Healthy Living 2016 - Kitsap Sun by Kitsap Sun Digital

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West Sound Guide 2016 The approach of spring means the countdown has begun for the Kitsap Sun’s annual publication about the people, places and things to do that make up our beautiful corner of the world.

The next edition of the visually stunning magazine that shows off our community publishes this May. So as you start to plan your summer and show off the area to friends and newcomers — don’t forget your West Sound Guide!

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Table of Contents Up for anything .......................................4 Energy plus experience ....................... 6 Q&A: Aaron Covey .................................. 8 Do we need resolutions? ...................10 Water’s tasteful experience ..............12 Add a superfood to your diet.............14 Check up checklist ...............................18 Paging Dr. Bloedel ............................... 20 Q&A: Jennifer Kreidler-Moss ........... 23 How Silverdale saved me ................. 24 Surpise fees after emergencies......26 Advice from cardiologists ................ 28 The ‘heart’ of sleep ............................. 29 Support groups..................................... 34 Healthy LIving 2016 is a publication of the Kitsap Sun, 545 Fifth Street, Bremerton, WA 98337 Editor: David Nelson Special Publications Producer: Marit Bockelie Contributors: Terri Gleich, Christopher Dunagan, Heather Morton, Katherine Barksdale, Sonja Morgan and Dr. Ginny Sugimoto Photographers: Larry Steagall, Meegan M. Reid

LArrY STEAgALL / KiTSAp SUn

Doug Witt, bottom of Bremerton works out with a class on a rowing machine at the Timberline CrossFit.

Cover image: Lisa Ballou of Silverdale trains through the winter by mountain biking in Newberry Hill Heritage Park. She’s one of several locals who compete in triathalons up to Ironman distance despite health challenges that could limit endurance or training.

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Contributed photo

Brian Whelan rides during the Cozumel Triathlon last November. Whelan, who has multiple sclerosis, has completed two triathlons of that distance, which includes a 2.4-mile swim, 112-mile bike ride and 26.2-mile run.

Up for anything

These aThleTes manage condiTions like arThriTis or ms To Train, compeTe and succeed in endurance sporTs By Terri Gleich

When Linda Banks crossed the Coeur d’Alene finish line on her 47th birthday and heard the words, “You are an Ironman,” she felt a surge of pure joy and shock. “Nobody was more surprised than

me,” she said of the June 2012 milestone. That Banks completed the endurance triathlon — a 2.4-mile swim, 112-mile bicycle ride and 26.2 mile run — under the 17-hour cutoff was a remarkable feat. But it was made

even more impressive because just four months earlier she had been diagnosed with rheumatoid arthritis. Commonly referred to as RA, the chronic inflammatory disorder causes the body’s immune system to attack its own tissue and is incurable.

At times, Banks suffers debilitating joint pain, extreme swelling and is unable to hold objects without dropping them. “People told me I was crazy, that I shouldn’t be doing it because of the RA,” she said. “I just put my head

HE A LT H Y L I V IN G Sp r in g 2 0 16 down and worked hard. I was determined.” And although she doesn’t intend to do another Ironman, Banks continues to race. She completed Disneyland’s Star Wars Half Marathon in January and has racked up about 40 finisher’s medals since 2009. “I find that if I’m not active, it hurts worse than if I am.” Incredibly, Banks isn’t alone. She’s one of several Kitsap athletes who have achieved elite Ironman status despite chronic health conditions. In November, Brian Whelan notched his second Ironman finish even though Multiple Sclerosis causes numbness and tingling from head to toe on the left side of his body and he describes his left foot as “a little bit dead.” Whelan doesn’t expect to do another Ironman, but he’s always looking for the next challenge. He approaches his disease, competition and life with the same determination. “You don’t stop. You try to figure out what you can do and you do it.” Kitsap TriBabes founder and coach Lisa Ballou echoes that resolve. She has participated in eight Ironman races even though she’s had epileptic seizures since age four. “I think there’s very few situations where movement isn’t the answer, no matter what your condition is,” she said. “I’ve been doing triathlons since 1995 and I’ve been doing Ironman races since 2004 and I’ve seen every type of condition. I’ve seen a huge variety of people competing and succeeding despite an amazing array of disabilities and chronic conditions.” Often, training helps them manage the symptoms and improve their quality of life, said Ballou, who coached Banks through her Ironman effort. They also inspire others. “I’ve seen these people kind of add the heart and soul to the event. You see somebody with

Contributed photo

Brian Whelan jogs into the transfer station after finishing the swim portion of the 2015 Cozumel Ironman.

Contributed photo

Linda Banks crosses the finish line at the Coeur D’alene Ironman Triathlon in 2012, just months after being diagnosed with rheumatoid arthritis.

a prosthetic leg cross the finish line and there’s not a dry eye in the house.” For the three Kitsap athletes, knowing when and how to modify their training has been key. Because the cartilage in her knees is severely damaged, Banks limited her running during training for Coeur d’Alene and focused on building the muscles around her knee and in her hips and back. “I did a lot more weight training than most triathletes do because I couldn’t hammer my joints.” Her longest run leading up to the Ironman was 12 miles and many of her training runs were done in place, either on a small

trampoline or using resistance bands. Running was also the most challenging part of Whelan’s training because of the numbness on his left side. To minimize falls, he had to specifically concentrate on picking up his left foot. Ballou focuses on strength training and works to build her endurance. She minimizes time spent in the anaerobic zone, where she’s working so hard that her muscles are not getting oxygen, because it reminds her of having a seizure. “Even with something like an Ironman, there’s a way to do it with moderation,” she said. That means being intelli-

gent and consistent in your approach and not trying to cram your training into too short an amount of time. Equally important are the mental adjustments. Banks received a month of mental coaching as a gift and said it changed her outlook in important ways. One of the themes: “What if you are capable of so much more than you think you are?” It led Banks to ponder whether her disease was limiting her or whether she was limiting herself. “It’s a huge distinction. It made me listen to my body much more than I had before and I think I pushed myself farther that I would have,” she

said. An optimist by nature, Whelan credits his faith in God with helping him overcome the challenge of his disease and finish Ironman Cozumel with five minutes to spare in November after failing on a previous attempt in 2010. His other successful Ironman finish was Coeur d’Alene in 2011. “I don’t play the victim card,” he said. “I’m grateful for what I have today and I realize that could change tomorrow.” “There are no excuses,” agreed Ballou. “If you want to do these things, do them. I see more positives coming out than negatives, given my 21 years in the sport.”

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MEEGAN M. REID / KITSAP SUN

Above: Tom Davis takes part in Martha & Mary’s intergenerational program that allows preschoolers to interact with seniors. Participating in activities like music or games together strengthens bonds between the organization’s two programs, a health and rehab facility and a childcare. The unique set up allows for daily interaction, which leaders say is beneficial to both generations. At center right: Sharon Sutton claps along as the group of preschoolers dance. Bottom right: Brandon Tweiten, 3, and Joyce Otterby, 89, concentrate on keeping the beach ball in the air by shaking the parachute.

Energy plus experience A progrAm bringing young children And seniors together is A thrill for both Age groups

By Terri Gleich

POULSBO — As four pastelclad girls dance joyfully amid a circle of nursing home residents in wheelchairs, preschooler Lincoln Westby quietly sits next to

69-year-old Tom Davis, clutching the man’s trembling hand. It’s part of Martha & Mary Health and Rehab Center’s Intergenerational Program and it’s the highlight of Davis’s day.

“I always have a good time withthekids,”hesaid,notingthat his own grandchildren are a sixhourflightawayinHawaii.“(My favorite part is) the children, the music and the jumping and the

twirling and the shouting.” OnarecentMondaymorning, six youngsters from Martha & Mary KIDS Early Learning Center sing, wave scarves and bounce a ball on a multi-colored

parachute, providing a zip of color to the institutional dining room. The children giggle as the ball rolls close to the edge and shriekwhenitescapesthecircle. Nine “grandmas” and

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MEEGAN M. REID / KITSAP SUN

Azy Worley, 4, twirls around with a scarf as she and fellow preschoolers perform songs and dance alone with residents as part of the intergenerational program at Martha & Mary in Poulsbo.

MEEGAN M. REID / KITSAP SUN

Preschoolers and residents work together to keep the beach ball in the air by waving a parachute up and down. all day,” she tells the kids. After the children leave, the seniors are still smiling. “It gives you a lift,” said Sharon Sutton, a 74-year-old grandmother and greatgrandmother. “It makes the time go faster and you look forward to the next time.” The Health and Rehab Center in Poulsbo is a 190bed skilled nursing facility that provides short-term rehab, memory care, hospice and long-term care. Within walking distance are the Child Care Center for infants, toddlers and preschool children, and the Children’s Learning Center for preschool and kindergarten students. Created in the early ‘90s, the Intergenerational Program has grown to include daily interactions between children and nursing home residents. Martha & Mary’s is the largest childcare program attached to long-term care in the country. Classes from the two Poulsbo childcare centers make regularly scheduled visits, and infants and toddlers periodically take stroller rides through the nursing home. The or-

ganization’s early learning center in Silverdale has a similar relationship with Crista Senior Living. In addition to music, intergenerational activities include crafts, ice cream socials, show and tell, trickor-treating and picnics. The kids make cards for the seniors on their birthdays and holidays. The seniors run an outdoor carnival for their young friends each summer and share a preThanksgiving feast at the childcare centers. Thenursinghome’slobby features a lasting tribute to the program — a glass art “TreeofLife”byLisaStirrett that includes leaves, flowers and snowflakes created together by seniors, kids, staff and volunteers. It represents the beauty and meaning in all the seasons of life. “When the two generations come together, it’s beautiful,” said Booher, the Martha &Mary KIDS program supervisor. “Everybody is grandma and grandpa. It’s understanding on both ends. The child helps the resident and the resident helps the child.”

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“grandpas” participate as much as they’re able, helping lift the parachute, tapping their feet and singing along. When the kids and staffers form a conga line, the wheelchairs stay put, but some seniors kick their legs to each side in time to the music. During “Head and Shoulders, Knees and Toes,” 89-year-old Joyce Otterby touches her head, shoulders and knees before enlisting one of the children to touch her toes. “These children, I am thrilled with them,” said Otterby, a new resident who wasattendingherfirstIntergenerational Program and looking forward to more. “They are so full of energy. They are doing what they love to do and they are so expressive and so cute.” The youngsters wrap up the half-hour program with hugs for their surrogate grandparents. Berni Booher, Martha & Mary KIDS program supervisor, encourages the tender moment: “This might be their only chance to get a hug from someone under five

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HealtHylife

Aaron Covey

Five questions For a north Kitsap educator who’s teaching teens that nutrition can also taste great. The Odin Inn isn’t Poulsbo’s most acclaimed restaurant, but it may be one of the city’s most interesting. That’s because it’s a laboratory at North Kitsap High School, where students are going far beyond basic culinary arts education. Classes on cooking are on display for students and members of the community who can eat at the Odin Inn — located next to the North Kitsap pool on campus, open weekdays from 10:30 to 1:30 — like any other restaurant in town. Aaron Covey is one of the teachers running the program, which has existed for years as part of NK’s curriculum. He’s also one leading the initiative to introduce students to more than pizza and burgers. With public concern across the country about childhood obesity and developing healthy habits in teenagers, and with a developing foodie culture in Kitsap County, we asked Aaron for a few tricks of the trade that could apply to your family’s dinner table. The Odin Inn helps students discover vegetables like heirloom tomatoes or herbs they may not regularly use at home. What have been the most popular choices among your students that would be simple, healthy ingredients parents can add to their kitchens?

Surprisingly enough, my students like the beets grown in our greenhouses. They’re

MEEGAN M. REID / KITSAP SUN

North Kitsap High School Culinary Arts instructor Aaron Covey holds a container of freshly harvested tomatoes in the kitchen at the Odin Inn. Covey is one of the teachers using the long-time program to introduce students to healthy habits.

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MEEGAN M. REID / KITSAP SUN

North Kitsap Culinary Arts students Noah Chesson, 17, (left) and Diana Soria, 15, (right) package freshly picked vegetables as instructor Valerie Randall (center) gets the scale ready to record the weight of their harvest in one of the greenhouses at North Kitsap High School on Monday, November 23. 2015. The produce harvested is used by students at the Odin Inn. like the beets grown in our greenhouses. They’re packed with vitamins and minerals, easy to grow and even have omega 3 fatty acids. When available, they love the snap peas as well. What changes do you see in attitudes toward nutrition among the students who either cook for or eat regularly at Odin Inn?

There’s definitely a shift in food choices taking place with our students. They see and hear about the consequences of poor nutrition constantly. I think the most effective tool in getting them interested is having them assist with the planting, cultivating and harvesting, then allowing them the freedom to research and prepare what sounds good to

them with those items vs. the standard preparation they’re accustom to. Your class is proving that teenagers do like to cook, when given the opportunity to learn. What’s your advice to parents who’d like to get their kids more involved in the kitchen at home?

It’s all about the ingredients and time. Unfortunately, the vast majority of us eat dinner on the fly during the week... Purchase different types of produce or cuts of meats you usually don’t prepare. Look up different ethnic recipes. It may take more time and energy, but the end result is worth it. What’s your favorite recipe on the Odin Inn menu?

That’s easy: Caprese

Salad. Fresh basil, fresh mozzarella and fresh picked tomatoes. Less is more. Finally, where do you personally go to find cooking inspiration? Where do you go for fresh ingredients, and what’s your favorite to cook with?

Fortunately I don’t have to travel too far... I enjoy the outdoors and harvesting my own ingredients when possible. Clams, crab, spot shrimp, salmon and halibut and oysters are well within striking distance in our surrounding waters, as well as berries, game and wild mushrooms in the woods. Favorite to cook with? I’d have to say halibut. It’s so versatile you could eat it every day for a year and never have to cook it the same way!

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Do We Need

New Year’s Resolutions?

If So, How Do We Keep Them? BY DR. GINNY SUGIMOTO

A new year is upon us, and a time for reﬂection for self and community. Like spring, this time of year always brings me a sense of renewal, and new hopes and dreams. In the spirit of celebration I want to wish you a Happy New Year, and many blessings for good physical and mental health in 2016. I started writing this column for the Kitsap Sun in January 2013 to give voice to what I saw as important health issues for our community. I also was taking the advice of surgeon and writer Dr. Atul Gawande on writing to avoid burnout in the demanding profession of medicine. The column has helped me grow as a person and as a professional, and so I continue. I want to thank the talented

writer Maria Dolan and the excellent editor Virginia Smyth, who have helped me write the columns over the past three years. I would also like to thank the Kitsap Sun for their ongoing support as publisher. My family traditionally toasts the New Year at midnight, giving thanks for our blessings and acknowledging the challenges of the year behind us. When my children were growing up I often insisted that each person write down their New Year’s resolutions sometime during the evening. It was not a popular exercise, but always interesting as we learned what was important to each other and shared our intentions for change. I think New Year’s resolutions are good because they require dedi-

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cated reﬂection reﬂection and they hopefully make us move to a healthier “new normal” in our lives. My nephew recently used this phrase as we sat in

my brother’s hospital room and learned of his diagnosis of heart failure. We all then contem-

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HE A LT H Y L I V IN G Sp r in g 2 0 16 plated the “new normal” we could create in our family by making changes to be more heart healthy — consume less salt, maintain a healthy body weight, and exercise more regularly. As I have reflected on resolutions, and how to keep them, I have been researching the best ways to break bad habits and form better ones. I’d like to share a little of what I’ve learned. The writer Charles Duhigg, who researched how we form habits for his book “The Power of Habit,” found that each habit is formed in a three-part process called a “habit loop.” There’s a trigger that cues your brain to initiate a certain behavior. There’s the behavior itself. And then there’s a reward for your brain — a chemical response — after you take the action. The trigger or cue can be the time of day, location, people around you, an action you just took or an emotion you’re feeling. The cue is what triggers your brain to repeat a behavior. For

instance, I always crave dark chocolate when I finish seeing patients between 5 p.m. and 6 p.m. The time is the cue. Then I eat chocolate, and I feel rewarded. Duhigg says the trick to changing habits and making them stick is to identify the cue, and then experiment with substitute actions that reward your brain. Realizing that eating chocolate every day does not help me lose weight, I have been experimenting with eating a healthy snack or drinking a cup of tea at that time instead. I could also try a walk, or a chat with a friend. The goal is to find a reward that works as well as the dark chocolate and is not full of calories. Forming a new habit follows a similar process. Choose a cue (gym bag at the door), choose a reward (episode of your favorite drama), and write down the plan for your routine — research shows that strengthens resolve. “When I see my gym bag at the door after work, I will go work out, and then I

may watch ‘The Blacklist’ tonight.” You can also share it with a group — just as I forced my family to do on New Year’s Eves in the past. Changing behavior may not be fast, and isn’t always easy. But the author says this new behavior will eventually become automatic. Some habits, of course, are much harder to break than others. Stopping smoking, for instance, or exercising when you are out of shape. To change these behaviors, signing up for the right program can work wonders. An analysis by the U.S. Preventive Services Task Force finds that programs that combine education with counseling or group sessions, and offer additional support through the phone or Internet, yield better outcomes than programs that don’t use this combination approach. This is the approach of familiar programs such as Free and Clear’s Quit for Life stop smoking program, and Weight Watchers’ weight loss programs.

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Other tips for keeping resolutions Change a keystone habit: Duhigg says some habits are especially powerful because they can have a ripple effect, leading to other life changes. For instance, running before work may lead to healthier eating habits, drinking morewater,andbeingmoreproductive. Make your new habits joy-inducing: I just started back to yoga, realizing that it is an exercise that brings me great joy and satisfaction. In the habit loop it is an action, and also a reward. Surround yourself with people who share your values and support your goals: Individual habits and those of the company you share are closely linked. We may feel comfortable in some relationships and communities that do not really support us when we see the need for change. Surround yourself with those who lift you up and support you, whether it is a spiritual community, book group, Alcoholics

Change your bad health habit while you are traveling: Since habits are formed during our routine lives, it wcan be helpful to start the new habit while you are away from that routine and your usual triggers. Don’t get stuck on obstacles: Believing that change is possible is a big hurdle. We tend to let doubts and fears define ouractions.Forme,keepingfocusedon the present and the goodness of life is essential for making change. Whatever yourcurrentcircumstances,trytofocus ongoodrelationships,laughter,andgood work to help make change possible. Whatever your resolutions, take heart that you are capable of change, and encourage yourself and others to move to a healthier new normal. This will have a cascade effect, improving your life and that of our community.

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Drinking water: A tasteful experience Water’s taste can differ for every person — here’s Why, and hoW to keep yours tasting best By Christopher Dunagan

When Michael Strahan took a sip of Silverdale’s wateronnationaltelevision,the co-host of “Live with Kelly and Michael” took almost no time to offer his opinion. “Ummm,” he said, “that’s some delicious H2O.” Silverdale’s tap water has fared well in national and regional taste tests in recent years.Still,itwasathrilltosee a glass of Silverdale’s drinking water compete for taste on television, said Morgan Johnson, general manager of Silverdale Water District. Johnson, who lives in Bremerton and thinks highly of his tap water at home, contendsthatdrinkingwater acrosstheKitsapPeninsulais amongthebest-tastingwater intheworld.Butit’sallamatter of taste, he said, and taste can be a tricky thing. The drinking water challenge on daytime TV last August was arranged by “Rodale’s Organic Life” magazine, which had placed Silverdale’swateramongthe top10inthecountry.Glasses containing five of the top 10 were placed before Michael Strahan and Busy Philipps, who was filling in for Kelly Ripa on “Live! With Kelly and Michael.” Strahan selected Silver-

dale’swaterasthebest,while Philipps preferred the water fromLouisville,Ky.,sayingit was the only one that stood out from the rest. “I think you build a taste forwater,”saidJohnson,who hasheadedupSilverdaleWater District for 30 years. “I’ve livedinthreedifferentwater systems and drank from all our wells. You grow accustomed to the taste. “It’s all about the chemical composition,” he continued. “Your water is running through all kind of organics and minerals. That will change the taste. Adding the right amount of chlorine (to a public water supply) is another thing. If I can taste the chlorine,itgoesto‘Idon’tlike this water.’”

WHAT IS TASTE ANYWAY? The human body has a built-in desire for water. It is called “thirst,” and health expertsadvisepeopletoyield totheirthirstbydrinkingwater. That will help ensure an adequate supply of this vital substance to keep the body functioning at a high level. One exception would be a person taking a medication that causes excessive thirst. The benefits of water are many, says Kathleen Zelman, a registered dietician

and director of nutrition for WebMD. Water is essential to digestion, circulation, nutrientabsorption,creationof saliva and maintenance of body temperature, she said. Drinking water in place of high-calorie drinks can help control body weight, she said, as can foods high in water, such as fruits, vegetables, broth-based soups, oatmeal and beans. Water helps energize muscles to avoid fatigue, keeps the skin healthy, helps the body excretewastesandhelpsmaintain normal bowel function. Thehumanbodyrelieson the senses of taste, smell and sighttorejectsubstancesthat could make a person sick. While many people believe that pure water has no taste, the substance that truly has no taste is the person’s own saliva,whichis slightlysalty. Many scientific experiments have been conducted ontheso-called“adaptation” of the taste buds. Generally, taste buds are adapted to saliva on the tongue, which gives saliva a neutral taste. If the tongue is exposed to water containing the same concentration of salt as saliva, the person tastes nothing. Only higher concentrations of salt are experienced as salty.

LARRY STEAGALL / KITSAP SUN

The water reservoir on top of Casad Dam holds a supply of about 60 percent of Bremerton’s drinking water. The dam was built in 1957 to provide water for city residents, and a facility built in 1999 helps keep drinking water safe and clean. If the tongue is continuouslybathedinasolutionthat is saltier than saliva, the taste budsadapttothathigherconcentration,soitbeginstotaste neutral. At that point, it takes anevenhigherconcentration

of salt to be experienced as a salty taste. Experiments have shown that when a group of people with normal taste buds is given pure distilled water to drink, most people do

not believe the water tastes normal. Some even say it is slightly bitter or sour, perhaps because it contains less salt than saliva, or perhaps because it is totally lacking inmineralsthatpeoplecome

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HE A LT H Y L I V IN G SP r In g 2 0 16 to expect. Other experiments suggest that when taste buds becomeadaptedtocitricacid solutions, such as grapefruit juice,thetasteofnormalwater is somewhat sweet. After adaptation to sugar, normal water tastes slightly sour or bitter. So the taste of water is not only personal —based on a person’s own saliva — it is also relative, depending on what the person has been eating or drinking before.

MINERALS, CHLORINE AND SAFETY KathleenCahall,waterresources manager for the city of Bremerton, said she occasionally receives complaints about the taste of Bremerton’s water. “The first thing I ask is whether they have recently moved from somewhere else,” Cahall said, adding that it can take time to grow accustomed to a new source of water. All the major water systems in Kitsap County are chlorinated to prevent the growth of bacteria and kill any germs that may get into the water system. Excessive chlorine can haveastrongsmellandtaste. Keeping chlorine within an accepted range minimizes the problem. Bremerton maintainschlorinelevelsbetween0.2and0.9milligrams per liter, depending in part on the location of the water within the piping network. The maximum allowed by regulation is 4.0 mg/l. Cahall said she advises people to keep a pitcher or jug of water in the refrigerator for drinking. That will help dissipate any residual chlorine while also conserving water, since people often runthetapuntilthewaterbecomes cold, she said. Colder water from the refrigerator

also tastes better, she added. While most water systems in Kitsap County draw their water from deep wells, Bremerton uses a combinationofwellwaterandsurface water. About 60 percent of Bremerton’s water comes from Casad Reservoir on theUnionRiver,deepwithin Bremerton’sprotectedwatershed. The surface supply may have a slightly different tastethanwellwater,sinceit comesfromaflowingstream and lake where it can pick up different minerals and naturalorganiccompounds. Water from the reservoir is so clean that it remains one ofthefewsurfacesuppliesin thenationthatdoesnotneed filtration, Cahall said. Because surface supplies are slightly more acidic that groundwater supplies, Bremerton uses a watertreatment system for corrosion control, which makes the water more alkaline (about 7.8 pH). The higher alkaline level prevents lead from leaching out of pipes in older houses where leadbased solder was used on copper pipes. Bremerton doesnothaveanypipeswith lead in its water-distribution system. Cahall said she finds it mind-boggling to think that water managers in Flint, Mich., failed to add corrosion controls when they began drawing water from the Flint River more than a year ago.Previously,thecityused water from Detroit, which did have corrosion controls. Tests of the highly corrosive water in Flint failed to identify dangerous levels of lead that were leaching out of city supply lines as well as pipes in older houses. Now investigators say the tests were not conducted according to state and federal rules, nor were they designed to

lookforthemostseriouslead contamination in the city. Lead affects the central nervous system and can cause permanentlearningdisabilities, especially in children. Bremerton complies with stringent state and federal rules, Cahall said, and the city regularly tests homes to make sure that the city’s corrosion control is doing the job. Testsofvariouschemicals are required of all major water systems throughout the state. Results, compiled in so-called “consumer confidence reports,” are provided towater customers. Many of the larger systems and those operated by Kitsap Public Utility District offer the information on their websites.

BOTTLED WATER AND FILTRATION While there is no reason to believe that bottled water is generally better than tap water, many people prefer to buy their drinking water inaplasticbottleratherthan

filling their own reusable container. Some people who prefer bottled water have experienced a problem with their own tap water at some point in their lives or they have come from states where violations of water-quality standardsaremorecommon, according to researchers from Vanderbilt and Duke universities who published theirstudyin“SocialScience Research Network.” Thestudyfoundthatmarketingeffortstoboosttheimage of bottled water over tap water can increase sales of bottled water. Taste, safety and convenience are major sellingpoints.Intermsofdemographics, higher-income people are attracted to the convenienceofbottledwater, while lower-income people are more focused on safety and taste — probably because they are more likely to livewherewaterisperceived asapossiblesourceofillness Campaigns that promote the benefits of tap water and

Any day is a good day for a stroll.

refillablebottlesoverthepurchase of bottled water often stress the cost of bottled water and the amount of plastic waste, which is not easily recycled. Bottled water is generally considered safe, but it can get by with less federal and state oversight than municipal water supplies. In a similar fashion, water filters are often promoted for their safety and health benefits, but the claims are frequently over-rated, especiallywhencomparedtomajor water systems in Kitsap County, Cahall said. “Consumer Reports,” whichrecentlytested42various water filters, found that many can remove contaminants, but one should never be duped by advertising suggesting that tap water is unsafe.Thefirststepforcustomers on a water system is toreviewthe testspublished as “consumer confidence reports.” For people with private wells and those who wish to know more about their specific tap water, tests

canbeconductedbyaprivate laboratory. If a filter is needed, it should be selected to filter out the specific contaminants of concern, according to Consumer Reports. That adviceisechoedbytheEnvironmentProtectionAgency. For people using filters, it is important to change the filterasoftenasrecommended bythemanufacturer,bothfor properfiltrationandbecause some filters can become a source of bacteria. “We don’t recommend home filtration systems for health reasons,” Cahall said. “Butifpeopledochooseafilter,theyshouldbeverycareful.Alotoffolksaretryingto sell very expensive systems. If you don’t like the chlorine in the water, a simple charcoal filter will do.” Christopher Dunaganhas been a science and environmental reporter for the Kitsap Sunfor threedecades. He’s nowa contributing writerfor the “Encyclopediaof Puget Sound,”a projectof the PugetSound Institute andUniversityof Washington.

Need A Lift?

Our gardens in the forest are like one giant refresh button for the soul. Open Tuesday - Sunday, 10 a.m. to 4 p.m. BAINBRIDGE ISLAND, WA www.bloedelreserve.org | 206-842-7631

3520 Kitsap Way, Bremerton 360-377-5582 www.arnoldshomefurnishings.com

HE A LT H Y L I V ING Sp r in g 2 0 16

Easy ways to add a super food to your diet Enjoy turmEric for tastE, and hEaling qualitiEs By HeatHer Morton, nD anD KatHerine BarKsHire, nD, rn

If you’re a regular reader of health news, you have certainly seen the recent articles praising turmeric as a super food. Turmeric, or Curcuma longa, has been used in many cultures as a food and medicinal agent for thousands of years. You have probably noticed it being sold as a supplementinvitaminsectionsand supplement shops everywhere. Turmeric is one of the most heavily researched plants in botanicalmedicine.Themostwidely studied medicinal constituents of turmeric are known as curcumi-

noids, which are present in the orange root-stem part known as the rhizome. Curcumin is the most active of these curcuminoids and has been found to inhibit several inflammatory enzymes. Thus, the anti-inflammatory benefits of turmeric are widespread throughout the body. If you have something that’sinflamed,itislikelyturmeric can help modulate or calm the inflammation.Inadditiontobeingan inflammationmodulator,turmeric has many other benefits, including the following: ■ Stimulation of the liver and gall bladder to make and release bile. This results in a powerful di-

gestive aid ideal for treating symptomsofdyspepsiaorindigestionas aresultoffatmalabsorption,which also improves the absorption of fat soluble vitamins (A,D, E, and K). Do you belch excessively or get heart burn after eating? Have you ever been told you have a Vitamin D deficiency or do you suffer from seasonal affective disorder (SAD)? Including turmeric in your whole foodsbaseddietwillprobablyhelp. ■ In individuals with high cholesterolorhighlycoagulableblood, turmericlowersplaquebuild-upin the arteries via inhibition of platelet, or clotting, activity. Caution is needed for those taking Warfarin,

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HE A LT H Y L I V IN G SP R IN G 2 0 16 a blood thinner. Seek advice from your health care provider. ■ A useful antimicrobial for ﬁghting infections. You can ﬁnd turmeric in many over-the-counter supplements used for treating the common cold or intestinal bug. It can also be used topically in a paste to treat skin infections, but be warned, this will leave a temporary stain on skin and a permanent stain on clothing. ■ There is evidence turmeric may prevent cancer by protecting our DNA from free radical damage. Turmeric supplements are frequently recommended and helpful for all forms of arthritis and other musculoskeletal conditions. Recent

Almond Butter, Turmeric and Ginger Cookies* Makes about 12 cookies

INGREDIENTS 1 cup almond butter**, creamy, roasted or raw 1 cup coconut sugar 1 tsp pure vanilla extract 1 whole egg 1 whole egg yolk 1 tbsp ground cinnamon 1 tsp ginger root, freshly ground 1 tbsp Turmeric, freshly ground (preferred) or powdered 1/2 tsp ground nutmeg, fresh 1/2 tsp baking soda 1/2 tsp sea salt 1/2 cup unsweetened shredded coconut 1/2 cup raw pecans, chopped

INSTRUCTIONS Preheat oven to 350 and line a baking sheet with parchment paper. Combine the almond butter and sugar in a bowl mix by

research demonstrates turmeric is useful for prevention of Alzheimer’s disease. With all these amazing beneﬁts, you may want to incorporate turmeric into your daily life. Luckily, this is easy and delicious! We have included recipes for one of our favorite traditional Ayurvedic beverages, a delicious creamy cauliﬂower dish, and a sweet treat. These are easy and relatively quick recipes to make. Note the importance of adding black pepper or consuming with fat for optimal intestinal absorption of the active constituents.

hand or with a mixer until combined Add the vanilla, egg, and egg yolk and mix. Add the ginger, Turmeric, nutmeg, baking soda and salt and mix

Coconut Curry Cauliﬂower with Kale*

Servings: 4-6

INGREDIENTS 1 tablespoon coconut oil 1/2 onion, thinly sliced 1 celery root, chopped 4 cloves garlic, minced 2-inch piece ginger, peeled and minced 1 head cauliﬂower, chopped 1/2 cup water or broth 1 tablespoon coconut aminos (or tamari/soy sauce) 2 teaspoons Turmeric 1/2 teaspoon sea salt 1 cup kale, shredded 1 1/2 cups coconut milk Salt and pepper to taste *Adapted from autoimmune-paleo.com/coconutcurried-cauliﬂower-with-kale. See this site for more whole foods based and delicious recipes.

INSTRUCTIONS Heat the coconut oil in the bottom of a large skillet or dutch oven on medium heat. When the oil is melted, add the onion and celery root and cook, stirring for eight minutes. Add the garlic and ginger, and cook for another minute, until fragrant. Add the cauliﬂower, water or broth, coconut aminos or tamari, Turmeric, and sea salt. Cook, covered, for 7-10 minutes, or until most of the liquid is absorbed, stirring occasionally. Add the kale, and coconut milk, and turn down to a simmer. Cook for another 7-10 minutes, until both are soft. Serve warm.

Add the shredded coconut and pecans and mix thoroughly Batter will be thick but not crumbly. If too crumbly, beat it longer Scoop a heaping tablespoon of dough and place on parchment paper. Slightly ﬂatten the top of the cookie. Repeat until dough is gone. Bake for 10-12 minutes. Let them cool on the baking sheet for a couple minute *Adapted from http://www.primalpalate.com/paleo-recipe/almondbutter-Turmeric-and-ginger-cookies **Any form of nut butter can be used in this recipe. Make sure there’s no added sugar in the ingredients, and we generally try to avoid peanut butter. Peanuts are delicious but full of an inﬂammatory intermediate called arachidonic acid. We naturally get plenty of these types of fats in our diet.

Warm Golden Milk* Servings: 2-4

Ingredients

Instructions

1 can of coconut milk plus 1 cup of water (or you can make it yourself) 1 teaspoon powdered Turmeric 1 teaspoon cinnamon Pinch of black pepper 1/4 tsp ginger powder Pinch of cayenne pepper (optional) 1 teaspoon raw honey or maple syrup (optional, if sweet enough, omit)

Blend all ingredients in a blender until smooth. Gently heat in a sauce pan Pour 6-8 oz into your favorite mug

*Adapted from http://wellnessmama.com/223/ turmeric-tea-recipe/. See this site for more whole foods based and delicious recipes.

Heather Morton, ND and Katherine Barkshire, ND, RNt, practice naturopathy at the Kitsap Clinic of Natural Medicine in Bremerton.

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Care that fits your life

YOU NEED HEALTH CARE. WE’VE GOT OPTIONS. When you need to see a doctor, you don’t always want to wait for an appointment. At MultiCare, you don’t have to. We’ve created a whole package of care options, from primary care and walk-in clinics to video visits and online consultations, offering you the ﬂexibility you need to ﬁt health care into your life—and budget. Get the care you need at multicare.org/choices.

to Your life

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HE A LT H Y L I V IN G Sp r in g 2 0 16 PAID ADVERTISMENT

Gig Harbor woman’s cancer in remission, thanks to DNA testing Little more than a year ago, Marie Dougil felt like she was nearly out of options. After five years of chemotherapy — trying first one drug, then another — the tumors in Dougil’s liver weren’t going away. Her doctor at the MultiCare Regional Cancer Center told her they might need to resume one of her previous chemotherapy drugs. Or, her doctor said, Dougil could try a new approach: personalized medicine, in which Multicare uses genetic material from a patient’s cancer cells to determine a treatment program specific to the patient. After all, it doesn’t get more individualized than DNA. So Dougil agreed. Just a few weeks later, the tests came back, identifying an oral medication as a potential match for Dougil’s cancer. She started taking the pill, Afinitor, nightly, and within three months, her tumors started shrinking, and her liver functions improved. Her cancer is now in remission. “It’s given me so much hope,” said Dougil, a 48-year-old Gig Harbor bookkeeper. “This specific testing they did is why my body is responding so well, because it’s personalized to me.” Through personalized medicine, doctors obtain DNA material from a patient’s biopsy. Next Generation Gene Sequencing analyzes the material, and doctors compare that evaluation with data on medications, clinical trials and other treatment options to recommend a plan that is customized to the patient. At MultiCare, many patients being treated for cancer are tested for genomic markers that could lead to various treatment options. As gene-sequencing technology has evolved in recent months, the approach has been applied to an increasing number of patients, usually after their cancer has progressed beyond standard treatment methods, said Jack Keech, MD, Dougil’s doctor at the MultiCare Cancer Center in Gig Harbor and an oncologist for 32 years. “We are truly in a revolutionary new era of cancer care,” Dr. Keech said. Dougil is no stranger to cancer. In 1997, she was diagnosed with breast cancer, which went into remission until 2009, when tumors emerged in her liver. By the time she was in her fifth year of chemotherapy, she was so exhausted she had to quit her job at Lighthouse Christian School. She could barely walk. These days, she can walk five miles regularly and has returned to the school part-time. “My quality of life has improved so much,” Dougil said. “I feel healthy, almost like I did before I was diagnosed.” She said she does miss one thing, though: the staff at the MultiCare Cancer Center. Because now that she no longer has chemotherapy, she doesn’t have to go to the doctor so often. Still, Dougil feels this new approach to cancer treatment was a blessing, and came at just the right time. “I am a woman of faith and I believe that God allows things to happen for a reason,” she said. “I feel that this new method of genetic testing is a huge blessing and came at the right time for a purpose. I want to encourage others, no matter what their prognosis, to live each day with purpose and to be a blessing to others.”

“It’s given me so much hope.”

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Check up checklist SET YOURSELF UP FOR A YEAR WITH THIS GUIDE The advice on regular maintenance for your body ranges from the simple — get your teeth cleaned every six months — to the more involved — do you understand your the health history in your family, and what it could mean? A checklist is often the best way to

stay on top of tasks that can occur over months, so here’s one to use when making an assessment of yourself. Keeping all of your appointments and notes in one pace is a way to see health holistically and keep those appointments and check ups organized in the coming year.

Eyesight:

Most optometrists recommend an eye exam at least every two years to evaluate your eyesight and screen for problems like glaucoma, cataracts or macular degeneration, and annually for people over 60. The American Optometric Association says children should have their ﬁrst eye exam at 6 months of age, another at age three and again at the start of school, and annual exams for children who do wear glasses.

Use this space to keep track of appointments:

Dental: It’s pretty straight for-

Use this space to keep track of appointments:

ward once you’ve found a family dentist. Floss and brush daily and go in for a cleaning and exam every six months.

Massage:

This alternative technique may be thought of as pampering rather than preventative, but the health effects of regular massage are evident, from stress relief to improved circulation and muscle health or recovery. There’s no universal schedule, but working with a therapist can help come up with a routine that makes a difference in your health. Use this space to keep track of appointments:

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Blood pressure & heart rate: Keeping an eye on

blood pressure doesn’t have to wait for yearly intervals, with the ability to do self-checks, though the frequency should be in consultation with your doctor or health provider is important. Even those with normal blood pressure readings of around 120/80 should check at least every two years from a provider. Testing your resting heart rate is a simple thing you can do regularly at home: Find your pulse after being seated and resting, and with a watch in hand count the number of beats per minute. The average resting heart rate is around 72 bpm, according to the YMCA, and an athletically ﬁt person could expect to be between 50 and 65 bpm.

Keep track of your numbers below:

Skin cancer: The Skin Cancer Foundation recommends a

monthly self-check from head to toe, looking at skin for any new spots or lesions and stay on top of issues that are most often curable. It’s best to begin the habit of monthly self-checks after a doctor’s examination of freckles and moles that may have potential for problems. Chose the same day each month for a ﬁve-minute review of yourself, and let your doctor know about any changes you notice.

Family health history:

Weight: Recording your weight regularly can be a

motivational tool in working toward or maintaining a healthy weight. Visit a scale once a month and keep a log of your weight, and consult your physician about setting targets for your ideal weight, which can vary as you age.

Keep track of your monthly weight below:

Agility and strength: According to the National Institute of Health, each year more than 2 million older Americans go to the emergency room after a fall. Three simple exercises done regularly provide a check on your balance and help sustain agility and strength, according to the NIH: 1.) Stand on one foot for at least 10 seconds, holding a sturdy chair for support, then alternate legs; 2.) Walk heel to toe, slowly, for at least 20 feet; 3.) Hold your arms out at shoulder height and walk in a straight line, lifting each knee as you take each step, for about 20 feet.

and behaviors are important to understand when visiting your priHave you talked with your mary physician. Schedparents, grandparents and ule a time to learn more other family members about about the prevalence of their personal health hischronic conditions like tory? It may be uncomfortable, but heart disease, cancer or diabetes, and family genetics, lifestyle choices write it down so the information can

be shared among generations. Recording at least three generations of health history is key, according to the Center for Disease Control. The CDC offers online tools and forms to help guide the process, at www.cdc.gov/genomics/famhistory. Make this the year you schedule a time to learn more about the speciﬁc preventive steps you can take.

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An appointment with ‘Dr. Bloedel’ HealtH benefits from a walk in tHe woods touted at iconic garden By Terri Gleich

Water gurgles. Birds chatter. Leaves rustle and dance. There’s the fresh, earthy scent of a world bathed in green. The setting is the Bloedel Reserve and walking its forested paths just might be the cure for what ails you. That’s the idea behind the public garden’s Strolls for Well-Being program, a continuation of the vision of founder Prentice Bloedel, who cleared some of the land for the 150-acre nature preserve by hand despite limping from the effects of childhood polio. “He found being out in nature really comforting to the soul,” said Erin Jennings, Bloedel’s marketing and outreach manager. The same is true for artist and writer Karen Gerstenberger, who loved the program so much after taking part in the fall 2014 pilot that she became a facilitator. Gerstenberger already knew the healing power of walking outdoors. Taking daily three- to six-mile treks was her therapy after losing her 12-year-old daughter to cancer. But she had been sidelined by a painful back injury when she heard about the Strolls

for Well-Being pilot. Because the walks were short, with plenty of stops built in for reflection, she signed up. It was life changing. “I began to see the forms, the colors, so many shades of green, the elegant lines in nature. As the garden transformed over the autumn season, it was breathtaking. It kind of blows your mind, pausing and stopping and really looking deeply.” Gerstenberger started taking photos, which led to drawing and eventually painting, something that she hadn’t been able to enjoy for years. “It was the beginning of me getting back to art,” she said. As a facilitator, Gerstenberger has witnessed others take a similarly healing journey. “It’s so beautiful to see what unfolds for each person.” The 12-week Bloedel program was inspired by a similar one at the Morikami Garden in Palm Beach County, Florida. Both are based on the Japanese principle of sh in rin-yok u, wh ich translates to “forest bathing.” Japanese health care providers prescribe it and studies have shown that the practice strengthens the immune system and helps with chronic stress

and depression. That’s why Ruth McCaffrey, a doctor of nursing practice and co-creator of both garden programs, tells participants to mark on their calendars that they have an appointment with “Dr. Bloedel.” “We find a lot of people tell us this is an opportunity to really step away from everything and just be in the moment and allow the garden to embrace them with its beauty and peacefulness and help them resolve issues they’ve been fighting to resolve,” she said. The program revolves around 12 self-guided walks with themes that include awareness, forgiveness, gratitude and fulfillment. Participants’ ref lective journey is guided by a workbook that features maps, photographs, inspirational quotes, places to pause and plenty of blank space for journaling. About 150 people completed Strolls for WellBeing last year. McCaffrey said the experience has led participants to reach out to estranged family members, reconcile the loss of loved ones and gain perspective on their place in the universe.

Kitsap sun file photo

A mother with two young daughters wanders through the gardens at Bloedel Reserve. The Reserve’s Strolls for Well-Being program offers a 12-week self-guided program to explore the area for health benefits.

HE A LT H Y L I V IN G sp r in g 2 0 16 “Many people talk about the garden being a force in their lives,” she said. “They say, ‘The garden is there for me and I know it is and I can go there whenever I need to.’” While most of the program is solitary, participants are invited to share their journey at group meetings at the beginning, middle and end of each 12-week session. Jennings said the gatherings are a time for people to bond and share how they have adapted elements to their individual needs. At the final meeting, participants are asked to distill their experience down to one word.

Among the answers: grateful, growth, enlightening, profound, peaceful and hopeful. Hall Ross, a Bloedel docent and Lutheran pastor who completed the program last fall, uses two words: tranquillity and peacefulness. “People come out here and they’re refreshed.” Strolls for Well-Being Dates: The next session begins April 22 or 23 and has a few open spots. The following session begins June 23. To register: Contact Erin Jennings at strolls@bloedelreserve.org

Kitsap sun file photo

Above: A family walk the Bloedel Reserve’s labyrinth during a morning visit to gardens on Bainbridge Island. Spending time in nature has healing qualities, both mentally and physically, and a program at Bloedel aims to encourage more people to walk the grounds. Below: Kitsap Sun file photo Barbara Nickerson works on a watercolor painting in the Japanese garden at Bloedel Reserve.

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A new style of medical practice Dr. Marie Matty & Dr. Andrea Chymiy have practiced medicine in the Kitsap community since 2003 Accepting New Patients! Most insurance plans accepted

Becoming a patient at Paciﬁca Medicine & Wellness offers you many beneﬁts • Easy appointment scheduling • 24/7 access to your doctor and staff via telephone and email • Same day or next day appointments • Wellness focus with access to health coaching, massage therapy and weight management services

WE PROVIDE:

• More time with your doctor – never feel rushed • Convenient online access to your health care information • Research shows this style of practice improves health outcomes, saves money and improves overall satisfaction

Preventative care for all ages • Chronic disease management • Wellness focus Geriatrics, Pediatrics & Women’s Health • Same day / Acute care visits

PACIFICA MEDICINE

In the Central Plaza Building near Central Market 19980 10th Ave. NE, Suite 202 • Poulsbo, WA 98370 (360) 979-0569 • www.paciﬁcamedicine.com e-mail: info@paciﬁcamedicine.com

SPECIAL ADVERTISING FEATURE

He a lt H y l i V iN G Sp r in g 2 0 16

HealtHylife

Poulsbo Family Doctors Jennifer Open New Clinic everyone.” Family doctors Andrea Chymiy and Marie Matty have been caring for patients “The monthly fee takes us out of the in North Kitsap for the past 12 years, but volume-driven fee-for-service health they have been finding it increasingly care model,” Matty said. The office has difficult to provide easy appointment the quality care scheduling, by they believe that phone or online, they should. and patients

usually get to talk with a “real human being” when they call, Matty said. The doctors offer telephone and Skype virtual visits in addition to traditional office visits, and the clinic has a dispensary for low-cost generic prescription drugs for their “We wanted to get back to why we patients. The clinic has also worked out became doctors in the first place,” says agreements with local labs for discounted Chymiy, “We enjoy getting to know our lab testing. patients, their families and their lives, and helping patients work toward their health At Pacifica the focus is on wellness, goals. With our new practice, we’re able and the clinic has a health coach and to to be the kind of doctors we always a massage therapist on staff. Pacifica wanted to be.” also shares space with an acupuncturist, and the clinic has two therapy dogs, Pacifica Medicine embraces two Westley, a Wheaten Terrier, and Lulu, new movements in primary care in the a Goldendoodle, who are available to U.S. Pacifica patients will be offered the patients. opportunity to enroll as Direct Primary

“Our patients were often having to wait several weeks to be seen, and when they did ﬁnally get in for an appointment we would not have enough time to spend with them,” said Dr. Matty.

Care patients where they pay a monthly fee covering all their visits and most tests, with no other charges and no need to bill insurance. Paciﬁca also offers patients a second option of becoming patients of Dr. Chymiy and Dr. Matty by enrolling in their Affordable Concierge Care practice. This option allows patients to use their insurance to cover visits while paying a low monthly fee to enjoy the expanded services offered at Paciﬁca. “Concierge medicine used to be reserved for very wealthy patients,” says Chymiy, “but more recently the trend has been toward concierge-type practices that are affordable for almost

Chymiy graduated from Tulane Medical School in New Orleans, and Matty is a graduate of the University of Washington Medical School in Seattle. The doctors met each other during their residency training program at Swedish Medical Center, in Seattle, and they jobshared for 12 years at The Doctors Clinic in Poulsbo before opening Pacifica. Pacifica Medicine & Wellness is at 19980 10th Ave. NE, Suite 202, Poulsbo. Interested patients can call (360) 979-0569, or check out www.pacificamedicine.com for more information and to schedule appointments.

Kreidler-Moss Five questions with an executive in the middle oF our country’s health care overhaul. After nearly 20 years in the health care industry, Dr. Jennifer Kreidler-Moss took over the reigns of the county’s nonpofit community based health provider in the summer of 2015, as CEO of Peninsula Community Health Services. At its six clinics PCHS provides primary care, dental, behavior health counseling, pharmacies and more, offering all services to patients regardless of their ability to pay. That mission puts PCHS in a position to be greatly affected by national policy like the Affordable Care Act, Medicaid and Medicare, in addition to the other forces shaping health care today. We asked KreidlerMoss for her perspective on what providers will do to survive, and how Kitsap residents can best utilitze the health care market. Kitsap County now has one of the lowest rates in the state for uninsured residents, which means PCHS is seeing more patients who now have coverage for preventive care. What’s the most effective way resident can use health insurance to move toward a healthier lifestyle?

Developing a relationship with a primary care provider (PCP) is the very first step to take on the road to a healthier life. In all the new and de-

veloping health care delivery models, the PCP is the primary partner to the patient in gaining access to all different types of care and support services. At PCHS, we aim to connect patients to a primary care team that their health goals and personality resonate with. The clinical team of the PCP and the medical assistant serve as the starting point for all care coordination, but the team expands dramatically behind the scenes to include the referral specialists for obtaining specialist access to care, the pharmacy team for all medication related issues, the navigator staff for help in obtaining insurance, the healthcare specialists for help with transportation and communication around high risk diseases or circumstances, such as recent hospitalizations, and the patient service center staff for help with appointments, messages to the care team, interpreter services and obtaining medical records. PCHS offers a wide range of care, from primary physicians to dental care and mental health services, and your organization is in the process of expanding. As you look at the community’s health needs for the near future, what should be at the top of any provider’s list?

Over the last 19 years that I have worked in health care, Kitsap County has grown immensely in the ability to provide quality, local, specialized care from dedicated community providers. PCHS has grown from three sites when I was a student in 2000, to 7 sites today as the largest group primary care practice in the county with more locations and programs on the horizon. In the postAffordable Care Act climate, we still help patients with access issues every day. Along with those that remain uninsured for a variety of reasons, we are finding insurance doesn’t necessarily equal access for those with Medicaid, Medicare, and our veterans. Being mindful of the need for more social services in Kitsap and creative ways to access the great services that do exist should be on everyone’s mind. It is a reality that there are more people without permanent shelter on our streets. The growing problems for our youth with addiction, suicide and depression are very real. The stories are rarely simple, but more access to mental health and substance abuse services See ExEcutivE, 27

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Firstperson

How fitness helped me fall in love with Silverdale

(Or maybe the Other way arOund) By Sonja Morgan

Moving to Silverdale changed my life. Here’s my story: before my husband deployed last year, we found out we were pregnant. We had tried for a very long time to have a child and after 5 years we were given the best gift — a healthy young boy. Three months after he was born, my husband returned from deployment and met his son for the first time. I had no problem losing my extra baby weight and life seemed good. I slowly stopped paying attention to what I was eating and put on an extra 20 pounds (basically weighing what I weighed when I was pregnant). And around the same time we got new orders to the USS Nimitz, given just four weeks to prepare for our move. Initially, I was disappointed at our new orders. I grew up near Bellevue and was happy to stay in the state, but our experience 11 years ago during our first Navy duty station wasn’t positive — that was before I learned that a new duty station is all about what you make it. I was trying to stay optimistic and decided that once I moved to Silverdale, I’d take the opportunity to accomplish a few things, like drop that extra weight. Moving to Silverdale was the best thing that could’ve ever happened to us. There’s something wonderful about the clean air, the endless trails, the programs for families and children. I like the people here — you go for a walk and everyone greets you. You’re surrounded by water and the community is so incredibly friendly to the military.

Shortly after our move, I made some goals for myself. First goal: lose 20 pounds this year. Second goal: after losing the 20 pounds, start running again. In order to put these goals to use, we went to take a tour of the Haselwood YMCA. At first glance it was any other gym, new and pretty, but then my eye caught glimpse of the indoor track above the gym — a place to walk when it rains! And, I noticed they allow strollers up there! If I had access to this, I had no excuse for not walking on days it rained. Having lived in the greater Seattle area earlier, I knew I needed this. I signed up just for the track, but quickly found out that they offered amazing programs like parent/child swim lessons starting for babies at just 6 months. I started meeting other parents who were going through similar walks in life. One of the ladies I met, Crystal, was also a military spouse, and our husbands were on the same ship. We instantly bonded over so many similarities but also our “want” for losing weight. We both attended Weight Watchers and Crystal switched from the online program to join me at the Silverdale location on Monday mornings. I began to walk on base every day, rain or shine (had to invest in a good rain jacket and stroller cover). I started to have moms come up to me and say how much of an inspiration I was, that they’d look out of their windows and see me walking in crazy weather and that it was giving them the “push” to also get out. People could also see that I was losing weight.

Courtesy photo

Sonja Morgan runs the Yukon Do It half marathon last December in Port Orchard. She finished with her best time for 13.1 miles, and now plans to run a full marathon. And, after the first 20 pounds flew off, I agreed to start a “couch to 5k” training program. I hate running, but grudgingly persevered — after all, I promised myself I’d do it. I’d lost the 20 pounds in less than 3 months! In April, we completed our first 5k. Crystal and I were running just 15-minute miles, but ran the entire distance without stopping! The weight continued to come off, and while we were walking around at the YMCA one day,we found a flier for a local running group: RIOT (Running Is

Our Therapy). Crystal got excited, but I was completely not excited. I’m not a runner, I insisted. But she was going to join either way, so I didn’t want to be left out and joined their Facebook page. Joining a Facebook group didn’t commit me to anything, I thought. RIOT is a group of people from different walks of life who have different running abilities, and all of them want to help each other. I’ve never seen a tighter group of people sincerely interested in the welfare of others. We’ve gone through trials, we’ve sweat together, cried together and

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Sonja Morgan of Silverdale, before and after she lost 65 pounds during 2015 while falling in love with a fitness community in Kitsap County.

shared laughs (especially on those impossible hills). We have fun — a word I would have never consider using to describe running. One of the best parts about the club was that even though we were so slow when we first started, some of the best runners would stay behind and help us along. I just couldn’t believe how friendly everyone was here! Some of my favorite trails are through the Clear Creek area in Silverdale as well as hills in Poulsbo and waterfront running in Port Orchard. In August, I ran my first half marathon since having a baby. I finally broke the three-hour mark, with a personal best (PR) of 2 hours, 50 minutes. I continued to run with RIOT, attended their group runs, pancake breakfast runs and watched what I ate. By the time October came around, I had achieved another goal — 62 pounds down! On Sunday, Dec. 27, I ran another half marathon of the year, Port Or-

chard’s “Yukon Do It.” Of course, I was aiming for a PR and of course, the forecast called for freezing rain. The rain came down hard, and it was cold, and half-way through the race it turned to snow…and I finished alongside three of my RIOT friends, in 2 hours and 18 minutes. What an emotional high and fabulous end to 2015! I know I couldn’t have done it back home. I didn’t have the access to this amazing running club, the amazing YMCA with the indoor track, and I wasn’t living in a city that is so friendly. So as you’re choosing resolutions, just remember that you live in a place that offers so many reasons to get outside, get off the couch and change your life — I did, and so can you! Sonja Morgan lost 65 pounds in 2015, going from a size 14 to a size 6 and taking nearly a full hour off of her best half marathon time while falling in love with Silverdale and Kitsap County. She’s now training for her first full marathon in 2016.

HE A LT H Y L I V ING SP r in g 2 0 16 AP PHoto/MAtt York, File

As health insurance plans become increasingly complicated, more patients are facing unexpected fees when they step outside their plan’s coverage network. In many cases, patients don’t realize they’ve received out-ofnetwork care until they’re slapped with a bill for hundreds or thousands of dollars. Surprise fees often arise when hospitals send blood samples or medical scans to outside facilities for development.

Surprise insurance fees often follow emergencies By Matthew Perrone Associated Press Health Writer

Recovering from a medical procedure is always a challenge, but getting hit with unexpected insurance fees can add financial hardship to the process. As health insurance plans become increasingly complicated, more patients are facing unexpected fees when they step outside their plan’s coverage network. In many cases, patients don’t realize they’ve received out-of-network care until they’re slapped with a bill for hundreds or thousands of dollars. Nearly a third of insured Americans who have financial problems tied to medical bills faced charges that their insurance would not cover, according to a recent survey by the Kaiser Family Foundation. These out-of-network charges were a surprise to nearly 70 percent of patients, who did not know the services were not covered, according to the non-partisan policy group. Here are some key questions and answers about out-of-network charges and potential steps for protecting yourself. Q: How does this problem occur?

It usually happens when people need to be hospitalized for medical care. Even though services from their primary physi-

Experts say there is little hard data on the cost of out-of-network charges or how frequently they occur. But a 2011 study by the state of New York found that the average out-of-network emergency bill was about $7,000. After assistance from insurance and other services, most consumers still had to pay roughly $3,780.

late yourself from surprise fees. But they warn that even these will not guarantee you won’t be touched by out-of-network providers. If possible, call the hospital in advance and make sure the surgeon and assistants handling the procedure are part of your insurance network. You can also talk to the hospital and request that any tests are sent to in-network laboratories for processing. Surprise fees often arise when hospitals send blood samples or medical scans to outside facilities for development. Even in these situations, however, hospitals often cannot tell you which radiologist or anesthesiologist will be handling your procedure. That means even if you’ve tried to pre-manage the process you may receive care from an out-of-network provider. “This is one of these situations that I think is very challenging for consumers. Consumers just don’t have any control,” says Georgetown University professor Kevin Lucia, an attorney who has studied the problem.

Q: Is there anything I can do to protect myself?

Q: I’ve already received a bill that includes these charges. What can I do now?

cian may be covered by their in-network insurance coverage, services provided by other professionals, such as anesthesiologists, radiologists and emergency doctors often aren’t. In those cases, the patient will be billed at out-of-network rates. The often-hefty bills leave many consumers angry and confused. Determining whether various specialists are in your network can be difficult, sometimes impossible, particularly during emergency situations. “You can’t wake up from a heart attack and say to the ambulance provider, ‘Excuse me, are you in my network?’” says Karen Pollitz, who has studied the issue for the Kaiser Family Foundation. Q: How much do these fees cost consumers?

If you have a scheduled surgical procedure coming up, experts say there are certain precautions you can take to insu-

The first step is to call your insurance company and let them know what happened. Some employer-sponsored health

plans have policies where patients are not responsible for out-of-network charges, especially if they occur during an emergency. Even if your plan doesn’t have such a benefit, insurance companies can try and work with the hospital to negotiate lower fees. You can also check if your state has a consumer assistance program to help patients with health insurance problems. Currently, ten states run such programs, including California, Illinois, Michigan and Maryland. Q: Is anyone working on a permanent solution to these problems?

Most experts who have studied the issue say legal changes are needed to protect consumers for surprise medical fees. In most cases that means new laws at the state level. New York recently implemented a law that relieves patients from out-of-network expenses that arise from emergencies or certain other circumstances. The law does not eliminate the fees, but instead requires insurance companies and hospitals to begin negotiations to resolve the charges. “The consumer is out of the process at that point,” says Pollitz. “They pay what they would have paid if they were in-network and then they’re done.”

HE A LT H Y L I V IN G sp r iN g 2 0 16 DaviD NelsoN | Kitsap suN

Jennifer Kreidler-Moss was hired as CEO of Peninsula Community Health Services in 2015, after nearly 20 years working in the nonprofit community based health care provider.

Executive from 23

are top on my list on things our community can improve to make a difference. Many things are fundamentally changing health care industry, from the ACA to hospital consolidation. What will be the role of community health service providers like PCHS in the future, and how is PCHS preparing for those changes?

As a community health center, our entire service delivery model is dynamically driven by the needs of the community we serve. For many years, the largest health care issue was lack of insurance for those of low-income. In 2012, when our uninsured rate peaked at 57 percent, PCHS did not close its doors to patients or prioritize the more favorably insured. In all discussions of health care reform today, the quality of the care delivered rises to the top of the priority list. PCHS adopted this priority into all the processes of the patient experience. We are a nationally accredited organization for ambulatory care, and in the last few years alone, we have received state and national

awards for Innovative Pha rmacy practices, blood pressure control rates and immunization rates. When Washington State became a Medicaid Expansion state, PCHS launched a new program of focused on eligibility, enrollment and outreach. As I mentioned earlier, with mental health and substance abuse being top needs in the county, PCHS is developing new and expanded programs to help meet more of the needs present. PCHS is an everchanging organization with resilient staff and an engaged community board of directors. We will continue to evolve and adapt to the current health care environment. You’re leading an organization that is focus on the health and well-being of many people, and it must be a busy job. What do you do to stay active and focus on your own health?

I sure wish I had the secret to personal wellness or even a clue to how to find an ideal work-life balance, but I fail miserably at both at times! I honestly love what I do. I think many of the employees at PCHS, both today and some who have moved on over my 13 years here, give themselves ful-

ly to those we serve. Can anyone have a bad day and not let their best shine through? You bet. But I also don’t think anyone comes to work every day just to do an OK job. It is that energy and spirit of the our collective group of care providers and support staff that helps me explain to my kids why I missed their school concert or couldn’t be a chaperone on their field trip. It is then the need to connect with them on the weekends or on evenings that I am home before they are asleep that trumps finding time to go to work out. Not to mention — I am just not a fan of physical exertion and I really like a Whopper from time to time. So, when I figure out the secret to balancing a high pace job, fostering the growth and development of three elementary schoolchildren, carving out adult time for my highly supportive hubby, finding personal time for myself and making a weight-reducing workout plan a priority, I will post it on the PCHS website and Facebook for the world to share! Until then, I’ll keep struggling like everyone else and hope to one day find the perfect balance.

History of PACIFIC SURGERY CENTER

• Pacific Surgery Center, established in 1985, is your community resource for excellence in outpatient surgical care. Having surgery in an outpatient setting offers you a high quality, cost effective alternative to the hospital.

• Our staff are professionals specializing in the care and treatment of patients undergoing outpatient surgery. Licensed by the state, Pacific Surgery Center is accredited by the Accreditation Association for Ambulatory Health Care. • Pacific Surgery Center is owned by a group of local medical professionals who are committed to excellence. It is important to the owners and staff that your experience at our center is a positive one.

• At Pacific Surgery Center you can expect more: more comfort, more privacy, more efficiency, and more caring. And you will find less: less waiting, less cost, and less worry. • We are a Multi-Specialty Ambulatory Surgery Center. Services include: ENT • Ophthalmology • Orthopedics General Surgery • Plastic Surgery • Podiatry Prostate Brachytherapy • Pain Management GI Endoscopy • Urology • GYN The center is committed to providing state of the art equipment and technology while providing an environment safe, efficient and cost effective to our patients and providers.

CREDENTIALED PROVIDERS: Endoscopy & General Surgery: Sheila Lally, DO

ENT:

Michael Jungkeit, MD David Kessler, MD

GYN:

Nancy Bohannon, MD Katherine Hebard, MD Anita McIntyre, MD Jennifer Quimby, MD

Ophthalmology:

Dale Holdren, MD Dana Jungschaffer, MD Paul Kremer, MD James Lin, MD David O’Morchoe, MD Scott Sorensen, MD

Orthopedic:

Dawson Brown, MD Gregory Duff, MD Stacee Kessinger, MD Kenneth Koskella, MD Erin Moyer, MD

“The Peninsula’s Premier Surgical Center” Celebrating Over 30 Years of Service

PACIFIC SURGERY CENTER

20669 Bond Road NE, Ste 200 | Poulsbo, WA 98370 360-779-6527 | info@pacificsurgerycenter.com

Pain Management: Jon Hillyer, MD Terry Pexton, DO

Podiatry:

David Gent, DPM

Radiology Oncology: Alex Hsi, MD

Urology:

Scott Bildsten, MD Keith Schulze, MD

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Five things cardiologists tell their friends heart-hearthy tips that go beyond the basics By Alison Bowen Chicago Tribune

Yeah, yeah, you already know the basics. Don’t smoke. Lay off the baconwrapped steak. But when cardiologists hang up their stethoscope for the day and head home from the office, what advice do they give those closest to them—their family and friends—abouthearthealth? Dr. Ronald J. Scheib, medical director at the Pritikin Longevity Center + Spa in Miami, doesn’t shy away from inquiring about his kids diets or singing the praises of exercise. “You kind of take that entire shtick home with you, because you live with it every day,” Scheib said. A common refrain on doctors’ spiel to patients: Trash the cigarettes. “Ibadgerthemabouttheir smoking,” said Dr. Robert Bonow, cardiologist and professor at Northwestern University Feinberg School of Medicine. Bonowcautionsthateven though awareness about heart disease has increased, it’s still the leading cause of death. He worries that a less active younger generation—one that spends a lot of sedentary time on the Internet—might chip away at gains made in combating heart disease.

Here are a few tidbits that might sound familiar to cardiologists’ friends and families: Monitor your numbers. “The key to all of this is to know your risk factor,” Bonow said. “Knowing your cholesterol is important.” Even in your 20s and 30s, you should be able to recite your cholesterol and blood pressure stats. A doctor can tell you whether those numbers need work. “The clock starts ticking very early,” Bonow said. Cut the sugar. “I’m a very aggressive opponent of everything which contains sugar,”saidDr.ReginaDruz, medical director at the IntegrativeCardiologyCenterof Long Island. Too much sugar can trigger multiple health problems, from excess weight to potential increases in blood pressureandtriglycerides— a type of fat circulating in the blood—that can boost the risk of heart disease. The American Heart Association recommends limiting your intake of added sugars _ sugars and syrups added to many processed foods and beverages _ to no more than 100 calories a day for most women (about 6teaspoons)and150calories a day (about 9 teaspoons) for most men. That’s roughly the equivalent of a 12-ounce can of regular soda.

“There’s no soda in my house,” said Druz, who isn’t a fan of artificial sweeteners either. “It’s prohibited.” Find a physical activity you enjoy. Experts often preach the importance of exercise. The key is to pick physical activity that you like. That way, you might even keep doing it. “It all depends on finding something that is repeatable and that is enjoyable,” ideally with a low risk of injury, Scheib said. AthiscenterinMiami,for example, pool equipment allowspeoplewithproblematic knees or backs to simulate a treadmill run in the water. Speaking at his Chicago office, Bonow nodded to the nearby escalators. “Take the stairs. Walk up the escalators,” he said. Get “a nice, brisk pace” going at least once a day. Bonow gives his bicycle a workout during warm weather and hops on a stationary bike in winter. Druz’s family takes bike rides together and goes for walks with the dog. Her three children are all active—they play tennis, volleyball and basketball and run track. Sometimes her daughter comes with her to zumba class. “They have internalized already that this is the routine,” she said, “that it’s part of health maintenance.”

It’s all about moderation. Occasionally indulging in a bit of cheat food is fine, Bonow and Druz said. Druz lets her kids have tortilla chips, if they put some guacamole on top. “Do they go for chips? Of course,” she said. “We can balance, perhaps, some bad with the good.” Bonow said eating a little red meat isn’t a problem, adding that portion size is more important than what you’re actually eating. “Keep your weight under control,” he said. He doesn’t bug his two

adult sons if they’re chomping down on pizza or burgers, he said. “They eat all kinds of things I don’t eat,” he said. “I don’t badger them. Occasionally a sideways glance.” Don’t worry too much _ it’s stressful. Patients can be panicky, Bonow said, bringing in pages of print-outs from the Internet. “They’re doing all the right stuff,” he said. But for some, it’s never enough. They still worry about other tests they think they should be taking, for example. A stressful workload or

lots of travel can take a toll on health, too. It’s important to balance that with things you enjoy. Scheib’s son spends long hours at a desk but spearfishes on the weekends. One of Scheib’s daughters travels one week out of the month. Shedoesn’teataswellonthe road _ “she gains 8 pounds,” he said _ so when she comes home she steers clear of red meat and pizza. Make sure you’re not compounding any health issuesbyaddingextraanxiety. Added Scheib: “Stress is an enormous trigger.”

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Getting to the ‘heart’ of Mayo CliniC news network

Doctors say inadequate sleep may lead to health problems, particularly with your heart.

sleep

Sleep is essential for a healthy heart. People who don’t sleep enough are at higher risk for heart disease. One study that examined data from 3,000 adults over age 45 found that those who slept fewer than six hours per night were about twice as likely to have a stroke or heart attack as people who slept six to eight hours per night. Sleep deprivation is a growing problem, with 28 percentofadultsnowreporting that they get six or fewer hours of sleep per night. It’s not clear why less sleep is detrimental to heart

health, but researchers understand that sleeping too little causes disruptions in many normal functions of the body, including blood sugar levels and blood pressure. “Lack of sleep also is a ‘weighty’ issue. In a 2012 study I conducted, 17 people ages 18 to 40 spent 15 days in ourresearchlabandwereallowed to eat as much as they wanted. Half the group was only allowed to sleep twothirds of their normal sleep time;theotherhalfservedas controls and were allowed the full amount,” says Mayo Clinic Health System cardi-

ologist Andrew Calvin. “We found that the test group ate an average of 559 additional calories each day. More importantly, it didn’t seem that the people who were awake longer burned more calories from additional activities. Our study concluded that if that rate of consumption kept going, the people who slept less could gain up to one pound a week.” “Furthermore, those in the study who slept less had signs that their blood vessels didn’t work as well, something called endothelialdysfunction.Endothelial dysfunction is found in peo-

ple at risk for heart attacks, so this is a worrisome finding that should be explored further,” adds Dr. Calvin. Another condition that can affect heart health is sleep apnea, a condition that causes people to wake frequently throughout the night. This disrupted sleep can lead to higher blood pressure at night and during the day, and may increase

the risk for heart attacks and stroke. One study found that over an eight-year period, men with severe sleep apnea were 58 percent more likely to develop congestive heart failure than men without the nighttime breathing disorder. But it doesn’t take a severe underlying sleep disorder to see effects on the heart. Poor sleeping, as a result of changing work

schedules or poor sleep habits, for example, can put you at risk as well. “Don’t compromise your heart health,” says Dr. Calvin. “Do your best to make quality sleep a priority in your life. This isn’t being lazy; it’s good wisdom. The National Sleep Foundation recommends that adults get seven to nine hours of sleep a night.”

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DO YOU SUFFER FROM DIZZINESS, VERTIGO, OR LOSS OF BALANCE? As many as 76 million Americans will experience these symptoms at some time during their lives. YOU DON’T HAVE TO SUFFER ... WE CAN HELP! EFFECTIVE TREATMENT FOR: Dizziness • Vertigo or Spinning Sensations • BPPV • Motion Sensitivity • Vestibular Dysfunction • Disorientation

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Extending the Reach of Physical Therapy

The words “physical therapy” are typically associated with rehabilitation after injury or surgery. At Kitsap Physical Therapy and Sports Clinics (KPT), prevention is a key focus to help avoid surgery or injury. “We’re about helping people improve their quality of life through evidence-based care,” says founder and CEO Mike Danford.

STAFF EXPERTISE, TRAINING AND EDUCATION Founded in 1979, KPT has 26 therapists (72 percent) who have their doctorate and/or are board-certified specialists. This high rate of board certification speaks to KPT’s commitment to quality of patient care (of 260,000 licensed physical therapists in the United States, only 7 percent are board-certified in a specialty). Additionally, Danford and Vice President Dave Damon have completed their postprofessional doctorate of physical therapy. This first-of-its-kind program includes coursework in radiology, medical screening, pharmacology and evidence-based practice. It also provides training in practice management and business administration. “This program will assure that KPT remains at the leading edge of physical therapy in Kitsap County,” Danford says. ORTHOPEDIC CARE Orthopedic care remains the foundation of KPT’s work. Whether it’s lower-back pain, a sprained ankle or post-operative care, every patient will receive a successful, personalized rehabilitation program. Scott Richards, PT, SCS, ATC, a partner and clinic director, says the RICE (rest, ice, compression, elevation) method can successfully treat minor sprains and strains — but more complicated conditions require a trained professional. “Physical therapy can significantly improve the rate of healing for more complex orthopedic injuries through a combination of manual therapy, modalities, education and specific stretching and strengthening exercises based on each individual’s condition,” he says.

FALL PREVENTION AND STRENGTH AND BALANCE TRAINING Dizziness, vertigo and loss of balance are problems affecting as many as 76 million Americans. KPT offers programs designed for individuals suffering from these conditions, as well as BPPV (benign paroxysmal positional vertigo), a common inner-ear problem affecting the vestibular system.

BPPV causes periods of dizziness or a spinning sensation when your head is moved in certain positions, lying down, turning over in bed or looking up. The condition can be treated quite effectively with a simple but very speciﬁc head and neck maneuver performed by a physical therapist. Fall prevention is designed for individuals at risk, including those suffering from arthritis and diabetes complications. DIABETES MANAGEMENT A 12-week program, geared to all ages, provides a supervised, safe environment that includes individualized exercises, glucose-level management and education on topics such as foot care, heart disease and joint pain. The program is tailored to the person’s health level and provides monitored progress, motivation and encouragement. OTHER SERVICES KPT’s services include a comprehensive list of specialty programs and preventive care services. The organization is committed to the community, and has been supporting local food banks, donating more than $50,000 since 2013 through programs like “Refer a Friend” (a $10 donation is made to the local food bank when you refer a friend). KPT Director John Carlson, PT (Arthritis Foundation Medical honoree) says: “Many times, we can help patients during a consultation to self-manage their condition or pain and if not, we are here to help you get back to an active, healthy lifestyle.” KPT is offering a free consultation to readers (by mentioning this article).

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The dialogue with your doctor By ElainE RogERs Tribune News Service

So, there’s that daily Facebook newsfeed and its bombardment of provocative promises about the curative powers of everything from pet ownership to meditation. Meanwhile, five minutes spent tuned in to what Dr. Oz is talking about is sure to add another superfood, spice or yoga stretch to your ever-expanding arsenal of nutraceuticals and hoping-they’re-healthy habits. It’s easy to see why most of us get confused about what we ought to be eating, taking or doing to optimize our health — and to know when or if to bring our family doctors in on the conversation.

HELP YOURSELF According to studies from the National Institutes of Health, a third of Americans seek help for their health outside of their doctor’s office, although most do so as a complement to conventional care — not as a replacement for it. And the U.S. National Center for Health Statistics (NCHS) reports that 18 percent of Americans use herbal supplements, more than double that of the next-most-popular complementary medicines — chiropractic and osteopathic manipulation (8.5 percent) and yoga (8.4 percent). “People are highly motivated now to try to stay healthy by taking vitamins, herbs and nutraceuticals or by seeking out complementary and alternative medical treatments,” says Dr. Darrin D’Agostino, chair of

the department of internal medicine at the University of North Texas Health Science Center at Fort Worth. “That’s a good thing. But, they also need to be taught to tell their doctors what vitamins they’re taking. It’s important, because it’s very easy to have drug interactions when those conversations aren’t taking place.”

PRESCRIBING WELLNESS D’Agostino is among a growing branch of physicians practicing what is called integrative medicine, acknowledging the merits of healing traditions like acupuncture, massage therapy, yoga and nutrition — termed complementary and alternate medicine (CAM) in medical circles — and actively incorporating them into their patients’ treatment plans. He and others say that integrative medicine and the concept of “treating the whole person rather than just the symptoms of illness” is becoming more mainstream, and even conventional physicians are increasingly more likely to discuss the nutraceuticals and wellness therapies patients have already prescribed for themselves, or to make suggestions about CAM treatments they might pursue. “I believe there is a benefit with integrating complementary and alternative medical treatments such as nutrition, exercise, yoga, massage, etc., into traditional/conventional medical practices,” says Dr. Lea Krekow, an oncologist at Texas Breast SpecialistsBedford and Texas Oncology’s Bedford and Grapevine locations. “Wellness is

more than just the absence of disease.”

PERSONAL TOUCH Integrative medical practitioners may keep registered dietitians on their staffs to provide nutritional counseling, or they might recommend alternative therapeutic approaches like massage therapy or acupuncture as complementary treatments to their conventional care. Dr. Elizabeth Carter, chair of the department of family medicine with Fort Worth’s JPS Health Network, says she was intrigued by her exposure to alternative medical treatments and eventually trained in acupuncture to provide this treatment option to her patients. “For years, I have been interested in offering more than prescriptions for different symptoms,” she says. “... I think there is a place for treatments that may complement traditional Western medicine and some treatments that should be offered before a pharmaceutical medication is offered.” D’Agostino says people commonly seek nutraceuticals and complementary and alternative medicine for medicinal purposes, “not just for wellness.” He says he believes it is a course of action that ought to be implemented with physician approval. “Those dialogues are really important,” he says. “We really need to get to a point where people go to their doctor when they’re healthy and become a partner with their physician to become healthy and stay healthy, rather than just going when we’re sick.”

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AMBULATORY SURGERY CENTER PACIFIC SURGERY CENTER 20669 Bond Road NE, Ste 200 Poulsbo, WA 98370 360-779-6527 www.pacificsurgerycenter.com

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LINDQUIST DENTAL CLINIC FOR CHILDREN, TACOMA 3875 S 66th Street Tacoma, WA 98444 253-539-7445 www.lindquistdental.org LOWELL STREET IMPLANT & SURGICAL CENTER SILVERDALE 3594 NW Lowell Street Silverdale, WA 98383 360-692-0300 www.lowellstreetcenter.org

DERMATOLOGY BAINBRIDGE SKIN SURGERY 271 Wyatt Way NE Bainbridge Island, WA 98110 206-317-6911 www.bainbridgeskinsurgery.com

ELDERLY CARE FAMILY FIRST ADULT FAMILY HOMES 4700 Point Fosdick Drive NW, Ste 312 Gig Harbor, WA 98335 253-853-2033 www.familyfirstafh.com

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EMERGENCY/ URGENT CARE DOCTORS CLINIC URGENT CARE 1651 NE Bentley Drive Bremerton, WA 98311 360-782-3400 www.thedoctorsclinic.com HARRISON MEDICAL CENTER, BREMERTON 2520 Cherry Avenue Bremerton, WA 98310 360-744-3911 www.harrisonmedical.org HARRISON MEDICAL CENTER, SILVERDALE 1800 NW Myrhe Road Silverdale, WA 98383 360-744-8800 www.harrisonmedical.org MULTICARE GIG HARBOR URGENT CARE 4545 Point Fosdick Drive NW Gig Harbor, WA 98335 253-530-8011 www.multicare.org

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DOCTORS CLINIC, SILVERDALE 9621 Ridgetop Boulevard NW Silverdale, WA 98383 360-782-3300 www.thedoctorsclinic.com DOCTORS CLINIC, SILVERDALE 2011 NW Myrhe Road Silverdale, WA 98383 360-830-1600 www.thedoctorsclinic.com MULTICARE GIG HARBOR MEDICAL PARK 4545 Point Fosdick Drive NW, Ste 250 Gig Harbor, WA 98335 253-530-8000 www.multicare.org PACIFICA MEDICINE & WELLNESS 19980 10th Avenue NE, Ste 202 Poulsbo, WA 98370 360-979-0569 www.pacificamedicine.com

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HE A LT H Y L I V IN G Sp r in g 2 0 16

HOME HEALTH CARE CARE PLUS HOME HEALTH 1950 Pottery Avenue Port Orchard, WA 98366 360-373-8016 www.mycareplus.com MARTHA & MARY AT HOME 403 Madison Avenue N, Ste 240 Bainbridge Island, WA 98110 877-266-2856 www.marthaandmary.org

HOSPITALS HARRISON MEDICAL CENTER, BREMERTON 2520 Cherry Avenue Bremerton, WA 98310 360-744-3911 www.harrisonmedical.org HARRISON MEDICAL CENTER, PORT ORCHARD 450 S Kitsap Boulevard, Ste 100 Port Orchard, WA 98366 360-744-6275 www.harrisonmedical.org HARRISON MEDICAL CENTER, POULSBO 19500 10th Avenue NW Poulsbo, WA 98370 360-394-6500 www.harrisonmedical.org

HARRISON MEDICAL CENTER, SILVERDALE 1800 NW Myrhe Road Silverdale, WA 98383 360-744-8800 www.harrisonmedical.org

INTERNAL MEDICINE OLYMPIC INTERNAL MEDICINE 2620 Wheaton Way Bremerton, WA 98310 360-377-3923 www.olympicinternalmed.com

MASSAGE THERAPY CENTERING MASSAGE ‘There is a Difference!’ 3100 Bucklin Hill Road, Ste 122 Silverdale, WA 98383 360-692-7800 www.centeringmassage.com

PEDIATRICS MARY BRIDGE PEDIATRIC SPECIALTY CLINIC, GIG HARBOR 4545 Point Fosdick Drive NW Gig Harbor, WA 98335 253-403-1419 www.multicare.org MARY BRIDGE PEDIATRIC SPECIALTY CLINIC, SILVERDALE 1780 NW Myrhe Road, Ste G220 Silverdale, WA 98383 253-403-1419 www.multicare.org

PHYSICAL THERAPY KITSAP PHYSICAL THERAPY AND SPORTS CLINICS, BAINBRIDGE ISLAND 911 Hildebrand Lane NE, Ste 101 Bainbridge Island, WA 98110 206-842-6288 www.kitsappt.com KITSAP PHYSICAL THERAPY AND SPORTS CLINICS, BREMERTON 2500 Cherry Avenue, Ste 203 Bremerton, WA 98310 360-792-1015 www.kitsappt.com KITSAP PHYSICAL THERAPY AND SPORTS CLINICS, KINGSTON 26001 Barber Cut-Off Road, Ste C-1 Kingston, WA 98346 360-297-7050 www.kitsappt.com KITSAP PHYSICAL THERAPY AND SPORTS CLINICS, PORT ORCHARD 1880 Pottery Ave, Ste 100 Port Orchard, WA 98366 360-895-9090 www.kitsappt.com

KITSAP PHYSICAL THERAPY AND SPORTS CLINICS, POULSBO NKMC 20730 Bond Road NE, Ste 106 Poulsbo, WA 98370 360-779-3764 www.kitsappt.com KITSAP PHYSICAL THERAPY AND SPORTS CLINICS, POULSBO VILLAGE 19319 7th Avenue, Ste 108 Poulsbo, WA 98370 360-779-3777 www.kitsappt.com KITSAP PHYSICAL THERAPY AND SPORTS CLINICS, SILVERDALE 2400 NW Myhre Road, Ste 102 Silverdale, WA 98383 360-613-1834 www.kitsappt.com

REHABILITATION LIFE CARE CENTER OF PORT ORCHARD 2031 Pottery Avenue Port Orchard, WA 98366 360-876-8035 www.lifecarecenterofportorchard.com MARTHA & MARY 19160 Front Street NE Poulsbo, WA 98370 360-779-7500 www.marthaandmary.org

SPECIAL CONTRIBUTOR ARNOLDS FURNITURE 3520 Kitsap Way Bremerton, WA 98312 360-377-5582 www.arnoldshomefurnishings.com BLOEDEL RESERVE 7571 NE Dolphin Drive Bainbridge Island, WA 98110 206-842-7631 www.bloedelreserve.org THE CASCADE TEAM, ROB DARLING 4502 Garden Place NW Gig Harbor, WA 98335 253-208-9351 www.thecascadeteam.com SMOKERS’ CHOICE Kitsap Mall Silverdale, WA 98383 360-698-0211

ROY ROBINSON RV 6616 35th Avenue NE Marysville, WA 98271 866-662-2386 www.royrobinsonrv.com WHISTLE WORKWEAR 2789 NW Randall Way Silverdale, WA 98383 360-698-0790 www.whistleworkwear.com

VEIN CARE NORTHWEST VEIN & AESTHETIC CENTER 4700 Point Fosdick Drive NW, Ste 307 Gig Harbor, WA 98335 877-512-1332 www.nwveins.com

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Rebecca Thompson, BC-HIS

Board Certified Hearing Instrument Specialist

DR. GARRITANO

Independent Hearing Instrument Provider Worked in industry over 12 years Working on the Kitsap Peninsula over 7 years

offers Health Breakthrough & Wellness Transformation programs (individual or groupp lients workshop packages available) to empower clients facing chronic health challenges by helping them to focus on clear and attainable goals, remove internal obstacles, and learn specific resilience skills to help them feel better.

SOLUTIONS 3100 NW Bucklin Hill Dr, Suite 103 Silverdale, WA 98383 • 360-692-6650

MY NAME: Joanna Garritano, MD

BUSINESS NAME: Nurture Healing BUSINESS EMAIL: joannagarritano@nurturehealing.orgg BUSINESS PHONE: 970-433-0918

Rebecca Thompson

kitsaphearing.com

hearingsolutions@kitsaphearing.com

Stefanie Nickels

HE A LT H Y L I V ING sp r in g 2 0 16

support groups and services AD/HDSUPPORT GROUP CHADD Meetings Support for parents, AD/ HD adults, educators and health professionals with speakers and open discussion. When: 7-8:30 p.m., second Tuesdays of the month at the Group Health Cooperative Classroom, 10452 Silverdale Way, Silverdale Info: chadd.org

ALSSUPPORT GROUP silverDAle support group When: 3-5 p.m., first Thursday of the month, Library, Silverdale United Methodist Church Info: carynw@alsa-ec.org

BRAININJURY SUPPORTGROUP BrAin injury AlliAnCe WAsHington— BreMerton/ silverDAle When: 4:30-6 p.m. , fourth Wednesday of the month, or 3-4:30 p.m., the second Thursday of each month at St. Paul’s Episcopal Church, 1137 Callow Ave., Bremerton Info: 360-744-8980, biawa. org/supportgroups.php

CANCERSUPPORT

ADvAnCeD CAnCer pAtient support group A new class open to advanced stage cancer patients; some sessions will be open to partners, family and support persons. When: 1:30-3 p.m. third Tuesday of the month at Harrison Medical Center, Silverdale—Garden Room Info: 360- 744-4990, harrisonmedical.org/oncology

HArMony Hill CAnCer retreAt Holds a three-day cancer retreat each month among other retreat and services offered. When: Changes monthly at Harmony Hill, 7362 E State Route 106, Union Info: 360-898-2363, harmonyhill.org

KitsAp CAnCer serviCes support group for frienDs, fAMily AnD CAregivers When: 1:30-3 p.m. Wednesdays, Saint Barnabas Episcopal Church, Bainbridge Island Info: kitsapcancerservices. org, 360-843-3539 or at Karen@kitsapcancerservices.org

KitsAp CAnCer serviCes support group BAinBriDge islAnD

For anyone diagnosed with cancer. When: 1-2:30 p.m. Mondays, Saint Barnabas Episcopal Church, Bainbridge Island Info: kitsapcancerservices. org, 360-843-3539 or at Karen@kitsapcancerservices.org

KitsAp CAnCer serviCes WoMen’s support group When: 10:30 a.m.-noon Mondays, St. Charles Episcopal Church, Poulsbo Info: kitsapcancerservices. org, 360-843-3539 or at Karen@kitsapcancerservices.org

looK gooD…feel Better Program sponsored by the American Cancer Society to help women learn makeup techniques, skincare and more in small groups. Please register. When:, 1-3 p.m., First Monday of each month at Aspen Conference Room, Harrison Bremerton, 2520 Cherry Ave.; 3-5 p.m., third Thursday of each month in the conference room at Harrison HealthPartners Poulsbo Hematology & Oncology, 19500 10th Ave. NE, Suite 100, Poulsbo Info: 800-ACS-2345 (800227-2345), harrisonmedical.org/oncology

Men’s CAnCer

Kitsap sun file photo

Grief support groups are available in Kitsap County.

support When: 10:30 a.m.-noon, last Thursday of each month, Harrison HealthPartners Poulsbo Hematology & Oncology, 19500 10th Ave., NE, Suite 100, Poulsbo Info: 360-598-7500, harrisonmedical.org/oncology; facilitated by Joe Jack Davis, MD

ovAriAn/ gyneCologiCAl CAnCer support group The group provides education, resources, and support for those affected by ovarian or gynecological cancer. Friends or loved ones welcome. When: 1 p.m., Third Tuesday of each month Rose Room (ground floor), Harrison Silverdale, 1800 NW Myhre Road Info: 360-744-4990, harrisonmedical.org/oncology; facilitated by Sue-Marie Casagrande, MSW

WoMen AnD CAnCer support group - poulsBo

HospiCe of KitsAp County support group

When: 10:30 a.m., first and third Thursday of each month, Harrison HealthPartners Poulsbo Hematology & Oncology , 19500 10th Ave. NE, Suite 100, Poulsbo Info: 360-598-7500, harrisonmedical.org/oncology; facilitated by Meg Mitchell, MSW

Ongoing, in a peer-support setting with a traditional drop-in format. When: 1:30 p.m., second and fourth Wednesdays and 5 p.m. ,first and third Wednesdays at Hospice of Kitsap County, 10356 Silverdale Way, Silverdale Info: hospicekc.org

WoMen AnD CAnCer support group BreMerton When: 10:30 a.m., second and fourth Thursday of each month, Harrison Bremerton, Radiation Oncology Library, 2520 Cherry Ave. Info: 360-744-4990, harrisonmedical.org/oncology; facilitated by Sue-Marie Casagrande, MSW

GRIEFSUPPORT GROUPS

CoMpAssionAte frienDs When: 7 p.m. on the third Tuesday of the month in the Iris Room, Harrison Memorial Hospital, 1780 NW Myhre Road, Silverdale Info: 360-620-4831 or carolyntopness@comcast.net

MSSUPPORT GROUPS BreMerton Ms ConneCtions support group

Kitsap sun file photo

Harmony Hill in Belfair offers retreat time for those with cancer or family members. When: Noon-2 p.m., third Wednesdays of the month, September through May, Central Kitsap Presbyterian Church, 9300 Nels Nelson Road, Bremerton Info: joyce.buell@yahoo. com, nationalMSsociety. org

Belfair Multiple ScleroSiS Support Group When: 6 p.m. on the third Thursday of the month at the Mary E. Theler Center, 22871 NE State Rt. 3 Belfair Info: 360-552-2362, amsinwa@gmail.com

When: 1:30-2:30 p.m., first Tuesdays monthly, Saint Paul’s Episcopal Church, Oliver Room, 700 Callahan Drive, Bremerton Info: 360-744-6220

parkinSon’S Group MoveMent claSS When: 9:30-10:30 a.m. Tuesdays and Thursdays starting in February at Kitsap Physical Therapy, 2400 NW Myhre Road, #102, Silverdale Info: 360-613-1834, kitsappt.com

WEIGHTLOSS

PARKINSON’S SUPPORTGROUP

take off poundS SenSiBly (topS)

parkinSon’S Support Group— kitSap county

TOPS is a non-profit support group that provides

sensible and encouraging weigh loss; 360-275-2179, tops.org

Bremerton When: 6 p.m. Tuesdays at Room 11--Holy Trinity Church, 4215 Pine Road NE Bremerton When: 6 p.m. Mondays at Family of God Lutheran Church, 7625 Central Valley Road NW central kitsap When: 8:30 p.m. Mondays at Central Kitsap Community Church, 6735 Stampede Blvd. NW poulsbo When: 4:45 p.m. Mondays at North Kitsap High School. 1780 NE Hostmark St.

poulsbo When: 8:30 a.m. Thursdays at Vinland Lutheran Church, 2750 NW Finn Hill Road

port orchard When: 5:30 p.m. Tuesdays at First Baptist Church, 2308 Sidney Ave.

port orchard When: 6:15 p.m. Mondays at Spirit of Life Lutheran Church, 3901 SE Mullinex Road

Silverdale When: 9 a.m. Wednesdays at Silverdale United Methodist Church, 9982 Silverdale Way NW

port orchard When: 5 p.m. Mondays at PNIA Multicultural Center, 1403 Sidney Ave.

Belfair When: 3 p.m. Mondays or 9:30 a.m. Thursdays at the Belfair Community Baptist Church, 23300 NE State Route 3

port orchard When: 6 p.m. Mondays at Church of Christ Port Orchard, 2585 Carr Lane SE port orchard When: 9:45 a.m. Tuesdays, 9 a.m. Wednesdays or 9:30 a.m. Thursdays at Active Club Building, 1025 Tacoma Ave.

WeiGht WatcherS 1-800-516-3535, weightwatchers.com

Bainbridge island When: 9:30 a.m. and 6:30 p.m. Thursdays at Filipino

American Hall, 7566 High School Road

port orchard When: 9:30 a.m., Monday; 10 a.m. and 12:15 Wednesdays; 5:45 p.m. Thursdays; 9 a.m. Saturdays at Towne Square Center, 1700 SE Mile Hill Dr. poulsbo When: 5:30 p.m. Tuesdays at Poulsbo Montclair Park, 1250 NE Lincoln Road Silverdale When: 9:30 a.m. and 6 p.m. Mondays; 5:15 p.m. Tuesdays; 9:30 a.m. Wednesdays; 9:30 a.m. and 12:15 p.m. Thursdays; 10 a.m. Fridays; 7:30 a.m., 9:30 a.m. and 11:30 a.m. on Saturdays at Weight Watchers, 3100 NW Bucklin Hill Road #112

Excellence in Patient Care

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Por t Orchard | Poulsbo | Silverdale