Methow Valley Health & Wellness 2017

METHOW VALLEY

Health & Wellness 2017 – 18

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AUTOIMMUNE diseases on the rise

How HORSE sense helps HUMANS

AGING with

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H e a lt h & W e l l n e s s 2 0 1 7 – 1 8

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M e t h o w Va l l e y

Methow Valley

Editor’s note

Health & Wellness

It takes a community

2017 – 18

Don Nelson, publisher/editor Darla Hussey, design Sheila Ward, advertising Dana Sphar, ad design & production Rebecca Vaughan, office manager

CONTRIBUTORS Ann McCreary Marcy Stamper

A publication of the Methow Valley News P.O. Box 97, Twisp, WA 98856 509.997.7011 • 509.997.3277 fax editor@methowvalleynews.com www.methowvalleynews.com Find us on Facebook C over photo by D onni R eddington

Health care isn’t just about doctors’ offices and hospitals and insurance plans. For those who are proactive about their health, it means taking a broad view of how they live and how they think about their futures. In the Methow Valley, it also can mean taking advantage of community connections that have developed over the years to help care for our aging population.

In Health & Wellness 2017–18, you’ll find a story about how several such programs work in the Methow Valley, and how they might benefit you. You may not know much about equine therapy, but in another article you’ll learn how it is effective for many people. Another article explores the mystery of why autoimmune diseases are more prevalent in the Pacific Northwest.

When it comes to decision-making about our well-being, we’re fortunate to have an array of health care choices in the valley or nearby, including doctors, nurses, nurse practitioners, first responders, specialists, dentists, naturopaths, spas, social service agencies, therapists, counselors, masseuses, herbalists, chiropractors, ophthalmologists, optometrists, pharmacists and insurance providers. Many of them are advertisers in Health & Wellness 2017–18, which makes the publication a year-round resource.

Don Nelson Publisher/Editor

Ta b l e o f Co n t e n t s Equine therapy

4 Extended independence

10 The autoimmune challenge

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M e t h o w Va l l e y

Equine therapy Working with horses can help humans address emotional and physical challenges

By M a rc y Sta m pe r

It may seem counterintuitive that a thousand-pound animal that doesn’t speak could help people communicate about some of the most sensitive personal issues they face.

But a program in

equine-facilitated psychotherapy led by Okanogan County Behavioral Healthcare (OBHC) at Methow Valley Riding Unlimited has done just that for a group of women recovering from PTSD and traumatic brain injury.

Methow Valley Riding Unlimited (MVRU) has been using horses in therapeutic ways for people with physical and emotional challenges for decades, but the specific focus on emotional therapy is new.

Still, all the programs inevitably incorporate some aspect of mental health. “I say that myself — I feel happier when I ride,” said Annie Budiselich, MVRU’s program director.

The equine therapy started as a pilot project in the spring with a trauma support group at Room One led by Savannah Miller, a

Women in the support group learn that horses respond readily to gentle contact, said mental health professional Savannah Miller (with Buttons) and Minbashian (with Finesse). Photo by M arcy Stamper

mental health professional with OBHC. The program blends individual and group therapy sessions

with monthly visits to the ranch, where the women develop life and social skills. Through their

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People learn concepts more effectively when working with horses and other animals because these experiential programs generate situations that closely resemble real life, said Miller. For example, some people set such strict boundaries in their personal relationships that it’s hard for them to let anybody in. Others don’t know how to create or maintain boundaries.

That’s where the horses come in.

Observing and working with the horses has helped the women to set boundaries – and to enforce them.

Miller has worked with many types of animals in her career, including horses, dogs, llamas and pigs. Each can have a different therapeutic effect on a client. Photo by M arcy Stamper

interaction with the horses, the women learn to read cues, set limits and strengthen their memory and concentration.

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Unlike the other programs at MVRU, the mental health program doesn’t involve riding horses.

Instead, the women do a variety

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of exercises with the horses, such as leading and grooming them, or coaxing them through an obstacle course.

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Building confidence Budiselich and MVRU Associate Director Jasmine Minbashian serve as equine specialists for the OBHC program, helping interpret the horses’ behavior and keeping everyone safe. They select horses that will help the women build confidence in setting limits, such as matching the women with a pushy or deferential animal.

“The women learn how to ask a large animal to back off,” said Miller. “The feedback I get is, if they could do that with a horse, they could do it with a person.”

At other times, Budiselich and Minbashian let the horses take the lead. “I’ve been doing this 30 years, and it’s still fascinating to me which horses will pick which people,” said Budiselich. She has watched as a big, imposing horse approaches a woman who is a bit nervous. “The horse may choose the most timid person — and know how to be gentle. The horse may

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come out of its box because it senses people need it in a different way.� “Working with horses is so real,� said Minbashian, who said she has seen people who are awkward when interacting with other people exhibit a natural comfort around horses. “Horses are prey animals — they’re very sensitive to your emotions and energy,� she said. Because they have to be prepared to run at any moment, horses are particularly intuitive. “And that creates a strong selfawareness in the clients,� said Minbashian.

Watching the horses as they interact with each other in the pasture or the corral teaches the women to read body language and other cues. Horses use their ears and tail in very subtle ways. “Horses are very clear with each other — they show who’s the boss, and who’s not,� said Minbashian. “Horses are so attuned to spatial dynamics — as soon as they see the

Women in the equine therapy group observe the horses in the field to understand their pecking order and how the horses communicate with one another. Minbashian is signaling Buttons, “the boss mare.� Photo by M arcy Stamper

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leader coming, they step out of the way,” she said. “It encourages the women to carry themselves in a way that brings awareness in real life.”

As the women in the recovery group picked up on the signals the horses use to communicate, they also became more aware of body language and gestures telegraphed by friends or family members.

“The cues translate more than you would think,” said Miller.

In one exercise, the women lead a horse with a halter. By applying light pressure and then releasing the halter as soon as the horse backs off, the women let the animal know how close they want it to come.

After that activity, some women said they realized they’d been badgering their friends and hadn’t let up even after their friends had accommodated their wishes, said Minbashian.

As one participant said, “I actually saw when I, myself, didn’t release pressure on people — and how they didn’t release pressure

on me — and how that felt. This really translated in a daily-life awareness.”

Trust and relaxation Miller studied animal-assisted therapy as part of her master’s in social work and has found that different animals have different therapeutic effects. When people with Alzheimer’s disease pet and handle dogs, they recalled memories of their own experiences with dogs. And teens in a residential

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Animals can be a catalyst for trust, particularly for people who have problems trusting human beings, said Miller. When there’s a therapy animal around, people tend to drop their guard. It’s not uncommon for the women in her support group to start pouring out their stories to the horses while they groom them, she said.

Sometimes it’s easier to relate

to an animal that appears to be dealing with similar issues. For example, women struggling with PTSD were drawn to one horse that is particularly tentative. They see that the horse needs extra time and space to overcome its hesitancy. “Everyone deals with trauma, even horses,” said Minbashian.

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M e t h o w Va l l e y

or set goals. In one activity, the women teach the horses to walk through an obstacle course, which incorporates problem-solving skills.

Grooming the horses also teaches the women to sense when the horses are comfortable and relaxed. “Horses are so sensitive that you want to be a calming force,” said Minbashian.

Beyond the specific therapeutic activities, the women in the trauma-recovery group simply prize their time at the ranch. Even those who’d never touched a horse became confident leading and working with the horses by the end of the program, said Miller.

And the program helped the women build connections so that their larger community feels safe, said Minbashian.

The horses also teach the value of patience and reinforcement.

One woman in the program said, “I learned it takes time to earn trust and respect. People now have to earn my trust, just like the horses did.”

“It’s all about empowerment.

Everyone who comes here develops that confidence,” said Minbashian. “Horses are special. They really want to connect with you.

It’s really powerful to be bonded, especially with a large animal like a horse.” ◆

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Methow at Home sponsors a variety of social events for members and volunteers, like this hike to Cutthroat Lake. . Photo courtesy of Methow At Home

Extended independence Aging at home, but not alone, in the Methow Valley

By A n n McCr e a ry

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“Here I am in the valley with no relatives, and I’m 69. I have an acre-and-a-quarter place, so my plate is full of challenges.”

Carolyn Bickford of Twisp, like many people who are growing older in the Methow Valley, realized that she would probably need help at some point with the challenges of continuing to live independently. When she learned two years

ago about a new program called Methow At Home, designed to help people stay in their homes as long as possible, “I was ecstatic to hear something like this was happening here,” Bickford said.

Methow At Home is based on a national movement aimed at helping people continue to live independently and be engaged in their community. Members pay

annual dues to receive support from volunteers with needs like transportation, household chores and repairs, temporary respite care and companionship.

Methow At Home is the newest among local community organizations created in recent years to help Methow Valley residents deal with aging and illness, and give them the support they need to M e t h o w Va l l e y

live independently for as long as possible.

With the same goal, but offering a different type of support, the Lookout Coalition was founded eight years ago by Raleigh Bowden, a retired physician who specialized in cancer treatment.

The coalition is a group of volunteer health professionals including retired physicians, social workers, counselors, nurse practitioners, meditation specialists, and hospice-trained community members.

Lookout Coalition volunteers provide house calls at no charge and assist residents with a wide range of issues, such as helping manage medications and treatment, assisting with medical and treatment decisions, providing referrals to doctors, social services and hospice, and providing community education.

In its first year, the Lookout coalition assisted 17 Methow Valley residents. This year, the Lookout Coalition expects to assist 120 new clients, and provides services to

about 40 residents each month, said Bowden. And, Bowden said, she expects the need for support to continue growing.

“In this valley, over 50 percent of the population is over 50 years old.

We have an aging community,” she said.

As people age, they increasingly need support to deal with medical and mental health issues, financial challenges and planning for their future, Bowden said. Many of those people are also “fiercely independent” and want more than anything to stay in their homes and in their community as long as they can.

But In a small, rural communities like the Methow Valley, coping with aging, illness and related issues can be daunting, even overwhelming. The nearest emergency room is 50 miles away. There is no evening or weekend medical care, and no weekend pharmacy after 1 p.m. Saturday.

“There are lots of cracks in the health care system in this valley,”

Bowden said. Fortunately for local residents, community organizations have evolved to help fill those “cracks” and support people’s desire to grow old — or even die — here in the Methow Valley.

The past 15 years have seen the creation of Guardian Angels, the Lookout Coalition and Methow At Home, all of which are focused on assisting people who are aging and/or coping with illness.

“When I first came here a lot of aging people were leaving because they said they had to be closer to

Building relationships Carolyn Bickford became a founding member of Methow At Home in 2015, and soon found she needed the assistance it offers.

“A couple of years ago I was having trouble with falling. I needed company with walking,” she said.

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Social and emotional support Like Methow At Home and Lookout Coalition, Methow Valley Guardian Angels is based on a model of volunteerism, with a focus on providing social and emotional support to people who are elderly or have chronic

disabilities. Guardian Angels matches them with a volunteer who provides a caring relationship, said administrator Eunice Marchbank.

“Often, though not always, our clients are somewhat isolated. Our goal is to visit and be a friend,” Marchbank said. “It’s a one-on-one relationship.”

“We try to match them with someone with similar interests, if that’s possible,” Marchbank said.

The volunteers, who are mostly retired people, generally spend time with the client once a week, or sometimes more often. The main goal is companionship — just spending time talking with each other, playing board games, or perhaps reading aloud.

Volunteers often provide transportation to medical appointments and shopping, which are important in helping the elderly or disabled person to stay at home, said Marchbank, who has been involved with the organization since it was formed in 2002.

“What often happens, and it usually does, they become friends and it continues on. That’s OK — that’s the whole point of this,” said Marchbank. Some of those friendships have lasted more than a decade, she said.

Guardian Angels, a program of The Cove, currently has 25 volunteers matched with 25 clients, and has assisted more than 175 people over the years. In addition to their one-on-one relationship with clients, Guardian Angels also helps relieve stress on

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training and background checks.

They shovel snow, take people to appointments, help with meals or housework, walk dogs, change batteries in smoke alarms, or simply check in on people, said director Deirdre Cassidy.

The organization has more than 120 people who have enrolled as members and pay yearly dues. But not all of those people receive services, Cassidy said. “Many signed up to support Methow At Home,” she said. The people in most need are generally people who have injuries and need meals, or the eldest people — those in their 80s or older, she said.

Bickford has become a volunteer for Methow At Home, as well as member who receives services. “I realized that as well as using volunteer services, I have things that I want to share. One of my main interests is growing trees from seeds, so that’s one of the things I’ve done — passed on trees and gardening advice,” Bickford said.

“One of the predictors of positive aging is volunteering,” Bickford said. “The more you have community engagement, the more you care about others, the more reasons you have to get up and do in the morning. We all need purpose.”

For more information: Guardian Angels Website: www.methowguardianangels. org Phone: 996-2569 Lookout Coalition Website: www.roomone.org/ aging-support/ Phone: 997-2050 Methow at Home Website: www.methowathome.org Phone: 996-5844

family members who are caring for elderly or disabled relatives, Marchbank said.

“Family member caregivers really have a rough job and they need respite. And it’s nice for a client to have someone to talk with who they’re not emotionally attached to,” she said.

Complex issues Helping older residents navigate the complex and interrelated issues they face with aging is one of the Lookout Coalition’s key goals.

“When dealing with the aging community you often have behavioral health and financial needs as well,” Bowden said. Most of the clients are poor, with incomes below $1,000 per month, and “up to one-third of our clients have some mental health issue” such as substance abuse or depression,

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Methow at Home. Don and Marcia Hazen of Mazama, who had joined as volunteers, offered to walk with her.

In the two years since, Bickford and the Hazens have become fast friends, a result that none of them anticipated. “This has been just a wonderful friendship,” Bickford said. Having someone to walk with her “was a lifesaver … I’m much more confident now.”

Don Hazen said he and Marcia would join Bickford each week for a walk or hike, and she would introduce them to parts of the valley that they hadn’t discovered.

“She would share stories about the area. It was wonderful. That was unexpected,” he said.

Bickford has joined the Hazens in Mazama for snowshoeing, and the Hazens have begun working with Bickford, a master gardener, in her large garden in Twisp.

“Carolyn has taught us more than we have helped her,” Hazen said. “She is a wonderful gardener, but her garden was getting bigger than her ability, so she invited us to join in her garden. Our relationship grew to the point where we could work together on a garden.”

Hazen said he has also helped other people through Methow at Home, including spending time with a person with dementia to provide respite for the spouse. “It helps both the person that’s affected and the spouse,” he said.

Since its launch in December 2015, Methow At Home has signed on 108 volunteers, who undergo

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she said.

That’s not the case for all the clients, however, Bowden said. Some have good financial resources, but need help navigating a difficult health situation, like cancer or dementia.

Lookout Coalition volunteers are available to discuss treatment options with clients, provide guidance on advanced directives and hospice care, and communicate with local medical providers. In some cases, they assist clients who are interested in the state’s “death with dignity” law.

The Lookout Coalition, which became a program of Room One five years ago, serves as an advocate for clients and helps connect them with needed social services and financial support. The group also works closely with the local ambulance service, Aero Methow Rescue Services, to help “frequent users” who repeatedly call Aero Methow.

“It may not be a medical emergency, but untreated medical

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problems,” Bowden said. Lookout Coalition members can help those people get the medical treatment or support they need, and prevent unnecessary emergency responses.

Bowden said she has been asked to speak at health care conferences around the state to talk about the Lookout Coalition. “There is no other practice like ours in our state,” she said. “You can imagine how much money it saves Medicaid and Medicare by preventing ambulance and emergency room and clinic visits, and hospital stays.”

In many cases clients are isolated and have trouble maintaining their homes, Bowden said. Lookout Coalition volunteers connect them to Guardian Angels or Methow At Home to give them the support they need to continue living on their own, Bowden said. “It is a real partnership effort to provide a safety net for people to stay at home.” ◆

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MV Citizens Council celebrates 40 years of activism Fight against ski resort launched broader agenda

By Ann McCreary

For many Methow Valley residents, the battle fought over a downhill ski resort in Mazama is a distant memory, or was over before they moved here.

But lessons learned during that conflict still guide the Methow Valley Citizens Council (MVCC), created four decades ago to lead the fight against the proposed Early Winters ski area.

“Forty years is a long time,” said Maggie Coon, who helped found MVCC in 1976, and has been involved in the organization for 15 of its 40 years, including her current position as chairman of the MVCC board of directors.

“MVCC has had significant influ-

ence on the way the Methow Valley has grown and developed over the last 40 years. We’ve helped … instill a culture of advocacy, which is very much alive and well in the Methow Valley today,” Coon said.

One of those early environmental advocates was Isabelle Spohn, who learned about plans for a destination ski hill at Sandy Butte soon after moving to Mazama in 1978. Spohn became involved in the new grassroots

group fighting the resort, and remained actively involved for 35 years.

“It seemed to me that many people [in the valley] hadn’t seen that kind of [development] happen before, and didn’t understand how quickly something like that could happen,” Spohn said.

“It had the possibility of having an enormous impact on the valley. It was so out of scale for the valley,” she said.

Even before MVCC was officially incorporated in 1976, some local citi-

zens were raising alarms about rumors that Aspen Ski Corp. was making plans for a destination ski resort called Early Winters that could accommodate as many as 10,000 skiers a day — at a time when the entire population of the valley was only about 3,500 year-round residents.

Bev and Jeff Zwar had recently moved to McFarland Creek when they

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THESE BIG PIGS WENT TO M ARKET Bear Fight scientist discovers evidence of water on Ceres Vital information transmitted by Dawn mission spacecraft

By Ann McCreary

Photo by Marcy Stamper Emily Paul put her pig, Darwin, on a diet to be sure it qualifies for the market auction. A high school junior, Paul said raising pigs for the fair has made a big difference in her college fund. In addition to the pig, she plans to exhibit homemade caramels.

Local 4-H swine raisers look forward to county fair, auction

By Marcy Stamper

Cody Wottlin wrapped his shoelaces in duct tape because his pig Schnizel finds them so irresistible.

But nibbling on the shoelaces is just for entertainment, said Wottlin, since Schnizel (formally known as Frederick Esquire III) is hardly lacking for nourishment. In fact, this year several of the pigs being raised by the Methow Valley Cascaders 4-H Club are on diets because they’re already nearing the maximum weight to be auctioned at the Okanogan County Fair.

(Pigs need to be between 230 and 290 pounds to qualify for the market auction at the fair.)

McKenna Ott is dealing with the opposite problem — she’s raising a pig from a late litter and it may not weigh enough for the auction.

“You never know till you show up — as soon as you cross the scales,

there’s no turning back,” said Erin White, the 4-H swine leader.

Every year there are a few pigs that don’t qualify for the weight class.

“Kids are devastated, but the parents are a lot more devastated,” said White.

“It’s hard to watch the kid put in all that work.”

If a pig is over or underweight, the child can still compete in fitting and showing, but will have to sell the animal privately, which rarely brings as much money as the auction at the fair.

“It was a cake-walk with these pigs — you could go right up to them from two months,” said Wottlin, an eighth-grader who speculated that the pigs he and his brother raised this year were so calm because they’d been handled from birth. “They’re pretty goodlooking, too,” he said.

Learning experience

Methow Valley kids expect to bring some 6,000 pounds of pork to the county fair this year — 22 kids have spent the past six months raising pigs.

“Kids tell their friends how fun it was, so lots join,” said White.

It is not uncommon for kids to sell a

Friday night light

pig at auction for $4 or $5 per pound, and some have scored as much as $7 per pound, earning more than $1,000 to put toward a college fund or a car.

The fair guarantees a price of 60 cents per pound, but that doesn’t come close to covering the typical $500 investment in the pig, food and supplies.

Emily and Bodie Paul like pigs for their generally equable disposition and the ability to earn money for college.

Their older brother raised steers, but steers demand a longer commitment and a bigger investment. They also tend to have less predictable personalities, said Emily, a junior in high school. She remembered one steer that was so gentle that her brother could read a book while lying on its back, but other steers would attack everything in sight, including the fence.

4-H exposes kids to a lot more than raising an animal. “It’s part of life — they learn that even if they feed the animals every day and do everything they’re supposed to do,” sometimes it just doesn’t work out, said See FAIR, FAIR A3

ADDRESS LABEL

That’s not to imply that Ceres provides any indication of supporting life, Combe said. Of interest, though, is the presence of the water ice on the surface of Ceres, Combe said.

Planetary scientists have long suspected that the interior of Ceres is composed of large amounts of water or ice, Combe said.

“We knew that from the measurements of density of Ceres there has to be some ice in the bulk of Ceres. It is not dense enough to be made entirely of rocks. The obvious component was ice,” he said.

A surprise

Finding the water ice on the surface was surprising, Combe said.

The water ice was detected using a Visible and InfraRed Mapping Spectrometer (VIR) carried aboard the Dawn spacecraft, which began orbiting Ceres in March 2015.

The VIR measures the sunlight scattered on the surface of Ceres in a range of wavelengths from the near ultraviolet to the near infrared. Data obtained through VIR reveals mineral and molecular composition, and in this case revealed the presence of water.

The water ice was observed in a 10-kilometer-wide crater named Oxo. See CERES, CERES A3

Photo courtesy of Bear Fight Institute Jean-Philippe Combe of the Bear Fight Institute near Winthrop has identified the presence of water ice on the dwarf planet, Ceres.

At 100, Enid Shaw reflects on a Methow Valley life well-lived

By Marcy Stamper

Photo by Don Nelson A brilliant sunset provided a colorful backdrop at Friday’s Liberty Bell football game.

A scientist at the Bear Fight Institute near Winthrop has described the first and only confirmed detection of water-rich material at the surface of Ceres, a dwarf planet in the asteroid belt between Mars and Jupiter.

Jean-Philippe Combe authored a research article published Friday (Sept. 2) in the journal Science, detailing the discovery of water ice on Ceres.

Information leading to Combe’s discovery was transmitted by NASA’s Dawn spacecraft, which is orbiting Ceres.

The detection of water ice on Ceres is inherently intriguing, Combe said in an interview last week.

“Anything that involves water is very interesting and exciting. Water is an essential substance in the general evolution of any planet, and also for the creation of life, the type of life that we know anyway,” Combe said.

“Water in our solar system is potentially related to creation of life. You have to start with detection of H20 to go further,” he said.

“I don’t know if people are making a fuss, although I have seen more people than in a long time,” said Enid Shaw, just over a week shy of her 100th birthday.

“It’s a lot of attention — that’s all I can tell you.”

Enid Pauline Gobat was born in Pateros on Sept. 16, 1916, and grew up there, literally among horses and buggies. This week, she was visiting with her granddaughter Amber at her home in Carlton, sharing memories about a century of change.

Shaw moved to the Methow Valley

THURS. Sept. 8

75° 46° A Few Clouds

FRI.

SAT.

when she was in her early 20s, after studying typing and commercial subjects in Spokane. She married Roy Richard Shaw (known as “Dick”) in 1937.

They raised their five children in a rudimentary two-room cottage that had once served as a teacher’s residence at the old Beaver Creek schoolhouse. They used to carry water up from the creek in 10-gallon cream cans. “It was a hill to climb, but not bad,” said Shaw. Dick also hauled water from town when he went to work.

When she was growing up, Enid’s See SHAW, A3

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Partly Sunny

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Somewhat Sunny

Sunny for the Most Part

Showers Possible

76° 52°

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WE ATHER DATA BASED ON ACCUWE ATHER .COM FOREC AST FOR T WISP

82° 42°

Enid Shaw

Photo by Marcy Stamper

INSIDE ...

DR. JONOTHAN MILLER

ROB LAMBERTON, PA-C

DR. JAMES LAMBERTON

OPINION . . . . . . . . . . . . . . A4 ARTS . . . . . . . . . . . . . . . . . . A5 WHAT’S HAPPENING . . . . A6 SPORTS . . . . . . . . . . . . . . . B1 CL ASSIFIEDS . . . . . . . . . . . B2 HARTS PASS . . . . . . . . . . . B4 COMMUNIT Y . . . . . . . . . . . B5 VALLEY LIFE . . . . . . . . . . . B6

H e a lt h & W e l l n e s s 2 0 1 7 – 1 8

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The autoimmune challenge A Northwest medical mystery — and the hunt for answers

By Sa m a n th a L a r son

It’s a mystery that has vexed medical researchers for years: Why some people’s immune systems misfire, attacking their own bodies. This type of misfire is at the root of maladies as diverse as rheumatoid arthritis, Type 1 diabetes and multiple sclerosis, or MS — “autoimmune” diseases that are on the rise nationwide.

Another mystery: Why some of these diseases, including MS, are more prevalent in the Pacific Northwest. While MS affects 1 in 1,000 Americans, the rate is twice as high here.

Scientists don’t know why, exactly, autoimmune diseases are becoming more common. They don’t know why exactly we’re more prone to autoimmune diseases in these parts, or sometimes even how to quickly and accurately diagnose them. Which is why every Tuesday morning when Dr. Jane Buckner makes her weekly visit to her clinic in Seattle’s First Hill neighborhood, she braces herself for questions to which she might not know the answer. Starting with the very basics: “What’s wrong with me?”

Buckner is a rheumatologist and also the president of the Benaroya Research Institute at Virginia Mason, a Seattle-based organization dedicated to researching the full suite of over 80 types of autoimmune diseases.

The crossover between these diseases, which tend to be treatable but not curable (why some diabetics must give themselves insulin shots throughout their 14

Researchers at Benaroya are focused on autoimmune diseases. Photo courtesy of Benaroya R esearch Institute

lives), is part of what make them so difficult to diagnose. “Most patients who come into my clinic have been feeling not quite right for quite a while,” Buckner says.

“And it’s hard to make the diagnoses, because autoimmune diseases can be kind of sneaky.”

But by examining autoimmune diseases with particular attention to their similarities, rather than their differences, Benaroya has found its way to the cutting edge of immunology research.

The ecosystem analogy “Think about ecosystems,” Buckner says. “If you change one aspect of an ecosystem — let’s say we get rid of mosquitoes — then something happens: Your birds aren’t there anymore. But [the outcome] is not always easy to predict, and humans have proven that time and time again.

“The immune system is as complex and as interrelated as an ecosystem,” she continues. “What we’re trying to understand is, what

happens when we perturb the system — why it doesn’t get back to the right balance again.”

Of course, scientists do have some clues as to the answers to these conundrums. The predisposition of Pacific Northwesters to develop autoimmune diseases is likely linked to the relative abundance of northern Europeans here (like the Norwegians of Ballard), who are genetically prone to these ailments. But that’s not the only factor: Immunologists think environmental factors such as the amount of sunshine and vitamin D play an important role, too.

“If I had a twin sister living in Florida, her risk of MS would be much lower than mine,” Bucker says.

The 25 principle investigators who come from a range of subspecialities to work together under Benaroya’s roof have some major advantages when it comes to piecing the remaining mysteries of autoimmune diseases together.

One is Benaroya’s biorepository,

a library of blood and serum samples that Benaroya doctors have been collecting (with permission from their patients) for over 15 years. This provides a wealth of data, especially as the available tools that allow researchers to analyze these samples have advanced even in the time since they started collecting them.

Here’s an example: After scientists completed sequencing the human genome in 2003, they were able to identify the parts of the genome that are linked with diseases — and building off of that, have begun to understand which genes are involved in autoimmunity.

Studying gene functions Using the biorepository samples, Benaroya researchers have been able to take that knowledge even further by looking at the DNA from their patients to figure out who had what gene variants, with the goal of getting a better idea of how those genes actually function.

“The underlying functions of the M e t h o w Va l l e y

genes that are linked to autoimmunity is an area that we’ve had a great deal of strength in,” Buckner says.

The institute has also been able to take big steps in getting to know the cells that they think drive autoimmune diseases: the CD4 T cells that are supposed to recognize nasty invaders like flu cells, but mix up nasty and nice in the case of autoimmunity.

CD4 T cells have been hard to study, because they’re really rare.

“There’s probably 10 in a million,” Buckner says. “It’s like finding a needle in a haystack.” But when Benaroya researcher Bill Kwok developed a technique over the past few years that uses a literal magnet to pull those figurative needles out, CD4 T cells suddenly became a lot easier to analyze.

Despite the better tools and more data available to them, however, Benaroya’s researchers still have a long road ahead of them. “I’m not always going to be able to tell a person why they have the bad luck of getting one of these diseases,”

Buckner says. “But if I can understand what’s going on with their immune system, that gets me to the point of telling them how I can help them.”

That also brings on a whole new set of questions, however. “How do we get that ecosystem back to the right place? Because our medications are helping control it, but they aren’t getting it back to a healthy place,” Buckner says.

A place where someone with lupus, psoriasis or MS can do more than manage a sneaky disease — they can get rid of it. “All those questions lead me back to my ultimate question. Which is: How do I cure these diseases?”

This article originally appeared on Crosscut, a Seattle-based nonprofit online news site. You can find the article at crosscut.com/2017/01/ benaroya-research-instituteautoimmune-ms-cure. Samantha Larson is a Seattle-based freelance journalist and the science correspondent for Crosscut. ◆

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powerfully advocating for the health and well-being of all people living in the Methow Valley.

Dr. Sierra Breitbeil, ND Naturopathic Physican 996-3970 • drsierra.com Sharon Cohen, MFA, RYT Mindfulness-Based Stress Reduction 449-2594 • mindfulmethow.com Susan Peterson, MS Licensed Mental Health Counselor Associate 341-4487 • suepetersonms.com

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