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Healthy You Winter 2016

Great ideas for kids brown bag lunches

IT’S THE WORLD’S FIRST 100% INVISIBLE HEARING AID, YET PEOPLE STILL WANT TO SHOW IT OFF. “People can walk right up to my ears and can’t see them.”

– Cookie

• Sits close to the eardrum so it uses your outer ear to give you incredibly clear, beautiful sound. • World’s first hearing device to be invisible from any angle, a full 360°.

INVISIBLE “The natural sound, I hear sounds I haven’t heard in years.”

– Stu

• Soft and comfortable, Lyric is not an implant, it’s the world’s first extendedwear hearing device and it lasts for months without replacement.**

“Tech Neck” and how to prevent it

INCREDIBLE “You don’t even have to take it out. You can wear it 24/7,* no one can see it, and I can’t even feel it.”

How seniors and HASSLE-FREE HEARING children can learn Join us for a Lunch and Learn: February 11th, 2015 from each 12:00pmother - 1:30pm / Lunch will be served S P O N S O R E Dby: BY Sponsored

When: Where:


As featured on:

– Grace

February 11th, 2015 Kitsap Regional Library Community Room our community 1700 NE Serving Lincoln Road exceptional Poulsbo, with WA 98370 not-for-profit care. 12:00pm - 1:30pm With special guest speaker Kevin Haslam, a Lyric specialist

Exceptional care that’s personal. It’s been our mission

What’s the difference between a physical and a wellness exam? How to select a gym for your age group

Call to RSVP today, Seating is Limited!

360-930-3241 www.peninsulahearing.com

*Individual replacement needs may vary. Duration of device battery life varies by patient and is subject to individual ear conditions. **Lyric is water resistant, not waterproof, and should not be completely submerged under water. †Professional fees may apply. Annual subscription begins the first day of trial. Lyric is not appropriate for all patients. See a Lyric Provider to determine if Lyric is right for you. Lyric, Distributed by Phonak, LLC ©2014. All rights reserved. MS036845 917





JANUARY 29, 2016

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JANUARY 29, 2016


Learn how to gather your family medical history A useful tool in understanding your health risks. By LESLIE KELLY



t’s important that you know the health history of all members of your family, especially your elders. Family members share genes, behaviors, lifestyles, and environments that together may influence their health and their risk of chronic disease. Most people have a family health history of some chronic diseases (e.g., cancer, coronary heart disease, and diabetes) and health conditions (e.g., high blood pressure and hypercholesterolemia). People who have a close family member with a chronic disease may have a higher risk of developing that disease. tFamily health history is a written or graphic record of the diseases and health conditions present in your family. A useful family health history shows three generations of your biological relatives, the age at diagnosis, and the age and cause of death of deceased family members. Family health history is a useful tool for understanding health risks and preventing disease in individuals and their close relatives. The first step is to talk to your family. Write down the names of blood relatives you need to include in your history. The most important relatives to include in your family health history are your parents, brothers and sisters, and your children. Next, you may want to talk to grandparents, uncles and aunts, nieces and nephews, and half-brothers and halfsisters.

Gathering your family health history should begin by talking to family members and then recording known risk factors to share with your physician. Contributed photo Ask questions. To find out about your risk for chronic diseases. Ask your relatives about which of these diseases they have had and when they were diagnosed. Questions can include: Do you have any chronic diseases, such as heart disease or diabetes, or health conditions such as high blood pressure or high cholesterol? Have you had any other serious diseases, such as cancer or stroke? How old were you when each of these diseases was diagnosed? What is our family’s ancestry – what country did we come from? For relatives who have died, be sure to ask about cause and age of death. Record the information and be sure to update it from time to time. To orga-

nize the information in your family health history you could use a free webbased tool such as “My Family Health Portrait.” Share family health history information with your doctor and other family members. Your family health history can give you an idea of your risk for chronic diseases like cancer, heart disease and diabetes, but it is not the only factor to consider. If you are concerned about diseases that are common in your family, talk to your doctor at your next visit. A doctor can evaluate all of the factors, including family health history, that may affect your risk of some diseases, and can recommend ways to reduce that risk. My Family Health Portrait lets you know your risk (increased, not

What’s Inside Creating your health history.............................. 3 What’s up at Anderson Dental........................... 4 Getting a good night’s sleep............................. 4 Physical exams: What to expect........................ 5 Young and old at Martha & Mary...................... 7 Staying positive................................................. 7 What the heck is ‘Tech Neck’?........................... 8 Peninsula Hearing has new tools..................... 10 Pacifica Medical opens in Poulsbo................... 10

For information about upcoming special publications, call 360-779-4464.

Publisher: Lori Maxim


Win ter 2016

IT’S THE WORL D’S FIRST 100% YET PEOPLE ST ILL WANT TO SH INVISIBLE HE ARING AID, OW IT OFF. “People can walk right up to my and can’t see ears them.”

– Cookie

– Stu

SPONSORED Spon sored by: BY

When: Where:

From: As featured


– Grace

will be served

February 11th, 2015 Kitsap Regional Libra Community Room ry 1700 NE Serv Lincoing our community ln Road Poulsbo, with excep WA 9837 0 tional 12:00pmnot-f or-profit care. - 1:30p m With special guest speaker Kevin Haslam, a Lyric specialist

Exceptional care that’s person al. It’s been our mission for over 120 years.

Call to RSVP tod ay, Seating is Lim ited!

What’s the differe nce between a physica l and a wellness exam? How to select a gym for your age group

360-930-3241 g.com

Our highly skill

ed a



Special Publications Editor: Leslie Kelly Writers: Leslie Kelly, Lesli Dullum-Tutterrow Advertising Director: Donna Etchey

Creative Services Manager: Bryon Kempf Marketing Artists: Mark Gillespie, Kelsey Thomas, John Rodriguez, Vanessa Calverley Sponsors: Anderson Dental, Peninsula Hearing, Pacifica Medical, and Martha & Mary Copyright 2016 Sound Publishing

www.peninsu lahearin

*Individual replaceme Annual subscriptio nt needs may vary. Duration n begins the first day of trial. of device battery life varies Lyric is not appropriat by patient e for all patients. and is subject to individual ear conditions See a Lyric Provider . **Lyric is water to determine resistant, not if Lyric is right waterproof, and for you. Lyric, A SUPPL EMEN should not be Distributed by completely submerge Phonak, LLC T OF THE BAINB ©2014. All rights d under water. RIDGE REVIE reserved. MS03684 †Professional fees may apply. 5 917 W , BREM



Sales Representatives: Bill McDonald, Sharon Allen, Ariel Naumann, Marleen Martinez, Tawna Grisham, Jessica Martindale

• Sits close to the eardrum so it uses your outer ear to give you incredibly clear, beautiful sound . • World’s first hearing device to be invisible from any angle , a full 360°. • Soft and comfo rtable, Lyric is not an implant, it’s the world wear hearing device ’s first extendedand it lasts for months withou t replacement.**

How seniors and -FREE HEARIN childreHASnSLEca n learGn Jo in us for a Lunch an from ea 12:ch he0pm 00pmot rd /LeaLunrn:chFebruary 11th, 2015 - 1:3 “You don’t even have to take it out. You can wear it 24/7 see it, and I can’t ,* no one can even feel it.”

Great ideas for kids brown bag lunches

“Tech Neck” and how to prevent it

“The natural soun d, I hear sounds I haven’t heard in years.”


Source: Centers for Disease Control and Prevention.

Healthy You is a quarterly publication of Sound Publishing.



increased) for diabetes and colon cancer based on your family health history and other risk factors. Even if you have a high risk family health history of diabetes, colon cancer, or another condition, that does not mean that you or your family members will definitely get that disease. It is important that you talk to your doctor about steps that you can take to lower your chances of getting the disease. Once you have your family health history gathered, be sure to take it along when you see your physician. Use it as a guide to your preventative health care. Gathering a complete and accurate family medical history is extremely important as genetic medicine explains more diseases. In fact, the Surgeon General has named Thanksgiving as Family History Day. Since several family members gather together on Thanksgiving Day, it’s a great opportunity to talk to family members and learn more about their health history. For more information, go to www. familyhealthhistory.org. Genetic Alliance also developed a collection of resources to guide you through the steps of collecting your family health history and sharing the information with your family and healthcare provider. Visit www.genesinlife.org for more information on the importance of family health history and more great tips and resources for collecting and sharing your health history.




JANUARY 29, 2016

Getting a good night’s sleep is sometimes hard By LESLIE KELLY



here’s nothing like a good night’s sleep. And there’s nothing as bad as not getting a good night’s sleep. According to David Corley, a sleep specialist with Harrison Medical Center, the best way to guarantee a good night’s sleep is to establish a routine. “To optimize sleep, you need to have a routine,” Corley said. “You need to go to bed the same time every night.” But just when that is, will depend on your age and how much sleep you need, he said. Suggested averages are: Age 0 to 3 months: 14 to 17 hours a day; infants 4 to 11 months, 12 to 15 hours a day; toddlers, ages 1 to 2 years need 11 to 14 hours a day; preschoolers ages 3 to 5 Dr. David Corley years need 10 Contributed photo to 13 hours a day; school-age children from 6 to 13 years old need 9 to 11 hours a day and teenagers 14 to 17 years should have eight to 10 hours of sleep a day. Corley said adults ages 18 to 65 years should get from seven to nine hours of sleep each night, and those 65 years of age or older should sleep seven to eight hours a day. “That’s how much sleep a normal person needs,” he said. “If you aren’t getting that and you’re waking up feeling tired, than you know you’re getting poor quality sleep.” In order to get a good night’s sleep, Corley suggests setting up the right envi-

The sleep study room at the Harrison Sleep Clinic is where professionals study the sleep habits of those who have problems sleeping. Contributed photo ronment. “Make sure you have your bedroom cool, quiet and an environment without bright lights,” he said. “That means turning off the TV and the laptop or phone at least an hour before you want to fall asleep.” He explained that a person’s brain preserves light and thinks it’s still daytime, if exposed to bright lights before bedtime. If you’re spending time in your bedroom or in bed prior to when you actually plan to go to sleep, that can be a problem, too. “Too much time awake in your bedroom will tell your brain it’s not the place for sleep,” he said. He said the brain will begin to release melatonin only an hour or two after sunset. If you are still exposed to bright light, the brain will not release the natural chemical that induces sleep. Another way to help your body prepare for sleep is to exercise at least 20 minutes a day, but not within four to five hours of the time you plan to go to sleep. Corley said don’t drink any caffeine after

lunch time, and don’t drink alcohol or smoke cigarettes within a few hours of sleep time. For children, he suggests a “wind down” time prior to bedtime. “Have a quiet time for the kids,” he said. “And keep the TV and the tablets out of the kids’ rooms.” Ideas include reading to children or have them read to you. Or tell stories to each other. What about sleeping with animals … the cats or dogs? “That’s something that depends on the person and the animal,” he said. “For some it’s reassuring. But for just as many others, it’s not.” For example, he said, if you shut your dog out of your room and he or she just whimpers outside your door, that will keep you up. But with other dogs, they won’t lay still and that will keep you from sleeping. The most recent Gallup Poll showed that from 40 to 50 percent of Americans don’t feel like they get enough sleep, Corley said.

“On average people in the 1940s got eight hours of sleep a night,” he said. “Now the average is 6.8 hours.” School-age children to teens need the most sleep, he said, because that’s when the brain is developing. “The brain’s neurons are making connections,” he said. “That’s when learning happens. It takes that deep rim sleep to realize the brain’s full potential.” If you are having a hard time getting good sleep, it is safe to try over the counter sleep aids, if you take them as directed, Corley said. But if the problems continue for more than a couple of months, then you should seek help. Harrison has sleep clinics in Bremerton and Poulsbo. Most of the time, patients are just seen in the office and can get help with their sleep problems by talking to sleep doctors. Sometimes, however, patients need to sleep overnight at the clinic and have their sleep patterns observed. It is at these clinics that problems such as sleep apnea are diagnosed. Other medical reasons for poor sleep can be chronic pain, restless leg syndrome, depression, high blood pressure, and learning disabilities such as ADHD. To find out more, call Harrison Sleep Disorders Center in Bremerton, 2520 Cherry Ave., Bremerton, 360-744-6812, or Harrison Sleep Disorders Center in Poulsbo, 19917 7th Ave. Northeast, Suite 210, Poulsbo, 360-782-5700. Dr. David E. Corley’s specialties include critical care, internal medicine, pulmonary medicine and sleep medicine. He is a graduate of Georgetown University School of Medicine, Washington, D.C., and had his internship and residency at Virginia Mason Medical Center in Seattle. He is one of six sleep specialists at Harrison Medical Center and has been in practice for more than 25 years.

Choosing a denturist takes knowledge and time By ANDERSON DENTURE and DENTAL

A denturist is the only professional legislated “exclusively” to serve individuals with removable dental prosthetics. A denturist’s entire required curriculum of study focuses on the oral health of those individuals needing a dental prosthetic and the actual fabrication of that appliance. The denturist actually makes your dentures. Your denturist is an expert in the design, construction, insertion and adjustment of removable dental appliances. Your licensed denturist has graduated from an accredited or approved college denturist program and passed the state’s board of health two-day examination. This board examination not only includes the sciences involving oral health issues, but also the technical skills necessary to actually fabricate your denture. This expertise makes choosing a denturist the best possible choice to help

you derive the maximum benefit from up-to-date dental prosthetic technology. When you choose a denturist for your denture needs, you can be assured of expert personalized care. Knowing you are being seen by the individual who will actually make your dental appliance offers confidence that your unique need will be met. Your denturist is devoted to creating full or partial dentures that fit well, look natural and attractive and allow you to maintain a healthy smile. The advantages of our dental center is that we offer both services of a denturist and dentist. We provide personalized professional services at affordable prices without compromising quality. Our attention to detail and warm personal service will make your visit to our dentist office enjoyable. We sincerely consider our patients part of our extended family and enjoy the times when they just drop in to say hello.

Sometimes, the pleasant chatter in our reception room is like a family reunion and every member of our staff enjoys helping each patient feel at home. We provide our patients the services of both a dentist for general dental needs and a denturist for denture services. Our in-house laboratory where our denturist actually fabricates the dental appliances offers our patients the most personal, affordable and expedient care available. Please call our office in Poulsbo at 360-779-1566 to set up an appointment with on of our dentists or denturists.

Bruce Anderson poses in his office with a set of dentures. Leslie Kelly photo

JANUARY 29, 2016



What you need to know about physical examinations By LESLIE KELLY



ou’ve heard it all before. Getting a physical examination is important to keeping well and detecting any problems before they become big health care issues. But just what should be a part of a physical exam? And what’s the difference between a physical exam and a wellness exam? According to the American Medical Association, a wellness exam is much like any other annual physical, except that it focuses not only on what the patient’s current condition is but also on what screenings (such as for cancers) and other preventive services (such as vaccinations) the patient might also need and for which most insurances pay the full cost. Unlike most regular physical checkups, the wellness exam includes an assessment for the detection of cognitive impairment — meaning the early signs of Alzheimer’s or other dementia. For older patients, part of the wellness exam is the preparation by the doctor of a written plan noting the screenings and other preventive services the patient should obtain. And, during wellness exams doctors are encouraged to discuss end-of-life planning with their patients, which includes an advance health care directive (also called a living will or power of attorney for health care).

For women (of any age)

Height and weight measurement (if not already done). Blood pressure and heart rate check. Screening for family medical issues, Assess your risk of future medical problems. Checking lymph glands in your neck, under your arms, and in the groin. A vision check and eye examination. Looking in your ears. Peering into your mouth to examine your teeth, gums, and the back of your throat. Feeling your thyroid gland (which is located in the front of your neck). Listening to your breathing. Listening to your heart. Feeling your belly for any lumps or painful spots, and checking the size of your liver and spleen. A pelvic exam, to check your vagina, uterus and ovaries. Routine checks for sexually transmitted infections are often done. A Pap test and HPV test can screen for cervical cancer and help assess risk. Beginning at age 21, women should have a pelvic exam and Pap smear every three years to check for cervical cancer. Ask your provider about the human papilloma virus (HPV) vaccine if you are between ages 18 - 26 and you have not received the HPV vaccine in the past. If you are over age 30 or your Pap smear and HPV test are normal, you only need a Pap smear every five years. If you have had your uterus and cervix removed (total hysterectomy), you do not need to have Pap smears. Women who are sexually active should be screened for chlamydia infection up until age 25. Women 26 years and older should be screened if at high risk.

Talking with your physician about health concerns should be part of your annual physical examination. Tests and procedures differ depending on age. Contributed photo Women also need a breast exam, looking for lumps or other abnormalities. Screening mammogram is not recommended for most women under age 40. If you have a mother or sister who had breast cancer at a younger age, or you have other risk factors for breast cancer, your provider may recommend a mammogram, breast ultrasound, or MRI scan. If you are between ages 20 - 40, your provider may do a complete breast exam every three years. If you are between ages 20 - 45, you should have a cholesterol screening if you have a higher risk for heart disease. In healthy women, screening will begin at age 45. If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely. If your blood pressure is above 135/80 mm Hg, your provider will test your blood sugar level for diabetes. If you have a body mass index (BMI) greater than 25 and have other risk factors for diabetes, you should be screened. Having a BMI over 25 means that you are overweight. You should also see a dentist and an eye doctor annually. And the AMA suggests that you should get a flu shot every year. After age 19, you should have one tetanus-diphtheria and acellular pertussis (TdAP) vaccine as one of your tetanus-diphtheria vaccines. You should have a tetanus-diphtheria booster every 10 years. You should receive two doses of varicella vaccine if you were born after 1980 and never had chickenpox or the varicella vaccine. Your provider may recommend other immunizations if you are at high risk for certain conditions, such as pneumonia. You should be screened for colon cancer only if you have a strong family

history of colon cancer or polyps, or if you have had inflammatory bowel disease or polyps yourself. After age 50, you should have a screening colonoscopy and then follow what your physician tells you. It may be that you will not need another colon screening for 10 years, if yours is normal. After the age of 50, women need to have a bone density screening every two to three years. Your physician may also ask about your mood, problems with depression, diet and exercise, alcohol and tobacco use, safety issues, such as using seat belts and smoke detectors. A physical should also include examining your skin, looking for abnormalities such as moles, growths or rashes, checking your joints, such as your knees, hips and shoulders, checking your back for any abnormal curves, checking your reflexes, strength, and sensation. Laboratory tests should include a complete blood count, chemistry panel and urinalysis.

For Men

In your 20s:

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Annual physical exam by your primary care physician, including blood pressure, and height/weight checks. Screening for testicular cancer, including monthly self exams. Cholesterol testing every five years. Depending on your individual circumstances, your doctor may want to do an electrocardiogram to check for heart disease, and blood tests to screen for diabetes, thyroid disease, liver problems, and anemia. Depending on risk factors, your doctor may also recommend screening for skin cancer, sexually transmitted diseases, HIV infection, and alcohol abuse. At age 30, an exam should include all of the above, plus a vision examination, screening for coronary heart disease in individuals with strong family history and/or risk factors. At 40, men should add a screening for prostate cancer, and a diabetes screening every three years over the age of 45. Depending on risk factors, your doctor may also recommend screening for skin cancer, oral cancer, sexually transmitted diseases, and alcohol abuse. Get a vision examination annually and a screening for coronary heart disease in individuals with strong family history and/or risk factors. In your 50s, add the following to your exam: screening for lipid disorders, electrocardiogram, vision and hearing examinations, screenings for prostate cancer, colon cancer with fecal occult blood testing, sigmoidoscopy, or colonoscopy, screening for coronary heart disease in individuals with strong family history and/or risk factors, and a screening for depression Your doctor will add a screening for osteoporosis, will continue colorectal screening based upon previous studies and results and will screen for depression, dementia and Alzheimer’s disease, once you turn 60. In your 70s and older, physicians suggest continued colorectal screening based upon previous studies and results. General screening until age 75. Discuss with your physician screening if aged 76-85 years old. Screening is not recommended for those older than 85. Doctors will continue to screen for depression, dementia and Alzheimer’s disease.

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JANUARY 29, 2016

CARING FOR GENERATIONS For 125 years Martha & Mary has served children, seniors and families in the West Sound, offering a continuum of care for life's transitions. Providing personalized service that feels like family, we are your trusted care partner for generations.

Rehab • Senior Housing • Home Care Care Management • Long Term Care • Children

JANUARY 29, 2016


Sharing among the generations at Martha & Mary By LESLIE KELLY



on’t be surprised if next time you drop by Martha & Mary Health and Rehab Center in Poulsbo, you see young children and seniors creating art together. Or sharing a dance. Or even eating ice cream. It’s all a part of the Intergenerational Program at Martha & Mary. The program couples children from the learning and child care centers with seniors who reside at the health care facility. “The program allows the kids to share with the seniors, and vice versa,” said Tracie Walthall, residential life services director with Martha & Mary. “But what they all learn, is that love and affection can come from anybody,” said Berni Booher, program supervisor at Martha & Mary KIDS Child Care Center. It doesn’t matter whether they are sharing an arts and crafts project, enjoying music, or just sitting and sharing a book or magazine, the children and the seniors are interacting. “The love they give each other has no barriers,” said Booher. “When they sing together it is the most beautiful sound.” It was more than 20 years ago when the program began, according to Walthall, who has worked for Martha & Mary for 26 years. “It was the brainchild of Joanna Carlson, who was then director of children’s services,” she said. “She worked with Randee Schmidt, the activities director, on creating an intergeneration program that would serve both the children and the residents.” Staff at Martha & Mary were aware that some of their residents didn’t have grandchildren, or didn’t get to see their grandchildren very often. And they knew, too, that some the children in their childcare

A resident at Martha & Mary shares time with a student from Martha & Mary’s KIDS child care center as part of its intergenerational program. Contributed photo center didn’t get to visit their grandparents much, or maybe didn’t even have grandparents. So the idea of getting those two groups together seemed very appropriate. Children, up to age 5, come in groups of six to 10 and visit the residents on the short term and long term residential care units and those in the Alzheimer’s unit daily. “Sometimes they’ll make crafts including hand-decorated paper bags that are used in the gift shop,” said Booher. Other times the children will sing and dance for the seniors. They take part in “Show and Share,” where the children bring special toys to show the seniors and the senior bring special items from their rooms to share with the kids. On holidays, the children make cards for their senior friends and deliver them room by room. They have holiday parties

and, of course, trick-or-treating. The children take special care to make birthday cards for the residents, and on each senior’s birthday, they deliver the cards and sing “Happy Birthday” to them. At Thanksgiving, some of the residents take a trip to see where the children attend school and are treated to a Thanksgiving dinner. There also are some older children who attend the M & M KIDS Before and After School program, who take time to visit with the senior residents. Currently there are 98 children in the child care center and 30 at the children’s learning center. There are 168 seniors who are residents at Martha & Mary. Sometimes the kids and the seniors share memories, like the time an elderly resident was asked about what kinds of games she played when she was young. “She told them ‘Red Rover,’ where


they’d throw a ball over the roof of a house,” said Booher. “The kids were like ‘Wow you did that?’” Booher said she’s seen some children be timid or reserved at first. “They aren’t sure how to act around older people,” she said. “But that goes away and the kids warm right up to them. There’s an acceptance of the aging process.” In some cases, the sharing isn’t even verbal. “I saw once where a little girl was sitting with an older lady and she’d look at a page in a magazine and then slide it over to the lady,” said Booher. “And then the lady would do the same thing. It was just their way of sharing.” The children also learn what behavior is needed when they go to “grandma and grandpa’s house,” she said. As for the seniors, there are some who don’t partake in activities at the health center. But they are always there when the kids come to visit, said Walthall. She added that there are those residents who don’t want to take part in exercise programs, but they’ll participate in the music and movement (creative dance) time with the kids. “The kids get them to try things,” said Booher. “There was this one time when the kids were making (paper) snowflakes with the residents and one lady said ‘Oh I can’t use scissors.’ A child stepped up and said ‘I’ll help you.’ “There’s just an acceptance between the kids and the residents. They know they can be friends and there are no barriers.” To learn more, call Martha & Mary, 360-779-7500, or go to www.marthandmary.org. Martha & Mary is celebrating its 125th anniversary this year.

Attitude and gratitude: ways to stay positive in 2016 By LESLI DULLUM-TUTTERROW Special to Healthy You

We are immersed in chaos and mayhem both at home and abroad, as exemplified by numerous mass shootings. We have economic uncertainty. Political self-interest often takes precedence over what is best for the majority. And of course, we have our enemies acting as the devil incarnate in the form of ISIS, wreaking havoc all over the world. It can be said we are living in challenging times. And yet, since the beginning of humanity there has been no shortage of greed, evil, and mayhem, dating back to Adam rolling Eve under the bus, or Jacob stealing Esau’s birthright. None of this chaos is new, rather it has taken on new and more tragic forms. So how do we avoid becoming fearful, joyless, negative, powerless, and pessimistic in the midst of what can certainly feel like overwhelming personal, local, and global problems? The answer, I believe, lies within us. Since many of our circumstances are beyond our control, we must learn to develop new habits that will help us cultivate healthy, positive attitudes. There is an old Native American tale that speaks of a young boy conversing

with his grandfather. The grandfather shares that there is a battle of two wolves living inside each one of us; one is good and the other is evil. The little boy inquires as to which one wins. The wise elder replies, “whichever one you feed.” We need to pay attention to which thoughts we feed, as they will form the basis of our feelings, attitudes, and ultimately, our actions. Since our circumstances encompass both elements we can influence and control, as well as things we cannot, we must choose where to focus our thoughts. Many of us experience a black cloud that ominously hangs over our head because we are so consumed with things we cannot control, we fail to see what we can control. To be clear, I’m not suggesting we put our head in the sand to the tragedy, chaos, or problems that befall us. I am suggesting, rather, that we identify and take action in areas we have control over, and surrender those we cannot control. This allows us to maintain more positive attitudes and is actually better for our mental, emotional, and physical health. In other words, becoming more positive is less about our external circum-

stances, and more about how we choose to think about them. This may necessitate retraining our thinking. Learning to focus on what we think and feel internally, rather than over-focusing on what is happening externally, is a process which requires effort and energy to become habit, yet will ultimately yield great rewards. In addition to developing the habit of tuning in inwardly, another beneficial habit we can cultivate is adopting a heart of gratitude. Research has shown that people who choose to feed their “gratitude bank,” i.e. optimists, are actually happier than those who feed “the other wolf.” Gratitude is not something that comes naturally for many of us. Rather, it needs to be practiced. One simple exercise is to purposefully begin every morning by thinking about something you’re thankful for. Keeping a daily gratitude journal is another way to form the habit of gratitude. Many things in life will inevitably remain beyond our control. Ultimately, when we choose to let go of what we cannot control, take action where we ought, and cultivate a heart of gratitude, we will make optimism our new norm. Start the year working on attitude and gratitude

and you’ll likely enjoy many positive days in 2016 and beyond. Lesli Dullum-Tutterrow is a certified counselor, author, speaker and owner of Optimal Wellness Inc. She counsels and consults for individuals and businesses. Email her at optimalwellnessconsulting@gmail.com


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JANUARY 29, 2016

Is your neck hurting? It just might be ‘Tech Neck’ By DR. ANGEL WUNDER Special to Healthy You

Our lives have become inundated with technology — computers, phones, tablet, even watches. We all tend to spend more and more time with these devices in a body position that is impacting our health on a daily basis. “Tech Neck” is the term used for this position, formerly known as “Student Syndrome” in chiropractic circles. This position is described as body flexion — head down, arms down and in front with the upper back rounded forward or slouched. Chronic flexion can lead to a multitude of problems from muscle spasms, cervicogenic headaches (headaches caused from the neck position), neck and back stiffness, lowered immune response, costal (rib) pain to hyperkyphosis (an increase in the curvature of the mid/upper back), hypo loridosis (decrease in the neck curvature) and Thoracic Outlet Syndrome (TOS). It can decrease respiratory function, impede digestion, increase symptoms of GERD and decrease the curvature of the lower back, leading to lower back issue like sciatica. Loss in the curvature of the neck is a common result both initially and overall. Did you know that your head weighs up to 35 pounds? Imagine taking a bowling ball and holding it in your palm. OK, not too tough, right? Now imagine holding the bowling ball palm down. This simulation

LEFT: Normal Loridotic Curvatature of the Cervical Spine; RIGHT: Hypoloridosis of the Cervical spine or “Tech Neck.” Photos courtesy of Yocum and Roe Radiology Guide, Vol. 2 gives you an idea of how body mechanics change when you lose the curvature in your neck from chronic flexion. As we continue to be in this position our joints begin to wear in that position making it easier and easier to slip into flexion. If your a leg crosser, try crossing your legs in the opposite way...probably not too comfortable? That’s an example of the wearing on the joints and the same can happen in the neck and upper back. So now that we are all so dependent on these devices and inherent body position, what do we do about it? Here are some simple things that help correct present

conditions and possibly prevent further problems: Sit up straight! Anyone hearing your mother’s voice in your head? It’s easier said than done! As we remain focused on our devices our bodies slowly go more and more into flexion. To prevent ourselves from slipping into flexion when using a desktop computer, raise the monitor to eye level or above. This will force your body to sit in a more ergonomic position as our body follows the position of the eyes. Consider getting a detached or wireless keyboard for laptops and tablets and keep the device on an

elevated surface. Hand held devices are a much more common and harder to control body position while using, so be sure to take frequent breaks from them. Stretching is an important subject with any sedentary activity. Be sure to incorporate mid-back straightening movements like arching your back and touching your elbows behind your back, neck stretches from side to side and leaning your head back with your head turned, standing side bends and twisting from the waist. These will help reduce muscle strain and thus decompressing your spine. Spinal decompression will allow waste materials to move out and nutrients to move into the most important parts of your body — the spinal column and brain. Wearing a thoracic harness such as an infinity strap is also an inexpensive way to get support while using these devices. If you experience pain with any of these stretches be sure to contact your chiropractor. Regular visits to your chiropractor can alleviate many of these conditions, keep your immune system strong and ensure that conditions do not progress. Dr. Angel Wunder is the owner of Wunderful Health Chiropractic and Wellness Center in Poulsbo. She attended Parker Chiropractic College in Dallas, Texas. She began her practice in Washington in 2001.

Things to think about when choosing a workout gym By LESLIE KELLY


It’s the first of the year and getting fit is on your mind. You want to join a gym, but you’re just not sure where to start. Here’s some help for area fitness leaders on how to choose a gym. All gyms are not created equal, so the first step is to visit a number of the gyms and exercise locales in your area. Think about the size of the place, and if you’ll feel comfortable in a crowd. Or

do you want a smaller gym with less people? Experts say to visit the gyms at the time of day when you’ll be working out. That way you will see just how busy the gym is when you’re gong to be there. Evaluate the equipment each gym has. Do you want treadmills, or rowing machines or bicycles to get your cardio in? How many are available? Which look as through they may be the most popular? If you like to use free

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weights or nautilus equipment, check out those things. Is the area where patrons lift weights somewhere that is inviting to both men and women? If you’re someone who wants to take exercise classes, find out the schedule and types of classes offered. Most places will allow you to take a class or two for free. Current popular classes include Zumba, step aerobics, Jazzercise, yoga, Barre classes and floor exercises. Some gymnasiums have

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additional things like racquet ball courts, tennis courts and swimming pools. In those cases, monthly dues may be more, but if that’s the kind of exercise you will do, it’s worth the price. And for some people walking a track is what they want. Check out area gyms to find out the size of track they have and how many rotations equal a mile. Both the Poulsbo Athletic Club and the YMCAs in Silverdale and Bremerton have pools. Poulsbo has a racquet-

ball court, and the YMCA in Silverdale has a quarter-mile indoor track. Some gyms offer classes for kids, access to physical and massage therapy and therapeutic spas. Olympic Fitness Club in Port Orchard is a club that has all of these. Another idea is to check with local parks and recreation department. Many times you can buy a month or six week pass which gives you enough time to decide if that class is the one for you. With any gym you join,

read the contract carefully, if you sign one. Most places will have a one-time joining fee, plus monthly dues. Sometimes the arrangements only allow an auto-deduct from an account or credit card. Be sure you are comfortable with those arrangements. The real key, fitness experts say, is to go somewhere that you’ll be comfortable. If you don’t find a gym that fits you, your fitness program won’t be successful.

A WOMAN PHYSICIAN CARING FOR WOMEN Dr. Gillian Esser obtained her undergraduate degree from University of California Berkeley, her Medical degree from University of Southern California and her Obstectrical/Gynecology Residency was completed at Women’s and Children’s Hospital in Los Angeles.


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JANUARY 29, 2016



Pack some fun and nutrition in your kids lunches By LESLI DULLUM-TUTTERROW Special to Healthy You


h, the dreaded brown bag lunch. It takes time to make and kids often leave it on the counter in their haste to catch the bus. Others chuck it, trade it, or leave the remnants in their backpacks until the malodorous smell has wafted through their backpack, into their locker, and back into the house. What can busy parents do to resurrect the brown bag lunch into something kids want to eat? The answer is plenty! Before we get to the actual contents however, let’s consider a few things that can help the whole process go smoother. Before the sandwich hits the lunch bag, talk to your kids about nutrition. Even preschool age kids can understand that healthy food gives them energy so they can run and play. Older kids can be taught that what you put into your body matters- their energy, mood, and brain will all be affected by what they eat. Sharing this with your kids will instill in them the value of healthy eating for life. Choose to model healthy eating. Keep your diet as close to nature and far away from the factory as possible. It rarely works well to live on candy bars and caffeine, but tell your children they should eat healthier. Learn what healthy eating really looks like. Read labels with your child so you can both learn what is beneficial and what foods to avoid. Avoid any food product that has sugar in the first four ingredients. Products with artificial colors or flavors are also to be avoided.

Creativity can help your kids enjoy their sack lunches that you pack for them to take to school. Think protein, good carbs and good fats. Contributed photo Each week consider replacing one standard snack with a less processed, sugary version. Enlist your children’s help at the grocery store to make finding healthy foods an adventure. Young children can help you find the red fruits or the orange vegetables. Consider engaging older kids to find healthy foods you can all prepare together. Show by example, you are willing to try new things. Saying no to the bad stuff and yes to the good sets an example of making beneficial food choices. When your child asks for something high in sugar or very processed, enlist their cooperation in finding a more suitable alternative. That

way you don’t have to keep saying an endless trail of Nooooo’s, rather you can say “let’s look for something similar to that.” This may take a few minutes but will be well worth the effort. Once you and your child have discovered what tastes good and is good for you, you are now ready to get packing. Rather than the traditional “sandwich and chips” mindset, focus on packing a wide array of colors. Your child needs protein, good carbs, good fats, and greens; essentially a variety of nutrients for their growing body. If there is myriad (natural) color in your child’s lunch, then you are probably hitting the mark. Some healthier lunches might include

almond butter with gluten free crackers or bread. Choose blueberries, strawberries, and a banana to round out the rainbow of colors your child needs. If your child enjoys things that crunch, try carrots, celery and peanut butter, or veggie sticks. Late July, Pop chips, Van’s and Annie’s are brands that offer some healthier alternatives for crackers and chips. Fage or Oinko greek yogurt paired with a banana and some trail mix provide protein along with dairy and fruit. Sliced apple with cheese cubes can also be an easy to eat treat. Additionally, fruit such as mandarin oranges or fruit cups packed in light juice — not heavy syrup — are also great. Avoid the puddings, fruits, and gelatins that contain artificial colors and flavors which not only lack real nutrients, but may be harmful in the long and short run. Buy organic where possible to reduce toxic exposure. With a bit of forethought and planning you can save money and provide great nutrition for your kids’ lunch. If you show by example the willingness to try healthier foods and make healthy eating a fun family affair you can send your kids packing in a good way. Lesli Dullum-Tutterrow is a certified counselor, author, speaker and owner of Optimal Wellness Inc. dba Optimal Wellness Consulting, and the Wellspring Company. She counsels and consults for individuals and businesses. Email her at optimalwellnessconsulting@gmail.com.

Caffeine choices: What’s a safe amount at what age? By LESLIE KELLY


It’s a cup or two of coffee. A Diet Pepsi. A Red Bull. Or even a Vivarin tablet. Caffeine. Most people need some of it every morning to achieve that “awake” feeling. But what’s a safe amount? According to the American Medical Association, a safe caffeine limit is the amount of caffeine a person can consume without experiencing any negative caffeine overdose symptoms. Medical officials say it’s difficult assign an exact amount for everyone because people can have different sensitivities or reactions to caffeine based on age, medical history, and tolerance. However, there is enough research available to make a recommendation based on an individual’s weight. For healthy adults with no medical issues, it is generally agreed upon that 300mg-400mg of caffeine can be consumed daily without any adverse effects. This is equivalent to about: • 5.2 Shots of espresso • Two 5 Hour Energy Shots • 1 Starbucks Venti brewed coffee •Two and one half 16 fl.oz. Monster Energy Drinks • Five 8 fl.oz. Red Bulls • 11.7 12 fl.oz. Cokes Medical authorities say that a daily safe dose of 400mg is safe for adults and

single doses of 200mg at one time are fine for those engaging in exercise directly after the dose. But with children, it’s another story. Because children’s brains are continuing to develop and their bodies are still growing, limited caffeine is recommended. A recent study from The University Children’s Hospital in Zurich showed the importance of sleep for a child’s developing brain. Caffeine can interfere with sleep, therefore, possibly hindering proper brain development, doctors say. Caffeine isn’t recommended for children under 12 years of age. Occasionally, some doctors may recommend caffeine for children diagnosed with ADHD, but generally there is no reason for children under 12 to consume caffeine. An occasional caffeinated soda or chocolate treat will likely pose no concern for children, and around 45mg per day is recognized as a safe amount. But caffeine shouldn’t be a daily part of a child’s diet. While greatly limiting caffeine to teens would be ideal, because of the

increasing demands placed on teenagers in regards to school, sports, and even work, caffeine consumption is becoming more common with this age group. Developing teens should have no more than 100mg of caffeine daily due to the importance of sleep, brain development, inexperience with caffeine, and possibly unknown medical conditions. This is equivalent to about: • 1.3 shots of espresso • 1.25 8 fl.oz. Red Bulls • .5 of a 5 Hour Energy Shot •.6 of a 16 fl.oz. can of Monster Energy Drink • .2 of a Starbucks Venti brewed coffee • 3 12 fl.oz. Cokes For those with health concerns, adults as well as children with either diagnosed or undiagnosed medical conditions caffeine can have adverse health implications, even small amounts. Caffeine is a stimulant and it increases heart rate as well as blood pressure. Therefore, those with heart arrhythmias, murmurs, and hypertension should limit their caffeine intake. Those with pre-existing arrhythmias, murmurs, and hypertension should limit caffeine to no more than 200mg daily and are advised to consult their physician before consuming caffeine. For those individuals with Type 2 Diabetes, the majority of the research shows that caffeine doesn’t increase

the risk of someone developing Type 2 Diabetes, but actually decreases risk. However, those already diagnosed with type 2 diabetes should limit caffeine consumption because it can impair glucose metabolism in diabetics. Those with Type 2 Diabetes should restrict their consumption to around 200mg daily or follow their doctor’s instructions concerning caffeine intake. For those ultra-sensitive to caffeine it is hard to determine an exact caffeine safe limit. Some people can have one cup of coffee (100mg-120mg) in the morning and still fail to get to sleep that evening. This is well after the caffeine’s effects should have worn off as it does for “normal” caffeine consumers. If the ultra-sensitive person chooses to consume caffeine, they should do so in small amounts until they find the amount that works, but doesn’t cause unwanted side-effects. These people should start with 50mg of caffeine daily and then slightly increase or decrease their consumption from there. This (50 mg) is equal to about: • 1.5 12 fl.oz. Cokes. • One 4 fl.oz. brewed coffee (not Starbucks). • One 8 fl.oz. strong black tea.



JANUARY 29, 2016

Clinic brings new concept in health care to Poulsbo It’s called concierge care and it’s gaining popularity in Kitsap County By LESLIE KELLY



reating a medical home for their patients is what Pacifica Medicine & Wellness is all about. That’s how its founding doctors, Marie Matty and Andrea Chymiy, describe what they’re providing in the Poulsbo community. “We want to be a place that our patients can count on, where they feel they are listened to and are not just a number,” Dr. Chymiy said. “We want to give each of them a medical home, where they are known and where they can come to us with any concern,” Dr. Matty said. After working together since 2003 at The Doctor’s Clinic, Matty and Chymiy opened Pacifica Medicine on Jan.19. “We’d been thinking about doing this for several years,” Matty said. “We were finding that we were so busy at our traditional fee-for-service practice that we were not able to spend the time we wanted with our patients. And we were being told by our patients that we were booked out several months and that they weren’t able to get in to see us.” At Pacifica the doctors are limiting their practice to 600 patients per doctor, compared to 2,500-plus patients per doctor at their previous practice. These lower patient numbers are made possible by monthly fees that patients pay to be part of the practice. Chymiy and Matty have created a hybrid medical practice that accepts patients with or without regular insurance. Patients with high-deductible insurance or no insurance can join Pacifica’s “Direct Primary Care” practice, where they pay a monthly fee, can be seen as often as needed, and are never billed for their visits. The monthly fee is age-based and ranges from $25$75. Patients who join Pacifica’s

From left, doctors Marie Matty and Andrea Chymiy have started their own medical practice with monthly fees. They also have plans for patients with insurance. Leslie Kelly photo

The staff at Pacifica Medicine & Wellness offers internal medicine care, massage therapy, and nutrition counseling in a calming environment. Leslie Kelly photo “Affordable Concierge” practice pay a lower monthly concierge fee ($10-$60) which enables their doctors to spend more time with their patients and be more accessible and available to them. Visits are billed to insurance. The clinic accepts most private health insurance plus Medicare and Medicaid. “The monthly fee takes us out of the volume-driven fee-for-service health

care model,” Matty said. The office has easy appointment scheduling, by phone or online, and patients usually get to talk with a “real human being” when they call, Matty said. The doctors plan to offer telephone or Skype virtual visits in addition to traditional office visits. The clinic will have a dispensary for prescription drugs for those who do not have prescription coverage, and has

worked out agreements with local labs for discounted lab testing. The clinic focuses on wellness, and has a wellness coach and massage therapist on staff. Pacifica shares space with a nutritionist and an acupuncturist. In all, there are eight employees at Pacifica plus two therapy dogs, Westley, a Wheaten terrier, and Lulu, a Goldendoodle, who are available to patients. The office is decorated in shades of blue with aromatherapy and background music that creates a soothing atmosphere for patients when they walk in the door. Chymiy and Matty are familiar with all the specialists and imaging centers in the area, and are able to provide referrals to specialists when needed. “We will have the time to call specialists ahead of time when a patient goes to see them,” Matty said, “and this will save the patient time.” Chymiy graduated from Tulane Medical School in New Orleans, and Matty is a graduate of the University of Washington Medical School in Seattle. The two primary care physicians met each other when they were in their residency training programs at Swedish Medical Center, in Seattle. “We met because we shared a desk when we worked at Swedish,” said Chymiy. They then job-shared for 12 years at The Doctors Clinic in Poulsbo. Their decision to create their own practice came from a desire to control their own destiny. “Being a part of the solution to what’s wrong with health care is something that’s important to us,” Matty said. “We want to have the opportunity to provide excellent health care in a way in which our patients are cared for personally, and our community is well-served.” Pacifica Medicine & Wellness is at 19980 10th Ave. NE, Suite 202, Poulsbo. Call 360-979-0569, or check out www. pacificamedicine.com for more information and to schedule appointments. Matty and Chymiy and their staff will be hosting a community open house on Feb. 10, from 5 – 7:30 p.m.

A new year brings new opportunities for new hearing By PENINSULA HEARING

A new year is well underway and with it an exciting adventure for those of us at Peninsula Hearing. We are now offering a new and different concept in hearing care called the Lyric. Lyric has been around for a few years, however Dr. Megan Nightingale at Peninsula Hearing in Poulsbo is the first hearing professional on the peninsula to offer Lyric. The Lyric concept is one similar to extended wear contact lenses for the eye. Lyric is still the only “extended wear” hearing device available. The concept centers on a very small device (about the size of a pinto bean) that is placed deep in the ear canal within about four millimeters of the ear drum.

Dr. Megan Nightingale Contributed photo

The device stays put in the canal until the battery dies which can be up to four months. The device is then taken out of the ear canal by a trained professional and a new

one is inserted in its place. The device is designed to be worn 24 hours a day, seven days a week. While the thought of a traditional hearing aid

being worn 24/7 is not very pleasant, Lyric, when properly placed in the ear canal can hardly be felt. The mechanics of the Lyric is surrounded by a spongy material that allows moisture to escape and the ear canal to breathe which is very important for ear canal health. The advantage of having a hearing device placed so close to the ear drum is that the sound is very natural because not as much amplification is needed as with a traditional device. Also, by virtue of the placement of Lyric the brain can take advantage of the ear’s natural background noise fighting capabilities. Lyric is very convenient for the user as well. One does not have to change batteries or take the device on and off the ear. The device can be adjusted for volume and turned into what is called “sleep

mode” for nighttime use by using a magnetic tool. Lyric is sold on a subscription basis for one, two or three years at a time. The makers of Lyric and Dr. Nightingale do understand that Lyric is clearly not for everyone. There are some people who cannot have anything in their ear canal and some whose hearing issues are so great that it is beyond the amplification ability of the Lyric. “For the people who have tried Lyric and liked it however, it is a miracle — they rave about it,” said Dr. Nightingale. If you are interested in learning more, call 360-697-3061 or 800-540-8698 for a complimentary evaluation and demonstration of the Lyric.


JANUARY 29, 2016

A new style of medical practice Dr. Marie Matty & Dr. Andrea Chymiy

have practiced medicine in the Kitsap Community since 2003

Now Open!

Accepting New Patients!

(360) 979-0569

~ Most insurance plans accepted ~

Becoming a patient at Pacifica Medicine & Wellness offers you many benefits • We limit our practice to 1/4 the normal number of patients seen by typical primary care doctors, enabling us to devote significantly more time to our patient panel. • Easy appointment scheduling: online or by phone • Enhanced access and communication: You will have 24/7 access to your doctor and staff via telephone and email • Same day or next day appointments when needed with your doctor

• More time with your doctor allowing all your questions to be answered – you will never feel rushed • Wellness focus allows access to health coaching, nutrition therapy, massage therapy and weight management services under one roof • Research shows this style of practice improves all patient health outcomes (including decreasing hospitalization rates by 90%!), saves money and improves overall satisfaction • Convenient and user friendly online access to your health care information through our patient portal

Preventative care for all ages • Chronic disease management • Wellness focus

WE PROVIDE: Geriatrics, Pediatrics & Women’s Health • Same day / Acute care visits


In the Central Plaza Building near Central Market 19980 10th Ave. NE, Suite 202 • Poulsbo, WA 98370 (360) 979-0569 • www.pacificamedicine.com e-mail: info@pacificamedicine.com




JANUARY 29, 2016


Profile for Sound Publishing

Healthy Living - Healthy You Winter Edition - 2016  


Healthy Living - Healthy You Winter Edition - 2016