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Port Townsend & Jefferson County Leader

2008 Health & Wellness Supplement to the Wednesday, July 16, 2008 Port Townsend & Jefferson County Leader

Personal Care is One of Our Specialties . . . a specialty only available at a small-town hospital

Hospital In-patient and Acute Care Emergency Medicine Surgery Sleep Medicine Family Birth Center Laboratory Services Primary Care Clinics Diagnostic Imaging Home Health Services Hospice

No one is just a number at Jefferson Healthcare. We treat every person like they are a personal friend or neighbor. We believe that this patient-centered care is as important to your well being as our high standards for delivery of professional, quality medicine. We hear from our patients—over and over again—how the caring attitude of our staff made a difference to their recovery. We hope you keep this in mind as you consider your future choices for health care.

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“It has been the best dental experience that I have ever had. The level of compassion and concern for my fear and comfort was wonderful and without fear. Thanks!” - Ron “All the staff of Dr. Savidge is so nice. With this procedure there was no pain during or after. I had no fear at all and I will keep up on my dental care from now on. Thank you very much!” - Cindy

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If you rest, you rust Rowers stay fit, involved in life no matter how gray their hair By Barney Burke Leader Staff Writer There sure are a lot of grayhaired people here in Jefferson County. But many of them stay so active you might think they’d have no use for rocking chairs in their golden years. “Unless they floated,” quips Jim Buckley, 68, an avid member of the Rat Island Rowing and Sculling Club. For Buckley and the hundred or so other members, the benefits of rowing include health, comradeship, and just getting out on the water. They often see harbor seals when they cruise around Rat Island, the sandspit located between Marrowstone and Indian islands. “I really like the mornings,” Buckley said of going out at 6 a.m. when the water is calmest. Like a lot of men in the club, Buckley rowed when he was in college. In those days, he notes, rowing was a male-dominated sport. Collegiate athletics offered few opportunities for women until Congress passed Title IX of the Education Amendments in 1972, he recalls. But rowing is attractive to women too, and maybe 75 percent of the club’s members are women, members say. And while men who didn’t row in college seem afraid to look silly as novice rowers, women don’t have that hang-up, says Buckley. “I’ve always done sports,” says Patricia Farmer, 69. She didn’t take up rowing until about five years ago. Farmer was just too busy, evidently. Bicycling. Horseback riding. Skiing (downhill and cross-country). Gardening. Tai Chi. Yoga. Pilates. “You still ski?” people ask Farmer, much to her disappointment. “You get so much more enjoyment out of life if you have all these interests,” says Farmer. Staying active physically goes hand in hand with staying active socially, Farmer says. The rowing club mixes people; boats have men and women, she notes, so  R 2008 Health & Wellness

“You can’t let the stiffness catch up with you.” Jim Mason, 60 on the benefits of staying active in life it’s a great way to expand your circle of friends. Meanwhile, she’s taking yoga, Pilates and French at Peninsula College. Saturday mornings, it’s Tai Chi. And she likes biking to Port Townsend or Old Fort Townsend from her home at Kala Point. “A lot of people find themselves alone in life, she observes. But here, “there’s a group or activity that will welcome you,” no matter what your interest. “It’s just so valuable to stay active,” agrees John Collins, 71. A former college rower, he has rowed at the master’s level for 10 years. As a lifelong bicyclist, a moderate ride for Collins is, oh, 80 miles. He racks up three or four thousand miles a year on his bike, unless he takes a long trip, like that American Lung Association charity ride to San Francisco last year. One day a week, Collins swings a hammer as a volunteer for Habitat for Humanity. And somehow, he still finds the time to serve on all kinds of local organizations, from the Northwest Maritime Center to the Port of Port Townsend Commission. He and his wife are avid sailors too. “It’s easier to stay active than regain,” Collins says of letting atrophy take over. Jim Mason, 60, didn’t row in college, but he always wanted to be a rower. After moving here from Salt Lake City, he joined the Rat Island Rowers and lost 20 pounds that first summer. Like other members, one of the things Mason enjoys most is the opportunity to pass on

Patricia Farmer and Jim Mason carry a rowing skull at the Cupola House in Port Townsend. Find out more about the Rat Island Rowing and Sculling Club at Photo by Barney Burke knowledge and skills to a new generation. The club has a regular program that takes middle school students out in longboats. “I retired early,” Mason explains. “I wanted time to do what I wanted to do.” He’s also

enjoys bicycling, hiking and white-water kayaking. “You just feel better” if you stay active, says Mason, who rows as often as six days a week. “You can’t let the stiffness catch up with you. “Find something you enjoy

doing,” Mason advises. “And if you lose interest, find something else to do.” Barney Burke can be contacted at Port Townsend & Jefferson County Leader

Inside If you rest, you rust: Staying fit . . . . . Guarding against HPV, cervical cancer Cancer busters . . . . . . . . . . . . . . . Eating better, and more cheaply . . . . Encropresis: Easy to treat . . . . . . . . Fifty? It’s time for a colonoscopy . . . . Access to healthcare . . . . . . . . . . .

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On the cover: Patricia Farmer, Jim Mason (center) and Jim Buckley are among the many Jefferson County residents who stay fit as they get older. All three are avid members of the Rat Island Rowing and Sculling Club. Cover photo by Barney Burke; cover design by Chris Hawley 2008 HEALTH & WELLNESS Special Section Editor: Barney Burke Lead Production: Chris Hawley THE LEADER 226 Adams Street, Port Townsend, WA 98368 • 360-385-2900 Website: Published continuously since October 2, 1889 Port Townsend Publishing Company • Scott Wilson, Publisher • Copyright 2008

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008 Health & Wellness R 5

Guarding against HPV, cervical cancer Recommended Gardasil vaccine helps prevent cervical cancer By Blythe Lawrence Leader Staff Writer The latest must-have amongst the teen set this season isn’t a Prada skirt or Gucci bag – it’s three pokes in the arm with potentially life-saving implications. The vaccine is called Gardasil, and although it’s been available for less than three years, its success rate at preventing infections caused by four types of genital human papillomavirus (HPV), some of which can lead to cervical cancer, has been nothing less than perfect. According to literature from the Vaccine Education Center at The Children’s Hospital of Philadelphia, in studies of more than 20,000 young women, Gardasil has been 100 percent effective at preventing infections caused by four of the most common strains of HPV, a virus transmitted through sexual contact. “Vaccines usually work in more than 95 percent of people, but 100 percent is very unusual,” said Jane Kurata, immunization coordinator at Jefferson County Public Health. Unlike the human immunodeficiency virus (HIV), HPV is not necessarily deadly. But cervical cancer, which can develop from some of the roughly 40 HPV strains, is common enough to be scary – about 4,000 women in the United States die of it each year, and another 10,000 develop it, said Lisa McKenzie, Communicable Disease Program coordi-

nator at Jefferson County Public Health. Some strains can cause genital warts, which can be uncomfortable but usually not dangerous. Other strains may go completely unnoticed. Still other strains can cause cervical cancer. Gardasil protects against two of the most potent cancer-causing strains. “HPV is the most common STI [sexually transmitted infection], and they figure more than half of people sexually active will be infected with it sometime in their lives,” McKenzie said. The U.S. Centers for Disease Control estimates that 20 million people in the United States had HPV in 2005. While HPV does not necessarily cause cervical cancer, those who are infected with it are more likely to get cervical cancer at some time in their lives, McKenzie said. While the vaccine prevents only four of the 40 or so HPV strains, two of those four are responsible for about 70 percent of cervical cancers. The other two cause about 90 percent of cases of anal and genital warts, one of the ways HPV manifests itself. Gardasil is a three-dose series of shots given within six months. The second dose is given two months after the first, and the third dose given four months after that. The vaccine has been available at Jefferson County Public Health

since May 2007, but may be just starting to go mainstream. Among girls ages 10–18, the Health Department averaged about 10 doses per month in 2007, McKenzie said. But during the past three months, the average has gone up to about 27 doses per month. The shots are recommended for girls as young as 9 and as old as 26, McKenzie said. It is recommended that girls have the shot before becoming sexually active, in order to reduce the risk of contracting HPV at all. Even if the patient does have HPV, the shots are still recommended, because it is possible a woman with HPV has only one strain and can still be protected from the three others, McKenzie said. Those who have had the vaccine are still recommended to have regular pap tests and annual physicals. Although Jefferson County has some of the state’s highest rates of parents who choose to sign waivers so their children don’t have to receive vaccinations to attend school, Kurata has not seen this attitude applied to Gardasil. “For most cases, I’ve been really impressed with how accepting people are,” Kurata said. “It prevents a certain type of cancer. Who would not want that for their daughter?” Blythe Lawrence can be contacted at

HPV by the numbers 3 - Number of shots required for the HPV vaccine 6 - Number of months between the first and last shot 33 - Maximum number of dollars women 18 and younger will pay per shot at the Jefferson County Health Department 4,000 - Number of women killed by cervical cancer per year in the United States 10,000 - Number of women who develop cervical cancer per year in the United States 2,000,000 - Number of people in the United States who have some strain of HPV, as of 2005

Gardasil FAQs Q: Should I have the vaccine if I’m not sexually active? A: If you ever plan on becoming sexually active, the answer is yes. You cannot get HPV without being sexually active, however. Q: Can I get HPV if my partner wears a condom? A: Yes. The condom does not prevent certain forms of skin-to-skin contact that can transmit HPV. Q: Could I get HPV and/or cervical cancer from the HPV vaccine? A: No. The vaccine is a “killed” vaccine, said Lisa McKenzie, Communicable Disease Program coordinator at Jefferson County Public Health. That means it cannot cause HPV or cervical cancer. Q: Do women who have the HPV vaccine need to worry about other sexually transmitted infections? A: Yes. The HPV vaccine protects against HPV only.

Jefferson County Public Health has noticed an increase within recent months in the number of women getting vaccinated for human papillomavirus. Submitted photo  R 2008 Health & Wellness

Q: Are there side effects to getting the shots? A: Some patients complain of pain or tenderness at the injection site a few days after getting a dose of Gardasil, McKenzie said. There is also the possibility of a mild fever during the first few days as the immune system kicks into gear and the body builds up antibodies. Those who are allergic to yeast should check with their doctors before having the shots. Sources: Jefferson County Public Health and the Vaccine Education Center at The Children’s Hospital of Philadelphia Port Townsend & Jefferson County Leader

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2008 Health & Wellness R 

Cancer busters Uptown Nutrition points patients, families to resources By Blythe Lawrence Leader Staff Writer The woman called Uptown Nutrition owner Suzy Carroll a few days after Christmas, whispering into the phone so her three children wouldn’t hear. “Suzy,” she said softly, “I have cancer.” Carroll, who had lost her father to melanoma during the mid-1990s, was stunned. She pictured what would come next for her friend – the agonizing period between diagnosis and learning the method of treat-

Foods that fight cancer Brussels sprouts Broccoli Cauliflower Cabbage Garlic Onions, shallots Spinach, watercress Freshly ground flax seeds Tomato paste Turmeric Black pepper Blueberries Raspberries Blackberries Dried cranberries Grapes Citrus fruit juice Green tea Source: Foods that Fight Cancer by Richard Beliveau and Denis Gingras  R 2008 Health & Wellness

“You get diagnosed with cancer, you get all this information, and you get totally overwhelmed.” Suzy Carroll owner Uptown Nutrition ment, likely followed by months of radiation and possibly chemotherapy. Carroll knew it, but realized her friend might not. “You get diagnosed with cancer, you get all this information, and you get totally overwhelmed,” Carroll said from her office at Uptown Nutrition in June. Wouldn’t it be nice, she reflected that December day after hanging up, if people had a resource center where they could go to get information on anything to do with cancer. It could be an oasis from doctors, specialists and sterilized instruments where they could do their own research and plan their next step. After devoting some shelf space at her store to cancer resource materials, Carroll found that some just want the books, which are available from the Lawrence Street store’s reference and lending libraries. Carroll gives Mauris Emeka’s Fear Cancer No More: Preventative and Healing Information Everyone Should Know, a book written in layman’s terms, free to customers who have been diagnosed with the disease. Others want to know if there are people out there they can talk to about their illness. For that, Carroll directs them to Linda Klinefelter, a patient navigator with Olympic Medical Center

Uptown Nutrition owner Suzy Carroll has devoted a portion of her time – and her store – to helping cancer patients find resources. Photo by Blythe Lawrence in Sequim. Klinefelter’s job is to support patients in dealing with all aspects of the treatment process, from helping them find out if they qualify for Medicaid to arranging rides to and from treatments. The service, available free to any cancer patient in Jefferson and Clallam counties, also addresses in-home care referrals, hospice counseling and finding financial resources. “For lack of any other description, [we offer] any other

service that can benefit a patient and their family,” Klinefelter said. “We don’t leave a stone unturned.” Carroll, a nutritional consultant, purchased Uptown Nutrition after watching Morgan Spurlock’s 2004 movie “Supersize Me,” which showed how quickly eating processed foods could break down the body. She’s quick to point out that she’s not a physician or a naturopath. But she’s seen firsthand what cancer can do to a person, and

is equally quick to say preventative measures can be taken. “Pretty much everyone knows someone who gets cancer,” Carroll said, but she also thinks it doesn’t have to be that way. Carroll argues that the industrialization of food has been harmful because the body does not know what to do with processed foods and they contain higher levels of toxicity than do natural foods. The amount of toxicity in – Continued on Page 10 – Port Townsend & Jefferson County Leader

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Uptown Nutrition owner Suzy Carroll offers discounts on supplements to cancer patients on limited incomes. Photo by Blythe Lawrence

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– Continued from Page 8 – a body can contribute to weakening the immune system and to cancer cell formation. “A lot of people will assume that cancer is due to our toxic environment, and that’s part of it, but about 70 percent of all cancers are preventable, by making good choices about what we put on our plates and put in our bodies,” Carroll said. For those who do develop cancer, Carroll suggests finding an oncologist who will work in tandem with a naturopath

to offset some of the effects of chemotherapy and/or radiation. In addition to the store’s libraries, Carroll offers cancer patients on limited incomes a discount program on the supplements Uptown Nutrition carries. “Supplementing when you have cancer can be expensive,” she said. “I will not profit off somebody who has cancer who is not in a good financial position.” Carroll also puts her cell phone number out there. Some of her customers want to be discreet about their conditions,

Books on cancer resources line the shelves at Uptown Nutrition. Photo by Blythe Lawrence she said. The woman on the phone went through surgery, then radiation for her cancer, and is now in remission. Carroll wants to expand her business to provide as much support for people like her friend as possible. “I really want to get out there and educate people,” Carroll said. “It’s such an important message.”

Blythe Lawrence can be contacted at

Reduction of carcinogenic potential Inhibition of tumoral cell growth Induction of tumoral cell death Interference with angiogenesis Impact on the immune system The chart above shows the ways some foods fight cancer. All inhibit tumoral cell growth. Source: Foods that Fight Cancer by Richard Beliveau and Denis Gingras 10 R 2008 Health & Wellness

One of the cancer-fighting products available at Uptown Nutrition is Sei Mee ground green tea. Photo by Barney Burke Port Townsend & Jefferson County Leader

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008 Health & Wellness R 11

One way to save money and eat healthfully is to grow some of your own food. Washington’s official state fruit is the apple; despite the cold spring of 2008, these apples, now the size of pingpong balls, should be ready for eating by fall. Photo by Barney Burke

Ideas on how to eat better and more cheaply By Catherine Kapp Leader Contributing Writer Economic conditions are adding emphasis to common questions about healthy diet. Here are 11 ideas on how to eat better and more cheaply:

in them. (Try reading the label sometime on a cake or pudding mix, and you will wonder why you don’t glow in the dark after eating them.)

1. Eat what is produced fresh locally if and when you can, for higher vitamin/nutritional content. If you have a little space, “locally” could mean growing lettuce starts in a box or two.

4. To learn to live with less salt and sugar, try switching gradually. Reduce the salt in your recipes a little each week, ditto with sugar. Gradually your taste buds will “tune down,” and you’ll suffer less withdrawal. This is true for caffeine too. Start with a ratio of one part decaffeinated coffee to three of caffeinated, then gradually increase the percentage of decaf to help you avoid the tiredness and headache sometimes associated with caffeine withdrawal.

2. Avoid processed foods. Canned soups, meats, fish and vegetables usually have a high salt content, and canned fruits are usually too full of sugar. 3.

Make your own convenience foods. They are much cheaper and you know what’s 12 R 2008 Health & Wellness

5. Lower cholesterol in egg

recipes by using one egg white for every two eggs. Use olive oil instead of butter whenever possible.

6. If your families are meatand-potato types, try adding ground vegetables to family favorites like meatloaf. 7. Bottled sauces and salad

dressings are fat traps and chemical dumps. It’s easy to make your own in “bulk” amounts and then freeze or refrigerate until needed. That way you control what’s in them. They also usually taste better.

8. Eat seasonally. While it’s nice to eat fresh raspberries at Christmas, those raspberries have traveled a long way and are tired. Given transportation costs, they

are also value-added and expensive. Watch what’s in plentiful supply in the produce section and what’s on special. That usually means it’s in season and will be at its peak for nutritional value and flavor.

9. Lose weight without “dieting.” More calories in, fewer burned equals weight gain. Burn more calories by increasing activity levels – this could be as simple as walking 30 minutes a day. Watch portion size. Successful “losers” often say they did it by reducing the portion size rather than by eliminating favorite foods. If you love ice cream and can’t live without it, by all means eat a little bowl of it – ditto with pasta or cookies. This way you don’t feel deprived and can stick with the lower calorie level over the long haul – which is the secret to not gaining it back the

minute you stop your regimen.

10. Fill up with low-calorie foods that are high in vitamins, fiber and minerals, and low in fat, salt and sugar. Vegetables are in this category, so try eating one vegetarian dinner a week, or add an extra vegetable to your usual dinner fare. 11. Fool your palate by “frying” foods in the oven. Spray with oil and cook at high temperature instead of frying in an inch or two of oil, which gets absorbed in cooking. This works for French fries, crab cakes and other foods that are so delicious because of their high fat content. Catherine Kapp of Port Townsend writes a “Seasonings” recipe column monthly for The Leader.

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Annual Exams Paps Menopause Care Contraception Tubal Sterilization Treatment for Heavy Periods Surgery – Hysterectomy, Repairs Jane Albee, ARNP • Robert H. Palmer, Jr., MD 1136 Water Street, Suite 105 • (360) 344-3700 Appointments available Monday-Thursday

2008 Health & Wellness R 13

Encropresis: Hard problem, easy to treat Fast-paced world, social pressures all relate to childhood constipation By Allison Arthur Leader Staff Writer Irritability. Tummy aches. Decreased appetite. Social isolation. And body odor. If a child or teen has those symptoms, a family doctor might call on Shena Kellewea, a nurse practitioner who specializes in a condition with a fancy name that is not easy to discuss over lunch: encropresis. Encropresis is fecal soiling after the age of 4. One to 3 percent of all school-age children suffer from encropresis, according to Kellewea, who joined Amy Irene Lynch, owner of Discovery Physical Therapy in Port Hadlock, in March. Kellewea focuses on encropresis while Lynch works with people who have enuresis, essentially wetting. “We were able to collaborate the two body areas,” Kellewea said. Kellewea acknowledges that encropresis is not well known. In fact, she learned about it by accident when she moved from Eugene, Ore., to Seattle to get a master’s degree in mental health from the University of Washington. She called about a job with nearby Children’s Hospital in Seattle. “When I called I did not know what encropresis was,” Kellewea acknowledged. Since the condition has mental health overtones, she took the job and learned a lot about encropresis at Children’s, got her master’s degree in child and adolescent mental health, and now has come to Jefferson

County to practice. She also works part-time for Jefferson County Public Health in maternal child health. The one thing Kellewea wants people to know is that there is an 80 percent success rate for treating encropresis. “It’s a difficult condition to have, but treatable with a high rate of success,” she said. Like adults with constipation issues, children with encropresis get backed up with excess stool. “Some kids pass stools the size of pop cans,” she said. “The colon gets backed up. They feel lousy,” she said of the condition. Often, children don’t know they’ve soiled their underwear with fecal matter because they’ve gotten so used to the smell that they don’t smell themselves. And that’s where Kellewea’s mental health training comes in. Kids with the condition often are teased at school, called names because they smell bad. That teasing exacerbates the problem because the children are less likely to use the public restrooms at school, opting to “wait to get home” where they can relieve themselves in private. Because it’s such a private matter, parents also have a hard time talking about it. “Sometimes they don’t want to tell their doctors because they’re embarrassed. They think that they’re doing something wrong with their child and they’re not. It’s more a matter of not knowing what to do,” Kellewea says.

Encropresis Center open Shena Kellewea operates the Encropresis Center at Discovery Physical Therapy in Port Hadlock from 9:30 a.m. to 5:30 p.m. Wednesdays. The encropresis center opened in March. In addition to most major insurance programs, the center accepts state Department of Social and Health Services medical coupons. For more information or for an appointment, call 385-9310. 14 R 2008 Health & Wellness

Shena Kellewea Photo by Allison Arthur

Nutrition connection

A poor diet – high in dairy and junk food and low on fiber – contributes to the problem, as does the modern rush, rush, rush lifestyle, Kellewea says encropresis experts believe. “Kids really don’t eat enough fiber, and they eat too much junk food and dairy. Dairy is very constipating,” she said.

And there are other issues, she’s discovered. One young boy she treated was fine for a year and then started having problems again. When Kellewea questioned him, she discovered that as soon as he got home he got on the computer, and even though he needed to go to the bathroom, he didn’t for fear his sister would snatch the computer. “If I get up my sister will take my place at the computer,” the boy told Kellewea. A solution for that child’s problem involved cooperation with the sister. Treatment for most encropresis cases essentially involves the use of stool softeners and laxatives – not enemas. Enemas, she said, are hard on both the child and the parent. X-rays are taken before and after treatment to ensure the bowels are moving properly. During a two-week treatment period, Kellewea works

“Sometimes they don’t want to tell their doctors because they’re embarrassed. They think that they’re doing something wrong with their child and they’re not. It’s more a matter of not knowing what to do.” Shena Kellewea Good fiber foods for children include popcorn, cereals, vegetables and dried fruits. Green peas are high in fiber and popular with kids. Another important point is for children to be given time to use the bathroom. “No one has time to sit on the toilet and go anymore,” she said. This is especially true for boys. For every girl diagnosed with encropresis, there are four to six boys who suffer. Kellewea says the suspicion is that boys are more reluctant to sit down, especially in public places. Many boys, in fact, rarely use school facilities, she said.

with school nurses and parents so that the child is sent to school with extra clothing and is given a private place to eliminate without being embarrassed by peers.

Ties to bed wetting, ADHD

Encropresis also has been connected to a related hard-totalk-about subject: bed wetting (enuresis), which is a condition Lynch treats. “ Tw e n t y percent have daytime wetting, and 33 percent have nighttime wetting,” Kellewea said, explaining that the pressure of a full colon on the bladder reduces the capacity to hold urine and can cause accidents. Children with encropresis

also suffer bladder infections because bacteria from the fecal soiling can spread. Children who have been diagnosed with Attention Deficit and Hyperactivity Disorder (ADHD) also have a higher incident of encropresis because they don’t take the time required to empty their bowels, she said. And there also are some medications, such as antihistamines, that have a drying effect that can exacerbate problems. Coercive toilet training – forcing a child – can also cause constipation that can lead to encropresis. And children also can fear that if they sit on the toilet they might fall in, she said. “Starting school and toilet training are the common times” for the problem to start, Kellewea says.

Social issues

There are social issues involved with the condition. Children with encropresis tend to shy away from “overnight” visits with friends and families, and even avoid vacations. “Kids end up isolated because no one wants to be around them,” she said. Children also become so embarrassed they go to great lengths to hide their soiled clothes. At school, children often can’t go to the bathroom when they need to go and are told to go during breaks. “Not everyone needs to go at the same time,” she said. For those who do need to go and can’t, or are having problems, Kellewea hopes they find her and learn more about the condition and the solution. Because the encropresis center is a specialty clinic, Kellewea said she can spend the time needed to help those suffering from the hard-to-talk-about but not-so-difficult-to-resolve problem.

Allison Arthur can be contacted at

Port Townsend & Jefferson County Leader


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2008 Health & Wellness R 15

Fifty? It’s time for a colonoscopy By Barney Burke Leader Staff Writer If you’re a baby boomer, chances are you never heard the term “colonoscopy” until 1985, when 74-year-old President Ronald Reagan had one and it dominated the evening news. During Reagan’s colonoscopy, doctors removed a small polyp and discovered a second, more dangerous tumor. The next day, surgeons removed that “villous adenoma” tumor and a 2-foot section of his colon. He lived to be 93. But don’t wait until it’s too late. Jay Monahan, husband of CBS television newscaster Katie Couric, died of colorectal cancer at 42. Often, it develops without any obvious symptoms, which is why colonoscopies can save your life. Doctors recommend having a colonoscopy at 50, and again every 10 years. If a polyp is found or other conditions warrant, follow-up colonoscopies should be every three to five years. “The majority of cancers start as a polyp,” said Dr. Jay Lawrence of Port Townsend. There are several other screening techniques, but colonoscopies are the most effective at detecting flat polyps, Lawrence said. Another advantage, said Dr. Ryan Ramos, is that a problem found during a colonoscopy can be treated during the same procedure. Although colorectal cancer is the third-leading cause of cancer-related deaths for men and women, 40 percent of people older than 50 have not been screened properly, according to the U.S. Centers for Disease Control and Prevention. Moreover, according to the CDC, 60 percent of colorectal cancers could be prevented if everyone were screened beginning at age 50. Some of the most effective advocates for colonoscopies are people who’ve had them. “We see patients at both ends of the spectrum,” Lawrence said, from pre-cancerous polyps to advanced cases of cancer that cannot be cured. Ramos said many of their patients are referred 16 R 2008 Health & Wellness

“The majority of cancers start as a polyp.” Dr. Jay Lawrence by friends who’ve had colonoscopies that revealed polyps – or worse. People who’ve had colonoscopies will tell you that preparation is the worst part. You follow a restricted diet for a few days in advance, and on the day before, don’t plan on going to work. You won’t be going far from the bathroom once the laxatives kick in. Stock the bathroom with the Sunday New York Times and make the best of it. The colonoscopy itself takes about 15 to 30 minutes, and the patient is typically given intravenous sedation. Afterward, the nurse will be able to share the results, including whether any polyps were removed. You’ll be able to go right home, but you won’t be able to drive a car until the next day. So kick back, eat well, and celebrate one of the most effective ways to beat cancer. Barney Burke can be contacted at

The diameter of a colonoscope is about a half an inch. In the tip of the instrument are ports for water and air, a tool for removing polyps, and a lens allowing the doctor to see everything clearly. Photo by Barney Burke

Above is a healthy colon. At right is a polyp; most colorectal cancers start as polyps. Photo courtesy of Dr. Jay Lawrence and Dr. Ryan Ramos Port Townsend & Jefferson County Leader

Estimated cancer deaths by type, 2008 Men Lung (31%) Prostate (10%) Colorectal (8%) Pancreatic (6%) Liver (4%) Other (41%) Source: American Cancer Society

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Dr. Ryan Ramos (left) and Dr. Jay Lawrence, holding colonoscope, in their Port Townsend office. A colonoscopy is the most effective way to screen for colorectal cancer, and it enables doctors to screen and remove polyps in one procedure. Photo by Barney Burke Port Townsend & Jefferson County Leader

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2008 Health & Wellness R 17


in Jefferson County


New Patients

What initials mean: JH: Doctors have contracts with Jefferson ARNP: Advanced Registered Nurse Practioner Healthcare Hospital. MD: Medical Doctor IND: Doctors are independent and not PA-C: Physician Assistant-Certified associated with Jefferson Healthcare.


*Doctors responding yes accept Department of Social and Health Services (DSHS) coupons for Medicaid. JEFFERSON MEDICAL AND PEDIATRIC GROUP 8 a.m.-5 p.m. Monday-Friday; 9 a.m. start on Tuesday; 385-4848 R. Corey Asbell Yes to all Limited JH R. Steven Butterfield Yes to all Limited JH Carolyn Day Yes to all Limited JH Shannan Kirchner Yes to al Limited JH Frank Magill Yes to all Limited JH Sarah Schmidt Yes to all Limited JH MADRONA URGENT CARE 9 a.m.-7 p.m. Monday-Friday; 9 a.m.-4 p.m. Saturday; 10 a.m.-2 p.m. Sunday; 344-3663 Bradley A. Bringgold Yes/Yes/No/Yes No JH Steven Hillman Yes/Yes/No/Yes No IND James C. Blair, III, PA-C Yes/Yes/No/Yes No IND MADRONA FAMILY MEDICINE 8 a.m.-5 p.m. Monday, Tuesday, Thursday, Friday; 8 a.m.-noon Wednesday; 385-5388 Bruce Stowe Yes/Yes/No/Yes Limited IND Sandra Vanvig Yes/Yes/No/Yes Limited IND MONROE STREET MEDICAL CLINIC 8 a.m.-5 p.m. Monday & Wednesday; 8 a.m.-2 p.m. Tuesday & Thursday; 8 a.m.-noon Friday; 385-5658 Douwe Rienstra No/Yes/No/Yes Yes IND OLYMPIC PRIMARY CARE 8 a.m. -5 p.m. Monday-Friday; 379-8031 Rachel Bickling Yes to all Yes JH Todd Carlson Yes to all No JH David Harris Yes to all Yes JH Joe Mattern Yes to all No JH Laura Hollister-Meadows Yes to all No JH Molly Hong Yes to all Yes JH Sara Katz Yes to all Yes JH PORT HADLOCK MEDICAL CARE 9 a.m.-5 p.m. Monday-Friday; 379-6737 Linda Pedersen Yes/Yes/Yes/No Yes IND Jeanne Battenburg Yes/Yes/Yes/No Yes IND PORT TOWNSEND FAMILY PHYSICIANS 8 a.m.-5 p.m. Monday-Friday; 385-3500 Bob Bammert Yes to all Limited JH Claus Janssen Yes to all Limited JH Richard Meadows Yes to all No JH Katherine Ottaway Yes to all Yes JH PORT TOWNSEND SURGICAL ASSOCIATES 9 a.m.-5 p.m. Monday-Friday; 385-5444 Jay Lawrence Yes to all Yes IND Ryan Ramos Yes to all Yes IND PORT TOWNSEND WOMEN’S CLINIC 9 a.m.-5 p.m. Monday-Thursday; 344-3700 Robert H. Palmer Jr. Yes to all By referral IND Jane Albee Yes to all Yes IND SOUTH COUNTY MEDICAL CLINIC 8:30 a.m.-5:30 p.m. Monday-Thursday; 765-3111 Merrily M. Mount Yes to all Yes JH STRAIT ORTHOPEDIC 8 a.m.-5 p.m. Monday-Friday; 344-3090 Tristan McGovern Yes to all Yes JH Kevin Hines Yes to all PA-C Dean Short Yes to all PA-C PHYSICIANS IN PRIVATE PRACTICE Insurance/Cash/DSHS*/Credit New Patients JH/Indept. Jonathan Collin N/Y/N/Y Yes IND Alan G. Greenwald Y/Y/Y/N Yes IND Jack Hutton Y/Y/N/N Yes IND Dimitri D. Kuznetsov Y/Y/Y/N Yes IND Richard Lynn Yes to all Limited JH Jessica Lund Y/Y/Y/N Yes IND Melanie McGrory N/Y/N/N Yes IND Jak Nikomborirak Yes to all Yes JH James Rotchford N/Y/Y/Y Limited IND

18 R 008 Health & Wellness




Pediatrics/Internal Pediatrics/Internal Family medicine Pediatrics/Internal Pediatrics/Internal


Family practice Emergency/family Orthopedics


Family medicine Family medicine


Family medicine


Family practice/OB Family practice/OB Family practice/OB Family practice/OB OB checks (Coming in the fall) Family/PA





General surgery General surgery


GYN Women’s health issues



Certification MD MD MD MD MD DPM MD MD MD


Specialty Preventive medicine Orthopedic surgery Neurology Urology Internal medicine Podiatry Family medicine Sleep medicine Pain/addiction

Phone 385-4555 344-0400 385-1729 385-2905 385-5330 385-6486 379-4767 683-8544 385-4843

Port Townsend & Jefferson County Leader


Jefferson County Public Health 615 Sheridan Street, Port Townsend, WA 98368 • 385-9400



Tobacco use: the nation’s number one cause of preventable death 45 WA youths begin smoking everyday. Surveys of adult smokers in WA State show that half of them had first tried cigarettes by age 14, and 70 percent of those were regular smokers before they left high school.* The younger you are when you start smoking cigarettes, the more likely you are to become strongly addicted to nicotine.

3 shots can protect you against the viruses that cause 70% of Cervical cancer & 90% of Genital warts.

Jefferson County adults are motivated to quit. 76% of everyday adult smokers in Jefferson County tried to quit smoking for one or more days during the past 12 months.**

Recommended for all girls and young women ages 9 through 26.

Increase your chances of quitting: • Call the WA State Quit Line: 1-800-Quit-Now

Low cost or free children’s vaccine available for ages 9 through 18 on a sliding scale.

Most effective strategies include: • Talk to your doctor about medication that may help you quit • Seek support through tobacco cessation classes or social

Free vaccine now available for low-income women ages 19-26.

Learn how to talk to loved ones who smoke :

Call Jefferson County Public Health 360-385-9400

Jefferson County Tobacco Prevention & Control Program: 360-385-9417 *Stopping the Sale of Tobacco to Kids, WA DOH fact sheet **Health of Jefferson County



Jefferson County Public Health Travel Clinic offers: • Vaccines for international travel • Malaria prevention information • Precautions to avoid travel-related diseases

You May Qualify for FREE VACCINE

See us 6 to 8 weeks before your trip. Call for an Appointment. Insurance can be billed. 360-385-9400

Have You: • Had more than 1 sex partner in the last 6 months? • Injected or snorted street drugs? • Been diagnosed with a sexually transmitted disease or Hepatitis C?

FREE HEPATITIS C TESTING Many people who are infected don’t know it. Risk factors include: • Exposure to someone else’s blood • Injecting or snorting street drugs • Having sex with someone who has Hepatitis C • Getting tattoos or piercings from a non-professional For more information on testing, call Jefferson County Public Health, 360-385-9400.

Illustration by Christine Thomas

THE KEY IS EARLY DETECTION THROUGH REGULAR SCREENING TESTS. Breast Cancer is more common in women over 40. However, 75% of women with breast cancer are over age 50. Beginning at age 40: • Have a mammogram (x-ray of the breast) every year. • Have a clinical breast exam by a health care provider every year. • Do a breast self-exam every month.

For Women Over 50

Have Peace of Mind! Regular cancer screenings can help you keep healthy as you grow older. Port Townsend & Jefferson County Leader

Cervical Cancer is preventable. The Pap test can find cell changes before they become cancer. • Most changes are easily treated. • Have a Pap every 1 to 3 years. Ask your health care provider about how often you need a Pap test.

Colon Cancer – Over 90% of colon cancer is curable when caught early. Colon health screenings can find and remove growths before they develop into cancer. • Start colon health screenings at age 50. • Find out your family history and discuss this with your health care provider. You may need to start screening tests at an earlier age.

Regular cervical and colon cancer screening can stop cancer before it starts. Regular mammograms can find cancer when it is the size of a small seed. Treatment is most successful at this early stage.

Take good care of yourself. Be your own best advocate. Get regular health screenings. If cost or lack of health insurance keeps you from getting care or if you don’t have a health care provider, call 385-9400 and ask about the Washington Breast and Cervical Health Program. For the Washington Colon Health Program call 1-800-756-5437. 2008 Health & Wellness R 19

20 R 2008 Health & Wellness

Port Townsend & Jefferson County Leader

Health & Wellness 2008  
Health & Wellness 2008  

The Port Townsend & Jefferson County Leader's 2008 publication of Health & Wellness.