INHealth 10/07/2014 by The Inlander

INHealth

HEALTHY LIVING IN THE INLAND NORTHWEST • FREE

w o l S n w Do e m Ti ted” s e r “ ng Looki easier e may b u think yo 27 than PAGE special report

A New Med School For Spokane? PAGE 15

OCTOBER-NOVEMBER, 2014

S U P P L E M E N T TO T H E I N L A N D E R

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MANAGING EDITOR Jacob H. Fries ART DIRECTOR Chris Bovey CALENDAR EDITOR Chey Scott PHOTOGRAPHER Young Kwak COPY EDITOR Michael Mahoney CONTRIBUTORS Carla Brannan, Jordy Byrd, Jim Campbell, Linda Hagen-Miller, E.J. Iannelli, Scott Leadingham, Deanna Pan, Stephen Schlange, Carrie Scozzaro, Matt Thompson, Daniel Walters, John White PRODUCTION MANAGER Wayne Hunt ADVERTISING SALES MANAGER Kristi Gotzian DIRECTOR OF MARKETING Kristina Elverum ADVERTISING SALES Autumn Adrian, Bonnie Amstutz, Bruce Deming, Gail Golden, Janet Pier, Carolyn Padgham-Walker, Emily Walden, Raevyn West SALES COORDINATION Rebecca Rison, Gilbert Sandoval, Denise Brewer, Brynn Schauer DESIGN AND PRODUCTION Tom Stover, Derrick King, Alissia Blackwood Mead, Jessie Spaccia DISTRIBUTION MANAGER Zach Johnson BUSINESS MANAGER Dee Ann Cook CREDIT MANAGER Kristin Wagner PUBLISHER Ted S. McGregor Jr. GENERAL MANAGER Jeremy McGregor

Celebrates

InHealth is published every other month and is available free at more than 500 locations throughout the Inland Northwest. One copy free per reader. Subscriptions are available and cost $2.50 per issue. Call x213. Reaching Us: Editorial: x261; Circulation: x226; Advertising: x215. COPYRIGHT All contents copyrighted © Inland Publications, Inc. 2014. InHealth is locally owned and has been published every other month by Inland Publications, Inc. since 2004.

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FROM THE EDITOR

Doctors Needed

Anne McGregor is the editor of InHealth. Email her at annem@inhealthnw.com.

DEDICATION “St. Luke’s is a place to nurture for “St. Luke’smy is apassion place to helping people healfor nurture my passion with proven therapies helping people heal and withcare.” proven therapies – DEAN BUNKOWSKE, PHYSICAL THERAPIST and care.” ST. LUKE’S REHABILITATION INSTITUTE – DEAN BUNKOWSKE, PHYSICAL THERAPIST ST. LUKE’S REHABILITATION INSTITUTE

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INSPIRING COLLABORATION. CONNECTING COMMUNITIES.

ad a long wait to get in to see a doctor lately? When I called to get my son into a specialist last February, I was told she was booked until October. I nearly fell off my chair. Luckily, a spot opened up in May — still a wait of more than two months. Getting him in for surgery took another two months. Trouble even finding a primary care doctor willing to take you on as a patient? It’s probably not much comfort, but you’re not alone. In this issue, our life coach Carla Brannan’s column is about making a life change — it’s titled “Awareness, Acceptance, Action!” Reading it, I considered how, as a state, we’ve been awfully slow at turning our awareness of the physician shortage into action. As you’ll read in Daniel Walters’ Special Report, “Delivering New Docs,” there are whole counties in Washington with only a handful of doctors — sometimes just one or two. More people than ever are now insured, but who will take care of them? I hope you’ll be ready to let your legislators know how you feel about the potential for a new medical school in Spokane after reading his story. But we’re not all about depth at InHealth. Sometimes we’re more, well, skin-deep. In “Facing the Future,” Linda Hagen-Miller takes a look at all the new, and minimally invasive, ways to make sure your face reflects just how young you feel. To your health!

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CHECK-IN STAY CONNECTED You can reach Editor Anne McGregor via email at annem@inhealthnw.com. The conversation continues on the Inlander Facebook page, and stay in touch with us at Inlander.com/InHealth.

ON OUR FACEBOOK

What do you think about a new med school in Spokane? MINDI FINCH When thinking about the need for more doctors, keep in mind how long many, many of us must wait for appointments. Upwards of a month before being able to see a specialist. We also have many more people with affordable access to health care via the ACA. The need for more doctors is great. JAMES GALLINA The feasibility study was highly questionable. Unfortunately, that’s a poor start to what is otherwise a promising endeavor. MAUREEN PHILLIP JONES According to UW the feasibility study was questionable. UW has financial reasons of it’s own to want to take over this initiative and push WSU out. WSU should be allowed to proceed. STEVE FAUST A medical school is a great idea. It doesn’t matter to me who runs it, and I would like both universities to stop wasting our money fighting with one another in a quest to expand their empires. I’m upset with WSU for initiating this food fight. ETHAN VANGELDER I’d love to see it happen. I’m currently a student at Shadle, and I’m extremely interested in practicing medicine. A medical school in Spokane would make my education so much more accessible. MARY BETH SHINN It’s about time Washington state increased the number of men and women we train as doctors. ANNE MONTGOMERY Spokane needs a medical school. I think UW and WSU should cooperate not compete. 

SUPERFOOD

Pick a Pear ATTRIBUTES: While Washington may be best known for its apples, the state is also the number one producer of fresh pears in the United States. The Northwest climate is perfect for pears, with about 10 varieties grown in Oregon and Washington orchards. SUPERPOWERS: Pears are an excellent source of fiber, and contain vitamin C and potassium. They’re easily digested and one of the least-allergenic foods — meaning almost anyone can eat them. And pears are pretty. Their voluptuous, Rubens-esque appearance and the ombre coloring make them the perfect choice for a fall table centerpiece. According to the USDA, keeping a bowl of fruit visible can help you consume more.

WEAKNESS: Pears require ripening off the tree and at room temperature. A ripe pear yields slightly at the stem — be attentive to the pressure-test because some pear varieties don’t change color as they ripen. It is normal for some varieties to have brown spots on the skin — they won’t affect taste. HOW TO USE THEM: Eat pears whole for a filling, lowcalorie snack, at just 100 calories for a medium-size fruit. For a quintessential Northwest fall treat, pears lend a buttery sweetness to spinach salad with balsamic vinaigrette. Dried cranberries and toasted hazelnuts add texture. — ANNE McGREGOR

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Genetic Testing, Better Prescribing John R. White chairs WSU-Spokane’s Department of Pharmacotherapy.

My best friend’s doctor just had her undergo a special genetic test. The doctor told her that the test was relatively new but that it was becoming common practice to help avoid side effects and to help make sure that the best medication is prescribed. What is this test, and should I get it?

enetic testing is changing the landscape of medication prescribing. We are now able to quickly and painlessly (sometimes with just a swab from the inside of the mouth) do a series of genetic tests that inform us about how you as an individual metabolize and react to many commonly prescribed medications. This approach is referred to as “personalized medicine.” By interpreting this test, clinical pharmacists can assist prescrib-

ers by predicting which medications are more likely to be effective and which medications are more likely to cause problems or interact with other previously prescribed medications. In some cases this test can also help prescribers determine the best dose for a medication. Researchers are still trying to determine how cost-effective this approach is. Two companies that do this type of testing in Washington state are Genelex (Seattle) and Natural Molecular Testing Corporation (Renton). Their websites offer a wealth of information. The test (actually several tests rolled into one) has many names but is best known as a medication metabolism profile. Anyone could potentially benefit from the test, but those who chronically take multiple medications are more likely to benefit. — JOHN R. WHITE

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Assessing Adolescents

recall lining up in the grade school locker room when football season started for the annual scoliosis check, heart exam and visit from Baron Von Turnencough. Though it was mainly embarrassing, there are a number of potential issues that Matt Thompson is might be discovered through this process, a pediatrician at some more serious than others: the athlete Spokane’s Kids Clinic. may have had a recent concussion that warrants delay of participation; they may have evidence of a contagious skin infection that should be treated; they may have an exam finding suggestive of a cardiac issue that requires more extensive evaluation; there may be evidence of unhealthy patterns of nutrition, vision problems that could impact safety, and so on.

These pre-participation exams (PPEs) are still often conducted en masse in school gyms and lunch rooms throughout the country, relatively quickly, though a bit more privately than when I was in school. Most years I am asked to participate as a clinician in these PPE blitzes. While I feel bad about it, I respectfully decline as a conscientious objector. This change of heart stems from my personal opinion that too many parents accept the PPE as a substitute for a comprehensive and timely well-visit. It is not. Among other things, the yearly well-visit is essential to promoting the trust and therapeutic alliance that is necessary when working with school-age and adolescent

patients. There simply is not enough time during a PPE to address the many relevant issues related to vaccinations, academics, relationships, reproductive health, mental health, substance abuse avoidance, injury prevention, altruism, character and resilience. Tackling these topics even in the 45 to 60 minutes set aside for an adolescent visit presents a formidable challenge. But the pre-participation evaluation can be seamlessly incorporated in this visit, allowing schools to get their required documentation, while not missing one of a precious few opportunities for primary care providers to have a positive impact during a high-stakes period of child development. — MATT THOMPSON, MD

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THEIR OWN WORDS

Dr. Henry Mroch Henry Mroch is a Spokane nephrologist who, for the last two-and-a-half years, has been networking with other Inland Northwest physicians as part of the Washington Alliance of Teaching Physicians to publicize the acute, and growing, need for more doctors in the state. In an August op-ed he co-authored for the Seattle Times, he wrote: “Outside of King County, the physician supply is simply inadequate. … The solution is straightforward: Establish an additional medical school in Washington.” So, we kind of thought we were getting a medical school when the second-year medical students could finally train here... Spokane does not have a medical school. You can’t write to it, you can’t call it, you can’t go there and park your car, you can’t send it a letter because it doesn’t exist. It’s all these disjointed pieces that haven’t come together. A lot has been written about the shortage of physicians — from family doctors to specialists. You arrived for this interview straight from the ICU. How serious is the shortage for someone like you, who’s walking those halls every day? I think we are in the emergency room, and we need help. Once all this gets started, the benefits will not be felt immediately. If the first class of the Washington State University School of Medicine matriculates in 2017, when does the first class graduate? It’s the class of ‘21. Now I’m starting to feel old. The clock keeps ticking, and the calendar keeps flipping whether we do it or not. What’s the next step? The assumption is that you would need to buy property, dig a hole, build a building, run plumbing, run electrical wires. That is simply not the case. Everything is already here. It’s just a matter of amalgamating it. We have the first-year faculty available, WSU has sponsored that through time. I think the UW deserves a lot of credit for bringing the Spokane medical education community to the point where something like this is even possible. They deserve a lot of credit. But moving forward, and that is a decision beyond me, the UW can’t be all things to all people. They have these WWAMI sites all over, that’s great. We don’t discredit that. But we need more. Spokane has battled a bit of an inferiority complex over the years. Are we really good enough to have a medical school? I think we’ll have the best one. You know, why not? You’ve got a medical school in Vermillion, South Dakota, which is population I-don’t-know. They have to send most of their students away to Minneapolis and other places because they don’t have all the stuff there, but by golly, they have a medical school. This is a place that has everything it needs, but we need to put a virtual shell around it and give it a name. — INTERVIEW COMPILED AND EDITED BY ANNE McGREGOR

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Masks and Grads

“G

ood education predicts good health,” says a recent report from the Centers for Disease Control. Helping at-risk kids graduate on time is the goal of the non-profit Communities in Schools of Spokane County, which is part of a nationwide drop-out prevention program. Executive Director Sherry Barrett says the CISS provides “wraparound” assistance to more than 3,000 local students. “We help them set goals so they can achieve school success. We also do monthly food distributions, and we have clothing closets that kids can access. We also provide hygiene items for students who need those.” Avoiding substance abuse and other risky behaviors are topics of seminars for kids, while parents learn effective strategies for dealing with their teens. Although grants support much of the group’s work, the Masque Your Aid Benefit and Auction, now in its seventh year, contributes important funds. And it’s fun. Along with a three-course dinner and the auction, Barrett says there will be live music, and a “nice cash prize” for best costume. The group hopes to raise $75,000 to benefit, “Kids who have amazing potential and oftentimes lots of barriers to educational success.” — ANNE McGREGOR Communities in Schools of Spokane County’s 7th Annual Masque-Your-Aid Benefit and Auction • Sat, Oct. 18 at 6 pm • $50 per ticket, $75 or two • Red Lion Hotel at the Park • 303 W. North River Dr. • 413-1436

LIFE COACHING

Awareness, Acceptance, Action!

Carla Brannan is a personal life coach in Spokane.

hat three changes would you like to make in your life? Jot down the first three that just popped into your head, before you started filtering your every thought. Okay, let’s say losing 15 pounds is first on your list. Where do you go from here? Change isn’t easy, or we’d all be at our maximum potential and you wouldn’t be reading, nor would I have written, this article. Here’s a three-step process for you to consider: Awareness, Acceptance and Action! You’re off to a good start, you’ve already completed step one! Awareness is naming the change you want to make. To be successful in creating lasting change, it is vital to accept what is true today. Doing this without judgment is key. It looks something like this: “My pants don’t button, and I feel ex-

hausted. I want to lose 15 pounds and be healthier. I can’t change my past choice to hit the snooze instead of getting up to exercise, nor my decision to eat cheesecake every time it’s offered.” Acceptance doesn’t mean you have to like the extra 15 pounds; it is simply a sincere acknowledgement of your current situation. Okay, now for the action. Choose one or two steps toward your goal that are a bit of a stretch but aren’t wildly unreasonable. If you haven’t been exercising, perhaps a 30-minute walk three times a week rather than a marathon training class would be a good start. Finding a buddy to work with is always helpful, too. With these steps in place, those pants will be baggy in no time, and you’ll be well versed at choosing fruit and conversation over cheesecake. — CARLA BRANNAN

Expanding The Washington State University health sciences campus in Spokane is growing to meet the demand for more healthcare professionals. It is an innovative environment where future physicians practice alongside prospective nurses, pharmacists and others. spokane.wsu.edu

E D U C AT I O N DEGREE PROGRAMS Health Policy and Administration Medical Sciences Nursing Nutrition and Exercise Physiology Pharmacy Speech and Hearing Sciences

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1 6 3 2 5 9 4 1 8 6 8 8 1

Sudoku

RATINGS: Gentle (left), Diabolical (right) To complete Sudoku, fill the board by entering numbers 1 to 9 such that each row, column and 3x3 box contains every number uniquely. Answers to all puzzles on page 44

PUZZLES BY JEFF WIDDERICH & ANDREW STUART www.syndicatedpuzzles.com

6 8

2 6

7 1 2 3 5 9 5 6

Codewords

Each letter has been replaced by with a number. Using the starter clues, work out the words that must go in each cell on the codeword grid. Some well-known phrases and names may also be found. For a two-letter clue, turn to page 21. 24

8 5

13 5

26 14

6 9

13 3

19 14

R M

6 20

R M

19 7

26 19

8 25

7 13

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Str8ts

RATING: Moderate Like Sudoku, no single number can repeat in any row or column. But rows and columns are divided by black squares into compartments. These need to be filled in with numbers that complete a ‘straight’ — a set of numbers with no gaps but can be in any order. Clues in black cells remove that number as an option in that row and column, and are not part of any straight. Glance at the solution above to see how ‘straights’ are formed.

8 5 3

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NEWS SPECIAL REPORT

Delivering New Docs Washington needs more doctors; how to actually train them is where the Cougs and Huskies just can’t agree BY DANIEL WALTERS

nder the chandeliers of the Spokane Club dining room in September, University of Washington President Michael Young stands at the podium in a Husky-purple tie. As the crowd of medical students, alumni and incoming UW undergrads dines on glazed salmon, Young gushes about UW’s prestige. “You will be enrolling in the 15th best university in the world. In the world,” Young says, alluding to a global ranking from Shanghai Jiao Tong University. “I occasionally call up the president of Stanford and Harvard and say, ‘You know, I can give you a little advice on how to be better.’” That prestige extends to its medical school, ranked as tops in the nation for primary care, family medicine and rural medicine. Three Nobel Prize winners sit on the faculty. ...continued on next page

JIM CAMPBELL ILLUSTRATION

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NEWS

“DELIVERING NEW DOCS,” CONTINUED... And it’s the only game in town. Other than Yakima’s private osteopathic school, it’s the only institution within a five-state swath — Washington, Wyoming, Alaska, Montana and Idaho, aka “WWAMI” — churning out doctors. And that, Washington State University leaders believe, highlights both a problem and an opportunity. Washington state has nearly 7 million people, but only 120 public medical school spots for its residents each year. And at least 800 Washington residents

apply annually. Only three states had a lower proportion of their in-state applicants get into medical school. It’s one reason why, also in September, the WSU Board of Regents voted to seek their own full-fledged medical school in Spokane. “There is no good reason to wait,” says WSU President Elson Floyd. “We’ve been waiting for over 100 years. It’s now time to act.” Yet the decision has sent shock waves through the community. Some worry that WSU’s plans could destroy the UW’s medical education in Spokane. But between

the two universities, there’s at least one point of agreement. “At the end of the day, our state has to do a hell of a lot more,” says WSU Board of Regents Chairman Mike Worthy. Washington state needs more doctors. The question is how to get them here.

THE DOCTOR IS OUT

“Unless we act now,” warns a flyer from the American Association of Medical Colleges, “America will face a shortage of more than 90,000 doctors in 10 years.” It’s a combination of factors: Baby

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An aerial view of the WSU-Spokane Riverpoint Campus. Thanks to years of public investment in new health sciences facilities, WSU says it will not need any new buildings to launch a medical school. ISAACSON AERIAL PHOTOGRAPHY/WSU-SPOKANE man went to Ferris High School and the University of Washington. She was ready to go to UW’s School of Medicine and applied twice — once in 2010 and once in 2011. Both times, she was rejected. Today she’s in her third year at the private Chicago Medical School at Rosalind Franklin University. The city of Chicago itself, she notes, has six medical schools and an osteopathic school. Hershman loves Rosalind Franklin, but there’s a very literal price of not getting into UW. “I’ll probably graduate with $260,000 in debt,” Hershman predicts. If she’d been at UW, she estimates in-state tuition would have reduced her debt load to $180,000.

“…by 2030 our entire state is going to need 4,000 more doctors. We are not producing them, and they’re not staying in Eastern Washington.”

boomers are aging, and more doctors are retiring. Washington state’s population of doctors is particularly old. And health care reform’s wave of the newly insured bumped up shortage estimates by 50 percent. “It’s predicted by 2030 our entire state is going to need 4,000 more doctors,” says Elaine Couture, chief executive of Providence Health Care in Eastern Washington. “We are not producing them, and they’re not staying in Eastern Washington.” Yet there are plenty of local students who want to go to medical school in Washington state but can’t: Sarah Hersh-

For her, that debt means potentially delaying having kids or buying a house. And it means she’s less likely to practice in Washington state. “Once you leave,” Hershman says, “you’re less likely to return.” Both UW and WSU say they want to dramatically expand the number of medical students educated in the state. UW wants to grow the size of each class in its Spokane program to at least 80 students, while WSU wants to eventually grow its own medical school to 120.

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NEWS

WSU President Elson Floyd says a locally controlled medical school is what’s best for Spokane and his university. “It was clear that the University of Washington was not committed, from my perspective,” Floyd says. “That’s the reason we engaged in the feasibility study. We just had to continue to move forward.” YOUNG KWAK PHOTO

“DELIVERING NEW DOCS,” CONTINUED... a doctor in Ritzville, a town of less than 1,700. He runs his own practice, estimating he works 70 to 80 hours a week. Even on vacation, he sometimes gets a call that he’s needed. “When one of [the doctors in Ritzville] gets ill or sick … it sends a ripple through the system” of the town’s doctors, he says. On average, the United States has a little over 24 doctors for every 10,000 people. But in Washington state, 18 out of the 39 counties have 10 or fewer physicians per 10,000 residents, according to WSU’s medical school feasibility study.

role when FSU launched its own medical school 15 years ago, and was part of the consulting group that studied the feasibility of WSU creating its own medical school. At FSU, she says, students train in rural community clinics instead of big, university-based research hospitals. As a result, most of its graduates go into primary care and stay in-state. Twenty percent are practicing in rural communities, better than the national average. “Even our doubters say we’ve succeeded beyond our wildest dreams,” Hurt says. “Any of the benchmarks you want for success, we’ve got them.” WSU wants to copy that model.

“[WSU’s] feasibility study essentially defunds WWAMI. It also raises the question… Is the legislature going to fund two medical schools?” Attracting medical students to practice in rural areas is an ongoing challenge, but Myra Hurt, associate dean at Florida State University’s school of medicine, suggests a possible solution. She played a major

But, UW argues, it practically invented the community-based model. “The model the consultants have proposed for WSU, and the one they’ve claimed is so cost-efficient and so forward-looking, is

exactly the model that has been used for 40 years at UW,” says UW Regent Orin Smith. In fact, when Florida State launched its medical school, Smith points out that UW’s WWAMI program was cited as an inspiration. “Very clearly, WWAMI is the cheapest and best way to supply medical education in the future,” says former Gov. Dan Evans. Evans was governor back in 1971 when WWAMI was launched. Today, at 88, he’s heading up a UW task force to reboot WWAMI. WSU’s projected cost per student for its new medical school is $90,000 — far cheaper than most medical schools. UW argues that WWAMI’s $70,000-per-student cost already beats that. But Hurt sees UW as clearly different from the vision of Florida State and WSU. Florida State recruits specifically in rural communities, whetting students’ appetites for medical education as early as middle school. WSU wants to do the same. WSU wants its admissions process to favor not just test scores and acumen, but location: By intentionally admitting rural students, the hope is, those students will be more likely to return to their hometowns to be doctors.

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5K Run or Walk Children’s Fun Run No matter who expands, medical school graduates will run into a logjam upstream: Before they can become doctors, they have to undertake a graduate medical residency. While nationally the number of medical school students graduating has increased significantly, the number of residency slots hasn’t — leaving more students competing for limited slots. “Creating more seats in medical school, without a concurrent increase in residency opportunities, will cause more future physicians to leave our state for residency positions elsewhere,” the UW argues on its Spokane Med School website. But here, too, the distribution is unequal. Of the 1,600 WWAMI residency slots in the state of Washington, a mere 100 are in the eastern half. While UW has been lobbying for more federal funding for residencies, it’s been WSU that recently brought more residencies to Washington: This year, WSU, the Empire Health Foundation and Providence used a federal grant to add six more residency slots. If federal grant funding holds, the coalition hopes to add 39 more residencies within the next five years.

WHY NOT BOTH?

At Avista headquarters, in a meeting in September over reforming WWAMI, the tension boils over: UW Regent Orin Smith turns his chair to look at WSU Regent Mike Worthy across the long, wooden conference table.

“[WSU’s] feasibility study essentially defunds WWAMI,” Smith says. “It also raises the question, Mike: Is the legislature going to fund two medical schools?” Even though the details haven’t been worked out, Worthy doesn’t see a problem: “The notion that WSU could not continue to be a WWAMI partner, I say, with all due respect, is ridiculous.” He argues that the school could use additional Riverpoint classrooms, cut programs, share faculty, and make other heroic efforts to ensure both programs could operate side by side. Both universities plan to ask Olympia to expand medical education during the next legislative session, which starts in January. UW wants $10 million to increase enrollment in Spokane. WSU doesn’t need a dime in new construction — its $80 million health sciences building opened last year. But it will ask for $2.5 million to help pay for planning and accreditation. Eventually it’ll need $47 million for annual operational costs. But both universities face a steep climb: The state expects a budget deficit in the billions. “I think the real risk,” says UW’s Smith, “is the legislature doesn’t have any money to begin with.” But Providence’s Elaine Couture says the pressing need dictates a look at all options: “This is not a new problem, in terms of our need for doctors,” she says. “This gap is big, it’s urgent, and it’s going to get worse. We don’t consider it a question of either/or, but rather both.” n

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The first-year class of UW-Medicine/WWAMI’s Spokane students on the night they were introduced in 2011 at WSU’s Riverpoint Campus. MIKE McCALL PHOTO OCTOBER-NOVEMBER, 2014 NEWS-MAIN inhealth 9-30-2014.indd 19

Health 19 9/24/14 4:31 PM

NEWS

COPING

After the Fire Okanogan County residents rebuild homes — and their emotional well-being — after a stressful summer BY SCOTT A. LEADINGHAM

f all goes according to plan, Dara Farmer will take a much-deserved vacation in November. A trip to Hawaii, Mexico or even sunny Arizona is preferred. If that plan keeps up accordingly, Frank Rogers will take time away from his duties as sheriff of Okanogan County to hunt — after a summer with barely a day off. Vacation? What’s that? But Mother Nature often has little regard for people’s recreation plans. Both Farmer and Rogers expressed those idyllic plans in August, in the midst of what everyone will admit was an extremely trying and stressful summer for residents of the Methow Valley and Okanogan County. At that time, mudslides and

flash floods had just inundated the region, destroying or damaging at least 10 homes and closing multiple highways and roads. That’s significant at any time, but this was the area that only weeks earlier was at the epicenter of national news as the Carlton Complex fire ballooned to 250,000 acres and destroyed an estimated 300 homes. As an employee at the Cinnamon Twisp Bakery in Twisp, Wash., Farmer saw up close the needs of the community reeling from the fires and later mudslides. At the height of the fire crisis in late July, the bakery was closed as power was cut off to most of the Methow Valley. Farmer and her fellow employees set up shop outside, giving away coffee and pastries for donations

to help fire victims. Their makeshift bake sale served much more than coffee to passing journalists. It became a community gathering place of sorts, where people who were displaced or just looking for information about the rapidly spreading fires could come and chat. Many residents were without a landline phone, and Farmer says the “community” cellphone they placed on their table became a necessary means of contact for residents trying to communicate with family and friends cut off from the valley. Their table was also a place for emotional release during a very stressful time. “We’ve offered a lot of comfort and support,” Farmer said in July. “If people need a hug, I give hugs 24/7. The awareness and hugs are on our menu.”

DOWN THE ROAD

With any disaster, the passage of time brings the realization that some semblance of normalcy will return. Or at least that’s

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the hope of aid organizations, governments, people rebuild and move on. But some and most importantly, victims. people will have lingering mental health As summer turns to fall and winter, the needs. There are signs to look out for that Headerhope is: for victims of the fire and mudslides indicate deeper issues — and the need for is that normalcy isn’t out of reach. With more long-term counseling. 100% Scratch Made Red Cross shelters closed and news crews He says for six to 12 weeks, most longpicture since moved on, the focusthe nowlogo is for is bigger. people will go through periods of crying, Make the "box" where residents to rebuild their homes — and their depression and anxiety, with difficulty Stack the green icon on top of the Bug and make them emotional well being. sleeping and eating. But that’s typical in Murray is one person helping in these kinds of situations. both a bitBill bigger. that process. As a mental health profession“Those aren’t symptoms of clinical Put wood grain (greys) under info athe says. “But if you get four to al based in Wenatchee, he hasthe longaddress helped hours depression,” people in need of counseling in northsix months bottom. Probably need to make the font darker browndown or the road and symptoms central Washington. The Carlton Complex are still there for significant depression or white so show wood background. fire it in will July was hisup firston time putting those anxiety, that is a sign of need for deeper skills to use in a disaster situation with mental health counseling.” the Red Cross. He worked two weeks at a For those with long-term needs — from shelter in Brewster after the nearby town of mental health counseling to physically Pateros had been hit hard by rebuilding or finding permathe fire. nent shelter — aid organiza“People came in in tions are “in for the long from the puzzle on page 13 shock,” Murray says of the haul,” says Nicolle LaFleur, 7 = E; 24 = T initial disaster response. executive director of the Red “They just came walking in the door lookCross Apple Valley and North Cascades. ing like they were in shock, and you didn’t The regional Red Cross is joining with need to be an expert to recognize it.” at least five other community relief and At that time, Murray and his fellow funding groups to provide ongoing, longrelief workers focused on meeting the imterm assistance and outreach. “With all mediate needs of fire victims: giving food of us joining together, we are pooling our and shelter, mapping out a plan for addressresources,” LaFleur says. “In the recovery ing living needs in the short-term, and phase there will be a lot of outreach to counseling for the initial shock of loss. people who have been affected. All the As time passes, Murray says, most groups are contributing to the management of that shock and anxiety will wear off as of the long-term puzzle.” n

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Dan Buettner

INNOVATION

Gettin’ the Blues Researchers discover tools for living longer, fuller lives BY JORDY BYRD

t was found, like many discoveries before it, on a quest. In 2004, National Geographic Fellow Dan Buettner led a team of scientists across the globe investigating one of the world’s greatest puzzles. The team found itself in Okinawa, Japan, studying the secret for longevity. Five years later, Buettner’s team had discovered four other communities he dubbed Blue Zones — pockets of the world where people live to be 100 at rates 10 times greater than in the United States. These communities, they found, share

nine commonalities (“What People in Blue Zones Share,” page 25) that contribute to healthy living. “We were always thinking, how can we bring these teachings back to our communities?” Buettner says. “This is how Blue Zones was born. Our goal was to make small adjustments to make the healthy choice, the easy choice.”

HELP IN NUMBERS

“Our culture and environment has evolved into putting the health responsibility on

the individual. We need the tools to help create an environment that curates health, instead of [one that] works against us,” says Buettner. Blue Zones is an organization that provides a framework and online tools for individuals, workplaces and even entire communities to work toward longer, healthier lives. In 2009, the organization created its first Blue Zones Community in Albert Lea, Minnesota. After just one year, participants added an estimated 2.9 years to their average lifespans, health care claims for city workers dropped 49 percent, obesity dropped 14 percent and smoking dropped 30 percent. “The first step to a healthier lifestyle is to take inventory of what you are doing right and what small things you need to change,” Buettner says. “Once you have an understanding of what needs to be adjusted, it’s much more manageable than just a vague idea of ‘I need to become healthier.’ There is no fountain of youth or magic pill we can take to live long, healthy lives. It takes many small changes to create an environment that curates healthy living.” Buettner will speak Oct. 28 in Spokane as part of Providence Health Care’s Town Hall Forum series, which sponsored T.R. Reid of the PBS documentary U.S. Health Care: The Good News in 2012. “We really wanted to focus on grassroots participation,” says Joseph Robb, director of marketing and public relations for Providence. “I wouldn’t say the primary goal is to make Spokane a Blue Zones Community — although we are open to it — but to bring Dan Buettner here to start the conversation.” Providence is hosting the free event in conjunction with Eastern Washington University, Group Health and the Empire Health Foundation. “It’s really a multifaceted, collaborative group that’s coming together for this event,” Robb says. “We want the community to come with their questions about what it takes to become a healthy community.”

ODDS AGAINST TOMORROW

Spokane County has inequities to overcome if it is to become a Blue Zone Community. The Spokane Regional Health District released the Odds Against Tomorrow ...continued on next page

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NEWS

BLUE ZONES

People live to be 100 at rates 10 times greater than in the U.S. in these Blue Zones

SARDINIA, ITALY Daily wine and laughter help Sardinian men enjoy the longest male lifespan

LOMA LINDA, CALIFORNIA Stress-reducing, healthy diet practices of local Seventh Day Adventists rub off on the whole town

COMPARING LIFESPANS

NICOYA, COSTA RICA Water naturally rich in calcium and magnesium may help prevent heart disease and weak bones

Washingtonians are doing something right. The average life expectancy of a person born in 2011 is 80.3 years. That’s about five years longer than those born in 1980, according to a 2013 report by the Washington State Department of Health. Rates in Spokane County are slightly worse, at 79.1 years, according to a 2013 report by the Spokane Regional Health District. But both the state and county fare better than the U.S. national average of 78.7 years. On average, Washingtonians live to ages similar to Slovenia, at 80.1 years, and Denmark, at 79.9 years, the United Kingdom at 81.1 years and Switzerland at 82.8 years, according to a 2011 report by the Organization for Economic Co-operation and Development. — JORDY BYRD

IKARIA, GREECE Napping, occasional fasting and drinking goat milk may add years to life

OKINAWA, JAPAN Dedication to family and friends lifts Okinawan women to the longest female lifespan

JESSIE SPACCIA MAP

“GETTIN’ THE BLUES,” CONTINUED... report in 2012, examining how social factors, ethnicity and neighborhood — 40 neighborhoods in the county and city — affected life expectancy. “What we found blew a lot of people’s minds,” says Adrian Dominguez, lead researcher and epidemiologist with the Spokane Regional Health District. “There is an almost 18-year difference between the most affluent and poorest neighborhoods in Spokane.” According to the report, residents of the Southgate neighborhood out near 57th and Regal lived the longest at 84.03 years; residents of downtown’s Riverside lived the shortest at 66.17 years.

Disparities between races and ethnicities also existed. American Indians and Alaskan Natives live 13 years less than white/nonHispanics; African Americans live 10 years less; Hispanics eight years less. “We need to recognize that these gaps exist, because no one wants to admit that this could happen in their community,” says Dominguez, who will speak in a community panel following Buettner’s presentation. “We have to recognize that inequalities are the result of social factors that affect the decisions that people make, and that the environment a person grows up in has a huge impact later on in their lives.” The report found that residents of affluent neighborhoods have more access to resources, healthy food and physical activity,

Stay Connected, Wherever You Are Follow the Inlander on Pinterest, Twitter, YouTube and Facebook for exclusive news, contests and more!

24 Health OCTOBER-NOVEMBER, 2014 NEWS inhealth 9-30-2014.indd 24

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WHAT PEOPLE IN BLUE ZONES SHARE ACTIVE EVERYDAY LIFESTYLE SENSE OF PURPOSE WAYS TO DE-STRESS AVOIDANCE OF OVEREATING PLANT-BASED DIETS

SRHD epidemiologist Adrian Dominguez will share his findings following the Blue Zones presentation. and were more educated. Underserved neighborhoods had fewer community resources and physical recreation, more fast food options and higher levels of unemployment. Dominguez says this gap will only close and people — all people — will only begin to live fuller, longer lives when our public mindset changes. “It’s not all about personal responsibility,” he says. “We need to get past the ‘pull yourself up by

SARAH WURTZ PHOTO

the bootstrap’ mentality, because many of the people that I’ve worked with don’t have the means to pull themselves up, because they don’t have the boots or the strap.”  “Blue Zones” featuring Dan Buettner, followed by a community health panel • Tuesday, Oct. 28, 6-8 pm • Free • Spokane Convention Center • 334 W. Spokane Falls Blvd. • bluezones.com

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LIVING

Facing the

Future

While you can’t turn back the hands of time, new minimally invasive products and procedures can help you look refreshed BY LINDA HAGEN-MILLER

“D

id you color your hair? Change your makeup? You look so…. rested.” You smile, not smugly you hope, and graciously accept the compliment. Maybe you’ll divulge that you recently had a cosmetic procedure, maybe not. The results are so subtle even your husband or your best friend probably won’t realize you’ve had “work” done. Welcome to the New Age of fillers, injectables, lasers and the myriad of non-surgical treatments. Technology and medical knowledge of how the body ages has propelled cosmetic surgery away from the slice-and-pull of facelifts into a new era of less invasive procedures that are often performed with local or topical anesthesia and come with considerably shorter healing time. “We know now it’s not just skin that is aging but a combination of skin, fat, bone and muscle,” says Cameron Chesnut, MD, a board certified and fellowship-trained cosmetic surgeon at Dermatology Specialists of Spokane. “The

“I wasn’t trying to look 30,” says Marcia Kramer. “I wanted to look brighter, healthier, and I think I do.” YOUNG KWAK PHOTO

...continued on next page OCTOBER-NOVEMBER, 2014 LIVING-MAIN inhealth 9-30-2014_OUTLINES.indd 27

Health 27 9/24/14 4:25 PM

LIVING

Cameron Chesnut, MD, readies equipment before a CO2 Laser Resurfacing procedure at Dermatology Specialists of Spokane. YOUNG KWAK PHOTOS

“FACING THE FUTURE,” CONTINUED... face is like a bed. You have the frame — the bones; the mattress— the soft tissue; and the bedspread — the skin. You can smooth the wrinkles out of the bedspread, but if there’s a weakened and diminished bed frame or a big dip in the mattress, you will never be able to hide it with a bedspread alone.” Today dozens of procedures are available to plump, fill, volumize, freeze or relax the wrinkles, bags, sags, spots or dips on your face, neck or décolletage. Often called lunchtime lifts, many take only 30 to 60 minutes and are performed in the physician’s office. Injections, lasers and dermabrasion can sting or burn, but most patients report minimal discomfort. Healing is much faster than traditional facelifts and takes from a few hours to a few weeks.

THINKING ABOUT A PROCEDURE?

Abraham Lincoln said you get the face you deserve at 40; George Orwell upped it a decade to 50. Smoking, sun, frowning, smiling, genetics, free radicals — in short, life — all eventually show up on your face no matter how much sunscreen and lotions you’ve used. Some people start cosmetic treatments as young as 30, but usually around 40 years of age, women — and a few men — look into the mirror and wonder how they got so old, or tired, or speckled. Physicians report that most of their patients are in their late-30s to mid-50s. Chesnut, who completed his plastic surgery fellowship at the University of California, Los Angeles, says there is a noticeable contrast in what people were looking for in California and what they want in the Northwest. “In L.A., it’s a status symbol to

look like you’ve had work done,” he says. “Up here, patients want subtle changes.”

WHAT TO EXPECT

Cosmetic surgery and procedures will not take 20 years off your face. They won’t save your marriage or land a job. They will not make you gorgeous if you aren’t already a stunner. But new procedures can give you a refreshed, rested look; lighten sun spots; de-puff eyes; reduce a baggy chin; brighten skin; and diminish crow’s feet, smile lines and other pesky wrinkles. Notice we have not used the words “erase” or “remove.” Disappearing acts are rarely possible, even with today’s advances in procedures. And cosmetic procedures are seldom a once-in-a-lifetime affair. The rate at which your skin ages and the treatment you choose determine how often you’ll be back,

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but expect to see your specialist every six to 12 months to keep up your new look. And be prepared to write some big checks: Procedures can run in the thousands of dollars.

IS IT WORTH IT?

When Marcia Kramer’s 65th birthday approached, she decided it was time to do something about sun spots and a saggy chin. “I’m an outdoorsy girl — I ski, hike,

(Above) Chesnut begins work with the laser to reduce fine lines, wrinkles or sun spots. (Below) Dermal fillers, like this Juvederm, can help diminish wrinkles and add volume to cheeks. bike — and all those years in the sun were showing. And that wobbly chin! They don’t make a chin bra, you know. It had to go.” Not an impulsive woman, Kramer researched procedures and results. She had relatives who had had facelifts, and witnessed their pain and lengthy healing and knew she didn’t want to go that route. She chose Smart Skin Fractionated CO2 for her face and Precision Tx Cynosure for her lower face and neck. In layman’s terms, that’s laser treatments and liposuction. “Was it worth it? Definitely!” Kramer says. “I wasn’t trying to look 30. I wanted to look brighter, healthier, and I think I do.” On the other hand, 50-something Janet, who prefers we not use her last name, is

not as enthusiastic. A year ago, she had Botox to diminish frown lines and laser skin rejuvenation to even out her skin tone. “The Botox definitely froze the frown lines in my forehead, and I saw some improvement with skin resurfacing,” she says. “But really, I didn’t see enough change to justify the expense. I don’t think I’ll have any more treatments done.”

THE MAZE OF PROVIDERS

Would you see an oral surgeon if you had bunions? An orthopedist if you were pregnant? Definitely not. They’re both doctors and they all know about human anatomy, but each is trained and certified in a different specialty. Your face is special, so choose who works on it carefully. “The Wild West cosmetic atmosphere of Spokane has been changing recently, as consumers have become more sophisticated and raised their cosmetic IQ,” says Chesnut. “A solid group of fellowship-trained cosmetic surgeons now exists in our community. “ A little insight into the process can be helpful for potential patients. “Board certification” means the physician has been trained beyond medical school and residency in a specific field. In the case of cosmetic surgery, the “core four” cosmetic specialties are dermatologic surgery, oculoplastic surgery, facial plastic surgery or plastic surgery. “Cosmetic surgery” per se is not a specialty. There is a Cosmetic Surgery Society, but they do not require additional training or a fellowship. Complicating matters are the dozens of societies, associations, boards and academies related to cosmetic surgery. Some, like the American Academy of Facial Plastic and Reconstructive Surgery, the American Society of Plastic Surgeons, the American Academy of Dermatology, and American Society of Oculoplastic and Reconstructive Surgery, have rigorous admittance standards; others are so relaxed they require only yearly dues. Keep in mind it is possible for a provider to become certified in some cosmetic procedures simply by attending a seminar or training program hosted by a vendor. So do your homework before submitting to a procedure. Find out how long the physician has been practicing and how many procedures they have performed. Verify the surgeon’s board certification, education and license with the state’s medical board and check whether disciplinary action has been taken against him or her. Personal recommendations are valu...continued on page 31

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LIVING

A SAMPLE OF COSMETIC PROCEDURES PROCEDURE

WHAT IT IS

WHAT IT DOES

HEALING/ DOWNTIME

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Botox/Dysport/Xeomin

Botulinum toxin injection

Decreases muscle movement that creates frown lines and crow’s feet

Minimal tenderness lasting a few hours; possible bruising lasting few days

$200-$600 every 3 to 6 months

Laser Skin Rejuvenation

Stimulates dermal cells and remodels collagen with laser

Reduces acne scars, fine lines, wrinkles, textural irregularities, sun spots, pore size

Minimal to moderate swelling depending on the intensity of the treatment, redness, itching lasting from 72 hours to one week

$300 to $1,300 may need 3 to 4 times to increase efficacy

Dermal Fillers (Restylane, Perlane, Belotero)

Hyaluronic acid gel injection

Enhance lips, diminish wrinkles, lines, scars; lift cheeks, create facial volume

Minimal to moderate tenderness, swelling, bruising lasting a few days

$500-$700 every 6-12 months

Ultherapy

Ultrasound collagen stimulation

Lifts and tightens eyelids, neck, chin and brow

Slight redness, tingling, swelling lasting a few hours

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Microdermabrasion

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“FACING THE FUTURE,” CONTINUED... able, too, so ask friends who have worked with a cosmetic surgeon for referrals. Get feedback from your family doctor and other medical acquaintances. At your interview/consultation, the physician should ask about your goals and expectations. If he or she thinks your expectations are unrealistic, do not run out the door. You need honest feedback from a professional in order to make good choices. “When a patient comes in to interview me, I first ask what’s bothering them most,” says Joel Sears, MD, of Advanced Dermatology. “There are so many tools available to improve looks or give someone a fresher appearance, but there are also limits to what we can accomplish. We don’t want patients to be disappointed, but we don’t push procedures on them either. ‘Never, never overdo’ is my motto.” The physician will suggest the most appropriate procedure, show you beforeand-after photos of patients, tell you where the procedure will be performed, how long it will take, and what immediate aftereffects to expect. He or she will give you a treatment plan and outline costs. Since cosmetic

surgery is elective, your insurance will not cover it.

FUTURE FACES

The past decade has brought us cosmetic fillers that last longer and have fewer side effects, along with new procedures that use light and lasers. A needle-free, topical Botox successor is undergoing clinical trials and seeking FDA approval. “Going forward into the future, we will continue to see procedures moving toward being less invasive in terms of shorter downtime and less risk,” says Wm. Philip Werschler, MD, of Spokane Dermatology Clinic. “For example, Ultherapy is an FDA-approved procedure for face lifting that has minimal to no downtime.” You may feel like a kid in a candy shop with all of these choices in front of you. Or you may weigh the pros and cons, costs and probable results, and decide not to have any cosmetic procedures. Some women are comfortable with the way they look well into their 60s and beyond. Lauren Bacall, known for her smoky voice and enduring beauty, said, “I think your whole life shows in your face, and you should be proud of that.” n

HELPFUL DEFINITIONS DERMATOLOGY: Treatment of the skin and its diseases. PLASTIC SURGERY: Repair or replacement of malformed, injured or lost organs or body parts. COSMETIC SURGERY: Aesthetic treatments to enhance areas of the body that function properly. OCULOPLASTIC SURGERY: Management of abnormalities and deformities of the eyelids, tear system, bony socket and the adjacent face.

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LIVING

COOKING

Mizuna chef Tyler Reynolds advocates careful sourcing of ingredients. YOUNG KWAK PHOTOS

Omnivore’s Delight Vegans, vegetarians and meat-eaters can all meet at Mizuna BY CARRIE SCOZZARO

t’s sort of ironic that Tyler Reynolds works at one of Spokane’s earliest and most-beloved vegetarian restaurants. “I actually come from a very meatbased environment,” says Reynolds, executive chef at Mizuna, which has over the years expanded its menu to include animal proteins, although they also focus on not only vegan/vegetarian food, but also organic, sustainably sourced products and a knack for being sensitive to dietary needs of diners. Reynolds grew up on the Palouse “where hunting and whole-animal butchery was a way of life. “A lot of the food we ate came from right outside the door or from the pantry that held our preserves,” he says. However, says Reynolds, he spent most

of his youth rejecting that way of life. “I didn’t want to be stuck on the farm. I hated hunting. I was a rebellious, political punk rocker and an artist,” says Reynolds. “I just did not know what my medium was.” Turns out it was food. Like many in the business, Reynolds started as a dishwasher — at the Harvester in Spangle, Washington — moving his way up the ladder and across the spectrum of restaurants: Blue Fish, Europa, Churchill’s Steakhouse, Vin Rouge and Maggie’s South Hill Grill. It was at the Mustard Seed that he met future Santé owner/chef Jeremy Hansen, whom he’d accompany to the prestigious James Beard Foundation dinner in 2013. “After running the kitchen at Santé for

three years,” says Reynolds, “I took my first executive chef position and the challenge of applying what I had learned about technique, texture and flavor to the loyal and rapidly growing vegan and vegetarian clientele at Mizuna.” When he’s working — which is most of the time, admits the young father of a five-year-old — he eats vegetarian, including raw foods. “I do understand the ethical reasons for being a vegetarian,” he says, “And even more so being a vegan. However, I do believe there are ways to be an ethical omnivore. And that the key is responsible sourcing of meat. It can be much more difficult to source, what are, in my opinion, ethically raised animals for consumption. But the benefits in nutrition, sustainability, and flavor are unbelievable.” For Reynolds, it comes down to balance and, ultimately, ensuring that the customer gets the very best he and his staff are capable of providing. “I have to know that whatever I serve is getting to the table as delicious as possible,” he says. 

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RECIPE

Chickpea Gnocchi with Pomodoro Sauce “This dish binds some of the best ingredients around together perfectly,” says Chef Tyler Reynolds. “It’s a dish that is somehow both hearty and light, just by using fresh tomatoes and basil.”

Gnocchi 1 cup dried chickpeas, soaked overnight 1/4 cup olive oil 1 egg (or egg substitute) 1 teaspoon salt 1 tablespoon cornstarch 3 to 4 cups all-purpose flour (recommend Shepherd’s Grain) 1/2 gallon boiling water for poaching NOTE: To make gluten-free, use chickpea flour instead of all-purpose flour, adjusting ratio of dry ingredients as needed to form dough 1. In a saucepan, cover soaked chickpeas with water allowing about an inch of water above the chickpeas. Bring to a boil over medium heat. Turn down heat and simmer until soft. If substituting canned chickpeas, they still need to be cooked and the yield needs to be about 3 cups cooked. 2. Meanwhile mix 3 cups of the flour with the cornstarch. 3. Strain cooked chickpeas and puree in a food processor with the oil. 4. In a large mixing bowl, mix the chickpea puree (mixing while still warm makes a fluffier gnocchi), egg and flour/cornstarch mixture into dough by hand. Add additional flour as needed, until dough no longer sticks to your fingers. Don’t overmix! 5. On a floured cutting board, roll out pieces of the dough into 3/4-inch logs using the palms of your hands. Cut logs into 3/4-inch square pillows (or use a gnocchi board). 6. Drop the gnocchi gently into the boiling

water (salt optional) and let cook until they have floated for about a minute. 7. Scoop out cooked gnocchi and either put directly into sauce or let cool. Cooled gnocchi can also be pan-seared in the same pan in which you build the tomato sauce.

Pomodoro Sauce 1.5 cups tomatoes (heirloom are best), large dice 1 cup zucchini (or other summer squash), medium dice 1/4 cup fresh basil, chiffonade 1 tablespoon minced shallot 1 tablespoon fresh minced garlic 3/4 cup white wine 1/4 cup extra virgin olive oil Optional: salt and pepper to taste, two tablespoons unsalted butter 1. In a large sauté pan, heat half the oil on high. 2. If searing the gnocchi before adding to the sauce, add them once the oil is hot, let sear on one side for one minute, then turn. 3. Add the squash, tomatoes, shallots, garlic and basil ribbons to sauté pan. 4. Sauté on high for 60-90 seconds to let all the ingredients bloom and release natural liquids. 5. Deglaze pan with the white wine and bring to a simmer, then reduce heat to medium-low. Add remainder of the oil and optional ingredients if you’re using them. 6. Cook on medium-low until sauce coats the back of a spoon. OCTOBER-NOVEMBER, 2014

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LIVING

In August, letters to parents at 25 Spokane schools had families wondering what to do next.

ANNE McGREGOR PHOTO

PARENTING

Choosing Schools Healthy schools are essential for kids, but some are struggling with not meeting standards BY E.J. IANNELLI

n or around August 16, thousands of parents and guardians of students in 25 schools throughout the Spokane Public Schools system received a letter signed by their school’s principal. In both tone and content it was similar to letters that went out across Washington state. The gist, at any rate, was that their school had not met a key requirement of the federal No Child Left Behind Act (2001), that requirement being a 100 percent, schoolwide pass rate on standardized tests in reading and math. In political and media shorthand, these schools were described as “failing.” “It’s a horrible word,” says Lorna Spear, director of Early Learning and Intervention Services for Spokane Public Schools. “In

terms of No Child Left Behind, failing really means that you didn’t meet the uniform standard bar. This year, the standard was 100 percent of your students meeting the bar in reading and math. A hundred percent. That includes everybody — English-language learners, special ed students, students from advantaged homes and disadvantaged homes. I and most of my colleagues believe that [100 percent success] is our obligation for all children, but it’s a pretty lofty goal at the same time, particularly as the targets change and move.”

GRADING ON THE CURVE

Since 2002, No Child Left Behind has required ever-increasing pass rates for all schools, known as adequate yearly progress

or AYP. Using high school as an example, AYP was represented by bars of 48.6 percent in reading and 24.8 percent in math back in 2002, later leaping to 74.3 and 62.4, respectively, in 2008, until finally reaching the 100 percent mark for both in 2014. While “adequate yearly progress” was in flux, so were the tests used to determine whether schools were measuring up. “It was the Washington Assessment of Student Learning, the WASL, in the beginning. Lately it’s been the Measurements of Student Progress [for grades 3 to 8] or the High School Proficiency Exam, the HSPE. Now it will be the Smarter Balanced Assessment, the new state testing,” Spear says, which is based on the new college- and career-oriented Common Core curriculum. Spear cites other factors that call the metrics of NCLB as well as its goals — frequently described as “unrealistic” and “unattainable,” even by proponents of school reform — into question. For example, some of the test results used to assess schools’ current proficiency are actually several years old. There’s also huge variance in proficiency among grade levels within the individual schools, with, say, sixth graders scoring exceptionally well on the tests and third graders performing below expecta...continued on next page tions.

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LIVING “CHOOSING SCHOOLS,” CONTINUED... And then there’s the regular influx of transfers and new arrivals, such as the refugees who have recently been resettled in Spokane through charitable organizations like World Relief. “Lots of these kids can get to standard,” says Spear. “They just need more time and more intensity of instruction. But this says you have to do it this year.” In the past, schools in Washington state that haven’t met the one-size-fits-all AYP targets for two successive years have been eligible for a waiver from the U.S. Department of Education. “What the waiver from No Child Left Behind allowed us to do is to say, okay, let’s look at the scores, let’s look at the data. You need two more reading teachers. We are going to give you that. We are going to take Title I dollars and support you with that,” says Spear. But Washington state legislators ddclined to link teacher evaluations to student test scores, so the waiver wasn’t renewed. “With where we’re at now, for a ‘failing’ school, there’s no leeway to give them extra support. Right now, what I’m doing

is spending printing money on letters. We’re going to spend money to buy buses to move kids to another school rather than to buy another teacher to put into that school to make a difference.”

STAY OR GO?

For Heather Gomez, a parent of two second-graders at Audubon Elementary, this broader context was unclear when she received the NCLB letter. The option in the letter to send her children to another school that was ostensibly meeting AYP goals seemed like the obvious choice. “My first reaction, honestly, was to jump all over it, because I felt like they would have so much more room for opportunity at a school where the test scores were higher,” she says. “It was a lot of emotion. What do I do? What’s best for my kids? What’s best for us as a family? And then I started thinking more and talking to my husband and my family about it, and I decided to stay for a number of reasons.” Along with their physical proximity to Audubon and their “connection” to the parents and teachers, one important reason was the school’s demonstrated commitment to her child’s progress. “One of our girls was

not where she needed to be in kindergarten or first grade, and the staff and teachers at Audubon did what they needed to do. I can say now that she’s doing excellently. They put her where she needed to be to get to the next grade and not have problems.” In deciding to stay, Gomez finds herself in the vast majority. Parents of just four of Audubon’s roughly 450 students have opted for special transfers. At nearby Garfield Elementary, only two of the approximately 500 students have “choiced out.” But Gomez did more than opt to keep her children at their home school. She’s since become even more involved in Audubon’s PTO, helping to run the biannual book fair and the Box Tops for Education committee. “If you take good kids out of it, where does that leave the school? Shouldn’t you as a school be doing what you can to get your numbers up and help your kids even more?” Spear would agree that the big-picture questions are the best ones to be asking. That’s why Spokane Public Schools is spearheading “holistic” educational initiatives like the Northeast Children’s Zone, which is based on the success of the Harlem Children’s Zone.

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Spokane School District’s Lorna Spear says labeling schools can make things worse. “We’ve been encouraging people to go to the teacher you trust, go to the principal, go to the school and say, ‘I’m just wondering about this.’ Because we do have room for improvement. We do clearly. But the

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ometimes it’s barely recognizable. Words on the page of your favorite book seem out of focus, and street signs appear farther away. Sometimes it’s inhibiting. Pill bottles, odometers and recipes become impossible to read. Although serious eye diseases require expert intervention, apps and software are helping people cope with, and sometimes even combat, decreased vision that comes with aging. Smart phone apps and tablets offer the ability to magnify fonts and transcribe audio into text. And new apps offer visual “exercise” programs that may help retrain aging eyes — or more accurately, the brain’s ability to work with information from the eyes. The UltimEyes app, available for $10, is designed to help users optimize their visual processing, including near

and far vision and the ability to better discern low-contrast images. It touts research showing some users could read two additional lines on eye charts after eight weeks of training. The GlassesOff app, with a list price of $60 (though discounts are offered), aims to improve near vision — “Free yourself from dependency on reading glasses!” — by enhancing the image processing function in the visual cortex of the brain through game-like challenges over a three-month period. “The technological revolution, particularly for iPads and tablets, has been helpful for people with vision loss,” Ophthalmologist Alison Granier of the North Idaho Eye Institute says. “I have a lot of patients that feel like they are more functional because of these apps.”

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of glaucoma, with people who are having trouble with pain control, we might use it… as it will also give pain relief.” While glaucoma is genetically-linked, “Cataracts are an inevitable part of aging,” Granier says. A cataract is a progressive clouding of the lens in the eye. “I think patients hear the word cataracts and think tumor or something fearful, but surgery [to treat cataracts] has improved in the last 10 to 20 years, and it’s not something to be afraid of.”

WINDOW ON YOUR HEALTH

Arlene Bennett listens as Optometrist Todd Wylie explains the results of her eye exam. YOUNG KWAK PHOTO Other apps are more simplistic. Eye Health Saver reminds users to save their vision by taking frequent breaks while reading, playing games or being online. The SightBook Application allows users to take a series of visual tests and share the results with their physicians to schedule appointments and monitor progress.

EXPERTS OFFER HELP

While vision apps might help some patients cope with minor eye issues, aging can also bring more serious problems. “Cataracts, the risk of glaucoma, and the risk of macular degeneration are the primary causes of vision loss for the elderly,” says Granier. Glaucoma is a “silent disease” that causes slowly progressive vision loss and usually goes unnoticed in its early stages, as it initially affects peripheral vision. Despite the legalization of marijuana, Granier says the drug’s publicized benefit for glaucoma sufferers may have been over-hyped. “[Marijuana] has been used in the past for treatment because it may have a very slight inter-ocular pressure lowering effect,” she says. “But the effect is so slight that it’s not commonly prescribed… For very advanced stages

Eyes can also reflect just how healthy the rest of the body is. The most common causes of blindness are macular degeneration and diabetic retinopathy. Macular degeneration results in vision loss in the center of the visual field. “The macula has the highest metabolic need of any tissue in our body,” says Optometrist Todd Wylie, owner of Advanced Eyecare & Optical. “That’s the number one spot in our body that needs maximum nutrients, oxygen and blood flow to remove waste.” Wylie encourages his patients to eat nutrient-rich diets of fruits, vegetables, leafy greens and fish. The less processed, the better. Although eye dryness is common with age, drinking up to three ounces of water every hour depending on body weight is recommended for proper hydration. He also encourages patients to incorporate highintensity interval training into their exercise routines to increase overall metabolic benefits to the body. “We are seeing people in their 50s with cataracts, and that’s a relatively recent occurrence,” Wylie says. “It’s due to poor general health. The eye is much more metabolically involved than we think.” Wylie says he’s also seeing an increased number of people with diabetes and resultant diabetic retinopathy — a result of changes in blood vessels of the retina. In some people with diabetic retinopathy, blood vessels swell and leak fluid. In others, abnormal new blood vessels grow on the surface of the retina. Wylie and Granier say an ongoing dialogue with your eye doctor and yearly examinations for people 60 and older will help detect signs of glaucoma, cataracts and macular degeneration, as well as allow for updating of any prescriptive lenses. And both say younger people will have to start paying attention to eye health, too. “People are living longer and suffering more with macular degeneration and poor vision,” Granier says. “It’s becoming more of a public health issue.” 

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LIVING OCTOBER - NOVEMBER EVENTS YWCA WOMEN OF ACHIEVEMENT LUNCHEON The 32nd annual event both celebrates high-achieving women in the community, and seeks to raise awareness of domestic violence. Event guest speaker is Hattie Kaufman, the first Native American journalist to anchor KING 5 News in Seattle, and to serve as a special correspondent for ABC’s Good Morning America. All proceeds benefit the YWCA’s services for domestic violence victims. Wed, Oct. 1, at 11:30 am. $125/person. Spokane Convention Center, 334 W. Spokane Falls Blvd. ywcaspokane.org (326-1190) LAUGH FOR THE CURE A night of laughter featuring comedian Gabriel Rutledge, joined by Heath Harmison, with proceeds benefiting the Susan G. Komen Eastern Washington Affiliate. Thur, Oct. 2, at 6 pm. The Lincoln Center, 1316 N. Lincoln. komeneasternwashington.org INTO AFRICA Partnering for Progress’ annual dinner and auction this year offers an African-themed menu, along with informational booths demonstrating the nonprofit’s work in Kenya helping provide access to health care, education and clean water. Fri, Oct. 3 at 5:30 pm. $60$65/person. Mirabeau Park Hotel, 1100 N. Sullivan Rd. partneringforprogress.org WALK TO END ALZHEIMER’S This 3-mile walk raises awareness and funds to fight the disease, the sixth leading cause of death in the U.S. Sat, Oct. 4, at 10 am. Free to participate. Riverfront Park. (473-3390) HOLISTIC FESTIVAL The 29th event features a variety of healthy-living possibilities, with free presentations

throughout the day, booths offering organic/natural products, body care and pain relief remedies. Also on site are practitioners of chiropractic, biofeedback, reflexology, astrology, Reiki and massage. Sat, Oct. 4, from 10 am-6 pm. $6 admission. CenterPlace, 2426 N. Discovery Pl. holisticfestivals.com (468-9001) HOEDOWN FOR HOPE The third annual benefit event for Spokane HOPE School with live music and dancing, a catered dinner and dessert. The nonprofit provides specialized services to children with hearing loss, regardless of families’ ability to pay. Sat, Oct. 4 at 5:30 pm. $55/person. Riverside Place, 1108 W. Riverside Ave. (951-1290) STEP OUT DIABETES WALK The American Diabetes Association hosts its annual awareness/fundraiser walk for people of all ages and activity levels; participants can walk any distance up to 4 1/2 miles. Sun, Oct. 5, at 8:30 am. Free. Riverfront Park. (624-7478) RUN FOR THE ANGELS The annual 5K walk/run benefits the Inland Northwest SIDS Foundation. Also includes a silent auction, kids activities and remembrance ceremony for SIDS victims. Sun, Oct. 5, from 12-5 pm. Riverstone Park, 1805 Tilford Ln., CdA. inwsids.org HIP & KNEE PAIN SEMINAR Informational event on causes of joint pain in the knees and hips, and how to treat it, hosted by the Joint Restoration Centers at Deaconess and Valley Hospitals. Tues, Oct. 7, from 6-7 pm. Free. Northern Quest Resort & Casino, 100 N. Hayford Rd. (473-5755)

NPR’s Dr. Zorba Paster at the Bing, Oct. 9 CIRCLE OF HOPE The ninth annual benefit breakfast shares and supports the mission and programs of the Spokane Guilds’ School. Thur, Oct. 9, from 7:30-8:30 am. Davenport Hotel, 10 S. Post. guildschool.org PEOPLE WHO CARE Transitions for Women’s 12th annual benefit breakfast and luncheon event, supporting the organization’s programs to aid local women and children. Thur, Oct. 9. Breakfast from 7:30-8:30 am, lunch from noon-1 pm. Red Lion at the Park, 303 W. North River Dr. help4women.org SPR PRESENTS DR. ZORBA PASTER The host of the public radio program “Zorba Paster On Your Health” comes to

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Spokane for a Q&A session and advice from his book, “The Longevity Code.” Thur, Oct. 9, at 7 pm. $20-$23. Bing Crosby Theater, 901 W. Sprague. (328-5729) BEYOND PINK The annual fundraiser event includes a silent auction, no host bar and hors d’oeuvres with a fashion show featuring local artists and designers work. Event proceeds support local women who cannot afford thermography. Fri, Oct. 10, at 5 pm. $50. Spokane Convention Center, 334 W. Spokane Falls Blvd. beyondpink.net BISHOP’S BRUNCH Catholic Charities of Spokane hosts its 29th annual fundraiser breakfast (formerly known as the Poor Man’s Meal) to support and share the mission of the House of Charity and Fr. Bach Haven. Sun, Oct. 12, from 10 am-1 pm. $10/person; $30/family. House of Charity, 32 W. Pacific Ave. catholiccharitiesspokane.org/events MASQUE-YOUR-AID The 7th annual gala and auction benefits Communities in Schools of Spokane County, which provide mentoring, resources and services to at-risk students at 20 regional schools. Sat, Oct. 18, from 6-9:30 pm. $50/person; $75/pair. Red Lion at the Park, 303 W. North River Dr. spokane.ciswa.org STOP VIOLENCE AGAINST WOMEN DAY A resource fair for domestic violence survivors and those who’ve lost their direction after an illness, accident, divorce, death of a loved one, change in career or other life-altering event. Local resources for physical, spiritual, mental and financial programs are on site. Sun, Oct. 19, from 11 am-5 pm. Free. Lincoln Center, 1316 N. Lincoln. facebook.com/ StopViolenceAgainstWomenDay (928-9664)

THE PUMPKIN BALL The 11th annual gala benefits Sacred Heart Children’s Hospital and the Vanessa Behan Crisis Nursery. Reception includes passed appetizers, live and silent auctions, three-course dinner, pumpkin carving competition and more. Sat, Oct. 25, at 5:30 pm. $150/ person. Spokane Convention Center, 334 W. Spokane Falls Blvd. thepumpkinball.org

EPICUREAN DELIGHT The 33rd annual fundraiser gala benefits the Blood Center Foundation and the Inland Northwest Blood Center. Event includes 30 local wineries and breweries, and 30+ local restaurants showcasing and sampling their menus. Fri, Nov. 14. $175/person. Spokane Convention Center, 334 W. Spokane Falls Blvd. bloodcenterfoundation.com/epicurean-delight

PURPLELIGHT A local candlelight vigil as part of a national event to raise awareness for pancreatic cancer, which has only a 6-percent, five-year survival rate. Sun, Oct. 26, from 7-8 pm. Central Valley High School, 821 S. Sullivan Rd. purplelight.org

HUMANE SOCIETY FURR BALL The 14th annual gala includes a dinner, live auction of decorated Christmas trees, a silent auction, parade of adoptable pets, live music and dancing. Sat, Nov. 15, at 5:30 pm. $125/person. Davenport Hotel, 10 S. Post. spokanehumanesociety.org

HOPE HOUSE CELEBRITY FASHION SHOW The 16th annual event features local figures modeling formal wear, along with a luncheon, wine tasting and silent auction. Proceeds support Volunteers of America of E. Wash. and N. Idaho. Fri, Oct. 31, from 11 am-2 pm. $45/person. Doubletree Hotel, 322 N. Spokane Falls Ct. voaspokane. org (624-2378)

NATIONAL VETERANS DAY RUN 2nd annual race offers a 11K, 5K and a 1-mile family and supporter walk/run. Sat, Nov. 15, 7 am. $5-$30. Riverfront Park. veteransdayrun.org

SUGAR RUSH SPOKANE Second annual 5K or 10K fun run/walk benefiting Inland Northwest Baby. Participants enjoy a cup of hot cocoa and chocolate treats at the finish line. Sat, Nov. 8, at 9 am. Riverfront Park. facebook.com/ ChocFroc/info HONORING HOMETOWN HEROES This annual luncheon event hosted by the Red Cross recognizes local leaders who have contributed to the community through acts of heroism and service. Wed, Nov. 12, from 12-1:30 pm. Free to attend, RSVP required. Northern Quest Resort & Casino, 100 N. Hayford. redcross.org (321-6058)

CANDLELIGHT VIGIL AGAINST POVERTY Catholic Charities of Spokane hosts a community vigil to promote awareness of poverty and its effects. Mon, Nov. 17, at 5:30 pm. Free to participate. House of Charity, 32 W. Pacific. catholiccharitiesspokane.org (358-4266) JINGLE BELL RUN This annual event is a fundraiser run for the Arthritis Foundation, with holiday-themed costumes strongly encouraged. Sat, Dec. 6, at 8 am. Riverfront Park. spokanejinglebellrun.kintera.org  The calendar is a free service, on a space-available basis. Mark submissions “InHealth Calendar” and include the time, date, address, cost and a contact phone number. Mail: 1227 W. Summit Parkway, Spokane, WA 99201; Fax: 325-0638; or E-mail: calendar@inhealthnw.com.

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LIVING

Jeni Riplinger-Hegsted with a student at St. Vincent de Paul in Coeur d’Alene: “It can be very… soothing.”

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Comforted by the Arts Jeni Riplinger-Hegsted brings color and creativity to Coeur d’Alene’s Art on the Edge program BY DEANNA PAN

here’s a wild thing in Jeni RiplingerHegsted’s studio. A furry, fourfoot-tall beast made of foam, wood and wire hovers in the corner, baring his pointed, paper-white teeth in a goofy grin. A blue herring hangs from the center of the ceiling. A giant papier-mâché box of french fries leans against one of three brightly colored walls. Here, it’s easy to forget you’re inside a drafty garage at the end of a cul-de-sac, and that’s the point. For Riplinger-Hegsted, artistic expression is a transformative experience — one that everyone deserves, but

often only the privileged have access to. As the director of St. Vincent de Paul’s Art on the Edge in Coeur d’Alene — a nonprofit that offers art classes to kids and adults, particularly those experiencing homelessness and poverty — she works to ensure that even the most vulnerable in her community can express themselves behind a pottery wheel or with a paintbrush. In August, Riplinger-Hegsted was awarded the Peirone Prize in the Inlander’s Give Guide. In the award’s fifth year, Kate Burke of the Lands Council in Spokane and Randy Ramos of the Spokane Tribal College also

won a Peirone Prize; you can read their stories at inlander.com/giveguide. People who are homeless or living in poverty “don’t have a lot of choice in their life,” Riplinger-Hegsted says. “They don’t have a choice about where they’re living, what they’re eating or how their time is spent. But then they come into the studio and it’s all about choice; it’s all about process. We’re focused on letting them have a time of relaxation, where they’re just able to play, just able to be free. It’s very therapeutic and soothing for what they’re going through.”

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Growing up in Coeur d’Alene, Riplinger-Hegsted imagined leaving her small town and moving to a big city with a thriving arts scene, like Seattle or Portland. Even as a kid, when she grew frustrated with her inability to paint or draw with any natural skill, she still fancied herself an artist. It wasn’t until she took her first pottery class in high school that she discovered where her true artistic talent lies. She continued studying her craft under former Coeur d’Alene potter Tim Musgrove. Later, Randy Ramos she started teaching extracurricular pottery classes at her kids’ elementary school. She also had a change of heart. When a job opened up at Art on the Edge, a friend encouraged her to combine her passions for art and philanthropy, and apply. “I realized I wanted to stay here and work on making this community all of the things it has the potential to be,” she says. “Coeur d’Alene has a real need for creative outlets for the Kate Burke at-risk and underserved population, so I wanted to be part of that.” Art on the Edge offers after-school classes, a week-long summer camp for kids and a variety of summer workshops in disciplines like painting, weaving, breakdancing and photography. The program survives on a meager budget of $28,000, donated materials and help from dozens of volunteers, including professional artists. On Monday nights, Riplinger-Hegsted teaches her own course, a women’s pottery class. Her students come from a diverse range of backgrounds. Some live in shelters or transitional housing. Some are domestic violence survivors or former drug addicts. Others — those who are paying to take the course — have never experienced anything like that in their lives. The most rewarding part of her job, Riplinger-Hegsted says, is watching those women make friendships despite their differences. “Once they are sitting down and making art together at the same table, all of that washes away. They’re all just women taking a pottery class,” she says. “[That’s] my piece of the puzzle — offering this experience of art here in the studio — and how that has a lasting effect on them.” n

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