Inhealth 8/3/2015

Elson Floyd’s Parting Gift 9 | Perils of Vaping

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| Understanding ADHD

Health

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SPOKANE • EASTERN WASHINGTON • NORTH IDAHO also at inlander.com/inhealth 1227 W. Summit Parkway, Spokane, Wash. 99201 phone: 509-325-0634

editor Anne McGregor

annem@inlander.com

managing editor Jacob H. Fries a r t DIRE C TOR Chris Bovey calendar editor Chey Scott photographer Young Kwak copy editor Michael Mahoney contributors Chelsea Bannach, Carla Brannan, Katy Burge, Jennifer DeBarros, E.J. Iannelli, Laura Johnson, Meghan Kirk, Linda Hagen Miller, Ben Montgomery, Matthew Salzano, Carrie Scozzaro, John R. White, Daniel Walters production manager Wayne Hunt a d v e r t i s i n g SALES MANAGER Kristi Gotzian director of marketing Kristina Elverum advertising sales Autumn Adrian, Bonnie Amstutz, Bruce Deming, Gail Golden, Janet Pier, Carolyn Padgham-Walker, Wanda Tashoff, Emily Walden Sales coordination Gilbert Sandoval, Denise Brewer, Brynn Schauer design and production Tom Stover, Derrick King, Alissia Blackwood Mead, Jessie Spaccia DISTRIBUTION MANAGER Justin Hynes 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: x215. copyright All contents copyrighted © Inland Publications, Inc. 2015. InHealth is locally owned and has been published every other month since 2004.

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

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FROM THE EDITOR

collaboration innovation collaboration drives innovative health care

At INHS collaboration drives everything we do.

Anne McGregor is the editor of InHealth.

Email her at annem@inlander.com.

Through innovative health care technology, health education and patient care, more than 1,000 INHS employees are creating tomorrow’s health care today.

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Unplug and Play

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have to admit a particular fondness for the topic of our cover story—play. In an era when self-worth is often equated with how packed our calendars are, giving in to experiences that may not really accomplish anything can seem rather worthless. But research suggests otherwise. Taking time for play helps energize you, relieve stress, and boost creativity. It offers the opportunity to deepen relationships, and even keeps your mind youthful. Finding a definition of play is surprisingly difficult, but basically the activity needs to be one you choose to do, alone or with others, which in some way is mentally removed from real or serious life, according to play expert Peter Gray. You have to active and alert — napping doesn’t count —but not stressed.

Cultivating aimlessness is now drawing the attention of entrepreneurs. Adult coloring books have zoomed to top seller status on Amazon. There are summer camps for adults, and in NYC, one forward-thinking business offers adults the opportunity, for a hefty fee, to relive preschool—fingerpainting is a top activity. But there’s no need to spend a lot of money or regress to being a 4 year old to enjoy some play time. Here are the criteria for choosing an activity: it has to be fun, it can’t fulfill an obligation, and it shouldn’t involve a screen of any kind. Now go explore.

To your health!

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check-in REMEMBRANCE

Bittersweet Victory

“T

here is no good reason to wait,” WSU President Elson Floyd told the Inlander in September of last year, outlining his plans to bring a new medical school to Eastern Washington. “We’ve been waiting for over 100 years. It’s now time to act.”

It seems there was even more behind Floyd’s impatience, as on June 5 he announced he was fighting cancer and would be taking a medical leave; on June 20, he passed away at age 59.

Floyd’s final months were a whirlwind, the effects of which will be felt for generations in Spokane and Eastern Washington. Just days after Floyd’s death, the Washington Legislature allocated $2.5 million to the start-up of a new medical school at WSU Spokane. Meanwhile, the University of Washington’s WWAMI program, also based in Spokane, was fully funded with $9 million.

“We feel extremely blessed and fortunate to come out where we have,” says interim WSU President Dan Bernardo. “It was a curvy road for sure, and for the last month we had to navigate that without Elson steering.”

“There was no better diplomat for higher education than Elson Floyd,” adds Sen. Michael Baumgartner (R-Spokane), who worked with Floyd to make the new med school possible. “This is a rare case where we can say a major project that will do great good for the state was accomplished in large part because of the vision of a single man.

WSU President Elson Floyd passed away June 20 — just days before his dreams of a WSU medical school became real. young kwak photo Elson Floyd saw it through, right to the end.”

Now the team at WSU’s Health Sciences of Spokane is getting started by applying for med school accreditation, looking to hire a dean for the new school and launching an ambitious $100 million fundraising campaign. There’s one bit of

PILL BOX

Accept No Substitutes My son takes extended-release methylphenidate once daily for his ADHD. I recently heard that there were concerns about this medication when the generic is used. Should I be worried?

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

stay connected Email InHealth Editor Anne McGregor at annem@inlander.com. The conversation continues on the Inlander Facebook page, and stay in touch with us at Inlander.com/InHealth.

Y

es. In November 2014, the FDA issued a warning about generic extended-release methylphenidate. When methylphenidate (initial brand name Ritalin) was first used, it needed to be administered three times daily because its effects wore off quickly. To circumvent this, a very effective extended release formula was developed — Concerta, by Janssen Pharmaceuticals, which allowed patients to take the medication once daily. This was an advance, as it allowed, for example, students to go to school all day without having to take medication while

business that’s been taken care of: the name of the new school. By act of the legislature and the WSU Board of Regents, the new school on Spokane’s Riverpoint Campus will be called the Elson S. Floyd School of Medicine.

— Ted S. McGregor Jr.

at school. Eventually, generic and cheaper versions of this extended-release methylphenidate medication were approved and marketed. Later, the FDA began to receive reports of problems, and upon analyzing the medications determined that two of the generic brands (manufactured

by Mallinckrodt Pharmaceuticals and Kudco Ireland Limited) may deliver the medication to the body at a slower rate, seven to 12 hours after it is taken. One generic brand also manufactured

by Janssen, but marketed by a company called Actavis, was found not to have problems. At this point, the FDA has changed the ratings for the Mallinckrodt and Kudco brand generics, and they should no longer be substituted for Concerta. If your son is being treated with extended-release methylphenidate, he should be receiving either Concerta or the generic from Actavis. Talk to your pharmacist about this if you are unsure. They will see that you get an appropriate, effective brand.

— John R. White

AUGUST-SEPTEMBER, 2015 CHECK-IN inhealth 8-3-2015.indd 9

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check-in LIFE COACHING

Learning for Grown-Ups

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Carla Brannan is a certified professional life coach in Spokane.

hat do you remember about riding your bicycle for the first time? Chances are, while the idea may have been very exciting, there was also a little apprehension or perhaps sheer terror, too. This rite of passage surely included numerous failed attempts before and after your backside plopped into the banana seat for the first time. But eventually, with encouragement and tons of practice, most of us learned to ride quite well.

I’m surprised how often I hear a version of: “I tried to ____ (golf, knit, sing, rock climb, change careers, play pinochle, learn Spanish, run a 10K, meditate, etc…) and I can’t do it. I went to the first class and I’m not good at it.”

Now that we’re grown up, we seem to think we should know

how to do everything with little or no training and/or practice.

We are uncomfortable, and therefore often unwilling, to let ourselves be beginners. How often do we quit before giving our new student selves a fair shake?

When we quit grown-up school because our expectations of ourselves are unreasonable, how are we cheating ourselves? After all, we only need to get up one more time than we fall down.

Life can be full of wonderful adventures when we give ourselves the patience, persistence and kindness we so easily give others.

Samuel Beckett, the 20th-century Irish playwright, said: “Ever tried. Ever failed. No matter. Try again. Fail again. Fail better.” Shall we move forward with this in mind, remembering that no one sits down and simply knits a sweater? And that when we practice, one stitch at a time, we’ll likely end up wearing our new handmade cardigan to keep us comfy — perhaps on a bike ride this fall.

— CARLA BRANNAN

GOOD READ

Healing Our Pets

W

ith all the human interest in complementary and alternative medicine, it was only a matter of time before people wondered if animals might benefit from these same treatments. Spokane veterinarian Dennis Thomas says he practiced traditional Western medicine for 30 years but became frustrated by “so many dead ends, so many limited opportunities.” He was drawn to exploring the deep, but intangible, connection between people and their pets. That, and a desire to have “more tools in my box,” led him to become certified in veterinary acupuncture and Chinese herbal therapy, and eventually to approach animal care with an eye toward energy levels. While his ideas on the intersection of biology and quantum physics are undeniably avant-garde, his book Whole-Pet Healing offers alternatives for pets who just haven’t been helped by traditional methods.

His chapter on “Letting Go” may prove especially comforting.

— ANNE McGREGOR Dennis Thomas will share his new book, Whole-Pet Healing, at Auntie’s on Saturday, Aug. 15 at 7 pm.

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Sparking Neighborhood Success

“A

ccess to resources is often dictated by a person’s zip code,” says Valerie Nafé. That’s about to change for kids and adults in Spokane’s West Central neighborhood, one of the region’s lowestincome zip codes, through an innovative program called the Spark Center.

“Amazing things happen when barriers to education and technology are removed, and when people have access to living resources such as tutors,” says Nafé, Spark’s executive director.

The Spark Center will in some ways be like a traditional library, offering a broad array of books for check-out, many donated by West Central resident and author Jess Walter. There will also be plenty of opportunities for hands-on learning, including a high-tech Maker’s Lab and 3-D printer for public use, as well as a fleet of the latest Mac computers equipped for those who want to work on digital arts, video or sound editing.

But the biggest resource may be something totally revolutionary.

“Through the Human Library, we help people identify their expertise, (their) passions and skill set — and raise it to the surface, then turn it out for the benefit of the community,” explains Nafé. “Our living resources volunteers

Executive Director Valerie Nafé (left) and Program Director Brooke Matson are coordinating innovative activities at Spark Center. MEGHAN KIRK PHOTO will be entered into the library system as living books. This concept is a reworking of volunteerism, the way to equalize and acknowledge that we all have needs, to eliminate notions of haves and have-nots.”

Additionally, the double-front space in Kendall Yards will provide a new home for the relatively new INK artspace, which features arts, music and writing programs.

Throughout the summer, interns have generated social media about the center, set to open in mid-August, but the lack of internet access in the West Central neighborhood led to an old-fashioned door-to-door campaign to get the word out.

For Nafé, the center has become something of a mission. “A disadvantaged kid by all definitions, my life was molded by those few who provided access to opportunities,” she says.

— ANNE McGREGOR Spark Center is located at 1214 W. Summit Parkway. Find out more at sparkwestcentral.org

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CHECK-IN SUPERFOOD

Josh Meckel

Festival of All Things Green

L

iving a life without meat seems impossible to some, but for people like Josh Meckel, it’s a no-brainer. Co-founder of the Inland Northwest Vegans (INVEG), Meckel has spent 22 years as a vegetarian, the past two-and-a-half years on a plant-based diet. Meckel prefers the term “plant-based” to “vegan” because he says “it is less aggressive.” At this year’s Spokane Vegfest, plantbased foods are exactly what you’ll find.

“The event is 100 percent plant-based,” Meckel says. “All the food, all the products, and even the beer is 100 percent plant-based.”

Last year, INVEG’s first annual Spokane Vegfest drew a crowd of more than 1,100 and featured 45 vendors. They’re upping the ante this year by making room for more than 100 vendors, including renowned chefs from all over the country, food trucks and healthy living exhibitors.

Complete with cooking demonstrations and an outdoor farmers market, you’re guaranteed to not leave hungry. Meckel says you don’t have to be vegetarian or vegan to come and enjoy the food.

“Omnivores are the most common [attendees].

About 50 to 60 percent — probably even higher

than that — aren’t vegetarian or plant-based,” says Meckel. An outdoor stage will feature live bands, yoga and massage. Key speakers include Jasmin Singer and Mariann Sullivan of Our Hen House.

For Meckel, Spokane Vegfest is bigger than just an event. “Our goal is just to show how to do things in a more compassionate way to our animals, environment and our bodies,” Meckel said. He also wants people to not be afraid to ask how to do that.

“I want to give people a safe place to learn about plant-based living,” Meckel said. “I won’t preach. I’ll be there to answer questions if people have questions — I love answering questions.”

— KATY BURGE Spokane Vegfest • Sat, Aug. 8, from 10 am-6 pm • Free • Spokane Community College • 1810 N. Greene St. • inveg.org/vegfest.html

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brain exercise

3

Sudoku

RatingS: Gentle (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.

8 9

Answers to all puzzles on page 40

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9 2 7 1 3

1

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2 1

puzzles by jeff widderich & andrew stuart www.syndicatedpuzzles.com

3 6 8

7 2

6 1

9 5 4

Codewords

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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 25.

16 21

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2 1 9 4 8 5 6 7 1 5 7 8 8 3 6 9 1 7 7 9 5 6 7 6 4 3

Str8ts

Rating: Moderate Like Sudoku, no single number can repeat in any row or column. But rows and columns are divided by black squares into compartments.

These need to be filled in with numbers that complete a ‘straight’ — a set of numbers with no gaps but can be in any order. Clues in black cells remove that number as an option in that row and column, and are not part of any straight. Glance at the solution above to see how ‘straights’ are formed.

7 8 9 7 3 3 6 7 5

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6 4 3

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NEWS E-cigs simulate smoking by turning liquids — often with flavorings and nicotine — into an aerosol, or vapor.

ADDICTION

THE NEW FIX Are e-cigarettes harming kids more than they’re helping adults?

BY DANIEL WALTERS

W

hen electronic cigarettes burst onto the scene a few years ago, they did so with an implicit promise: Finally, an effective way to quit smoking. (For legal reasons, of course, this promise had to remain implicit.) With the possibility of getting the kick of nicotine without risking the carcinogenic side effects, the business of “vaping” is on fire.

One Wells Fargo analyst predicted that by the end of 2015, the vaporizer market will have grown to $3.5 billion, a 40 percent leap in a single year.

There’s one particular market that’s growing especially quickly: A market where e-cigs are mostly illegal. In a single year — 2013 to 2014 — e-cigarette use tripled among middle and high school students, the Centers for Disease Control and Prevention found. More kids, these days, are vaping than smoking. ...continued on next page

Health 15 NEWS-MAIN inhealth 8-3-2015.indd 15

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NEWS

“We saw cigarette kids immediately become e-cig kids,” says Phil High-Edward, assistant principal at Spokane’s Shadle Park High School. During the 2014-15 school year, he confiscated numerous vaporizers, including some homemade ones (inset). YOUNG KWAK PHOTOS

“THE NEW FIX,” CONTINUED...

Phil High-Edward, assistant principal at Shadle Park High School, doesn’t doubt that at all. He’s seen it unfold before his eyes. “We saw the cigarette kids immediately become e-cig kids,” High-Edward says.

He caught more than two dozen kids with e-cigarettes during the past school year, but only a handful of kids with traditional cigarettes.

One of the devices’ big selling points — the lack of intense odor — has become

9 • 12 • 15 St. John, WA

a huge problem for administrators. They used to literally be able to sniff out cigarette smokers. The evidence hung in the air in an actual cloud. That’s not the case anymore.

“The old adage of ‘smoking in the boys room’ has turned to ‘smoking in the hallway’ and ‘smoking in the classroom,’” High-Edward says. A teacher will turn around to write something on a whiteboard, and a kid will pull out his e-cig, take a puff, and hide it before the teacher turns back.

An entire subculture has emerged, complete with inventors and entrepreneurs. High-Edward pulls out one jury-rigged e-cig device that appears to be largely homemade. He says several Shadle students offered repair services for vaping devices, charging peers $5 to $10 for their work.

While the CDC found that cigarette use has declined among high school students overall, the recent steep decline started before the introduction of ecigarettes. The explosion of hookah and

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e-cig use has overwhelmed the decrease in conventional cigarettes.

Among middle-schoolers, there hasn’t been a recent decrease in cigarette use — meanwhile, hookah use nearly doubled and e-cigarette use more than tripled. “Kids

claiming not to. Sometimes, administrators say, kids steal the e-cigs from their parents or older siblings. Other times, parents give them e-cigs intentionally, thinking they’re better than smoking. High-Edward doesn’t buy that argument.

“Marketing that we’re seeing for e-cigarettes looks just like tobacco marketing did in the 1950s.” who have never smoked, who probably would never have smoked, are ingesting chemicals into their lungs,” says Wendy Bleecker, director of student services at Spokane Public Schools. “I believe it’s increasing kids’ usage of nicotine.”

Complicating matters further, it’s not always nicotine in the e-cig cartridges. It can also be THC, the active ingredient in marijuana. Administrators can’t always tell which is which without testing the canisters.

Today, it’s illegal to sell such tobacco products, including e-cigs, to minors in Washington state. In 2011, the Spokane Regional Health Department found nearly every area e-cig shop sold to minors, despite

“You just trade addictions,” he says.

“There’s still a monkey on your back. Still something you feel you need to have to function.”

Selling smoke

The television advertisement is shot entirely in soft black and white, but for the blue of the Blu e-cig device and logo. Blade actor Stephen Dorff, with a rugged goatee and a casual suit jacket, stands on a beach, waves roaring in the background.

“I’m tired of being a walking ashtray,” he says. “I’m Stephen Dorff. I’ve been a smoker for 20 years, and I just found the smarter alternative. Blu e-cigs. Blu lets me ...continued on next page

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news “the new fix,” continued... enjoy smoking without affecting the people around me. Because it’s vapor, not tobacco smoke.” No ash, he says. No offensive odor.

You can smoke “virtually anywhere.”

He pauses, takes a long puff of the ecig, the end glowing blue against the black and white. Smoke — or vapor, technically — rolls out of his mouth, billowing toward the camera.

“We’re all adults here,” Dorff says. “It’s time we take our freedom back.”

The tiny disclaimer at the bottom of the screen says NOT FOR SALE TO MINORS. But minors are still persuaded.

After all, the ad says, here’s how you can look like an adult, without any of the negative consequences.

That ad and three others were part of a study published in the American Journal of Preventive Medicine, showing that the likelihood of future use increased 50 percent among adolescents who saw the ads versus a control group. Another 2014 study showed that youth exposure to e-cig ads more than doubled between 2011 to 2014.

Much of the marketing, CDC Director Tom Frieden said in a press briefing in

“I’ve been smoking for 20 years, and I just found the smarter alternative,” says Blade actor Stephen Dorff in an ad for Blu e-cigs.

April, seems reminiscent of Don Draper pitching Lucky Strike ads on Mad Men. “Marketing that we’re seeing for ecigarettes looks just like tobacco marketing did in the 1950s,” Frieden said. “E-cigarette marketing expenditures tripled each year from 2011 to 2013. Marketing is about sex, free samples, flavors, aggressive marketing promotion and distribution.”

While adults often mock e-cigarette use

as dorky or sleazy — consider comedian Rob Delaney’s #ChristianDadsWhoVape Twitter gag — they’ve caught on in high schools. “It’s the next fad, the coolest thing,” says Spokane Public Schools’ Bleecker. “Kids who have never smoked before are using them and are getting addicted really quickly.”

In some cases, the products themselves can be the advertisement. Steve Fisk, princi-

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pal of North Central High School, sees the rows and rows of nicotine flavors — “Check out 300+ flavor combos,” the Smart Smoke website raves — as the sort of thing that targets kids. “If you go to a candy aisle, how many fruit flavors do you see? Five or six? Grape, cherry, watermelon, lemon,” Fisk says. “And these things aren’t Jolly Ranchers.”

nicotine is still nicotine

Exactly how dangerous — or how safe — e-cigarettes are remains a huge unanswered question. The notion that they’re safe, or at least safer, is part of what makes them so compelling.

“We have a certain amount of parents that purchase e-cigs for their kids, saying, well, it’s less harmful than a pack of Marlboros,” High-Edwards says. But even without the same stew of carcinogens, nicotine is still nicotine. And for kids, nicotine isn’t just addictive. It can have permanent consequences.

“Smoking cigarettes during adolescence has been associated with lasting cognitive impairments, including memory and attention,” says the CDC’s Frieden. “That’s the impact of the nicotine, not the tobacco. …

Animal studies have compelling additional evidence that nicotine exposure causes both long-term structural and functional changes to the brain.”

Typically, nicotine levels in e-cigs have been lower than traditional cigarettes. But earlier this year, Pax Labs landed $46.7 million in investment. The big secret?

They blast out the nicotine.

“It’s 10 times as much nicotine as other e-cigarettes on the market, which sounds crazy high, but it’s actually what you get per puff from a cigarette,” Pax co-founder Adam Bowen recently told Inc. magazine.

Will e-cigs, for the most part, remain safer than traditional cigarettes? A 2012 literature review by Richard O’Connor, associate professor of oncology at the Roswell Park Cancer Institute, found that the “limited data” suggested that health risks of the devices were unlikely to approach the cancer-causing dangers of cigarettes. Nonetheless, the sheer variety of devices, combined with the lack of quality control, makes drawing conclusions complicated. One recent study, for example, found that e-cig devices could ...continued on next page

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Health 19 7/23/15 10:19 AM

news

Turning 21

R

ight now, like most states in the union, Washington allows 18-year-olds to purchase both electronic and traditional cigarettes.

In Hawaii, it’s different. In June 2015, the governor of Hawaii signed a bill to raise the smoking age to 21. This year, Washington Attorney General Bob Ferguson has been pushing for his state to do the same.

“From my standpoint, trying to prioritize the legislative agenda, I can’t find a greater priority than literally saving lives,” Ferguson tells InHealth. “We said 21 is the age for smoking marijuana. We said it for consuming alcohol. To have smoking any cigarettes at that age makes sense.”

And yes, that includes e-cigarettes. “I think the long-term health effects for e-cigarettes are largely unknown at this point,” he says.

In the legislature, the measure received bipartisan support, clearing the House Health Care & Wellness Committee with plenty of breathing room. When it arrived at the House Finance Committee, things got more compli-

Attorney General Bob Ferguson cated. The Institute of Medicine estimates that raising the smoking age to 21 would reduce the amount of smoking for 15- and 17-year-olds by as

much as 25 percent.

Since Washington raises tax revenue by charging major fees on cigarettes, a reduction in smoking would cost the state significant amounts of money: an estimated $10 million a year.

“Long-term, we’d save many millions of dollars of cost to the state by having fewer teenagers getting addicted to nicotine,” Ferguson says.

By the time the bill got out of the finance committee, however, it was watered down, only raising the age to 19. Amid the hubbub at the end of the legislative session, the bill went nowhere. The story’s not over yet, though.

“You’re going to see this bill come back again next year,” Ferguson says. “Seventyfive percent of Americans support raising the smoking age to 21. The public supports this.”

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“the new fix,” continued... pump out dangerous amounts of formaldehyde, but only if the voltage on the devices was cranked up to atypically high, undesirable levels.

In July, Congressional Republicans narrowly blocked an amendment that would have subjected e-cigs to FDA pre-review.

“The GOP should be the party of freedom of inhalation,” National Review writer Jim Geraghty suggested on Twitter.

The big question — what is the longterm health impact of using e-cigs? — remains an open one. After all, the device was invented just a little more than a decade ago.

What is starting to become clear, however, is that the hope that e-cigarettes would help large numbers of adults quit smoking just isn’t being borne out by the numbers.

Three-quarters of the folks who smoke ecigarettes still smoke regular cigarettes. The CDC is worried the trend could go the other way as well — that e-cigarettes could be a gateway drug to classic cigarettes.

“We do know that with addiction, the possibility of progression to other forms of tobacco is significant,” says Frieden.

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One of the big claims about vaping — you see it in Blu e-cigarette ads — is that it doesn’t affect others. Secondhand smoke, the health concern that got cigarettes banned from diners, bars and bowling alleys, supposedly doesn’t apply to vaping.

Not so fast, studies have shown. In February, researchers at Johns Hopkins University released a study showing effects on the immune systems of mice exposed to human-equivalent levels of e-cigarette vapor. When the mice got sick, the mild impacts of inflammation resulting from

protein damage grew far worse.

“Our findings suggest that e-cigarettes are not neutral in terms of the effects on the lungs,” researcher Shyam Biswal said in a statement. But when compared with the savage secondhand effects of cigarette smoke, e-cig vapor seems healthier. The chemicals in the vapor tended to be far more diluted in an average room than cigarette smoke. Ultimately, it’s the dose, as any scientist will tell you, that makes the poison. As for the long-term impact of secondhand vapor, we’ll just have to wait and see. n

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NEWS

BEST PRACTICES

Now pregnant with her first child, Alicia McNamara says she was “really, really nervous” about seeking assistance conceiving. JENNIFER DEBARROS PHOTO

Fertile Strategies New options for couples having trouble conceiving

BY CHELSEA BANNACH

F

irst comes love, then comes marriage, then comes a baby in a baby carriage.

At least, that was the plan for Alicia McNamara and many others like her. But after two years of trying to get pregnant, McNamara and her husband decided they needed help.

So, McNamara, 24, went to Seattle Reproductive Medicine’s Spokane clinic, which opened in Spokane Valley in late 2013. “I was really, really nervous,” she says. “You’re admitting something is wrong and you don’t know what you’re going to find out.”

McNamara, SRM Spokane’s secondever patient, is now expecting her first baby after receiving treatment there.

A COMMON PROBLEM

McNamara isn’t alone. Talking about infertility — which is medically defined as being unable to conceive after one year of unprotected sex — can be uncomfortable, but it’s actually fairly prevalent. Somewhere around 10 percent of women of reproductive age are infertile, says Thomas Fisher, a fertility doctor at SRM Spokane.

“It’s a lot more common than people

realize,” says Fisher. He gained firsthand experience with what infertility is like after he and his wife struggled to have children of their own, eventually doing so with the help of in-vitro fertilization, or IVF. For a spontaneous pregnancy to occur, women need functioning ovaries, Fallopian tubes, a uterus and sperm. Medical conditions impacting any of these can contribute to infertility.

Polycystic ovarian syndrome, a hormonal imbalance that can result in erratic ovulation, is the most common cause of infertility related to the ovary. Diminished ovarian reserve, which occurs when the number of eggs is reduced for a variety of reasons, often due to the mother’s age, also can play a role.

After an egg is released, it has to be captured and transported via the Fallopian tubes. Here, the most common risk factors for infertility are blockages that can be caused by a history of pelvic infection, gonorrhea or chlamydia, endometriosis or abdominal surgery.

Age, smoking, excessive alcohol use, extreme weight gain or loss, and excessive physical or emotional stress resulting in amenorrhea — an absence of menstrual periods — can also lead to female infertility.

It’s not just a woman’s problem, though. Male fertility is typically evaluated with a semen analysis, in which an andrologist examines the concentration, motility and morphology, or shape, of the sperm.

Medical conditions such as cystic fibrosis, trauma, and infection can cause male infertility, as can unhealthy habits such as heavy alcohol use, anabolic steroid use, testosterone injections and smoking. Often times, the reason for an abnormal semen analysis is unclear.

Frustratingly, for many patients, including McNamara and her husband, the cause of infertility remains unknown.

“We went in there and did all the tests,” she said. “We basically had unexplained infertility.”

TYPES OF TREATMENTS

The good news for couples struggling with infertility? There are numerous treatment options out there, and fertility clinics in Spokane are comparable to those in bigger cities such as Seattle or Portland.

Patients can take medications to stimulate ovulation, coupling those with timed intercourse to increase their chances of conceiving.

Often, couples initially try intrauterine insemination, or IUI, Fisher says, which is a form of artificial insemination bypassing ...continued on page 24

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news dad,” Fisher said.

Risks with IVF are rare, but can include infection, bleeding, injury to other abdominal tissues and side effects from hormonal medications.

“In general, people tolerate IVF very well,” Fisher said. “Most of them are so grateful to be doing something, and working toward that pregnancy, that they have high tolerance of anything. We talk about all these risks with the patients, but it’s quite rare that a person has an issue.”

Improving technology As she looks at sonograms, McNamara reflects on the process of getting pregnant. jennifer debarros photo

“fertile strategies,” continued... the cervix, which can sometimes act as a barrier to the uterus.

IUI can be used in a variety of situations and is one of the more affordable options. That treatment alone, which costs less than $1,000, can be combined with oral and injectable medications to improve chances of success. The rate of success for IUI ranges from 5 percent to 20 percent, and risks with IUI are uncommon.

IVF is another conventional, but more complex, treatment. Medications are used to stimulate the ovaries to grow multiple follicles, and the eggs are then retrieved from the growing follicles. The eggs and sperm are placed together to allow for fertilization, and after developing in the embryology lab, the embryo or embryos are transferred into the uterus.

“We put the pieces together so they can potentially fertilize, but it’s still a molecular interaction of the DNA from mom and

The first IVF baby was born in 1978 in England and in 1982 in the United States.

“This field of medicine is really rather new,” says Dr. Brenda Houmard, also of SRM Spokane.

Improved technology has led to better success rates, Houmard says. Most of that resulted from improved embryology culture conditions and different protocols for stimulating the ovaries. In addition, she says, the advent of a process called cryogenic vitrification has allowed patients to freeze their eggs and embryos.

“We couldn’t really successfully freeze eggs prior to this technology, and it just re-

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cently has gone from experimental status to routine use,” she says. “So that’s exciting.”

Other cutting-edge services currently available include pre-implantation genetic diagnosis, state-of-the-art science enabling the selection of embryos that do not possess specific genetic disorders or chromosomal abnormalities. Fertility preservation for men and women is an option for those experiencing a life-changing event such as cancer, or simply a lifestyle decision to delay parenthood.

Patients may also benefit from acupuncture and nutritional education.

When selecting a clinic or health care provider for infertility treatment, Fisher says, “I think that the most important thing is comfort.” And if you can, talk to people you know to get referrals to a fertility specialist. Word of mouth can be a great way to go about choosing a clinic.

McNamara says her nurses and doctors offered compassionate and responsive care, something she says is crucial: “Personal touch is so, so important.”

“They were always willing to help and answer my questions,” she said. “Nothing seemed silly or stupid.”

A new patient likely will undergo an Happily ever after array of diagnostic lab work, such as blood McNamara became pregnant in March tests, and possibly an ultrasound. The with the help of IVF and is expecting her fertility specialist might prescribe medicafirst baby in December. tion, and should talk to you about your test “Going in and taking that first step, and results, goals and finances, because many seeing the doctor, was the best thing that insurance companies do not cover reprowe did,” she says. ductive services.

Most experts agree that women youngMcNamara says the whole experience er than 35 should try to get pregnant for at was worth it. “We definitely want more least one year before seeking than one,” McNamara says. medical advice. Women “I’m one of four, he’s one 35 or older should see a of three. If we can, I would from the puzzle on page 13 health care provider after six absolutely go through the 15 = C; 24 = S; 11 = E months of trying. process again.” n

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living

kids health

Power

of

play

The importance of just being a kid goes far beyond having fun

BY CHELSEA BANNACH

F

or children, playtime is serious business.

It enhances learning and helps shape our brains in ways that have lifelong implications. But some educators are concerned that kindergarten curricula have become too academic in recent years, despite research showing the importance of play in human development.

Now some states, including Washington, are getting back to the basics and training teachers in the importance of this keystone of the kindergarten classroom. In Spokane Public Schools, the concept of play is an integral part of the kindergarten curriculum, says Lorna Spear, the district’s director of early learning and intervention.

“Sometimes I think we forget children want to read,” Spear says. “They want to be able to engage in books. They want to be able to count things and add. We just need to present it in a way that’s engaging and keeps them wanting to learn. It’s not about making kids learn to read.”

Play with a purpose

In a June draft of the Washington State Full-Day Kindergarten Guide, the state Office of Superintendent of Public Instruction writes, “Sadly, in recent years, kindergarten has become more about test scores than about child development.” ...continued on next page

Game play helps kids learn social and problem-solving skills, as well as how to deal with frustration and anxiety.

Health 27 LIVING-MAIN inhealth 8-3-2015.indd 27

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LIVING: KIDS HEALTH “POWER OF PLAY,” CONTINUED...

As schools across the country push for better reading and mathematics scores in response to the No Child Left Behind Act, Race to the Top, and the widely adopted Common Core Standards, standardized instruction, worksheets and rote learning have overshadowed playtime in many classrooms, even for kindergartners.

“They don’t even realize they’re learning when it’s playful.”

“Research is now beginning to look at the student outcomes associated with the removal of play from early learning environments, and the results are not favorable,” the draft reads. “While policies are requiring more testing be done on our young learners, business leaders know that in order to create a generation of problem solvers and critical thinkers, play must be

restored to the classrooms.”

Research strongly suggests, for example, that working with blocks increases a child’s spatial reasoning, leading to higher achievement in geography, science, technology, engineering and mathematics.

But encouraging more play doesn’t mean more time for “anything goes.” It’s purposeful play, Spear says, and it’s done with intention.

“They’re having a good time, but it’s with a framework of learning behind it,” she says. “I think there’s confusion sometimes. When we’re structuring ideas for children, they’re active, they’re engaged, but there is learning behind it.”

In the 2014-15 school year, the district adopted a new curriculum called Lit Fit for all kindergarten classes, which engages children in movement-based learning activities that emphasize math and literacy skills, focusing on firing up the entire brain through movement. A fitness and health teacher teams up with a kindergarten teacher in the gym, and kids go from station to station for different activities that combine literacy and physical activity.

One station might have a ladder, with cards in between rungs that have word and

a picture. The children at that station get to jump through each rung and sound out the word on the card before moving on. Teachers often stay at the most difficult stations to assist the children as needed.

“They’re doing all this physical activity,” Spear says. “Sometimes there’s problem solving. They’re meeting fitness and health standards, and literacy and numeracy simultaneously, with both experts in the room. It’s probably the best thing we’ve ever done.”

Lit Fit isn’t the only time that play is incorporated. The 2013 decision to switch to full-day kindergarten gives teachers the chance to work more purposeful play into the classroom throughout the day, which is broken up into full-group activities, small-group stations that the children rotate between and individual writing, reading and math practice.

The morning greeting — a staple in many kindergarten classrooms — is an active, highly engaging, full-group activity that signals the state of the day, says Karin Thompson, elementary curriculum coordinator for Spokane Public Schools.

During the morning meeting, children come together to sing songs about the days

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of the week, for example, or the life cycle of a tree. They introduce themselves, and greet and shake hands with each other, a ritual that helps them learn social skills.

Then, they might work on language skills through storytelling, sharing with their peers something they did over the weekend or talking about their favorite book.

In a small group rotation, children might work on literacy through creative play, forming the same letter using a variety of art mediums such as clay or finger paint.

“There’s actually a lot happening, with them working with that letter in all these different mediums,” Thompson says.

And it’s not just a constant stream of purposeful play; there’s quiet, individual time throughout the day, too.

“It’s finding that balance for their class,” she says.

Lighting up the brain

Play starts with an infant’s first social smile, called “attunement play,” according to the National Institute of Play, which advocates for more scientific research into the neurobiology of play.

It goes like this: When an infant makes eye contact with its mother, each experiences a spontaneous surge of joy. The baby responds with a radiant smile, the mother with her own smile and baby talk. Researchers know, through electroencephalograms and other imaging technologies, that the right cerebral cortex, which organizes emotional control, is attuned in both infant and mother. Research suggests that the importance of play starts in infancy and pervades our lifespans.

They identify several other types of play: attachment play, body play and movement, object play, social play, imaginative and pretend play, storytelling-narrative play and creative play — all of which play a role in human development.

Dr. Stuart Brown, a pioneer in research on play, said in a 2008 TED Talk that plenty of play in childhood makes for happy, smart adults, and keeping it up can make us smarter at any age. “Nothing lights up the brain like play,” he said.

“And it’s hugely important in learning and crafting the brain,” Brown continued.

“So it’s not just something you do in your spare time.”

Spokane-area pediatric occupational therapist Susie LaBarre says her garage is full of toys. They’re the tools she has used during her 16 years of work to help children reach their potential in learning through play.

“It’s an unconscious occurrence for these kids,” LaBarre says. “They don’t even

Marly, Claire, Grace and Wyatt collaborate on a problem-solving game outside Spokane’s Jefferson Elementary. Young Kwak photo realize they’re learning when it’s playful. That’s what’s neat — when learning becomes a result of play.”

Children progress through different stages when they play, and each helps the child learn different skills. In the first couple of years, it’s sensory-motor play, in which children try to understand their body and the new sensations around them.

Then they move into imaginary play, which helps them understand the social world around them and navigate complex events happening around them. “Fantasy play helps them understand reality,” LaBarre says.

Constructural play begets creativity, allowing children to develop motor and cognitive skills through spontaneous creativity.

Game play allows children to develop control, understand rules and navigate social pressure — “the idea that if you’re going to break the rules, you’re taking away from the enjoyment of the group,” LaBarre says.

It helps them learn social skills, problem-solving skills, risk taking and how to deal with frustration, failure and anxiety, and to make sense of them world around them. It’s important for the development of confidence and self-esteem, in addition to the development of gross and fine motor skills and cognition, she says. The list goes on. Simply put, learning is enhanced by

play.

“The enthusiasm, the energy, is different. The individual comes out,” LaBarre says of using play versus rote learning for children. And educators can identify where children are having difficulty more readily than when they’re sitting at a desk.

Scientists have also shown a neurobiological connection between vestibular input — achieved through movement — and language skills. Vestibular and language pathways are located near one another and both begin to be processed in the receptors of the ear, LaBarre says. “We see language improve when children are involved in sensory-rich activities that allow the body to move, especially when movement involves changes in the child’s head position like rolling, somersaults, jumping and crawling through tunnels. A child’s speech can improve during vestibular activities.”

LaBarre hopes that play will serve as a classroom cornerstone for educators and policy makers. “I think teachers are really having a hard time. [They’re] feeling like they’re not doing their job if it’s not in the standardized instruction,” LaBarre says. “I think there’s hopefully going to be a pendulum shift saying ‘OK, we can still meet these criteria and still incorporate play,’ but I think it’s going to take a while to get to that point.” n AUGUST-SEPTEMBER, 2015

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living: kids health

Precious Time The Young Child Expo Spokane focuses on ways to foster healthy childhoods

BY ANNE McGREGOR

A

s Donald Rumsfeld famously declared, there are things “we don’t know we don’t know.” While the statement has been subject to endless ridicule, it does have an unsettling application to raising and educating children.

Often, one of the hardest things for a parent to perceive is the revelation of a developmental issue affecting their own child.

Childhood “quirks” can be dismissed as something that runs in the family, or just a unique feature of the child. That’s unfortunate, because the prognosis for many issues affecting learning is much better with early intervention. Although Washington state

offers many programs to assist young children and their families, consistently identifying and connecting people who could benefit from those services has always been a challenge.

That’s just one issue that Gonzaga University’s Dean of the School of Education, Vincent Alfonso, hopes the first Young Child Expo & Conference Spokane can address. As part of the three-day expo, presented by GU and Los Niños Services at the new Davenport Grand Hotel, Alfonso has invited the state’s business, education and government leaders to participate in a leadership summit. The goal is to get them

all in a room and ask them to come up with creative ideas to help kids who need help to get that help in a timely manner: “The earlier we invest,” he says, “and the more we invest — and it is not just about money, it’s about time, it’s about energy, it’s about nurturing — there’s just clear, huge benefits to society down the road.”

The goal is for each of the summit attendees to leave with a mission to accomplish before the next convention. “What are we going to do about this collectively?”

Alfonso asks.

One thing he advocates is creating a program of universal screening for children when they enter the school system. “We are working on it in this state. It is very cost-effective and very time-efficient. [With universal screening], every kid — every kid — who enters the school system, at whatever age, is screened for health, language, cognitive functioning, academics, socialization.”

While many schools already use community volunteers to screen for vision and hearing problems, the more comprehensive screen could probably still be done by nonprofessionals, Alfonso says. “The maximum time is a half-hour, and you obtain so much information. You can then provide

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Vincent Alfonso anticipates as many as 500 people will gather for the first Young Child Expo and Conference at the Grand Hotel in Spokane. JENNIFER DEBARROS PHOTO

services for the kids you identify.”

The leadership summit is just one aspect of the three-day expo, expected to attract teachers, psychologists, therapists, pediatricians and daycare providers, as well as parents, to learn from 40 expert presenters from around the nation. Workshop topics include incorporating art, music and dance into learning, dealing with problem behaviors related to autism, and strategies to identify and help kids with feeding issues. Keynote addresses aimed at professionals in early childhood learning and care, as well as parents and interested community members, are planned. Whitworth President Beck Taylor will present information on “developmental economics” — the costs and benefits of early intervention; Yale’s Marc Brackett will speak about social and emotional learning and how to foster that in the classroom; WSU Spokane’s Chris Blodgett will share his expertise on tactics to ameliorate the long-lasting effects of adverse childhood experiences; and Sam Whiting, CEO of Thrive Washington, the state’s public-private partnership for early learning, will discuss efforts to make sure all kids are ready for school.

In addition to typical convention activi-

ties like receptions and a trip to the casino, networking will be fostered through an innovative plan called dine-arounds — attendees are encouraged to take advantage of local restaurant discounts to arrange impromptu dinners, where they can socialize with new friends and colleagues. Alfonso hopes that these are lasting collaborations, with effects that will ripple forth from the Expo.

The Young Child Expo Spokane marks the first time the convention will take place outside of Alfonso’s former hometown of New York City, where it has become a sellout event, attracting 1,500 people annually. Though he expects more modest attendance at this year’s Spokane event, the passion infusing both endeavors is the same. “Our youngest children are our greatest resource,” Alfonso says. “If we want a productive, independent society, we have to focus on early childhood and early learning.”  The Young Child Expo runs Sept. 30 to Oct. 2. For information on attending and continuing education opportunities for professionals, go to youngchildexpo.com/ spokane-conference

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living: kids health

Occupational therapist Don Kammerer uses colorful toys to help fidgety kids learn strategies to focus in the classroom. Young Kwak photo

Learning to Learn

Tackling the many variations of ADHD challenges therapists, parents, teachers and kids

BY LINDA HAGEN MILLER

J

ason has a new backpack, Ashley’s signed up for soccer, and Matthew already knows what his science project will be. Soon school corridors will be full of noisy, eager kids ready for a new school year, and parents across the nation will cross their fingers that this will be a year of learning, growing, making friends and fitting in.

No parent hopes this will be the year they will be told Jason or Ashley or Matthew is being disruptive in class, cannot get along with other children, doesn’t focus or has no impulse control. Not one parent, or

child for that matter, hopes this is the year he or she will be diagnosed with ADHD. Attention deficit hyperactivity disorder is usually first diagnosed between the ages of 3 and 6. It is four times more common in boys than girls, and although symptoms can change over time and often lessen as the child grows older and learns coping skills, there is no cure. From 50 percent to 70 percent of adults diagnosed with ADHD as children continue to exhibit ADHD characteristics.

“Years ago, hyperactive, impulsive or unfocused children would be diagnosed as

having a hyperkinetic disease or defect of moral control,” says Matt Thompson, MD, a pediatrician at Spokane’s Kids Clinic and an InHealth columnist.

“Neither label was particularly accurate.

We now realize that ADHD is not a good or bad condition, but a complex neurobiological disorder,” he says, noting that it’s important to rule out other medical conditions that can also affect a child’s ability to concentrate and cause disruptive behavior, including middle ear infections, seizures, anxiety, depression, sleep or genetic disorders and hearing or vision problems.

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Thompson says diagnosing ADHD can be assisted through the use of validated tools such as the Vanderbilt Assessment Scale, which is administered to the child’s parents, teachers, coaches and others who come in close contact with him or her. The test consists of more than 50 questions dealing with issues that range from antsy behavior to delinquent acts, depression and academic achievement.

Educators are frequently the first to

are considered stimulants. It may seem counterintuitive to prescribe a stimulant to a hyperactive child, but the drugs stimulate parts of the brain needed for focus, impulse control and organization.

The drugs can have negative side effects, including decreased appetite, sleep problems, repetitive movements, personality changes and hallucinations. One drug, Strattera, has been linked to suicidal thoughts, but medical professionals stress

“What if it’s just a kid being who he is? Just because he has too much energy for you doesn’t mean he has too much energy for himself.” point out a child’s disruptive or unfocused behavior to parents. When it becomes necessary to talk to parents about their child, Hamblen Elementary fifth-grade teacher Lisa Smith says it’s not her job or profession to give a diagnosis of ADHD. She does present parents with carefully documented incidents, classroom modification techniques she’s tried and the results. If the parents ask for additional suggestions, she will direct them to their pediatrician. In her years as a teacher, she has learned that each child’s situation is unique. “Some children may have the stereotypical behaviors of ADHD/ADD and might do great with prescription medications, some might not; some might do well with natural remedies, some might not,” says Smith.

Treatment, not cure

The Centers for Disease Control and Prevention reports that 6.4 million American children between the ages of 4 and 17 were diagnosed with ADHD in 2011, representing a whopping 42 percent increase over an eight-year period. The same study reports that the percentage of children between 4 and 17 taking medication for ADHD increased by 28 percent between 2007 and 2011.

“The increase in medication has been a function of large amounts of empirical evidence that supports its use and efficacy for students with ADHD,” says Tim McLaughlin, professor of Special Education at Gonzaga University who has published numerous articles regarding ADHD. “New medications such as Concerta, Strattera and Adderall have been quite effective,” McLaughlin adds. “In addition, Ritalin remains highly effective.”

Adderall and Ritalin are the most commonly prescribed medications; both

that this is rare, and that underlying conditions such as depression, alcohol or drug abuse, a family history of suicide, bipolar disorder and schizophrenia are frequently present.

“There is no one-size-fits-all medication,” Thompson says. “Dosages, extended release preparations and use of adjuvant medications need to be fine-tuned to find the ideal combination.”

Recent British research has revealed a possible relationship between consumption of food additives, artificial colors and preservatives and ADHD, but no link between junk food, sugar and ADHD has been proven. Similarly, any connection between television and video games and ADHD is also unproven.

That doesn’t mean there aren’t things besides medication that can assist in managing ADHD. McLaughlin stresses the importance of a multipronged approach.

“If I had a child with ADHD,” McLaughlin says, “he or she would receive medication treatment, behavior therapy interventions in the home and at school, and directive counseling for the parents and his siblings.”

Best practices

“When Kyle was in kindergarten and first grade, we began to realize it was hard for him to stay focused unless he was doing something he really enjoyed,” says Betsy, a Spokane mom whose name has been changed here to protect her privacy. “He had been wearing glasses with high correction since he was 3, and at first we thought it was a vision issue. He didn’t have trouble sitting still, he’s a hard worker, teachers love him and he gets along fine with other kids.” ...continued on next page

role models A bouncing-off-the-wall kid who cannot seem to stick with anything could also be a child, and later an adult, capable of “hyperfocus” — the ability to hone in on one thing and make it great. Notables who were either diagnosed with ADHD or suspected of having the condition include: Albert Einstein The theoretical physicist was known to be oblivious to his surroundings and extremely forgetful.

And then there was the hair.

Michael Phelps Eighteen Olympic gold medals in swimming attest to Phelps’ athletic ability. His mother says swimming helped him redirect his energy into success.

Justin Timberlake The boy-band phenom says he has ADHD combined with OCD, but that hasn’t stopped him from “bringing sexy back,” becoming a successful actor and producer.

Jim Carrey The comedian, who seems to be playing himself in most of his films, says he got through school by being the class clown.

Walt Disney The visionary was able to mix details and dreams to create the most famous theme parks of all time.

Will Smith From Fresh Prince to rapper to respected actor and producer.

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living: kids health “learning to learn,” continued...

But while Betsy was volunteering in Kyle’s classroom, she observed him drifting off and losing interest. After vision issues were ruled out, she and her husband decided to have him tested for a learning disability. He was diagnosed with ADD. “My husband and I know how important it is for children to get a good foundation from K to fourth grade,” Betsy says.

“As a teacher, I also know you can set a child up for failure if you try to fit a square peg in a round hole. We thought long and hard about putting Kyle on ADD medication; I did a lot of research beforehand.”

They worked with their pediatrician to adjust Kyle’s medication, conferred with his teachers and watched their son make steady progress. Kyle was medicated from first through fourth grade and now, going into the fifth grade, is up to and above grade level. He’ll try being off medication this year, and the family will continue to keep close tabs on his progress.

Amy (also not her real name) is a special education teacher with an ADD son and an ADHD son. Under the guidance of

Lisa Smith employs behavior techniques to make sure “everyone’s needs are being met” in her Hamblen Elementary fifth grade classroom. young kwak photo

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her boys’ pediatrician, they added occupational therapy to the menu of medication, parental monitoring and communication with teachers and their pediatrician.

“OT helps with a lot of things,” Amy says, “including self-control, self-confidence, proprioceptive processing and the vestibular system.” The proprioceptive system is made up of muscles, joints and tendons and contributes to a person’s awareness of body position (think: knowing how to sit in a chair) and fine motor skills (handwriting, buttoning a shirt). The vestibular system contributes to balance.

Although an occupational therapy gym full of swings, mats and exercise balls may look like a playground, it’s actually a place for kids to learn strategies that can help recalibrate their over- or underactive sensory systems, improve fine motor coordination and develop organizational skills.

“One compensatory strategy for a kiddo who can’t concentrate or sit still,” says occupational therapist Don Kammerer at St. Luke’s Rehabilitation Institute, “is to give them a squishy ball so they can fidget with that.”

“Another is a wobbly chair — not one that will fall over, of course,” he continues.

defining ADHD Attention Deficit Hyperactivity Disorder is one of the most common developmental disorders of childhood. The syndrome has three subtypes: Predominantly Inattentive Easily distracted, does not pay attention to details or follow instructions, is oblivious to daily routines, has difficulty organizing and finishing tasks. Also known as ADD (Attention Deficit Disorder).

Predominantly Hyperactive-Impulsive Restless, fidgets, talks a lot, impulsive, interrupts, grab things from playmates.

Combined Presentation The above symptoms are equally present.

Another is a pencil box that’s been filled with 5 pounds of weight. When an antsy child puts it in their lap, the weight helps them calm down. These methods, and many more, help an easily distracted

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child focus on the task at hand.

In her classroom, Lisa Smith has had success using behavior modification techniques. For instance, one student might learn better standing up; another might need to be in a quiet place. She’s utilized exercise balls instead of chairs, and will allow a child to take a break when she notices that he or she is struggling. Sometimes she simply walks over to the student and places her hand on his or her shoulder or desk to help them regain focus.

“It is an incredible dance we do daily to make sure everyone’s needs are being met,” she says.

Ditching the meds

In the movie Different Drummers, produced and co-written by Spokane’s Lyle Hatcher, the mother of a hyperactive fourth grader in a 1960s classroom dumps his Ritalin down the drain. When a local high school class screened the movie not long ago, they broke out in applause when viewing that scene. Hatcher believes he knows why.

“They saw a mom stand up for her son,” Hatcher says. “I know, because I was that kid.”

Energetic, hyperactive and frequently unfocused, Hatcher’s school principal insisted he should be medicated. His parents reluctantly agreed, but after three months they didn’t like the changes in his personality and decided to take him off Ritalin.

To channel his excessive energy, Hatcher went from medication to running, sometimes as many as 10 miles a day. He became a wrestler in high school, a soccer coach as an adult, and at one point, singlehandedly cleared out 23,000 pounds of trash along the Spokane River. He went on to build a successful career as a financial consultant and has become a passionate anti-ADHD drug advocate.

“Diagnosing kids with ADHD and giving them drugs has become an epidemic in this country,” Hatcher says. “If a kid is rowdy and animated, we give him a pill to ‘fix it.’ What if it’s just a kid being who he is? Just because he has too much energy for you doesn’t mean he has too much energy for himself.”

Medicating hyperactive or unfocused children will continue to be an intensely personal decision a family must make in concert with their pediatrician. Some, like the Hatchers, will opt out. Others, like Amy, will choose medication, occupational therapy and monitoring. She says they were thrilled and relieved to hear their 7-year-old son who has ADHD recently say, “I’ve never been able to accomplish so much before! I feel exactly like myself.” n AUGUST-SEPTEMBER, 2015

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LIVING

COOKING

McLane Farms owners Angeline and Justin McLane take farm-to-table a step further than most, supplying their own restaurant, Garnet Cafe and chef Joe Zornick (right), with vegetables, eggs, poultry and meat. YOUNG KWAK PHOTOS

Full Circle The farm-to-table ethic keeps fresh ingredients on local menus and brings growers together

BY CARRIE SCOZZARO

W

hether it’s eggs in the Kootenai omelet or ground beef in their Shepherd’s Pie, Garnet Cafe chef Joe Zornick can tell you where those ingredients come from: McLane Farms.

“Farm to table for me,” says Zornick.

“It’s like Christmas Day every time I put an order in. It is incredibly awesome to be able to communicate with the farm and have them make certain cuts, or prep certain animals for specials coming up.”

Zornick benefits from an unusually direct connection with the growers of his ingredients, as the owners of McLane farms also own the Garnet Cafe. Justin and Ange-

line McLane can assure Zornick, and cafe customers, that the produce, dairy, meat and other goods on the menu were personally raised on their farm outside Coeur d’Alene, and are pesticide-free, sustainable and high quality.

Since relocating to the area in 2006, the McLanes have expanded their farm to include cows, chickens, ducks, quail, sheep, goats, Berkshire pigs and a third of an acre of produce. In addition to supplying Garnet Cafe with ingredients, they sell some produce via their website and are in the midst of obtaining USDA Organic certification.

“Real food from real people-run farms,

that are not heavily subsidized and do not use industrialized farming methods, is not as cheap,” says Angeline McLane. “But we believe it is worth it.”

It’s a message McLane is passionate about, and she’s found an ideal promotional vehicle in the Inland Northwest Food Network. “I love what she is doing,” says McLane of INFNW director Teri McKenzie, “and her focus on local farmers and local foods, and on educating people on what that means.”

McLane met McKenzie at an Earth Day fair last year. Later, when McKenzie was organizing a community event called “Know Your Farmer, Know Your Food,” the McLanes were a natural choice as presenters.

“I’m a firm believer in the power of story,” says McKenzie. “I thought it would be most effective to invite a group of farmers, ranchers, and producers to share their stories, thereby providing a glimpse into the realities of what it takes to bring us all our food.”

Together with six other growers — Killarney Farms, Pokey Creek Farm, Byrum Family Farm, Wheyward Goat Cheese, Wild & Sweet Rich Honey and

36 Health AUGUST-SEPTEMBER, 2015 LIVING inhealth 8-3-2015.indd 36

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NOW OPEN!

RECIPE

Pork Shoulder Tacos

A fragrant blend of spices infuses this pork — cooked slowly to ensure tenderness. It should be prepared a day ahead to allow the meat to reabsorb the cooking juices. Garnet Cafe uses McLane Farms’ 100 percent Berkshire pork for this meal that’s big enough to feed a hungry crowd at a summer reunion or a football party.

Taco Meat 5 pound pork shoulder roast 1 Tablespoon paprika 3 Tablespoons salt 1 Tablespoon black pepper 1 Tablespoon garlic powder 1 teaspoon cayenne 1 teaspoon cumin 1 Tablespoon brown sugar 1 Tablespoon thyme 3 yellow onions, rough chopped 10 garlic cloves, smashed 3 stems/leaves parsley 5 bay leaves 1 Tablespoon oregano 60 ounces of beer, preferably ale (the alcohol will cook off) Oil, such as canola Combine first eight spices and rub them into pork shoulder until they’re absorbed. Coat bottom of large pan with oil and heat to near smoking. Sear each side of the pork shoulder, 1-2 minutes each side. Remove from pan and set aside to rest. Chop onions and smash garlic. Put these in a roasting pan large enough to ensure meat isn’t crowded and that there’s room for liquid. It will need to be at least 6” deep. Add bay leaves, parsley stems and oregano to roasting pan. Place pork should in the pan, and fill

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pan half-way with beer and the rest with water, about a quarter inch from the top. Cover tightly with plastic wrap and then with foil. Place in a 250° oven for 4 1/2 hours.

Once cook time has elapsed, peel back covering and use metal tongs to tear the meat. If it tears easily then it’s done; if it’s difficult to tear, cover it up and cook for another 30 minutes, then check again. Repeat as needed. Once properly cooked, leave covered and let cool in the refrigerator overnight or at least 8 hours to enable juices to soak back into the meat. Shred just prior to serving.

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Preparing the Tacos 1 yellow onion, chopped fine 1 bunch cilantro, rough chop 1 red cabbage, shaved thin 1 lime, cut into wedges Sriracha mixed with a little mayo Corn tortillas Assemble garnishes. You can adjust amounts to taste (or even add other vegetables, such as tomato or avocado). Heat small batches of pork in a skillet on medium heat. Heat tortillas in a separate pan, also medium heat (no oil). Fork a little warmed pork into a corn tortilla and garnish with yellow onion, cilantro and cabbage. To serve, squeeze lime over taco to taste and finish with a drizzle of the sriracha mayo. n 50 TAPS

Cable Creek Farm — the presenters offered a cross section of North Idaho food producers, says McKenzie.

For Paris Byrum of Byrum Family Farm, the experience was enjoyable and informative. “After the event, we were able to talk to people interested in carrying our chickens in a co-op in Washington state, and a young adult interested in growing chickens as a business himself,” says Byrum, whose family grows pastured, nonGMO, vaccine- and antibiotic-free poultry on their Spirit Lake acreage.

“I think this is a particularly powerful way for the public to gain insight and appreciation into the lives of those who bring

us our food,” says McKenzie. “It is truly a labor of love, with long hours and oft-times grueling work. My sense was that a lot of people left the event with their eyes and minds wide open.”

Planning for next year’s event is progressing, says McKenzie, who knows now to prepare for larger crowds. This year’s event, which included dinner, blossomed from 30 attendees to 130 and represented people of all ages and backgrounds.

“I love bringing people together who normally don’t fraternize with one another,” McKenzie says. “We need to do more of that, to remind us of our humanity and what unites us.” n

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living

WOMEN’S HEALTH

Back to Bras

Victoria Zvoncheck-Ferro says she can find a perfectly-fitted bra for any woman: “No set has beat me yet.” JENNIFER DEBARROS PHOTO

A good bra can improve myriad health issues — and make you happy

BY LAURA JOHNSON

T

hey come in all sizes — miniscule, balloon-shaped or perfectly reconstructed. And while many women would prefer to pop on a comfy old bra and not think another thing about it, an ill-ftting undergarment can lead to poor

posture, back and even breathing issues.

This is something Victoria ZvoncheckFerro witnesses first hand at Audrey’s Boutique on North Division. Women from all over the region come to her store, which she’s owned for three years, for its wide

selection of bras — we’re talking from size 28 around the ribcage to a size N cup.

“No set has beat me yet,” says Zvoncheck-Ferro, who is colloquially known as the bra whisperer thanks to her uncanny ability to guess any woman’s breast measurements. “I can always find something that will work.”

Getting fitted for a bra can be rather uncomfortable, especially for women who don’t necessarily feel happy about their bodies. But remove the emotion and a bra is simply about the architecture, comfortably shaping the breast tissue and “holding the girls up there,” ZvoncheckFerro says.

Often, women will come in to her shop looking for a dress or top and come

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Every Woman Deserves Support

T

he woman hadn’t gotten a new bra in three years. The tattered one she was wearing didn’t fit correctly. And there, in a mall fitting room last May, Christine Weaver saw how a new, well-fit bra could profoundly impact a woman’s life.

“She could raise her arms without her girls falling out,” recalls Weaver of the woman she took dress shopping for last year’s Catholic Charities GALA fundraiser. “She started crying.”

This got Weaver thinking about an often-overlooked issue in the world of charitable institutions — properly fitted bras. Deciding to throw a bra party for low-income women who needed them, the idea for Breast Intentions was born.

Officially a non-profit for about six months, Weaver, along with Julie Tucker and Nanette Peterson, have put on multiple bra Nanette Peterson, Christine Weaver and Julie Tucker (left to right) offer events with the help of local donations and businesses like Nordstrom and Title bra-fitting events through their new charity, Breast Intentions.

Nine. They hope to expand the organization to other cities across the country.

Weaver says recipients have told her they feel more put together, one Title Nine Fundraiser Customers can choose to donate nine percent of woman told her she got her femininity back. purchases to Breast Intentions on Friday, Aug. 28, from 10 am - 6 pm at Title “We’re helping to make these women feel special in a relaxed environNine, 928 S Perry St., 535-4839. For more information on donating new or ment,” Weaver says. “The stories we’ve heard, this is just the most amazing gently used bras go to facebook.com/breastintentionswa or email breastintthing.” entions@comcast.net.

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out with a new bra as well. With a properly fitting brassiere, Zvoncheck-Ferro says, clothes hang sleekly, making a person look younger and adding a newfound confidence.

“A bra is not a garment other people will see,” explains Zvoncheck-Ferro, who is also a certified mastectomy fitter. “Women will spend more time on outer clothing, but they don’t get that underwear is the foundation of an outfit. A good bra will make you feel beautiful.”

For Zvoncheck-Ferro this isn’t just some selling tactic. Some of her customers through the years have experienced major health improvements — everything from

eradicating back pain to feeling less tired, simply because they have a bra that fits.

For some women, however, a bra may not be enough.

In the chiropractic field for 18 years, Dr. Michael R. Valente often works with women whose spine and back issues stem from excess breast tissue. He’ll sometimes suggest his patients switch to wearing a sports bra to relieve tension, but also teaches exercises to do at home meant to increase tone in the posterior shoulder muscles.

“Your spine should be shaped like an S, not a C,” Valente says. “Breast support is a serious thing.”

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And if none of this works: “Breast reduction surgery can be the last ditch effort, and is necessary for some women, but we’ll try to get the muscles strengthened first as best we can,” Valente says.

But even armed with the right bra and back exercises, Zvoncheck-Ferro admits that breasts will droop, stretch marks are bound to happen and that gravity always wins.

“Listen, boobs are funny to talk about, my day consists of boobs,” ZvoncheckFerro says. “But women need to know that buying a bra that fits, from wherever that might be, is a simple thing you can do to improve your overall well being.” n

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living

BOOMERS

As Spokane’s Tap Grandmas perfect a routine at rehearsal, both their brains and bodies are getting a beneficial workout. jennifer debarros photo

Breaking a Fall Preventing falls is a mind-body exercise

BY E.J. IANNELLI

T

he sound of thunder rolls across the parquet flooring of the Corbin Senior Center. Stomp! Tickety tickety clack. Three lines of grinning female tap dancers click a circuitous path forward and back, miming thumb-and-pinky telephones to the swing of Glenn Miller’s “PEnnsylvania 6-5000.”

When the last brassy note of the song rings out, the women rest, grab a drink of water. Then their instructor shouts, “Let’s do the Charleston!” and the dancers, winded but exuberant, launch into a choreographed unison of swinging arms

and bowed legs.

These are the Tap Grandmas. Led

by Joan Hamilton, a retired gym teacher, they range in age from 60 to 84. “It’s fluid motion that keeps them engaged,” says Hamilton. “I always tell them that at the end they’re going to be able to join The Rockettes.”

Ask one of the Tap Grandmas why she’s here on this sweltering Thursday morning, and she’ll probably say it’s for the fun and socialization. But exercise like this is actually providing a host of interrelated benefits: increased strength, improved

coordination, better balance. All of which can help prevent falls.

The term fall might sound fairly benign, but it’s serious business for all age groups — and the elderly in particular.

The World Health Organization estimates that, each year, 28 percent to 35 percent of people aged 65 experience a fall. For those past 70 years of age, the incidence is even higher at 32 percent to 42 percent, and among that demographic, falls can end with a hip fracture or head trauma.

Although injuries can be but aren’t usually fatal, they can still result in hospitalization, follow-up surgeries, lengthy rehabilitation and diminished mobility afterwards. In the United States, the combined medical costs for falls treated in the emergency room for those aged 65 and up totaled $6.3 billion in 2005, according to data from the Centers for Disease Control and Prevention. In 2013, the inflation-adjusted direct medical costs of falls among older adults totaled more than $34 billion.

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E N R I C H E D L I V I N G . L A S T I N G VA L U E .

W

ith a view to sparing aging adults that physical, emotional and financial pain, Ellen Pell became a proponent of the Stay Active and Independent for Life (SAIL) exercise program while serving as director of Wellness Place in Wenatchee. She moved to Spokane about a year ago with the hope of getting the program running locally.

“We had a good working relationship with physical therapists and physicians,” says Pell, “and we found that we were not only getting people aged 65 and over, we were starting to get people who were recovering from cardiac arrest, traumatic brain injuries, people with Parkinson’s, people with MS. SAIL’s slow, rhythmic program doesn’t just help to increase their heart and muscle strength but also elongates those muscles and keeps them more flexible.”

“If you don’t use it,” Pell adds, “you lose it.”

That mantra is repeated by Kimberly Cleary, a professor in Eastern Washington University’s College of Health Science and Public Health.

“That saying really applies to older adults,” says Cleary. “As physical therapists, we see this vicious cycle where older adults start to have problems getting around, so they stop doing as much. They impose limits on themselves. And then you end up losing muscle mass, losing aerobic capacity, and it’s hard for people to bounce back.”

However, she stresses the importance of finding a physician-approved exercise regimen before deciding to dive in.

“It can be safe for older adults to engage in vigorous exercise — absolutely,” Cleary says. “But if an older adult is new to exercise, it’s really critical they get checked out first. And it’s also critical that they build up gradually. A lot of people want to jump in with both feet. Easing in is important.”

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he notion of “use it or lose it” applies to the mind as well as muscles.

Both Pell and Cleary say that mental acuity — awareness of one’s surroundings, the ability to react to unexpected situations — is an often overlooked but crucial area of fall prevention. Pell witnessed the results firsthand with SAIL. “We saw an increase in mental clarity as well as physical aspects — just by integrating exercises where we’d throw a ball and you’d name your favorite pie or what child is your oldest. That part of it was really impressive to me.”

By tracking routine fitness checks of in...continued on next page

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living Creating Healthier Communities Class

“breaking a fall,” continued...

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Learn How To: • Deal with symptoms of diabetes including fatigue, pain, hyper- and hypoglycemia, stress and emotional problems such as depression, anger, fear and frustration • Exercise to maintain and improve strength and endurance • Eat healthy • Properly use medication • Work more effectively with your health care providers

Family members and caregivers are welcome.

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This project was supported by funds from the Group Health Research Institute Pathways to Diabetes Self-Care Project wellness.inhs.org Community Wellness is a service of Inland Northwest Health Services (INHS). INHS is a non-profit corporation in Spokane, Washington providing collaboration in health care services on behalf of the community and its member organization Providence Health Care.

Dancing may help prevent falls and related injuries. jennifer debarros photo dividual SAIL participants, Wellness Place has been able to point to overall increases in core strength, agility and mobility, not to mention emotional and social well-being.

What’s more, recent research has shown that moderately strenuous exercise involving active response, such as dance, actually enhances the “neuroplastic benefits” of that activity. Which is to say, more than just addressing basic strength and balance, it keeps the brain’s neurons limber and working in harmony with the musculoskeletal system.

For Cherie Beckstrom, all those rewards are icing on the cake. She joined the Tap Grandmas last December, just days after she turned 70.

“Tap has added so much to my life, and it’s hard to say why,” she says. “Someone asked me once, ‘Why do you tap?’ Well, you know, it’s not possible to tap and not feel happy. These women, mostly older, tapping and having fun together with fun music — I get uplifted and inspired by it.

When I’m here, I forget I’m sweating and exercising. It’s so joyful and light.” n To learn more about the Tap Grandmas, contact Joan Hamilton, tapgrandmas. com, 624-4758. Contact your local senior center to find out more about SAIL and other classes, or check out spokanecares. org/community-centers-spokane. For general information on fall prevention, contact the Spokane Regional Health District: srhd.org/topics/falls.

42 Health AUGUST-SEPTEMBER, 2015 LIVING inhealth 8-3-2015.indd 42

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living AUG. - SEPT. events BLOOD DONATION | Give blood at the Inland Northwest Blood Center, which requires up to 200 donors each day to ensure that the blood bank is adequately stocked.

Donors can schedule an appointment online or donate during walk-in hours. Spokane office: Mon, Fri, Sat from 7 am-3 pm; Tue-Thu, 11 am-6 pm. Coeur d’Alene office: Mon, Fri, 7 am-3 pm; Tue-Thu, 11 am-6 pm; Sat 10 am-3 pm. inbcsaves.org (423-0151) 2014 FREE STATE PARK DAYS | Washington State Parks and Recreation allows visitors access to all state parks without needing a Discover Pass. Includes access to Riverside State Park and Mt. Spokane State Park. Upcoming “free” days include Aug. 25 and Sept. 26. parks.wa.gov BABYSITTING BASICS | This course is designed for youths ages 10 to 15, preparing them to become successful babysitters, and includes instruction in infant care, CPR, discipline issues, safety and more. Offered Aug. 14, from 9 am-2 pm. $40; online registration available. St. Luke’s Rehabilitation Institute, 711 S. Cowley. inhs.org (232-8138) INBODY 570 TESTS | INHS Community Wellness has a new machine available to the public which provides a complete picture of body composition, including weight, body mass index, body fat mass, basal metabolic rate and more. Appointments available on Aug. 4, Aug. 18, Sept. 1, Sept. 8 and Oct. 6. $20/test. INHS Community Wellness Center, 501 N. Riverpoint Blvd., Suite 245. inhs.org PERRY NEIGHBORHOOD STREET RIDE | Members of the Spokane Bicycle Club and the Spokane Regional Health District host a relaxed ride around the neighborhood for riders to practice their safe riding skills and socialize. Sun, Aug. 2, at 1:30 pm. Free. Meets at Two Wheel Transit, 817 S. Perry. on.fb.me/1FPi6L4 (mmckay@srhd.org) THE SHOWCASE | The second annual event to benefit the Community Cancer Fund hosts professional athletes and golfers from around the U.S. Mon, Aug. 3, at 11 am. $50/ person. Coeur d’Alene Resort Golf Course, 900 S. Floating Green Dr. showcasegolf.com KIDICAL MASS | Kids and their families are invited to a safe, afternoon bike ride of about three miles. All types of bikes, trailers, Xtracycles, bakfiets, tandems, folding bikes, trikes are welcome. Sat, Aug. 8, at 1 pm. Free. Two Wheel Transit, 817 S. Perry. summerparkways.com CELEBRATE LIFE FUN RUN/WALK | The annual fundraiser walk/run across Sandpoint’s Long Bridge was founded in memory of Jenny Myer, and benefits the Bonner General Hospital’s programs that support cancer patients. Sat, Aug. 8, at 9 am. $20-$30. celebratelifefunrunwalk.org COEUR D’ALENE TRIATHLON | Races include an Olympicdistance tri (individual and relay team options), a sprint and a duathlon. Sat, Aug. 8. $50-$90. cdatriathlon.com MT. SPOKANE HUCKLEBEARY EPIC | Choose from 20-, 40-, or 60-mile mountain bike route options. Five dollars from each registration supports trail building and maintenance in the Mt. Spokane trail system. Sat, Aug. 8, at 8 am. $55-$75. Starts at Selkirk Lodge, on North Mt. Spokane Park Dr. mtspokanehucklebearyepic.com (879-5119) SPOKANE TO SANDPOINT RELAY | The 8th annual, 200mile relay race starts atop Mt. Spokane and is open to teams of 4-12 runners. Aug. 14-15. $420/high school team; $900/team of 4-6; $1440/team of 7-12. Aug. 14-15. Starts at Mt. Spokane State Park. spokanetosandpoint.com

charity

Finding the Finish Line

W

ith each step, a movement comes closer to a much-anticipated finish line. The Spokane AIDS Network (SAN) has teamed up with two Western Washington organizations, Seattle-based Lifelong and the Pierce County AIDS Foundation (PCAF), to cohesively rebrand their AIDS walks, into the End AIDS Walks.

Spokane’s End AIDS Walk is Saturday, September 26, and SAN encourages walkers to register and donate online, but happily welcomes anyone, regardless of registration status.

The End AIDS Washington campaign was launched on World AIDS day — December 1, 2014 — by Governor Jay Inslee.

STRIDE FOR STRONG BONES | The fifth annual osteoporosis awareness 5K walk/run also features a raffle, bone screenings and educational information and presentations. Sat, Aug. 15, at 9 am. $15-$25. Waterfront Park, Medical Lake. wastrongbones.org (953-9924) PADDLE, SPLASH AND PLAY | The second annual event hosted by the Spokane Canoe and Kayak Club lets kids and their families test out various paddle-powered crafts on the Spokane River. Try out canoes, kayaks of all types, stand-up paddleboards and more. Bring a life jacket; Discover Pass also required. Sat, Aug. 15, from 10 am-2 pm. Free. Riverside State Park, Nine Mile Recreation Area, 11226 W. Charles Rd. sckc.ws DINNER UNDER THE STARS | Enjoy dinner with live music, and can bid for local artisan goods in a silent auction.

Proceeds support the Shared Harvest Community Garden.

Sat, Aug. 15, from 6-9 pm. $25/person. Shared Harvest Community Garden, 1004 E. Foster Ave., CdA. kealliance. org/dinner-under-the-stars (208-667-9093) 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. 16.

Olympic triathlon starts at 7:30 am, sprint distance at 8:15 am. $90-$100/individual, $155-$160/team. Waterfront Park, Medical Lake. emdesports.com (953-9924)

It’s a coalition of advocates whose goal is to halve the number of new HIV infections in Washington state by 2020.

An estimated 14,000 people live with HIV in the state, according to End AIDS Washington. Reducing new infections by 50 percent would make Washington’s transmission rate among the lowest in the U.S. Ariel Holcomb-Hockin, a case manager at SAN, echoes concerns from groups in Western Washington, who say these new, collaborative End AIDS Walks are all about fighting together to achieve the ambitious statewide goal. “Part of it is just joining together and saying, ‘This is Washington’s goal, this is the governor’s goal, and Washington state is unique in doing this.’”

— MATTHEW SALZANO End AIDS Walk Spokane • Sat, Sept. 26, at 11 am • Starts/ends in Riverfront Park at Northbank Shelter • sanwalk.org MILLWOOD DAZE | The annual community celebration includes a 5K run/walk benefiting Meals on Wheels Spokane, as well activities, games, live music and the Red Wagon Parade. Sat, Aug. 22; race begins at 9 am. $25$30/registration fee for the run. Race starts/ends near the Millwood Presbyterian Church, 3223 N. Marguerite Rd. mowspokane.org (232-0864) PRIEST LAKE TRIATHLON | The annual event at the scenic North Idaho lake offers Olympic and sprint distance courses, with individual and relay options for both. Sat, Aug. 29. Starts/ends at Hill’s Resort, 4777 W. Lakeshore Rd., Priest Lake. priestlakerace.com (208-946-9543) MARCH FOR THE FALLEN | Sign up for a 5K, 10K or 15K run, or the 15K march. The annual event honors all of Washington’s fallen military members, with proceeds donated to local veterans groups. Sat, Sept. 12, from 8 am-4 pm. $30. At Riverside State Park, Seven Mile Trailhead of the Centennial Trail. marchforthefallen.com CANCER CAN’T GOLF TOURNEY & DINNER | Cancer Can’t hosts a scramble-style golf tournament (at Indian Canyon, tee off at 12:30 pm) and a dinner with an auction, featuring keynote speaker Sean Swarner, who survived two separate cancers and to summit Mt. Everest with only one lung. Sat, Sept. 12, at 6 pm. $300-$600/team of four.

Dinner at the Lincoln Center, cancercant.info continued on next page…

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LIVING AUG. - SEPT. EVENTS GLOW IN THE PARK | This fun run through downtown Spokane features runners in neon and glow sticks, with proceeds benefiting the Inland NW Boys and Girls Club.

Sat, Sept. 12, pre-race events begin at 6 pm. $12-$34. At the Spokane Convention Center, the5kglowrun.com SPOKANE HEART & STROKE WALK | The annual walk/ run benefits the local chapter of the American Heart Association, and offers a both a non-competitive (free) and a timed 5K ($30) race. Sat, Sept. 12. Starts/ends in Riverfront Park, Spokane. spokaneheartwalk.org

NEWPORT BIAYAKATHON | A fast-paced kayak and bike race along the Pend Oreille River with proceeds benefiting the Pend Oreille Youth Task Force. Sat, Sept. 12, at 10 am. $25/persoon Starts in Oldtown Rotary Park, just across the river from Newport. biayakatahon.weebly.com COBRA POLO CLASSIC | The annual fundraiser features gourmet food, local wine, beer, and cocktails, paired with a silent auction, beautiful hats, a cigar and whiskey tent, and a lively game of polo. All proceeds support Ronald McDonald House Charities of Spokane. Sun, Sept. 13, from noon-4 pm. $200-$230/person. Spokane Polo Club grounds, 7500 W. Hwy. 2, mhcspokane.org/events/21

SPOKEFEST | The community cycling festival welcomes thousands of residents to downtown Spokane, for group bike rides, cycling safety tips, a bike swap and expo, and more. Choose from a 1- to 2- mile family ride, or 9-, 21- or 50-mile rides. Sun, Sept. 13, from 8 am-2 pm. $8-$25/person. Riverfront Park, Spokane. spokefest.org BIKE MS | The “Cycle the Silver Valley” event runs through beautiful North Idaho, to raise awareness and funds to support research and treatment of multiple sclerosis. Ride as an individual or as part of a team. Sept. 19-20. $75/ registration; $250/fundraising min. Starts/ends at Silver Mountain Resort, bikems.org (800-344-4867 x. 5)

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SCENIC HALF | The annual race winds through downtown Sandpoint and along the shores of Lake Pend Oreille.

Choose from a full, half-marathon, a 10K or a 5K distance.

Proceeds benefit the Greater Sandpoint Chamber of Commerce and the Community Cancer Services. Sun, Sept. 20. $25-$70/person. scenichalf.com (208-263-2161) JDRF ONE WALK | The local event, a 5K awareness walk, for the Juvenile Diabetes Research Foundation raises funds to research treatments and potential cures for type 1 diabetes.

Sun, Sept. 20, at 11 am. Starts/ends in Riverfront Park, Spokane. jdrf.org (459-6307)

CARING FOR KIDS LUNCHEON | The annual event raises funds for Catholic Charities’ St. Anne’s Children and Family Center and the Morning Star Boys’ Ranch. This year’s keynote speaker is Nancy Bartley, author of The Boy Who Shot the Sheriff - the Redemption of Herbert Niccolls Jr. Thu, Sept. 24, at 11:30 am. $50-$100/person. DoubleTree Hotel, catholiccharitiesspokane.org (358-4254) HAPPY GIRLS RUN | The women’s race series comes to Spokane for a second year, offering a course of varied terrain, pre- and post-race yoga, music and swag bags. Includes 5K, 10K and half-marathon routes. Sat, Sept. 26. $30-$90.

Riverside State Park. happygirlsrun.com/spokane

HOEDOWN FOR HOPE | The fourth annual benefit event for the Spokane HOPE School includes dinner, live music, dancing, live/silent auctions, raffles and more. Sat, Oct. 3, from 5-10 pm. $55/person. Spokane Convention Center, 334 W. Spokane Falls Blvd. spokanehopeschool.org (8637079)  The calendar is a free service, on a space-available basis.

Mark submissions “InHealth Calendar” and include the time, date, address, cost and a contact phone number. Mail: 1227 W. Summit Pkwy, Spokane, WA 99201; or E-mail: calendar@inlander.com.

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LIVING ESSAY

Born to Walk Put one foot in front of the other until you find what you’ve been missing

BY BEN MONTGOMERY

W

e were out of water. Had been for three hours, maybe longer. Our canteens were dry. So were the wine bottles we had drained the night before, passing them around a campfire between country songs. I could feel my heartbeat in my tongue.

The Marufo Vega trail in the Big Bend National Park is only a 14-mile round trip, a challenging two-day hike through the desert mountains of West Texas, much of it hugging the slow-moving Rio Grande. But we hadn’t seen the telltale rock cairns that mark the path in hours. We’d missed a switchback and followed a game trail for miles through bulrushes and down into a canyon. We realized we were off, but rather than turn back and retrace our steps, we plunged up the canyon, marching against the brutal sun, hoping it would eventually deliver us to the other side of the mountains, to the flatlands, where our van was parked on a small gravel lot.

There were six of us on that walk in the spring of 2001. Me, my two high-school buddies, my two older brothers, and two of their friends. I was the guy with the map because I was the guy who had planned this trip. All is equal among men during good times, by and large, but when imaginations start to churn against the probability of death, when water runs dry and tongues begin to swell, the guy with the map is an easy target for hate.

“Where the f--- are we?” my brother Paul

asked. We had stopped in the hot shade of a sheer cliff. I checked the map again, but it was worthless without a compass and some definite sense of bearing. I dropped my pack and sized up the nearest mountain.

“I’ll be back,” I said.

My plan was to climb the mountain, eyeball our van on the other side of the ridge and return with a way out. Maybe we’d sing songs on the walk to the van and guzzle the warm beer we’d left in the back seat.

Alas, as I crested the mountain, I found a loneliness that snatched my breath. As far as I could see in every direction were mountains upon mountains. There was no parking lot, no telephone lines, no ribbons of asphalt unspooling toward the promise of civilization. They say West Texas is one of most sparsely populated parts of the country. The rugged evidence stretched before me on top of that desperate peak.

And it’s the closest I’ve come to heaven.

A

re you tired, lonely, bored with life? Do you have diabetes, anxiety, depression or cancer? Are you worried about the loose skin around your neck or the fat hanging over your jeans or your receding hairline?

Then go test yourself against the earth.

Throw your Fitbit in the garbage, leave your treadmill under the bed in the guest room, and go.

Roaming the Selkirk Mountains of British Columbia.

DAVID R. GLUNS PHOTO COURTESY OF MOUNTAIN TREK

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Don’t tell anybody. No Facebook updates.

Hell, leave your phone at home. Just go take a long walk. It’s that simple. Put one foot in front of the other until you find what you’ve been missing.

Because we are missing something.

Man has relied on bipedal locomotion for about 6 million years. Our bodies, our anatomy, evolved for walking. The British writer Bruce Chatwin wrote that everything from our brains to our big toes are built for long journeys on foot.

Only recently have humans in large numbers chosen to sit and ride rather than walk.

At the beginning of the 20th century, the United States had just 100 miles of paved highway. Starting in the 1950s, when the suburbs were expanding and automakers were setting sales records year after year, the federal government would pave 40,000 additional miles to meet the growing demand for a faster way from A to B. This automobile explosion dovetailed with another dramatic shift in how we live.

In 1950, barely 10 percent of American families had a television set. By the end of the decade, 90 percent of us owned TVs. Peter Steinhart noted the change in Audubon in 1987, when Americans spent four hours a day in front of the television: “We experience life not through the soles of our feet but through the seats of our pants.”

In 1955, two emissaries from the sports world addressed a large gathering of family doctors in California. The point of their keynote was that the kids entering their programs were physically different than youngsters they trained in the past. Their bodies were different. The coaches, for the first time, had to build muscle instead of stretch muscle, they said. Right before their eyes, they were witnessing the evolution brought about by these American lifestyles and they pointed to the culprit: Kids don’t walk anymore.

Anthropologists estimate that early man walked 20 miles a day. The written record of the mental and physical benefits of walking goes back to ancient times. Prominent Roman writer Pliny the Elder (23-79 A.D.) described walking as one of the “Medicines of the Will.” Hippocrates said walking was “man’s best medicine” and prescribed walks to treat emotional problems, hallucinations and digestive disorders. Aristotle lectured while strolling.

Some of the best thinkers, writers, musicians and artists have extolled the virtues of walking. Da Vinci designed elevated streets to protect walkers from cart traffic.

Johann Sebastian Bach walked 200 miles to

hear a man play the organ. William Wordsworth was said to have walked 180,000 miles in his lifetime. Charles Dickens once said, “The sum of the whole is this: Walk and be happy; Walk and be healthy.”

Robert Louis Stevenson wrote of “brief but priceless meetings which only trampers know.” Friedrich Wilhelm Nietzsche said, “Only those thoughts that come by walking have any value.”

In an 1862 essay in the Atlantic, Henry David Thoreau warned about the coming of the “man-trap” — the automobile — that would “confine men to the public road, and walking over the surface of God’s earth shall be construed to mean trespassing on some gentleman’s grounds.”

“Let us improve our opportunities, then,” he wrote, “before the evil days are upon us.”

I

n his new book Born to Walk: The Transformative Power of a Pedestrian Act, Dan Rubinstein again makes the case that walking connects us to ourselves, our fellow citizens and where we are right now.

It also affords us the gift of time. “Done by choice, untethered from the market and wireless contraptions, it can be an act of defiance,” he writes. “In the early decades of the 21st century, an era of climactic convulsions, rapacious profiteering, crushing debt, deadly ‘lifestyle’ diseases and the attenuation of non-virtual community, these are precious commodities.”

Indeed.

I walked down from that mountaintop in Texas with a fulfilling sense of insignificance. The group received the bad news as you’d expect, and desperation settled on us.

So we walked. We turned back in silence and put one foot in front of the other. Miles later, we found the Rio Grande and drank her warm water on our bellies and filled our canteens. Miles later, we found the trail and a fallen sign that marked the switchback we had missed. Miles later, we found our van.

The next day, drinking cold Tecate in a cantina in a little Mexican village called Boquillas del Carmen, we talked about how we had not only made it, but we felt more alive than ever. Our long walk had pricked some membrane between us and our primitive selves. We had found triumph in survival itself, a step at a time.  Ben Montgomery is a reporter for the Tampa Bay Times and author of Grandma Gatewood’s Walk: The Inspiring Story of the Woman Who Saved the Appalachian Trail.

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