Inhealth June 2013 by The Inlander

INHealth

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Health SPOKANE • EASTERN W ASHINGTON • NORTH IDAHO 9 S. Washington St., 4th Floor, Spokane, Wash. 99201 phone: 509-325-0634

editor Anne McGregor

annem@inhealthnw.com

managing editor Jacob H. Fries a r t DIRE C TOR Chris Bovey calendar editor Chey Scott photographer Young Kwak

Bridging Distances. Serving Communities.

contributors Cat Carrel, Heather Caro, Jennifer DeBarros, Nicholas Deshais, Lisa Fairbanks-Rossi, Heidi Groover, Jacob Jones, Jo Miller, Sarah Munds, Deanna Pan, Stephen Schlange, Carrie Scozzaro, Matt Thompson, Daniel Walters, John R. White

From critical care transport, medical rehabilitation and

production manager Wayne Hunt

professional health education to advancing health care

a d v e r t i s i n g SALES MANAGER Kristi Gotzian

technology, connecting patients and health care organizations and getting injured workers back on the job, INHS is bridging

director of marketing Kristina Elverum

distances, connecting communities and improving health.

advertising sales Tami Booey, Kristin Wagner, Bruce Deming, Carolyn Padgham-Walker, Emily Walden, Jamie Albertini, Jean Russell, Autumn Adrian

To view the INHS Community Report, visit www.inhs.org/2012CommunityReport.

Sales coordination Raevyn West, Rebecca Rison, Angela Rendall

St. Luke’s Rehabilitation Institute

Community Wellness

Information Resource Management (IRM)

Center of Occupational Health & Education (COHE)

Northwest MedStar

Health Training

Northwest TeleHealth

Center of Philanthropy

design and production Tom Stover, Derrick King, Alissia Blackwood, Jessie Spaccia DISTRIBUTION MANAGER Trevor Rendall business manager Dee Ann Cook credit manager Gail Golden publisher Ted S. McGregor Jr. general manager Jeremy McGregor

InHealth is published every other month and is available free at more than 500 locations throughout the Inland Northwest. One copy free per reader. Subscriptions are available and cost $2.50 per issue. Call x213. Reaching Us: Editorial: x261; Circulation: x226; Advertising: x223. copyright All contents copyrighted © Inland Publications, Inc. 2013. InHealth is locally owned and has been published every other month by Inland Publications, Inc. since 2004.

Inland Northwest Health Services (INHS) is a non-profit corporation in Spokane, Washington providing collaboration in health care services on behalf of the community and its member organizations Providence Health Care and Empire Health Foundation.

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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ometimes you do something that might be considered merely unwise by more charitable folks, or simply crazy by unflinchingly honest types. Adopting two puppies, as we recently did at our house, is the type of thing that qualifies as crazy. At a total combined weight of eight pounds, the puppies’ impact on our household can hardly be overstated. So in hopes that they’re actually worth the hullabaloo, I did a little research to soothe my sleepdeprived brain. Are pets good for us? Thank goodness, the answer seems to be yes. A study out just this spring shows that dog owners seem to have a lower incidence of heart disease. There are a lot of possible explanations, but among other things, research shows dog owners are 54 percent more likely to get the recommended daily amount of activity. Even better, just playing with a pet helps raise serotonin and dopamine levels — hormones that can increase a sense of satisfaction and well-being. Taking care of our precious pets is a multibillion-dollar industry, now featuring genetic testing and full dental workups. You’ll learn all about it in our special “High-Tech Pets” feature. And just when you thought health care was complicated enough, guess what? Now you can sign your critter up for its own health insurance plan. To your health!

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CHECK-IN

STAY CONNECTED Send letters and story ideas to InHealth Editor Anne McGregor at annem@inhealthnw.com. Join the conversation on the InHealth Facebook page and at InHealthNW.com.

ON OUR FACEBOOK

How has having a pet helped you or your family? JESSE ACOSTA: My closest confidant and loyal friend who was always there to make me smile even on the worst days was my dog. Dogs are man’s best friend. Animals bring out the humanity in people, as backwards as that sounds. MARK THAYER: Yes, when I don’t have a cat, I am way more stressed and get mad much easier. I also sleep better with a cat nearby.

THEIR OWN WORDS

Marquette Hendrickx Marquette Hendrickx is the grants manager at the Benewah Medical and Wellness Center in Plummer, Idaho. A graduate of the University of Idaho with a Master’s Degree from Gonzaga University, Hendrickx is also a member of the Coeur d’Alene Tribe. In October 2012, the Benewah Medical Center opened in a building designed by NAC Architecture of Spokane. The center is believed to be the first joint venture in the U.S. between a tribe and city municipality for the purpose of providing health care for all residents.

BILL TURNER: Our dogs give my family hours of comedic enjoyment. Our dogs are absolute idiots and prove that point on a daily basis!

What makes you happy when you show up to work here? Well, you saw the building. It’s very beautiful. But I think just knowing that we’re all here for a common purpose, and that’s to serve the community. Each of us do various jobs here. I write grants, but it’s still a big part of the whole puzzle. Just knowing that you’re a part of something bigger in the community.

JESSE JOHNSON: When I found out that our Dachshund liked to hike, I got off the treadmill and began exploring the outdoors. She never quits, doesn’t like breaks and always want to go.

What’s new? We have a new grant funded through the CDC that’s a community transformation grant. So it is not just direct service, it is getting out into the community, into the schools, into workplaces helping implement employee wellness programs, looking at restaurants to help revise menus to offer healthier options.

KARI JESSOP: Filled part of the hole for my daughter when my son left for the Army.

It’s hard to get people to change their habits. Do you think your emphasis on preventive care is working? It is getting out there more, the more people see how much it helps. In the past year, I’ve seen people take the initiative to go to the wellness center and lose 40, 50, 100 pounds. People are really taking their health seriously. The manager at the store is working with us and the community transformation grant to offer healthier choices in the store … because it’s difficult here in the rural community. A lot of people have to go to Spokane or Coeur d’Alene to do their food shopping. So having healthier options down here — fresh fruits and vegetables, whole grains — where they can access them and not spend twice as much is important.

JESSIE SPACCIA: Our pets bring us happiness every day. Any time either of us is having a bad day, our babies are there to brighten it. Couldn’t live without ’em. STEPHANIE HEITNER: They keep me sane. They provide petting therapy when I come home stressed from work! They love me no matter what, and keep me balanced. TYLER WILTSE: I have fortunately spent much of my youth and some of my adult years with horses, dogs and cats that are capable of expressing “perfect love.” 

What is unique about a tribal-run health center? A lot of providers haven’t worked in native communities. Establishing that cultural competence right away is important. It is so important to learn about the history of the tribe. As a health care provider, you need to develop trust with the native patient before they’re going to open up because of the historical trauma. Building trust is really important. — INTERVIEW BY ANNE McGREGOR

|MIKE McCALL PHOTO

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CHECK-IN CHARITY CORNER

Heading for Home

Cat Carrel is a certified life coach in Spokane. LIFE COACHING

Positive Flow

ave you ever wondered why it’s so difficult to change the way we think? Our thought processes evolve over the course of our lives. By the time we are adults, our way of thinking is deeply ingrained. Now imagine that our thoughts are like a river. We can see that the longer we think a certain way, the deeper the path these thoughts can cut in our minds. The course of negative thinking is the most difficult to change. At times that path of gloom may seem as deep as the Grand Canyon! If we become mindful of the way we think — dismissing negative views and reinforcing positive ones — we can begin to divert that deeply cut path into another course. Like a small stream that breaks away from the powerful river, it may seem daunting at first. The more we concentrate on the positive the more we reinforce our new way of thinking, and eventually our happier thoughts run their own course of positivity through our minds. This summer, become mindful of your thoughts and choose the path that you wish to flow. — CAT CARREL

hat better way to celebrate the Fourth of July than with a footrace, some baseball and fireworks? For the second year in a row, the Spokane Indians are opening up their home field to hundreds of runners. The Pennant Run features 1K and 5K courses that wind through the Spokane Fairgrounds, with both races ending in a victorious lap around the bases at Avista Stadium. The finish line is, of course, home plate. There’s also a Little Slugger’s Dash for kids. Participants get a technical T-shirt, while winners receive an engraved bat saluting their efforts. Everyone gets a ticket to the baseball game that evening, and fireworks will cap off the day. Best of all, proceeds from entry fees will benefit Wounded Warriors, the organization that helps severely injured service members as they transition back to civilian life. “The Wounded Warriors, they touch a lot of lives,” says Indians Promotions Coordinator Alex Capeloto. Pennant Run, July 4 at 10 am. $15-$30, kids under 3 free. Avista Stadium, 602 N. Havana St. spokaneindianspennantrun.com (535-2922)

PILL BOX

Sound Sleeping Is there a new side-effect-free sleeping pill?

T John R. White is a pharmacy professor at WSU-Spokane.

he search for the “holy grail” of insomnia continues. Every few years a new medication for insomnia is brought to market with claims of little or no side-effects. Typically within a year or two we realize that side-effects are a problem. This is the story of many different sleeping pills over the years, including some that we later determined to be quite dangerous and actually removed from the market. Now the story may be different. As neuroscientists learn more about sleep, better medications become a possibility, even a probability. Most current prescription sleeping pills target a group of receptors in the brain called GABA receptors, which, when blocked, not only force the brain to go to sleep but have deleterious effects on memory and even attention the following day. A new drug currently before the FDA is much more specific in its target. The drug, suvorexant, blocks naturally produced substances called orexins. The normal effect of orexins is to keep us awake. Blocking orexins makes it easier to go to sleep and does not have the typical side-effects seen with other sleeping medications. About 10 percent of people taking this medication have reported sleepiness when they woke up, and about 6 to 8 percent reported having headaches. Still, if this medication is approved, it likely will be superior to other currently used prescription sleep aids. As with any medication, however, the real test will be determining if more side-effects crop up after it is used by hundreds of thousands of people. — JOHN R. WHITE

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

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SUPERFOOD

Berry Healthy Attributes: The strawberry is one popular berry. Nationally, consumption has doubled in the past 20 years. Although strawberries are available yearround, the tastiest ones are local: Pick your own at the Green Bluff Strawberry Celebration June 29-30 and July 6-7. Superpowers: Dare to compare — a serving of eight strawberries has half the sugar of an apple, twice as much fiber as a serving of grapes, and one-third the calories of a banana. Regularly eating strawberries may delay cognitive aging and reduce the risk for heart disease. Strawberries are a “superfood” for those with diabetes.

Weaknesses: Fresh berries spoil quickly at room temperature and last only about three days in the refrigerator. Don’t wash them until you’re ready to eat them.

ask dr. matt

Teenage Jitters

Matt Thompson is a pediatrician at Spokane’s Kids Clinic.

or about 80 percent of adults every day, caffeine in moderate doses delivers increased feelings of alertness, decreased feelings of fatigue and gives a handy kick of energy. Through a bit of chemical chicanery, caffeine seems to trick the body into disregarding signals that it is fatigued and needs rest. After all, actual rest takes too long. Ain’t nobody got time for that, especially teenagers who have many pictures to post and tweets to send. But what are the limits of safety when it comes to consumption of caffeine by teens and children? The answer is not clear, as caffeine has many elements beyond how it may affect blood pressure, appetite, blood sugar level, etc. After a chewing gum giant recently launched a product containing the equivalent caffeine content of four cups of coffee

How to use them: Slice a generous portion of fresh strawberries into a salad of fresh spinach and thinly sliced red onion. Dress lightly with poppy seed dressing. Top with slivered almonds. — Anne McGregor

per pack, the FDA chimed in that maybe they ought to look into the growing trend of adding caffeine and other stimulants to food products. The manufacturer soon pulled the gum from the market. This is not the first time the FDA has been involved with caffeine regulation — they did so in the 1950s when deciding a safe amount to allow in cola. They similarly stepped in a few years ago when the production of a beverage combining caffeine and alcohol was deemed a dangerous marriage. Such stealthy stimulants do concern me considerably when it comes to the health and well-being of our children. I worry that, while an adult might say “Whoa!” if they saw an 11-yearold pour a cup of coffee, they might not notice the same kid chewing a piece of “double latte mochachino with room for cream” gum. And I think even more pressing is what happens to kids who become accustomed to overriding the body’s intrinsic traffic lights that are designed to elicit the urge for essential rest. Good call FDA, I’m glad somebody is watching out for us. — Matt Thompson

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CHECK-IN

HEALTH NEWS

Saving a Life

“S

udden cardiac arrest is a national health crisis,” says Ryan Schaefer. “It is one of the biggest killers in the U.S. today.” CPR can save a life, but Schaefer, an RN and coordinator of electrophysiology at Providence Medical Center, says research showed bystanders weren’t that eager to attempt it in an emergency. They lacked confidence in their skills — that they would remember how to do the breathing and compressions correctly, and in the right ratios. And then there was “the yuck factor,” says Schaefer, meaning people were reluctant to give rescue breaths to someone they didn’t know. Interestingly, research showed that people who did attempt the rescue breathing had a hard time with it, sometimes taking up to 30 seconds to deliver the requisite two breaths, critical time during which the victim was without blood flow. Now, the recommendation is much simpler. “If you see a person that has suddenly collapsed, they are unconscious, they are not responding to any arousal at all, or not breathing at all — they need CPR,” says Schaefer. It’s easy, he says. “The simplicity of CPR is push hard and fast in the middle of the chest until they wake up or help arrives.” If you want to get more technical, the compression rate is about 100 times per minute, at a depth of two inches. Need help keeping time? Try compression to the rhythm of that old — and now aptly named — Bee Gees hit, “Stayin’ Alive.” — ANNE McGREGOR

GOOD READ

Bathing Like Benjamin

oes good health play a role in the creative process? It can, argues Mason Currey, who spent more than two years blogging about the way some of the greatest artists and thinkers worked. Now he’s collected his findings in his new book DAILY RITUALS. And while there’s plenty of alcohol and coffee in the 161 short profiles, there are also long walks (Georgia O’Keeffe liked to kill rattlesnakes on her morning constitutionals) and power napping (Frank Lloyd Wright would nod off three times a day). There are some oddballs for sure: Victor Hugo would swallow two raw eggs every morning, while the German poet Friedrich Schiller kept rotting apples in his study; the smell apparently reminded him to get back to work. And Benjamin Franklin swore by his “air bath.” “I rise early every morning, and sit in my chamber without any clothes whatever, half an hour or an hour,” he wrote in his Autobiography. “And if I return to bed… I make a supplement to my night’s rest of one or two hours of the most pleasing sleep that can be imagined.” Whether it was the bath or the extra two hours of sleep, Franklin’s ritual made his mind really crackle. Mostly these artists share a ferocious focus on their subjects that veers into obsession. There’s probably a gene for that, but that’s another book. — TED S. McGREGOR JR.

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BRAIN EXERCISE

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

Sudoku

RATINGS: Moderate (both puzzles) To complete Sudoku, fill the board by entering numbers 1 to 9 such that each row, column and 3x3 box contains every number uniquely. Answers to all puzzles on page 41

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

Codewords

Each letter has been replaced by with a number. Using the starter clues, work out the words that must go in each cell on the codeword grid. Some well-known phrases and names may also be found. For a two-letter clue, turn to page 23. 17

17 17

14 17

17 3

21 1

8 2

24 21

7 19

14 7

21 11

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

5 6 7 2 9 4

2 6

9 5 8 8

4 3 4 8 7 5 6

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.

4 1 3

8 9

5 4 2

1 3 2

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news in-depth

Rehab Reality Inside the long and frustrating struggle to conquer addiction story by Nicholas Deshais n photos by young kwak

oys are stacked on the front porch of the Isabella House, but the kids are nowhere to be seen. Inside the front door and behind a red, velvety curtain in the imposing 113-yearold house on the edge of Coeur d’Alene Park in Browne’s Addition, their playroom is also abandoned, smelling faintly of cleaning product. “The kids are at the park,” says Art Jacobs, who runs the house. “The women are meeting.” Jacobs is leading a tour of the inpatient facility, which serves chemically dependent “pregnant or post-partum women.” There’s the TV room with seats

for a dozen or more people, the dining area for twice as many and the kitchen, where a woman is lining up frozen burger patties on a baking sheet. Behind a closed door, the women who live here are talking. In the stairwell, a whiteboard gives the only real clue as to why all these women live together. It has the names of the residents gridded out below strange headers like “Blackout” and “Phase One.” There’s one ominous category: “AWOL.” The women who live here have been nurses, teachers, homeless. They’re young and older. The one thing that

connects them is addiction, be it meth, prescription drugs or alcohol. And now, for reasons usually beyond their control, they stay here for up to six months to get clean, share in the housekeeping duties and babysitting, and help guide each other to a sobriety that sticks. “The longer they stay, the better their chances of recovery,” says Jacobs. “I tell my patients every day is a critical day, an important day.” The Isabella House, run by New Horizon Care Centers, is just one of nine residential treatment agencies in Spokane that has a contract to do business with the state. It’s also one of dozens of programs and services aimed to help people kick whatever chemical they’ve staked their lives upon. The state’s Department of Social and Health Services alone certifies 47 chemical dependency services in Spokane County. The county’s Community Services, Housing, and Community Development Department certifies 24 providers, though there is some overlap. It’s a system designed to help people stop using drugs, a bulwark against the ...continued on next page

Isabella House in Browne’s Addition

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news “rehab reality,” continued... corruption of the basic underpinnings of society. But it’s a complicated and opaque system. And conquering addiction — both physically and mentally — is an enormous task. It’s no wonder some say the system doesn’t do enough, or doesn’t work at all. “Overall, there is definitely a need for additional funding for substance abuse,” says Christine Barada, director of the county’s community services department. “We work with a large number of providers in the community. Those providers will tell you they struggle to provide the services.” Asked if there are people out there who can’t get help simply because there’s not enough money available to fund the programs at an adequate level, Barada doesn’t have to think long about it. “There are a lot more,” she says. “Specifically, lower income people.”

istorically, the state doled out its funding based on population. In Spokane County’s case, this amounted to the county receiving just 8 percent of funding allocated for chemical dependency in the state.

Art Jacobs of the Isabella House: “I tell my patients every day is a critical day, an important day.”

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“Moving forward into our new contract year, we have a new formula that will be based on the number of people who are at 200 percent or less of the federal poverty line,” says Charisse Pope, the county’s drug and alcohol coordinator. “These folks need more help. They are the ones who have lost their homes or are in jeopardy of losing them.”

There’s the money dedicated to methadone or suboxone. There’s adult outpatient and youth outpatient, detoxification, sobering, and child care for individuals in treatment and people who fall under the involuntary treatment act. The county also receives Medicaid through the state, which can be used for dependency programs. It gets grants and

According to the National Institutes of Health, 23.2 million people in the United States needed treatment for a drug or alcohol problem in 2007. Only 2.4 million got it. In other words, nine of 10 people who needed help didn’t get it. Simply put, this is a good thing. But there’s nothing simple about the way treating drug abuse is funded. “The challenge is it comes in different streams,” says Pope. “Each stream is targeted to different individuals with different rules. That’s a real challenge. Sometimes the funding is lopsided.”

aid for people who fall under the federal poverty level. Money comes in for parents who are in jeopardy of losing children if they don’t get treatment. There’s funding for people who get in trouble with the law. That’s not even the end of it. The state itself takes care of a slew of other programs without the county’s help, including inpa-

tient facilities like the Isabella House. As Jacobs enters just about every room at Isabella House with barely a knock, it’s clear that the women signed over any right to privacy when they entered the door. “They don’t have it,” he says. “We need to be able to go into their rooms at all times.” When the women want to leave the house, they have to make a request. They have to say where exactly they’re going, when they’re leaving and when they’ll be back. They have to call every hour to check in. They gave their life to drugs; now they’ve given their lives to Isabella. The difference is, the 23 women and their 18 kids are doing it together. Some of them are relearning what it’s like to lead a drug-free life as an adult. Others are learning it for the first time.

hose at Isabella House are, in a sense, lucky. They are receiving treatment. According to the National Institutes of Health, 23.2 million people in the United States needed treatment for a drug or alcohol problem in 2007. Only 2.4 million got it. In other words, nine of 10 ...continued on next page

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news “rehab reality,” continued... people who needed help didn’t get it. For nearly everyone in treatment, conquering substance abuse is an uphill climb. Studies have shown that drug abuse has a long life, in many cases lasting more than a decade from first use to last. One study of opiate users showed that over the course of 12 months, more than two-thirds relapsed to daily use. In all likelihood, staying clean will take more than one episode of treatment. Spokane Valley’s Laurie Taggart has watched both of her sons struggle, again and again, to overcome addiction. Her oldest son’s troubles began when he got a DUI at 17. He sought treatment at Lakeside Recovery Center, but the teen was out of place among 50-year-old alcoholics. A minor-in-possession charge in Cheney came when he was 19. And after failing a third drug test stemming from that charge, a judge ordered his arrest, and he was sent to Geiger Corrections Center in Airway Heights. “He told me he saw worse stuff there than ever before,” Taggart says. “The first time he saw heroin was there.” Now 23, he’s in jail in Wheatland, Wyoming. Taggart isn’t sure for how long. Her youngest son is now 21 and still lives at home, pouring cement by day to pay off the $5,000 in court fines he’s accrued getting in trouble as a teen. Problems, she says, really began when he was devastated after getting cut from the high school baseball team. He started drinking and smoking pot. Then he tried to sell a breath mint as Ecstasy to a classmate. He was arrested and charged with a felony, says Taggart. His life tumbled after that. He was enrolled in Daybreak Youth Services’ outpatient program. Then he was sent to 40 days in the wilderness with the SUWS Wilderness program in Idaho, an accredited intervention program for kids. He came back “looking great,” says Taggart, but it didn’t stick. He’s finally broken free from some of his demons, but “he’s still struggling,” says Taggart, adding hopefully, “He’s not drinking.” She keeps both her boys on her health insurance, just in case they want to enter a program, but she looks skeptically at the system she’s been involved with so far. She doesn’t blame anyone other than her kids — and herself — and she doesn’t view them as unwilling victims. She just wishes something had worked. “Kids can’t do a 12-step program. They don’t get it,” she says. With offenses racking up thousands

A Painful Process

New Vision’s Jina Doggett: “We are the only medical detox on this side of the Cascades.”

icking drugs is complicated in part because of the painful process of withdrawal. The New Vision program at Providence Holy Family Hospital focuses on helping people through those initial tough days without chemicals. But while desperate family members may want to drop off an addict, that’s not part of the plan. “We are a self-referred service. So we don’t do any involuntary treatment. The patient has to be the one to call us,” says Jina Doggett, service coordinator at New Vision. “Intake takes about 30 minutes over the phone. We’re asking them demographic info, use history, medication that they’re on, anything the doctor would need to know, insurance info.” When the patient shows up, they have to show signs of withdrawal. Then it’s a three-day stay, on average, with their own private room and bathroom. “We don’t want them mingling with other patients. It’s more of a private process,” says Doggett. “There’s nothing social about ours. There’s no behavioral health program. It’s strictly a medical-based service.” As a “medical stabilization service,” there’s 24-hour supervision by a medical professional and a doctor on hand to dispense medication. The goal: to get patients medically stabilized so they won’t be distracted when they’re at inpatient or outpatient services following their stay. About 30 to 40 patients receive care each month, at an average cost of $5,325 for a three-day stay. “We are the only medical detox on this side of the Cascades. We don’t have a charity bed — yet,” says Doggett. “But we do accept Medicaid. We accept any insurance, state or private. And we do accept cash.” — nicholas deshais

of dollars in fines, Taggart says it becomes harder and harder for people to get out of the system. “Once they get into the court system, that’s what’s wrong with it, you can’t get out.”

andra Altshuler doesn’t blame Taggart for being frustrated. Kicking a habit is a tough task, with substance abuse treatment programs nationwide suc-

ceeding with just 40 percent of their clients. “I look at research all the time,” says Altshuler, the coordinator of Behavioral Health Adult Felony Therapeutic Drug Court, which is part of the Spokane County Superior Courts. “We really can’t predict who will succeed and graduate. We can’t predict it. The good news of that, in my opinion, is we don’t exclude people.” Altshuler says the drug court she runs

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has a 70 percent success rate, something she lays squarely on the shoulders on the coupling of addiction treatment with the court system, a concept borne out by the latest research. “We have the threat of the law behind us,” she says. “I hate to be harsh about it, but that’s the truth of it. … The judge doesn’t sit there and yell at them, but it’s a full-blown courtroom hearing.”

The added bonus for the graduates is simple and real: Their charges are dropped. After all, this is a court, and the people who wound up here were in trouble with the law. Altshuler notes the court doesn’t accept violent or sex offenders. Nationwide, addicts have about an 80 percent recidivism rate, meaning the vast majority break the law after being released from incarceration. Drug courts

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The added bonus for Drug Court graduates is simple and real: Their charges are dropped. “By the time they graduate, they’re committed citizens rather than a drain on society.” It’s also a full year of participation by the people who sign up, ending with at least four months of sobriety, checked by random drug tests. Throughout the year, the court’s participants become more and more involved in what Altshuler calls the “recovery community.” “By the time they graduate, they’re committed citizens rather than a drain on society, so to speak,” she says.

across the country average about 35 percent. “Ours has a 20 to 25 percent recidivism rate,” she says. “Even those who have left the program [prematurely] … have a 45 percent recidivism rate. So at least we helped them in some way.” For some, at least, “it is possible,” says Altshuler. “It is absolutely possible” to get out of the system. 

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ike most new mothers, Coeur d’Alene resident Rebecca Schroeder remembers feeling in awe of her baby boy when he was born in the summer of 2007. In the days following his birth, she recalls counting Brady’s tiny toes and smoothing his blond hair. But at his twoweek follow-up appointment, her baby was already showing signs that something was terribly wrong. “That’s when I first heard the words ‘failure to thrive,’” says Schroeder as she numbly recalls Brady’s steady weight loss, shrill cries and a nurse repeating a heel-stick screening test for a disease called cystic fibrosis. Cystic fibrosis, Rebecca and her husband Brock would learn, is a rare but fatal genetic disease affecting around 35,000 Americans (70,000 worldwide). Due to a dysfunctional protein, people with CF produce thick, sticky mucus that clogs the lungs, obstructs the pancreas and decreases the body’s ability to absorb food. CF patients often lead lives punctuated by lengthy hospital stays and strict medication regimes. And despite advances, their average life

expectancy is still only in the mid-30s. A confirmation call from the pediatrician’s office quickly launched the young family into a whirlwind of doctor’s appointments, testing and consults, including a prescription for pancreatic enzymes that had to be force-fed to Brady with every meal, and that he would need to take for the rest of his life. “That was overwhelming,” recalls Rebecca. “And that’s one of the minor things now.” By the time Brady was 2, old enough to graduate to a fitted “shaker” vest that mechanically loosens stubborn secretions in the lungs, he no longer protested the necessary medical treatments. In fact, he had been holding his nebulizer on his own during treatments since he was 9 months old. Still, despite diligent compliance with his medical regimen, by the age of 4, Brady had endured multiple surgeries to remove his tonsils and adenoids, and to clear away the aggressively growing nasal polyps that took away his sense of smell and threatened to break the fragile bones in his skull. Soon he was cycling on three-week bursts of pred-

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nisone and steroid rinses just to maintain his airway. The downward spiral came to a screeching halt once Brady was prescribed the breakthrough drug Kalydeco, which received FDA approval in January 2012 for people ages 6 and older with a specific gene mutation affecting only about 3 percent of CF sufferers. Though not a cure, the drug dramatically slows the progression of cystic fibrosis. Remarkably, the wonder drug was financed almost entirely by the nonprofit, donorsupported Cystic Fibrosis Foundation. And though it targets only a few CF sufferers, the possibilities it represents have sent ripples of excitement throughout the medical community. It’s also making waves for the cost — nearly $300,000 a year — steep enough to cause many insurance companies to balk at coverage. The company that makes Kalydeco defends the cost. “Kalydeco is the first medicine to treat the underlying cause of CF in patients with the G551D mutation and we believe the price reflects the benefit to these patients, the cost of the medicine’s development and our continued investment in the research and development of other

potential new medicines for CF,” says Nikki Levy, senior director of corporate communications at Vertex Pharmaceuticals. As is often the case with other unusually pricey medications, Vertex works with families to make the treatment affordable. “Most patients taking Kalydeco who use our copay program have a fixed co-pay of $15,” says Levy. In clinical trials, Kalydeco was nicknamed “blue lightning” because of its fast results. “As soon as Brady started taking the pills, the intense observation period started,” says Rebecca. After three days his snoring ceased and he began commenting on the way things smelled around him. “It gave him back one of his senses,” says Rebecca, who recalls Brady sniffing food, flowers and even rocks with glee. Brady also began gaining weight and his personality changed from irritable to inquisitive. A follow-up sweat test revealed Brady’s chloride levels had dropped to an astounding 17 mm/L from a baseline of 105 mm/L (a level greater than 60 is considered diagnostic of CF in those 6 months or older). The Schroeders are proponents of the drug — Rebecca, a chemistry major, even tattooed the Kalydeco molecule across

her foot — but are quick to admit it is no substitute for a cure. A recent gastrointestinal illness led to Brady requiring intense nebulizer treatments after just a few missed doses of Kalydeco. It was a humbling reminder of how fragile his health still is. “We don’t know what the future holds for Brady,” says Brock, who explains that they have not yet decreased Brady’s 28pill daily medication regimen, though his overall health has improved greatly. In fact, the family has been able to enjoy many firsts over the past year, including camping trips, vacations and even a live Christmas tree. “We’re constantly trying to find a new normal,” he says. Promising new drug trials are underway that may benefit more than 50 percent of the CF population and bring a new normal to families around the world. “Everybody in the community really has this idea that we’re going to cure this disease,” says Rebecca, who serves on a CF Parent and Family Advisory Board and organizes several annual fundraisers to benefit the CF Foundation. “But when you’re dealing with a disease like CF,” she says with a sigh, “you don’t have the luxury of time.” 

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Client advocate Mark Garrett at the Spokane Aids Network office. stephen schlange photo public health

New Age of AIDS The fight against AIDS has come a long way — but there’s still no cure By Daniel Walters

he exam room was cold, clinical, defined by sterile white walls. When the nurse came in with his diagnosis, she was crying. She didn’t even have to say anything. Mark Burnett knew. This was in 1988 in Santa Rosa, Calif. Then and there, AIDS was a death sen-

tence. His reaction to finding out he had it, he says, was typical. “There’s denial, there’s anger. There’s desire to make it go away,” Burnett says. But there was a part of him that knew it was coming. He was gay, dating another gay man he suspected had the disease.

“He knew he was probably HIV positive, but refused to get tested,” Burnett says. Burnett had used condoms to try to protect himself, but apparently it hadn’t been enough. Back then, there was a pill you could take to treat AIDS. But Burnett says he knew it wouldn’t necessarily extend his life, or make it any better, and it came with a price tag and side effects. And so he went without. He tried unconventional therapies instead — burning his skin with acetic acid and chugging hydrogen peroxide. Whether they worked or not, it gave him just enough hope. He put his head down, pouring himself into his work. The disease stripped away his immune system until his T-cells had dwindled to nearly nothing. “It was scarier than hell when you’re running on empty,”

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Burnett says. “You feel like the bubble child.” He was saved by an opportune medical breakthrough. A new drug regimen — a cocktail of different medications that attack HIV/AIDS simultaneously at a variety of different stages. He started taking the new medications, and moved to Spokane. A quarter-century after being marked for death, Burnett lives on.

oday, Burnett’s a client advocate with the Spokane AIDS Network — working to help people like him. He’s seen the way education and treatment has advanced over the past 25 years, nationally and in the Inland Northwest. In Spokane, the rate of infection is significantly lower than in Washington state as a whole. From 2002 to 2010, the infection rate in Spokane remained stable — about 24 new cases a year. But that stability also means the infection rate has not decreased. “That indicates that people are still becoming exposed to and infected with HIV,” says Lisa St. John, the HIV/STD program

200 the number of needles that a person can exchange in a single visit. St. John worries the cap will hurt drug users who exchange needles for a wide variety of people, many of whom are reluctant to come to the Health District in person.

urnett sits in a conference room at the Spokane AIDS Network headquarters on the lower South Hill. Other than a small decal on the window, it doesn’t look like a building focused on AIDS, or even an office. If anything, it appears to be a suburban house, with a front porch and Victorian-style architecture. In a way, the anonymity provided here is recognition that AIDS patients, even with decades of national education, still fear the ignorance of others. By now everyone should know that, for all but the most bizarre outliers, HIV is only passed on through sexual contact, shared needles, or pregnancy. Sadly, some people still cling to old fears. “Even though we’re over 20 years into this epidemic, we still have people living

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From 2002 to 2010, the infection rate in Spokane remained stable — about 24 new cases a year. But that stability also means the infection rate has not decreased. manager for the Spokane Regional Health with HIV who have family members who District. are afraid to eat dinner with them,” St. John And while the rate of those dying says. “And folks who are afraid to ride in from AIDS has fallen statewide thanks to the car with them.” medical advances, it’s remained stable in Those obsolete notions aren’t just unkind, they can be dangerous. Spokane. “That lack of understanding strongly “We see a disproportionate impact on contributes to people who do have HIV communities of color and ethnic communities,” Burnett says. The infection rate for being unnecessarily isolated,” St. John black individuals in Spokane County is five says. “And watching other people be that times higher than that for white individuals. isolated, and seeing the stigma, really does The vast majority of those infected are deter people from getting tested.” men — and more than 60 percent of those Getting tested is easier than ever. A who contract HIV in Spoblood draw and lengthy kane County are men who wait have been replaced by have sex with other men. a simple oral swab, with refrom the puzzle on page 13 sults available in 20 minutes. “Having multiple relation3 = G; 14 = E Last year, the Health District ships at the same time can processed 350 of these tests. spread the disease a lot While improved treatments have transfaster,” Burnett says. “It’s amazing when you put that into a [mathematical] formula, formed the lives of people infected with what happens.” HIV, they’ve also had the effect of removing the disease from the front page. But Spokane, however, has been a leader in patients like Burnett still have AIDS. He trying to address the next most common remains on disability. His immune system way to spread the disease: intravenous drug remains compromised. And so for now, he use. The Health District’s needle exchange still has a mission. program, one of the first in the state, exchanged 800,000 needles last year for more “We can end AIDS in our lifetime,” than 1,700 people. Burnett says. “We’re not going to quit until But lately, budget cuts have capped at we find a cure.” n

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Medical samples being prepared at Incyte Diagnostics in Spokane Valley. stephen schlange photo how it works

Where Your Lab Tests Go Technology and competition are driving the new world of lab testing BY HEIDI GROOVER

nside one transparent plastic container on a rack of shelves is someone’s big toe. Inside another, someone else’s uterus. In the complex and bureaucratic health care system, this bright room and its rack of shelves are where lab samples come to be assigned meaning and translated into treatment. The sprawling building in a Spokane Valley business park houses Incyte Diagnostics, where many of Spokane’s non-blood lab samples come to be analyzed before doc-

tors tell their patients everything looks good or that they’ll be needing some more tests or treatments. Samples fall into two broad categories: clinical or anatomic pathology, says Incyte COO Gary Gemar. Between those groups, labs provide about 70 percent of the diagnostic information doctors use to assess patients. Pathology examines what causes diseases — blood or other body fluid samples fall into the clinical category, and tissues, such as biopsy and surgery samples, are

categorized as anatomic. Here at Incyte, the focus is on anatomic pathology, slicing and studying everything from the toe and uterus to some 95,000 pap smears a year. “We’re key in the whole health care model,” Gemar says. “We’re supporting physicians in making a diagnosis.” The process is a crucial one for doctors and patients, whether the tests are routine or because of special worries, and it’s one that’s becoming increasingly technologically advanced and competitive.

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Bruce Cutter, a hematologist and oncologist at Group Health, says fast and accurate lab results are “critical” for good patient care. With his specialty evaluating and treating blood disorders and cancers, Cutter says the many lab samples he sends out for analysis not only help him diagnose patients, but also help decide which treatment to use and assist in monitoring patients’ progress. While most tests he orders require no fasting or special behaviors beforehand, Cutter advises patients to always double-check with their doctor or nurse to see if there are any requirements to prepare for giving a sample. “Usually a lab is not the be-all-end-all, but it complements the history and physical exam of the patient,” he says. “Without accurate and also timely results, we’re in pretty big trouble.”

hen a sample arrives at Incyte by courier from a hospital or doctor’s office, it’s assigned a bar code. That string of numbers and lines will follow the sample through the lab, from the desk where it’s checked in to the room where a piece about the thickness of a nickel is sliced off, placed in a small, brightly colored plastic container and treated in chemical solutions to preserve it. From there, an even thinner slice is set on a slide and stained for analysis by a computer, a medical professional or both, depending on the type of sample. Pap smear samples are sent through a machine that can recognize any abnormalities, which triggers them for a technologist’s review. Other types of samples, like tissue taken from a biopsy or that big toe, are analyzed by technologists and pathologists. At Incyte, many of these pathologists have sub-specialities like urology or dermatology, so those types of samples are usually sent to them for expert review. As pathology assistants and doctors gaze into microscopes or at microscopic images projected onto a computer screen, they dictate what they see. That’s later transcribed and added to the sample’s information, which travels with that bar code it was given when it arrived. Sitting in white lab coats under fluorescent lights, technologists work day and night shifts to keep results moving quickly. They have education ranging from a two-year associate’s degree and on-the-job training to a full medical degree, depending on their job, and get ongoing education and training to keep up on new technologies and methods. Incyte touts its bar coding system as a way to do the obvious but crucial: make sure the right patient name and information is assigned to the right sample to avoid

mix-ups. That system also allows each technologist or doctor along the way to pull up the same reports and information about the sample. In the future, the lab will likely invest in technology that allows slides to be “totally digitized,” Gemar says. With such a digital scanning process, doctors across different states would be able to more efficiently share and analyze samples. From hiring pathologists with specialties to planning for future equipment, it’s all part of staying the most attractive place for doctors to send their samples. “Pathology used to be very noncompetitive,” Gemar says. As a metric, the company used to have no sales force. Now it has salespeople across the Northwest. “Competitors are all over the place now.”

atient samples make their way to Spokane’s other major lab, PAML — Pathology Associates Medical Laboratories — from nearby Sacred Heart and states as far away as New Jersey, says PAML President and CEO Francisco Velazquez. The blood and tissue samples that come to PAML are “on the higher end of the spectrum, as opposed to routine,” Velazquez says, from cholesterol to leukemia tests. That’s because the equipment and medical expertise needed to analyze more complicated lab tests is too expensive for every doctor’s office or hospital to provide. Like the pap tests at Incyte, PAML uses sophisticated computers to look for irregularities in tests it gets high volumes of, like a cholesterol panel, and enlists a human eye if something is unusual. A blood test to look for a disease like leukemia, though, is seen by three experts at the lab before results are decided. Along the way, internal and external checks ensure quality — and competitiveness. “Every step of the way has checks and balances, sometimes double- or triple-checks to make sure that when we provide a result or interpretation it’s the best that can be provided,” Velazquez says. National industry groups perform inspections and blind tests where they send a sample to the lab to be tested and compare the accuracy of the results to other labs. Phlebotomists, who draw blood, are trained to double-check that they are taking the right sample from the right person, safety steps like hand-washing and disinfection are emphasized, and couriers use temperaturecontrolled vehicles to protect samples. “We may not know the patients that we’re serving … but every time a patient is referred to us it’s very serious business,” Velazquez says. “We are part of that process and what we do can be life-changing.” 

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Gonzaga helps connect students with mentors in every career field.

Embrace the opportunity to mentor a student In a recent public service announcement, Colin Powell spoke about the importance of ensuring that all of America’s young people are well equipped to lead healthy and productive lives. Their ultimate well-being, the retired four-star general stressed, will have sweeping effects. “Our nation’s future success,” Powell said, “depends on how well we prepare our young people to thrive in a highly competitive world.” To whom does this essential task fall? Teachers? Business leaders? It actually falls to anyone who is willing to share their time and experience. “You can play an important role in helping a young person achieve success by volunteering as a mentor,” Powell said. “Mentors can inspire young people to stay in school, believe in themselves and live up to their potential.” Today, and throughout its 125-year history, Gonzaga University has focused on developing young men and women dedicated to serving others. Mentoring is one meaningful way to fulfill that fundamental mission. The Gonzaga Alumni Mentoring Program – more commonly

known as GAMP – boasts more than 2,400 mentors throughout the country in every career field. This helps ensure GU students and recent graduates have the support and encouragement to achieve post-graduation success. Mentoring can be simple for working professionals because you already know the answers. Your experience and practical knowledge of the business world provides real-world insight that students cannot glean from textbooks and classroom theories. Conduct informational interviews, review résumés. Challenge your mentee. Ask them questions that force them to reflect on their career aspirations. Help them become well-informed decision makers. Whether we realize it or not, we have all probably benefited from mentoring at some point. It is unlikely that any of us have reached our professional stations without some guidance along the way. Now it is our privilege and responsibility to pay it forward. Let’s create a cycle of mentoring.

To learn more about mentoring opportunities through GAMP, contact the Gonzaga University Career Center: 509-313-4234 or gonzaga.edu/GAMP.

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26 Health JUNE-JULY, 2013 News_inhealth_june_2013.indd 26

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LIVING Pet Care Goes

High

Tech From DNA tests to insurance plans, the world of pet health care keeps expanding

BY CHEY SCOTT

ant a dog that lives to hunt? How about one that runs like the wind? Maybe one that doesn’t shed? Prospective pet owners are often willing to shell out hundreds, or even thousands, of dollars for a purebred pup, hoping the little dog will have the perfect mix of good looks and instinctive talents. The downside can be that these selectively bred dogs also carry a higher risk than their mutt counterparts of developing a genetic disorder. Paw Print Genetics, a new startup in Spokane, offers clinical genetic diagnostics of dogs. “We’re hoping breeders use our services before breeding to avoid passing along a disorder to the puppies,” says the company’s CEO and founder Lisa Shaffer. “For pet owners, you want to know what you’re getting into because, with some of these diseases, the dog can die young or it could cost thousands of dollars in vet bills to stabilize the pet.” Veterinarians can also request tests if they think a dog’s symptoms could be due to an inherited trait. And the company recently began offering tests to curious owners on its website. Shaffer notes Paw Print does not test which breeds a mixed-breed dog may have in its lineage. ...continued on next page

German Shepherd Leonidas, a member of the Spokane Police Department’s K-9 Unit, was on hand for the ribbon-cutting ceremony (inset) at Paw Print Genetics in May. YOUNG KWAK PHOTOS JUNE-JULY, 2013 Living_inhealth_june_2013.indd 27

Health 27 5/22/13 3:54 PM

living

Dr. Mark Schrag of Hunter Veterinary Clinic (right) draws blood from a dachshund named Butters, with assistant Kyle Hunter. YOUNG KWAK PHOTO

“pet care goes high-tech,” continued...

Herders At Risk Herding dogs are family favorites because

of their lively temperaments and because they love to run. But some of these dogs carry an ominous genetic mutation called MDR1. Katrina Mealey, a pharmacologist and internal medicine specialist at Washington State University’s College of Veterinary Medicine, published her discovery of the MDR1 mutation back in 2001. Affected dogs can include Australian shepherds, border collies, collies, German shepherds, Shetland sheepdogs and English shepherds, Mealey says. The gene isn’t a problem until the dog is prescribed certain medications used as pre-anesthetics and to treat heart problems or pain. Dogs carrying the mutation aren’t able to excrete the drugs, which can build up to life-threatening toxicity, even when given at what’s considered a safe, normal dosage. Some dogs die, while others may require long and costly stays in an ICU.

Now that the genetic anomaly is known, veterinarians across the U.S. can order preventive testing by sending DNA samples to WSU for testing to determine if a dog is an MDR1 carrier. The test is $70, and Mealey says the veterinary teaching school’s lab on the Pullman campus runs up to 200 tests a week. She and a team of colleagues are continuing to research other potential genetic mutations that can cause drug susceptibility in other breeds and animals.

Speed Saves Lives Over the past decade, most veterinary

clinics — including small, locally owned practices — have acquired specialized equipment to run biochemical analyses of an animal’s blood, which can help to diagnose disease or illness. Dr. Mark Schrag, with Spokane’s Hunter Veterinary Clinic, says that in the past, vet clinics without such equipment would

have to send patients’ blood samples to a larger lab facility, meaning the results — and thus a diagnosis — wouldn’t be available for several days. “You’d wait much longer and wouldn’t know what to do,” Schrag says of the older process. “Now, if you bring us a sick pet, we can get an answer relatively quickly.” He adds that most blood tests can be run in 15 to 20 minutes, while the client is there. Citing an example of a cat on the brink of kidney failure, Schrag says getting the animal’s blood work results right away could mean the difference between a successful intervention and the cat dying before the results were returned from an offsite lab.

Doggie Deductibles Just like medical insurance plans protect

us from the high costs that can result from an unexpected illness or injury, specialized insurance plans for a four-legged compan-

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ion can also serve as a safety net for those “what if” accidents or illnesses a pet may experience. With so many pet insurance plans out there, deciding what level of coverage is best for your pet can seem a bit overwhelming. Unlike human medical insurance, pet insurance plans don’t cover routine preventive care, like vaccines, spay or neuter surgeries and general wellness care, says Jill Shovelier, a licensed veterinary technician at the Indian Trail Animal Hospital in north Spokane. “Each plan is a little different in terms of what they do or don’t cover, but most of our clients we’ve seen with [pet insurance]

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Did You Know? Americans spent nearly $53 billion on their pets in 2012. — American Pet Products Association have coverage for unexpected, catastrophic illnesses or things they’re not prepared for that would cost several thousands of dollars,” Shovelier says. She estimates about a third of her clinic’s clients have some type of pet insurance, adding that she’s noticed an increase over the past several years in the number of people who’ve enrolled in a pet plan. Considering your pet’s age, current health and your lifestyle are just a few things to keep in mind when shopping for pet insurance. Shovelier suggests researching whether a plan has any coverage exclusions for specific breeds that are more prone to develop certain diseases, if it covers pre-existing health conditions (the majority of plans don’t) and what kinds of waiting periods there may be before you’re able to submit a claim. Not sold on the idea of pet insurance? There are other measures pet parents can take to save money and keep a beloved dog or cat healthy without pet insurance. Don’t skip preventive care, and don’t ignore minor health issues that could turn into serious problems for your pet down the road.

Going Alternative If medication and traditional treatment just

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living “pet care goes high-tech,” continued... practices at Legacy Animal Medical Center in Liberty Lake, says she offers animal acupuncture and herbal treatments, mostly for pets suffering from chronic conditions that haven’t responded to other treatments. The premise behind pet acupuncture is

Did You Know? American dog owners spend, on average, about $650 on vet visits per year. — American Pet Products Association the same as with humans; addressing imbalances in the body that could be allowing it to harbor disease or pain, Bright explains. Obviously it’s a little more difficult to get a dog or a cat to lie still while tiny needles are being poked into its skin, but she adds that many patients she’s worked with have experienced successful results after acupunc-

ture treatments. Dachshunds are a breed she commonly treats using acupuncture, as they are more prone than most breeds to suffer from disc disease, which causes chronic pain and, in some cases, paralysis.

Pets Need Blood, Too “I always tell people to imagine themselves

moving to a town that has no blood bank available, and then something happens to them. What do you do?” asks Dr. Jane Wardrop, a professor at Washington State University’s College of Veterinary Medicine, and the college’s transfusion services director. Animal blood donors are just as crucial to veterinary medicine as human donors are to blood banks and hospitals. Yet the continuous need in veterinary medicine for eligible blood donors isn’t something that may frequently come to mind for many pet owners. Some of the most common reasons an animal may require a life-saving blood transfusion include a severe loss of blood due to an accident, a disease attacking its blood cells or blood loss during a surgical procedure, Wardrop explains.

WSU’s transfusion program continually recruits eligible volunteer donors, Waldrop says. The program generally recruits pet owners who live in the Greater Palouse region, mostly because owners can be asked to bring their pet in every few months to donate, or could be on-call to donate during an emergency situation. Pet owners outside of the Pullman area who’re interested in finding out if their dog or cat is an eligible donor should contact their veterinarian, Waldrop says. In a heavily populated metro area like Spokane, the need for a regularly stocked pet blood bank is often great, she adds. Both cats and dogs have different blood types and can’t accept blood from a different species or a non-compatible blood type.

Don’t Forget to Brush It’s been ingrained into just about all of us

since we were children to brush our teeth at least twice a day. But not as many people may know they should also try to brush their dog’s or cat’s teeth at least three times a week. It’s easier said than done, but this little act can improve your pet’s health — and save on future vet bills.

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Kaitlen Veal of Lincoln Heights Veterinary Clinic finds better health can start with a dog’s teeth. Dr. Sara Shaw at Lincoln Heights Veterinary Clinic says a decaying or abscessed tooth can release bacteria that travel through the bloodstream, ultimately affecting the heart or kidneys. “With advances in dental X-rays we

can learn more about the state of the tooth,” Shaw says. “We’ve really started to learn more about the importance of [animal dental health]. I get reports from people saying, ‘After my dog’s teeth were cleaned, it was happier and brighter.’”

STEPHEN SCHLANGE PHOTO

Not all animals need a professional dental cleaning from a veterinarian every year, Shaw says, but keeping teeth healthy with regular brushing and the occasional exam may mean a pet gets more timely care for any problem teeth. 

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living

In the Saltroom, clients relax with hopes of easier breathing.

Jennifer DeBarros photos

ALT MEDicine

Is Halotherapy Worth Its Salt? Fans of alternative medicine say breathing salt-infused air helps treat respiratory problems, but doctors aren’t so sure

By Deanna Pan

nside a small, dimly lit room, fine snow-white salt covers the walls, ceiling and floor. In the corner, two Himalayan crystal salt lamps emit a gentle orange glow. Over faint ambient music, a generator hums, dispersing microscopic salt particles into the air. There are three lounge chairs, where patrons can kick back, close their eyes and inhale. A box of Kleenex is conveniently within reach. “They’ll be sitting in there and be blowing up a storm after about half an hour. They’re draining. They’re like Niagara,” says Laura Viherlahti, owner of the aptly named Saltroom of Spokane. “They don’t have blocked sinuses when they walk out.” For those suffering from a spate of allergies, persistent cough, plugged nose or scratchy throat, Viherlahti and her small but devoted clientele say breathing a little sodium chloride may help clear away pesky symptoms.

Known as ‘halotherapy’ (‘halos’ is the Greek word for salt), the practice has been popular in Central and Eastern Europe for decades, although it’s virtually unknown in the United States. Man-made salt chambers, designed to replicate conditions in underground salt caves, have been cropping up across the country in recent years, in cities like Los Angeles, New York and Orlando, Fla. Scientific evidence in English-language journals supporting halotherapy is sparse, but that hasn’t stopped respiratory sufferers from trying it out. Halotherapy might relieve some respiratory ailments because “salt has a high osmotic pressure,” explains Dr. Norman Edelman, chief medical officer of the American Lung Association. “It will draw water out of the airways of the lungs and liquefy the mucus... People will be able to cough it up better.”

But many physicians, Edelman included, are skeptical of the benefits of breathing salty air. The Centers for Disease Control and Prevention has never researched halotherapy. The National Institute of Health hasn’t heard of it, and the Food and Drug Administration hasn’t approved it. “Certainly that sort of thing would need to be done with a lot of supervision,” says Dr. Teal Hallstrand, a pulmonologist at the University of Washington who worries that exposure to a high concentration of sodium might cause asthma patients’ airways to constrict and trigger worse symptoms. “I would advise them against it,” he says. Back at the Saltroom of Spokane, Viherlahti dismisses her detractors: “It’s symptom management,” she says. “We’re not claiming to cure anything… This is just another alternative to help with the condition that’s there.” Outside the salt chamber, she measures

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Owner Laura Viherlahti outside the Saltroom of Spokane. half a cup of fine pharmaceutical-grade salt and pours it into a halo generator, a stainless-steel blockish contraption with a knob and several switches, mounted to the wall. Small blades inside the generator pummel the salt until it’s tiny — less than five microns — before being blown into the room as a mist. Viherlahti guesses her clients inhale the equivalent of two shakes of salt while spending an hour in the salt room. “It’s like being at the ocean,” she says. “I always tell my clients that if they are not allowed to go to the beach for some reason, then they shouldn’t come here. So it’s really not much salt.” A single 60-minute session in the salt room costs $25, or $85 if you’d like a massage from Sabrina Caldwell, the spa’s licensed massage therapist. But Viherlahti recommends visiting several times in a row; she charges $100 for five sessions and $150 for 10. (In case you’re wondering, insurance doesn’t cover it.) Viherlahti opened the Saltroom in 2006, marketed under the name Salt Crystal Cottage. “Everybody thought it was some kind of voodoo hoo-hoo, something weird,” she says. She got the idea from her Finnish father-in-law, a serial entrepreneur who has dabbled in ergonomic furniture, homeopathic magnets and therapeutic peat. After visiting a salt room at a children’s hospital in St. Petersburg, Russia in the 1980s, he developed a line of halo generators and started selling them to spas, hotels and medical facilities throughout Europe. Business at the Saltroom “has been really slow,” and Viherlahti, who recently has devoted herself full-time to the enterprise, is hoping to change that. Although her clientele is small, it’s dedicated and effusive. Jamie LaRoque of the South Hill gets a

massage at the Saltroom every week. Ever since she started visiting regularly, she says she’s had fewer sinus migraines. A chronic allergy sufferer, she “can breathe a lot better. “Immediately, my nose and my sinuses completely cleared — not even just for the couple hours afterward,” LaRoque says. “It’s been night and day for me… I can blow my nose and everything’s gone.” n

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COOKING

Culinary Culture Healthy food with a French twist STORY BY CARRIE SCOZZARO  PHOTOS BY YOUNG KWAK

rench cuisine has gotten a bit of a bum rap when it comes to healthy eating. “Foie gras is very rich,” admits Laurent Zirotti, ‘“yet you only eat it once a year.” Zirotti is the culinary half of the husbandwife team behind North Idaho’s Fleur de Sel restaurant. Portions, ingredients, cooking methods, even the dining process itself are vastly different in France, notes Zirotti, who moved

to the United States from southern France in the early ’80s with his wife Patricia. True, Zirotti modified his marinated quail stuffed with decadent chicken-mushroom mousse for our readers (see recipe), and yes, butter, cream and rich sauces are a staple of classical French cooking. Yet restaurant cooking and home cooking are different, says Zirotti. French home cooking means less processed food, less meat, more seasonal ingredients.

ABOVE: Laurent and Patricia Zirotti among scenes from their Fleur de Sel restaurant in Post Falls. “Four ounces of meat is a large portion” for a French meal, says Zirotti, whose love of food originated with his French mother and Italian grandmother. “She has no cholesterol,” he says of his 82-year-old mother, whose hearty meals never lacked for rich flavors. Zirotti remembers coming home from boarding school at age 10 — the food was awful, he says — relishing his mother’s cooking, and realizing the profound connec-

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RECIPE tion between food and feeling. By 14, Zirotti was old enough to work in the nearby Peugeot factory, but a single day on the job solidified his desire to break with family tradition. At 15, young Zirotti, the only one in his family who did not work for the French auto manufacturer, enrolled and was accepted in the prestigious Thonon-les-Bains Culinary Academy. “I never looked back,” he says. Another difference between American and French cuisine, says Zirotti, is how people eat; in France, it’s not uncommon to enjoy a leisurely, multicourse meal, often followed by a nap. Contrast that to American fast food, eating in front of the television or in the car. Food, he says, is meant to be savored. That’s apropos to Fleur de Sel’s reputation as a destination restaurant. It’s not uncommon for diners to spend several hours there. “What is healthy for the mind is healthy for the body,” says Zirotti. Fleur de Sel’s menu features more vegetarian and vegan dishes than if he were cooking in France, says Zirotti. But 30plus years in America — including several in San Francisco and Billings, Montana, where the Zirottis operated Enzo Mediterranean Bistro — have shaped his culinary viewpoint in many ways. “I cook from my roots,” says Zirotti, originally from the Piedmont region. Yet he’s also inspired by new ingredients, food trends, dining out and recreating classic French dishes with his own twist. When he’s not in the kitchen — which is rare — Zirotti enjoys sharing his love of French cooking with others, such as the dessert class he conducted this spring at Post Falls’ Jacklin Arts and Cultural Center. “I wouldn’t mind ending my career teaching,” he says. Fortunately for Fleur de Sel fans, the end is nowhere in sight. n

Warm Quinoa Salad with Grilled Chicken

Invest in Your Health By investing in a healthy diet

Enjoy this light, healthy salad (pictured left) created by Fleur de Sel Chef Laurent Zirotti on a beautiful warm day.

Quinoa Salad

¼ cup olive oil ¼ red onion, chopped ½ pound asparagus, cut into ½ inch sections 1 tablespoon chopped garlic ½ patty pan, zucchini or crook neck squash, cut in quarters 1 tablespoon capers ½ cup grape tomatoes Corn cut fresh from two cobs ½ pound baby kale, torn into pieces ½ cup garbanzo beans, rinsed

Pour olive oil in sauce pan. Turn heat to medium. Add vegetables to pan as you cut them. Stir as you go. Season to taste with salt and pepper. Cook until vegetables are translucent and kale is wilted, about five minutes after last ingredient is in the pan. Set aside to cool.

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Whisk marinade ingredients together. Marinate chicken for ½ day in refrigerator covered. Heat grill to high. Cook chicken breast, seasoning it with some Herbes de Provence, black pepper and salt (sea salt is ideal). Remove chicken to clean plate and let rest.

TO PLATE

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JUNE-JULY, 2013 Cook_inhealth_june_2013.indd 35

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living

PARENTING

Beyond the Cabin The lifelong impact of summer camp STORY BY By Lisa Fairbanks-Rossi n PHOTOS BY STEPHEN SCHLANGE

hat’s your speed? A one-hour “Mommy and Me” art class involving repurposed popsicle sticks, a day camp requiring your child’s first school bus ride, or a full week away from home, camping lakeside? Whichever you choose, our community offers a staggering number of options for summer camp. And whether you choose to send your child and your cash — and for residen-

tial camps, we’re talking about a sizable amount of cash — to Selkirk, Cocolalla, Eureka, Reed, Spalding, Lutherhaven, Shoshone, Four Echoes, Easton or Sweyolakan, former campers can all but guarantee there will be huge, lasting social returns. “I can’t think of anything more powerful that shaped me as a person,” asserts former Camp Reed counselor Ed Reese. As much as he wanted to attend a residential summer camp as a kid, his family

couldn’t afford it, so Reese attended various day camps and waited until high school to enroll in the CIT (counselor in training) program. “I literally can’t imagine how different my life would be if camp hadn’t part of it,” says Reese. “But if I were to guess, I would have become a mechanical engineer; I would have hung out with other engineers. I would have been the guy who maybe said something funny a couple times a year.” As it turns out, Reese, who described himself as a “painfully shy” student who “never fit in and was never confident,” transformed in all of these areas after the summer of 1987, his first as camp counselor. Reese now runs his own online marketing company and is known in professional circles for being both confident and funny. “I am successful in front of directors of really large companies because I did skits at Camp Reed,” he declares. And at 6-foot4, with a bellowing but kind voice, you

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believe what this guy says. “I know how to get in front of people now, because I led 10 campers in a cabin.” And while Reese has a more corporate position these days, he’s worked several jobs reflective of his time as a camp counselor, including teaching English to teenagers in Korea and driving a tour bus through Alaska. Dan Ward, recently promoted to captain on the Spokane Valley Fire Department, says his time as both camper and counselor have had a great deal to do with who he is as a father and a professional. “When you’re a little kid, [camp] is magical because there’s so many caring people that take an interest in you,” Ward recalls. “And when you work as a staff member, your faith in mankind gets reset. “Every day was fun and exciting,” he explains. “It made me realize I couldn’t do a desk job for the rest of my life. And it probably helped steer me towards being a firefighter.”

he doesn’t remember which summer she won for, but former “Camper of the Week” Katie Yarno knows the award is still in her childhood bedroom. Now a 35-year-old wife and mother, Yarno was a four-time camper. In fact, one summer she went to two sessions. After experiencing her 9-year-old stepson’s breakthrough over swimming in open water (among other things) last year, she has registered him in a second year of camp this summer, and already is planning her younger sons’ camps. “I will do a mini-camp for my [almost 4-year-old] son, and maybe next summer when my baby is a little bigger, we’ll do a family camp,” she says. Luckily, her husband is a summer camp alum as well, so he and both sets of grandparents know the week away is a worthy expense. “We mentioned camp to my husband’s folks, and they were willing to help,” says Yarno. Now that their son Ben has been once, “It would crush him to not be able to go again. So, it was either the grandparents, or it was going on the credit card,” she says. “I would do anything to put money aside for camp. It’s worth the investment.” Neither Yarno, nor her predecessors, Ward and Reese, can exactly pinpoint what’s universally formative about summer camp, but they try to explain. “They do a wonderful job making every child feel special, and included,” says Yarno. “There’s such a sense of community... There’s something magical about it.”

o Dr. Leni Cramer, the profundity of summer camp is grounded in psychology and human design. “Our focus in standard classrooms is on what kids can’t do, and trying to improve it,“ explains Cramer, who, after teaching in Spokane elementary classrooms for 30 years, has opened her own project-based preschool. “Summer camp may be one of the few opportunities children get to experience what they are innately good at. They get to explore all their intelligence strengths.” Cramer is referring to educational theorist Howard Gardner’s “Nine Intelligences.” The theory proposes that there are different domains of cognitive abilities — logical, spatial, linguistic, bodily-kinesthetic, musical, interpersonal (connect with others), intrapersonal (connection to self), naturalistic and existential. Summer camp may help kids connect to innate abilities they don’t get to explore in school. “Obviously, bodily-kinesthetic intelligence is a huge piece at summer camps. There is a lot of athletics, horse riding,

swimming. And interpersonal intelligence is strengthened by playing and working with other kids,” Cramer says. “Spatial intelligence gets attention in arts and crafts. If you have high environmental intelligence, you’re going to love being in the wilderness. If you don’t, then you’ll develop some,” she says. And perhaps most important, says Cramer, “the kids will be challenged to get in there, not hang back.” “As a kid, I don’t think you ever get that sense of acceptance” anywhere else, says Yarno. “All the adults at camp believe in you. They want to see you shine. They work to bring out the best in each kid.” And in that case, Cramer invokes the choice theory of William Glasser, which states that humans “are driven by our genes to satisfy five basic needs: survival, love and belonging, power, freedom and fun.” “Camp provides that freedom to make choices, it creates love and belonging, and you get confidence because you find out you’re good at something, or you improve,” concludes Cramer. “It meets all of our basic human needs.” n JUNE-JULY, 2013

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living

55-PLUS

Checkup for Men Many factors play into health as men age, but understanding risks helps set priorities BY JACOB JONES

r. Bob Riggs, with the Group Health Veradale Medical Center in Spokane Valley, says one of the greatest hurdles to keeping men healthy as they age is just getting them into a doctor’s office. Statistically, men put off medical appointments more often than women. Unless they have an emergency or an ongoing health issue, many fail to schedule checkups or screenings. “Usually, the reason a guy comes in for

a physical is because his wife made him,” Riggs says. “They just don’t show up. It’s a pretty big problem.” Even men who feel they are living a healthy lifestyle should occasionally seek out a doctor for regular testing and a general health assessment. “It’s hard to get them to do it,” Riggs acknowledges. So if you or a man you know is putting off a visit to a physician, Riggs offers several tips to help reduce personal risks and maintain a healthy lifestyle:

Gather Info

No one knows your body better than you do. And your body is a result of your heritage, so take the time to assess your family history. You may need to take steps to mitigate your risks if a male family member had a heart attack before age 45, or a female before age 55. Does high blood pressure run in your family? Likewise, having a close relative with diabetes may mean you’re at higher risk. After checking out your family history, consider how you’re feeling in the present. Any nagging worries or strange symptoms? “Be attentive for signs that you’re not well,” Riggs says.

Exercise

One of the simplest yet most important ways to stay healthy is to stay active. Riggs says men should regularly exercise for at least 30 minutes a day. “Walking, running, bicycling, swimming, something that is aerobic is really pretty important,” he says. Exercise helps lower blood pressure

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and reduce the risk of heart disease. It also keeps off extra pounds that can lead to a variety of health problems. Riggs says men should commit to a regular exercise schedule and avoid long breaks. “If you quit,” he says, “it’s harder to get going again.”

EAT HEALTHY

How your body holds up depends a lot on what you put into it. Riggs suggests a diet loaded with lots of fruits and vegetables, ideally five to 10 servings a day. He says many people might find that excessive, but people who maintain those levels live healthier lives. “Not too much meat,” he says. “Not too much starch.” The American Heart Association also recommends low-fat dairy products and lean meats. Fats and sugars should be limited to just a few servings a week.

GET SCREENED



Riggs says men should schedule routine physicals and track their blood pressure as they get older. Those with ongoing medical concerns should get more regular checkups, while healthier individuals should be able to get away with an appointment every couple of years. Blood pressure serves as an indicator of many health risks, he says. Men with blood pressure higher than 120 over 80 should consult with a doctor about management options. The American Urological Association recently released new guidelines for prostate

cancer screening, urging the moderate use of testing to avoid unnecessary procedures. Riggs also encourages men to follow American Cancer Society recommendations for colonoscopies, scheduling a screening every 10 years after turning 50. He says some patients may prefer the less invasive fecal immunochemical test, which should be performed annually. “It’s a simple test,” he says.

AVOID VICES



Smoking continues to be one of the most clear-cut indicators of the potential for health problems. Riggs says those who smoke will likely suffer from a variety of additional health complications with higher risks for heart disease, stroke and cancer. “You kind of [have] to divide the world of older, middle-aged men into, I’d say, two main groups,” he says. “Do they smoke … or do they not smoke?” A fit and active 70-year-old will likely have fewer health complications than an overweight 55-year-old who smokes. Men should also limit alcohol to two or fewer drinks a day. Riggs also recommends an annual flu shot, as well as an aspirin regimen for men with elevated risks for heart attack or stroke. He says he regularly takes aspirin, but does not endorse its use for everyone. Most of the ways older men can take better care of themselves involve being willing to approach their doctors with their concerns, and taking a common-sense approach to maintaining a healthy lifestyle. “It’s simple stuff that your mom told you,” he says. 

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living june-july health events VANESSA’S PROMISE BENEFIT LUNCHEON “Love Handed Down” is the theme of the Vanessa Behan Crisis Nursery’s fundraiser event this year, featuring keynote presentations by members of Vanessa Behan’s family, on June 4 from noon-1 pm. Spokane Convention Center, 334 W. Spokane Falls Blvd. vanessabehan.org (340-0479) FIRE ON THE RUNWAY Local firefighters and models take to the runway in an annual fundraiser event for the Red Cross, on June 7 from 7-10 pm. $50. The Lincoln Center, 1316 N. Lincoln St. redcross.org (326-3330) CPR CLASS Learn how to perform CPR on adults, children and infants, as well as to assist a choking victim. This class educates community members who do not need a CPR certification card. June 11 and July 9 from 6-8 pm. $10. St. Luke’s, 711 S. Cowley St. cherspokane.org (232-8138) THE POUR Attend a gourmet winemaker’s dinner and auction benefiting the child psychiatry program at Sacred Heart Children’s Hospital and Family Maternity Center at Providence Holy Family Hospital, on June 15 from 5:30-10 pm. Arbor Crest Winery, 4705 N. Fruit Hill Rd. thepour. info (474-2819) LOREEN MILLER BIKE RIDE & WALK OF HOPE The annual fundraiser event for Cancer Patient Care includes a 5-mile fun run or a bike ride, with cycling distances of 12, 25, 50 or 100 miles, on June 15, times vary. $10-$120. Mt. Spokane High School, 6015 E. Mt. Spokane Park Dr. cancerpatientcare.org (456-0446)

charity

Pedaling Forward H

aley Lebsack never met her husband’s sister Sunny, a bubbly girl who passed away at 17 after an auto accident. People who knew Sunny described her as an “old soul,” a vibrant teenager who loved and cared for others throughout her short lifetime. Altruism that would extend even after her death, as Sunny helped more than 100 people through tissue and organ donation. Now Haley Lebsack, along with family and friends, will join together for a memorial bike ride from Spokane to Sun Valley, Idaho, to raise funds and awareness of the growing need for organ donors. In the week it takes Sunny’s Pedal riders to travel the 580 miles from Spokane to Sun Valley, approximately 230 new patients will be added to the national organ donor waiting list. The goal: Each rider will raise $2,000 for the tissue and organ donation nonprofit Donate Life. The journey: a week on the open road, passing the message of the lasting impact organ donation has on the lives of others. — SARAH MUNDS Sunny’s Pedal • Saturday, Aug. 9 to Friday, Aug. 16 • Starts at Lewis and Clark High School • 521 W. Fourth Ave. • facebook.com/sunnyspedal • 380-9800

SKYTONA TRIKE RACE Big Sky’s Tavern hosts this annual fundraiser event, benefiting Cancer Patient Care, on June 15. Big Sky’s Tavern, 5510 N. Market St. bigskystavern.com (489-2073)

LET’S CLIMB A MOUNTAIN Create a team or participate solo in the 34.3-mile race from The Clock Tower in Riverfront Park to the top of Mt. Spokane. July 13 at 6 am (solo) or 6:30 am (teams.) $55-$70/solo; $23-$28/team member. Starts in Riverfront Park, 705 N. Howard St. letsclimbamountain.com

SUMMER PARKWAYS Walk, cycle, skate or jog the fourmile course closed to cars and featuring booths, entertainment and more on June 19 from 6-9 pm in the Comstock/Manito neighborhood on the South Hill. summerparkways.com

VALLEY GIRL TRIATHLON This year is the women’s-only sprint distance triathlon’s 10th anniversary. July 14 starting at 7:45 am. Race starts and ends in Liberty Lake, Wash. valleygirltri.com

HEALTHY COOKING CLASS Learn what changes to make to your diet and lifestyle to help lower your risk for heart disease, including how to prepare a healthy, nutritious meal and how to eat healthy on a budget. Classes offered on June 20 and July 18 from 6:30-8 pm. Free. Newton Lounge, 1603 N. Belt St. cherspokane.org (232-8138) MAD HATTER TEA Join Alice and the Mad Hatter for an afternoon of tea, refreshments, music and more in a benefit event for The Franciscan Place at St. Joseph Family Center, on June 23 from 1-4 pm. Ages 21+. $50. St. Joseph Family Center, 1016 N. Superior St. sjfconling.org (4836495) RECONNECTION WORKSHOP A workshop for military families providing post-deployment skill building on the topic of communicating clearly. June 27 at 6 pm. American Red Cross, 315 W. Nora Ave. (326-3330)

JACEY’S RACE A timed 5K race and 1K kids’ fun run benefiting local families with children who are currently being treated for cancer or other life-threatening illness. July 14 starting at 8:30 am. $15-$30. Sandpoint High School, 410 S. Division Ave. jaceys-race.com SUMMER FUN RUN SERIES The U District Foundation’s annual 5K fun run series is hosted by U District PT, on July 16, 23 and 30. Races start at 6:30 and all racers are timed and can enjoy David’s Pizza after the race. $5/adults, kids/ free. U District PT, 730 N. Hamilton St. (458-7686) MOUNTAIN TRAIL RUN The second annual Schweitzer Mountain Trail Run offers 3.5-mile and 10-mile races. July 20 at 10 am. $15-$45. Schweitzer Mountain Resort, 10000 Schweitzer Mountain Rd., Sandpoint. smtrailrun. com (208-263-9555)

HOOPFEST Participate in or be a spectator at Spokane’s annual three-on-three basketball tournament, on June 29 and 30. Team fees $128-$168. Free to watch. Downtown Spokane. spokanehoopfest.net (624-2414)

MUDDY MILES Get covered in mud during this 2-mile obstacle course and race, on July 20 from 3-6 pm. $8-$11/ kids, $26/adult or $90/family, $140/team of five. North Idaho Fairgrounds, 4056 N. Government Way, Coeur d’Alene. muddymiles.org

BLOOD DRIVE Donors can give blood by appointment or on a walk-in basis. July 12 from 9:30 am-4 pm. Kootenai Medical Center, 2003 Kootenai Health Way, CdA. kootenaihealth.org (800-423-0151)

SPOKENYA The fourth annual 7K run/walk benefits efforts to bring clean water to Adeido, Kenya. July 20 at 9 am. $20-$25. Starts at Life Center Church, 1202 N. Government Way. spokenyarun.org

ZAK! OPEN The dinner, auction and golf tournament for the Rypien Foundation and the Boys & Girls Clubs of Spokane County. July 28 at Northern Quest, July 29 at Spokane Country Club. zakcharityopen.org (244-8656) BARE BUNS FUN RUN Annual clothing optional 5K fun run/walk. July 28 at 9:30 am. $18-$28. Kaniksu Ranch Family Nudist Park, 4295 N. Deer Lake Rd., Loon Lake, Wash. kaniksufamily.com (327-6833) RACE THE RIVER Sprint-distance triathlon race. July 28 at $80/individual, $160/relay team of 2-3 members. Riverstone Park, Coeur d’Alene. racetheriver.com LONG BRIDGE SWIM Swim 1.76 miles across Lake Pend Oreille in Sandpoint in the annual event that helps fund swimming lessons for local kids and adults. Aug. 3 at 9 am. $25-$30. Downtown Sandpoint. longbridgeswim.org 8 LAKES LEG ACHES Cycling race through West Spokane, Cheney and Medical Lake, offering 15-, 30-, 45-, or 75mile routes, with the longest route passing eight area lakes. Aug. 3. $45-$225. lcsnw.org (343-5020) MIDNIGHT CENTURY Join others on a 100-mile nighttime bicycle ride on dirt roads through rural areas around Spokane. Aug. 3 at 11:59 pm. Free. The Elk Public House, 1931 W. Pacific Ave. midnightcentury.com KIDICAL MASS BIKE RIDE Participate in a three-mile family ride on anything with wheels that rolls, hosted by Spokane’s Summer Parkways, that highlights safe riding practices on the road. Sept. 12 at 5 pm. Free. South Perry Neighborhood. summerparkways.com n 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: 9 S. Washington, 4th Floor, Spokane, WA 99201; Fax: 325-0638; or E-mail: calendar@inhealthnw.com.

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living

Marlene Alford, executive director of the Women’s and Children’s Free Restaurant, as preparations are made for the day’s meal. stephen schlange photo PEOPLE

Dining with Dignity Marlene Alford channels her passion for food at the Women’s and Children’s Free Restaurant By Jo Miller

arlene Alford grew up eating a hot breakfast every morning and coming home from school to cookies fresh out of the oven. She met a stark contrast to her upbringing when she started volunteering at the Women’s and Children’s Free Restaurant in 1998. “To see a whole different side of life — moms who would take home salad in a baggie so that they would have something later — was kind of a real shock to me,” she says. Alford, who has been the executive

director of the restaurant for 10 years, became part of the organization when they needed a chef to fill in. At the time, she was working for a chef and was also about to open her own catering business, but set it back a while to help out. She came down and cooked for two weeks and never left. “Serving $75-a-plate corporate dinners was not as rewarding as serving a wonderful home-cooked meal to a family,” Alford says. “Good food should be shared.” The Women’s and Children’s Free Restaurant serves lunch once a week and

dinner twice a week to women and children in need. The restaurant has been operating from the basement of Christ Our Hope Bible Church for 25 years. It’s very much like going out to eat, Alford says. It’s not come in, go through the line, get food and go. There are servers for every table and the dining room is arranged specifically to cultivate conversation. “The root of our mission is making sure that every plate of food that is served is healthy, is delicious and served with dignity,” she says. Alford always cooked her own meals from scratch, so she runs the restaurant the same way. The kitchen works with whole foods, makes a majority of the meals from scratch, and serves two fresh veggies with every meal. All soups are homemade and entrées are presented restaurant-style. There’s milk and juice to drink — pure juice, not artificial. And coffee is set out just to get people to stick around. “The ladies and kids we serve probably need nutrition more than most,” she says.

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“Any time we can help a mother learn to choose healthy choices, it just benefits their family.” The organization’s relationships allow them to focus on nutrition. The Women’s and Children’s Free Restaurant partners with a local church’s community garden, getting fresh produce throughout the week. The restaurant also delivers meals for other organizations to serve, such as Vanessa Behan Crisis Nursery and Hope House. A very small percentage of the restaurant’s guests are actually homeless, Alford says. It’s a lot of seniors and working moms who just need some support. When they come in, no questions are asked of them and they don’t need to prove their need. They just dine. Alford says it’s a challenge keeping up with the need in the community because they’re a small organization with a limited staff. That is one reason the restaurant will move to a larger location within the next year — to increase their impact. They already have a fundraising campaign underway to help purchase a permanent location in a low-income area.

When they come in, no questions are asked of them and they don’t need to prove their need. They just dine. Alford sees the needs they currently meet and her biggest joy, she says, is walking into the dining room and seeing families eating beautiful meals. She felt the impact of her work one particular night a few years ago when a young mom with three children came to dinner. With no family in town, the woman watched her kids around the clock and looked worn out, Alford says. “When she came and sat down, she said, ‘Don’t ever think we’re not grateful for what you do. We may not always say thank you, but when we have a bad day it’s probably the kind of day the volunteers here could never understand,’” she says. “We’re kind of privileged in a way because what we do, day in and day out, makes a difference in a family’s life,” she says. “I think it’s sometimes rare that people can work at a job that they have so much passion for, and it makes a difference.” n

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