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physically, mentally, spiritually
LiveWell
Issue 9 Spring 2016
EXPANDED HORIZONS
Why travel experiences can be the best medicine around
HEALTHY AND HAPPY New pot shops promoting now-legal options
FOOD ALLERGIES Cooking for Special Diets THE POWER OF FLOWERS A super scent is a great natural remedy spokesman.com/health
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TABLE OF CONTENTS
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TRAVEL ADVENTURES
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SEASONAL EATING
How getting out of our comfort zone Is it time for spring cleaning can be super for our relationships for your diet?
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COOKING WITH CARE Allergy sufferers can learn to substitute
F LOWER POWER
Why our brains crave pleasant scents
6 FITNESS FAILS Learning to overcome gym anxieties can lead to a healthier you
16 COOKING WHILE BATTLING CANCER Boost your immune system with these healthy ingredients
18 A CLOSER LOOK AT DAIRY ALLERGIES Milk products may be in more food than you would guess
20 FEELING FUZZY? Learn how to keep ‘brain fog’ at bay by changing your diet
24 BIKING SAFELY New riders can get the skinny on safer spots to ride around Spokane
26 FEAR FACTORS Learn common reasons why some things give us the heebie-jeebies
28 A QUALITY FOCUS New pot shops put extra effort into inspection
30 CANNABIS CUSTOMERS RECEIVE EDUCATION Many options beyond smoking
32 OTHER POSSIBLE BENEFITS OF POT Older THC studies now getting a second look
34 WHY PEOPLE LOVE VAPING Medical pros vary on safety of alternatives to cigarettes
36 LIFE LESSONS How future vets are learning empathy during the grieving process
39 HAPPY MEMORIES Families create inspiring ways to remember departed loved ones
42 HEALTHY TEETH, HEALTHY BODIES Why good dental habits can benefit your whole body
Connect with us!
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Advertising Supplement to The Spokesman−Review an S−R Media Company • spokesman.com • Sunday, April 24, 2016
Calendar of Events May
July
May 1 Bloomsday
July 9 The Dirty Dash, Riverside State Park
The world’s largest timed road race invites fitness fans to run, walk, or push themselves through a 12K course through Spokane. Bloomsday celebrates 40 years, and more than 50,000 people are expected take part. www.bloomsdayrun.org
Get fit and get muddy by navigating a sloppy 5K course. www.thedirtydash.com/
May 29 Coeur d’Alene Marathon
If you’ve been wanting to try new outdoor recreation activities for your health, check out this event that includes demos and clinics for StandUp Paddleboards, mountain bikes, rock climbing, slacklining and more. www.spokatopia.com/
Enjoy a scenic full or half marathon or a 5K. www.cdamarathon.com/
June June 5 Windermere Marathon and Half Marathon, Spokane Besides providing great scenery, the USATF-certified event is a qualifier for Boston. Finishers also receive a special medallion and a rose. windermeremarathon.com/
June 11 Color Me Rad, Spokane County Raceway Lots of bright paint and bright clothing make this 5K ‘80s-themed fitness event awesome to the max. www.colormerad.com/location/spokane/
July 9 Spokatopia Outdoor Adventure Festival, throughout Spokane
August Aug. 14 Coeur d’Alene Crossing Join in the fun with thousands of other water fans as you swim 2.4 miles across Lake Coeur d’Alene. Event benefits Union Gospel Mission, North Idaho College Booster Club and Coeur d’Alene Area Swim Team. cdacrossing.com
Northwest Attorneys
Helping People Solve Problems®
Up for fun and fitness this spring and summer? Then check out these wellness events taking place in the Inland Northwest.
IF YOU’VE BEEN HARMED BY A DRUG OR MEDICAL DEVICE, INCLUDING:
Pelvic Mesh • IVC Filter • Xarelto • Invokana
For story suggestions contact Joe Butler at (509) 459-5059 or joebu@spokesman.com
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We are attorneys, not case brokers; we will represent you.
For advertising opportunities contact Bill Davidson at (509) 459-5272 or billd@spokesman.com.
LOCAL ATTORNEYS WITH NATIONAL EXPERIENCE
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1626 Lincoln Way Coeur d’Alene, Idaho 83814
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Contributors STACI LEHMAN
RENEE SANDE
Staci Lehman is a local freelance writer and public outreach professional. You can read more of her work at www.StaciLehman.com.
A Spokane native, Renee Sande has spent 15 years in communications, from PR to publishing, and is currently a freelance writer and designer who enjoys traveling and the greener side of things. Reneesandecom.com
S. MICHAL BENNETT S. Michal Bennett is a freelance writer, editor, poet and blogger. She and her husband live in Coeur d’Alene, where she often succumbs to the allure of the outdoors, local living, and fresh, delicious food and drink adventures. Learn more at www.shortandtasty.blogspot.com.
SHALLAN KNOWLES Shallan Knowles is a web designer, photographer, yoga instructor and owner of GlutenFreeSpoakne.com, which covers gluten-free dining options around the Inland Northwest.
BILL DAVIDSON MARIESA STOKES Living the dream and loving the view, Mariesa Stokes is a Spokane transplant, health and wellness writer and obsessive beagle mom. Explore more of her work at mariesastokes.com.
Bill Davidson has worked for The Spokesman-Review for the past 8 years. Working with his great healthcare clients to communicate their programs and care solutions in LiveWell is a pleasure!
CHERYL-ANNE MILLSAP JEAN ARTHUR Jean Arthur writes from Bozeman, Mont., where her latest book on hiking and culturally significant areas in Northwest Montana, “Top Trails: Glacier National Park,” was published by Wilderness Press.
ERIKA PRINS Erika Prins lives and writes in downtown Spokane. She stays healthy by running, playing Ultimate Frisbee and eating her vegetables. Find more of her writing at erikaprins.com.
Cheryl-Anne Millsap is a travel writer whose audio essays can be heard on Spokane Public Radio and on public radio stations across the country. She is the author of ‘Home Planet: A Life in Four Seasons.’
DAN WEBSTER Dan Webster writes for Spokane7.com, and he both reviews movies for Spokane Public Radio and serves as co-host of the radio station’s popular moviediscussion show “Movies 101.”
COURTNEY DUNHAM Courtney Dunham is a screenwriter and co-founder of Garage Girls Productions. She believes living well includes time with her people, dogs, and traveling. She enjoys watching movies and football, and walking at the ocean.
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Fitness fails Gyms try to reduce fears of not fitting in
By Erika Prins LiveWell Correspondent Going to the gym and getting laughed or silently judged by other members — you know, the ones with the sculpted, tan, shiny muscles, who you’re sure know exactly what they’re doing — is the stuff of nightmares. “This is honestly the No. 1 reason people don’t join a gym right away,” said Chanze Patterson, partner and executive director of fitness at Muv Fitness. “[Prospective members] feel like they have to be fit or they have to lose weight before they join.” But that nightmare is far from the reality, according to Patterson. She and John Harshman, health and wellness director at the North Spokane YMCA, have a few tips to talk newcomers out of common gym anxieties. 1. I’m not in gym shape, so I can’t join yet. Tip: Go anyway. Just like you, most members are there because they want to get into better shape.
2. I don’t own the right shoes or that correct brand of workout clothes. Tip: Think more about how you feel in your clothes than whether they’re up to pro-athlete standards. Seeing what your body can do builds confidence—the outfit that feels “blah” when you get there may feel much better once you’ve broken your own Personal Record on the stair climber or sweated your way through your first Barre class. Feeling your clothes in action can make you aware of spots that rub and fit issues to be aware of before dropping a bunch of cash on stylish outfits that may not suit your needs. After a few workouts, you’ll have a better idea of whether you do need a new item or two.
Harshman says those grunting weightlifters may have more in common with new members than they think.
For a basic workout, anything comfortable and flexible will do. Today, Patterson is wearing yoga pants and Chuck Taylors, which wouldn’t be ideal for a jog on the treadmill, but are just fine for the stationary bike and weightlifting.
“Maybe they themselves have gone through a process where they’ve lost 15, 20 pounds— and they may now be ‘in shape,’ but they’ve still been through that process,” he said. “The reality is, they typically are some of the nicest people in the gym. But if you don’t get out of that comfort zone and break down some of those stereotypes, you’ll never know.”
If it turns out you love to run, you can invest in a pair of quality running Photo by Erika Prins Spokane resident Taylor Weech exercises at Central YMCA. shoes a
The gym is a perfect place to start working toward fitness goals. For the most part, members are more concerned with their own bodies and workouts than forming opinions about the physiques of those around them. In fact, they’re likely a little insecure, too.
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little farther down the line. Perhaps you’ll prefer group yoga classes and won’t need those running shoes after all. Despite being a career gym rat, Patterson’s criteria remain simple: “Whatever’s comfortable, as long as it’s not jeans.” 3. I don’t know how to use the machines and free weights. Tip: Get help from the trainers. They love to share their knowledge! Both the YMCA and Muv offer new members two free personal training sessions. They’re an opportunity to learn the machines, set goals and make a realistic plan for how to achieve them. At Muv, members also get one free training session per month for the life of their membership. Even when you’re not making the most of your free sessions, the trainers and other staff at a gym hang around specifically to assist members, says Harshman. Approaching them with questions is the best way to let them know how they can help you. “Don’t be afraid to ask anything,” said Patterson. “We’ve probably heard it before. You’re not going to be the first person to ask.”
In fact, she says, she’s passionate about working out and enjoys any chance she gets to share her knowledge with others. “We’re little fitness encyclopedias and an encyclopedia only does so much good sitting on the shelf.” 4. I’d like to do a group fitness class, but I don’t know if I can keep up. Tip: Get there early and communicate with your instructor about your needs. Taking a yoga, Pilates or other group fitness class at the YMCA can help you connect with other gym-goers, Harshman says. “You get a small community feel in those classes. The more you are connected to other people, the more successful you will be at a gym,” he said. Some YMCA classes, like Silver Sneakers classes for seniors, tailor workouts to the needs of a particular demographic group, which can lead to friendships centered around fitness goals.
Courtesy Muv Fitness The staff at Muv Fitness tries to emphasize person touches in its personal training and continue the relationship beyond initial orientation.
Still, trying a new class can feel intimidating, especially if you don’t know what to expect.
the workout to fit your current abilities.
Harshman recommends asking a staff member to introduce you to the instructor and help you get comfortable in the class. Let the instructor know you’re new and they can help you adjust
“The No. 1 thing is just to encourage people to ask questions,” he said. “That’s what we’re here for: We’re here to help.”
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The power of T
FL WERS Pleasant aromas can be a natural antidepressant By Staci Lehman LiveWell Correspondent Have you picked out your yard’s spring wardrobe yet? When deciding what kind of flowers and plants to buy this year to dress up your yard, don’t just consider color. Think about what your plants will smell like. The scent of a plant can act as a kind of an all-natural aromatherapy to change your mood for the better. The practice of aromatherapy uses oils extracted from flowers and plants to enhance psychological and physical health. The fragrance of fresh flowers and bedding plants can also have a similar pleasing effect. Just ask Kathy Blair, greenhouse manager at Appleway Florist and Greenhouse in Spokane Valley, who says many floral options can increase your sense of well-being and just make you feel happy. It doesn’t have to be something extra special, expensive or especially exotic either – even common plants can make a big difference, such as petunias. “Blue and white petunias are most fragrant, especially at night after the light has been on them all day,” Blair said. She also recommends roses for a quick attitude boost. For those who equate the smell of roses with funerals or elderly relatives, Blair says there is now a range of different fragrances for different
rose varieties. She recommends a purplish-blue rose called Lavonda that she says smells “like heaven.” For a spicier scent, Blair recommends Stargazer lilies, which are often used to liven up bouquets with their strong fragrance. When shopping for plants for their therapeutic aromatic power, keep in mind that brightly colored blooms generally have the strongest smells. Light-colored blossoms such as white, pink and yellow have the faintest fragrance. There is an exception for carnations: white ones have a cheery smell similar to cinnamon. Plants don’t need to be a blooming flower to have a positive effect on your outlook either. Blair says orange and lemon scents are known for their ability to improve moods. While growing citrus outside in Spokane’s climate may be near impossible, there are dwarf tree varieties that can be grown indoors. Herbs also have aromatherapy properties. Lavender is renowned for calming and aiding sleep. Top photo by Staci Lehman. Debbie Fleming, an Appleway Florist and Greenhouse employee, puts together a fragrant bouquet of white roses and lilies.
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Chamomile and peppermint are calming in other ways; they are used to settle upset stomachs. Plus Blair says peppermint has an alternate use that also raises spirits. “I get several kinds of peppermint. People make mojitos out of it,” she said. Once you’ve decided what to plant, where should you plant your mood-boosting flowers to get the maximum impact? Blair recommends areas anywhere you spend time. If you have a favorite spot on the deck, put your plants in pots near there. Many people grow herbs in windowsills, not just for the light, but for the added bonus of the smell. And others cluster them around walkways or regularlytraveled areas. “I had one customer who would get geraniums and plant them outside her door,” said Blair. “She would ruffle them every time she came in or out for the smell.” But why do flowers have such a strong impact on our emotions? While there is no proven medical evidence that aromatherapy prevents or cures disease, there is research showing that it improves moods and general well-being. The influence of aroma is believed to occur in the limbic system, located under the cerebrum in the brain. The limbic system includes the olfactory
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bulb, which transmits smell information from the nose to be processed in the brain. The limbic system also supports functions such as emotion and long-term memory. When these functions work together, they associate a memory with a smell, which in turns cues an emotion. Flowers, having an attractive smell, generally generate positive emotions. Plants can even help heal people faster, according to a 2008 Kansas State University study which indicated that patients in hospital rooms with flowers and plants required less post-operative pain medication. They also had lower blood pressure, were less stressed or tired, and displayed a more positive outlook than patients in rooms without plants. Lilac photos by Shallan Knowles. Many Spokane residents appreciate the aroma of lilacs.
Plants can also keep you physically healthy by keeping critters away. “At our cabin I crunch up the leaves of geraniums to release the smell and never got bit by mosquitoes,” Blair said. While it is a little too early for mosquitoes now, it is almost time to plant your flowers for the season. The old rule about waiting to plant annuals until at least Mother’s Day still applies, according to Blair. Perennials can be planted a little earlier, right about now, in April.
Blair says many people come to wander the greenhouses this time of year because the heat feels good and they tell her the flowers make them feel good. She also has employees who work there for the same reason. “I’ve had two people that I interviewed and when I asked why they want to work here they said, ‘Because it makes me happy when I come in here.’” E N R I C H E D L I V I N G . L A S T I N G VA L U E .
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Can travel boost our mental health or drive us batty?
EXPANDED HORIZONS By Cheryl-Anne Millsap LiveWell Correspondent
Somewhere around day three of your vacation, you realized that constant twinge in your neck has lessened. You’re actually sleeping better. You’re waking up on your own, without the jangle of the alarm, and you can’t remember the last time you felt so rested. You’re relaxed and happy. You might even ask yourself why you don’t get out of town more often. That’s when you start to suspect that, for all its hassles and irritations, travel might actually be good for you.
Mind and Body There’s scientific evidence that the sense of satisfaction and stress-relief you experience when traveling is real. “Travel is a mind-expanding experience, especially when you look at different cultures, eat different food, and see different ways of doing things,” said Randi O’Brien, a Psychiatric Nurse Practitioner who teaches psychiatric nursing at Washington State University. “When you come home you’ve let your mind expand.” She says travel benefits us in ways we may not even realize. Dr. Melissa Flaherty, a Spokane hospitalist and emergency room physician, says there are clear mental and physical benefits to getting away from the work and worry of our everyday lives. “Even a short vacation provides more positive thoughts for longer than a similar time in a well-known environment,” she said.“People who experience more positive thoughts have much less depression, fewer headaches, fewer ulcers, and other illnesses.” And for senior travelers, there’s evidence that travel can keep the mind sharp and limber. “We know that people who keep their minds stimulated and active are less likely to develop dementia or, if they do develop it, it occurs at an older age,” says Flaherty. “The novelty of travel presents many mind-challenging situations, finding directions, seeing and learning about new sights and cultures, calculating money exchanges, adjusting to time variations, to mention just a few.”
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Photo by Cheryl-Anne Millsap Travel can be a boost to one’s mental health, especially with memorable moments like a sunset aboard a cruise ship.
Rekindling Romance In 2013 the National Travel Association released a report based on a survey of 1,000 couples suggesting that couples who travel together have better and more frequent sex. Evidence suggests the rekindled romance lingers even after the trip is over and they’re back home and back to work. Katy (last name withheld because she doesn’t want to embarrass her teenage sons) agrees. She plans adults-only getaways for herself and her husband several times a year because she believes the time spent together ramps up the romance. “We’re young again when we go away,� she said. “We do silly things like skinny dipping in the pool or making out on the balcony. He buys me lingerie and surprises me with it. I put a bottle of champagne by the tub. The point is, we don’t act like Mom and Dad. We act like the two people who fell in love and became Mom and Dad.�
Family Fun Travel isn’t just for grown-ups. Family vacations open a wider door to the world for children. Robin Andrus, a child psychologist, believes travel and hands-on experiences can make a big difference in a child’s development. And it isn’t necessary to go around the world to reap the benefit. “Local travel opens up a richness in experiences equally as valuable as travel afar,� she said. “I have seen children demonstrate initial hesitance with new places and experiences, but then exuberance and joy as they feel supported by adults and explore their new surroundings.�
Unexpected Benefits Travel keeps the mind sharp and puts the sizzle back in relationships, but there are a number of small, sometimes unexpected benefits from adventuring. Frequent travelers find they’re more physically active while on vacation. It’s easy to walk for miles when visiting large cities like Paris, London or even New York, burning extra calories as you go.
International travel often puts you in situations where you have to solve problems and face challenges like navigating unknown cities and cultures, and communicate with people who many not speak your language. For most people, that boosts self-confidence and heightens the enjoyment. Flaherty asserts that one small but important benefit of travel is that it lifts us out of a narrow view of our own lives. “Often when we travel, we learn how privileged we are. We put our lives more appropriately into perspective, and by seeing challenges others face, realize ours are often minimal by comparison,� she said. “This helps to decrease the ‘poor me’ thought process, which can also reduce stress and depression.�
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The Spring Plate Discover what fruits, veggies can best boost your health this season By S. Michal Bennett LiveWell Correspondent Spring is a time of renewal and cleansing as we shed the heaviness and gloom of winter and anticipate the arrival of abundant sunshine and blossoming gardens. As nature rejuvenates itself, our cultural habits drive us towards tasks like cleaning out closets, organizing desks, painting old walls and revitalizing ourselves on other levels. With a little thoughtfulness, we can also refresh our diets and prepare our bodies, inside and out, for the warmth and activity of summer.
From Heavy to Light Cold-weather foods, such as stews, home-baked breads and meats slathered in rich sauces and gravies, are excellent for warming and comforting us during the harsh cold weather months. But in spring, sticking to this type of hefty diet can cause lethargy, an excess of mucus and perhaps an influx of seasonal allergies. When ‘spring cleaning’ your grocery list for lighter fare, think about ways to incorporate more spicy, astringent and pungent foods into your menu. Sauté some bitter greens, such as dandelion or arugula, and add them to your eggs in the morning. A snack of apples baked with cardamom and ginger can warm up your senses while invigorating your constitution. Spice up burgers and chicken breasts with green chilies or pickled jalapenos, and complement them with a light side of quinoa. Finally, cut back on sugar, dairy and oily foods, opting instead for a bowl of berries drizzled with raw honey and topped with a mash of dates, nuts and seeds. Check out “Ani’s Raw Food Desserts” for incredibly tasty, refined sugarfree and easy-to-make treats that will satisfy your sweet tooth and stimulate your body.
Photos by Shallan Knowles The greater Spokane area has about a dozen farmers markets, where it’s easy to get fresh, seasonal produce from local farmers and craftspeople. The Spokane Farmers Market, top and bottom, features a variety of vendors, including Tarawyn Waters, top photo, from Urban Eden Farms.
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The Return of Fresh This season also signifies the return of fresh, local foods. Here in the Inland Northwest, lettuces and hardy greens, like kale and collards, thrive in the cool rainy weather. Tropical fruits from other regions are still available, but strawberries are beginning to flourish right around now. Wild mushrooms also enjoy the damp, thawing soil, so get out there and hunt morels! Now is also the time to start plants indoors and sprout herbs. A fantastic way to mildly detox and add concentrated nutrients to your diet is microgreens. Microgreens are herb or vegetable seedlings harvested less than 14 days after germination.” Remember Chia Pets? Those kitschy items that sprout grass are actually incubators for chia microgreens. The Journal of Agricultural and Food Chemistry and other studies show that microgreens have a range of 4 to 40 percent more nutrient concentration, compared to their mature versions. Growing microgreens is as easy as nurturing plant starters, and there are kits available online or at your favorite garden center to make it even simpler.
What’s Available Now Want to eat healthier, seasonal food but not interested in growing your own? Many of these items are fresh and fruiting right now in our part of the world.
Strawberries Cabbage Wild greens Rhubarb Endive Onions Artichokes Fennel Parsnips Asparagus Garlic Turnips Brussels sprouts Leafy greens Sunchokes For more information regarding seasonal foods, ask the produce staff at your favorite grocer or visit localfoods.about.com.
Gluten Free? Yes Please! A gluten free diet is no longer restrictive, or bland! The options for f lavorful, healthy food start at Huckleberry’s. Come check out our ever-growing gluten free options; including scratch made salads & entrees in our Bistro, and desserts in our Bakery Department!
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COOKING FOR SPECIAL DIETS By Jean Arthur
processed.”
LiveWell Correspondent
Consumers must learn to read ingredient labels, as well as understand what may be in processed foods in an eatery.
“I thought my roommate and I were best friends until he tried to kill me,” said Mitchell Sanford, a Montana State University student from New Hampshire. “He offered me chocolate chip cookies, and I asked, ‘Any nuts?’ ‘No,’ he said. I ate one. A minute went by, and I started to feel it, my face getting puffy, skin itchy.” “I asked, ‘Are you sure there were no nuts?’” Sanford recalled. “Before I knew it, we’re in the truck heading to the ER.” Peanuts, tree nuts, milk, egg, wheat, soy, fish and crustacean shellfish: these foods represent the eight top foods that cause most allergies in the U.S. They also constitute some of the most common ingredients in meals in America’s restaurants, prepackaged foods in grocery stores, and sauces and flavorings in the pantry and refrigerator shelves. While it may make sense to simply avoid allergens, it’s also important for allergy sufferers or those who cook for them to know the troublemakers, including some of the hidden ingredients as well as pseudonyms for these products. For example, tree nuts and peanuts appear in cooking oils, extracts and distillates, which are used in chocolates, cereals, crackers, flavored coffee, frozen desserts, BBQ sauces and marinades. And cookies! Another common culprit, wheat and its allergen, gluten, is found in whole wheat and its relative. Wheat gluten is in everything from couscous to faro, Kamut (khorasan wheat), spelt and triticale. Wheat may be hidden in flavoring, both artificial and natural, as well as caramel color, some food starches, and soy, shoyu, tamari and teriyaki sauces. Even catsup! As frustrating and overwhelming as an allergy can be, the Federal Food Allergen Labeling and Consumer Protection Act requires that all packaged food sold in the U.S. must list on the label the specific tree nut. The ALCPA also demands that the word “wheat” appear if the product is an FDA-regulated food, and “made in facility where nuts are
Such ingredients impact 1 in 13 U.S. children, according to Food Allergy Research & Education, a Virginia-based research organization, which also notes that 15 million Americans have a food allergy. Including Sanford. “We were a quarter of the way to the ER, we’ve blown two stop signs and three red lights, five traffic violations and 12 blaring, honking horns,” said Sanford. “If the allergy reaction doesn’t kill me, this drive will.” Sanford’s reaction didn’t come from a packaged treat, however. The culprit was baked in a home kitchen. For cookie bakers and home chefs, it’s difficult to understand the challenges in cooking for those with food allergies or food sensitivities, but not impossible to revise recipes and purify kitchens. “When cooking for friends or family members with food allergies, it’s important to recognize that a kitchen may have allergens that affect people with allergies even if you’re not using those ingredients,” said Lynn Paul, Montana State University Extension Food and Nutrition Specialist. “Research tells us that before cooking for someone with a food allergy, you need to be sure the cooking utensils, tools and surfaces are cleaned with hot, soapy water, and rinsed thoroughly with hot water.” She says making the kitchen allergen-free means cleaning microscopic proteins in the food. “Cleaning wipes, the sterilizing antibacterial products, do not take care of the allergen protein molecules,” she said. Certainly ridding the foodprep area of bacterial contaminants is important, “but the issue here is with cross-contact of offending foods.” Paul suggests that when cooking for someone with food allergies or other dietary needs, prepare the allergy-free foods first, “and wash your hands, wash your hands, wash your hands.”
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Allergies, health issues require different focus in the kitchen Bakers may contaminate the allergy-free zone even after touching a cabinet handle or drawer. Remember that it’s not just a crumb that contaminates a gluten-free item; the protein molecule is microscopic. A reaction to a food allergy can range from a minor rash, tummy aches and death from anaphylactic shock. For Sanford, the latter is his reality. “I could tell I was losing oxygen,” he said of the ER road trip. “I really wanted to pass out. Every time I closed my eyes, my eyelids get heavier, and finally we walk into the ER, and BAM. I hit the floor.” Paul says people tend to focus on the food itself, but that’s only part of the battle. “I recommend asking your guest, or the parent of a child with a food allergy, very specific questions: ‘Here is what I’m preparing—will that work?’’” she said. “Ask the guest or parent for recipes so you can be assured that serving is allergen-free.” “My other recommendation has everyone bring their own dish to share and keep allergy-free dishes separate.” While one wayward nut-encrusted cookie nearly undid Sanford, the medical crew injected him with 150 mg Benadryl and 70 mg of epinephrine. The first was an antihistamine to counteract the allergen, and the second provided a burst of adrenalin, “which makes you feel like Superman!” Luckily for future shoppers, more and more grocers reserve shelves and freezer space for allergy-free foods.
It’s tempting to delve into how someone developed an allergy after a food allergy diagnosis. Researchers at the University of Melbourne and the Murdoch Children’s Research Institute studied 57,000 5-year-old children, seeking information regarding environment factors. The study found that kids who migrated to Australia from their birthplace in Asia had a decreased risk for allergy. The study, published in the scholarly journal, Clinical and Experimental Allergy, noted that something — an unknown something — in the Asian environment protects children from food allergies. The lead researcher, Kate Allen, noted that Australia faces an epidemic of food allergies, and Australian-born children of Asian descent were more likely to have nut allergy than non-Asian children. Children born in Asia who migrated to Australia were at decreased risk. “We know there are rising rates of migration from East Asia to Australia,” Allen says on the Murdoch Children’s Research Institute blog. “Our finding that migration from Asia to Australia after birth can protect against early onset allergic disease such as food allergy provides a potent clue to follow when trying to understand why food allergy is on the rise.” The question remains: Why are allergy rates increasing? Allen joins other researchers’ hygiene hypothesis, which suggests that children who grow up in scrubbed, sanitized and limited microbial exposure may contribute to the rise in allergies. Studies such as one from University of Gothenburg in Sweden found a culprit in modern dishwashers that disallow introduction of harmless microbes that the human system relied upon to build immunity against food allergies. The study found that the hot water of in a dishwasher kills microbial entities that are beneficial in preventing food allergies. Additionally, children raised in households where dishes were hand-washed were less likely to develop hay fever, asthma and eczema.
For example, Huckleberry’s Natural Market, with locations in Washington, Idaho, Montana and Oregon, assures consumers that all foods are safe. Many alternative products can replace wheat flour with oat flour, rice flour and tapioca starch. Alternative oils and crunchy ingredients replace nuts.
And for Sanford, the college student? He’s fine.
Paul emphasizes education and label reading. One important element of self-education is knowing about food allergy recall alerts. Several useful websites are created by the government, like www.fsis.usda.gov/recalls, or not-for profit organizations like www.kidswithfoodallergies.org/ and www.foodallergy.org maintain updated notices about mislabeled or recalled foods.
For More Information www.kidswithfoodallergies.org/ www.foodallergy.org.
“I’ve been through the emergency room a few times. Everything is normal once again, well as normal as life can be. I’m still alive, and my roommate wasn’t arrested for my attempted murder.”
Researcher Kate Allen’s complete paper can be viewed at http://www.ncbi.nlm.nih.gov/pubmed/26728850
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CANCER
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&COOKING An improved diet can help your fight
LiveWell Correspondent
with berries or watermelon in the base of water container is helpful to minimize the “tinny” taste.
A diagnosis of allergies or auto-immune problems aren’t the only reasons that may require changes to one’s diet.
Q. How do you plan/prepare meals for those patients, especially if the ingredient is one used in most recipes?
Health experts often recommend dietary modifications for those battling cancer; an optimal diet can include foods that rebuild the body’s cells and raise energy levels, especially for anyone receiving chemotherapy or radiation.
A. I mostly recommend preparing and consuming more anti-inflammatory foods such as what’s highlighted in Dr. Andrew Weil’s meal plan approach at www.DrWeil.com. Also I suggest Rebecca Katz’s cookbook “The Cancer Fighting Kitchen.”
By Jean Arthur
Each patient and survivor is unique and should consult a registered dietitian to develop an individual plan for oncology patients and possible side effects. Integrative nutrition based on scientifically sound nutrition therapies, special needs, cultural beliefs and values merge for optimal diet plans and often are primarily plant-based diets. Heather Gabbert, MS, RD, CD, a registered dietitian at Spokane’s Cancer Care Northwest, specializes in oncology and wellness and disease prevention. Here are some of her common questions regarding diet and cooking for patients and survivors.
Q. What are some of the more common foods that cancer patients cannot tolerate?
A. Most commonly, greasy foods and drinking water are not tolerated due to feeling of fullness and taste changes. Avoiding greasy foods, and using healthier fat sources such as coconut oil, olive oil, and avocado are recommended. Also, increasing intake of Omega 3s, such as wild-caught Alaskan salmon, will decrease inflammation and are generally well tolerated. Flavoring water
Q. What are optional or replacement ingredients for foods that you cannot use for those patients, and how do you manage a recipe differently if necessary? A. I suggest anywhere you use butter, try coconut oil. Add anti-inflammatory herbs/spices/root to foods such as turmeric and cinnamon. Scramble an egg in 1 tsp coconut oil and sprinkle in ¼ tsp turmeric, for example.
Q. Why can some cancer patients not tolerate particular foods if they were able to eat those items pre-treatment? A. One thing to remember is that most patients who are going through cancer treatment are experiencing symptoms such as possible taste changes, smells bothering them, and flat-out do not feel like eating or get full fast when eating. Offering small amounts at a time is less overwhelming to the eyes and stomach of a person in cancer treatment. We pro-actively manage symptoms to minimize effects on nutritional intake as best we can.
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Photos by Shallan Knowles Heather Gabbert, MS, RD, CD, a registered dietitian at Spokane’s Cancer Care Northwest, says people interested in eating better, or who need to for health reasons, can find a variety of items at stores such as Huckleberry’s. These include ‘super foods’ such as blueberries, broccoli, greens, and quinoa.
The best thing a patient can do is consume more Omega 3s which have a strong influence on appetite and that feeling of fullness following only a few bites of foods, called “early satiety.” If unable to consume Omega 3s, a supplement may be considered to get over that hump and improve appetite and allow a patient to consume more at a time, thus leading to better nutrition intake and weight maintenance. A food group not well tolerated typically during or after cancer treatment may be dairy. Many patients become lactose intolerant. We then suggest lactose-free milk, which is also hormone and antibiotic free, or recommend almond milk or another plant-based milk as an alternative.
Q. Any final advice? A. Omega 3s, Omega 3s, Omega 3s! Consume more of these as tolerated as they are the most powerful anti-inflammatory, naturally occurring in the diet. Gold standard source is wild-caught Alaskan salmon. Other sources include herring, halibut, black cod, trout and mackerel. Some plant sources of Omega 3s include walnuts, chia seeds, flaxseeds and pumpkin seeds. Also important is making sure the gut (gastrointestinal tract) is functioning optimally. Probiotics from fermented food sources are recommended daily by the American Institute of Cancer Research. This includes yogurt, kefir, kambucha, kimchi and sauerkraut. Consume mini meals consisting of a small, balanced plate of healthy fats, fiber-containing carbohydrates, and mostly plant proteins or lean animal sourced proteins, throughout the day at about three hours apart or so to promote stable blood sugar throughout the day. This keeps the body revved up all day long!
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Examining
DAIRY ALLERGIES GIES Milk-based ingredients present in more foods than many expect off this diarrhea h enzyme can result l in gas, d h or abdominal cramping. This intolerance can be temporary as a side effect of an infection, or permanent.
By S. Michal Bennett LiveWell Correspondent According to the U.S. Food and Drug Administration, about 2 percent of adults and about 5 percent of infants and young children in the U.S. suffer from food allergies — roughly 3 million people.
Some say that raw dairy can even reverse lactose intolerance, but there is no current scientific evidence to prove this – only testimonials.
Studies have shown that food allergies and the severity of reactions to them can change throughout a person’s life, and some children even outgrow some allergies during puberty.
An allergy, on the other hand, is an abnormal immune system response to a food. Allergic reactions to dairy can range from mild symptoms like itching in the mouth, hives, a drop in blood pressure, swelling, breathing problems, or even death.
Still, the FDA reports that around 30,000 consumers require emergency room treatment and 150 Americans die each year because of allergic reactions to food. The FDA’s Food Allergen Labeling and Consumer Protection Act of 2004 has identified eight major food allergens: milk/ dairy, eggs, fish, Crustacean shellfish, tree nuts, peanuts, wheat and soybeans. Dairy, whether from a cow, sheep, goat or buffalo, is one of the most common. Dr. Kenneth Wakefield of the Asthma & Allergy of Idaho clinic in Coeur d’Alene always tells parents of children with dairy allergies to be optimistic. “A proven dairy allergy is much more common in children than adults,” said Wakefield. “A great deal of babies will grow out of it before
Skin and blood allergy testing is recommended to determine the specificity and severity of food allergies. Allergies in action
Parents trying to learn more about dairy allergies first need to learn that it’s different than being lactose intolerant.
There are two main proteins in cow’s milk — casein and whey. Casein is the protein found in milk curds. Whey is in the milk liquid left after milk curdles. Allergic reactions occur when someone’s immune system identifies these proteins as toxic and releases antibodies to neutralize them. Those with allergies may react to either or both proteins, and manifestations can be immediate or delayed.
Those with lactose intolerance have a deficiency in the enzyme lactase and aren’t able to digest lactose, the sugar in milk. Lactase is required to metabolize lactose, and the lack
While some adults suffer from milk allergies, children are the most susceptible, which requires parents to be aware of trigger foods and help them avoid them.
they get to school age, some will stay allergic a little longer but then grow out of it, and some will keep the allergy into adulthood.” What Is A Dairy Allergy?
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Some are obvious, such as butter or ice cream, but dairy proteins are found in a large variety of foods, including hot dogs and even meat-free hot dogs.
alleviate and even prevent the progression of food allergies in children. Still, there are many unanswered questions in causes along with methods to reduce symptoms or counteract the immune system response.
Ingesting these items can cause a quick reaction in some, which is why EpiPens are becoming more common – small-size injectors that deliver a quick burst of epinephrine to reduce reactions, including relaxing airways that may be swelling.
The current thinking is that simple avoidance might be the best treatment and pay attention to ingredients.
Allergies on the rise
Food companies are required to label ingredients containing or derived from allergens in two ways: either by listing the major allergen in parentheses after the ingredient: “whey (milk),” or after the ingredients list: “Contains milk.”
In 2013, it was estimated that the rate of food allergies had more than doubled in 10 years. At that time, one in 10 children between the ages of three and five had a food allergy. At Asthma and Allergy of Idaho, between 12 to 20 patients are seen each day, and Wakefield said about 2 percent are there for suspected dairy allergies. While many studies have been conducted to determine the cause of food allergies, only a few offer conclusive solutions. Evidence from a European study shows that diet during pregnancy and early childhood can affect certain food allergies. Another study found that the injurious oils in fast food increase the risk of a child’s allergies and asthma if consumed during pregnancy.
However, this can be a challenge with processed food, since labels may not be that clear, or dangerous ingredients may go by different names.
Reading the labels isn’t possible at restaurants or at other people’s homes, and cross-contamination is also a concern, which can occur in restaurant kitchens, at deli and meat slicers and when visiting friends or family. Parents are encouraged to ask questions, carry therapeutic enzymes (such as Enzymedica’s DairyAssist) and always have an EpiPen on hand.
Evidence has been presented recommending the Mediterranean diet — more fruits, grains and healthier oils — during pregnancy to reduce allergies. It is undeniable that a healthy diet during all stages of development can
Living with allergies can be exhausting and poses a high level of stress. But there are some useful Spokane-area resources. • Your local natural food store may have nutrition, wellness and dietary resources to make your diet and home safer. • Find an allergy support group near you through the Food Allergy Research & Education (FARE). FARE is a national organization dedicated to making “the world safe for people with food allergies.” It creates hope through funding research, and has seen major advances in understanding allergies, protecting patients and even possibly finding a cure. Visit www.foodallergy.org for more info. • Research clinical trials, which are currently being conducted using therapies such as oral immunotherapy, sublingual immunotherapy and Chinese herbal therapy. • Educate yourself. The FDA (www.fda.gov) has extensive data into regulations, distinctions and allergen protocol.
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Are you feeling ‘Brain Fog’ is a thing, and may indicate larger health issues By Staci Lehman LiveWell Correspondent We all have days when we just can’t think straight or simply feel out of it. While it’s easy to dismiss an occasional lack of clarity as “a case of the Mondays,” are these periods of confusion due to simple forgetfulness, an indicator of Alzheimer’s disease or a relatively new ailment called “brain fog”?
math quickly in their heads,” said Dr. Steven Pugh, staff neurologist at the Providence Neurology Clinic and Multiple Sclerosis Center in Spokane. “There are patients who come in and say ‘I just don’t feel like my thinking is clear, that I’m quite awake, or that my brain is operating normally.’”
Diet, exercise and lifestyle “make a huge difference and
Brain fog is not necessarily a clinical diagnosis but is becoming a general catch-all term for ongoing or persistent feelings of confusion, forgetfulness and problems focusing.
they’re free. You don’t have to get testing to see if any of these are what’s affecting your cognitive abilities.
”
If you recognize the feelings, Pugh says not to assume the worst. This type of fuzzy thinking is likely more of a symptom of something else and is often caused by lack of sleep, low blood sugar, allergies, dehydration or medications. On occasion, brain fog can also be attributed to more serious diseases and illnesses, such as diabetes, Lupus, liver disease, cancer, thyroid disease or Chronic Fatigue Syndrome. Don’t panic though: the cause and the cure are often fairly simple.
In the short term, brain fog can be an – Dr. Steven Pugh, staff neurologist, Providence annoyance, but if it continues over Neurology Clinic and Multiple Sclerosis Center time, brain fog can cause a person to become detached, discouraged and depressed, and may even impact “A lot of time what’s wrong isn’t all these diseases, but someone’s lifestyle – what they eat and lack of physical activity,” Pugh said. performance at school or work. “Often people can’t remember the name of a movie or an actor, they get a little stuck there. They have delayed processing where they can’t do
Being overweight or obese, or general inactivity, sometimes comes Continued on Page 23
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Does brain fog begin in the belly? By Staci Lehman LiveWell Correspondent
Ammi Midstokke knows all about brain fog. The nutritional therapy practitioner regularly works with people experiencing forms of cognitive dysfunction – or in layman’s terms, their thinking is kind of muddled. She practices at Two Birds Nutrition in Sandpoint, which specializes in nutritional aspects of brain function and examines the connection between the stomach and the brain. “Eighty percent of my clients come in with brain fog as one of many symptoms,” she said. Often, the fog goes away simply by cutting back on carbohydrates and sugar, which can cause inflammation. Inflammation is often valuable in helping the body heal. When you’re injured, white blood cells destroy bacteria and mend broken tissue. Pain, heat, redness and swelling are positive signs that your immune system is hard at work.
brain fog is caused by undiagnosed food allergies. Testing can determine exactly what foods a client is allergic to and if it is the cooked or uncooked forms that are causing the problem.
time to talk about changing lifestyles,” she said. “You can’t run a practice like that – it’s cost prohibitive to spend an hour talking about things like eating sauerkraut.”
Midstokke starts off by testing 100 foods with 85 percent reliability through a simple finger prick and blood test.
Sometimes the process works the other way; a patient will be diagnosed with high cholesterol or as pre-diabetic, and their doctor will refer them to Midstokke or another nutritionist to learn how to manage their conditions. Midstokke says collaboration is the ideal situation.
The most common suspects of food allergies are wheat, eggs and dairy. “A lot of people have all three,” said Midstokke. Once foods such as gluten, dairy and eggs are confirmed to be allergens and are removed from a client’s diet, the difference is noticeable within two weeks. If food allergies don’t turn out to be the prime culprit, brain fog may be caused by autoimmune diseases like Lupus, Multiple Sclerosis or Hashimotos, a condition in which the immune system attacks the thyroid gland. Sometimes, people with these chronic conditions have been visiting many doctors and have undergone many tests with no conclusive diagnosis.
However, if inflammation becomes chronic, the immune system can mistakenly attack normal cells, opening the body up to infection and autoimmune disease. Because the body and brain are so closely linked through the Vagus nerve, which extends from the brainstem to the abdomen, Midstokke says gut inflammation can contribute to a foggy brain.
As a Nutritional Therapy Practitioner, not a physician, Midstokke can’t diagnose specific diseases, but can spot warning signs, perform tests, and work with the client’s primary provider on treatment options.
It’s not always a case of carb overload or too many chips or cookies. Sometimes,
“It’s hard to find a practitioner versed in all of this. Often, doctors don’t have the
Nutritionists often have an advantage over doctors in that they can spend more time talking about medical issues, diet and lifestyle.
Brain fog can affect anyone, even children. According to Midstokke, brain fog can be mistaken for Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder. Children often can’t describe the difficulties they are experiencing so they act out, throw tantrums or perform poorly in school due to frustration or problems concentrating. This can also be due to food allergies, too much sugar or being on what she calls a “sugar roller coaster.” When people of any age skip breakfast, or don’t eat often enough, their body begins to break down tissue to create blood sugar. When that wears off, the person experiences a blood sugar drop and fatigue symptoms. To give themselves an energy lift, they may have a sugary snack, or the body can break down more tissue, which triggers more highs and lows. “You’re going from being malnourished to inflamed to malnourished to inflamed all day,” said Midstokke. If you’re experiencing brain fog or clarity issues, Midstokke advises people to accurately seek out a cause, whether this starts with a doctor or a nutritionist.
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with side effects that are major contributing factors to brain fog. Some types of diabetes, consumption of excess carbohydrates and reduced oxygen to the brain, due to clogged arteries or low blood pressure, can also muddle brain activity. One obvious way to fight mental confusion caused by obesity is through a better diet and more exercise. Physical activity has other benefits: it increases circulation to every part of the body, and delivers glucose and oxygen to the brain, which spurs brain activity. This can help even those who aren’t necessarily overweight but may be having a hard time thinking straight. “Take a look at how much water you are drinking. Dehydration can cause cognitive issues. Poor sleep habits are a cause of daytime sleepiness. Same with how much caffeine you are consuming,” Pugh said. Stress can also contribute to a loss of mental clarity. Over a long period, it can cause poor decision making, anxiety, depression, insomnia and memory loss. However, Pugh doesn’t write off all cases of brain fog purely to lifestyle/poor habits. Upping one’s exercise regimen doesn’t seem to help with illnesses associated with brain fog such as Chronic Fatigue Syndrome. If increased activity makes symptoms worse, it may signal a different medical issue. In this case, your first step is to visit your family doctor for basic tests, evaluating blood cells, W B LE NOILA A AV
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Photo by Shallan Knowles Ever feel like you’re losing your marbles? As illustrated by Spokane resident Bea Lackaff, feelings of confusion or poor memory can be caused by poor diets, low physical activity or certain medications.
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allergies and medications. “Just about any medication you take has the potential to cause side effects to the brain. Antihistamines, anti-depressants, chemotherapy, blood pressure medicine,â€? said Pugh. If initial tests rule out these possibilities, a specialist such as a neurologist may be able to dig deeper. Experts can also look at autoimmune diseases such as Chronic Fatigue Syndrome or EpsteinBarr virus as possible culprits. “The reality is that brain fog can accompany any disease from COPD to cancer, to thyroid disease to liver disease‌ If you tell me that you’re fatigued, it doesn’t really tell anything about what the cause is,â€? Pugh said. “When I have a patient that comes in saying ‘I have fatigue or brain fog,’ I try to determine if they are talking about a cognitive process or a strength issue.â€? People shouldn’t panic if they have periods of feeling out of it. There’s a higher probably that you’re not suffering from a life-changing disease. While this analysis may sound oversimplified, a good starting place is to focus on the basic things that can be contributing to your lack of clarity: caloric carbohydrates like refined sugars, the benefits of proper hydration and exercise. “These three things make a huge difference and they’re free. You don’t have to get testing to see if any of these are what’s affecting your cognitive abilities,â€? Pugh said.
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Finally, one of the nation’s leading back If you’re currently seeing a doctor (or chiropain experts – Robert Gordon, a specialist practor), thinking about it, or just don’t want from Spokane Valley who has already helped to face the hassle of talking to your insurance, 100’s of people over the last three decades but still want to get some real help, then you with his back pain recovery advice – has reneed this free report which reveals everything cently released a new free 12 page “Back Pain you need to know about how to actually get to Consumer Awarenessâ€? report that reveals the the bottom of your back pain without needbest kept secret in Spokane Valley... How to ing a referral from a doctor! actually get to the bottom of back pain withMore: It includes at least 3 ways to ease out talking to your insurance, a chiropractor, back pain at home that most people say they or needing a referral from your doctor. were shocked (and disappointed!) that no one Back Pain “Truthsâ€? 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BIKE SAFETY for New Riders By Erika Prins
LiveWell Correspondent For busy people who can’t always find time for a workout, riding a bicycle for transportation can be a perfect solution: it’s a chance to catch some rays on the go, parking is always free and even a short pre-work ride can elevate energy and alertness. Before hopping on the bike, it’s important to become familiar with local and state laws, which can ease the transition from four wheels to two.
Be visible. “Anything you can do to be seen sooner so that drivers have a chance to plan their path,” said Eileen Hyatt, certified instructor with the League of American Bicyclists. Being seen doesn’t just mean wearing bright clothing and equipping your bike with bright lights. A rider’s position on the road impacts whether or not drivers can see them, Hyatt says. Riding as close to the curb as possible may seem like the safest option, but it’s not where drivers look for other road users. “Most crashes happen at intersections,” she said. “Most drivers aren’t looking at the curb.” Instead, Hyatt recommends riding in the right tire track when using the roadway feels like a safe option. “It makes you more visible to people coming behind you. It gives you a little space to move over if you need to, and it allows you to be seen.” There’s no one right way to use a road, she said, since lane width, vehicle speed and many other factors vary from street to street. “Every road’s different, every situation is different.”
Be predictable. Angry drivers can feel much more threatening when you’re on a bike. They may not be entirely avoidable, but the best way for all road users to respect one another is to avoid startling each other. “Let people know what you’re going to do before you do it,” Hyatt said. “When you surprise people, their first reaction is fear, but that quickly flips to anger.” Take a seat on the therapist’s couch for a moment. Anger, called a “secondary” emotion, often starts with feeling vulnerable and afraid. If a driver feels caught off guard by a person on a bike popping out in front of them, their heart-stopping moment can quickly turn to road rage.
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The right lane isn’t the only lane for bikes. For the most part, riding in the right-hand lane makes sense for bicyclists because they’re likely slower than other road users. But, just like people in cars, people on bikes should pass on the left and use appropriate turning lanes. “You stay on the right because you’re slower — that’s called speed positioning — but you also have to consider your destination position,” Hyatt said. “So when you go left, you negotiate moving to the left lane.” Bicyclists should clearly communicate with drivers about their intentions and yield to the vehicles already in the lane. In fact, says Hyatt, the principle of yielding to the traffic moving in a straight line most always applies: “When you are changing direction — that means if you change lanes, if you turn left, if you turn right, you have to yield to others. If you’re continuing on a straight line, it’s your space.”
Washington State doesn’t require helmets — but Spokane does. When checking on bike laws, riders should check both state and local laws. Helmet requirements differ from city to city within the state.
Photo by Erika Prins Omar Akkari and Erin Schafer ride through Spokane.
All Spokane riders in the City of Spokane must wear a helmet. In Spokane County, kids ages 3-16 must wear helmets when riding anything with wheels, including bikes, scooters and skateboards.
More information about local bike laws can be found at:
Idaho does not require riders to wear helmets, though the City of Coeur d’Alene recommends wearing one on its website.
League of American Bicyclists: bikeleague.org/statebikelaws
Laws aside, your noggin is about as dingproof as your iPhone screen. Even a minor spill can cause serious damage.
Idaho Transportation Department: itd.idaho.gov Washington Department of Transportation: wsdot.wa.gov
Riding on sidewalks is OK, except when it isn’t. Bicyclists may ride on the sidewalk or the street, depending on where they feel most
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safe, in both Idaho and Washington — for the most part. But there may be bans on sidewalk use in most dense urban districts, such as downtown Spokane. In Coeur d’Alene, riders may not ride on sidewalks downtown on Sherman Avenue between First and Sixth Street or on portions of Lakeside Avenue
Rules differ for cyclists on the road and on the sidewalk. The rules of the road also apply to bicyclists on the road, with a few extra protections in Washington for bicyclists and other “vulnerable users” like motorcyclists and mopeds. That means riders must pass on the left, ride with traffic and use signals and obey all signs and traffic lights — though riders may cautiously proceed through sensored traffic lights triggered by motor vehicles. Likewise, on the sidewalks, pedestrian laws apply to cyclists, with some extra protection for those not on two wheels. Pedestrians get the right-of-way on sidewalks in Idaho and Washington. Idaho state law and Spokane’s municipal code both require cyclists to give pedestrians an audible heads-up before passing.
Never ride against traffic. Though it falls under the umbrella of “obey all traffic laws,” this common mistake bears repeating. Riding with the flow of traffic doesn’t just mean ensuring cars can safely pass slower cyclists — it also means riding in the same direction as traffic. Riding against traffic is illegal and unsafe.
Tap experienced riders for their route recommendations. “When people consider [how] they should bike to work, they’re thinking about the streets they drive to work, and they’re going ‘no way,’” Hyatt said. But the better bike routes often utilize less-trafficky side streets. She recommends checking out a local bike route map — find one for Spokane at srtc. org — to see what routes around town other bicyclists recommend.
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FEAR OF SPIDERS AND OTHER COMMON PHOBIAS Treatment options can vary By Dan Webster LiveWell Correspondent
So what really scares you? The answer may vary depending on the severity of reaction it generates and how many others share that particular reaction. And, of course, who is doing the measuring. For instance, a study in 2015 by the Wilkinson College of Arts, Humanities and Social Sciences asked 1,541 adults across the country about 88 common types of fears. The study identified eight “Domains of Fear,” separating different fears, including personal anxieties (public speaking); environment (climate change, pollution); technology (robots, cyber-crime). Topping the “Very Afraid” list included: Corruption in Government Cyberterrorism Corporate tracking of personal information Terrorist attacks Government tracking of personal information Economic collapse While all these calamities are often out of one’s control, and may cause varying degrees of anxiety in some, they also don’t compare to the “classic” phobias. According to Fearof.net, a phobia resource, the updated list of favorite irrational fears for 2016 includes: Trypophobia (holes) Aerophobia (flying) Mysophobia (germs) Claustrophobia (small spaces) Astraphobia (lightning/thunder) Cynophobia (dogs) Agorophobia (open/crowded spaces) Acrophobia (heights) Ophidophobia (snakes) Arachnophobia (spiders)
In 1990, Amblin Entertainment released a comic-horror movie titled “Arachnophobia.” Its tagline was simple: “Eight legs. Two fangs. And an attitude.” While the movie was a modest success, grossing more than $53 million, many viewers were more affected by the horror than the comedy. That’s because many of those people were exactly what the film’s title suggests: deathly afraid of spiders. Some people, in fact, see spiders as nightmarish. One such someone is the actor Chris Pine. “Not a fan of spiders,” the “Star Trek” star admitted to the Associated Press. “I saw ‘Arachnophobia,’ which was singlehandedly rated in the top three worst choices of my life.” Pine is hardly alone. Arachnophobia is one of the most prevalent of human fears, along with glossophobia (fear of public speaking), aviatophobia (fear of flying), claustrophobia (fear of enclosed places) and even coulrophobia (fear of clowns). By fear, we don’t mean a simple nagging worry. We mean a gutclenching, fight-or-flight, debilitating sensation. Here’s how the Mayo Clinic defines the term phobia: “An overwhelming and unreasonable fear of an object or situation that poses little real danger but provokes anxiety and avoidance.” The fluttering in your belly that you feel when, say, preparing to address an audience is one thing. A phobia, the Mayo Clinic asserts, “is long-lasting, causes intense physical and psychological reactions, and can affect your ability to function normally at work or in social settings.”
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Think of former NFL coach and football broadcaster John Madden. For years, Madden traveled between stadiums in a specially designed RV. Popular belief was that he was afraid of flying. But as he clarified to the New York Post, Madden suffered from another kind of phobia. “Claustrophobia,” Madden said. “When I coached, I flew all the time. I would get in there. They would shut the door and I would feel that I have to get out. And then have a panic attack. It happened three times, and on the third time, I said, ‘This is it. If I get down from this one, I’m never going to get on another airplane the rest of my life,’ which I didn’t.” Clearly, not everyone enjoys the same kind of options that Madden did. Most of us either find ways to avoid our phobias, grit and bear them or – if they are debilitating enough – seek treatment. According the U.S. Food and Drug Administration, phobias exist under the general heading of anxiety disorders, and come in three general types:
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Specific or simple phobias – fear of an object of situation (spiders, heights, flying); Social phobias – fear of embarrassment in a social setting; Agoraphobia – fear of public places. And while theories on the exact cause of phobias range from past trauma (e.g., especially creepy clowns at a child’s birthday party) to long-evolved instinctual fears (early humans remembering that spiders and snakes might be poisonous), treatments can vary almost as widely. Some examples cited by the Mayo Clinic fall under two general categories: Medication – Prescribed drugs can include everything from beta-blockers to antidepressants to sedatives; Psychotherapy – Talk therapy can include sessions of desensitization (or exposure) therapy, which “focuses on changing your response to the object or situation that you fear”; and cognitive behavioral therapy, which keys on alternative attitudes that help in learning “ways to cope with the feared object or situation differently.”
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Group Thinking and the Roots of Collective Evil:
For the truly debilitated, professional guidance can be a lifesaver. Just look online under “phobia treatment” for a local source. Until then, those afraid of spiders in particular, take a lesson from Chris Pine: Whatever you do, don’t watch “Arachnophobia.”
Implications for Health Care
20TH ANNUAL ROBERT F.E. STIER MEMORIAL LECTURE IN MEDICINE
PRESENTED BY
Free Public Lecture: Thurs., April 28, at 4:00 PM
Salvatore Mangione, MD
WSU Health Sciences Spokane, Academic Center, Room 20 600 N Riverpoint Blvd, Spokane
Associate Professor of Medicine
RSVP by April 25 at spokane.wsu.edu/stierlecturersvp2016 More information at bfruci@wsu.edu or 509-358-7837.
Director, Physical Diagnosis Course & Humanities Curriculum Sidney Kimmel Medical College at Thomas Jefferson University
Associate Director, Internal Medicine Residency
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LOCAL POT SHOP FOCUSES ON QUALITY By Courtney Dunham
LiveWell Correspondent New customers at Green Star Cannabis Can may think owner Sam Calvert is a scientist deep into re research when they see him with a scope at his desk. And he is, so sort of, as he meticulously inspects newly arrived marijuana for abnormalities. Green Star Cannabis goes to great lengths to inspect the quality of its products, which is evident by how many inspection scopes burn out, and how big the rejection pile grows with product that doesn’t meet their sta standards. Calvert uses the sc scope to look for spider mites, mold and other inconsistencies th that affect the quality of the product. “We always st start with that and if it doesn’t pass my scope, then it goes in the rejection pile,” Calvert said. “It happens a lot with new growe growers.”
Many use vape pens as alternative to allevia alleviate health is issues
Any pro product that does pass the initial scope still has to meet all of the requirements on a product review feedback form. Calvert said the shop ends up turning away about 50 percent of the pro products through the scope and about 35 percent through the rrest of the review process. “Some of it can absolutely be horrible and wet, and we can see stuff that shouldn’t be there even with the naked eye,” he said. “It’s like telling me you’re going to give me a Pepsi and then sell me a root beer. It’s not going to work.” Calvert and his trained 8-member staff are proud to be part of the only shop in Spokane that sells indoor, hand-trimmed pot, which he buys from Tier1 and 2 small-batch growers. Indoors, the grower has control of the environment. They can have a very clean and hygienic space compared to the many
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possible variables that can impact an outdoor operation. This is especially important for growers who are hoping to sell their plant product for medicinal use. When cannabis is cultivated medicinally, it needs to be completely free of germs, fungus, parasites or any other microscopic organisms that can cause illness. People with weak and sensitive immune systems or breathing problems need to consume products that are free of insects, spores or pesticides.
using cannabis has helped them, but that story will stay deep in my heart.” Calvert encourages his customers, and anyone who is interested in using cannabis for whatever reason, to keep a journal on what strains and products work best for them. He also sees many people who don’t want to smoke, especially women, but are interested in using pot to ease some of their symptoms. He recommends using vaporizers and pure cartridges where you can still get the benefits of cannabis without the smoke.
Calvert and staff also look for handtrimmed buds with the trichomes intact. Auto-trimmed buds that go through a machine may have damaged trichomes, which hold a ton of the THC that creates “the high.”
Green Star is an authorized dealer for Atmos, which makes the R2, a powerful vape pen that can be used for oils, wax, honey juice and dry herb. This alternative is especially great for people who want to be discreet too.
“We are searching high and low for the best product available – whatever that turns out to be,” he said.
Michelle McDermott chose a vape pen to help with insomnia. She was looking for an alternative to taking Ambien and other pharmaceutical drugs that she didn’t feel safe using anymore.
Green Star, the closest pot store to downtown Spokane, was one of the first shops to get a license to operate in Spokane, but Calvert waited to open so his customers wouldn’t find high prices due to taxes or inflation by growers. It all comes down to putting the customer first at Green Star.
“You can’t even pronounce many of the ingredients in a lot of painkillers or sleep aids, which I used for years,” she said. “When I chose to start using pot as a relaxant instead, I knew exactly what I was putting in my body.”
“A budtender meets you at the door and stays with you the whole time to answer all of your questions and help you find exactly what is best for you,” Calvert said.
Her budtender recommended Indica, which is great for people who struggle to get to sleep. Indicas produce very sedative effects and users often feel sleepy and very relaxed after using it.
Hearing back from his customers who have gotten relief from using cannabis for a variety of physical ailments means the most to Calvert.
McDermott admits, though, that she didn’t want to smoke anything, and found that a vape pen was perfect.
“We had a gentleman come in who was anemic and couldn’t gain weight no matter what he had tried and was very frail,” he said. “He came in one month later and had gained 15 pounds. I’ve heard a lot of success stories from my customers on how
This is exactly what Calvert encourages. “I want customers to educate themselves with true data to decide what the best approach and option is for their needs,” he said. “It’s always all about the customer and what is best for him or her.”
Photos by Courtney Dunham Top photo, Sam Calvert, owner of Green Star Cannabis, examines a strain of marijuana for parasites, fungus, pesticides or other contaminants. The shop, below, includes an educational component to this new legal product.
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New cannabis shops enjoy educating curious customers Owners promote variety of uses beyond smoking One establishment leading the way is Sativa Sisters, whose staff focuses on making LiveWell Correspondent customers feel at ease the moment they walk Numerous national polls show that a growing into the store. number of Americans support some form of cannabis legalization, and this is evident “We strive to be very friendly and welcome in Spokane, where legal marijuana sales all the questions people have,” said Manager continue to boom. Eric Skaar. “We really try and educate them about safety and the effect. We ask them what
By Courtney Dunham
type of experience they are looking for, which is a great way to start the conversation.” It’s hard to miss the cheery and bright green building on Trent Avenue, and the inviting lighting is designed to make the experience not only more comfortable, but free of any shame or ignominy that once was attached to seeking out something that, until recently, was illegal. Although the stigma over buying or using marijuana has lessened, many still have curiosity and interest in trying it for recreation and as a medical alternative, but are hesitant to take that first step. Skaar understands this, which is why education on the process and experience is vital. When Sativa Sisters first opened its doors, he said many of their customers were older than the stereotypical younger consumer. “The majority were over 40, but now we see people anywhere from 21 to their 80s,” Skaar said. “Some people have never used it before, whereas some haven’t used it in 30 years. They come from all walks of life.” He thinks the increased age range not only
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reflects a reduction of the stigma, plus the welcoming efforts of store staff. “We know all of our growers very well, and we can tell you what’s exactly in it—the THC level, what batch, the effects and what, if any, pesticides were used,” he said. This information is something buyers will not find on the black market, where they may encounter a cheaper product, but from ill-informed ‘sellers’ with no strictly enforced guidelines for quality or safety. Sativa and Indica are the two major types of cannabis plants, which can be mixed to create hybrid strains. Each strain has its own range of effects on the body and mind resulting in a wide range of medicinal benefits. According to Live Science, Indica plants Photos by Courtney Dunham Sativa Sisters tries to make the environment as typically grow short and wide, compared to welcoming to all types of customers and ages, including a coffee area. Sativa plants which grow tall and thin. Indica plants are better suited for indoor growing said. “Plus, it’s the most discreet, which is because of their short growth, and Sativa very important to some people.” plants are better suited for outdoor growing because some strains can reach over 25 feet in Tinctures absorb into your system through height. the mouth about 15 minutes faster than The ‘high’ produced from smoking Indica is a edibles, which are another popular alternative strong physical body high that can make you to smoking. Unlike edibles, Skaar said it’s a lot harder to overdo tinctures. sleepy or ‘couch-locked,’ and provides deep relaxation, compared to a Sativa high, known But if you do choose this method than keep to be more energetic and uplifting. to the Colorado slogan, “Start low. Stay Marijuana strains range from pure Sativas to slow.” pure Indicas and hybrid strains consisting of Abbey Reyes, 42, chose to try cannabis for both. Because Sativa and Indica buds have pain relief from rheumatoid arthritis. A few very different medicinal benefits and effects, certain strains can be targeted to better treat friends encouraged her to look into it. She said edibles didn’t turn out to be the best specific illnesses. option for her. The options to consume cannabis are as “I never knew how much I should eat for varied as the strains themselves. sure and frankly didn’t want to have to worry about it,” she said. “Now I just do tinctures Skaar said he is a big fan of the tinctures— liquid extracts of cannabis—which are useful because I know exactly how much to take and it’s easy and quick.” alternatives for people who aren’t interested in smoking. Reyes replaced several prescription drugs that she was taking for her RA with one tincture “It’s the oldest form of herbal medicine,” he
hybrid and has found more relief without the added side effects of the meds she had been taking. “I felt like I was putting poison into my body before, which just didn’t sit or feel right,” she said. “Now I know exactly what I’m taking and feel so much better for it.” Skaar is excited about the future of cannabis in Washington State and the growing alternative methods available, which he hopes will erase the stigma even more. In the future he said he’d love to have higher doses available for medical patients, and see smoking lounges approved. Reyes seconded that motion. “If we have bars where people can share a glass of wine or beer together, why can’t we have pot lounges?” she asked. “It’s legal now and so many more people smoke or use it than we realize.”
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By Courtney Dunham LiveWell Correspondent Deaths from drug overdoses reached an all-time high in 2014, according to the Centers for Disease Control and Prevention. Overdoses of prescription drugs and heroin continue to be the leading cause of unintentional death for Americans, rising 14 percent from 2013 to 2014. Last year, 47,055 people died from drug overdoses – 1.5 times greater than the number killed in car crashes. Opioids are involved in 61 percent of all drug overdose deaths. The latest CDC data finds that deaths from natural opiates such as morphine, codeine and semisynthetic prescription pain killers like oxycodone and hydrocodone jumped 10 percent from 2013 to 2014. These alarming stats have many people looking into alternative methods to manage pain and other health challenges. Cannabis shop owners often hear about improved conditions from their customers, and decades of research and personal anecdotes point to a variety of medical uses for pot.
Legal pot legally eyed for medical benefits Boosters hope it can reduce rising prescription overdoses
THC, or tetrahydrocannabinol, is the most recognized ingredient in cannabis. It is best known for causing the high users get from consuming marijuana. As a result, THC has caused the most controversy surrounding the plant’s medical use, with many health professionals citing the high as a drawback. However, while compounds like cannabidiol (CBD) have started to gain favor due to a lack of psycho-activity, research have revealed a number of medical benefits unique to THC. These are the most reported benefits by The Institute for Ethics and Emerging Technologies:
Pain relief Studies show that THC activates pathways in the central nervous system, which block pain signals heading to the brain. Likewise, cannabis has been shown to be especially effective against neuropathic pain, or nerve-related pain.
PTSD The high from THC is also associated with temporary impairments of memory. While some users may cconsider this a flaw, people battling post-traumatic stress disorder may find the idea of impaired memory downright therapeutic. A big part of PTSD involves rrecalling painful memories, and recent studies confirm tthat oral doses of THC can help relieve flashbacks, agitation and nightmares.
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NEW STANDARD PRICING FOR YOU Because We Only Sell Good, Great or Exceptional Products Anyway! Nausea and vomiting THC has been available in pill form to relieve nausea in cancer patients since the 1980s. Marinol, a pill containing synthetic THC, was the first THC-based medication to be approved by the FDA for this purpose. Since then, other THC pills have been developed and prescribed to patients undergoing chemotherapy, including a pill called Cesamet.
Increased appetite THC can work as a powerful appetite stimulant in both healthy and ailing users. Similarly, Marinol and Cesamet are regularly prescribed to boost appetite in patients with cancer and HIV-associated wasting syndrome. A number of studies conducted with Marinol suggest that THC can also stimulate weight gain in patients with anorexia.
Asthma THC’s ability to improve breathing in asthmatics is supported by research dating back to the 1970s. Following trials that showed smoking marijuana could help calm asthma attacks, scientists tried (and failed) to develop an inhaler that could deliver THC. While the THC inhaler idea was ultimately abandoned, some say modern-day vaporizers might be the solution.
Glaucoma Another benefit of THC recognized early on was its potential to relieve eye pressure in patients with glaucoma. After studies in the 1970s showed that smoking marijuana could reduce symptoms in glaucoma sufferers, scientists tried (and failed again) to develop a way to administer THC in eye drops. The idea proved too complicated due to the fact that THC is not soluble in water. While some glaucoma patients rely on medical marijuana, The American Glaucoma Society maintains the position that its effects are too short-lived (lasting 3-4 hours) to be considered a viable treatment option.
Sleep aid THC trials conducted in the 1970s found that oral doses of THC helped both healthy individuals and insomniacs fall asleep faster. Interestingly, more recent studies suggest THC may also improve nighttime breathing and reduce sleep interruptions in those who suffer from sleep apnea. Researchers are currently working to develop a THC-based medicine for treating the condition.
Customer Service:
When you enter the store, you’ll be greeted by your own, highly qualified and educated Budtender. He or she will stay with you during your entire visit: It’s up to you! We’re here to help each and every visitor! We don’t sit behind a counter and hand you products from a menu!
Quality:
We’ve been open since the market began almost two years ago, and we immediately added two additional levels of quality assurance. Every product is placed under a microscope where we carefully look for things like powdery mildew, dead spider mites, and chemical burns. It is then sent out for additional testing where smell, taste, and effect are further evaluated. If it does not pass our testing, it does not come into your store!
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This product has intoxicating effects and may be habit forming. Marijuana can impair concentration, coordination, and judgement. Do not operate a vehicle or machinery under the influence of this drug. There may be health risks associated with consumption of this product. For use only by adults twenty-one and older. Keep out of the reach of children.
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The Dubious Values of Vaping By Dan Webster LiveWell Correspondent A couple of years ago, as singer-songwriter Kevin Devine performed with his band at Spokane’s Knitting Factory, the air over the dance floor was filled periodically with plumed streams of what looked like smoke. The streams came from the mouths of three young women who took turns sucking on a small, tubed instrument and then blowing distinct white clouds toward the ceiling. The sight felt reminiscent of a past time, to the era in which cigarette smoking was common – and legal – in public venues. Only this wasn’t traditional smoking. The women were sucking on a shared electronic cigarette, a battery-powered device that heats a liquid containing nicotine and other chemicals, often laced with some kind of flavoring. And they looked as if they were enjoying it. Since its invention in 2003 by a Chinese pharmacist named Hon Lik, the electronic cigarette has come to be known by different names: the e-cigarette, vaping dispenser or the more formal “electronic nicotine delivery system.” Its use is growing: according to the U.S. Centers for Disease Control and Prevention, the number of middle school
Photos by Shallan Knowles Lilac City Vapor offers a variety of flavors and electronic vaping devices as alternatives to cigarettes.
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and high school students using e-cigarettes tripled between 2013 and 2014. From the beginning, e-cigarettes have been extolled as a safer alternative to the more traditional nicotine delivery systems: cigarettes, cigars, pipes and even chew. But the truth regarding the health benefits of vaping is debatable, and really depends on who is doing the talking. One thing is clear: the vapor produced by an e-cigarette, while simulating the effects of traditional cigarettes, delivers nicotine without including many of the toxic chemicals produced by burning tobacco leaves. Yet according to sources, including the National Institute on Drug Abuse, e-cigarettes carry their own brand of ill effects, including:
1. Addiction to nicotine. 2. Production of known carcinogens such as formaldehyde and acetaldehyde. Then there’s also minuscule metal particles from the vaporizing device itself. A 2015 study at the Harvard School of Public Health linked diacetyl, a flavoring chemical found in more than 75 percent of flavored e-cigarettes, with cases of severe respiratory disease.
3. Active immune system suppression. A recent study from the University of North Carolina found that vaping suppresses more than 350 genes involved in the human immune system. The study, cited by arstechnica.com, suggests that e-cigarette users “may have compromised immune
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responses, making them potentially more vulnerable to infections and diseases.”
4. Progression to ‘old-school’ cigarettes. According to a 2015 study by the Journal of the American Medical Association (JAMA) Pediatrics, teens who try e-cigarettes are more likely to want to try traditional cigarettes. Yet the questions involving the safety of e-cigarettes are hardly simple. E-cigarettes also have their defenders who say the habit is healthier for people’s bodies and people around them. A 2015 report by Public Health England states that “the current best estimate is that e-cigarettes are around 95 percent less harmful than smoking.” And despite what the JAMA Pediatrics study claims, vaping is seen by some as a good way to transition away from traditional tobacco use, the harmful effects of which have been proven conclusively (no thanks to the tobacco industry). Nicotine is addictive, but it has health benefits, too. In limited quantities, nicotine has been cited as a useful tool for certain mental disorders; it has been used to treat everything from Attention-Deficit/Hyperactivity Disorder (ADHD) to Parkinson’s disease and even Tourette
syndrome. As for suppressing the immune system, even the UNC researchers can’t say with any degree of certainty that e-cigarettes lead to “boosted infection risks or other immune diseases.” As one member of the study admitted, “We don’t know.” The Harvard study? Co-author David Christiani told the Harvard Gazette, “Since most of the health concerns about e-cigarettes have focused on nicotine, there is still much we do not know about e-cigarettes.” One point about e-cigarettes everyone acknowledges is the need for more studies. Until such data become available, maybe one of the authors of the Public Health England report has the best advice. “(T)he evidence consistently finds that e-cigarettes are another tool for stopping smoking,” said Professor Ann McNeil of King’s College London, “and in my view smokers should try vaping, and vapers should stop smoking entirely.”
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Pet Loss Hotline By Mariesa Stokes LiveWell Correspondent When Dr. Kathleen Ruby began work as a counselor at Washington State University’s College of Veterinary Medicine, she faced an interesting request. The students, who were already studying the science of euthanasia, wanted to learn more about the emotional side of death. They felt they would become better care providers if they better understood more about grief and bereavement. According to Ruby, the short lives of pets compared to humans, combined with the general acceptance of euthanasia, means modern veterinarians can face patient death up to five times more often than ‘people’ doctors. Ruby said her students were concerned about the quality of life of not just the patients but also the people who loved them. They also wanted to know how to care for the whole family, before and after a pet’s death. In 1990 this idea evolved into “Pet Loss Hotline” – a course that transforms the way students approach euthanasia, compassion and end-of-life care, while helping grieving families around the world. Today, the course is taught by Valerie Russo, Ph.D, LMHC, and Andra Edwards, DVM. Russo is also a counselor who provides mental health services to students at all levels in the WSU program. Edwards is a practicing veterinarian and took the class in 2005.
Veterinary students help others while learning about love and loss Student receive classroom instruction from Russo and Edwards, and also volunteer shifts answering phones and answering emails from grieving owners. Overseeing the student volunteers are two managers who are previous students, such as third-year student Nicole Schwinkendorf. The program receives annual funding from Purina, which helps cover costs like brochure cards and resource materials. This year Purina also paid for a new computer for the hotline office. The “Pet Loss Hotline” course is an elective, but both instructors believe it would benefit all veterinary students. “I would like to see students take it right away,” said Russo. “It can provide a basis to thread through as they begin to really understand the human-animal bond.” Edwards agreed. “This class was absolutely invaluable to me as a brand new ‘baby vet’ in the real world,” she said. “I use the things I learned every day,
just as much or even more than the medical knowledge.” Calls and emails come in from around the world. “Sometimes they call because they live by themselves and have no one else to talk to,” said Schwinkendorf. “To me that’s the saddest part. Typically these are older people, and the animal was their main social connection, and it may be the one relationship they had, so that loss is devastating.” Many contacts come in from people whose pets aren’t gone yet, asking how they’ll know when it’s time. Most want to know about the grief process, said Russo. “A lot of our handouts have to do with the grief process – that and talking to children about pet loss,” she said. “A lot of people don’t know how to talk to their kids. A lot of folks are trying to make decisions about their pets’ lives. They want to know things like ‘how do you determine the pet’s quality of life?’” Some reach out right after a pet passes, and
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others call around the anniversary of a pet’s death. Volunteers offer tools to help cope with loss as well as ideas on how to find closure – without judging anyone’s grief.
Grieving pet parents shared what their vets’ office staffs have done that showed compassion.
“We ask the students to pay attention to the kinds of calls and emails they’re getting, especially those who reach out repeatedly,” said Russo. “They’re in different stages of the grief process, and it’s interesting for them to be able to see that and understand how they can be supportive.”
“Every time one of my pets has passed or been put down I have received a card from the vet’s office. I think it’s a sweet thing, and I think that is hard for them, too. My vets have taken good care of my cats and me, too.” – Karen Mobley
Over the years the hotline has moved from handwritten notes to computer records, and the classes reflect changes in veterinary medicine, such as the increased popularity of animal hospice. But the core topics remain the same. “We get a lot of students who are worried about the often-mysterious subject of euthanasia and all the emotions surrounding it,” Edwards explained. “They want to know what to expect and how to compassionately interact with their clients in their time of grief.” She says after 11 years in private practice – seeing so much end of life, experiencing so many sad diagnoses and providing countless euthanasias – she can give the students an excellent “real world” perspective, with successes and failures. “I teach my students first and foremost, to not fear the euthanasia procedure, but to embrace it as one of the most special gifts that they can provide for their clients and patients. Instead of dreading the sadness and high emotion, it’s good to try to think about what a difference you, as the vet, can make for people who are losing their beloved pet. In a well-done euthanasia experience, the veterinarian has the ability to take away the clients’ guilt, anxiety and fear, and leave them with just their grief. That is an amazing thing!” Dr. Nick Snider is a 2014 graduate of WSU’s College of Veterinary Medicine. He had personal experience with loss when he enrolled in the Pet Loss Hotline class but says the course helped him better understand how people deal with grief.
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Photo by Mariesa Stokes Dr. Nick Snider from SouthCare Medical Center learned about grief from his own dog, Molly, preceding page, and a course at Washington State University’s College of Veterinary Medicine.
“Manning the hotline and talking to people brought home the different ways everyone goes through the grief process,” says Snider, who now practices at SouthCare Animal Medical Center in Spokane. “Grieving is such a personal thing, and I hadn’t thought about it that way before the class. That experience helped shape how I approach it.” Snider listens to the needs of the entire family – both animal and human members. During an exam he might get down on the floor and offer belly rubs to aid an animal’s anxiety. But he also helps human family members by offering insight, support, encouragement and even hugs and tissues when needed. “Family members go through different stages of grief at different times. It’s important to me to gauge where each one is and to recognize there are different levels of bonds,” he says. “Some people may not have anyone else. Their pets have been there every day and have seen them through everything. They’re losing Continued on Page 38
“When I lost Inky, I got a card with everyone’s signature, but one of the vet assistants who knew Inky well wrote a short note. They included Inky’s paw print and a tuft of her hair… They now have a candle on the check-in desk with a sign saying, ‘if this candle is lit, someone is saying goodbye to their beloved pet. We ask that you be respectful and keep your voice low during their time of grief.’” – Danny Barnes “When I had to put my beloved Dax to sleep in October, I received a card with his little paw prints in heart-shaped plaster.” – Michelle Snyder “We got a lovely card, signed by all who had been there ‘that’ evening. We received a beautiful dog angel pin. I wore it for a long time.” – Debbie Patching “Our vet offers in-home euthanasia, and it was the best thing that could have happened when it was time to say goodbye to Sketchy. Later that day we received a nice plant basket and handwritten card from everyone at the office.” – Brad Fletcher
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Hotline co-manager Nicole Schwinkendorf says the Pet Loss course includes logistical ways veterinarian practices can be more sensitive to grieving families: • Designated rooms in veterinary offices that have softer, not clinical, lighting for euthanasia • Separate entrances and exits so grieving human family members don’t have to walk through a room full of people and pets • Scheduling euthanasia first thing in the morning or last thing in the afternoon when the office is less busy • Staff awareness when euthanasia appointments are scheduled, and the need to be cognizant when interacting with human family members • The importance of vets remaining present and not rushing through important moments for clients to say good-bye
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Photo by Mariesa Stokes Dr. Nick Snider examines Don Draper, a beagle-basset at a Spokane clinic. Continued from previous page.
everything they love.” Snider lost his beloved 8-year old Golden Retriever Molly to bone cancer in 2014. He is acutely aware of how much it hurts to say goodbye. “The pain is just like losing any member of the family. That can be hard to express to people, to coworkers or friends. For most people, it’s not ‘just a dog.’”
gets full, and then it spills over and makes a mess. This often manifests as compassion fatigue, or burnout, which is harmful to the overall quality of life of the veterinarian. It also decreases the quality of care that they are able to provide clients and patients.” She stresses the importance of staying in touch with family and friends, actively taking part in hobbies unrelated to veterinary medicine, and finding ways to “bail out their buckets.”
For veterinarians like Snider, sometimes the job is nothing short of heartbreaking. So much “It can’t not take an emotional toll,” she says. compassion can come at a cost so it’s critical to ”It’s important to learn to recognize when you need help. No one should ever feel guilty for exercise self-care. realizing their bucket is overflowing and the “There are tough days when you really feel it. need to reach out to friends, family or a health I’m fortunate that my wife is so understanding. care provider for help.” I can tell her when I’m feeling fragile and When Washington State University is in emotionally spent,” said Snider. “We need session, the Pet Loss Hotline phones are staffed to be aware of our own mental health and Monday through Thursday from 7-9 p.m., know when there needs to be a conversation. and from 1-3 p.m. Saturdays. You can call Compassion fatigue is very real.” during these times or leave a message anytime Edwards uses the analogy of a bucket of water at (866) 266-8635 or (509) 335-5704. You to teach about compassion fatigue. can also send emails to plhl@vetmed.wsu. edu. When school is not in session, hours are “All of these really emotional experiences abbreviated but calls and emails are returned add up, like water being slowly poured into a bucket,” she says. “It’s all fine until your bucket promptly.
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Creatively coping How families honor lost, but not forgotten parents, children By Mariesa Stokes LiveWell Correspondent
In 1990, I gave birth to – and buried – my only child. Born with Down syndrome and a severe heart defect, Cayleigh lived just 2 ½ months.
When my grief was fresh and raw, every Mother’s Day was like an even deeper stab to my heart. I had no little arms to hug me, no sticky kisses, no handmade construction paper cards or macaroni presents. When I went out, I had no child in tow. I wasn’t offered a single-stemmed rose at restaurants or church, and I never had the “Happy Mother’s Day” greetings of the day directed at me.
Many people think of Mother’s Day and Father’s Day as the ultimate Hallmark holidays, with mandatory The second Mother’s Day Sunday after Cayleigh died, I kept myself busy at the restaurant where I worked. touches like breakfast in bed, then flowers for After the brunch rush was over, I sat underneath a booth table in the corner and sobbed. The hollowness in my mom or a tie for dad. heart, the sense of being so alone, and the feeling of being surrounded by people who couldn’t begin to comprehend the significance of the day was more than I could bear. I vowed to never, ever work on Mother’s Day again. I made a But for anyone who has lost parents, promise to myself that it would be my day – whether one to cry, to laugh or to remember – it was going to be a day for me. children or spouses, or families brought together by adoption, observing either I spent the next decade unraveling my sorrow. I isolated myself, afraid of what people would think if I treated myself the same as any other mother. I stayed home and cried alone. And then I grew tired of hiding my daughter’s legacy and my life as a of these “parent” holidays can provide childless mother, and I turned my grief into gratitude. a completely different perspective. Instead of being heartwarming, like Now, 25 years after Cayleigh’s death, Mother’s Day is a truly, profoundly special day for me. It’s the day I honor the beauty and the greeting card industry expects not the sadness – the blessings of carrying a child for nine months, growing a human being in my own body and experiencing what it us to feel, both days can make means to bring a life into the world. It’s a celebration of me as a mother – in the only way I know how to be a mother. the normal feelings of loss even I spend every Mother’s Day at a spa – I indulge, I go over the top spoiling myself. I deserve it just as much as any other mother. more painful. But Mother’s Day is also a time to honor the child who made me a parent. Throughout the year, my husband and I actively parent Cayleigh’s Sometimes, however, memory – we volunteer, contribute and otherwise support causes we likely would have been involved with if she was still alive. people are able to come We have attended events for Parent Advocates Down Syndrome and worked booths and laced up our up with creative ways ys sneakers for National Down Syndrome Society’s Buddy Walk. For the last three years on Mother’s to honor someone’s Day evening, I’ve registered to do two things that terrify me – raise money and rappel off of a 20-story memory, which building – in her memory. For the past three years I’ve gone “Over the Edge” for Special Olympics can be powerful, Washington and for two of those years, I was the event’s top fundraiser. meaningful and Over the years my perspective has changed, and so has my perception of the holiday I once dreaded. I healing. have empty arms, not an empty heart. My love for my daughter is just as fierce as the next woman’s. Like most other mothers, I take care of her in the best way I can – and for me that happens to be through her memory. It’s taken tremendous courage for me to parent a child who is no longer living. And to me, that’s something worth celebrating. Courtesy photo Writer Mariesa Stokes, above, with her daughter Cayleigh. Below, Stokes became active in supporting Down Syndrome causes and Special Olympics, including rappelling down a Spokane building for a funrd-raiser.
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Abby Jackson lost her mom Gerry Adderly on Feb. 19, 2009. On every Mother’s Day since then, she and her sister remember her in a special way that makes them laugh more than cry. “We used to always buy her a flowering basket. She absolutely adored them but would inevitably kill them within six weeks, either by over- or under-watering,” Abby said. Gerry’s daughters’ new spring tradition starts at a local nursery. “We pick out all the fun basket stuffers that we adore, then go back to one of our homes and put them together,” she laughed. “And we keep them alive all summer!” What makes their tradition even more special is that each time they look at the baskets throughout the summer it’s a reminder of their mom and of each other. Courtesy photo Abby Jackson creates hanging baskets in memory of her mother Gerry each Mother’s Day.
“It’s always such a lovely day with lots of giggles and maybe a few tears. Great memories are being created and being remembered,” Jackson said.
After close to two years of home studies, psychiatric evaluations, fingerprinting and more, in winter 2000, George Knapp and Sandy Altshuler-Knapp stood in a courtroom in Ulyanovsk, Russia, arguing passionately to be allowed to adopt two children. The heartache, struggle and time spent fighting for their right to have a family paid off. On February 9 of that year, they brought home 15-month old Rena and 10-month old Pavi. The couple is delighted that they now get to celebrate Mother’s Day and Father’s Day with their kids. But for these adoptive parents, the days are about so much more than breakfast in bed and family hikes. “On Mother’s Day and Father’s Day, we talk aloud about the sacrifice and selflessness of each of their birth parents,” explains Sandy. “If it wasn’t for them, we wouldn’t be the family we are.” Courtesy photo The Knapp family, Rena, Pavi, and George.
The Knapps believe deeply in the importance of always acknowledging the loving act of Rena’s and Pavi’s birth mothers, who each chose an adoption plan to ensure the children would have better lives.
“Birth mothers make the absolute most difficult decision for motherhood. No birth mother ever, ever, ever ‘gives up’ her child,” said Sandy. “An adoption plan is the quintessential act of a mother – selflessly acting in the best interests of their children, despite their own pain. They should be praised for their sacrifice and honored for their selflessness on Mother’s Day, Father’s Day and every day.”
A.J. Steiner lives in the home that once belonged to her grandparents. On Mother’s Day, she observes a “traditionally non-traditional tradition” in her Nana’s memory. A.J. starts the day by recognizing her mom in some way – maybe with a gift, movie or lunch. Then she goes home to honor her Nana by doing two things she taught A.J. to love. “Nana created her rose garden with her original ‘proper ladies’” said A.J. “So I plant a new addition in her rose garden by adding either a new ‘wild’ or ‘found girl’ each year.” After spending the afternoon outside, Steiner heads to the kitchen for another Mother’s Day tradition. “I end my day by cooking and enjoying one of Nana’s recipes. And I always set a plate for her with a cup of tea,” she said. Courtesy photo A.J. Steiner remembers cooking traditions – and tea – with her mother and grandparents.
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Kathy Taylor Swehla was only 14 when her father left for work and never came home. That day in 1971, Clyde Taylor suffered a deadly heart attack. The sudden loss of a man so beloved by his family was devastating. While growing up, her family put a lot of effort into preserving the memories of relatives who have passed on. For instance, she never knew her grandfather but heard many family stories. So when she had a son, Kathy wanted him to have the same connection to her dad. But she also wanted to help her little boy feel close to his grandfather in ways that went beyond talking about him and looking at photographs. “When Five Mile Plateau was still open space, it was so close to the sky,” Kathy recalled. “On Father’s Day when Skylar was young, we would get helium balloons and attach things to the end of the strings. I would write a note about how my life was, Skylar would draw a picture or trace his hand, maybe we’d add a photo. Then we’d head up to the Plateau, to where there was no end to the horizon. We’d lie on our backs and let the balloons go and we’d stay there until they floated so far we couldn’t see them anymore.” Admittedly, it’s hard to form a bond with someone who’s already gone, but Kathy was determined to try. She hopes the ways she and Skylar honored her father when he was young helped him to feel a true connection. At the very least, she believes her son understands the depth of love she had for her father.
Courtesy photo Kathy Taylor and her father Clyde Taylor
“People really don’t think about it, or they don’t feel like they have permission, to try and continue or have some kind of positive experience around the person who has passed – like it’s not OK to wear Dad’s shirt to feel close to him, or to try to connect a little boy to his long lost Grandpa. I very rarely hear of people looking for some kind of happiness in the memories they have. I hope talking about it touches some people and empowers them to find positive ways to keep their loved ones in their lives.”
Sandra Ham is the busy mother of three kids in college, and she’s also a widow. Her husband Gordon died from prostate cancer on Sept. 11, 2012. His memory still fills her heart and their home. “I always called him the man of my dreams because that’s what he was,” said Sandra, holding back tears. “He was really too good to be true. I think that God knew he was going to be gone soon and that’s why I got the really best of him for the best years of my life.” Married for nearly 23 years, the devoted husband and father enjoyed running, hiking and spending time with his family. Gordon was a retired U.S. Navy Petty Officer. He was quiet and shy, but was best known for being really funny. “He always came out with these jokes,” said Sandra. “He always had us laughing.” Each year since Gordon has been gone, Sandra and their children, Kelsey, Brittany and Jason, remember him in a way he would have loved. Courtesy photo Sandra Ham, left, remembers her husband Gordon with their children Kelsey, Jason and Brittany.
“There’s always a race for prostate cancer on Father’s Day that we do in his honor,” she says. “After the race we go visit his grave and treat it as special family time like we did when he was with us. We make a joy out of it, we talk about him and his jokes and we laugh – we don’t want to be sad.”
Sandra says she believes he’s right there with them, still joking around. “He always teased me because I hate getting wet. One sunny and beautiful Father’s Day we were there and this cloud came. You could see everywhere else around us was blue, but it started raining – just above us. We also had a joke about a pumpkin. One time at his grave I found a little pumpkin and no one knows how it got there. Every time I go see him there’s a little sign. It’s clear to us there are little signs from him that mean something.”
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THE DENTAL CONNECTION By Renée Sande LiveWell Correspondent It’s disheartening enough that dental-related illness causes kids to miss 51 million school hours and their parents to lose 25 million work hours in the U.S. each year. But did you know that an unhealthy mouth can put your overall health at risk? Ignoring those tender gums in the back of your mouth, brushing once a day or thinking flossing isn’t necessary can easily lead to gum disease, which in turn can cause or exacerbate chronic conditions throughout your body. “General medicine is doing a much better job at conveying that poor oral health can have a negative effect on the body,” said Dr. Mark Jensen of Millwood Family Dental. Called gingivitis in its early stages and periodontal disease in later stages, gum disease is caused by plaque buildup along and below the gum line. When this bacterium dislodges from the gums and enters the bloodstream is when it can cause other problems. For years, studies have shown a strong association between gum disease and other health conditions such stroke, diabetes, heart disease, pregnancy complications, respiratory disease, Alzheimer’s disease, rheumatoid arthritis and osteoporosis.
mouth to rid itself of excess sugar. This excess sugar in the mouth can cause a breeding ground for bacteria. “I see more and more patients coming to our office because their doctors have instructed them to do so due to a health condition such as diabetes, or prior to a surgery,” said Jensen. “The awareness is definitely exciting for dentistry in terms of the whole body health approach.” Despite this increased awareness, more than 75 percent of Americans still suffer from some form of gum disease. Dental decay is currently the most common chronic childhood disease in the United States, affecting 16.5 million children, according to the Partnership for Healthy Mouths, Healthy Lives. The Partnership started a three-year public service ad campaign in 2012 focusing on educating and raising awareness of children’s oral health and its tie to disease prevention. More than 1.3 million visitors have been to the campaign website, 2min2xday.org, which offers free, two-minute videos featuring characters from children’s shows and networks. Kids are encouraged to watch while brushing.
The campaign also received media exposure through TV, radio, print, outdoor and digital public service Because of this connection, dentists are increasingly becoming an integral advertisements in English and part of caring for a patient’s whole body health. Spanish. More parents are Like in Jensen’s office, which now has a blood pressure monitor, a tool more reporting that their children commonly seen in medical doctor’s offices. He also discusses more healthare brushing their teeth for two related topics with patients and answers questions. minutes, twice a day. “I like the fact that we can screen our patients for certain types of health Many dental problems can be issues such as heart disease; these are daily conversations we are having,” avoided through simple changes Jensen said. in routines, and we’re seeing now The Academy of General Dentistry, proper diagnosis and treatment of tooth how receptive Americans are to and gum infections in some patients have led to a decrease in blood pressure this message,” said Gary Price, medications and improved overall health. secretary and CEO of the Dental Trade Alliance Foundation, a While there are different theories as to the specific cause and effect of oral partner in the campaign. bacteria on systemic health conditions, one theory is that oral bacteria can be drawn into the lower respiratory tract through normal breathing, where it “While there is the need for colonizes and causes a bacterial infection. broader, more long-term research It is also thought that oral bacteria can attach to blood vessels, with the potential to increase clot formation. Inflammation caused by gum disease may also trigger clot formation. Certain conditions like diabetes have been found to have the potential to not only be exacerbated by oral bacteria, but be a trigger for bacteria in the mouth as well. While gum disease can increase blood sugar levels, causing a diabetic difficulty in controlling the amount of glucose in their blood, diabetes can lead to gum disease as it thickens blood vessels, making it harder for the
Better oral hygiene becoming linked to better health
as to the negative effects poor oral health can have on the body, the basics are introducing children to oral care early in life, to make flossing a big player and brushing two times a day for two minutes each time,” said Jensen. “And of course, making regular visits to your dentist.”
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WAYS TO KEEP TEETH AND GUMS HEALTHY
Brush your teeth for two minutes, twice a day. Floss or use another between-the-teeth cleaner once a day. Consider using an antimicrobial (germ-fighting) mouth-rinse every day. Replace your toothbrush every three to four months or sooner if bristles are frayed. Choose dental products with the American Dental Association (ADA) Seal of Acceptance. This tells you that the product is safe and does what it claims. Schedule regular dental visits. They are the only way to remove tartar, thus bacteria, along the gumline. Tell your dentist about changes in your overall health, including medication use. Don’t smoke or chew tobacco. If you do, talk to your dentist about options for quitting. Manage dry mouth. Too little saliva in the mouth can lead to tooth decay and gum disease. Eat a healthy diet and limit between-meal snacks.
WARNING SIGNS OF GUM DISEASE If you notice any of the signs below, see your dentist. You can also have periodontal disease and not notice warning signs, which is why regular dental checkups are important. Gums that bleed when you brush or floss Red, swollen or tender gums Gums that have pulled away from your teeth Bad breath that doesn’t go away Pus between your teeth and gums A change in the way teeth fit together when you bite A change in the fit of partial dentures
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I SET GOALS AND BEAT WHATEVER CHALLENGE IS AHEAD. Susannah Mourton, MD, Gynecologic Oncologist Cancer Care Northwest
Dr. Susannah Mourton remains focused to deal with what’s around the next bend, setting goals when faced with challenges in both work and play. That’s why she’s part of the MOST COMPREHENSIVE CANCER CENTER in the Inland Northwest, with the REGION’S TOP CANCER EXPERTS in medical, surgical, radiation oncology, breast and gynecologic oncology, and hematology. At Cancer Care Northwest, you don’t just get a doctor... you get an INTEGRATED TEAM of leading cancer specialists who are fully committed to beating cancer, right here at home.
509.228.1000 (WA) | 208.754.3100 (ID) Eastern Washington and Northern Idaho www.cancercarenorthwest.com comprehensive / innovative / compassionate / integrated