Inhealth 08/01/2014 by The Inlander

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32 d r a h c r O e h t n i t u 20 O g n i p p o h S r u o Y y f Simpli 27 n a i r a t e g e V Going AUGUST-SEPTEMBER, 2014

SPECIAL SUPPLEMENT TO THE INLANDER

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The need is here. So we hear. Community Cancer Fund works collaboratively with existing regional cancer organizations to fund gaps in services, and to benefit Inland Northwest families. Visit CommunityCancerFund.org to learn how the funds we raise here, stay here. Because we want to make sure cancer doesn’t.

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small enough to see your dream… big enough t0 make it happen.

Health SPOKANE • EASTERN WASHINGTON • NORTH IDAHO 1227 W. Summit Parkway, Spokane, Wash. 99201 PHONE: 509-325-0634

EDITOR Anne McGregor

annem@inhealthnw.com

MANAGING EDITOR Jacob H. Fries ART DIRECTOR Chris Bovey CALENDAR EDITOR Chey Scott PHOTOGRAPHER Young Kwak CONTRIBUTORS Carla Brannan, Lisa Fairbanks-Rossi, Heidi Groover, Jacob Jones, Lisa Waananen Jones, Jenna Mulligan, Deanna Pan, Stephen Schlange, Carrie Scozzaro, Daniel Walters, John White, Franny Wright

EVERYONE IN EASTERN WASHINGTON CAN JOIN WWW.UHSCU.ORG 16402 EAST SPRAGUE

UNITED HEALTH SERVICES CREDIT UNION

DEDICATED TO YOUR FINANCIAL HEALTH

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

InHealth

Never miss an issue Find more local stories on topics important to you: parenting, health trends, super foods and much more! Search the full issue archives or by the category you are most interested in.

Only on Inlander.com

DESIGN AND PRODUCTION Tom Stover, Derrick King, Alissia Blackwood Mead, Jessie Spaccia DISTRIBUTION MANAGER Trevor Rendall BUSINESS MANAGER Dee Ann Cook CREDIT MANAGER Kristin Wagner PUBLISHER Ted S. McGregor Jr. GENERAL MANAGER Jeremy McGregor

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: x223. 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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INSIDE

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CHECK-IN PAGE 9

PAGE 10

SUPERFOOD 9 LIFE COACHING 9

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FROM THE EDITOR

Personal Tastes

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

DEDICATION

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

Dean is one of 1,000 dedicated INHS employees making a difference in our communities for the last 20 years. Find his inspirational story at INHS .ORG/INHS20

ood has clearly taken hold of our cultural consciousness. Our immediate and extended family meals are filled with discussion of not only each person’s particular likes and dislikes, but also the ethics of what we’re eating. It’s not always a pleasant conversation, and sometimes I wonder how we got here. When I was growing up, we just had dinner. My brother and I ate it. We didn’t know anything about “kids meals” and none of our friends did either. And you surely didn’t arrive at someone’s house for an occasion with a list of your dietary requirements. In the Betty Crocker Cookbook from 1950, recommendations were charmingly basic — serve something cold at each meal, even in the winter, and mix in a few crunchy items. And dinner needed to include at least one serving of meat, fish or poultry: “Without one of the three, it is an unsatisfactory meal for most people.” Clearly those days are long gone, and thankfully, so is the chow mein loaf from page 394. It’s no longer essential for a “good” meal to include meat. We have new needs and new priorities in planning our diets, and in this issue we look at meal planning for people with diabetes, ways to cut back on salt and whether a plant-based diet is actually better for your health — and the planet’s. We also sprinkled recipes from local chefs throughout the issue — a testament to the vigorous and thoughtful approaches to putting a meal on the table here in the Inland Northwest. To your health!

INSPIRING COLLABORATION. CONNECTING COMMUNITIES.

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CHECK-IN STAY CONNECTED

SUPERFOOD

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

Tomato, Tomahto

ON OUR FACEBOOK

What worries you most about food? AMY McINTYRE: I worry about having not only money to buy enough, but enough money to buy healthy food. JAMIE ELLIOTT: I worry about the cost, as well as all the chemicals they put in our food! I also worry about not having enough funds to buy the better foods, because they cost so damn much! RACHEL BAILEY: I worry about the cost first, then the GMOs. Feeding a family of four with one being vegetarian gets very expensive here. The cost of food is outrageous, and that really keeps me from doing the best I can for my family. ELLEN MACCARONE: I worry a lot about our food system and what it has done to our health and the health of the environment.

ATTRIBUTES: Thought to be poisonous just a couple of hundred years ago, tomatoes are now the second-mostconsumed vegetable in the U.S. (bested only by potatoes, according to the USDA). There are at least 10,000 varieties of tomatoes, but just a few are available in stores year-round. All varieties, including flavor-laden heirlooms, can prove challenging to Inland Northwest growers because of the area’s short growing season. To improve chances of getting a good harvest, WSU’s extension office recommends reducing watering and pinching off blossoms and small fruit by midAugust, to encourage the already-growing fruit to ripen. SUPERPOWERS: Tomatoes are loaded with powerful antioxidants, including vitamin C, which can combat the formation of free radicals that may lead to cancer. They also contain lots of lycopene, which research shows may reduce the risk of prostate cancer. And they’re rich sources of vitamin A and folic acid. The fiber, potassium and choline in tomatoes help support a healthy heart. WEAKNESSES: Is it a vegetable or fruit? Botanically, tomatoes are fruits. For culinary purposes, and according to a U.S. Supreme Court ruling, tomatoes are vegetables. Whether fruit or vegetable, just don’t eat the leaves of this plant from the nightshade family — they’re poisonous. HOW TO USE IT: Slice fresh tomatoes directly onto your dinner plate for the world’s easiest side dish. Or to preserve that summer goodness for the dark days of winter, blanch tomatoes in boiling water, remove skins, scoop out the seeds, drain excess juice and place tomatoes in freezer bags, removing as much air as possible, and freeze. — ANNE McGREGOR

BRYCE R. WALTON: No worries. Mac ’n Cheese, Pizza Rita and other yummy food. Life is too damn short to worry about what you eat. Eat what you want, when you want and walk 3-12 miles a week and you’ll be just fine. CATHY WASSON: GMOs!!! That’s what scares me but the only talk I see is online. Not a damn thing on our wonderful news channels. They’d rather talk about Kim Kardashian. STEVE FITZGERALD: It’s crazy… In a matter of just a couple thousand years we’ve taken food, one of our most important products, and made it into one of our most dangerous NICOLE LIVINGSTON: I worry about cost and nutrition. I hate buying processed stuff but sometimes you have to choose between affordable and filling, or pricey and nutritional. 

LIFE COACHING

Perhaps a Pause

S Carla Brannan is a personal life coach in Spokane.

ummer is waning. Who thinks it was too short? For many of us, our days are already overloaded. Summer, with all its offerings, simply adds more to our to-do lists. It’s easy to forget to take a break, or pause for even one second. But if we do, we can give ourselves a fresh start any time of day. Pausing, even briefly, to focus on our breath can bring us back to our center, reset our focus, release stress from our bodies and clear any negative thoughts in our heads. We are ready to move forward with more energy and a sense of ease. When do you need to pause? Frequently, we’re able to power on through. Yet sometimes, realizing we forgot our lunch on the kitchen counter or receiving a sideways glance from our favorite barista can set our minds off on a noxious tangent of negativity and crabbiness. My body always tells me when pausing is needed: clenching my jaw, picking my nails or tightening in my throat or shoulders. It’s great when I recognize these signs while I’m still in front of the barista with the displeasing look. I can tune in to my breath, inhaling and exhaling effortlessly, and reset my body by firmly planting my feet and dropping my shoulders. A mental gratitude list is helpful, too. Usually, I can then continue with a pleasant conversation and happily come up with a different plan for lunch. Consider creating a pause that fits you, give it a try and notice how it changes your experience. — CARLA BRANNAN

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CHECK-IN

Spokane native Alex Prugh will play the Showcase.

CHARITY CORNER

Teeing Off On Cancer

or just $20, Inland Northwest golf fans will have a rare chance to see professionals from the PGA Tour in action on Aug. 18. The pros will be paired with well-known sports figures — some local heroes as well as ESPN personalities — for a nine-hole exhibition at the Coeur d’Alene Resort Golf Course. It’s all part of an effort to raise money for the Community Cancer Fund and the V Foundation. Course grounds will open to the public at 9 am with on-site shops, food and beverages, as well as a Fan Zone including a beer garden and interactive Nike Golf demo center. Clinics and activities with

PILL BOX

Science Fiction? I recently heard that a birth-control microchip was being developed. Is this true and if so, how would it work?

John R. White chairs WSU-Spokane’s Department of Pharmacotherapy.

es, it’s true. A company called MicroCHIPS — with the help of the Bill and Melinda Gates Foundation — is developing such a device. The chip, implanted under the skin, would be a wireless drug delivery device that would deliver levonorgestrel, a synthetic hormone used in contraceptives. The chip would deliver a daily dose every

professional golfers also will take place before the Showcase tees off. Former Gonzaga and now Los Angeles Lakers center Robert Sacre and Super Bowl XXVI MVP Mark Rypien, as well as Zags men’s basketball coach Mark Few, new Oregon State men’s basketball coach Wayne Tinkle and ESPN’s Neil Everett (a graduate of Lewis and Clark High School), Sean McDonough and Fran Fraschilla will pair up with golf pros, including Ferris grad and now PGA tour player Alex Prugh, for the exhibition. Event sponsors will join the celebrities for golf and a dinner/auction on Sunday, Aug. 17. “It felt like a good time to put our best foot forward to make a local impact and support the local fight against cancer, the patients and their families,” founder Jerid Keefer says of the newly formed Community Cancer Fund. The fund will help provide local cancer prevention and screening programs, as well as support cancer patients and their families at every stage of their illness and recovery. The V Foundation has awarded more than $115 million to cancer research projects. — FRANNY WRIGHT The Showcase • Mon, Aug 18, at noon, grounds open at 9 am • $20 • Coeur d’Alene Resort Golf Course • 900 S. Floating Green Dr. • showcasegolf.com

day for as long as 16 years. Currently, contraceptive implants (progestin) last three years and must be surgically removed to stop their activity prior to that. This system would come with a remote control that could be turned off and on simply by pressing a button. This would allow women to discontinue their birth control with the push of a button. There are potential security problems associated with this kind of system, and MicroCHIPS is working to make sure that the system is secure and protected from hackers. It is hoped that this microchip birth-control technology will be available in the United States by 2018. — JOHN R. WHITE

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THEIR OWN WORDS

Dr. Kevin Mulvey Dr. Kevin Mulvey is the Medical Director of Oncology Services at Kootenai Health. He graduated from Columbia University College of Physicians and Surgeons in New York, and has practiced in southeastern Idaho and Minnesota. He says he and his family are happy to be back in the “green part” of Idaho. He’s especially pleased with the early steps toward the creation of a comprehensive, top-notch regional care network through the newly formed cancer alliance among Kootenai Health, Providence and Cancer Care Northwest. “We have a rebirth of the cancer program, which had gone through some hard times,” he says. Cancer is a topic that scares a lot of people. Why did you choose oncology? When I was in medical school and early in internal medicine training, I gravitated to oncology. It was fascinating in terms of the science and the pace of improvements. … And one of the appeals is that people have a serious illness that requires complex decision-making. It is an intense juncture in their life. People have an intense relationship with the doctor. I didn’t want to be an organ specialist. I wanted to be taking care of the whole person. But doesn’t it get depressing? I think many people have a fairly nihilistic view of oncology, that it’s a doom-and-gloom profession. That nobody survives. The reality is that we’re making great strides. People are living longer. People are living better. It’s not a depressing field. There’s a lot of joy in it. Even those who succumb to their disease, it is a tremendous privilege to be involved in their lives. It is a gift that you are able to help them through that transition.

It seems that there has been some degree of disappointment that we don’t yet have a “cure” for cancer. But how much progress has been made? In the 20-plus years I’ve been doing this, in big strokes, what we’ve accomplished is more effective and less toxic chemotherapy. And phenomenally more effective supportive care — the ability to manage the side effects of chemo, the ability to mitigate the risk of infection. But in the last 10 years, the real change has been moving from treating cancer like one-size-fits-all to personalized therapy. The identification of specific molecular and biological markers has allowed us to identify treatments that specifically target the individual’s cancer. These developments have improved the outcomes for many cancers, including breast, colon and lung cancer. — INTERVIEWED BY ANNE McGREGOR

STEPHEN SCHLANGE PHOTO

memorable

5 0 9 . 2 7 9 . 7 0 0 7 w w w . s p o k a n e c e n t e r. c o m

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CHECK-IN MILESTONE

Inland Northwest Health Services Turns 20

hysical therapist Dean Bunkowske remembers a time when St. Luke’s Rehabilitation Institute was St. Luke’s Memorial Hospital. This was in 1981, when he moved to Spokane from Miami. Back then, St. Luke’s was a general hospital with a 12-bed rehabilitation unit. In 1993, St. Luke’s merged with Deaconess Medical Center. A year later, Spokane’s four major hospitals — Providence Sacred Heart, Providence Holy Family, Deaconess and Valley Hospital and Medical Center — joined forces to create the nonprofit Inland Northwest Health Services (INHS) to manage a critical care air transport service and the new St. Luke’s Rehabilitation Institute (pictured). “We had the nursing staff that came over from the different hospitals and we had therapists who really wanted to do and were dedicated to rehab. It was a joyous coming together of a staff that had the same idea,” Bunkowske says. Celebrating its 20th birthday this year, INHS has grown into one of Spokane County’s largest employers with more than 1,000 workers. Its air ambulance program, Northwest MedStar, has

has expanded to serve Moses Lake, Pullman, the Tri-Cities, Brewster, Wash., and Missoula. The health care information technology division provides an electronic medical records network used by more than three dozen hospitals and physician offices across the region. Other divisions offer training for EMTs and paramedics and community wellness programs. Meanwhile, St. Luke’s Rehabilitation Institute’s downtown campus has become the region’s largest free-standing inpatient rehabilitation center for patients who have experienced a stroke, brain or spinal cord injury, with outpatient care provided there and at other locations, including OZ Fitness centers. Despite these changes, Bunkowske says the most important — and his favorite — part of his job as a physical therapist hasn’t been affected. “It’s the one-to-one contact with patients and family that has kept me going through all these years,” he says. “It’s a service for me I really enjoy — getting to know people and assisting them on their life’s journey with the difficulties they may have.” — DEANNA PAN

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Sudoku

RATINGS: Moderate (left), Tough (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

6 5 3 7 2 6 5

1 7

7 8 4 9 2 3

8 5

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

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 three-letter clue, turn to page 24. 19

10 18

3 12

10 12

4 12

16 21

23 24

25 6

20 6

15 5

23 6

6 4

16 15

15 6

6 11

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

3 1

2 4 1 5

7 6 9 1

9 6

8 5

6 3 1 8

1 5

4 9 7

5 2

Str8ts

RATING: Gentle 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.

6 8 3 2

9 7 6

4 2 8 9 6 5 1 7 8 3 7

BRAIN EXERCISE

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NEWS

BEST PRACTICES

The Power of Touch High-tech tests and state-of-the-art imaging can’t replace a physician’s hands BY DANIEL WALTERS

oday, hospitals and doctors’ offices are full of sleek and shiny equipment, high-tech wonders that spin, scan, analyze and probe. They can track brain waves and heartbeats. They can read the composition of blood and tissue. X-rays, MRIs and CT scans have allowed medicine to make glorious strides and save countless lives. But amid all that buzzing and scanning, many experienced doctors worry they’re

neglecting a simpler, perhaps even more important skill: the physical exam. “The electronic medical record and advanced imaging technology have not only seduced doctors away from the bedside but also devalued the importance of their role there,” Stanford University’s Abraham Verghese says in an editorial in The BMJ (formerly the British Medical Journal). Anyone who has come to the doctor’s office with a problem knows what it’s like:

The cold stethoscope against your chest. The light peering into your eyes and ears. The thermometer and the blood pressure cuff. “Turn your head and cough.” Those simple interactions can communicate vast amounts of information to a skilled doctor — they can save patients and the medical institution money by eliminating needless tests and by catching maladies far before they become much worse.

eorge Novan, associate dean of the college of medical science at WSUSpokane, is an evangelist of sorts, trying to spread the good word about the physical exam. “I came into medicine when there was much more reliance on [medical] history and physical exam skills,” Novan says. “As we’ve become more high-tech, and as we’ve had more and more interactions with computers, there may be a tendency ...continued on next page AUGUST-SEPTEMBER, 2014

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NEWS

“THE POWER OF TOUCH,” CONTINUED... to relegate medical exams further down the list.” On the first day of class, he sometimes shows his medical students a slide show. Click. A slide of Sir Arthur Conan Doyle. Click. Doyle’s teacher, Joseph Bell. Both were physicians. Doyle based his iconic character, observant detective Sherlock Holmes, on Bell, who wrote A Manual of the Operations of Surgery and lived at a tipping point where new innovations made actual medical diagnoses possible. “This is medical detective work,” Novan says, bringing the point home. “In an era before there were X-rays, before there were MRIs and CAT scans, there were physicians able to diagnose things based on listening — listening to the patient, listening through the stethoscope and examining with their hands.” Physical exams and conversations with patients can’t tell you everything. An X-ray, for example, can reveal evidence of pneumonia much more clearly than a

Dr. George Novan urges medical students to practice the art of the physical exam. YOUNG KWAK PHOTO stethoscope. But the physical exam often can tell doctors which test to use or not use in a diagnosis. “An echocardiogram, which bounces sound waves off the heart valves — it’s basically sonar for the heart — will do a much better job at defining a valve abnormality than listening for murmurs,” Novan says. But is it best to give every patient an echocardiogram, he asks, “or would it be better to listen to a heart murmur and then have an echocardiogram?” A Johns Hopkins program trains doctors to differentiate benign heart murmurs from dangerous ones with only a stethoscope. Echocardiograms are expensive. If a skilled doctor can rule out the need for one, it saves everyone a lot of money. “I think the patient-listening doctor who does a focused physical examination can get to the bottom of most things without laboratory or imaging tests,” says Matt Handley, medical director for quality at the Group Health Cooperative. Some physical

exam techniques, he says, like testing the size of the spleen or liver, are unreliable. But others are superior to tests: A physical exam and patient history can detect a female urinary tract infection much more effectively, Handley says, than a urine test. Two studies showed that tracking eye movements during a physical exam can differentiate between inner ear problems and a stroke better than an initial MRI. MRIs and CT scans carry the additional danger of showing harmless abnormalities that could lead to unnecessary tests and complications. The value of exams goes far deeper than diagnoses. “The physical exam is learning to find things, but it also is part of a ritual, part of a tradition — it’s also a connection being built,” Novan says. Standing before the TED talk stage, Verghese, the Stanford doctor, talks with a soft, multicultural blend of an accent. He tells of a woman who collapsed during a doctor’s visit and was rushed into an MRI.

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Interior Design... Your Way “The real tragedy was, she had been seen at four or five other health care institutions ... four or five opportunities to see the breast mass, to touch the breast mass, intervene at a much earlier stage than when we saw her,” Verghese says. “This is not an unusual story.” In other words, she’d had plenty of tests, but had never received a physical exam that would have detected her breast cancer. “We’re losing a ritual that I believe is transformative, transcendent and is at the heart of the patient/physician relationship,” Verghese says. “The ritual of one individu-

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Stanford’s Abraham Verghese al coming to another and telling you things they would not tell their preacher and rabbi, and incredibly, on top of that, disrobing and allowing touch. I would submit that that is a ritual of exceeding importance.” That intimacy, he argues, is more than diagnosis: It’s forging a relationship. The underlying problem: doctors have a very small amount of time for visits. Today, a visit of only 15 minutes is typical, according to Kaiser Health News. Some are even shorter, lasting less than four minutes. When residents practiced their physical exam skills on Novan, he spotted bad habits. “They’re sometimes speeding things up and shortcutting and not doing things the right way. I had a resident examine me and listen to my heart and lungs through a shirt,” Novan says. “The acoustics change when you do something like that.” The lack of primary care doctors, the influx of aging baby boomers and Obamacare’s wave of newly insured patients means more pressure than ever to quickly diagnose, then move on. That’s where doctors make errors. That’s why they tend to interrupt patients’ explanations. “It might not be unusual for a patient to be interrupted within 18 seconds of being asked what’s going on,” Novan says. The problem with interrupting, Novan ...continued on next page

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NEWS

Eleven-month-old Beckett Smith crawls away during an exam with nurse practitioner Brooke Jordan. YOUNG KWAK PHOTO

“THE POWER OF TOUCH,” CONTINUED... says, is that the patient may be hesitant to share the fears and worries of themselves and their family regarding the illness. “That’s going to impact how they perceive their illness and how they respond,” Novan says. A patient may come in for a cough, but have a deeper worry because

their father died from cancer. That’s an opportunity to listen to them, to address their concerns and quell their fears. A good doctor can detect uncertainty or hesitancy — a patient may squirm or fidget or become uncomfortable. Then the doctor knows how to probe further, to try to get

at what a patient is really feeling. “You can take brief notes, but you don’t want to take word for word, because you’ll miss seeing things,” Novan says. “People will answer a question ‘no.’ But the way they answer it — the body language — will tell you there’s something else behind it.“

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ot everyone is a traditionalist, of course, when it comes to the promise of medicine. In an article on TechCrunch.com, Sun Microsystems co-founder Vinod Khosla argued in a 2012 article that that computerized algorithms, getting more adept all the time, could someday replace most of what primary care physicians do. “If 90 percent of the time the doctor knows exactly the right kind of diagnosis from these very few and superficial inputs … does it really require 10-plus years of intense education for every diagnostician?” Khosla wrote. Today’s medical algorithms are shoddy and easy to mock. But algorithms get better all the time, and Khosla greets this possibility with excitement. “I doubt very much if within 10 to 15 years … I won’t be able to ask Siri’s great, great grandchild (Version 9.0?) for an opinion far more accurate than the one I get today from the average physician,” Khosla says. “Eventually, we won’t need the average doctor and will have much better and cheaper care for 90 to 99 percent of our medical needs.”

TINY PATIENTS After all, Watson — that IBM computer that trounced superstar nerd Ken Jennings on Jeopardy! — now has software intended to help doctors comb through medical records to help make diagnoses. But that approach has genuine skeptics. Verghese contrasts an oil painting from 1891, of a doctor at the bedside of a dying patient, with a picture of a crowd of modern doctors, in lab coats and ties, crowded around a laptop in a conference room. “The patient in the bed has almost become an icon for the ‘real’ patient” he says. “The real patient often wonders ‘Where is everyone? When are they going to come by and explain this to me? Who’s in charge?’” In other words, we have more tools than ever to diagnose medical conditions: The key is knowing when and where to use them. The invention of the screwdriver didn’t make the hammer obsolete. All the tests and data and fancy equipment can’t compensate, Novan says, for true personal interaction between doctor and patient. “There’s a quote by Francis Peabody,” Novan says. “‘The secret of the care of the patient is in caring for the patient.’” n

iving a physical exam to a kid is a whole different challenge than giving one to an adult. Children can be more fidgety, more prone to tears and more unable to articulate exactly what’s wrong. Brooke Jordan, a nurse practitioner with Northwest Spokane Pediatrics, says she’ll sometimes give kids a few tongue depressors or let them play with her stethoscope. She may play with them for a few moments before the physical exam begins — a way to get them to trust her. Some kids are clearly nervous. She’ll let them hold the otoscope light into their ears. “If they have a stuffed animal, we’ll pretend to listen to the stuffed animal before we listen to them,” Jordan says. She’ll check their immunization records. The questions she asks the parents go far beyond simple medical history. Are they wearing helmets when they’re riding bikes? Life jackets when boating? Do they have the right booster seat or car seat? After all, she usually sees children before they develop problems that could affect them for the rest of their lives. “One of the biggest things we focus on is the patient education,” says Jordan. “I believe the preventative side is key to maintaining health.” — DANIEL WALTERS

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NEWS

Suzie’s MAPS founder Suzie Willcox demonstrates how to use the kiosk in the South Hill Rosauers. STEPHEN SCHLANGE PHOTO INNOVATION

Meal Planner Diagnosed with diabetes, Suzie Willcox designed a way to make shopping easier for those on special diets BY LISA WAANANEN JONES

uzie Willcox expected the doctor to say something was wrong with her heart. She’d been having dizzy spells, and both her parents had died of massive coronaries. So the true diagnosis — diabetes — came as a surprise. Another surprise came when Willcox,

who had always been a good cook and conscientious about nutrition, took a diabetes education class and realized how difficult it can be for newly diagnosed people who are learning about healthy meal planning for the first time. “I was pretty shocked at people

not knowing the difference between a carbohydrate and a protein,” Willcox says. “I just started thinking about that: ‘Gosh, this is really hard for people — and it’s hard for me. I wonder how I can make this easier?’” She’s recalling the story at the Rosauers

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grocery store on 29th Avenue, seven Many factors can make it difficult: years after she was diagnosed. Nearby is old habits, cost, other family members’ the answer she’s been puzzling over and preferences, conflicting information and planning all that time: a cheerful, brightconfusion. Patients often have other health green kiosk that greets shoppers as they issues as well, and must work closely with head toward the produce section. their team of health care providers. This is Suzie’s MAPS — Meals Already “One of the most important things Planned System — one of three kiosks is to really have a good support team,” installed in local Rosauers stores for beta says registered nurse Anne Vold, another testing. The touch-screen guides users certified diabetes educator with Providence. through the options: Select the number of Providence has been an enthusiastic people you’re cooking for, choose one of supporter of Suzie’s MAPS, sending out several featured recipes, and then take the information to employees and putting printed recipe and shopping list to finish posters in the elevators so patients and the meal. caregivers know where to find kiosks. What differentiates Suzie’s MAPS from Particularly because of the convenience and the abundance of recipes on the Internet customized recipes, Bolam and Vold believe is the careful thought she puts into it — Suzie’s MAPS can be a part of that support the recipes change based on the weekly patients need to successfully follow through specials, and ingredients are organized with diet changes. by the aisle where they can be found in side from the acronym, Suzie’s that particular store. A healthy menu plan MAPS also represents the way doesn’t do people any good if they can’t Willcox envisions diabetes as sort find or afford the ingredients, Willcox says. of a journey, with The diabetes menu her menu plans is Suzie’s MAPS helping others flagship, but the Rosauers, 2610 E. 29th Ave., Spokane find the way. She kiosks also have Rosauers, 9414 N. Division St., Spokane and her husband, menus for hearthealthy and glutenRosauers, 10618 E. Sprague Ave., Spokane Valley Greg, have owned businesses for free meals — and decades, but this others in the works is the most personal, and every decision — with the same goal of linking healthy has her detail-oriented touch. intentions to actual shopping. Energetic and persistent, Willcox “They can just come in, and they don’t went through many versions and have to think about calculating anything,” disappointments — “doors closed and Willcox says. “Here it is, and they can just heartbreaking things” — before getting to use it.” the version that’s had an overwhelmingly he problem Willcox identified after positive response at demonstrations. she was diagnosed is well-known to Providence and Rosauers have both been doctors and educators: It’s difficult encouraging, she says, as are the smiles for people to successfully form new eating from people who try out the kiosk and say habits, even if they know it’s important for it’s a good idea. their health. The ideal diet for people with “I’m still dazzled when I hear that, and diabetes is essentially a healthy one — it’s it pleases me so,” Willcox says. “I guess I’m not about restrictions so much as about amazed at all this.” balanced, consistent meals to keep blood The team has eagerly incorporated sugar in check. feedback about improving the system — Each experience is different, but paRosauers suggested more photos of food, tients diagnosed with diabetes are typically a father asked about displaying nutrition referred to group classes or one-on-one information with the recipes — and has sessions to learn about the disease and plans to add other features, like showing how they should be eating. But following the price associated with a convenience through can be challenging, says Megan option vs. home-cooked. Willcox would Bolam, a registered dietitian and certified like to have menus for a full range of diabetes educator with Providence Health allergies, and also plans to have novelty Care. menus like a Mother’s Day brunch for dads “When they’re first diagnosed, some who are shopping and cooking. people can be so overwhelmed that it’s bet“There’s lots of fun things to do with ter to find out what they’re doing well and this,” she says. “The ideas come so fast I then introduce small steps,” she says. can hardly keep up with them.” n

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AUGUST-SEPTEMBER, 2014 NEWS inhealth 8-1-2014.indd 21

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NEWS

John Murphy leads a Mental Health First Aid class earlier this year at WSU Spokane. YOUNG KWAK PHOTOS MENTAL HEALTH

What Should You Do? Like CPR or the Heimlich maneuver, Mental Health First Aid can prepare you for a crisis BY DEANNA PAN

ad’s heart has stopped beating; you press the palms of your hands hard and fast into his chest and begin CPR. Your dining companion is choking; you wrap your arms around her waist and give her the Heimlich maneuver. You know to reach for the bottle of aspirin if someone is suffering from a heart attack. You know to apply pressure to a wound to stop it from bleeding. But what do you do if your son or daughter has become withdrawn and depressed? How do you help a neighbor you notice is talking to someone who isn’t there? What do you say to a loved one who tells you she intends to take her own life? Like other first aid protocols — think ABC (Airway, Breathing and Circulation) or RICE (Rest, Ice, Compression and Elevation) — you follow ALGEE, explains John Murphy, a certified Mental Health First Aid instructor. It’s a mnemonic device:

4 Assess for risk of suicide or harm; 4 Listen nonjudgmentally; 4 Give reassurance and information; 4 Encourage appropriate professional help; and 4 Encourage self-help and other support strategies. On a Wednesday in May, in a basement classroom at Washington State University’s Spokane campus, Murphy, the programs manager for Passages, a support organization for people recovering from mental illness, teaches Mental Health First Aid to a class of 16 people from varying fields — social services, advocacy, mental health and student affairs. Murphy is one of the first instructors trained in Mental Health First Aid in Washington state. For the past five years he has been teaching, on average, a dozen classes a year at colleges, police departments, state hospitals and local churches. His classes are always full. Lately, there have been waiting

lists to get in. Throughout the course, Murphy, who has bipolar disorder, draws from his own experience as an “irritable manic” who would stay up for six days straight and avoid taking his medication before he checked into Eastern State Hospital in the 1980s. “My big thing is to get people who are showing symptoms, or are in crisis, the help they need instead of being left on their own,” Murphy says. “Many people see someone in crisis and they turn away and leave, because they don’t know how to help them.” The course was invented in 2001 by Australian couple Betty Kitchener, a psychiatric nurse, and Anthony Jorm, a mental health professor and researcher. It has since been adopted in more than 20 countries around the world. Here, Mental Health First Aid has even received the president’s seal of approval: In January

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2013, in the wake of the mass shooting who don’t have access to it,” Gibb says. at Sandy Hook Elementary School in “It’s far more likely you will come into Newtown, Conn., President Obama contact with someone who’s in emotional endorsed the training program to help distress than someone who’s choking on a teachers and staff in schools identify signs piece of food.” of mental illness among students. Beyond preparing people for mental Bryan Gibb, director of public health emergencies, Gibb hopes the course education for the National Council will reduce the stigma of mental illness, for Behavioral Health, which runs the which far too often discourages people American program, says the popularity of from seeking help in the first place. Mental Health First Aid has grown since it “As a society, we don’t necessarily was first introduced in the United States in think of mental illness as something that 2008. He estimates that more than 250,000 can be helped by these kinds of first aid Americans will be trained in Mental Health First Aid by the end of the If you’re interested in taking a class with John Murphy at WSU Spokane, year. please email jmurphy@passagesfs.org for dates and information. Frontier Gibb says the mission Behavioral Health also is offering youth and adult versions of Mental Health of Mental Health First First Aid training to the public on the following dates: Sept. 12 (adult), Oct. Aid is twofold: About one 3 (adult) and Oct. 13 (youth). The cost to participate is $25. To register for a in four people in the U.S. class or inquire about the program, email tduncan@smhca.org. will experience symptoms of a mental illness or substance abuse interventions,” Gibb says. “We think of disorder in a given year. Yet, according to mental illness as a death sentence, or the Substance Abuse and Mental Health something that means someone should just Services Administration, less than 40 be locked up, or as a character flaw.” percent of them seek treatment. The eight-hour course covers a range “So there’s a lot of people who might of mental health problems and their risk benefit from treatment or interventions factors, symptoms and treatment, including

GET TRAINED

depression, anxiety, trauma, eating disorders, psychosis and substance abuse disorders. Participants learn the difference between mood and thought disorders. Through role-playing, they learn how to talk to someone who’s suicidal or selfinjuring; how to safely approach a person in the midst of a psychotic break; what interventions to use and which resources to contact for help. In one simulation, students don a pair of headphones and listen to an MP3 recording to get an idea of what it’s like to hear voices. “I wanted to educate myself more about how to differentiate between various mental health conditions and situations, so I’d know when it was appropriate to refer people to proper professionals,” says Kathleen Werr, one of the course participants. Werr helps run Autistic Network of Unique Eccentrics, a local peer support group for autistic adults. At the training at WSU, she noticed some similarities between behaviors commonly associated with autism and symptoms of mental health crises. “I need to know the difference between people just expressing frustrations and difficulties, and when they’re in crisis,” she says. n

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NEWS THE LAW

Questions About Cannabis Legal marijuana is here, and there are a few things you should know BY HEIDI GROOVER

fter voters approved Initiative 502 in 2012, possessing an ounce of marijuana became legal for adults 21 and older in Washington. And last month, the Washington State Liquor Control Board finally allowed retail stores to open for business.

WHAT IF I LIVE IN IDAHO?

WHAT’S LEGAL AND WHAT’S NOT?

CAN I GET FIRED FOR SMOKING POT?

If you’re under 21, sorry. No recreational cannabis for you. If you’re 21 or older, you can now enter a state-licensed pot store, show your ID and buy up to one ounce. There is no public consumption (you could get a $50 ticket); no sharing with minors (that’s still a felony and the authorities are taking it very seriously); if it’s in your car,

keep the packaging closed; and don’t drive high — it’s illegal. Don’t transport marijuana across the border. It’s illegal there and that’s unlikely to change in the near future.

gets you high — is in the product. You’ll also see the product’s weight, its harvest date and warnings about its intoxicating effects. Edibles will have recommended serving sizes (the state defines one serving as 10 milligrams of active THC).

WHAT’S THE DIFFERENCE BETWEEN MEDICAL AND RECREATIONAL POT?

Yes, pot has been sort of legal here for more than a decade, and you or someone you know may WHAT’S ON THE LABEL? already have a hookup. But from the puzzle on page 13 On labels, you’ll find the that market is for medical 5 = R; 6 = E; 19 = I name of the product or strain users, and there are plenty and its “potency profile,” of people out there who explaining how much THC — the stuff that need marijuana as medicine, which is why Yes. Employers are still free to enforce weed-free workplaces.

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One of the first baggies of marijuana sold legally in Spokane, at Green Leaf on July 8. trying to fold the two industries together has been so controversial. For now, Washington’s medical marijuana collective gardens will live on in the legal gray areas alongside the recreational market.

WHO SHOULD NOT SMOKE POT?

Kids. Without a doctor’s recommendation for medical marijuana, it’s illegal for anyone under 21 to possess pot in Washington, and some research shows it

YOUNG KWAK PHOTO

can interfere with brain development. The National Alliance on Mental Illness warns against the use of marijuana by anyone with risk of or a diagnosed mental illness because it can worsen their symptoms. n

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LIVING The benefits of meatless eating BY JACOB JONES

g n i o G een FOOD

r G

ehind the glass counter of Boots Bakery & Lounge on Main Avenue, the packed shelves hold a host of sweet and savory delights — curried lentils, minted fruits, pastries, greens and cakes. Despite every dish being vegan, meaning no meat or animal products, the options prove a colorful bounty. Tessa Trow sits at a table in the back, turning from her laptop to a plate of seasoned vegetable salad. A co-founder of the Inland Northwest Vegan Society, Trow rejects the popular impression that giving up meat means giving up a wide variety of meal options or tastes. “A lot of people think that being vegan is restrictive,” she says. “I think the opposite.” Most people might order a hamburger. She can order a black bean, lentil or beet burger. Many shoppers will pick up a gallon of dairy milk. She can pick from soy, almond, rice or others. “I have 30 types to choose from,” she says. ...continued on next page

Tessa Trow and Josh Meckel, co-founders of Spokane VegFest. YOUNG KWAK PHOTO

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LIVING “GOING GREEN,” CONTINUED... Most nutrition experts agree that a plant-based diet can provide significant health advantages, with research finding reduced risks of cancer and cardiovascular problems. Many vegetarians cite environmental impacts or humane animal practices as part of their decision to change their food habits. Much of American food culture still revolves around the perceived staples of meat and potatoes, but as the popularity of vegetarian diets has increased, local markets and select restaurants have shifted to accommodate them. Trow and her partner, Josh Meckel, recently organized VegFest 2014 in Spokane to share their

RECIPE

Boots Bakery Tofu Scramble

Boots Bakery has you covered from breakfast to dessert with vegetarian/vegan and mostly gluten-free dishes, like this one below. Here tofu gives you the protein you need to jumpstart your day, while plenty of veggies help you feel full but not weighed down.

The Scramble

1 lb. extra firm tofu, ½” to ¾” cubed (substitute flavored tofu if you want) 3 red potatoes, roasted or boiled, then cubed 1 yam or sweet potato, roasted or boiled, then cubed 1 red or yellow pepper, roasted or sautéed, then cubed 3 cups greens (collard, cabbage, spinach, etc.), rough chopped

The Sauce

½ cup Bragg liquid amino acid (can substitute low-sodium soy sauce) 1 cup water ¼ cup oil (optional) 2 tablespoons cumin ½ teaspoon crushed red pepper 1 tablespoon fresh minced garlic (can substitute granulated garlic) 1. Whisk sauce ingredients together. 2. Pour over tofu and bake uncovered for about 35 minutes at 350 degrees. Alternately: cook tofu in a frying pan with the sauce. 3. Let sauce reduce by about half. 4. After the tofu is done, add cooked veggies and toss to coat. 5. Toss in greens to wilt them and serve warm.

passion for vegan living. They believe Spokane is ready to embrace a new way of looking at food. “We were hoping for about 500 people to come,” she says of June’s VegFest. “We had 1,100. Our biggest complaint was that the venue was too small, which I take as a compliment.”

Complete Without Meat

In her office at Providence Sacred Heart Medical Center, clinical nutrition manager Nicky Desmond lists a wide variety of health benefits linked to plant-based diets in recent research studies. Balanced vegan and vegetarian diets can dramatically reduce the risks of many common ailments. “Vegetarian diets are associated with lower cholesterol levels,” she says. “They’re associated with lower blood pressure, lower body mass index, lower cancer rates … lower risk of developing type-2 diabetes, lower risk of hypertension.” Some of the most compelling research comes out of Loma Linda University, where researchers have spent 12 years monitoring a sample of more than 73,000 Seventh-day Adventists, about half of whom adhere to a vegetarian-style diet. No other research has examined eating habits on such a large scale, and the results strongly support plant-based diets. The studies have found that Adventists, whose practices encourage vegetarianism and prohibit smoking or drinking, tend to live longer than others in the same area. Rates of high cholesterol, cancer, diabetes and high blood pressure all decreased as meat was removed from the diet, dropping from non-vegetarian to semi-vegetarian to vegetarian to vegan. Loma Linda’s latest study, announced in June, finds the mortality rate for nonvegetarians runs almost 20 percent higher than that of vegetarians. Researchers suggest even slight diet changes can have health benefits. “The takeaway message,” study coauthor Sam Soret says in a news release, “is that relatively small reductions in the consumption of animal products result in non-trivial environmental and health benefits.” Desmond says meat in moderation obviously can provide certain nutrients, but she emphasizes that meat does not have a monopoly on any vitamins or minerals. A balanced vegetarian diet can safely feed almost anyone from growing children to pregnant women. Modern vegetarian or vegan food choices offer plenty of protein, iron and calcium, she says. Many fortified products provide vitamin D or B12.

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What’s

Tarawyn Waters connects with customers at Thursday Market in Spokane’s South Perry District.| YOUNG KWAK PHOTO “[But] just because a food label says ‘vegan’ or ‘vegetarian’ does not equate to health,” Desmond warns, citing candy and chips. “As with most things in health, variety is key. It’s important to be eating a variety of whole grains … legumes, fruits and vegetables.”

Environmental Impacts

When Jim Schrock sells his produce at Spokane farmers markets, he often gets a few surprised looks when he explains he grows and harvests his lettuce, tomatoes and other vegetables just two miles away. “Their eyebrows really go up,” he says. Schrock owns the 38-acre Urban Eden Farm in the Vinegar Flats area of West Spokane along Highway 195. There, he and his partners strive for a low-input, almost closed-loop farming model, with hopes of a more efficient and sustainable operation. “It’s a lot of shovel work,” he says. “We use a lot of hand labor.” Workers enrich the soil with local leaves and manure. Schrock says they rotate crops over the same land to cycle in fresh nutrients. Farming partner Tarawyn Waters argues that those deliberate practices make for better produce and a smaller impact on the environment. “As practicing organic farmers,” she adds, “our goal is to produce food while establishing an ecological balance. … We practice organic farming because it is better

for the earth and every living thing on it.” Vegans and vegetarians often cite the environmental benefits of a plant-based diets, and research supports many of those claims, but like almost any generalization, it’s complicated. For his part, Schrock says he enjoys the opportunity to meet his customers and build a new connection. “They like to be able to look us in the eye and ask us questions,” he says. “We can stand behind [our produce] pretty strongly.” But support of organic farming and locally grown food can easily be embraced by meat eaters. The real concern for many vegetarians is the environmental cost of producing beef. Cattle emit methane, a problematic greenhouse gas, as part of digestion. A 2011 study from the Environmental Working Group concluded that beef, which makes up 30 percent of meat consumed in America, results in the equivalent of close to 60 pounds of carbon dioxide per edible kilogram of beef. Lamb and cheese also rated high on greenhouse gas emission rates. “While best management practices can demonstrably reduce overall … environmental harm,” the report states, “the most effective and efficient way to reduce greenhouse gas emissions and environmental impacts from livestock is simply to eat, waste and produce less meat and dairy.” A report from the UN’s Food and ...continued on next page

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LIVING “GOING GREEN,” CONTINUED... Agriculture Organization calculated that meat livestock contribute 37 percent of all human-caused methane. About 33 percent of the world’s arable land is also used for grazing or feed crops. Many vegetarians also cite studies saying it takes 6 pounds of feed to produce each pound of beef — along

diets resulted in 22 percent fewer greenhouse gas emissions while vegetarian diets saw a 29 percent drop, indicating even limited changes in diet could provide benefits. Research shows poultry and pork produce fewer emissions per pound, but still much more than most vegetables. However, a recent Washington Post analysis of an Environmental Working Group study notes that vegetables cannot just replace beef’s caloric value, pound for pound. If foods are rated by emissions per calorie, the analysis found, beef still proves four times less efficient than tofu and 39 times less efficient than legumes, but some meats like pork and chicken rated similarly to popular vegetables like broccoli and tomatoes.

“We practice organic farming because it is better for the earth and every living thing on it.”

— TARAWYN WATERS, URBAN EDEN FARM with all the water, land and energy. The Loma Linda University Seventhday Adventists study outlined significant reductions in greenhouse gas emissions from plant-based diets. The study found that semi-vegetarian

Most animal advocates or vegetarians would suggest that meat lovers at least consider purchasing meat from smallscale, grass-fed cattle farms. Some research suggests such ranching operations practice more ethical animal treatment and may graze on land unsuitable for farming that would otherwise go unused. Such practices also avoid the cramped conditions of large feedlots. Other researchers, including Jude Capper of Washington State University, argue that feedlots provide more efficient livestock management, with a reduced impact on land and resources per pound of beef. Capper says modern lots have cut emissions and dramatically increased production in order to meet the world’s growing demand for food. But environmental impact extends beyond production methods. Schrock says he saves in transportation costs and greenhouse emission impacts by selling close to home. His vegetables don’t get trucked in from California or flown from the coast. He can harvest his produce in the morning, and with just a 10-minute drive, have his pumpkins, kale and carrots out for

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RECIPE customers to enjoy. Waters says she finds many modern food production practices troubling. It’s important to remember that food selection does have an impact. “Where you spend your money,” she says, “is a powerful way to show what is truly important to you.”

“It’s Never Been Easier”

Both Desmond and Trow have seen an increased interest in and openness toward vegan and vegetarian eating. As more people have embraced eating local or growing their own food, more coops and restaurants have supported vegetarian options. “It’s never been easier,” Trow says, noting that Spokane has embraced vegan living in many ways. “We could always do better. Most communities could always do better.” For transitioning to a new diet, Desmond recommends trying a few meatless options at local restaurants.

She says many know how to substitute tofu or remove meat from otherwise familiar dishes. Mexican fare, pasta and stir-fry also offer easy options for reducing meat. “There’s just a whole plethora out there for vegetarian meals now,” she says, citing Meatless Monday and other resources. Trow recommends the book Betty Goes Vegan, which provides vegan alternative recipes for many traditional American meals. She and others acknowledge that changing a diet can be a very personal decision that, in the case of veganism or vegetarianism, often impacts daily lifestyle or social situations. Such a diet may force a more contentious approach to eating, but it also can be rewarding, both physically and mentally. She encourages everyone to explore their own path, even if it takes baby steps. “It’s a personal decision that affects the entire planet,” she says, adding, “Doing something is better than nothing.” n

White House Grill Hummus

The White House Grill’s Raci Erdem puts a lot of garlic in his hummus, but you can tone it down… or add even more! Hummus can be made ahead and refrigerated. Serve with warm pita or sliced veggies for a nourishing meal. 2, 15-ounce cans garbanzo beans 8 cloves garlic salt 2 tablespoons tahini (available in the health food section of most grocery stores) 5 tablespoons fresh lemon juice 3 tablespoons canola oil 1 teaspoon sumac (available at the International Food Store, 3021 E. Mission) olive oil chili powder lemon wedges Drain garbanzos but reserve liquid. In blender, mix garlic and salt. Add garbanzo beans, half a can of the reserved liquid and blend. Add tahini, lemon juice, canola oil and sumac and blend to a smooth paste. You can add a bit more reserved liquid from the garbanzos if the mixture is too thick. Cover and refrigerate. To serve, spread on platter and drizzle with a little olive oil. Garnish with lemon wedges and a sprinkling of chili powder.

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LIVING

The Coles have something to harvest from July through October at their Green Bluff orchard. YOUNG KWAK PHOTOS COOKING

Branching Out Steve and Marie Cole, both farmers and physical therapists, get the most out of their land through organic practices BY CARRIE SCOZZARO

ou’ll find abundance at Cole’s Orchard — 900 trees producing apricots, pears, prunes and 13 varieties of apples, as well as vegetables and fresh-cut flowers. What you won’t find are pesticides or chemical fertilizers. Fifteen years after Steve and Marie Cole established the orchard at the curve of Dunn and Greenbluff roads, they became the only certified organic orchard in Spokane County. Crop loss vacillated, now hovering around two to three percent, says Steve, and there were rough times. “One year I only sold prunes and vegetables… [I] was ready to shut the whole operation down,”

he says. “Stubbornness got me through to the next year.” Both the Coles are familiar with farming. Marie’s family had a 500-acre cattle ranch in Eastern Washington, while Steve worked in an orchard as a youngster one year in Norway and again while attending college in north central Washington. The orchard is actually their second vocation. Marie directs the Spokane Falls Community College’s Physical Therapy Assistant program, while Steve’s logged 21 years in Group Health’s PT department. Physical therapy, says Steve, is akin to orchard management. “We focus on prevention in the clinic, promoting

strengthening, increasing range of motion and teaching good body mechanics and posture to prevent the injury from returning. In the garden, I grow cover crops and green manure to strengthen the soil and rotate crops to prevent diseases from ever occurring.” They grow what they like to eat, says Steve, but ripening dates are important. Steve’s plan is to create a continuous calendar of new fruit ripening each week from July through October. The current schedule is packed: apricots and early apples, like Lodi (July-August); peaches and more apples, such as Gravenstein (August); fall apples like Honey Crisp, Spartan

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100% scratch made menu Gluten free & VegEtarian Options

RECIPES

Savory Apple Salsa

A few years ago, Spokane Community College chef instructor Peter Tobin created this salsa for Main Market CoOp’s “In the Field” agri-tour program using produce from Cole’s Orchard. Marie Cole describes it as the best she’s ever tasted. ¼ cup lime juice 2 tart apples (McIntosh or Spartans), cored and diced 1 small onion, finely diced Handful of cilantro, rough chopped 1 red chili, seeded & minced 1 green or red pepper, diced 2 tablespoons minced ginger 1 tablespoon sugar salt ½ cup toasted walnuts or pecans

and McIntosh (September-October); prunes (September and October); pears (October). Vegetables are a recent addition and their harvest dates are similarly staggered: tomatoes, sweet peppers, eggplant, carrots, beets, swiss chard, a dozen or so types of summer and winter squash, and basil. They alternate crops through two hoop houses, and the lavender and flowers are both ideal bee attractors. Come harvest, Steve does most of the work himself, although friends and family pitch in, and the Coles will barter produce for labor. They sell customer-direct, taking phone orders in summer for early fruit, transforming their garage in the fall for more regular hours when the apples stack up. Marie handles the vegetable starts, helps trap gophers — the family cat pitches in, too — and does the Orchard’s paperwork. She also cooks for the family, often using their homegrown products. As she unseals a jar of applesauce to share with us on a sweltering summer evening, Marie looks out her dining room window westward towards the rolling expanse of Green Bluff. Her living room looks out on the orchard. She talks about being part of the community: church, family, friends, helping other growers, the Grange. It’s a community that includes the consumer, who can be assured that their health is in good hands. 

1. Pour lime juice in non-reactive bowl. 2. Toss diced apples with onion in the juice. 3. Add cilantro, peppers, ginger and sugar and toss to combine. 4. Season with salt to taste. 5. Add nuts Makes 3 cups

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Perfect Applesauce

When Marie Cole makes applesauce, she freezes some, but also cans enough to send off with her college-bound daughter. Gravenstein apples, says Marie, provide the right texture and tartness for this treasured family recipe. And she often uses the applesauce in lieu of oil in things like pancakes and muffins. Slice and core apples to fill a stockpot (quantity will depend on size of pot). Put an inch or so of water in the bottom. Cove the pot tightly, using foil as needed, and bake in 350 degree oven until apples are completely dissolved. Let cool and run through food mill or processor to form a puree. Optional: Add sugar and/or cinnamon to taste.

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LIVING

Faith and Addie share a Captain Underpants book at the downtown Spokane Library. STEPHEN SCHLANGE PHOTO PARENTING

Parental Controls

There are ways for parents to restrict access to cable TV and the Internet, at least at home, but what about books at school? BY LISA FAIRBANKS-ROSSI

t happened to The Wonderful Wizard of Oz and The Lord of the Rings for being “unwholesome” and “ungodly.” The Catcher in the Rye was “anti-white,” and To Kill a Mockingbird was “anti-black.” Pulling provocative books off library shelves seems like a vestige of a more uptight culture — something that happened 50 or 100 years ago. But concerns over what kids read is very much a contemporary issue. The American Library Association uses the term “challenge” to describe “an attempt to remove or restrict materials,

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based upon the objections of a person or group.” While many young readers have grown up enthralled with The Hunger Games trilogy and the Harry Potter series, those books are among the most challenged of the past two decades — denounced for being “anti-ethnic,” “violent,” “anti-family” and even “satanic.” So who’s in charge of deciding what books kids can access? “Parents have every right to ask us to reconsider whether a book should be on our shelves,” explains Gary Simundson, a high school librarian and adjunct professor for Central Washington University’s Educational Library Media program.

Jefferson Elementary School. “It’s a semiclassic. The cover is a little girl with a deer, and this little kindergartner had checked it out and brought it back in to me and said, ‘My mom wants to know why you have God in the library.’ “I told her, ‘I’m not sure what you mean. The book is about nature, and life,’” says Davis. “I knew it mentioned God a few times in the text, but honestly, I wasn’t sure where to go with her. ‘We have lots of different books about lots of different ideas,’” she told the 5-year-old with a tiny, furrowed brow. “’If that’s not a book you like, then you don’t have to take it.’ Davis recalls saying.

While many young readers have grown up enthralled with The Hunger Games trilogy and the Harry Potter series, those books are among the most challenged of the past two decades… But complaints don’t always lead to a formal challenge, and even then there’s no guarantee a book will be whisked away. If a parent is upset about a book, “I tell them, ‘Thank you for your concern. I’m glad you brought this to me; we try to have a balance, and your child did exactly what she’s supposed to do by deciding she didn’t want to read it,’” Simundson explains. “If they are really upset still, I ask them, ‘What would you like to see happen?’ They usually want it taken off the shelf, so I tell them, ‘There is a formal process we go through. I can get you the paperwork.’” The paperwork varies little from school district to school district, as most follow the basic tenets of the ALA’s Library Bill of Rights. Spokane Public Schools’ form is buried at the end of the seven-page “Criteria for the Selection of Instructional Materials” and asks complainants for a thoughtful statement of objection and “understanding of the teaching and instructional context within which the material is used.” “They will often take the paperwork, and it doesn’t go anywhere,” Simundson admits.

DEFINING “OBJECTIONABLE”

It’s not just sex and violence that irks parents. “There’s a children’s book by Rosemary Wells, called Forest of Dreams,” explains Yvonne Davis, the librarian at

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“If she’d been older, I could have explained, ‘There’s lot of books about God over in the 200 section of nonfiction’ [the Religion section]. FILENAME: And who sends a AD SIZE: PUB kindergartner to hash FALCOS_060314_6THPG out an issue?” Davis 6TH PG V INH says, laughing. PUB DATE: AE: AA MODIFIED: She admits that all06/03/2014 librarians grapple DS: JS DK FRIDAY, 5/23/2014 - 3:23PM with offering equitable access while still FULL FILEPATH: being mindful of the sometimes contrasting Advertising:Accounts:D-F:Falco's Fireplace and Spa:06.03.14 6th pg:Falcos_060314_6thpg desires and needs of adolescent readers. URL LINK: “My middle school colleagues wonder if 12http://www.inlander.com and 13-year-old readers need to read plot lines of characters in their late teens. We all agree there’s time for all that later. … But then, we don’t want to restrict access to the here’s a difference more voracious and mature readers. It’s a between finding somewhere conflicted thing.” you can stay, and somewhere Telia Sherwood, who runs two elementary school libraries for Spokane you never want to leave. Public Schools, says the most recent Now offering month-to-month challenge she received was about a picture options in our cottage homes book called A Tale of Two Mommies. “I love that book because it’s not gender-based,” Cottages | Senior Apartments | Assisted Living she says. “It doesn’t even show their Rehabilitation and Skilled Care faces. This little boy had brought it home because he liked the pictures. The parents, To learn more about our community and service, call (509) 924-6161 at first, wanted me to take it off the shelf,” or visit www.good-sam.com Sherwood explains. “I told them we have families of that makeup in the building, and in society, and kids want to see what it’s like.” Sherwood stayed calm and diplomatic. “I said, ‘If you don’t want your child ...continued on next page

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LIVING “PARENTAL CONTROLS,” CONTINUED... exposed, that is your prerogative,’ and I referred to the policies, which state, ‘The library is a place for fair and equal rights of all students.’ If you bring it back to the policy, there’s not much they can do unless they want to challenge the policy, and that’s not under my jurisdiction anyway.” Sometimes it’s not so much the content as the general impression that a book isn’t, well, very literary, that leads to a challenge. Simundson has testified twice in the past few years to avoid a removal; once to defend the Goosebumps series. “Even if books don’t have literary merit, if reluctant readers are reading them, then education is happening,” he says. Diane Brooks — quick to admit she is a “hovering helicopter” parent who restricts her kids’ access to television, social media and music — says she would prefer that librarians filter reading material far more than they do. The family lives in the TriCities, and now that Brooks’ daughter is in eighth grade, she says it’s getting harder to monitor her access to information. “I don’t want to make choices for other parents, but what I continue to discover is that

most parents don’t know what their kids have access to in the library. And that teachers tend to go off of other teachers’ advice, and they don’t know everything that’s in the books, either.” Sherwood says that if she knows a high-quality book is controversial, she reads it. “If I have to fight for it, I need to know why I bought it,” she says. “And the library is a place for all sorts of viewpoints. There are so many things we’re not talking about in students’ lives, and if they are relating in a piece of literature, then that is fantastic. I’m willing to push boundaries more so than a lot of librarians.”

ROOM FOR DISCUSSION?

Spokane-based juvenile fiction author Chris Crutcher, whose novels deal with themes of abuse, neglect and unexpected

Spokane author Chris Crutcher has had nearly all his books challenged as inappropriate for school libraries in various parts of the nation.

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heroism, says it’s not a sense of rejection or loss of income that hurts when his books are removed from schools. It’s the loss of conversation. “You’re not censoring the book … what you’re doing is stopping discussion about that book in the place where you’d think we’d want to have discussion, which is school,” he says. Since 1995, nearly every one of Crutcher’s 13 novels has been challenged. A few have been removed. According to his website, in 2009 a teacher in Kentucky

was fired over having his book, Deadline, in her curriculum. (The district superintendent was the one of the complainants.) “I’m so used to the struggle that I don’t have a lot of personal feeling when one of my books gets challenged,” he says. “The one thing you do know as an author is that if your books are getting challenged or5.0 h banned, that you have a significant following. Otherwise your books would never blip the censors’ radar.” Although “reconsideration” may sound more thoughtful or diplomatic than “censorship,” Crutcher, Sherwood and the ALA believe there’s no distinction. “When you decide to either not put a book on the shelf or remove it, it’s the same thing,” Sherwood says. “The library is supposed to be a place where children’s worlds are expanded. When a book is pulled, it fundamentally makes their world narrower.” 

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LIVING

Duane Sunwold is an instructor at the Inland Northwest Culinary Academy at SCC, where he helps new chefs learn to boost flavor without salt. STEPHEN SCHLANGE PHOTO BOOMERS

Hold the Salt A new effort is underway to cut sodium consumption in Spokane, and it may be especially important for seniors BY HEIDI GROOVER

t’s easy to do. In that lunch-hour stop at a local sandwich shop, you may have accounted for a major portion of your daily sodium allowance. Natalie Tauzin, a registered dietitian at the Spokane Regional Health District, breaks it down: 300 milligrams of salt in the bread, 600 for turkey, 300 for cheese,

100 in a dollop of mustard. Add a pickle for another 250 and chips for 200 more. “You’re leaving that meal with 1,600 milligrams of sodium and you thought you made a really healthy choice,” Tauzin says. And that’s just lunch. With hypertension affecting more than 30 percent of adults in the United States,

sodium reduction is becoming a major front in the fight to improve Americans’ health. Simply put, sodium makes the heart work harder, leaving it more susceptible to things like heart disease and stroke and contributing to high blood pressure, also called hypertension. (“Salt” and “sodium” often are used interchangeably because much of our sodium consumption comes from salt, though not all salts contain sodium.) So while exact sodium intake limits can be controversial, it’s well accepted that reduction would be helpful for many adults. The current recommended maximum daily intake for adults is 2,300 milligrams, but half of the U.S. population should actually be limiting themselves to 1,500 milligrams per day, according to the Centers for Disease Control. The lower intake is recommended for those who are

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RECIPE 51 or older, African American or have high blood pressure, diabetes or chronic kidney disease. By CDC estimates, 90 percent of Americans are eating too much salt. In our region, federal grant funding is allowing the Spokane Regional Health District to work with local restaurants to cut down on the salt they’re selling, with hopes of making customers across the region healthier. Currently, the focus is on pizza restaurants, whether “in name or primary focus,” says Tauzin, who’s leading the project. Nearly all the ingredients on your favorite pizza may be high-sodium culprits: the dough, the sauce, the cheese, the meat. Tauzin and others working on the grant are starting with the sauce, often made from juicy canned tomatoes that may also be bathed in extra salt to keep them plump. They’re analyzing the nutritional characteristics of the menu items at four local pizza restaurants and other groups, like Providence and Gonzaga’s dining service. A chef will then work with kitchen staff to help cut salt without losing flavor. The group also is working with local food distributors, encouraging them to carry lower-sodium prepared foods like salad dressings or those tomatoes used for pizza sauces. “A lot of times [the label] ‘healthy’ is met with reservation, like, ‘What do you mean? Is there any flavor?” Tauzin says. But the flavor of lower sodium recipes may actually be just as appealing if customers don’t overthink it. A survey by the National Cancer Institute, a division of the National Institutes of Health, offered participants seven different dishes, each in an original version and a reduced-sodium version, without telling them which was which. For all but one dish — a salad with the feta cheese removed to cut salt — participants said they were as likely or even more likely to buy the reduced-sodium option as the original one.

alt reduction may not really need to be a specialized effort, but just part of the healthy, balanced diet toward which we should all be striving. Cutting down on processed foods and focusing on getting potassium-rich whole fruits and vegetables into meals is key (potassium helps offset the effects of salt, according to the American Heart Association). That can be especially difficult for people as they age, say food providers at local retirement communities. “Quality of life is a big aspect, at least for the senior population,” says April Ross, a registered diet technician at Rockwood Retirement Communities. Sodium reduction has to be balanced with caution against imposing too many dietary restrictions that can discourage people from eating enough to get their required nutrients, Ross says. That can be especially important among seniors, who may already struggle to eat enough because of reduced appetites or social factors. “A lot of these folks are alone. They’re eating alone, shopping alone, cooking alone,” says Sue Nott, director of food and nutrition services at Touchmark Retirement Community. “That can really affect somebody’s appetite, so it does become more challenging.” Ross and Nott both say moderation is key. It’s not practical to ask people to give up all the food they like, even if those things are sources of excess fat and salt. Instead, they encourage people to eat some nutritionally dense foods — things like berries, greens or eggs — before filling up on less healthy options. “What it boils down to is eating a variety of foods,” Nott says. “I would never deny them ice cream or bacon or the things they want. I just try to encourage them: ‘Have some fruit with that’ or ‘Look at this beautiful salad we have today.’” n

Herb Lemon Chicken Makes 12 3 oz. servings For cooking at home, Duane Sunwold suggests looking for salt-free spice blends and using acids like fruit vinegars and lemon or pineapple juice to help flavor meals. Here, he shares a salt-free herb blend and a technique for using it to prepare chicken.

Herb Blend for Chicken

1 tablespoon ground thyme 1 tablespoon dried basil 1 tablespoon dried rosemary 1 tablespoon dried sage 1½ teaspoons dry mustard 1 tablespoon chopped fresh parsley

Herb Lemon Chicken

4 pound whole chicken 1 recipe of Herb Blend for Chicken 10 to 15 parsley stems 2 whole lemons, juiced; save the lemons

Remove the neck and giblets from chicken, rinse the chicken and pat dry. Sprinkle half of the spice blend into the cavity of the chicken; also put the parsley stems and whole lemons inside the chicken. Pour lemon juice over the chicken and sprinkle with the rest of the herb blend. Roast the chicken in a preheated, 350-degree oven for 1 to 1½ hours or until the chicken reaches an internal temperature of 165 degrees; remove from the oven, cover with foil and let rest for 10 minutes before serving.

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LIVING AUG. - SEPT. EVENTS 2014 FREE STATE PARK DAYS Washington State Parks and Rec allows visitors access to all state parks without needing a Discovery Pass. Includes access to Riverside State Park and Mt. Spokane State Park. “Free” days include Aug. 25, Sept. 27 and Nov. 11. parks.wa.gov 8 LAKES LEG ACHES The 16th annual bike ride heads through West Spokane, Cheney and Medical Lake, offering 15-, 30-, 45-, or 75-mile routes, with the longest route passing eight area lakes. Proceeds benefit the Sexual Assault Family Trauma Response Center of Lutheran Community Services. Sat, Aug. 2. $45-$300. Starts at Group Health, 5615 Sunset Hwy. lcsnw.org (343-5020) LILAC CITY CHARITY KICKBALL TOURNAMENT A kickball tournament hosted by Dan Dickau, benefiting local charities in the area. Open to co-ed teams of 10-15 players/team; offering competitive and friendly divisions. Event also includes a beer garden, food vendors and raffle. Sat, Aug. 2, starting at 9 am. $350/team. Franklin Park, 302 W. Queen Ave. idolsports.com (480-635-8720) MIDNIGHT CENTURY An annual, informal and unsupported 100-mile nighttime bicycle ride on dirt roads through rural areas around town. Sat, Aug. 2, at 11:59 pm. Free. Starts at the Elk Public House. midnightcentury.com LONG BRIDGE SWIM Swim 1.76 miles across Lake Pend Oreille in Sandpoint in the 20th annual open-water event which helps fund swimming lessons for local children and adults. Sat, Aug. 2, at 9 am. $20-$30. Downtown Sandpoint, Idaho. longbridgeswim.org

THE COLOR RUN The 5K, untimed race douses runners in eco-friendly paint and includes an after-run “Finish Festival.” Sun, Aug. 3, at 8 am. $40-$45/individual, or $35-$40/person in a team of 4+ runners. Downtown Spokane. thecolorrun.com/spokane PITCH FOR THE CURE The 8th annual event hosted by the Spokane Indians includes a 1-mile walk around the stadium and a pregame ceremony. Proceeds benefit the Eastern Washington affiliate of Susan G. Komen. Sun, Aug. 3, at 3 pm. $15/kids, $25/adults. Avista Stadium, 602 N. Havana St. komeneasternwashington.org (343-6811) COEUR D’ALENE TRIATHLON The 31st annual scenic triathlon, duathlon, or sprint-distance triathlon through Coeur d’Alene and along the Spokane River. Sat, Aug. 9, starting at 7 am. $50-$90. Downtown Coeur d’Alene. cdatriathlon.com (877-782-9232) PADDLE, SPLASH & PLAY Children can paddle kayaks, canoes and stand up paddle boards in a safe, supervised setting, with all equipment provided by the Spokane Canoe & Kayak Club. Sat, Aug. 9, from 10 am-2 pm. Free; Discover Pass required. Riverside State Park, Nine Mile Recreation Area, 11226 W. Charles Rd. (951-2871) SPOKANE TO SANDPOINT RELAY The 7th annual overnight team relay starts at the top of Mt. Spokane and ends at the beach in Sandpoint after 200 miles. Proceeds benefit local nonprofits. Open to teams of up to 12 runners. Aug. 15-16. $420/high school team, $840-$1440/ adult runner team. spokanetosandpoint.com STRIDE FOR STRONG BONES The fourth annual osteoporosis awareness 5K walk/run also features a

raffle, bone screenings and educational information and presentations. Sat, Aug. 16, at 9 am. $15-$25. Waterfront Park, Medical Lake. wastrongbones.org (953-9924) WEST PLAINS WUNDERWOMAN TRIATHLON The women-only event includes sprint and Olympic distance courses, and raises awareness for women’s osteoporosis. Also includes free bone-density screenings. Sun, Aug. 17. Olympic triathlon starts at 7:30 am, sprint distance at 8:15 am. $90-$100/individual, $145-$155/team. Waterfront Park, Medical Lake. emdesports.com (953-9924) LUNCH & LEARN: ALL ABOUT FOOD Lunchtime presentation covering food and nutrition, including organic vs. non-organic foods, what to eat for more energy and sustained health and more. Thu, Aug. 21 from noon-1 pm. Free; attendees should bring their own lunches. INHS Wellness Center, 501 N. Riverpoint Blvd., Ste. 245. wellness.inhs.org SPOKANE RIVER CLASSIC A casual or competitive event offering a 1.3-mile and 5.4-mile course with buoys, open to kayaks, canoes and stand-up paddle boards. Event followed by root beer, food trucks and a beer garden. Sat, Aug. 23, from 7:30 am-1:30 pm. $20. Put in at the McKinstry building’s river access point, 850 E. Spokane Falls Blvd. sckc.ws/src CHILDHOOD CANCER AWARENESS WALK The fifth annual 3-mile walk in Medical Lake includes a barbecue and live entertainment, and is hosted by the Clayton Schneider Foundation. Sat, Aug. 23, at 10 am. Free, registration required. $15 T-shirts available. Medical Lake, Waterfront Park. facebook.com/theclaytonschneiderfoundation. …Events continue on page 42

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here is a simple goal behind the Happy Girls Run series: get active and start smiling. This September, for the first time, the race will bring that message to the trails of Riverside State Park. Produced by Lay It Out Events, based in Bend, Oregon, the Happy Girls Run series began there in 2011. The races, also held in Sisters, Oregon, and Portland this year, are designed to appeal to seasoned and first-time runners alike. Although guys are welcome to participate, the awards portion of the race is for females only. Men can, however, sign up as pacers, encouraging runners along the way. The goal? Simply to provide an inspiring, joyful experience for all the participants. And it seems organizers have a pretty good idea of how to make a girl smile. Extensive goody bags come with registration for the half-marathon ($85),

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LIVING AUG. - SEPT. EVENTS

KIDICAL MASS BIKE RIDE Participate in a 3-mile family ride on anything with wheels that rolls, hosted by Spokane’s Summer Parkways, and that highlights safe riding practices on the road. Thur, Sept. 11, from 5:30-6:30 pm. Free. South Perry Neighborhood; Starts at Two Wheel Transit, 817 S. Perry St. summerparkways.com

PRIEST LAKE TRIATHLON Participate as a team or individually in an Olympic- or sprint-distance triathlon. Sat, Aug. 23, starting at 8 am. $65-$210. Hill’s Resort, Priest Lake, Idaho. priestlakerace.com 08-946-9543

SPOKANE HEART & STROKE WALK A walk/run benefiting the local chapter of the American Heart Association. The 5K walk is non-competitive; the 5K run is chipped/timed and is now a second seed qualifier for Bloomsday 2015. Sat, Sept. 13, at 9 am. Riverfront Park spokaneheartwalk. org (536-1500)

MILLWOOD DAZE The 6th annual community celebration includes a 5K run/walk (9 am) benefiting Meals on Wheels Spokane, as well as a farmers market, food, entertainment and entertainment. Sun, Aug. 24, from 8 am-3 pm. $20$30. Downtown Millwood. mowspokane.org (232-0864)

BIKE MS A two-day, bike 55-150 mile ride through the Silver Valley to benefit the National MS Society. Sept 1314. $65/registration with a $200 fundraising min. Start/ finish at Silver Mountain Resort, Kellogg. bikems.org

WOMEN’S WEEKEND 2014 A three-day retreat offering relaxation, adventure and fun with catered meals and activities, an annual Girl Scout fundraising event. Sept. 5-7. $225/person. Camp Four Echoes, 22270 S. Four Echoes Rd., Worley. gsewni.org (747-8091 x. 204)

MARCH FOR THE FALLEN A run/walk/march with competitive and non-competitive divisions to honor all of Washington’s fallen military members. Sat, Sept. 13, at 8 am. $20-$30. Riverside State Park, Seven Mile Airstrip area. marchforthefallen.com (370-0597)

NEWPORT BIAYAKATHON The 3rd annual cycling and kayak race benefits local substance abuse awareness program the Pend Oreille Youth Task Force, and features a 6-mile bike ride and 2-mile paddle. Sat, Sept. 6, at 9 am. $20. Newport City Park. biayakathon.weebly.com

PROVIDENCE ICE CREAM SOCIAL Holy Family Hospital celebrates its 50th Anniversary this year, and hosts a community celebration with Ben & Jerry’s ice cream, snacks, tours and family activities. Sat, Sept. 20. Free. Holy Family Hospital. providence.org (474-2397)

SPOKEFEST The 7th annual community cycling festival includes a 1- to 2-mile family ride, a 9-mile Spokane Falls loop, a 21-mile river loop, or the 50-mile Four Mounds Half Century loop. Sun, Sept. 7 starting at 8 am. $8-$20. spokefest.org

SCENIC HALF Event includes a half marathon, 10K and 5K distances, with proceeds benefiting the Greater Sandpoint Chamber and the Community Cancer Services local nonprofit. Sun, Sept. 21, starting at 8:30 am. $20$72. Starts/ends at Sandpoint City Beach. scenichalf.com

COBRA POLO CLASSIC The 10th annual charity polo match benefits the Ronald McDonald House Charities of Spokane. Sun, Sept. 7, from 12-4 pm. $200/person. Spokane Polo Club, 7500 U.S. Hwy. 2. rmhcspokane.org

RACE FOR THE CURE CdA A 1-mile, 5K or 10K run/walk to promote breast cancer awareness and raise funds for local breast-health programs. Sun, Sept. 21, at 9 am. $10-$55. Starts/ends at North Idaho College, 1000 W. Garden Ave, CdA. komenidaho.org (208-384-0013) DIABETES WALK A 3-mile walk to benefit the juvenile Diabetes Foundation, which supports type 1 diabetes research. Sun, Sept. 21, at 10 am. Riverfront Park, 507 N. Howard St. jdrfnorthwest.org (578-0033) CARING FOR KIDS LUNCHEON The annual event features a presentation by keynote speaker Nada Stockton, athlete mother and wife to basketball great John Stockton. Proceeds benefit the St. Anne’s Children & Family Center and Morning Star Boys’ Ranch. Thur, Sept. 25, at 11:30 am. $50+. Doubletree Hotel, 322 N. Spokane Falls Ct. catholiccharitiesspokane.org (358-4250) AIDS WALK The annual fundraiser walk benefits local HIV/ AIDS care services and prevention education programs. Sat, Sept. 27. Riverfront Park, 507 N. Howard. san-nw.org (455-8993) WILD MOOSE CHASE TRAIL RUN Eastern Washington University’s Doctor of Physical Therapy Class of 2016 hosts the 4th race, offering three distances (5, 10 and 25K), with proceeds helping send students to the annual Combined Sections Meeting (CSM) in Indianapolis. Sat, Sept. 27, at 8 am. $10-$35. Starts/ends at the Selkirk Lodge on Mt. Spokane. wildmoosechasetrailrun.com (907-317-1215) DUCK RACE The El Katif Shrine hosts event this annual event to benefit the Shriner’s Hospitals for Children Spokane. Sun, Sept. 28. $5/duck. Riverfront Park, 507 N. Howard St. elkatif.org (624-2762) n

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LIVING

PEOPLE

P4P founders Sandy Ivers and Stacey Mainer (above right) work to better the lives of women and children in Kopanga, Kenya.

Responding to Need Area residents travel to rural Kenya as part of an effort to improve education, health care and nutrition BY CHEY SCOTT

o much has changed in the tiny, remote village of Kopanga, Kenya, in the past eight years. There are more sources of clean water than ever before. There’s a new health clinic. Malnutrition in infants and children is declining. The village residents aren’t sick as often from drinking dirty water, eating bacteria-tainted food or other poor hygiene habits. Teen pregnancy rates are dropping. And thanks to scholarships, 11 students have been able to stay in school

instead of dropping out because they don’t have or know of any other options. All of this progress has been the ongoing work of Spokane-based humanitarian nonprofit Partnering for Progress, or P4P. Since its co-founders Sandy Ivers and Stacey Mainer took their first volunteer medical trip in June 2007 to the poverty-stricken region of southwestern Kenya, P4P has been actively working to improve basic living conditions there with the underlying goal of ending the

cycle of poverty. Since that first visit, Partnering for Progress has continued to organize at least two trips a year, with more than 80 volunteers from the greater Inland Northwest traveling to Kopanga to volunteer their expertise in health care, education and other areas. The next visit is scheduled for November. Helen Biggs, a retired teacher and P4P member, has traveled with the organization (all members travel at their own expense) a half-dozen times. More memorable than the physical changes in the village each time she has traveled, though, are the people. “The last time I was there, I was without Stacey and Sandy and had never traveled without them,” Biggs recalls. “I walked in [to the school], and everyone knew who I was... it’s a sense of community above and beyond.” As the group readies the November journey’s agenda, its members can reflect on all that’s been accomplished so far. Partnering for Progress’ work is guided by the philosophy of giving a hand up, not a

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Do what makes you smile! hand out, to ensure that all of its projects become self-sustaining when left as the responsibility of the Kopanga community. So far, that hasn’t been a problem, and the residents have been tremendously responsive and eager to learn from their American supporters. “We want to help them achieve what they want, not tell them what they need and then give it to them,” Biggs says. The first project, and one of the biggest, was planning the construction of a clinic to replace a primitive, overwhelmed rural facility — where babies were delivered on the floor — that served up to a thousand people a month, many for preventable conditions. The new Comprehensive Rural Health Clinic building was completed back in 2009, but P4P continues to support it by helping buy pharmaceuticals, training medical workers and volunteers, and educating local residents about preventing the spread of disease. A newer program is finding funding for scholarships to send high-achieving, motivated students to Kenyan high schools. For many students, high school is costprohibitive because of required uniforms, books and boarding fees. Currently the nonprofit is supporting for 11 Kopangan students, totaling $5,500 per year, executive director Dia Maurer says. “It changes lives,” she comments. “It’s directly impacting their health and their children and the community’s health.” The group, with an annual budget of $90,000, all from donations and fundraisers, has also started an infant nutrition program called the Power of Milk to help babies identified as being at risk for malnutrition. The infants and their caregivers attend a free weekly class that teaches cooking skills and provides a cup of milk to each baby. “There are several instances where a caregiver is a grandmother or someone else because the [baby’s] parents are gone,” Maurer explains, adding that the level of malnutrition is so severe in some cases, they’ve seen 3-year-olds weighing less than 20 pounds. Though she has yet to travel to Kopanga, Maurer says that really doesn’t matter. “I think everyone engaged has a passion for the planet and all peoples,” she says. “We come with different motivations, but I think everyone involved sees Kenyans as brothers and sisters … it’s an honor to be able to serve these people.” n

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