2011
Live Healthy 2011
Live Healthy 2011
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have any concerns about specific items that appear in Live Healthy, consult your personal physician about their effects on your health.
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Live Healthy 2011
Weight Loss Diabetes
Live Healthy 2011 By JOEL ASCHBRENNER H&N Staff Repor ter Originally published in the Jan. 4, 2011 Herald and News
Live Healthy 2011
here is no miracle way to lose weight. The best way to shed pounds and keep them off is to make long‑term lifestyle changes and to find a simple weight‑loss plan that you can stick with, local experts say.
Fonseca also said it is helpful to keep a log of what you eat and how much you exercise. “Sometimes people don’t realize how little they move in a day if they are sitting at a desk,” she said.
Obesity is linked to increased risks of heart disease, diabetes, high blood pressure and other serious health risks, and is a growing problem in Klamath County, where obesity rates hover above state averages, health experts say.
A decade ago, Fonseca decided to get in shape to be able to keep up with her children. She began working out, lost 60 pounds and became a personal trainer. She recommends 90 minutes of strength
Most simple diets can be effective if you stick to them, said Patty Case, a registered dietitian at Oregon State University’s Klamath Basin Research and Extension Center.
training a week and 30 minutes of cardiovascular activity five times a week, but added that those just beginning a workout regiment should start slower. Tonia Henderson, a registered dietitian at Sky Lakes
“Keep it simple,” she said. “The more complex a diet is the more you increase the likelihood of not being able to stick with it.”
Medical Center, said she watches her weight by not eating meat and avoiding sweets. She said it is important to start small when you trying to lose
The most important part of picking a diet or creating a weight-loss plan, Case said, is to find one you will not quit. A person’s body learns to resist diets, so someone who starts and stops diets often has more trouble losing weight, she said.
weight and set realistic goals. Jennifer Lehman, a registered dietitian and certified diabetes educator at Sky Lakes, says dieting doesn’t work. Losing weight, she says, takes lifestyle changes.
Wendy Fonseca, a personal trainer and fitness director at the Klamath Family YMCA, said practicing portion control is one of the best ways to lose weight. She advises clients to eat small, balanced meals every three hours.
“We get the title of ‘food police,’ ” she said about her job, ”but it’s more than that. We work with lifestyle choices.” >
Live Healthy 2011
Many lifestyle choices start at the grocery store, like buying fruit instead of sweets, she said. It is much easier to resist the temptation to eat unhealthy foods, like ice cream, if those foods are not in your house, she said. Lehman added that learning how to cook could help you eat healthier. If you know how to properly prepare fruits and vegetables you are more likely to eat them and more likely to pass those healthy
eather, poverty, culture contribute to high obesity rates
eating habits on to your family. Find ways to cook your favorite foods in a healthier way, Lehman also advised.
Klamath County has a slightly higher rate of obesity than the state average, which local experts say is caused by economic, cultural and environmental factors.
“Just because a cookie recipe calls for a pound of butter does not mean you need to use a pound of butter,” she said. “You can make good food that is still healthy.”
Thirty-nine percent of Klamath County residents are considered overweight and more than half of those are considered obese. Statewide, 37 percent are overweight. Of those, 59 percent are obese. A person is considered obese if their BMI (body mass index) — the percent of a person’s body weight made up of fat — is more than 30 percent. A person is considered overweight if their BMI is between 25 percent and 30 percent. Comparatively high levels of poverty in Klamath County could be one of the reasons for its high obesity rate, said Patty Case, a registered dietician at Oregon State University’s Klamath Basin Research and Extension Center. Healthier foods, like fresh produce, often are more expensive than
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Live Healthy 2011 processed foods high in fat and sugar, she said. “You fill up but you don’t get your body adequate nourishment and that has negative long-term effects,” Case said.
Weight-loss tips from local experts
Fresh healthy foods, however, have become more accessible for some, said Melissa Klegseth, health educator at the Klamath County Public Health Department. This summer, for example, the Klamath Falls Farmers’ Market began accepting Oregon Trail Cards, a form of food stamps. Tonia Henderson, a registered dietitian at Sky Lakes Medical Center, said it is important for people to realize that fruits and vegetables can be inexpensive and healthy if bought frozen or canned.
• Keep a food and exercise log
“A lot of people in the community have the perception that healthy food is expensive and not tasty,” she said.
•
• Find a workout or diet partner • Don’t wait until you feel the effects of obesity
to try to lose weight • Start with small reachable goals • Don’t diet, make lifestyle changes like changing • • •
•
Case said Klamath County residents traditionally value hearty foods that are often high calories.
•
“Culturally we tend to be a meat and potatoes kind of community, although I am seeing that change some,” she said. Environmentally, Klamath County’s cold temperatures and heavy snows can leave residents with few options for exercise during the winter.
what types of foods you buy and when you eat Talk to your doctor before you start an exercise or nutrition plan Eat small meals throughout the day Drink at least 64 ounces of water each day If you diet, use a simple program that you will be able to stick with Avoid sugary drinks that are high in calories but do not make you feel full Do not start and stop diets frequently, as it will be harder to lose weight as your body resists the diet
What can you get for your calories? One pound of fat: 3,500 calories One 12-ounce light beer: 102 calories One 5-ounce glass of red wine: 225 calories One large egg: 70 calories
“We have harsh winters here,” Klegseth said. “It’s hard for people to get out and get physical activity.”
One medium banana: 105 calories One quarter-pound hamburger patty 15% fat: 193 calories One 3-ounce piece of chicken breast: 141 calories One 3-ounce piece of coho salmon: 152 calories One 2.5-ounce carrot: 30 calories One 6.1-ounce baked potato: 163 calories
Residents who might walk or bike to work or school living in a more temperate area, Case said, are more likely to drive because of Klamath County’s cold weather. “It’s just hard for people to get out and be mobile and active,” she said. ❖
Live Healthy 2011
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Live Healthy 2011
We either do the job or we don’t, healing the patient is the only thing that matters. Every day when we come to work, we know there are no shortcuts or excuses. Good enough doesn’t work here, we do. We are healers.
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Live Healthy 2011 By JOEL ASCHBRENNER H&N Staff Repor ter Originally published in the Feb. 08, 2011 Herald and News
at healthy and exercise: that is the best way to prevent and manage diabetes, health care professionals say. “Part of why diabetes is such an epidemic right now is our eating habits and sedentary lifestyle,” said Paula Sue Smith, a registered dietitian and certified diabetes educator at Sky Lakes Medical Center. About 6 percent of Klamath County residents and the same percentage of Oregonians are diabetic, according to a 2008 Klamath County Health Department Study.
Diabetes is a disease that interrupts the way the body processes sugar in the blood. Someone with type 1 diabetes does not produce insulin, a substance needed to break down sugar in the blood for the body to use, while someone with type 2 diabetes either does not produce enough insulin or their body resists insulin. Type 1 diabetes is an autoimmune disease that is not preventable and requires insulin injections, while type 2 is often preventable and can be managed with diet, exercise and medication, before insulin injections are required. Being overweight puts people at a higher risk of developing type 2 diabetes. Fat in the blood stream can mask insulin molecules, preventing them from effectively transporting sugar from the blood to cells where it can be processed, Smith said.
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Exercise helps prevent and manage type 2 diabetes by reducing insulin resistance in the cells that process sugar in the blood, also called blood glucose, said Jennifer Lehman, who also works as a registered dietitian and certified diabetes educator at Sky Lakes. “We see blood glucose decrease dramatically just by adding in a little exercise,” Lehman said. Exercise and a healthy diet also help reduce fat and cholesterol in the bloodstream that prevent insulin from helping the body process glucose. Despite a common misconception, Smith said, fighting off type 2 diabetes takes more than just decreasing sugar intake. A diet that is low in fat, sugar and processed foods and high in fresh produce and whole grains is best for preventing or controlling type 2 diabetes, as well as general health.
Types of Diabetes Diabetes comes in two forms: type 1 and 2. Type 1 diabetes is an unpreventable autoimmune disease, in which the body does not produce insulin. It is managed with insulin injections. Type 2 diabetes either restricts the body’s ability to produce insulin or increases resistance to insulin, causing glucose to accumulate in the blood stream instead of being used by the body.
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Diabetes services
Assistance with meal planning for specialized diets or medical conditions. The Sky Lakes Diabetes Services Education Program is recognized by the American Diabetes Association.
“When glucose is high, that means the cells are starving,” said Tonia Henderson, a dietitian at Sky Lakes Medical Center. “The cells don’t know that carbohydrates and sugar are hanging out in the blood.”
That means coverage by Medicare for comprehensive diabetes education.
Type 2 diabetes cannot become type 1, but patients with severe type 2 diabetes often require insulin injections. Most type 2 diabetics, however, begin treatment with oral medications. Neither type of diabetes is curable, but patients diagnosed as pre-diabetic can manage their blood glucose, with diet, exercise and medication to prevent the onset of type 2 diabetes.
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“Everyone thinks if you have diabetes you can’t eat sugar,” Smith said. “They can eat anything they want if they manage their portions.” For someone who already has type 2 diabetes, Smith said, it is important to eat small meals throughout the day on a regular schedule, to ensure the body has time to process glucose.
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“Initially it takes a lot of thought to manage your diabetes,” she said. Type 2 diabetes has symptoms, though some people can have blood glucose three times the normal level without feeling the effects and many people live with the disease for five or six years before being diagnosed, Lehman said. While the immediate effects of type 2 diabetes can be difficult to recognize, the long-term effects are serious. Diabetes was the underlying cause of death for more than 71,000 Americans in 2007, the seventh leading cause of death, according to the Centers for Disease Control. >
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The disease can increase the risk of coronary problems like heart attack and stroke, because a buildup of unprocessed glucose makes the blood thicker, forcing the heart to pump harder to circulate it throughout the body, Lehman said. Diabetes is also the leading cause of new cases of blindness in adults and the leading cause of kidney failure in the U.S., according to the CDC. High glucose levels in the blood also lead to an increased risk of infection, as blood weighed down with glucose has less capacity to carry oxygen, nutrients and other substances needed to fight infections, especially in extremities like feet, to which blood must travel farther. The extra sugar in the blood also gives bacteria more to feed on.
numbers 25.8 million Americans are diabetic 186,000 Oregonians have been diagnosed with diabetes 76,000 Oregonians are undiagnosed diabetic 8.3 percent of Americans are diabetic -CDC, Oregon Department of Human Ser vices Neuropathy, or the loss of sensation in a certain area, can also result from diabetes, and can allow infections to go unnoticed. Untreated infections can grow and require tissue to be removed, making foot amputations common among patients with severe cases of either type 1 or 2 diabetes, Smith said. Klamath Falls resident Henry Peterson found out he would lose his right leg two years ago when he was diagnosed with type 2 diabetes. After doctors amputated his right leg, he began putting too much pressure on his left leg, causing fractures to form in his foot. His diabetes prevented enough blood flow to his foot to heal the fractures, and last year doctors had to amputate his lower left leg. “Don’t believe that diabetes can’t hurt you — it can,” said Peterson, who now lives at Plum Ridge, a residential care facility in Klamath Falls. Amputations and most instances of type 2 diabetes are preventable, Smith said, if people take the right steps to improve their health. “We start with baby steps,” she said. “Every tiny little thing you do can make a difference, whether it’s drinking an extra glass of water a day or parking a little farther away at the grocery store.” ❖
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Testing for diabetes Blood Glucose Levels: Normal: 70-100 mg/dL Pre-diabetic: 101-125 mg/dL Diabetic: 126 mg/dL and above Patients should be tested for diabetes annually, or more frequently for patients with specific risk factors or who have already been diagnosed as pre-diabetic. Blood glucose, an indicator of diabetes, can be tested with a normal blood sample. This test, however, only gives a reading of a patient’s blood glucose level, which can change depending on what the person has eaten recently, at that point in time. A new test, called A1C, measures blood glucose on hemoglobin in the blood and gives a more accurate reading of a patient’s average blood glucose level, said Paula Sue Smith, a diabetes educator at Sky Lakes Medical Center.
Risk factors for type 2 diabetes - Being overweight - Living an inactive or sedentary life - Having an immediate family member with diabetes - Having high cholesterol - Being older than 45 - Race: several ethnic groups are more at risk for diabetes, including: African Americans, Hispanics, Asian Americans and Native Americans. -Mayo Clinic
Warning signs of diabetes -
Frequent urination Infections that don’t heal Increased hunger Increased thirst Unexplained weight loss Fatigue Blurred vision
Live Healthy 2011
The fair provides information through presentations and informational exhibits. The entire event is aimed at helping people cope with diabetes and manage the disease.
By SARA IRVINE Sky Lakes Medical Center
roviding a Diabetes Connection More than 18 million Americans have diabetes. Millions more have the disease but have yet to be diagnosed. And the rate in Oregon is higher than the national average. This is one of the reasons why each November, Sky Lakes Medical Center brings together a network of diabetesrelated resources at the Living Smart with Diabetes Health Fair.
Free lab tests check glucose and cholesterol levels. “This allows individuals to monitor their numbers,” says Jennifer Lehman, a Sky Lakes dietitian and a certified diabetes educator. “It’s a wake-up call for those who are on the border of type 2 diabetes.”
Sixteen diabetes specialty organizations and resources were
A panel of physicians, educators, and clinicians fields questions on living with diabetes. Among those asking the questions are the recently diagnosed and their loved ones, who may never have had the opportunity to speak with this variety of specialists at one time.
represented at the fair.
“The disease affects so many parts of a person’s body, so physicians, dietitians, podiatry, pharmacists, and physical therapy all play a role in the treatment of diabetes,” Lehman emphasizes.
for the health fair. Nearly
National organizations, as well as local companies, are represented at the event. Information on insulin pumps, special shoes, and financial assistance is readily available. >
Four of them were national companies that do not have an extension in Klamath Falls, but came specifically 100 participants were connected with resources to manage diabetes. READ MORE AT
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Live Healthy 2011
“A support network is so important,” says Lehman. “I almost equate the diagnosis of diabetes with other lifelong diseases. Negative connotations are involved, but knowing you’re not the only person who’s going through it can make a huge difference.” Lehman goes on to say that family support is great, but they don’t always get it. Sometimes it takes someone else living with the same disease to really feel understood. “That’s the whole point of our diabetes-specialized health fair: To connect people with resources they need,” says Lehman. The rate of type 2 diabetes diagnoses is increasing at an incredible rate. “Education and awareness is the key to battling this preventable disease,” says Lehman. A lack of access to screening and risk counseling can keep people from finding out if they have diabetes or what to do if they’ve been diagnosed. With more than 16 percent of Oregonians having no health insurance, free access to screenings is increasingly important. And that is why Sky Lakes is committed to this yearly event during November, Diabetes Awareness Month. Sky Lakes Diabetes Services can answer your questions. Call 541.274.2633. ❖
Living well with diabetes Diabetes is a health condition that can impact your entire body. But taking care of yourself can help delay or prevent the onset of diabetes-related complications. Eyes People with diabetes are more likely to develop eye problems, including cataracts, glaucoma, diabetic retinopathy, and vision loss or blindness. Early detection and treatment of eye problems is essential. Mouth Diabetics have a higher risk for gum disease, which can lead to tooth loss and other mouth-related problems, and even heart disease. Practice good oral hygiene and see your dentist regularly.
Heart Diabetes increases the risk of heart attack, stroke and complications related to poor circulation. Controlling your blood glucose levels—as well as your blood pressure and cholesterol levels— is critical. Kidneys High blood glucose levels can damage the kidneys over time. Prevent kidney damage by managing blood pressure and blood glucose levels, and checking for protein in the urine once a year.
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Skin Diabetics can be prone to skin conditions such as bacterial or fungal infections and itching. They may also develop skin spots and scaly patches. Most can be prevented or easily treated if caught early. Feet If you have diabetes, you’re most likely to develop foot problems if you have nerve damage or poor blood flow in your feet. Check your feet daily for cuts, sores or swelling, wear shoes that fit well and protect your feet from extreme heat or cold.
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Live Healthy 2011
xercise for all-over health Looking for a prescription for overall good health? One that can improve your fitness level from head to toe? Better still, one that’s absolutely free? Look no further than exercise. A complete exercise program —one that includes aerobic, strength and flexibility training — has been shown to help prevent or manage nearly every known ailment and affliction.
Exercise and your body Combat cardiovascular disease. Regular exercise helps lower blood pressure and cholesterol. With your blood flowing more smoothly throughout your body, your risk of heart disease, heart attack and stroke goes down. Defeat diabetes. The primary cause of type 2 diabetes is being overweight. Exercise, combined with a nutritionally sound diet, helps you lose weight, which can prevent — and in some cases reverse — type 2 diabetes. Cancel cancer. The National Cancer Institute says that physical activity is strongly associated with a reduced risk of colon and breast cancer. Several studies also have found links between exercise and a reduced risk of prostate, lung and endometrial (lining of the uterus) cancers. Control chronic conditions. Increased strength and flexibility can help control the symptoms of many chronic conditions, including arthritis, back pain and osteoporosis.
Exercise and your mind Stop stress. Ever hear of the “high” distance runners experience? Exercise stimulates various brain chemicals, which leave many regular exercisers feeling happier and more relaxed. Maintain mental health. Exercise has been proven to reduce feelings of depression and anxiety. It may also reduce the risk of many forms of dementia, including Alzheimer’s disease. Boost body image. Exercise helps you look and feel better. A better body image can improve your self-esteem and selfconfidence. Remember to check with your doctor before starting an exercise program. ❖
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Walk on Trying to lose those last five pounds, or even more? A study published in the Annals of Family Medicine reported that pedometer-based walking programs may do the trick. Researchers analyzed nine studies that examined the effectiveness of weight-loss programs that included walking but no dietary changes. The results demonstrated that the average participant in such a pedometer-based walking program can expect to lose about one pound every 10 weeks, or about five pounds a year. A one-mile walk comprises approximately 2,000 steps, which can be taken as part of a single exercise session or throughout the day. This flexibility makes it easier for people to reach a relatively high step-count goal, according to the researchers. The higher the step count, the greater the potential weight loss. Plus, a regular program of physical activity can help reduce the risk of cardiovascular problems, lower blood pressure and help maintain lean muscle tissue. Pedometers—and walking—are an inexpensive way to get more activity into your day.
Live Healthy 2011
FOR EVERY ACCIDENT, THERE’S A RECOVERY WAITING TO HAPPEN. Accidents happen. They’re an uncontrollable part of life. What you can control is how you are going to treat and recover from an accident. At the Klamath Orthopedic & Sports Medicine Clinic we have the specialized training, expertise, experience and compassionate care to get you back on your feet. Our doctors and support team are specialists in Bone and Joint Surgery, Sports Medicine and Arthroscopy, Hand Surgery, Spine Surgery Joint Replacement Surgery, Upper and Lower Extremity Surgery, Foot and Ankle Surgery, Musculoskeletal Trauma and Fracture Care. So, when accidents happen, we’ll be waiting to help.
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You might have uttered, “Oh my aching joints.” But how much do you really know about the joints that keep us flexible and link the 206 bones in our bodies? Take our quiz to find out.
1. Cracking your knuckles can lead to arthritis. (True/False) Dr. Michael Casey M.D.
Dr. Karl Wenner M.D.
2. Which home remedy has been found to ease aching joints? a) Vinegar b) Yellow raisins soaked in gin c) Fish d) Bee-sting therapy
3. What exercises are good for joints? Dr. Kevin Heaton D.O.
a) Swimming b) Walking c) Yoga d) Jogging on the weekends
4. Osteoarthritis (OA), or Dr. Edward Van Tassel D.O.
degenerative joint disease, is just a fancy name for the inevitable aches and pains of old age. (True/False)
5. For every 1 pound of weight lost, Dr. Karl Knudsen M.D.
the load exerted in your knees-the body’s biggest and heaviest joint-is reduced by 4 pounds. (True/False)
6. Doctors can slow or reverse joint Dr. Jason Conaughty M.D.
damage. (True/False)
SCORE:
klamathbones.com
1. False. Cracking your knuckles can irritate tendons and cause swelling around a joint, according to the Arthritis Foundation. In the word “arthritis,” arth means joint and itis means swelling, so arthritis is swelling inside the joint.
2. C. Studies show omega-3 fatty acids found in salmon and mackerel may reduce pain and inflammation in stiff joints. There is no evidence backing bee‑sting therapy, eating gin-soaked raisins or drinking vinegar, according to the Arthritis Foundation.
3. A, B and C. Swimming and yoga can improve joint strength. Walking is a weight-bearing exercise that will strengthen bones and joints. However, if you’re a weekend runner who is overweight, you might create injury.
4. False. Just like heart disease, there are things you can do to delay the onset of OA. Controllable OA risk factors include weight, repeated overuse of certain joints and lack of physical activity.
5. True. When you lose 11 pounds, it’s
4-5: Like a ball-and-socket joint, you’re good all around.
like losing 44 pounds across your knees, the Arthritis Foundation reports. One study showed that obese people who lost just 11 pounds reduced their risk of OA by 50 percent.
2-3: You need more range of motion.
6. False. But there are things they
6: You’re a joint genius.
541.884.7746
ANSWERS
Live Healthy 2011
Joint effort quiz
0-1: Please don’t tell us you’re eating yellow raisins soaked in gin.
can do to help people become active, which reduces joint pain. Talk to your doctor about pain medications or other therapies that may help.
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Live Healthy 2011
Experts agree: If you take care of your heart today, you’ll significantly reduce your risk for problems tomorrow. And a heart-healthy lifestyle isn’t as tough as you might think. Rather than a list of things to do and things to avoid, the American Heart Association says it’s really all about having a strategy of moderation and modification. In that sensible spirit, here are nine things everyone can do to help prevent heart disease.
1. Make small changes, one step at a time Many of the nine strategies are interconnected, and this one relates to the other eight. Incorporate a change and let it become embedded in your lifestyle – let it become a habit – and then move on to the next change.
2. Eat good foods and avoid bad ones Fresh vegetables, fruits, whole grains and lean proteins are the foundation of a heart-smart diet. And certain foods have added benefits. Brightly colored vegetables such as tomatoes and peppers, as well as fish and fish oil, can promote cardiovascular health.
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3. Get moving and be strong Just 30 minutes of aerobic exercise five days a week is enough to promote cardiovascular health. Plus, the effects of exercise are cumulative: five minutes climbing the stairs, 15 minutes walking during your lunch break ... and before you know it, you’ve got your 30 minutes in. Also incorporate up to three weekly sessions of weight training into your routine, the AHA suggests. This can be as simple as carrying hand weights while you walk or doing push-ups and pull-ups. Increasing muscle mass and lowering fat mass helps your body burn fats and carbohydrates more efficiently, the AHA reports.
4. Maintain a healthy weight Being overweight significantly increases your risk of heart disease. But don’t try to lose all the weight at once. A program of diet and exercise that takes weight off gradually — roughly one to two pounds a month — is ideal.
5. Kick the habit
8. Chill out
There is nothing about smoking that’s good for anyone. Cigarette smokers are up to three times more likely to die from coronary heart disease than nonsmokers, according to the American Heart Association. Talk to your doctor about resources for giving up tobacco for good.
Reducing stress is another important component of a heart-friendly lifestyle. Healthy social outlets, supportive relationships and having fun are three ways to keep stress at bay.
6. Start each day with a plan to be
healthy Wake up every morning thinking about what you’re going to do to improve your health, such as exercising or seeking stress relief. You may not manage it every day, but you’ll have a much better chance of achieving your goal if you think about your day’s plan.
7. Watch your numbers High cholesterol, high blood pressure and diabetes are major risk factors for heart disease. Have cholesterol, blood pressure and blood sugar levels checked at least once a year, and if they’re higher than they should be, take the necessary steps to control them. Exercise and a healthy diet can help bring these numbers to acceptable levels, and medication can be added for people who need it.
Live Healthy 2011
When it comes to heart disease, fat is one of the biggest baddies, particularly saturated and trans fats, which can raise cholesterol and put on pounds. But, in moderation, some fats are good for your heart, such as olive oil and fats in such foods as avocados and salmon.
“Blowing off steam” is equally important. Studies have demonstrated that internalizing hostility can be enormously destructive. Have some outlet that allows you to decompress and redirect your energies, the AHA says.
9. Enjoy life Some indulgences – such as moderate amounts of dark chocolate and alcohol – can have positive effects for your heart. There are a number of complex substances in dark chocolate that directly promote vascular health, and consumption of no more than 10 drinks per week has been associated with a reduction of cardiovascular events, research indicates. Of course, not everyone drinks alcohol or likes chocolate. What matters most is making healthy decisions that make sense for you and the life you want to live. Follow a prudent diet, but still enjoy some indulgences once in a while. You have to balance that indulgence with the rest of your choices in a way that allows you to lead a heart-healthy lifestyle every day for years to come. ❖
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Live Healthy 2011 By JOEL ASCHBRENNER H&N Staff Repor ter Originally published in the Jan. 18, 2011 Herald and News
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Live Healthy 2011
f you have high cholesterol, you are twice as likely to have a heart attack or stroke than someone with healthy levels, experts say.
How does cholesterol hurt you?
“Cholesterol could kill you,� said Jennifer Lehman, a registered dietitian at Sky Lakes Medical Center.
By itself, high cholesterol can be damaging enough to cause a serious medical issue like a heart attack or stroke, but, more often, serious problems come when high cholesterol is paired with other ailments like high blood pressure or diabetes.
The good news for the estimated 102 million Americans with high cholesterol is that improving cholesterol levels can be simple.
Dr. Alejandro Rey, a family practice doctor now at Cascades East Family Practice, said he tells his patients it is important to monitor their cholesterol levels because high cholesterol can lead to the development of heart disease, one of the leading causes of death and health issues in the nation.
Cholesterol is a type of fat found in the blood. The body needs cholesterol to function and produces it naturally, but more cholesterol is added to the bloodstream by eating animal fats found in meat and dairy products. Lowering cholesterol is as easy as eating less food high in cholesterol, saturated fat and trans fat, eating more whole grains, produce and fish, and exercising, health care professionals say.
Cholesterol is tiny balls of fat covered in protein found in the blood. If there is too much of the unhealthy LDL cholesterol or not enough of the healthy HDL cholesterol, fatty plaque can begin to build up on arterial walls.
Cholesterol is not found in plants, so fats like vegetable or olive oil are healthier than those produced by animals, like butter or the fat naturally contained in a cut of meat, said Tonia Henderson, a dietitian at Sky Lakes. Additionally, fish and nuts contain fats that have been linked to improving cholesterol levels and lowering risks of heart disease, she said. >
The more plaque on the walls of the arteries, the less room there is for blood to flow and the greater chance of having a heart attack or stroke. High blood pressure can compound this risk by damaging arterial walls, leaving spots for plaque to accumulate. Diabetes can increase the level of LDLs and decrease HDLs.
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Live Healthy 2011
Recommended cholesterol levels
HDL, LDL what’s the difference?
Total cholesterol: Less than 200mg/dL HDL: More than 60 mg/dL LDL: Less than 100 mg/dL Triglycerides: Less than 150 mg/dL - American Heart Association
Not all cholesterol is bad cholesterol. While low-density lipoproteins (LDLs) can build up in the bloodstream and clog arteries, high-density lipoproteins (HDLs) taxi fat molecules from the bloodstream to the liver to be broken down.
Patty Case, a registered dietitian at Oregon State University Klamath Basin Research and Extension Center, said she recommends people eat more fiber-rich foods, nuts, whole grains, fresh fruits and vegetables, and fish two to three times a week. “Be real careful with the amount of meat you eat,” she said. “Make sure that it is not the center of the plate and make sure you use a leaner cut.” Dieting alone often is not enough to lower cholesterol and should always be done in conjunction with exercise, Case said. Exercise can lower the unhealthy low-density lipoproteins and raise levels of healthy highdensity lipoproteins, she said. For some, however, diet and exercise are not enough to improve cholesterol levels and medication is required. Lehman said blood pressure medication can be very effective, but should be taken in addition to diet and exercise. “If medication is necessary, it does not take the place of lifestyle changes,” she said. “A pill is not a cure all.” ❖
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“It’s like a garbage truck that moves the trash out of the body,” said Patty Case, a registered dietitian at the Oregon State University Klamath Basin Research and Extension Center. Doctors recommend patients maintain HDL levels greater than 60 mg/dL and LDL levels less than 100 mg/dL. High levels of cholesterol, especially LDLs, can lead to major health problems, but the body does need a certain amount of cholesterol to function and produces it naturally. “It’s something that is necessary for our bodies,” said Tonia Henderson, a dietitian at Sky Lakes Medical Center. “I think cholesterol gets a bad rap.” Triglycerides, a type fat in the blood, also are measured with cholesterol. Because they come from fat in food, triglyceride levels in the body rise and fall often depending on what a person has eaten and are affected by the consumption of fats, sugars and alcohol. Doctors recommend patients maintain triglyceride levels below 150 mg/dL.
High cholesterol generally carries no symptoms, but can lead to major health issues like stroke and heart attack. That’s why, local health care professionals say, it is important to have your blood pressure tested. “It’s fixable,” said dietitian Tonia Henderson. “You can do something about it, but you have to know you have it.”
Live Healthy 2011
Getting tested
For someone with few risk factors, a cholesterol test every five years is enough, but for those likely to have or develop high cholesterol, more frequent testing is recommended. Risk factors include: • Genetics: Someone with a family history of high cholesterol or heart disease is more likely to develop the same problems. • Poor diet: Eating foods high in cholesterol, saturated fat and trans fat, like red meat and dairy, increases cholesterol levels in the body. • Lack of exercise: Exercising helps increase the healthy HDL cholesterol while reducing the unhealthy LDL cholesterol. • Obesity: Having a body mass index greater than 30 increases the risk of high cholesterol.
• High blood pressure: Increased pressure on the arterial walls, because of high blood pressure, damages the arteries leaving spots for fatty LDL cholesterol to accumulate and clog arteries. • Smoking: Smoking lowers levels of the healthy HDL cholesterol, temporarily increases blood pressure and damages blood vessel walls, leaving them susceptible to the accumulation of fatty deposits. • Diabetes: High blood sugar contributes to high levels of unhealthy LDL cholesterol and low levels of healthy HDL cholesterol. -Mayo Clinic
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ate* didn’t let a litany of illnesses, including rheumatoid arthritis and Type 2 diabetes, slow her from managing her family’s business. That is until January 2010, when her husband, Chuck*, concerned that his bedridden wife was experiencing worse than normal pain and an altered mental state, rushed her to the emergency room despite the family’s lack of health insurance. The news wasn’t good. Doctors added respiratory and congestive heart failure and gastro-intestinal bleeding to the 60something’s list of medical issues. But she was soon stabilized and admitted into the hospital for what was to be a six-week stay. Many people would wonder how she could go so long without seeking the proper treatment. The answer isn’t that complicated. Many hard-working, self-employed people without health insurance put off regular doctor visits and medications because they fear the out-of-pocket costs will be too much of a burden on their families. Besides, Chuck was doing a Herculean job of caring for his wife with meals and hygiene assistance, often in-between jobs.
Kate’s situation highlights the common misconception that uninsured people are all alone when it comes to their medical expenses. Kate and Chuck, like many others, simply weren’t aware of the financial assistance programs available at Sky Lakes; programs that help them pay medical bills and help them navigate with the complicated application and follow-up processes involved with government programs such as Medicaid or Social Security Disability Insurance (SSDI). There is a dedicated advocacy team at Sky Lakes that can help patients like Kate. The team helps locate and secure financial assistance from a variety of local, state and federal sources. The team, composed of representatives from Chamberlin Edmonds, an eligibility and enrollment services company, screens qualifying patients for coverage and walks them through the application process.
Due to the nature of Kate’s disabling condition, her application process went quickly with patient advocates enrolling Kate in SSDI and Supplemental Security Income (SSI) programs within just a few
Learn more about this and other programs to help patients by calling 541.882.6311 weeks. Without it, Kate and Chuck would have been left with crushing debt, not only from her hospital stay, but also her outpatient nursing facility care. As a result of her new health coverage, Kate is now taking the right medications and paying regular visits to her physician. Kate and her husband hope that others will learn from their experience and ask for assistance. Kate now has medical coverage to take with her beyond Sky Lakes, and a huge burden has been lifted from her family. ❖
* Names changed for this story
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Live Healthy 2011 By LEE BEACH H&N Staff Repor ter
aul Stewart Cancer Survivor Just like anyone else who hears the diagnosis of cancer, Paul Stewart, president and CEO of Sky Lakes Medical Center, said it hit him “like a sucker punch,” a blow by an opponent he would face more than once. This reaction was despite his knowledge of hospitals and medical care, particularly the Cancer Treatment Center, with which he was intimately involved in the effort to help make the center that now serves this community a reality. “There was no family history, and I was completely asymptomatic,” he said. “The only risk factor I had was that I was a male.” It was 2000, and Stewart had been diagnosed with testicular cancer, a germ cell tumor of the testis called a seminoma. Stewart felt the lump through self-examination on a Thursday, saw his physician on Friday for a biopsy and was in surgery to remove it by Saturday. In the interim, he did research for the best course of treatment, and decided he could get everything he needed to fight it here in Klamath Falls, under the care of Drs. Carol Fellows and Henry Louderbaugh.
Sharing with family His wife, Suzanne, was with him in the doctor’s office when he got the diagnosis. “Both my wife and I were thinking — how do you mentally and psychologically deal with it? We were both going through all the Kubler‑Ross stages – anger, denial … ,” he said. “We have five children, three of whom were still at home. We sat down as a family and discussed what the diagnosis was and explained how I would be treated, and that the type of cancer I had is considered highly treatable.” Still, one of their sons was living in Portugal at the time and couldn’t be there with his dad and the rest of the family. Stewart said it was harder for him, and they spent considerable time on the phone talking. >
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Paul Stewart
Kubler‑Ross Stages of Grief Elizabeth Kübler-Ross was a doctor in Switzerland who spent time with dying people, both comforting and studying them. She wrote a book, called ‘On Death and Dying’ which included a cycle of emotional states that is often referred to (but not exclusively called) the Grief Cycle (through which patients diagnosed with fatal or potentially fatal illnesses progress in their thought processes). The cycles include immobilization, denial, anger, bargaining, depression, testing and acceptance. - www.changingminds.org
Live Healthy 2011
Treatment Treatment consisted of surgery and a daily 15-20 minute dose of radiation therapy for six weeks, no chemotherapy because, “it seemed early enough.” The side effects included “feeling a little weak, having foods I normally like not tasting good and losing a little weight,” he said.
“On the second go around,” said Stewart, “we still had one daughter at home, a senior in high school. To have it recur was hard – she was brave and we had a bonding experience. I’ve been blessed to have a supportive wife and family to lean on. It’s difficult for a family to deal with,” he added.
Stewart was still able to continue working full time during the treatment. His evaluation of the cancer services and treatments he received: “I know the capabilities, strengths and weaknesses, and I know you can get just about everything you need here.” The one possible exception, he said, was pediatric cancer care.
Stewart considered treatment options again, consulting with a specialist in Indiana, and again chose to be treated here. He was started on a regime of chemotherapy. With this treatment came some major physical side effects: persistent nausea and vomiting, loss of appetite and subsequent weight loss, lack of energy, hair loss and occasional severe dehydration.
Receiving this diagnosis, going through treatment, and seeing its impact on his family has given him a window into the lives of other people facing cancer: “I have sympathy and empathy for every individual going through this,” he said. That sensitivity has translated into sharing his experience with others fighting the disease. He and Suzanne have spoken frankly and openly in support of patients at several cancer support groups conducted on a regular basis in the Basin.
A recurrence He followed up after the course of treatment with annual checkups, tests and a healthy lifestyle. “I’m a poster child. I was healthy, active and I was doing everything I should.”
To get through it, Stewart again relied on family as well as his own inner strength: “Having a good support network, letting your family share emotions and feelings and maintaining a positive attitude is essential,” he said. There supporting him, too, was the staff at the Cancer Treatment Center. Of those people he said, “I believe most of the staff at the CTC do not see their work as a job – more of a mission – to ease the burden of the illness and relieve as much of the pain and concern as possible while bringing a measure of support and peace. They function as a close knit family would to come together
So, when Stewart received a phone call from Dr. Carl Jung, radiation oncologist, while he and his family were traveling back East, it still came as a shock – another “sucker punch,” he said. It was 2005, four and one-half years since his first diagnosis, he was asymptomatic, and there was something suspicious on a CT scan. “It was tiny, just a 5 centimeter tumor, and the doctor had seen just the tip of it — I was lucky (that he saw it). I got a biopsy, and it was the same type of tumor, just in a different location.” He realizes, even though he had undergone successful surgery and radiation previously and had annual scans, that imaging studies don’t pick up microcellular carcinomas, which remain in the body and may develop into tumors at a later time. The family was again faced with the specter of possibly losing their husband and father.
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Cancer treatment services accredited Thirty percent of centers provide about 80 percent of cancer care in the country, according to Paul Stewart, president and CEO of Sky Lakes Medical Center. Local cancer treatment services, at the Cancer Treatment Center and through Sky Lakes Medical Center have been accredited with commendation by the American College of Surgeons Commission on Cancer. “A three-year accreditation is granted,” he said, “and only between 10 and 20 (cancer services programs) get accreditation with commendation instead of just accreditation — statistically one percent.”
Looking ahead Stewart admits, “There is literally not a day I don’t think about it.” Yet today, he looks ahead to December, an anniversary which will mark 10 years since his first diagnosis of cancer, and 5 years since his second diagnosis, with no further sign of recurrence of the cancer. His family didn’t wait for that “official” date to acknowledge how, as a family, they have gone through this with him. “On Father’s Day this year, Suzanne put all the e-mails about our experiences together in a scrapbook. It was very touching.” Despite the disappointment of a recurrence, Stewart doesn’t let what could be considered bad luck dominate his life. ”If you’re dwelling on the bad side of things, you can’t live life fully. For me, it has put into perspective what is important in life.” ❖ - Originally published in the Oct. 24, 2010 Herald and News
He had been intimately involved in the process of helping get it constructed, only to become a patient there 10 years later. Now serving as president and CEO of Sky Lakes Medical Center, at the time, he was an assistant administrator who worked on the hospital’s long-range planning to determine if a cancer treatment center was feasible for this area. “We went to other CTCs to see how they operated,” he said. “We asked (ourselves), can we afford it and do it in a quality fashion? To become good at any treatments, you have to be doing them numerous times, not just a few monthly. I spent a lot of my time evaluating equipment options, business plans and capital planning.
Some discouraging words Some insurance companies and foundations they approached for funding said the center would be out of business in two to three years, according to Stewart. That didn’t prove to be the case – they had a successful fundraising campaign, and from the beginning, the center drew a consistent caseload of patients. It now has garnered accreditation with commendation. The Cancer Treatment Center began service on the third floor of the hospital before occupying its first structure. It then moved to a former dental surgery clinic that had been remodeled — its present site is on Uhrmann Road. The center has expanded since, onto adjoining property that was donated. “We have been asked to speak at national cancer symposiums on how we did it,” he said. Yet, the greatest challenge has been recruiting.
By LEE BEACH H&N Staff Repor ter
aul Stewart Helps Start CTC When the Cancer Treatment Center opened in January, 1990, Paul Stewart couldn’t have imagined how it would impact his own life.
“The most difficult task is recruiting, attracting providers in a remote area. We were incredibly successful,” he said. “The anchor was recruiting Carol Fellows and Henry Louderbaugh.”
A home away from home In addition to the medical treatments, the center has an adjunct to serve families of patients, some of whom come a great distance for care. “I fondly remember being with Hugh Currin in my van, going to the different centers for 18 months to two years,” Stewart reminisced about the years leading up to creation of the CTC. Currin House was named in honor of long-time area physician Dr. Hugh B. Currin. >
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Live Healthy 2011
to support their patients. They are both competent and compassionate and deeply care for the people they see and treat and take care of.”
Live Healthy 2011
“I’m especially happy about Hugh Currin House,” he said. “It provides people coming from remote areas a place to stay.” A cancer advisory committee subcommittee of the Sky Lakes Medical Center Foundation, Inc. oversees expenditures for Hugh Currin House as well as a certain amount that goes to non-treatment needs, such as helping families in need buy gas when they are here for treatment. “I’m immensely proud of what this community has done in creating this CTC,” said Stewart. “These (the CTC and Hugh Currin House) have served as role models for other communities.” ❖ - Originally published in the Oct. 24, 2010 Herald and News
Hugh Currin House A residential duplex, Hugh Currin House has three bedrooms, each with a private bath, with six beds on each side – accommodating up to 12 people (each patient may bring one family member or friend). There is a shared living room, kitchen and dining room on each side. Meals may be prepared on the premises or purchased at the hospital’s cafeteria. Next to the house is a six-pad RV park. Hookups for electricity, water and sewer are provided as well as bathroom, shower and laundry facilities. There is no charge to stay at the house, thanks to a large number of donors who have given generously so that such a place would be available when needed, however, residents are asked to consider a donation of $10 per night. Reservations are available on a first-come, first-served basis with priority given to patients of the Cancer Treatment Center. Call 541-274-4171.
-SkyLakes.org
By JOEL ASCHBRENNER H&N Staff Repor ter
ancer Prevention READ MORE AT
skylakes.org
Cancer is the second leading cause of death in the United States, killing nearly 600,000 Americans each year, according to the American Cancer Society. Many cases are not preventable, but there are several things you can do to decrease your risk of developing cancer, local doctors say. Avoiding tobacco use is the best and most documented way to help prevent cancer, said Brad Kramer, a radiation oncologist at Sky Lakes Medical Center’s Cancer Treatment Center. But beyond that, here are several steps you can take to reduce your cancer risk.
Eat fresh produce A healthy diet is one way to fend off cancer, local doctors say. While claims of “super foods” that prevent cancer are usually unfounded, there are certain foods that studies show can reduce the risk of certain cancers, said Dr. Nasser Abu-Erreish, a medical oncologist at Sky Lakes Medical Center’s Cancer Treatment Center. Brightly colored vegetables, like eggplant and carrots, and fruits high in antioxidants, like kiwi and berries, have been shown to fend off some types of cancer, Abu-Erreish said. “All the berries are really good for you,” he said. Broccoli and brussels sprouts also have been linked to cancer prevention, said Dr. Brad Kramer, radiation oncologist at the Cancer Treatment Center. But eating more fresh fruits and vegetables in general is the best dietary way to ward off cancer. However, eating healthy is not a cure-all, Kramer said. A heavy smoker will not prevent lung cancer just by getting more antioxidants, he said. The way you cook your food can also play a role. Burnt food contains nitrates, which are linked to some kinds of cancers. This
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is why people native to Southeast Asia, where food is often cooked in woks at very high temperatures, have an increased incidence of stomach cancer, Kramer said. Studies show excessive alcohol consumption — more than one drink a day — can increase the risk certain cancers, Abu-Erreish said, including cancer of the breasts, neck, pancreas and esophagus, especially when combined with tobacco.
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“Smoking and alcohol are a particularly dangerous combination,” he said. “The risks are synergistic, not just additive.”
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Exercise and avoid obesity Behind tobacco use, obesity tops the list of risk factors for cancer, said Dr. Brad Kramer, a radiation oncologist at Sky Lakes Medical Center’s Cancer Treatment Center.
He is currently accepting new patients
Studies linking obesity and cancer are not 100 percent definitive, Kramer said, but indicate fat produces hormones that increase the risk of developing cancer. Some cancers are attributed to an increase in saturated fat consumption, said Dr. Nasser Abu-Erreish, a medical oncologist at the Cancer Treatment Center. Saturated fat comes from animals and is found in food like red meat, butter and chicken skin. Saturated fat, he said, has been shown to oxidize fatty acids, which can be carcinogenic and cause cancer, especially in the colon. Exercise helps reduce some of these cancer risks, Abu-Erreish said. “Exercise has been shown to improve circulation to the tissue, so it can detoxify the body of any cancer causing chemicals,” he said, recommending at least 30 minutes of exercise, three times a week.
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Stay out of the sun When it comes to protecting yourself from skin cancer, your mom was right: Put on sunscreen early and often, said Dr. Brad Kramer, a radiation oncologist at Sky Lakes Medical Center’s Cancer Treatment Center. While it might look good for a few days, “A suntan is a traumatic event for the body,” Kramer said. “It’s actually a sign of trauma.” >
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Sunburns are worse. A person who has had more than five sunburns is twice as likely to develop melanoma, a type of skin cancer, than someone who has not had a sunburn. Skin cancer is the most common form of cancer and is diagnosed in about 2 million Americans each year, according to the Skin Cancer Foundation. Protection from the sun is particularly important for children. “Most of us get the worst of our exposure when we’re kids, so it’s important that parents and grandparents cover their kids up or smother them in sunscreen,” Kramer said. Patients should be tested for colon, breast, prostate and skin cancers regularly, he said. Those with a family history or risk factors for certain types of cancer should be screened for those cancers, he said.
Cancer in Oregon Average cases per year (2004-2008): 18,455 MOST COMMON TYPES OF CANCER IN OREGON Digestive system: 3,122 Genital system (male): 2,850 Breast: 2,753 cases per year Respiratory system: 2,711 Colon/rectal: 1,728 Urinary system: 1,474 Skin: 1,073 Genital system (female): 1,017
A colonoscopy can detect colon cancer and in some cases prevent it, said Dr. Brad Kramer, a radiation oncologist at the Sky Lakes Cancer Treatment Center. New colonoscopy methods can detect precancerous areas likely to develop into cancer if left untreated he said. Men should begin getting colonoscopies at the age of 50, or 40 for men with a family history of colon cancer.
-Oregon Cancer Registry
Exposure to UV rays in a tanning bed, he said, is as or more dangerous than exposure to the sun. “There is no question that tanning beds are harmful,” he said. Dr. Nasser Abu-Erreish, a medical oncologist at the Cancer Treatment Center, said it is important to remember excessive sun exposure also causes premature aging of the skin and skin diseases that can develop into cancer. He recommends using sunscreen with a sun protection factor (SPF) of 15 or higher and reapplying sunscreen every few hours, especially after getting wet.
Get screened Early detection is the best way to fight some cancers, said Dr. Nasser Abu-Erreish, a medical oncologist at Sky Lakes Medical Center’s Cancer Treatment Center.
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Tips to cancer prevention: • Don’t use tobacco • Don’t drink excessive amounts of alcohol • Eat fresh vegetables, like carrots, eggplant, broccoli and brussels sprouts • Eat fruits high in antioxidants, like berries • Avoid eating excessive amounts of burnt food • Avoid eating saturated fat • Wear sunscreen and avoid excessive exposure to the sun or tanning beds • Exercise for at least 30 minutes, three times a week • Females between ages 11-26 should get vaccinated for human papillomavirus (HPV)
Abu-Erreish said new techniques allow doctors to test for colon cancer in some patients with less invasive methods. Women older than fifty should get annual mammograms, which detect breast cancer, and women between 40 and 50 should get one every two years, Abu-Erreish said.
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Health care providers may also perform a clinical breast examine, in which breasts are examined for lumps or other abnormalities that could indicate cancer. A clinical breast examine is recommended every three years for women between 20 and 40. Women in their 20s should perform self-breast exams to regularly, according to the American Cancer Society. A blood test is now available to help detect prostate cancer. The test, called a prostate-specific antigen, detects levels of a protein produced in the prostate. A high level of these proteins indicates prostate cancer, according to the National Cancer Institute. The PSA test, however, should be done in conjunction with a rectal examine, the traditional screening method for prostate cancer, Abu-Erreish said. Most men should get screened for prostate cancer annually starting at age 50, while men with a family history of prostate cancer and African-American men, who have a high incidence of prostate cancer, should get screened annually starting at age 40, he said. The National Cancer Institute recommends monthly self-screenings for skin cancer. Melanomas, cancerous tumors found mostly on the skin, are usually visible with the naked eye and often look like a misshaped mole. A regular skin check by a doctor is recommended for people who have already had skin cancer.
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- Originally published Feb. 15, 2011 in the Herald and News
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Live Healthy 2011 By CELIA FREEMAN, MBA Director of Residency Administration Cascades East Family Medicine
In 2010, Cascades East was surveyed by the ACGME and proudly received a full five-year reaccreditation with no citations – a very rare accomplishment. The physicians and staff at Cascades East are dedicated to providing personal, comprehensive, and continuing health care for people of all ages, their families, and the rural community of Klamath Falls.
ascades East, a three-year rural Family Medicine Training Program, was established in 1994 and remains Oregon Health & Science University’s (OHSU) only off-site residency training program. Cascades East is accredited by the Accreditation Council for Graduate Medical Education (ACGME). The accreditation is administered through Oregon Health & Science University and the operations are owned and operated as a department of Sky Lakes Medical Center.
Each year, a class of exceptional physicians graduates and a new class begins training. Cascades East would like to thank the class of 2011 who have graciously served this community while specializing in rural family medicine training: Carey Allen, M.D. Heidi Allen, M.D. Jerry Flynn, MD Matt Edmonds, M.D.
Sheila Santa, M.D. Natalie Speck, M.D. Maggie Wilson, M.D. Chris Zowtiak, M.D.
Please help Cascades East welcome the following physicians to Klamath Falls: Jinnell Lewis, M.D. Grant Botker, M.D. Holly Montjoy, M.D. Greg Burnett, M.D. Ian Panuncilamun, M.D. Siobhan Cooper, M.D. Kelley Patterson, M.D. Courtney Hayashi, M.D. Eric Scrivner, M.D.
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Family medicine
Cascades East Family Medicine Residency Program has
In most rural communities, family physicians offer a foundation to the medical care system. In towns with less than 10,000 people, family physicians represent 42 percent of all actively practicing physicians. The family physician provides a broad spectrum of clinical care, creating a base that is expanded on and complemented by medical specialists and nonphysician health care providers.
continued to attract outstanding physicians since its first class. The program has continued to grow, from an original offering of four resident first-year positions per year to eight official first-year positions currently. Those aren’t the only numbers that highlight the ongoing success of Cascades East. • 120 residents have been enrolled in the program; • Not including active residents, 88 of 95 completed their training at Cascades East; • 80 percent of graduates are actively practicing family medicine in rural communities; and • 87 are certified by the American Board of Family Medicine. Cascades East Family Medicine Residency Program receives approximately 1,000 applications annually – almost 20 percent of the total applicants to family medicine programs. During the period of October to January annually, some 85 qualified medical students interview for the residency training the program. Cascades East, like most similar programs, participate
Rural health care delivery systems in the U.S. rely heavily on the supply of well-trained family physicians. Family medicine residency programs play an essential role in producing primary care physicians with the knowledge and skills required for rural practice. The Rural Health Research Center reports that graduates from rural residency programs are three times more likely to practice in rural areas than urban residency program graduates. However, less than 8 percent of family medicine training in the U.S. actually occurs in rural communities. Cascades East Family Medicine Residency Program understands the importance of training of future rural physicians. And the program looks forward to many more years of successful training with the ongoing, and much appreciated, support of the Klamath Falls community. ❖
in the National Resident Matching Program (NRMP). The NRMP utilizes a specialized computer program to systematically and fairly match applicant preferences with program preferences to fill available residency
Congratulations!
training positions at teaching hospitals in the United States. Cascades East has consistently filled all available positions through the NRMP Match, despite tough competition. In 2011, the NRMP reported:
Jim Calvert, MD Oregon Family Physician of the Year, 2011
• 453 Family medicine residency programs in the U.S.; • 2,708 first-year available family medicine positions
The Oregon Academy of Family Physicians
through the NRMP (that’s 100 more than in 2010, 200
recognizes your loyal and dedicated service to your
more than in 2009);
patients, community and the profession of medicine.
• 5,121 applications to family medicine programs; and • 2,555 positions were filled through the NRMP Match. Family Medicine Programs continued to experience the strongest growth among primary care specialties in the
All of us at Sky Lakes sincerely appreciate all you do. Our community is a better place because of your professionalism, your passion for healing, and your hard work to make lives better.
number of positions filled by U.S. medical school graduates. Nearly half of the family medicine programs had positions filled by graduates of U.S. medical schools, an 11percent increase over 2010. SkyLakes.org
Live Healthy 2011
It’s in the numbers
uitting tobacco use is the most important thing people can do for their health, experts say, but there’s no one proven method to do so. “I’ve seen people quit all the different ways, and I’ve seen people who haven’t quit trying all the different ways,” said Dr. Brad Kramer, a radiation oncologist at the Sky Lakes Cancer Treatment Center in Klamath Falls.
By JOEL ASCHBRENNER H&N Staff Repor ter
Tobacco Use in Klamath County per year 11,109 adults smoke regularly 3,567 people suffer from a serious illness caused by tobacco use 183 people die from tobacco use 45 people die from lung cancer $33 million is spent on medical care for tobacco related illnesses $30 million in productivity is lost due to tobaccorelated deaths 25 percent of all deaths are tobacco related
-Oregon Health Authority
Creating a plan also helps, Reeves said. Know when you are going to quit and how you are going to do it. Make sure you know how you are going to avoid the urge to smoke and have something to do to suppress that urge if it arises. “We tell them to pick a day to quit smoking,” Reeves said. “Then it is like Christmas, something they look forward to.” If you’re helping someone else quit, studies show positive reinforcement is better than negative, Kramer said. If you tell the person about the risks of tobacco use, be sure also to tell them about the positive things about quitting, including small things like wearing clothes that don’t smell like smoke, saving money by not buying tobacco, having more energy or breathing easier.
In Klamath County, tobacco use costs the medical community millions and contributes to 25 percent of deaths each year.
Smoking cessation methods seem to be working, as per-capita cigarette consumption has steadily declined since 1993 in Oregon and the U.S.
Nearly 60 percent of the county’s smokers tried to quit in 2010, according to an Oregon Health Authority report. How they did so varied, and so did the success rate.
Statewide cigarette sales dropped 48 percent in that time, from 93.1 packs per person to 47.9 packs per person in 2009, according to the Oregon Health Authority. ❖ - Originally published in the jan. 25, 2011 Herald and News
For some nicotine, replacement gums or patches were effective. Others tried to quit cold turkey and some were successful using hypnosis or acupuncture, Kramer said.
Tips to avoid urges to use tobacco
Some use prescription medication to help with the addiction.
• Avoid places where you routinely used tobacco. • Get rid of lighters, ashtrays and tobacco merchandise that can give you an excuse to use tobacco again. • Keep busy to avoid urge to smoke or chew. • Have something to keep your hands busy, like a stress ball, to help fight the urge use tobacco. • Have gum, hard candy or other snacks on hand to help fight tobacco urges. • Get your teeth cleaned when you quit. It will help motivate you to stay tobacco free. • Designate rooms in your home where you used to smoke as smoke-free areas. • Make a plan and pick a day to quit tobacco use.
A prescription should not be the first choice, but it can be effective, Kramer said. If a prescription is necessary, he said, cost should not be a problem because pharmacies often offer prescriptions for less than the cost of a pack of smokes. LaVonne Reeves, a certified prevention specialist for Lutheran Community Services Northwest, said lifestyle changes can make giving up tobacco easier. “Smoking is a habit and you will find yourself reaching for that cigarette at the same time every day. You need to find something to replace that habit,” said Reeves, who runs Not. On. Tobacco, a local program to help teen tobacco users voluntarily quit.
- LaVonne Reeves, certified prevention specialists, Lutheran Community Ser vices Northwest
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Live Healthy 2011
By the numbers
If you routinely use tobacco in the morning, try stretching at that time instead, Reeves said. If you smoke when you talk on the phone, make a phone calls in a place where smoking isn’t allowed.
Live Healthy 2011
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ittle kids,
big
dangers Five mistakes even great parents make—and how you can avoid them You take nothing more seriously than your role as a parent. You’ve bought every book your pediatrician has recommended, and you read about the newest and best parenting techniques. Yet even the most vigilant parents may be making common mistakes despite—or because of—their vigilance. Learn about five hidden hazards that parents may miss, and how to keep your child out of harm’s way. Mistake: Buying your child the latest fashionable hoodie—with drawstrings. Keep ’em safe: Drawstrings in some of the most common winter weather clothing can be dangerous. “These can become a strangulation hazard for children,” says Chrissy Cianflone, the director of program operations for Safe Kids USA. She recommends keeping your child warm with turtlenecks, hats and earmuffs, and removing the drawstrings from sweatshirts, coats and other items. Mistake: Putting your baby to sleep in a pillowy bed. Keep ’em safe: Although a crib filled with pillows and stuffed animals looks cozy, it could be lethal for your baby. Some parents continue to hear conflicting messages about how and where babies should sleep, but Cianflone wants to set the record straight: “Babies should lie on their backs facing up, in a crib with a firm mattress and well-fitted sheet.” Keep the crib as empty as possible. Mistake: Thinking that a window screen is a strong enough safety guard. Keep ’em safe: Screens keep bugs out, but they don’t keep children in. Because your little ones love exploring new places, put up baby gates and install window guards (which keep windows from opening
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Hard-to-heal wounds demand advanced care.That’s why there’s the Advanced Wound Care Clinic at Sky Lakes. By using cutting edge treatments and sophisticated case management, we help patients with chronic wounds heal faster. And when wounds heal, lives improve. For more information, please call the Advanced Wound Care Clinic at Sky Lakes today at 541.274.3850.
541.274.3 850
Live Healthy 2011
more than 4 inches) to keep kids safe. Mistake: Getting your child to take medicine by calling it “candy.” Keep ’em safe: Calling medicine by any other name could create harmful confusion. Instead, explain the distinction clearly. And be sure to store all medicine in a locked cabinet out of reach of children. “It’s important to remember that childresistant caps on medicine bottles does not mean they are childproof,” Cianflone says. Mistake: Thinking you need to pay a lot for safety. Keep ’em safe: Higher prices and fancy brand names don’t necessarily mean the products will do a better job at keeping your child safe, says Cianflone. “Keeping an eye on your child at all times is the best way to keep them safe,” she says. This is especially important around water. Drowning is silent and can happen in seconds, no matter what type of lifesaving water devices you may have. ❖
Live Healthy 2011
Here’s an alarming statistic: If the health trends remain constant, about 35 million of today’s 83 million children eventually will die from heart and blood vessel disease, reports the American Heart Association (AHA). But it doesn’t have to be that way. “If parents get some healthy routines down early in life with diet and exercise, they can help prevent their children from becoming one of these statistics,” says Stephen Pophal, M.D., a pediatric cardiologist and an AHA spokesman.
Here are four action steps the AHA recommends to protect your child’s heart:
1. Designate one day a week as Family Healthy-Heart Day. Fun activities for kids include coloring a food pyramid or filling vials with the amount of sugar in one soda. 2. Write out a heart-healthy menu for that day, including breakfast, lunch, dinner and snacks. 3. Choose at least one physical activity that lasts 30 minutes or three activities that last 10 minutes each. 4. During the day, talk about things you’re doing as a family to keep your hearts healthy. ❖
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NEW PATIENTS ARE ALWAYS WELCOME
Our Mission: • • • • •
Provide efficient, high quality service Create and maintain a friendly, professional environment Value your child, our patient, and affirm your family and its role in creating a positive, healthy environment Provide appropriate intervention and referrals Teach parents how to care for children who are affected by disease, illness or injury
We offer 24-hour physician coverage and after-hour emergency care. If you are pregnant, call us to schedule a free pre-delivery consultation.
Nicola J. Cherry, MD • Rick Zwartverwer, MD Robert Sears, MD • Jennifer Lovell, CPNP Summer Office Hours: Monday through Friday 8:00 a.m. - 5:00 p.m. and Saturday 9:00 a.m. - Noon Walk In Hours: Mon-Fri: 8:00 a.m. - 10:00 a.m. and 4:00 p.m. - 5:00 p.m. 2580 Daggett Ave. • Klamath Falls, OR 97601 • 541-884-1224 Please visit our website at: www.cckonline.com
Live Healthy 2011
1. Be active. For kids, activity is about play, not work. Look
o help your children grow up strong and healthy, being active as a family is just part of the equation. You want to help them balance the energy they take in through food with the energy needed to keep their bodies going and perform daily activities. “Being fit is a way of saying a person eats well, gets a lot of physical activity and has a healthy weight,” says Kathy Kaehler, personal trainer and creator of the FitKids 5 Minute-A-Day exercise program (ultimatefitkids.com). Kids respond better to lifestyle changes that promote wellness when you explain fitness in positive terms. Instead of focusing on negative messages about television or unhealthy snacks, encourage your children to:
for fun ways to move together as a family. “Blow up a balloon and play ‘How long can you keep it in the air?’” Kaehler says. Or make quick work of chores. “Turn on some rock music on Saturday morning and have an aerobic-paced family cleanup time,” says Stephen J. Virgilio, Ph.D., author of Active Start for Healthy Kids.
2. Drink smart. Serve kids water or low-fat milk at meals instead of soda or sugary beverages. Sweetened drinks sneak in empty calories that can sabotage energy balance. You can add a little juice to water to change the flavor.
3. Become food adventurers. Your kids may have favorite foods, but the best way to get the nutrition their bodies need is to eat a variety of foods—especially fruits and vegetables. If your children love dips, try serving fruit slices with yogurt or veggie slices with healthy dressing. Let them go shopping with you and pick out a new fruit or vegetable to try. You can include puréed vegetables in soups or stews, or offer kids an assortment of vegetables to decorate their own veggie pizzas. Also, bananas and berries make great cereal toppers. ❖
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Live Healthy 2011
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Live Healthy 2011
A simple plan to add about five cups of fruits and vegetables to your daily diet: 1. Have a glass of 100 percent fruit or vegetable juice at breakfast.
2. Top your cereal with sliced bananas, blueberries or strawberries.
3. Have a salad with lunch, and carrot sticks
iva veggies
for an afternoon snack.
“Eat your vegetables.” How many times
4. Include a vegetable with dinner.
did your mother tell you that? Turns out, she was right. Vegetables, fruits and other plant-based foods contain essential vitamins, minerals and fiber that may help protect you from many diseases. People who eat more plant-based foods as part of a healthful diet are likely to have reduced risk of chronic diseases, including stroke and other cardiovascular diseases,
Sweet and Sour Leafy Green Salad 5 cups torn and lightly packed romaine lettuce leaves 3 cups lightly packed spinach leaves
according to the American Cancer Society
2 cups sliced mushrooms
(ACS). Research shows 30 percent of
2 oranges, peeled and sliced
cancers are related to issues of nutrition, including obesity, which a plant-filled diet
1 cup halved, pitted prunes
can help you avoid.
½ cup sliced red onion
The ACS recommends everyone eat five
½ cup nonfat honey mustard dressing
or more servings of fruits and vegetables
¼ tsp. coarsely ground black pepper
each day. Also, eat other foods from plant sources, such as whole grains and beans, several times a day. Do not skip green and dark yellow vegetables, beans, soybean products
and
cruciferous
vegetables,
such as broccoli, brussels sprouts and cabbage. They may not be your favorites, but research shows they help reduce your risk of colon and stomach cancers. ❖
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Toss all ingredients in a large bowl. Makes 4 servings.
Nutrition information per serving: 190 calories, 4 g protein, 1 g total fat, 0 g saturated fat, 0 mg cholesterol, 47 g total carbohydrate, 7 g fiber, 310 mg sodium
Live Healthy 2011
ecipes
Smoked Turkey and Jack Cheese Quesadillas Prep time: 5 minutes Serves 2; serving size: 1 quesadilla
Ingredients • 4 8-in diameter whole wheat or regular flour tortillas • 2∕3 cup shredded, fat-free Monterey jack, fat-free jalapenoflavored jack cheese, or fat-free cheddar cheese, divided • ¼ cup chopped canned mild green chiles or coarsely chopped bottled roasted red sweet pepper, well drained, divided • 1∕3 cup diced (¼-in) fresh tomato • 4 to 6 large very thin slices (about 5 oz) smoked lean turkey breast
Preparation 1. Lay a tortilla on a microwave-safe plate. Sprinkle the tortilla
Nutrition Facts Exchanges/Choices
evenly with ¼ of the cheese. Cover the plate with a plastic microwave cover. Microwave on 50 percent power for 1 minute. If the cheese isn’t partially melted, continue microwaving on 50 percent power just until it partially melts, stopping and checking every 30 seconds. 2. Spread half the green chiles (or red sweet pepper) and half the tomato over the cheese (or sprinkle the green pepper over the melted cheese). Lay half the turkey slices over the top, pressing down lightly. Sprinkle ¼ cup of the cheese over the turkey. Cover the cheese with a second tortilla. 3. Return the quesadilla to the microwave oven. Cover with a plastic microwave cover. Microwave on 50 percent power for 1 minute. Lift the edge of the tortilla to see if the cheese is melted; if not, continue microwaving, checking every 20 seconds until the cheese is melted. 4. Repeat the assembly and microwaving process for the second quesadilla. Cut the quesadillas into wedges and serve.
1 Vegetable 3 Lean Meat 1 Fat
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Calories 210 Calories from Fat 90 Total Fat 10.0 g Saturated Fat 2.0 g Trans Fat 0.0 g Cholesterol 70 mg Sodium 110 mg Total Carbohydrate 5 g Dietary Fiber 2 g Sugars 3 g Protein 24 g
Live Healthy 2011
Turkey Swiss Panini Nutrition Facts
Ingredients • • • • • • • • • • • •
1 Tbsp plus 1 tsp balsamic vinegar 5 tsp canola oil 2 medium garlic cloves, minced ½ of 16 oz multigrain Italian bread, halved lengthwise, and then each half cut into four pieces 2 medium whole green onions, finely chopped 1 cup (½ oz) loosely packed fresh spinach leaves ¼ lb deli-sliced oven roasted turkey breast 1 medium tomato, cut into 8 slices 4 thin slices (3 oz total) reduced-fat Swiss cheese Canola cooking spray 3 cups halved strawberries
Preparation 1. Combine vinegar, 4 teaspoons canola oil, and garlic in a small bowl. Stir until well blended. Drizzle one side of each bread slice with vinegar mixture and top four bread slices (oil side up) with equal amounts of filling ingredients in the order listed, beginning with green onions. Top with remaining bread slices (oil side down) and press down slightly. 2. Coat a medium nonstick skillet with cooking spray, add ½ teaspoon of oil, tilt skillet to coat bottom lightly, and place over medium heat. Add 2 sandwiches, then place dinner plate and 4 bread plates on top of the sandwiches. Cook 4 minutes, turn sandwiches, top with plates, and cook 2-3 minutes or until cheese melts. 3. Place on a serving platter, cover with foil to keep warm, repeat with remaining ½ teaspoon canola oil and two sandwiches. Serve with strawberry halves on the side.
Flavorful tip: Coating the skillet with canola oil cooking spray and using a small amount of canola oil to brown the sandwiches provides optimum moisture and flavor to the sandwiches.
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Exchanges/Choices 1 ½ Starch ½ Fruit 1 Vegetable 2 Lean Meat 1 ½ Fat
Calories: 335 Calories from Fat: 110 Total Fat: 12 g Saturated Fat: 2.7 g Trans Fat: 0 g Cholesterol: 20 mg Sodium: 585 mg Total Carbohydrate: 37 g Dietary Fiber: 7 g Sugars: 11 g Protein: 22 g
Live Healthy 2011
Tasty Pasta Soup
Nutrition Facts
Prep time: 5 min Serves 6
Ingredients • 3 cups leftover cooked pasa • 4 cups low-fat, low-sodium chicken broth • 1 cup leftover cooked, diced chicken • ½ cup canned diced tomatoes
Preparation 1. Take 3 cups leftover cooked pasta and add it to 4 cups low-fat, low‑sodium chicken broth. 2. Bring to a boil. 3. Add 1 cup leftover cooked, diced chicken and ½ cup canned diced tomatoes. Cook for 5 minutes.
Honey Lemon Chicken Serves 4; serving size ¼ recipe
Ingredients • • • • •
2 Tbsp honey 2 Tbsp freshly squeezed lemon juice 4 cloves garlic, minced ½ tsp black pepper 8 boneless, skinless chicken thighs
Preparation 1. Preheat oven to 375°F. 2. In a bowl, combine honey, lemon juice, garlic, and pepper. 3. Coat chicken with honey mixture, and arrange in a baking dish. Bake for 40 minutes, until juices run clear when chicken is pierced.
Nutrition Facts ½ Carbohydrate 4 Lean Meat 1 Fat Calories: 255 Calories from Fat: 100 Total Fat: 11.0 g Saturated Fat: 3.2 g
Polyunsaturated Fat: Monounsaturated Fat: Cholesterol: 100 mg Sodium: 95 mg Total Carbohydrate: 10 g Dietary Fiber: 0 g Sugars: 9 g Protein: 27 g
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Exchange/Choices 1 ½ Starch 1 Very Lean Meat Calories: 162 Calories from Fat: 34 Total Fat: 4 g Saturated Fat: 1 g Polyunsaturated Fat: Monounsaturated Fat: Cholesterol: 21 mg Sodium: 92 mg Total Carbohydrate: 22 g Dietary Fiber: 1 g Sugars: 2 g Protein: 12 g
Nutrition Facts Exchange/Choices 1 ½ Carbohydrate
Lemon Poppy Seed Angel Food Cake Serves 12; serving size: 1 slice
Calories: 127 Calories from Fat: 0 g Total Fat: 0 g Saturated Fat: 0 g
Polyunsaturated Fat: Monounsaturated Fat: Cholesterol: 0 mg Sodium: 55 mg Total Carbohydrate: 26 g Dietary Fiber: 0 g Sugars: 14 g Protein: 5 g
Ingredients • • • • • • • • •
1 cup cake flour ¾ cup granular no-calorie sweetener ¼ cup cornstarch 2 tsps fresh grated lemon zest 1 Tbsp poppy seeds 12 large egg whites ½ tsp cream of tartar 1 tsp lemon extract ¾ cup granulated sugar
Preparation 1. Preheat the oven to 350°F. 2. Sift together the flour, no-calorie sweetener,
3.
4.
5.
6.
and cornstarch. Stir in the lemon zest and poppy seeds and set aside. Combine the egg whites and cream of tartar in a large bowl. Beat at medium speed until foamy. Beat in the lemon extract. Beat in the sugar, 1 Tbsp at a time, beating at high speed until stiff peaks form. Spoon the flour mixture over the egg white mixture in 4 additions, gently folding in after each addition. Pour the batter into an ungreased 10-in tube pan. Bake 20 to 25 minutes or until a wooden toothpick inserted in the center of the cake comes out clean. Invert the cake pan and cool the cake completely. Loosen the cake from sides of pan with a thin metal spatula. Invert the cake onto a serving platter. The cake can be covered in an airtight container and stored at room temperature up to 2 days. ❖
Now Offering allergy service
Dr. Richard DeVore has added nasal allergy testing and treatment to his recently opened practice in the new Sky Lakes Ear, Nose and Throat Clinic. He was board certified in otolaryngology in 1989, and has special interest in endoscopic sinus surgery, thyroid and parathyroid surgery, pediatric ENT, and inhalant allergies. He is accepting new patients.
The Sky Lakes Ear, Nose and Throat Clinic 2617 Almond Street
541.850.7680 SkyLakes.org
Recycle youR ScRap Metal HuGe Selection of NeW & ReMNaNt Steel for all your Metal NeeDS.
Americans use over 100 million steel cans and over 200 million aluminum beverage cans
EVERy Day
Aluminum Steel Brass
Stainless Copper and More
That’s enough to rebuild the entire U.S. commercial airliner fleet every three months! WE DELIVER
Recycling Services • Now Taking Batteries 2825 Broadmore St. · Klamath Falls, OR · 541.883.3583
Live Healthy 2011
Eat out without guilt Sticking to a sensible eating plan in restaurants can be a challenge, but not impossible. It takes discipline.
Also, order sauces and dressings on the side. Consider splitting large portions with a friend or take home leftovers.
The American Dietetic Association suggests choosing menu items that include terms like baked, braised, broiled, grilled, poached, roasted, steamed or stir-fried.
You also can ask the server or chef how meals are prepared. Many restaurants will accommodate special requests, such as not adding extra salt to your meal. ❖
hat’s the secret to healthy aging? Is there any way to stay vigorous, alert and happy into our 70s, 80s and beyond? A recent study into the habits of healthy older Americans answers with a resounding yes. In fact, the remarkable study outlines seven crucial elements that go into successful aging. And most of them are under your control. The study, published in the American Journal of Psychiatry, is the longest continuous study of this kind ever done. Researchers from Harvard University studied about 700 males—including Harvard students and inner-city teens— over six decades, beginning in the 1940s. They used questionnaires and physical exams to track physical and mental health, independence and enjoyment of life. They found that those men who reached age 70 or 80 without mental impairment or major physical disability followed the kinds of lifestyle choices that health experts and common sense have been preaching for years.
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The 7 Steps Here’s what the most successful seniors had in common:
1. They didn’t smoke. 2. They didn’t abuse alcohol. 3. They exercised regularly. 4. They had 16 or more years of schooling. 5. They maintained a healthy weight. 6. They had healthy marriages. 7. They developed mature coping skills. All of these steps are at least somewhat within your control. The researchers found the only factor outside of your control—a history of depression—decreased your odds of healthy aging. Of course, several of these are the same things your doctor has been telling you for years. Smoking, excessive drinking, being overweight or obese and lack of exercise have a long track record of damaging health. Plenty of research backs up these commonsense recommendations. Some of the others make sense when you think about them, too. Education, for instance, is important. Researchers found that although inner-city men usually declined faster in old age, those who earned a college degree aged as well as those subjects who entered Harvard as young men.
Marti Baird, MSN, NP Amy Holweger, MSN, FNP Women’s Primary Care and Gynecological Care Annual Women’s Exams • Primary Care • Menopausal Management Same Day Appointment for Immediate Care • Colposcopy Cryotherapy • Bio-Identical Hormones • B-12 Shots Oregon Contraceptive Care Program Low Cost Programs for Eligible Women • Blood Draw Station Oregon Breast and Cervical Cancer Program (BCCP) 1903 Austin Street, Suite B • Klamath Falls, OR 97603
(541) 205-6262 www.klamathwomensclinic.com
medical weight loss ARE YOU READY TO MAKE THE CHANGE?
The lesson: An active mind helps lead to healthier golden years. Healthy marriages free of divorce or serious strife also helped slow the aging process. In fact, those with strong social ties throughout their life age more successfully. A positive view of marriage, family and community is key to a happy life.
COME IN & SHOP FOR: PROTEIN BARS, SHAKES, DRINK
Likewise, mature coping skills, such as a sense of humor when faced with conflict or stress, seem to make aging a more healthful experience. The researchers found that the sooner people adopt these habits, the better. But even those approaching or in their senior years can improve their chances of aging gracefully by eating better, exercising more, keeping mentally challenged and staying socially active. ❖
SUPPLEMENTS, ENTREES, COOKIES, COFFEE & SNACKS.
"There's not a day that goes by that I don't appreciate what Dr. Hempel has done for me." Julie Rokes Medical Weight Loss Patient
ERIC HEMPEL, DO | CATHY NOBLE, PA-C 2625 CROSBY AVE, KLAMATH FALLS 884-2900 | ASPENFAMILYMEDICINE.COM
(Complete listing in the telephone directory)
“The HOME Team” We don’t just sell houses. We help create homeowners! 403 Main St . • Klamath Falls, OR 97601 541-884-1717 • 1-800-460-8124 Fax: 541-883-2207 Visit our website at
www .fnrhomes .com
Debra Gisriel, GRI, CDPE, Principal Broker
IMPORTANT NUMBERS:
Pacific Power . . . . . . . . . . 888-221-7070 Gas: Avista Utilities . . . . . . . . . . . . 800-659-4427 Water: City of K-Falls . . . . . . . . . . . 541-883-5301 Garbage: Waste Mgmt . . . . . . . . . . . 541-884-7706 Telephone: Qwest . . . . . . . . . . . . . . . . . . 800-244-1111 Cable TV: Charter . . . . . . . . . . . . . . . . . . 877-728-3814 Satellite TV: DirecTV . . . . . . . . . . . . . . . 888-777-2454 Satellite TV: Dish Network . . . . . . . 800-823-4929 Newspaper: Herald and News . . 541-885-4410 City Police (Non-Emergency) . . . . . . 541-883-5336 Real Estate: Fisher Nicholson . . 800-460-8124 Electric:
NOTES:
541-882-6311 541-274-6269 541-274-6311 541-274-6240 541-274-6287 541-274-6740 541-274-6221 541-274-6260 541-274-4797 541-274-6282 541-274-4171 541-274-6289 541-274-4700 541-274-3800 541-274-6406
COMMUNITY SERVICE NUMBERS Klamath Falls Police Department (non-emergency) Klamath Crisis Center Klamath County Fire District No. 1 (non-emergency) Klamath County Public Health Klamath County Sheriff’s Office (non-emergency) Oregon Road Conditions Poison Control Center Senior Citizens Council
541-883-5336 541-884-0390 541-885-2056 541-884-4167 541-883-5130 800-977-6368 800-452-7165 541-883-7171
RECORD YOUR FREQUENTLY USED NUMBERS HERE Physician Physician Pharmacy
In-house Telecom & Utilities Concierge Services 541-880-8623
Sky Lakes Medical Center, main Diagnostic Imaging Emergency Department Lab Services Medical Records Outpatient Scheduling Financial Counseling (Business Office) Personnel (Human Resources) Public Relations Resource Management Cancer Treatment Center CARES Day Surgery Diabetes/Nutrition Services Outpatient Rehabilitation Services
Insurance Company (home) ID# Agent Insurance Company (auto) ID# Agent Insurance Company (medical) ID# Agent
LIVE HEALTHY • STAY HEALTHY Start at Merit’s Home Center. Before you can bring home healthier food choices, you need the right equipment to store and prepare your food, and clean up afterwards. Merit’s features kitchen groups from Frigidaire and Electrolux that will get the job done ... and look great doing it!
Professional Series Stainless Group • 30” Freestanding Gas Range • 27.8 cu. ft. French Door Refrigerator • Fully Integrated Dishwasher • 1.8 cu. ft. Over-the-Range Microwave FPGF3081KF / FPHB2899LF / FPHD2481KF / FPBM189KF
Wave-Touch Series Stainless Group • 30” Freestanding Gas Range • 27.8 cu. ft. French Door Refrigerator • Fully Integrated Dishwasher • 2.0 cu. ft. Over-the-Range Microwave EW30GF65GS / EW28BS71IS / EWDW6505GS / EI30SM55JS
Live Healthy 2011 Walking is an easy, cost-free way to lose weight and significantly improve your overall health. You don’t need a treadmill or a trainer — just a little commitment, some creativity, and the world around you. Sky Lakes Medical Center is challenging every Southern Oregon resident to get into better shape by trying to walk 10,000 steps per day. Walk with a friend at lunchtime, park at the back of the parking lot, or take the stairs. Find little ways to walk farther each day and start stepping towards your goal for improved health. It’s closer than you think.
SkyLakes.org
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