad and I felt guilty.
I was not raised like this. My family ate together every night of the week when After that, I realized I'd have to take a I was growing up, and my mother dutimore balanced approach. »i i« c» se s PI«c » « r P« « « h~ PS "" ' I've made a deal with myself. When fully served a vegetable and enforced the " ' was hard. (Later she ate the chiPs.) eating of said vegetable and the drinking I go out to eat, I almost always order a of a full glass of milk. side salad. I eat it first, then the entree. At But I was also a skinny kid who played sports about three hours leastone daya week, I try not to eat meat. I can do that — I grew up each day, and was burning enough calories in the average day to eat Catholic with Fish Fridays. I've started slipping greens into my pasta sauce. like a linebacker. Problem? When I stopped playing sports for three hours each day, I t ' s not great. But it's certainly an improvement. And if I've learned I continued to eat like a linebacker. I don't look like a linebacker. But I to stuff fewer cookies into my mouth because I'm full from eating am vain enough to worry that someday I will. salad, who knows what 2013 might hold?•
Page 54
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